Ukwehla kweHepatocerebral

Ukwehla kweHepatocerebral ukuphazamiseka kobuchopho okwenzeka kubantu abanokulimala kwesibindi.

Lesi simo singenzeka kunoma yikuphi ukwehluleka kwesibindi okutholakele, kufaka phakathi i-hepatitis enamandla.

Ukulimala kwesibindi kungaholela ekwakhiweni kwe-ammonia nezinye izinto ezinobuthi emzimbeni. Lokhu kwenzeka lapho isibindi singasebenzi kahle. Akuphuli futhi kuqede la makhemikhali. Izinto ezinobuthi zingalimaza izicubu zobuchopho.

Izindawo ezithile zobuchopho, njenge-basal ganglia, kungenzeka zilimale ngokwehluleka kwesibindi. I-basal ganglia isiza ukulawula ukunyakaza. Lesi simo uhlobo lwe "non-Wilsonian". Lokhu kusho ukuthi ukulimala kwesibindi akubangelwa yimali yethusi esibindini. Lesi isici esiyinhloko sesifo seWilson.

Izimpawu zingafaka:

• Kunzima ukuhamba
• Umsebenzi wengqondo okhubazekile
• I-jaundice
• Imisipha spasm (myoclonus)
• Ukuqina
• Ukunikina izingalo, ikhanda (ukuthuthumela)
• Ukudikiza
• Ukunyakaza okungalawuleki komzimba (chorea)
• Ukuhamba okungazinzile (ataxia)

Izimpawu zifaka:

• I-Coma
• Uketshezi esiswini olwenza ukuvuvukala (ascites)
• Ukopha emathunjini kusuka emithanjeni ekhulisiwe kumbhobho wokudla (ama-esophageal varices)

Ukuhlolwa kwesistimu yezinzwa (i-neurological) kungakhombisa izimpawu ze:

• Ukuwohloka komqondo
• Ukunyakaza okungazinikeli
• Ukungazinzi kokuhamba

Ukuhlolwa kwelabhorethri kungakhombisa izinga eliphakeme le-ammonia egazini nasekusebenzeni kwesibindi okungavamile.

Ezinye izivivinyo zingafaka:

• I-MRI yekhanda
• I-EEG (ingakhombisa ukwehlisa okujwayelekile kwamagagasi obuchopho)
• I-CT scan yekhanda

Ukwelashwa kusiza ukunciphisa amakhemikhali anobuthi awakhe kusukela ekuhlulekeni kwesibindi. Kungabandakanya ama-antibiotics noma umuthi ofana ne-lactulose, owehlisa izinga le-ammonia egazini.

Ukwelashwa okubizwa nge- branched-chain amino acid therapy nakho kunga:

• Thuthukisa izimpawu
• Buyisela emuva ukulimala kobuchopho

Akukho ukwelashwa okuqondile kwe-neurologic syndrome, ngoba kubangelwa ukulimala kwesibindi okungenakulungiswa. Ukufakelwa kwesibindi kungaselapha isifo sesibindi. Kodwa-ke, lo msebenzi kungenzeka ungaguquli izimpawu zokulimala kobuchopho.

Lesi yisimo sesikhathi eside (esingapheli) esingaholela ezinkingeni zesistimu yezinzwa ezingalungiseki.

Umuntu angaqhubeka nokubi kakhulu futhi afe ngaphandle kokufakelwa kwesibindi. Uma ukufakelwa kwenziwa kusenesikhathi, i-neurological syndrome ingabuyiselwa emuva.

Izinkinga zifaka:

• Ikhoma ye-hepatic
• Ukulimala okukhulu kobuchopho

Shayela umhlinzeki wakho wezokunakekelwa kwezempilo uma unezimpawu zesifo sesibindi.

Akunakwenzeka ukuvimbela zonke izinhlobo zezifo zesibindi. Kodwa-ke, isifo sokusha kwesibindi esidakayo negciwane kungavinjelwa.

Ukunciphisa ubungozi bokuthola i-hepatitis yotshwala noma ye-virus:

• Gwema imikhuba eyingozi, njengokusebenzisa izidakamizwa i-IV noma ucansi olungaphephile.
• Ungaphuzi, noma uphuze ngokulinganisela kuphela.

Ukwehla kwesifo sohlobo lwe-hepatocerebral; I-hepatic encephalopathy; I-Portosystemic encephalopathy

• I-anatomy yesibindi

IGarcia-Tsao G. Cirrhosis nokulandelana kwayo. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 153.

Haq IU, Tate JA, Siddiqui MS, Okun MS. Ukubuka konke komtholampilo kokuphazamiseka kokuhamba.Ku: Winn HR, ed. Ukuhlinzwa Kwe-Youmans neWinn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2017: isahluko 84.