Amadoda asengozini enkulu yesi sifo
I-Hepatitis B ukuvuvukala kwesibindi esibangelwa yi-virus. Ehlabathini lonke, kukho izigidi ezingaphezu kwezigidi ezingama-400 ezihambayo ezingapheliyo zokuhamba kwe-hepatitis B. Abantu abangama-200,000 abanesivumelwano sokubulala i-hepatitis B minyaka yonke e-US, ukuya kwi-10 ukuya ku-15 000 baya kuhlakulela uhlobo olusisigxina lwesifo. Amadoda anamaxesha amathandathu angaphezu kwamabhinqa ukuba abe yizithuthi ezingapheliyo zegciwane lesifo se-hepatitis B (HBV), kodwa izizathu ezi zicacileyo.
Iintlobo ze-Hepatitis B
Kubantu abadala abadala abafumana igciwane lesifo se-Hepatitis B, ama-95 ekhulwini acacisa intsholongwane kwaye akaqhubeki ukuba nesimo esingapheliyo sesifo. Abanye abantu banemiqondiso embalwa okanye akukho nanye, ngoko banako ukuqonda ukuba banayo i-HBV okanye ukuba bayenayo.
Abantu abaninzi abadala baya kucima intsholongwane ngokupheleleyo kwiinyanga ezintandathu. Iindaba ezilungileyo kukuba ama-antibodies ezikhuselekileyo eziveliswayo xa ulwa nentsholongwane kuthetha ukuba abantu ababenayo ayayi kuze babe nexhala malunga ne-HBV kwakhona-baya kuba ne-immune.
Kukho iintlobo ezintathu zokungenwa kwe-hepatitis B:
- Iimpawu eziphilileyo zempilo ye-hepatitis B azifaki iintsholongwane kwabanye kwaye, nangona zingenokuba yingozi enkulu yecrhosis kunye nomhlaza wesibindi kunabantu bonke, ngokuqhelekileyo bahlala ubomi obuqhelekileyo. Intsholongwane ingasetyenziswa kwakhona xa amasosha omzimba ekhutshiswayo, njengengxaki yesifo esibi, ngexesha lotyando ngeziyobisi ezingenayo i-immunosuppressant izifo ezifana nomhlaza okanye iAIDS, okanye kunye neziyobisi ezifana ne-steroids.
- I-hepatitis B yokusuleleka kwintsholongwane engapheliyo iyingozi kakhulu. Umntu onalo unokuba nesibindi esiphezulu kwaye esonakalisweyo nangona umntu enesibonakaliso esincinci okanye ezingekho. Abantu abanolu hlobo lwe-hepatitis B banamathuba okuba nesifo esiqhubekayo esikhokelela kwi-cirrhosis. Amaphesenti amahlanu ukuya ku-10 anokuxolelwa ngokukhawuleza, angabalulekanga kwabanye, kwaye angagcini umonakalo wesibindi okanye ungasondelanga, nangona ngezinye izihlandlo ukususelwa kwintsholongwane.
- I-hepatitis B engapheliyo yintsholongwane yintsholongwane yintsholongwane yintsholongwane ngokuguqulwa ngokusisigxina kwe-virus ye-virus ye-hepatitis B. Labo abanalo banako ukusuleleka kwabanye kwaye kucatshangelwa ukuba banganyangeki unyango kunezinye iintlobo zesifo.
Ukuthunyelwa
I-Hepatitis B idluliselwa ngamanzi afanelekileyo afana nomzimba:
- Igazi
- I swe swe
- Iinyembezi
- Saliva
- Imihla
- Iimfihlo zengqondo
- Igazi
- Ubisi lwebele
Ukutshintshwa kuyenzeka kwakhona xa usebenzisa i-syringe efanayo nomntu osulelekileyo, njengokufumanisa igazi ngaphambi kowe-1975 (ukunikezelwa kwegazi ngoku kulandwa kwamanye amazwe) kwaye ufumana amathambo okanye ukubhoboza umzimba.
I-Hepatitis B inokudluliselwa ngexesha lokubeletha ukusuka kumama ukuya kumntwana, ngexesha leenkqubo zonyango, ngokubakho emsebenzini, nangesikhathi sokulala ngesondo. Ukuba ne-Hepatitis B ayithethi ukuba umntu usuleleka kwabanye abantu, kuphela abantu abathile abane-HBV abachaphazelekayo.
