Ngaba ngamanye amaxesha uziva uxinezelekile okanye intlungu esifubeni sakho? Okanye ngaba ufumana kunzima ukuphefumla xa udiniwe kancinci? Ezi zinto zingaba ziimpawu zemithambo yegazi entliziyweni yethu (imithambo ye-coronary) evaleka kancinci kancinci. Kufana nodaka oluqokelelana ngaphakathi kumbhobho wamanzi endlwini yethu kwaye luvaleka kancinci kancinci. Ukuba oku akunyangeki, kunokukhokelela ekuhlaselweni yintliziyo. Kodwa ungakhathazeki, amayeza anamhlanje anonyango olusebenzayo kakhulu koku. Namhlanje siza kuthetha ngendlela yonyango enokuvuselela intliziyo enjalo.
Yintoni le Coronary Revascularization?
Oku kunokuvakala ngathi ligama elide nelingaqhelekanga, kodwa intsingiselo yalo ilula kakhulu. Igama elithi "Coronary" libhekisa kwimithambo yegazi edibana nentliziyo. Igama elithi "Revascularization" lithetha "ukubuyisela ukuhamba kwegazi kwakhona." Ngoko ke, ngamazwi alula, iCoronary Revascularization lunyango olubuyisela ukuhamba kwegazi entliziyweni xa izihlunu zentliziyo zingafumani igazi elilifunayo (imeko esiyibiza ngokuba yi-ischemia kumayeza) . Nokuba kungokuvula kwakhona umthambo wegazi ovalekileyo okanye ngokudala indlela entsha yokujikeleza ukuvaleka.
Olu nyango lunokunciphisa umonakalo entliziyweni yakho emva kokuhlaselwa yintliziyo, kwaye lunokuthintela ukuba usengozini enkulu yokuba nesifo sentliziyo.
Ngokuyintloko sithetha ngeendlela ezimbini zonyango phantsi koku:
1. Ungenelelo lwe-Percutaneous Coronary (PCI): Oku kubizwa ngokuba yi-"stent placement." Oku kuquka ukungena ngaphakathi kwimithambo yegazi, ukususa ukuvaleka, nokudala indlela yokuhamba kwegazi, ngaphandle kotyando.
2. I-Coronary Artery Bypass Grafting (CABG): Oku kwaziwa ngokuba yi-"Bypass Surgery." Oku kuquka ukudala indlela entsha (bypass) ejikeleze umthambo wegazi ovalekileyo kusetyenziswa isiqwenga somthambo wegazi esithathwe kwenye indawo yomzimba.
| Indlela yonyango | Kalula nje... |
|---|---|
| I-PCI (ukubekwa kwe-stent) | Kufana nokufaka ucingo ngaphakathi kombhobho ovalekileyo, uwuvuthele, uze ulungise indlela. Akukho monakalo mkhulu. |
| I-CABG (Utyando lwe-Bypass) | Njengokwakha indlela entsha yokudlula kwindlela exakekileyo, umthambo omtsha wegazi uyafakelwa ukuze udlule umthambo wegazi ovalekileyo. Olu lutyando. |
Ngubani ofuna olu nyango?
Nabani na ohamba kancinci kwegazi entliziyweni angazuza kolu nyango. Eyona nto ibangela oku sisifo semithambo yegazi yentliziyo . Umngcipheko wale meko uyanda ngokuhamba kweminyaka. Ke ngoko, abantu abangaphezu kweminyaka engama-65 ubudala badla ngokuba ngabona badinga olu nyango kakhulu.
Khawucinge nje, into etyebileyo eyenziwe ngeoyile kunye ne-cholesterol (esiyibiza ngokuba yi-plaque) iqokelelana kancinci kancinci ngaphakathi kwemithambo yegazi yethu. Le nkqubo ibizwa ngokuba yi-atherosclerosis . Kufana neoyile enamathela kumbhobho wesinki wasekhitshini ize ivaleke. Ekuhambeni kwexesha, le ntsalela iyawunciphisa umthambo wegazi. Ukuba ngenye imini le ntsalela iyaqhuma, ihlwili legazi linokwenziwa kuloo ndawo kwaye livale ngokupheleleyo umthambo wegazi. Kulapho inxalenye yentliziyo iyeka ukufumana igazi, nto leyo ebangela ukuhlaselwa yintliziyo.
