Ngaba ngamanye amaxesha uziva uxinezelekile okanye intlungu esifubeni sakho xa udiniwe kancinci, okanye xa unyuka izinyuko? Okanye ngaba unengxaki yokuphefumla? Oku kungaba kukudinwa okuqhelekileyo, kodwa ngamanye amaxesha kunokuba yingxaki ngomthambo othwala igazi entliziyweni yethu. Namhlanje siza kuthetha ngemeko enzima kancinci, kodwa kubaluleke kakhulu ukuba uyiqaphele. Leyo yimeko ebizwa ngokuba yi-CTO, okanye i-Chronic Total Occlusion.
Ngamafutshane, yintoni i-CTO (Chronic Total Occlusion)?
Khawuthelekelele ukuba unombhobho oyintloko ozisa amanzi endlwini yakho. Ekuhambeni kwexesha, lo mbhobho uvaleka ngumhlwa nothuli, uze ekugqibeleni uvaleke ngokupheleleyo, nto leyo ethintela nokuba lithontsi lamanzi ukuba lingaphumi.
Kwenzeka into efanayo ezintliziyweni zethu. Sinemithambo yegazi (esiyibiza ngokuba yimithambo yentliziyo) enika igazi elicocekileyo ezintliziyweni zethu. Ukuba izinto ezifana neoyile kunye ne-cholesterol zifakwa ngaphakathi kwezi veins kangangexesha elithile, kwaye umthambo uvalwe ngokupheleleyo (100%), oko kuthetha ukuba ukuba olu valo luqhubeka ixesha elingaphezu kweenyanga ezintathu , silubiza loo meko ngokuba yiChronic Total Occlusion (CTO) .
Xa umthambo uvalekile ngokupheleleyo ngale ndlela, inxalenye yentliziyo echaphazelekileyo ayifumani ioksijini kunye nezondlo ezifunekayo. Oku kunokubangela iimpawu ezifana neentlungu zesifuba kunye nobunzima bokuphefumla. Kwezinye iimeko, oku kunokuba nzima, kuze kukhokelele ekuhlaselweni yintliziyo.
Ngubani osengozini enkulu yokuhlaselwa yile meko ye-CTO?
I-CTO ixhaphake kakhulu kubantu abanesifo sentliziyo, ingakumbi isifo semithambo yegazi yentliziyo (CAD). Kuqikelelwa ukuba malunga nomntu omnye kwabathathu abane-CAD nabo banokuba ne-CTO.
Izinto ezifanayo ezibangela umngcipheko ezidla ngokubangela isifo sentliziyo nazo zinegalelo kwi-CTO. Jonga ukuze ubone ukuba unazo na ezi zinto.
| Into enobungozi | Ingcaciso elula |
|---|---|
| Ukutshaya | Olu lolona tshaba luphambili. Ukutshaya kuyayonakalisa imithambo yegazi kwaye kukhawulezise ukwakheka kweentsalela ngaphakathi kuyo. |
| Uxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu) | Njengoko uxinzelelo lusanda, iindonga zemithambo yegazi ziyawohloka kwaye amathuba okufakwa kwe-cholesterol ayanda. |
| I-cholesterol ephezulu (i-Hyperlipidemia) | Xa ubungakanani be-cholesterol embi (LDL) egazini busanda, buqala ukuhla ngqo eludongeni lwemithambo yegazi. |
| Isifo seswekile | Ukuba amanqanaba eswekile akalawulwa, yonakalisa imithambo yegazi kwaye yandisa ukwakheka kwezi ntsalela. |
| Ukutyeba kakhulu | Ubunzima bomzimba bunxulunyaniswa nesifo sentliziyo. I-BMI engaphezulu kwama-30 isengozini enkulu. |
| Imbali yosapho yesifo sentliziyo | Ukuba umama wakho, utata, okanye abantakwenu banesifo sentliziyo, nawe usenokuba sengozini. |
| Ukungazilolongi | Ukungawugcini umzimba wakho usebenza kufana negalelo kwisifo sentliziyo. |
| Uhlaselo lwentliziyo lwangaphambili okanye utyando lwe-bypass | Ukuba ukhe wahlaselwa yintliziyo ngaphambili okanye watyandwa nge-bypass, usemngciphekweni wokuba ne-CTO kwenye imithambo yegazi. |
Eyona nto ibalulekileyo kukuba umngcipheko wokuba ne-CTO uyanda ngokuhamba kweminyaka. Ngoko ke, kufuneka sinyamekele iintliziyo zethu ngakumbi njengoko sikhula.
