Indlela ingxaki yesibindi echaphazela ngayo izintso ngokuthe ngqo: Masifunde ngqo ngeHepatorenal Syndrome!

Ngaba wakha wacinga ukuba ingxaki enkulu ngesibindi sakho inokubangela ukuba zombini izintso zakho ezisempilweni ngokupheleleyo ziyeke ukusebenza ngaxeshanye? Yingcinga eyoyikisayo, akunjalo? Namhlanje siza kuthetha ngemeko enzima, esongela ubomi enokwenzeka xa isibindi singasebenzi kakuhle. Le yinto oogqirha abayibiza ngokuba yiHepatorenal Syndrome (HRS) . Makhe sijonge ukuba yintoni, kutheni isenzeka, kunye nokunye esinokukwenza.

Yintoni iHepatorenal Syndrome?

Ngamafutshane, i-hepatorenal syndrome (HRS) yimeko apho isibindi sakho singasebenzi kakuhle, ingxaki enkulu eyenzeka kwizigaba zokugqibela zokungasebenzi kakuhle kwesibindi. Okwenzekayo kule meko kukuba izintso zakho zilahlekelwa ngumsebenzi wazo ngequbuliso ngenxa yeengxaki zesibindi. Okukhethekileyo kukuba oku kuthathwa njengokusilela kwezintso okukhawulezileyo ngaphambi kwezintso . Oku kuthetha ukuba unokuba nale meko nokuba awunaso isifo sezintso sangaphambili kwaye akukho tshintsho lomzimba okanye umonakalo kwizintso zakho. Izintso zakho zisenokuba ziphilile ngokupheleleyo, kodwa ngenxa yengxaki yesibindi, ukuhanjiswa kwegazi kuzo kuyaphazamiseka, kwaye azikwazi ukwenza umsebenzi wazo.

Cinga ngayo njengempompo yamanzi esebenza kakuhle, kodwa ukuba umbhobho wamanzi oya kwitanki yamanzi uvaliwe, amanzi awayi kuphuma. Izintso zilungile, kodwa iingxaki zesibindi zibangela ukuba imithambo yegazi ethwala igazi ezintsoni ivaleke kwaye inciphe. Emva koko, izintso azifumani igazi ezilifunayo, kwaye ukusebenza kwazo kuyehla kancinci kancinci. Oku kuthathwa njengengxamiseko , kwaye kwiimeko ezininzi, unyango oluhlala luhleli loku kukufakelwa isibindi .

Ngubani ochaphazeleka kakhulu yile meko?

Le meko, ebizwa ngokuba yi-hepatorenal syndrome (HRS), ichaphazela kakhulu abantu abanesifo sesibindi esinzima . Ngokukodwa, abantu abanesifo sesibindi esingapheliyo nesiqhubekayo , abasibindi sabo siye saba buthathaka kancinci kancinci ngokuhamba kwexesha, basengozini enkulu yale meko. Ubusazi na ukuba ngenxa yesifo sesibindi esihlala ixesha elide, izicubu zesibindi ziba namabala kwaye isibindi siba lukhuni. Siyibiza ngokuba yi- cirrhosis . Ngenxa yale meko, ukuhanjiswa kwegazi esibindini kuyatshintsha, kwaye ngokuhamba kwexesha, isibindi siyeka ukusebenza.

Kwakhona, kwimeko yokungasebenzi kakuhle kwesibindi okwenzeka ngequbuliso ngenxa yesizathu esithileNangona kunjalo, i-HRS inokwenzeka. Izifundo zibonise ukuba i-HRS inokwenzeka kubantu abafikelela kwi-40% abanesifo sesibindi esikwinqanaba lokugqibela. Nangona inokwenzeka nakubani na ubudala kunye nesini, ixhaphake kakhulu kubantu abakwisiqingatha sesibini sobomi babo. Ikwakhona nakwi-10% yabantu abalaliswe esibhedlele ngenxa yokungasebenzi kakuhle kwesibindi okungapheliyo okanye okukhawulezileyo. Nangona kukho izizathu ezingaphezu kwesinye zokungasebenzi kakuhle kwezintso ngenxa yesifo sesibindi, i-HRS yahlukile kuba iyenzeka kubantu abangenaso isifo sezintso ngaphambili.

I-cirrhosis ibangela njani i-hepatorenal syndrome?

Lo ngumba onzima kancinci. Kusekho izimvo ezahlukeneyo phakathi kwabaphandi malunga nendlela isifo sesibindi esibangela ngayo i-hepatorenal syndrome (HRS), oko kukuthi, i-pathophysiology yaso.

