ʻO nā mea āpau āu e ʻike ai e pili ana i ka Portal Hypertension

Anter

• ʻOiaʻiʻo wikiwiki
• Nā ʻōuli
• Nā Kumu
• Nā kumu weliweli
• Kānāwai
• Lapaʻau
• Nā pilikia
• Outlook
• Nā ʻōlelo aʻoaʻo no ka pale ʻana
• Q&A: Portt hypertension me ka ʻole cirrhosis
• Q:
• A:

Hōʻike Overview

Lawe ke kīʻaha awa i ke koko mai kou ʻōpū, pancreas, a me nā mea digestive i kou ake. ʻOkoʻa ia mai nā veins ʻē aʻe, a lawe nā mea āpau i ke koko i kou puʻuwai.

He mea nui ke akepaʻa i kou holo ʻana. Hoʻopili ia i nā mea make a me nā mea ʻino ʻē aʻe i waiho ʻia i loko o kāu kahe koko. Ke kiʻekiʻe loa ke kaomi koko i loko o ka vein portal, loaʻa iā ʻoe ke kiʻekiʻe o ka puka.

Hiki i ka hypertension portal ke koʻikoʻi loa, akā hiki ke mālama ʻia inā ʻike ʻia i ka manawa. ʻAʻole maʻalahi ka nānā ʻana i nā manawa a pau. ʻO ka maʻamau, lilo ʻoe i mea makaʻala i ke ʻano ke hoʻomaka ʻoe e ʻike i nā ʻōuli.

ʻOiaʻiʻo wikiwiki

Hāpai nā aʻa i ke koko momona o ka oxygen mai kou puʻuwai i kāu mau lālā, nā mākala, a me nāʻiʻo ʻē aʻe. Hāpai nā veins i ke koko i kou puʻuwai, koe wale no ka vein portal, kahi e hāpai i ke koko i kou ake.

Nā ʻōuli

ʻO ke kahe gastrointestinal ka hōʻailona mua o ka hypertension portal. Hiki i ka ʻeleʻele, nā noho tarry ke hōʻailona o ke kahe o ka gastrointestinal. ʻIke maoli paha ʻoe i ke koko i loko o kāu mau noho.

ʻO kekahi ʻōuli kahi ascites, kahi paʻa o ka wai i kou ʻōpū. Hoʻomaopopo paha ʻoe i ka nui ʻana o kou ʻōpū ma muli o ka ascites. Hiki i ke ʻano ke hoʻonā i ka cramp, bloating, a me ka hanu ʻole.

A ʻo ka lilo ʻana o ka hoʻopoina a huikau paha he hopena ia o ka pilikia holo e pili ana i kou ake.

Nā Kumu

ʻO ke kumu nui o ka hypertension portal ka cirrhosis. He ʻili kēia o ke akepaʻa. Hiki ke hopena mai nā ʻano like ʻole e like me ka hepatitis (kahi maʻi hōʻeha) a i ʻole ka hōʻino ʻana i ka waiʻona.

ʻO nā maʻi maʻi autoimmune o ke akepaʻa e like me ka hepatitis autoimmune, cholangitis sclerosing mua, a me cholangitis biliary mua nā kumu o ka cirrhosis a me ka hypertension portal.

Ke hōʻeha ʻia kou akepaʻa, hoʻāʻo ia e hoʻōla iā ia iho. ʻO kēia ke kumu o ka hana ʻana i nāʻiʻo makaʻu. ʻOi aku ka paʻakikī o ka scarring i kou ake e hana i kāna hana.

ʻO nā kumu cirrhosis ʻē aʻe:

• maʻi maʻi ʻalekiko ʻaʻaleka ʻole
• kūkulu hao i kou kino
• cystic fibrosis
• ʻāpana kino bile i hoʻomohala maikaʻi ʻole ʻia
• maʻi ʻaʻai
• hopena i kekahi mau lāʻau, e like me methotrexate

Hiki i ka Cirrhosis ke hana i nā pā o ka paina o ka puka aniani e lilo i kaulike ʻole. Hiki i kēia ke hoʻonui i ke kūpaʻa i ke kahe o ke koko. ʻO ka hopena, hoʻonui ke kahe o ke koko i ka portal vein.

