Xa usiya kugqirha, usenokuba uqaphele ukuba ugqirha ubeka i-stethoscope kungekuphela nje esifubeni sakho, kodwa ngamanye amaxesha kumacala omabini entamo yakho. Xa ubona oko, usenokuba nexhala kancinci ukuba uthi, "Ndiva isandi esincinci siphuma emthanjeni wegazi entanyeni yam." Kuqhelekile ngokwenene. Kodwa ungoyiki. Oku akusoloko kubonisa isifo esinzulu. Namhlanje sithetha ngemeko abantu abaninzi abangazange bayive, kodwa ekufanele kakhulu ukuyazi, ebizwa ngokuba yi-'carotid bruit.'
Kalula nje, yintoni le ncasa ye-carotid bruit?
'I-carotid bruit' ayisosifo. Sisandi esiviwa ngugqirha kuphela nge-stethoscope. Ngokuchanekileyo, sisandi esingaqhelekanga, esikhawulezayo 'sokukhwaza' osivayo xa igazi lihamba 'kwimithambo ye-carotid' kumacala omabini entamo yakho.
Khawuthelekelele, xa amanzi ephuma ngokukhululeka ngombhobho wamanzi, akukho sandi. Kodwa ukuba kukho ukuvaleka okuncinci okanye ukungcola kumbhobho, amanzi aphuma ngokukhawuleza nangokungalawulekiyo, kwaye kuvakala isandi. Oku kuyafana noku. Umthambo ophambili ohambisa igazi engqondweni yethu yi-carotid artery. Xa kukho naluphi na uthintelo lokuhamba kwegazi ngomthambo, ukuhamba kwegazi kuba yi-turbulent flow (ukugeleza kwe-turbulent) kwaye esi sandi siyadalwa.
Into ebalulekileyo kukuba, awukwazi ukuva oku. Le yinto ugqirha anokuyifumana ngengozi ngexesha lokuhlolwa rhoqo. Ke ngoko, sibona oku 'njengophawu lweklinikhi' kunokuba kube luphawu.
Kutheni kukho ingxolo engaka? Yintoni eyona nto iphambili?
Eyona nto iphambili neyona ixhaphakileyo yoku yimeko ebizwa ngokuba yi -'atherosclerosis' . Eli gama livakala linzima, akunjalo? Kodwa lilula kakhulu.
Ngamafutshane, okwenzekayo kukuba i-cholesterol, amafutha, kunye nezinye izinto ziqokelelana eludongeni lwangaphakathi lwemithambo yegazi yethu kwaye zenze 'iiplaque' . Kufana ne-limescale eqokelelana ngaphakathi kombhobho wamanzi. Njengoko ezi plaque zikhula kancinci kancinci, indlela yegazi iyancipha. Emva koko, xa igazi lizama ukungena kuloo ndawo imxinwa, eso sandi sicaphukisayo, okanye 'isandi', siyavakala.
Oku kuncitshiswa kwe-carotid artery kubizwa ngokuba yi-'Carotid Artery Stenosis' .
Le yinto ekufuneka ixhalatyelwe. Kuba xa umthambo oyintloko othwala igazi usiya ebuchotsheni uvalekile, ingqondo inokuphelelwa yioksijini kunye nezondlo. Kwakhona, ngamanye amaxesha iqhekeza elincinci le-plaque linokwaphuka lize livale ngokupheleleyo omnye umthambo omncinci ebuchotsheni. Oku kwandisa umngcipheko wokuhlaselwa yi-ischemic transient (TIA) okanye i-ischemic stroke .
Ngoko ke, ukuba ugqirha uyasiva esi sandi, usisebenzisa njengesixhobo esibalulekileyo sokufumanisa ukuba kukho umngcipheko onjalo na.
Ngaba zikho ezinye izizathu?
Ewe. Akusoloko kungenxa yokugcinwa kwe-cholesterol. Ngamanye amaxesha,
- Esi sandi sinokubangelwa nalutshintsho kwisakhiwo seendonga zemithambo yegazi, njengeFibromuscular Dysplasia (FMD) .
