Transjugular intrahepatic portosystemic shunt (MAZANO)

Transjugular intrahepatic portosystemic shunt (MAZANO) maitiro ekugadzira kubatana kutsva pakati pemidziyo miviri yeropa muchiropa chako. Iwe unogona kuda maitiro aya kana uine matambudziko akakomba echiropa.

Iyi haisi nzira yekuvhiya. Izvo zvinoitwa neanopindira radiologist achishandisa x-ray nhungamiro. Radiologist chiremba anoshandisa hunyanzvi hwekufungidzira kuongorora pamwe nekurapa zvirwere.

Iwe uchakumbirwa kurara nemusana. Iwe unozobatanidzwa kune monitors ayo anozotarisa yako yekurova kwemoyo uye BP.

Iwe uchave unogashira yemuno anesthesia uye mishonga yekukuzorodza iwe. Izvi zvinokuita iwe usarwadziwa-uye usarara. Kana, iwe unogona kunge uine general anesthesia (yakarara uye isina kurwadziwa).

Munguva yekuita:

• Chiremba anoisa catheter (inochinjika chubhu) kuburikidza neganda rako kupinda mutsinga iri mumutsipa wako. Tsinga iyi inonzi jugular vein. Pamugumo wekateti pane kabhaluni kadiki uye simbi mesh stent (chubhu).
• Uchishandisa x-ray muchina, chiremba anotungamira iyo catheter kupinda mutsinga iri muchiropa chako.
• Dhayi (musiyano wezvinhu) inozojowa mutsinga kuitira kuti igoonekwa zvakajeka.
• Bhaluni rakafemerwa kuisa stent. Unogona kunzwa kurwadziwa kana izvi zvikaitika.
• Chiremba anoshandisa iyo stent kubatanidza yako portal vein kune imwe yeako hepatic mutsinga.
• Pakupera kwemaitiro, yako portal vein kumanikidzwa kuyerwa kuti uone kuti yadzika.
• Iyo catheter ine chibharanzi inozobviswa.
• Mushure mekuita, bhandeji diki rinoiswa pamusoro penzvimbo yemutsipa. Iko kazhinji hakuna masiteki.
• Maitiro acho anotora maminetsi makumi matanhatu kusvika makumi mapfumbamwe kuti apedze.

Iyi nzira nyowani inobvumidza ropa kuyerera zvirinani. Icharerutsa kumanikidza mutsinga dzedumbu rako, esophagus, ura, uye chiropa.

Kazhinji, ropa rinouya kubva mudumbu rako, mudumbu, uye ura zvinotanga kuyerera nepachiropa. Kana chiropa chako chakakuvara zvakanyanya uye paine mabhuroko, ropa harigone kuyerera kuburikidza naro zviri nyore. Izvi zvinodaidzwa kuti portal hypertension (kuwedzerwa kumanikidza uye kuchengetedza kweiyo portal vein). Tsinga dzinogona kubvaruka (kuputika), zvichikonzera kubuda ropa kwakakomba.

Zvinowanzo kukonzera portal hypertension ndezvi:

• Kunwa doro kunokonzera kukanganisa kwechiropa (cirrhosis)
• Ropa rinovhara mutsinga inoyerera ichibva pachiropa ichienda pamoyo
• Yakawandisa simbi muropa (hemochromatosis)
• Hepatitis B kana hepatitis C

Kana portal hypertension ikaitika, unogona kunge uine:

• Kubuda ropa kubva mutsinga dzedumbu, esophagus, kana ura (variceal kubuda ropa)
• Kuvaka kwemvura mudumbu (ascites)
• Kuvakwa kwemvura iri muchipfuva (hydrothorax)

Maitiro aya anotendera ropa kuyerera zvirinani muchiropa chako, mudumbu, esophagus, uye ura, uyezve ndokudzokera pamoyo wako.

