Ngaba uyayazi imeko ebizwa ngokuba yi-'Endoleak' eyenzeka emva konyango lwe-aneurysm?

Ngaba wakha weva nge-'Aneurysm', imeko apho udonga lwe-aorta okanye umthambo omkhulu wegazi emzimbeni uba buthathaka kwaye uvuthuluke njengebhaluni? Mhlawumbi ukhe waba nayo, kwaye oogqirha bayinyange ngokufaka ityhubhu encinci ebizwa ngokuba yi-'Stent Graft', inkqubo ebizwa ngokuba yi-'Endovascular', oko kuthetha ukuba ngaphandle kokwenza umngxuma omkhulu. Cinga ngayo njengokuvuza kumbhobho wamanzi omdala. Ngoko oogqirha bafaka enye ityhubhu ngaphakathi kokuvuza ukuze bayiqinise. Nangona kunjalo, ngamanye amaxesha emva kolo nyango, igazi elincinci liqala ukuvuza kwi-'Stent Graft', liye kwingxowa apho yayikhona i-'Aneurysm'. Yiloo nto siyibiza ngokuba yi-'Endoleak' kunyango. Namhlanje, siza kuthetha ngeenkcukacha ezithe vetshe malunga nokuba yintoni kanye kanye le nto, kutheni isenzeka, ingaba iyingozi, indlela yokuyifumanisa, kunye nokuba zeziphi iindlela zonyango.

Yintoni kanye kanye i-`Endoleak`?

Ngamafutshane, i-`Endoleak` ithetha ukuba emva kokuba i-`Aneurysm` inyangiwe yaza yavalwa, igazi liqala ukugeleza kwakhona ngaphakathi kwingxowa endala ye-`Aneurysm`. Ngoku, khangela, ngesiqhelo xa i-`Aneurysm` inyangwa, igazi lakho ligeleza kuphela ngetyhubhu entsha ye-`Stent Graft`. Le `Stent Graft` ifana nenkxaso yodonga lwemithambo yegazi ebuthathaka. Ke ngoko, igazi aligelezi kwinxalenye eyonakeleyo, evuvukileyo yemithambo yegazi, oko kukuthi, i-`Aneurysm Sac`. Emva koko i-`Aneurysm` iyayeka ukuba nkulu kwaye iqhume. Kufanele ukuba kulungile ukuba akukho gazi.

Nangona kunjalo, ukuba ngesizathu esithile igazi liyavuza ngaphandle kwe-'Stent Graft' kwaye lingene kwi-'Aneurysm Sac', oko kubizwa ngokuba yi-'Endoleak'. Kukho izizathu ezahlukeneyo zokuba le 'Endoleak' yenzeka. Ezinye zazo zibangelwa ziingxaki ze-'Graft' ngokwayo, kwaye ezinye zazo zisenokuba zibangelwa zeminye imithambo yegazi emincinci eqala kwi-'Aneurysm Sac'. Kufana namanzi avuzayo kwezinye iindawo emva kokuba uphahla luvuliwe.

Ukuba i-`Endoleak` yenzeka kwiintsuku ezingama-30 emva kolu nyango lwe-`Endovascular`, siyibiza ngokuba yi-`endoleaks zakuqala`` . Ezo zikhula emva kweentsuku ezingama-30 zibizwa ngokuba yi -`secondary endoleaks`` okanye `late endoleaks`` .

Ixhaphake kangakanani i-`Endoleak`?

Ngoku usenokuba uyazibuza ukuba le 'Endoleak' yinto eyenzeka kuye wonke umntu okanye yinto eyenzeka rhoqo. Enyanisweni, le meko 'ye-Endoleak' inokwenzeka kumntu omnye kwaba-4 abafumana 'Ukulungiswa kwe-Endovascular Aneurysm' (siyibiza ngokuba yi-'EVAR' ngamafutshane - olu lunyango ikakhulu lwe-'Aneurysm' eludongeni lwesisu) okanye 'Ukulungiswa kwe-Thoracic Endovascular Aneurysm' ('TEVAR') ye-'Aneurysm' esifubeni . Ngoko ke, ayisiyonto ingaqhelekanga. Yiyo loo nto kubaluleke kakhulu ukuqaphela oku.

