Umthambo wegazi oyintloko othwala igazi lisuka entliziyweni yakho liye emzimbeni wakho wonke, i-aorta, ufana nombhobho oyintloko ophuma kwitanki yethu yamanzi ekhaya. Ngamanye amaxesha lo mbhobho uba buthathaka uze uqale ukudumba njengebhaluni endala. Kwizonyango, oku sikubiza ngokuba yi-aneurysm. Ingakumbi ukuba indawo ekufutshane nentliziyo, i-ascending aorta, idumba ngolu hlobo, kunokuba yinto enzulu kancinci. Namhlanje siza kuthetha ngotyando olwenziwayo kule meko.
Olu tyando lwenziwa njani?
Ngamafutshane, le meko ilungiswa ngotyando oluvulekileyo lwendabuko. Ugqirha wakho wentliziyo ususa inxalenye ebuthathaka nedumbileyo ye-aorta yakho aze ayitshintshe ngetyhubhu eyenziwe ngezinto ezenziwe ngokwenziwa, ebizwa ngokuba yi-graft. Le graft isebenza njengomgca omtsha we-aorta yakho. Emva koko igazi lihamba kuyo ngaphandle kokuphazamiseka. Olu tyando lwenziwa kwigumbi lotyando esibhedlele.
Ngubani odinga olu tyando?
Ukuba i-aneurysm kwi-ascending aorta yakho iyaqhekeka okanye iyaqhekeka , yingxamiseko. Oku sikubiza ngokuba yi-Type A dissection. Olu lutyando olungxamisekileyo ekufuneka lwenziwe ngoko nangoko ukuze kusindiswe ubomi bakho.
Kwakhona, ukuba une-aneurysm esengozini yokuqhuma okanye ukuqhekeka, unokufuna ukwenza olu tyando. Ugqirha wakho uza kwenza uvavanyo lwemifanekiso (njenge-CT scans, i-MRI scans) kanye okanye kabini ngonyaka ukujonga imeko yayo. Ngamanye amaxesha, ukuba i-aneurysm incinci kakhulu okanye ikhula kancinci, utyando lusenokungafuneki okwethutyana. Nangona kunjalo, ukuba inkulu okanye ibonisa iimpawu zokukhula ngokukhawuleza , inokufuna ukulungiswa ngotyando ngaphambi kokuba iqhume okanye iqhekeke.
Ngamafutshane, ukuba iingozi zokulibazisa unyango zingaphezulu kweengozi zotyando, ugqirha wakho uya kucebisa utyando.
Liliphi ixesha elifanelekileyo lokwenza utyando?
Zininzi izinto ezimisela ixesha elifanelekileyo lokwenza olu tyando. Eyona nto ibalulekileyo kwezi kukuba ngaba uneempawu na. Ukongeza, izinto ezinje ngobukhulu be-aneurysm, ukukhula kwayo ngokukhawuleza, ubungakanani bomzimba wakho, kunye nazo naziphi na ezinye iimeko zempilo onokuba nazo nazo zidlala indima.
Iimpawu ezifuna utyando olungxamisekileyo
Ukuba uva iintlungu esifubeni, oko kungaba luphawu lokuba i-aneurysm sele iza kuqhuma. Kwiimeko ezinjalo, kufuneka utyando olungxamisekileyo.
| Iimpawu zengxamiseko - yiya esibhedlele ngoko nangoko! | |
|---|---|
| Intlungu ebuhlungu ngequbuliso | Intlungu ebuhlungu esifubeni okanye emqolo ongasentla evakala ngathi kukho into ekrazukileyo ngaphakathi. |
| Iintlungu zesifuba | Naluphi na uhlobo lwentlungu esifubeni. |
| Utshintsho lolusu | Ulusu luyanamathela, lubile. |
| Ubunzima bokuphefumla | Ukukhohlela, ukurhawuzelela, okanye ubunzima bokuphefumla. |
| Ezinye iimpawu | Ukudinwa, ukuquleka, ukubetha kwentliziyo ngokukhawuleza, isicaphucaphu nokuhlanza, ukuphefumla nzima. |
Ukuba ufumana naziphi na kwezi mpawu, musa ukulibazisa. Tsalela umnxeba kwi-ambulensi ka-1990 ngoko nangoko okanye uye kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele esikufutshane.
