Zvaunofanira kuziva nezveHepatopulmonary Syndrome!

Kana iwe kana mumwe munhu waunoziva ane chirwere chechiropa, kana kuti iwe pachako uine chirwere ichi, zvakakosha kuziva nezvechirwere ichi chinogona kukonzera kutadza kufema. Tinochidana kuti Hepatopulmonary Syndrome. Zita racho ringanzwika serakaoma, asi ngatirambei tichiri nyore, handiti? Nekuti idambudziko rinobva pachiropa kuenda kumapapu.

Chii chaizvo chinonzi Hepatopulmonary Syndrome?

Zvichitaurwa zviri nyore, chirwere chehepatopulmonary syndrome idambudziko risingawanzoitiki asi rakakomba rechirwere chechiropa chinogona kukanganisa mapapu. Izwi rekuti "hepato" rinoreva "zvine chekuita nechiropa." "pulmonary" zvinoreva "zvine chekuita nemapapu." Waizviziva here kuti chiropa nemapapu edu zvakabatana netsinga dzeropa?

Fungidzira, kana munhu aine chirwere chechiropa, kunyanya chirwere chakadai secirrhosis, apo chiropa chinooma uye chinopera simba, dzimwe tsinga dzeropa dzakabatana nemapapu dzinokura zvisina kufanira. Sekunge bharumu rinoputika. Mukurapa, tinodana izvi kuti "Vasodilation" . Kana tsinga dzeropa dzichikura nenzira iyi, maitiro akajairika ekuyerera kweropa mumapapu anochinja. Dzimwe nguva, ropa harisangani neokisijeni mumapapu zvakanaka, asi rinopfuura nepakati pawo zvakananga. Kuyerera kweropa kwakadaro kusingawanzoitiki kunonzi "Shunts" . Kukura kwetsinga dzeropa mumapapu kunokonzerwa ne "Vasodilation", uye huwandu hweokisijeni muropa hunoderera nekuda kwe "Shunts" idzodzo. Tinodaidza izvi kuti "Hypoxemia" . Unonzwisisa here?

Dambudziko iri rinokukanganisa sei? Uri kunetseka kufema here?

Zvino ungave uchifunga kuti, "Zvakanaka, izvi zvinondikanganisa sei?" Chinhu chikuru chinokanganisa izvi kuoma kwekufema (Dyspnea) . Izvi hazvingoerekana zvaitika, asi zvinowedzera zvishoma nezvishoma. Vamwe vanhu vangasazviona zvakanyanya pakutanga. Asi nekufamba kwenguva, chirwere ichi chinogona kutowedzera zvakanyanya zvekuti chinova chakaoma kufema kunyangwe wakamira wakamira.

Vamwe vanhu vanoomerwa nekufema pavanenge vakagara kana vakamira, asi vanonzwa zviri nani pavanenge vakarara. Kune vamwe, zvakasiyana; vanonetseka nekufema pavanenge vakarara, uye vanonzwa zviri nani pavanenge vakagara. Zvisinei, nekuda kwekuti kupfupika uku kwekufema kunowedzera kuipa nekufamba kwenguva, tinokudana kuti Chronic Respiratory Failure. Izvi zvinoreva kuti zvese hazvimire kamwe kamwe, asi zvishoma nezvishoma nhengo dzemuviri wako nenyama hadzina kuwana oxygen yakakwana. Tinodana izvi kuti hypoxia .

Ichi chirwere chine njodzi zvikuru. Unoziva here? Okisijeni inokosha kumiviri yedu. Kana ikarasikirwa zvachose, inogona kukonzera kukuvara kwechigarire kunhengo dzinokosha dzakadai seuropi nemoyo. Kana ikasarapwa zvakanaka, chirwere ichi chinogona kuisa hupenyu panjodzi.

Ndiani ane mukana mukuru wekuwana chirwere chehepatopulmonary syndrome?

Ongororo yakawana kuti chikamu chimwe muzvina, kana kuti 25%, yevanhu vane chirwere chechiropa chisingaperi vanowana chirwere chehepatopulmonary syndrome. Chinogonawo kuitika kana chiropa chikangoerekana chakundikana zvakanyanya, chinonzi acute liver failure, asi hazviwanzoitiki.

Kazhinji, izvi ndizvo zvinoitika: Kurwara kwechiropa kunokonzera kuwedzera kwekumanikidzwa mutsinga dzeropa dzakabatana nechiropa. Mukurapa, tinozvidaidza kuti ``Portal Hypertension'' . Dambudziko rekuti ``Portal Hypertension'' ndiro rinoita kuti tsinga dzeropa mumapapu dziwedzere muvanhu, zvichikonzera chirwere ichi chehepatopulmonary. Zvisinei, kashoma, ``Portal Hypertension'' inogona kuitika nekuda kwezvimwe zvikonzero, zvakaita sekugwamba kweropa, uye chirwere ichi chinogonawo kuitika kuburikidza nazvo.

