Ngaba uziva uphelelwa ngumoya okanye uphefumla kancinci xa uzibhokoxa, unyuka izinyuko, okanye usenza imisebenzi eqhelekileyo? Ngamanye amaxesha unobangela woku unokuba yi-blood clot endala ebisoloko imiphunga yakho ixesha elide. Ngokwesiqhelo, nokuba uzama ukulawula le meko ngamayeza, ukuba oko akusebenzi, oogqirha bakuthumela kutyando olukhethekileyo olunokusindisa ubomi bakho. Namhlanje sithetha ngotyando oluntsonkothileyo, kodwa olubaluleke kakhulu, i-PTE.
Yintoni le PTE utyando?
Ngamafutshane, i-PTE sisifinyezo se- Pulmonary Thromboendarterectomy . Le yinkqubo yotyando esusa amahlwili egazi amadala kunye nezicubu ezixineneyo ezinamathele kwimithambo yegazi ephambili (imithambo yegazi) emiphungeni yakho. Le yinkqubo enzima kancinci efuna ulwazi olukhethekileyo. Kodwa inokuphilisa ngokupheleleyo abanye abaguli.
Ziziphi iimeko ezinyangwa ngotyando lwe-PTE?
Olu tyando lwenziwa ikakhulu ukunyanga imeko ebizwa ngokuba yi -CTEPH (Chronic Thromboembolic Pulmonary Hypertension) . Usenokucinga, 'Elo ligama elide kakhulu,' akunjalo? Masihlale silula.
Khawucinge nje, umntu unegazi eliqhekekileyo emiphungeni yakhe. Siyibiza ngokuba yi-"Pulmonary Embolism (PE)`. Uninzi lwexesha, la mahlwili egazi ayanyibilika xa enikwa izinto zokunciphisa igazi. Kodwa kunqabile kakhulu, kwabanye abantu, la mahlwili egazi awanyibiliki ngokupheleleyo, kodwa anamathela eludongeni lwemithambo yegazi emiphungeni, kwaye ngokuhamba kwexesha, aguquke abe ziingceba.
Xa amahlwili egazi amadala kunye nezicubu ezibomvu zivala imithambo yegazi emiphungeni, uxinzelelo lwegazi olungaphakathi kwezo mithambo luba phezulu kakhulu. Yiloo nto siyibiza ngokuba yi-CTEPH.
Oku kubangela ukuba icala lasekunene lentliziyo lisebenze nzima ukupompa igazi liye emiphungeni. Ekuhambeni kwexesha, oku kunokukhokelela kwiimeko ezinzima ezifana nokusilela kwentliziyo kunye nomonakalo wemiphunga. Unyango olulodwa olunokunyanga i-CTEPH lutyando lwe-PTE.
Ngubani ofuna olu tyando? Ngaba wonke umntu angalufumana?
Ukuba une-CTEPH, zininzi izinto eziya kuqinisekisa ukuba ungenza utyando lwe-PTE.
| Uqwalaselo | Inkcazo |
|---|---|
| Ubunzima beempawu | Iimpawu zakho zinzima kangakanani, njengokuphefumla nzima nokuphefumla kancinci. |
| Indawo apho igazi liqhekeka khona | Inyani yokuba amahlwili egazi kunye nezicubu zesilonda nazo zifumaneka kwiindawo apho zinokususwa khona ngokukhuselekileyo ngotyando. |
| Impilo yakho iyonke | Ubudala bakho, ukusebenza kwentliziyo yakho kunye nemiphunga, kunye nokuba unezinye izifo na nazo zibalulekile. |
Ayingabo bonke abaguli beCTEPH abafanelekileyo kolu tyando. Malunga nama-40% abaguli abafanelekanga kolu tyando. Isizathu soku kukuba lutyando oluntsonkothileyo kakhulu.
Kutheni olu tyando lunzima kangaka?
Khawuthelekelele ukuba ngexesha lotyando, intliziyo yakho kunye nemiphunga zifakwa kumatshini we-cardiopulmonary bypass ukuze zincede ngomsebenzi othile. Emva koko, ukuze ugqirha otyandayo abone ngaphakathi kwemiphunga yakho, ubushushu bomzimba wakho buyehla bufike kwi-18 degrees Celsius (65°F), kwaye ukujikeleza kwegazi lakho kuyeke okomzuzwana. Oku kubizwa ngokuba yi-'deep hypothermic circulatory arrest'. Ungakhathazeki, le nkqubo ivumela ugqirha otyandayo ukuba asuse amahlwili egazi kunye nezicubu ezibomvu ngokucocekileyo ngelixa ekhusela ingqondo yakho kuyo nayiphi na ingozi.
Ungayilungiselela njani utyando?