Izimpawu kunye neMpawu
Kukho iindlela ezininzi abantu abanokufumana ukuba bane-hepatitis. Ngenxa yokuba ngamanye amaxesha kuninzi iimpawu ezithile ezingaphezu kokukhathala, umzekelo, ukuba kunokufunyanwa kuphela xa kuhlolwa iimvavanyo ngegazi-ngamanye amaxesha ngenxa yezizathu ezingahambelaniyo, ezifana nokunikezela ngeminikelo yegazi, ngenjongo yomshuwalense, ukuhlolwa kwezempilo jikelele okanye xa ukulimala okunxulumene nomsebenzi.
I-Acute Hepatitis B
Ngendlela enzima, iimpawu ze-hepatitis B zingenza umntu azive egula kakhulu. Abanye bangakholelwa ukuba banomkhuhlane kanti abanye bangenayo impawu nhlobo.
Iimpawu ziquka i-jaundice, i-fever, intlungu yesisu, isondlo esingenasiphelo, isisongela, ukuhlanza, ukukhathala, umchamo omnyama omnyama, izigqoko ezimbala ezikhanyayo, iintlungu zomzimba kunye nokuxhamla. Isibindi singabuye sandiswe kwaye sithethe.
I-hepatitis e-Fulminant yindlela eqhelekileyo kodwa inqabileyo kakhulu ye -hepatitis . Kungase kuqale ngokukhathala kunye nesiphithiphithi, kodwa, kwiiveki ezimbalwa, iimpawu kunye neempawu ziya kuthiwa. Kwiiveki ezimbini emva kokuba i-jaundice ikhula, i-encephalopathy ikhula.
I-Encephalopathy yimeko yokukhubazeka okanye isimo sengqondo esitshintshileyo. Ngomfanekiso walo omnene, kunokubakho ukukhumbula ukulahleka kwexesha elifutshane, ukulibala, ukutsalana kwentetho, ubuntu obuncinane okanye ukuguquka kokuziphatha, okanye utshintsho kwiindlela zokulala.
Ngomntu onzima kakhulu, umntu unokufumana ukulahlekelwa kwememori enzulu (engazi usuku, unyaka, igama labo okanye idilesi), ukudideka, ukubonisa ukuziphatha okungafanelekanga, ukulungelelanisa ukulungelelanisa, i-asterixis (ukutsalwa okungalawulwayo kwezandla), fetor hepaticus ( ukungcola ukuphefumula), kunye ne-coma. Ukufikelela kuma-85 ekhulwini abantu abanolu hlobo lwe-hepatitis engabonakaliyo baya kufa ngaphandle kokufakelwa kwesibindi .
I-Hepatitis B engapheliyo
Kwakhona, iimpawu kunye neempawu ziyahluka kwaye abantu abaninzi baya kuba bengazi ukuba nantoni na inzulu ayiphutha okanye bafumana iimpawu ezingacacanga. Ezi ziquka ukukhathala okulula okanye okungazinzi, i-jaundice, kunye nesibindi esandisiweyo. Ngelishwa, ukuba i-hepatitis engapheliyo ingasuswanga ngumzimba okanye ayiphathwa ngempumelelo kwaye iyaphiliswa, isifo sesibindi okanye ukungaphumeleli kwesibindi kunokubangelwa.
Uvavanyo lwegazi
Iimvavanyo zegazi ziza kubonisa ubukho besifo kwaye oko kuchaphazelekayo. Uvavanyo lwegazi lwe-hepatitis B lwe-serology luya kuphawula ngokuchanekileyo uhlobo lwe-hepatitis njengokuba kukho iintlobo ezahlukeneyo zegciwane.
Umsebenzi weBindi
Ezi ziphumo zegazi zibonisa indlela isibindi sisisebenza ngayo kodwa asiyikuvavanya ngokucacileyo yonke imisebenzi nemininzi ekhoyo ukuba isibindi sinembopheleleko emzimbeni wethu. Bayiqwalasela izinga le-enzyme yesibindi, i-transaminase kunye ne-enzyme ye-cholestatic, i-bilirubin, kunye namazinga eprotheyini yesibindi, zonke ezinokuchaphazeleka yi-virus yesibindi.
Amanqanaba aphakamileyo ama-transaminase egazini ahlala ebonakalisa ukuba kakubi kangakanani isibindi sokutsha okanye ukulimala. Ukuphakanyiswa kwezi zinto kunokubakho ngenxa yesifo sesibindi sesifo somzimba, izibilini zesibindi, kunye nokuhluleka kwentliziyo. Izigaba eziqhelekileyo ze-AST kunye ne-ALT transaminases ziphakathi kwe-0 ukuya ku-40 IU / L kunye ne-0 ukuya ku-45 IU / L ngokulandelanayo. Kwi-hepatitis B engapheliyo, amanqanaba ngokuqhelekileyo amaxesha amabini anesithathu ngaphezu kwebala eliqhelekileyo.
