Yonke into ekufuneka uyazi ngePortal Hypertension

Umxholo

• Inyaniso ekhawulezayo
• Iimpawu
• Oonobangela
• Imiba yomngcipheko
• Uxilongo
• Unyango
• Iingxaki
• Imbonakalo
• Iingcebiso zokuthintela
• I-Q & A: Uxinzelelo lwePortal ngaphandle kwesibindi
• Q:
• A:

Ushwankathelo

I-portal vein ithwala igazi esiswini sakho, kwi-pancreas, nakwamanye amalungu okugaya kwisibindi sakho. Yahlukile kwezinye iimithambo, zonke ezihambisa igazi entliziyweni yakho.

Isibindi sidlala indima ebalulekileyo ekujikelezeni kwakho. Icoca i-toxins kunye nenye inkunkuma ebekwe kumalungu ethu okugaya egazini lakho. Xa uxinzelelo lwegazi kwi-portal vein luphezulu kakhulu, une-portal hypertension.

Uxinzelelo lwe-portal lunokuba lubi kakhulu, nangona luyanyangeka ukuba lufunyenwe ngexesha. Akusoloko kulula ukuxilonga, nangona kunjalo. Ngokwesiqhelo, uya waziswa ngemeko xa uqala ukufumana iimpawu.

Inyaniso ekhawulezayo

Iimithambo zithwala igazi eline-oksijini ephuma entliziyweni yakho iye kumalungu akho, izihlunu, kunye nezinye izicwili. Imithambo ibuyisela igazi entliziyweni yakho, ngaphandle kwe-portal vein, ehambisa igazi kwisibindi sakho.

Iimpawu

Ukopha emathunjini kuhlala kungumqondiso wokuqala wexinzelelo lwegazi. Umnyama, izitulo zokulinda zingangumqondiso wokopha kwesisu. Unokwabona igazi kwizitulo zakho.

Olunye uphawu yi-ascites, eyakha ulwelo esiswini sakho. Ungaqaphela ukuba isisu sakho siyakhula ngenxa ye-ascites. Le meko inokubangela nesitampu, ukudumba kunye nokuphefumla okufutshane.

Kananjalo, ukulibala okanye ukudideka kunokuba sisiphumo sengxaki yokujikeleza enxulumene nesibindi sakho.

Oonobangela

Unobangela ophambili wexinzelelo lwe-portal yi-cirrhosis. Oku kukukrala kwesibindi. Inokubangela iimeko ezininzi ezinje nge-hepatitis (isifo sokudumba) okanye utywala.

Izifo ezisebenza ngokuzimela kwesibindi ezinje nge-autoimmune hepatitis, isifo sokuqaqanjelwa sisifo esikunyango, kunye ne-biliary cholangitis ephambili ikwangunobangela we-cirrhosis kunye ne-portal hypertension.

Nanini na xa kwenzekile isibindi sakho, siyazama ukuzinyanga. Oku kubangela ukuba izicubu ezibomvu zenze. Ukunqongophala okuninzi kwenza kube nzima kwisibindi sakho ukwenza umsebenzi waso.

Ezinye izizathu ze-cirrhosis zibandakanya:

• isifo sesibindi esinamafutha esingatyisi
• intsimbi yokwakha emzimbeni wakho
• icystic fibrosis
• imibhobho yenyongo engaphuhlanga kakuhle
• izifo zesibindi
• ukuphendula kumayeza athile, njenge-methotrexate

I-Cirrhosis inokubangela ukuba iindonga zangaphakathi ezigudileyo zangaphakathi kwe-portal vein zingaqheleki. Oku kunokunyusa ukumelana nokuhamba kwegazi. Ngenxa yoko, uxinzelelo lwegazi kwi-portal vein iyanda.

Ihlwili legazi linokuphinda lenze kwi-portal vein. Oku kunokunyusa uxinzelelo lokuhamba kwegazi ngokuchasene neendonga zomthambo wegazi.

Imiba yomngcipheko

Abantu abasemngciphekweni okhulayo we-cirrhosis basemngciphekweni wokonyuka koxinzelelo lwegazi. Ukuba unembali ende yokusetyenziswa gwenxa kotywala, ujongene nomngcipheko ophezulu wokuqina kwesibindi. Usemngciphekweni omkhulu wesifo sokudumba kwesibindi ukuba kukho oku kulandelayo okusebenzayo kuwe:

• Usebenzisa iinaliti ukutofa iziyobisi.
• Wafumana iitattoo okanye ukugqojozwa kwindawo engacocekanga.
• Usebenza kwindawo apho unokudibana neenaliti ezosulelekileyo okanye igazi elosulelekileyo.
• Utofelwe igazi ngaphambi kowe-1992.
• Umama wakho unesifo sokudumba kwesibindi.
• Ukwabelana ngesondo ngokungakhuselekanga namaqabane amaninzi.

Uxilongo

Uxinzelelo lwe-portal kunzima ukufumanisa ukuba iimpawu azicacanga. Ukuhlolwa okunje nge-doppler ultrasound kuluncedo. I-ultrasound inokutyhila imeko ye-portal vein kunye nendlela igazi elihamba ngayo. Ukuba i-ultrasound ayihambelani, ukuskena kwe-CT kunokuba luncedo.

Enye indlela yokujonga esetyenziswa ngokubanzi kukulinganisa ukuqina kwesibindi sakho kunye nezicubu ezijikelezileyo. I-Elastography ilinganisa indlela izicubu eziphendula ngayo xa zityhalwa okanye zifunwa. Ukutyeba okungalunganga kubonisa ukuba kukho izifo.

