Cirrhosis yachiwindi mwa agalu

Cirrhosis mwa Agalu: Zofunikira

• Cirrhosis ndi matenda a chiwindi omwe alibe mankhwala.
• Ndilofala kwambiri mwa agalu akuluakulu kusiyana ndi ang'onoang'ono.
• Zomwe zimayambitsa matendawa ndizosiyana kwambiri.
• Zizindikiro zazikulu za matenda a chiwindi mwa agalu ndi monga kuchepa kwa njala, kusanza, kusinthika kwa ndowe ndi mkodzo.

Zifukwa za cirrhosis

Zifukwa za chitukuko cha kusintha kwa cirrhotic ndizosiyana. Kuti pakhale kusintha kulikonse mu minofu ya chiwindi, kuchitapo kanthu kowononga ndikofunikira. Mu agalu, izi zikhoza kukhala zosiyanasiyana poizoni, mankhwala, matenda ndi invasive njira. Poyankha zochita zowonongazo, kufa kwa hepatocytes - maselo a chiwindi kumachitika. Thupi limayesa kukana njirayi ndikuyambitsa njira zolipirira, malo a maselo akufa ayenera kutengedwa ndi chinachake. Ma cell olumikizana amakula mwachangu kuposa hepatocytes, ndipo galu amakulitsa chiwindi cha fibrosis. Kenako njira ya angiogenesis imayamba - kupangidwa kwa mitsempha yatsopano yamagazi. Zombo zatsopano zimazunguliridwa ndi minofu yolumikizana, yomwe imachepetsa kuchuluka kwake. Zotengerazo zimapanga maukonde atsopano, kulumikiza ziwiya zazikulu za chiwindi - mtsempha wamagazi ndi mtsempha wa portal. Koma mitsempha yatsopanoyi imatha kudutsa magazi ochepa, komanso imakhala ndi kuthamanga kwambiri kuposa momwe ziyenera kukhalira. Zotsatira zake, kupanikizika kumayamba kuchuluka mumtsempha wa portal, zomwe zimatsogolera ku portal hypertension.

Zinthu zazikulu zomwe zimawononga chiwindi ndi izi:

1. Mankhwala

   Mankhwala ena, akamwedwa mosalamulirika, angayambitse kusintha kwakukulu m’chiŵindi. Mankhwalawa akuphatikizapo phenobarbital, yomwe nthawi zambiri imagwiritsidwa ntchito pochiza matenda agalu. Kukonzekera kwa Glucocorticoid pamilingo yayikulu komanso kwa nthawi yayitali kumabweretsanso zovuta zoyipa, kuphatikiza matenda a chiwindi. Agalu ena ali ndi hypersensitive antiparasitic mankhwala mebendazole (omwe sapezeka kawirikawiri pamsika posachedwapa), pa mlingo waukulu adzakhala poizoni kwambiri. Maantibayotiki ochokera ku gulu la tetracycline ndi mankhwala ena opha tizilombo (ketoconazole) akhoza kukhala owopsa ngati atagwiritsidwa ntchito mosalamulirika. Paracetamol, ngakhale mu Mlingo wapakatikati, imatha kuyambitsa kusintha kosasinthika kwa chiwindi mwa agalu.

2. Toxini

   Agalu amakonda kutafuna zinthu zosiyanasiyana zosadyedwa. Ethylene glycol yomwe ili mu antifreeze ndi yokoma, ndipo agalu samanyalanyaza kuidya ngati atasiyidwa. Kutafuna chingamu ndi mankhwala otsukira mano kwa anthu ali ndi xylitol, yomwe ilinso poizoni kwa nyama. Mabatire odyedwa amayamba kutulutsa okosijeni m'mimba mwa galu ndikutulutsa zitsulo zolemera. Ma Aflatoxins amatulutsidwa ndi mafangasi ambiri owopsa (monga nkhungu) ndipo amakhala ndi hepatotoxic. Ma fungicides, mankhwala ophera tizirombo ndi ena a rodenticides amakhala oopsa kwambiri akamwedwa.

