Ngaba ngamanye amaxesha ukhe uqaqanjelwe sisifuba, okanye uzive utyhafile emva kokuzilolonga kancinci, uze uzibuze, "Ngaba kukho ukuvaleka kwenye yemithambo yam yentliziyo?" Xa unamathandabuzo anjalo, ugqirha unokukucela ukuba wenze i-coronary angiogram, oluvavanyo olubandakanya i-catheterization yentliziyo. Ingajonga naziphi na izithintelo okanye i-stenosis kwimithambo yentliziyo ehambisa igazi entliziyweni. Kodwa ngamanye amaxesha, nasemva kokubona oku kuvimbeka, kunzima ukumisela ngokuchanekileyo ukuba kunzulu ngokwaneleyo na ukuba kufuneke i-stent okanye ukuba ingalawulwa ngamayeza kuphela. Kulapho olu vavanyo lukhethekileyo olubizwa ngokuba yiFractional Flow Reserve okanye i-FFR luluncedo khona.
Kalula nje, yintoni le FFR?
Khawuthelekelele ukuba kukho umbhobho wamanzi, kwaye kukho iqhekeza elincinci lothuli elinamathele embindini wombhobho. Ngoku, uxinzelelo lwamanzi ahamba ngombhobho lwahlukile kancinci ngaphambi nasemva kokuvaleka, akunjalo? Uvavanyo lwe-FFR lwenza into efanayo.
Ngamafutshane, i-FFR yindlela yokulinganisa ukuba ingakanani na i-blood flow eya kwimisipha yentliziyo ethintelwe kukuvaleka kwenye yemithambo yakho yentliziyo. Kule nto, uxinzelelo lwegazi lulinganiswa kumacala omabini okuvaleka. Ngokuthelekisa amaxabiso amabini oxinzelelo, ugqirha ugqiba ukuba ingaba ukuvaleka kuyingozi na kwimisipha yentliziyo okanye akunjalo.
Olu vavanyo luyinkqubo engaphantsi kakhulu eyenziwa ngexesha lokufakwa kwe-catheter yentliziyo.
Lufuneka nini uvavanyo lwe-FFR?
Asinguye wonke umntu odinga olu vavanyo. Ugqirha uhlala egqiba ekubeni enze uvavanyo lwe-FFR kwezi meko zilandelayo:
- Ukuvaleka okuPhakathi: Ukuba i-angiogram ibonisa ukuvaleka okuphakathi kwe-50% kunye ne-70% yomthambo, kunzima ukutsho ngokuqinisekileyo ukuba ngaba i-stent iyafuneka na. Kwiimeko ezinjalo, i-FFR ilinganisa ngqo ukuba ukuvaleka kukuthintela kangakanani ukuhamba kwegazi.
- Xa kukho ukuvaleka okuninzi: Ngamanye amaxesha umntu unokuba nokuvaleka okuncinci okuninzi emithanjeni yakhe. I-FFR inokunceda ekuchongeni ukuba loluphi ukuvaleka okuchaphazela kakhulu ukuhamba kwegazi, ngaphandle kokubeka ii-stents kuyo nganye.
- Emva kokufakwa kwe-stent: Ngamanye amaxesha emva kokufakwa kwe-stent, uvavanyo lwe-FFR lunokwenziwa ukuqinisekisa ukuba isebenza kakuhle kwaye ukuhamba kwegazi kubuyele esiqhelweni.
Nangona kunjalo, ukuba ukuvaleka komthambo kungaphantsi kwama-30% (oko kuthetha ukuba akukho kuvaleka okukhulu) okanye ngaphezulu kwama-90% (oko kuthetha ukuba kukho ukuvaleka okukhulu okufuna unyango), uvavanyo lwe-FFR alusoloko luyimfuneko. Kuba ngelo xesha, isigqibo malunga nonyango sinokwenziwa nge-angiogram ngokwayo.
Yintoni umahluko phakathi kwe-FFR kunye ne-iFR?
Usenokuba ukhe weva nge-iFR (i-instant wave-free ratio). Zombini ezi zilinganisa ubunzima bokuvaleka komthambo. Umahluko ophambili kukuba kuvavanyo lwe-FFR, kunikwa iyeza elikhethekileyo, elifana ne-adenosine, ukuze kuphuculwe ukuhamba kwegazi ukuya entliziyweni. Kuvavanyo lwe-iFR, endaweni yokunika iyeza elinjalo, uxinzelelo lulinganiswa ngexesha elithile kwintliziyo. Ugqirha wakho uya kugqiba ukuba zeziphi kwezi ndlela zimbini ezikulungeleyo.
