Umthambo wegazi omkhulu emzimbeni wethu yi-aorta, esiyibiza ngokuba yi-"Aorta" ngesiNgesi. Cinga ngayo njengombhobho wamanzi ophambili emzimbeni wethu. Ngulo osasaza igazi lisuka entliziyweni liye emzimbeni wonke. Ngamanye amaxesha, udonga lwalo mthambo wegazi luba buthathaka luze luqale ukudumba njengebhaluni. Oku sikubiza ngokuba yi-"Aneurysm" kumayeza. Eyona nto iyingozi kukuba olu dumba luyanda kwaye kukho ithuba lokuba luqhume ngequbuliso. Ngoko ke namhlanje siza kuthetha ngendlela yonyango yanamhlanje enokuthintela le meko iyingozi ngaphandle kokwenza umsi omkhulu emzimbeni kwaye ngaphandle komzamo omkhulu.
Kalula nje, yintoni i-EVAR?
Intsingiselo epheleleyo ye-EVAR ithi `(Endovascular Aneurysm Repair)`. NgesiSinhala, kukulungiswa okwenziwa ngaphakathi kwemithambo yegazi. Olu asilotyando olukhulu . Oko kuthetha ukuba endaweni yokwenza utyando olukhulu ngokusika isisu, olu nyango lwenziwa kusetyenziswa umngxuma omncinci kakhulu.
Khawuthelekelele ukuba umbhobho wamanzi omdala uvuvukile kwaye uza kugqabhuka. Endaweni yokuwusika umbhobho uwususe, okwenzekayo apha kufana nokuwulungisa ngokufaka umbhobho obhityileyo noqinileyo ngaphakathi kuwo. Oogqirha bafaka umbhobho owenziwe ngokukodwa (iStent Graft) kumthambo wegazi ovuvukileyo. Oku kufana nomgca okhethekileyo owenziwe ngelaphu kunye ne-mesh yesinyithi. Xa oku kufakwa, igazi lihamba ngembhobho entsha. Emva koko, akukho xinzelelo lufakwa eludongeni olubuthathaka noluvuvukileyo. Ke ngoko, umngcipheko wokugqabhuka kwawo ususwa ngokupheleleyo.
Kutheni sifuna unyango lwe-EVAR?
Eyona njongo iphambili nekuphela kwayo kukuthintela i-Abdominal Aortic Aneurysm ukuba ingaqhekeki . Kuba ukuba oko kuyenzeka, yimeko esongela ubomi kakhulu kwaye ibulala.
Xa udonga lomthambo wegazi lubuthathaka, uxinzelelo lwegazi olungena ngokubetha kwentliziyo nganye lubangela ukuba loo ndawo ibuthathaka idumbe. Ifana neqamza elikwitayara. Ayinakukhula ngokungenammiselo. Ngaxa lithile, iyaqhuma. Ukuba oko kuyenzeka, igazi elininzi linokugeleza emzimbeni, kwaye ukufa kunokwenzeka kwimizuzu embalwa.
Ngoko ke into eyenziwa lunyango lwe-EVAR kukufaka loo ``(Stent Graft)``, itshintshe ukuhamba kwegazi, kwaye inciphise uxinzelelo eludongeni oludumbileyo. Oko phantse kuyimisa ngokupheleleyo ingozi yokuqhekeka.
Ngamafutshane, oku kufana nokuthomalalisa ibhombu. Ususa ingozi ngaphambi kokuba iqhume.
Ngubani ofanelekileyo kolu nyango lwe-EVAR?
Olu nyango alwenziwa ngoko nangoko kuye wonke umntu one-aneurysm yesisu. Ugqirha wakho uza kujonga izinto ezininzi ukuze agqibe ukuba olu nyango lukulungele na.
- Ukuba i-aneurysm yakho inkulu ngokwaneleyo , okanyeUkuba iiskeni zibonisa ukuba ikhula ngokukhawuleza kwixesha elifutshane.
- Ukuba awukwazi ukuthwala umngcipheko wotyando olukhulu olufana notyando lwesisu ngenxa yezinye iimeko zempilo (ezifana nesifo sentliziyo okanye isifo semiphunga).
- Ukuba imithambo yegazi engaphezulu nangaphantsi kweqhubu iphilile kwaye inamandla (kuba kufuneka kubekho indawo efanelekileyo yokufaka umbhobho omtsha).
Kusemva kokuqwalasela izinto ezinje apho ugqirha agqiba kwelokuba unyango lwe-EVAR lulungele wena.
Yeyiphi indlela ekhethekileyo ebizwa ngokuba yi-FEVAR?
Umthambo omkhulu we-iliac esiswini sethu ufana nesiqu somthi. Ukhula ube yimithambo yegazi emincinci ethwala igazi iye kwizitho ezisesiswini sethu (njengezintso namathumbu). Ngamanye amaxesha i-aneurysm isondela kakhulu apho la masebe ahlala khona. Kwimeko enjalo, ityhubhu ethe tye esetyenziswa kwi-EVAR eqhelekileyo ayinakufakwa, kuba ukwenza njalo kuya kuyithintela indlela igazi elihamba ngayo kula masebe.
