Wakambonzwa nezvedambudziko apo kumanikidzwa mutsinga diki dzeropa dziri mukati memapapu kunowedzera kamwe kamwe here? Zvakaita sechimwe chinhu chinonamirwa mupombi yemvura uye kumanikidzwa kunowedzera. Ndizvo zvinoreva CTEPH. Kunyange zvazvo zita racho ringanzwika serakareba zvishoma, zviri nyore kunzwisisa. Idambudziko risingawanzoitiki, asi rinokosha ratinofanira kuziva tese.
Zvichitaurwa zviri nyore, chii chinonzi CTEPH?
CTEPH iBP yakakwira mumapapu. Mukurapa, tinoidaidza kuti `(Pulmonary Hypertension)`. Asi izvi zvakasiyana neBP yakakwira yakajairika. Pane chikonzero chaicho chinoita kuti CTEPH iitike. Kureva kuti, mavhandi eropa akambova mutsinga dzeropa dzemapapu `(Pulmonary Embolism)` haanyungudike zvakanaka .
Fungidzira munhu aine ropa rakagwamba mumapapu ake. Kazhinji, mashandiro emuviri wedu ndiwo anonyungudutsa ropa iri nekufamba kwenguva. Asi mune vamwe vanhu, ropa iri harinyungudike zvachose. Pane kudaro, rinova nyama yekare yakaita semavanga inogara mutsinga dzeropa. Nekufamba kwenguva, mavanga aya anoita kuti tsinga dzeropa dzitete.
Kana mitsipa yeropa ikaita diki, mwoyo unofanirwa kushanda nesimba kuti upombe ropa nepakati pemitsipa iyoyo yakamanikana. Izvi zvinoita kuti kumanikidzwa kuri mukati memitsipa yeropa mumapapu kukwire zvakanyanya. Ndizvo zvatinodaidza kuti CTEPH (Chronic Thromboembolic Pulmonary Hypertension) .
Chinhu chakakosha ndechekuti chirwere ichi chinongoitika chete kuvanhu vane nhoroondo ye pulmonary embolism. Kana kumanikidzwa mumapapu kwakanyanya vasina nhoroondo yakadaro, chinogona kunge chiri chimwe chirwere.
CTEPH inokanganisa sei muviri wako?
Rutivi rwerudyi rwemwoyo wedu runopomba ropa risina okisijeni uye risina kuchena kuenda kumapapu kuti richeneswe. Zvino, kana tsinga dzeropa mumapapu dzikava shoma nekuda kweCTEPH uye kumanikidzwa kwacho kuchiwedzera, rutivi rwerudyi rwemwoyo runofanira kutarisana nechipingamupinyi chikuru mukusundira ropa iri kumapapu.
Izvi zvinokonzera matambudziko makuru maviri:
1. Kuremedza moyo zvakanyanya: Paunoshanda nesimba seizvi nguva dzese, rutivi rwerudyi rwemoyo runotanga kupera simba. Izvi zvakafanana nepombi yemvura inoshanda nesimba kuzadza nzvimbo yakavharika. Nekufamba kwenguva, pombi inopera simba.
2. Kuderera kwehuwandu hweokisijeni mumuviri: Ropa harikwanisi kupfuura nemumapapu zvakanaka uye kutora okisijeni. Izvi zvinoita kuti huwandu hweokisijeni mumuviri hudzike. Izvi ndizvo zvatinoona sezviratidzo zvakaita sekuneta uye kushaya mweya.
Ndezvipi zvinhu zvinowedzera njodzi yekubatwa neCTEPH?
