Kusokonekera kwa hepatocerebral

Hepatocerebral degeneration ndi vuto laubongo lomwe limapezeka mwa anthu omwe ali ndi vuto la chiwindi.

Izi zitha kuchitika mulimonse momwe chiwindi chimapezera cholephera, kuphatikiza chiwindi chachikulu.

Kuwonongeka kwa chiwindi kumatha kubweretsa kuchuluka kwa ammonia ndi zinthu zina zowopsa m'thupi. Izi zimachitika pamene chiwindi sichigwira bwino ntchito. Sichiwonongeka ndikuchotsa mankhwalawa. Zipangizo zapoizoni zitha kuwononga minofu yaubongo.

Madera ena aubongo, monga basal ganglia, amatha kuvulala chifukwa cha kulephera kwa chiwindi. Basal ganglia amathandizira kuwongolera mayendedwe. Vutoli ndi mtundu wa "non-Wilsonian". Izi zikutanthauza kuti kuwonongeka kwa chiwindi sikumayambitsidwa ndi zopangira zamkuwa m'chiwindi. Ichi ndiye gawo lofunikira la matenda a Wilson.

Zizindikiro zimaphatikizapo:

• Kuvuta kuyenda
• Ntchito yanzeru yolakwika
• Jaundice
• Kutupa kwa minofu (myoclonus)
• Kukhala okhwima
• Kugwirana manja, mutu (kunjenjemera)
• Kugwedezeka
• Kusuntha kosalamulirika kwa thupi (chorea)
• Kuyenda kosakhazikika (ataxia)

Zizindikiro zimaphatikizapo:

• Coma
• Chamadzimadzi m'mimba chomwe chimayambitsa kutupa (ascites)
• Kutuluka m'mimba kuchokera m'mitsempha yowonjezera mu chitoliro cha chakudya (esophageal varices)

Kuyesa kwamanjenje (kwamitsempha) kumatha kuwonetsa zizindikiro za:

• Kusokonezeka maganizo
• Kusuntha kosadzipereka
• Kuyenda kusakhazikika

Kuyesa kwa labotale kumatha kuwonetsa kuchuluka kwa ammonia m'magazi komanso chiwindi chachilendo.

Mayesero ena atha kuphatikizira:

• MRI ya mutu
• EEG (imatha kuwonetsa kuchepa kwamafunde amubongo)
• Kujambula kwa CT pamutu

Chithandizo chimathandiza kuchepetsa mankhwala oopsa omwe amayamba chifukwa cha kulephera kwa chiwindi. Zitha kuphatikizira maantibayotiki kapena mankhwala monga lactulose, omwe amatsitsa ammonia m'magazi.

Chithandizo chotchedwa branched-chain amino acid therapy chitha kukhalanso:

• Sinthani zizindikilo
• Bweretsani kuwonongeka kwa ubongo

Palibe chithandizo chenicheni cha matenda a neurologic, chifukwa amayamba chifukwa cha kuwonongeka kwa chiwindi kosasinthika. Kuika chiwindi kumachiritsa matenda a chiwindi. Komabe, opaleshoniyi singasinthe zomwe zimapangitsa kuti ubongo uwonongeka.

Uwu ndi mkhalidwe wa nthawi yayitali (wosatha) womwe ungayambitse zizindikiritso zamanjenje zosasinthika.

Munthuyo akhoza kupitilirabe kukulira ndikufa popanda kumuika chiwindi. Ng'anjo ikachitika msanga, matenda amitsempha amatha kusintha.

Zovuta zimaphatikizapo:

• Chikomokere
• Kuwonongeka kwakukulu kwa ubongo

Itanani yemwe akukuthandizani ngati muli ndi zizindikilo za matenda a chiwindi.

Sizingatheke kupewa mitundu yonse yamatenda a chiwindi. Komabe, matenda a chiwindi omwe amamwa mowa mwauchidakwa amatha kupewedwa.

Kuchepetsa chiopsezo chanu chotenga matenda a chiwindi kapena mowa:

• Pewani machitidwe owopsa, monga kugwiritsa ntchito mankhwala osokoneza bongo a IV kapena kugonana mosadziteteza.
• Osamwa, kapena kumwa pang'ono pang'ono.

Matenda omwe amapezeka (Non-Wilsonian) a hepatocerebral degenal; Kusokonezeka kwa chiwindi; Matenda osokoneza bongo

• Matenda a chiwindi

Garcia-Tsao G. Cirrhosis ndi sequelae yake. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. Wolemba 25. Philadelphia, PA: Elsevier Saunders; 2016: chap 153.

Haq IU, Tate JA, Siddiqui MS, Okun MS. Chipatala mwachidule cha zovuta zoyenda.Mu: Winn HR, mkonzi. Opaleshoni ya Youmans ndi Winn Neurological. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2017: mutu 84.