Kuthekani ukuba bangafaka ikhamera encinci entliziyweni yakho baze bayijonge? Oko kukufaka i-catheterization yentliziyo!

Ngaba uhlala uphathwa ziintlungu esifubeni? Okanye ugqirha wakho urhanela ukuba unengxaki yentliziyo? Namhlanje siza kuthetha ngovavanyo olukhethekileyo olwenziwayo ukuze kubonwe ukuba kwenzeka ntoni ngaphakathi entliziyweni yakho. Oku sikubiza ngokuba yi-`(Cardiac Catheterization)`. Igama lisenokuvakala ngathi yinto enkulu, kodwa ungoyiki. Masithethe ngale nto ngokulula.

Yintoni iCardiac Catheterization? Ngamafutshane...

Khawucinge ukuba ubufuna ukujonga ukuba imithambo yegazi engaphakathi entliziyweni yakho, iityhubhu ezincinci ezithwala igazi entliziyweni yakho, zisebenza kakuhle na kwaye ukuba kukho ukuvaleka kwenye indawo. Kulapho ke olu vavanyo lwe-"Cardiac Catheterization" lwenziwa khona.

Ngamafutshane, oku kuquka ukudlulisa umbhobho omncinci kakhulu, omncinci (okwabizwa ngokuba yi-"catheter") ngemithambo yegazi emikhulu engalweni okanye emqolo wakho uye entliziyweni yakho. Kufana nokufaka ikhamera encinci ngaphakathi. Xa umbhobho ungena entliziyweni yakho, oogqirha banokubona ngokucacileyo imithambo yegazi ephambili entliziyweni yakho, njenge-"coronary arteries" (imithambo yegazi ehambisa igazi kwimisipha yentliziyo) okanye i-"pulmonary artery" (umthambo othwala igazi ukusuka entliziyweni ukuya emiphungeni). Oku kunokubonisa ngokuchanekileyo ukuba kukho ingxaki kwimilo okanye umsebenzi wentliziyo.

Olu asilotyando olukhulu. Oko kuthetha ukuba akukho nxeba likhulu emzimbeni. Ngoko ke ixesha lokuchacha lifutshane kakhulu kunotyando. Nangona kunjalo, ngamanye amaxesha emva kolu vavanyo, kuxhomekeke kwiziphumo, ugqirha unokugqiba ekubeni udinga utyando.

Olu vavanyo lwenziwa yingcali yentliziyo efumene uqeqesho olukhethekileyo kweli candelo kunye neqela lakhe. Eli qela lijoyinwe ngabanye oogqirha, abahlengikazi kunye neengcali.

Ziziphi iintlobo ze-catheterization yentliziyo?

Kukho iintlobo ezimbini eziphambili zale nto:

1. Ukufakwa kwe-catheter yentliziyo ekhohlo: Oku kuquka ukudlulisa umbhobho omncinci (i-catheter) nge-artery uye entliziyweni. Le nkqubo ikuvumela ukuba ubone imeko yee-chambers kunye ne-coronary arteries kwicala lasekhohlo lentliziyo yakho, kwaye ulinganise uxinzelelo kwelo cala.

2. Ukufakwa kwe-catheter yentliziyo yasekunene: Kule nto, kufakwa ityhubhu ngomthambo. Oku kusenza sikwazi ukubona amagumbi ecala lasekunene lentliziyo kunye noxinzelelo olukwelo cala.

Kutheni ugqirha angacebisa olu vavanyo lwe-cardiac catheterization?

Kukho izizathu ezahlukeneyo zokuba ugqirha angacebisa olu vavanyo. Makhe sijonge ukuba zeziphi:

• Ukuba ufumana iintlungu zesifuba rhoqo okanye isingqisho sentliziyo esingaqhelekanga, fumana unobangela.
• Thatha isampuli yegazi okanye iqhekeza elincinci kakhulu lesicwili entliziyweni uze ulivavanye (`(biopsy)`).
• Qinisekisa ukuba akukho ngxaki kwimithambo yakho yentliziyo okanye kwiivalvu zentliziyo.
• Jonga ukuba izihlunu zentliziyo zisebenza kakuhle na uze ubone ukuba kukho isifo sentliziyo (cardiomyopathy).
• Jonga iingxaki zemithambo yegazi ekhokelela emiphungeni yakho (imithambo yegazi yemiphunga) kunye noxinzelelo lwegazi oluphezulu (ingcinezelo yegazi yemiphunga).
• Jonga ukuhamba kwegazi, amanqanaba eoksijini, kunye noxinzelelo kwiindawo ezahlukeneyo zentliziyo.
• Fumana ulwazi olungenakufumaneka ngokuchanekileyo kwezinye iimvavanyo.
• Gqiba ukuba loluphi unyango olufunekayo emva koko. Umzekelo, ukuba umthambo wegazi uvalekile, oku kuya kunceda ekugqibeni ukuba uwucoce na, ufake i-stent, okanye wenze utyando olufana ne-coronary artery bypass graft (CABG).
• Olu vavanyo lubalulekile xa uceba ukufakelwa intliziyo.

Isebenza njani i-catheterization yentliziyo?

Mandikucacise oku kancinci. Emva kokuba ugqirha efake loo mbhobho mncinci entliziyweni, ulwelo olukhethekileyo (olubizwa ngokuba yi-'contrast material') lufakwa ngaloo mbhobho entliziyweni nakwimithambo yegazi. Olu lwelo lwenza imithambo yegazi kunye namagumbi entliziyo abonakale ngokucacileyo kwimifanekiso ye-'X-ray'.

Njengoko olu lwelo luhamba entliziyweni, lurekhodwa kwi-X-ray (ekwabizwa ngokuba yi-coronary angiogram). Ukusuka kule mifanekiso yedijithali, ugqirha anga:

• Fumana ngqo apho umthambo wentliziyo uvalekile okanye uncitshiswe khona.
• Hlola ubungakanani kunye nokuma kwamagumbi entliziyo kunye nemithambo yegazi.
• Jonga ukuba akukho nakuphi na ukopha okanye ukukrweleka okungaqhelekanga.

Ngamanye amaxesha, ukuba ufuna ulwazi oluthe kratya, ezinye iimvavanyo ezikhethekileyo zingenziwa ngexesha elinye nale "Cardiac Catheterization". Umzekelo:

• I-intravascular ultrasound (IVUS): Oku kungasetyenziselwa ukubona i-plaque kunye ne-calcium deposits ngaphakathi kwemithambo yegazi, kunye nokujonga ukuba i-stent ikhona na.
• Indawo yokugcina ukuhamba kwegazi (i-FFR): Oku kusetyenziswa ukulinganisa uxinzelelo kumacala omabini emithambo yegazi evalekileyo nokufumanisa ukuba ukuvaleka kukhulu ngokwaneleyo ukuba kufuneke unyango.
• `(Optical coherence tomography - OCT)`: Oku kungathatha imifanekiso ecacileyo yangaphakathi kwemithambo yegazi.

Kwakhona, ngamanye amaxesha ugqirha angenza unyango oluthile ngelixa esenza olu "Catheterization lweCardiac". Olu asilotyando.

• I-Angioplasty: Ukwandisa imithambo yentliziyo enciphileyo kunye nokuphucula ukuhamba kwegazi ukuya entliziyweni.
• `(Ukubekwa kwe-Stent)`: Ukufaka isixhobo esincinci esifana ne-mesh (`(Stent)`) kumthambo obanzi ukuze ungaphinde unciphe.
• I-Valvuloplasty: Ukuvula ivalvu yentliziyo enciphileyo.
• `(Ukujikeleza)`: Unyango lokususa iidiphozithi zecalcium kwimithambo yegazi.
• I-Intravascular lithotripsy: Oku kuquka ukusebenzisa ibhaluni ekhethekileyo kunye namaza oxinzelelo ukuze kwahlulwe i-calcium.
• `(Ukususwa kwentliziyo)`:Unyango lokulungisa isingqisho sentliziyo esingaqhelekanga.

Khawucinge ukuba bekuya kuba luncedo kangakanani ukuba ubunokufumana iingxaki zentliziyo yakho ngovavanyo olunye, kwaye ngamanye amaxesha uzinyange apho? Yiloo nto kanye le nto ithethwayo.

Olu vavanyo lwe-Heart Cath luthatha ixesha elingakanani?

