Isibindi sakho siyisitho esibaluleke kakhulu emzimbeni wethu. Kodwa ngenxa yezifo ezithile, ikakhulukazi lapho isibindi sonakele , ingcindezi emithanjeni yegazi exhunywe kuso inganda kakhulu. Lokhu kungaholela ezimweni eziyingozi njengokuhlanza igazi ngokuzumayo. Namuhla sikhuluma ngokuhlinzwa okukhethekile okwenziwa ukusindisa izimpilo ezimweni ezinjalo. Lokhu kubizwa ngokuthi ukuhlinzwa kwe-DSRS.
Kuyini i-Distal Splenorenal Shunt (DSRS)?
Kalula nje, i-Distal Splenorenal Shunt (DSRS ) inqubo yokuhlinzwa ekhulula ingcindezi emthanjeni wakho we-portal. Manje ungase uzibuze ukuthi iyini i-portal vein. I-portal vein iwumthambo wegazi oyinhloko othwala igazi lisuka emgudwini wokugaya ukudla ( esiswini , emathunjini, njll.) liye esibindini.
Ezinye izimo zezokwelapha zibangela ukuthi ingcindezi kulo mthambo ikhuphuke kakhulu. Siyibiza ngokuthi i-Portal Hypertension . Odokotela abahlinzayo basebenzisa le nqubo ye-DSRS ukulawula ukopha nezinye izinkinga ezibangelwa yilo mfutho ophezulu.
Into ebalulekile ukuthi ukuhlinzwa kwe-DSRS akukwazi ukwelapha imbangela eyinhloko ye-Portal Hypertension. Kodwa-ke, kungasiza ekuphatheni izimpawu eziyingozi ezivelayo. Ngemva kwalokhu kuhlinzwa, kuzodingeka uqhubeke nokuhlolwa nokulandelela nodokotela wakho ukuze aqaphe isimo sakho.
Okokuqala, ake siqonde ukuthi iyini i-Portal Hypertension?
Umfutho wegazi ophezulu we-Portal, njengoba sishilo ngaphambili, umfutho wegazi ophezulu emthanjeni we-portal. Imbangela eyinhloko yalokhu ukulimala kwesibindi. Isibonelo, isimo esifana ne -cirrhosis singabangela isibindi ukuba siqine, sivimbele ukugeleza kwegazi kuso.
Cabanga ukuthi kwenzekani uma ipayipi lamanzi livaleka phakathi. Ingcindezi engaphakathi kwepayipi iyanda, futhi amanzi azama ukuphuma kwezinye izindawo, akunjalo? Ngokufanayo, lapho igazi lingakwazi ukudlula esibindini, ingcindezi emithanjeni yesango iyanda.
Ngenxa yalo mfutho wegazi ophakeme, igazi liqala ukuthola ezinye izindlela zokugeleza. Le mithambo yegazi emisha, enezindonga ezibuthakathaka yilokho esikubiza ngokuthi 'ama-varice' . Lokhu kwakha kakhulu emhubheni nasesiswini sakho.
Njengoba ingcindezi ikhuphuka, la ma-varice ayavuvukala, izindonga zawo zinciphe futhi zibe buthaka. Angavuza uketshezi esiswini (lokhu kubizwa ngokuthi ama-ascites ), futhi into eyingozi kakhulu ukuthi angaqhuma aqale ukopha. Lesi yisimo esiphuthumayo sezokwelapha.
Kwenzekani ngempela ngesikhathi sokuhlinzwa kwe-DSRS?
Ukuhlinzwa kwe-DSRS kusebenza ngokuphambukisa ukugeleza kwegazi okweqile emthanjeni we-portal kanye nokunciphisa ukucindezeleka kwawo. Lokhu kufana nokwakha umgwaqo omusha odlulayo ukuze kuncishiswe ithrafikhi enkulu edolobheni.
Ngesikhathi salolu hlinzo, udokotela ohlinzayo uzokwenza okulandelayo:
1. Umthambo we-splenic we-spleen yakho uhlukaniswe nomthambo we-portal.
2. Ngemuva kwalokho umthambo we-splenic ohlukanisiwe uxhunywa emthanjeni wezinso wenso yakho yangakwesobunxele.
Ngokudala indlela entsha yokugeleza kwegazi ngale ndlela, ingcindezi emthanjeni we-portal iyancishiswa, ukuvuvukala kwemithambo yegazi kuyancishiswa, futhi ukuhlinzwa kwenzelwe ukuqinisekisa ukuthi isibindi siyaqhubeka nokuthola igazi esilidingayo.
Ubani odinga ukuhlinzwa kwe-DSRS?