Ingaba i-`Endoleak` iyingozi?

Oku kusenokukoyikisa kancinci. "Owu, ndiyoyika ukuba iza kuphuma igazi kwakhona, akunjalo?" Usenokucinga. Kodwa ayizizo zonke ii-endoleaks eziyingozi . Ezinye ii-endoleaks azibangeli monakalo kwaye ziyaphola ngokwazo. Njengokuba inxeba elincinci liziphilisa ngokwalo. Kwiimeko ezinjalo, ugqirha wakho unokugqiba ekubeni ajonge imeko yakho. Oku kuthetha ukuqhubeka nokwenza uvavanyo aze abone ukuba kwenzeka ntoni.

Nangona kunjalo, ezinye iintlobo ze-'Endoleak' zimbi ngakumbi. Ukuthintela ukuba i-'Aneurysm' ingaphindi ikhule kwaye iqhume, kufuneka inyangwe ngokukhawuleza. Kuba ukuba i-'Aneurysm' iyaqhuma, inokuba yingozi ebomini. Ngoko ke, nokuba oku kuyingozi okanye akunjalo kuxhomekeke kuhlobo lwe-'Endoleak' kunye nendawo ekuyo. Oogqirha benza izigqibo ngokusekelwe kuzo zonke ezi zinto.

Zeziphi iintlobo ze-'Endoleak' ezikhoyo?

Okwangoku kukho iintlobo ezintlanu ze-'Endoleak' ezichongiweyo. Uhlobo ngalunye lunesizathu esahlukileyo. Njengokuba isifo ngasinye sinesizathu saso. Ngophuhliso lwetekhnoloji entsha ye-'Stent Graft', ezinye iintlobo ze-'Endoleak' ngoku ziye zehla kancinci, nto leyo ilungileyo.

Kwezi , i-`Type 2 Endoleak` yeyona ixhaphakileyo . Nangona kunjalo , i-`Type 1` kunye ne-`Type 3` endoleaks ziyingozi ngakumbi , njengoko zonyusa umngcipheko wokuqhuma kwe-`Aneurysm` (`rupturing`). Makhe sijonge ezi ntlobo ngokusondeleyo.

`Uhlobo 1 lwe-Endoleak`

Oku kwenzeka xa i-stent graft ingafakwanga kakuhle eludongeni lomthambo wegazi, oko kuthetha ukuba ayivalwanga kakuhle. Khawuthelekelele, ukuba kukho umsantsa omncinci phakathi kwesiciko nodonga, amanzi aya kuvuza ukusuka apho, kwaye igazi liya kuvuza ukusuka kwisiphelo esiphezulu (esikufutshane) okanye esisezantsi (esikude) se-stent graft kwaye lingene kwi-aneurysm sac. Uhlobo lwe-1 endoleak yimeko enzima, ngoko ke idla ngokufuna unyango olukhawulezileyo. Ezi zinokwenzeka ukuba ziqhekeke i-aneurysm kunezinye iintlobo. Ukuba oogqirha bayakubona oku, baya kuthatha inyathelo ngokukhawuleza.

`Uhlobo 2 lwe-Endoleak`

Olu lolona hlobo luqhelekileyo lwe-endoleak . Luqheleke kakhulu emva kwe-EVAR kune-TEVAR kwi-aneurysms yesisu. Oku kuvuza kwenzeka xa igazi liphuma kwi-aorta yakho okanye kwi-stented artery lingena kwi-aneurysm sac ngemithambo yegazi emincinci (imithambo yegazi okanye imithambo yegazi). Khawuthelekelele ukuba i-aorta yakho inamasebe amancinci (amasebe). Ngoku, nokuba sifaka i-stent graft entsha ukuvala umngxuma kwi-aorta, elinye igazi lisenokuphuma kuloo masebe. Yiyo loo nto i-Type 2 endoleak injalo.