3. matenda

   Matenda a chiwindi omwe amapezeka kwambiri mwa agalu ndi leptospirosis. Leptospira ndi mabakiteriya omwe amalowa m'chiwindi, impso, mapapo ndi ziwalo zina zamoyo. Matendawa amapezeka makamaka kudzera m'madzi omwe ali ndi kachilombo (kawirikawiri m'madzi) kapena mutadya makoswe omwe amwalira ndi matendawa. Matenda ena ndi matenda a chiwindi chifukwa cha adenovirus mtundu 1. Posachedwapa, matendawa si ambiri ndipo pafupifupi sizichitika chifukwa chikumbumtima katemera agalu zoweta.

4. Kuitana

   Tizilombo toyambitsa matenda sitipezeka m'chiwindi cha agalu. Mankhwala a helminth omwe amafalikira mwachindunji m'chiwindi (Opisthorchis felineus) amachititsa opisthorchiasis. Matendawa amapezeka chifukwa chodya nsomba zomwe zili ndi matenda osatetezedwa. Ma helminths ena (toxocars, roundworms) amathanso kusamukira ku chiwindi m'kati mwa moyo wawo ndikugona pamenepo ngati mphutsi.

Zizindikiro za chiwindi matenda enaake agalu

Zizindikiro zachipatala zomwe zimachitika ndi matenda a chiwindi mwa agalu zimatha kukhala zosiyanasiyana. Kuopsa kwawo kudzadalira siteji ya matendawa. Galu akhoza kutsika, kutopa msanga. Ambiri a tsiku adzagona. Kulemera kwa thupi kumachepa pang'onopang'ono. Kufuna kudya kumakhala kwaulesi, ndipo ludzu limatha kukhala mkati mwanthawi yake ndikuwonjezeka. Kusanza kumachitika nthawi ndi nthawi, kusanza kwa bile ndikotheka. Mpando udzakhala wosakhazikika, kutsekula m'mimba kumasinthasintha ndi kudzimbidwa. Mtundu wa mkodzo ukhoza kukhala wakuda, pafupifupi bulauni. M'malo mwake, ndowe zimatha kutaya mtundu ndikukhala imvi kapena zoyera. Khungu ndi mucous zimagwira ntchito zosiyanasiyana nthawi zina kukhala icteric, ndiko kuti, kupeza chikasu kulocha. Chifukwa cha matenda oopsa mu zipata mtsempha wa chiwindi, nthawi zambiri n`zotheka kuzindikira kuchuluka kwa voliyumu pamimba chifukwa ascitic madzimadzi mmenemo.

Kawirikawiri, chiwindi chimapanga zinthu zosiyanasiyana za dongosolo la magazi, kuphatikizapo vitamini K. Ndi matenda a cirrhosis, kupanga zinthuzi kumachepetsedwa, kutuluka kwa magazi kumawonedwa: magazi samayima bwino pamalo ovulala, zonyansa za magazi zimawonekera mumkodzo ndipo ndowe, m`kamwa kumatuluka magazi, mabala amaoneka pathupi. Mu magawo owopsa a cirrhosis, zochitika zamanjenje zitha kupezeka chifukwa chakukula kwa hepatic encephalopathy. Chiweto chimakhala ndi zogwedera, kunjenjemera, kusalumikizana bwino. Imfa yotheka ya chiweto.

Diagnostics

Kuzindikira kwa matenda a cirrhosis kumakhazikitsidwa m'njira yovuta, ndiko kuti, ndikofunikira kuganizira mbiri ya moyo ndi matenda, zizindikiro zachipatala ndi deta kuchokera ku maphunziro owonetsa ndi ma laboratory. M'pofunika kukumbukira ngati galuyo akanakhalapo ndi poizoni, kaya anam'patsa mankhwala okha. Komanso, adokotala adzathandizidwa ndi deta ya katemera omwe alipo komanso mankhwala oletsa tizilombo toyambitsa matenda.

