Pokanga hei whakamama i te pēhanga i roto i ngā oko toto o te ate: Kia mōhio tātou ki te DSRS (Distal Splenorenal Shunt)

He tino hira te ate i roto i tō tātou tinana. Engari nā ētahi mate , inā koa ka pakaru te ate , ka nui haere te pēhanga i roto i ngā uaua toto e hono ana ki reira. Ka taea e tēnei te arahi ki ngā āhuatanga morearea pērā i te ruaki toto ohorere. I tēnei rā ka kōrero tātou mō tētahi pokanga motuhake e mahia ana hei whakaora i ngā oranga i roto i ēnei āhuatanga. Ka kiia tēnei ko te pokanga DSRS.

He aha te Distal Splenorenal Shunt (DSRS)?

He whakarāpopototanga noa iho, ko te Distal Splenorenal Shunt (DSRS ) he tikanga pokanga e whakaiti ana i te pēhanga i roto i tō uaua portal. Tērā pea kei te whakaaro koe he aha te uaua portal. Ko te uaua portal te uaua toto matua e kawe ana i te toto mai i te ara kai ( puku , whekau, me ētahi atu) ki te ate.

Ko ētahi āhuatanga hauora ka nui rawa te pikinga o te pēhanga i roto i tēnei uaua. Ka kiia e mātou ko te Portal Hypertension . Ka whakamahia e ngā taote pokanga tēnei tikanga DSRS hei whakahaere i te toto me ētahi atu raruraru i puta mai i tēnei pēhanga teitei.

Tuatahi, kia mārama tātou he aha te Portal Hypertension?

Ko te toto toto tiketike o te portal, e ai ki tā mātou i kōrero ai i mua ake nei, ko te toto toto tiketike i roto i te uaua portal. Ko te tino take o tēnei ko te kino o te ate. Hei tauira, ka taea e te mate pēnei i te cirrhosis te whakakeke i te ate, ka aukati i te rere o te toto i roto.

Whakaarohia te mea ka tupu mēnā ka āraia he paipa wai i waenganui. Ka piki ake te pēhanga i roto i te paipa, ā, ka ngana te wai ki te puta mai i ētahi atu wāhi, tika? Waihoki, ina kore e taea e te toto te haere mā te ate, ka piki ake te pēhanga i roto i te uaua tomokanga.

Nā te nui o te toto e rere ana, ka tīmata te toto ki te kimi huarahi kē atu hei rere. Ko ēnei oko toto hou, ngoikore te pakitara, koia ēnei e kiia nei e tātou ko ngā 'varices' . Ko te nuinga o ēnei ka puta i roto i tō korokoro me tō puku.

I te pikinga o te pēhanga, ka pupuhi ēnei varicose, ka angiangi, ka ngoikore hoki ō rātou pakitara. Ka taea e rātou te turuturu wai ki roto i te puku (e kiia ana tēnei ko te ascites ), ā, ko te mea tino morearea ko te pahū ka tīmata te toto. He āhuatanga ohorere hauora tēnei.

He aha tonu te mea e tupu ana i te wā o te pokanga DSRS?

Ko te mahi a te pokanga DSRS mā te tahuri ke i te rere nui o te toto i roto i te uaua portal me te whakaiti i tōna pēhanga. He rite tēnei ki te hanga i tētahi ara whakawhiti hou hei whakamama i te waka taumaha i roto i te tāone.

I tēnei mahi, ka mahia e te taote pokanga ngā mahi e whai ake nei:

1. Kua wehea te uaua whēkau o tō whēkau mai i te uaua portal.

2. Kātahi ka honoa te uaua whēkau kua wehea ki te uaua whatukuhu o tō whatukuhu maui.

Mā te waihanga i tētahi ara hou mō te rere o te toto i tēnei ara, ka whakaitihia te pēhanga i roto i te uaua portal, ka whakaitihia te pupuhi o ngā varices, ā, kua hangaia te pokanga kia mau tonu te ate ki te whiwhi i te toto e hiahiatia ana.

Ko wai e hiahia ana ki te pokanga DSRS?

Tērā pea ka tūtohutia tēnei pokanga mēnā ka kitea e tō tākuta kua nui haere, kua toto rānei ō uaua esophageal, o te puku rānei (varices). He otinga anō hoki tēnei mō ētahi atu raruraru e pā mai ana i te Portal Hypertension.

Ka taea e te ripanga i raro nei te whakamārama atu i tēnei.

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

Ko te whāinga matua o ngā maimoatanga shunt katoa mō te toto toto tiketike ko te whakaiti i te pēhanga i roto i te uaua portal me te whakahaere i te toto. Heoi, he rerekētanga te huarahi e mahia ai ēnei.

