Hepatopulmonary syndrome: yintoni, iimpawu kunye nonyango

Umxholo

• Ziintoni iimpawu
• Yintoni ebangela hepatopulmonary syndrome
• Uxilongo lwenziwa njani
• Yintoni unyango

I-hepatopulmonary syndrome ibonakaliswa ngokuxinwa kwemithambo kunye nemithambo yemiphunga eyenzeka kubantu abanexinzelelo lwegazi kwi-portal vein yesibindi. Ngenxa yokwandiswa kwemithambo yemiphunga, isantya sentliziyo siyonyuka sibangela ukuba igazi elimpontshelwe emzimbeni lingabinayo ioksijini eyaneleyo.

Unyango lwesi sifo luquka unyango lweoksijini, ukunciphisa uxinzelelo lwe-portal vein kwaye, kwiimeko ezinzima kakhulu, ukufakelwa kwesibindi.

Ziintoni iimpawu

Iimpawu ezinokuthi zenzeke kubantu abane-syndrome ukuphefumula okufutshane xa bemi okanye behleli. Ukongeza, uninzi lwabantu abane-hepatopulmonary syndrome bakwanazo neempawu zesifo sesibindi esinganyangekiyo, ezinokwahluka, kuxhomekeke kwingxaki ebangela oko.

Yintoni ebangela hepatopulmonary syndrome

Ngaphantsi kweemeko eziqhelekileyo, i-endothelin 1 eveliswa sisibindi inomsebenzi wokulawula ithoni yemithambo yemiphunga kwaye xa ibophelela kwii-receptors ezikwi-vascular smooth muscle tissue, i-endothelin 1 ivelisa i-vasoconstriction. Nangona kunjalo, xa ibophelela kwii-receptors ezikwi-pulmonary vascular endothelium, ivelisa i-vasodilation ngenxa yokuhlanganiswa kwe-nitric oxide. Ke, i-endothelin 1 ibhalansi ye-vasoconstrictor kunye nefuthe le-vasodilator kwaye inceda ukugcina umoya ongenisa umoya ngaphakathi kwiiparameter eziqhelekileyo.

Nangona kunjalo, xa kwenzeka ukulimala kwesibindi, i-endothelin ifikelela ekujikelezeni kwemiphunga kwaye inxibelelana ngokukhethekileyo ne-pulmonary vascular endothelium, ikhuthaza i-vasodilation ye-pulmonary. Ukongeza, kwi-cirrhosis kukho ukonyuka kwamanqanaba e-alpha ye-tumor alpha, enegalelo ekuqokeleleni ii-macrophages kwimbonakalo yeenqanawa ze-pulmonary ezikhuthaza ukuveliswa kwe-nitric oxide, ekonyusa i-vasodilation yemiphunga, ethintela i-oxygenation yazo zonke igazi elimpontshelwe.emiphungeni.

Uxilongo lwenziwa njani

Ukuxilongwa kubandakanya ukuvavanywa kwezonyango kunye neemvavanyo ezinjenge-echocardiography eyahlukileyo, i-scutigraphy yenyukliya yemiphunga, iimvavanyo zomsebenzi we-pulmonary.

Ukongeza, ugqirha unokulinganisa ubungakanani beoksijini egazini nge-oximetry. Jonga ukuba yintoni ioximetry kunye nendlela elinganiswa ngayo.

Yintoni unyango

Olona nyango luphambili lwe-hepatopulmonary syndrome kukulawulwa kweoksijini eyongezelelweyo yokuphelisa ukuphefumla okufutshane, nangona ixesha lihamba kufuneka isidingo sokongezwa kweoksijini.

Okwangoku, akukho longenelelo lwe-pharmacological lubonakaliswe ukuba lutshintshe kakhulu kwaye luphucula i-oxygenation ye-arterial. Ke, ukufakelwa isibindi kuphela kwendlela efanelekileyo yokunyanga isisombululo sale ngxaki.