Pakuwunika, mtundu wa mucous nembanemba, kuchuluka kwa capillary kudzazidwa, kuchuluka kwa kuchepa kwa madzi m'thupi, kupweteka ndi kusintha kwa pathological m'mimba, komanso kutentha kwa thupi kumawunikidwa. Kuyezetsa magazi kwachilengedwe komanso kwachilengedwe kwachilengedwe kumatengedwa. Pakuyezetsa magazi kwachipatala, kuchepa kwa magazi m'thupi kumatha kuzindikirika, mawonekedwe a leukocyte nthawi zambiri amakhala opanda kusintha kwakukulu. Malinga ndi mayeso am'magazi am'magazi, kuchuluka kwa michere ya chiwindi ndi bilirubin kumawonedwa. Mu gawo lalikulu la cirrhosis, sipangakhale kusintha kwa kuyezetsa magazi kwa biochemical, popeza maselo omwe amapanga zinthuzi amwalira kwathunthu.

Ndi magazi otsika a albumin, nthawi zambiri padzakhalanso kutuluka m'mimba kapena pachifuwa. Nthawi zina, glucose ndi urea zimachepa. Ndi kuchuluka kwa bile acid, mapangidwe achiwiri a hepatic shunts amatha kukayikira.

Kuyezetsa magazi kwa leptospirosis ndi microagglutination kumalimbikitsidwa nthawi zambiri. Kuphunzira za chiwindi chopatsirana, njira ya polymerase chain reaction kapena enzyme immunoassay imagwiritsidwa ntchito. An ultrasound wa pamimba patsekeke ndi kutsindika pa chiwindi m`dera ndi kuvomerezedwa. Pamaso pa effusion, madzimadzi amatengedwa kuti akaphunzire kuti asaphatikizepo chotupa ndi njira zotupa.

The chomaliza matenda a matenda enaake nthawi zambiri akhoza kupangidwa kokha mothandizidwa ndi histological kufufuza.

Chithandizo cha chiwindi matenda enaake agalu

Ngati galu wadya chinthu chakupha, muyenera kulankhulana ndi chipatala chapafupi mwamsanga. Ku chipatala, atha kulangizidwa kuti apangitse kusanza kuti atulutse poizoni kapena chapamimba mwachangu. Droppers amaperekedwa kuti athetse kuledzera. Ngati mankhwala akupha adziwika, mankhwala oyenera angagwiritsidwe ntchito.

Kuchiza matenda opatsirana kumaphatikizapo kuyambitsa antibacterial, antifungal ndi antiparasite mankhwala. Kusintha kwa Sami cirrhotic m'chiwindi, mwatsoka, sikungasinthe. Mbali imeneyo ya minyewa yachiwindi, yomwe inalowedwa m’malo ndi minyewa yolumikizira, sithanso kuchira. Chithandizo chokhacho chodziwika komanso chothandizira cha chiwindi cha chiwindi mwa agalu chimagwiritsidwa ntchito. Zakudya zapadera zochizira zimaperekedwa kwa matenda a chiwindi. Mavitamini monga vitamini B12, E ndi K akhoza kuwonjezeredwa.

Mankhwala a choleretic amaperekedwa, ndiye kuti, mankhwala a choleretic. Nthawi zina mankhwala ochokera ku gulu la hepatoprotectors amalembedwa. Ngakhale mankhwalawa sali m'nkhokwe yamankhwala ozikidwa pa umboni, mukawagwiritsa ntchito, zotsatira zabwino zimatha kudziwika. Mankhwalawa akuphatikizapo S-adenosylmethionine ndi mkaka nthula zipatso.

Prevention

Pofuna kupewa chitukuko cha matenda a chiwindi, kuphatikizapo matenda enaake agalu, m`pofunika kutsatira mfundo zofunika kusunga Pet. Ndikofunikira kuchotsa zinthu zonse zapoizoni pakupeza galu. Ndikofunikira kuchita chaka chilichonse katemera wathunthu, womwe umaphatikizapo chitetezo ku matenda a chiwindi ndi mitundu ingapo ya leptospirosis. Njira zodzitetezera ku tizirombo ta m'kati zimachitika kasachepera kanayi pachaka kwa agalu oyenda komanso mwezi kwa agalu omwe amasaka kapena kudya nyama yaiwisi.

Kufufuza kwachipatala kwapachaka kumathandiza kuzindikira matendawa kumayambiriro ndi kutenga njira zoyenera panthawi yake.

22 2021 Juni

Kusinthidwa: 28 June 2021