Ukugoba kwegazi emthanjeni wesibindi (i-Portal Vein Thrombosis): Ake sixoxe ngalokhu!

Kunezifo ezithile ezikhula buthule emzimbeni ngaphandle kokuba sibonise izimpawu. Esinye salezo zimo ukuqhekeka kwegazi emthanjeni we-portal wesibindi, noma ngokwezokwelapha, isimo esibizwa ngokuthi ``Portal Vein Thrombosis`` . Lokhu kungaba yinto engathí sina, ngakho ake sixoxe ngakho ngemininingwane eyengeziwe, akunjalo?

Kuyini lokhu okubizwa ngokuthi i-portal vein thrombosis (`(Portal Vein Thrombosis)`)?

Kalula nje, isibindi sakho sinomthambo wegazi oyinhloko oletha igazi esibindini sakho lisuka kwezinye izitho esiswini sakho (njengesisu sakho namathumbu). Lokhu kubizwa ngokuthi umthambo we-portal . Lapho kwakheka i-clot yegazi (i-thrombus) emthanjeni we-portal, emagatsheni ahlukana aye esibindini, noma komunye wemithambo enikeza igazi kuso (njenge-superior mesenteric vein kanye nomthambo we-splenic), sinciphisa noma sivimbe ngokuphelele umthambo, obizwa ngokuthi i-portal vein thrombosis, noma i-PVT.

Empeleni lesi yisimo esibucayi. Kodwa ngokuvamile asibonisi zimpawu ekuqaleni. Ngakho-ke, ungase ungazi ukuthi unalolu hlobo lwegazi eliqhekekile. Lungatholakala ngengozi ngesikhathi sokuhlolwa kokunye, noma lungatholakala kuphela ngemva kwenkinga efana nomfutho wegazi ophakeme (ukwanda kwengcindezi emithanjeni yesibindi). Lezi zinkinga zingaba yingozi empilweni uma zingelashwa kahle. Ikakhulukazi uma unezimpawu ezifana nokuhlanza igazi noma ukuphuma kwegazi esitulweni sakho, kuyingozi futhi kufanele ufune iseluleko sezokwelapha ngokushesha.

Abantu abane-fibrosis yesibindi, ikakhulukazi i-cirrhosis, basengozini enkulu yokuthola i-portal vein thrombosis. Abantu abanezinye izimo zezokwelapha, njengezinkinga zokujiya kwegazi, nabo basengozini enkulu. Ngakho-ke, uma unezinye zalezi zici eziyingozi, kubalulekile ukukhuluma nodokotela, uhlolwe, bese uthola ukuthi unesifo futhi welashwe ngokushesha okukhulu.

Ingabe zikhona izinhlobo ze-portal vein thrombosis (PVT)?

Yebo, odokotela bahlukanisa le "Portal Vein Thrombosis" ibe izinhlobo ezimbili eziyinhloko, kuye ngokuthi umuntu uyithuthukisa kanjani:

• I-Cirrhotic Portal Vein Thrombosis (PVT) uhlobo oluvame kakhulu lwe-thrombosis oluvela kwi-cirrhosis . Lesi yisimo lapho kwakheka khona amahlule egazi emthanjeni we-portal kubantu abane-cirrhosis.
• I-Non-cirrhotic Portal Vein Thrombosis (PVT): Lokhu kuqubuka kwegazi okwakheka kumuntu ongenaso isifo sokuqina kwesibindi.

Ukuqonda lokhu kuhlukaniswa kubalulekile ekuhleleni ukwelashwa. Isibonelo, odokotela benza izinqumo zokwelashwa ngokusekelwe ekutheni une-cirrhosis noma cha. Ukuba ne-cirrhosis kwandisa ingozi yakho yezinkinga, okungathinta ukubikezela kwakho. Kodwa-ke, odokotela bahlala befunda kabanzi ngazo zombili izinhlobo ze-portal vein thrombosis kanye nendlela yokunciphisa izinkinga. Ngakho-ke kubalulekile ukukhuluma nodokotela wakho mayelana nezinketho zakho zokwelashwa nokuthi yini ongayilindela.

Sivame kangakanani lesi simo?

I-Portal Vein Thrombosis ayivamile kubantu abangenaso isifo sesibindi. Kodwa-ke, amanye amaqembu, ikakhulukazi lawo ane-cirrhosis, asengozini enkulu. Cishe umuntu oyedwa kwabane abane-cirrhosis uzoba ne-PVT. Lokhu kungenxa yokuthi izicubu zesilonda esibindini zinciphisa ukuhamba kwegazi. Uma ukuhamba kwegazi kuhamba kancane, amahlule egazi avame ukwakheka.

