Hepatic encephalopathy (HE) (inonziwo portosystemic encephalopathy ) ndiyo mamiriro apo chirwere cheropa chinokanganisa uropi hunoshanda. Anowanzoitika kuvanhu vane zvirwere zvakadai sehepatitis kana chiropa chinonzi cirrhosis . Inogonawo kukura semugumisi wekenza yeropa . Sezvo zvirwere zvechiropa zvinopfuurira, maronda ane chiropa ane hutano anofanira kubvisa kubva muropa pane kuenda kune uropi uye kuchinja kukwanisa kwaro kuita zvakanaka, funga zvakajeka, uye yeuka mashoko.
Nenguva isipi, izvi zvinokonzera kurasikirwa mupfungwa zvinoporesa.
Zviratidzo Zvitsva
Anokwanisa kukanganisa zvose mano ekuziva uye masimba. Kana iwe uine chirwere chechiropa, unofanirwa kukumbira nhengo yemhuri kana shamwari kuti akubatsire kutarisa boka iri rezviratidzo uye ugozviudza kuna chiremba wako pakarepo kuti uongorore nokukurumidza uye kurapwa.
Zviratidzo zvinowanikwa kubva pakuonekwa zvisingaoneki kuchinja kwekutadza kusateerera. Dzinosanganisira:
- Kusanganiswa
- Kurasika kurasika
- Dambudziko rekutarisa kana kuchengetedza kutarisa
- Kushungurudzwa kwenguva, nzvimbo kana musi
- Unhu hunochinja
- Zvishoma nezvishoma zvinoita nguva, zvose mumuviri nepfungwa
- Zvakaoma kana kuti tsika dzisina kukodzera
- Kusakwanisa kuita zvidzidzo zvemasvomhu matambudziko
- Kupisa kunotapira kunhu
- Kugunun'una uye kuputika kwemaoko kana makumbo
- Kufungira kumusoro uye pasi kwemaoko paunenge wakavabata zvakananga kunze
- Slurring of speech
- Yakaderedza kusvinura
Nhanho dzeHepatic Encephalopathy
Anokwanisa kuiswa mumatanho akasiyana-anonziwo makirasi-anofambira mberi kubva kudiki kusvika ku coma.
IWest Haven Grading System inoputsa zvikamu zve HE sezvinotevera.
Bhuku 0: Minimal HE
Minimal HE ingaguma nekunyengera, kuchinja kuduku mune mano ako okufunga zvakajeka, dambudziko-kugadzirisa, uye yeuka mashoko. Zvingaita zviratidzo zvinogona kusanganisira kuoma kwakawanda kuita mabasa kubasa rako kana kutyaira zvinyorwa nekuda kwekukurumidza kupindura nguva kana kuderedza kubatana.
Minimal HE dzimwe nguva angapukunyuka kuona kunze kwekunge chiremba anozviona nokuda kwekuongorora kwekuziva.
Bhuku 1: Akanaka HE
Unyoro anokwanisa kukonzera humwe humwe kana mafungiro akachinjwa uye kushaya simba kwekuisa pfungwa pane rimwe basa. Dzimwe nguva, zvinetso nehope zvinokura panguva ino.
Bhuku 2: Moderate HE
Maitiro akaoma kana kuti asina kukodzera anogona kukura mu HE inonyoresa. Kuyeuka kwako kunogona kuipa, sekugona kwako kukwanisa kuita masvomhu kuverenga. Kunyora kunogona kuva kwakaoma nokuti maoko ako angave akazununguka kana akaoma.
Bhuku 3: Ane Hutu
Mukuru HE anogona kuchinja maitiro. Semuenzaniso, iwe unogona kusava nechivimbo pamusoro pezuva ripi kana kuti uri kupi. Unhu hwako hunogona kunge husina kunaka uye hunoti unzwe urope kana kuti unonetseka. Unyanzvi hwepfungwa uye hwepanyama huri kuramba huchiramba mu HE.
Bhuku 4: Coma
Muchikamu chino, iwe ucharasikirwa uye ugove wakavhengana (usingateereri).
Ndinoziva Sei Kana Ndine HE?
Kana iwe uine zvimwe zvezviratidzo zvinorondedzerwa pamusoro apa asi hauna matambudziko nechiropa chako, zvinogona kuti zviratidzo zvako zvinokonzerwa nechikonzero chakasiyana chokukanganwa. Kuchinja kwepfungwa kunogona kukonzerwa nehuwandu hwemamiriro ezvinhu, zvimwe zvacho zvinoshandiswa zvakare (zvakadai se delirium ) nezvimwe zvinofambira mberi (zvakadai seAlzheimer's disease ).
