Hepatopulmonary syndrome: chii, zviratidzo uye kurapwa

Zvemukati

• Ndezvipi zviratidzo
• Chii chinokonzera hepatopulmonary syndrome
• Maitiro ekuongororwa kunoitwa
• Chii chinonzi kurapwa

Hepatopulmonary syndrome inoratidzirwa nekuwedzeredzwa kwetsinga uye tsinga dzemapapu dzinoitika kune vanhu vane yakakwira BP muropa rechipfuva. Nekuda kwekuwedzeredzwa kwetsinga dzemapapu, kurovera kwemoyo kunowedzera zvichikonzera kuti ropa rinoputirwa mumuviri riwane oxygen yakakwana.

Kurapa kwechirwere ichi kunosanganisira kurapwa kweoksijeni, kudzikiswa kwekumanikidzwa kweiyo portal vein uye, mumatambudziko akakomba, kuisirwa chiropa.

Ndezvipi zviratidzo

Zviratidzo zvinogona kuitika kune vanhu vane chirwere ichi kupfupika kwemweya kana wakamira kana kugara. Uye zvakare, vanhu vazhinji vane hepatopulmonary syndrome vanewo zviratidzo zvechirwere chechiropa chisingaperi, icho chinogona kusiyana, zvichienderana nedambudziko rinozvikonzera.

Chii chinokonzera hepatopulmonary syndrome

Pasi pemamiriro ezvinhu akajairika, endothelin 1 inogadzirwa nechiropa ine basa rekugadzirisa pulmonary vascular toni uye painosunga kune zvinogamuchirwa zviri mune vascular smooth muscle tishu, endothelin 1 inogadzira vasoconstriction. Nekudaro, kana ichisunga kune zvinogamuchirwa zviri mupulmonary vascular endothelium, inogadzira vasodilation nekuda kwekutanga kwe nitric oxide. Nekudaro, endothelin 1 inoenzanisa vasoconstrictor yayo uye vasodilator mhedzisiro uye inobatsira kuchengetedza pulmonary kufefetera mukati meyakajairika parameter.

Zvisinei, apo kukuvara kwechiropa kunoitika, endothelin inosvika pakutenderera kwemapapu uye inopindirana zvakasarudzika nemapermonary vascular endothelium, ichikurudzira pulmonary vasodilation. Uye zvakare, mune cirrhosis kune kuwedzera kwezvikamu zvebundu necrosis factor alpha, iyo inobatsira mukuunganidza macrophages mune lumen yemidziyo yemapurmoni inokurudzira kugadzirwa kwe nitric oxide, zvakare ichikonzera pulmonary vasodilation, ichitadzisa oxygenation yezvose iro rakapurwa ropa. kuenda kumapapu.

Maitiro ekuongororwa kunoitwa

Iko kuongororwa kunoitwa nekuongororwa kwechiremba uye bvunzo senge musiyano echocardiography, nyukireya lung scintigraphy, pulmonary basa bvunzo.

Uye zvakare, chiremba anogona zvakare kuyera huwandu hweokisijeni muropa kuburikidza neoximetry. Ona chii chinonzi oximetry uye kuti chinoyerwa sei.

Chii chinonzi kurapwa

Mushonga mukuru wehepatopulmonary syndrome ndeyekugadziriswa kweyekuwedzera okisijeni kuti ubvise mweya wekufema, zvisinei nekufamba kwenguva kuda kwekuwedzera kweoksijeni kunogona kuwedzera.

Parizvino, hapana kupindira kwemishonga kwakaratidzwa kuchinja zvakanyanya uye kugadzirisa arterial oxygenation. Nekudaro, kuisirwa chiropa ndiyo chete inoshanda nzira yekurapa yekugadziriswa kwedambudziko iri.