Ufanele uzilungiselele njani ngaphambi kovavanyo?
Ugqirha wakho uza kukunika imiyalelo ekhethekileyo ngaphambi kolu vavanyo, kwaye kubaluleke kakhulu ukuyilandela.
- Ulwazi ngamayeza: Usenokucelwa ukuba uyeke ukusebenzisa amanye amayeza, ingakumbi amayeza okunciphisa igazi, kwiintsuku ezimbalwa ngaphambi kovavanyo. Qiniseka ukuba uxelela ugqirha wakho ngawo onke amayeza owasebenzisayo.
- Ukutya Neziselo: Uya kucetyiswa ukuba ungatyi okanye ungaseli nantoni na emva kweentsuku ezimnyama ebusuku ngaphambi kovavanyo.
- Umncedisi: Ekubeni uza kufakwa i-anesthesia ngexesha lovavanyo, kubalulekile ukuba ube nomntu oza kukusa ekhaya emva kovavanyo.
Kwenzeka ntoni ngexesha lovavanyo?
Ukuba wenza uvavanyo lwe-FFR kuphela, kuthatha ngaphantsi kwemizuzu engama-60. Nangona kunjalo, ukuba ugqiba ekubeni ubeke i-stent ngoko nangoko ngokusekelwe kwiziphumo, kuya kuthatha ixesha elide. Yonke inkqubo ihamba ngolu hlobo:
1. Ukuba ndindisholo: Okokuqala, kufakwa inaliti encinci yeyeza lokuphelisa iintlungu emthanjeni ongalweni, esinqeni, okanye entanyeni apho kuza kufakwa khona i-catheter.
2. Ukufakwa kwe-catheter: Okulandelayo, kufakwa ityhubhu encinci (i-catheter) kwindawo engenanto iye kwenye yemithambo yakho yegazi.
3. Ukuya entliziyweni: Le catheter ikhokelwa ngononophelo kwimithambo yentliziyo kusetyenziswa ubuchwepheshe be-X-ray (fluoroscopy).
4. Ukufakwa kwedayi: Okulandelayo, kufakwa idayi ekhethekileyo (i-contrast media) emithanjeni ngale tube. Ingaphakathi lemithambo emva koko lingabonakala ngokucacileyo kwi-X-ray.
5. Intambo yoxinzelelo: Kulapho umsebenzi wokwenyani uqala khona. Intambo encinci kakhulu enezinzwa idluliselwa kwi-catheter ize ifakwe kumthambo ovalekileyo.
6. Ukulinganisa uxinzelelo: Olu cingo loxinzelelo lusetyenziselwa ukulinganisa uxinzelelo lwegazi ngaphambi nasemva kokuba umthambo uvalekile.
7. Ukunika amayeza:Ukuze ufumane umlinganiselo ochanekileyo, kufuneka ukhawulezise ukuhamba kwegazi entliziyweni yakho. Ngenxa yesi sizathu, uza kunikwa iyeza elibizwa ngokuba yi-adenosine. Xa unikwa eli yeza, unokufumana iintlungu esifubeni kunye nobunzima bokuphefumla malunga nomzuzu. Oku kuqhelekile, ungakhathazeki. Oku kuthetha ukuba eli yeza liyasebenza kwaye ngoku lixesha elifanelekileyo lokufunda.
8. Isigqibo soNyango: Emva kokufumana ixabiso le-FFR, ugqirha uya kugqiba ukuba ngaba kufuneka ufake i-stent okanye cha. Ukuba kuyimfuneko, i-stent ingafakwa kwangoko emva kokwenza i-angioplasty.
9. Isiphelo: Xa umsebenzi ugqityiwe, i-catheter iyasuswa, uxinzelelo lufakwa kwindawo yokufaka, kwaye kufakwa iplasta.
Ungaziqonda njani iziphumo?