- Kwanakwabanye abantu abaphilileyo, esi sandi sinokuviwa ngenxa yomahluko omncinci kwindlela imithambo yegazi ehlelwe ngayo.
Ugqirha wakho uza kufumanisa unobangela emva kokuqwalasela imbali yakho yezonyango kunye nezinye izinto.
Ngaba ukuba ne-carotid bruit yimeko embi kakhulu?
Lo mbuzo awunakuphendulwa ngo-"ewe" okanye "hayi" ngqo.
Ngamanye amaxesha, oku kungaba yimpawu ebalulekileyo ebonisa umngcipheko omkhulu westroke. Kodwa, akunjalo rhoqo.
Khawuthelekelele ugqirha wakho efana nomcuphi. Esi sandi 'seBruit' 'sibubungqina' bokuqala abufumanayo. Obo bungqina bodwa abumxeleli ukuba "nanku umtyholi." Kufuneka aphande ngakumbi. Ngokufanayo, ukuva nje esi sandi akubonisi ukuba unesifo esinzulu. Luphawu nje lokuba kufuneka uphando olongezelelweyo.
Abanye abantu abaphilileyo banokusiva esi sandi. Kwakhona, ngamanye amaxesha imithambo yentamo ingavalwa ngama-90% kodwa ingasiva esi sandi. Ngoko ke, khumbula ukuba esi sisiqendu esinye nje sephazili.
Ukuba ugqirha uthi kukho i-carotid bruit, kuza kwenzeka ntoni emva koko?
Ugqirha wakho akayi koyikiswa yile ngxolo. Into elandelayo aza kuyenza kukufumanisa ukuba yintoni kanye kanye ebangela le ngxolo. Uvavanyo olulula kakhulu nolungenabuhlungu oludla ngokwenziwa sisikeni 'seCarotid Duplex Ultrasound' .
Oku kufana nokuhlolwa okwenziwe kubafazi abakhulelweyo. Kusebenzisa amaza esandi ukuthatha imifanekiso yemithambo yegazi entanyeni. Kungenza oku kulandelayo:
- Jonga ukuba akukho cholesterol plaques ngaphakathi kwemithambo yegazi.
- Ukuba ikho, linganisa ngqo ukuba ingakanani imithambo evalekileyo.
- Jonga isantya kunye nepatheni yokuhamba kwegazi.
Ngokusekelwe kwiziphumo zolu vavanyo, ugqirha uya kugqiba ukuba uyalufuna na unyango okanye awulufuni, kwaye ukuba kunjalo, yintoni omawuyenze.
Ngokukodwa, ukuba unenye okanye ngaphezulu kwezi zinto zilandelayo eziyingozi, ugqirha wakho uya kucebisa olu vavanyo.
| Izinto ezibangela umngcipheko we-carotid artery stenosis | |
|---|---|
| Isifo seMitha yeCoronary | Ukuba i-cholesterol ibekwe kwimithambo yentliziyo, kusenokwenzeka ukuba ivele nakwimithambo yentamo. |
| Isifo Seswekile (iDiabetes Mellitus) | Isifo seswekile singonakalisa imithambo yegazi. |
| Igazi elonyukayo | Xa uxinzelelo lusanda, iindonga zangaphakathi zemithambo yegazi ziyayonakala kwaye kuba lula ukuba i-cholesterol iqokeleleke. |
| I-Cholesterol ephezulu | Le yeyona nto iphambili ekwakhiweni kwe-plaque. |
| Ukutshaya (Ukusetyenziswa kwecuba) | Ukutshaya kufana nokutyhefa imithambo yegazi yakho ngokuthe ngqo. |
| Ubudala | Ngokuqhelekileyo, abantu abangaphezu kweminyaka engama-65 ubudala basengozini enkulu. |
| Imbali yoSapho | Ukuba kukho umntu kusapho lwakho oye waba nestroke, nawe usenokuba sengozini. |
Zithini iindlela zonyango zoku?
Iindaba ezimnandi zezokuba ayinguye wonke umntu odinga utyando okanye iinkqubo. Unyango luxhomekeke ekubeni imithambo yakho ivalekile kangakanani, ubudala bakho, kunye nazo naziphi na ezinye iimeko zempilo onokuba nazo.
