Isibindi singesinye sezitho ezibaluleke kakhulu emzimbeni wethu. Kodwa ngezinye izikhathi, ukulimala kwesibindi kungabangela izinkinga ezinkulu emzimbeni esingaziboni. Enye yezinkinga ezinjalo ukwanda kwengcindezi emithanjeni eletha igazi esibindini. Lokhu kucindezela okuphezulu kungabangela ngisho nokopha okuyingozi. Namuhla sikhuluma ngokuhlinzwa okukhethekile okungasiza ekusindiseni izimpilo ezimweni ezinjalo. Lokho yi-Distal Splenorenal Shunt, noma ukuhlinzwa kwe-DSRS ngamafuphi.
Kuyini lokhu 'kwe-Portal Hypertension'?
Ake sikubeke kalula lokhu. Cabanga ukuthi ipayipi lamanzi eliyinhloko endlini yakho livaliwe. Kwenzekani-ke? Amanzi abhajwa endaweni eyodwa, ingcindezi iyanda, futhi ngezinye izikhathi aqala ukuvuza evela kwezinye izindawo. Kwenzeka into efanayo emizimbeni yethu.
Ngemva kokuba ukudla esikudlayo sekugayiwe, igazi elimunce lezo zakhamzimba liyiswa esibindini ngomthambo wegazi omkhulu obizwa ngokuthi i-portal vein . Uma isibindi sonakele ngandlela thile (isibonelo, ngenxa yesimo esifana ne-cirrhosis), igazi alikwazi ukugeleza kalula ngalo mthambo we-portal. Kufana nepayipi lamanzi elibhajwayo.
Uma ukugeleza kwegazi kuvimbekile ngale ndlela, ingcindezi ngaphakathi kwe-portal vein iyanda kakhulu. Lokhu sikubiza ngokuthi 'i-Portal Hypertension' .
Ngenxa yalokhu kucindezela okuphezulu, igazi liqala ukuthola ezinye izindlela. Le mithambo yegazi emisha (esiyibiza ngokuthi ama-varice ) ivame ukwakheka esiswini noma emhubheni. Le mithambo yegazi ebuthakathaka kakhulu, enezindonga ezincane. Lapho ingcindezi ikhula kakhulu, iyavuvukala, iqhume, bese iqala ukuphuma igazi. Lesi yisimo esiyingozi esidinga ukwelashwa okuphuthumayo.
Ngakho-ke lokhu kuhlinzwa kwe-DSRS kwenziwani?
Ukuhlinzwa kwe-DSRS, uma sikubeka kalula, kuyindlela entsha 'yokudlula' kokugeleza kwegazi okuvinjiwe. Lokhu kuhlinzwa kuhilela ukuphambukisa igazi elithile ohlelweni lwemithambo yegazi olunomfutho ophezulu bese belithumela endaweni enomfutho ophansi.
Nansi indlela yokwenza lokhu:
Udokotela ohlinzayo uhlukanisa ngokucophelela umthambo we-splenic nomthambo we-portal, ongaphansi kwengcindezi ephezulu. Ngemuva kwalokho, umthambo uxhumeke nomthambo wezinso osezinso zakho zesobunxele. Umthambo wezinso uwumthambo onengcindezi ephansi, ogoqekile kahle.
Kalula nje, kufana nokususa ezinye izimoto emgwaqweni omatasa bese uziqondisa emgwaqweni ongaxinene kakhulu. Lokhu kunciphisa ingcindezi emthanjeni we-portal, okungasiza ekulawuleni ingozi yokopha okuyingozi.
Kunini lapho kudingeka khona ukuhlinzwa kwe-DSRS?
Ngemva kokuba udokotela wakho esenze izivivinyo ezahlukahlukene, angase akuncome lokhu kuhlinzwa uma imithambo evuvukele emgogodleni noma esiswini sakho ivuvukele noma iphuma igazi. Ngaphezu kwalokho, lokhu kuhlinzwa kungasiza futhi ekulawuleni ezinye izinkinga ezibangelwa umfutho wegazi ophezulu we-portal.
| Inkinga | Incazelo elula |
|---|---|
| Ukopha okubangelwa ukuhlanza noma indle | Kungabangelwa ukuqhekeka kwemithambo yegazi ebuthakathaka (ama-varice). |
| Ukuqongelela koketshezi esiswini (ama-Ascites) | Uketshezi oluphuma emithanjeni yegazi luye emgodini wesisu ngenxa yokucindezeleka okuphezulu. Kuzwakala sengathi isisu sigcwele. |
| Ukuvuvukala kwemilenze (i-Edema) | Ukuvuvukala kwemilenze nezinyawo ngenxa yokushintsha kwebhalansi yoketshezi lomzimba. |
| Ubende obukhulu (i-Hypersplenism) | Ubende luyakhula ngenxa yokuqhekeka kwegazi. |
| Ukwehluleka kwezinso nokulahlekelwa yinkumbulo | Ezinye izinkinga ezinkulu ezingase zenzeke ngenxa yokusebenza kwesibindi okungasebenzi kahle. |
Uyini umehluko phakathi kwe-DSRS nezinye izinhlobo zama-shunt?
Kunezinhlobo eziningana ze-shunt ezisetshenziswa ukunciphisa ingcindezi emthanjeni we-portal. Umgomo oyinhloko wazo zonke lezi zinto ukulawula ukopha.
