Ngaba ugqirha wakho ukhe wakuxelela ukuba une-Atrial Fibrillation, ukubetha kwentliziyo okukhawulezayo ngendlela engaqhelekanga? Mhlawumbi uyazi ukuba abantu abanale meko banamathuba aphindwe kathathu ukuya kahlanu okuba nestroke kunezinye. Isizathu esiphambili soku kukuqhekeka kwegazi okwenzeka ngaphakathi entliziyweni. Ngoko ke namhlanje sithetha ngonyango olukhethekileyo oluye lwazisa isiqabu esikhulu kubantu abaninzi kwaye lusetyenziselwa ukunciphisa le ngozi iyingozi.
Ngamafutshane, yintoni iLeft Atrial Appendage Closure?
Kulungile, eli lisenokuvakala njengegama elintsonkothileyo, kodwa ibali lilula kakhulu. Cinga nge-atrium yasekhohlo, igumbi eliphezulu lentliziyo yethu. Kukho inxalenye encinci efana nengxowa ephuma eludongeni lwale gumbi. Yiloo nto oogqirha bayibiza ngokuba yi-Left Atrial Appendage (LAA) .
Ngokwesiqhelo, xa intliziyo ibetha kakuhle, igazi lingena kule sac lize liphume kwakhona. Kodwa kumntu one- Atrial Fibrillation (Afib), amagumbi aphezulu entliziyo awanciphisi kakuhle, kodwa endaweni yoko ayaqhaqhazela. Emva koko, igazi liyaqokelelana kuloo sac ebizwa ngokuba yi-LAA, kwaye amahlwili egazi aqala ukwakheka. Ama-90% amahlwili egazi abangela ukufa kwabantu abane-Afib akhiwa kule sac incinci ebizwa ngokuba yi-LAA.
Ngoko ke, iLeft Atrial Appendage Closure (LAA Closure) yinkqubo yotyando, okanye ukunqunyulwa okuncinci, okusebenzisa ukunqunyulwa okuncinci ukuvala i-LAA, ibhegi apho kwakheka khona amahlwili egazi. Xa oku kuvaliwe, nokuba amahlwili egazi ayenzeka apho, awakwazi ukungena egazini aze aye engqondweni. Oku kunciphisa kakhulu umngcipheko westroke.
Eyona nto ingcono kukuba ukuvala le nxalenye ye-LAA akuchaphazeli yonke imisebenzi yentliziyo. Intliziyo ingasebenza kakuhle ngaphandle kwayo.
Ngubani ofuna olu nyango?
Olu nyango lucetyiswa kakhulu kubantu abane-Atrial Fibrillation (Afib) abasengozini enkulu yestroke. Lusisombululo esilungileyo ngakumbi kwabo baneengxaki nge-blood thinners.
Oogqirha badla ngokunika amayeza okunciphisa igazi afana ne -warfarin (Coumadin®) ukunciphisa umngcipheko wesifo sohlangothi. Kodwa abanye abantu baneengxaki ngala mayeza:
- Uvavanyo lwegazi oluqhelekileyo: Kufuneka uvavanye igazi rhoqo ukuqinisekisa ukuba uthatha idosi echanekileyo yamayeza.
- Ukulawula ukutya: Ezinye ukutya, njengemifuno equlethe i-vitamin K, kusenokufuneka zincitshiswe.
- Umngcipheko wokopha: Eli yeza linokuyicothisa inkqubo yokopha nokuba kungenzakalanga kancinci. Oku kuyingozi kumntu owela rhoqo okanye osengozini yokopha emathunjini.
- Eli yeza alisebenzi kwabanye abantu.
I-Apixaban (Eliquis®), i-rivaroxaban (Xarelto®) ngaphandle kwe-warfarinNangona kukho amayeza amatsha afana nala, awasebenzi kuwo wonke umntu. Abiza kakhulu kwabanye abantu, kwaye anokuba nengozi yokopha.
