Cirrhosis yechiropa mumbwa

Cirrhosis muImbwa: Zvinokosha

• Cirrhosis chirwere chisingaperi chisingarapike.
• Inowanzoitika mumbwa dzakura pane diki.
• Zvikonzero zvekukura kwechirwere zvakasiyana zvakanyanya.
• Zviratidzo zvikuru zvechiropa cirrhosis mumbwa zvinosanganisira kuderera kwechido, kurutsa, kushanduka kwetsvina uye weti.

Zvikonzero zve cirrhosis

Zvikonzero zvekuvandudzwa kwe cirrhotic shanduko zvakasiyana. Nekuitika kwekuchinja kupi zvako mumatishu echiropa, chiito chechinhu chinokuvadza chinodiwa. Mune imbwa, izvi zvinogona kuva zvakasiyana-siyana chepfu, zvinodhaka, utachiona uye invasive maitiro. Mukupindura kune chiito chechinhu chinokuvadza, kufa kwehepatocytes - masero echiropa anoitika. Muviri unoedza kuramba maitiro aya uye unomutsa maitiro ekubhadhara, nzvimbo yemasero akafa inofanira kutorwa nechimwe chinhu. Masero anobatana anokura nekukurumidza kupfuura hepatocytes, uye imbwa inogadzira chiropa fibrosis. Zvadaro nzira ye angiogenesis inotanga - kuumbwa kwemidziyo mitsva yeropa. Midziyo mitsva yakakomberedzwa nekubatanidza tishu, izvo zvinoderedza huwandu hwavo. Iyo midziyo inoumba network itsva, inobatanidza midziyo mikuru yechiropa - hepatic artery uye portal vein. Asi iyo itsva vasculature inokwanisa kupfuudza chiyero chidiki cheropa, uye zvakare inochengetedza yakanyanya kudzvanywa kupfuura iyo inofanirwa kuve yakajairika. Nekuda kweizvozvo, kudzvanywa kunotanga kukwira mutsinga ye portal, zvichitungamira kune portal hypertension.

Zvinhu zvikuru zvinokuvadza chiropa ndezvizvi:

1. Zvigadzirwa zvemishonga

   Mimwe mishonga, kana ikatorwa isingadzoreki, inogona kutungamirira kukuchinja kwakakomba muchiropa. Mishonga iyi inosanganisira phenobarbital, iyo inowanzoshandiswa pakugadzirisa chirwere chembwa. Kugadzirira kweGlucocorticoid mumazinga akakwirira uye kwenguva refu kunotungamirirawo kumigumisiro yakakomba, kusanganisira chirwere chechiropa. Dzimwe imbwa dzinonzwa hypersensitive kune antiparasitic drug mebendazole (iyo isingawanzo kuwanikwa pamusika nguva pfupi yadarika), mumhando yepamusoro inove ine muchetura zvakanyanya. Mishonga inorwisa mabhakitiriya kubva muboka retetracycline nemimwe mishonga inorwisa fungal (ketoconazole) inogona kuva nengozi zvikuru kana ikashandiswa zvisina kudzorwa. Paracetamol, kunyangwe mumadhisi epakati, inogona kukonzera shanduko isingachinjiki muchiropa mumbwa.

2. Toxin

   Imbwa dzinofarira kutsenga zvakasiyana siyana zvisingadyiwe. Iyo ethylene glycol iri mu antifreeze inotapira mukuravira, uye imbwa hadziregeredze kuita mabiko pairi kana yakasara mukuwana kwadzo. Kutsenga mazino uye mishonga yemazino kuvanhu ine xylitol, iyo ine chepfu zvakare kumhuka. Mabhatiri anodyiwa anotanga kuita oxidize mudumbu rembwa uye kuburitsa heavy metals. Aflatoxins inovanzwa nefungus dzakawanda (eg molds) uye ine hepatotoxic mhedzisiro. Fungicides, mishonga yezvipembenene nemamwe ma rodenticides ane muchetura zvakanyanya kana akadyiwa.

