Malangizo azachipatala a hemochromatosis: njira zodziwira matenda ndi matenda a matenda amisempha

Hemochromatosis ndi cholowa chamilandu chomwe chimalumikizidwa ndi kuyamwa kwazitsulo kwambiri m'zakudya zam'mimba komanso kudziunjikira kwake kokwanira kwambiri m'malo osiyanasiyana amkati.

Chiwindi chimavutika kuposa ena. Kuzindikira koyambirira kwa hemochromatosis, kuzindikira kwake ndi chithandizo chake sichingalole kukula kwa zotsatira.

Hemochromatosis: nthenda yanji?

Kuti mumvetse tanthauzo la matendawa, muyenera kudziwa kuchuluka kwa chitsulo chomwe munthu ayenera kukhala nacho. Mwa amuna, chitsulo chimakhala pafupifupi 500-1500 mg, ndipo mwa akazi, kuyambira 300 mpaka 1000 mg. Zizindikiro zimangotengera osati jenda, komanso kulemera kwa munthuyo. Oposa theka la kuchuluka kwazitsulo zonse zili mu hemoglobin.

Pafupifupi 20 mg ya microelement iyi imalowa m'thupi ndi chakudya patsiku. Mwa awa, 1-1,5 mg yokha imamenyedwa m'matumbo. Ndi hemochromatosis (GC) kapena siderophilia, monga momwe matendawa amatchedwanso, kuyamwa kumawonjezeka mpaka 4 mg patsiku, ndipo chitsulo chimadziunjikira pang'onopang'ono mu minofu ya ziwalo zosiyanasiyana.

Chiwindi chathanzi komanso hemochromatosis

Kuchuluka kwake kumawononga mamolekyulu a mapuloteni ndi zakudya, motero gawoyo palokha. Odwala omwe ali ndi GC, kuchuluka kwa chitsulo mu chiwindi kumatha kufika 1% yaumidwe wachipangacho, womwe umadzaza ndi matenda enaake, komanso mu gawo limodzi mwa magawo atatu a khansa ya chiwindi. Zowonongeka ndi chitsulo chowonjezereka, kapamba amatha kupereka chidwi kuti chikule.

Kuyika mu pituitary gland, chitsulo chimawononga dongosolo lonse la endocrine. Ziwalo zoberekera zimavutika kwambiri kuposa ena: Amuna amakhala ndi vuto losagwirizana, ndipo azimayi amatha kubereka.

Zomwe zimachitika

Cholinga chachikulu cha GC ndi "kutayika" kwa majini, kapena, mtundu wa HFE. Ndiye amene amawongolera njira ya kapangidwe ka mankhwala ndi kuchuluka kwa chitsulo cholowa mthupi monga gawo la chakudya. Kusinthika komwe kumachitika kumabweretsa chisokonezo chachitsulo.

Zomwe zimayambitsa GC ndi:

• thalassemia. Poterepa, mawonekedwe a hemoglobin amawonongeka ndi chitsulo;
• hepatitis;
• chitsulo chimatha kuwonjezeka chifukwa chogwiritsa ntchito magazi pafupipafupi. Chowonadi ndi chakuti nthawi yayitali yachilendo maselo ofiira achilendo ndi ofupikirapo kuposa awo. Akamwalira, amapangira chitsulo;
• hemodialysis njira.

Khodi ya ICD-10 ndi gulu

Mmagulu omwe amavomerezedwa kaamba ka matenda a GC, code E83.1 yaperekedwa.

Mtsempha wongoganiza, pulayimale (kapena cholowa cha GC) ndi sekondale amadziwika:

• choyambirira. Matenda amtunduwu ali ndi chibadwa chabadwa ndipo chotsatira cha chilema mu dongosolo la enzyme lomwe limakhudza kagayidwe kachitsulo. Amapezeka mwa anthu atatu mwa anthu 1000. Amadziwika kuti abambo amatenga matenda amtunduwu ndipo amavutika kwambiri katatu kuposa azimayi;
• sekondale. Cholinga chake ndimadwala matenda a chiwindi (omwe nthawi zambiri amawonedwa ndi zakumwa zoledzeretsa), kuthira magazi, kudzichitira nokha mavitamini omwe amakhala ndi chitsulo chambiri. Zomwe zimapangitsa kuti akhale ndi GC ndizovuta za pakhungu ndi matenda a magazi.