Njodzi dzinogona kuitika nemaitiro aya ndedzinotevera:

• Kukuvadza kumidziyo yeropa
• Kupindwa nechando
• Hepatic encephalopathy (chirwere chinokanganisa kusangana, kushanda kwepfungwa, uye ndangariro, uye zvinogona kutungamira kukoma)
• Utachiona, kupwanya, kana kubuda ropa
• Zviitiko kumishonga kana dhayi
• Kuomarara, kupwanya, kana kushushikana mumutsipa

Njodzi dzinowanzoitika ndedzekuti:

• Kubuda ropa mudumbu
• Kuvharirwa mune stent
• Kucheka kwemitsipa yeropa muchiropa
• Zvinetso zvemwoyo kana zvisina kujairika moyo mutinhimira
• Kubatwa kweiyo stent

Chiremba wako anogona kukukumbira kuti uve nemiedzo iyi:

• Ropa bvunzo (yakazara ropa kuverenga, electrolyte, uye itsvo bvunzo)
• Chest x-ray kana ECG

Udza mupi wako wezvehutano:

• Kana iwe uri kana uchigona kuve nepamuviri
• Chero mishonga yauri kutora, kunyangwe zvinodhaka, zvinowedzera, kana mahebhu awakatenga pasina mushonga (chiremba wako anogona kukukumbira kuti urege kunwa ropa rakapfava senge aspirin, heparin, warfarin, kana zvimwe zvinochenesa ropa mazuva mashoma maitiro acho asati aitwa)

Pazuva rekuita kwako:

• Tevedzera rairo pamusoro penguva yekurega kudya uye kunwa usati waitwa.
• Kumbira chiremba wako kuti ndeapi mishonga yaunofanira kutora pazuva rekuita. Tora mishonga iyi nekamwe kamvura.
• Tevedza rairo pakutora shawa usati waitwa.
• Svika nenguva kuchipatara.
• Iwe unofanirwa kuronga kunorara kuchipatara.

Mushure mekuita, iwe uchapora mukamuri rako rechipatara. Unozotariswa nekubuda ropa. Iwe uchafanirwa kuchengetedza musoro wako wakasimudzwa.

Iko kazhinji hakuna kurwadziwa mushure mekuita.

Uchakwanisa kuenda kumba kana uchinge wave nani. Iri rinogona kunge riri zuva rinotevera maitiro.

Vanhu vazhinji vanodzokera kumabasa avo ezuva nezuva mumazuva manomwe kusvika gumi.

Chiremba wako angangoita ultrasound mushure mekuita maitiro kuti ave nechokwadi chekuti stent iri kushanda nemazvo.

Iwe uchazobvunzwa kuti uve nekudzokorora ultrasound mumavhiki mashoma kuti uve nechokwadi chekuti MAZANO maitiro ari kushanda.

Wako radiologist anogona kukuudza ipapo ipapo mashandiro acho mashandiro. Vanhu vazhinji vanopora zvakanaka.

MAZANO anoshanda munenge makumi masere kubva muzana kusvika makumi mapfumbamwe kubva muzana (90%) eportal hypertension kesi.

Maitiro acho akachengeteka zvakanyanya kupfuura kuvhiya uye haabatanidze chero kucheka kana kusona.

MAZANO; Cirrhosis - MAZANO; Kukundikana kwechiropa - MAZANO

• Cirrhosis - kubuda

• Transjugular intrahepatic portosystemic shunt

Darcy MD. Transjugular intrahepatic portosystemic shunting: zvinoratidza uye maitiro. Muna: Jarnagin WR, rakanyorwa. Kuvhiya kwaBlumgart kweRopa, Biliary Tract, uye Pancreas. 6th ed. Philadelphia, PA: Elsevier; 2017: chits. 87.

Dariushnia SR, Haskal ZJ, Midia M, et al. Hunhu hwekuvandudza nhungamiro ye transjugular intrahepatic portosystemic shunts. J Vasc Kupindira Radiol. 2016; 27 (1): 1-7. PMID: 26614596 www.ncbi.nlm.nih.gov/pubmed/26614596.