Ingaba imithambo yegazi ethwala igazi izise ezintsoni zakho inciphile? (I-Renal Artery Stenosis) Masithethe ngale nto!

Izintso zezinye zezitho ezibalulekileyo emzimbeni wethu. Zifana nesihluzo esicoca inkunkuma emzimbeni wethu. Kodwa ngamanye amaxesha, ngaphandle kokwazi kwethu, imijelo ephambili ehambisa igazi kwizintso, oko kukuthi imithambo yezintso, inokuvaleka. Oku sibiza ngokwezonyango ngokuba yi-'Renal Artery Stenosis' (RAS) okanye isifo semithambo yezintso. Esi sinokuba yimeko enzima, njengoko sinokukhokelela kwiimeko ezifana noxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu) , isifo sezintso esingapheliyo (isifo sezintso esingapheliyo), kwaye ekugqibeleni ukungasebenzi kakuhle kwezintso. Ngoko ke, kubaluleke kakhulu ukuqaphela oku.

Ngubani osengozini enkulu yokuhlaselwa sesi sifo?

Ngamafutshane, nangona le meko inokukhula nakubani na, abanye abantu basengozini enkulu. Abantu abane -atherosclerosis basengozini enkulu. I-atherosclerosis yimeko apho izinto ezinamafutha ezifana ne-cholesterol kunye ne-plaque ziqokelelana eludongeni lwemithambo yegazi yethu, nto leyo enokubangela ukuvaleka. Cinga ngayo njengombhobho wamanzi ovalwa luthuli ngokuhamba kwexesha.

Ngoko ke, ukuba unezinye zezinto ezibangela umngcipheko ezingezantsi, kungcono ukuba uqaphele ngakumbi:

• Ukuba unesifo seswekile .
• Ukuba kukho umntu kusapho onesifo sentliziyo (oko kukuthi, ikhonkco elidluliselwa kwilifa).
• Ukuba une- high blood pressure .
• Ukuba unezinga eliphezulu le-cholesterol egazini .
• Ukutyeba kakhulu kuthetha ukuba nobunzima bomzimba obuninzi kakhulu.
• Umngcipheko uyanda xa ukhula (amadoda angaphezu kweminyaka engama-45 ubudala, abafazi abangaphezu kweminyaka engama-55 ubudala).
• Ukutya okungekho mgangathweni , oko kuthetha ukutya rhoqo ukutya okunetyuwa eninzi, ioyile kunye neswekile.
• Ukuba utshaya , oku kuyingozi kwizinto ezininzi.

Luluphi ulwalamano phakathi kwe-stenosis yemithambo yezintso kunye nesifo semithambo ejikeleze umzimba?

Nantsi enye into ebalulekileyo. Le renal artery stenosis (RAS) ichaphazela imithambo yegazi ethwala igazi ezintso. Kodwa kukho enye imeko ebizwa ngokuba yi -'Peripheral Artery Disease' (PAD) . Kule meko, imithambo yegazi ethwala igazi esuka entliziyweni iye ezingalweni nasemilenzeni iyavaleka. Khawuthelekelele, xa uhamba, uziva iintlungu emilenzeni yakho, kwaye emva kwexesha elithile ungahamba kwakhona, unokubona iimpawu zale PAD.

Eyona nto ibangela i-RAS kunye ne-PAD idla ngokuba yi-atherosclerosis ekhankanyiweyo ngaphambili . Izifundo zibonise ukuba phakathi kwe-14% kunye ne-35% yabantu abane-PAD banokuba ne-RAS. Oku kuthetha ukuba kukho unxibelelwano oluqinileyo phakathi kwezi zimbini.

Ukongeza, abantu abanesifo sezintso esinganyangekiyo, esinokubangelwa yi-RAS, bafunyenwe besengozini enkulu yokufumana i-PAD. Umntu onezi meko zombini usengozini enkulu yokufumana iingxaki zempilo ezinzulu, ezifana nokuhlaselwa yintliziyo, istroke, kunye nokulahlekelwa ngamalungu omzimba . Ngoko ke, kubalulekile ukuzazi ezi zinto.