Ubungakanani be-aneurysm
Ubungakanani be-aneurysm yeyona nto ibalulekileyo ekucwangciseni utyando. Utyando lunokufuneka xa lufikelela kolu bukhulu lulandelayo:
- Umyinge: 5.5 cm
- Kwabo baneengxaki ezifana neMarfan syndrome: 4.5 centimeters
- Kwabo baneengxaki ezifana ne-Loeys-Dietz syndrome: 4.0 centimeters
Isantya ekhula ngaso i-aneurysm
Nokuba i-aneurysm incinci kune-5.5 centimeters, ukuba ikhula ngokukhawuleza, kuya kufuneka utyando kungekudala.
- Ngokomyinge: 1 cm ngonyaka okanye 0.5 cm kwiinyanga ezi-6.
- Kubantu abaneemeko ezithile (umz. i-bicuspid aortic valve): Ukuba ikhula nge-0.5 cm ngonyaka.
Izinto ezikhethekileyo kuwe
Ugqirha wakho uza kuqwalasela nobukhulu bomzimba wakho kunye nezinye iimeko zempilo. Umzekelo, i-aneurysm encinci kumntu omncinci inokuba yingozi, nokuba incinci. Kwakhona, ukuba unolunye utyando lwentliziyo, ugqirha wakho unokucebisa ukuba ulungise i-aneurysm ngexesha elinye nolo tyando. Oku kunokunceda ukuthintela utyando oluzayo.
Ngaba ezinye iindlela (endovascular) azinakusetyenziswa koku?
Ukulungiswa kwe-Thoracic endovascular aortic repair (TEVAR) yinkqubo esetyenziselwa ukulungisa ii-aneurysms kwi-aorta ye-thoracic ehlayo. Nangona kunjalo, le nkqubo ayisetyenziswa rhoqo kwi-ascensing aorta, umthambo oqala entliziyweni. Oku kungenxa yokuba ulwakhiwo kunye noxinzelelo lwegazi lwala macandelo mabini zahlukile.
Nangona kunjalo, kwiimeko ezingxamisekileyo, i-TEVAR isetyenziselwe ukusindisa ubomi besigulana esibuthathaka kakhulu ukuba singatyandwa ngendlela yesintu. Abaphandi okwangoku baphuhlisa izixhobo ezintsha ezihambelana ne-ascending aorta. Ngoko ke le ndlela isenokuba yinto eqhelekileyo kwixesha elizayo. Kodwa okwangoku, unyango olungcono noluqhelekileyo lutyando oluvulekileyo.
Kwenzeka ntoni ngaphambi kotyando?
Kuya kufuneka ubone ugqirha wakho kwiiveki ezimbalwa ngaphambi kotyando. Impilo yakho iya kuvavanywa kwaye kuya kwenziwa uvavanyo olufunekayo.
Uvavanyo oluqhelekileyo:
- Uvavanyo lwegazi: Jonga ukusebenza kwezintso.
- I-CT okanye i-Heart MRI: Ihlola zonke iindawo ze-aorta. Ukuba kukho ingxaki kwi-aortic valve, ingalungiswa ngexesha lotyando.
- I-Coronary angiography: Ukujonga ukuba akukho mafutha agciniweyo (i-atherosclerosis) kwimithambo yegazi ehambisa igazi entliziyweni.
- I-Duplex ultrasound: Ijonga imeko yemithambo yegazi entanyeni (imithambo ye-carotid). Iingxaki ngezi zinto zinokunyusa umngcipheko we-stroke ngexesha lotyando.
Izinto onokuzixoxa nogqirha:
- Amayeza owasebenzisayo: Ufanele uxelele ugqirha wakho malunga nawo onke amayeza, iivithamini, kunye namayeza esintu owasebenzisayo. Amanye amayeza anokufuna ukuba uyeke ukuwasebenzisa ngaphambi kotyando.
- Ezinye izifo: Ukuba unezifo ezifana noxinzelelo lwegazi oluphezulu, kufuneka zilawulwe kakuhle ngaphambi kotyando.