Zithini iimpawu ze-CTO?
Iimpawu ze-CTO zinokwahluka kumntu nomntu. Abanye abantu basenokungabi nazo kwaphela iimpawu. Nangona kunjalo, ezona mpawu zixhaphakileyo zezi:
- Intlungu yesifuba, ukuqina, okanye uxinzelelo: Kusenokuvakala ngathi kukho umntu ocinezela isifuba sakho.
- Ubunzima bokuphefumla (i-Dyspnea):Ukuziva uphelelwa ngumphefumlo xa uzibhokoxa, njengaxa uhamba umgama omfutshane okanye unyuka izinyuko.
- Ukudinwa kakhulu: Ukudinwa ngalo lonke ixesha, nokuba awusebenzi.
- Ndiziva ndinesizungu.
- Ukubetha kwentliziyo okungaqhelekanga.
- Isicaphucaphu.
- Intlungu engalweni engentla: ingakumbi engalweni yasekhohlo.
Into ebalulekileyo kukuba ezi mpawu zixhaphake kakhulu xa udiniwe. Ziyaphela xa uphumle. Nangona kunjalo, ngamanye amaxesha ezi mpawu zinokuvela nokuba awudiniwe konke konke.
Ugqirha uyifumana njani le nto?
Ukuba unale mpawu, ngokuqinisekileyo kuya kufuneka ubone ugqirha. Uza kukuhlola aze, ukuba kuyimfuneko, akuthumelele uvavanyo oluninzi.
Uvavanyo oluphambili lokuqinisekisa ukuba unayo i-CTO yi -coronary angiogram . Kule nto, ityhubhu encinci kakhulu idluliselwa ngemithambo engalweni okanye emlenzeni ukuya kwimithambo yentliziyo, kwaye kufakwa ulwelo olukhethekileyo (idayi engafaniyo). Emva koko, kuthathwa i-X-ray ukuze kubonwe indlela olu lwelo luhamba ngayo ngemithambo yentliziyo. Ukuba kukho ukuvaleka kwemithambo, olu lwelo alunakuqhubeka nokuhamba, ngoko ke luya kubonakala ngokucacileyo.
Ukongeza, ugqirha unokucebisa ezinye iimvavanyo ezifana nezi:
- I-ECG (i-Electrocardiogram): Jonga umsebenzi wombane wentliziyo.
- I-Echocardiogram (Echo): Iskeni yokujonga ukusebenza kwentliziyo kunye nokuhamba kwegazi.
- Uvavanyo loxinzelelo: Jonga indlela intliziyo yakho esabela ngayo xa uzibhokoxa kancinci (njengokubaleka kwi-treadmill).
- I-Cardiac MRI: Fumana umfanekiso ocacileyo wesakhiwo sentliziyo kunye nokuhamba kwegazi.
Ziziphi iindlela zonyango ze-CTO?
Ukuba ufunyaniswe une-CTO, ungoyiki. Ngoku kukho iindlela ezininzi zonyango ezisebenzayo zoku. Isicwangciso sonyango siya kuxhomekeka kubukhali beempawu zakho, indawo ovalekileyo kuyo umthambo, kunye nempilo yakho iyonke. Kukho iintlobo ezimbini eziphambili zonyango.