Zithini iimpawu? Siyibona njani le nto?

Rhoqo, olu hlobo lwe-renal artery stenosis (RAS) alubonisi zimpawu kwasekuqaleni. Kufana nokuba luyakuchwechwa luze lwenze isifo sibe sibi kakhulu. Iingxaki, ezinje ngoxinzelelo lwegazi oluphezulu kunye nokungasebenzi kakuhle kwezintso, ziqala ukuvela xa isifo sinzima kakhulu. Xa izintso zingasebenzi kakuhle, ezi mpawu zinokuvela. Jonga ukuba unayo na kwezi:

• Ngaba unengxaki yokugxila okanye uziva udidekile ?
• Awukwazi ukulala? (Ubunzima bokulala)
• Ngaba kukho iindawo emzimbeni wakho ezidumbileyo ngamanzi? (Ukudumba), ingakumbi emilenzeni nasemaqatheni.
• Ngaba uziva udiniwe ngalo lonke ixesha ? Ngaba uyadinwa nasemva kokuba wenze umsebenzi omncinci?
• Ingaba uphathwa ziintloko ezibuhlungu rhoqo ?
• Ngaba uphelelwe ngumdla wokutya ?
• Ngaba ukhe uzive iintlungu zemisipha okanye ukuqaqamba ?
• Ngaba unesicaphucaphu kwaye uhlanza ?
• Ngaba ukhe uphelelwe ngumphefumlo (dyspnea) ? Ngaba ukhe uphelelwe ngumphefumlo nasemva kokuhamba okwethutyana?
• Utshintsho lolusu - izinto ezifana nolusu olomileyo, ukurhawuzelela, okanye ukuba mnyama kolusu.
• Ingaba unciphisa umzimba ngaphandle kwesizathu? (Ukunciphisa umzimba ngendlela engachazekiyo)
• Ngaba uchama rhoqo okanye kancinci kunesiqhelo?

Ukuba unenye okanye ezimbini kwezi mpawu akuthethi ukuba unesifo. Nangona kunjalo, ukuba unezinye zezi mpawu, kulungile ukufuna ingcebiso kugqirha.

Kutheni le mithambo yezintso ivalekile? Zithini izizathu?

Kukho izizathu ezibini eziphambili zoku.

1. Ubukhulu becala, phakathi kwama-60% nama-90% eemeko ze-RAS zibangelwa yimeko ebesithethe ngayo ngaphambili , i-atherosclerosis . Oku kukuqokelelana kwamafutha (i-plaque) eludongeni lwemithambo yegazi, okuyenza inciphe kancinci kancinci. Le yeyona nto ixhaphakileyo.

2. Ezinye iimeko zihlala zibangelwa yimeko ebizwa ngokuba yi -'Fibromuscular dysplasia' . Oku kwahlukile kancinci. Kulapho iiseli ezikwiindonga zemithambo yegazi zikhula ngendlela engaqhelekanga kwaye zibangele ukuba imithambo yegazi inciphe. Oku akusiyo i-fatty deposit. Le meko ixhaphake kakhulu kwabasetyhini. Kucingelwa ukuba ibangelwa yimfuza okanye iihomoni.

Zithini iziphumo ebezingalindelekanga (iingxaki) ezinokubakho ngenxa yoku?

I-stenosis yemithambo yezintso ayisiyonto ilula. Ukuba ayilawulwa kakuhle, inokukhokelela kwezinye iingxaki ezininzi. Umzekelo:

• Isifo sezintso esingapheliyo: Ukwehla kancinci kancinci kokusebenza kwezintso.
• Isifo semithambo yegazi: Ukuvaleka okufanayo kunokwenzeka kwimithambo yegazi ehambisa igazi entliziyweni.
• Ukuwohloka kwezintso: Ubungakanani bezintso bunokuncipha.
• Ukungasebenzi kakuhle kwezintso: Ekugqibeleni, izintso zinokuyeka ukusebenza ngokupheleleyo, zifune i-dialysis okanye ukufakelwa izintso.
• Isifo semithambo yegazi ejikeleze umzimba: Ukuvaleka kwemithambo yegazi ethwala igazi iye emalungwini.
• Uxinzelelo lwegazi oluphezulu kwizintso: Uxinzelelo lwegazi oluphezulu kwimithambo yezintso.

