Isifo sikashukela sithinta kabi isimo sazo zonke izitho ezibalulekile. Phakathi kwabo, isibindi singenye yokuqala yokuhlupheka, njengoba igazi lidlula kukho ngaso sonke isikhathi. Eminye yemisebenzi yalesi sitho ukwakhiwa nokulondolozwa kwe-glycogen carbohydrate reservity kanye nokulawulwa kwe-metabolism. Ngenxa yokuphazamiseka kwe-endocrine, ukufafazwa kwegazi esibindini kuya ngokuya kukhulu, lapho kufanele ihlanzwe khona ngezinto ezinobuthi, ama-hormone, izinto ezidingida umzimba kanye nemikhiqizo yokuphela komzimba. Kepha kunobudlelwano obuhlukile, ngoba ezinye izifo zesibindi ngokwazo zingavusa ukukhula kwesifo sikashukela sohlobo 2. Imvamisa lokhu kubangelwa ukungondleki kanye nokuhlala phansi.
Indima yesibindi ku-carbohydrate metabolism
Isibindi siyidepho likashukela, eligcinwa kuyo ngesimo se-glycogen polysaccharide, equkethe izinsalela eziningi ze-carbohydrate. Ngesidingo sebhayoloji, ngaphansi kwethonya lama-enzyme, i-glycogen ihlephuka kushukela, futhi ingena egazini. Inqubo ebalulekile ye-biochemical, gluconeogenesis, nayo yenzeka esibindini. Kuyinto yokusabela ukwakheka kwe-glucose evela kwezinye izinto eziphilayo. IGluconeogenesis ivumela umzimba ukuthi ugcwalise kabusha ama-carbohydrate ngaphansi kwezimo ezibucayi: ngokuzikhandla ngokomzimba okubuthakathaka kanye nokubulawa yindlala isikhathi eside.
Isifo sikashukela i-mellitus nesibindi zihlobene kakhulu, futhi lokhu kuyithinta kabi inhlala-kahle yesiguli kanye nesimo jikelele sempilo yakhe. Emangqamuzaneni alesi sitho, izinga lama-enzyme adingekayo ekubambeni ushukela liyancipha. Ngenxa yalokhu, ingena egazini ngamanani amakhulu kakhulu kunesidingo. Lokhu kusabela akuyeki ngisho ne-hyperglycemia, yize ngokujwayelekile esimweni esinjalo isibindi kufanele siyeke ukuphonsa ushukela egazini bese siqala ukudala idepho ye-glycogen.
I-Gluconeogenesis yinto eyenzeka kakhulu kwisifo sikashukela, ngenxa yokuthi isiguli singangezelela ngokushesha amazinga eglucose. Le ndlela futhi iqala ukusebenza ngokungalungile, futhi iqala hhayi kuphela kulezo zimo lapho idingeka. Izicubu ze-Adipose zesibindi zanda ngevolumu ngenxa yokuntuleka kwe-insulin yohlobo 1 sikashukela nokuqunjelwa ngokweqile kwama-triglycerides. Lokhu kuholela ekuqhakameni kwesibindi hepatosis kanye nokukhula kwayo okuphakeme kwevolumu, ukuphazamiseka kwezinkinga ezijwayelekile zokusebenza nezinkinga zokugaya ukudla.
Isifo sikashukela sohlobo 1 sivame ukuhlotshaniswa ne-hepatitis engatheleleki. Ngokuphikisana nesizinda se-pancreatic pathology, isiguli singase siqale ukukhulisa amasosha omzimba ngokumelene namaseli wesibindi sakhe. Kulokhu, sikhuluma nge-autoimmune hepatitis, edinga ukubhekwa njalo kwezokwelashwa.
Ukuvela kwe-pathologies kumakhanseleni kuvame ukuholela ekusebenzeni kwesibindi kokuphazamiseka kanye okuphambene nalokho, ngoba imisebenzi yabo ihlobene kakhulu.
I-Cirrhosis ne-hepatosis enamafutha
I-Cirrhosis yisifo sesibindi esingalapheki ngokwemvelo futhi sibonisa ukwephulwa kwesakhiwo sayo esivamile. Izicubu ezixhunywayo ziqala ukukhula kakhulu, futhi izinguquko ze-cicatricial zenzeka kumaseli ayo asebenzayo. Konke lokhu kuholela ekungenakwenzeka komsebenzi ogcwele womzimba kanye nokuwohloka kwenhlala-kahle yesiguli.