3. zvirwere

   Chirwere chetachiona chechiropa mumbwa ndeye leptospirosis. Leptospira mabhakitiriya anopinda muchiropa, itsvo, mapapu uye mamwe matishu echipenyu. Utachiona hunonyanya kuitika kuburikidza nemvura ine utachiona (kazhinji mumapuddles) kana mushure mekudya makonzo anenge afa nechirwere. Chimwe chirwere chinotapukira hepatitis chinokonzerwa neadenovirus type 1. Munguva pfupi yapfuura, chirwere ichi hachina kunyanya kuitika uye chinenge chisingaitiki nekuda kwekudzivirira kwehana kwembwa dzomumba.

4. Invasions

   Zvipembenene hazviwanzowanikwi pachiropa chembwa. A helminth iyo parasitizes zvakananga muchiropa (Opisthorchis felineus) inokonzera opisthorchiasis. Utachiona hunoitika kuburikidza nekudya hove dzine utachiona dzisina kurapwa. Dzimwe helminths (toxocars, roundworms) vanokwanisawo kutamira kuchiropa munguva yehupenyu hwavo uye vanorara imomo nenzira yehonye.

Zviratidzo zvechiropa cirrhosis mumbwa

Zviratidzo zvekiriniki zvinoitika nechiropa cirrhosis mumbwa zvinogona kunge zvakasiyana. Kuoma kwavo kuchaenderana nedanho rechirwere. Imbwa inogona kuita shoma, inoneta nekukurumidza. Zvizhinji zvezuva zvicharara. Huremu hwemuviri huchaderera zvishoma nezvishoma. Kudya kunononoka, uye nyota inogona kuva mukati meyakajairika uye kuwedzera. Kurutsa kuchaitika nguva nenguva, kurutsa kwe bile kunogoneka. Chigaro chinenge chisina kugadzikana, manyoka anochinjana nekuvhara. Rudzi rweweti rinogona kusviba, rinenge shava. Feces inogona, pane zvinopesana, kurasikirwa nemuvara uye kuva grey kana chena. Ganda uye mucous membranes mune dzimwe nguva inova icteric, ndiko kuti, kuwana yero tint. Nekuda kwehypertension mune portal vein yechiropa, zvinowanzogoneka kucherechedza kuwedzera kwevhoriyamu yemudumbu nekuda kweascitic fluid mairi.

Kazhinji, chiropa chinobudisa zvinhu zvakasiyana-siyana zveropa coagulation system, kusanganisira vitamini K. Ne cirrhosis, kugadzirwa kwezvinhu izvi kunoderedzwa, kubuda ropa kunogona kuonekwa: ropa harina kumira zvakanaka panzvimbo yekukuvara, kusvibiswa kweropa kunoonekwa mumuguta uye. tsvina, matinji achibuda ropa, mavanga anobuda pamuviri. Mumatanho akanyanya e cirrhosis, tsinga dzinoitika dzinogona kuwanikwa nekuda kwekukura kwehepatic encephalopathy. Mhuka yacho ine kugwinha, kudedera, kusashanda zvakanaka. Zvinogoneka kufa kwechipfuwo.

Diagnostics

Kuongororwa kwe cirrhosis kunotangwa nenzira yakaoma, ndiko kuti, zvakakosha kufunga nezve nhoroondo yehupenyu nehurwere, zviratidzo zvekiriniki uye data kubva kuongororo yekuona uye laboratori. Zvakakosha kuyeuka kana imbwa yaigona kuve yakasvibiswa nechimwe chinhu, kana vakamupa mimwe mishonga iri yoga. Zvakare, chiremba anozobatsirwa nedata pamusoro pemajekiseni aripo uye marapirwo anorwisa tupukanana.

