Uxinzelelo lwe-portal: yintoni, iimpawu kunye nonyango

Umxholo

• Iimpawu eziphambili
• Indlela yokuqinisekisa ukuxilongwa
• Yintoni ebangela uxinzelelo lwegazi kwi-portal
• Unyango lwenziwa njani

Uxinzelelo lwe-portal kukonyuka koxinzelelo kwinkqubo yemithambo ethatha igazi lisuka kwizitho zesisu lisiya esibindini, elinokukhokelela kubunzima obufana ne-esophageal varices, hemorrhage, spleen and enite ascites, equka ukudumba kwesisu.

Ngokwesiqhelo, olu hlobo lwexinzelelo lwegazi lwenzeka xa sele kukho ukwenzakala okanye isifo esibindini, njenge-cirrhosis okanye i-schistosomiasis, umzekelo kwaye, ke, ixhaphake kakhulu kwizigulana zesibindi.

Ukunciphisa uxinzelelo kwimithambo yesibindi kuyimfuneko ukunyanga nokuzama ukunyanga ingxaki yesibindi, nangona kunjalo, ukuba oku akunakwenzeka, ugqirha unokuyalela amayeza ukuzama ukulawula uxinzelelo kwaye, kwiimeko ezinzima kakhulu, ukucebisa utyando, umzekelo.

Iimpawu eziphambili

Akusoloko kunokwenzeka ukuba uchonge iimpawu kwimeko yexinzelelo lwe-portal, nangona kunjalo, abantu abanesifo sesibindi esinokubangela i-cirrhosis basemngciphekweni omkhulu wokukhula kwale meko.

Kwiimeko apho kunokwenzeka ukuba uchonge naluphi na uphawu lwexinzelelo lwe-portal, ezona mpawu ziqhelekileyo zibandakanya:

• Isisu esidumbileyo;
• Ii-esophageal varices;
• Ukuphalaza igazi;
• Izitulo ezimnyama kakhulu kunye neentsana;
• Iinyawo nemilenze idumbile;
• Iimpawu.

Kwiimeko ezinzima kakhulu, ukudideka kwengqondo kunye nokuquleka kunokwenzeka, kubangelwa kukufika kweetyhefu kwingqondo. Kodwa le ngxaki inokwenzeka nakwesiphi na isifo sesibindi, kuba umzimba awusakwazi ukucoca igazi ngokufanelekileyo, kwaye akufuneki ukuba unxulumene kuphela noxinzelelo lwegazi.

Kuqhelekile ukuba abantu abane-portal hypertension bafumane i-jaundice, kulapho ulusu namehlo ajika abe tyheli, kodwa olu phawu lubonakala njengesiqhelo sesi sifo esibindini.

Indlela yokuqinisekisa ukuxilongwa

Kwiimeko ezininzi, i-hepatologist inokuchonga imeko yoxinzelelo lwegazi oluphezulu xa umntu enembali yesifo sesibindi kunye neempawu ezinje ngesisu esidumbileyo, imithambo edibeneyo kunye nehemorrhoids, umzekelo.

Nangona kunjalo, iimvavanyo ezininzi zaselebhu, ezinje nge-endoscopy, i-ultrasound okanye uvavanyo lwegazi, kunokuba yimfuneko ukuqinisekisa isifo, ngakumbi xa kungekho zimpawu zibonakalayo zoxinzelelo lwegazi.

Yintoni ebangela uxinzelelo lwegazi kwi-portal

Uxinzelelo lwe-portal luvela xa kukho isithintelo ekujikelezeni kwegazi kwimithambo yesibindi. Ngesi sizathu, esona sizathu siqhelekileyo sisifo sokuqina kwesibindi, imeko apho kuvela khona amanxeba kwinyama yesibindi, ethintela kungekuphela kokusebenza kwelungu, kodwa nokuhamba kwegazi.

Nangona kunjalo, kukho ezinye izizathu eziqhelekileyo, ezinje:

• Thrombosis udakada okanye imithambo wesibindi;
• ISchistosomiasis;
• I-Hepatic fibrosis.

Ukongeza, utshintsho lwentliziyo oluthintela ukujikeleza kwegazi okuqhelekileyo emva kwesibindi kunokubangela uxinzelelo lwegazi. Kwezi meko, ezona ngxaki zixhaphakileyo kukusilela kwentliziyo elungileyo, isifo se-pericarditis okanye isifo se-Budd-Chiari.

Unyango lwenziwa njani

Uninzi lweziganeko zoxinzelelo lwexinzelelo lwezibuko alunanyango, kuba akunakwenzeka ukunyanga isifo esisisiseko. Nangona kunjalo, kunokwenzeka ukulawula iimpawu kunye nokuthintela ukubonakala kweengxaki. Ukulungiselela le nto, ezona ntlobo zonyango zisetyenzisiweyo zibandakanya:

• Unyango oluphezulu lwexinzelelo lwegazi, ezinjenge-nadolol okanye ipropranolol: banciphisa uxinzelelo kwimithambo yegazi kwaye, ke ngoko, banciphisa umngcipheko wokuqhekeka kwee-esophageal varices okanye hemorrhoids;
• Unyango lwesisu, ikakhulu i-lactulose: enceda ekupheliseni i-ammonia kunye neetyhefu ezifumanekayo emzimbeni, ukunceda ukulwa nokudideka;
• Unyango lwe-Endoscopic: Isetyenziselwa ukunyanga ii-varices esophageal varices kunye nokubathintela ekuphukeni.
• Ugqirha: inokwenziwa ukuguqula ukujikeleza kwegazi lesibindi kwaye, ke, ukunciphisa uxinzelelo kwinkqubo ye-portal, kungenjalo, ukwenza ukufakelwa kwesibindi, umzekelo.

Ukongeza, ukuthintelwa kwetyuwa kunye nokusetyenziswa kwe-diuretics, enje nge-furosemide, kuyacetyiswa ukulawula i-ascites kunye nokuthintela iingxaki zezintso.

Kubalulekile ukuba umntu one-portal hypertension abe nenkathalo yemihla ngemihla ukulawula isifo sesibindi kunye nokuthintela ukwanda koxinzelelo lwegazi kunye nezinye iingxaki. Ke kuyacetyiswa ukuba kuthintelwe ukusela iziselo ezinxilisayo kunye nokubheja kukutya okunamafutha asezantsi. Bona ngakumbi malunga nokhathalela xa unesifo sesibindi.