Parenchymal jaundice: zviratidzo, zvinokonzera, kuongororwa

Nhasi, pane zvirwere zvakasiyana siyana izvo vanhu vasingawanzokutarisana nazvo. Zvisinei, iwe uchiri kuda kuziva pamusoro pavo zvishoma. Pashure pezvose, somuenzaniso, unogona kudzivisa kuitika kwezvinetso zvakadaro. Ndicho chikonzero ndinoda kukutaurira zvakadzama pamusoro pehutachiona huno, seprisymalmal jaundice.

Terminology

Usati wagadzirisa chirwere chacho pachako, unofunga kusarudza pamusoro pemafungiro achashandiswa zvakashandiswa munyaya ino. Saka, chirwere chinopisa chirwere chirwere, kana kuti pane, chiratidzo chakakosha chinoratidzika, chinoratidzwa nekupenya kweicteric maruva kwete kwete chete ganda, asiwo mucous membrane (sclera yemeso). Izvi zvinokonzerwa nekuti bilirubin iri kuwedzera zvishoma nezvishoma mumuviri wemurwere (iyi ndeye bile pigment). Zvakakoshawo kuziva kuti chiratidzo ichi chinoratidzira chinoratidza kuti murwere ane zvinetso nechiropa, izvo zvinoda kugadziriswa nekukurumidza.

Zvinonakidza kuti mumishonga panewowo pfungwa yechinjace yenhema. Muchiitiko ichi, kwete bilirubin inowanikwa mumuviri wemunhu, asi carotene, chinhu chechisikigo, chinoita kuti kuve kweganda kuitika. Saka, izvi zvinogona kuitika kana kakawanda uye zvakakura kuti zvive kudya karoti, dzungu, marangi, uyewo bheet. Dambudziko rakafanana rinogona kubuda kana iwe ukadya picric acid kwenguva yakareba , pamwe nemimwe mishonga.

Clinical picture

Izvozvo zvinoratidzika sei seprisymalmal jaundice? Iyo pathogenesis yechirwere ndeyotevera. Saka, pakutanga zvinofanira kuzivikanwa kuti mukushanda kwemazuva ose, bilirubin, bile pigment, yakanyanyiswa kubva mumuviri nemaitiro. Kana paine zvimwe zvinetso mubasa rechiropa, rinotanga kuwedzera mumuviri, richiratidza izvi nekuita ruvara rweganda, uyewo mucous membrane. Kutarisa kuburikidza neruzivo rwechinangwa chechirwere chemajeri, zvakakosha kutaura zvakare kuti dambudziko iri rine matanho matatu ekukura.

1. Nzvimbo yekutanga. Muchiitiko ichi, basa re enzyme rinoderera, hepatocyte membrane inokuvadza, kurondedzera bilirubin kunoguma kuwanzobudiswa.
2. Muchikamu chechipiri chechirwere, varwere vane dambudziko rakadaro se hyperfermentia, kuperevedza kwehepatocyte membrane kunowedzera. Pain in the side in appearance because of pressing the capillaries.
3. Pachitatu chechitatu kune kukanganisa kwekugadziriswa kwebilirubin, kushaya kwechiropa kunoitika . Uyewo, urinhi inova yakajeka, marwadzo ari mudivi anogara achinzwa.

Zvakakosha kuziva kuti zvakakosha kutanga kurwisa jaundice parenchymal pamatanho ekutanga ekutanga kwechirwere. Pashure pezvose, munyaya iyi, unogona kukurira dambudziko racho nyore nyore uye nokukurumidza. Kana "kunonoka" kutanga kwegadziriro yekudzoka kuchitatu chechitatu, zvichange zvakaoma zvikuru kuporesa chirwere ichi.

Zvinokonzera dambudziko racho

Sei chirwere chinopisa chinogona kuitika, chii chinoita kuti zvivepo?

• Chokutanga pane zvose, zvinofanira kuonekwa kuti dambudziko guru munyaya iyi ndiro rinopararira: aya mavairusi, mabhakitiriya, chepfu. Kazhinji kazhinji munyaya iyi tiri kutaura pamusoro pezvirwere zvakadai semarariya, chirwere, toxoplasmosis, nezvimwewo.
• Kukundwa kwe hepatocides nehoyioni zvose zvakasikwa uye zvisingaiti. Uturu hwehutu hwemuviri hunogona kuitika nekuda kwekushandisa funguru ine uchetura, urombo husina kunaka, pashure pokutora arsenic kana nyoka kuruma.
• Kutungamirira kunetso iyi kunogonawo kugamuchira mamwe mishonga ine hepatotoxic effect. Muchiitiko ichi, kazhinji kacho kugadzirira kwakadai se "Paracetamol" kana ma antibiotics.

Heredity

Tichifunga nezvezvikonzero zvinokonzera chirwere chenduru, inofanirawo kutaurwa kuti chirwere ichi chinewo nhaka. Izvi zvinoreva kuti inogona kutapudzwa nehutano kubva kune umwe wemhuri kune imwe.

• Panogona kuva nekushaiwa kweprotein yakananga, iyo iri pamusoro pechiropa.
• Chikonzero chacho chingave kushayikwa kwekodhi yekemikisi chaiyo, inonzi UDP-glucuronyltransferase.
• Hereditary chirwere cheWilson-Konovalov, apo mhangura inounganidza mu hepatocytes, nekuda kweizvi chiremera chechimiro kushanda kwechirongwa ichi kunovhiringidzwa.