Hiki i ke kōkō koko ke hana i loko o ka uaua o ka puka. Hiki i kēia ke hoʻonui i ke kaomi o ke kahe o ke koko i nā paia o ka ipu koko.

Nā kumu weliweli

ʻO ka poʻe i ka nui o ka makaʻu no ka cirrhosis aia i ka nui o ka makaʻu no ka hypertension portal. Inā loaʻa iā ʻoe kahi moʻolelo lōʻihi o ka hōʻino ʻana i ka waiʻona, kū ʻoe i ka makaʻu kiʻekiʻe o ka cirrhosis. Aia ʻoe i ka makaʻu kiʻekiʻe o ka maʻi hepatitis inā pili kekahi o kēia mau mea iā ʻoe:

• Hoʻohana ʻoe i nā nila.
• Loaʻa iā ʻoe nā peʻa a i ʻole nā ​​ʻoki ʻana i nā kūlana unsanitary.
• Hana ʻoe ma kahi kahi i launa pū ai me nā nila kolo a i ʻole ke koko i loaʻa.
• Ua loaʻa iā ʻoe kahi hoʻololi koko ma mua o 1992.
• He hepatitis kou makuahine.
• He moe kolohe ʻole kāu me nā hoa he nui.

Kānāwai

He paʻakikī ke kuhi hypertension i ka hōʻailona inā ʻaʻole maopopo nā ʻōuli. Kōkua nā kānana e like me ka ultrasound doppler. Hiki i kahi ultrasound ke hōʻike i ke kūlana o ka vein portal a pehea e kahe ai ke koko ma waena o ia. Inā kuhi ʻole kahi ultrasound, kōkua paha kahi scan CT.

ʻO kekahi ʻano hana kānana e lilo nei i mea hoʻohana nui ʻia ke ana ʻana o ka elasticity o kou ake a me nā mea a puni. Ana ʻo Elastography i ka pane o ke kiko i ka wā e hoʻokuʻi ʻia ai a hoʻāʻo ʻia ai paha. Hōʻike ka maikaʻi ʻole i ka hele ʻana o nā maʻi.

Inā ua hiki mai ke kahe o ka gastrointestinal, e hoʻokolo ʻia paha ʻoe i kahi hoʻokolohua endoscopic. Hoʻopili kēia i ka hoʻohana ʻana o kahi mea lahilahi, maʻalahi me kahi kāmela i hoʻokahi wē e hiki ai i kāu kauka ke ʻike i nā mea kūloko.

Hiki ke hoʻoholo ʻia ke kaomi koko i loko o ka hoʻokomo ʻana i kahi catheter i hoʻokau ʻia me kahi mea kaomi koko i loko o kahi aa i loko o kou ake a lawe i kahi ana.

Lapaʻau

Hiki i nā loli nohona e like me kēia ke kōkua i ka mālama ʻana i ka hypertension portal:

• hoʻomaikaʻi i kāu papaʻai
• ka hōʻalo ʻana i ka inu rama
• hoʻoikaika kino mau
• haʻalele i ka puhipaka inā puhipaka ʻoe

ʻO nā lāʻau e like me beta-blockers he mea nui e kōkua i ka hōʻemi ʻana i kou kaomi koko a hoʻomaha i kāu mau kīʻaha koko. ʻO nā lāʻau ʻē aʻe, e like me propranolol a me isosorbide, hiki ke kōkua i ka hoʻohaʻahaʻa ʻana i ke kaomi i loko o ka pūnae puka. Hiki iā lākou ke hōʻemi i ka makaʻu o ke kahe ʻana o loko.

Inā ʻoe e ʻike i ka ascites, hiki i kāu kauka ke kuhikuhi i ka diuretic e kōkua ai i ka hōʻemi ʻana i nā pae wai i kou kino. Pono e pāpā kapu loa ʻia ʻo Sodium e kōkua i ka hoʻēmi ʻana i ka paʻa ʻana o ka wai.

