Transjugular intrahepatic portosystemic shunt (MALANGIZO)

Transjugular intrahepatic portosystemic shunt (MALANGIZO) ndi njira yopangira kulumikizana kwatsopano pakati pamitsempha yamagazi iwiri m'chiwindi. Mungafunike njirayi ngati muli ndi vuto lalikulu la chiwindi.

Iyi si njira yochitira opaleshoni. Zimachitika ndi radiologist yemwe amagwiritsa ntchito malangizo a x-ray. Katswiri wa zamagetsi ndi dokotala yemwe amagwiritsa ntchito njira zowonera kuti apeze matenda ndikuchiza.

Mudzafunsidwa kuti mugone chagada. Mudzalumikizidwa ndi oyang'anira omwe adzawone kugunda kwa mtima kwanu ndi kuthamanga kwa magazi.

Mwinanso mulandila mankhwala oletsa ululu am'deralo ndi mankhwala okutulutsani. Izi zidzakupangitsani kumva kupweteka komanso kugona. Kapena, mutha kukhala ndi anesthesia wamba (ogona komanso opanda ululu).

Pa ndondomekoyi:

• Dokotala amalowetsa catheter (chubu chosinthasintha) kudzera pakhungu lanu mumitsempha m'khosi mwanu. Mtengowu umatchedwa mtsempha wopindika. Pamapeto pa catheter pali kabuluni kakang'ono ndi thumba lachitsulo (chubu).
• Pogwiritsa ntchito makina a x-ray, dokotalayo amatsogolera catheter mumtsempha wa chiwindi chanu.
• Kenako utoto (jekeseni) umalowetsedwa mumtsempha kuti uoneke bwino.
• Baluniyo imakhudzidwa kuti iike stent. Mutha kumva kuwawa pang'ono izi zikachitika.
• Dokotala amagwiritsa ntchito stent kuti agwirizanitse mitsempha yanu yam'mbali ndi imodzi mwamitsempha yanu yotupa.
• Pamapeto pa njirayi, kuthamanga kwanu kwamitsempha yam'mbali kumayesedwa kuti mutsimikizire kuti watsika.
• Catheter yokhala ndi buluni imachotsedwa.
• Pambuyo pa ndondomekoyi, bandeji yaying'ono imayikidwa pakhosi. Nthawi zambiri sipamakhala ulusi.
• Njirayi imatenga pafupifupi mphindi 60 mpaka 90 kuti amalize.

Njira yatsopanoyi ipangitsa kuti magazi aziyenda bwino. Idzachepetsa kupanikizika pamitsempha ya m'mimba, pammero, m'matumbo, ndi pachiwindi.

Nthawi zambiri, magazi omwe amatuluka m'mimba, m'mimba, ndi m'matumbo mumayambira pachiwindi. Chiwindi chanu chikawonongeka kwambiri ndipo pamakhala zotchinga, magazi samadutsamo mosavuta. Izi zimatchedwa portal hypertension (kukakamizidwa kowonjezereka ndi kusungidwa kwa mtsempha wama portal). Mitsempha imatha kutseguka (kuphulika), ndikupangitsa magazi kutuluka kwambiri.

Zomwe zimayambitsa matenda oopsa a portal ndi:

• Kumwa mowa kumayambitsa zipsera m'chiwindi (cirrhosis)
• Magazi amatsekemera mumtsinje womwe umachokera pachiwindi kupita pamtima
• Zitsulo zambiri m'chiwindi (hemochromatosis)
• Hepatitis B kapena hepatitis C

Matenda oopsa a portal amapezeka, mutha kukhala ndi:

• Kutuluka magazi kuchokera m'mitsempha yam'mimba, m'mimba, kapena m'matumbo (magazi opatsirana mwazi)
• Kupanga kwamadzimadzi m'mimba (ascites)
• Kupanga kwamadzimadzi pachifuwa (hydrothorax)

Njirayi imalola kuti magazi aziyenda bwino m'chiwindi, m'mimba, m'mimba, ndi m'matumbo, kenako ndikubwerera kumtima kwanu.

