Sonke silivile igama elithi "uhlaselo lwentliziyo" kaninzi, akunjalo? Mhlawumbi omnye wamalungu osapho lwethu okanye umhlobo ukhe waba nalo. Kodwa ubusazi na ukuba kukho iintlobo ezahlukeneyo zohlaselo lwentliziyo? Namhlanje siza kuthetha ngohlobo olubi ngakumbi nolufuna unyango olukhawulezileyo. Oogqirha balubiza ngokuba yi-STEMI. Musani ukukhathazeka, masithethe ngalo ngokulula.
Kutheni ibizwa ngokuba yi-STEMI? Ithetha ukuthini?
Ngamafutshane, ukuhlaselwa yintliziyo kuxa umthambo ohambisa igazi entliziyweni uvaleka ngequbuliso, nto leyo ethintela ukuhamba kwegazi ukuya kwimisipha yentliziyo. Ngokwezonyango, oku kubizwa ngokuba yi-"Myocardial Infarction".
Ngoku masibone ukuba igama elithi STEMI livela njani. Mhlawumbi ukhe wayibona i-ECG ithathwa esibhedlele. Olu luvavanyo olujonga ukusebenza kombane kwentliziyo. Kule nto, ukubetha kwentliziyo kuboniswa njengegrafu yomgca. Kufana nomgca ogobileyo, njengenduli okanye ithambeka.
Kukho inxalenye ekhethekileyo yale ECG, ebizwa ngokuba yi "ST-segment". Kumntu ophilileyo, le nxalenye idla ngokuba tyaba. Nangona kunjalo, xa umthambo omkhulu ohambisa igazi entliziyweni uvalekile ngokupheleleyo, oko kukuthi, xa kusenzeka uhlaselo olukhulu lwentliziyo, le nxalenye ye-ST iyaphakama. Njengenduli encinci.
Oku kubizwa ngokuba yi -ST-Elevation Myocardial Infarction kuba icandelo le-ST kwi-ECG liphakanyisiwe. Isifinyezo salo yi -STEMI .
Olu tshintsho lwe-ECG luphawu olubaluleke kakhulu koogqirha, kuba luthetha ukuba inxalenye enkulu yentliziyo ayifumani gazi laneleyo, kwaye loo nxalenye yentliziyo iyafa. Oku kuthetha ukuba unyango kufuneka luqalwe ngoko nangoko, ngaphandle kokulibazisa nomzuzu omnye .
Kwenzeka njani i-STEMI? Kwenzeka ntoni emzimbeni?
Ixesha elininzi, oku kubangelwa yi-plaque, ukuqokelelwa kwamafutha kunye ne-cholesterol ngaphakathi kwemithambo yegazi yentliziyo (imithambo ye-coronary). Cinga ngayo njengomhlwa owenzeka ngaphakathi kombhobho wamanzi.
Ezi plaque ziya zikhula kancinci kancinci. Ngenye imini, enye yezi plaque ingaqhuma ngequbuliso. Emva koko umzimba wethu ucinge ukuba kukho ukwenzakala apho. Ngoko ke yenza ihlwili legazi ukuze kupholiswe loo ngozi. Kodwa eli hlwili legazi likhula ngequbuliso lize livale ngokupheleleyo loo mthambo.
Kulapho ke ingxaki yokwenyani iqala khona.
1. Xa umthambo uvalekile ngokupheleleyo, iiseli zemisipha yentliziyo ezifumana igazi kuwo ziyaphelelwa yioksijini. Le meko siyibiza ngokuba yi-`(ischemia)`.
2. Ngaphandle kweoksijini, la maqhekeza enyama aqala ukufa kancinci kancinci.
3. Ukuba inxalenye enkulu yentliziyo iyasilela ngale ndlela, intliziyo ayikwazi ukupompa igazi elaneleyo emzimbeni. Oku kunokukhokelela kwimeko ebulalayo ebizwa ngokuba yi-"cardiogenic shock".
4. Kwakhona, izihlunu zentliziyo ezonakeleyo zinokuphazamisa ukusebenza kombane kwentliziyo, nto leyo ebangela ukuba intliziyo iyeke ukubetha ngequbuliso (ukuma kwentliziyo).
I-STEMI idla ngokuba sisifo sentliziyo esibi kakhulu. Yiyo loo nto kubalulekile ukuya esibhedlele kwangoko xa iimpawu ziqala. Ukuba ungayivula ngokukhawuleza imithambo yegazi evalekileyo kwaye ubuyisele ukuhamba kwegazi, ungawunciphisa kakhulu umonakalo entliziyweni.
Yintoni umahluko phakathi kwe-STEMI kunye ne-NSTEMI?
