Intliziyo yakho yeyona ndawo iphambili yokumpompa umzimba wakho wonke. Ngoko ke umthambo wegazi omkhulu, omkhulu ophuma entliziyweni kwaye uthwala igazi elicocekileyo nelicebileyo ngeoksijini emzimbeni wakho wonke ubizwa ngokuba yi-aorta. Cinga ngayo njengombhobho wamanzi ophambili ohambisa amanzi endlwini yakho. Ukuqhekeka kwe-Aortic kuxa udonga lwalo mthambo wegazi uphambili lukrazuka ngaphakathi. Le yimeko engxamisekileyo eyingozi kakhulu, esongela ubomi edla ngokwenzeka ngequbuliso, ngaphandle kwesilumkiso sangaphambili.
Yintoni i-Aortic Dissection? Masiyiqonde ngokulula
I-aorta yethu ngumthambo wegazi owenziwe ziingqimba ezintathu. Ifana nodonga olunezingqimba ezintathu. Ukuba ngesizathu esithile, kukrazuka ngaphakathi kolu donga, igazi elihamba phantsi koxinzelelo oluphezulu lingena kwingxondorha lize liqalise ukuvuza phakathi kweengqimba ezimbini zodonga. Njengoko igazi lizaliswa ngale ndlela, ezi zingqimba zimbini zahlukana. Yiloo nto siyibiza ngokuba kukuqhekeka.
Cinga ngayo ngathi yindlela eqhekeka kabini. Xa oku kusenzeka, ukuhamba kwegazi okuqhelekileyo kwiindawo ezahlukeneyo zomzimba kuyaphazamiseka. Kwaye ngamanye amaxesha, le mithambo mikhulu ingagqabhuka ngokupheleleyo (ukuqhekeka).
Le yingxamiseko yezonyango. Ukuba ayifunyaniswanga kwaye ayinyangwa ngokukhawuleza, inokukhokelela ekufeni ngequbuliso. Kungoko ke, kubaluleke kakhulu ukukwazi oku.
Ziziphi iintlobo eziphambili zokuqhekeka kwe-aorta?
Oogqirha bahlula le meko ibe ziintlobo ezimbini eziphambili, ezibizwa ngokuba yiStanford classification, esekwe kwindawo apho ukukrazuka kwenzeka khona.
| Uhlobo | Inkcazo |
|---|---|
| Uhlobo lweStanford A | Olu lolona hlobo luqhelekileyo noluyingozi kakhulu . Ukukrazuka kwenzeka kwinxalenye ephezulu ye-aorta, ekufutshane nentliziyo (i-ascending aorta). Oku kunokuba yingozi ebomini ngoko nangoko, ngoko ke utyando olungxamisekileyo ludla ngokufuneka. |
| Uhlobo lweStanford B | Ukukrazuka kwenzeka kwi-aorta ehlayo, kude kancinci nentliziyo. Oku kusenokungabi yingozi ngoko nangoko njengohlobo A. Ukuba ukunikezelwa kwegazi kwizitho zomzimba akunqunyulwanga, kunokulawulwa ngamayeza , ngaphandle kwesidingo sotyando olungxamisekileyo. |
Zithini iimpawu zoku? Ungazibona njani?
Uphawu oluphambili lokuqhekeka kwe-aorta kukuba kwenzeka ngequbuliso . Akukho zimpawu zilumkisayo. Kungenzeka nangaliphi na ixesha, njengaxa ulele, uphumle, okanye wenza umsebenzi onzima.
Ezi ziimpawu ezinokubonwa ngokubanzi:
- Intlungu ebuhlungu ngequbuliso, enganyamezelekiyo, esifubeni okanye emqolo ongasentla. Abantu abaninzi bayichaza njengemvakalelo "yokukrazulwa" okanye "yokuhlatywa" . Olu lolona phawu luphambili noluqhelekileyo.
- Intlungu ebuhlungu yesisu.
- Ubunzima bokuphefumla (i-Dyspnea).
