Ngaba wakha weva ngesifo semithambo yegazi emithanjeni yegazi? Uninzi lwethu luye lweva ngaso. Ngokwezonyango, oku kubizwa ngokuba yiCoronary Artery Disease ( CAD ). Ngamafutshane, yimeko apho amafutha kunye ne-cholesterol kwakheka kwimithambo yegazi ethwala igazi entliziyweni, nto leyo enciphisa ukuhamba kwegazi. Kodwa le mithambo yegazi inokuvaleka ngeendlela ezahlukeneyo. Namhlanje, siza kuthetha ngemeko enzima ngakumbi efuna ingqalelo ekhethekileyo. Oko kukuthi, xa amafutha eqokelelana aze avale imithambo yegazi apho imithambo yegazi enkulu entliziyweni yahlulahlula ibe lisebe elincinci. Khawucinge ngengxinano yezithuthi kwindlela efana no-Y, kanye apho iindlela ezimbini zahlukana khona. Oogqirha bakubiza oku ngokuthi 'yiBifurcation Blockage'.
Yintoni kanye kanye le nto kuthiwa yiBifurcation Blockage?
Kulungile, masiyibeke ngendlela elula le nto. Intliziyo yakho sisihlunu esisebenza ngokungayekiyo. Ifumana amandla kunye neoksijini eyidingayo kwimithambo yegazi ebizwa ngokuba yimithambo yentliziyo. Le mithambo iphambili ikhula ibe ngamasebe amancinci ukuze ithwale igazi liye kuzo zonke iindawo zentliziyo.
Ngoku, oku kuValeka kweBifurcation kwenzeka xa kwakheka idiphozithi yamafutha (esiyibiza ngokuba yi -plaque ) apho umthambo omkhulu wahlulahlula ube lisebe elincinci, oko kukuthi, kwindawo edibanayo ne-Y. Le plaque ithintela ukuhamba kwegazi. Oogqirha babiza eli sebe lincinci ngokuthi “isitya esisecaleni kwesebe.” Le plaque ikwabizwa ngokuba “sisilonda se-bifurcation.”
Le ndawo inzima kancinci ukuvaleka kunezinye iindawo. Ngenxa yokuba ukuhamba kwegazi noxinzelelo zahlukile apha, kukho ithuba elikhulu lokuba i-plaque ikhule kwezi ndawo. Kwaye kunokuba nzima ngakumbi ukuyinyanga.
Ngaba kukho iintlobo eziphambili zale ngxaki?
Ewe, oogqirha bahlula olu xinaniso ngokobunzima, oko kukuthi, ubungakanani bomthambo ovalekileyo. Oku kubizwa ngokuba yi-stenosis . Kukho iintlobo ezimbini eziphambili.
| Uhlobo lokuvaleka | Ingcaciso elula |
|---|---|
| Ukuvalwa okulula | Kulapho umthambo wegazi uvalekile ngaphantsi kwama-70%. Oku kuthetha ukuba kusekho indawo yokuba igazi lihambe. Kulula ukunyanga oku. |
| Ukuvaleka okuntsonkothileyo | Apha, umthambo wegazi uvalekile ngaphezu kwama-70%, oko kuthetha ukuba uvalekile kakhulu. Ngamanye amaxesha kunokubakho ukuvaleka okungaphezulu kwesinye. Okanye oku kungavaleka kunokubangelwa kukuqhekeka kwegazi okanye ukubola kwegazi. Enye into kukuba, ngamanye amaxesha ukuba elo sebe lincinci liyaqhekeka kwi-engile ebukhali kakhulu (ngaphezulu kwama-70 degrees), kunzima kakhulu ukufaka izixhobo kunye nokunyanga loo ndawo. |
Ixhaphake kangakanani le meko kwilizwe lethu?
Le yimeko eqhelekileyo kakhulu. Uqikelelo lubonisa ukuba phakathi kwe-15% kunye ne-20% yazo zonke iimeko zesifo semithambo yentliziyo (CAD) ezifuna unyango ziwela kolu didi, olwaziwa ngokuba yi-bifurcation blockages. Ngamafutshane, kwizigulane ezili-100 eziza esibhedlele zinemithambo yentliziyo evalekileyo, malunga ne-15-20 zinomvalo kule ndawo. Ngoko ke, oku akuyonto ifanele ithathwe lula.
Kutheni oku kusenzeka? Yintoni isizathu sokwenyani sale nto?