Usenokuba ukhe weva nge-NSTEMI. Kukho umahluko omkhulu phakathi kwezi zimbini.
| Uphawu | I-STEMI (uhlobo oluqatha) | I-NSTEMI (uhlobo olungenzima kangako) |
|---|---|---|
| Ukuvaleka kwemithambo yegazi | Ivalwe ngokupheleleyo. Ukuhamba kwegazi kuyeke ngokupheleleyo. | Inxalenye yayo kuphela evalekileyo. Kusaqhubeka ukuhamba kwegazi elithile. |
| Utshintsho lwe-ECG | Inxalenye ye-ST icacile ukuba iphakanyisiwe (i-ST-Elevation). | Ukuphakama kwe-ST segment akukho. Ezinye iinguqu ezincinci zinokubonwa. |
| Umonakalo wentliziyo | Ngokwesiqhelo kwenzeka umonakalo omkhulu. | Umonakalo uphantsi kakhulu. |
| Ukuchongwa | Ingafunyanwa ngoko nangoko nge-ECG. | Ukuze kuchongwe, kufuneka uvavanyo olukhangela i-enzyme ebizwa ngokuba yiTroponin egazini. |
Ngubani osengozini enkulu yokuphuhlisa oku?
Izinto ezibangela ukuhlaselwa yintliziyo zinokwahlulwa zibe ngamacandelo amabini: ezo sinokuzilawula nezo singenakukwazi ukuzilawula.
| Izinto ezinobungozi esinokuzitshintsha | Izinto ezinobungozi esingenakuzitshintsha |
|---|---|
| 🚬 Ukutshaya: Olu lolona tshaba lukhulu. | 👴 Ubudala: Umngcipheko uyanda ngokuhamba kweminyaka. |
| 🍔 I-cholesterol ephezulu: Ukutya okunamafutha amaninzi. | 👨👩👧 Imbali yosapho: Abazali, abantakwabo noodadewabo abanesifo sentliziyo besebancinci. |
| 🩺 Uxinzelelo lwegazi oluphezulu: Olungalawulekiyo. | 🧍♂️ Isini: Amadoda ngokubanzi asengozini enkulu xa esemncinci. Abafazi basengozini enkulu emva kokuya exesheni. |
| 🍬 Isifo seswekile: Ukungalawuli amanqanaba eswekile egazini. | 🧬 Izizathu zemfuza: Ezinye zeemeko ezikhoyo xa umntwana ezalwa. |
| ⚖️ Ukutyeba kakhulu kunye nesisu esivele ngaphandle. | |
| 🏃 Ukungazilolongi kakuhle kunye nendlela yokuphila yokuhlala phantsi. | |
| 😥 Uxinzelelo olugqithisileyo. |
Ziziphi iimpawu ezinokuchongwa?
Iimpawu zokuhlaselwa yintliziyo azifani kuye wonke umntu, kodwa ezona mpawu zixhaphakileyo zezi:
- Intlungu okanye ukungakhululeki esifubeni: Olu luphawu oluphambili. Lunokuvakala ngathi yimvakalelo eqinileyo, enzima, okanye enciphayo embindini wesifuba. Le ntlungu inokuhlala ixesha elingaphezulu kwemizuzu embalwa.
- Intlungu isasazeka kwezinye iindawo: Intlungu yesifuba ingasasazeka ingalweni yasekhohlo, kuzo zombini iingalo, amahlombe, intamo, umhlathi, umqolo, okanye isisu esingaphezulu.
- Ubunzima bokuphefumla: Usenokuziva uphelelwa ngumphefumlo, nokuba unentlungu esifubeni okanye awunayo.
- Ukubila: Ungaziva ubanda ngequbuliso uze uqalise ukubila.
- Isicaphucaphu nokuhlanza: Kungavakala ngathi sisisu esibuhlungu, njenge-gastritis.
- Ukudinwa nokuquleka: Ukuziva unesizungu kwaye ungakwazi ukuma.
- Ukuziva uloyiko olukhulu: Usenokuziva uloyiko olukhulu, ude woyike nokufa, ngaphandle kwesizathu.
Iimpawu ezithile kubafazi
Abafazi ngamanye amaxesha basenokungaziva iintlungu zesifuba eziqhele ukwenzeka, endaweni yoko, banokufumana iimpawu ezifana nezi.
- Ukudinwa okungaqhelekanga: Ukuziva udiniwe kakhulu kangangeentsuku ezininzi.
- Ukungalali.
- Ubunzima bokuphefumla.
- Intlungu emqolo, emagxeni, nasemhlathini.
- Isicaphucaphu nokuhlanza.
Eyona nto ibalulekileyo kukuba, ukuba ufumana iimpawu ezinje, musa ukucinga nje ukuba, "Oku kusenokuba yi-gastritis," kodwa yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) esibhedlele ngoko nangoko.
