I-hepatitis encephalopathy (HE) (ebizwa nangokuthi i- portosystemic encephalopathy ) yisimo lapho isifo sesibindi sithinta ukusebenza kobuchopho. Uvame ukuvela kubantu abanezifo ezifana ne- hepatitis noma i- cirrhosis yesibindi . Kungabuye futhi ikhule ngenxa yomdlavuza wesibindi . Njengoba isifo sesibindi sithuthuka, izinambuzane ezinesibindi esinempilo kufanele zisuse egazini esikhundleni sokuhamba ukuya ebuchosheni futhi zithinte ikhono layo lokusebenza ngendlela evamile, cabanga ngokucacile, futhi ukhumbule ulwazi.
Ngenhlanhla, lesi sizathu sokulahlekelwa inkumbulo siyaphathwa.
Izimpawu Ezinkulu
UTHI angathinta kokubili amakhono okuqonda nokusebenza ngokomzimba. Uma unesifo sesibindi, kufanele ucele ilungu lomndeni noma umngane ukuthi akusize ubukele leli qembu lezimpawu bese ubika udokotela wakho ngokushesha ukuze kuhlolwe ngokushesha futhi ukwelashwa.
Izimpawu zivela ekushintsheni kwengqondo okungabonakali kokungaphenduli. Zihlanganisa:
- Ukudideka
- Ukulahlekelwa kwememori
- Kunzima ukugxila noma ukugcina ukunakekelwa
- Ukukhathazeka isikhathi, indawo noma idethi
- Izinguquko zomuntu
- Izikhathi ezithinta kancane, kokubili ngokomzimba nangokwengqondo
- Kunzima noma ukuziphatha okungalungile komphakathi
- Ukungakwazi ukwenza izinkinga eziyisisekelo zezibalo
- Ukuphefumula okunomnandi omuhle
- Ukuthuthumela nokugubha izingalo noma imilenze
- Ukujikijela phezulu nangaphansi kwezingalo uma ubambelela ngqo
- Ukuthutha kwenkulumo
- Nciphise ukuqapha
Izigaba ze-Hepatic Encephalopathy
I-HE ingahlukaniswa ngezigaba ezahlukene-ebizwa nangokuthi amamaki-aqhubekela phambili avela kancane kuya ku-coma.
Uhlelo lwe-West Haven Grading lusehlisa izigaba ze-HE kanje.
Ibanga lesi-0: HE encane
I-Minimal HE ingabangela ukuguqulwa, izinguquko ezincane emandleni akho okucabanga ngokucacile, ukuxazulula izinkinga, nokukhumbula ulwazi. Izimpawu ezingenzeka zingabandakanya ubunzima obuningi bokufeza imisebenzi emsebenzini wakho noma ukushayela izinkampani ngenxa yokuhamba kwesikhathi esincane noma ukunciphisa ukusebenzisana.
Ngezinye izikhathi i-HE encane ingaphunyuka ukuthola ngaphandle uma udokotela ewuhlola ngesimo sokuhlolwa kwengqondo.
Ibanga 1: I-HE enhle
Ubumnene HE kungabangela ubuntu obunye noma isimo sengqondo sishintshe futhi kunciphise ikhono lokugxila emsebenzini. Ngezinye izikhathi, izinkinga zokulala zikhula ngalesi sigaba.
Ibanga lesi-2: I-Moderate HE
Ukuziphatha okunzima noma okungalungile kungathuthuka ku-HE ngokulinganisela. Imemori yakho ingaba yimbi kakhulu, njengoba kungenzeka ukuthi ikhono lakho lokwenza izibalo zezibalo. Ukubhala kungase kube nzima ngoba izandla zakho zingase zithuthuke noma zenzeke.
Ibanga lesi-3: Omkhulu HE
I-HE enamandla ingathinta ukuma. Isibonelo, ungase ungaqiniseki ukuthi ungakanani usuku noma ukuphi. Ukuziphatha kwakho kungase kungabi nakakhulu emphakathini futhi ungase uzwe ubuthongo obukhulu noma ukhathazekile. Amandla engqondo nangokomzimba aqhubeka nokwehla ku-HE.
Ibanga 4: I-Coma
Kulesi sigaba, uzolahlekelwa ukwazi futhi ube ngumuntu ohambelana naye (ongaphenduli).
Ngingazi kanjani ukuthi nginakho?
Uma unesinye sezibonakaliso ezichazwe ngenhla kodwa ungenayo izinkinga ngesibindi sakho, kungenzeka ukuthi izimpawu zakho zibangelwa imbangela ehlukile yokukhohlwa. Ukuguqulwa kwamandla emzimbeni kungabangelwa yizimo eziningi, ezinye zazo eziguquguqukayo (njenge- delirium ) nezinye eziqhubekayo (njenge- Alzheimer's disease ).
