Umele ukuba uqaphele ukuba njengoko imibhobho yamanzi emakhaya ethu iguga, iyavaleka luthuli nomhlwa. Ngokufanayo, imithambo yegazi emizimbeni yethu, iityhubhu ezithwala igazi, inokuvaleka zizinto ezahlukeneyo ngokuhamba kwexesha. Xa umthambo wegazi uvaleka, ukuhamba kwegazi kuyaphazamiseka. Kwiimeko ezinjalo, inkqubo yokususa izinto ezivalekileyo ngotyando kunye nokucoca umthambo wegazi ibizwa ngokuba yi-"Endarterectomy".
Yintoni i-Endarterectomy? Kwenzeka ntoni kanye kanye?
Ngamafutshane, i-endarterectomy yinkqubo yotyando yokuvula kwakhona imithambo yegazi evalekileyo okanye exineneyo. I-plaque yingqimba eqinileyo nenamathelayo yamafutha kunye ne-calcium eqokelelana ngaphakathi kwemithambo yegazi yethu. Ifana nomhlwa owenzeka kumbhobho wamanzi. Kolu tyando, oogqirha bavula umthambo wegazi baze bakhuphe i-plaque eqokelelene ngaphakathi.
Xa i-plaque isuswa ngale ndlela, isithuba esingaphakathi kwemithambo yegazi siyanda. Oku kuvumela igazi ukuba liphinde lihambe kakuhle. Oku kunokunciphisa kakhulu umngcipheko wokuqhekeka kwegazi kunye neemeko ezinzulu ezifana nestroke .
Olu tyando ludla ngokwenziwa xa imeko eyaziwa ngokuba yi-atherosclerosis, eyi-plaque eqokelelene kwimithambo yegazi, iba mandundu, ingakumbi kwabo babonisa iimpawu.
Iimeko eziphambili ezinyangwa ngolu tyando zezi:
- Isifo seMitha yoMthambo oPheleleyo (i-PAD): Oku kwenzeka xa i-plaque iqokelelana kwimithambo yegazi ethwala igazi iye emilenzeni okanye ezingalweni zakho, izithintele. Oku kunokubangela iintlungu emilenzeni yakho xa uhamba, amanxeba angapholiyo, kwaye kwiimeko ezimbi kakhulu, ukufa kwezicubu (gangrene).
- Isifo seCarotid Artery: Oku kukwanda kwe-plaque kwimithambo emibini ephambili entanyeni yethu ethwala igazi ukuya engqondweni. Ukuba le mithambo iyancipha, ukuhamba kwegazi ukuya engqondweni kunokunqanyulwa, okukhokelela kwi-stroke, i-transient ischemic attack (TIA), okanye ukulahleka kombono okwethutyana.
Ziziphi iintlobo zotyando lwe-endarterectomy?
Kukho iintlobo ezahlukeneyo zolu tyando kuxhomekeke ekubeni lwenziwa phi. Ukuze kube lula kuwe ukuqonda, makhe sijonge ngale ndlela.
| Uhlobo lotyando | Indawo yokususa ukuvaleka | Ukubaluleka |
|---|---|---|
| Utyando lwe-Carotid Endarterectomy | Umthambo othwala igazi ukuya engqondweni ngentamo. | Utyando oluqhelekileyo olwenziwayo. Lunciphisa umngcipheko wokukhubazeka. |
| Utyando lwe-Aortic kunye ne-Iliac Endarterectomy | Imithambo ephambili esiswini nakwi-pelvis. | Lutyando oluqhelekileyo olwenziwayo. |
| Utyando lwe-Femoral Endarterectomy | Imithambo yegazi ehamba ukusuka kwindawo yempumlo ukuya emilenzeni. | Ibuyisela ukujikeleza kwegazi emilenzeni. |
| Utyando lwe-Endarterectomy lweCoronary | Imithambo yentliziyo, enika igazi entliziyweni. | Idla ngokwenziwa ngotyando lwe-bypass. |
| Utyando lwe-Endarterectomy lweMiphunga | Imithambo yemiphunga. | Lutyando olungaqhelekanga ukwenziwa. |
Uzilungiselela njani ngaphambi kotyando?