Unyango lunokwahlulwa lube ziinxalenye ezintathu eziphambili.
1. Amayeza
Oku kudla ngokuba yinto yokuqala ekufuneka uqale ngayo. Oku kunokwanela, ingakumbi ukuba ukuvaleka kwemithambo akukubi kangako.
- Amayeza okwehlisa i-cholesterol: La mayeza anceda ekunciphiseni inqanaba le-cholesterol embi egazini kwaye ayeke ukwakheka kwe-plaque.
- Amayeza oxinzelelo lwegazi: Alawula uxinzelelo lwegazi kwaye anciphisa umonakalo kwimithambo yegazi.
- Amayeza okulwa nokugabha kwegazi: Ngamanye amaxesha, amayeza afana ne-aspirin anokunikwa ukunciphisa umngcipheko wokugabha kwegazi.
2. Utshintsho kwindlela yokuphila
Oku kunokuba kubaluleke ngaphezu kwamayeza. Ezi zinto ziya kunceda ekulawuleni ukuxinana kwemithambo yegazi ngakumbi.
- Yeka ukutshaya ngokupheleleyo: Ukuba ungumntu otshayayo, eyona nto ingcono onokuyenza kukuyeka namhlanje. Thetha nogqirha wakho ukuba ufuna uncedo ngale nto.
- Ukutya okunempilo kwentliziyo: Nciphisa ukutya okuneoyile eninzi, ityuwa, kunye neswekile. Tshintsha inyama ebomvu (inyama yenkomo, inyama yehagu) ngentlanzi kunye nenkukhu. Faka imifuno, iziqhamo kunye nemifuno emininzi ekutyeni kwakho.
- Zilolonge rhoqo: Kungaba lula njengokuhamba imizuzu engama-30 ngosuku. Ngaphambi kokuba uqale umthambo omtsha, thetha nogqirha wakho ukuze ubone ukuba yintoni ekulungeleyo.
3. Utyando kunye nezinye iinkqubo
Ezi ziyimfuneko kuphela xa imithambo yegazi inciphile kakhulu (i-stenosis enzima) kwaye ugqirha ufumanisa ukuba umngcipheko we-stroke uphezulu kakhulu.
- Utyando lwe-Carotid Endarterectomy: Oku kuquka ukwenza umngxuma omncinci entanyeni, ukuvula umthambo wegazi, nokususa ngotyando ii-cholesterol plaques eziqokelelene ngaphakathi.
- I-Carotid Angioplasty kunye ne-Stenting: Oku kuquka ukudlulisa isixhobo esifana nenaliti kwimithambo yegazi kunye nokukhupha ibhaluni encinci ukuze kwandiswe ukuvaleka. Emva koko, ityhubhu encinci ye-mesh ebizwa ngokuba yi-stent ifakwa kwi-artery ukuze ithintele ukuba ingaphinde inciphe.
Khumbula, ngugqirha wakho kuphela onokugqiba ukuba loluphi unyango olulungele wena. Musa ukusekela izigqibo zakho zonyango kwinto oyifunda kwi-intanethi okanye oyivayo kwabanye.
Umyalezo Wokuya Ekhaya
- I-carotid bruit ayisosifo, sisandi nje esiviwa ngugqirha kuphela nge-stethoscope. Musa ukoyika ukuba uyasiva.
- Nangona unobangela oyintloko woku kukufakwa kwe-cholesterol kwimithambo yegazi (i-atherosclerosis), akusoloko kubangelwa yimeko embi kakhulu.
- Eli licebiso elibalulekileyo ekufuneka uliqwalasele xa kufikwa kumngcipheko westroke. Ngoko ke ukuba ugqirha wakho ukhankanya oku, musa ukukubetha ngoyaba.
- Ugqirha wakho uhlala esenza iskeni esilula esibizwa ngokuba yi-'Carotid Duplex Ultrasound' ukuqinisekisa imeko.
- Nokuba unyango luyadingeka okanye alufuneki, kwaye kufuneka wenze ntoni ukuba luyadingeka, kuxhomekeke kubungakanani bokuvimbeka kunye nempilo yakho iyonke. Xoxa ngayo yonke into nogqirha wakho.
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