Uninzi lwexesha, ii-Endoleaks zohlobo lwesibini zifunyaniswa zingadlulanga iintsuku ezingama-30 emva konyango lwakho lwe-Endovascular. Nangona kunjalo, ngamanye amaxesha zinokuvela kamva, ezaziwa ngokuba yi-"late endoleaks." Malunga nama-40% ee-Endoleaks zohlobo lwesibini zifunyaniswa emva kweentsuku ezingama-30. Malunga nama-8% afunyaniswa emva konyaka wonyango.

Kodwa uninzi lwe-'Type 2 Endoleaks' alunabungozi kangako . Ziya zisiba ngcono zodwa emva kweenyanga ezintandathu ngaphandle konyango. Kuba loo mithambo yegazi mincinci iyazivalela yodwa. Nokuba ayibi ngcono, ukuba i-'Aneurysm Sac' izinzile kwaye ayibi nkulu, ugqirha angayijonga. Kodwa ngamanye amaxesha, ngokuhamba kwexesha, le 'Type 2 Endoleak' inokubangela utshintsho kwi-'Aneurysm Sac' ize iguquke ibe yi-'Endoleak' eyingozi ngakumbi efana ne-'Type 1' okanye 'Type 3'. Ukuba oko kuyenzeka, unyango luyafuneka. Ukuba i-'Aneurysm' inkulu kune-5 millimeters (`5mm`), unokufuna unyango. Ukuba i-'Aneurysm' ayinyangwa, kukho ithuba lokuba i-'Aneurysm' iya kuqhuma.

`Uhlobo lwesithathu lwe-Endoleak`

I-Endoleak yohlobo lwesithathu yenzeka xa izinto ezidityanisiweyo ze-stent graft yakho zahlukana, okanye ukuba ilaphu le-graft ngokwalo likrazuka okanye likrazuke. Oku kufana nombhobho owahlukana kwijoyinti, okanye umngxuma uvela kumbhobho ngokwawo. Njenge-Endoleak yohlobo lwe-1, kukho umngcipheko wokuqhuma kwe-aneurysm kuba igazi lihamba ngqo kwi-aneurysm sac phantsi koxinzelelo. Ke ngoko, unyango olukhawulezileyo lubalulekile. Nangona kunjalo, ngokuqhubela phambili kuyilo lwesixhobo, ii-Endoleak zohlobo lwesithathu azixhaphakanga.

`Uhlobo lwesi-4 lwe-Endoleak`

Oku kwenzeka xa igazi livuza ngemingxuma emincinci kwi-stent graft (i-poresity yezinto ezifakelweyo). Oku kudla ngokubonakala kwangethuba kunyango, kodwa kudla ngokuziphelela. Le yingxaki engaqhelekanga ye-graft, kwaye ayixhaphakanga kakhulu kwii-graft ezisetyenziswayo namhlanje.

`Uhlobo 5 lwe-Endoleak`

`Uhlobo lwe-5 Endoleak` lukwabizwa ngokuba yi-`Endotension``. Oku kuyamangalisa kancinci. Okwenzekayo kweli tyala kukuba, nangona kungekho phawu lwe-`Endoleak`` kwiimvavanyo ze-`Imaging``, i-`Aneurysm Sac`` iyaqhubeka nokukhula. Nangona unobangela ochanekileyo woku ungacacanga, kucingelwa ukuba kunokubakho ``ukudluliselwa koxinzelelo`` nge-`Stent Graft``, nangona kungekho kuvuza kwegazi okubonakalayo. Le yimeko ekufuneka ijongwe.

Zithini iimpawu ze-`Endoleak`?