Zowopsa zomwe zingachitike ndi njirayi ndi:

• Kuwonongeka kwa mitsempha yamagazi
• Malungo
• Hepatic encephalopathy (vuto lomwe limakhudza kusunthika, magwiridwe antchito, kukumbukira, ndipo limatha kubweretsa chikomokere)
• Kutenga, kuvulaza, kapena kutuluka magazi
• Zomwe zimachitika ndi mankhwala kapena utoto
• Kuuma, mabala, kapena kupweteka m'khosi

Zowopsa zambiri ndi izi:

• Kutuluka magazi m'mimba
• Kutsekedwa mu stent
• Kudula mitsempha ya magazi m'chiwindi
• Mavuto amtima kapena nyimbo zosadziwika
• Matenda a stent

Dokotala wanu akhoza kukupemphani kuti muyesedwe izi:

• Kuyezetsa magazi (kuwerengera kwathunthu magazi, ma electrolyte, ndi mayeso a impso)
• X-ray pachifuwa kapena ECG

Uzani wothandizira zaumoyo wanu:

• Ngati muli ndi pakati kapena mutha kukhala ndi pakati
• Mankhwala aliwonse omwe mukumwa, ngakhale mankhwala, zowonjezera, kapena zitsamba zomwe mudagula popanda mankhwala (adokotala angakufunseni kuti musiye kumwa mankhwala ochepetsa magazi monga aspirin, heparin, warfarin, kapena ochepetsa magazi masiku angapo asanachitike)

Patsiku lanu:

• Tsatirani malangizo pa nthawi yosiya kudya ndi kumwa musanachitike.
• Funsani dokotala wanu za mankhwala omwe muyenera kumwa patsiku la ndondomekoyi. Imwani mankhwalawa ndikumwa pang'ono madzi.
• Tsatirani malangizo pakusamba musanachitike.
• Fikani pa nthawi yake kuchipatala.
• Muyenera kukonzekera kugona kuchipatala usiku wonse.

Pambuyo pochita izi, mudzachira kuchipinda kwanu. Udzayang'aniridwa ndi magazi. Muyenera kupititsa patsogolo mutu wanu.

Nthawi zambiri sipamakhala kupweteka pambuyo pochita izi.

Mudzatha kupita kwanu mukadzakhala bwino. Izi zitha kukhala tsiku lotsatira ndondomekoyi.

Anthu ambiri amabwerera ku zochitika zawo za tsiku ndi tsiku m'masiku 7 mpaka 10.

Dokotala wanu akhoza kupanga ultrasound pambuyo pa njirayi kuti muwonetsetse kuti stent ikugwira ntchito molondola.

Mudzafunsidwa kuti mukhale ndi ultrasound mobwerezabwereza m'masabata angapo kuti muwonetsetse kuti njira za MALANGIZO zikugwira ntchito.

Dokotala wanu akhoza kukuwuzani nthawi yomweyo momwe njirayi imagwirira ntchito. Anthu ambiri amachira.

MALANGIZO amagwira ntchito pafupifupi 80% mpaka 90% yamatenda oopsa a portal.

Njirayi ndi yotetezeka kwambiri kuposa opaleshoni ndipo siphatikizapo kudula kapena kudula.

MALANGIZO; Matenda enaake - MALANGIZO; Kulephera kwa chiwindi - MALANGIZO

• Matenda enaake - kumaliseche

• Transjugular intrahepatic portosystemic shunt

(Adasankhidwa) Darcy MD. Transjugular intrahepatic portosystemic shunting: zisonyezo ndi maluso. Mu: Jarnagin WR, Mkonzi. Opaleshoni ya Blumgart ya Chiwindi, Biliary Tract, ndi Pancreas. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2017: mutu 87.

Dariushnia SR, Haskal ZJ, Midia M, ndi al. Malangizo othandizira kukonza magwiridwe antchito amtundu wa intrahepatic portosystemic shunts. J Vasc Interv Radiol. 2016; 27 (1): 1-7. PMID: 26614596 www.ncbi.nlm.nih.gov/pubmed/26614596.