Portacaval shunting

Portacaval shunting kurapwa kwekuvhiya kugadzira kubatana kutsva pakati pemidziyo yeropa mudumbu rako. Inoshandiswa kurapa vanhu vane matambudziko akakomba echiropa.

Portacaval shunting kuvhiya kukuru. Inosanganisira kucheka kukuru (incision) mudumbu nzvimbo (dumbu). Chiremba anovhiya anobva aita kubatana pakati peiyo portal vein (iyo inopa yakawanda yeropa reropa) uye yakaderera vena cava (tsinga inoburitsa ropa kubva kuzhinji kwechikamu chepazasi chemuviri.)

Iko kubatana kutsva kunotsausa ropa kuyerera kubva pachiropa. Izvi zvinoderedza kuwedzerwa kweropa muvharo remusuwo uye kunoderedza njodzi yekubvaruka (kubvaruka) nekubuda ropa kubva mutsinga mudumbu nemudumbu.

Kazhinji, ropa rinouya kubva mudumbu rako, mudumbu, uye ura zvinotanga kuyerera nepachiropa. Kana chiropa chako chakakuvara zvakanyanya uye paine zvivharo, ropa harigone kuyerera kuburikidza naro nyore. Izvi zvinonzi portal hypertension (kuwedzerwa kumanikidzwa uye kuchengetedza kweiyo portal vein.) Tsinga dzinogona kuzaruka (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 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)

Portacaval shunting inotsausa chikamu cheropa rako kuyerera kubva pachiropa. Izvi zvinovandudza kuyerera kweropa mudumbu rako, esophagus, uye ura.

Portacaval shunting inowanzoitwa kana transjugular intrahepatic portosystemic shunting (MAZANO) isina kushanda. MAZANO ndeaya akareruka uye mashoma maitiro maitiro.

Ngozi dzeanesthesia uye kuvhiyiwa kazhinji ndezvi:

• Allergy kumishonga, matambudziko kufema
• Kubuda ropa, kugwamba kweropa, kana hutachiona

Ngozi dzekuvhiya uku dzinosanganisira:

• Chiropa kutadza
• Kuwedzeredza kwehepatic encephalopathy (chirwere chinokanganisa kusangana, chimiro chepfungwa, uye ndangariro - zvinogona kutungamira kukoma)

Vanhu vane chirwere chechiropa vari panjodzi yakakura kwazvo yezvinetso mushure mekuvhiyiwa.

Vanhu vane chirwere chakakomba chechiropa chiri kuramba chichiwedzera chingangoda kutariswa nekuda kwekuchinjika kwechiropa.

Shunt - portacaval; Kukundikana kwechiropa - portacaval shunt; Cirrhosis - portacaval shunt

Henderson JM, Rosemurgy AS, Pinson CW. Technique ye portosystemic shunting: portocaval, distal splenorenal, mesocaval. Muna: Jarnagin WR, rakanyorwa. Kuvhiya kwaBlumgart kweRopa, Biliary Tract, uye Pancreas. 6th ed. Philadelphia, PA: Elsevier; 2017: chits. 86.

Shah VH, Kamath PS. Portal hypertension uye variceal kubuda ropa. Muna: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger uye Fordtran's Gastrointestinal uye Chirwere Chirwere: Pathophysiology / Diagnosis / Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits 92.