Kwenzeka njani oku ngokwenene? ​​(I-Pathophysiology)

Njengoko sisazi, ukungasebenzi kakuhle kwezintso kwenzeka xa imithambo yegazi kwizintso incipha, ivalekile, kwaye ukuhamba kwegazi kuyo kuncipha. Abaphandi bakholelwa ukuba oku kuncipha kwemithambo yegazi kubangelwa kukudibana kwezinto ezinxulumene nesifo sesibindi kunye nokungasebenzi kakuhle kwesibindi. Isizathu esiphambili soku yi-portal hypertension .

I-Portal hypertension yimeko apho uxinzelelo lwegazi kwi-portal vein, umthambo ophambili odlula esibindini sakho, kunye nemithambo edibana nayo kwaye inwebeka kuyo yonke inkqubo yakho yokugaya ukutya, iyanda. Eyona nto ixhaphakileyo yoku yi -cirrhosis . I-Cirrhosis inokubangela imeko ebizwa ngokuba yi-cirrhosis cardiomyopathy , ebangela ukuba eminye yemithambo emzimbeni wakho ibe banzi ngendlela engaqhelekanga. Olu tshintsho luntsonkothileyo lokuhamba kwegazi lubangela ukuba eminye imithambo yegazi ivuleke ngelixa eminye (ingakumbi leyo isezintsoni zakho) incipha. Cinga ngayo njengokuxinana kwezithuthi kwelinye icala lendlela, okuchaphazela namanye amacala.

Ziziphi izinto ezibangela ukuba le meko ibe mandundu?

Kukho ezinye izinto ezinxulumene nesifo sesibindi ezinokuba "yimbangela" okanye zibangele i-HRS. Eyona ixhaphakileyo kwezi yi-Spontaneous Bacterial Peritonitis (SBP) . Olu lusulelo lwebhaktiriya kwi-membrane yesisu sakho (i-peritoneum). I-SBP yingxaki ye- ascites , eqokelelana kolwelo esiswini. I-Ascites ibangelwa kukuvuza kolwelo oluvela kwimithambo esiswini ngenxa yoxinzelelo lwegazi oluphezulu.

Khawucinge nje, ukuba isisu sakho sizele ngamanzi (ii-ascites), iintsholongwane zinokungena lula apho zize zibangele usulelo. Yiloo nto ibizwa ngokuba yi-spontaneous bacterial peritonitis (SBP).

Kwakhona, uxinzelelo lwegazi oluphezulu lwe-portal lunokubangela ukuba imithambo yakho iqhume ize yophe igazi esiswini sakho.Ukulahleka kwegazi ngokukhawuleza ngenxa yokopha kwamathumbu yenye into ebangela oko. Ayikokuphela koko, kodwa ukusetyenziswa kakhulu kwe-diuretics , okanye "iipilisi zamanzi," nako kunokuba yimbangela. I-Diuretics isebenza ngokususa ulwelo olugqithisileyo emzimbeni. Abantu abanesifo sesibindi esiqhubele phambili banokuthatha ezi pilisi zamanzi xa benesifo se-ascites okanye i-edema , oku kukudumba komzimba.

Zithini iimpawu?

Abantu abane-hepatorenal syndrome (HRS) badla ngokuqala bazive bengaphili kakuhle, bengenampilo. Iimpawu ziquka:

• Ukudinwa
• Isicaphucaphu
• Isisu esibuhlungu
• Incasa embi emlonyeni

Ukongeza, banokuba neempawu zesifo sesibindi esiqhubele phambili okanye ukungasebenzi kakuhle kwesibindi. Ezi ziquka:

• I-Jaundice (ukutyheli kwamhlophe emehlweni)
• Ukudumba okulula nokopha igazi
• Indle enemibala ekhanyayo kunye nomchamo omnyama
• Ukudumba kwesisu (ngenxa ye-ascites, ukwanda kwesibindi okanye i-spleen)
• Ulusu olurhawuzelelayo
• Ukudideka, ukulahlekelwa yinkumbulo, okanye ukozela (Hepatic Encephalopathy)

Xa ukungasebenzi kakuhle kwezintso kuba nzima, ungabona ukuba umchamo owuvelisayo wehlile kakhulu .

Uyibona njani le nto?

I-Hepatorenal syndrome (HRS) luhlobo lokungasebenzi kakuhle kwezintso oluvela xa kukho isifo sesibindi esinzima kwaye kungekho sizathu simbi sokungasebenzi kakuhle kwezintso. Ngoko ke, oogqirha bafumanisa oku ngokuqinisekisa kuqala isifo sesibindi kunye nokungasebenzi kakuhle kwezintso, baze emva koko basuse ezinye izizathu ezinokubakho zokungasebenzi kakuhle kwezintso. Ukuze benze oku, basebenzisa iimvavanyo ezahlukeneyo zomfanekiso , ezifana neeskeni, uvavanyo lwegazi, kunye novavanyo lomchamo, ukujonga indlela isibindi sakho kunye nezintso ezisebenza ngayo.

