Wake wambona othile emndenini wakho, mhlawumbe ubaba wakho, umalume wakho, noma umuntu omaziyo, ngokuzumayo enza ngendlela exakile? Ingabe kumane nje ukulahlekelwa yinkumbulo, ukudideka okuncane, ukuthukuthela ngezinto ezincane kakhulu, noma ukuhlala ulele emini? Sivame ukucabanga ngalezi zinto njengezinto ezivamile ezenzeka njengoba sikhula. Kodwa-ke, ngezinye izikhathi lokhu kungabangelwa inkinga enkulu ngesibindi sakhe. Yilokho esikubiza ngokuthi 'i-Hepatic Encephalopathy' ngokwezokwelapha. Nakuba igama lingase lizwakale lesabeka, ake sixoxe ngakho kalula.
Kalula nje, iyini i-Hepatic Encephalopathy?
Lokhu kulula kakhulu ukukuqonda. Kunezingxenye ezimbili kuleli gama. Igama elithi “Hepatic” lisho ukuthi ‘kuhlobene nesibindi’. Igama elithi “Encephalopathy” lisho ‘ukungasebenzi kahle kobuchopho’. Ngakho-ke uma uhlanganisa lokhu kokubili, kusho ukuthi ubuchopho buthintwa ukusebenza kahle kwesibindi.
Cabanga ukuthi 'isihlungi' esikhulu kunazo zonke emzimbeni wethu yisibindi. Omunye wemisebenzi eyinhloko yesibindi ukuhlunga ubuthi, njenge-ammonia, egazini ngemva kokugaya ukudla esikudlayo nesikuphuzayo. Manje cabanga, kwenzekani uma lesi sihlungi singasebenzi kahle? Lawo ma-toxin ('ama-Neurotoxin') awahlungwa futhi angene ngqo egazini. Leli gazi elinobuthi lihamba emzimbeni wonke futhi ekugcineni lifinyelele ebuchosheni. Amaseli obuchopho awakwazi ukusingatha la ma-toxin. Yilapho ubuchopho buqala ukusebenza ngendlela engajwayelekile. Yingakho zonke lezo zimpawu ziqala ukubonakala.
Ziyini izimpawu zalesi simo?
Izimpawu zingahluka kumuntu nomuntu. Abanye abantu bangase bazizwe ngokuzumayo, kanti abanye bangase baziveze kancane kancane. Ngezinye izinsuku, izimpawu zingase ziphele, kodwa zingase ziphinde zivele. Lezi izimpawu zakho:
- Isimo sengqondo nobuntu
- Ukuziphatha nokulawula umfutho
- Ukuze inkumbulo, ukugxila kanye nokucabanga
- Ukuqwashisa kanye nezindlela zokulala
- Imisebenzi yokuxhumanisa kanye neyokunyakaza
Kungathinta. Odokotela bahlukanisa lesi simo ngezigaba eziningana kuye ngokuthi lezi zimpawu zibucayi kangakanani. Ake sibone ukuthi ziyini lezo zigaba.
Izigaba zezimpawu (Uhlelo Lokulinganisa)
Indlela evamile esetshenziswa ukuxilonga lokhu yi-"West Haven Criteria." Lokhu kuhlukanisa izigaba kusukela ku-0 kuya ku-4.
| Ibanga | Izimpawu ezingabonakala |
|---|---|
| Isigaba 0 | Azikho izimpawu zangaphandle. Kodwa nguyena kuphela noma labo abasondelene naye kakhulu abangabona izinguquko ezincane enkumbulo nasekunakeni. Zingatholakala kuphela ngokuhlolwa kwezokwelapha. |
| Isigaba 1 | Manje sengiqala ukubona izimpawu ezithile. Ngiyakhohlwa izinto ezincane, imizwa yami iyashintsha njalo (ngiyajabula ngesinye isikhathi, ngidabukile ngesinye isikhathi). Nginenkinga yokwenza izibalo ezilula njengokuhlanganisa nokususa. Nginenkinga yokwenza umsebenzi omuhle njengokubhala ngesandla. Esinye sezimpawu ezibaluleke kakhulu ukozela emini kanye nokungakwazi ukulala ebusuku. |
| Isigaba sesi-2 | Ushintsho olucacile ebuntwini lungabonakala. Baziphatha futhi bakhuluma ngendlela engaguquki. Bavame ukuba novalo futhi bangabi nandaba. Bayakhohlwa isikhathi, usuku, nonyaka. Inkulumo yabo iba yimbi ('Inkulumo engaqondakali'). |
| Isigaba 3 | Isimo manje sesibucayi. Indlela yokucabanga, ukunyakaza komzimba kuhamba kancane kakhulu. Ukukhohlwa ukuthi ukuphi ('Ukudideka'). Ukozela ngokweqile kanye nokungabi nandaba nalokho okwenzekayo eduze kwakho. Udidekile kakhulu, ezinye izinto ziyalibaleka ngokuphelele. Uma welula izingalo zakho, zivele zithuthumele njengenyoni ishaya amaphiko ayo. Lokhu sikubiza ngokuthi 'i-Asterixis'. |
| Isigaba 4 | Ulahlekelwa ingqondo ngokuphelele. Lokho kusho ukuthi ungena e-coma. Lokhu kusongela ngisho nokuphila. |
Okubalulekile: Uma uzwa izimpawu zesigaba sesi-2 noma sesi-3, ikakhulukazi ukozela ngokweqile, ukudideka, kanye nokuxhawulana, kuyisimo esiphuthumayo. Kufanele uyiswe esibhedlela, okungcono kakhulu eMnyangweni Wezimo Eziphuthumayo (ETU), ngokushesha okukhulu.
