Ngaba ugqirha wakha wakuxelela okanye wakuxelela umhlobo wakho ukuba 'une-heart block'? Mhlawumbi wena ngokwakho uziva uxinezelekile esifubeni sakho, intlungu, kunye nobunzima bokuphefumla xa unyuka izinyuko okanye uzibhokoxa kancinci? Namhlanje siza kuthetha ngonyango oogqirha abalubiza ngokuba yi-'Angioplasty' okanye 'PCI'. Musa ukoyika xa usiva eli gama, olu asilotyando lukhulu okanye olungenalusini njengoko unokucinga. Masithethe ngayo yonke into ngokulula.
Yintoni i-PCI? Ngamafutshane...
Ngamafutshane, i-Percutaneous Coronary Intervention (PCI) yinkqubo esusa ukuvaleka kwemithambo yegazi ethwala igazi ukuya entliziyweni (esiyibiza ngokuba yimithambo yegazi yentliziyo) kwaye ivumela ukuhamba kwegazi kuqhubeke. Cinga ngayo njengombhobho wamanzi ovalekileyo kwaye ungahambi kakuhle. I-PCI ifana nokususa ukuvaleka nokucoca umbhobho kwakhona.
Abantu abaninzi bayayazi le ndlela yonyango njenge- angioplasty . Usenokuba ukhe weva ngayo ngaphambili. Ibandakanya ukufaka umbhobho omncinci (i-catheter) ngomthambo osengalweni okanye emlenzeni wakho ukuya kumthambo oxineneyo entliziyweni yakho, uze emva koko uvuthele ibhaluni encinci ekupheleni kombhobho ukuze kwandiswe indawo exineneyo.
Emva kokuba umthambo ukhululwe, kubekwa ityhubhu encinci efana ne-mesh ukuze ingaphinde idilike. Oku sikubiza ngokuba yi-stent . Kufana nenkxaso ngaphakathi kwetonela esele iza kudilika.
Uninzi lwee-stents ezintsha luneyeza elinciphisa umngcipheko wokuba umthambo uvaleke kwakhona. Ezi sizibiza ngokuba 'zii-stent ezithintela ukusetyenziswa kweziyobisi'. Oku kuphumela kwiziphumo ezingcono nangakumbi.
Ngubani ofuna olu nyango?
Ekuhambeni kwexesha, izinto ezifana neoyile kunye ne-cholesterol ziyaqokelelana kwimithambo yethu yegazi, zenze umaleko otyebileyo. Kufana nomhlwa oqokelelana ngaphakathi kombhobho wamanzi omdala. Kwizonyango, lo maleko siwubiza ngokuba yi-'plaque. ' Imeko apho la ma-plaque aqokelelana khona kwimithambo yegazi, encipha kwaye etyebisa udonga, ibizwa ngokuba yi-atherosclerosis .
Oku kubangela ukuba imithambo yegazi inciphe kwaye intliziyo ingafumani igazi elifunekayo. Kulapho:
- Xa uzibhokoxa kancinci, ukhwela izinyuko, okanye uhamba ngokukhawuleza, uziva intlungu okanye ukuxinana esifubeni sakho . Oku kubizwa ngokuba yi -angina .
- Kuya kuba nzima ukuphefumla, ndiziva ngathi ndiyaphambana.
Kubantu abanezi mpawu, unyango lwe-PCI lwenziwa ukuze kususwe ibhloko kwaye kubuyiselwe ukuhamba kwegazi.
Kwakhona, ukuhlaselwa yintliziyo ngequbulisoI-PCI lunyango olukhulu olusindisa ubomi kumntu onesifo sentliziyo. Ukuhlaselwa sisifo sentliziyo kuxa umthambo wegazi uvalekile ngokupheleleyo, nto leyo ethintela ukuhamba kwegazi ukuya kwinxalenye yentliziyo. Emva koko, ukuvalwa kufuneka kuvulwe ngokukhawuleza kwaye igazi linokupompelwa. I-PCI ingakwenza oko ngokukhawuleza kwaye inciphise kakhulu umonakalo entliziyweni.
Ngaba kukho naziphi na iimeko apho unyango lwe-PCI lungafanele lwenziwe?
Ingcali yakho yentliziyo iya kugqiba ukuba ngaba uyayidinga le nto, nokuba ungayilawula ngamayeza eyedwa, okanye nokuba ufuna utyando olukhulu olubizwa ngokuba yi-coronary artery bypass graft (CABG). Oku kwahlukile kumntu ngamnye.
Xa esenza eso sigqibo, ugqirha uqwalasela ngokukodwa ezi zinto:
- Zingaphi imithambo yakho evalekileyo, ukuba ivalekile kangakanani, kwaye ikuphi.
