Ngaba ukhe weva ngemithambo yegazi emikhulu neyona ibalulekileyo emzimbeni wakho, i-aorta? Cinga ngayo njengombhobho wamanzi ophambili ozisa amanzi endlwini yethu. Xa intliziyo ipompa igazi elicocekileyo, elo gazi lisasazeka emzimbeni wonke ngale aorta. Ngoko ke, xa indawo eludongeni lwale mthambo wegazi ibaluleke kakhulu iba buthathaka kwaye iphuma njengeqamza kwitayara endala, siyibiza ngokuba yi-'aneurysm' kunyango. Ukuba le qhuma iyenzeka kwinxalenye ye-aorta ehamba esifubeni, siyibiza ngokuba yi-'Thoracic Aortic Aneurysm'. Nangona eli gama liyoyikisa kancinci, masithethe ngalo ngokucacileyo nangokulula.
Yintoni i-aneurysm ye-aortic yesifuba?
Ngamafutshane, i-aorta ngumthambo wegazi oyintloko emzimbeni wethu oqala entliziyweni yakho, udlule esifubeni sakho nasesiswini, uze uphele kufutshane ne-pelvis yakho. Ukuba kukho ubuthathaka kwenye yeendonga zayo, uxinzelelo oluvela kwigazi oluhamba kuyo lubangela ukuba loo ndawo ibuthathaka idumbe njengebhaluni. Oku sikubiza ngokuba yi-aneurysm.
Le meko ayiqhelekanga kangako. Ngokwezibalo, ichaphazela umntu omnye kwishumi lamawaka. Ngoko ke musa ukoyika xa usiva eli gama.
Ngubani ofuna utyando ngenxa yesi simo?
Ayinguye wonke umntu onolu hlobo lokudumba oza kufuna utyando. Ugqirha wakho uza kuqwalasela izinto ezininzi ukuze agqibe ukuba uyaludinga na utyando okanye akunjalo.
- Ubungakanani be-aneurysm: Le yeyona nto ibalulekileyo. Ngokuqhelekileyo, ukuba i-aneurysm inkulu kune-5.5 centimeters , okanye ukuba ikhula ngokukhawuleza ngaphezu kwe-0.5 centimeters kwiinyanga ezintandathu , ugqirha wakho unokuqwalasela utyando.
- Iimpawu zakho: Ngamanye amaxesha oku kudumba kunokubangela iimpawu ezifana neentlungu zesifuba kunye nobunzima bokuphefumla. Ukuba oku kuyenzeka, utyando lunokucetyiswa, nokuba ubungakanani buncinci.
- Impilo yakho iyonke: Ubudala bakho kunye nokuba unezinye iimeko zempilo (umz. isifo seswekile, isifo sentliziyo) nazo ziyayichaphazela le sigqibo.
Eyona nto ibalulekileyo kukuba esi sigqibo senziwe ngugqirha wakho. Ngoko ke, ungathandabuzi ukuxoxa ngayo nayiphi na imibuzo okanye iinkxalabo onokuba nazo nogqirha wakho.
Zeziphi iintlobo zotyando ezikhoyo koku?
Kukho iintlobo ezimbini eziphambili zotyando lokunyanga le meko. Masiqonde ngokucacileyo umahluko phakathi kwezi zimbini.