Icho chiratidzo chikuru chekuita

Tichifunga nezvechirwere chakadaro, segurukota rinouraya, zviratidzo - ndizvo zvinodawo kuudzwa. Saka, chii chinoratidzwa nechirwere ichi?

1. Chokutanga, dambudziko iri rinoratidzwa nekukona kweganda, pamwe chete nemucu membrane, kunyanya chirwere chemaziso.
2. Uyezve, murwere angave ane nyoro.
3. Kune hutano, fever, a migraine.
4. Kazhinji varwere vanong'un'una pamusoro pokurasikirwa nechido, zvichiita kuti kurasikirwa kwomuviri.
5. Kunewo maronda emasumbu uye kushaya simba.

Zviratidzo zvekuongorora zviri kuchinja zvakare.

• Mhuka yacho inova chiedza, zvinyoro zvishoma. Zvose zvinoitika nekuda kwe kurasikirwa kwe sterocilin, imwe bile bile pigment.
• Urine inochinjawo maruva. Inogona kunge yakanyanya kujeka kana kuti yakasviba.
• Muropa revarwere, zvinyorwa zvakananga uye zvisingaoneki bilirubin inowedzera.

Diagnostics

Unogona sei kunzwisisa kuti munhu ane jaundice yepamusoro? Kuongororwa - ndizvo zvichakuudza nezvekuvapo kwechirwere ichi. Nekuda kwaunoda:

1. Kufambisa tsanangudzo yakawanda yehuta, feces, neropa.
2. Kuongororwa kwechirwere chekliniki yose.
3. Kugadziriswa kwezvinhu zvehupenyu kweropa.
4. Zvimwe zvidzidzo zvinobatsira zvinogona kugoverwa.

Clinical analyzes

Kana murwere wacho aine tsvina nemucheni , saka mune chirwere ichi, bilirubin uye urobilin zvinowedzera zvakanyanya, uye chiyero che sterbilin chinowira, chinokonzera kuora kwemavara evanhu.

Kuongorora ropa kunofanirawo kudiwa. Munyaya iyi, leukocytosis uye anemia zvinogona kuonekwa. Kana murwere ane chirwere chinopisa, chirwere chechiochemistry cheropa ndicho chinokosha zvakare. Pano, nhamba dzomukati uye dzisina kuiswa bilirubin uye urobilin dzichawedzerwa.

Mune zvimwe zviitiko, murwere achapiwa uye zvimwe zvidzidzo zvakare. Inogona kuva:

• Kusarudza kwehuwandu hwe folic acid uye vitamini B12 muropa.
• Tsanangudzo yevanokunda.
• Coprogram: kuongorora zvirwere uye helminths.

Ongororo yeAppo

Nyanzvi ine ruzivo inogona kusiyanisa nyore nyore chirwere cheparajaic jaundice kubva pane chirwere chakazara. Zvisinei, pane dzimwe nguva, kunyange magumo anozivikanwa zvikuru emishonga anoda zvimwe zvidzidzo zvekushandisa kuti ave nechokwadi chekuongorora. Muchiitiko ichi, murwere anogona kugoverwa:

1. Radiography . Kuziva zvinetso nedumbu, sopu uye matumbo.
2. Cholecystography . Zvakakosha kunzwisisa kana pane matombo mujeri.
3. Ultrasound inogona kupa ruzivo pamusoro pemamiriro eropa uye zvimwe zvikamu zvinokosha.
4. CT kana MRI .

Kakawanda kazhinji, varwere vanorayirwa chiropa chinopesana.

Kurapa

Izvo zvinofanira kuonekwa kuti izvi zvirwere zvine nzira dzakasiyana-siyana dzekudzibvisa. Zvose zvinoenderana nehuwandu hwekuregererwa kwechirwere chepasi. Kazhinji kacho, vanachiremba vanopa mishonga inobvisa bilirubin yakawanda kubva mumuviri. Zvisinei, mishonga haibatsiri nguva dzose. Muchiitiko ichi, vanachiremba vanokwanisa kupa chirongwa chakadai se phototherapy. Uye zvose nokuti ultraviolet inokwanisa kukurumidza kuputsa maserolekita e bilirubin uye kubatsira kukurumidza kubviswa. Nechirwere ichi, zvinokoshawo kutora uturu hwevhithamini, kunyanya B uye C, lipoic acid uye amino acids.

Kudzivirira uye Matambudziko

Sezvo kuora mwoyo jaundice chiratidzo chakakomba chinowanzopesana nemamiriro ezvimwe zvirwere (viral hepatitis B neC, matombo mumucheka, nezvimwewo), zvakakosha kutanga kutanga kubvisa zvirwere izvi munguva. Pashure pezvose, tinofanira kuyeuka kuti kana iwe usingabatsiri murwere nenguva, zvinogona kuguma mune zvimwe zvinetso. Zita: murwere anogona kukanganisa basa rechiropa uye gallbladder. Panguva imwecheteyo, kuwedzera kwejeri yebilirubin kunokonzera kudhakwa kwemuviri, izvo zvinokanganisa zvakanyanya basa rezvikamu zvaro zvose.