Ingaba ukuhamba kwegazi lakho ukuya emilenzeni kunciphile? Masithethe ngotyando lwe-Aortobifemoral Bypass

Ngaba uziva intlungu ebukhali okanye ukuxinana emilenzeni yakho, ingakumbi emathangeni nasemaqakaleni, xa uhamba umgama omfutshane? Intlungu iyaphela emva kwexesha elithile, kodwa ibuya xa uqala ukuhamba kwakhona? Okanye ngaba uvelisa amanxeba emilenzeni yakho ngaphandle kwesizathu esicacileyo kwaye athatha ixesha elide ukuphola? Ukuba unale mpawu, ugqirha wakho usenokuba uthethe nawe ngotyando. Usenokuba woyika kancinci xa usiva eli gama. Namhlanje sithetha ngaloo nto, utyando olubizwa ngokuba yi-Aortobifemoral Bypass. Ungakhathazeki, masichaze oku ngokulula.

Ngamafutshane, yintoni i-Aortobifemoral Bypass?

Khawuthelekelele ukuba indlela enkulu kwisixeko ivaliwe ngokupheleleyo ngenxa yezithuthi. Akukho ndlela yokuba izithuthi zidlule. Wenza ntoni ke ngoko? Siyayiphepha loo ndawo ivaliweyo size sakhe indlela entsha 'yokudlula' ukuze sifike kwelinye icala, akunjalo? Yiloo nto le nkqubo yotyando iyenzayo.

I-Aortobifemoral bypass lutyando olubandakanya imithambo yegazi emzimbeni wethu. Kule nto, oogqirha benza indlela entsha, ebizwa ngokuba yi-bypass , yokudlula kwiindawo ezivalekileyo okanye ezinciphileyo zemithambo yegazi ephambili esiswini sethu. Oku kubuyisela ukuhamba kwegazi emilenzeni yethu.

Kolu tyando, oogqirha basebenzisa umthambo wegazi owenziweyo, obizwa ngokuba yi- graft . Lo mthambo udla ngokwenziwa ngezinto ezifana ne-polyester. Masiqonde ukuba yafumana njani igama lawo:

• Igama elithi "Aorto" libhekisa kumthambo wegazi omkhulu emzimbeni wethu, i-aorta . Liqala entliziyweni lize lidlule esifubeni liye esiswini.
• Igama elithi "Femoral" libhekisa kwimithambo ye-femoral, eqala emqolo wethu ize ihambe ngasemathangeni ethu iye ngasemva kwamadolo ethu.
• Igama elithi "Bi" lithetha 'ezimbini'. Oko kuthetha ukuba olu xhulumaniso luqhagamshela kwimithambo yomibini ye-femoral kwimilenze yakho yomibini.

Le graft ibukeka ngathi yi-"Y" ejonge phezulu. Isiphelo esinye phezulu siqhagamshelwe kwinxalenye esezantsi ye-aorta esiswini. Imilenze emibini ye-Y iqhagamshelwe kwimithambo ye-femoral emilenzeni. Ngale ndlela, igazi linokunqumla ukuvaleka kwaye lihambe lula liye emilenzeni.

Kutheni sidinga olu hlobo lotyando?

Olu tyando lwenziwa ikakhulu njengonyango lwesifo esibizwa ngokuba yi -Aortoiliac occlusive disease . Nangona igama lisenokuvakala liyinkimbinkimbi, ibali lilula kakhulu. Okwenzekayo kukuba i-cholesterol kunye nezinye iidipozithi zamafutha (i-plaque) ziyaqokelelana ngokuhamba kwexesha kwimithambo yegazi ephambili esiswini nakwi-pelvis yethu. Imithambo yegazi ephambili echaphazeleka ngolu hlobo yile:

• I-aorta yesisu: Le yinxalenye ye-aorta ehla isuka ngaphakathi esiswini sethu.
• Imithambo ye-Iliac:Ezi ziqala kufutshane ne-groin apho i-aorta yahlukana khona ibe zimbini. Ezi zezo zihamba ziye kwindawo ye-groin zize zibe yi-femoral arteries.

Xa i-plaque iqokelelana ngaphakathi kwezi mithambo yegazi ize iyinciphise, amalungu asezantsi omzimba wethu, njengemilenze, iinyawo, kunye nezinye izitho ezisesinqeni, awafumani igazi elifunekayo elineoksijini. Xa le meko iba mandundu, iingxaki ezahlukeneyo zinokwenzeka.

Ingaba olu lutyando olukhulu? Ngaba kukho ezinye iindlela?

Ewe, i-aortobifemoral bypass lutyando oluvulekileyo olwenziwa ngokusikwa okukhulu esiswini. Ke ngoko, luthathwa njengotyando olukhulu, okanye olukhulu.

Kodwa kule mihla, ngenxa yokuqhubela phambili kwetekhnoloji, kukho ezinye iindlela zonyango zoku. Enye yezona ziphambili yindlela ebizwa ngokuba yi -aortoiliac stenting ene-bifurcation reconstruction (AISBR) . Le yindlela yotyando lwe-endovascular .

