Momwe vuto la chiwindi limakhudzira ubongo: Tiyeni tikambirane za matenda a chiwindi (Hepatic Encephalopathy) mwachidule.

Kodi munayamba mwaonapo munthu m'banja mwanu, mwina bambo anu, amalume anu, kapena munthu amene mumamudziwa, akuchita zinthu zachilendo mwadzidzidzi? Kodi ndi kuiwala zinthu, kusokonezeka pang'ono, kukwiya ndi zinthu zazing'ono, kapena kugona nthawi zonse masana? Nthawi zambiri timaganiza kuti izi ndi zinthu zachilendo zomwe zimachitika tikamakula. Komabe, nthawi zina izi zimatha chifukwa cha vuto lalikulu la chiwindi chawo. Ndicho chimene timachitcha 'Hepatic Encephalopathy' m'mawu azachipatala. Ngakhale dzinalo lingamveke loopsa, tiyeni tikambirane mwachidule.

Mwachidule, kodi Hepatic Encephalopathy ndi chiyani?

Izi n'zosavuta kuzimvetsa. Dzinali lili ndi magawo awiri. Mawu oti "hepatic" amatanthauza 'zokhudzana ndi chiwindi'. Mawu oti "Encephalopathy" amatanthauza 'kulephera kugwira ntchito kwa ubongo'. Choncho mukaphatikiza zonsezi, zikutanthauza kuti ubongo umakhudzidwa ndi kulephera kugwira ntchito kwa chiwindi.

Tangoganizani kuti 'fyuluta' kapena 'fyuluta' yayikulu m'thupi lathu ndi chiwindi. Chimodzi mwa ntchito zazikulu za chiwindi ndikusefa poizoni, monga ammonia, kuchokera m'magazi titamaliza kugaya chakudya chomwe timadya ndi kumwa. Tsopano tangoganizani, chimachitika ndi chiyani ngati fyuluta iyi sigwira ntchito bwino? Ma poizoni amenewo ('Neurotoxins') sakusefedwa ndipo amapita mwachindunji m'magazi. Magazi oopsa awa amayenda m'thupi lonse ndipo pamapeto pake amafika muubongo. Maselo a ubongo sangathe kuthana ndi poizoni awa. Pamenepo ubongo umayamba kugwira ntchito molakwika. Ndicho chifukwa chake zizindikiro zonsezi zimayamba kuwonekera.

Kodi zizindikiro za vutoli ndi ziti?

Zizindikiro zimatha kusiyana malinga ndi munthu. Anthu ena angakumane nazo mwadzidzidzi, pomwe ena angayambe kuziona pang'onopang'ono. Masiku ena, zizindikiro zimatha kuchepa, koma zingabwerenso. Zizindikiro zanu ndi izi:

• Maganizo ndi umunthu
• Khalidwe ndi kuwongolera maganizo
• Kwa kukumbukira, kuganizira ndi kuganiza
• Kuzindikira ndi machitidwe ogona
• Kugwirizana ndi ntchito zamagalimoto

Zingakhudze. Madokotala amagawa vutoli m'magawo angapo kutengera kuopsa kwa zizindikirozi. Tiyeni tiwone magawo amenewo.

Magawo a zizindikiro (Dongosolo Lowerengera)

Njira yodziwika bwino yogwiritsira ntchito pozindikira izi ndi ``West Haven Criteria.'' Izi zimagawa magawo kuyambira 0 mpaka 4.

N’chifukwa chiyani izi zikuchitika? Kodi zifukwa zake ndi ziti?

Monga tafotokozera kale, chifukwa chachikulu ndi kulephera kwa chiwindi kusefa poizoni. Pali njira zingapo zomwe izi zingachitikire. Madokotala amagawa Hepatic Encephalopathy m'mitundu itatu kutengera zomwe zimayambitsa.

