Ngaba wakha wacinga ukuba imithambo yegazi engaphakathi emizimbeni yethu ifana nemibhobho yamanzi endlwini? Njengokuba ngokuhamba kwexesha, uthuli nomhlwa kwakheka ngaphakathi kwemibhobho yamanzi kwaye kuvala ukuhamba kwamanzi, izinto ezifana neoyile namafutha nazo zinokuqokelelana ngaphakathi kwimithambo yegazi yethu kwaye zivale ukuhamba kwegazi. Yiloo nto siyibiza ngokuba yi-'Endarterectomy', inkqubo yotyando yokucoca umthambo wegazi onjalo ovaliweyo. Namhlanje, siza kuthetha ngale nto ngokulula.
Ngamafutshane, yintoni i-Endarterectomy?
I-Endarterectomy (ebizwa ngokuba yi-en-da-te-rek-to-me) yinkqubo yotyando yokuvula kwakhona imithambo yegazi evalekileyo okanye enciphileyo. Kule nkqubo, oogqirha basusa i-plaque , umaleko otyebileyo wamafutha, i-calcium, kunye ne-plaque eqokelelene ngaphakathi kwemithambo yegazi yakho.
Njengokucoca ukungcola ngaphakathi kumbhobho wamanzi nokuvumela amanzi ukuba ahambe kakuhle kwakhona, emva kolu tyando, ukujikeleza kwegazi kwimithambo yegazi kuyabuyiselwa. Oku kunciphisa kakhulu umngcipheko weemeko eziyingozi ezifana nokuqhekeka kwegazi kunye nestroke .
Olu tyando ludla ngokwenziwa njengonyango lwemeko ebizwa ngokuba yi-atherosclerosis. Oku kuxa i-plaque iqokelelana ngaphakathi kwemithambo yegazi, nto leyo ebangela ukuba iqine kancinci kancinci kwaye inciphe. Olu tyando ludla ngokucetyiswa kwiimeko ezineempawu, ezinzima ngokuphakathi zemithambo yegazi evalekileyo.
Kukho iimeko ezimbini eziphambili ezinyangwa ngolu tyando:
- Isifo seMitha yoMthambo oPheleleyo (i-PAD): Oku kukuqokelelana kwe-plaque kwimithambo yegazi ehambisa igazi emilenzeni okanye ezingalweni zakho. Oku kunokubangela ukuba imilenze yakho ibe buhlungu xa uhamba, amanxeba aphole kancinci, kwaye ngamanye amaxesha nokufa kwezicubu (gangrene).
- Isifo seCarotid Artery: Esi sisifo esibi kakhulu. Sibangelwa kukwakheka kweplaque kwimithambo emibini ephambili entanyeni ethwala igazi liye engqondweni. Ukuba ayinyangwa, inokukhokelela kwistroke okanye kwi-transient ischemic attack (TIA).
Ziziphi iintlobo zotyando lwe-endarterectomy?
Uhlobo lotyando luyahluka ngokuxhomekeke ekubeni umthambo wegazi uvalekile phi emzimbeni wakho. Jonga le theyibhile ingezantsi ukuze kube lula kuwe.
| Uhlobo lotyando | Ukucoca umthambo wegazi kunye nenkcazo |
|---|---|
| Utyando lwe-Carotid Endarterectomy | Ukucoca imithambo yegazi ethwala igazi liye engqondweni ukusuka kumacala omabini entamo. Olu lolona hlobo luxhaphakileyo. |
| Utyando lwe-Femoral Endarterectomy | Ukucoca imithambo ephambili (imithambo ye-femoral) esuka kwindawo ye-groin ukuya emilenzeni. |
| Utyando lwe-Aortic kunye ne-Iliac Endarterectomy | Ukucoca imithambo yegazi ephambili esiswini (esiswini) nakwiindawo ze-pelvic (ezinqeni). |
| Utyando lwe-Endarterectomy lweCoronary | Ukucoca imithambo yentliziyo ehambisa igazi entliziyweni ngokwayo. |
| Utyando lwe-Endarterectomy lweMiphunga | Ukususa amahlwili egazi amadala kwimithambo yegazi ethwala igazi ukuya emiphungeni. Oku kudla ngokwenziwa rhoqo. |
Ndingazilungiselela njani ngaphambi kotyando?
