I-cirrhosis yesibindi ezinjeni

I-Cirrhosis Ezinjeni: Okubalulekile

• I-Cirrhosis yisifo sesibindi esingalapheki esingelapheki.
• Kuvame kakhulu ezinjeni ezindala kunezincane.
• Izimbangela zokuthuthukiswa kwalesi sifo zihluke kakhulu.
• Izimpawu eziyinhloko ze-cirrhosis yesibindi ezinjeni zihlanganisa ukuncipha kwesifiso sokudla, ukuhlanza, ukuguquguquka kombala wendle nomchamo.

Izinkinga ze-cirrhosis

Izizathu zokuthuthukiswa kwezinguquko ze-cirrhotic zihlukahlukene. Ukuze kwenzeke noma yiziphi izinguquko ezicutshini zesibindi, isenzo sesici esilimazayo siyadingeka. Ezinjeni, lezi zingaba ubuthi obuhlukahlukene, izidakamizwa, izinqubo ezithathelwanayo nezihlaselayo. Ukusabela esenzweni sesici esilimazayo, ukufa kwama-hepatocytes - amaseli esibindi kwenzeka. Umzimba uzama ukumelana nale nqubo futhi wenze kusebenze izinqubo zokunxephezela, indawo yamaseli afile kufanele ithathwe okuthile. Amaseli ezicubu ezixhumeneyo akhula ngokushesha kunama-hepatocyte, futhi inja iba ne-fibrosis yesibindi. Khona-ke inqubo ye-angiogenesis iqala - ukwakheka kwemithambo yegazi emisha. Imikhumbi emisha izungezwe izicubu ezixhumeneyo, ezinciphisa umthamo wazo. Izitsha zakha inethiwekhi entsha, exhuma izitsha eziyinhloko zesibindi - i-hepatic artery kanye ne-portal vein. Kodwa i-vasculature entsha iyakwazi ukudlulisa umthamo omncane wegazi, futhi iphinde igcine ukucindezela okuphezulu kunalokho okufanele kube okujwayelekile. Ngenxa yalokho, ingcindezi iqala ukwakheka emthanjeni we-portal, okuholela ku-portal hypertension.

Izici eziyinhloko ezilimaza isibindi zimi kanje:

1. Imikhiqizo yokwelapha

   Ezinye izidakamizwa, uma zithathwa ngokungalawuleki, zingaholela ekushintsheni okukhulu esibindini. Le mithi ihlanganisa i-phenobarbital, evame ukusetshenziselwa i-convulsive syndrome ezinjeni. Amalungiselelo e-Glucocorticoid ngemithamo ephezulu kanye nenkambo ende nawo aholela emiphumeleni emibi kakhulu, kufaka phakathi isifo sesibindi. Ezinye izinja zingezwani kahle nomuthi we-antiparasite i-mebendazole (okungavamile ukutholakala emakethe kamuva nje), ngemithamo ephezulu izoba yingozi kakhulu. Ama-antibiotic eqembu le-tetracycline kanye neminye imithi elwa nefungal (ketoconazole) ingaba yingozi kakhulu uma isetshenziswa ngokungalawuleki. I-Paracetamol, ngisho nangemithamo ephakathi, ingabangela izinguquko ezingenakulungiseka esibindini ezinjeni.

2. Izinxube

   Izinja ziyakuthanda ukuhlafuna izinto ezihlukahlukene ezingadliwa. I-ethylene glycol equkethwe ku-antifreeze inokunambitheka okumnandi, futhi izinja azidebeseleli ukuzitika ngayo uma ishiywe lapho isakwazi ukuyifinyelela. Izinsini ezihlafunwayo kanye nemithi yokuxubha kubantu iqukethe i-xylitol, ewubuthi futhi ezilwaneni. Amabhethri adliwe aqala ukufaka i-oxidize esiswini senja futhi akhiphe izinsimbi ezinzima. Ubuthi be-aflatoxin bukhishwa isikhunta esinamagciwane amaningi (isb. isikhunta) futhi sibe nomthelela we-hepatotoxic. Ama-fungicides, ama-insecticide kanye namanye ama-rodenticides anobuthi obukhulu uma engenile.

