I-Hepatosplenomegaly: Okudingeka Ukwazi

-Delile

• Izindima zesibindi nobende
• Izimpawu
• Izimbangela nezici zobungozi
• Izifo
• Izifo ze-hematological
• Izifo ze-Metabolic
• Ezinye izimo
• Ezinganeni
• Ukuxilongwa
• Izinkinga
• Ukwelashwa
• Umbono
• Ukuvimbela

Ukubuka konke

I-Hepatosplenomegaly (HPM) yisifo lapho isibindi kanye nobende buvuvukale ngaphezulusayizi wabo ojwayelekile, ngenxa yesinye sezimbangela.

Igama lalesi simo - hepatosplenomegaly - livela emagameni amabili alenzayo:

• hepatomegaly: ukuvuvukala noma ukukhulisa isibindi
• i-splenomegaly: ukuvuvukala noma ukukhulisa ubende

Akuwona wonke amacala e-HPM anzima. Ezinye zingasuswa ngokungenelela okuncane. Kodwa-ke, i-HPM ingakhombisa inkinga enkulu, njenge-lysosomal storage disorder noma umdlavuza.

Izindima zesibindi nobende

Isibindi sinezindima ezahlukahlukene ezibandakanya ukukhipha ubuthi egazini lakho, ukuhlanganisa amaprotheni, nokulwa nezifo. Futhi inengxenye ebalulekile ekukhiqizeni kokubili ama-amino acid kanye nosawoti we-bile.

Umzimba wakho udinga i-iron ukukhiqiza amangqamuzana abomvu egazi, futhi inqubo yakho yesibindi futhi igcine i-ayina. Mhlawumbe okwaziwa kakhulu izindima zesibindi sakho ukucubungula udoti womzimba wakho, ongakhishwa lapho.

Ubende bungesinye sezitho zomzimba wakho okungukuthi, ubukhulu, esingaqondakali kahle kubantu abaningi. Ubende bunendawo ebalulekile kumasosha akho omzimba. Iyayisiza ukukhomba amagciwane, okuyi-bacteria, ama-virus, noma ama-microorganisms akwazi ukudala izifo. Bese kwakha amasosha omzimba okulwa nawo.

Ubende lwakho luhlanza negazi futhi lwakhiwa uginindela obomvu nomhlophe odingekayo ukukhiqiza nokuhlanza amaseli egazi. Funda kabanzi mayelana nobende.

Izimpawu

Abantu abane-hepatosplenomegaly bangabika eyodwa noma eziningi zalezi zimpawu ezilandelayo:

• ukukhathala
• ubuhlungu

Ezinye izimpawu, ezingaba nzima, zifaka:

• ubuhlungu besisu esifundeni esingenhla kwesokudla
• ububele esifundeni esifanele sesisu
• isicanucanu nokuhlanza
• ukuvuvukala kwesisu
• imfiva
• ukulunywa okuphikelelayo
• i-jaundice, ekhonjiswa ngamehlo aphuzi nesikhumba
• umchamo onsundu
• indle enombala wobumba

Izimbangela nezici zobungozi

Izici zobungozi be-hepatomegaly zifaka:

• ukukhuluphala ngokweqile
• umlutha wotshwala
• umdlavuza wesibindi
• i-hepatitis
• isifo sikashukela
• cholesterol ephezulu

I-Splenomegaly ibangelwa i-hepatomegaly cishe amaphesenti angama-30 esikhathi. Kunezimbangela eziningi ezahlukahlukene zesifo sesibindi:

Izifo

• isifo sokusha kwesibindi kohlobo
• i-mononucleosis esithathelwanayo, eyaziwa nangokuthi i-glandular fever noma "isifo sokuqabula" futhi esibangelwa igciwane le-Epstein-Barr
• i-cytomegalovirus, isimo emndenini wegciwane le-herpes
• i-brucellosis, igciwane elidluliswa ngokudla okungcolisiwe noma ukuxhumana nesilwane esinegciwane
• umalaleveva, isifo esithwalwa omiyane esingasongela ukuphila
• i-leishmaniasis, isifo esibangelwa amagciwane I-Leishmania futhi usakaze ngokulunywa yimpukane yesihlabathi
• i-schistosomiasis, edalwa yisibungu esiyisinanakazana esithinta umgudu noma amathumbu
• isifo septicemic, esibangelwa i Yersinia pestis ukutheleleka futhi kungasongela impilo

Izifo ze-hematological

• ukuphazamiseka kwe-myeloproliferative, lapho umnkantsha wethambo ukhiqiza amaseli amaningi kakhulu
• i-leukemia, noma umdlavuza womnkantsha wethambo
• i-lymphoma, noma isimila segazi esivela kumaseli e-lymphatic
• i-sickle cell anemia, ukuphazamiseka kwegazi okuzuzwe njengefa okutholakala ezinganeni lapho amangqamuzana e-hemoglobin engakwazi ukudlulisa umoya-mpilo
• i-thalassemia, isifo segazi esizuzwe njengefa lapho i-hemoglobin yakhiwa ngokungajwayelekile
• i-myelofibrosis, umdlavuza ongavamile womnkantsha wamathambo

