Portosystemic shunts yog qhov tsis xws luag hauv cov ntshav ntws ntawm lub plab thiab lub siab. Shunts yog vim cov hlab ntsha txawv txav, shunting ntshav mus rau hauv lub cev thiab hla lub siab thiab nws cov txheej txheem metabolic.
Thaum cov ntshav tsis ntws mus rau lub siab ib txwm, muaj ntau yam teeb meem kev noj qab haus huv tuaj yeem ua rau, suav nrog kev loj hlob tsis zoo, poob phaus, teeb meem kev coj tus cwj pwm, thiab teeb meem paj hlwb xws li qaug dab peg thiab coma. Qee qhov portosystemic shunts yog qhov hnyav thiab ua rau muaj kev phom sij rau lub neej thiab, tsis muaj kev kho kom raug, tuaj yeem ua rau cov txiaj ntsig tsis zoo rau tus dev.
Portosystemic Shunt yog dab tsi?
Portosystemic shunts, tseem hu ua hepatic los yog daim siab shunts, yog congenital los yog kis tau tus kab mob uas tshwm sim nyob rau hauv dev thaum muaj ib tug txawv txav ntawm cov ntshav ntawm lub siab mus rau lwm qhov ntawm lub cev. Feem ntau, cov ntshav ntws hauv plab hnyuv (piv txwv li, txoj hnyuv, txiav, spleen) ntws mus rau hauv cov hlab ntsha portal kom xa mus rau lub siab kom metabolized thiab ua tiav.
Nrog ib tug portosystemic shunt, cov ntshav ntws ncaj nraim mus rau lub cev tsis mus ua ntej mus rau lub siab, los ntawm ib tug txawv txav kev twb kev txuas ntawm lub portal hlab ntsha, ib tug ntawm nws cov ceg, los yog lwm yam hlab ntsha. Qhov kev hloov pauv ntawm cov ntshav tsis zoo no ua rau muaj cov co toxins, cov khoom pov tseg, thiab cov as-ham hla lub siab thiab nws cov txheej txheem metabolic, ua rau muaj ntau yam teeb meem kev noj qab haus huv.
Ntxiv rau, daim siab tsis tau txais cov as-ham tseem ceeb rau nws txoj kev loj hlob thiab kev saib xyuas. Tus mob tuaj yeem sib txawv hauv qhov hnyav thiab tuaj yeem ua rau ntau yam tsos mob thiab teeb meem hauv dev. Feem ntau, lub portosystemic shunt yog ib qho kev tsis haum xeeb uas ib tug dev tau yug los nrog.
Dab tsi yog cov cim qhia ntawm Portosystemic Shunt?
Cov cim qhia ntawm lub portosystemic shunt nyob rau hauv dev tuaj yeem txawv nyob ntawm seb qhov mob hnyav npaum li cas thiab qhov chaw ntawm shunt. Feem ntau cov cim qhia ntawm portosystemic shunt muaj xws li hauv qab no:
- Txoj kev loj hlob tsis zoo los yog stunted hauv menyuam dev
- Cov leeg nqaij tsis zoo
- poob phaus
- Cov tsos mob tsis zoo ntawm lub paj hlwb lossis kev coj cwj pwm (piv txwv li, tsis muaj npe, kev nyuaj siab, tsis meej pem, ntsia hauv qhov chaw, ncig, lub taub hau nias, dig muag)
- Tshuaj ntsuab
Cov cim qhia tsawg dua ntawm cov kab mob portosystemic shunt tuaj yeem suav nrog:
- Cov tsos mob ntawm plab hnyuv (xws li ntuav, raws plab, lossis cem quav)
- Pab tsis qab los
- Nyob nqhis dej thiab tso zis ntau ntxiv
- Coma
Cov dev uas muaj cov shunts portosystemic feem ntau siv sijhawm ntev dua kom sawv los ntawm kev siv tshuaj loog. Qee qhov kev coj cwj pwm zoo li kev tsis sib haum xeeb thiab kev ncig tsuas yog tshwm sim tom qab noj mov uas muaj protein ntau. Hauv qee tus dev, cov cim qhia ntawm lawv qhov portosystemic shunt yuav tsis tshwm sim kom txog thaum lawv laus dua.