Iphathwa njani?

Nangona i-HRS yimeko embi kakhulu ngenxa yokungasebenzi kakuhle kwezintso, ingcambu yengxaki isesibindini . I-Hepatorenal syndrome (HRS) ichazwa njengohlobo "lwe-prerenal" lokungasebenzi kakuhle kwezintso kuba izintso zakho ziphilile ngenye indlela. Enyanisweni, ukuba izintso zakho zithathwa zize zifakwe emzimbeni womnye umntu, ziya kusebenza kakuhle. Ngokufanayo, ukuba ukusebenza kwesibindi sakho kubuyela esiqhelweni, kukho ithuba elihle lokuba izintso zakho ziya kuqala ukusebenza kwakhona.

Abanye abantu abanesifo sesibindi esingapheliyo banokuphinda basebenze kwakhona kwisibindi sabo kunye nezintso. Kodwa bonke abanye abantu baya kufuna ukufakelwa isibindi . Basenokufuna ukufakelwa isibindi ngaxa lithile, kodwa i-HRS yenza ukuba isidingo sibe singxamiseke nangakumbi. Nangona kunjalo, ayinguye wonke umntu ofanelekela ukufakelwa isibindi, kwaye nokuba bayakwenza oko, kufuneka balinde de bafumane esinye.

Ngexesha elinje, unyango olukhawulezileyo kunye nolawulo olufanelekileyo zezona zinto zibalulekileyo.

Okwangoku, ugqirha wakho okanye umongikazi uza kuzama ukugcina ukusebenza kwezintso zakho kangangoko kunokwenzeka aze anciphise iimpawu kunye nemiphumo emibi yale meko. La manyathelo anokuphucula impilo yakho iyonke kwaye akuncede ukulungiselela ukufakelwa isibindi. Anokunceda ukuphucula iziphumo zokufakelwa isibindi ukuba unayo. Nangona kunjalo, la mayeza awanyangeki . Olu nyango lunokuquka:

• Ii-IV fluids , ezizinto ezifana ne-saline, zinikwa ukulungisa ukungalingani kwe-electrolyte emzimbeni kunye nokunceda ukuhamba kwegazi ukuya kwizintso.
• Ukuyeka amayeza athile, anjenge -diuretics (iipilisi zamanzi).
• Ukunika amayeza okubulala iintsholongwane kwiintsholongwane ezinxulumene noko.
• I-Paracentesis yenziwa ukuze kususwe ulwelo olugqithisileyo oluqokelelene ngenxa ye-ascites.
• Ukunika amayeza abizwa ngokuba yi- vasoconstrictors . La mayeza asebenza ngokunciphisa imithambo yegazi yakho ebanzi ngokungaqhelekanga nokwandisa ukuhamba kwegazi ukuya kwizintso.
• I-Hemodialysis , eyi-blood dialysis, lunyango lokunceda izintso zakho ezixinezelekileyo.

Ngaba ingathintelwa?

Eyona ndlela ilungileyo yokuthintela i-hepatorenal syndrome (HRS) kukulawula isifo sesibindi ngaphambi kokuba siqhubekele kwi-cirrhosis . Isifo sesibindi esingapheliyo yimeko ekhula kancinci kwiminyaka emininzi. Abantu abaziyo ukuba banale meko banokulawula kwaye ngamanye amaxesha babuyisele ukuqhubela phambili kwesi sifo ngokwenza izinto ezinje ngokunciphisa utywala, ukunciphisa umzimba, kunye nokuphucula ukutya kwabo. Nangona kunjalo, ngenxa yokuba abantu abaninzi bengabonakalisi zimpawu, isenokungafumaneki ngaphandle kovavanyo lwezonyango oluqhelekileyo.

Ukuba sele une-cirrhosis, akukho ndlela yokuqikelela okanye yokuthintela i-HRS ukuba ikhule. Nangona kunjalo, i-Spontaneous Bacterial Peritonitis (SBP)Oko kuthethiweyo, ungayiphepha eyona "into ebangela" oku. I-SBP ibangela malunga ne-25% yamatyala e-HRS kubantu abane-cirrhosis. Ngoko ke, ukuba ugqirha wakho ucinga ukuba usemngciphekweni omkhulu we-SBP, ukuthatha amayeza okubulala iintsholongwane njengendlela yokuthintela kunokunciphisa esi sizathu kwaye kunciphise amathuba akho okuphuhlisa i-HRS.