Sezvambotaurwa, chikonzero chikuru ndechekuti ropa rinogwamba mumapapu harinyungudike zvachose. Zvisinei, vamwe vanhu vane mukana mukuru wekuva nechirwere ichi. Ngatitarisei kuti zvinhu izvi zvine njodzi ndezvipi.
| Chinhu chine njodzi | Tsananguro |
|---|---|
| Rudzi rweropa | Kuva neropa risiri 'O'. |
| Zvirwere zvekugwamba kweropa | Kana iwe pachako kana mumwe munhu mumhuri yako aine chirwere chekugwamba kweropa (semuenzaniso Antiphospholipid Syndrome ). |
| Kubviswa kwetsvina | Kubviswa kweplenectomy (kuvhiyiwa kwekubviswa kweplenectomy) . |
| Utachiona hwenguva refu | Kutapurirana kwenguva refu kwakadai sekutapurirana kwemapfupa (osteomyelitis) . |
| Zvimwe zvirwere | Mamwe marudzi egomarara nezvirwere zvakaita seInflammatory Bowel Disease . |
| Zvimwe zvinhu | Kuva mukadzi, kuva nepacemaker mumoyo, uye kutora mishonga ye thyroid hormone zvinhu zvinogona kukonzera hutachiona. |
Ndezvipi zviratidzo zvechirwere ichi?
Zviratidzo zveCTEPH zvingasava pachena pakutanga. Zvinokura zvishoma nezvishoma. Ungafunga kuti uku kungori kuneta kwakajairika. Asi zvakakosha zvikuru kutarisisa zviratidzo izvi.
| Chiratidzo | Mamwe mashoko |
|---|---|
| Kuoma kufema | Zvinonyanya kuitika kana ukashanda nesimba, sekufamba kana kukwira masitepisi. Sezvo chirwere ichi chichienderera mberi, kusagadzikana uku kunogona kuitika kunyangwe wakangomira. |
| Kuneta kwakanyanya uye kuneta | Kunzwa kuneta nguva dzese kunyangwe pasina basa rauri kuita. |
| Kurwadziwa kwechipfuva kana kuomarara | Kurwadziwa uku kunogona kuitika nekuti moyo unofanirwa kushanda nesimba. |
| Kuzvimba kwemakumbo netsoka (Edema) | Nekuda kwekusashanda zvakanaka kwemoyo, mvura inoungana mumuviri, zvichikonzera kuzvimba mumakumbo. |
| Dzungu uye kupera simba (Syncope) | Izvi zvinogona kuitika kana uropi husingagamuchire okisijeni yakakwana. |
| Kurova kwemoyo | Kunzwa sekunge uri kunzwa kurova kwemoyo wako wega. |
| Kuchinja kweruvara rwebhuruu (Cyanosis) | Miromo nezvigunwe zvinoshanduka kuita bhuruu nekuda kwekushaya okisijeni yakakwana muropa. |
Kana uine zviratidzo izvi, kunyanya kana wakambova neropa rakagwamba mumapapu, ndapota ona chiremba wako nekukasika.
CTEPH inoonekwa sei?
Kana ukaona chiremba, achakubvunza nezvezviratidzo zvako uye achakuongorora. Kana paine fungidziro yekuti une CTEPH, vachakukurudzira kuti uongorore kakawanda kuti uone kana chirwere chacho chawanikwa.
- V/Q scan: Izvi zvinotarisa kuti ropa rinoyerera sei kuenda kumapapu uye kuti mweya unofamba sei nepakati pawo. Iyi scan inogona kuona nzvimbo dzine ropa rakagwamba, sezvo kuyerera kweropa kuchiderera.
- Transthoracic Echocardiogram (TTE): Izvi zvinogona kuongorora kumanikidzwa kuri kurudyi kwemoyo uye kuti mwoyo hauna simba zvakadii.
- CT Pulmonary Angiogram: Iyi iCT scan yakakosha iyo inogona kuona zvakajeka magwamba eropa akare uye kutetepa kwetsinga dzeropa mumapapu.
Mimwe miedzo yekusimbisa
Kana chirwere chacho changosimbiswa, dzimwe bvunzo dzakawanda dzinogona kuitwa kuti dzionekwe kuti chakakomba sei uye kuronga kurapwa kwacho.
- Kuchenesa Mwoyo Wakarurama: Iyi ndiyo nzira chaiyo yekuyera kumanikidzwa kwemapapu. Chubhu diki (catheter) inopinzwa netsinga yeropa mumuviri ichienda kurudyi kwemoyo netsinga huru yeropa inoenda kumapapu, uye kumanikidzwa kunoyerwa.
- Bvunzo yeKushushikana Kwekurovedza Muviri: Bvunzo iyi inoitirwa kuona kuti moyo wako nemapapu zvinoshanda sei paunenge uchirovedza muviri.