Iziphumo zovavanyo lwe-FFR ziza ngenani. Eli nani kulula kakhulu ukuliqonda.
| Isiphumo se-FFR | Ingaba ithetha ntoni? |
|---|---|
| 0.94 ukuya kwi-1.0 (eqhelekileyo) | Kuhle kakhulu! Ukuhamba kwegazi kwentliziyo yakho kulungile kakhulu. Ukuvaleka okubonakalayo kumthambo wegazi akubangeli naluphi na ukuphazamiseka okukhulu ekuhambeni kwegazi. I-stent ayisoloko iyimfuneko, kwaye le meko inokulawulwa ngamayeza. |
| Ukuba ingaphantsi kwe-0.80 | Kwimeko enjalo, umlinganiselo wegazi oya kwimisipha yentliziyo unciphile kakhulu ngenxa yokuncitshiswa komthambo. Ugqirha unethuba elikhulu lokugqiba ekubeni enze unyango olufana nokufaka i-stent (angioplasty). |
| Umzekelo: Kuthekani ukuba ixabiso le-FFR liyi-0.75? | Oku kuthetha ukuba uxinzelelo lwegazi luye lwehla ngama-25% ngenxa yokuncitshiswa kwemithambo yegazi. Oku kuthetha ukuba kukho ukuvaleka kwe-25% kwendlela igazi elihamba ngayo ukuya kwimisipha yentliziyo. |
Yintoni onokuyilindela emva kovavanyo?
Iingxaki ezinkulu azifane zenzeke emva kovavanyo lwe-FFR.
- Ukubuyela ekhaya:Ukuba i-stent ayifakwanga, uya kukwazi ukuya ekhaya emva kweeyure ezimbalwa zokujonga. Ukuba i-stent ifakiwe, kunokufuneka uhlale esibhedlele ngobo busuku.
- Ukuphumla: Kungcono ukuphumla usuku olunye okanye ezimbini emva kokuba ubuyele ekhaya. Kusenokubakho ukukrweleka kunye nobuhlungu apho kufakwe khona i-catheter.
- Iziphumo ebezingalindelekanga: Izinto ezifana neentlungu zesifuba ezibangelwa liyeza le-adenosine ziya kuphela ngokupheleleyo kwimizuzu embalwa.
Ukuba ufumana ezi mpawu, fowunela ugqirha wakho ngoko nangoko.
Ukuba ufumana naziphi na kwezi mpawu zilandelayo emva kokuba ubuyele ekhaya uvela kuvavanyo, yazisa ugqirha wakho ngoko nangoko. Ukuba kuyimfuneko, yiya kwiSebe leNgxamiseko (ETU) lesibhedlele esikufutshane.
- Intlungu ebuhlungu esifubeni
- Ubunzima bokuphefumla
- Ifiva
- Ukopha, ukudumba, okanye iintlungu eziqatha kwindawo yokufaka i-catheter
- Isiyezi
- Utshintsho olungaqhelekanga kwisantya sentliziyo (i-palpitations)
I-FFR luvavanyo olubaluleke kakhulu kunyango lwesifo sentliziyo. Inceda oogqirha ukuba bafumanise ubukhali bokuvaleka komthambo, baphephe ukufakwa kwe-stent ngokungeyomfuneko, kwaye bakhethe unyango olungcono kuwe, endaweni yokuthembela kuphela kwinto ebonwa kwi-angiogram. Ngoko ke, ukuba ugqirha wakho ucebisa olu vavanyo, ungoyiki ukubuza nayiphi na imibuzo onokuba nayo.
Umyalezo Wokuya Ekhaya
- I-FFR (Fractional Flow Reserve) luvavanyo olukhethekileyo olulinganisa ubukhali bokuvaleka kwemithambo yentliziyo.
- Oku kubaluleke kakhulu ekuqinisekiseni ukuba i-stent iyimfuneko na okanye ayifuneki kwi-angiogram okanye ukuvaleka okuphakathi (50%-70%).
- Olu vavanyo lwenziwa ngexesha lokufakwa kwe-catheter yentliziyo.
- Ukuba isiphumo singaphantsi kwe-0.80, oko kubonisa ukuba ukuvaleka kubangela ukuvaleka okukhulu kwegazi kwaye kunokufuna unyango.
- Olu vavanyo luvumela oogqirha ukuba banciphise ukufakwa kwe-stent ngokungeyomfuneko kwaye banike unyango olufanelekileyo kumguli.
💬 Comments (0)
Akukho zimvo zithunyelweyo okwangoku. Faka uluvo lwakho apha okokuqala.
Faka uluvo lwakho