Isizathu esiphambili soku yi-fatty deposits ebizwa ngokuba yi-plaque esithethe ngayo ngaphambili. Oku kufana nokuqokelelwa komhlwa kunye nokungcola kumbhobho wamanzi ngokuhamba kwexesha, okubangela imingxunya kumbhobho. Le plaque yenziwa kukuqokelelwa kwe-cholesterol, amafutha kunye ne-calcium kwiindonga zemithambo yegazi yethu. Ekuhambeni kwexesha, le plaque ikhula ibe nkulu kwaye inciphise ukuhamba kwegazi ngemithambo yegazi. Ekugqibeleni, intliziyo ayifumani igazi elifunekayo. Le meko siyibiza ngokuba yi-atherosclerosis . Ukuvaleka kwe-bifurcation nako kubangelwa yile meko ye-atherosclerosis.
Ngubani osengozini enkulu?
Nangona le meko inokuvela nakubani na, abanye abantu basengozini enkulu. Ukuba unenye okanye ngaphezulu kwezi zinto ziyingozi, kulungile ukuba uqaphele ngakumbi.
| Into enobungozi | Ingcaciso elula |
|---|---|
| Ubudala kunye nesini | Umngcipheko uphezulu kubafazi emva kokuya exesheni kunye namadoda angaphezu kweminyaka engama-45 ubudala. |
| Isifo seswekile | Isifo seswekile singonakalisa imithambo yegazi, nto leyo eyenza kube lula ukuba i-plaque iqokeleleke. |
| Ukutyeba kakhulu okanye ukutyeba kakhulu | Njengoko ubunzima bomzimba busanda, nezinye izinto ezinobungozi ezifana ne-cholesterol kunye noxinzelelo lwegazi oluphezulu nazo ziyanda. |
| Imbali yosapho | Ukuba kukho umntu kusapho lwakho (umama, utata, abantakwenu noodadewabo) onesifo sentliziyo, nawe usengozini enkulu. |
| Uxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu) | Xa uxinzelelo lusanda, iindonga zemithambo yegazi ziyabola kwaye i-plaque inokwakheka lula. |
| I-cholesterol ephezulu | Le yeyona nto iphambili ebangela ukwakheka kwe-plaque. Umngcipheko uphezulu ukuba kukho inqanaba eliphezulu le-cholesterol embi (LDL) egazini. |
| Ukungazilolongi kakuhle kunye nokutya okungenasondlo | Abantu abangazivocavociyo emzimbeni kwaye batya ukutya okuneoyile eninzi, iswekile, netyuwa basengozini enkulu. |
| Ukutshaya | Ukutshaya kuyayonakalisa ngokuthe ngqo imithambo yegazi kwaye kwandisa umngcipheko wokuqhekeka kwegazi. |
Ziziphi iimpawu onokuzifumana?
Ukuvaleka kwe-bifurcation luhlobo lwesifo se-coronary artery (CAD), ngoko ke iimpawu ziyafana. Ukuba unenye okanye ngaphezulu kwezi mpawu, bonana nogqirha ngoko nangoko.
- Intlungu okanye uxinzelelo esifubeni (i-Angina): Olu luphawu oluphambili. Lunokuvakala ngathi kukucudiswa okanye ukucudiswa embindini wesifuba.
- Ukuphefumla kancinci: Ukuziva uphelelwa ngumphefumlo xa udiniwe kancinci, okanye xa unyuka izinyuko.
- Ukudinwa ngokungaqhelekanga: Ukudinwa kakhulu okanye ubuthathaka ngaphandle kwesizathu.
- Intlungu yegxalaba okanye yengalo: Intlungu ehamba ngengalo yasekhohlo, ngakumbi.
- Ukudinwa okanye ukutyhafa : Ukuziva ujikeleza kwaye ungakwazi ukuma.
- Isicaphucaphu: Ukuziva ngathi uhlanza.
- Ndiziva ndibanda kwaye ndibila.
- Ukuziva ukubetha kwentliziyo okungaqhelekanga (iHeart Palpitations).
Into ebalulekileyo kukuba ayinguye wonke umntu oza kuba nazo zonke ezi mpawu. Abanye abantu banokuba nale meko ngaphandle kweempawu kwaphela. Ngoko ke, bubulumko ukuya kugqirha rhoqo ukuba unezinto ezinokubangela umngcipheko.
Ugqirha uyifumana njani le nto?
Xa uxelela ugqirha wakho ngeempawu ozikhankanyileyo apha ngasentla, uza kukuhlola aze akuthumelele iimvavanyo ezininzi ukuqinisekisa le meko.
- I-ECG (i-Electrocardiogram): Le ivavanya umsebenzi wombane wentliziyo ukuze kubonwe ukuba akukho monakalo na entliziyweni.
- Uvavanyo loxinzelelo: I-ECG ithathwa ngelixa uhamba kwi-treadmill, ijonga indlela intliziyo yakho esebenza ngayo xa uxinezelekile.