Le yingxaki abantu abaninzi abanayo. Ngokuqhelekileyo akukho zimpawu onokulindela ukuzibona ukuba une-endoleak. Usenokungawuboni umahluko. I-endoleak ifunyanwa ngovavanyo lwemifanekiso olwenziwe ngomhla wonyango lwakho nangovavanyo olulandelayo olwenziwe emva koko.Yiyo loo nto kubaluleke kangaka ukuya kuvavanyo olulandelayo. Ukuya kuvavanyo kanye ngemihla ugqirha athi yeyona ndlela yokufumanisa into efana nale ngokukhawuleza.

Nangona kunjalo, ukuba i-aneurysm iba nkulu kwaye iqhuma (i-aneurysm iyaqhuma) ngenxa ye-endoleak (ingakumbi uhlobo oluyingozi), yingxamiseko yezonyango . Ukuba oku kuyenzeka, ezi mpawu zilandelayo zinokuvela. Ukuba oku kuyenzeka , kufuneka utsalele umnxeba ku-911 okanye uye esibhedlele esikufutshane ngoko nangoko :

• Umzimba ubanda kwaye ubila (`Ulusu oluxineneyo, olubilayo`).
• Ukudinwa, ukuziva ngathi ujikeleza entloko.
• Ukuquleka, ukulahlekelwa zingqondo.
• Ukubetha kwentliziyo kuyakhawuleza (`Ukubetha kwentliziyo okukhawulezayo`).
• Isicaphucaphu nokuhlanza.
• Ubunzima bokuphefumla, ukuziva ngathi uyafuthaniseka (ukuphelelwa ngumoya).
• Intlungu ebuhlungu ngequbuliso esiswini, emqolo okanye emilenzeni.
• Intlungu ebukhali nekrazukileyo esifubeni okanye emqolo ngequbuliso.

Ukuba ezi mpawu ziyavela, musa ukulibazisa.

Uyifumana njani i-`Endoleak`?

Njengoko bekutshiwo ngaphambili, i-endoleak ifunyaniswa ngovavanyo lwemifanekiso. Olu vavanyo lwenziwa ngexesha nasemva kokulungiswa kwe-endovascular aneurysm yakho. Uninzi lwexesha, ifunyaniswa ngosuku olunye okanye kwiintsuku ezingama-30 emva kwenkqubo. Nangona kunjalo, ngamanye amaxesha inokwenzeka ukuya kuthi ga kwiinyanga ezili-12 okanye nangaphezulu. Yiyo loo nto kubaluleke kakhulu ukugcina onke amadinga akho okulandela. Njengokulungisa imoto, le yinto ekufuneka iqwalaselwe rhoqo.

Uvavanyo lokufumanisa i-`Endoleak`

Iimvavanyo eziphambili ezisetyenziselwa ukufumanisa i-`Endoleak` ngexesha nasemva konyango zezi:

• `I-Computed Tomography (CT) scans`: Oku kuthatha imifanekiso enqamlezileyo yangaphakathi lomzimba. `I-Stent Graft`, `I-Aneurysm Sac`, kunye nokuvuza kwegazi kunokubonakala ngokucacileyo.
• I-Doppler Ultrasound: Oku kusebenzisa amaza esandi ukujonga indlela igazi elihamba ngayo. Kunokubona ukuba kukho i-endoleak kunye nendlela igazi elihamba ngayo.
• I-Angiogram: Kule nto, kufakwa ulwelo olukhethekileyo (idayi yomahluko) kwimithambo yegazi kwaye kuthathwa imifanekiso ye-X-reyi. Ukuhamba kwegazi kunye nokuvuza kunokubonakala ngokucacileyo.

Olu vavanyo lunokunceda ekuqinisekiseni ukuba unyango lwakho luphumelele na, ukuba i-stent graft ikhona na, kwaye ukuba kukho ukuvuza okujikeleze i-stent.

Kuya kufuneka wenze olu vavanyo lwe-'imaging' kangangeenyanga okanye iminyaka emva konyango. Ugqirha wakho uza kukuxelela ngezi mvavanyo kunye nokuba kufuneka uzenze kangaphi. Nangona kunjalo, ezi mvavanyo zibalulekile ukuze kubanjwe nayiphi na 'endoleak' enokuthi ivele kamva ('endoleaks yesibini') ngokukhawuleza kwaye uyinyange ukuba kuyimfuneko.