Zizindikiro

Primary hemochromatosis (PCH) imadziwika ndi chitukuko pang'onopang'ono, ndipo koyambirira, odwala amadandaula kuti watopa. Amatha kuvutitsidwa ndi kupweteka kumbali yakumanja ndi khungu louma.

Gawo lowonjezedwa la PCH limadziwika ndi:

• mtundu wa nkhope, khosi, mikono ndi mikwingwirima. Amakhala ndi mkuwa wamkuwa;
• matenda a chiwindi. Anazindikira mu 95% ya milandu;
• kulephera kwa mtima;
• nyamakazi;
• shuga mellitus: 50% ya milandu;
• kukulira ndulu;
• kusowa pogonana.

M'magawo omaliza, matenda oopsa a portal ndi ascites amawonedwa. Khansa ya chiwindi imayamba.

Sekondale

Popeza chitsulo chowonjezera chimapangidwa pakapita zaka, zizindikiritso zoyambirira za sekondale ya GC zimawonekera mwa amuna pambuyo pa zaka 40, ndipo mwa akazi pambuyo pa zaka 60.

Zizindikiro zake ndi izi:

• melasma;
• kutopa ndi kuchepa thupi;
• utachepa libido;
• kukulitsa ndi kufalikira kwa minyewa ya chiwindi;
• cirrhosis (gawo lomaliza la GC).

Kuyesa kwa magazi ndi njira zina zodziwira matenda

Dokotala wazachipatala amatsimikizira kuti amadziwika ndi matendawa. M'mayambiriro oyamba a matendawa, kuyesa kwa Laborator ndikofunikira kwambiri.

Ndi GC, kuyesedwa kwapadera kwa magazi kumachitika kuti muwone zofunikira za chitsulo mu plasma, kuthekera kwake kotsika kwa chitsulo ndikudzikulitsa ndi transerrin.

Chizindikiro chachikulu cha matendawa ndi hemosiderin amaika mu hepatocytes a chiwindi, pakhungu ndi ziwalo zina, zomwe zimakhala "dzimbiri" chifukwa chochulukirapo. Kuyesedwa kwa magazi kumafunikiranso pakuwonetsa zamankhwala am'thupi, komanso shuga. Kuphatikiza apo, kuyesedwa kwa chiwindi kumatengedwa.

Kuphatikiza apo, maphunziro othandiza amachitidwanso:

• chiwindi biopsy ndiye njira yayikulu yotsimikizira GC;
• Ultrasound yam'mimba;
• Chiwindi MRI (nthawi zina);
• echocardiography, kupatula / kutsimikizira mtima;
• kuphatikiza radiology.

Kodi kuchitira hemochromatosis?

Mankhwala othandizira

Ndikofunikira kumvetsetsa kuti ndi hemochromatosis wodziwika bwino, kudya kuyenera kukhala kwa moyo wonse.

Lamulo lalikulu ndikuchepetsa kwambiri zakudya zamagulu azitsulo, makamaka:

• tchizi zolimba ndi nsomba zam'nyanja;
• chimanga: oat, mapira ndi buckwheat;
• buledi wakuda;
• nyemba ndi zipatso zouma;
• ascorbic acid ndi mankhwala okhala ndi mavitamini C ambiri;
• offal, makamaka chiwindi, sichitha.

Mowa ndi mtheradi. Koma tiyi ndi khofi, m'malo mwake, akuwonetsedwa. Ali ndi tannin, amene amachepetsa kuyamwa kwachitsulo.

Mndandanda wa mankhwala ogwiritsidwa ntchito

Mankhwalawa amachitika ndi mankhwala omwe amachotsa chitsulo m'thupi la wodwalayo. Pa gawo loyamba, mavitamini A, E ndi folic acid ndi omwe amapatsidwa. Kenako ikani ma chelators (monga Desferal).

Kuchotsera

Mlingo wa jekeseni: 1g / tsiku. Patha 500 mg wa mankhwalawa amapereka zotsatira zowoneka: mpaka 43 mg wachitsulo amachotsedwa. Maphunzirowa amatha mpaka miyezi 1.5. Kugwiritsa ntchito kwa nthawi yayitali ndi koopsa: kuyambitsanso mandala ndikotheka.