- Indlela oziva ngayo: Xelela ugqirha wakho ukuba unesifo esithile, esifana nomkhuhlane, umkhuhlane, okanye i-herpes.
- Ukutshaya: Ukutshaya kufuneka kuyekwe ngokupheleleyo ubuncinane inyanga enye ngaphambi kotyando.
Ugqirha wakho uza kukunika imiyalelo ecacileyo ngomhla wotyando lwakho. Ukulandela loo miyalelo kubaluleke kakhulu ukuze utyando lwakho luphumelele.
Kwenzeka ntoni ngexesha lotyando?
Ngexesha lotyando, uza kufakwa phantsi kwe-anesthesia eqhelekileyo. Ngoko ke awuyi kuva nto. Ugqirha uza kwenza i-sternotomy ephakathi kwesifuba sakho, asuse inxalenye ebuthathaka ye-aorta yakho, aze ayifake endaweni yayo i-graft. Ngexesha elithile ngexesha lotyando, uza kuqhagamshelwa kumatshini we-cardiopulmonary bypass. Olu tyando ludla ngokuthatha malunga neeyure ezi-3-4.
Kwenzeka ntoni emva kotyando?
Emva kotyando, uza kungeniswa kwigumbi lokhathalelo olunzulu (ICU). Apho uza kubekwa esweni iintsuku ezimbalwa. Emva koko, uza kudluliselwa kwigumbi eliqhelekileyo. Ixesha lokuhlala esibhedlele lingaba ziintsuku ezi-4 ukuya kwezili-10.
Ngethuba ndisesibhedlele,
- Uza kufakwa i-catheter yomchamo.
- Amayeza (i-anticoagulants) anikwa ukuthintela ukujiya kwegazi.
- Iikawusi ezikhethekileyo zokucinezela zinxitywa ukuthintela ukuqhekeka kwegazi emilenzeni.
- Usenokuqhagamshelwa kumatshini ukuze akuncede uphefumle.
- Kuza kunikwa amayeza okunciphisa iintlungu.
Kufuneka uqale ukuhamba kancinci uze ufumane amandla akho kwakhona. Kodwa yonke into mayiyenziwe kancinci, ngokwemiyalelo kagqirha. Ekubeni ungenakuqhuba imoto xa usiya ekhaya, kubalulekile ukuba nomntu oza kuhamba nawe.
Iingenelo, iingozi, kunye nexesha lokuchacha kolu tyando
| Icandelo | Inkcazo |
|---|---|
| Iingenelo | Utyando olucwangcisiweyo lunokuthintela ukuqhuma okanye ukuqhekeka kwe-aneurysm. Utyando olungxamisekileyo lunokusindisa ubomi. |
| Iingozi | Njengakwezinye iintlobo zotyando olukhulu, kukho iingozi, ezinje ngokopha, amahlwili egazi, usulelo, ukuhlaselwa yintliziyo, isifo sohlangothi, kunye nokungasebenzi kakuhle kwezintso. Umngcipheko uphezulu kubantu abanezinye izifo ezinzulu. Ugqirha wakho uza kuxoxa ngemingcipheko yakho. |
| Impumelelo kunye nobomi obude | Utyando olucwangcisiweyo (olukhethiweyo) luphumelele nge-95% - 98%. Abantu abanjalo banokulindela ukuba baphile ubomi obufanayo nabantu ngokubanzi. Nangona kunjalo, izinga lempumelelo yotyando olungxamisekileyo liphantsi kakhulu. Ke ngoko, ukufunyanwa kwangethuba kunye nonyango kubaluleke kakhulu. |
| Ixesha lokuchacha | Kungathatha iiveki ezi-4-6 okanye iinyanga ukuba uphile ngokupheleleyo. Emva kokuphuma esibhedlele, ungafumana amandla ngokukhawuleza ngokuthatha inxaxheba kwinkqubo yokuvuselela intliziyo. |
Izinto ekufuneka zilandelwe ngexesha lokuchacha
- Kuphephe ukuqhuba: Musa ukuqhuba ude ugqirha wakho akunike imvume.
- Kuphephe ukuphakamisa iintsimbi: Musa ukuphakamisa ubunzima obungaphezulu kweekhilogram ezili-10 (4.5 kg) kangangeeveki ezi-4-6.