Lokhu kuhlinzwa kunganconywa uma udokotela wakho ethola ukuthi imithambo yakho yomphimbo noma yesisu (ama-varice) ikhuphukile noma iyopha. Kungaba futhi ikhambi kwezinye izinkinga ezibangelwa yi-Portal Hypertension.
Ithebula elingezansi lingachaza lokhu kabanzi.
| Izimpawu/isimo | Incazelo elula |
|---|---|
| Ukopha okubangelwa ukuhlanza noma indle | Lesi yisibonakaliso esibalulekile sokuqhuma kwemithambo ye-varicose. |
| Ukopha kwamathumbu | Isimo esingenhla sichazwa ngenye indlela. |
| Ama-Ascites | Uketshezi oluphuma emithanjeni yegazi luye emgodini wesisu ngenxa yokucindezela okuphezulu. |
| Ukuvuvukala kwemilenze nezinyawo (i-Edema) | Kungabangelwa izinguquko ebhalansini loketshezi lomzimba. |
| Ubende obukhulu (i-Hypersplenism) | Ubende luyakhula ngenxa yokwanda kwegazi eligeleza kulo. |
| Ukwehluleka kwezinso | Ukungasebenzi kahle kwesibindi kungathinta nezinso. |
| Ukukhubazeka Okuncane Kokuqonda | Ubuthi okufanele bususwe esibindini buqoqana egazini futhi buthinte ubuchopho. |
Uyini umehluko phakathi kwe-DSRS nezinye izindlela zokwelapha ze-shunt?
Umgomo ojwayelekile wazo zonke izindlela zokwelapha i-shunt ye-portal hypertension ukunciphisa ingcindezi emthanjeni we-portal nokulawula ukopha. Kodwa-ke, kunezindlela ezahlukene zokwelapha lokhu.
- I-Transjugular Intrahepatic Portosystemic Shunt (AMACEBISO): Lena akuyona inqubo yokuhlinzwa. Ihilela ukufaka ithubhu elifana ne-catheter ngomthambo osentanyeni nokudala uxhumano phakathi komthambo we-portal nomthambo wesibindi ngaphakathi kwesibindi. Le nqubo ye-TIPS ivame kakhulu kune-DSRS kulezi zinsuku.
- I-proximal splenorenal shunt: Lena futhi inqubo yokuhlinzwa. Kodwa-ke, kungadinga ukususwa kwe-spleen uqobo.
- I-spontaneous splenorenal shunt (SSRS): Lena akuyona inqubo yokuhlinzwa. Kuwukuxhumana okwakheka ngokwemvelo emzimbeni lapho isifo sesibindi sibi kakhulu. Lokhu kubonisa ukuthi lesi sifo sesiqhubeke kakhulu.
Yini ongayilindela ngaphambi kokuhlinzwa?
Udokotela wakho uzoqala ngokubuza ngomlando wakho wezokwelapha bese ekuxilonga. Ngemuva kwalokho, uzokwenza izivivinyo eziningana ukuze anqume impilo yakho jikelele, ukusebenza kwesibindi, kanye nobunzima bomfutho wegazi ophezulu we-portal yakho.
Lezi zivivinyo zingafaka:
- Ukuhlolwa kwegazi
- Ukuhlolwa kokusebenza kwesibindi
- I-X-ray yesifuba
- I-ECG (i-Electrocardiogram)
- I-Angiogram - Lolu uhlobo lokuhlolwa olukhethekile olubheka isimo semithambo yegazi.
- I-endoscopy ephezulu - ukuhlolwa kwengaphakathi le-esophagus kanye nesisu kusetshenziswa ipayipi elinekhamera
Ithimba lakho lezokwelapha lizokunikeza imiyalelo ecacile ngaphambi kokuhlinzwa.
- Yimiphi imithi okufanele iyekwe ngaphambi kokuhlinzwa?
- Yiziphi izinto okufanele ngiziphathe uma ngifika esibhedlela?
- Isikhathi esiqondile sokuyeka ukudla nokuphuza ngaphambi kokuhlinzwa.
Buza udokotela noma yimiphi imibuzo noma ukukhathazeka onakho ngalokhu bese uchazelwa kahle. Ungagcini lutho kuwe.
Kwenzekani ngesikhathi sokuhlinzwa?
Ukuhlinzwa kwe-DSRS kuvame ukuthatha cishe amahora amane . Okokuqala, unikezwa i-anesthesia ejwayelekile. Lokhu kusho ukuthi awuzizwa ubuhlungu futhi ulele ngokuphelele.