Ngaphambi kokuba wenze olu tyando, ugqirha uza kwenza uvavanyo oluninzi ukuze abone ukuba lungakanani na kwaye luphi na ukuvalwa kwemithambo yegazi.
- I-Doppler ultrasound: Iskeni esebenzisa amaza esandi ukujonga ukuhamba kwegazi kunye nokuvaleka.
- I-CT angiography: Isebenzisa ii-X-reyi ezikhethekileyo kunye nedayi yokwahlulahlula ukwenza imifanekiso yemithambo yegazi enamacala amathathu (3D).
- I-Angiography: Idayi ifakwa ngqo kwi-artery kwaye ii-X-ray zisetyenziselwa ukuthatha imifanekiso yemithambo yegazi.
- I-MRA (i-Magnetic Resonance Angiography - i-MRA):Imifanekiso eneenkcukacha zemithambo yegazi ifunyanwa kusetyenziswa iimagnethi kunye namaza erediyo.
Emva kwezi mvavanyo, ugqirha wakho uza kukunika imiyalelo yendlela yokulungiselela utyando. Usenokucelwa ukuba uyeke okwethutyana ukuthatha amayeza athile, afana ne-blood thinners. Usenokucelwa ukuba uqale ukuthatha amayeza athile, afana ne-aspirin. Kufuneka wenze konke oku kanye njengoko ugqirha wakho ekuxelele.
Kuya kufuneka uzile ukutya (ungatyi okanye usele nantoni na) kangangeeyure ezimbalwa ngaphambi kotyando. Iqela le-anesthesia liza kukunika imiyalelo ethile malunga noku.
Lwenziwa njani utyando?
Uza kunikwa i-anesthesia ukuthintela ukuba ungaziva naziphi na iintlungu ngexesha lotyando. Uninzi lwabantu lunikwa i-anesthesia eqhelekileyo. Oku kuthetha ukuba uza kube ulele ngexesha lotyando. Nangona kunjalo, ngamanye amaxesha, ngakumbi kutyando olufana ne-carotid endarterectomy, ungagcinwa uphaphile kwaye yindawo ekuthethwa ngayo kuphela eya kuba ne-numbness (local anesthesia) ukuze kube lula ukubona ukusebenza kwengqondo.
Nantsi inkcazo yenyathelo ngenyathelo yoko kwenzekayo ngexesha lotyando:
1. Ukusikwa kwesikhumba: Kusikwa kancinci eluswini ngqo phezu komthambo ovalekileyo.
2. Ukususwa kweplaque: Umthambo uyavulwa kwaye umaleko weplaque efakwe ngaphakathi uyakhuhlwa ngononophelo.
3. Ukuvala umthambo: Umthambo uyathungwa uvalwe. Ngamanye amaxesha, kuthungwa indawo encinci ukuze kuthintelwe umthambo ukuba ungaphindi unciphe. Le ndawo ingenziwa ngokwenziwa okanye ingaba sisiqwenga sethishu esithathwe komnye umthambo emzimbeni wakho.
4. Ukuvalwa kwesikhumba: Ekugqibeleni, ukusika kwesikhumba kuvalwa ngezitishi.
Utyando lweCarotid Endarterectomy ludla ngokuthatha malunga neyure okanye ezimbini. Ixesha lotyando lwezinye iintlobo linokwahluka.
Ziziphi iingenelo kunye neengozi ezinokubakho zotyando?
Eyona nto ibalulekileyo kukuba ukuba ugqirha ucebisa ukuba wenze olu tyando, oko kuthetha ukuba iingenelo zokwenza olu tyando zingaphezulu kakhulu kuneengozi zokungalwenzi.
Iingenelo eziphambili:
- Ukuvaleka kuyasuswa kwaye umthambo wegazi ubuyela esiqhelweni.
- Njengoko ukujikeleza kwegazi kubuyela esiqhelweni, izinto ezifana neentlungu zomlenze kunye namanxeba angapholiyo ziqala ukuphola.