Ziziphi iindlela zonyango ze-`Endoleak`?

Iqela lakho lezonyango liza kunyanga i-Endoleak yakho ngokweemfuno zakho. Indlela elawulwa ngayo i-Endoleak yahlukile kumntu ngamnye. Oku kuya kuxhomekeka kuhlobo lomzimba wakho (umzekelo, ubude bentamo yakho ye-aneurysm, indawo yemithambo yegazi, njl.njl.), uhlobo lwe-Endoleak, kunye nendawo ekuyo. Ngokubanzi, kukho iindlela ezintathu eziphambili zokunyanga i-Endoleak: ukuqwalasela, unyango lwe-endovascular, kunye/okanye utyando oluvulekileyo.

Ukuqwalaselwa

Ukuba une-endoleak engembi kangako, efana ne-endoleak yohlobo lwesibini, ugqirha wakho unokucebisa indlela "yokulinda ngononophelo" ukuze abone ukuba iza kuphola yodwa na. Oku kunokwenzeka ukuba imithambo yegazi edibeneyo iyawa (iwa), imise ukuhanjiswa kwegazi kwi-aneurysm sac. Nangona kunjalo, ukuba i-endoleak ibangela ukuba i-aneurysm sac ibe nkulu (oko kukuthi, ibe nkulu kune-5 mm), uya kufuna unyango lokuthintela ukuba ingaqhekeki.

Unyango lwe-Endovascular

Olu lolona nyango luqhelekileyo lwe-endovascular aneurysm. Ugqirha wakho otyandayo angenza ukulungiswa kwe-endovascular aneurysm esebenzisa iindlela ezingaphantsi kakhulu. Ezi zingabandakanya:

• Ukuvala imithambo yegazi ehambisa igazi kwi-aneurysm. Oko kukuthi, kufakwa into ekhethekileyo (i-embolizing agent) kwimithambo yegazi emincinci ebangela i-Type 2 Endoleak ize ivaleke.
• I-`Stent Graft` yinkqubo equka ukubeka ezinye iziqwenga ze-`Stent` (`cuffs okanye izandiso`) ngaphaya kokuvuza, yandisa indawo yomthambo wakho omkhulu (`Aorta`) apho i-`Stent` yayibekwe khona. Oku kudla ngokwenziwa kwi-`Type 1 Endoleak`.
• Ukuya ngqo kwingxowa ye-aneurysm uze uvale ingxowa ye-aneurysm usebenzisa izinto ezifana neglu.

Ezi ndlela zivumela ukuba unyango lwenziwe ngaphandle kokusikwa okukhulu, ngokusebenzisa umngxuma omncinci.

Utyando (`Utyando Oluvulelekileyo`)

Ukuba unyango lwe-endovascular alunakwenzeka okanye aluphumeleli, utyando oluvulekileyo ludla ngokuba yindlela yokugqibela. Oku kubandakanya ukwenza umsikelo omkhulu, ukungena kwi-aneurysm, kunye nokulungisa i-stent graft okanye ukufaka entsha. Oku kunqabile kakhulu, njengoko iindlela ze-endovascular ngoku ziphucuke kakhulu.

Yintoni onokuyilindela ukuba une-`endoleak`?

Uninzi lwexesha, i-Endoleak ayifuni unyango, ingakumbi uhlobo lwesibini. Nokuba unyango luyadingeka, kukho iindlela ezininzi ezingangenisi kakhulu ezifuna ukusikwa okuncinci. Olu nyango lwe-Endovascular lubonise amazinga aphezulu empumelelo. Ukongeza, ubuchwepheshe obutsha buyaqhubeka nokuphucula ukusetyenziswa kwe-stent grafts ezinciphisa umngcipheko we-Endoleak.