- Isiyezi okanye i-vertigo.
- Ukwehla ngequbuliso koxinzelelo lwegazi (uxinzelelo lwegazi oluphantsi).
- Ukubetha kwentliziyo okubuthathaka nokukhawulezayo.
- Ukubila okugqithisileyo.
- Ukudideka.
- Ukulahlekelwa ngumbono.
- Iimpawu zestroke. Umzekelo, ubuthathaka kwelinye icala lomzimba okanye ubunzima bokuthetha.
Ukuba ufumana iintlungu eziqatha esifubeni okanye ezinye iimpawu ezifana nezi, kuya kufuneka uye kwiSebe lezeMpilo eziNgxamisekileyo (ETU) esibhedlele ngoko nangoko, ngaphandle kokulibazisa . Musa ukucinga ukuba esi sisifo sentliziyo. Unyango lwezi meko zimbini lwahlukile.
Kutheni oku kusenzeka? Zithini izinto ezibangela umngcipheko?
Eyona nto ibangela ukuqhekeka kwe-aorta kukubuthathaka kancinci kancinci kodonga lwe-aorta ngokuhamba kwexesha. Oku kubuthathaka kwenzeka ngasese kangangeminyaka, kwaye ekugqibeleni kukrazuke kwindawo ebuthathaka kakhulu.
Eyona nto iphambili neyona ixhaphakileyo ebangela oku kukungalawuleki koxinzelelo lwegazi oluphezulu (iHypertension) . Uxinzelelo lwegazi oluphezulu lonakalisa udonga lwemithambo yegazi, nto leyo eyenza ukuba ingaguquguquki kwaye ibe buthathaka.
Ezinye izinto ezinobungozi zezi:
- I-atherosclerosis okanye i-cholesterol ephezulu.
- Ukusetyenziswa kweemveliso zecuba (ukutshaya).
- I-Aortic aneurysm.
- Izifo zevalvu ye-aorta yentliziyo.
- Iziphene zentliziyo ezizalwa nazo, umzekelo, ivalvu ye-aorta ye-bicuspid (iivalvu ezimbini endaweni yezintathu eziqhelekileyo).
- Izifo zezicubu ezidityanisiweyo, ezifana neMarfan syndrome kunye ne-Ehlers-Danlos syndrome . Ezi ziimeko ezinokuzuzwa njengelifa.
- Ukuba kukho umntu kusapho okhe wahluthwa umthambo wentliziyo ngaphambili.
- Ukulimala kakhulu esifubeni (umz., ingozi enkulu yemoto).
- Ukuba phakathi kweminyaka engama-40 ukuya kwengama-70 ubudala.
- Uxinzelelo lwegazi oluphezulu ngexesha lokukhulelwa.
- Ukusetyenziswa kweziyobisi ezifana ne-cocaine.
Ugqirha uyixilonga njani le nto?
Xa usiya esibhedlele, ugqirha unokurhanela ukuba le meko ibangelwa ziimpawu zakho. Nangona kunjalo, kuba ezi mpawu zifana nokuhlaselwa yintliziyo okanye isifo sohlangothi, kufuneka kwenziwe uvavanyo oluninzi ngokukhawuleza ukuze kuqinisekiswe ukuba unayo.
- I-CT scan (i-Computed Tomography): Le yeyona ndlela ilungileyo nekhawulezayo yokubona ngokucacileyo i-aorta xa kukho imeko engxamisekileyo.
- I-Echocardiogram: Olu luvavanyo lwe-ultrasound. I-transesophageal echocardiogram (TEE) inokubonisa i-aorta ngokucacileyo kune-transthoracic echocardiogram.
- I-X-ray yesifuba: Inganika umbono ocacileyo wokuba i-aorta ikhulisiwe na.
- I-MRI (iMagnetic Resonance Imaging): Nangona oku kunokuvelisa imifanekiso ecacileyo kakhulu, ayisetyenziswa rhoqo kwiimeko ezingxamisekileyo kuba kuthatha ixesha elide kune-CT scan.