- Ngaphandle kwesifo sentliziyo, ngaba unazo ezinye izifo ezifana nesifo seswekile okanye isifo sezintso?
- Isebenza njani intshukumo yokupompa kwemisipha yentliziyo yakho, izinto ezifana neminyaka yakho?
Ngoko ke, ugqirha uza kukuchazela ukuba loluphi unyango olufanelekileyo kuwe.
Yintoni omele uyenze ngaphambi kokuba unyango luqale?
Ngaphandle kokuba kukuhlaselwa yintliziyo ngequbuliso, ugqirha wakho uza kukunika iingcebiso malunga nendlela yokuzilungiselela oku.
- Ukutya nokusela: Uya kucelwa ukuba uyeke ukutya nokusela iiyure ezi-6-8 ngaphambi konyango.
- Amayeza: Eyona nto ibalulekileyo kukuba ukuba uthatha amayeza okunciphisa igazi okanye naliphi na elinye iyeza, kufuneka uxelele ugqirha wakho. Banokukucela ukuba uyeke ukuwathatha kwiintsuku ezimbalwa ngaphambi konyango lwakho. Kungenjalo, unokufumana ukopha okwandileyo ngexesha lonyango. Kufuneka wenze oku kanye njengoko ugqirha wakho ekuxelele. Ungaze uyeke okanye utshintshe amayeza akho wedwa.
Kwenzeka ntoni ngexesha lonyango?
Musa ukoyika xa usiva oku, akuyonto inkulu njengoko ucinga. Oku kwenziwa ngugqirha ofumene uqeqesho olukhethekileyo lokunyanga izifo zentliziyo (Interventional Cardiologist). Uza kunikwa i-anesthetic ekhaphukhaphu ukuze uhlale uphumle kwaye uzolile. Ngoko awuyi kuva ntlungu, kodwa uza kube uvukile. Uza kuva ukuba ugqirha uthini.
Nazi iindlela ezilula zonyango:
| Amanyathelo | Kwenzekani? |
|---|---|
| 1. Ukufumana ukufikelela | Ityhubhu encinci (isheya) ifakwa kumthambo omkhulu engalweni yakho, kufutshane nesandla sakho (i-radial artery) okanye kwi-groin yakho (i-femoral artery). Oku kufana nesango apho kudluliselwa khona ezinye izixhobo. |
| 2. Ukuthumela i-catheter | Ityhubhu encinci kakhulu neguquguqukayo (i-catheter) idlula kwityhubhu ebibekwe ngaphambili ize ingene kwimithambo yentliziyo esentliziyweni. Awuyi kukuva oku. |
| 3. Ukunyamekela ibhloko | Ulwelo olukhethekileyo (idayi echaseneyo) olubonakala ngokucacileyo kwi-X-ray lufakwa emthanjeni nge-catheter. Ugqirha unokubona ngqo apho umthambo ukhoyo kwaye uvalekile kangakanani kwi-X-ray monitor. |
| 4. Ukuvula umthambo | Okulandelayo, olunye ucingo olubhityileyo olunebhaluni ludlula kwibhloko, kwaye ibhaluni iyavuthelwa ukuze icinezele umaleko wegazi ovalelweyo eludongeni lomthambo, nto leyo edala indlela yokuba igazi lihambe ngayo. |
| 5. Ukubeka i-stent | Ukuze umthambo ungavaleki kwakhona, kufakwa i-stent ize inamathele kwindawo evulekileyo. |
| 6. Ukugqiba | Wakuba umsebenzi ugqityiwe, i-catheter kunye nezinye izixhobo ziyasuswa, uxinzelelo lufakwa kwindawo apho ityhubhu ifakwe khona, kwaye kufakwa ibhandishi. |
Yonke le nkqubo ingathatha naphi na ukusuka kwimizuzu engama-30 ukuya kwiiyure ezimbini, kuxhomekeke ekubeni imithambo yakho ivalekile na.
Kwenzeka ntoni emva konyango?
Emva kwe-PCI, uza kugcinwa kwindawo yokuchacha iiyure ezimbalwa ukuze ujonge izinga lentliziyo yakho kunye noxinzelelo lwegazi. Kunokubakho ukukruquka okanye ubuhlungu apho kufakwe khona i-catheter. Oku kuqhelekile kwaye kuya kuphela kwiintsuku ezimbalwa. Kwiimeko ezininzi, uya kukwazi ukuya ekhaya ngobo busuku okanye kusasa olulandelayo.
Ziziphi iingenelo kunye neengozi zale ndlela yonyango?
Njengalo naluphi na unyango, olu luneenzuzo kunye neengozi ezincinci.