Izifo ze-Metabolic

• Isifo i-Niemann-Pick, isifo esibi kakhulu semetabolism esibandakanya ukuqoqana kwamafutha kumaseli
• Isifo sikaGaucher, isimo sofuzo esidala ukuqoqwa kwamafutha ezithweni nasemangqamuzaneni ahlukene
• I-Hurler syndrome, ukuphazamiseka kofuzo okunengozi eyengeziwe yokufa ngaphambi kwesikhathi ngokulimala komzimba

Ezinye izimo

• izifo ezingapheli zesibindi, kufaka phakathi i-hepatitis esebenzayo engapheli
• i-amyloidosis, ukuqongelela okungavamile, okungavamile kwamaprotheni agoqiwe
• systemic lupus erythematosus, uhlobo oluvame kakhulu lwesifo se-autoimmune isifo se-lupus
• sarcoidosis, isimo lapho amaseli wokuvuvukala abonakala ezithweni ezahlukahlukene
• i-trypanosomiasis, isifo esiyimfucumfucu esidluliselwa ngokulunywa yimpukane enesifo
• ukushoda kwama-sulfatase amaningi, ukuntuleka kwe-enzyme okungajwayelekile
• i-osteopetrosis, okuyisifo esingajwayelekile esizuzwe njengefa lapho amathambo elukhuni futhi eqina kunokujwayelekile

Ezinganeni

Izimbangela ezivamile ze-hepatosplenomegaly ezinganeni zingafingqwa ngale ndlela elandelayo:

• izinsana: ukuphazamiseka kokugcina kanye ne-thalassemia
• izinsana: isibindi asikwazi ukucubungula i-glucocerebroside, engaholela ekulimaleni okukhulu kohlelo lwemizwa oluphakathi
• izingane ezindala: umalaleveva, i-kala azar, i-enteric fever, ne-sepsis

Ukuxilongwa

Lezi izivivinyo eziningi udokotela wakho angaku-oda ukusiza ukuthola ukuxilongwa okucacile kwe-hepatosplenomegaly. Lezi izi:

• i-ultrasound, evame ukunconywa ngemuva kokutholakala kwesisindo esiswini ngesikhathi sokuhlolwa komzimba
• i-CT scan, engaveza isibindi esandisiwe noma ubende kanye nezitho ezizungezile
• ukuhlolwa kwegazi, kufaka phakathi ukuhlolwa kokusebenza kwesibindi nokuhlolwa kwegazi
• ukuskena kwe-MRI ukuqinisekisa ukuxilongwa ngemuva kokuhlolwa komzimba

Izinkinga

Izinkinga ezivame kakhulu ze-hepatosplenomegaly yilezi:

• ukopha
• igazi esitokisini
• igazi ebuhlanzweni
• ukwehluleka kwesibindi
• ukucabanga kwengqondo

Ukwelashwa

Ukwelashwa kwe-hepatosplenomegaly kungahluka kuye ngomuntu kuye ngombangela wesimo.

Ngenxa yalokhu, indlela engcono kakhulu yokwenza ukukhuluma nodokotela wakho mayelana nokuxilongwa kwakho kanye nezincomo zokwelashwa.

Bangaphakamisa:

• Ukwenza izinguquko endleleni yokuphila ngokubonisana nodokotela wakho. Izinhloso zakho ezijwayelekile kufanele kube ukuyeka ukuphuza noma, okungenani, ukunciphisa ukuphuza kwakho utshwala ngangokunokwenzeka; zijwayeze njalo ngangokunokwenzeka; futhi ujabulele ukudla okunempilo. Nawa amanye amathiphu wokunamathela ekudleni okunempilo.
• Ukuphumula, i-hydration, nemithi. Okunye ukutheleleka okungatheni okuholela ku-hepatosplenomegaly kungaphathwa nje ngemithi efanelekile bese uphumula ngenkathi uqinisekisa ukuthi awuphelelwa ngamanzi emzimbeni. Uma unesifo esithathelwanayo, ukwelashwa kwakho kuzoba kabili: imithi yokwelapha izimpawu kanye nemithi ethile yokususa igciwane elithelelanayo.
• Ukwelashwa komdlavuza. Lapho imbangela eyisisekelo kungumdlavuza, udinga ukwelashwa okufanelekile okungafaka i-chemotherapy, i-radiotherapy, nokuhlinzwa ukuze ususe isimila.
• Ukufakelwa kwesibindi. Uma icala lakho linzima, njengasezigabeni zokugcina ze-cirrhosis, ungahle udinge ukufakelwa kwesibindi. Funda amaqiniso ngokufakelwa kwesibindi.

Umbono

Ngenxa yezimbangela ezahlukahlukene, i-hepatosplenomegaly ayinamphumela othile. Isimo sakho sincike ezintweni ezahlukahlukene, kufaka phakathi imbangela, ubucayi, kanye nempatho oyitholayo.

I-HPM yaphambilini itholakala futhi yelashwa, iba ngcono. Bheka udokotela wakho uma ubona izimpawu ezingavamile noma usola ukuthi kukhona okungahambi kahle.

Ukuvimbela

Ngoba izimbangela ze-hepatosplenomegaly zihlukahlukene kakhulu, akunakuvinjelwa njalo. Noma kunjalo, indlela yokuphila enempilo ingasiza kuphela. Gwema utshwala, zivocavoca umzimba, futhi udle ukudla okunempilo ukusiza ukunciphisa izinto eziningi eziyingozi.