Yog tias koj pom ib qho ntawm cov cim saum toj no hauv koj cov dev, nws yog ib qho tseem ceeb uas yuav tau nrhiav kev kho tsiaj rau kev ntsuam xyuas kom raug.
Dab tsi yog qhov ua rau ntawm Portosystemic Shunt?
Portosystemic shunts yog tshwm sim los ntawm qhov txawv txav ntawm cov ntshav los ntawm cov hlab ntsha portal mus rau cov hlab ntsha, ua rau cov ntshav hla lub siab thiab nws cov haujlwm tseem ceeb hauv metabolic. Cov dev muaj peev xwm muaj qhov portosystemic shunt raws li qhov tsis xws luag hauv lub cev (qhov txawv txav uas lawv yug los nrog) lossis ua teeb meem lawv tsim tom qab lub neej (qhov tau txais shunt). Portosystemic shunts tuaj yeem kis tau los ntawm kev raug mob, kab mob siab heev (cirrhosis), lossis lwm yam mob.
Feem ntau portosystemic shunts hauv dev yog congenital defects. Ib txhia ntawm cov congenital defects kuj tau txais txiaj ntsig, txhais tau hais tias tus dev tsim lub shunt vim yog cov noob caj noob ces. Lub hauv paus caj ces ntawm portosystemic shunts tsis to taub tag nrho, tab sis qee yam tsiaj tau paub tias yuav muaj kev pheej hmoo ntau ntawm portosystemic shunts, suav nrog Yorkshire Terriers, M altese, Poodles, Irish Setters, Dachshunds, Australian Cattle Dogs, Miniature Schnauzers, thiab Labrador Retrievers.
Muaj ob hom congenital portosystemic shunts: intrahepatic (hauv daim siab) thiab extrahepatic (sab nraum daim siab). Ib leeg extrahepatic shunts yuav luag txhua lub sijhawm thiab feem ntau cuam tshuam rau cov dev me me (piv txwv li, Yorkshire Terriers). Ib leeg intrahepatic shunts yuav cuam tshuam rau cov dev loj dua.
Tau txais portosystemic shunts feem ntau yog tshwm sim los ntawm cov kab mob siab xws li mob siab los yog cirrhosis. Nrog rau cov xwm txheej no, daim siab sim ua kom them nyiaj rau qhov teeb meem, ua rau ntau lub nkoj tsim cov shunt kom ncua lossis tiv thaiv daim siab tsis ua haujlwm. Tau txais portosystemic shunts tuaj yeem tshwm sim hauv txhua tus tsiaj lossis yug tsiaj.
Kuv Yuav Ua Li Cas Saib Xyuas Tus Aub Nrog Kev Ua Haujlwm Zoo?
Kev saib xyuas thiab kev kho mob rau tus aub nrog lub portosystemic shunt sib txawv nyob ntawm seb qhov mob hnyav thiab kev noj qab haus huv tag nrho ntawm tus dev. Tus qauv kev kho mob rau lub congenital portosystemic shunt yog phais ligation ntawm lub nkoj txawv txav ua rau lub shunt. Tshuaj ib leeg tsis tuaj yeem daws qhov teeb meem no. Vim tias daim siab xav tau cov khoom siv los ntawm cov hlab ntsha ntawm cov hlab ntsha hauv cov hlab ntsha kom ua haujlwm kom raug, kev kho phais yog tsim nyog; txwv tsis pub, txoj sia nyob mus ntev yuav tsis zoo li.
Ua ntej kev kho phais, kev kho mob tau pib ua kom tus dev nyob ruaj khov thiab txo qis cov tsos mob ntawm lub paj hlwb (xws li tus cwj pwm txawv txav thiab qaug dab peg) tshwm sim los ntawm shunt. Lub hom phiaj ntawm kev kho mob yog kom txo qis kev tsim khoom thiab nqus cov khoom pov tseg xws li ammonia. Hauv qhov xwm txheej hnyav, qee tus dev xav tau kev txhawb nqa ntxiv rau kev ruaj khov ua ntej kev phais (xws li kev kho cov kua dej hauv cov hlab ntsha, tshuaj qaug dab peg, thiab lwm yam).
