Okudingeka ukwazi nge-Hepatopulmonary Syndrome!

Uma wena noma othile omaziyo enesifo sesibindi, noma uma nawe unalesi simo, kubalulekile ukuqaphela lesi simo esingabangela ubunzima bokuphefumula ngezinye izikhathi. Sisibiza ngokuthi i-Hepatopulmonary Syndrome. Igama lingase lizwakale liyinkimbinkimbi kancane, kodwa ake sigcine kulula, akunjalo? Ngoba kuyinkinga esuka esibindini iye emaphashini.

Iyini ngempela i-Hepatopulmonary Syndrome?

Kalula nje, i-hepatopulmonary syndrome iyinkinga engavamile kodwa engathi sína yesifo sesibindi engathinta amaphaphu. Igama elithi "hepato" lisho "okuphathelene nesibindi." "pulmonary" lisho "okuphathelene namaphaphu." Ubuwazi ukuthi isibindi namaphaphu ethu axhunywe yimithambo yegazi?

Ake ucabange nje, lapho umuntu enesifo sesibindi, ikakhulukazi isimo esifana ne-cirrhosis, lapho isibindi siba siqinile futhi sincipha, eminye imithambo yegazi exhunywe emaphashini iyanda ngokungadingekile. Njengokukhukhumala kwebhaluni. Kwezokwelapha, lokhu sikubiza ngokuthi "i-Vasodilation" . Lapho imithambo yegazi ikhula ngale ndlela, iphethini evamile yokugeleza kwegazi emaphashini iyashintsha. Ngezinye izikhathi, igazi alihlangani kahle nomoya-mpilo emaphashini, kodwa kunalokho lidlula ngqo kuwo. Ukugeleza kwegazi okungajwayelekile okunjalo kubizwa ngokuthi "ama-Shunt" . Ukwanda kwemithambo yegazi emaphashini kungenxa "ye-Vasodilation", futhi izinga lomoya-mpilo egazini liyehla ngenxa yalawo "ma-Shunt". Lokhu sikubiza ngokuthi "i-Hypoxemia" . Uyaqonda?

Lesi simo sikuthinta kanjani? Ingabe unenkinga yokuphefumula?

Manje ungase ucabange, "Kulungile, lokhu kungithinta kanjani?" Into eyinhloko ethinta lokhu ubunzima bokuphefumula (i-Dyspnea) . Lokhu akuveli ngokuzumayo, kodwa kuyanda kancane kancane. Abanye abantu bangase bangakuqapheli kangako ekuqaleni. Kodwa ngokuhamba kwesikhathi, lesi simo singaba sibi kakhulu kangangokuthi kuba nzima ukuphefumula ngisho nalapho umile.

Abanye abantu bakuthola kunzima ukuphefumula lapho behleli noma bemi, kodwa bazizwa bengcono lapho belele. Kwabanye, kuphambene nalokho; banenkinga yokuphefumula lapho belele, futhi bazizwa bengcono lapho behleli. Kodwa-ke, ngenxa yokuthi lokhu kuphelelwa umoya kuya kuba kubi ngokuhamba kwesikhathi, sikubiza ngokuthi i-Chronic Respiratory Failure. Lokhu kusho ukuthi konke akumi ngokuzumayo, kodwa kancane kancane izitho nezicubu zomzimba wakho azitholi umoya-mpilo owanele. Lokhu sikubiza ngokuthi i-hypoxia .

Lesi yisimo esiyingozi kakhulu. Uyazi ukuthini? I-oksijini ibalulekile emizimbeni yethu. Uma ilahleka ngokuphelele, ingabangela umonakalo ongapheli ezithweni ezibalulekile njengobuchopho nenhliziyo. Uma ingelashwa kahle, lesi simo singasongela ukuphila.

Ubani onamathuba amaningi okuthola isifo se-hepatopulmonary?

Ucwaningo luthole ukuthi cishe ingxenye yesine, noma ama-25%, abantu abanesifo sesibindi esingamahlalakhona baba ne-hepatopulmonary syndrome. Kungavela nasezimweni zokwehluleka kwesibindi okungazelelwe, okubizwa ngokuthi ukwehluleka kwesibindi okubukhali, kodwa akuvamile.

Esikhathini esiningi, yilokhu okwenzekayo: I-cirrhosis yesibindi ibangela ukucindezeleka okukhulu emithanjeni yegazi exhunywe esibindini. Kwezokwelapha, sikubiza ngokuthi "i-Portal Hypertension" . Leso simo "se-Portal Hypertension" yisona esibangela ukuthi imithambo yegazi emaphashini ivuleke kwabanye abantu, okubangela lesi sifo se-hepatopulmonary. Kodwa-ke, akuvamile kakhulu ukuthi "i-Portal Hypertension" ivele ngenxa yezinye izimbangela, njengezinhlayiya zegazi, futhi lesi sifo singavela nangalokho.

