Ingaba unehlwili legazi emthanjeni engqondweni yakho? (Cerebral Venous Sinus Thrombosis - CVST) Masifunde ngayo.

Ngaba wakha waba nentloko ebuhlungu ebonakala ngathi iya isiba mandundu yonke imihla? Okanye ngaba ngequbuliso wakha waba nemeko efana nokuxhuzula? Ngamanye amaxesha ezi zinokuba luphawu lwento ethile enzulu. Namhlanje siza kuthetha ngemeko ethile enokubangela oku, oku kukuphuma kwegazi kumthambo omkhulu engqondweni.

Yintoni iCerebral Venous Sinus Thrombosis (CVST)?

Ngamafutshane, iCerebral Venous Sinus Thrombosis , okanye iCVST ngamafutshane, lihlwili legazi elenzeka ngaphakathi komthambo omkhulu wegazi, umthambo, engqondweni yakho. Esi sisifo esingaqhelekanga, kodwa simalunga ne-1% yazo zonke izibetho ezaziwayo.

Khawuthelekelele, xa igazi liqhekeka kumthambo omkhulu engqondweni yakho, igazi liqala ukuhamba ngendlela engalunganga endaweni yendlela elungileyo. Oku kubangela ukuba uxinzelelo ngaphakathi kwengqondo lunyuke, nto leyo ebangela ukuba ingqondo idumbe. Oku kufana nombhobho wamanzi ovalekileyo obangela ukuba amanzi abuyele umva.

Amahlwili egazi anje ngala adla ngokwenzeka kwiisinuses engqondweni yakho:

• I-sinus eguqukayo
• I-sinus ye-sagittal ephezulu
• I-sinus engaphantsi kwe-sagittal
• Iisinuses zeSigmoid
• I-Cavernous sinus
• Iisinus ezinzulu ze-cortex yakho

Ngubani ochaphazeleka kakhulu yile meko (CVST)?

Le meko (CVST) ixhaphake kakhulu kwabasetyhini . Ixhaphake kakhulu kubantu abaphakathi kweminyaka engama-40 ukuya kwengama-50 ubudala, kodwa inokwenzeka kwasebancinci, kwanakwiintsana .

Usenokwenzeka ukuba ube ne-CVST ukuba unenye yezi meko zilandelayo okanye izinto ezinobungozi:

• Isifo seNephrotic - Esi sisifo esinxulumene nezintso.
• Iimeko zomhlaza.
• I-Vasculitis - Oku kukudumba kwemithambo yegazi.
• I-Sarcoidosis.
• Ukutyeba kakhulu.
• Usulelo lwe-Covid-19 (`COVID-19`).
• I-Thrombophilia - Le yimeko ezuzwe njengelifa apho igazi lakho liqina lula.
• Isifo sesibindi.

Ixhaphake kangakanani i-CVST?

I-CVST yimeko engaqhelekanga kakhulu . Abaphandi baqikelela ukuba ichaphazela abantu ababini (`2`) kunye nabalishumi elinesihlanu (`15`) kwisigidi sabantu ngonyaka. Kukwaqikelelwa ukuba malunga nesixhenxe (`7`) kwisigidi ngasinye sabantwana kunye neentsana ziba ne-CVST minyaka le. Ngoko ke ungabona, ayixhaphakanga kangako.

Zeziphi iziphumo ezinokubakho emzimbeni wam yiCVST?

Kukho iingxaki ezininzi ezinokwenzeka ngenxa ye-CVST. Nazi:

• Ukulahlekelwa ngumbono.
• Ukopha kwegazi ngaphakathi kwemithambo yegazi (`ukuvuza kwegazi`) - oko kukuthi, ukulahleka kwegazi okuvela kwimithambo yegazi eqhumayo.
• Intloko ebuhlungu kakhulu.
• Ukuhluthwa.
• Imeko efana nestroke.

Zithini iimpawu zeCVST?

Iimpawu ze-CVST zinokwahluka ngokuxhomekeke kubukhali behlwili legazi kunye nendawo elikuyo engqondweni .