Kukwiimeko ezinzima kangaka apho kusetyenziswa indlela ekhethekileyo ebizwa ngokuba yi-FEVAR (Fenestrated Endovascular Aneurysm Repair). Kwi-`(Stent Graft)` esetyenziswa apha, kwenziwa imingxunya emincinci efana neefestile ukuze ilingane namasebe. Emva kokuba kufakwe ityhubhu ephambili, kufakwa i-`(Stent)` encinci eyahlukileyo ngaloo mafestile kwimithambo yegazi efana nesebe ukuqinisekisa ukuhamba kwegazi. Nangona oku kunzima kancinci, kuyinzuzo enkulu ukukwazi ukuphilisa i-`(Aneurysm)` kwiindawo ezinzima kangaka ngaphandle kokwenza utyando olukhulu.
Yintoni umahluko phakathi kwe-EVAR kunye ne-TEVAR?
Zombini ezi ziindlela zonyango ezifanayo. Umahluko ukwindawo yonyango.
- I-EVAR: Yenzelwa ii-aneurysms zesisu (esiswini) .
- I-TEVAR (Ukulungiswa kwe-Thoracic Endovascular Aneurysm): yenzelwe ii-aneurysms esifubeni (esifubeni) .
Ziziphi iingenelo zonyango lwe-EVAR?
Xa kuthelekiswa notyando olukhulu, unyango lwe-EVAR luneengenelo ezininzi ezicacileyo. Luyinkqubo engenazo izihlunu kangako.
| Inzuzo | Kalula nje... |
|---|---|
| Ixesha elincinci esibhedlele | Nangona utyando olukhulu luthatha malunga neveki, olu luza kuthatha iintsuku ezimbini okanye ezintathu. |
| Ubungakanani bokulahleka kwegazi buphantsi. | Ekubeni kungekho nxeba likhulu, akukho gazi lininzi. |
| Iintlungu ezincinci ngexesha lokuphiliswa | Ekubeni kungekho monakalo mkhulu, iintlungu zincinci kakhulu. Iipilisi zokubulala iintlungu zifuneka ixesha elifutshane kuphela. |
| Ungabuyela kubomi obuqhelekileyo ngokukhawuleza. | Ungabuyela emsebenzini kwisithuba senyanga, ngaphandle kokulinda iinyanga. |
| Iingozi ngexesha lotyando ziphantsi. | Umngcipheko wokuhlaselwa yintliziyo okanye ukufa ngexesha lotyando uphantsi kunaxa utyando olukhulu. |
| Ixesha lotyando lincinci. | Olu nyango lunokwenziwa ngexesha elifutshane kunotyando oluvulekileyo. |
Ngaba kukho naziphi na iingozi ngonyango lwe-EVAR?
Nangona i-EVAR ilunyango oluphumelele kakhulu nolukhuselekileyo, njengakwezinye iinkqubo zonyango, kukho iingozi ezincinci ezinokwenzeka. Nangona kunjalo, ezi azixhaphakanga kakhulu.
| Umngcipheko | Inkcazo |
|---|---|
| Ukugabha kwegazi | Kukho umngcipheko wokuba igazi liqhekeke kwimithambo yegazi, ingakumbi kwimithambo enzulu yemilenze (Deep Vein Thrombosis - DVT). |
| I-Endoleak | Igazi elincinci kakhulu liyavuza phakathi kwe-stent graft esandul’ ukufakwa kunye nodonga lomthambo wegazi, nto leyo ebangela ukuba i-aneurysm izalise igazi kwakhona. Le yeyona ngxaki iphambili enokwenzeka ngexesha lonyango. |
| Ezinye iingxaki | Ukuhlaselwa yintliziyo, usulelo, ukungasebenzi kakuhle kwezintso, kunye nokopha kakhulu kunokwenzeka, kodwa ezi aziqhelekanga. |
Lwenziwa njani utyando lwe-EVAR? Inyathelo ngenyathelo
Kulungile, ngoku masibone ukuba olu nyango lwenziwa njani ngokwenene. Wakuba uluqondile kakuhle olu nyango, akuyi kubakho loyiko lungafunekiyo.
1. I-Anesthesia: Okokuqala, uza kunikwa i-anesthesia ukuqinisekisa ukuba awuva ntlungu okanye ukungakhululeki. Usenokulaliswa ngokupheleleyo, okanye usenokuba ungazi nto kangako.
2. Ukufikelela: Ugqirha uza kusebenzisa imithambo yegazi ephambili kwindawo yakho yamathumbu (i-Femoral Arteries). Kuza kwenziwa umngxuma omncinci kuphela eluswini.
3. Ukufakwa kwe-catheter: Okulandelayo, ityhubhu encinci kakhulu, eguquguqukayo (i-catheter) equlethe i-stent graft ifakwa ngomngxuma ukuya kwimithambo yegazi.