Ngamafutshane, oku kuquka ukufaka i-cannula kumthambo wegazi ngomngxuma omncinci kwi-groin, ukuya kwindawo evalekileyo, nokufaka ityhubhu encinci efana ne-mesh (i-stent) kuyo ukuze kwandiswe umthambo wegazi kwakhona. Le ndlela ayinazo iingxaki ezininzi zotyando kwaye ihlala ixesha elifutshane esibhedlele.

Ugqirha wakho uya kugqiba ukuba loluphi ukhetho olulungele wena. Ngokwesiqhelo, ukutshiza nge-stenting kuyacetyiswa kubantu abasengozini enkulu yotyando olukhulu ngenxa yezinye iimeko zonyango. Nangona kunjalo, ngamanye amaxesha, kuxhomekeke kubukhulu bokuvaleka, utyando oluvulekileyo lunokufuneka. Ngoko ke thetha nogqirha wakho malunga neendlela onokukhetha kuzo kunye nezinto ezilungileyo nezingalunganga.

Sizilungiselela njani ngaphambi kotyando?

Utyando olukhulu olufana nolu lufuna amalungiselelo amaninzi. Iqela lakho lezonyango liza kukunika imiyalelo efunekayo. Ngokubanzi, kufuneka uzinyamekele ezi zinto.

• Ukuyeka ukutshaya: Ukuba utshaya, kufuneka uyeke ngokupheleleyo ubuncinane iiveki ezi-3-4 ngaphambi kotyando. Ukuyeka ukutshaya kubaluleke kakhulu kwimpumelelo yotyando, kunye nempilo yentliziyo yakho kunye nemithambo yegazi kamva.
• Xelela ugqirha wakho ngayo nayiphi na imithi oyithathayo: Ukuba usela amayeza ezinto ezifana nesifo seswekile okanye uxinzelelo lwegazi oluphezulu, kufuneka umxelele ugqirha wakho ngayo. Amanye amayeza anokufuna ukuyeka okanye kutshintshwe umthamo ngaphambi kotyando.
• Ukuzila ukutya ngaphambi kotyando: Uza kuyalelwa ukuba ungatyi okanye usele emva kobusuku ngaphambi kotyando. Landela le miyalelo ngokuchanekileyo.
• Ukufumana uvavanyo olufunekayo: Kuya kufuneka wenze uvavanyo oluninzi ukuqinisekisa impilo yakho ngaphambi kotyando.
• I-Ankle-brachial index (ABI): Uvavanyo olulinganisa uxinzelelo lwegazi emilenzeni.
• I-ultrasound yemithambo yegazi (i-Doppler scan): I-scan yokujonga ngokusondeleyo ukuhamba kwegazi ngaphakathi kwemithambo yegazi kunye naluphi na uvalo.
• Uvavanyo olufana ne-ECG kunye ne-Echo olujonga impilo yentliziyo kunye nemithambo yegazi yentliziyo.

Kwenzeka ntoni ngokwenene ngexesha lotyando?

Awuyi kuva nto ngexesha lotyando, njengoko uza kuba phantsi kwe-anesthesia jikelele. Iqela lotyando liza kulandela la manyathelo:

1. I-Anesthesia: Ulala ubuthongo obunzulu.

2. Ukwenza imingxunya: Okokuqala, kwenziwa umngxunya omkhulu (i-laparotomy) ecaleni kwesisu ukuze kufikelelwe kwi-aorta. Emva koko, kwenziwa eminye imingxunya emibini phezulu kwe-groin ukuze kufikelelwe kwimithambo ye-femoral.

3. Ukufakelwa kwe-graft:Ugqirha uthatha umthambo wegazi owenziweyo omile okwe-"Y" aze athunge isiphelo sawo esingaphezulu ngaphezu kokuvaleka kwi-aorta. Imilenze emibini esezantsi ye-Y ithungelwe phantsi kokuvaleka kwimithambo ye-femoral.

4. Ukuvala amanxeba: Emva kokuba kwenziwe i-bypass entsha, amanxeba afakwe esiswini nasemqolo avalwa ngezititshi okanye nge-staples.

Olu tyando lonke ludla ngokuthatha iiyure ezi-2 ukuya kwezi-6 .

Kwenzeka ntoni esibhedlele emva kotyando?

Emva kotyando, kuya kufuneka uhlale esibhedlele phakathi kweentsuku ezi-4 nezi-7. Ngeli xesha, iqela lezonyango liza kukunyamekela kakuhle.

• Uza kugcinwa kwigumbi lokhathalelo olunzulu (ICU) okanye kwigumbi elikhethekileyo kwaye ujongwe ngokusondeleyo kuzo naziphi na iingxaki, ingakumbi usulelo.
• Ndihlala ndijonga ukuba igazi lihamba kakuhle na emilenzeni yakho .
• Baza kukunceda kancinci kancinci uhambe. Okokuqala umgama omfutshane, uze wonyuse umgama imihla ngemihla.
• Iipilisi zokunciphisa iintlungu zinikwa ukulawula iintlungu.