Uvavanyo oluqhelekileyo lwe-cardiac catheterization, olujonga imithambo yakho yentliziyo kuphela, luthatha malunga nemizuzu engama-30. Nangona kunjalo, eli xesha linokwahluka ngokuxhomekeke kwinjongo yovavanyo.

Kodwa, xa udibanisa ixesha lokulungiselela oku kunye nexesha lokuphola emva kovavanyo, kuya kufuneka uhlale esibhedlele imini yonke. Kungathatha iiyure ezintlanu, ezisithoba, okanye nangaphezulu. Nokuba uvukile ngexesha lovavanyo, kuya kufuneka ubekele bucala usuku lonke loku. Ukuba ngesizathu esithile oogqirha bagqiba ekubeni benze inkqubo efana ne-angioplasty, kungathatha ixesha elide, mhlawumbi iiyure ezininzi.

Yintoni onokuyilindela ngaphambi kovavanyo?

Ngaphambi kokuba wenze i-`(Cardiac Catheterization)`, kufuneka uqaphele ezi zinto:

• Kuya kufuneka uyeke ukutya nokusela kangangeeyure ezimbalwa ngaphambi kovavanyo (ngesiqhelo malunga neeyure ezintandathu ukuya kwezisibhozo).
• Ugqirha wakho angakuxelela ukuba uyeke okwethutyana ukuthatha amayeza athile okanye utshintshe umthamo. Ufanele wenze njalo ngokufanelekileyo.
• Ufanele uxelele ugqirha wakho ngazo zonke izinto ezibangela ukuba ungabi namdla kwizinto ezithile kunye nazo zonke izinto ozisebenzisayo.

Emva kokuba ufikile esibhedlele:

• Kufuneka unxibe ilokhwe oyinikwe sisibhedlele.
• Umbhobho omncinci (ongena emthanjeni - IV) uza kufakwa emthanjeni osengalweni yakho ukuze ukunike amayeza kunye nolwelo.
• Kufuneka ulale ebhedini ekhethekileyo. Ngaphezulu kwale bhedi kukho ikhamera enkulu ye-X-ray kunye neemonitha zeTV ezininzi.
• Ulusu lulungiselelwa apho umbhobho omncinci (i-catheter) uza kufakwa khona (nokuba kusengalo okanye emqolo).
• Iipatches ezincinci, ezithe tyaba nezinamathelayo (ii-electrode) zibekwe esifubeni sakho. Ezi ziqhagamshelwe kwi-electrocardiograph monitor (EKG). Oku kujonga izinga lentliziyo yakho kunye nesingqisho.
• Uza kunikwa isithomalalisi esithambileyo ukukunceda uphumle, kodwa uza kuhlala uphaphile kwaye uphaphile kulo lonke uvavanyo.
• Kucetyiswa ukuba uqaphele izinto ezifana ne-allergies, isicaphucaphu, kunye nokungonwabi esifubeni.

Kwenzeka ntoni ngexesha lovavanyo?

Ngexesha lokuhlolwa kwentliziyo, ugqirha uya kwenza oku kulandelayo:

• Iyeza lokudambisa iintlungu lifakwa phantsi kolusu lwakho ngenaliti encinci.
• I-sheath encinci yeplastiki ('i-sheath yokungenisa' - i-catheter idlula apha) ifakwa kwimithambo yegazi engalweni yakho, entanyeni, okanye emqolo.
• I-catheter ifakwa nge-sheath ize isiwe entliziyweni. (Ungaziva ucinezelekile kancinci xa kufakwa i-sheath okanye i-catheter, kodwa akufuneki kube buhlungu.)
• Ukuze i-catheter ibekwe kakuhle, unokucelwa ukuba ujike intloko yakho okanye uphefumle nzulu uze uyibambe imizuzwana embalwa.
• Igumbi lifiphele, kwaye inani elincinci lolwelo olukhethekileyo (izinto ezichaseneyo) lifakwa nge-catheter kwimithambo yakho yegazi nakwiigumbi zentliziyo. Ngeli xesha, ungaziva ubushushu emzimbeni okanye ebusweni bakho imizuzwana embalwa .
• Usebenzisa ikhamera ye-X-reyi, ulwelo luya kudlula kwimithambo yakho yegazi nakwiindawo zentliziyo ukuze uthathe imifanekiso (uya kucelwa ukuba ubambe umphefumlo wakho ngelixa kuthathwa i-X-reyi).
• Ngelixa uhleli, baza kuyisusa i-catheter kunye ne-sheath.
• Izibane zivuliwe kwakhona.

