Oko kufuneka ukwazi ngeHepatopulmonary Syndrome!

Ukuba wena okanye umntu omaziyo unesifo sesibindi, okanye ukuba nawe unayo le meko, kubalulekile ukuba uqaphele le meko enokubangela ubunzima bokuphefumla ngamanye amaxesha. Siyibiza ngokuba yiHepatopulmonary Syndrome. Eli gama lisenokuvakala linzima kancinci, kodwa masiligcine lilula, akunjalo? Kuba yingxaki esuka kwisibindi iye emiphungeni.

Yintoni kanye kanye iHepatopulmonary Syndrome?

Ngamafutshane, i-hepatopulmonary syndrome yingxaki engaqhelekanga kodwa enzima yesifo sesibindi enokuchaphazela imiphunga. Igama elithi "hepato" lithetha "okuphathelele isibindi." "pulmonary" lithetha "okuphathelele imiphunga." Ubusazi na ukuba isibindi sethu nemiphunga yethu iqhagamshelwe yimithambo yegazi?

Khawucinge nje, xa umntu enesifo sesibindi, ingakumbi imeko efana ne-cirrhosis, apho isibindi siba lukhuni size sinciphe, eminye yemithambo yegazi edibene nemiphunga iyanda ngokungeyomfuneko. Njengebhaluni evuthelayo. Kwizonyango, sibiza oku ngokuthi "i-Vasodilation" . Xa imithambo yegazi ikhula ngale ndlela, indlela eqhelekileyo yokuhamba kwegazi emiphungeni iyatshintsha. Ngamanye amaxesha, igazi alixubeki kakuhle neoksijini emiphungeni, kodwa endaweni yoko lidlula ngqo kuyo. Ukuhamba kwegazi okungahambelaniyo okunjalo kubizwa ngokuba yi- "Shunts" . Ukwanda kwemithambo yegazi emiphungeni kungenxa ye-"Vasodilation", kwaye inqanaba leoksijini egazini liyehla ngenxa yezo "Shunts". Sibiza oku ngokuthi "Hypoxemia" . Uyaqonda?

Ingaba le meko ikuchaphazela njani? Ngaba unengxaki yokuphefumla?

Ngoku usenokuba ucinga, "Kulungile, oku kundichaphazela njani?" Eyona nto iphambili echaphazela oku kubunzima bokuphefumla (i-Dyspnea) . Oku akuveli ngequbuliso, kodwa kuyanda kancinci kancinci. Abanye abantu basenokungayiqapheli kangako ekuqaleni. Kodwa ngokuhamba kwexesha, le meko inokuba nzima kangangokuba kube nzima ukuphefumla nokuba ume ngxi.

Abanye abantu bakufumanisa kunzima ukuphefumla xa behleli okanye bemile, kodwa bazive bengcono xa belele. Kwabanye, kukwahlukile; banengxaki yokuphefumla xa belele, kwaye bazive bebhetele xa behleli. Nangona kunjalo, ngenxa yokuba oku kuphefumla kancinci kuya kuba mandundu ngokuhamba kwexesha, sikubiza ngokuba yi-Chronic Respiratory Failure. Oku kuthetha ukuba yonke into ayimi ngequbuliso, kodwa kancinci kancinci amalungu omzimba wakho kunye nezicubu azifumani ioksijini eyaneleyo. Oku sikubiza ngokuba yi -hypoxia .

Le yimeko eyingozi kakhulu. Uyazi ukuba yintoni? Ioksijini ibalulekile emizimbeni yethu. Xa ilahlekile ngokupheleleyo, inokubangela umonakalo osisigxina kwizitho ezibalulekileyo ezifana nengqondo nentliziyo. Ukuba ayinyangwa kakuhle, le meko inokuba yingozi ebomini.

Ngubani onokuba nethuba elikhulu lokufumana isifo sesibindi?

Uphando lufumanise ukuba malunga nekota, okanye ama-25%, abantu abanesifo sesibindi esinganyangekiyo baba ne-hepatopulmonary syndrome. Inokwenzeka nakwimeko yokusilela kwesibindi ngequbuliso, okubizwa ngokuba kukusilela kwesibindi okukhawulezileyo, kodwa ayixhaphakanga kangako.

Ixesha elininzi, nantsi into eyenzekayo: I-Cirrhosis yesibindi ibangela uxinzelelo oluphezulu kwimithambo yegazi edibene nesibindi. Kwizonyango, siyibiza ngokuba yi- "Portal Hypertension" . Loo meko ye-"Portal Hypertension" yiyo ebangela ukuba imithambo yegazi emiphungeni ikhule kwabanye abantu, nto leyo ebangela esi sifo se-hepatopulmonary syndrome. Nangona kunjalo, kunqabile kakhulu ukuba i-"Portal Hypertension" ivele ngenxa yezinye izizathu, ezinje ngamahlwili egazi, kwaye esi sifo sinokwenzeka nangenxa yoko.