Mtundu A

Izi zimachitika chifukwa cha kulephera kwa chiwindi mwadzidzidzi (`Acute Liver Failure`). Izi zikutanthauza kuti chiwindi cha munthu amene sanadwalepo kale chimasiya kugwira ntchito mwadzidzidzi mkati mwa masiku ochepa. Izi zitha kuchitika chifukwa cha:

• Matenda opatsirana ndi mavairasi (monga chiwindi cha chiwindi A, B)
• Kumwa mankhwala ena mopitirira muyeso , makamaka paracetamol, ndi chifukwa chachikulu cha izi. Ngati inu kapena munthu amene mumamudziwa wamwa mopitirira muyeso, imbani National Poison Information Center ku Colombo National Hospital nthawi yomweyo ndipo mupite naye kuchipatala.
• Kupha poizoni, monga mitundu ina ya bowa.

Iyi ndi nkhani yofunika kwambiri komanso yofunika kwambiri.

Mtundu B

Izi n'zovuta pang'ono. Mwachidule, magazi omwe ayenera kupita ku chiwindi kuti akayeretsedwe amadutsa chiwindi ndikulowa mwachindunji m'magazi kudzera munjira ina ('portosystemic shunt'). Izi zimalola poizoni m'magazi kupita ku ubongo popanda kusefedwa.

Mtundu C

Mtundu uwu ndi wofala kwambiri. Izi zimachitika pamene chiwindi chikulephera kugwira ntchito pang'onopang'ono chifukwa cha matenda a chiwindi omwe amatenga nthawi yayitali (`Chronic Liver Disease`). Chifukwa chachikulu cha izi ndi cirrhosis. Cirrhosis ndi vuto lomwe chiwindi chimawonongeka pakapita nthawi, chimavulala, ndipo chimakhala cholimba komanso chosagwira ntchito bwino. Izi zitha kuchitika chifukwa cha:

• Kumwa mowa mopitirira muyeso kwa nthawi yayitali.
• Matenda opatsirana ndi mavairasi monga hepatitis B ndi C.
• Matenda a Chiwindi Chonenepa.

Zochitika Zoyambitsa

Munthu amene ali ndi matenda aakulu a chiwindi, monga cirrhosis, akhoza kukhala moyo wabwinobwino mpaka pamlingo winawake. Komabe, zizindikiro za `Hepatic Encephalopathy` zimatha kuwonekera mwadzidzidzi. Izi zimachitika chifukwa cha chochitika chomwe chimaika mtolo wosapiririka pachiwindi. Zochitika zotere timazitcha `Zoyambitsa`.

• Kudzimbidwa: Pamene kudzimbidwa kumachitika, poizoni amakhala m'matumbo kwa nthawi yayitali, zomwe zimapangitsa kuti alowe m'magazi kwambiri.
• Kusowa madzi m'thupi: Pamene madzi sakwanira m'thupi, ntchito ya impso imafookanso, zomwe zimachepetsa kwambiri kuchotsedwa kwa poizoni.
• Matenda: Matenda aliwonse m'thupi (monga matenda a mkodzo, matenda a m'mapapo) amaika chiwopsezo chachikulu pachiwindi.
• Kutuluka magazi m'mimba: Ngati magazi akutuluka, monga m'chilonda cha m'mimba, poizoni wambiri monga ammonia amapangidwa magazi akamagayidwa m'matumbo.
• Kumwa mankhwala owononga chiwindi, monga mapiritsi ogonetsa ndi ochepetsa ululu.
• Kumwa mowa wambiri nthawi imodzi.

Kodi dokotala amazindikira bwanji izi?

Mukapita ndi wokondedwa wanu kwa dokotala yemwe ali ndi zizindikirozi, chinthu choyamba chomwe angachite ndikufunsani inu ndi wodwalayo za zizindikirozo. Kenako, adzakuyesani thupi. Adzafufuza ngati pali kunjenjemera.