Bese kuba yithimba lokuhlinzwa, njengoba sixoxile ngaphambili:
1. Umthambo we-splenic uhlukaniswe nomthambo we-portal.
2. Thatha lowo mthambo uwuxhume emthanjeni wezinso wenso yesobunxele.
Yini okufanele ngiyilindele ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, kuzodingeka uhlale esibhedlela cishe isonto noma izinsuku eziyishumi . Phakathi nalesi sikhathi, ithimba lezokwelapha lizokunakekela kahle.
- Kufakwa i-catheter yesikhashana ukuze kukhishwe umchamo.
- Ipayipi le-nasogastric lifakwa ngekhala cishe amahora angama-24 ukuze kukhishwe umoya noketshezi esiswini.
- I-IV izofakwa emthanjeni entanyeni yakho ukuze ikunike imithi kanye noketshezi.
- Uzonikezwa iphampu yobuhlungu oziphathela yona ukuze ulawule ubuhlungu.
Cishe isonto ngemuva kokuhlinzwa, uzobe usuhlolwa futhi i-angiogram ukuze uhlole ukuthi i-shunt isebenza kahle. Uma usukwazi ukudla nokuphuza, uzonikezwa uketshezi kuqala, bese kuba yizinto eziqinile. Ngaphambi kokuba uye ekhaya, isazi sokudla sizohlangana nawe ukuze sixoxe ngokudla okufanele. Ukudla okunosawoti omncane nokunamafutha amancane kuvame ukunconywa.
Ingabe zikhona izingozi kulokhu kuhlinzwa?
Njenganoma yikuphi ukuhlinzwa, kunezingozi ezithile, kodwa i-DSRS ngokuvamile iyinqubo ephephile kakhulu futhi ephumelelayo.
Ingozi yokopha futhi iphakeme ngenyanga yokuqala ngemva kokuhlinzwa. Kodwa ungakhathazeki. Ithimba lakho lezokwelapha lizokusiza ukuthi uphathe le ngozi futhi likugcine unolwazi oluhle ngayo.
Yini okufanele uyenze ngesikhathi sokululama kwakho ngemva kokubuyela ekhaya?
Kubaluleke kakhulu ukulandela imiyalelo enikezwe udokotela wakho kanye nochwepheshe wezokudla ngokucophelela ukuze ululame ngokushesha. Buza udokotela wakho ukuthi ungaqhubeka nini nemisebenzi evamile kanye nokuzivocavoca.
Kuzodingeka ukuthi uhlolwe igazi njalo ukuze uhlole ukuthi isibindi sakho sisebenza kanjani. Ungalokothi uphuthelwe ama-aphoyintimenti akho okulandelela. Udokotela wakho uzoqhubeka nokuqapha isimo sakho futhi akunike iseluleko osidingayo ukuze uhlale uphilile.
Yiziphi izimpawu ezidinga usizo lwezokwelapha ngokushesha?
Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, kungaba uphawu lwesimo esibucayi. Ngakho-ke , iya eMnyangweni Wezimo Eziphuthumayo wesibhedlela (ETU) ngokushesha noma ushayele isevisi ye-ambulensi ka-1990.
- Ukukhwehlela
- Ubunzima bokuphefumula
- Ukuphonsa isipelingi
- Imfiva
- Ubuhlungu besifuba
- Ukujuluka kakhulu kunokujwayelekile
Kuvamile ukuzizwa wesaba futhi ukhathazekile uma uthola ukuthi unesifo esifana ne-Portal Hypertension. Kodwa udokotela wakho uzohlala nawe phansi, aqaphe izimpawu zakho, futhi akusize uzilawule. Uma kudingeka, ukuhlinzwa okufana ne-DSRS kungasiza ekulawuleni ingozi yakho yokopha futhi kukusize uphile impilo engcono.
Umlayezo Wokuya Nawe Ekhaya
- I-DSRS ukuhlinzwa okwenziwa ukuze kuncishiswe ukucindezeleka okuphezulu emthanjeni we-portal.
- Umgomo oyinhloko walokhu ukulawula izinkinga eziyingozi njengokuphuma kwegazi okubangelwa yi-Portal Hypertension.
- Lokhu kuhlinzwa akusiqedi isifo sesibindi, kodwa kungasiza kakhulu ekulawuleni izimpawu.
- Kubaluleke kakhulu ukulandela imiyalelo kadokotela ngemva kokuhlinzwa, ikakhulukazi ukudla okudlayo kanye nokuya emitholampilo ngesikhathi.
- Uma uhlangabezana nezimpawu ezifana nobunzima bokuphefumula, ubuhlungu besifuba, noma ukujuluka ngokweqile, funa iseluleko sezokwelapha ngokushesha.
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