1. Ungenelelo lweCoronary oluhamba ngeenyawo (PCI)
Olu lolona nyango lusetyenziswa kakhulu, olungelulo utyando. Lwenziwa ngendlela efanayo ne-angiogram.
- Ityhubhu encinci kakhulu (i-catheter) idluliselwa ngemithambo engalweni okanye emlenzeni ukuya entliziyweni apho kukho umthambo ovalekileyo.
- Ibhaluni encinci idlula kuloo mbhobho ize ivuthelwe kwindawo evalekileyo. Umaleko weoyile oqokelelene ngaphakathi komthambo uyacinezelwa emacaleni, uvula umthambo.
- Emva koko, ityhubhu encinci ye-mesh ebizwa ngokuba yi -stent ibekwa phezu komnyango. I-stent inceda ukugcina umthambo uvulekile kwaye ithintele ukuba ungavaleki kwakhona.
Izifundo zibonise ukuba le ndlela iyasebenza kwizigulane ezimalunga ne-86%.
2. I-Coronary Artery Bypass Graft (CABG)
Olu lutyando lwentliziyo evulekileyo. Lucetyiswa kuphela xa imithambo emininzi ivaliwe, okanye ukuba ukuvaleka kunzima kakhulu ukuba kuvulwe nge-PCI.
Ngamafutshane, oku kuquka ukudala "indlela yokudlula" yomthambo ovalekileyo. Oko kukuthi, iqhekeza lomthambo elivela kwenye indawo yomzimba wakho (ngokuqhelekileyo elivela esifubeni okanye emlenzeni) liyathathwa kwaye kudalwe indlela entsha yokuba igazi lijikeleze indawo evalekileyo.
Olu tyando luvelisa iziphumo eziphumelelayo kwizigulane ezimalunga nama-60%.
Ugqirha wakho wentliziyo uza kukuchazela ngokweenkcukacha ukuba loluphi unyango olufanelekileyo kuwe.
Imibuzo omele uyibuze ugqirha wakho
Ukuba ufunyaniswe une-CTO, kuyinto eqhelekileyo ukuba nemibuzo emininzi engqondweni yakho. Musa ukoyika okanye ungathandabuzi ukubuza le mibuzo kugqirha wakho.
- "Gqirha, zithini iimpawu zokuqala zale CTO?"
- "Zeziphi iimvavanyo ekufuneka ndizenze ukuqinisekisa oku?"
- "Zeziphi iinguqu ekufuneka ndizenze kwindlela endiphila ngayo ukuze ndithintele le meko ukuba ingenzeki?"
- "Zeziphi iindlela zonyango endinazo? Yeyiphi eyona ilungileyo kum?"
- "Emva konyango, lingakanani ithuba lokuba le meko iphinde yenzeke?"
Umyalezo Wokuya Ekhaya
- I-CTO (Chronic Total Occlusion) yimeko enzima apho umthambo wegazi ohambisa igazi entliziyweni uvalekile ngokupheleleyo (100%) kangangeenyanga ezingaphezu kwe-3.
- Isizathu esiphambili soku kukubekwa kwezinto ezifana ne -cholesterol kunye neoyile eludongeni lwemithambo yegazi.
- Ukutshaya, uxinzelelo lwegazi oluphezulu, isifo seswekile, kunye ne-cholesterol ephezulu zezona zinto ziphambili ezibangela umngcipheko. Kubaluleke kakhulu ukulawula ezi zinto.
- Ukuba uneempawu ezifana neentlungu esifubeni, ubunzima bokuphefumla, okanye ukudinwa kakhulu , musa ukuzityeshela kwaye funa ingcebiso kagqirha ngoko nangoko.
- Ungakhathazeki, ngoku kukho unyango oluphumelele kakhulu olufana ne-PCI (stent placement) kunye ne-CABG (bypass surgery).
- Indlela yokuphila esempilweni (ukutya okunempilo, ukuzilolonga) kunye nokusela amayeza owanikwe ngugqirha wakho kuya kunceda kakhulu ekulawuleni le meko.
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