- I-Echocardiogram: I-ultrasound scan yentliziyo.
- I-Catheterization yentliziyo (iCoronary Angiogram): Olu luvavanyo oluphambili lokujonga ukuba kukho naziphi na izithintelo kwimithambo yakho yegazi. Ityhubhu encinci ifakwa emlenzeni okanye engalweni yakho, ifakwe kwimithambo esentliziyweni yakho, kwaye kufakwa ulwelo olukhethekileyo, kwaye kuthathwa imifanekiso ye-X-ray. Oku kukuvumela ukuba ubone apho izithintelo zikhoyo ngokucacileyo.
- I-CCTA (iCoronary Computed Tomography Angiogram): Oku kufana ne-angiogram, kodwa luvavanyo olwenziwa kusetyenziswa umatshini we-CT scan ngaphandle kokufaka ityhubhu emzimbeni.
Olu vavanyo luza kuvumela ugqirha wakho ukuba aqinisekise ngokuchanekileyo ukuba unesithintelo se-bifurcation kunye nokuba sibi kangakanani.
Zithini iindlela zonyango zoku?
Ukunyanga ukuvaleka kwe-bifurcation kunzima ngakumbi kuba imithambo esecaleni incinci kakhulu, nto leyo eyenza kube nzima ukuyinyanga ngezixhobo kunomthambo oyintloko.
Unyango oluphambili yi -angioplasty kunye ne-stenting . Olu asilotyando. Oku kubizwa ngokuba yi-Percutaneous Coronary Intervention (PCI).
Nantsi into eyenzekayo apha:
1. Ugqirha uza kuyityumza ulusu lwengalo okanye umlenze wakho, enze umngxuma omncinci, aze afake i-catheter kuyo.Ityhubhu encinci kakhulu, eguquguqukayo ebizwa ngokuba yi-catheter ifakwa kwimithambo yegazi.
2. Emva koko, ngelixa ujonge isikrini se-X-ray, ityhubhu ikhokelwa kwindawo echanekileyo yomthambo ovalekileyo entliziyweni.
3. Kukho ibhaluni encinci ekupheleni kwe-catheter. Xa ifika kwindawo evalekileyo, ibhaluni iyavuthelana. Emva koko i-plaque icinezela eludongeni lomthambo, ivule kwakhona indlela evalekileyo.
4. Emva koko, ukuze ukuvulwa kungavaleki kwakhona, kufakwa ityhubhu encinci ye-mesh ebizwa ngokuba yi- stent kuloo ndawo.
Emva kolu nyango, ugqirha wakho uza kukunika amayeza akhethekileyo (unyango oluphindwe kabini lwe-antiplatelet) ukuthintela ukuba amahlwili egazi angabikho ngaphakathi kwi-stent. Kubalulekile ukuba uwathathe la mayeza ixesha elithile elimiselweyo.
Ziziphi iindlela zonyango?
Kukho iindlela ezimbini eziphambili zokuvala i-bifurcation nge-stenting.
- Ukubeka I-Stenting Yesikhashana: Kule ndlela, ugqirha ubeka i-stent kuphela kumthambo oyintloko. Isebe elincinci alifakwa. I-stent ingafakwa kwisebe elincinci kamva, kuphela ukuba uphinda ubonakalise iimpawu.
- Iinkqubo ze-Two-Stent: Ukuba ukuvaleka kuyinkimbinkimbi kakhulu, ugqirha unokugqiba ekubeni abeke ii-stent kumthambo oyintloko nakwisebe elincinci eliphumayo.
Ngaba kukho naziphi na iingxaki ezinokwenzeka emva konyango?
Nangona i-angioplasty kunye ne-stenting ziyindlela yonyango ephumelelayo, iingxaki zinokwenzeka kubantu abambalwa kakhulu .
| Ingxaki | Ingcaciso elula |
|---|---|
| I-In-stent Restenosis | Oku kuthetha ukuba izicubu zesilonda zenzeka phantsi kwe-stent, nto leyo ebangela ukuba umthambo unciphe kwakhona. Oku kudla ngokwenzeka kwiinyanga ezi-6 emva konyango. Ukuba oku kuyenzeka, unokufuna olunye unyango lwe-angioplasty okanye olunye unyango. |
| I-Stent Thrombosis | Le yimeko enzima, kodwa engaqhelekanga kakhulu, apho ihlwili legazi lenzeka ngaphakathi kwi-stent lize ngequbuliso livale umthambo. Ukuthintela oku, kufuneka uthathe amayeza athintela ukujiya kwegazi ngokufanelekileyo. |
Ngaba olu hlobo lwemeko alunakuthintelwa?