ʻO kahi lapaʻau i kapa ʻia ʻo sclerotherapy a i ʻole ke kāʻei e hoʻohana i kahi hopena e hiki ke kōkua i ka hōʻoki ʻana i ke kahe ʻana i nā kīʻaha koko o kou ake. Hoʻopili ka launa ʻana i ke kau ʻana i nā kāʻei kāpili e pale i ke kahe o ke kahe olakino i nā veins hoʻonui ʻia, i ʻike ʻia ʻo varises a i ʻole varicose veins, i loko o kāu ʻōnaehana digestive.

Ua kapa ʻia kekahi ʻano hoʻomaʻamaʻa e kaulana nui nei nonsurgical transjugular intrahepatic intrahepatic portal-systemic shunt (TIPSS). Kōkua kēia hana i ka mālama ʻana i ke kahe nui. Hoʻokumu ia i nā ala hou no ke kahe o ke koko mai ke aniani puka i loko o nā kīʻaha koko ʻē aʻe.

Nā pilikia

ʻO kekahi o nā pilikia maʻamau e pili pū ana me ka hypertension portal ʻo ia ka portal hypertensive gastropathy. Hoʻopilikia ke ʻano i ka membrane mucus o kou ʻōpū a hoʻonui i nā kīʻaha koko.

ʻO nā ala i hana ʻia ma waena o nā kīʻaha koko ma TIPSS hiki ke pale ʻia. Hiki i kēia ke alakaʻi i ke kahe hou. Inā hoʻomau nā pilikia o ke ake, hiki iā ʻoe ke loaʻa nā pilikia ʻike hou pū kekahi.

Outlook

ʻAʻole hiki iā ʻoe ke hoʻohuli i nā ʻino i hoʻokumu ʻia e ka cirrhosis, akā hiki iā ʻoe ke mālama i ka hypertension portal. Lawe paha ia i kahi hui o kahi nohona olakino, nā lāʻau, a me nā hana. Pono pono nā ultrasounds e nānā i ke olakino o kou ake a me nā hopena o kahi hana TIPSS.

Aia iā ʻoe e hōʻalo i ka wai ʻona a ola i kahi ola olakino inā loaʻa iā ʻoe ke kiʻekiʻe o ka puka. Pono ʻoe e hāhai i nā ʻōlelo aʻoaʻo a kāu kauka. Hele kēia no nā lāʻau lapaʻau a me nā wā koho hope.

Nā ʻōlelo aʻoaʻo no ka pale ʻana

Inu waiʻona me ke akahai, inā paha. A hana i nā kaʻina hana e hōʻalo ai i ka hepatitis. E kamaʻilio me kāu kauka e pili ana i nā maʻi hepatitis a inā ʻoe e loaʻa iā lākou. Hiki paha iā ʻoe ke nānā ʻia no ka maʻi hepatita inā ʻoe i kahi hui makaʻu.

Hoʻokumu ʻia ka hypertension Portal e ka hōʻemi ʻana i ke olakino ate, akā hiki paha iā ʻoe ke pale aku i kēia maʻi maʻi paʻakikī ma o nā koho olakino olakino.

Q&A: Portt hypertension me ka ʻole cirrhosis

Q:

Hiki iā ʻoe ke hoʻomohala i ka hypertension portal me ka ʻole cirrhosis?

Hoʻomanawanui inoa ʻole

A:

He hiki nō naʻe, kākaʻikahi wale nō. ʻO ka hypertension portal me ka ʻole cirrhosis i kapa ʻia ʻo idiopathic non-cirrhotic portal hypertension (INCPH). Aia he ʻelima mau ākea ākea o nā kumu o INCPH: nā maʻi immunological, nā maʻi mau, ʻike ʻia i nā toxins a i ʻole kekahi mau lāʻau, nā maʻi genetics, a me nā kūlana prothrombotic. Hiki i ka hapa nui o kēia mau ʻāpana ke hoʻololi i ke kāʻei maʻamau a hana i nā ʻōpili liʻiliʻi e hana, a hiki i INCPH. ʻOi aku ka maikaʻi o ka nānā o ka poʻe me INCPH no ka mea he akepaʻa ka hana maʻamau.

ʻO Carissa Stephens, kahu hānai ICU pēpē Pane nā pane i nā manaʻo o kā mākou kauka loea. Hoʻomaopopo ʻike ʻike ʻole ʻia nā ʻike āpau a pono ʻole e noʻonoʻo ʻia he ʻōlelo aʻoaʻo olakino.