He otinga mō te toto i puta mai i ngā mate ate: Me ako tātou mō te pokanga Distal Splenorenal Shunt (DSRS)

Ko te ate tētahi o ngā okana tino nui o te tinana. Engari i ētahi wā, ka pā mai ngā raruraru nui ki roto i te tinana nā te kino o te ate, kāore e kitea. Ko tētahi o aua raruraru ko te pikinga o te pēhanga i roto i ngā uaua e kawe ana i te toto ki te ate. Ka taea e tēnei pēhanga teitei te whakaputa toto kino. I tēnei rā kei te kōrero tātou mō tētahi pokanga motuhake ka taea te āwhina i te whakaora i ngā oranga i roto i ēnei āhuatanga. Ko te Distal Splenorenal Shunt, ko te pokanga DSRS rānei.

He aha tēnei 'Portal Hypertension'?

Me whakarāpopoto noa iho tēnei. Whakaarohia kua āraia te paipa wai matua o tō whare. Ka ahatia? Ka mau te wai ki tētahi wāhi, ka piki te pēhanga, ā, i ētahi wā ka tīmata te turuturu mai i ētahi atu wāhi. Ka pērā anō te āhua o roto i ō tātou tinana.

I muri i te nakunaku o te kai e kainga ana e tātou, ka haria te toto kua mimiti i aua matūkai ki te ate mā roto i tētahi oko toto nui e kiia nei ko te uaua tomokanga . Mēnā kua pakaru te ate i tētahi ara (hei tauira, nā tētahi āhuatanga pēnei i te cirrhosis), kāore e taea e te toto te rere ngāwari mā roto i tēnei uaua tomokanga. He rite ki tētahi paipa wai e mau ana.

Ina āraia te rere o te toto i tēnei ara, ka tino piki te pēhanga i roto i te uaua portal. Ka kiia tēnei ko te 'Portal Hypertension' .

Nā te nui o te toto toto, ka tīmata te toto ki te kimi huarahi kē atu. He maha ngā wā ka puta mai ēnei oko toto hou (e kiia ana ko ngā varices ) i roto i te puku, i te korokoro rānei. He uaua ngoikore rawa ēnei, he angiangi te pakitara. Ina piki haere te toto toto, ka pupuhi, ka pakū, ka tīmata te toto. He āhuatanga morearea tēnei e hiahia ana kia rongoatia wawetia.

Nā, he aha te mahi a tēnei pokanga DSRS?

Ko te pokanga DSRS, ki te kī māmā noa iho, he 'arai' hou mō te rere o te toto kua āraia. Ko tēnei pokanga he tahuri ke i ētahi toto mai i te pūnaha uaua tomokanga pēhanga teitei ka tukuna ki tētahi wāhi pēhanga iti iho.

Anei te huarahi ki te mahi i tēnei:

Ka āta wehea e te taote pokanga te uaua whēkau mai i te uaua portal, kei raro i te pēhanga teitei. Kātahi ka honoa te uaua ki te uaua whatukuhu i roto i tō whatukuhu maui. He uaua pēhanga iti te uaua whatukuhu, he porowhita pai.

He rite ki te tango i ētahi waka i tētahi rori pukumahi, ka tukuna atu ki tētahi rori kāore i te tino pukumahi. Ka whakaitihia te pēhanga i roto i te uaua portal, ka āwhina i te whakahaere i te mōrearea o te toto kino.

Āhea te wā e hiahiatia ai te pokanga DSRS?

I muri i te whakahaerenga a tō tākuta i ngā whakamātautau maha, ka tūtohu pea ia i tēnei pokanga mēnā kei te pupuhi, kei te toto rānei ngā uaua varicose i roto i tō korokoro, i tō puku rānei. Hei tāpiri, ka taea hoki e tēnei pokanga te āwhina ki te whakahaere i ētahi atu raruraru i puta mai i te toto toto tiketike.

He aha te rerekētanga i waenga i te DSRS me ētahi atu momo shunt?

He maha ngā momo pokanga e whakamahia ana hei whakaiti i te pēhanga i roto i te uaua portal. Ko te whāinga matua o ēnei katoa ko te whakahaere i te toto.