Munguva yekuongororwa, ruvara rwemucous membranes, chiyero chekuzadza capillary, chiyero chekupera mvura, kurwadziwa uye pathological shanduko mudumbu, uye tembiricha yemuviri inoongororwa. General kiriniki uye biochemical ropa bvunzo inotorwa. Mukuongororwa kweropa kwekliniki, anemia inogona kuonekwa, iyo leukocyte formula inowanzove isina kuchinja kukuru. Zvinoenderana neiyo biochemical ropa test, kuwedzera kwechiropa enzymes uye bilirubin kunoonekwa. Muchikamu chakanyanya che cirrhosis, panogona kunge pasina shanduko mukuongororwa kweropa rebiochemical, sezvo masero anogadzira zvinhu izvi akafa zvachose.

Neyero yakaderera yealbumin yeropa, panowanzovawo nekuputika mudumbu kana chipfuva. Mune zvimwe zviitiko, glucose yeropa uye urea zvichaderedzwa. Nekuwedzera kwehuwandu hwe bile acids, kuumbwa kwechipiri hepatic shunts kunogona kufungidzirwa.

Kuongororwa kweropa kwe leptospirosis ne microagglutination inowanzokurudzirwa. Kudzidza nezvehutachiona hwehepatitis, nzira yepolymerase chain reaction kana enzyme immunoassay inoshandiswa. An ultrasound yedumbu remudumbu nekusimbisa panzvimbo yechiropa inosungirwa. Mukuvapo kwe effusion, mvura inotorwa pakudzidza kwayo kuitira kusabvisa bundu uye maitiro ekuzvimba.

Kuongororwa kwekupedzisira kwe cirrhosis muzviitiko zvakawanda kunogona kuitwa chete nerubatsiro rwekuongorora histological.

Kurapa kwechiropa cirrhosis mumbwa

Kana imbwa yakadya chinhu chine chepfu, unofanira kuonana nekiriniki iri pedyo nekukurumidza. Mukiriniki, zvinogona kukurudzirwa kukurudzira kurutsa kuitira kukurumidza kubudisa muchetura kana gastric lavage. Madonhwe anorayirwa kuti abvise kudhakwa. Kana chinhu chine muchetura chikazivikanwa, mushonga wakakodzera unogona kushandiswa.

Kurapa kwezvirwere zvinotapukira kunosanganisira kuiswa kwemishonga inorwisa mabhakitiriya, antifungal uye antiparasite. Sami cirrhotic shanduko muchiropa, zvinosuruvarisa, haidzoreki. Chikamu ichocho chenyama yechiropa, icho chakatsiviwa ne-connective tissue, hachichakwanisi kupora. Chete chiratidzo uye chinotsigira kurapwa kwechiropa cirrhosis mumbwa chinoshandiswa. Zvokudya zvakakosha zvekurapa zvinotarirwa kune zvirwere zvechiropa. Mavhitamini akadai sevhitamini B12, E uye K anogona kuwedzerwa.

Choleretic mishonga inorayirwa, kureva, choleretic zvinodhaka. Dzimwe nguva mishonga kubva kuboka re hepatoprotectors inorayirwa. Kunyangwe mishonga iyi isiri yedhatabhesi yehuchapupu-hwakavakirwa mushonga, kana uchiishandisa, mhedzisiro yakanaka inogona kucherechedzwa. Mishonga iyi inosanganisira S-adenosylmethionine nemuchero wemukaka mbira.

dziviriro

Kuti udzivise kukura kwezvirwere zvechiropa, kusanganisira cirrhosis mumbwa, zvakakosha kutevera mitemo yekutanga yekuchengetedza chipfuwo. Zvakakosha kubvisa zvinhu zvose zvine chepfu kubva pakuwana kwembwa. Izvo zvinodikanwa kuita gore rega rega rejekiseni yekudzivirira, iyo inosanganisira kudzivirira kubva kune inotapukira hepatitis uye akati wandei emhando dze leptospirosis. Mishonga yekudzivirira yezvipembenene zvemukati inoitwa kanenge kana pagore kune imbwa dzinofamba uye pamwedzi kune imbwa dzinovhima kana kudya nyama mbishi.

Kuongororwa kwechiremba kwegore negore kunobatsira kuziva chirwere mumatanho ekutanga uye kutora matanho anodiwa munguva.

22 2021 Chikumi

Yakagadziridzwa: 28 June 2021