Kana iwe uine chiropa chechipatara chakadai sehepatitis kana cirrhosis, zvinowanzoita kuti HE ndiye chikonzero chezviratidzo zvako. Chero nzira, unofanirwa kuonana nechiremba wako pakarepo kana ukacherechedza kukwanisa kwepfungwa kuchinja nokuti zvikonzero zvakasiyana zvekurasikirwa kwepfungwa zvine migumisiro iri nani kana vakabata uye vachirapwa kare.
Kuziva uye Zvikonzero
Nemhaka yokuti HE inogona kuenda asina kuwanikwa kusvikira pane zvishoma, zvakaoma kuwana mhinduro yakarurama pamusoro peHIV. Zvidzidzo zvinoratidza kuti pakati pe30 kusvika ku70 muzana yevanhu vane chiropa chinonzi cirrhosis kukura HE.
Iye anowanzoongororwa nekutonga kunze kwemamwe mamiriro ezvinhu. Kana zviratidzo zvichibva kuna HE, dzinowanzotanga kuvandudza nokukurumidza kana mukati maawa 72 mushure mekunge mushonga watanga.
Saka, kuvandudzwa mushure mokunge kurapwa kwave kwatangwa (kana kushaikwa kwayo) dzimwe nguva kunoshandiswa kusimbisa kana kutonga HE.
Zvimwe zvekuedza zvinogona kuitwa kuti zviongorore kana HE aripo zvinosanganisira kuyeza kwekuyera kuongororwa kwemazi, kuongororwa kwenhamba yemamoniya, kuedza kushanda kwechiropa, EEG , nekuedza kwekufungidzira, zvakadai seMRI kana CT scan
Apo HE inowanikwa kune vanhu vane zvinetso zveropa, pane kazhinji kechimwe chinhu chinokonzera HE kukura. Izvi zvinogona kusanganisira zvirwere, mamwe mishonga yakadai se diuretics (mishonga inokuita kuti urinate zvimwe), kupera simba, kuvhiringidza, kunwa doro rakawandisa, kuvhiyiwa kwemazuva ano, uye kuvakoka (GI) kubuda ropa.
Kurapa uye Kurapa
Mishonga inopesana zvichienderana nekuti chinokonzera chikonzero che HE chave chakaonekwa. Mishonga inogona kusanganisira mishonga inorwisa mabhakitiriya, kurega mamwe mishonga ingangodaro inokonzera mamwe matambudziko, kurapa nemishonga yakadai se lactulose kana polyethylene glycol, kutarisana nezvinetso zvinobuda ropa, kuderedza ammonia, uye kurapa zvinetso zvepvo.
Kufanirwa kwevanhu vane HE kunopesana zvikuru. Vamwe vanhu vane HE vanopindura zvakanyanya kurapwa uye basa ravo rakanaka rinodzoka. Vamwe vane maitiro akaoma kana kuti anodzokorora a HE uye vanogona kuguma muchipatara kana mune mamiriro ezvinhu anotyisa.
Vanenge vatatu vevanhu avo HE vachabva vavandudza kana chikonzero chaicho che HE ichicherechedza uye chichibatwa muzvikamu zvayo zvekare. Zvisinei, kana HE isati yabatwa zvisina kufanira kana kuti isingateereri kurapwa, inogona kuguma nekufa.
Nemhaka yekubudirira kwekurapwa kwekutanga, kumwe kutsvakurudza kunoratidza kuti vanhu vane zvirwere zvechiropa vanofanira kugara vachiongororwa HE kuburikidza nemuedzo wekuziva kuti HE inogona kubatwa uye kurapwa isati yafambira mberi kusvika mumatanho akawedzerwa.
> Sources:
> American Liver Foundation. Ndezvipi zvikamu zvehepatic encephalopathy?
> The Cleveland Clinic Foundation. Hepatic Encephalopathy.
> National Organisation for Rare Disorders. Hepatic Encephalopathy.
> Raphael KC, Matuja SS, Shen NT, Liwa AC, Jaka H. Hepatic Encephalopathy; kupararira, kukonzera zvinhu uye zvinetso zvehutungamiri mumamiriro ekugadzirisa-zvishoma. Nhaurwa yeMatumbo uye Digestive System . 2016; 6 (3).
> US National Library of Medicine. Kurasikirwa kweuropi kushanda - chirwere cheropa.