Ugqirha wakho uza kukunika yonke imiyalelo oyifunayo ngaphambi kotyando. Bahlala bekuxelela ukuba unikele ingqalelo kwezi zinto:
- Amayeza: Uza kucelwa ukuba uyeke ukuthatha amayeza okunciphisa igazi (afana ne-aspirin kunye ne-warfarin) kunye nezinye izithomalalisi zentlungu (ii-NSAID) kwiintsuku ezimbalwa ngaphambi kotyando, kuba ezi zinokunyusa umngcipheko wokopha ngexesha lotyando.
- Ukutya Neziselo: Uza kucelwa ukuba uzile ukutya (ungatyi okanye usele) iiyure ezininzi ngaphambi kotyando. Kukhuselekile ukuba nesisu esingenanto xa unikwa i-anesthesia.
- Ukutshaya notywala: Ukuba usebenzisa zombini ezi ndlela, kubaluleke kakhulu ukuyeka ngokupheleleyo ngaphambi kotyando, kuba ziyalibazisa inkqubo yokuphiliswa kwaye zonyusa umngcipheko weengxaki.
Kwenzeka ntoni emva kotyando?
Emva kotyando, uza kungeniswa kwigumbi lonyango oluphezulu (ICU). Uza kuhlala apho ngobo busuku. Ngentsasa elandelayo, baza kujonga ukuba ungakwazi na ukuphefumla wedwa baze bakhuphe isixhobo somoya.
Ngokwesiqhelo uza kuhlala esibhedlele iintsuku ezisi-7 ukuya kwezili-10. Ngeli xesha, uza kuqala ukuhamba kancinci kancinci. Uza kuvavanywa ukuze ubone ukuba uyayidinga na ioksijini ngaphambi kokuba ugoduke. Oku kufana namava okuchacha emva kotyando lwentliziyo oluvulekileyo.
Zithini iingenelo kunye neengozi?
Njengalo naluphi na utyando, i-PTE ineenzuzo kunye neengozi.
| Iingenelo | Iingozi |
|---|---|
| Amathuba okufumana unyango olupheleleyo kwi-CTEPH. | Umngcipheko wokufa ngexesha lotyando (ngoku uphantsi njenge-1%). |
| Uphuculo olukhulu kwindlela yokuphefumla kunye nokukwazi ukuzilolonga. | Umngcipheko westroke (1%-2%). |
| Ukubuyiselwa komonakalo kwicala lasekunene lentliziyo. | I-pulmonary hypertension (PH) ihlala ikwinqanaba elithile nasemva kotyando. |
| Ukukwazi ukuphila ubomi obude nobunempilo emva kotyando. | Ukuqokelelana kolwelo olujikeleze intliziyo (i-pericardial effusion). |
Ingxamiseko!
Ukuba ufumana iintlungu zesifuba ezingalindelekanga, ezinzima, ukuphefumla okunzima, okanye ukuquleka emva kotyando, yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele esikufutshane ngoko nangoko. Kwakhona, ukuba ufumana iimpawu ezifana nokudumba, ukubomvu, ubomvu, okanye umkhuhlane kwindawo yotyando, bona ugqirha wakho ngoko nangoko.
Linjani ixesha lokuchacha?
Kuthatha malunga neenyanga ezi-3 ukuba umntu aphile ngokupheleleyo.
- Iiveki zokuqala ezi-6: Akukho kuqhuba, ukuya emsebenzini, okanye ukuphakamisa ubunzima obungaphezulu kwe-4.5 kg (10 lbs).
- Iiveki 7 ukuya kwi-12: Ingaphakamisa ubunzima obufikelela kwi-11 kg (25 lbs).
- Emva kweeveki ezili-12: Akusoloko kukho miqathango.
Amandla akho okuphefumla kunye nokuzilolonga angaphucuka kancinci kancinci ukuya kuthi ga kwiminyaka emi-4 emva kotyando.
Umyalezo Wokuya Ekhaya
- Nangona i-PTE ilutyando oluntsonkothileyo lokususa amahlwili egazi amadala emiphungeni, inokunyanga ngokupheleleyo imeko ebizwa ngokuba yi-CTEPH.
- Olu tyando alulungelanga wonke umntu. Ugqirha wakho kunye neqela leengcali baya kugqiba ukuba lukulungele na.
- Nangona ixesha lokuchacha lide kancinci, umgangatho wobomi bakho, amandla okuphefumla, kunye nokuhambahamba kuya kuphucuka kakhulu emva kotyando.
- Emva kotyando, kuya kufuneka uthathe amayeza okuthintela ukugabha kwegazi ubomi bakho bonke ukuze uthintele ukwakheka kwamahlwili egazi kwakhona.
- Kubalulekile ukubona ugqirha wakho ngexesha kwaye uvavanywe. Musa ukoyika ukuthetha nogqirha wakho ngayo nayiphi na ingxaki onokuba unayo.
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