Kuphatikiza apo, mayeso angapo angachitike kuti apeze chifukwa chenicheni:

• Kuyezetsa magazi: Izi zimatha kuyeza kuchuluka kwa ma enzymes a chiwindi, kuchuluka kwa ammonia m'magazi, ndikupereka chithunzi chonse cha momwe chiwindi chimagwira ntchito.
• Kujambula kwa Ultrasound: Kuyang'ana momwe chiwindi chilili komanso mitsempha yamagazi yozungulira chiwindicho.
• Kujambula ubongo (CT scan kapena MRI): Kufufuza kutupa kapena mavuto ena mu ubongo.
• Kuyesa kwa EEG: Kuyeza ntchito yamagetsi ya ubongo kuti muwone ngati pali zolakwika zilizonse.

Kodi mankhwala ochizira izi ndi otani?

Pali zolinga zitatu zazikulu za chithandizo:

1. Kuthana ndi vuto ladzidzidzi: Kupeza ndi kuchiza chomwe chimayambitsa (monga matenda, kudzimbidwa) chomwe chinayambitsa kuwonjezeka kwadzidzidzi kwa zizindikiro.

2. Kuchiza chomwe chimayambitsa: Kukonzekera chithandizo kutengera chomwe chimayambitsa matenda a chiwindi.

3. Kuchepetsa kuchuluka kwa poizoni m'magazi: Ichi ndiye chinthu chofunikira kwambiri.

Pali mitundu iwiri ikuluikulu ya mankhwala omwe amaperekedwa kuti achepetse kuchuluka kwa poizoni m'magazi:

• Lactulose: Iyi ndi mankhwala amadzimadzi omwe amamwedwa pakamwa. Amagwira ntchito poyeretsa m'mimba ndikuchotsa poizoni m'matumbo mwachangu. Amalamuliranso mabakiteriya omwe amapanga poizoni m'matumbo.
• Rifaximin: Iyi ndi mankhwala opha mabakiteriya. Imagwira ntchito popha mabakiteriya oopsa m'matumbo ndikuchepetsa kupanga poizoni.

Mankhwalawa amatha kuchepetsa zizindikiro zake. Komabe, ngati matenda a chiwindi omwe ali mkati mwake sanachiritsidwe, vutoli likhoza kubwereranso. Ngati chiwindi chalephera kwathunthu, njira yokhayo yothetsera vutoli ndi kuika chiwindi .

Kodi ndingakhale bwanji ndi vutoli?

Kukhala ndi matenda a chiwindi osatha komanso matenda a chiwindi ndi zovuta. Komabe, mukayang'aniridwa bwino, mutha kukhala ndi moyo wabwino.

• Lumikizanani ndi dokotala wanu: Pitani kuzipatala nthawi yake. Imwani mankhwala anu nthawi yake. Ngati muwona kusintha kulikonse mu zizindikiro zanu, dziwitsani dokotala wanu nthawi yomweyo.
• Pezani thandizo kuchokera kwa achibale: Popeza odwalawa amatha kuiwala zinthu zina, thandizo la wachibale ndilofunika kwambiri pazinthu monga kupereka mankhwala ndi kuwatengera kwa dokotala.
• Samalani zakudya zanu: Idyani zakudya zopatsa thanzi. Funsani dokotala wanu za kuchuluka kwa nyama yomwe muyenera kudya.
• Pewani kudzimbidwa:Imwani madzi ambiri tsiku lililonse, idyani zakudya zokhala ndi ulusi wambiri (zipatso, ndiwo zamasamba). Imwani mankhwala a `Lactulose` monga momwe dokotala wanenera.
• Siyani kumwa mowa kotheratu: Si bwino kumwa ngakhale dontho limodzi.
• Pewani kuyendetsa galimoto: Kuyendetsa galimoto ndi koopsa kwambiri ngati muli ndi vutoli, ngakhale pang'ono chabe, chifukwa lingawononge chidwi chanu komanso luso lanu lopanga zisankho.

Matendawa akakukhudzani inu kapena wokondedwa wanu, akhoza kukhala oopsa kwambiri. Koma kumbukirani kuti, ndi chithandizo choyenera komanso chikondi ndi chisamaliro cha banja lanu, mutha kukhala ndi vutoli.