Zithini iimpumelelo kunye neengozi zolu tyando?

Olu tyando luphumelele kakhulu. Ngokwezibalo, phakathi kwama-80% nama-95% otyando lugcina ukuhamba kwegazi ngempumelelo iminyaka emi-5. Kwiminyaka eli-10, izinga lempumelelo liphakathi kwama-74% nama-86%.

Njengakwezinye iintlobo zotyando olukhulu, kukho iingozi kunye neengxaki ezinokwenzeka. Ngaphambi kokuba uphakuzele, khumbula ukuba iqela lezonyango liya kwenza konke okusemandleni alo ukunciphisa amathuba okuba oku kwenzeke.

Iingxaki ezinokwenzeka:

• Ukuhlaselwa yintliziyo
• Istroke
• Ukopha kakhulu
• Amahlwili egazi
• Usulelo lwamanxeba ngotyando
• Usulelo lwe-graft
• Ukungasebenzi kakuhle kwezintso
• Ukungaphumeleli kwemiphunga

Thetha ngokukhululekileyo nogqirha wakho ngale mingcipheko ngaphambi kotyando kwaye ubuze nayiphi na imibuzo onayo.

Ukuchacha kunye neendlela zokuzikhusela emva kokubuyela ekhaya

Kungathatha iinyanga ezi-2 ukuya kwezi-3 ukuze uphile ngokupheleleyo, kodwa kufuneka ukwazi ukuqalisa imisebenzi yakho yesiqhelo kancinci kancinci kwiiveki ezi-4 ukuya kwezi-6.

Ukusikwa kusenokuba buhlungu kwiiveki ezimbalwa zokuqala. Sebenzisa amayeza okudambisa iintlungu achazwe ngugqirha wakho koku.

• Sela amayeza akho kanye njengoko kuyalelwe: Sela onke amayeza owalelwe ngugqirha wakho ngexesha elifanelekileyo nangedosi efanelekileyo.
• Gcina amanxeba ecocekile: Landela imiyalelo kagqirha wakho ngononophelo malunga nokuhlamba nokufaka amayeza.
• Umthambo:Eyona ndlela ilungileyo yokuzilolonga xa usekwinqanaba lokuqala kukuhamba. Yandisa kancinci kancinci umgama owuhambayo yonke imihla. Kodwa ungenzi nzima ngaphezu kokuba ugqirha wakho ekucebisa.
• Kuphephe ukuphakamisa iintsimbi: Kuphephe ukuphakamisa iintsimbi ngokupheleleyo kangangeenyanga ezimbalwa.

Buza ugqirha wakho ukuba ungaqalisa nini ukuqhuba kwakhona, ukuya emsebenzini, nokwenza umthambo onzima.

Ndifanele ndimfowunele nini ugqirha?

Ukuba ufumanisa naziphi na ezi mpawu zilandelayo emva kokubuyela ekhaya, fowunela ugqirha wakho okanye uye esibhedlele ngoko nangoko .

Yintoni omawuyenze xa kukho imeko engxamisekileyo? (Imeko engxamisekileyo)

Ukuba ufumana naziphi na kwezi mpawu zilandelayo zokuhlaselwa yintliziyo okanye isifo sohlangothi , fowunela inkonzo ye-ambulensi ka-1990 ngaphandle kokulibazisa okanye uye kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele esikufutshane.

Iimpawu zokuhlaselwa yintliziyo

• Intlungu, ukuqina, okanye ukungakhululeki embindini wesifuba.
• Ubunzima bokuphefumla.
• Isicaphucaphu, ukungonwabi esiswini.
• Ukubetha kwentliziyo.
• Ukudinwa kakhulu.
• Ukudinwa, ukulahlekelwa zingqondo.
• Ukubila okugqithisileyo.

Iimpawu zestroke

• Ukuba ndindisholo okanye ubuthathaka kwelinye icala lomzimba (ubuso, ingalo, okanye umlenze).
• Ubunzima bokuthetha okanye ukungakwazi ukuthetha kakuhle.
• Ukulahlekelwa ngumbono ngequbuliso, umbono omnye okanye emibini.
• Intloko ebuhlungu kakhulu ngequbuliso.
• Ubunzima bokuhamba, ukulahlekelwa yibhalansi.

Ukujongana notyando olukhulu kunokuba luxinzelelo ngokweemvakalelo. Yinto eqhelekileyo leyo. Thetha ngoloyiko lwakho kunye neenkxalabo zakho nosapho lwakho, kunye nogqirha wakho kunye neqela lezonyango. Ukufumana lonke ulwazi oludingayo kunye nokulungiselela kakuhle kwengqondo kuya kunceda kakhulu kwinkqubo yokuphiliswa.