Ndezvipi zvinorapwa izvi?
Mashoko akanaka nezveCTEPH ndeekuti chirwere chinorapika. Varwere vazhinji vanogona kurerukirwa nekuvhiyiwa kana mamwe marapirwo. Kune nzira mbiri huru dzekurapa.
1. Kuvhiyiwa kweEndarter yeMapupa (PTE):
Uku kuvhiyiwa kwemoyo kwakavhurika. Mukuita uku, vanachiremba vanovhura tsinga huru dzeropa mumapapu vobvisa mavanga eropa akare uye mavanga angave akaungana mukati. Kunyangwe uku kuvhiyiwa kwakaoma zvikuru, kana kukabudirira, kune mukana mukuru wekurapa chirwere chose.
2. Pulmonary Balloon Angioplasty (BPA):
Kurapa uku kunoshandiswa kuvanhu vane ropa rakagwamba mutsinga diki zvekuti havakwanise kuvhiyiwa. Mukurapa uku, chubhu diki (catheter) inopinzwa mutsinga iri mugumbo uye bharumu diki riri kumagumo rinoshandiswa kufuridza nekukudza tsinga yakamanikana. Izvi hazvisi zvikuru sekuvhiyiwa.
Kurapa uku kwose kunogona kurapa CTEPH zvachose. Mushure mekurapwa, vanhu vazhinji vanogona kurarama hupenyu hwakajairika.
Dzimwe nguva, kune avo vasingakwanisi kuvhiyiwa kana kuti vachiri nepressure yakanyanya mumapapu mushure mekuvhiyiwa, mishonga yakakosha (semuenzaniso, Riociguat) inopiwa kudzora pressure iyoyo.
Zvinhu zvekuziva kana uchigara neCTEPH
Hupenyu hwako huchavandudzika zvakanyanya mushure mekurapwa, asi pane zvinhu zvishoma zvaunofanira kuziva.
- Mishonga yekuderedza ropa kwehupenyu hwese: Uchafanira kutora mishonga yekuderedza ropa kwehupenyu hwako hwese kuti ropa risarambe richigwamba. Zvakakosha kutevedzera mirairo yachiremba wako nemazvo.
- Kudya: Kana uri kutora mushonga wakaita se'Warfarin', unofanira kungwarira nezvekudya zvine vhitamini K yakawanda (senge kabheji, sipinachi, broccoli). Taura nachiremba wako nezvenyaya iyi.
- Dzivisa kusvuta: Kusvuta kunokanganisa mapapu ako zvikuru. Kana uri munhu anosvuta, zvakakosha kuti urege zvachose.
- Kurovedza muviri zvishoma: Kurovedza muviri zvishoma, sekufamba netsoka, kunogona kubatsira kuwedzera simba rako. Zvisinei, iva nechokwadi chekubvunza chiremba wako usati watanga chero chirongwa chekurovedza muviri. Unogona kutumirwa kuchirongwa chekurapa chinotariswa nachiremba chinonzi ``Pulmonary Rehabilitation.''
- Hutano hwepfungwa: Kurarama nechirwere chakadai kwenguva refu kunogona kukonzera kunzwa kwekushushikana, kuzvidya mwoyo, kana kuora mwoyo. Kana uri kunzwa seizvi, usanyara kutaura nachiremba wako kana mumwe munhu ari pedyo newe.
Mharidzo Yekuenda Nayo Kumba
- CTEPH chirwere cheBP chakakwira chinokonzerwa nekugwamba kweropa kwakasakara kunonamira mutsinga dzeropa dzemapapu.
- Usavhiringidze izvi neBP yakakwira.
- Kana uine zviratidzo zvakaita sekushaya mweya, kuneta zvakanyanya, kana kuzvimba mumakumbo ako, kunyanya kana uine nhoroondo yekugwamba kweropa, enda kuna chiremba nekukasika.
- Chirwere ichi chinogona kurapwa zvachose nekuvhiyiwa kana dzimwe nzira.
- Kunyangwe mushure mekurapwa, tevera mirairo yachiremba wako nemazvo, kunyanya maererano nekutora mishonga inobvisa ropa.
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