Ngoko ke, kubantu abanolu hlobo lokuvaleka, olu nyango lusetyenziselwa ukubuyisela ngokukhawuleza ukuhamba kwegazi ngaphambi kokuba iiseli zentliziyo zife.
Zeziphi iimeko ezinyangwa ngolu hlobo lonyango?
Olu nyango lusetyenziswa kakhulu kwiimeko eziphantsi kodidi lwe-acute coronary syndrome. Oko kukuthi:
- Uhlaselo lwentliziyo: Ukonakala kwemisipha yentliziyo ngenxa yokuvaleka ngequbuliso komthambo wegazi.
- I-Stable Angina: Imeko apho intlungu yesifuba ibakho ngexesha lokuzilolonga, njengaxa unyuka izinyuko, ize iphele xa uphumle.
- I-Angina Engazinzanga: Imeko eyingozi ebonakaliswa ziintlungu zesifuba eziba mandundu nokuba uphumle.
Kwenzeka ntoni ngaphambi konyango?
Wakuba ugqibe ekubeni wenze olunye lwala mayeza, oogqirha baya kwenza uvavanyo oluninzi ukuze bahlole ngokuchanekileyo imeko yakho baze bacebe eyona ndlela ilungileyo yonyango.
| Uvavanyo | Wenza ntoni nje? |
|---|---|
| I-Electrocardiogram (ECG okanye i-EKG) | Umsebenzi wombane wentliziyo uyajongwa. |
| I-Echocardiogram | Kufana nokuskena, ukujonga ukusebenza kunye nobukhulu bentliziyo. |
| Ukufakwa kwe-catheter kwintliziyo / i-Angiogram | Kufakwa ulwelo olukhethekileyo kwimithambo yegazi kwaye kuthathwa i-X-ray ukuze kubonwe ukuba ivaliwe phi kwaye ingakanani. |
| i-CT scan angiography | I-CT scan ijonga ukuba kukho imiqobo kwimithambo yegazi. |
| Uvavanyo lwegazi | Izinto ezifana nee-enzymes kunye namanqanaba e-cholesterol ziyajongwa ukuze kubonwe ukuba intliziyo yonakele na. |
Ngaphandle kokuba yingxamiseko, kuya kufuneka uzile ukutya kangangeeyure ezisi-8 ngaphambi kokuba kwenziwe inkqubo. Ngaphambi kokuba inkqubo iqale, umgca we-IV (ityhubhu ekunika i-saline) uya kufakwa emthanjeni ongalweni yakho. Kulapho amayeza afunekayo kunye nolwelo luya kunikwa khona umzimba wakho. Kwi-PCI, uya kunikwa i-sedation. Kwi-CABG bypass surgery, uya kufakwa phantsi kwe-anesthesia eqhelekileyo.
Kwenzeka ntoni ngexesha lonyango?
Nangona injongo yeenkqubo ze-PCI kunye ne-CABG ifana, indlela ezenziwa ngayo yahlukile kakhulu.
Inkqubo yokubeka i-stent kwi-PCI (PCI)
Apha, ugqirha ufaka ityhubhu encinci kakhulu neguquguqukayo (catheter) kumthambo wegazi omkhulu, nokuba udlula esihlahleni okanye emqolo. Emva koko umbhobho ukhokelwa kumthambo wegazi ovalekileyo entliziyweni yakho phantsi kwesikhokelo se-X-ray.
Okulandelayo, ibhaluni encinci ekupheleni kombhobho iyavuthelwa kwindawo evalekileyo kuyo. Oku kubangela ukuba umthambo wegazi onciphileyo wande ukusuka ngaphakathi. Oku kubizwa ngokuba yi-balloon angioplasty .
Khawuthelekelele, okwenzekayo apha kufana nokufaka ibhaluni ngaphakathi kwipayipi evalekileyo uze uyivuthele, utyhale uthuli olungaphakathi kwipayipi kumacala omabini, udale indlela.
