Masithethe ngomthambo wegazi omkhulu nobaluleke kakhulu emzimbeni wakho. Siwubiza ngokuba yi-"aorta." Cinga ngawo njengombhobho ophambili othwala amanzi ukusuka kwitanki yamanzi ukuya ekhitshini nakwigumbi lokuhlambela endlwini yethu. Kukule aorta apho igazi elicocekileyo, elinomoya-mpilo omninzi lisasazeka khona emzimbeni wonke. Kodwa ngamanye amaxesha lo mthambo uphambili unokuba neengxaki. Iindonga zawo zinokuba buthathaka kwaye zivuvuke njengebhaluni, okanye zinokuqhekeka ngequbuliso. Kulapho oogqirha bathetha khona ngotyando lwe-"aorta". Eli gama livakala lisoyikisa kancinci, kodwa masiliqonde ngokulula.
Yintoni utyando lwe-Aorta?
Ngamafutshane, utyando lwe-aorta bypass luyinkqubo yokulungisa isiphene okanye umonakalo kulo mthambo wegazi uphambili emzimbeni wakho. Luqhagamshela entliziyweni, ludlule esifubeni luye esiswini, luze lungene kwimithambo yegazi ehambisa igazi emilenzeni.
Xa iindonga zale aorta ziba buthathaka ngesizathu esithile, uxinzelelo lwegazi luyayolula kancinci kancinci luze luqale ukudumba njengebhaluni . Kwizonyango, oku sikubiza ngokuba yi-aneurysm . Ngamanye amaxesha, ulwelo olungaphakathi kodonga lwemithambo yegazi lunokukrazuka, kwaye igazi lingavuza phakathi kwezi layer zimbini. Oku sikubiza ngokuba kukuqhekeka . I-aorta evuvukileyo okanye ekrazukileyo ngale ndlela ingaqhuma ngequbuliso (ukuqhekeka) . Ukuba oko kuyenzeka, yimeko eyingozi kakhulu ebomini. Ngoko ke injongo ephambili yolu tyando kukulungisa le ngxaki ngaphambi kokuba kwenzeke ingozi enjalo.
Kukweziphi iimeko apho olu hlobo lotyando lufunekayo?
Ugqirha wakho uza kucebisa olu hlobo lotyando ukuba i-aneurysm inkulu kunobukhulu obuthile, okanye ukuba ikhula ngokukhawuleza kunesiqhelo. Obu bukhulu bumiselwa ngokuvavanya ngononophelo iingozi zotyando kunye nomonakalo onokubakho wokungatyandwa. Imeko yevalvu yentliziyo, ingakumbi ukuba i-aorta idumbile kufutshane nentliziyo, nayo iyasichaphazela esi sigqibo.
Eyona nto ibalulekileyo kukwenza utyando ngaphambi kokuba kubekho umngcipheko wokuqhuma kwe-aorta.
Kukho izizathu ezininzi zokuba kutheni i-aorta inokudumba okanye iqhekeke ngale ndlela:
- Ukuqina nokuqina kweendonga zemithambo yegazi: Oku sikubiza ngokuba yi-'Atherosclerosis'.
- Uxinzelelo lwegazi oluphezulu: Oko kuthetha 'uxinzelelo lwegazi oluphezulu'.
- Izifo zezicubu ezidityanisiweyo: Umzekelo, iimeko ezifana ne-'Marfan Syndrome'.
- Ukulimala okubangelwe ziingozi.
Ii-Aneurysms zahlulwe zibe ziintlobo ezahlukeneyo ngokuxhomekeke kwindawo ezifumaneka kuyo.
| Uhlobo lwe-Aneurysm | Indawo |
|---|---|
| I-Aneurysm ye-Aortic yesisu | Ukwenzeka kwinxalenye ehamba kwindawo yesisu. |
| I-Aneurysm ye-Thoracic Aortic | Ivela kwindawo yesifuba. Oku kungaba kwingcambu ye-aorta, i-ascending aorta, i-aorta arch, okanye i-descending aorta. |
| I-Thoracoabdominal Aortic Aneurysm | Ukusasazeka esifubeni nakwisisu. |
Lubaluleke kangakanani utyando lwe-aorta?