Chikonzero chaicho cheizvi chii?

Kutaura zvazviri, masayendisiti haasati aziva kuti sei chirwere ichi, chinonzi portal hypertension, chichikonzera kuti mitsipa yeropa mumapapu iwedzere (vasodilation) mune vamwe vanhu. Kune dzidziso dzakawanda nemaonero pamusoro pacho. Hazvina kujeka kuti nei zvisingaitike kune wese munhu, asi kune vamwe vanhu chete. Hazviratidzike sezvine chekuita zvakananga nekuoma kwechirwere chechiropa.

Asi chimwe chinhu chakajeka. Kuwanda kweropa mumapapu kunokonzera kudzikira kwehuwandu hweokisijeni muropa (Hypoxemia). Zvichitaurwa zviri nyore, pane kusaenzana pakati pehuwandu hwemhepo inopinda mumapapu nehuwandu hweropa rinopfuura nemumapapu. Ichi ndicho chikonzero nei muviri usingawani huwandu hweokisijeni hwaunoda.

Zviratidzo zvacho ndezvipi? Tinozviziva sei?

Kana chirwere cheHepatopulmonary Syndrome chisina kunyanya kuoma, ungasaona zviratidzo. Chiratidzo chekutanga chinowanikwa nevanhu vazhinji, sezvambotaurwa , kuoma kufema (Dyspnea) . Zvisinei, pane zvikonzero zvakawanda zvinoita kuti kufema kuve kwakaoma. Munhu ane chirwere chechiropa anogona kusangana nematambudziko ekufema nenzira dzakasiyana-siyana. Nokudaro, dzimwe nguva varwere navanachiremba vanogona kusaziva izvi pakarepo sechiratidzo cheHepatopulmonary Syndrome.

Sezvo mamiriro acho achikura, unogona zvakare kuona zvimwe zviratidzo zvakaita se:

• Platypnoea: Apa ndipo paunoomerwa nekufema paunenge wakagara kana kumira, asi uchinzwa zororo paunenge wakarara pasi.
• Orthopnea: Izvi zvakasiyana. Zvinonetsa kufema kana wakarara pasi, asi zviri nani kana wakagara.
• Cyanosis: Kuchinja ruvara rwebhuruu rwemiromo, nzara, uye dzimwe nguva ganda nekuda kwekushaikwa kweokisijeni mumuviri. Ichi chiratidzo chinoonekwa.
• Zvigunwe zvakakomberedzwa:Migumo yeminwe kana zvigunwe zvinoita seyakazvimba uye yakazvimba, semigumo yedrumstick. Ichi chimwe chiratidzo chekushaya oksijeni mumuviri.

Pamusoro pezviratidzo izvi, unogona kunge uine zviratidzo zvinowanzoonekwa nechirwere chechiropa uye/kana BP yepamusoro. Semuenzaniso:

• Spider angiomas: Tsinga dzeropa diki, dzvuku, dzakaita sedzakaita ...
• Mitsipa yeropa yakakura: Mitsipa yeropa yakakura inoonekwa mudumbu kana pagurokuro.
• Nhoroondo yekubuda ropa mudumbu kare.
• Kuzvimba kwedumbu (Ascites)

Vanachiremba vanoongorora sei izvi?

Vanachiremba vanoziva chirwere ichi chehepatopulmonary kana zviratidzo zvikuru zvitatu zvikaitika pamwe chete:

1. Kukwira Kweropa Panze: Izvi zvinowanzoitika kana paine chirwere chechiropa.

2. Kukura kwetsinga dzeropa mumapapu: Izvi zvinoreva kuti tsinga dzeropa dziri mukati memapapu dzakakura.

3. Kuderera kwehuwandu hweokisijeni muropa (Hypoxemia) .

Kazhinji, paunotanga chirwere ichi (Hepatopulmonary Syndrome), vanachiremba vako vanenge vatoona kuti une chirwere chechiropa (Chirwere cheChiropa) kana kuti (Portal Hypertension). Zvikasadaro, timu yako yezvekurapa inotanga yaita scan dzakasiyana-siyana uye bvunzo dzeropa kuti ione kana paine kukuvara kwechiropa. Zvadaro vachatarisa mitsipa iri mumapapu ako uye voyera kuti oxygen yakawanda sei iri muropa rako. Miedzo iyi inogona kuratidza zvakajeka kuti mitsipa yeropa iri mumapapu ako iri kukura (Vasodilation), izvo zviri kukonzera oxygen shoma muropa rako (Hypoxemia).