Emva koko, ukuze umthambo wegazi obanzi ungaphinde unciphe, kufakwa isakhelo sesinyithi esincinci esenziwe njenge-mesh endaweni yaso. Oku sikubiza ngokuba yi-stent . Amanye ama-stents aneyeza kuwo elithintela umthambo wegazi ukuba ungaphindi unciphe. La ma-stents abizwa ngokuba yi-drug-eluting stents . Emva kokuba umsebenzi ugqityiwe, ityhubhu iyakhutshwa, kufakwe umthungo omncinci apho wawufakwe khona, kwaye unyango lugqityiwe.
Indlela ye-CABG (Utyando lwe-Bypass)
Le yindlela yotyando. Ugqirha uqala ngokuthatha iqhekeza legazi eliphilileyo kwenye indawo emzimbeni wakho (ngesiqhelo emlenzeni, engalweni, okanye esifubeni sakho).
Emva koko, intliziyo ifikelelwa ngeendlela ezimbini:
- Utyando oluvulekileyo: Ukusika kwenziwa iisentimitha ezimbalwa ukusuka embindini wesifuba, kuvula ithambo lesifuba (sternum) ukuze lifikelele entliziyweni.
- Utyando olungenabungozi kangako: Oku kuquka ukwenza umsike omnye okanye ngaphezulu esifubeni nokusebenzisa ikhamera kunye nezixhobo ezikhethekileyo ukufikelela entliziyweni ngeembambo. Ngamanye amaxesha oku kwenziwa ngotyando lwerobhothi.
Ngexesha lotyando, intliziyo inokumiswa okwethutyana ize iqhagamshelwe kumatshini we-heart -lung bypass ukuze yenze lo msebenzi. Nangona kunjalo, ezinye iindlela zotyando zenziwa ngelixa intliziyo isabetha (off-pump bypass).
Emva koko ugqirha usebenzisa umthambo wegazi osusiweyo ngaphambili ukudala indlela entsha ngokudibanisa umthambo wegazi ovalekileyo ngaphezulu nangaphantsi kwawo. Kufana nokwenza indlela entsha yokudlula kwindlela exakekileyo. Oku kuyayidlula le ndlela yokuvala kwaye kuvumela igazi ukuba lihambe liye kwimisipha yentliziyo kwindlela entsha. Nje ukuba indlela yokudlula igqityiwe, isifuba siyavalwa, kuthungwe, kwaye utyando lugqityiwe.
Kwenzeka ntoni emva konyango?
Uza kufuna ixesha elithile ukuze uphile emva kwenkqubo. Eli xesha lixhomekeke kuhlobo lwenkqubo oye wayenza (i-PCI okanye i-CABG) kunye nempilo yakho iyonke. Ngokwesiqhelo, uza kubuyela esiqhelweni kwiintsuku ezimbalwa emva kwe-PCI. Nangona kunjalo, kungathatha iiveki ezininzi okanye iinyanga emva kotyando lwe-CABG.
Ngexesha lokuchacha kwakho, ugqirha wakho unokukuthumela kwinkqubo yokuvuselela intliziyo . Kwezi nkqubo, oogqirha, abahlengikazi, abaqeqeshi bomthambo, kunye neengcali zesondlo basebenzisana ukukunceda.
- Ngowuphi umthambo ofanelekileyo kuwe?
- Ziziphi ukutya omele ukutye?
- Indlela yokuthatha amayeza ngokuchanekileyo?
- Ungaphila njani ubomi obusempilweni kwakhona?
Ndiza kukwazisa ngayo yonke into ethethwayo.
Kwakhona, kubalulekile ukuya kwiindibano zokulandelela ezibonelelwe ngugqirha. Ukusela amayeza akho ngexesha, ukulawula ukutya kwakho, kunye nokulandela imiyalelo kagqirha wakho kubaluleke kakhulu ekukhawuleziseni ukuchacha kwakho nokuthintela ukuphinda kwenzeke kwesi sifo.
Zithini iingenelo kunye neengozi zale nyango?
Njengakwezinye iindlela zonyango, ezi ndlela zinezibonelelo kunye neengozi.