Enyanisweni, olu lutyando olunzima . Kuba i-aorta yeyona nto iphambili ehambisa igazi emzimbeni wonke. Ukuba ukusebenza kwayo kuyeka nokuba kuncinci, umzimba wonke uya kungasebenzi kakuhle.
Kodwa kukho into ebaluleke kakhulu ekufuneka uyiqonde apha. Impumelelo kunye nokhuseleko lotyando olukhethwayo, olucwangcisiweyo nolulungiselelwe kwangaphambili, luphezulu kakhulu kunotyando olungxamisekileyo, olwenziwa xa i-aneurysm sele iza kuqhuma. Abo benza utyando ngaphambi kokuba luqhume banethuba elikhulu lokusindisa ubomi babo.
Lwenziwa njani olu tyando? Ziziphi iindlela ezisetyenziswayo?
Ngokuxhomekeke kwimeko yakho, ugqirha uneendlela ezininzi eziphambili zokwenza olu tyando.
1. Utyando Oluvulekileyo: Kule ndlela, utyando lwenziwa ngokusika esifubeni (sternotomy), ngokuvula isifuba phakathi kweembambo ezimbini (thoracotomy), okanye ngokusika isisu. Le yindlela yendabuko.
2. Indlela Engena Ngobuninzi okanye Indlela Yemithambo Yegazi:Le yindlela entsha. Akukho sithuba sikhulu. Endaweni yoko, kwenziwa umngxuma omncinci ngemithambo yegazi emqolo, kwaye isixhobo esibizwa ngokuba yi-stent graft sifakwa kuyo kusetyenziswa i-catheter kwindawo yengxaki yemithambo yegazi.
Cinga ngayo njengokulungisa umbhobho wamanzi omdala ngokufaka omtsha ngaphakathi. Le stent yityhubhu eyenziwe nge-mesh yesinyithi kunye nelaphu elikhethekileyo. Xa ifakwa ngaphakathi kwi-aneurysm, igazi lihamba ngale tyhubhu intsha. Emva koko uxinzelelo lwegazi alufikeleli eludongeni olubuthathaka obeluvuvukala. Ke ngoko, luyeka ukuqhuma.
Ziziphi iingenelo zendlela ye-endovascular?
- Ixesha elichithwa esibhedlele lifutshane.
- Olu khetho lungcono kwabo bangenako ukuthwala umngcipheko wotyando oluvulekileyo.
- Ekubeni kungekho kusikwa okukhulu, ixesha lokuphiliswa lifutshane kakhulu.
Uzilungiselela njani ngaphambi kotyando?
Kukho izinto ezimbalwa ekufuneka uzenze ngaphambi kotyando.
- Xelela ugqirha wakho ngazo zonke amayeza owasebenzisayo (kwanalawo angamiselwanga ngugqirha). Amanye amayeza anokufuna ukuba uyeke ukuwasebenzisa kwiintsuku ezimbalwa ngaphambi kotyando.
- Fumana zonke iimvavanyo kunye novavanyo lwegazi kwiiodolo zakho zikagqirha, ezinje ngee-EKG kunye nee-CT scans, ngexesha elifanelekileyo.
- Lungiselela umntu oza kukunceda ukuya nokubuya esibhedlele. Kukwangumbono omhle ukuba nomntu oza kukunceda kwiintsuku zokuqala emva kotyando xa ufika ekhaya.
- Buza ugqirha wakho ukuba umele uyeke nini ukutya nokusela ngobusuku bangaphambi kotyando.
Kwenzeka ntoni ngexesha nasemva kotyando?
Uhlobo lotyando luya kwahluka ngokuxhomekeke kwingxaki ye-aorta yakho kunye nohlobo lotyando. Ngokwesiqhelo, ugqirha uza kususa inxalenye eyonakeleyo, evuvukileyo ye-artery aze ayitshintshe nge -graft eyenziwe ngezinto zokwenziwa ezifana neDacron .