Yintoni isizathu sokwenene soku?

Enyanisweni, izazinzulu azikayazi kakuhle ukuba kutheni le meko, ebizwa ngokuba yi-portal hypertension, ibangela ukuba imithambo yegazi emiphungeni ikhule (i-vasodilation) kwabanye abantu. Kukho iingcamango ezininzi kunye nezimvo ngayo. Akucaci nokuba kutheni ingenzeki kubo bonke abantu, kodwa kwabanye abantu kuphela. Akubonakali ngathi inxulumene ngokuthe ngqo nobunzima besifo sesibindi.

Kodwa kukho into enye ecacileyo. I-Vasodilation emiphungeni ibangela ukwehla kwamanqanaba eoksijini egazini (i-Hypoxemia). Ngamafutshane, kukho ukungalingani phakathi kobungakanani bomoya ongena emiphungeni kunye nobungakanani begazi elidlula emiphungeni. Yiyo loo nto umzimba ungafumani ubungakanani beoksijini obuyidingayo.

Zithini iimpawu? Siyibona njani le nto?

Ukuba imeko yeHepatopulmonary Syndrome ayinzima kangako, usenokungaziboni naziphi na iimpawu. Uphawu lokuqala abantu abaninzi abaluvayo, njengoko bekutshiwo ngaphambili , kubunzima bokuphefumla (Dyspnea) . Nangona kunjalo, zininzi izizathu zokuba ukuphefumla kube nzima. Umntu onesifo sesibindi unokufumana ubunzima bokuphefumla ngeendlela ezahlukeneyo. Ke ngoko, ngamanye amaxesha izigulane kunye noogqirha banokungaqondi ngokukhawuleza oku njengophawu lweHepatopulmonary Syndrome.

Njengoko imeko isiya isiba mandundu, unokufumana nezinye iimpawu ezifana nezi:

• I-Platypnoea: Oku kwenzeka xa unengxaki yokuphefumla xa uhleli okanye umile, kodwa uzive ukhululekile xa ulele.
• I-Orthopnea: Le yindlela eyahlukileyo. Kunzima ukuphefumla xa ulele phantsi, kodwa kungcono xa uhleli.
• I-Cyanosis: Ukutshintsha kombala oluhlaza okwesibhakabhaka kwimilebe, ezinzipho, kwaye ngamanye amaxesha ulusu ngenxa yokunqongophala kweoksijini emzimbeni. Olu luphawu olubonakalayo.
• Iminwe eneeklabhu:Iincam zeminwe okanye iinzwane zibonakala zidumbile kwaye zivuvukile, njengeencam zedrumstick. Olu lolunye uphawu lokungabikho koxinzelelo lwegazi emzimbeni.

Ukongeza kwezi mpawu, usenokuba neempawu eziqhelekileyo kwisifo sesibindi kunye/okanye uxinzelelo lwegazi oluphezulu lwe-portal. Umzekelo:

• I-spider angiomas: Imithambo yegazi emincinci, ebomvu, efana nesigcawu ebonakala phantsi kwesikhumba.
• Imithambo yegazi enee-varicose: Imithambo yegazi emikhulu ibonakala esiswini okanye emqaleni.
• Imbali yokopha kwamathumbu ngaphambili.
• Ii-Ascites (ukudumba kwesisu)

Oogqirha bayixilonga njani le nto?

Oogqirha bayayiqonda le hepatopulmonary syndrome xa iimpawu ezintathu eziphambili zivela kunye:

1. Uxinzelelo lwegazi oluphezulu: Oku kudla ngokwenzeka xa unesifo sesibindi.

2. Ukwanda kwemithambo yegazi ngaphakathi kwemiphunga: Oku kuthetha ukuba imithambo yegazi engaphakathi kwemiphunga iyavuleka.

3. Ukwehla kwamanqanaba eoksijini egazini (Hypoxemia) .

Ixesha elininzi, xa unesifo se-`(Hepatopulmonary Syndrome)`, oogqirha bakho sele befumanise ukuba unesifo sesibindi `(Isifo sesibindi)` okanye `(I-Portal Hypertension).` Ngaphandle koko, iqela lakho lezonyango liza kuqala lenze iiskeni ezahlukeneyo kunye novavanyo lwegazi ukuze libone ukuba kukho umonakalo wesibindi na. Emva koko liza kujonga imithambo emiphungeni yakho kwaye lilinganise ukuba ingakanani ioksijini egazini lakho. Olu vavanyo lunokubonisa ngokucacileyo ukuba imithambo yegazi emiphungeni yakho iyanda `(Vasodilation)`, nto leyo ebangela ukuba ioksijini iphantsi egazini lakho `(Hypoxemia).`

Zeziphi iimvavanyo ezikhethekileyo ezenziwayo koku?

