Ngaba wakha weva ukuba umthambo wegazi obalulekileyo emzimbeni wethu unokudumba njengebhaluni? Le yimeko eyoyikisayo ngokwenene. Kodwa ungakhathazeki, ngokuhambela phambili kwesayensi yezonyango, oku ngoku kunokuphathwa ngendlela elula ngaphandle kokwenza umsikelo omkhulu. Namhlanje siza kuthetha ngayo. Le ndlela ibizwa ngokuba yi-EVAR.
Kalula nje, yintoni i-EVAR?
Intsingiselo epheleleyo ye-EVAR yi -Endovascular Aneurysm Repair . Olu lutyando olungenamsebenzi kangako. Lusetyenziselwa ukunyanga ii-aneurysms, okanye njengoko sizibiza ngokwezonyango , ii-aneurysms , kwi-aorta, umthambo wegazi oyintloko esiswini sethu.
Khawucinge ukuba umthambo wegazi omkhulu emzimbeni wethu yi-aorta. Kulapho igazi lisasazeka khona lisuka entliziyweni liye emzimbeni wonke. Ngamanye amaxesha, xa indawo eludongeni lwalo mthambo wegazi iba buthathaka, uxinzelelo lwegazi lubangela ukuba loo ndawo ibuthathaka idubule njengebhaluni. Yiloo nto siyibiza ngokuba yi-aneurysm.
Kunyango lwe-EVAR, kwenziwa imingxunya emibini emincinci kuphela kumacala omabini omthambo, kwaye kudluliselwa izixhobo ezikhethekileyo kuyo ukulungisa umthambo wegazi odumbileyo ngaphakathi.
Kutheni le nto siludinga olu nyango lwe-EVAR?
Injongo ephambili yolu nyango kukuthintela ukuba umthambo wegazi ofana nebhaluni (i-aneurysm) ungadubuli, kuba ukuba uyadubula, uyingozi enkulu kubomi.
Ukuba umthambo wegazi uyaqhuma, ukuphuma kwegazi elininzi emzimbeni kuqala ukwenzeka, nto leyo enokuba yingozi ebomini kwimizuzu embalwa.
Kwi-EVAR unyango, oogqirha bafaka ityhubhu ekhethekileyo (i-stent graft) eyenziwe ngelaphu kunye ne-mesh yesinyithi kwimithambo yegazi evuvukileyo. Emva kokuba le tyhubhu ifakiwe, igazi lihamba ngale tyhubhu intsha. Emva koko uxinzelelo lwegazi alufikeleli eludongeni olubuthathaka lwemithambo yegazi evuvukileyo. Ke ngoko, umngcipheko wokugqabhuka kwayo phantse upheliswe ngokupheleleyo.
Ngubani olu nyango lwe-EVAR olufaneleke kakhulu kuye?
Ukuba une-aortic aneurysm, olu nyango lunokuba lufanelekile kuwe. Nangona kunjalo, ayizizo zonke ii-aneurysms ezinyangwa ngaxeshanye. Ugqirha wakho unokuqwalasela i-EVAR kwezi meko zilandelayo:
- Ukuba i-aneurysm yakho inkulu okanye incinci kodwa ikhula ngokukhawuleza .
- Ukuba umzimba wakho awukwazi ukunyamezela utyando oluvulekileyo olunenxeba elikhulu.
- Ukuba imithambo yegazi engaphezulu nangaphantsi kwe-aneurysm iphilile .
Ngaba zikho ezinye iindlela ezifana ne-EVAR? (FEVAR kunye ne-TEVAR)
Ewe, le ndlela yonyango isetyenziswa ngotshintsho oluncinci kuxhomekeke kwindawo ekuyo i-aneurysm.
Yintoni i-FEVAR?