- Ukuzilolonga: Kuphephe ukuzilolonga okunzima okukwenza uzive uphelelwa ngumphefumlo. Buza ugqirha wakho ukuba loluphi uhlobo lokuzilolonga olukufaneleyo.
- Ukhathalelo Lokusikwa: Gcina isisikwa sicocekile. Jonga yonke imihla ukuba kukho iimpawu zokuba bomvu, ukudumba, okanye ububomvu. Ukubamba umqamelo esifubeni sakho xa ukhohlela okanye uthimla kuya kunceda ukunciphisa iintlungu.
Ngaba kufuneka nditshintshe indlela endiphila ngayo emva kotyando?
Ewe. Kubaluleke kakhulu ukwenza utshintsho kwindlela ophila ngayo ukuze kuncitshiswe umngcipheko wesifo sentliziyo kwixesha elizayo.
- Yitya ukutya okunempilo kwentliziyo: ingakumbi ukunciphisa ityuwa (i-sodium).
- Ukuzilolonga: Buza ugqirha wakho malunga nokuzilolonga okufanelekileyo kuwe.
- Ukuba uyatshaya, yeka ngoko nangoko: Ukutshaya kubangela umonakalo omkhulu kwimithambo yegazi yakho.
- Lawula uxinzelelo lwegazi oluphezulu, i-cholesterol kunye nesifo seswekile.
Ndifanele ndimbone nini ugqirha?
Nika ingqalelo emzimbeni wakho ngexesha lokuchacha kwakho. Ukuba ufumana naziphi na kwezi mpawu zilandelayo, fowunela ugqirha wakho ngoko nangoko.
| Iimpawu ekufuneka uzijonge | |
|---|---|
| Iingxaki zokusikwa | |
| - Ububomvu, iintlungu, ubushushu, okanye ukudumba. - Igazi okanye ulwelo olucacileyo oluphuma ngebhandishi. - Ukukhupha ubovu obuluhlaza okanye obumthubi. - Ukwahlulwa komphetho kwindlela yokusika. | |
| Ezinye iingxaki ezinzulu | |
| - Intlungu esifubeni okanye ukuphefumla kancinci nokuba uphumle. - Ukudumba kwemilenze okanye ukungakwazi ukuhambisa imilenze. - Ukuba nesiyezi, ukuquleka, okanye ukudinwa kakhulu. - Ukukhohlela igazi, okanye i-mucus etyheli/eluhlaza. - Ukugodola okanye umkhuhlane. - Igazi esitulweni. |
Kuqhelekile ukuba nemibuzo emininzi ngaphambi kokuba wenze utyando olunje. Thetha nogqirha wakho ngayo yonke loo nto ngokukhululekileyo. Xa ugqirha ecebisa olu tyando, bathi iingozi zokungalwenzi utyando ziphezulu kakhulu kunokuba lunjalo. Abantu abachachayo emva kotyando olucwangcisiweyo bayaqhubeka nokuphila ubomi obuqhelekileyo. Ngoko ke ngeqela elifanelekileyo lezonyango kunye nonyango olufanelekileyo, ungachacha ngokukhawuleza kwaye ubuyele kubomi bakho obuqhelekileyo.
Umyalezo Wokuya Ekhaya
- I-Aneurysm ye-Aortic enyukayo kukuvuvukala kwe-aorta yentliziyo. Le yimeko enzima efuna ukubekwa esweni ngokusondeleyo.
- Izinga lempumelelo yotyando olukhethwayo liphezulu kakhulu. Ngoko ke, musa ukulibazisa utyando ukuba kukho umngcipheko.
- Ukuba ufumana intlungu yesifuba okanye yomqolo ngequbuliso, eqatha, oko kungaba luphawu lokuqhekeka kwe-aneurysm. Yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele ngoko nangoko.
- Kuthatha ixesha ukuchacha emva kotyando. Landela imiyalelo kagqirha wakho ngokuchanekileyo.
- Ukulandela indlela yokuphila enempilo yentliziyo emva kotyando kubaluleke kakhulu kwimpilo yakho yexesha elide.
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