Izimbangela ze-cirrhosis zibandakanya:
- ukutheleleka ngegciwane;
- ukusetshenziswa kabi kotshwala
- izilonda fungal;
- ukuhlaselwa kwe-helminthic.
Ngenxa ye-cirrhosis, isibindi asikwazi ukubhidliza kahle i-insulin, okuholela ezingeni layo elikhuphukayo egazini. Umuzwa wezicubu kuleli hormone uyancipha, umuntu uba nesifo se-metabolic, okuyisandulela sesifo sikashukela sohlobo 2.
Uma i-cirrhosis iba khona ngokwasemuva kwe-mellitus yesifo sikashukela, okungajwayelekile kakhulu, ukubonakala kwayo kungathandeki, futhi isifundo siyashesha. Ngenxa yokuphazamiseka okukhulu kwe-metabolic, umzimba wesiguli uya buthaka futhi awukwazi ukumelana nezinye izifo. I-Cirrhosis in diabetesics kunzima kakhulu ukwelapha ngokuqhathaniswa neziguli ezingenakho okubi emzimbeni we-carbohydrate metabolism. Lesi sici singenye yezizathu ezenza ukuthi odokotela ngokwezigaba bangancomi ukuphuza utshwala ezigulini ezinesifo sikashukela.
I-Fatty hepatosis yisimo esibuhlungu sesibindi lapho inani elithile lama-deposits lamafutha linqunywa esakhiweni salo. Amafutha ngokweqile ayawuvimbela ukuthi usebenze ngokujwayelekile, ngenxa yalokho isiguli sinenkinga yokudla okuvela emzimbeni futhi sikhulisa ubungozi bokuthola i-mellitus engavikelekile yesifo sikashukela. Kepha i-hepatosis nayo ingakhula kubantu asebevele benesifo sikashukela sohlobo 1. Ngenxa yokungalingani kwama-hormone kumaseli wesibindi, kwenzeka izinguquko ezibucayi, ezingavinjelwa kuphela ngosizo lokudla nemithi ejwayelekile.
Ama-pathologies wesibindi amaningi anganqunywa yi-ultrasound.
Izimpawu Zokukhubazeka
Akusikhona ukuthi ngaso sonke isikhathi izifo zesibindi ziqala ukukhathaza isiguli ekuqaleni kokuvela kwazo. Ngisho nokukhuluphala kwesibindi kungaba yi-asymptomatic, ngaphezu kwalokho, kungenzeka hhayi kuphela ngokweqile, kepha nangesisindo somzimba esijwayelekile. Ubuhlungu esibindini buvela kuphela lapho i-capsule noma i-bile ducts yazo idonswa enqubweni ye-pathological.
Akuhlehlisiwe ukuvakashela udokotela uma umuntu ephawula lezo zimpawu:
- usizi esiswini ngemuva kokudla;
- Ubuhlungu ku-hypochondrium efanele;
- ukunambitheka okumunyu emlonyeni esiswini esingenalutho noma ngemuva kokudla;
- ukuqhakaza njalo;
- isicanucanu nokuhlanza
- imivimbo yesikhumba;
- ukusabela okwenziwa njalo.
Ngokwazo, lezi zimpawu azikhombisi izinkinga zesibindi, kepha udokotela ofanelekayo kuphela ongathola lokhu futhi athole imbangela yangempela yalesi sifo. Ngaphezu kokuhlolwa kwangaphandle nokubukeka kwesisu, izindlela ezingezelelwe zelebhu kanye nezinsizakalo zingabekelwa umuntu.