Iyini imbangela yangempela yalokhu?

Eqinisweni, ososayensi abakakazi kahle ukuthi kungani lesi simo, esibizwa ngokuthi i-portal hypertension, sibangela ukuba imithambo yegazi emaphashini ikhule (i-vasodilation) kwabanye abantu. Kunemibono eminingi kanye nemibono ngakho. Akucaci kahle ukuthi kungani kungenzeki kuwo wonke umuntu, kodwa kwabanye abantu kuphela. Akubonakali kuhlobene ngqo nobunzima besifo sesibindi.

Kodwa into eyodwa icacile. Ukwanda kwe-vasodilation emaphashini kubangela ukwehla kwamazinga omoya-mpilo egazini (i-Hypoxemia). Kalula nje, kukhona ukungalingani phakathi komoya ongena emaphashini kanye nenani legazi elidlula emaphashini. Yingakho umzimba ungatholi inani lomoya-mpilo olidingayo.

Ziyini izimpawu? Sikubona kanjani lokhu?

Uma isimo se-Hepatopulmonary Syndrome singesibi kakhulu, ungase ungaziboni izimpawu. Uphawu lokuqala abantu abaningi abaluzwayo, njengoba kushiwo ngaphambili , ubunzima bokuphefumula (i-Dyspnea) . Kodwa-ke, kunezizathu eziningi zokuthi kungani ukuphefumula kungaba nzima. Umuntu onesifo sesibindi angaba nobunzima bokuphefumula ngezindlela ezahlukene. Ngakho-ke, ngezinye izikhathi iziguli nodokotela bangase bangakuqapheli ngokushesha lokhu njengophawu lwe-Hepatopulmonary Syndrome.

Njengoba isimo siba sibi kakhulu, ungase ubhekane nezinye izimpawu ezifana nalezi:

• I-Platypnoea: Lokhu kwenzeka lapho unenkinga yokuphefumula uma uhleli noma umile, kodwa uzizwe ukhululekile lapho ulele phansi.
• I-Orthopnea: Lokhu kuphambene nalokho. Kunzima ukuphefumula uma ulele phansi, kodwa kungcono uma uhleli phezulu.
• I-Cyanosis: Ukushintsha kombala wezindebe, izinzipho, futhi ngezinye izikhathi isikhumba ngenxa yokuntuleka komoya-mpilo emzimbeni. Lokhu kuyimpawu ebonakalayo.
• Iminwe eboshwe ngenduku:Izihloko zeminwe noma zezinzwane zibonakala zivuvukele futhi zikhukhumele, njengeziphetho zenduku. Lokhu kungenye inkomba yokuthi umuntu akanaso isifo sokuphuza utshwala.

Ngaphezu kwalezi zimpawu, ungase ube nezimpawu ezivamile zesifo sesibindi kanye/noma umfutho wegazi ophakeme we-portal. Isibonelo:

• I-spider angiomas: Imithambo yegazi emincane, ebomvu, efana nesicabucabu ebonakala ngaphansi kwesikhumba.
• Imithambo yegazi ekhulisiwe: Imithambo yegazi emikhulu ibonakala esiswini noma emhubheni.
• Umlando wokopha kwamathumbu ngaphambilini.
• Ama-Ascites (ukuvuvukala kwesisu)

Odokotela bakuthola kanjani lokhu?

Odokotela bayaqaphela lesi sifo se-hepatopulmonary lapho kuvela izimpawu ezintathu eziyinhloko ndawonye:

1. Umfutho wegazi ophezulu we-Portal: Lokhu kuvame ukwenzeka ngesifo sesibindi.

2. Ukwanda kwemithambo yegazi emaphashini: Lokhu kusho ukuthi imithambo yegazi engaphakathi kwamaphaphu iyavuleka.

3. Ukwehla kwamazinga omoya-mpilo egazini (i-Hypoxemia) .

Esikhathini esiningi, uma uba nalesi sifo (i-Hepatopulmonary Syndrome)`, odokotela bakho sebevele bathole ukuthi unesifo sesibindi `(Isifo Sesibindi)` noma `(I-Portal Hypertension).` Ngaphandle kwalokho, ithimba lakho lezokwelapha lizoqala ngokwenza amaskeni ahlukahlukene kanye nokuhlolwa kwegazi ukuze libone ukuthi kukhona yini umonakalo wesibindi. Bese bezobheka imithambo emaphashini akho bese belinganisa ukuthi ingakanani i-oxygen egazini lakho. Lokhu kuhlolwa kungabonisa ngokusobala ukuthi imithambo yegazi emaphashini akho iyakhula `(i-Vasodilation)`, okubangela i-oxygen ephansi egazini lakho `(i-Hypoxemia).`

Yiziphi izivivinyo ezikhethekile ezenziwayo ngalokhu?