- Umngcipheko we-stroke uncitshiswe kakhulu.
- Kwiimeko ezininzi, iziphumo zotyando zihlala iminyaka.
Iingozi ezinokubakho:
Njengakwezinye iintlobo zotyando, kukho iingozi ezincinci ezibandakanyekileyo.
- Ukopha
- Iingxaki zentliziyo ezifana nokuhlaselwa yintliziyo
- Iimeko ezichaphazelayo
- Ukonakala kwemithambo-luvo (okudla ngokuba yinto yexeshana)
- Ukuncitshiswa kwakhona komthambo emva kotyando
- Ukukhubazeka komzimba
Kodwa kubantu abaninzi, umngcipheko weengxaki ezinkulu uphantsi kakhulu.
Kuthatha ixesha elingakanani ukuphola emva kotyando?
Ubude bexesha oza kuhlala esibhedlele emva kotyando buya kwahluka ngokuxhomekeke kuhlobo lotyando olwenziweyo.
| Uhlobo lotyando | Ubude obuqhelekileyo bokuhlala esibhedlele |
|---|---|
| Utyando lwe-Carotid Endarterectomy | Usuku olu-1 |
| Utyando lwe-Femoral Endarterectomy | Iintsuku ezi-2-4 |
| Utyando lwe-Aortic okanye lwe-Visceral Endarterectomy | Malunga neveki |
| Utyando lwe-Endarterectomy lweMiphunga | Malunga neentsuku ezili-10 |
Emva kokuba ubuyele ekhaya, kubaluleke kakhulu ukuphumla nokusela amayeza akho njengoko ugqirha wakho ekuyalele. Uza kucelwa ukuba uze ekliniki ukuze ufumane utyelelo olulandelayo emva kweeveki ezi-4. Emva koko isilonda siya kuhlolwa. Uninzi lwabantu lunokubuyela emsebenzini emva kolu tyelelo ekliniki.
Kodwa ukuba ungumntu ophakamisa izinto ezisindayo, kuya kufuneka uphumle inyanga okanye ezimbini ude uphile ngokupheleleyo. Ingakumbi ukuba ukhe wenziwa utyando lwesisu, ayingombono ulungileyo ukuphakamisa ngaphezu kweekhilogram ezi-5 kangangeenyanga ezimbini.
Ufanele ufowunele ugqirha nini ngoko nangoko?
Ukuba ufumana naziphi na kwezi mpawu zilandelayo emva kotyando lwakho, yazisa ugqirha wakho ngoko nangoko okanye uye kwiSebe leNgxamiseko (ETU) lesibhedlele esikufutshane.
- Iintlungu zesifuba
- Ubunzima bokuphefumla
- Ukuba uziva umkhuhlane okanye umkhuhlane
- Ukuba kukho ukudumba, ukuba bomvu, okanye ulwelo olufana nobovu oluphuma kwindawo yokusikwa
- Ukuba uziva ubuthathaka okanye ungenamsebenzi emzimbeni wakho
- Ukuba ubona utshintsho embonweni, intetho engacacanga, okanye ukugoba kwelinye icala lobuso bakho
- Isicaphucaphu okanye ukuhlanza
Umyalezo Wokuya Ekhaya
- I-Endarterectomy yinkqubo yotyando esusa amanqatha (i-plaque) ngaphakathi kwemithambo yegazi kwaye ibuyisele ukuhamba kwegazi.
- Olu tyando lunokunciphisa kakhulu umngcipheko wezifo ezinzulu ezifana nokukhubazeka.
- Nangona olu lutyando olukhulu, iingenelo ziphezulu kakhulu xa lwenziwa kwisigulana esifanelekileyo.
- Kubaluleke kakhulu ukulandela imiyalelo kagqirha wakho ngqo, ngaphambi nasemva kotyando.
- Ukuba ufumana naziphi na iimpawu ezilumkisayo emva kotyando, funa ingcebiso kagqirha ngoko nangoko. Ukuba uneengxaki ngempilo yakho, ungoyiki ukuzixoxa nogqirha wakho.
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