Oogqirha benza uvavanyo oluninzi ukuqinisekisa le meko. Ezinye zazo zezi:

• I-pulse oximetry: Mhlawumbi sele ukhe wayenza le nto ngaphambili. Luvavanyo olulula kakhulu, olungenabuhlungu. Isixhobo esincinci esifana ne-clip sincamathiselwe kwincam yomnwe wakho. Sikhanyisa ukukhanya ngomnwe wakho kwaye silinganise ubungakanani bokukhanya okuphuma kwelinye icala, okusetyenziselwa ukulinganisa ukuba ingakanani ioksijini egazini lakho (i-Oxygen Saturation). Olu luvavanyo olusisiseko.
• Igesi Yegazi Emithanjeni (ABG): Ukuba i-pulse oximetry ibonisa ukuba ioksijini yegazi lakho iphantsi, uvavanyo olulandelayo oza kulwenza yi-ABG. Olu luneenkcukacha ezithe vetshe. Isampuli encinci yegazi ithathwa kumthambo osesihlahleni sakho. Isampuli yegazi iyavavanywa ukuze kuchongwe ubungakanani beoksijini enyibilikisiweyo egazini lakho (PaO2). Olu luvavanyo lokuba imiphunga yakho iyifunxa kakuhle kangakanani ioksijini egazini lakho.
• Umahluko kwi-Echocardiography:Le yeyona ndlela ilungileyo yokufumana imithambo yemiphunga evulelekileyo. I-echocardiogram yi-ultrasound. Isebenzisa amaza esandi aqhelekileyo ukuthabatha imifanekiso yentliziyo yakho kunye nemithambo emiphungeni yakho. Kwi-ultrasound ephuculweyo, i-arhente yokwahlulahlula, ulwelo olukhethekileyo, ifakwa kwimithambo ukuze imithambo ibonakale ngakumbi. Xa une-echocardiogram yokwahlulahlula, ingcali ifaka isisombululo se-saline esivuthuzayo kwimithambo yakho. Esi sisisombululo esenziwe ngokongeza amaqamza amancinci omoya emanzini anetyuwa. Emva koko bayajonga ukuba la maqamza amancinci ahamba ukusuka kwicala lasekunene lentliziyo yakho ukuya kwicala lasekhohlo ngokuhamba kwexesha (ukusuka ekunene ukuya ekhohlo kwentliziyo). Oku kunokubaxelela ukuba unayo `(Hepatopulmonary Syndrome)` okanye akunjalo.

Iphathwa njani le nto?

Unyango olulodwa kuphela lwangoku lwe-hepatopulmonary syndrome yi -oxygen eyongezelelweyo . Unyango lwe-oksijini lubandakanya ukuphefumla i-oxygen eyi-100% ukunceda umzimba wakho. Kusenokufuneka ufumane i-oksijini kwigumbi elinoxinzelelo esibhedlele, elibizwa ngokuba yi-hyperbaric oxygen therapy. Okanye, unokunikwa isixhobo onokusithatha uye naso ekhaya, njengemaski ye-oksijini. I-oksijini inokunceda ukunciphisa iimpawu, ingakumbi ukuphefumla kancinci, kwaye igcine izicubu zomzimba wakho zisebenza kakuhle ngokuzinika i-oksijini eziyidingayo.

Ingaba isifo sesibindi esibizwa ngokuba yi-hepatopulmonary syndrome siyaphinda sibuye? Ngaba sinokunyangeka ngokupheleleyo?

Unyango olulodwa kuphela olunyanga le hepatopulmonary syndrome kukufakelwa kwesibindi . Ewe, undive kakuhle. Emva kokufakelwa kwesibindi ngempumelelo, ukwandiswa kwemithambo yegazi emiphungeni (vasodilation) kunye nokungabikho komoya-mpilo egazini (hypoxemia) kuyatshintsha kancinci kancinci. Oko kuthetha ukuba kuya kuba ngcono. Kuthatha malunga neenyanga ezintandathu ukuya kwezilishumi elinesibini ukuba umsebenzi wakho wemiphunga ubuyele esiqhelweni.

Nangona kunjalo, ayinguye wonke umntu ofanelekileyo ukufakelwa isibindi. Kukho izizathu ezahlukeneyo zoku. Nokuba bayafaneleka, kukho amaxesha apho kufuneka balinde ixesha elide ukuze isibindi sifumaneke. Ngoko ke olu nyango lufana nogqatso oluchasene nexesha.

Ingaba oku kuyabulala? Kuthekani ngexesha lokusinda?