Iiprotheni zesibindi
I-albinini, i-prothrombin kunye ne-immunoglobulins-iiprotheni ezenziwe ngesibindi-zihlolwe kwaye amanqanaba angavamile zibonisa ukukhathazeka okukhulu kwesibindi. Ixesha leprothrombin kufuneka lizimisele, kwakhona, kuba isibindi sivelisa amaninzi amanqaku okuvalwa okufunekayo ukuba ayeke ukuphuma.
Isibilini seBil
I-biopsy yesibindi yenye yezona ndlela eziphambili kwaye zichanekileyo ezinokuchonga ukuba ziyakwazi ukuba yiyiphi into engalunganga ngesibindi kunye nokuba yonakaliswe kakubi kangakanani. Njengoko izifo ezininzi zesibindi zithinta lonke iqumrhu elifanayo, isampuli encinane efunyenwe yi-biopsy, ngokuqhelekileyo eyenziwe phantsi kwe-anesthetic yendawo, iya kubonisa naziphi na izinto ezingaqhelekanga. Kukho ininzi, i-biopsy yesibindi ekhokelwayo iyisisombululo sokuphepha nokusebenza kakuhle.
Unyango
I-FDA (Ukutya kunye noLawulo lweeDrug) iye yamkela iintlobo ezimbini zeziyobisi, i-interferon ye-alpha kunye ne-lamivudine. I-interferon ye-Alpha, enikezwe ngogaya, ivuselela umzimba womzimba kwaye ilawulwa iiveki ezili-16. Kubiza kakhulu kwaye kunemiphumo emibi, ezimbalwa zazo ezinzulu. I-Lamivudine, ithathwe ngomlomo kwiiveki ezingama-52, nangona ineemiphumo ezimbalwa zempembelelo, ayikho ixesha elide lihlala njenge-interferon. Ukuphindaphinda kuyinto eqhelekileyo kwaye ukusetyenziswa kwayo kunokukhokelela ekumanyeni kwe-anti-virus.
Iimpendulo zempendulo kumachiza kwiinkqubo zonyango eziphumelelayo ziyahluka. Ngo-2002, i-FDA ibike ukuba "ngaphezu kwama-50 ekhulwini kwizigulane ezinama-ALT amanqanaba angaphezu kwamahlanu umda osemgangathweni oqhelekileyo oqhelekileyo, kodwa ezantsi (iipesenti ezingama-20 ukuya kuma-35 ekhulwini) kwizigulane ezinezinga le-ALT ngaphantsi kwamaxesha aphindwe kabini umda ophezulu eziqhelekileyo. Kwizigulane ezinezinga le-ALT ngaphantsi kwamaxesha amabini umda ophezulu wezinto eziqhelekileyo, amazinga okuphendula ayimpofu kwaye unyango kufuneka luchazwe. "
Uhlobo olutsha lwe-drug-nucleotide analogue adefovir dipivoxil (i-Hepsera) -offers isithuba esinokuthi sesithathu kwaye samkelwe yi-FDA kunyango lwe-hepatitis B ngoSeptemba 2002.
I-Acute Hepatitis B
I-hepatitis B echaphazelekayo iphathwa ngokufanelekileyo kunye nokuphuphuma kwamanzi. Akunakudingi ukuphumla kokulala; kuxhomekeke kwindlela ozigula ngayo.
Ukuba ufike kuyo, akukho sizathu sokuba ungayi kusebenza. Kubalulekile ukukholisa ubomi obunempilo, ngokoyeka ukutshaya (zama nzima!) Kwaye udle ukutya okunempilo. Ngokuqinisekileyo unxilise iinyanga ezincinane njengoko isibindi sidinga ixesha lokubuyela.
I-Hepatitis B engapheliyo
Kwabo bantu abo imizimba yabo ayikwazi ukususa intsholongwane, i-HBV iya kuqhubeka ibe yimeko engapheliyo. Kungekudala bekungekho unyango lwe-hepatitis B; Nangona kunjalo, ngoku kukho inani lezonyango ezikhoyo ezibonakala ziphumelela kakhulu.
Ixesha elizayo likhangeleka kakhulu kwaye izazinzulu kunye neenkampani zonyango zithemba ukuba, kwiminyaka embalwa ezayo, unyango luya kufumaneka ukuba luya kunika bonke abantu abane-hepatitis B.