Luhlobo luni lonyango oluqhutywa esibhedlele?
Kwi-STEMI, ixesha libaluleke kakhulu ekusindiseni ubomi, ngoko ke unyango lukhawuleza kakhulu.
1. Ukuxilongwa kwangoko: Wakuba nje usiwe kwi-ETU, kuthathwa i-ECG ukuqinisekisa ukuba yi-STEMI.
2. Amayeza okunyibilikisa amahlwili egazi: Kwezinye izibhedlele, kunikwa inaliti (i-thrombolysis) ukuze kunyibilikiswe amahlwili egazi avalelekileyo.
3. I-Angioplasty kunye nokubekwa kwe-stent (PCI): Olu lolona nyango lubalaseleyo nolwanamhlanje lwe-STEMI. Kule meko, kufakwa ityhubhu encinci kakhulu ngomthambo osengalweni okanye emlenzeni entliziyweni ukuya kumthambo ovalekileyo. Emva koko, ibhaluni encinci ekupheleni kombhobho iyavuthelwa ukuze ivule umthambo ovalekileyo, kwaye isixhobo esifana ne-mesh esibizwa ngokuba yi-``stent`` sibekwa kuloo ndawo ukuze sithintele ukuba singavaleki kwakhona. Oku kubizwa ngokuba yi-``(Percutaneous Coronary Intervention - PCI)```.
4. Utyando lwe-bypass (Utyando lwe-CABG): Ukuba imithambo yegazi emininzi ivaliwe okanye i-PCI ayinakwenzeka, kwenziwa utyando lokudala imithambo yegazi emitsha. Oku kufana nokwakha 'i-flyover' entsha yokudlula indlela evaliweyo.
5. Amanye amayeza:Ukongeza kwezi ndlela zonyango, amayeza aliqela, afana nemithi yokunciphisa igazi (efana ne-aspirin), amayeza okwehlisa i-cholesterol (statins), kunye namayeza okulawula izinga lentliziyo (ii-beta-blockers), kuya kufuneka athathwe ubomi bakho bonke.
Ndingenza ntoni xa kukho imeko engxamisekileyo? Nditsalele umnxeba ku-1990? Okanye ndihambe ngemoto?
Lo ngumbuzo obaluleke kakhulu. Ukuba ukrokrela ukuba wena okanye umntu osondeleyo kuwe uneempawu zokuhlaselwa yintliziyo, ungaze uziqhubele esibhedlele. Ungaze ucele omnye umntu ukuba akuqhubele.
Eyona nto ingcono onokuyenza kukufowunela inkonzo ye-ambulensi ngoko nangoko, njengango-1990.
kutheni kunjalo?
- Amagosa akwi-ambulensi aqeqeshwe ngokukodwa kwezi ntlobo zeemeko ezingxamisekileyo. Angaqalisa ukubonelela ngonyango olusisiseko (olufana neoksijini) ngelixa usiwa esibhedlele.
- Banokwazisa i-ETU yesibhedlele kwangaphambili baze banike iinkcukacha malunga nesigulana. Emva koko, xa ufika, oogqirha kunye nabahlengikazi baya kuba bekulungele ukukunyanga. Oko kusindisa ixesha elixabisekileyo.
- Ukuba kwenzeka imeko engxamisekileyo, efana nokuma kwentliziyo, i-ambulensi inezixhobo ezifunekayo (ezifana ne-defibrillator) zokuyinyanga. Awunakukwenza oko emotweni yasekhaya.
Khumbula, umzuzwana ngamnye ubalulekile kwi-STEMI. Ngoko ke ukwenza isigqibo esifanelekileyo kunokusindisa ubomi.
Umyalezo Wokuya Ekhaya
- I-STEMI luhlobo olubi kakhulu lokuhlaselwa yintliziyo olubangelwa kukuvaleka ngokupheleleyo komthambo ohambisa igazi entliziyweni.
- Iimpawu eziphambili ziintlungu eziqatha esifubeni, ukuphefumla kancinci, kunye nokubila. Musa ukuyityeshela kuba yi-gastritis.
- Ukuba ufumana naziphi na kwezi mpawu, fowunela i-ambulensi ngaphandle kokulibazisa kwaye uye kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele.
- Ixesha libaluleke kakhulu. Ukuba unyango lunokuqaliswa ngokukhawuleza, umonakalo entliziyweni ungancitshiswa kakhulu.
- Le meko inokuthintelwa ngokuphepha ukutshaya, ukulawula i-cholesterol, uxinzelelo lwegazi, nesifo seswekile, ukutya ukutya okunempilo, kunye nokuzilolonga. Thetha nogqirha wakho ngale nto rhoqo.
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