Qee qhov xwm txheej, kev tswj hwm kev kho mob ntawm lub portosystemic shunt kuj yog ib qho kev xaiv thaum tus dev muaj teeb meem kev noj qab haus huv uas tuaj yeem cuam tshuam nws txoj kev phais thiab rov qab los lossis thaum phais nws tus kheej tsis zoo li kho qhov teeb meem.
Kev tswj hwm kev noj qab haus huv suav nrog kev hloov pauv kev noj zaub mov kom txo qis cov protein ntau, lactulose (txo kev nqus ntawm ammonia), thiab qee zaum, tshuaj tua kab mob kom txo tau cov kab mob plab hnyuv loj.
Cov lus nug nquag nug (FAQs)
Portosystemic shunt kuaj mob li cas?
Yog tias koj tus dev tau pom cov tsos mob ntawm tus kabmob portosystemic shunt, nws yog ib qho tseem ceeb uas yuav tau nrhiav kev kho tsiaj rau kev ntsuam xyuas thiab kev kho mob. Nyob ntawm koj tus dev cov tsos mob thiab keeb kwm, koj tus kws kho tsiaj yuav pom zoo cov kev sim hauv qab no los kuaj qhov teeb meem:
- Tshuaj ntshav Cell suav thiab Serum Chemistry: Cov kev ntsuam xyuas no yuav qhia pom qhov txawv txav xws li ntshav ntshav, ntshav qis urea nitrogen (BUN), qis albumin, thiab nce siab enzymes (ALP)., ALT).
- Urinalysis: Cov zis los ntawm cov dev nrog portosystemic shunts yog qee zaum dilute, qhia cov tsos mob ntawm tus kab mob, thiab muaj peev xwm muaj me me crystals hu ua ammonium biurate crystals.
- Bile Acids Test: Qhov no yog kev kuaj lub siab ua haujlwm. Feem ntau, ib tug dev nrog ib tug portosystemic shunt yuav muaj ntau cov kua tsib acids. Cov kua tsib ntau ntxiv tsis yog qhov tshwj xeeb rau lub portosystemic shunt tab sis tuaj yeem tshwm sim thaum muaj kab mob siab.
- Ammonia Tolerance Test, Abdominal Ultrasound, Computed Tomography (CT) Scan, Nuclear Scintigraphy, Portography, Sib Nqus Resonance Imaging (MRI), thiab kev soj ntsuam phais yog tag nrho cov kev kuaj mob ntxiv. tuaj yeem ua tau los kuaj xyuas qhov portosystemic shunt.
Dab tsi yog qhov Prognosis rau tus dev Nrog Portosystemic Shunt?
Qhov hnyav ntawm portosystemic shunts tuaj yeem sib txawv heev, nrog rau qee qhov mob hnyav thiab ua rau muaj kev hem thawj rau lub neej. Tom qab kev hloov pauv kev noj zaub mov thiab tshuaj noj, feem ntau cov dev nrog portosystemic shunts pib txhim kho tam sim ntawd. Txawm li cas los xij, kev hloov pauv tshuaj thiab kev noj zaub mov ib leeg yuav tsis kho tus kab mob portosystemic shunt tag nrho, yog li nyob rau hauv cov xwm txheej no, tshwj tsis yog kev phais ua tiav, kev muaj sia nyob mus ntev tsis xav tau.
Cov dev uas muaj ib qho kev mob ntxiv rau lub cev muaj qhov pom zoo nrog kev phais. Cov dev uas muaj intrahepatic shunts (shunts nyob rau hauv lub siab nws tus kheej) muaj kev pheej hmoo rau cov teeb meem tom qab phais.
Conclusion
Nyob ntawm lub hauv paus chiv keeb ntawm shunt, tus aub lub hnub nyoog, thiab tag nrho cov mob, kev phais los yog kev kho mob yuav tswj tus mob no. Vim tias qee qhov xwm txheej ntawm cov shunts portosystemic tuaj yeem ua rau mob hnyav thiab ua rau muaj kev phom sij rau lub neej, yog tias koj tus dev pom cov tsos mob ntawm shunt, nws yog ib qho tseem ceeb kom koj tus dev soj ntsuam los ntawm kws kho tsiaj rau kev kuaj mob thiab cov lus pom zoo kho mob.
