I-distlenorenal shunt ehlukile

I-distal splenorenal shunt (i-DSRS) uhlobo lokuhlinzwa olwenziwe ukunciphisa ingcindezi eyengeziwe emthanjeni we-portal. I-portal vein ithwala igazi lisuka ezithweni zakho zokugaya liye esibindini sakho.

Ngesikhathi se-DSRS, umthambo ovela ebuchosheni bakho uyasuswa emthanjeni we-portal. Umthambo ubese unamathiselwa emthanjeni ezinsozweni zakho zangakwesokunxele. Lokhu kusiza ukunciphisa ukugeleza kwegazi nge-portal vein.

Umthambo we-portal uletha igazi elisuka emathunjini, ubende, amanyikwe, nenyongo iye esibindini. Lapho ukugeleza kwegazi kuvinjiwe, ingcindezi kulo mthambo iba phezulu kakhulu. Lokhu kubizwa ngokuthi yi-portal hypertension. Kuvame ukwenzeka ngenxa yokulimala kwesibindi okubangelwa:

• Ukusetshenziswa kotshwala
• I-hepatitis yegciwane engapheli
• Amahlule egazi
• Izinkinga ezithile zokuzalwa
• I-cirrhosis ye-biliary eyinhloko (isibazi sesibindi esibangelwa yimibhobho ye-bile evinjiwe)

Lapho igazi lingakwazi ukugeleza ngokujwayelekile ngomgudu we-portal, kuthatha enye indlela. Ngenxa yalokhu, imithambo yegazi evuvukele ebizwa nge-varices form. Zakha izindonga ezincane ezingaphuka futhi zophe.

Ungaba nalokhu kuhlinzwa uma ukuhlolwa kwe-imaging okufana ne-endoscopy noma ama-x-ray kukhombisa ukuthi unama-varices wokopha. Ukuhlinzwa kwe-DSRS kunciphisa ingcindezi kuma-varices futhi kusiza ukulawula ukopha.

Izingozi ze-anesthesia nokuhlinzwa ngokujwayelekile yilezi:

• Ukungezwani komzimba nemithi noma izinkinga zokuphefumula
• Ukopha, amahlule egazi, noma ukutheleleka

Izingozi zalokhu kuhlinzwa zifaka:

• Ukwakhiwa koketshezi esiswini (ascites)
• Phinda ukuphuma kwegazi kuma-varices
• I-Encephalopathy (ukulahleka kobuchopho ngoba isibindi asikwazi ukususa ubuthi egazini)

Ngaphambi kokuhlinzwa, ungahle ube nokuhlolwa okuthile:

• I-angiogram (ukubuka ngaphakathi kwemithambo yegazi)
• Ukuhlolwa kwegazi
• I-Endoscopy

Nikeza umhlinzeki wakho wezokunakekelwa kwezempilo uhlu lwayo yonke imishanguzo oyisebenzisayo kufaka phakathi imishanguzo kadokotela kanye ne-counter-the-counter, amakhambi, nezithako. Buza ukuthi ikuphi okudingeka uyeke ukuthatha ngaphambi kokuhlinzwa, nokuthi yikuphi okufanele uthathe ekuseni yokuhlinzwa.

Umhlinzeki wakho uzochaza inqubo futhi akutshele ukuthi uyeke nini ukudla nokuphuza ngaphambi kokuhlinzwa.

Lindela ukuhlala izinsuku ezingu-7 kuya kwezingu-10 esibhedlela ngemuva kokuhlinzwa ukuze ululame.

Uma uvuka ngemuva kokuhlinzwa uzoba:

• Ishubhu emthanjeni wakho (IV) elizothwala uketshezi nomuthi egazini lakho
• Ipayipi elisesiswini sakho ukukhipha umchamo
• Ishubhu le-NG (nasogastric) elingena ngamakhala akho lingene esiswini sakho ukukhipha igesi noketshezi
• Iphampu enenkinobho ungayicindezela lapho udinga umuthi wezinhlungu

Njengoba ukwazi ukudla nokuphuza, uzonikezwa iziphuzo nokudla.

Ungahle ube nokuhlolwa kwe-imaging ukubona ukuthi i-shunt iyasebenza yini.

Ungahlangana nesazi sokudla, futhi ufunde ukuthi ungadla kanjani ukudla okunamafutha amancane, okunosawoti omncane.

Ngemuva kokuhlinzwa kwe-DSRS, ukuphuma kwegazi kulawulwa kubantu abaningi abane-portal hypertension. Ingozi ephezulu yokopha futhi isenyangeni yokuqala ngemuva kokuhlinzwa.

DSRS; Inqubo ehlukanisiwe ye-splenorenal shunt; I-renal - i-splenic venous shunt; UWarren shunt; I-cirrhosis - i-distlenorenal ye-distal; Ukwehluleka kwesibindi - i-distlenorenal distal; Ingcindezi ye-portal vein - i-distlen splenorenal shunt

Dudeja V, Fong Y. Isibindi. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; I-2017: isahluko 53.

Amaviki SR, Ottmann SE, Orloff MS. Umfutho wegazi ophezulu wePortal: indima yezinqubo zokuvimbela. Ku: UCameron JL, uCameron AM, ama-eds. Ukwelashwa Kwamanje. Umhlaka 13. IPhiladelphia, PA: Elsevier; 2020: 387-389.