Phlebotomy ndi njira zina zochizira

Phlebotomy ndiyosavuta kwambiri ndipo, munthawi yomweyo, chithandizo chamankhwala chosagwirizana ndi mankhwala cha GC.

Chikwangwani chimapangidwa m'mitsempha ya wodwala, ndipo magazi amatuluka m'thupi. Pafupifupi 500 ml amatsanulidwa sabata limodzi.

Njirayi imangotuluka. Magazi amayesedwa pafupipafupi kuti apatsidwe ferrin: ayenera kugwera mpaka 50. Izi zimatha kutenga zaka 2-3. Kuphatikiza apo, mankhwalawa amayang'aniridwa kuti akhalebe oyenera pazinthuzi.

Kuchiza ndi wowerengeka azitsamba

Mankhwalawa amathandizira odwala matenda ofooka.

Chithandizo cha chiwindi:

• dzungu. Ndibwino kuti muziwaphika ndi kuphika. Masamba amawonjezeredwa ku saladi kapena kusakanizidwa ndi uchi - chokoma komanso chopatsa thanzi! Madzi a dzungu amawonetsedwanso: theka lagalasi pamimba yopanda kanthu;
• kachikumbu -Chinthu china chothandiza cha GC. Gwiritsani ntchito yaiwisi kapena yowiritsa. Wathanzi komanso wathanzi watsopano.

Kwa chithandizo cha mtima, mutha kulangiza infusions wa hawthorn, adonis kapena mamawort. Zitsamba zimathiridwa ndi madzi otentha ndipo, atatha kukakamira, amaledzera malinga ndi malangizo.

Chithandizo cha kapamba:

• kutsitsa mbewu kungathandize. Kukula: 1 tbsp. zopangira kwa 1 tbsp. madzi. Mbeu zophika zimaphika kwa mphindi 5, utakhazikika ndikuyamba musanadye 1 tbsp;
• uchi ndi sinamoni. Kukula: 1 tbsp. ufa kwa 1 tbsp ya madzi. Kuumirira mphindi 15-30. ndi kuwonjezera uchi. Siyani kwa maola ena awiri. Njira zonse zimayenera kuledzera tsiku limodzi.

Oatmeal othandiza komanso osaphika (ndi mankhusu). Kukula: 100 ga phala kuti 1.5 malita a madzi. Wiritsani kwa theka la ola. Kenako, m'mbale momwe momwe oats anaphikidwira, ikuphwanya mpaka gruel ndikuwiritsanso kwa mphindi 40. Moyo wa msuzi wosefedwayo suwapitilira masiku awiri. Imwani kapu imodzi theka musanadye.

Therapy Odwala Matenda

Chuma chambiri mu ziwalo zimatsogolera pakupanga ma pathologies angapo. Zonse zimafuna chithandizo chothandizira. Mwachitsanzo, ngati GC idathandizira kukulitsa matenda ashuga, omalizirawa akuyenera kuthandizidwa, osasamala kuchuluka kwa shuga.

Kuzindikira komanso malangizo akulu azachipatala

Koma ngati chithandizocho chikuchitika moyang'aniridwa ndi achipatala komanso pa nthawi, ndiye kuti moyo wa wodwalayo ukuwonjezeka.

Pokhala matenda obadwa nawo, hemochromatosis mu 25% ya milandu amapezeka mwa abale ake. Chifukwa chake, ayenera kuyesedwa. Izi zimathandizira kuzindikira matendawa ngakhale mawonetsedwe azachipatala komanso mtsogolo popewa zovuta zake.

Pankhani ya sekondale ya GC, zakudya zimalimbikitsidwa, ndikofunikira kuti chitetezo cha chiwindi ndi magazi zizilamulidwa. Hemochromatosis yomwe yapezeka nthawi yapakati (kapena pa kukonzekera) siowopsa.

Makanema okhudzana nawo

Pazizindikiro, zoyambitsa ndi njira zochizira hemochromatosis mu kanema:

Tsoka ilo, chifukwa chachikulu cha hemochromatosis sichinadziwikebe. Koma pakadali pano, njira yapadera yokwaniritsira chithandizo yapangidwa ndipo ikugwiritsidwa ntchito mwachangu, cholinga chake ndikusokoneza mawonetsedwe azachipatala ndikuchepetsa chiopsezo cha zovuta zake.