Ngokuqinisekileyo kunokwenzeka. Isifo sentliziyo sinxulumene kakhulu nendlela esiphila ngayo. Ngoko ke, ukwamkela indlela yokuphila enempilo yentliziyo kunokunciphisa kakhulu umngcipheko wokuba nale meko.
- Yitya ukutya okunempilo kwentliziyo. Nciphisa ukutya okuneoyile eninzi, ityuwa, kunye neswekile kangangoko unako. Faka iziqhamo, imifuno, iimbotyi, iintlanzi ezincinci, kunye neenkozo ezipheleleyo ekutyeni kwakho.
- Ukuba uyatshaya, yeka namhlanje. Ukutshaya yenye yezona ntshaba zinkulu zentliziyo.
- Zilolonge rhoqo. Yenza into efana nokuhamba ngeenyawo okanye ukukhwela ibhayisekile ubuncinane imizuzu engama-30 ngosuku.
- Lawula ubunzima bomzimba wakho. Kukho ubunzima obuthile obufanele ubude bakho. Zama ukubugcina bunjalo.
- Ukuba unesifo seswekile, uxinzelelo lwegazi oluphezulu, okanye i-cholesterol, zilawule ngokuthatha amayeza achazwe ngugqirha wakho.
- Nciphisa uxinzelelo. Kulungile kakhulu ukuzibandakanya kwizinto ezifana neyoga kunye nokucamngca.
- Nciphisa ukusetyenziswa kotywala.
Ufanele uye nini kugqirha ngoko nangoko?
Khumbula oku: Ukuba ufumana iimpawu zokuhlaselwa yintliziyo, ezinje ngentlungu yesifuba engxamisekileyo, ukuphefumla kancinci, okanye ukubila, musa ukulibazisa umzuzwana. Fowunela i-911 ngoko nangoko okanye uyise isigulana kwiSebe leNgxamiseko (ETU) lesibhedlele esikufutshane.
Ukongeza, ukuba ufumana ezi mpawu zilandelayo rhoqo, qiniseka ukuba ubona ugqirha ukuze akunike ingcebiso.
- Intlungu yesifuba (i-angina), intlungu yengalo okanye yamagxa
- Ndiziva ndibanda kwaye ndibila
- Ubunzima bokuphefumla
- Ukudinwa okanye ubuthathaka obungachazekiyo
Imibuzo omele uyibuze ugqirha wakho
Xa ufumanisa ukuba unale meko, kuyinto eqhelekileyo ukuba nemibuzo emininzi engqondweni yakho. Musa ukufihla nantoni na, buza ugqirha wakho uze ufumane impendulo.
- Yintoni ebangela ukuba ndizive ndibambeke ngolu hlobo?
- Ngaba kukho umngcipheko wokuvaleka okufanayo kweminye imithambo yegazi yam?
- Ngaba i-angioplasty kunye ne-stenting zinokunyanga ngokupheleleyo olu thintelo?
- Luhlobo luni lwe-stent ondicebisa lona?
- Zingaphi ii-stents ekufuneka ndizibeke?
- Ndingenza ntoni ukuze ndikhusele intliziyo yam?
- Zeziphi iingxaki ekufuneka ndizixhalabele emva konyango?
Ndiyathemba ukuba olu lwazi luza kukunceda uqonde ngcono le meko. Khumbula, le asiyonto yokoyika, kodwa yinto ekufuneka ilawulwe ngokufanelekileyo.
Umyalezo Wokuya Ekhaya
- Ukuvaleka kwemithambo yegazi emithanjeni luhlobo oluthile lokuvaleka okwenzekayo apho umthambo wegazi entliziyweni wahlukana ube ngamasebe. Oku kuyinkimbinkimbi ngakumbi kunokuvaleka okuqhelekileyo.
- Iimpawu ziyafana nezo zesifo sentliziyo esiqhelekileyo. Iintlungu zesifuba kunye nokuphefumla kancinci zezona ziphambili. Ungaze uzityeshele ezi.
- Ukufakwa kwe-stent lunyango oluphumelelayo, kodwa kufuna ukungenelela kogqirha onamava.
- Okubaluleke ngaphezu konyango kukutshintsha indlela ophila ngayo. Ukutya ngendlela efanelekileyo, ukuzilolonga, kunye nokuphepha imikhwa emibi kubalulekile.
- Intlungu ebuhlungu esifubeni yingxamiseko. Yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) esibhedlele ngoko nangoko.
Isifo sentliziyo, ukuvaleka kweBifurcation, isifo seCoronary Artery, iStenting, iAngioplasty, iintlungu zesifuba, uhlaselo lwentliziyo
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