Kwezinye iimeko ezinzima, ingakumbi ukuba i-aneurysm isasazeke ukusuka esifubeni ukuya esiswini, iindlela ezikhethekileyo ezifana nenkqubo ye-"elephant trunk" enamanqanaba amabini ziyasetyenziswa.
Emva kotyando, uza kuqala ungeniswe kwigumbi labagula kakhulu (ICU) . Xa ubuyela ezingqondweni, usenokuba nombhobho wokuphefumla emqaleni wakho. Uza kususwa xa sele ukwazi ukuphefumla wedwa. Uza kukwazi ukuqala ukuhamba kancinci. Emva koko uza kudluliselwa kwigumbi eliqhelekileyo. Ugqirha uza kukuxelela xa sele ukulungele ukuya ekhaya.
Kuthatha ixesha elingakanani ukuchacha? Zithini iingozi?
Ixesha lokuchacha liyahluka ngokuxhomekeke kuhlobo lotyando.
- Emva kotyando oluvulekileyo: Kuya kufuneka uhlale esibhedlele kangangeveki. Kungathatha malunga neenyanga ezimbini ukuya kwezintathu ukuze uphile ngokupheleleyo.
- Emva kotyando lwe-Endovascular: Kufuneka uhlale esibhedlele usuku olunye okanye ezimbini kuphela. Ixesha elifutshane, malunga neeveki ezimbini ukuya kwezintathu, lanele ukuba uphile ngokupheleleyo.
Njengakwezinye iintlobo zotyando olukhulu, kukho iingozi. Iingxaki ezinje ngokopha, isifo sohlangothi, ukuhlaselwa yintliziyo, ukungasebenzi kakuhle kwezintso, usulelo, kunye nokuqhekeka kwegazi zinokwenzeka. Nangona kunjalo, ezi ngozi zingancitshiswa ngotyando olucwangcisiweyo kakuhle olwenziwe phantsi kweliso leqela lezonyango elinobuchule.
Ukuba ufumana ezi mpawu zilandelayo emva kotyando, kufuneka wazise ugqirha wakho ngoko nangoko .
| Uphawu | Inkcazo |
|---|---|
| Utshintsho kwindlela yokusika | Ububomvu, ukudumba, okanye ulwelo olufana nobovu oluphuma kwindawo yokusikwa. |
| Ifiva | Ukuba ufumana umkhuhlane ngaphandle kwesizathu. |
| Iintlungu zesifuba | Intlungu yesifuba ngequbuliso. |
| Ubunzima bokuphefumla | Ukuba uziva uphelelwa ngumphefumlo okanye kunzima ukuphefumla. |
Emva kotyando, uya kuba notyelelo oluqhubekayo rhoqo nogqirha wakho. Emva koko baya kwenza i-CT okanye i-MRI scan ukujonga imeko ye-graft kunye nazo naziphi na ezinye iingxaki nge-aorta.
Umyalezo Wokuya Ekhaya
- I-aorta ngumthambo wegazi oyintloko emzimbeni wakho. Ifana nombhobho wamanzi oyintloko endlwini yakho.
- Iindonga zayo zinokuba buthathaka kwaye zidumbe njengebhaluni (i-aneurysm) okanye zikrazuke (ziqhekeke). Ezi meko zinokuba yingozi ebomini ukuba ziyaqhekeka.
- Utyando lwevalvu yomthambo wentliziyo lunokuthintela le ngozi. Lunokusindisa ubomi bakho.
- Utyando olucwangcisiweyo kwangaphambili lukhuselekile kwaye luphumelele ngakumbi kunotyando olungxamisekileyo.
- Kukho iintlobo ezimbini eziphambili zotyando: utyando oluvulelekileyo kunye notyando olungenamda lwe-endovascular. Ugqirha wakho uya kugqiba ukuba yeyiphi indlela efanelekileyo kuwe.
- Kubaluleke kakhulu ukulandela imiyalelo efanelekileyo yezonyango kunye nokuhlolwa rhoqo nasemva kotyando.
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