Iingenelo eziphambili
- Ukuchacha ngokukhawuleza: Ekubeni olu tyando lungelulo olukhulu, ungachacha kwaye ubuyele kubomi obuqhelekileyo ngokukhawuleza kunokuba utyando lwe-bypass.
- Ukuphelisa iimpawu: Izinto ezifana neentlungu zesifuba (i-angina) kunye nokuphefumla kancinci xa uzama (ukuphelelwa ngamandla) ziyancipha kakhulu.
- Ukusindisa ubomi: Oku kunokusindisa ubomi ngokunciphisa umonakalo entliziyweni ngexesha lokuhlaselwa yintliziyo.
Iingozi ezinokubakho
Nangona i-PCI iyindlela ekhuselekileyo kakhulu , kukho iingxaki ezimbalwa ezingaqhelekanga ezinokwenzeka.
- Ukopha okanye usulelo kwindawo efakwe kuyo ityhubhu.
- Amahlwili egazi aqala ngaphakathi kwi-stent (amayeza anikwa ukuthintela oku).
- Umthambo onyangiweyo uyavaleka kwakhona ekuhambeni kwexesha.
- Ukonakala kwezintso (ingakumbi kubantu abanesifo sezintso esele sikhona).
- Kunqabile kakhulu ukuba kubekho istroke.
Kodwa khumbula, xa oogqirha besebenzisa i-stent engayisebenzisiyo amayeza, amathuba okuba umthambo uvaleke kwakhona angaphantsi kwe-5%. Oko kuthetha ukuba kwiimeko ezingama-95 kwezili-100, ingxaki ayizukubakho.
Kuthatha ixesha elingakanani ukuba ndilulame kwaye ndifanele ndixhalabele ntoni?
Ngokwesiqhelo ungabuyela kwimisebenzi yakho yesiqhelo kwisithuba seveki. Nangona kunjalo, ukuba unomsebenzi ofuna ukuphakamisa izinto ezinzima okanye ukuzilolonga ngokomzimba, kungathatha ixesha ngaphambi kokuba ubuyele emsebenzini. Thetha nogqirha wakho ngale nto.
Le yeyona nto ibalulekileyo:
Emva konyango, ugqirha wakho uza kukunika amayeza okuthintela ukugabha kwegazi (afana neClopidogrel, Prasugrel, Ticagrelor). Kubalulekile ukuthatha la mayeza njengoko kuchaziwe, ngaphandle kokulahlekelwa lusuku olunye. La mayeza athintela ukugabha kwegazi ukuba kungenzeki ngaphakathi kwi-stent. Ngoko ke, landela imiyalelo kagqirha wakho ngokuchanekileyo.
Ndifanele ndiphinde ndimbone ugqirha nini kwakhona?
Ukuba ufumana naziphi na kwezi mpawu zilandelayo emva kokuba ubuyele ekhaya emva konyango, yazisa ugqirha wakho ngoko nangoko okanye uye kwiSebe leNgxamiseko (ETU) lesibhedlele esikufutshane.
| Iimpawu ekufuneka uziqaphele |
|---|
| Kukho ukopha okuqhubekayo, ulwelo olufana nobovu oluphuma kwindawo apho ityhubhu ifakwe khona, okanye ukudumba okugqithisileyo kwindawo leyo. |
| Ukuphinda kwentlungu yesifuba (i-angina) okanye ukuphefumla kancinci njengangaphambi konyango. |
| Ndiziva ndibanda kwaye ndifumana umkhuhlane. |
| Ukuba ndindisholo okanye ukubanda engalweni okanye emlenzeni apho kufakwe khona ityhubhu. |
| Ukudinwa okanye ukuquleka (syncope). |
| Ukuqala okutsha kobunzima bokuphefumla (ukuphelelwa ngamandla). |
Umyalezo Wokuya Ekhaya
- I-PCI yindlela yonyango engenalo utyando, esebenza kakhulu kwaye ikhuselekileyo yokuvula imivalo kwimithambo yentliziyo.
- Oku kunciphisa kakhulu iimpawu ezifana neentlungu zesifuba kunye nokuphefumla kancinci. Kubalulekile nasekusindiseni ubomi xa kukho isifo sentliziyo.
- Emva konyango, kubalulekile ukuthatha amayeza okunciphisa igazi anikwe ngugqirha kanye njengoko enikwe, ungaphoswa lusuku olunye. Abaluleke kakhulu ebomini bakho.
- Kwanasemva konyango, ukwamkela indlela yokuphila elungileyo (ukutya okunesondlo, ukuzilolonga, ukuphepha ukutshaya notywala, kunye nokunciphisa uxinzelelo) kunokunceda kakhulu ekuthinteleni ukuba imithambo yegazi ingaphindi ivaleke.
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