Yingakho kubaluleke kakhulu ukubona ugqirha ngokukhawuleza ukuba urhanela imeko efana nale okanye uneempawu.

Sichongwa njani esi sifo ngokuchanekileyo?

Ngamanye amaxesha, oogqirha bafumana i-renal artery stenosis ngengozi. Oko kukuthi, xa bekuvavanya enye imeko. Nangona kunjalo, ukuba ugqirha wakho ukrokrela ukuba une-RAS, banokwenza ezinye iimvavanyo, ezifana nezi:

• Uvavanyo lomzimba: Okokuqala, uza kuhlolwa kakuhle. Uxinzelelo lwakho lwegazi luza kuhlolwa. Kwabanye abantu, le meko inokubangela uxinzelelo lwegazi oluphezulu olungalawulekiyo. Baza kukhangela ukudumba kwamalungu akho baze bamamele ukuphefumla kwakho. Ugqirha unokubeka i-stethoscope phezu kwezintso zakho ukuze amamele ukugquma kwegazi. Usenokuva isandi 'sokukhwaza' njengoko igazi lihamba ngemithambo evalekileyo. Uphawu oluphambili lwe-RAS luxinzelelo lwegazi oluphezulu olungachazwanga .
• Uvavanyo lokusebenza kwezintso: Okulandelayo, kwenziwa uvavanyo lwegazi nomchamo ukuze kubonwe ukuba izintso zakho zisebenza kakuhle kangakanani. Olu vavanyo lujonga amanqanaba aphezulu enkunkuma efana neproteni, i-creatinine , kunye ne-nitrogen emzimbeni wakho. Ezi zizinto ekufuneka izintso zakho zihluze ziphume emzimbeni wakho. Ukuba ziphezulu, oko kuthetha ukuba izintso zakho azihluzi kakuhle inkunkuma.
• Iiskeni zemifanekiso: Ukongeza, kukho iintlobo ngeentlobo zeeskeni zemifanekiso ezinokusetyenziselwa ukubona ukuba zinkulu kangakanani na izintso zakho kunye nokuba igazi lihamba kakuhle kangakanani kuzo. Ezi zinokubonisa nokuba imithambo yakho inciphile kangakanani na. Ugqirha wakho unokucebisa ukubaUsenokucelwa ukuba wenze i-renal scan, i-duplex ultrasound, i-computerized tomographic angiography (CTA), okanye i-magnetic resonance angiogram (MRA) . Ezi skeni zinokubonelela ngomfanekiso ocacileyo wemithambo yezintso.

Zithini iindlela zonyango zoku?

Unyango oluphambili lwale meko (RAS) kukutshintsha indlela yokuphila kunye namayeza . Zombini mazisetyenziswe kunye. Nangona kunjalo, ukuba imithambo yezintso inciphile kakhulu, kukho umngcipheko wokuvaleka kwemithambo, ukuba amayeza awakwazi ukulawula uxinzelelo, okanye ukuba ukusebenza kwezintso kuyaqhubeka nokuwohloka, utyando lunokufuneka.

Le meko ingalawulwa njani ngokutshintsha indlela yokuphila?

Oku kubaluleke kakhulu. Ukusela amayeza kuphela akwanelanga. Ugqirha wakho ngokuqinisekileyo uza kucebisa utshintsho oluthile kwindlela ophila ngayo oluya kunceda ekulawuleni le meko (RAS) kunye nokunciphisa uxinzelelo lwakho lwegazi oluphezulu. Ezi zizinto ngokuqinisekileyo omele uzenze:

• Ukutya ukutya okunempilo: Yitya ukutya okunamafutha aphantsi, i-cholesterol, ityuwa (isodium), kunye neswekile. Oku kuthetha ukunciphisa irayisi eqhotsiweyo, ukutya okuqhotsiweyo, iziselo ezineswekile, kunye nokutya okulula okunamafutha. Faka imifuno, iziqhamo, kunye namandongomane akhuliswe ekhaya ekutyeni kwakho. Nokuba utshintsho oluncinci olufana nolu lunokwenza umahluko omkhulu.
• Ukuzilolonga rhoqo: Yenza into efana nokuhamba okanye ukukhwela ibhayisekile ubuncinane imizuzu engama-30 ngosuku. Ukuzilolonga akuthethi ukuya ejimini.
• Ukunciphisa umzimba: Zama ukugcina ubunzima obufanele ubude bakho.
• Ukuyeka ukutshaya: Ukuba uyatshaya, yeka ngoko nangoko. Oku kunokuba nzima, kodwa kukho iindlela zokufumana uncedo.

Luluphi uncedo olunikezelwa ngamayeza?

Kunye notshintsho kwindlela yokuphila, ugqirha wakho unokukunika amayeza aliqela okunceda ukulawula uxinzelelo lwegazi oluphezulu kunye nokuthintela okanye ukulawula ukuqhubeka kwesifo sezintso. La mayeza kufuneka asetyenziswe kanye njengoko ugqirha wakho ekuxelela.

• Amayeza anjenge -ACE inhibitors kunye ne -Angiotensin Receptor Blockers (ARBs) avimba iihomoni ezithile ezinokuthintela imithambo yegazi yakho.
• Izinto ezilwa nokwaphuka kwegazi, ezifana ne -aspirin , zinceda igazi lihambe ngemithambo ngokulula.
• Ii-Beta-blockers kunye nee-calcium channel blockers, ezinciphisa uxinzelelo lwegazi oluphezulu.
• I-Diuretics , eyaziwa ngokuba 'ziipilisi zamanzi', isebenza ngokunceda izintso zakho zisuse amanzi agqithisileyo kunye netyuwa emzimbeni wakho, inciphisa uxinzelelo lwakho lwegazi.
• Yehlisa amanqanaba e-cholesterol egaziniIistatini.

Luhlobo luni lotyando olukhoyo koku?

Ukuba imeko (i-RAS) inzima ngokwaneleyo ukuba ingalawulwa ngamayeza kunye notshintsho kwindlela yokuphila, njengaxa umthambo uvalekile ngaphezu kwama-70%, utyando lunokufuneka. Kukho iintlobo ezintathu eziphambili zotyando:

1. I-Angioplasty kunye ne-stenting: Le yeyona nkqubo ixhaphakileyo. Kule nkqubo, ugqirha wotyando ufaka ityhubhu encinci, eguquguqukayo (i-catheter) kumthambo wakho wezintso ovalekileyo, nokuba kudlula kwi-groin okanye engalweni yakho. Emva koko i-catheter ivuthelwa ngebhaluni encinci ekupheleni ukuze yandise umthambo. I -stent (ityhubhu encinci efana ne-mesh) ifakwa kumthambo ukuze ingavaleki kwakhona kwaye ivumele igazi ukuba lihambe liye kwizintso. Le yinkqubo engenelelayo kancinci.

2. Ukudlula kwimithambo yegazi yezintso: Olu lutyando olukhulu. Lufana nokudlula kwentliziyo. Kule nkqubo, ugqirha udala indlela entsha yokuba igazi lihambe liye kwizintso, edlula kwimithambo yegazi yezintso evalekileyo okanye evalekileyo. Oku kudla ngokubandakanya ukusebenzisa i-graft evela emlenzeni wakho okanye kwityhubhu yokwenziwa. Le graft okanye ityhubhu iqhagamshelwe kwimithambo yegazi ekhoyo esempilweni, kwaye elinye icala liqhagamshelwe kwimithambo yegazi evalekileyo, phakathi kwemithambo yegazi evalekileyo kunye nezintso.

3. Utyando lwe-Renal endarterectomy: Kule nkqubo, ugqirha otyandayo uvula umthambo wezintso ovalekileyo aze asuse i-plaque kunye nezinye izinto ezithintela ukuhamba kwegazi.

Ugqirha wakho uya kugqiba ukuba loluphi utyando olulungele wena.