Yiziphi izinkinga ezingaba khona ze-portal vein thrombosis (PVT)?

Lezi zinkinga zingahluka kuye ngokuthi ikuphi ihlule legazi kanye nezinye izimo zezokwelapha eziyisisekelo onazo. Ezinye zezinkinga ezingase zenzeke zifaka:

• Ukuvuvukala kwemithambo yegazi emgogodleni (esophageal varices)
• Ukopha Kwamathumbu (GI)
• Ukulimala kwamathumbu ngenxa yokuncipha kokunikezwa kwegazi (`(Mesenteric Ischemia)`)
• Ukwanda kwengcindezi emithanjeni yesibindi (`(Portal Hypertension)`)
• I-splenomegaly (ubende obukhulu)

Ziyini izimpawu ze-portal vein thrombosis (PVT)?

Abantu abaningi abanazo izimpawu. Odokotela bavame ukuxilonga lesi simo ngokuhlolwa kwezithombe okwenziwe ngesinye isizathu.

Kodwa-ke, uma kuvela izinkinga, izimpawu zingase zivele. Izimpawu ezinjalo zifaka:

• Ukuhlanza igazi.
• Igazi esitulweni (kungaba mnyama noma obomvu).
• Ukuqunjelwa kwesisu, ukuqunjelwa.
• Ukuvuvukala kwemilenze namaqakala (`(Edema)`).
• Ubuhlungu besisu, ukuxhuga.

Yini ebangela ukuqhekeka kwegazi kulo mthambo we-portal?

Odokotela bakubiza lokhu ngokuthi isimo 'esinezinto eziningi' . Lokhu kusho ukuthi ngokuvamile kubangelwa inhlanganisela yezici ezimbili noma ngaphezulu.

Kunezici ezintathu eziyinhloko ezifaka isandla ekwakhekeni kwehlule legazi ku-"Portal Vein" yakho:

• Ukuba nesimo sokujiya kwegazi (`(Isimo Esijiya igazi)`). Lokhu kusho ukuthi igazi lakho lijiya ngokushesha kunomuntu ojwayelekile.
• Ukuhamba kwegazi kancane esibindini.
• Ukulimala odongeni lwangaphakathi (i-endothelium) lomthambo we-portal.

Yiziphi izinto ezibangela lesi simo?

Izimo zezokwelapha ezahlukahlukene zingandisa ingozi yakho yokujiya kwegazi kanye nokugeleza kwegazi kancane esibindini. Ezinye zalezi zici eziyingozi zifaka:

• Izimila Zesisu.
• I-Antiphospholipid syndrome (`(I-Antiphospholipid Syndrome)`).
• Ukuntuleka kwe-Antithrombin (`(Ukuntuleka kwe-Antithrombin)`).
• I-Fibrosis yesibindi (`(i-Cirrhosis)`).
• I-Factor V Leiden (`(Factor V Leiden)`) - Lesi yisimo sofuzo esithinta ukujiya kwegazi.
• Ukutheleleka kwesisu (isb. i-pancreatitis).
• Ama-neoplasm e-Myeloproliferative (`(Ama-Neoplasm e-Myeloproliferative)`) - Lezi yizifo ezihlobene nomnkantsha wamathambo.
• Icala elibi lomfutho wegazi ophezulu we-portal.
• Ukukhulelwa.
• Ukuntuleka Kwamaprotheni C (`(Ukuntuleka Kwamaprotheni C)`).
• Ukuntuleka kwe-Protein S (`(Ukuntuleka kwe-Protein S)`).
• Ukuguqulwa kwezakhi zofuzo ze-Prothrombin (`(Ukuguqulwa kwezakhi zofuzo ze-Prothrombin)`).

Ngaphezu kwalokho, okunye ukuhlinzwa kwesisu (isib. i-splenectomy) kungalimaza nodonga lwangaphakathi lomthambo wegazi, okwandisa le ngozi.

Itholakala kanjani i-portal vein thrombosis (PVT)?

Odokotela baxilonga lesi simo ngokuhlolwa okuphelele ngokomzimba kanye nokuhlolwa okuhlukahlukene. Bazobuza nangomlando wakho wezokwelapha ukuze babone ukuthi unazo yini izici eziyingozi zokuthuthukisa i-"Portal Vein Thrombosis".

Yiziphi izivivinyo ezenziwayo ukuze kutholakale lokhu?