Ukuba uneHepatopulmonary Syndrome, mhlawumbi sele uneChronic Liver Disease. Isifo sesibindi esikwinqanaba lokugqibela sisifo esinokubulala ngaphandle kokufakelwa isibindi. IHepatopulmonary Syndrome yenye yeziphumo ebezingalindelekanga kunye neengxaki ezihambisana nayo. Abantu abaninzi abafi ngenxa yeHepatopulmonary Syndrome, okukukungabikho kweoksijini (hypoxemia), kodwa ikwanegalelo kwimpilo yabo iyonke kwaye inciphisa ubomi babo.

Ixesha onokuphila ngalo neHepatopulmonary Syndrome lixhomekeke kwizinto ezininzi. Oku kuquka ukuba isifo sakho sesibindi sibi kangakanani, impilo yakho iyonke, kunye nokuba unezinye iimeko zempilo. Ngokomyinge, umntu one-cirrhosis yesibindi kodwa engenayo iHepatopulmonary Syndrome unokuphila iminyaka emalunga nesixhenxe ngaphandle kokufakelwa isibindi. Nangona kunjalo, kumntu one-cirrhosis kunye neHepatopulmonary Syndrome, ixesha eliqhelekileyo lokuphila ngaphandle kokufakelwa isibindi linokwehliswa libe yiminyaka emibini.

Abanye abantu banokuba ne-mild hepatopulmonary syndrome, engeyonto imbi njengesifo sesibindi. Banokukwazi ukuphila ixesha elide ngonyango oluxhasayo. Kwakhona, abanye abantu basenokungasindi xa befakelwa isibindi ukuba isifo sabo sibi kakhulu. Umyinge wokusinda kweminyaka emihlanu kubantu abane-hepatopulmonary syndrome abaye bafakelwa isibindi ngempumelelo umalunga nama-70%. Oku kuphantsi kancinci kunezinga lokusinda lilonke emva kokufakelwa isibindi (75%).

Isifo sesibindi sichaphazela wonke umntu ngendlela eyahlukileyo. I-Hepatopulmonary Syndrome yimeko engaqhelekanga nenokuba yingozi enokwenzeka. Usenokuba awuzange uve ngayo ide yenzeke kuwe okanye kumntu osondeleyo kuwe.

Abantu abaninzi baneempawu ezimbalwa okanye abanazo kwaphela. Kodwa kwabanye, ingakumbi abo sele besempilweni embi, oku kunokuvakala ngathi “yingxaki yokugqibela.” Njengesifo sesibindi, i-hepatopulmonary syndrome (HPS) iba mandundu ngokuhamba kwexesha. Ukuba sele ukuluhlu lokulinda ukufakelwa isibindi, uya kunyuswa kuluhlu xa ufunyaniswa une-HPS. Oku kungenxa yokuba oogqirha bayazi ukuba le meko inokubunciphisa ubomi bakho kwaye inciphise umgangatho wobomi bakho - kwaye bayazi ukuba ukufakelwa isibindi kunokusinyanga. Okwangoku, ukuqhubeka nonyango lwe-oxygen kunokukunceda ufumane isiqabu kwaye kukuncede uphile ixesha elide.

Okokugqibela, ezinye izinto ezibalulekileyo ekufuneka uzikhumbule

Ngoko ke, ndiyathemba ukuba ufumene ingcaciso ethile kwinto esiyithethileyo malunga neHepatopulmonary Syndrome. Gcina ezi ngongoma engqondweni:

• Le yingxaki engaqhelekanga kodwa enokuba yingozi kakhulu yesifo sesibindi .
• Uphawu oluphambili kubunzima bokuphefumla (ukuphelelwa ngamandla) , ingakumbi kumntu onesifo sesibindi.
• Ukuba umntu onesifo sesibindi ufumana ubunzima bokuphefumla, le meko (iHepatopulmonary Syndrome) nayo kufuneka ikrokrelwe kwaye ugqirha makaxelelwe ngayo.
• Ukufakelwa kwesibindi lolona nyango lonyango olufumanekayo okwangoku.
• De kube lukhona olo nyango, unyango lweoksijini lunokunceda ukulawula iimpawu kwaye luqhubeke nobomi.
• Ukuba wena okanye umntu omaziyo unezi mpawu, kubaluleke kakhulu ukubona ugqirha ngokukhawuleza ukuze ufumane ingcebiso. Kuba, ukuba ziqatshelwe kwangethuba, kulula ukuzilawula kwaye ucwangcise unyango olongezelelweyo. Musa ukoyika, kodwa kungcono ukuba uqaphele.

Isifo se - Hepatopulmonary, isifo sesibindi, isifo semiphunga, ubunzima bokuphefumla, ukunqongophala komoya-mpilo, isifo sesibindi, ukufakelwa kwesibindi