Cinga nge-aorta yethu njengesiqu somthi. Ukusuka kwesi siqu, amasebe (imithambo emincinci) athwala igazi ukuya kwizitho ezisesiswini sethu (ezifana nezintso namathumbu) ayahlukana. Ngamanye amaxesha i-aneurysm yenzeka kufutshane nendawo apho elinye lala masebe lahlukana khona. Kwimeko enjalo, kunzima ukwenza i-EVAR eqhelekileyo.
Kukwiimeko ezinzima kangaka apho kusetyenziswa indlela ekhethekileyo ebizwa ngokuba yi -FEVAR (Fenestrated Endovascular Aneurysm Repair) . I-stent graft esetyenziswa apha inemingxuma emincinci (iifenestrations) eyenzelwe ukulingana apho amasebe ahlukana khona. Ngaloo mingxuma, ii-stent ezincinci ezahlukeneyo zingafakwa kuloo masebe. Njengetyhubhu eyenzelwe ukulingana nesiqu kunye namasebe omthi.
Umahluko phakathi kwe-EVAR kunye ne-TEVAR
Oku kulula kakhulu.
- I-EVAR yenziwa kwi-aneurysms esiswini (esiswini) .
- I-TEVAR (Thoracic Endovascular Aneurysm Repair) yenziwa kwi-aneurysms esifubeni (isifuba) .
I-TEVAR idla ngokuba yimpumelelo enkulu kwi-aneurysms kwimithambo emikhulu ehamba ngesifuba, kude kancinci nentliziyo. Nangona kunjalo, kwi-aneurysms ezikufutshane nentliziyo, utyando oluvulekileyo ludla ngokufuneka.
| Iingenelo eziphambili zonyango lwe-EVAR | |
|---|---|
| Inzuzo | Inkcazo |
| Inani leentsuku esibhedlele liyancipha. | Ungaya ekhaya kwangethuba kunokuba utyando oluvulekileyo. |
| Ukopha kancinci | Ekubeni kungekho nxeba likhulu, inani legazi eliphuma emzimbeni lincinci kakhulu. |
| Iintlungu ezincinci ngexesha lokuphiliswa | Ekubeni kungekho monakalo mkhulu, iintlungu nokungonwabi kuncinci. |
| Phila kwangoko | Ungabuyela kwimisebenzi yesiqhelo ngoko nangoko. |
| Ixesha lotyando lincinci. | Utyando lunokugqitywa ngexesha elifutshane kunotyando oluvulekileyo. |
Ngaba kukho naziphi na iingozi ngolu nyango?
I-EVAR lunyango olukhuselekileyo noluphumelele kakhulu, kodwa njengalo naluphi na utyando, kukho ithuba elincinci leengxaki.
- Amahlwili egazi: Ngamanye amaxesha amahlwili egazi anokwakheka kwimithambo enzulu yemilenze. Oku sikubiza ngokuba yiDeep Vein Thrombosis (DVT) .
- I-Endoleak: Kwanasemva kokuba i-stent ifakiwe, inani elincinci legazi liyavuza phakathi kwe-stent nodonga lomthambo wegazi kwaye lijoyina i-aneurysm.
- Usulelo: Usulelo kwindawo yokwenzakala.
- Ukungasebenzi kakuhle kwezintso
- Ukuhlaselwa yintliziyo
- Ukopha kakhulu
Ezi ngozi ziphantsi kakhulu. Ugqirha wakho uza kukuchazela konke oku ngaphambi kotyando.
Lwenziwa njani utyando?
Kulungile, ngoku makhe sijonge amanyathelo abandakanyekayo kolu tyando.
1. Okokuqala, uza kunikwa i-anesthesia ukuze ulale okanye ulale kancinci. Ngoko awuyi kuva ntlungu.
2. Okulandelayo, ugqirha uza kufikelela kwi-aneurysm esiswini sakho ngemithambo ye-femoral ekwi-groin yakho.
3. Kusetyenziswa iinaliti ezimbini ezibhityileyo kakhulu, kufakwa i-catheter , ityhubhu ebhityileyo neguquguqukayo, kule mithambo mibini. I-stent graft esiyikhankanyileyo ngaphambili igoqwe ngaphakathi kule catheter.