Udokotela wakho angase acele ukuhlolwa okufana nalokhu ukuze kutholakale "i-Portal Vein Thrombosis" futhi kubhekwe izinkinga:

• Ukuskena kwe-CT (`(Ukuskena kwe-Computed Tomography (CT))`).
• Ukuhlolwa kwe-Doppler ultrasound (`(Doppler Ultrasound)`). Lokhu kungasetshenziswa ukubona ukuthi igazi ligeleza kanjani emithanjeni yegazi nokuthi ngabe kukhona yini amahlule egazi.
• Ukuhlolwa kokusebenza kwesibindi (`(Ukuhlolwa Kokusebenza Kwesibindi)`).
• Ukuskena kwe-MRI (`(I-Magnetic Resonance Imaging (MRI))`.)

Uhlelo lwakho lokwelashwa luzonqunywa ngokusekelwe emiphumeleni yalezi zivivinyo.

Odokotela baphatha kanjani i-portal vein thrombosis (PVT)?

Odokotela banquma ukwelashwa kwesiguli ngasinye ngokwaso. Okusho ukuthi, bahlela ukwelashwa ngokwezidingo zakho. Kunezici eziningana ezithinta lokhu:

• Lapho kukhona khona ihlule legazi.
• Imbangela yokwakheka kwamahlule egazi.
• Ezinye izimo zezokwelapha eziyisisekelo onazo (isib. isifo sokuqina kwesibindi).
• Kungakhathaliseki ukuthi kunezinkinga.
• Umlando wakho wonke wezokwelapha.

Izinketho zokwelapha zingafaka:

• Ama-Anticoagulant: Le mithi isiza ekuvimbeleni ukuqhekeka kwegazi ukuthi kukhule futhi ivimbele ukwakheka kwamahlule amasha. Kodwa-ke, ngenxa yokuthi abantu abane-cirrhosis basengozini enkulu yokopha ngaphakathi, odokotela basebenzisa le mithi ngokuqapha okukhulu.
• Ukwelashwa Nge-Thrombolytic:Uma ama-anticoagulant ewodwa enganele, lokhu kwelashwa kunganikezwa njengoketshezi olufakwa emthanjeni (IV) noma ngepayipi elincane (catheter) ukuze kuncibilikiswe ihlule legazi. Odokotela bangase basebenzise le ndlela uma amathumbu akho engatholi igazi elanele.
• I-Transjugular Intrahepatic Portosystemic Shunt (AMACEBISO): Lena futhi inqubo esebenzisa i-catheter encane. Isetshenziselwa ukulawula izinkinga ze-portal vein thrombosis, ikakhulukazi ukuphuma kwegazi kwe-GI. Ihilela ukudala umhubhe odlula esibindini sakho nokuxhuma i-portal vein yakho nomthambo omkhulu esibindini sakho. Le ndlela entsha ivumela igazi elivela emathunjini akho ukuthi lidlule isibindi. Lokhu kunciphisa ingcindezi emithanjeni esibindini sakho, kunciphisa ingozi yokopha. Kodwa-ke, njengoba isibindi sakho sivame ukuhlunga ubuthi obuvela egazini lakho, igazi elingahlungiwe manje selijikeleza emzimbeni wakho. Ngakho-ke, enye ingozi yalokhu kwelashwa ukuthi ubuthi bungahamba buye ebuchosheni futhi buthinte ukusebenza kobuchopho (`(Hepatic Encephalopathy)`).

Kubaluleke kakhulu ukuxoxa ngezinzuzo kanye nokungalungi kwalezi zindlela zokwelapha nodokotela wakho ukuze uqonde izinzuzo kanye nokungalungi kwazo okungaba khona kuye ngesimo sakho.

Iyini iphrojekthi yalesi simo?

Udokotela wakho ungumuntu ongcono kakhulu ongambuza mayelana nokubikezelwa kwesimo sakho. Uzokutshela ukuthi yini ongayilindela ngokusekelwe esimweni sakho. Amathuba okusinda kanye nobude besikhathi sokuphila ngenxa ye-portal vein thrombosis angahluka kuye ngokuthi:

• Imbangela yokwakheka kwamahlule egazi.
• Kungakhathaliseki ukuthi une-`(Cirrhosis)` noma cha.
• Ezinye izimo zezokwelapha eziyisisekelo onazo.
• Izinkinga ezivelayo.
• Isimo sesibindi sakho.

Ngokuvamile, ukuxilongwa kusenesikhathi kanye nokwelashwa kungandisa amathuba akho okululama.

