Hepatorenal syndrome: chii chiri, chinokonzera uye kurapwa

Zvemukati

• Mhando dzeHepatorrenal Syndrome
• Zvinogona kukonzerwa
• Ndezvipi zviratidzo
• Kurapwa kunoitwa sei

Hepatorenal syndrome idambudziko rakakura rinowanzozviratidza muvanhu vane chirwere cheropa chakakwirisa, senge cirrhosis kana kukundikana kwechiropa, icho chinozivikanwawo nekudzikira kweitsvo basa, uko vasoconstriction yakasimba inoitika, zvichikonzera kudzikiswa kwakanyanya kweiyo mwero we glomerular. kusefa uye zvichidaro kune chakakomba itsvo kutadza. Kune rimwe divi, yekuwedzera-renal vasodilation inoitika, inotungamira kune systemic hypotension.

Hepatorenal syndrome inowanzo kuuraya mamiriro, kunze kwekunge chiropa chirimwa chikaitwa, kunova kurapwa kwesarudzo yechirwere ichi.

Mhando dzeHepatorrenal Syndrome

Mhando mbiri dze hepatorrenal syndrome dzinogona kuitika. Type 1, inosanganisirwa nekukasira kweitsvo kukundikana uye kuwanda kwe creatinine, uye mhando 2, iyo inosangana neinononoka itsvo kutadza, iyo inofambidzana nezviratidzo zvakavanzika.

Zvinogona kukonzerwa

Kazhinji, hepatorrenal syndrome inokonzerwa necirrhosis yechiropa, iyo njodzi inogona kuwedzera kana zvinwiwa zvinodhaka zvikamwiwa, hutachiona hweitsvo hukaitika, kana munhu aine BP isina kugadzikana, kana kana achishandisa diuretics.

Mukuwedzera kune cirrhosis, zvimwe zvirwere zvinosangana nekusingaperi uye kwakakomba kwechiropa kukundikana ne portal hypertension, senge doro rekuzvimba chiropa uye chakakomba chiropa kutadza kunogona zvakare kumutsa hepatorrenal syndrome. Dzidza maitiro ekuziva chiropa cirrhosis uye kuti chirwere chinoonekwa sei.

Izvi zvinokanganisa chiropa zvinotungamira kune yakasimba vasoconstriction muitsvo, izvo zvinoguma nekudzikiswa kwakacherechedzwa muiyo glomerular filtration rate uye zvichikonzeresa zvakanyanya renal kutadza.

Ndezvipi zviratidzo

Zviratidzo zvakajairika zvinogona kukonzerwa nehepatorrenal syndrome ndeye jaundice, yakaderedzwa weti kubuda, yakasviba weti, kuzvimba kwemudumbu, kuvhiringidzika, delirium, kusvotwa uye kurutsa, kuora mwoyo uye kuwedzera huremu.

Kurapwa kunoitwa sei

Chiropa kuisirwa ndiko kurapwa kwesarudzo ye hepatorrenal syndrome, iyo inobvumira itsvo kupora. Nekudaro, dialysis inogona kunge ichidikanwa kudzikamisa murwere. Tsvaga kuti hemodialysis inoitwa sei uye ndedzipi njodzi dzekurapwa uku.

Chiremba anogona zvakare kunyorera vasoconstrictors, iyo inobatsira kudzikisira iyo endogenous chiitiko chevasoconstrictors, ichiwedzera iyo inoshanda renal kuyerera kweropa. Uye zvakare, ivo vanoshandiswa zvakare kugadzirisa BP, iyo inowanzo kuve yakaderera mushure me dialysis. Iyo inonyanya kushandiswa ndeyevasopressin analogue, senge terlipressin, semuenzaniso, uye alpha-adrenergics, senge adrenaline uye midodrine.