4. Ngelixa ejonge isikrini esikhethekileyo esifana ne-X-ray, ugqirha ukhokela le catheter ecaleni komthambo wegazi ukuya kwindawo apho kukho i-aneurysm.
5. Xa sele ikwindawo efanelekileyo, ityhubhu ye-stent engaphakathi kwi-catheter iyandiswa. Emva koko iyandiswa ngaphakathi kwemithambo yegazi, idala indlela entsha neyomeleleyo yokuhamba kwegazi.
6. Le tyhubhu ye-stent inamathele ngokuqinileyo eludongeni lomthambo wegazi, ithintela igazi ukuba lingangeni kwi-aneurysm.
7. Emva kokuba inkqubo igqityiwe, i-catheter isuswa ngononophelo. Amanxeba mancinci kangangokuba akufuneki nokuthungwa. Kufakwa iplasta encinci enxebeni ukuze iphole.
Linjani ixesha lokuchacha emva kotyando?
Ngokwesiqhelo kuthatha iintsuku ezimbalwa ukuya kwinyanga ukuze uphile ngokupheleleyo.
- Kuya kufuneka uhlale esibhedlele iintsuku ezimbini okanye ezintathu.
- Ungaqala ukutya nokusela kwangoko emva kokusebenzisa i-anesthesia.
- Ungavuka ebhedini uhambe ngoncedo lwabahlengikazi.
- Usenokuziva udiniwe kwaye uqaqanjelwa kancinci kangangeentsuku ezimbalwa emva kokuba ubuyele ekhaya. Ufanele usebenzise amayeza okuthomalalisa iintlungu owanikwe wona ngokufanelekileyo.
- Kuphephe ukuqhuba imoto ude uthathe amayeza okudambisa iintlungu.
- Uninzi lwabantu lunokubuyela emsebenzini kwinyanga nje enye.
- Ufanele ukuphephe ukuphakamisa naziphi na izinto ezinzima kangangeeveki ezi-4 ukuya kwezi-6.
| Ukuba unale mpawu, bonana nogqirha wakho ngoko nangoko. | |
|---|---|
| Uphawu | Inkcazo |
| Ukudumba kwemilenze, iintlungu | Ezi zisenokuba ziimpawu ze-deep vein thrombosis (DVT) emilenzeni. Oku kuquka ulusu olubandayo emilenzeni. |
| Ukudinwa okanye ukuquleka | Kusenokuba luphawu lwengxaki ethile ngaphakathi. |
| Intlungu yomqolo, esifubeni, okanye esiswini | Oku kungaba yingxaki nge-stent okanye i-aneurysm. |
| Ukubetha kwentliziyo | Ukubetha kwentliziyo okukhawulezayo ngendlela engaqhelekanga (I-Heart Palpitations). |
| Ubomvu okanye intlungu kwindawo yesinqe | Kungaba luphawu losulelo kwindawo yotyando. |
Umyalezo Wokuya Ekhaya
- I-EVAR yindlela engcono kakhulu, engayi kuchaphazela kakhulu indlela yotyando oluvulekileyo lwendabuko.
- Emva kolu nyango, uza kuphila ngokukhawuleza kwaye ukwazi ukuya ekhaya ngokukhawuleza.
- Kwanasemva kokuba uphilile, kufuneka unyamekele intliziyo yakho kunye nemithambo yegazi. Izinto ezifana nokuzilolonga nokunciphisa ityuwa ekutyeni kwakho zinokunceda ekuthinteleni iingxaki zexesha elizayo.
- Eyona nto ibalulekileyo kukubona ugqirha kwakhona ngexesha elibekiweyo ukuze kwenziwe uvavanyo olulandelayo. Ngale ndlela, ungajonga ukuba i-stent oyifakileyo isebenza kakuhle na kwaye kukho naziphi na ezinye iingxaki.
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