Iimpawu eziphambili ezinokubonwa zezi:

• Intloko ebuhlungu iyanda kancinci kancinci (le yeyona mpawu ixhaphakileyo).
• Ukuxhuzula.
• Utshintsho kwisimo sengqondo kunye/okanye iingxaki ezintsha zemithambo-luvo, njengakwimeko yokopha okukhulu kwengqondo.

Zithini izizathu zeCVST?

Kukho izinto ezininzi ezinokubangela i-CVST:

• Ukuba ukhulelwe .
• Ukusetyenziswa kweepilisi zokulawula ukukhulelwa (izithinteli zokukhulelwa ezithathwa ngomlomo).
• Ukuba sengozini enkulu (ukwenzakala).
• Ukuba nesifo esizuzwe njengelifa esibangela ukuba igazi lijijeke lula, umzekelo, i-thrombophilia.
• Ukwenzeka kosulelo (umzekelo, usulelo lwe-COVID-19).

Kwakhona, inani elincinci kakhulu labantu liye laxelwa ukuba linesifo se-CVST emva kokufumana isitofu se-COVID-19. Nangona kunjalo, kubalulekile ukukhumbula ukuba oku kuyinto engaqhelekanga .

Oogqirha bayixilonga njani i-CVST?

Ugqirha wakho uza kusebenzisa uvavanyo lwemifanekiso yobuchopho ukuze abone ukuba unayo na i-CVST. Ukuxilongwa ngokukhawuleza kubalulekile ukuze kuthintelwe iingxaki.

Ziziphi iimvavanyo ezisetyenziselwa ukuchonga i-CVST?

Ukuze axilonge i-CVST, ugqirha wakho unokwenza iimvavanyo zomfanekiso ezifana nezi:

• Uvavanyo lwe-MRI yobuchopho (magnetic resonance imaging) lwenziwe kusetyenziswa idayi yokwahlulahlula.
• I-brain CT scan (`Brain CT - computed tomography`) yenziwa kusetyenziswa idayi.
• I-Magnetic Resonance Venography (MRV), i-CT Venography (CT venography) okanye i-Cerebral Angiography (Cerebral Angiography).

Ukongeza, uvavanyo lwegazi, olufana nephaneli yokubola kwegazi, lunokwenziwa ukujonga naziphi na iingxaki zokubola kwegazi.

Iphathwa njani i-CVST?

Kukho iindlela ezahlukeneyo zokunyanga i-CVST, kuquka:

• Ii-Anticoagulants : Umzekelo, i-heparin. Ezi zinokunikwa kwanangexesha lokukhulelwa.
• I-Thrombolytics (iziyobisi ezisusa amahlwili).
• Ukuba ukujiya kwegazi lakho kubangelwa lusulelo, kunikwa amayeza okubulala iintsholongwane .
• Kwiimeko ezinzima kakhulu, kwenziwa utyando lokususa ihlwili legazi (`Thrombectomy`) .
• I-Acetazolamide okanye ezinye iindlela zonyango zokunciphisa uxinzelelo olungaphakathi kwengqondo yakho (uxinzelelo lwangaphakathi kwentloko).
• Ukuba kukho ukuxhuzula, kunikwa amayeza okulwa nokuxhuzula .

Ngokuxhomekeke kwisizathu se-CVST yakho, kunokufuneka uthathe i-warfarin (umz. iCoumadin®, iJantoven®) okanye i-anticoagulant yomlomo ngqo (umz. iRivaroxaban, iApixaban okanye iDabigatran) kangangeenyanga ezintathu ukuya kwezili-12. Abantu abaneengxaki ezifana ne-thrombophilia banokufuna ukuthatha i-warfarin ubomi babo bonke.

Zithini iingxaki okanye iziphumo ebezingalindelekanga zonyango?

