Ukulahlekelwa ukusebenza kobuchopho - isifo sesibindi

Ukulahleka kokusebenza kobuchopho kwenzeka lapho isibindi singakwazi ukukhipha ubuthi egazini. Lokhu kubizwa ngokuthi i-hepatic encephalopathy (HE). Le nkinga ingavela ngokuzumayo noma ingahle ikhule kancane ngokuhamba kwesikhathi.

Umsebenzi obalulekile wesibindi ukwenza izinto ezinobuthi emzimbeni zingabi nabungozi. Lezi zinto zingenziwa ngumzimba (i-ammonia), noma izinto ozithathayo (imithi).

Lapho isibindi sonakele, la "poison" angakha egazini futhi athinte ukusebenza kwesistimu yezinzwa. Umphumela ungaba yi-HE.

UNGENZEKA ngokuzumayo futhi ungagula ngokushesha okukhulu.Izimbangela ze-HE zingafaka:

• Ukutheleleka kwe-Hepatitis A noma B (akuvamile ukwenzeka ngale ndlela)
• Ukuvalwa kokuphakelwa kwegazi esibindini
• Ubuthi ngoshevu noma imithi ehlukile
• Ukuqunjelwa
• Ukopha okuphezulu emathunjini

Abantu abanokulimala okukhulu kwesibindi bavame ukuhlushwa yi-HE. Umphumela wokuphela kokulimala okungapheli kwesibindi yi-cirrhosis. Izimbangela ezivamile zezifo ezingapheli zesibindi yilezi:

• Ukutheleleka okukhulu kwe-hepatitis B noma i-C
• Ukuphuza ngokweqile
• I-hepatitis ezenzakalelayo
• Ukuphazamiseka kwemifudlana ebilisiwe
• Eminye imithi
• Isifo sesibindi esinamafutha se-Nonalcoholic (NAFLD) kanye ne-nonalcoholic steatohepatitis (NASH)

Lapho usenomonakalo wesibindi, iziqephu zokwanda kokusebenza kobuchopho zingadalwa ngu:

• Uketshezi oluncane lomzimba (ukomisa)
• Ukudla amaprotheni amaningi
• I-potassium ephansi noma amazinga e-sodium
• Ukopha okuvela emathunjini, isisu, noma ipayipi lokudla (isophagus)
• Izifo
• Izinkinga zezinso
• Izinga le-oxygen ephansi emzimbeni
• Ukubekwa nge-shunt noma izinkinga
• Ukuhlinzwa
• Ubuhlungu be-narcotic noma imishanguzo yokuthambisa

Izinkinga ezingabonakala zifana ne-HE zingafaka:

• Ukudakwa kotshwala
• Ukuhoxiswa kotshwala
• Ukopha ngaphansi kogebhezi (i-subdural hematoma)
• Ukuphazamiseka kobuchopho okubangelwa ukungabi novithamini B1 (I-Wernicke-Korsakoff syndrome)

Kwezinye izimo, HE uyinkinga yesikhashana engalungiswa. Kungase futhi kwenzeke njengengxenye yenkinga yesikhathi eside (engapheli) yesifo sesibindi esiya siba sibi ngokuhamba kwesikhathi.

Izimpawu ze-HE zibekwa esikalini samabanga 1 kuye ku-4. Zingaqala kancane futhi zibe zimbi ngokuhamba kwesikhathi.

Izimpawu zokuqala zingaba mnene futhi zifake:

• Ukuphefumula ngephunga elimnandi noma elimnandi
• Izinguquko emaphethini wokulala
• Izinguquko ekucabangeni
• Ukudideka okuncane
• Ukukhohlwa
• Ubuntu noma imizwa iyashintsha
• Ukuhlushwa okungalungile nokwahlulela
• Ukuqina kokubhala ngesandla noma ukulahleka kokunye ukunyakaza kwezandla okuncane

Izimpawu ezinzima zingafaka:

• Ukunyakaza okungajwayelekile noma ukuxhawulana kwezandla noma izingalo
• Ukuyaluza, isasasa, noma ukuquleka (kwenzeka ngokungavamile)
• Ukudideka
• Ukozela noma ukudideka
• Ukuziphatha noma izinguquko zobuntu
• Inkulumo eshisiwe
• Ukuhamba okuhamba kancane noma okuvilaphayo

Abantu abane-HE bangaquleka, bangaphenduli, futhi mhlawumbe bangene ku-coma.