Ingabe i-portal vein thrombosis (PVT) ingavinjelwa?

Amahlule egazi, okuhlanganisa nalawo asemzimbeni we-portal, awakwazi ukuvinjelwa ngaso sonke isikhathi. Kodwa-ke, kunezinto ezithile ongazenza ukuze unciphise ingozi yakho:

• Hamba uyohlolwa minyaka yonke, futhi ube khona kuzo zonke izivivinyo zokulandelela udokotela wakho aziyalelayo. Isibonelo, uma une-cirrhosis ezigabeni zayo zokuqala, ukutholakala kusenesikhathi kungasiza ekuvimbeleni i-PVT.
• Sebenza nodokotela wakho ukuze uphathe noma yiziphi izimo zezokwelapha eziyisisekelo ongase ube nazo. Isibonelo, uma unesifo esifana nesifo sikashukela (`(Diabetes Mellitus)`), silawule kahle.
• Thatha yonke imithi yakho njengoba uyalelwe, ngezikhathi ezifanele.
• Uma uthola izimpawu ezintsha, noma uma izimpawu zakho zishintsha, tshela udokotela wakho ngokushesha.

Kufanele ngimbone nini udokotela?

Qiniseka ukuthi uya kohlolwa njalo ngonyaka. Uma uthola izimpawu ezintsha, ezingachazeki, bonana nodokotela wakho kuqala.

Uma unesifo esisodwa noma ngaphezulu esibangela ingozi (i-Portal Vein Thrombosis)`, kuwumqondo omuhle ukukhuluma nodokotela wakho ngaso. Uzokubuza ngezinga lakho lengozi nokuthi yini ongayenza ukuze ulinciphise.

Kufanele ngiye nini e-Emergency Treatment Unit (ETU) ?

Inkinga ye-portal vein thrombosis ukuphuma kwegazi okunamandla esiswini (GI). Izimpawu zivame ukuvela ngokuzumayo futhi zingaba zimbi kakhulu. Uma unezinye zalezi zimpawu, iya esibhedlela noma ushayele u-911 ngokushesha:

• Uma uzizwa unesizungu noma uphelelwa amandla (i-syncope).
• Uma unendle emnyama noma ebomvu, noma uma uhlanza igazi.
• Uma ukushaya kwenhliziyo kushesha.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Nansi eminye imibuzo ezokusiza ukuthi ufunde kabanzi ngesimo sakho:

• Kungani ngithole leli hlwili legazi?
• Yiluphi uhlelo lokwelashwa olungcono kakhulu kimi?
• Ingabe ngidinga ukuthatha noma yimuphi umuthi? Uma kunjalo, isikhathi esingakanani?
• Yiziphi izinzuzo kanye nokungalungi kwalezi zindlela zokwelapha?
• Yini okufanele ngiyilindele njengoba ngilulama?
• Iyini iphrogramu yami yesikhathi eside (`(Isibikezelo)`)?

Ukuthola ukuthi une-blood clot kungaba yinto esabekayo. Esimweni esifana ne-"Portal Vein Thrombosis", ungase uzibuze ukuthi yiziphi izinkinga ezizokwenzeka nokuthi zizoba zimbi kangakanani. Bhala phansi imibuzo yakho bese wabelana ngayo nodokotela wakho. Funda konke okudingeka ukwazi ngesimo sakho kanye nezinketho zokwelashwa. Kanye nodokotela wakho, ungathola indlela yokululama.

Izinto ezibaluleke kakhulu okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ngakho-ke, ukufingqa lokho ebesikhuluma ngakho, i-Portal Vein Thrombosis iyi-blood clot evimba umthambo oyinhloko othwala igazi uye esibindini.

Nakuba ngokuvamile kungabonakali zimpawu ekuqaleni, lokhu kungaba yisimo esibi kakhulu, ikakhulukazi kubantu abane-cirrhosis.

Uma uzwa ukuhlanza igazi noma igazi esitulweni sakho, funa iseluleko sezokwelapha ngokushesha.

Uma unezici eziyingozi, kubalulekile ukukhuluma nodokotela wakho ngazo bese uthola ukuhlolwa okudingekayo. Ukutholwa kusenesikhathi kanye nokwelashwa kungcono kakhulu. Landela imiyalelo kadokotela wakho ngokucophelela, futhi ungesabi ukubuza imibuzo uma unayo. Hlala uphilile!

I- Portal vein thrombosis, amahlule egazi esibindini, i-cirrhosis, i-hematemesis, isifo sesibindi, ukuvaleka kwemithambo yegazi, i-PVT