Kungani lokhu kwenzeka? Yiziphi izizathu?
Njengoba sixoxile ngaphambili, imbangela enkulu ukungakwazi kwesibindi ukuhlunga ubuthi. Kunezindlela eziningana lokhu okungenzeka ngazo. Odokotela bahlukanisa i-Hepatic Encephalopathy ibe izinhlobo ezintathu ngokusekelwe kulezi zimbangela.
Uhlobo A
Lokhu kubangelwa ukwehluleka kwesibindi okungazelelwe (`Ukwehluleka Kwesibindi Okukhulu`). Lokhu kusho ukuthi isibindi somuntu ongakaze abe nokugula kwangaphambilini siyayeka ukusebenza ngokuzumayo zingakapheli izinsuku ezimbalwa. Lokhu kungabangelwa yi:
- Ukutheleleka ngegciwane (isib. i-hepatitis A, B)
- Ukuthatha imithi eminingi ngokweqile , ikakhulukazi i-paracetamol, kuyimbangela enkulu yalokhu. Uma wena noma othile omaziyo esebenzise lokhu ngokweqile, shayela i-National Poison Information Center eColombo National Hospital ngokushesha bese umyisa esibhedlela.
- Ubuthi, njengezinhlobo ezithile zamakhowe.
Lesi yisimo esiphuthumayo kakhulu nesibucayi.
Uhlobo B
Lokhu kuyinkimbinkimbi kancane. Kalula nje, igazi okufanele liye esibindini ukuze lihlanzwe lidlula isibindi bese lingena ngqo ekujikelezeni kwegazi lomzimba ngendlela ehlukile (i-'portosystemic shunt'). Lokhu kuvumela ubuthi egazini ukuthi buye ebuchosheni ngaphandle kokuhluzwa.
Uhlobo C
Lolu uhlobo oluvame kakhulu. Lokhu kwenzeka lapho isibindi sihluleka kancane kancane ngenxa yesifo sesibindi sesikhathi eside (`Isifo Sesibindi Esingapheli`). Imbangela eyinhloko yalokhu yi -cirrhosis. I-cirrhosis yisimo lapho isibindi sonakala khona ngokuhamba kwesikhathi, sibe nezibazi, futhi sibe nzima futhi singakwazi ukusebenza kahle. Lokhu kungabangelwa yi:
- Ukuphuza utshwala ngokweqile isikhathi eside.
- Izifo ezingamahlalakhona ezibangelwa amagciwane njenge-hepatitis B kanye ne-C.
- Isifo Sesibindi Esinamafutha.
Imicimbi Ebangela Ukuqala
Umuntu onesifo sesibindi esingamahlalakhona, njenge-cirrhosis, angaphila impilo evamile ngezinga elithile. Kodwa-ke, izimpawu ze-'Hepatic Encephalopathy' zingavela ngokuzumayo. Lokhu kubangelwa yisenzakalo esibeka umthwalo ongabekezeleleki esibindini. Sibiza lezo zenzakalo ngokuthi 'Izisusa'.
- Ukuqunjelwa: Uma kwenzeka ukuqunjelwa, ubuthi buhlala emathunjini isikhathi eside, okubangela ukuthi bungene egazini kakhudlwana.
- Ukuphelelwa amanzi emzimbeni: Uma kungekho manzi anele emzimbeni, ukusebenza kwezinso nakho kuyawohloka, okunciphisa kakhulu ukususwa kobuthi.
- Ukutheleleka: Noma yikuphi ukutheleleka emzimbeni (isib. ukutheleleka komgudu womchamo, ukutheleleka kwamaphaphu) kubeka ubunzima obukhulu esibindini.
- Ukopha okuvela ohlelweni lokugaya ukudla: Uma kukhona ukopha, njengokuphuma esilondeni sesisu, kukhiqizwa inani elikhulu lobuthi obufana ne-ammonia njengoba igazi ligaywa emathunjini.
- Ukuthatha imithi eyingozi esibindini, njengamaphilisi okulala kanye nemithi yokubulala izinhlungu.
- Ukuphuza utshwala obuningi ngesikhathi esisodwa.
Udokotela uhlonza kanjani lokhu?
Uma uyisa othandekayo wakho kudokotela onalezi zimpawu, into yokuqala azoyenza ukukubuza wena nesiguli ngezimpawu. Ngemuva kwalokho, bazokwenza ukuhlolwa ngokomzimba. Bazohlola i-asterixis (ukuthuthumela).
