I-hepatic encephalopathy (HE) (ebizwa ngokuba yi- portosystemic encephalopathy ) yimeko apho isifo sesibindi sichaphazela ukusebenza kwengqondo. Udla ngokuphindaphindiweyo kubantu abafumana izifo ezifana ne- hepatitis okanye i- cirrhosis yesibindi . Iyakhula kwakhona ngenxa yesifo somhlaza . Njengoko isifo sesibindi siyaqhubeka, iibhokhwe ezinobungozi obuphilileyo kufuneka zisuse egazini, zihambe ukuya kwiingqondo kwaye zichaphazele ukukwazi ukwenza ngokuqhelekileyo, cinga ngokucacileyo kwaye ukhumbule ulwazi.
Ngenhlanhla, le nto yokubangela ukulahlekelwa kwememori iyaphathwa.
Iimpawu ezinkulu
UYE unokuchaphazela zombini ubuchule bokuqonda. Ukuba unesifo sesibindi, kufuneka ucele ilungu lentsapho okanye umhlobo ukuba akuncede uqaphele eli qela leempawu uze uxelele ugqirha wakho ngokukhawuleza ukuba uvavanywe ngokukhawuleza kunye nonyango.
Iimpawu zivela kwiinguqu ezingqondweni ezingabonakaliyo zokungaphenduli. Ziquka:
- Ukudideka
- Ukulahleka kwememori
- Unzima ukugxila okanye ukugcina ingqalelo
- Ukuphazamiseka kwixesha, indawo okanye usuku
- Utshintsho lwabantu
- Ixesha elithatha ixesha elifutshane lokuphendula, ngokusemzimbeni nasengqondweni
- Inkathazo okanye ukuziphatha okungafanelekanga kuluntu
- Ukungakwazi ukwenza iingxaki zezibalo eziphambili
- Umphunga ophethe iphunga elimnandi
- Ukukhwaza kunye nokugxotha kweengalo okanye imilenze
- Ukuqhawula phezulu nokuhla kweengalo xa ubambelela ngqo
- Ukudibanisa intetho
- Ukunyusa ukuphazamiseka
Izigaba ze-Hepatic Encephalopathy
UYE unokuhlaziywa kwizigaba ezahlukeneyo-ezibizwa ngokuba ngama-grade-okuqhubekayo ukusuka ekuncinci ukuya ku-coma.
I-West Haven Grading System ichitha iinqanaba ze-HE ngolu hlobo lulandelayo.
Bakala 0: INgcaciso HE
INgcinci HE ingakhokelela ekutshintsheni, utshintsho oluncinci kumandla akho okucinga ngokucacileyo, ukusombulula iingxaki, nokukhumbula ulwazi. Imiqondiso enokwenzeka inokubandakanya ubunzima obunzima bokufeza imisebenzi emsebenzini wakho okanye ukuqhubela iilaphulelo ngenxa yokuphucula ixesha okanye ukunciphisa ukulungelelanisa.
Ngamanye amaxesha angasinda ukufumana ngaphandle kokuba ugqirha uyayifaka kwi-test testing.
Bakala 1: Mild HE
Ubumnene angenza ubuntu okanye isimo sengqondo sitshintshe kunye nokunciphisa amandla okugxila kumsebenzi. Ngamanye amaxesha, iingxaki zokuhlala zilele kule nqanaba.
IBakala 2: I-HE
Ukuziphatha okucelomngeni okanye okungafanelekanga kungahlakulela kwi-HE. Imemori yakho ingaba yimbi ngakumbi, njengokuba unako ukukwazi ukwenza izibalo zamatriki. Ukubhala kunokuba nzima kunokuba izandla zakho zibe zintlone okanye zenzeke.
IBanga 3: I-HE
I-HE ephezulu ingathintela ukuqhelaniswa. Ngokomzekelo, unokuba ungaqinisekanga ukuba ungakanani umhla okanye ukuphi. Ukuziphatha kwakho kungabikho kancinci kuluntu kwaye uziva ulele kakhulu okanye uxhala. Amandla engqondo nangokwenyama aqhubeka nokuhla e-HE.
Bakala 4: iComa
Kule nqanaba, uya kulahleka kwaye ube ngumntu odibeneyo (ongaphenduliyo).
Ndingazi njani ukuba ndi-HE?
Ukuba uneminye impawu echazwe ngasentla kodwa ungenayo ingxaki kwisibindi sakho, mhlawumbi ukuba iimpawu zakho zibangelwa yinto ehlukile yokulibala. Ukuguqulwa kwamandla engqondo kungabangelwa yimimiselo emininzi, ezinye zazo ziguqulwa (njenge- delirium ) kunye nezinye eziqhubekayo (njenge- Alzheimer's disease ).