Ukuba une-endoleak, ungoyiki. Ugqirha wakho uza kukuchazela iindlela zonyango lwakho. Eyona nto ibalulekileyo kukuba uza kuqhubeka nokuvavanywa emva kokuba i-endoleak iphilile.Kubaluleke kakhulu ukuchonga nokunyanga naziphi na iingxaki zexesha elizayo nge-stent graft yakho ngokukhawuleza, njengokugcina imoto icocekile.

Ndifanele ndimbone nini ugqirha wam?

Qiniseka ukuba ugcina onke amadinga okulandela emva konyango lwakho lwe-EVAR okanye lwe-TEVAR. Ugqirha wakho uza kukuxelela ukuba kufuneka wenze uvavanyo lwemifanekiso kangaphi. Ngokwesiqhelo, ziya kuba zisondelelene ekuqaleni, kodwa zinokuba ziphindaphindeka ngokuhamba kwexesha. Landela loo miyalelo ngokuchanekileyo.

Kwakhona, ukuba ufumana naziphi na iimpawu ezingxamisekileyo ezihambisana nokuqhekeka kwe-aneurysm, njengoko bekutshiwo ngaphambili, yiya esibhedlele ngoko nangoko ngaphandle kokulinda.

Imibuzo omele uyibuze ugqirha wakho

Emva kwenkqubo yakho ye-EVAR okanye ye-TEVAR, buza ugqirha wakho malunga nemingcipheko yeengxaki. Kwakhona, thetha ngovavanyo olulandelayo kunye novavanyo lomfanekiso onokululindela. Ungabuza imibuzo efana nale:

• Zithini iziphumo ebezingalindelekanga (iingxaki) ezinokubakho ngenxa yolu nyango? Ingakanani ingozi yam yokuba ne-endoleak?
• Kufuneka ndiye kangaphi ukuze ndilandelelwe? Zeziphi iimvavanyo (ezifana ne-CT, i-ultrasound) ekufuneka ndizenze?
• Ziziphi iindlela zonyango endinazo ukuba ndifumana i-`endoleak`?
• Zeziphi iinguqu endinokuzitshintsha kwindlela yam yokuphila ukuze ndincede intliziyo yam ibe sempilweni kwaye ndigcine i-stent graft yam ikwimeko entle? (umzekelo, ukuyeka ukutshaya, ukuzilolonga, ukutya okunempilo)

Kubaluleke kakhulu ukubuza imibuzo efana nale ukuze uqonde ngcono imeko yakho.

Sithini isigidimi esinokusithatha ekhaya kweli bali?

I-Endoleak yingxaki elawulekayo enokwenzeka emva kokulungiswa kwe-endovascular aneurysm. Usenokungadingi naluphi na unyango. Nangona kunjalo, ukuba uyalufuna, ugqirha wakho uya kuthetha nawe malunga neendlela zonyango ezifanelekileyo kuwe.

Kuqhelekile ukuba iingxaki ezinje zivele emva kwenkqubo esindisa ubomi, efana nokunyanga i-aneurysm. Nangona kunjalo, iingenelo zenkqubo zingaphezulu kakhulu kuneengozi . Ngoko ke musa ukoyika ukuba ufumana ulwazi nge-endoleak.

Eyona nto ibalulekileyo kukuya kwintlanganiso yokulandelelana enikwa ngugqirha kwaye ufumane uvavanyo alucebisayo. Ngale ndlela, naziphi na iingxaki zinokuchongwa kwaye zinyangwe ngokukhawuleza.

Ukuba uziva udiniwe kwaye uxinezelekile, kuyinto eqhelekileyo. Abantu abaninzi badlula kwinto efanayo nawe. Thetha nogqirha wakho kunye nosapho lwakho malunga neendlela zokulawula uxinzelelo oluza nokuchacha. Awuwedwa.

I- Endoleak, i-Aneurysm, i-Stent Graft, i-EVAR, i-TEVAR, ukopha, i-Aneurysm, i-Stent Graft, isifo sentliziyo