3. Izifo

   Ukutheleleka kwesibindi okuvame kakhulu ezinjeni yi-leptospirosis. I-Leptospira amabhaktheriya angena esibindini, ezinso, emaphashini nakwezinye izicubu zezinto eziphilayo. Ukutheleleka kwenzeka kakhulu emanzini anegciwane (izikhathi eziningi emachibini) noma ngemva kokudla amagundane abulewe yilesi sifo. Esinye isifo i-hepatitis ethathelwanayo ebangelwa uhlobo lwe-adenovirus 1. Muva nje, lesi sifo asivamile kakhulu futhi cishe asenzeki ngenxa yokugoma ngonembeza wezinja ezifuywayo.

4. Ukuhlasela

   Amagciwane awavamile esibindini sezinja. I-helminth eyenza i-parasitize ngqo esibindini (i-Opisthorchis felineus) ibangela i-opisthorchiasis. Ukutheleleka kwenzeka ngokudla inhlanzi engelashiwe. Amanye ama-helminths (ama-toxocars, ama-roundworms) nawo ayakwazi ukuthuthela esibindi ngesikhathi sokuphila kwawo futhi alale lapho ngesimo sezibungu.

Izimpawu ze-cirrhosis yesibindi ezinjeni

Izimpawu zomtholampilo ezenzeka nge-cirrhosis yesibindi ezinjeni zingahlukahluka kakhulu. Ukuqina kwabo kuzoncika esigabeni sesifo. Inja ingase inganyakazi, isheshe ikhathale. Iningi losuku lizolala. Isisindo somzimba sizokwehla kancane kancane. Isifiso sokudla siyavilapha, futhi ukoma kungaba phakathi kwebanga elivamile futhi kwande. Ukuhlanza kuzokwenzeka ngezikhathi ezithile, ukuhlanza kwe-bile kungenzeka. Isihlalo sizobe singazinzile, isifo sohudo sishintshana nokuqunjelwa. Umbala womchamo ungase ube mnyama, ucishe ube nsundu. Ngokuphambene nalokho, indle ingase ilahlekelwe umbala futhi ibe mpunga noma ibe mhlophe. Isikhumba kanye nolwelwesi lwamafinyila kwezinye izimo kuba icteric, okungukuthi, uthole tint ophuzi. Ngenxa yomfutho wegazi ophakeme ku-portal vein yesibindi, kuvame ukuqaphela ukwanda komthamo wesisu ngenxa yoketshezi lwe-ascitic kulo.

Ngokuvamile, isibindi sikhiqiza izici ezihlukahlukene zesistimu ye-coagulation yegazi, kuhlanganise ne-vitamin K. Nge-cirrhosis, ukukhiqizwa kwalezi zinto kuyancipha, ukuphuma kwegazi kungabonwa: igazi alimi kahle endaweni yokulimala, ukungcola kwegazi kubonakala emcinini futhi indle, izinsini zopha, imihuzuko ivela emzimbeni. Ezigabeni ezimbi kakhulu ze-cirrhosis, izinzwa zemizwa zingatholakala ngenxa yokuthuthukiswa kwe-hepatic encephalopathy. Isilwane esifuywayo sinokudlikizeka, ukundindizela, ukungasebenzi kahle kokuxhumana. Ukufa okungenzeka kwesilwane.

Diagnostics

Ukuxilongwa kwe-cirrhosis kusungulwa ngendlela eyinkimbinkimbi, okungukuthi, kuyadingeka ukucabangela umlando wokuphila nokugula, izimpawu zomtholampilo kanye nedatha evela ezifundweni ezibukwayo nezaselebhu. Kudingekile ukukhumbula ukuthi ingabe inja yayingadliswa yini ushevu ngokuthile, kungakhathaliseki ukuthi bayinikeze imithi ethile iyodwa. Futhi, udokotela uzosizwa ngemininingwane yemigomo etholakalayo kanye nokwelashwa okulwa nama-parasite.

Ngesikhathi sokuhlolwa, umbala wolwelwesi lwamafinyila, izinga lokugcwaliswa kwe-capillary, izinga lokuphelelwa amanzi emzimbeni, ubuhlungu kanye nezinguquko ze-pathological esiswini, nokushisa komzimba kuyahlolwa. Ukuhlolwa kwegazi okujwayelekile komtholampilo kanye ne-biochemical kuyathathwa. Ekuhlolweni kwegazi lomtholampilo, i-anemia ingatholwa, ifomula ye-leukocyte ngokuvamile ayinazo izinguquko ezibalulekile. Ngokusho kokuhlolwa kwegazi le-biochemical, ukwanda kwama-enzyme esibindi kanye ne-bilirubin kutholwa. Esigabeni esibi kakhulu se-cirrhosis, angeke kube khona izinguquko ekuhlolweni kwegazi le-biochemical, ngoba amangqamuzana akhiqiza lezi zinto afile ngokuphelele.