Zimbalwa kakhulu iziphetho zezinzwa endaweni yesibindi, ngakho-ke uma kwenzeka inkinga, kungenzeka ukuthi ayizwakali isikhathi eside. Kungakho kudingekile ukuthi ubhekane nezivivinyo ezijwayelekile zokuvimbela udokotela, noma ngabe akukho okulimazayo kumuntu
Ukuxilonga
Ukuxilongwa ngesikhathi sokuphazamiseka kwesibindi kukuvumela ukuthi uqale ngokushesha ukwelashwa okudingekayo futhi wehlise nengozi yokuthola izifo zayo ezinkulu ngokuzayo. Zonke iziguli ezinesifo sikashukela zidinga ukucubungula isibindi se-ultrasound sesibindi, i-gall bladder ne-biliary okungenani okungenani ezinyangeni eziyisithupha.
Ezifundweni zaselebhu ngokuya ngokuhlola umsebenzi owenziwa yilesi sitho, ukuhlolwa kwegazi okunamakhemikhali anjengolwazi:
Isifo sikashukela kanye nokuqina kwamadoda- umsebenzi we-enzyme AST ne-ALT (amartotransferase ye-aspartate ne-alanine aminotransferase);
- izinga le-bilirubin (ngokuqondile nangokungaqondile);
- ingqikithi yamaprotheni;
- i-albhamuin okuhlushwa;
- ukuqoqwa kwe-alkaline phosphatase (ALP) ne-gamma-glutamyltransferase (GGT).
Ngemiphumela yalokhu kuhlaziya (kubizwa nangokuthi "izivivinyo zesibindi") kanye nesiphetho se-ultrasound, isiguli sidinga ukubona udokotela, futhi uma siphambuka kokujwayelekile, ungazenzisi. Ngemuva kokuthola ukuxilongwa okuqondile nokuxilongwa okugcwele, uchwepheshe angancoma ukwelashwa okudingakalayo, ebheka izici zenkambo yesifo sikashukela.
Ukwelashwa
Njengoba isibindi sivame ukuhlupheka ngenxa yokudla inani elikhulu lemithi enolaka, kuphela inani elincane lemithi elisetshenziselwa ukwelashwa kwalo, okuyiqiniso, elingenakusatshalaliswa nalo. Njengomthetho, lokhu kufaka:
- ukwelashwa okuyisidakamizwa okuyisisekelo okuhlose ukulungisa i-carbohydrate metabolism (insulin noma amaphilisi);
- i-hepatoprotectors (izidakamizwa ukuvikela isibindi nokwenza imisebenzi yaso ibe ngejwayelekile);
- i-ursodeoxycholic acid (ithuthukisa ukuphuma kwe-bile futhi ivimbele ukuvuvukala);
- amavithamini kanye nezakhiwo zamaminerali;
- i-lactulose (yokuhlanza umzimba njalo umzimba ngendlela yemvelo).
Isisekelo sokwelashwa okungeyona yezidakamizwa ukudla. Ngezifo zesibindi, isiguli singalandela imigomo yokudla okunempilo okunconyelwe bonke abanesifo sikashukela. Ukudla okumnene nokudla okwanele kwamanzi kusiza ukuguqula izinqubo ze-metabolic, futhi ukwakheka kahle kwamakhemikhali wezitsha kunganciphisa amazinga kashukela. Kusukela kumenyu yeziguli, ushukela kanye nemikhiqizo ekuqukethe, isinkwa esimhlophe nemikhiqizo kafulawa, amaswidi, inyama enamafutha nenhlanzi, inyama ebhemayo kanye no-ukhukhamba akufakiwe ngokuphelele. Kungcono futhi ukwenqaba imifino ethosiwe, ngoba, ngaphandle kokuqukethwe okuphansi kwekhalori nokuqukethwe okune-carbohydrate ephansi, angacasula ama-pancreas futhi andise isimo sesibindi.
Ezinye izidakamizwa zokwelapha isifo sikashukela zine-hepatotoxicity. Le yimpahla engemihle, okuholela ekuphazamisweni kwesibindi nezinguquko ezihlelekile zesakhiwo kuyo. Kungakho, lapho ukhetha umuthi ongapheli, kubalulekile ukuthi i-endocrinologist icabangele wonke ama-nuances futhi yazise isiguli ngemiphumela emibi engenzeka kanye nezimpawu ezethusayo. Ukuqapha njalo ushukela kanye nokulethwa njalo kwegazi lokuhlola igazi kukuvumela ukuthi ubone isikhathi sokuqala kwezinkinga esibindini bese ulungisa ukwelashwa.