Ngoko ke, kwabo bakufumanisa kunzima ukuqhubeka nokusela amayeza okunciphisa igazi ngenxa yezizathu ezinje ngezi, ungathetha nogqirha wakho malunga nonyango olubizwa ngokuba yi-LAA Closure.
Zeziphi iindlela ezisetyenziswayo ukuvala i-LAA?
Kukho iindlela ezahlukeneyo kunye nezixhobo zokuvala le nxalenye ye-LAA. Ezinye zezi:
| Uhlobo lwesixhobo | Ingaba isebenza kanjani | Imizekelo |
|---|---|---|
| Izixhobo ze-LAA ezifihlakeleyo | Ezi zifana nesigqubuthelo sebhotile. Umlomo we-LAA, apho uqhagamshela khona kwi-atrium yasekhohlo yentliziyo, uvalwa ngesi sixhobo. Emva koko, nokuba igazi liqhekeka ngaphakathi, alikwazi ukuphuma. | I-WATCHMAN™, i-Amulet™, i-WaveCrest™ |
| Isikliphu esibambe isiseko se-LAA | Oku kufana ne-clothespin. Le clip isetyenziselwa ukubamba i-LAA endaweni yayo (ezantsi) nokuyivala. | I-AtriClip™ |
| Iindlela zokuvala kusetyenziswa iiluphu okanye izititshi | Ibhendi okanye iluphu ekhethekileyo ibekwa ijikeleze isiseko se-LAA kwaye iqiniswe ukuze ivalwe. | ILariat™, eSierra™ |
Ukulungiselela nokwenza unyango
Ngaphambi konyango
Ngaphambi kokuba ufumane olu nyango, ugqirha wakho uza kuhlola intliziyo yakho nge -Transesophageal Echocardiogram (TEE).Kwenziwa iskeni ebizwa ngokuba yi-TEE okanye i-cardiac CT scan. I-TEE ibandakanya ukufaka ikhamera encinci ezantsi kwe-esophagus ukuze kulinganiswe imo kunye nobukhulu be-LAA entliziyweni. Oku kungenxa yokuba ayizizo zonke ii-LAA ezifanayo. Ii-LAA zabanye abantu zimile njengephiko lenkukhu, ngelixa ii-LAA zabanye zimile njengebhabhathane. Olu skeni lusetyenziselwa ukukhetha isixhobo kunye nobukhulu obufanelekileyo kuwe.
Ukongeza, uya kucetyiswa ukuba uyeke ukutya nokusela (ukuzila ukutya) kangangeeyure ezimbalwa ngaphambi konyango.
Ngexesha lonyango
Kukho iindlela ezimbini eziphambili zokwenza oku.
1. Ukuyenza ngexesha elinye nolunye utyando lwentliziyo: Ukuba wenza olunye utyando olukhulu lwentliziyo, njengotyando lwe-bypass, ugqirha angasika aze asuse le nxalenye ye-LAA ngexesha elinye, okanye ayithunge ivalwe.
2. Ukungangeni kakhulu: Le yindlela eqhelekileyo. Akukho mingxunya mikhulu apha. Nantsi into eyenzekayo:
- Kwenziwa umngxuma omncinci eluswini kufutshane ne-groin, kwaye ityhubhu encinci ebizwa ngokuba yi-catheter idluliselwa ngemithambo yegazi apho iye entliziyweni.
- Le tube ifakwa ukusuka kwi-atrium yasekunene yentliziyo ukuya kwi-atrium yasekhohlo, ngomngxuma omncinci eludongeni phakathi kwamagumbi amabini. (Ungakhathazeki, le mngxuma idla ngokuzivalela yodwa kwiinyanga ezi-6).
- Emva koko ityhubhu idluliselwa kwi-LAA, kwaye isixhobo esikhethwe ngaphambili sinyanzelwa ukuba sivale umlomo we-LAA.