Ngaphezu kwalokho, kungenziwa izivivinyo eziningana ukuthola imbangela eqondile:
- Ukuhlolwa kwegazi: Lokhu kungalinganisa amazinga e-enzyme yesibindi, amazinga e-ammonia egazini, futhi kunikeze isithombe esiphelele sokusebenza kwesibindi.
- Ukuskena nge-ultrasound: Hlola isimo sesibindi kanye nemithambo yegazi esizungezile.
- Ukuskena kobuchopho (i-CT scan noma i-MRI): Ukuhlola ukuvuvukala noma ezinye izinkinga ebuchosheni.
- Ukuhlolwa kwe-EEG: Kulinganisa umsebenzi kagesi wobuchopho ukuze kubonakale ukuthi kukhona yini ukuphazamiseka kwengqondo.
Yiziphi izindlela zokwelapha lokhu?
Kunezinhloso ezintathu eziyinhloko zokwelashwa:
1. Ukuphatha isimo esiphuthumayo: Ukuthola nokwelapha imbangela (isib. ukutheleleka, ukuqunjelwa) okubangele ukwanda kwezimpawu ngokuzumayo.
2. Ukwelapha imbangela eyisisekelo: Ukuhlela ukwelashwa okusekelwe embangela yesifo sesibindi.
3. Ukunciphisa izinga lobuthi egazini: Lena yinto ebaluleke kakhulu.
Kunezinhlobo ezimbili eziyinhloko zemithi enikezwa ukunciphisa izinga lobuthi egazini:
- I-Lactulose: Lona umuthi owuketshezi othathwa ngomlomo. Usebenza ngokuhlanza isisu nokususa ubuthi emathunjini ngokushesha. Uphinde ulawule amabhaktheriya akhiqiza ubuthi emathunjini.
- I-Rifaximin: Lona umuthi wokubulala amagciwane. Usebenza ngokubulala amagciwane ayingozi emathunjini nokunciphisa ukukhiqizwa kobuthi.
Lokhu kwelashwa kungalawula kakhulu izimpawu. Kodwa-ke, uma isifo sesibindi esiyisisekelo singelashwa, lesi simo singaphinde sibuye. Uma isibindi sehlulekile ngokuphelele, ukufakelwa isibindi kungaba yisisombululo kuphela.
Ungaphila kanjani nalesi simo?
Ukuphila nesifo sesibindi esingamahlalakhona kanye ne-Hepatic Encephalopathy kuyinselele. Kodwa-ke, ngokuphathwa kahle, ungaphila impilo enhle.
- Hlala uxhumane nodokotela wakho: Yiya emitholampilo ngesikhathi. Thatha imithi yakho ngesikhathi. Uma ubona noma yiziphi izinguquko ezimpawu zakho, yazisa udokotela wakho ngokushesha.
- Thola usizo emndenini: Njengoba lezi ziguli zingakhohlwa ezinye izinto, usizo lwelungu lomndeni lubaluleke kakhulu ezintweni ezifana nokunikeza imithi nokuyiyisa kudokotela.
- Nakekela ukudla kwakho okunomsoco: Yidla ukudla okunempilo. Xhumana nodokotela wakho mayelana nenani lenyama okufanele uyidle.
- Vimbela ukuqunjelwa:Phuza amanzi amaningi nsuku zonke, udle ukudla okune-fiber eningi (izithelo, imifino). Thatha umuthi we-'Lactulose' njengoba nje udokotela ekuyalile.
- Yeka ukuphuza utshwala ngokuphelele: Akukuhle ukuphuza ngisho neconsi elilodwa.
- Gwema ukushayela: Ukushayela kuyingozi kakhulu uma unalesi simo, ngisho noma kancane, ngoba kungalimaza ukugxilisa ingqondo kwakho kanye nekhono lakho lokwenza izinqumo.
Uma lesi simo sikuthinta wena noma othandekayo wakho, kungaba kubi kakhulu. Kodwa khumbula, ngokuphathwa okufanele kanye nothando nokunakekelwa komndeni wakho, ungaphila nalesi simo.
Umlayezo Wokuya Nawe Ekhaya
- I-'Hepatic Encephalopathy' yisimo lapho ubuthi buqongelela egazini futhi buthinte ubuchopho ngoba isibindi asisebenzi kahle.
- Ukulahlekelwa yinkumbulo, izinguquko zokuziphatha, ukozela, kanye nokudideka yizimpawu eziyinhloko.
- Uma ubhekene nezimpawu ezifana nokulala ngokweqile kanye nokulahlekelwa ukwazi, kuyisimo esiphuthumayo sezokwelapha. Bonana nodokotela ngokushesha.
- Kubalulekile ukuzivikela ezintweni ezifana nokuqunjelwa, izifo, kanye nokuphelelwa ngamanzi emzimbeni, njengoba kungenza lesi simo sibe sibi kakhulu.
- Ngokwelashwa okufanele (njenge-'Lactulose' kanye ne-'Rifaximin'), izimpawu zingaguqulwa futhi zilawulwe kahle.
- Ukusekelwa, uthando, kanye nokunakekelwa komndeni wesiguli kubaluleke kakhulu kulesi sikhathi.
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