Ndedzipi bvunzo dzakakosha dzinoitwa pakuita izvi?

Vanachiremba vanoita bvunzo dzinoverengeka kuti vasimbise chirwere ichi. Mimwe yacho ndeiyi:

• Kuyera pulse oximetry: Pamwe wakambozviita kare. Kuyedza kuri nyore kwazvo, kusingarwadzi. Kamuchina kadiki kakaita seclip kanosungirirwa pamucheto wemunwe wako. Kanovheneka chiedza kuburikidza nemunwe wako uye kanoyera huwandu hwechiedza chinobuda kune rimwe divi, iro rinoshandiswa kuyera kuti oxygen yakawanda sei iri muropa rako (Oxygen Saturation). Uku kuyedza kwekutanga.
• Gasi reRopa reArterial (ABG): Kana pulse oximetry ichiratidza kuti okisijeni yeropa rako yakaderera, bvunzo inotevera yauchaita iABG. Iyi inyaya yakadzama. Sampuro diki yeropa inotorwa kubva mutsinga iri muruoko rwako. Sampuro yeropa inoedzwa kuti ione huwandu hweokisijeni yakanyungudika muropa rako (PaO2). Ichi chiyero chekuti mapapu ako ari kupinza okisijeni zvakanaka sei muropa rako.
• Kusiyana kweEchocardiography:Iyi ndiyo nzira yakanakisisa yekuongorora tsinga dzemapapu dzakakura. Echocardiogram iultrasound. Inoshandisa mafungu enzwi ane frequency yakakwira kutora mifananidzo yemoyo wako netsinga dziri mumapapu ako. Muultrasound inowedzerwa contrast, contrast agent, mvura yakakosha, inopinzwa mutsinga kuti tsinga dzionekwe zviri nani. Kana waita contrast echocardiogram, nyanzvi inopinzwa saline solution yakavhunduka mutsinga yako. Iyi imhinduro inogadzirwa nekuwedzera mabubbles emhepo mumvura ine munyu. Zvadaro vanotarisa kuti vaone kana mabubbles aya madiki achifamba kubva kurudyi rwemoyo wako kuenda kuruboshwe nekufamba kwenguva (kurudyi kuenda kuruboshwe cardiac shunt). Izvi zvinogona kuvaudza kana une `(Hepatopulmonary Syndrome)` kana kwete.

Izvi zvinorapwa sei?

Kurapa kwechirwere chehepatopulmonary syndrome kuripo parizvino ioxygen yekuwedzera . Kurapa neoxygen kunosanganisira kufema oxygen 100% kuti muviri wako ubatsire. Ungangoda kuwana oxygen kubva mukamuri rine pressurized muchipatara, rinonzi hyperbaric oxygen therapy. Kana, ungangopihwa mudziyo waunogona kuenda nawo kumba, wakadai se oxygen mask. Oxygen inogona kubatsira kuderedza zviratidzo, kunyanya kufema nehasha, uye kuchengetedza nhengo dzemuviri wako dzichishanda zvakanaka nekudzipa oxygen yadzinoda.

Chirwere chehepatopulmonary syndrome chinodzokazve here? Chinogona kurapwa zvizere here?

Mushonga wega wekurapa chirwere ichi chehepatopulmonary syndrome kuisirwa chiropa . Ehe, wanzwa zvakanaka. Mushure mekuisirwa chiropa zvakanaka, kukura kwetsinga dzeropa mumapapu (vasodilation) uye kushaikwa kweokisijeni muropa (hypoxemia) zvinodzokera shure zvishoma nezvishoma. Izvi zvinoreva kuti zvinova nani. Zvinotora mwedzi mitanhatu kusvika gumi nemiviri kuti mapapu ako adzokere pakushanda kwakajairika.

Zvisinei, havasi vese vanokodzera kuisirwa chiropa. Kune zvikonzero zvakasiyana-siyana zveizvi. Kunyangwe kana vakakodzera, pane dzimwe nguva dzavanofanira kumirira kwenguva yakareba kuti chiropa chigamuchirwe. Saka kupora uku kwakafanana nekumhanya nenguva.

Izvi zvinouraya here? Ko nguva yekupona?