• Te Tātaritanga Splenorenal Distal (DSRS): Koinei te pokanga e kōrerohia ana ināianei. Kei roto i tēnei ko te mahi pokanga tuwhera me te hanga i tētahi arai mā te whakamahi i tētahi uaua i roto i te tinana.
• Te Huringa Portosystemic Intrahepatic Transjugular (TIPS):He rerekē tēnei i te DSRS. Kāore e hiahiatia he pokanga nui. Engari, ka whakauruhia he ngongo angiangi, pērā i te catheter, mā roto i te uaua i te kaki, ka hono i te uaua tomokanga ki te uaua matua e puta atu ana i te ate (uaua hepatic) mai i roto i te ate. Koinei te tikanga e whakamahia whānuitia ana i tēnei wā.

Mā tō tīma hauora e whakatau ko tēhea tikanga te mea pai mōu.

He aha ngā mea hei tumanako atu i mua i te pokanga?

I mua i te whakarite i tō pokanga, ka tangohia e tō tākuta tō hītori hauora katoa, ā, ka whakahaerehia he whakamātautau tinana. Tērā pea ka tonoa e rātou ētahi whakamātautau hei aromatawai i tō hauora whānui, te mahi a te ate, me te kaha o tō toto toto tiketike.

Kei roto pea i tēnei:

• Ngā whakamātautau toto
• Ngā whakamātautau mahi ate
• X-ray o te uma
• Whakamātautau EKG
• Angiogram - hei tirotiro i te āhua o ngā oko toto
• Endoscopy o runga - hei tirotiro i roto i te korokoro me te puku

Mā te tīma hauora koe e hoatu he tohutohu mārama mō te whakarite mō te pokanga. Hei tauira, mā rātou koe e kī atu he aha ngā rongoā hei whakamutu i te tango, he aha ngā mea hei kawe mai ki te hōhipera, me te wā hei whakamutu i te kai me te inu. Pātai atu ki a rātou mō ngā pātai, ngā āwangawanga rānei kei a koe i tēnei wā.

Me pēhea te mahi i te pokanga?

E whā hāora te roa o te pokanga DSRS. Tuatahi, ka tukuna koe ki raro i te mate whakamoe whānui. Nō reira, kei te moe koe i te roanga o te pokanga, ā, kāore koe e mamae. E ai ki tā mātou i kōrero ai i mua ake nei, ka āta tangohia e te tīma pokanga te uaua whēkau ka hono atu ki te uaua whatukuhu.

He aha ngā mea ka tupu i muri i te pokanga?

I muri i te pokanga, me noho koe ki te hōhipera mō te wiki, tekau rānei ngā rā. I tēnei wā, ka tiakina pai koe e te tīma hauora.

• Ka whakauruhia he katitere rangitahi hei tango i te mimi.
• Ka whakauruhia he ngongo nasogastric (ngongo NG) mō te 24 hāora hei tango i te hau me te wai mai i te puku.
• Ka honoa he aho tote (IV) ki tētahi uaua i te kaki hei hoatu rongoā me ngā wai.
• Ka hoatu ki a koe he papu mamae e whakahaerehia ana e koe anō hei whakahaere i te mamae.

Tata ki te wiki i muri i te pokanga, ka whai angiogram anō koe hei tirotiro kei te tika te mahi a te shunt hou. Ina taea e koe te kai, ka whakamōhiotia mārire koe ki ngā wai me ngā totoka. I mua i tō hokinga ki te kāinga, ka tūtaki te tohunga kai ki a koe ki te matapaki i tētahi kai e tika ana māu. He maha ngā wā ka tūtohuhia he kai iti te tote, iti te ngako.

Āhea koe me rapu tohutohu hauora tonu?

I muri i tō hokinga ki te kāinga, me tino tiaki koe i tō oranga. Mēnā ka puta mai tētahi o ngā tohu e whai ake nei, waea atu ki tō tākuta tonu atu, haere rānei ki te Tari Whawhati Tata (ETU) o te hōhipera tata ki a koe.

• Maremare
• Te uaua ki te manawa
• Hei maka karakia
• Kirika
• Mamae o te uma
• Te werawera nui atu i te tikanga

He mea noa te māharahara me te manukanuka mō te mahi i tēnei momo pokanga. Engari kia maumahara, he huarahi tino whai hua te DSRS hei tiaki i a koe mai i ngā raruraru kino o te toto toto tiketike.