Ngaphambi kolu tyando, ugqirha uza kwenza uvavanyo oluninzi ukuze afumanise ukuba umthambo wakho wegazi uvalekile kangakanani na.
- I-Doppler Ultrasound: Oku kusebenzisa amaza esandi ukubona apho imithambo yegazi ivaliwe khona kunye nobungakanani begazi elihambayo.
- I-CT Angiography: Kule meko, kufakwa ulwelo olukhethekileyo (idayi engafaniyo) emthanjeni osengalweni yakho, kwaye i-CT scan isetyenziselwa ukuthatha umfanekiso wemithambo yegazi yakho onemilinganiselo emithathu (3D).
- I-Angiography: Kule nkqubo, ulwelo olukhethekileyo lufakwa ngqo kwimithambo yegazi kwaye kuthathwa imifanekiso ye-X-ray.
- I-Magnetic Resonance Angiography (MRA): Isebenzisa iimagnethi kunye namaza erediyo ukuthatha imifanekiso yemithambo yegazi.
Ukongeza, ugqirha wakho uza kukunika imiyalelo yendlela yokulungiselela utyando. Usenokucelwa ukuba uyeke okwethutyana ukusebenzisa amayeza athile, afana ne-blood thinners (anticoagulants). Ngamanye amaxesha, unokucelwa ukuba uqale ukusebenzisa amayeza anjenge-aspirin.
Kuya kufuneka uzile ukutya iiyure ezimbalwa ngaphambi kotyando. Iqela le-anesthesiology liza kukuxelela into omawuyenze. Usenokwenza uvavanyo olufana ne-'Echocardiogram' okanye 'Stress Test' ukujonga impilo yentliziyo yakho.
Ngubani ongenakukwazi ukwenza olu tyando?
Abanye abantu abaneengxaki ezithile zempilo basengozini enkulu yolu tyando, ngoko oogqirha abalucebisi kubo. Umzekelo:
- Ukuba unesifo sentliziyo esinzima kakhulu ukuba ungasilawula (ukusilela kwentliziyo okubangelwa kukunganyamezelani).
- Ukuba usandul' ukuba nesifo sentliziyo.
- Ukuba uneempawu zesifo sentliziyo ezingenakunyangeka.
- Ukuba unesifo esibi semiphunga esifana ne-emphysema okanye i-COPD.
- Ukuba sele ufumene unyango lwe-radiation kwindawo apho utyando luza kwenziwa khona ngaphambili.
- Ukuba kukho usulelo kuloo ndawo.
Kodwa ungakhathazeki. Nokuba umntu onje, ugqirha ngamanye amaxesha uya kuzama ukususa ukuvaleka ngokubeka i-stent ngaphakathi kwemithambo yegazi, njengotyando lwe-atherectomy.
Lwenziwa njani utyando?
Uza kunikwa i-anesthesia ukuze ungeva ntlungu ngexesha lotyando. Ngokuqhelekileyo, uza kunikwa i-anesthesia eqhelekileyo. Oku kuthetha ukuba uza kuba ungekho zingqondweni. Nangona kunjalo, kwezinye iimeko, ingakumbi xa ucoca imithambo entanyeni yakho (carotid endarterectomy), ungagcinwa uvukile kwaye uphelelwe yingqondo kuloo ndawo (local anesthesia) ngexesha lotyando kuba kuyimfuneko ukujonga umsebenzi wobuchopho bakho.
Ngexesha lotyando, ugqirha:
1. Ukusika kwenziwa ngokusika ulusu phezu komthambo wegazi ovalekileyo.
2. Umthambo wegazi uyavulwa kwaye umaleko we-'plaque' ngaphakathi ususwa ngononophelo.
3. Umthambo wegazi uthungwa uvalwe. Ngamanye amaxesha, ukuze kuthintelwe indawo ukuba inganciphi kwakhona, kusetyenziswa i-'patch' yokwenziwa (i-patch) okanye iqhekeza lomthambo ophilileyo elithathwe kwenye inxalenye yomzimba wakho ukuze kwandiswe indawo kancinci.