Uma unesifo sesibindi esinjenge-hepatitis noma i-cirrhosis, cishe kungenzeka ukuthi nguye oyimbangela yezibonakaliso zakho. Kungakhathaliseki ukuthi yikuphi, kufanele uxhumane nodokotela wakho ngokushesha uma ubona ushintsho lwekhono lwezingqondo ngoba izimbangela eziningana zokulahlekelwa kwememori zinemiphumela engcono uma zibanjwa futhi ziphathwa ngokushesha.
Ukuxilongwa Nezizathu
Ngenxa yokuthi angase ahambe angatholakali kuze kube yizigaba kamuva, kunzima ukuqoqa idatha enembile mayelana nokukhula kwe-HE. Ucwaningo lubonisa ukuthi phakathi kwamaphesenti angu-30 kuya kwangu-70 abantu abane-cirrhosis yesibindi bahlakulela i-HE.
Ngokuvamile uthola ukuthi uthola izimo ezithile. Uma izimpawu zivela ku-HE, zizoqala ukuthuthukisa ngokushesha ngemva kwamahora angu-72 ngemva kokuqala ukwelashwa.
Ngakho-ke, ukuthuthukiswa ngemuva kokuqala ukwelashwa (noma ukungabi nalutho) ngezinye izikhathi kusetshenziselwa ukuqinisekisa noma ukulawula i-HE.
Ezinye izivivinyo ezingase zenziwe ukuze zihlolwe ukuthi ngabe ukhona yini zibandakanya ukuhlolwa okuphelele kwegazi, ukuhlolwa kwezinga le-ammonia, ukuhlolwa kokusebenza kwesibindi, i- EEG , nokuhlolwa kwe-imaging, njenge- MRI noma i- CT scan
Ngenkathi i-HE ivela kubantu abanezinkinga zesibindi, ngokuvamile kuvame ukuhlasela okubangela ukuthi u-HE akhule. Lezi zimbangela zingabandakanya ukutheleleka, imishanguzo ethile efana ne- diuretics (imithi eyenza ukuthi uhleleke ngaphezulu), ukuphelelwa amandla kwamanzi, ukuqothulwa, ukuphuza utshwala obuningi, ukuhlinzeka kwamuva, nokuvinjelwa kwamathumbu (GI).
Ukwelashwa nokubikezelwa
Ukwelashwa kuyahluka kuye ngokuthi ngabe imbangela ethile ye-HE ibonwe. Ukwelashwa kungabandakanya ama-antibiotic, ukuyeka imithi ethile engabangela ezinye izinkinga, ukuphatha ngemithi efana ne-lactulose noma i-polyethylene glycol, ekubhekaneni nezinkinga zokuphuma kwegazi, ukunciphisa amazinga e-ammonia, nokuphathwa kwezinkinga zezinso.
Ukuchazwa kwabantu abane-HE kuyahluka kakhulu. Abanye abantu abane-HE baphendula kahle kakhulu ekwelapheni kanye nokubuyiswa kwabo okujwayelekile okusebenzayo. Ezinye zinezikhukhula ezinzima noma eziphindaphindiwe ze-HE futhi zingaphelela esibhedlela noma esimweni esisongela ukuphila.
Cishe ingxenye eyodwa kwezintathu zabantu abazokwenza ngcono uma ngabe imbangela ethile ye-HE ibonakala futhi iphathwe ngezigaba zayo zangaphambili. Kodwa-ke, uma u-HE engelashwa ngokushesha noma engaphenduli ukwelashwa, kungabangela ukufa.
Ngenxa yokuphumelela kokunakekelwa kokuqala, ucwaningo oluthile lubonisa ukuthi abantu abanezifo zesibindi kufanele bahlolwe njalo nge-HE ngokusebenzisa izivivinyo zokucabanga ukuze i-HE ingabanjwa futhi iphathwe ngaphambi kokuba iqhubekele ezingeni eliphezulu kakhulu.
> Imithombo:
> I-American Liver Foundation. Yiziphi izigaba ze-encephalopathy ye-hepatic?
> I-Cleveland Clinic Foundation. I-Hepatic Encephalopathy.
> Inhlangano Kazwelonke Yezinkinga Ezinzima. I-Hepatic Encephalopathy.
> Raphael KC, Matuja SS, Shen NT, Liwa AC, Jaka H. Hepatic Encephalopathy; ukusabalalisa, izici zokuqeda kanye nezinselele zokuphatha esimweni esinqunyiwe semithombo. I-Journal Yezinqubo Zokunambitha Nokugaya . 2016; 6 (3).
> I-Library Kazwelonke Kazwelonke Yezokwelapha. Ukulahlekelwa kobuchopho ukusebenza - isifo sesibindi.