Kurasikirwa kwehuropi basa - chirwere chechiropa

Kurasikirwa kwehuropi basa kunoitika kana chiropa chisingakwanise kubvisa chepfu kubva muropa. Izvi zvinonzi hepatic encephalopathy (HE). Dambudziko iri rinogona kuitika kamwe kamwe kana kuti rinogona kukura zvishoma nezvishoma nekufamba kwenguva.

Basa rakakosha rechiropa kuita kuti zvinhu zvine chepfu mumuviri zvisava nenjodzi. Izvi zvinhu zvinogona kugadzirwa nemuviri (ammonia), kana zvinhu zvaunotora (mishonga).

Kana chiropa chikakuvara, idzi "chepfu" dzinogona kuvaka muropa uye kukanganisa basa rehurongwa hwemitsipa. Mhedzisiro yacho inogona kunge iri HE.

ANOGONA kuitika kamwe kamwe uye unogona kurwara nekukasira.Zvinokonzera HE zvinogona kusanganisira:

• Hepatitis A kana B hutachiona (zvisingawanzo kuitika nenzira iyi)
• Kuvharirwa kweropa kuchiropa
• Kuchetura nehupfu hwakasiyana kana mishonga
• Kuzvimbirwa
• Kumusoro kwepamuviri kubuda ropa

Vanhu vane kukuvara kwakakomba kwechiropa kazhinji vanotambura kubva kuHE. Mhedzisiro mhedzisiro yekusingaperi kwechiropa kukuvara ndeye cirrhosis. Zvinowanzokonzera chirwere chisingaperi chechiropa ndeichi:

• Yakakomba hepatitis B kana C hutachiona
• Kunwa doro zvisina kufanira
• Autoimmune hepatitis
• Bile duct kusagadzikana
• Mimwe mishonga
• Nonalcoholic fatty chiropa chirwere (NAFLD) uye nonalcoholic steatohepatitis (NASH)

Paunenge uchinge uine kukuvara kwechiropa, zvikamu zvekuwedzera kwehuropi basa zvinogona kukonzerwa ne:

• Pasina mvura yemuviri (kupera mvura mumuviri)
• Kudya zvakawandisa mapuroteni
• Potasiamu yakaderera kana sosiamu
• Kubuda ropa kubva mumatumbu, mudumbu, kana pombi yezvikafu (esophagus)
• Zvirwere
• Zvinetso zveitsvo
• Low oxygen mazinga mumuviri
• Shunt kuiswa kana matambudziko
• Kuvhiya
• Kurwadziwa kweNarcotic kana mishonga inonyaradza

Kukanganisika kunogona kuoneka kwakafanana neHE kunogona kusanganisira:

• Doro kudhakwa
• Kunwa doro
• Kubuda ropa pasi pehenya (subdural hematoma)
• Brain kusagadzikana kunokonzerwa nekushaikwa kwevhitamini B1 (Wernicke-Korsakoff syndrome)

Mune zvimwe zviitiko, HE idambudziko-renguva pfupi rinogona kugadziriswa. Izvo zvinogona zvakare kuitika sechikamu chenguva refu (chisingaperi) dambudziko kubva kuchiropa chirwere chinowedzera kuwedzera nekufamba kwenguva.

Zviratidzo zveHE zvakaiswa pamwero wechiyero 1 kusvika ku4. Zvinogona kutanga zvishoma nezvishoma uye zvichitowedzera nekufamba kwenguva.

