I-hypertension ye-Portal yimeko ebangelwa zizifo zesibindi. Luhlobo loxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi), kodwa kunokuba luchaphazele umzimba wonke, luyachaphazela kakhulu imithanjeni ye-portal ephuma emathunjini ukuya esibindi. Ingxaki enkulu ye-hepatitis yobunxila kunye ne-cirrhosis yesibindi, kwaye ingabangela ukuvuvukala nokukhupha.
Igazi lihamba ngeBindi: Indlela esebenza ngayo
Isibindi sithola igazi kwimithombo emibini.
Igazi elitsha, elivela entliziyweni, linika iimfuno zesibindi ngokwazo. Kwakhona, ngenxa yokuba isibindi sihlutha iibhoksi kunye neenkqubo zondlobo, igazi eliphuma emathunjini kunye nezinye izitho zenkqubo yokugaya zingena nge-veal vein. Igazi kwi-portal vein lihamba ngqo kwisibindi kwaye ikwazi ukusebenzisana ne- hepatocytes (iiseli zesibindi). Igazi liyaqhubeka libindi kwaye libuyela entliziyweni nasemiphakeni ngokusebenzisa iitshini ezahlukeneyo zeenqanawa-iimvumba ze-hepatic.
Ukuba indlela eya esibindini emathunjini ivaliwe okanye iyancipha ngenxa yokhuselo, ke uxinzelelo luya kwandisa inkqubo yokutya. Oku kuye kwacaciswa kum ngokucinga ngesosiko se-portal njengengadi yomyezo kunye nokukhazamiseka njengekink kwi-hose. Uyazi ngamava ukuba uxinzelelo lukhula emanzini. Into efanayo inokuthi yenzeke emzimbeni wethu, ngaphandle kokuba, ngokungafani nombhobho wamanzi, iimvumba zethu zivuza xa uxinzelelo luyakha.
Oku "kuphazamisa" yinto ebangela ukuba u-ascitic umthamo kwaye umbane we ascites, okanye ukwakhiwa kwamanzi.
Yintoni Ebangelwa Ukuvalwa?
I-cirrhosis yesibindi ingabangela i- fibrosis ebanzi. I-Fibrosis yimbangela eqhelekileyo yokuxinzeleleka kwegazi, nakuba kukho ezinye izimbangela ezininzi (njenge-schistosomias, i-sarcoidosis, kunye nesifo sofuba).
Ukuqhwala kakhulu kwe-fibrosis kukuphazamisa ukuhamba kwamanzi ngamanzi. Ukusebenzisa ukufanisa kwethu ngasentla, i-fibrosis "i-kink kwi-hose." I-fibrosis iyakujikeleza iinqwelo ngaphakathi kwesibindi ezenza kube nzima ukuba igazi ligijime. Njengoko igazi kunye namanzi asemzimbeni azama ukucoca ngebhubhiso elivinjiweyo, uxinzelelo lwakhiwa kwi-portal system, ekhokelela kwiingxaki ezingaphezulu.
Ziziphi iingxaki ezibangelwa yi-Portal Hypertension?
Iingxaki ezibalulekileyo ezinxulumene nomfutho wexinzelelo lwengxowankulu yi-ascites (ukuqokelela kwamanzi amaninzi kumathishini afaka izitho kunye nodonga lwesisu) kunye nama-varice (iimvumba ezigxile kwi-esophagus, esiswini okanye emathuneni obangelwa ukuphuma kwegazi).
Ii-Varices zibangelwa ngqo yi-portal hypertension. Xa ukuphuma kwegazi kwisibindi kuphazamiseka, igazi lingagxininiswa kwiinkqubo ze-portal venous system (inkqubo yeethambo ezithutha igazi phakathi kwenkqubo yokutya kunye nesibindi) kunye nenkqubo ye-venic system (inkqubo yeemvini ezibuyisela igazi entliziyweni). Iindlela zokubambisana kwezi zimbini ziinkqubo ezincinci, iimitha zegazi ezibuthathaka ezibizwa ngokuba yi-capillaries. Ezi nqanawa azikwazi ukujamelana nokunyuswa kwengcinezelo yegazi kwaye zifakwe okanye zixutywe.
Iinqanawa ezinjalo ziyakubonwa ngaphantsi kwendawo yesisu okanye isisu ngexesha lenkqubo ebizwa ngokuba yi-endoscopy. Zibuthakathaka kwaye zisengozini yokuphuma kwamanzi.
Ngaba i-Portal Hypertension Ingozi?
Ewe, kuba i-portal blood pressure ingabangela ukuphuma kwegazi. Kwiimeko ezininzi, ezi ziphazamiso eziphazamisayo zibhekwa njengongxamiseko lwezonyango kuba izinga lokufa (inani labantu abafa) ukusuka kwisiqhelana esisebenzayo se-varice yegazi li malunga ne-70%. Iindlululo zokuxhamla zixhaphake kakhulu kubantu abane-cirrhosis eziphambili kwaye kuqikelelwa ukuba omnye kwaba bantu abathathu abane-varices baya kuphucula igazi.
I-Portal Hypertension Iyabonwa Njani?
Nabani na ophethe i-cirrhosis eziphambili baya kujongwa ngokukhawuleza ekuphuhliseni i-portal hypertension, esoloko ixilongwa ngokuba khona kwesinye okanye ngaphezulu kwezi zinto zilandelayo:
- Thrombocytopenia
- I-Splenomegaly (ipeni ekhulisiweyo)
- Encephalopathy
- Ukuba neyodwa yeengxaki ze-portal hypertension (ascites kunye ne-esophageal varices)
Imithombo:
> Bacon, BR. I-Cirrhosis kunye neengxaki zayo. Ku: AS Fauci, E Braunwald, DL Kasper, SL Hauser, DL Longo, JL Jameson, J Loscaizo (eds), i -Principals of Medicine Internal , 17e. New York, McGraw-Hill, 2008. 1976-1978.
> Crawford, JM. Isibindi kunye neBiliary Tract. Ku: V Kumar, AK Abbas, N Fausto (eds), uRobbins kunye neCotran Pathologic Basis of Disease , 7e. Philadelphia, uElsevier Saunders, 2005. 883-885.
> Shah VH, iKamath PS. I-Portal Hypertension kunye neBastrointestinal Bleeding. Ku: M Feldman, uLS Friedman, uLJ Brandt (eds), izifo zesisu kunye nezifo zesifo , 8e. Philadelphia, Elsevier, 2006. 1899-1928.