Ukuba uthatha i-warfarin, kubaluleke kakhulu ukuthatha idosi echanekileyo oyimiselweyo . Yiyo loo nto ugqirha wakho eza kujonga rhoqo ukujiya kwegazi lakho. Idosi oyinikwayo kufuneka yanele ukunqanda ukwakheka kwamahlwili egazi anokukwenzakalisa, kodwa ingabi phezulu kakhulu kangangokuba awunakukwazi ukuyeka ukopha ukuba usika ingalo okanye umlenze wakho. Ngoko ke kufuneka ufumane ibhalansi efanelekileyo.

Ndiza kuziva bhetele nini emva konyango?

Xa ufumana i-heparin, nokuba nge-IV okanye ngenaliti, iqala ukusebenza ngokukhawuleza . I-Warfarin ingathatha malunga neveki ukusebenza, ngoko ugqirha wakho uza kukugcina usebenzisa i-heparin ide isebenze. Emva koko, ungayeka ukuthatha i-heparin kwaye uthathe i-warfarin kuphela.

Okanye, ukuba ugqirha wakho ukhetha i-anticoagulant yomlomo ngqo, inganciphisa igazi lakho liye kwinqanaba olifunayo kwiiyure ezimbalwa. Njengoko ihlwili legazi liqala ukunyibilika kwaye uxinzelelo ngaphakathi kwengqondo luyancipha, uya kuqala ukuziva ungcono kancinci kancinci.

Ndingawunciphisa njani umngcipheko wokuba ne-CVST?

Ukuba ukhe waba neCVST ngexesha lokukhulelwa, ukuthatha i-anticoagulant ngexesha lokukhulelwa okulandelayo kunokunciphisa le ngozi.

Izinto zokuthintela ukukhulelwa ezithethwa ngomlomo nazo zingumngcipheko we-CVST. Ngoko ke, ungayinciphisa le ngozi ngokungazisebenzisi iipilisi zokuthintela ukukhulelwa. Ungasebenzisa indlela yokuthintela ukukhulelwa ene-progestin kuphela endaweni yoko.

Ukutshaya xa usebenzisa iipilisi zokulawula ukukhulelwa kwandisa umngcipheko we-CVST . Ukuphepha zombini ezi zinto kunokunceda ekuthinteleni i-CVST.

Ukuba ndinayo (i-CVST), ndimele ndilindele ntoni?

Ngaphambili, malunga nama-50% kuphela abantu ababene-CVST basindile. Kodwa ngoku imeko ingcono kakhulu.Izinga lokufa ngenxa yesi sifo ngoku liphantsi kakhulu, phakathi kwe-5% kunye ne-10%. Oku kungenxa yeteknoloji yobugcisa bokufota kunye neendlela zonyango eziphambili.

Nangona kunjalo, i-CVST inokuphinda ivele . Yiyo loo nto ugqirha wakho eza kukunika amayeza okunciphisa igazi (i-anticoagulants).

Ihlala ixesha elingakanani imeko (ye-CVST)?

(CVST) inokuhlala iiyure ukuya kwiiveki. Imeko yakho isenokuwela kwenye yezi ndidi zilandelayo:

• I-Acute: Ukuya kuthi ga kwiiyure ezingama-48.
• I-Subacute: Ingaphezulu kweeyure ezingama-48, kodwa ukuya kuthi ga kwiintsuku ezingama-30. (Olu lolona hlobo luqhelekileyo.)
• Ezingapheliyo: Ezihlala inyanga okanye ngaphezulu.

Iyintoni imbonakalo yesimo (se-CVST)?

Ithemba labantu abane-CVST abafumana ukuxilongwa nonyango olufanelekileyo lilungile . Nangona kunjalo, i-CVST ingaba yingozi ukuba ayifunyaniswanga kwaye inyangwe kwangethuba. Yiyo loo nto kubalulekile ukufuna iingcebiso zonyango ngokukhawuleza xa iimpawu zibonakala.

Ndingazinyamekela njani?