Yintoni onokuyilindela emva kokufakwa kwe-catheter yentliziyo?

Emva kokuba uhlolo lugqityiwe, ugqirha uyayisusa i-catheter kunye ne-sheath.

Ukuba i-catheter ifakiwe esandleni sakho:

• Ibhandeji lifakwa apho ityhubhu ifakiwe khona.
• Kufuneka ugcine ingalo yakho ithe tye ubuncinane iyure enye (kodwa ungahamba).
• Uza kuhlolwa iiyure ezimbalwa ukuze kubonwe ukuba akukho zimpawu okanye iziphumo ebezingalindelekanga.
• Baza kukunika imiyalelo yokuba ungazinyamekela njani izandla zakho xa usiya ekhaya.
• Ukuba uziva ngathi uyopha (umanzi, ushushu), ukuba iminwe yakho ayisebenzi kakuhle, okanye ukuba uziva into engaqhelekanga, kufuneka uxelele ugqirha wakho.

Ukuba i-catheter ifakwe kwi-groin yakho:

• Indawo yokufaka inxeba iqinisiwe, ngamanye amaxesha nge-suture okanye "iplagi" (oku kunciphisa ukopha).
• Bakuxelela ukuba ulale ebhedini imilenze yakho ithe tye kangangeeyure ezimbini ukuya kwezintandathu ukuze uyeke ukopha (ngeli xesha kungancitshiswa ukuba ufaka "iplagi"). Bakuxelela nokuba ungaphakamisi intloko yakho ngaphezu kwemiqamelo emibini.
• Ukukhusela kwizifo, kufakwa ibhandishi ecocekileyo phezu kwendawo yempundu kwaye ihlolwe rhoqo.
• Ukuba uziva uphuma igazi (umanzi, ushushu), ukuba iinzwane zakho azinangqondo, okanye ukuba uziva into engaqhelekanga, mxelele.

Ukubuyiselwa emva kweCatheterization yentliziyo

Zikhathalele ezi zinto ngexesha lokuchacha kwakho:

• Kufuneka usele amanzi amaninzi ukuze ukhuphe ulwelo olukhethekileyo (izinto ezichaseneyo).
• Ugqirha uza kukuxelela ukuba uza kuya ekhaya ngaloo mini okanye uza kuhlala esibhedlele ubusuku bonke (nokuba yeyiphi na indlela, uza kujongwa iiyure ezimbalwa emva kovavanyo).
• Thetha nogqirha wakho malunga nendlela yokunyamekela inxeba.
• Udinga umntu oza kukuyisa ekhaya ngemoto (ukuba ikhaya lakho likude ngeeyure ezimbini, hlala ehotele uze uhambe imizuzu emihlanu ukuya kwelishumi ngeyure nganye).

Ngokwesiqhelo ungaqhuba emva kweeyure ezingama-24 uphumile esibhedlele. Ngokuxhomekeke kwindawo efakwe kuyo i-catheter, kufuneka uphephe imisebenzi enzima (efana nemidlalo okanye ukuphakamisa izinto ezisindayo) kangangeentsuku ezimbini ukuya kwezintlanu. Ugqirha wakho uza kukuxelela ukuba ungabuyela nini emsebenzini.

Xa usekhaya, akuyonto ilungileyo ukuntywilisela inxeba emanzini kangangeveki.Oko kuthetha ukuba akufanele uqubhe okanye ungene ebhafini. Kodwa ungahlamba emva kweeyure ezingama-24 emva kovavanyo.

Zithini iingozi zolu vavanyo?

Njengakwiimvavanyo zonyango zonke, kukho iingozi ezincinci ezibandakanyekayo, kodwa ezi azixhaphakanga kakhulu.