4. Isikhokelo: Le catheter kufuneka iqondiswe ngemithambo yegazi, ukuya ngqo kwindawo apho kukho i-aneurysm esiswini. Ukuze akubone oku kanye, ugqirha usebenzisa iteknoloji ekhethekileyo yokufota efana ne-X-ray (Real-time imaging). Oku kuthetha ukuba benza oku ngokubukela i-catheter ishukuma ngaphakathi emzimbeni.
5. Ukubekwa kweStent Graft: Xa ikwindawo efanelekileyo, ugqirha uya kuyinweba i-stent graft ngaphakathi kwi-catheter. Emva koko iya kwanda ngaphakathi kwemithambo yegazi ize izincamathele ngokuqinileyo eludongeni, idale indlela entsha neyomeleleyo yokuhamba kwegazi.
6. Ukugqiba: Nje ukuba i-`(Stent Graft)` ibekwe kakuhle, i-catheter isuswa ngononophelo. Umngxuma osesinqeni mncinci kangangokuba akufuneki nokuba uthungwe . Kunokufakwa into efana neplasta encinci.
Kuthatha ixesha elingakanani ukuphola emva kotyando?
Nangona ixesha lokuphiliswa linokwahluka kumntu nomntu, oku kudla ngokwenzeka.
- Kuya kufuneka uhlale esibhedlele iintsuku ezimbalwa.
- Emva kokusebenzisa i-anesthesia, uya kukwazi ukutya nokusela emva koko.
- Ngoncedo lwabahlengikazi, bamxelela ukuba avuke ebhedini aze aqalise ukuhamba ngokukhawuleza.
- Uza kuziva udiniwe kancinci kwiintsuku ezimbalwa zokuqala emva kokuba ubuyele ekhaya, kwaye kuya kufuneka uthathe amayeza entlungu. Yinto eqhelekileyo leyo.
- Musa ukuqhuba imoto ude uthathe amayeza okudambisa iintlungu .
- Uninzi lwabantu luyakwazi ukubuyela kwimisebenzi yalo kwisithuba senyanga .
- Ufanele ukuphephe ukuphakamisa iintsimbi kangangeeveki ezi-4-6 .
Ukuba unale mpawu, bonana nogqirha ngokukhawuleza!
Emva kokuba ubuyele ekhaya, kubalulekile ukuba unikele ingqalelo emzimbeni wakho. Ukuba ufumana naziphi na iimpawu ezingezantsi, fowunela ugqirha wakho ngoko nangoko.
- Ukudumba, iintlungu, okanye ulusu olupholileyo emilenzeni, ingakumbi emilenzeni engezantsi (ezi zinokuba ziimpawu ze-DVT).
- Ukuba uziva unesizungu okanye utyhafile .
- Ukuba ufumana iintlungu eziqatha esiswini, esifubeni, okanye emqolo .
- Ukubetha kwentliziyo kwenzeka xa uziva intliziyo yakho ibetha ngokukhawuleza.
- Ukuba ufumana ububomvu kwindawo yesinqe okanye ezinye iintlungu ezingaqhelekanga zomlenze .
Unyango lwe-EVAR lolona hlobo lungcono kakhulu, olungenabuhlungu kakhulu kunotyando oluvulekileyo lwendabuko. Ungaphila ngokukhawuleza uze ugoduke. Nangona kunjalo, awunakulibala ukuba unyango luphumelele. Njengoko ugqirha esitsho, kubalulekile ukubuya ngexesha elicwangcisiweyo uze wenze olunye uvavanyo. Yiyo loo ndlela onokujonga ngayo ukuba i-`(Stent Graft)` ebeyifakiwe isebenza kakuhle na kwaye ingaba kukho naziphi na iingxaki ezifana ne-`(Endoleak)`.
Umyalezo Wokuya Ekhaya
- I-EVAR yindlela yonyango yanamhlanje engasetyenziswa kakhulu, esetyenziselwa ukuthintela ukugqabhuka kwe-aneurysm kumthambo wegazi oyintloko esiswini, i-aorta.
- Apha, kufakwa i-stent graft kwimithambo yegazi kusetyenziswa ityhubhu encinci ebizwa ngokuba yi-catheter, efakwa nge-groin, ngaphandle kokwenza umsikelo omkhulu.
- Ixesha lokuhlala esibhedlele, iintlungu, kunye nexesha lokuchacha lincinci kakhulu kunelo lotyando oluvulekileyo.
- Nokuba sele kudlule unyango, kubalulekile ukuqhubeka nokuya kuhlolwa njengoko ugqirha emyalele. Oku kuya kunceda ekuchongeni iingxaki ezinokubakho kwangethuba.
- Ukuba ufumana naziphi na iimpawu ezingaqhelekanga (ukudumba kwemilenze, iintlungu eziqatha, isiyezi) emva kotyando, funa ingcebiso kagqirha ngokukhawuleza.
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