4. Ekugqibeleni, ulusu luvalwe kwaye luthungwe.
Iingenelo, iingozi, kunye nexesha lokubuyela kwimeko yesiqhelo
Eyona nzuzo iphambili yolu tyando kukuba luvula umthambo wegazi ovalekileyo kwaye lubuyisele ukuhamba kwegazi. Oku kunciphisa kakhulu iintlungu zomlenze, amanxeba angapholiyo, ingakumbi umngcipheko westroke. Iziphumo zolu tyando zihlala iminyaka.
Njengakwezinye iintlobo zotyando, kukho iingozi ezithile ezibandakanyekileyo, kodwa amathuba okuba oku kwenzeke aphantsi.
- Ukopha
- Isifo sentliziyo, njengokuhlaselwa yintliziyo
- Iintsholongwane
- Ukonakala kwemithambo-luvo (okudla ngokuba yinto yexeshana)
- Ukuncitshiswa komthambo ofanayo nowenziwe utyando
- `Istroke`
Eyona nto ibalulekileyo kukuqonda ukuba ugqirha wakho ucebisa olu tyando kuba iingenelo zolu tyando zingaphezulu kakhulu kuneengozi.
Kuthatha ixesha elingakanani ukuphiliswa?
Ubude bexesha oza kuhlala esibhedlele buxhomekeke kuhlobo lotyando olwenziweyo.
- Utyando lweCarotid (umthambo wentamo): malunga nosuku.
- Ngotyando lwe-femoral (umthambo wemilenze): Malunga neentsuku ezimbini ukuya kwezine.
- Utyando lwe-Aortic (i-abdominal artery): malunga neveki.
Uza kucelwa ukuba uze kulandelelwa emva kweeveki ezine emva kotyando. Uninzi lwabantu lunokubuyela emsebenzini emva kolu landelelwaniso. Nangona kunjalo, ukuba unomsebenzi ofuna ukuthwala izinto ezinzima, kungathatha inyanga okanye ezimbini ukuba uphile ngokupheleleyo.
Ndifanele ndimfowunele nini ugqirha?
Ukuba ufumana naziphi na iimpawu ezingezantsi emva kotyando lwakho, kufuneka ufowunele ugqirha wakho ngoko nangoko okanye uye kwiSebe leNgxamiseko (i-ETU) lesibhedlele esikufutshane nawe.
- Iintlungu zesifuba
- Ubunzima bokuphefumla
- Ukuba uziva umkhuhlane okanye umkhuhlane
- Ukuba uziva ubuthathaka okanye ungenamsebenzi kwindawo yokusikwa
- Ukuba kukho ukudumba, ukuba bomvu, okanye ulwelo olufana nobovu olujikeleze i-incision
- Utshintsho embonweni, intetho engacacanga, okanye ukugoba kwelinye icala lobuso
- Ukuba isicaphucaphu okanye ukuhlanza kwenzeka
Umyalezo Wokuya Ekhaya
- I-Endarterectomy yinkqubo yotyando esusa i-plaque (ii-fat deposits) ngaphakathi kwemithambo yegazi ize icoce umthambo.
- Olu tyando lunokunciphisa kakhulu umngcipheko wezifo ezinzima ezifana nestroke.
- Ngaphambi kotyando, kwenziwa uvavanyo oluninzi ukuze kubonwe ubungakanani bokuvaleka kunye nempilo yentliziyo yakho.
- Nangona olu lutyando olukhulu, yindlela yonyango eneziphumo eziphumelelayo kwaye ihlala iminyaka.
- Kuthatha ixesha elithile ukuba umntu aphile emva kotyando. Ngeli xesha, kubaluleke kakhulu ukulandela imiyalelo kagqirha ngokuchanekileyo.
- Ukuba kukho naziphi na iimpawu eziyingozi ezibonakala emva kotyando, funa ingcebiso kagqirha ngokukhawuleza.
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