Kuhlelo lokugeleza kwegazi, enye yemikhumbi enkulu kunazo zonke yi-vein portal. Ngokucindezela kwe-hydrostatic, i-portal hypertension ivela ngaphakathi kuyo. Lesi simo asibhekwa njengesifo esizimele, njengoba kwenzeka ngokumelene nesizinda samanye ama-pathologies ahlobene nokuphazamiseka kwegazi kwezindaweni ezihlukile kanye nomsuka ohlukile.
Ukuhlukaniswa kwesifo se-hypertension ye-portal
Kunezinhlobo ezine eziyinhloko zesifo esibhekene nalokhu:
- i-prehepatic;
- intrahepatic;
- i-superhepatic;
- kuxutshwe.
I-pre-hepatic or subhepatic portal hypertension ibhekwa kakhulu kunayo yokwelashwa kwezifo, njengoba ivela ngenxa yokungabi nabantwana okungenasifo somzimba.
Uhlobo lwe-syndrome lwe-Intrahepatic kuma-95% wamacala ahlotshaniswa nesigaba esibucayi se-cirrhosis yesibindi noma ingcindezi yayo. Ukukhubazeka okuncane okuvamile kwenzeka ngenxa yezinqubo ze-sclerotic ku-parenchyma nezicubu zangaphakathi zelungu.
I-superhepatic noma i-extrahepatic portal yomshuwalense wegazi ingenxa yokuphuma kobunzima bezinto eziphilayo ezivela emithanjeni yesibindi. Lokhu kungenzeka ngenxa yokwandisa i-viscosity yegazi, ukutholakala kwe-plaque ye-cholesterol, i-endocrine ne-hepatological diseases.
Ifomu elixubile le-hypertension liwumphumela we-portal vein thrombosis e-cirrhosis yesibindi esinamandla.
Njengoba kubonakala, izimbangela eziyinhloko zokuthuthukiswa kwezilwane ziyinkinga yokujikeleza, izifo zesifo sofuba, ukucindezeleka kwe-portal vein, izicubu nama-cysts esibindi. Izici ezivusa amadlingozi nazo zingenza iziqu zemithi, i-endocrine, izifo ze-vascular.
Izimpawu ze-hypertension ye-portal
Umtholampilo we-syndrome ochazwe uhlanganisa izikhalazo ezilandelayo:
- ukuqhuma, ukwanda ngobukhulu bayo;
- umuzwa wokucindezela ku-hypochondrium enhle, ubunzima;
- ngezinye izikhathi - isihlalo sinomnyama kakhulu, cishe kumnyama;
- ukukhathazeka;
- ukungabikho kwengqondo, ukukhohlwa;
- ukulala, ukukhathala okuqhubekayo;
- i-icterus yesikhumba;
- ascites ;
- ubuhlungu esifundeni se-epigastric;
- ukuhlanzeka nokuhlanza;
- ukuphefumula, ukuvuvukala;
- ukuphuma kwe-esisophageal-gastric;
- ukulahlekelwa kwesifiso;
- ukunganakwa.
Ngezici eziningi, izimpawu zifana nokubonakaliswa kwesifo sofuba, kepha uthuthuke ngokushesha nangaphezulu kakhulu.
Izimpawu ze-hypertension ye-portal kwi-ultrasound
Ngesikhathi sokuhlolwa kwe-ultrasound, itholakala:
- ukwandisa ngobukhulu besibindi nesipere;
- Ukuba khona kwezindwangu zegazi ezibonakala ngokucacile emithanjeni yegazi;
- Ukwandiswa kwezibani zezinzwa ze-splenic ne-portal.
Ngaphezu kwalokho, ukuxilongwa okunembile kwengozi yomshuwalense kuzodingeka wenze izivivinyo zelabhorethri:
- igazi (jikelele, i- biochemical );
- umchamo kanye nesikhumba.
Iphinde isetshenziswe i-X-ray, i-rheogepatografiya, i-splenomanometry, ukuskena kwesibindi, i-splenoportografiya, i-tissue biopsy.
Ukwelashwa kwesifo somfutho wegazi
Izigaba zokuqala ze-pathology zithatha ukwelashwa okulondolozayo ngokusebenzisa izidakamizwa eziphuthumayo, ikakhulukazi - i-Vasopressin noma izifanisi zayo.
Ngaphambi kokuphuma kwegazi noma ukucindezeleka, ukucindezela kwe-vein nge-Sengshtaken-Blackmore probe noma i-sclerotherapy isetshenziselwa izinsuku ezingu-2-3.
Uma izindlela zokwelashwa ezizimele zingenayo i-efficacy, kuhlinzekwa ukusebenza. Kuye ngezinhloso zokungenelela kokuhlinzwa, lezi zinhlobo ezilandelayo ziyahlukaniswa:
- Ukususwa kwe-ascites kusuka emgodini wesisu.
- Ukudala izindlela ezintsha zokususa igazi.
- Ukuthuthukiswa kwegazi lokuphuma kwegazi kanye nezinqubo zokuvuselela ezithombeni.
- Ukunciphisa ukugeleza kwezinto eziphilayo zamanzi emzimbeni.
- Ukukhipha ukuxhumana phakathi kwemisipha yesisu nesisu.