Ukuba ukopha kwamathumbu kwenzekile, uya kuba novavanyo lwe-endoscopic. Oku kubandakanya ukusetyenziswa kwesixhobo esincinci, esiguquguqukayo esinekhamera kwelinye icala evumela ugqirha wakho ukuba abone amalungu angaphakathi.

Uxinzelelo lwe-vein yegazi luxinekile ngokufaka i-catheter efakwe uxinzelelo lwegazi kumthambo wesibindi sakho kwaye uthathe umlinganiso.

Unyango

Utshintsho kwindlela yokuphila enje ngala inokunceda ukunyanga uxinzelelo lwegazi kwi-portal:

• ukuphucula ukutya kwakho
• ukunqanda ukusela utywala
• ukuzilolonga rhoqo
• ukuyeka ukutshaya ukuba uyatshaya

Amayeza anjenge-beta-blockers nawo ayanceda ekunciphiseni uxinzelelo lwegazi kunye nokuphumla kwemithambo yegazi. Olunye unyango, njengepropranolol kunye ne-isosorbide, lunokunceda ukunciphisa uxinzelelo kwi-portal vein, nayo. Banokunciphisa umngcipheko wokopha okungaphezulu ngaphakathi.

Ukuba ufumana i-ascites, ugqirha wakho unokumisela i-diuretic ukunceda ukunciphisa amanqanaba e-fluid emzimbeni wakho. Isodiyam kufuneka ithintelwe ngokuqatha ukunceda ukunciphisa ukugcinwa kwamanzi.

Unyango olubizwa ngokuba yi-sclerotherapy okanye i-banding lusebenzisa isisombululo esinokukunceda uyeke ukopha kwimithambo yegazi yesibindi sakho. Ukubopha ibhendi kubandakanya ukubekwa kweebhendi zerabha ukunqanda ukuhamba kwegazi okungenampilo kwimithambo eyandisiweyo, eyaziwa ngokuba yi-varices okanye varicose veins, kwinkqubo yakho yokwetyisa.

Olunye unyango olwandayo lubizwa ngokuba yi-transversion transjugular intrahepatic portal-systemic shunt (TIPSS). Olu nyango lunceda ukulawula ukopha kakhulu. Yenza iindlela ezintsha zokuhamba kwegazi ukusuka kumngxuma wesango ukuya kweminye imithambo yegazi.

Iingxaki

Enye yeengxaki eziqhelekileyo ezinxulunyaniswa noxinzelelo lwe-portal yi-portal hypertensive gastropathy. Imeko ichaphazela inwebu yencindi yesisu sakho kwaye yandisa imithambo yegazi.

Iindlela ezenziwe phakathi kwemithambo yegazi kwi-TIPSS zinokuvaleka. Oku kunokukhokelela ekuphumeni kwegazi. Ukuba iingxaki zesibindi ziyaqhubeka, unokuba nezinye iingxaki zokuqonda.

Imbonakalo

Awunakho ukuwutshintsha umonakalo obangelwe kukuqina kwesibindi, kodwa unganyanga i-portal hypertension. Ingathatha indibaniselwano yendlela yokuphila esempilweni, amayeza, kunye nongenelelo. Ukulandelelwa kwee-ultrasound kuya kufuneka ukubeka esweni impilo yesibindi sakho kunye neziphumo zenkqubo ye-TIPSS.

Iya kuba nguwe ukuthintela utywala kwaye uphile impilo esempilweni ukuba une-portal hypertension. Kuya kufuneka ukuba ulandele imiyalelo kagqirha wakho. Oku kuya kunyango kunye nokuqeshwa okulandelayo.

Iingcebiso zokuthintela

Sela utywala ngokuphakathi, ukuba kunjalo. Kwaye uthathe amanyathelo okuphepha i-hepatitis. Thetha nogqirha wakho malunga nokugonywa kwe-hepatitis kunye nokuba ufanele ukuba unayo. Unokufuna kwakhona ukuba uhlolwe i-hepatitis ukuba uhlala kwiqela elisemngciphekweni.

Uxinzelelo lwe-portal lubangelwa kukuwohloka kwempilo yesibindi, kodwa unokukwazi ukusiphepha esi sifo sinengxaki ngokukhetha indlela yokuphila esempilweni.

I-Q & A: Uxinzelelo lwePortal ngaphandle kwesibindi

Q:

Ngaba ungaluphucula uxinzelelo lwexinzelelo lwe-portal ngaphandle kwesibindi?

Isigulana esingaziwayo

A:

Kunokwenzeka, nangona kunqabile. Uxinzelelo lwe-portal ngaphandle kwe-cirrhosis ibizwa ngokuba yi-idiopathic non-cirrhotic portal hypertension (INCPH). Kukho iindidi ezintlanu ezibanzi zoonobangela be-INCPH: ukuphazamiseka komzimba, usulelo olungapheliyo, ukubonakaliswa kwetyhefu okanye amayeza athile, ukuphazamiseka kwemfuza, kunye neemeko zeprothrombotic. Uninzi lwezi ndidi lunokutshintsha ukujija okuqhelekileyo kwaye lubangele amahlwili amancinci ukuba enze, ekhokelela kwi-INCPH. Abantu abane-INCPH bahlala benembono engcono kuba banesibindi esisebenza ngokuqhelekileyo.

UCarissa Stephens, umongikazi we-ICU wabantwana Iimpendulo zimele uluvo lweengcali zethu zonyango. Yonke imixholo inolwazi ngokungqongqo kwaye akufuneki ukuba ithathelwe ingqalelo njengengcebiso yezonyango.