Odokotela benza izivivinyo eziningana ukuqinisekisa lesi simo. Ezinye zazo yilezi:

• I-Pulse oximetry: Cishe uke wakwenza lokhu ngaphambili. Kuwukuhlolwa okulula kakhulu, okungenabuhlungu. Idivayisi encane efana ne-clip inamathiselwe esihlokweni somunwe wakho. Ikhanyisa ukukhanya ngomunwe wakho futhi ilinganise inani lokukhanya okuphuma ngakolunye uhlangothi, okusetshenziselwa ukukala ukuthi ingakanani i-oxygen egazini lakho (i-Oxygen Saturation). Lokhu ukuhlolwa okuyisisekelo.
• Igesi Yegazi Emithanjeni (i-ABG): Uma i-oximetry ye-pulse ikhombisa ukuthi umoya-mpilo wegazi lakho uphansi, ukuhlolwa okulandelayo ozokwenza yi-ABG. Lokhu kunemininingwane eminingi. Isampula encane yegazi ithathwa emthanjeni osesihlakaleni sakho. Isampula yegazi ihlolwa ukuze kutholakale inani lomoya-mpilo oncibilikisiwe egazini lakho (i-PaO2). Lesi isilinganiso sokuthi amaphaphu akho amunca kahle kangakanani umoya-mpilo egazini lakho.
• I-Echocardiography ehlukanisayo:Lena indlela engcono kakhulu yokuthola imithambo yamaphaphu evulekile. I-echocardiogram iyi-ultrasound. Isebenzisa amaza omsindo avame kakhulu ukuthatha izithombe zenhliziyo yakho kanye nemithambo emaphashini akho. Ku-ultrasound ethuthukisiwe, i-ejenti yokuhlukanisa, uketshezi olukhethekile, ifakwa emthanjeni ukuze imithambo ibonakale kakhudlwana. Uma une-echocardiogram yokuhlukanisa, uchwepheshe ufaka isisombululo se-saline esivuvukile emthanjeni wakho. Lesi yisisombululo esenziwe ngokufaka amabhamuza amancane omoya emanzini anosawoti. Bese bebheka ukuthi la mabhamuza amancane asuka ohlangothini lwesokudla lwenhliziyo yakho aye ohlangothini lwesobunxele ngokuhamba kwesikhathi (kwesokudla kuya kwesobunxele i-cardiac shunt). Lokhu kungabatshela ukuthi une-`(Hepatopulmonary Syndrome)` noma cha.

Kuphathwa kanjani lokhu?

Ukwelashwa okuwukuphela kwamanje kwe-hepatopulmonary syndrome yi -oxygen eyengeziwe . Ukwelashwa nge-oxygen kuhilela ukuphefumula i-oxygen engu-100% ukusiza umzimba wakho. Kungase kudingeke uthole i-oxygen ekamelweni elinomfutho esibhedlela, elibizwa ngokuthi i-hyperbaric oxygen therapy. Noma, unganikwa idivayisi ongayithatha uye nayo ekhaya, njengemaski ye-oxygen. I-oxygen ingasiza ekunciphiseni izimpawu, ikakhulukazi ukuphelelwa umoya, futhi igcine izicubu zomzimba wakho zisebenza kahle ngokuzinikeza i-oxygen eziyidingayo.

Ingabe isifo sesibindi esibangelwa yi-hepatopulmonary syndrome siyabuya? Ingabe singalapheka ngokuphelele?

Ukwelashwa okuwukuphela kwendlela yokwelapha lesi sifo se-hepatopulmonary syndrome ukufakelwa kwesibindi . Yebo, ungizwile kahle. Ngemva kokufakelwa kwesibindi ngempumelelo, ukwandiswa kwemithambo yegazi emaphashini (i-vasodilation) kanye nokuntuleka komoya-mpilo egazini (i-hypoxemia) kuyashintsha kancane kancane. Lokho kusho ukuthi kuba ngcono. Kuthatha cishe izinyanga eziyisithupha kuya kweziyishumi nambili ukuthi umsebenzi wamaphaphu akho ubuyele esimweni esijwayelekile.

Kodwa-ke, akuwona wonke umuntu ofanelekela ukufakelwa isibindi. Kunezizathu ezahlukahlukene zalokhu. Ngisho noma befaneleka, kunezikhathi lapho kufanele balinde isikhathi eside ukuze isibindi samukelwe. Ngakho-ke lokhu kuphulukiswa kufana nomjaho nesikhathi.

Ingabe lokhu kuyabulala? Kuthiwani ngesikhathi sokusinda?