Ngokuvamile abantu abakwazi ukuzinakekela ngenxa yalezi zimpawu.

Izimpawu zokushintsha kwesistimu yezinzwa zingafaka:

• Ukuxhawulana kwezandla ("ukundindizela okukhulu") lapho uzama ukubamba izingalo phambi komzimba nokuphakamisa izandla
• Izinkinga ngokucabanga nokwenza imisebenzi yengqondo
• Izimpawu zesifo sesibindi, njengesikhumba esiphuzi namehlo (i-jaundice) nokuqoqwa koketshezi esiswini (ascites)
• Iphunga elifanele ukuphefumula nomchamo

Ukuhlolwa okwenziwe kungafaka:

• Qedela ukubalwa kwegazi noma i-hematocrit ukuhlola i-anemia
• I-CT scan yekhanda noma i-MRI
• I-EEG
• Ukuhlolwa kokusebenza kwesibindi
• Isikhathi se-Prothrombin
• Izinga le-serum ammonia
• Izinga le-sodium egazini
• Izinga le-potassium egazini
• BUN (blood urea nitrogen) ne-creatinine ukubona ukuthi izinso zisebenza kanjani

Ukwelashwa kwe-HE kuncike embangela.

Uma izinguquko ekusebenzeni kobuchopho zinzima, ukuhlala esibhedlela kungadingeka.

• Ukopha emkhakheni wokugaya ukudla kufanele kumiswe.
• Ukutheleleka, ukwehluleka kwezinso, kanye nezinguquko emazingeni e-sodium ne-potassium kudinga ukwelashwa.

Imithi inikezwa ukusiza izinga eliphansi le-ammonia nokwenza ngcono ukusebenza kobuchopho. Imithi enikeziwe ingafaka:

• I-Lactulose ukuvimbela amabhaktheriya emathunjini ekudaleni i-ammonia. Kungadala isifo sohudo.
• I-Neomycin ne-rifaximin nazo zinciphisa inani le-ammonia eyenziwe emathunjini.
• Uma i-HE ithuthuka ngenkathi ithatha i-rifaximin, kufanele iqhubeke unomphela.

Kufanele ugweme:

• Noma imuphi umuthi wokuthambisa, i-tranquilizers, nanoma yimiphi eminye imithi ephuke isibindi
• Imithi equkethe i-ammonium (kufaka phakathi ama-antacids athile)

Umhlinzeki wakho wezokunakekelwa kwempilo angase asikisele eminye imithi nokwelashwa. Lokhu kungaba nemiphumela ehlukahlukene.

Umbono we-HE uncike ekuphathweni kwembangela ye-HE. Izinhlobo ezingalapheki zalesi sifo zivame ukuqhubeka nokuba zimbi zibuye zibuye.

Izigaba ezimbili zokuqala zesifo zibikezela okuhle. Isigaba sesithathu nesine sinezimpawu ezimbi zokubikezela.

Shayela umhlinzeki wakho uma wena noma abantu abaseduze kwakho bebona noma yiziphi izinkinga ngesimo sakho sengqondo noma uhlelo lwezinzwa. Lokhu kubalulekile kubantu asebevele benenkinga yesibindi. UNGASHAYA ngokushesha ngokushesha futhi abe isimo esiphuthumayo.

Ukwelapha izinkinga zesibindi kungavimbela i-HE. Ukugwema utshwala nezidakamizwa ezifakwa emithanjeni kungavimbela ukuphazamiseka okuningi kwesibindi.

Ikhoma hepatic; I-Encephalopathy - i-hepatic; I-hepatic encephalopathy; I-Portosystemic encephalopathy

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