- I-Distal Splenorenal Shunt (DSRS): Lokhu ukuhlinzwa esikhuluma ngakho manje. Lokhu kuhilela ukwenza ukuhlinzwa okuvulekile nokudala i-bypass kusetshenziswa umthambo emzimbeni.
- I-Transjugular Intrahepatic Portosystemic Shunt (AMACEBISO):Lokhu kuhlukile kancane ku-DSRS. Akubandakanyi ukuhlinzwa okukhulu. Esikhundleni salokho, ithubhu elincane, njenge-catheter, lifakwa ngomthambo osentanyeni bese lixhuma umthambo wesango nomthambo oyinhloko ophuma esibindini (umthambo wesibindi) ngaphakathi kwesibindi. Lena yindlela esetshenziswa kakhulu njengamanje.
Ithimba lakho lezokwelapha lizonquma ukuthi iyiphi indlela engcono kakhulu kuwe.
Yini ongayilindela ngaphambi kokuhlinzwa?
Ngaphambi kokuhlela ukuhlinzwa kwakho, udokotela wakho uzothatha umlando wakho wezokwelapha ophelele futhi enze ukuhlolwa ngokomzimba. Bangase futhi bahlele ukuhlolwa okuningana ukuhlola impilo yakho iyonke, ukusebenza kwesibindi, kanye nobunzima bomfutho wegazi ophezulu we-portal yakho.
Lokhu kungafaka:
- Ukuhlolwa kwegazi
- Ukuhlolwa kokusebenza kwesibindi
- I-X-ray yesifuba
- Ukuhlolwa kwe-EKG
- I-Angiogram - ukubheka isimo semithambo yegazi
- I-endoscopy ephezulu - ukubheka ngaphakathi komphimbo kanye nesisu
Ithimba lezokwelapha lizokunikeza imiyalelo ecacile yokuthi ungalungiselela kanjani ukuhlinzwa. Isibonelo, bazokutshela ukuthi yimiphi imithi okufanele uyeke ukuyithatha, ukuthi yini okufanele uyilethe esibhedlela, nokuthi kufanele uyeke nini ukudla nokuphuza. Babuze nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho ngalesi sikhathi.
Kwenziwa kanjani ukuhlinzwa?
Ukuhlinzwa kwe-DSRS kuvame ukuthatha cishe amahora amane. Okokuqala, ufakwa ngaphansi kwe-anesthesia ejwayelekile. Ngakho-ke ulele phakathi nokuhlinzwa futhi awuzizwa ubuhlungu. Ithimba lokuhlinzwa, njengoba sixoxile ngaphambili, lisusa ngokucophelela umthambo we-splenic bese liwuxhumanisa nomthambo wezinso.
Kwenzekani 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 (ipayipi le-NG) lifakwa cishe amahora angama-24 ukuze kukhishwe umoya noketshezi esiswini.
- Umugqa we-saline (IV) uxhunywe emthanjeni osentanyeni ukuze unikeze imithi kanye noketshezi.
- Uzonikezwa iphampu yobuhlungu oziphathela yona ukuze ulawule ubuhlungu.
Cishe isonto ngemuva kokuhlinzwa, uzobe usuhlolwa i-angiogram ukuze uhlole ukuthi i-shunt entsha isebenza kahle. Uma usukwazi ukudla, uzoqala kancane kancane ukuthola uketshezi nezinto eziqinile. Ngaphambi kokuba uye ekhaya, isazi sokudla sizohlangana nawe ukuze sixoxe ngokudla okufanele. Ukudla okunosawoti omncane nokunamafutha amancane kuvame ukunconywa.
Kunini lapho kufanele ufune khona iseluleko sezokwelapha ngokushesha?
Ngemva kokubuyela ekhaya, kufanele unakekele kakhulu ukululama kwakho. Uma uthola noma yiziphi izimpawu ezilandelayo, shayela udokotela wakho ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze nawe.
- Ukukhwehlela
- Ubunzima bokuphefumula
- Ukuphonsa isipelingi
- Imfiva
- Ubuhlungu besifuba
- Ukujuluka kakhulu kunokujwayelekile
Kuvamile ukuzizwa ukhathazekile kancane futhi ukhathazekile ngokwenza lolu hlobo lokuhlinzwa. Kodwa khumbula, i-DSRS iyindlela ephumelela kakhulu yokuzivikela ezinkingeni eziyingozi ze-portal hypertension.
Umlayezo Wokuya Nawe Ekhaya
- I-DSRS iwukuhlinzwa okwelapha umfutho wegazi ophakeme we-portal, okuyinkinga yesifo sesibindi.
- Lokhu kusetshenziselwa kakhulu ukulawula ukopha okungaba yingozi empilweni.
- Lokhu ukuhlinzwa okukhulu impela, futhi kuzodingeka uhlale esibhedlela izinsuku eziningana ngemva kwalokho.
- Kubaluleke kakhulu ukulandela imiyalelo kadokotela kanye nochwepheshe wezokudla ukuze ululame ngokushesha ngemva kokuhlinzwa.
- Uma kuvela izimpawu eziphuthumayo, funa iseluleko sezokwelapha ngokushesha.
💬 Comments (0)
Awekho amazwana athunyelwe okwamanje. Faka amazwana akho lapha okokuqala ngqa.
Engeza amazwana akho