Zviratidzo zvekutanga zvinogona kuve zvakapfava uye zvinosanganisira:

• Kufema ne musty kana hwema hunotapira
• Shanduko mumaitiro ekurara
• Shanduko mukufunga
• Nyonganiso nyonganiso
• Kukanganwa
• Hunhu kana manzwiro anochinja
• Kusanyatso tarisisa uye kutonga
• Kuwedzeredza kwekunyora kana kurasikirwa kwemamwe madiki maoko kufambisa

Zviratidzo zvakakomba zvinogona kusanganisira:

• Kufamba zvisina kujairika kana kukwazisana nemaoko kana maoko
• Kushungurudzika, kufara, kana kubatwa (kunoitika kashoma)
• Kuora mwoyo
• Kukotsira kana kuvhiringidzika
• Maitiro kana hunhu hunoshanduka
• Kutaura kwakadzikira
• Inononoka kana kuita husimbe

Vanhu vane HE vanogona kuve vasina chavanoziva, vasingateereri, uye pamwe vachipinda mukoma.

Vanhu kazhinji havagone kuzviriritira nekuda kwezviratidzo izvi.

Zviratidzo zveystem system shanduko dzinogona kusanganisira:

• Kuzunza maoko ("kurova kudedera") kana uchiedza kubata maoko pamberi pemuviri nekusimudza maoko
• Matambudziko nekufunga uye kuita epfungwa mabasa
• Zviratidzo zvechiropa chirwere, senge yeyero ganda uye maziso (jaundice) uye kuunganidzwa kwemvura mudumbu (ascites)
• Musty munhuwi wekufema neweti

Bvunzo dzinoitwa dzinogona kusanganisira:

• Pedzisa kuverenga ropa kana hematocrit kuti utarise kushomeka kweropa
• CT scan yemusoro kana MRI
• EEG
• Chiropa basa bvunzo
• Prothrombin nguva
• Serum ammonia chikamu
• Sodium level muropa
• Potasiamu muropa
• BUN (ropa urea nitrogen) uye creatinine kuona kuti itsvo dziri kushanda sei

Kurapa kweHE kunoenderana nechikonzero.

Kana shanduko muhuropi inoshanda zvakanyanya, kugara muchipatara kunogona kudikanwa.

• Kubuda ropa munzvimbo yekugaya kunofanira kumiswa.
• Hutachiona, itsvo kutadza, uye shanduko mune sodium uye potasiamu mazinga anoda kurapwa.

Mishonga inopihwa kubatsira kudzikisa mwero weammonia uye kugadzirisa mashandiro ehuropi. Mishonga yakapihwa inogona kusanganisira:

• Lactulose kudzivirira mabhakitiriya mumatumbu kubva mukugadzira ammonia. Zvinogona kukonzera manyoka.
• Neomycin uye rifaximin inoderedzawo huwandu hweammonia inogadzirwa mumatumbu.
• Kana iyo HE ichivandudza painotora rifaximin, inofanirwa kuenderera nekusingaperi.

Iwe unofanirwa kudzivirira:

• Chero mishonga inodzora, inozorodza, uye chero mimwe mishonga inoputswa nechiropa
• Mishonga ine ammonium (kusanganisira mamwe maantacid)

Anopa hutano hwako anogona kupa mamwe mishonga uye marapirwo. Izvi zvinogona kuve nemhedzisiro dzakasiyana.

Maonero e HE anoenderana nekutungamira kwechikonzero cheHE. Mafomu asingaperi echirwere ichi anowanzo ramba achiwedzera uye achidzoka.

Matanho maviri ekutanga echirwere ane fungidziro yakanaka. Chikamu chechitatu nechina chine fungidziro yakaipa.

Fonera waunopa kana iwe kana vanhu vakakukomberedza vachiona chero matambudziko nehutano hwako hwepfungwa kana hunyanzvi hwehurongwa. Izvi zvakakosha kune vanhu vatove nechiropa chirwere. ANOGONA kukurumidza kukurumidza uye kuita mamiriro ekukurumidzira.

Kurapa matambudziko echiropa kunogona kudzivirira HE. Kudzivisa doro uye kupinza mishonga kunogona kudzivirira kusagadzikana kwakawanda kwechiropa.

Hepatic coma; Encephalopathy - hepatic; Hepatic encephalopathy; Portosystemic encephalopathy

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