• Te Huringa Portosystemic Intrahepatic Transjugular (TIPS): Ehara tēnei i te pokanga. Ko te whakaurunga he ngongo rite ki te catheter mā roto i te uaua i te kaki, ka hanga he hononga i waenga i te uaua portal me te uaua ate i roto i te ate. He mea noa ake tēnei tikanga TIPS i te DSRS i ēnei rā.
• Proximal splenorenal shunt: He tikanga pokanga anō hoki tēnei. Heoi anō, me tango pea te whēkau.
• Te pokanga splenorenal tūpono (SSRS): Ehara tēnei i te pokanga. He hononga e hangaia ana e te tinana ina tino kino te mate ate. He tohu tēnei kua tino horapa te mate.

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

Ka pātai tuatahi tō tākuta mō tō hītori hauora, ā, ka tirotirohia koe. Kātahi ka whakahaerehia e rātou ētahi whakamātautau hei whakatau i tō hauora whānui, te mahi a te ate, me te kaha o tō toto toto tiketike.

Kei roto pea i ēnei whakamātautau:

• Ngā whakamātautau toto
• Ngā whakamātautau mahi ate
• X-ray o te uma
• ECG (Electrocardiogram)
• Angiogram - He whakamātautau motuhake tēnei e tirotiro ana i te āhua o ngā uaua toto.
• Endoscopy o runga - te tirotiro i te roto o te esophagus me te puku mā te whakamahi i te ngongo me te kāmera

Ma tō tīma hauora koe e hoatu he huinga tohutohu mārama i mua i te pokanga.

• He aha ngā rongoā me mutu te tango i mua i te pokanga?
• He aha ngā mea me mauria e au ina tae mai ahau ki te hōhipera?
• Te wā tika hei whakamutu i te kai me te inu i mua i te pokanga.

He aha ngā mea ka tupu i te wā o te pokanga?

E whā hāora te roa o te pokanga DSRS. Tuatahi, ka hoatu he rongoā whakamoe whānui ki a koe. Ko te tikanga kāore koe e mamae, ā, kua moe katoa koe.

Kātahi ka tae mai te tīma pokanga, e ai ki tā tātou i kōrero ai i mua ake nei:

1. Kua wehea te uaua whēkau mai i te uaua portal.

2. Tangohia taua uaua ka hono atu ki te uaua whatukuhu o te whatukuhu maui.

He aha taku e tumanako ai 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 whakatakotoria he katitere rangitahi hei tango i te mimi.
• Ka whakauruhia he ngongo nasogastric mā roto i te ihu mō te 24 hāora hei tango i te hau me ngā wai mai i te puku.
• Ka whakanohoia he IV ki roto i tētahi uaua i tō kaki hei hoatu rongoā me ngā wai ki a koe.
• 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. Ina taea e koe te kai me te inu, ka hoatu he wai ki a koe i te tuatahi, kātahi ka hoatu he kai 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 .

He tūponotanga kei roto i tēnei pokanga?

Pērā i ngā pokanga katoa, he tūponotanga kei reira, engari he tikanga haumaru, he angitu hoki te DSRS.

Ka nui ake te mōrearea o te toto anō i te marama tuatahi i muri i te pokanga. Kaua e manukanuka. Mā tō rōpū hauora koe e āwhina ki te whakahaere i tēnei mōrearea, ā, mā rātou anō koe e whakamōhio atu.

Me aha koe i te wā e ora ana koe i muri i te hokinga ki te kāinga?

He mea tino nui kia ata whai i ngā tohutohu a tō tākuta me tō kaiora kia tere ai tō ora. Pātai atu ki tō tākuta āhea koe ka taea te hoki anō ki ngā mahi o ia rā me te whakakori tinana.

Me whai whakamātautau toto auau koe hei tirotiro i te mahi a tō ate. Kaua rawa e mahue ō wā tirotiro. Ka aroturuki tonu tō tākuta i tō āhua, ā, ka hoatu e ia ngā tohutohu e hiahiatia ana e koe kia noho hauora ai.

He aha ngā tohu e hiahia ana kia rapua he awhina hauora tonu?

• 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 mataku me te manukanuka ina rongo koe kei a koe tētahi mate pēnei i te Portal Hypertension. Engari ka noho tahi tō tākuta me koe, ka aroturuki i ō tohumate, ā, ka āwhina i a koe ki te whakahaere i aua tohumate. Mena e tika ana, ka taea e te pokanga pēnei i te DSRS te āwhina i te whakahaere i tō mōrearea o te toto me te āwhina i a koe kia ora pai ake.