Unyango olunonyango lwe-anti-virus lufumaneka kubantu abane-hepatitis B engapheliyo nangona kungenakunyuswa kubo bonke abantu abane-HIV. Unyango lujoliswe ekunciphiseni igciwane lesifo se-hepatitis B nokuyeka ukugula kwesibindi.
Prognosis
- Phantse iipesenti ezimbini zabantu abane-hepatitis B ezingapheliyo ziyaqhubeka nokuphuhlisa i-cirrhosis ngonyaka.
- Kwiminyaka engaphezu kwemihlanu, ukunyuka kwamathuba okukhula kwe-cirrhosis ngama-15 ukuya kuma-20 ekhulwini.
- Isilinganiso seminyaka emihlanu yokusinda emva kwe-cirrhosis sikhula phakathi kwama-52 no-80 ekhulwini.
- Ukuba i-cirrhosis echithwayo (i-cirrhosis ehamba kunye neengxaki ezinjengegazi kunye ne-encephalopathy) zikhula, amazinga okuphila ahla ukuya kuma-14 ukuya kuma-32 ekhulwini.
- Ngenxa yengozi yomdlavuza wesibindi , malunga nesigidi abantu emhlabeni jikelele bafa minyaka yonke kwiingxaki ze-hepatitis B.
Ukugqithisa akuncinci kakhulu kulabo banezinto ezilandelayo:
- Ubuthathaka impilo jikelele
- Ukufikeleleka kwiinkqubo zezempilo ezingenasisiseko, ukungabikho kwemali, ukucoceka kococeko, njl njl
- Ubudala
- Izifo zesifo se-hepatitis D kunye ne-hepatitis B kunye kunye
- Izifo ezibangelwa yi-hepatitis C kunye ne-hepatitis B kunye kunye
- I-hepatitis ephezulu
- Ukusetyenziswa kotywala emva kokuxilongwa kwe-hepatitis engapheliyo
Qaphela: I-Hepatitis D (i-HDV) inokuphela kuphela ne-virus ye-hepatitis B. I-Hepatitis D idluliselwa ngendlela efanayo ne-hepatitis B kwaye ingabanjwa ngexesha elifanayo ne-HBV (usulelo-ntsho) okanye emva kokusuleleka kwe-HBV. Usulelo lwe-Co-infection luyaziwa ukucima umzimba (90 ukuya ku-95 ekhulwini). Kwimeko yokungafihlisi, i-70 ukuya kuma-95 ekhulwini iyaqhubeka ibe ne-HDV engapheliyo.
Thintelo
I-vaccine iyatholakala kwaye ikwacetyiswa kwabo basengozini okanye banxibelelana nesi sifo. Isitofu sokugonywa singama-90 ukuya kuma-95 ekhulwini ekusebenzeni ukukhusela i-hepatitis B kunye nesimo esingapheliyo sesifo.
Amashumi asixhenxe anesithoba kwiiNtsapho zeMpilo Yehlabathi ziye zamkela umgaqo-nkqubo wokugonywa kwe-hepatitis B. Ngelishwa, iindleko zokugonywa kunye neendlela ezilula zokusasazela le ntsholongwane kuthetha ukuba iziganeko ezipheleleyo zokutheleleka kwe-hepatitis B ziyaqhubeka zikhula.
Abantu abaziyo ukuba abanesifo se-hepatitis B banokuthi bathathe amanyathelo okuthintela ukuthintela abanye. Ezi zibandakanya ukulahlwa okufanelekileyo kwezinto ezinobungozi, usebenzisa iibhokhwe eziqhekezayo kunye neesisisi, ungalokothi ukwabelana ngamasilane kunye nemivimbo kunye nabanye, uhlale usebenzisa iikhondom kunye nokuphepha ukulala .
Ukuba umsebenzi wakho uquka ukusebenza kwiindawo ezinobungozi, kufuneka uqhagamshelane nogqirha wakho ukuze ucebise malunga nokuqapha kunye nayiphi na imiphumo enokuba nayo kwimpilo yakho yesikhathi esizayo. Bonke abantu abane-hepatitis B kufuneka bafumane isitofu sokukhusela i-hepatitis A ukukhusela ukusuleleka.
Ukujamelana
Ukuba ufumanisa ukuba une-hepatitis B, ungadikibali. Fumana ugqirha ochwepheni we-hepatology ukuze akucebise ngezona ndlela zonyango kunye nendlela onokuyandisa ngayo impilo yakho ukulwa nesifo.
Khumbula, awuyedwa. Kukho izigidi zabantu abane-hepatitis B. Fumana iqela loxhaso lendawo kwi-intanethi okanye ubuze iqela lakho lezonyango elibonelela ngononophelo lweenkqubo ezikhoyo.