Sizikhusela njani kwesi sifo? (Ukuthintela)

“Ukuthintela kungcono kunokunyanga,” batsho. Ngoko ke, nazi ezinye izinto onokuzenza ukunciphisa umngcipheko wakho wokuba nale meko (i-RAS):

• Yitya ukutya okunesondlo .
• Zilolonge rhoqo .
• Ukulawula uxinzelelo lwakho lwegazi . Jonga uxinzelelo lwakho lwegazi rhoqo.
• Ukugcina ubunzima bomzimba busempilweni .
• Musa ukutshaya .

Ukwenza ezi zinto akuyi kuthintela nje kuphela ukuvaleka kwemithambo yezintso, kodwa kuya kukukhusela nakwezinye izifo ezininzi.

Iyintoni imbono yomntu onesi sifo?

Isifo semithambo yezintso (i-RAS) yimeko eqhubekayo eqhubeka iba mandundu ngokuhamba kwexesha. Imbonakalo yomntu onesi sifo ixhomekeke kubukhali besifo, ukuba sifunyanwa kwangethuba kangakanani, kunye nokuba usabela njani kunyango.

Uphando lubonise ukuba yi-48% kuphela yabantu abane-95% nangaphezulu yemithambo yezintso evalekileyo abanomlinganiselo wokusinda iminyaka emine. Oko kuthetha ukuba sisiqingatha kuphela sabantu abavalekileyo phantse ngokupheleleyo abasindayo emva kweminyaka emine emva kokufunyaniswa ukuba bane-HIV.Kungoko ke, kubaluleke kakhulu ukuqaphela le meko kwangethuba uze ufumane unyango. Ukuba ifunyenwe kwangethuba, umonakalo kwizintso unokuncipha kwaye ixesha lokuphila linokwandiswa.

Ndifanele ndimbone nini ugqirha ngale nto?

Ukuba unenye okanye ngaphezulu kwezi mpawu zilandelayo, bonana nogqirha ngokukhawuleza . Ezi zisenokuba ziimpawu zokusebenza kwezintso okuphantsi kakhulu :

• Ukuba uziva incasa yesinyithi emlonyeni wakho.
• Ukuba unentlungu esiswini .
• Ukuba unengxaki yokugxila, ukudideka okanye iingxaki zokugxila .
• Ukuba ubungakanani bomchamo buphantsi kakhulu (Umchamo uphantsi) .
• Ukuba isicaphucaphu nokuhlanza kuyaqhubeka.
• Ukuba unesifo sokuxhuzula .
• Ukudumba emilenzeni, ezingalweni okanye ebusweni .

Musa ukuzityeshela ezi zinto. Ukuba ufumana unyango ngokukhawuleza, unokuthintela umonakalo omkhulu.

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

I-Renal Artery Stenosis (RAS) kukuncitshiswa kwemithambo yegazi ehambisa igazi kwizintso. Eyona nto ibangela oku kukugcwala kwamafutha kwimithambo yegazi (atherosclerosis) . Oku kunokukhokelela kwiingxaki zempilo ezinzulu ezifana noxinzelelo lwegazi oluphezulu, isifo sezintso esingapheliyo, kunye nokungasebenzi kakuhle kwezintso.

Khumbula, oku akusoloko kubonisa zimpawu ekuqaleni, kodwa kunokuba yingozi ukuba akunyangelwanga ngokufanelekileyo.

Utshintsho kwindlela yokuphila (ukutya okunempilo, umthambo, kunye nokuyeka ukutshaya) kunye namayeza anikwe ngugqirha wakho zezona ndlela zonyango ziphambili. Kwezinye iimeko, utyando lunokufuneka. Ke ngoko, ukuqaphela iimpawu, ukulawula izinto ezinobungozi ukuba unazo, kunye nokufuna iingcebiso zonyango ngexesha kubaluleke kakhulu ukugcina izintso zakho ziphilile. Nyamekela umzimba wakho, kuba impilo yeyona nto ibalulekileyo!

I- Renal Artery Stenosis, Uxinzelelo lwegazi oluphezulu, Isifo sezintso, I-Atherosclerosis, I-Arterial Stenosis, Impilo yezintso