Ngezinga eliphansi le-albumin yegazi, ngokuvamile kuzoba nokuphuma kwamanzi emgodini wesisu noma wesifuba. Kwezinye izimo, i-glucose yegazi ne-urea izoncishiswa. Ngokukhuphuka kwezinga le-bile acids, ukwakheka kwe-hepatic shunts yesibili kungasolwa.

Ukuhlolwa kwegazi kwe-leptospirosis nge-microagglutination kuvame ukunconywa. Ukutadisha i-hepatitis ethathelwanayo, indlela ye-polymerase chain reaction noma i-enzyme immunoassay isetshenziswa. I-ultrasound yomgodi wesisu ngokugcizelela endaweni yesibindi iphoqelekile. Lapho kukhona i-effusion, uketshezi luthathwa ukuze lufundwe ukuze kukhishwe i-tumor kanye nezinqubo zokuvuvukala.

Ukuxilongwa kokugcina kwe-cirrhosis ezimweni eziningi kungenziwa kuphela ngosizo lokuhlolwa kwe-histological.

Ukwelashwa kwe-cirrhosis yesibindi ezinjeni

Uma inja idle into enobuthi, kufanele uxhumane nomtholampilo oseduze ngokushesha ngangokunokwenzeka. Emtholampilo, kungase kuphakanyiswe ukuhlanza ukuze kukhishwe ngokushesha ubuthi noma ukugezwa kwesisu. Ama-droppers anqunyelwe ukunciphisa ukudakwa. Uma into enobuthi yaziwa, kungasetshenziswa ikhambi elifanele.

Ukwelashwa kwezifo ezithathelwanayo kuhlanganisa ukwethulwa kwezidakamizwa ezilwa namagciwane, i-antifungal kanye ne-antiparasite. Izinguquko ze-Sami cirrhotic esibindini, ngeshwa, azibuyiseleki emuva. Leyo ngxenye yezicubu zesibindi, eyathathelwa indawo izicubu ezixhumeneyo, ayisakwazi ukululama. Kusetshenziswa kuphela ukwelashwa okuyizimpawu nokusekelayo kwe-cirrhosis yesibindi ezinjeni. Izidlo ezikhethekile zokwelapha zinqunyelwe izifo zesibindi. Amavithamini anjengovithamini B12, E no-K angase engezwe.

Izidakamizwa ze-Choleretic zinqunyelwe, okungukuthi, izidakamizwa ze-choleretic. Ngezinye izikhathi izidakamizwa ezivela eqenjini lama-hepatoprotectors zinqunywa. Nakuba le mithi ingeyona ingxenye yolwazi lwemithi esekelwe ebufakazini, lapho uyisebenzisa, umphumela omuhle ungaqashelwa kaningi. Le mithi ihlanganisa i-S-adenosylmethionine kanye ne-milk thistle fruit extract.

Prevention

Ukuvimbela ukuthuthukiswa kwezifo zesibindi, kuhlanganise ne-cirrhosis ezinjeni, kuyadingeka ukulandela imithetho eyisisekelo yokugcina isilwane. Kuyadingeka ukususa zonke izinto ezinobuthi ekufinyeleleni kwenja. Kuyadingeka ukwenza ukugoma okuphelele konyaka, okubandakanya ukuvikela i-hepatitis ethathelwanayo kanye nezinhlobo ezimbalwa ze-leptospirosis. Ukwelapha okuvimbela izimuncagazi zangaphakathi kwenziwa okungenani izikhathi ezine ngonyaka ezinjeni ezihambayo futhi nyanga zonke ezinjeni ezizingelayo noma ezidla inyama eluhlaza.

Ukuhlolwa kwezokwelapha kwaminyaka yonke kusiza ukuhlonza lesi sifo ezigabeni zokuqala futhi uthathe izinyathelo ezidingekayo ngesikhathi.

22 2021 Juni

Kubuyekezwe: 28 Juni 2021