Zithini iingenelo?
- Amandla okusindisa ubomi: Olu nyango lusindisa ubomi kwiimeko ezifana nokuhlaselwa yintliziyo.
- Ukuthintela ukuhlaselwa yintliziyo: Ukuba ubona ukuvaleka kwemithambo yegazi yakho kwangethuba, ungakuthintela ukuhlaselwa yintliziyo ngokuyinyanga ngaphambi kokuba yenzeke.
- Ukukhusela ukusebenza kwentliziyo: Ukuba inyangwa ngokukhawuleza, umonakalo kwimisipha yentliziyo unokuthintelwa ngokupheleleyo okanye uncitshiswe.
Zithini iingozi kunye neengxaki?
Umngcipheko uxhomekeke kunyango, iminyaka yakho, kunye nezinye iimeko zempilo onazo (ezifana nesifo seswekile kunye noxinzelelo lwegazi oluphezulu).
| Indlela yonyango | Iingozi eziqhelekileyo |
|---|---|
| I-PCI (ukubekwa kwe-stent) | Ukonakala kwentliziyo okanye imithambo yegazi, ukubetha kwentliziyo okungahambelaniyo (arrhythmias) , ukuqhekeka kwegazi, isifo sohlangothi, okanye ukopha. |
| I-CABG (Utyando lwe-Bypass) | Iingozi ezihambisana notyando. Umzekelo, iintlungu, ukopha kakhulu, usulelo lwenxeba. |
Kodwa musa ukoyika ezi zinto. Ugqirha wakho uza kukuchazela yonke into kakuhle aze enze konke okusemandleni akhe ukunciphisa iingozi zakho. Ukuba unemibuzo okanye iinkxalabo, buza ugqirha wakho ngoko nangoko.
Kuza kuthatha ixesha elingakanani ukuze ndiphile? Kuza kufuneka ndiphinde ndiye kugqirha nini?
Nangona ungabuyela kubomi obuqhelekileyo kwiintsuku ezimbalwa emva kwe-PCI, kungathatha iinyanga ezininzi ukuba uphile ngokupheleleyo emva kotyando lwe-CABG. Ugqirha wakho uza kukuxelela ngokuthe ngqo ukuba kufuneka uphumle ixesha elingakanani, oko unako nokungenakukwenza.
Emva konyango, ukuba kukho ezi mpawu zilandelayo, kufuneka ubone ugqirha ngoko nangoko .
- Intlungu yesifuba (i-Angina)
- Ubunzima bokuphefumla (i-Dyspnea)
- Ukudinwa okanye ukuziva ukhathazekile
- Ukulahlekelwa yingqondo
Kuqhelekile ukuba noloyiko kunye nexhala xa usiva ngengxaki yentliziyo. Nangona kunjalo, olu nyango lubizwa ngokuba yiCoronary Revascularization lunokuphucula kakhulu iingxaki zentliziyo kwaye luthintele ukuba zingabi mandundu. Eyona nto ibalulekileyo kukuqonda olu nyango ngokufanelekileyo, ufumane uncedo lwezonyango olufunekayo ngaphandle koloyiko, kwaye uzame ukuphila ubomi obusempilweni nobonwabisayo kwakhona.
Umyalezo Wokuya Ekhaya
- Ukuvuselelwa kwemithambo yegazi yentliziyo (Coronary revascularization) kubhekisa kunyango olubuyisela ukuhamba kwegazi kwimithambo yegazi evalekileyo entliziyweni.
- I-PCI (ukubekwa kwe-stent) kunye ne -CABG (utyando lwe-bypass) zezona ndlela zimbini ziphambili.
- Olu nyango lunokuthintela ukuhlaselwa yintliziyo kwaye lusindise ubomi.
- Emva konyango, kubaluleke kakhulu ukulandela imiyalelo yezonyango ngokuchanekileyo, ukusela amayeza, ukulawula ukutya kwakho, kunye nokuzilolonga.
- Thetha ngokukhululekileyo nogqirha wakho malunga nokuba loluphi unyango olulungele imeko yakho kunye nezinto ezilungileyo nezingalunganga.
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