Uma une-Hepatopulmonary Syndrome, cishe usuvele une-Chronic Liver Disease. Isifo sesibindi sesigaba sokugcina yisimo esingaba yingozi ngaphandle kokufakelwa isibindi. I-Hepatopulmonary Syndrome ingenye yemiphumela emibi nezinkinga ezihambisana nayo. Abantu abaningi abafi ngenxa ye-Hepatopulmonary Syndrome, okuwukuntuleka komoya-mpilo (i-hypoxemia), kodwa futhi kunegalelo empilweni yabo iyonke futhi kufinyeze isikhathi sabo sokuphila.

Ukuthi ungaphila isikhathi esingakanani ne-Hepatopulmonary Syndrome kuncike ezintweni eziningi. Lokhu kufaka phakathi ukuthi isifo sakho sesibindi sibi kangakanani, impilo yakho iyonke, nokuthi unezinye izimo zezokwelapha yini. Ngokwesilinganiso, umuntu one-cirrhosis yesibindi kodwa engenayo i-Hepatopulmonary Syndrome angaphila iminyaka engaba yisikhombisa ngaphandle kokufakelwa isibindi. Kodwa-ke, kumuntu one-cirrhosis kanye ne-Hepatopulmonary Syndrome, isilinganiso sobude bokuphila ngaphandle kokufakelwa isibindi singancishiswa sibe yiminyaka emibili.

Abanye abantu bangase babe ne-hepatopulmonary syndrome encane, engeyimbi kangako njengesifo sesibindi. Bangase bakwazi ukuphila isikhathi eside ngokwelashwa okusekelayo. Futhi, abanye abantu bangase bangasindi ekufakweni kwesibindi uma isifo sabo sibi kakhulu. Izinga lokusinda elijwayelekile leminyaka emihlanu kubantu abane-hepatopulmonary syndrome abafakelwe isibindi ngempumelelo licishe libe ngu-70%. Lokhu kuphansi kancane kunezinga lokusinda lilonke ngemva kokufakelwa isibindi (75%).

Isifo sesibindi sithinta wonke umuntu ngendlela ehlukile. I-Hepatopulmonary Syndrome yisimo esingavamile futhi esingaba yingozi esingase senzeke. Kungenzeka ukuthi awukaze uzwe ngaso kuze kube yilapho senzeke kuwe noma kothile oseduze nawe.

Abantu abaningi banezimpawu ezimbalwa noma abanazo nhlobo. Kodwa kwabanye, ikakhulukazi labo asebevele benempilo embi, lokhu kungazwakala sengathi “udoti wokugcina.” Njengesifo sesibindi, i-hepatopulmonary syndrome (HPS) iba yimbi kakhulu ngokuhamba kwesikhathi. Uma usuvele usohlwini lokulinda lokufakelwa isibindi, uzokhushulelwa phezulu ohlwini uma utholakala une-HPS. Lokhu kungenxa yokuthi odokotela bayazi ukuthi lesi simo singanciphisa isikhathi sakho sokuphila futhi sinciphise ikhwalithi yokuphila kwakho - futhi bayazi ukuthi ukufakelwa isibindi kungayilapha. Okwamanje, ukwelashwa okuqhubekayo komoya-mpilo kungakusiza uthole impumuzo futhi kukusize uphile isikhathi eside.

Okokugcina, ezinye izinto ezibalulekile okudingeka uzikhumbule

Ngakho-ke, ngithemba ukuthi uthole ukucaca okuthile kulokho esikuxoxile nge-Hepatopulmonary Syndrome. Khumbula la maphuzu:

• Lokhu kuyinkinga engavamile kodwa engaba yingozi yesifo sesibindi .
• Uphawu oluyinhloko ubunzima bokuphefumula (ukuphelelwa umoya) , ikakhulukazi kumuntu onesifo sesibindi.
• Uma umuntu onesifo sesibindi eba nobunzima bokuphefumula, lesi simo (i-Hepatopulmonary Syndrome) kufanele sisolwe futhi udokotela kufanele atshelwe ngaso.
• Ukufakelwa kwesibindi kuwukuphela kokwelashwa okwelaphayo okutholakalayo njengamanje.
• Kuze kube yilapho lokho kwelashwa sekutholakala, ukwelashwa komoya-mpilo kungasiza ekulawuleni izimpawu futhi kuqhubeke nokuphila.
• Uma wena noma othile omaziyo enalezi zimpawu, kubaluleke kakhulu ukubonana nodokotela ngokushesha ukuze uthole iseluleko. Ngoba, uma kuqashelwa kusenesikhathi, kulula ukuphatha nokuhlela ukwelashwa okwengeziwe. Ungesabi, kodwa kungcono ukuqaphela.

Isifo se - Hepatopulmonary, isifo sesibindi, isifo samaphaphu, ubunzima bokuphefumula, ukuntuleka komoya-mpilo, i-cirrhosis, ukufakelwa kwesibindi