Kana uine Hepatopulmonary Syndrome, pamwe watova neChronic Liver Disease. Chirwere chechiropa chinoguma nechikamu chekupedzisira chirwere chinogona kuuraya pasina kuisirwa chiropa. Hepatopulmonary Syndrome ingori imwe yemigumisiro nematambudziko anouya nayo. Vanhu vazhinji havafi neHepatopulmonary Syndrome, inova kushaikwa kweoxygen (hypoxemia), asi inobatsirawo pahutano hwavo hwese uye inopfupisa hupenyu hwavo.

Kuti unogona kurarama kwenguva yakareba sei neHepatopulmonary Syndrome zvinoenderana nezvinhu zvakawanda. Izvi zvinosanganisira kuti chirwere chako chechiropa chakakomba sei, hutano hwako hwese, uye kana uine zvimwe zvirwere. Paavhareji, munhu ane cirrhosis yechiropa asi asina Hepatopulmonary Syndrome anogona kurarama kwemakore angangoita manomwe asina kuisirwa chiropa. Zvisinei, kune munhu ane cirrhosis neHepatopulmonary Syndrome, avhareji yehupenyu hunotarisirwa pasina kuisirwa chiropa inogona kuderedzwa kusvika makore angangoita maviri.

Vamwe vanhu vanogona kunge vaine chirwere chehepatopulmonary chisina kunyanya kuipa, icho chisina kuipa sechirwere chechiropa. Vangakwanisa kurarama kwenguva yakareba nekurapwa kwavanotsigira. Uyewo, vamwe vanhu vangasapona mushure mekuisirwa chiropa kana chirwere chavo chakanyanya kuipa. Avhareji yekurarama kwemakore mashanu kune vanhu vane chirwere chehepatopulmonary syndrome vakaisirwa chiropa zvakanaka inenge 70%. Izvi zvakaderera zvishoma pane huwandu hwese hwekurarama mushure mekuisirwa chiropa (75%).

Chirwere chechiropa chinobata munhu wese zvakasiyana. Hepatopulmonary Syndrome chirwere chisingawanzoitiki uye chinogona kuuraya chinogona kuitika. Ungave usina kumbonzwa nezvacho kusvika chaitika kwauri kana kune mumwe munhu ari pedyo newe.

Vanhu vazhinji vane zviratidzo zvishoma kana kuti havana kana zviratidzo zvacho. Asi kune vamwe, kunyanya avo vatove vasina hutano hwakanaka, izvi zvinogona kunzwa se "dambudziko rekupedzisira." Kufanana nechirwere chechiropa, hepatopulmonary syndrome (HPS) inotowedzera kuipa nekufamba kwenguva. Kana watove pane runyorwa rwevanhu vanomirira kuiswa chiropa, uchakwidzwa pamusoro perunyorwa kana waonekwa uine HPS. Izvi zvinodaro nekuti vanachiremba vanoziva kuti chirwere ichi chinogona kupfupisa hupenyu hwako uye kuderedza hupenyu hwako - uye vanoziva kuti kuiswa chiropa kunogona kuchirapa. Panguva ino, kuramba uchirapa neoxygen kunogona kukubatsira kuwana zororo uye kukubatsira kurarama kwenguva yakareba.

Chekupedzisira, zvimwe zvinhu zvakakosha zvaunofanira kurangarira

Saka, ndinovimba kuti wanzwisisa zvatakurukura nezveHepatopulmonary Syndrome. Ramba uchifunga nezvepfungwa idzi:

• Ichi idambudziko risingawanzoitiki asi rinogona kunge rakakomba rinokonzerwa nechirwere chechiropa .
• Chiratidzo chikuru kutadza kufema zvakanaka (dyspnea) , kunyanya kumunhu ane chirwere chechiropa.
• Kana munhu ane chirwere chechiropa achinetseka kufema, chirwere ichi (Hepatopulmonary Syndrome) chinofanirawo kufungidzirwa uye chiremba anofanira kuudzwa nezvazvo.
• Kuisirwa chiropa ndiyo chete nzira yekurapa iripo parizvino.
• Kusvikira kurapwa ikoko kwavapo, kurapwa neokisijeni kunogona kubatsira kudzora zviratidzo uye kuchengetedza hupenyu.
• Kana iwe kana mumwe munhu waunoziva aine zviratidzo izvi, zvakakosha kuti uone chiremba nekukasika kuti akupe mazano. Nekuti, kana zvikaonekwa nekukurumidza, zviri nyore kuzvigadzirisa uye kuronga kurapwa kwakawedzerwa. Usavhunduke, asi zvakanaka kuziva.

Hepatopulmonary syndrome, chirwere chechiropa, chirwere chemapapu, kunetseka kufema, kushaikwa kweokisijeni, cirrhosis, kuisirwa chiropa