Ngaba oku kunganyangeka? Ngaba kusongela ubomi?

Ngaphandle kokufakelwa isibindi, abantu abaninzi bakwimeko embi kakhulu. Ukuba i-HRS iba mandundu ngequbuliso kwaye ukufakelwa isibindi kungafumaneki, ixesha eliqhelekileyo lokusinda ziiveki ezimbini kuphela. Kwi-HRS engapheliyo, ixesha eliqhelekileyo lokusinda ngaphandle kokufakelwa liziinyanga ezintathu ukuya kwezintandathu . Ngokuxhomekeke ekubeni isibindi siyasilela kangakanani na, imeko inokuba mandundu ngokukhawuleza. Kwakhona, ukuba imeko iba mandundu ngokukhawuleza, ungagula kakhulu ukuba ungafakelwa isityalo, nto leyo enokuba nzima.

Nangona kunjalo, ukuba utyandwa isibindi, imeko yakho iya kuphucuka kakhulu . Abantu abane-HRS banethuba elingama-60% lokusinda kwiminyaka emithathu emva kotyandwa isibindi. Oku kuphantsi kancinci kunezinga lokusinda leminyaka emithathu kubantu abadla ngotyandwa isibindi (75%). Uninzi lwabantu luza kubuyela kwisiqhelo kwiiveki ezimbalwa. Inani elincinci kakhulu (malunga ne-5%) linokufuna ukuqhubeka ne-dialysis .

Nokuba ungumntu onesifo sesibindi esiwohlokayo kancinci kancinci okanye uqalise ngequbuliso isifo se-hepatorenal syndrome (HRS) esikhawulezise ixesha lakho, ukuba kuluhlu lokulinda lwabanikeli besibindi akuyongcinga ilungileyo. Kuba azikho izibindi zaneleyo zabantu abakuluhlu olo. Nangona kunjalo, ukuba unokufumana umntu onikela ngesibindi ophilayo , usenokunganyanzelekanga ukuba ube kuluhlu, kwaye iziphumo zakho zempilo zizonke zinokuphucuka.

Abanikeli abaphilayo bangabantu abazinikeleyo abasempilweni, ngokuqhelekileyo abantu obathandayo, abafanelana nohlobo lwegazi lakho kunye nobukhulu bomzimba wakho. Kwaneqhekeza elincinci lesibindi elithathwe komnye umntu ophilayo linokukhula libe sisibindi esipheleleyo kuwe nakulowo unikelayo. Kwakhona, izibilini eziphilayo zisenokuba kwimeko engcono kunezibilini ezithathwe kubanikeli abaswelekileyo. Oogqirha benza konke okusemandleni abo ukwenza utyando lwaba banikeli abaphilayo abanesibindi lube yinto encinci kangangoko kunokwenzeka.

Okokugqibela, izinto ekufuneka uzikhumbule

Ngoko ke, mhlawumbi ngoku uyaqonda ukuba i-hepatorenal syndrome yimeko enzima efuna ingqalelo kuba ichaphazela izintso ngenxa yeengxaki zesibindi.

• Impilo yesibindi ibaluleke kakhulu:Ukuba unesifo sesibindi, kubaluleke kakhulu ukusilawula ngokufanelekileyo, ingakumbi ukuthintela ukuba singaqhubeki siye kwiimeko ezifana ne-cirrhosis.
• Nika ingqalelo kwiimpawu: Ukuba uneempawu ezinxulumene nesifo sesibindi okanye uzive ungaphili kakuhle, bona ugqirha ngokukhawuleza.
• Cinga ngezintso zakho: Xa uneengxaki zesibindi, kufuneka unyamekele izintso zakho. Ukuba uneempawu ezifana nokuncipha komchamo, xelela ugqirha wakho.
• Kukho unyango: Nangona i-HRS iyimeko enzima, unyango olufana nokufakelwa isibindi lunokusindisa ubomi. Ngoko ke musa ukuphelelwa lithemba.
• Indlela yokuphila ibalulekile: Izinto ezifana nendlela yokuphila enempilo, ukutya okunesondlo, kunye nokuphepha utywala kunceda ukugcina isibindi sisempilweni.

Ndiyathemba ukuba olu lwazi luza kukunceda. Ukuba wena okanye umntu omaziyo unengxaki efana nale, eyona nto ingcono onokuyenza kukufuna ingcebiso yezonyango ngokukhawuleza.

Isifo sesibindi , isifo sesibindi, ukungasebenzi kakuhle kwezintso, isifo sokuqina kwesibindi, ukufakelwa kwesibindi, uxinzelelo lwegazi oluphezulu lwe-portal, i-ascites