Ukuba unesifo sesibindi esinjenge-hepatitis okanye i-cirrhosis, kunokwenzeka ukuba nguye unobangela weempawu zakho. Ngandlela-thile, kufuneka uqhagamshelane nodokotela wakho ngokukhawuleza ukuba ubona ukuguqulwa kwamandla engqondo kuba iimbangela ezininzi zokulahlekelwa kwememori ziphumo ezilungileyo xa zibanjwe kwaye ziphathwa ngokukhawuleza.
Ukuxilongwa kunye Nezizathu
Kungenxa yokuba UNGUYA kungena kwi-interns ukuya kwinqanaba elizayo, kunzima ukuqokelela idatha echanekileyo kwi-HE. Uphando lubonisa ukuba phakathi kwama-30 ukuya kuma-70 ekhulwini abantu abane-cirrhosis yesibindi bahlakulela i-HE.
UVAVANYO ngokuqhelekileyo ufumaniswe ngenye iimeko. Ukuba iimpawu zivela ku-HE, ziza kuqala ukuphucula ngokukhawuleza emva kweeyure ezingama-72 emva kokuba unyango luqale.
Ngako oko, uphuculo emva kokuba uqaliswe unyango (okanye ukungabi naso) ngamanye amaxesha kusetyenziswa ukuqinisekisa okanye ukulawula i-HE.
Ezinye zeemvavanyo ezinokuqhutywa ukuba zivandlakanywe ukuba zikhoyo zibandakanya uvavanyo olupheleleyo lweemvavanyo zegazi, uvavanyo lwezinga le-ammonia, iimvavanyo zokusebenza kwesibindi, i- EEG , kunye neemvavanyo zokucinga, ezifana ne- MRI okanye iTT scan
Nangona ebonakalayo kubantu abaneengxaki zesibindi, kudla ngokubakho okubangela ukuba i-HE iphuhlise. Ezi zizathu zingabandakanya izifo, amayeza athile afana ne- diuretics (amayeza anokubangela ukuba ujikeleze ngaphezulu), ukutywa kwamanzi, ukutywala, ukusela utywala obuninzi, ukuhlinzwa kwangoku, kunye nesisu (GI) ukuphuma.
Unyango kunye nePrognosis
Unyango luyahluka ngoxhomekeke ekubeni ngaba isisombululo esithile se-HE sichazwe. Unyango lunokuquka i-antibiotics, ukuyeka amayeza athile anokubangela ezinye iingxaki, unyango ngamachiza afana ne-lactulose okanye i-polyethylene glycol, ukujongana neengxaki zokuphuma kwegazi, ukunciphisa ama-ammonia kunye nokuphathwa kweengxaki zeengtso.
Ukugxekwa kwabantu abane-HE kuyahluka kakhulu. Abanye abantu abanokuphendula ngokunyanga kakhulu kunyango kunye nemisebenzi yabo evamile yokubuyisela. Abanye banomsebenzi obunzima okanye ophindaphindiweyo we-HE kwaye banokupheliswa esibhedlele okanye kwindawo esongela ubomi.
Phantse kwekota ezintathu zabantu abaya kuphucula ukuba isizathu esithile se-HE sibonakaliswe kwaye siyaphathwa kwizigaba zayo zangaphambili. Nangona kunjalo, ukuba INYE ayiphathwe ngokukhawuleza okanye ayiphenduli unyango, inokuphumela ekufeni.
Ngenxa yokuphumelela kwonyango lokuqala, uphando oluthile lubonisa ukuba abantu abanezifo zesibindi kufuneka bahlolwe rhoqo kwi-HE ngokusebenzisa iimvavanyo zengqondo ukuze i-HE ingabanjwa kwaye iphathwe ngaphambi kokuba iqhubele phambili kwiinqanaba eziphambili.
> Imithombo:
> I-American Liver Foundation. Ziziphi izigaba ze-hepatic encephalopathy?
> I-Cleveland Clinic Foundation. I-Hepatic Encephalopathy.
> I-National Organisation for Disorder Disorders. I-Hepatic Encephalopathy.
> Raphael KC, Matuja SS, Shen NT, Liwa AC, Jaka H. Hepatic Encephalopathy; ukuxhaphaka kwezinto, iziganeko zokukhawulela kunye nemingeni yolawulo kwisicwangciso esingenamlinganiselo. Umbhalo weNkqubo yeZisisu kunye neSigestive System . 2016; 6 (3).
> Ilayibrari yeSizwe ka-US yamayeza. Ukulahlekelwa kwengqondo yengqondo - isifo sesibindi.