Emva kokuba ufumene i-CVST, ugqirha wakho uya kufuna ukuthintela ukuba ungaphindi ufumane ihlwili legazi. Oku kuthetha ukuba kuya kufuneka uqhubeke nokuthatha i-anticoagulant okanye "i-blood thinner" efana ne-warfarin.

Nangona oku kukukhusela kwiingozi zegazi, kwandisa umngcipheko wokopha ngenxa yokwenzakala okuncinci kwemihla ngemihla. Ke ngoko, kufuneka ulumke kakhulu xa usebenzisa izinto ezibukhali ezifana neemela . Kusenokuba ngcono ukusebenzisa i-razor yombane endaweni ye-razor eqhelekileyo.

Ndifanele ndimbone nini ugqirha wam?

Ufanele ubonane nogqirha wakho rhoqo (mhlawumbi rhoqo emva kweenyanga ezimbalwa) ngelixa uthatha amayeza okunciphisa igazi (i-anticoagulants). Ukuba uphoswe yidosi ye-warfarin, tsalela umnxeba ugqirha wakho ngoko nangoko.

Kwiinyanga ezintathu ukuya kwezintandathu emva kokuba une-CVST, unokufuna olunye uvavanyo lwe-CT okanye i-MRI enedayi ukujonga imeko ye-clot yegazi engqondweni yakho.

Ndingaya nini kwigumbi likaxakeka?

Ukuba usebenzisa iWarfarin kwaye unezinye zezi mpawu zokopha, fowunela ku-1990 (inkonzo ye-ambulensi yongxamiseko yaseSri Lanka) ngoko nangoko, okanye uye kwicandelo lezonyango olungxamisekileyo lesibhedlele elikufutshane ngokukhawuleza :

• Ukopha okungenakunqandeka .
• Intloko ebuhlungu kakhulu .
• Igazi elibomvu eliqaqambileyo xa ukhohlela, uhlanza, okanye ukhupha indle.

Ndingayibuza yiphi imibuzo ugqirha wam?

Ungabuza ugqirha imibuzo efana nale:

• Kutheni ndifumene le meko (CVST)?
• Kuza kufuneka ndifumane unyango ixesha elingakanani?
• Iyintoni ingozi yam yokuphinda ndibe ne-CVST?

Ngenxa yokuba i-CVST ingaphinda ivele, kubalulekile ukugcina onke amadinga okulandela kunye nogqirha wakho. Baza kufuna ukuqinisekisa ukuba uthatha amayeza afanelekileyo ukuthintela ukuba i-CVST ingaphindi yenzeke. Ukuba uthatha amayeza okunciphisa igazi, kufuneka uphephe nemisebenzi enokubangela ukwenzakala. Nezinto zemihla ngemihla ezifana neemela kunye nezikere zinokubangela ukopha. Ngoko ke ngumbono olungileyo ukusebenzisa ezinye iindlela ezikhuselekileyo ezifana nerazor yombane.

Ngoko ke, sithini isigidimi esifanele sisikhumbule kweli bali?

Ngamafutshane, i-CVST yimeko engaqhelekanga kodwa enzulu apho igazi liqhekeka khona emthanjeni wegazi engqondweni. Ukuba ufumana iimpawu ezifana neentloko ezibuhlungu neziya ziba mandundu kunye nokuxhuzula, bona ugqirha ngokukhawuleza . Ukuxilongwa kwangoko kunye nonyango kunokukhokelela kwiziphumo ezingcono. Izinto zokunciphisa igazi zezona zinto ziphambili kunyango. Kufuneka uqaphele ukopha xa usebenzisa la mayeza. Kubalulekile ukuthatha amayeza akho kanye njengoko ugqirha wakho ekuxelela kwaye ulandele ugqirha wakho. Khumbula, awuwedwa, kwaye ugqirha wakho ukhona ukuze athethe nawe aze akuncede.

I- Cerebral venous sinus thrombosis, i-CVST, ukugabha kwegazi ebuchotsheni, intloko ebuhlungu, izinto ezinciphisa igazi, istroke, ukuxhuzula