Iphathwa njani?
Indlela yonyango ixhomekeke kwindawo apho kukrazuke khona (Uhlobo A okanye Uhlobo B) kunye nemeko yesigulana.
Utyando kunye nolunye unyango
1. Ukutshintshwa kweGraft: Olu lutyando lwentliziyo evulekileyo. Kolu tyando, ugqirha ususa inxalenye eyonakeleyo ye-aorta aze ayifake igraft eyenziweyo. Olu tyando lwenziwa njengonyango olungxamisekileyo lokususwa kwe-Type A.
2. Ukulungiswa kwe-Endovascular Stent-Graft: Oku kuquka ukwenza ukusika okuncinci emthanjeni wegazi emqolo kunye nokusebenzisa iingcingo kunye nee-catheters ukufaka ityhubhu yentsimbi (stent graft) kwindawo ebuthathaka ye-aorta. Oku kuqinisa udonga olubuthathaka ngaphakathi. Le ndlela idla ngokusetyenziswa ekuqhawuleni i-Type B enzima.
3. Indlela Exutyiweyo: Kwezinye iimeko ezinzima, zombini iindlela zotyando oluvulekileyo kunye neendlela zokufakelwa kwe-stent zisenokufuneka zisetyenziswe kunye.
Amayeza (amayeza)
Amayeza asetyenziswa kakhulu ngaphambi kotyando, emva kotyando, nakwiimeko zohlobo B apho utyando lungadingeki.
- Amayeza anjenge- beta-blockers anokunikwa ukunciphisa izinga lentliziyo kunye noxinzelelo lwegazi. Oku kunciphisa uxinzelelo kwi-aorta kwaye kuthintele ukukrazuka ukuba kungasasazeki ngakumbi.
- Kufuneka usele amayeza ubomi bakho bonke ukuze ulawule uxinzelelo lwakho lwegazi.
Ngaba oku kungathintelwa?
Asinakutshintsha ezinye izinto ezinobungozi (umz. izifo ezidluliselwa kwilifa). Nangona kunjalo, kukho izinto esinokuzilawula.
- Gcina uxinzelelo lwakho lwegazi lulawulwa kakuhle.Ukuba une-high blood pressure, sela amayeza achazwe ngugqirha wakho ngokuchanekileyo uze unciphise ityuwa oyityayo.
- Ukuba uyatshaya, yeka ngoko nangoko.
- Gcina ubunzima bomzimba busempilweni.
- Ukuba kukho nabani na kusapho lwakho (abazali, abantakwenu noodadewabo) okhe waba nale meko, thetha nogqirha wakho ngayo uze wenze uvavanyo olufunekayo.
- Ukunxiba ibhanti yesihlalo kunokuthintela ukwenzakala esifubeni kwingozi yemoto.
Umyalezo Wokuya Ekhaya
- Ukuqhekeka kwe-aorta kukukrazuka komthambo wegazi oyintloko ophuma entliziyweni. Le yimeko embi kakhulu, esongela ubomi.
- Ukuba ufumana intlungu ekhawulezileyo, enganyamezelekiyo, "ekrazukileyo" esifubeni okanye emqolo wakho , oku kungenzeka. Yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele ngaphandle kokulibazisa.
- Eyona nto ibangela oku kukungalawuleki koxinzelelo lwegazi oluphezulu. Ngoko ke jonga uxinzelelo lwakho lwegazi rhoqo kwaye ululawule.
- Nokuba emva konyango, kufuneka uhlale phantsi kweliso likagqirha ubomi bakho bonke. Fumana uvavanyo rhoqo (CT okanye MRI) kwaye uthathe amayeza amiselweyo kanye njengoko kubhaliwe.
- Kuphephe ukwenza umthambo onzima njengokuphakamisa iintsimbi. Nangona kunjalo, umthambo ophakathi njengokuhamba ngeenyawo kunye nokukhwela ibhayisekile kulungile. Cela ingcebiso kugqirha wakho ngale nto.
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