- Konke oku kwenziwa ngokujonga ngaphakathi ngeeskeni ezifana neFluoroscopy (ividiyo yeX-ray) kunye neTEE .
- Xa umsebenzi ugqityiwe, i-catheter iyakhutshwa.
Kwenzeka ntoni emva konyango?
Ukuba olu nyango lwenziwa ngokusikwa okuncinci, mhlawumbi kuya kufuneka uhlale esibhedlele ubusuku obunye kuphela uze ukwazi ukuya ekhaya ngosuku olulandelayo.
Isicwangciso samayeza siza kutshintsha kancinci emva kokuba ubuyele ekhaya.
- Ngokwesiqhelo, kwiintsuku zokuqala ezingama-45 , uya kuxelelwa ukuba uthathe i-anticoagulant kunye ne-aspirin. Ngeli xesha, izicubu zolusu ziya kwakheka zijikeleze isixhobo, zisivale kakuhle.
- Nje ukuba i-TEE scan emva kweentsuku ezingama-45 iqinisekise ukuba i-LAA ivaliwe ngokupheleleyo, ungayeka ukuthatha amayeza okunciphisa igazi. Emva koko uza kunikwa i-clopidogrel (Plavix®) kunye ne-aspirin kangangeenyanga ezi-6 .
- Ngamanye amaxesha ugqirha ucebisa ukuba kusetyenziswe i-aspirin ixesha elide.
Eyona nto ibalulekileyo kukuba, ungayeki ukuthatha amayeza de ugqirha wakho akuxelele ukuba uye. Qiniseka ukuba uya kwiindawo zokulandelela ngexesha.
Zithini iingenelo kunye neengozi?
Njengakwezinye iindlela zonyango, kukho iingenelo kunye neengozi ezincinci. Ugqirha wakho uza kukuchazela zonke ezi zinto.
| Iingenelo zonyango | Iingozi/Iingxaki Ezinokwenzeka |
|---|---|
|
|
Kufuneka uthethe nini nogqirha?
Ukuba ufumana naziphi na kwezi mpawu zilandelayo emva kokuba ubuyele ekhaya emva konyango, yazisa ugqirha wakho ngoko nangoko.
- Umkhuhlane okanye ezinye iimpawu zosulelo (ukudumba, ukubomvu kwenxeba).
- Ukubetha kwentliziyo okungaqhelekanga, ukuziva ngathi ubetha esifubeni.
- Intlungu ebuhlungu esifubeni.
- Ubunzima bokuphefumla.
Ukuphila ne-Afib kunokuba yingxaki, ingakumbi ukuba uneengxaki ngemithi yakho yokunciphisa igazi. Ukuvalwa kwe-LAA akuyonto yomntu wonke, kodwa kunokuba lukhetho kuwe. Ngoko ke thetha nogqirha wakho wentliziyo, ubuze imibuzo yakho, kwaye wenze isigqibo esikulungeleyo.
Umyalezo Wokuya Ekhaya
- Ukuvalwa kwe-Left Atrial Appendage (LAA) lunyango oluphumelelayo lokunciphisa umngcipheko we-stroke kubantu abane-Atrial Fibrillation (Afib).
- Oku kwenzelwa ukuthintela ukuba amahlwili egazi angabikho ngaphakathi kwingxowa encinci entliziyweni ebizwa ngokuba yi-LAA, ngokuvala loo ngxowa.
- Oku kungaba sisisombululo esilungileyo kwabo banengxaki yokuqhubeka nokuthatha amayeza okunciphisa igazi.
- Ufanele uxoxe nogqirha wakho ukuba olu nyango lukulungele na.
- Emva konyango, kubaluleke kakhulu ukusela amayeza akho njengoko ugqirha wakho ecebisa kwaye uye kuvavanywa ngexesha.
💬 Comments (0)
Akukho zimvo zithunyelweyo okwangoku. Faka uluvo lwakho apha okokuqala.
Faka uluvo lwakho