• Ukusabela kokunganyamezelani.
• Isingqisho sentliziyo esingaqhelekanga.
• Uxinzelelo lwegazi oluphantsi.
• Ukopha okanye usulelo kwindawo yokufaka i-catheter.
• Ukuwa komphunga (i-pneumothorax).
• Intlungu yesifuba engapheliyo.
• Ukungasebenzi kakuhle kwezintso.
• Ukuqokelelana kolwelo olujikeleze intliziyo (`(i-cardiac tamponade)`).
• Ukuqhekeka kwegazi, ukuhlaselwa yintliziyo, isifo sohlangothi okanye ukufa (ezi aziqhelekanga kakhulu ).
• Ukufuneka ukuba wenze utyando olungxamisekileyo, umzekelo utyando lwe-coronary artery bypass graft (CABG).

Xa uthetha nogqirha wakho, qiniseka ukuba uyaziqonda zonke ezi ngozi. Kwakhona, buza ukuba kutheni ucelwa ukuba wenze olu vavanyo. Nangona le ingeyonkqubo yotyando, ingabonakala ngathi yinkqubo enzima. Nangona kunjalo, khumbula ukuba iingxaki ezivela kule nkqubo azixhaphakanga.

Zithini iziphumo? Ithini intsingiselo kaEva?

Emva kokufakwa kwe-catheter yentliziyo, ugqirha wakho uya kuba nolwazi oluninzi olubalulekileyo oluza kukunceda ugqibe ngenkqubo yakho elandelayo yonyango. Iziphumo zingahluka ngokuxhomekeke kwisizathu sovavanyo.

Ugqirha anga:

• Fumana ingxaki, njengokuvaleka kwenye yemithambo yakho yentliziyo, uze uyinyange ngoko nangoko.
• Chonga imeko yempilo efuna utyando.
• Isampuli yesihlunu sentliziyo yakho ithunyelwa kwilebhu ukuze ihlolwe "i-biopsy".
• Fumana ulwazi oludingayo ukuze ucwangcise unyango.
• Qinisekisa ukuba intliziyo yakho isebenza kakuhle emva konyango lwangaphambili.

Ziza kwaziwa nini iziphumo?

Ugqirha wakho angathetha nawe ngeziphumo ngoko nangoko, kodwa ekubeni kuthatha ixesha ukuba into efana nesampuli yethishu ihlalutywe kwilebhu, kungathatha iintsuku ezimbalwa ukufumana iziphumo.

Ukuba iziphumo aziqhelekanga, yintoni oyenzayo emva koko?

Ukuba ugqirha ufumana naziphi na iingxaki ngexesha lotyando lwentliziyo, uya kuceba ukuvavanywa okanye unyango olongezelelweyo. Ngolwazi olufunyenweyo, usenokulungiselela notyando.

Ndifanele ndimtsalele umnxeba nini ugqirha?

Ukuba ufumana naziphi na ezi mpawu emva kokufakwa kwe-catheter yentliziyo, fowunela ugqirha wakho ngoko nangoko:

• Ukuba ufumana umkhuhlane .
• Ukuba uziva unesizungu .
• Ukuba kukho intlungu, ukudumba, ukopha, okanye ubomvu kwindawo apho kufakwe khona i-catheter.
• Ukuba unentlungu esifubeni .
• Ukuba unengxaki yokuphefumla .
• Ukuba ukubetha kwentliziyo yakho kuvakala kungaqhelekanga .

Ukuba uziva ngathi unesifo sentliziyo okanye isifo sohlangothi, funa uncedo lwezonyango ngokukhawuleza.

Okokugqibela, yintoni ekufuneka uyikhumbule (Umyalezo Wokuya Ekhaya)

Kunokuba yinto eyoyikisayo ukucinga ukuba kukho umntu ojonge ngaphakathi entliziyweni yakho. Kodwa khumbula, le `(Cardiac Catheterization)` ayilotyando, kwaye uneqela lezonyango elinobuchule lokukunyamekela. Ulwazi olufunyenwe kolu vavanyo luxabiseke kakhulu koogqirha abakhetha unyango olufanelekileyo kuwe. Ke ngoko, olu vavanyo linyathelo elinye nje kwindlela eya ekuchacheni kwakho. Ungaze woyike ukubuza ugqirha wakho nayiphi na imibuzo okanye amathandabuzo onawo. Kubaluleke kakhulu ukucacisa oko kusengqondweni yakho.

Ukufakwa kwe -catheter kwintliziyo, isifo sentliziyo, i-angiogram, i-stent, uvavanyo lwentliziyo, unyango lwentliziyo, impilo yentliziyo