Ukonakala kweHepatocerebral

Ukonakala kwe-Hepatocerebral sisifo sengqondo esenzeka kubantu abanomonakalo wesibindi.

Le meko inokubakho nakweyiphi na imeko yokufumana ukusilela kwesibindi, kubandakanya ne-hepatitis ebukhali.

Umonakalo wesibindi unokukhokelela ekwakhiweni kwe-ammonia kunye nezinye izinto eziyityhefu emzimbeni. Oku kwenzeka xa isibindi singasebenzi kakuhle. Ayophuli kwaye iphelise le michiza. Izinto eziyityhefu zinokonakalisa izicwili zobuchopho.

Iindawo ezithile zobuchopho, ezinjenge-basal ganglia, kunokwenzeka ukuba zenzakale ngenxa yokusilela kwesibindi. I-basal ganglia inceda ukulawula ukuhamba. Le meko luhlobo "non-Wilsonian". Oku kuthetha ukuba ukonakala kwesibindi akubangelwa ziidipozithi zobhedu esibindini. Eli luphawu oluphambili lwesifo seWilson.

Iimpawu zingabandakanya:

• Kunzima ukuhamba
• Umsebenzi wokungasebenzi kakuhle kwengqondo
• I-jaundice
• Imisipha spasm (myoclonus)
• Ubungqongqo
• Ukushukuma kweengalo, intloko (ukungcangcazela)
• Ukujijisa
• Ukuhamba okungalawulekiyo komzimba (chorea)
• Ukuhamba okungazinzanga (ataxia)

Iimpawu zibandakanya:

• Coma
• Ulwelo esiswini olwenza ukudumba (ascites)
• Ukopha emathunjini kwimithambo eyandisiweyo kumbhobho wokutya (ii-esophageal varices)

Inkqubo ye-nervous (neurological) yovavanyo inokubonisa iimpawu zoku:

• Isifo sengqondo esiyingozi
• Iintshukumo zokuzibandakanya
• Ukungazinzi kokuhamba

Uvavanyo lweLebhu lunokubonisa inqanaba eliphezulu le-ammonia kwigazi kunye nokusebenza kwesibindi ngokungaqhelekanga.

Olunye uvavanyo lunokubandakanya:

• I-MRI yentloko
• I-EEG (ingabonisa ukucotha ngokubanzi kwamaza engqondo)
• Ukuvavanywa kwentloko kwe-CT

Unyango lunceda ukunciphisa iikhemikhali eziyityhefu ezakha ngenxa yokusilela kwesibindi. Ingabandakanya i-antibiotics okanye iyeza elifana ne-lactulose, elehlisa izinga le-ammonia egazini.

Unyango olubizwa ngokuba yi-branched-chain chain lwe-amino acid unyango lunokuthi:

• Ukuphucula iimpawu
• Ukuguqula umonakalo wengqondo

Akukho lunyango oluthile lwe-neurologic syndrome, kuba ibangelwa ngumonakalo wesibindi ongenakulungiseka. Ukufakelwa kwesibindi kunokunyanga isifo sesibindi. Nangona kunjalo, lo msebenzi awunakuguqula iimpawu zokonakala kwengqondo.

Le yimeko yexesha elide (engapheliyo) enokuthi ikhokelele kwinkqubo yeempawu zemithambo-luvo engenakuphikwa.

Umntu angaqhubeka esiba mandundu kwaye asweleke ngaphandle kokufakelwa isibindi. Ukuba ukufakelwa kwenziwa kwangoko, isifo se-neurological syndrome sinokubuyela umva.

Iingxaki zibandakanya:

• Ikhoma yeHepatic
• Umonakalo omkhulu wobuchopho

Fowunela umboneleli wakho wezempilo ukuba unayo nayiphi na impawu zesifo sesibindi.

Akunakwenzeka ukuthintela zonke iintlobo zesifo sesibindi. Nangona kunjalo, i-hepatitis enotywala kunye nentsholongwane inokuthintelwa.

Ukunciphisa umngcipheko wokufumana i-hepatitis yotywala okanye yentsholongwane:

• Kunqande isimilo esiyingozi, njengokusebenzisa iziyobisi nge-IV okanye isondo esingakhuselekanga.
• Musa ukusela, okanye usele nje ngokumodareyitha.

Ukufumana okungapheliyo kwe-hepatocerebral engafunyanwanga (engekhoyo-Wilsonian); Ecephalopathy yesibindi; Inkqubo yesifo seengcongconi

• I-anatomy yesibindi

UGarcia-Tsao G. Cirrhosis kunye nokulandelelana kwayo. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Umhla wama-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 153.

Haq IU, Tate JA, Siddiqui MS, Okun MS. Isishwankathelo seklinikhi sokuphazamiseka kwentshukumo.Ku: Winn HR, ed. Ugqirha we-Youmans kunye no-Winn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2017: isahl. 84.