Hepatopulmonary Syndrome: he aha ia, nā ʻōuli a me nā lāʻau
Anter
Hoʻomaopopo ʻia ka maʻi Hepatopulmonary e ka dilation o nā aʻa a me nā uaua o nā akemāmā e kū i ka poʻe me ke koko kiʻekiʻe ma ka puka o ke ake. Ma muli o ka hoʻonui ʻia ʻana o nā aʻa o nā akemāmā, hoʻonui ka nui o ka puʻuwai e hoʻonui ana i ke koko i hoʻoheheʻe ʻia i loko o ke kino i lawa ʻole ka oxygen.
ʻO ka mālama ʻana i kēia maʻi ʻo ia hoʻi ka oxygen therapy, kahi hoʻēmi o ke kaomi o ka pūnaʻi puka a, i nā hihia ʻoi aku ka nui, ka lawe ʻana o ke ake.
He aha nā hōʻailona
ʻO nā ʻōuli e hiki ke loaʻa i ka poʻe me kēia maʻi ka pōkole o ka hanu ke kū a noho paha. Eia kekahi, ʻo ka hapanui o ka poʻe me ka maʻi hepatopulmonary i loaʻa pū kekahi mau ʻōuli o ka maʻi maʻi mau, a hiki ke loli, e pili ana i ka pilikia i loaʻa iā ia.
He aha ke kumu o ka maʻi hepopulmonary
Ma lalo o nā kūlana maʻamau, hana ʻia ka endothelin 1 e ke akepaʻa i ke kaohi ʻana i ka leo o ke aʻa pulmonary a ke nakinaki ʻia ia i nā mea loaʻa i loko o ka mola puʻupuʻu puʻupuʻu, hana ka endothelin 1 i ka vasoconstriction. Eia naʻe, ke nakinaki ia i nā mea loaʻa i loaʻa i ka endothelium vascular pulmonary, hana ia vasodilation ma muli o ke synthesity o nitric oxide. No laila, endothelin 1 kaulike i kāna hopena vasoconstrictor a me vasodilator a kōkua i ka mālama ʻana i ka ea o ka pulmonary ma waena o nā palena maʻamau.
Eia nō naʻe, ke hiki mai ka hōʻino o ke ake, hiki i ka endothelin ka holo ʻana o ka pulmonary a launa pū me ka endothelium vascular pulmonary, e hāpai ana i ka vasodilation pulmonary. Eia hou, i ka cirrhosis aia kahi hoʻonui i nā pae o ka tumo nezrosis factor alpha, ka mea e kōkua ai i ka hōʻiliʻili o nā macrophages i ka lumen o nā kīʻaha pulmonary e hoʻoulu ai i ka hana o nitric oxide, e hoʻonāukiuki ana hoʻi i ka vasodilation pulmonary, e ālai ana i ka oxygenation o nā mea āpau. ke kīpē o ke koko.
Pehea e hana ʻia ai ke kuhi
ʻO ke kuhi ka loiloi loiloi lapaʻau a me nā hoʻokolohua e like me ka echocardiography ʻokoʻa, nukilima scintigraphy nukelea, hoʻokolohua hana pulmonary.
Eia hou, hiki i ke kauka ke ana i ka nui o ka oxygen i loko o ke koko ma o ka oximetry. E ʻike he aha ka oximetry a pehea e ana ai.
He aha ka lāʻau
ʻO ka lapaʻau nui no ka maʻi hepatopulmonary ka mālama ʻana o ka oxygen supplemental e hōʻoluʻolu i ka hanu, akā ʻoi aku ka lōʻihi o ka manawa e māhuahua ai ka pono o ka oxygen.
I kēia manawa, ʻaʻole i hōʻike ʻia kahi hoʻopili lāʻau i hoʻololi nui a hoʻomaikaʻi i ka oxygenation arterial. No laila, ʻo ka lawe ʻana i ke akepaʻa wale nō ke koho therapeutic kūpono no ka hoʻonā ʻana i kēia pilikia.