| Uhlobo lotyando | Indlela yokwenza oku ilula. |
|---|---|
| Ukulungiswa kwe-Open Thoracic Aneurysm | Le yindlela yotyando yesintu. Ugqirha wenza utyando olude ecaleni kwesifuba sakho aze afikelele kwinxalenye eyonakeleyo ye-aorta yakho. Emva koko, inxalenye evuvukileyo nebuthathaka iyasuswa ize ithatyathelwe indawo yi-graft yokwenziwa. Olu lutyando olukhulu. |
| Utyando lwe-Endovascular (TEVAR) | Le yindlela yanamhlanje, engeyongozi kangako. Isifuba sakho asigqobhozwanga. Endaweni yoko, ugqirha wakho ufaka ityhubhu encinci kakhulu (i-catheter) ngemithambo yegazi ekwisinqe sakho. Ngale tyhubhu, isixhobo esikhethekileyo esifana ne-mesh (i-stent graft) sidluliselwa kwindawo evuvukileyo size solulwe ngaphakathi. Igazi emva koko lihamba ngetyhubhu entsha. Akukho xinzelelo eludongeni oluvuvukileyo. |
Iqela lezonyango liza kugqiba ukuba loluphi utyando olulungele wena ngokusekwe kwindawo kunye nobukhulu beqhubu lakho, kunye nemeko yakho yempilo.
Kutheni olu tyando lubaluleke kangaka?
Isizathu esiphambili sokwenza olu tyando kukuthintela ukuqhekeka kwe-aneurysm eyenziwe kwi-aorta.
Khawucinge nje, oku kudumba okufana nebhaluni kunokuqhuma ngenye imini ngenxa yoxinzelelo lwegazi oluphezulu ngaphakathi. Ukuba oko kuyenzeka, kuya kubakho ukopha okukhulu emzimbeni, okuyingozi enkulu kakhulu kwaye ekhawulezileyo ebomini. Ke ngoko, ukuba oogqirha bacinga ukuba umngcipheko wokudumba oku kuqhuma mkhulu kakhulu kunomngcipheko wotyando, bacebisa olu tyando. Ngamanye amazwi, eli linyathelo lokuthintela oku ngaphambi kokuba kube yingozi enkulu.
Kwenzeka ntoni ngaphambi kotyando?
Wakuba ugqibe ekubeni wenze utyando, kukho amanyathelo aliqela onokuwathatha ukuze ulungiselele.
- Iiskeni: Ugqirha uza kusebenzisa iiskeni ezikhethekileyo, ezifana ne-CT scan, ukuze afunde ngakumbi ubungakanani kunye nemeko yokudumba kwakho.
- Amayeza: Usenokunikwa amayeza athile kwiintsuku ezimbalwa ngaphambi kotyando ukulawula uxinzelelo lwegazi lakho kunye nokukhulula imithambo yegazi yakho.
- Amayeza athintela ukujiya kwegazi:Ukuba uthatha amayeza okunciphisa igazi (i-anticoagulants), ugqirha wakho uya kukucebisa ukuba uyeke ukuwasebenzisa kwiintsuku ezimbalwa ngaphambi kotyando.
Iqela lakho lezonyango liza kukunika imiyalelo ecacileyo ngayo yonke le nto.
Kwenzeka ntoni ngexesha lotyando?
Okwenzekayo kwiintlobo ezimbini zotyando kwahlukile kancinci.
Indlela yokwenza utyando oluvulekileyo
- Ugqirha wenza umsikelo omde ecaleni kwesifuba.
- Ngokusebenzisa izixhobo ezikhethekileyo, ukuhamba kwegazi kwinxalenye yomthambo osebenzayo kuyamiswa okwethutyana.
- Emva koko, inxalenye eyonakeleyo nedumbileyo iyasikwa ize isuswe, kuze kufakwe i-graft endaweni yayo ukuze kubuyiselwe ukuhamba kwegazi.
- Ekugqibeleni, i-incision ivalwa ngezititshi.
Indlela utyando lwe-TEVAR olwenziwa ngayo
- Ugqirha ufaka umbhobho omncinci (i-catheter) aze afake iingcingo ngemithambo yegazi ekwindawo yakho yokuphefumla.
- Le tube ikhokelwa kwindawo ekuyo i-aneurysm esifubeni kusetyenziswa ubuchwepheshe obufana ne-X-ray.
- Ukuze imithambo yegazi ibonakale ngokucacileyo, kufakwa ulwelo olukhethekileyo (idayi echaseneyo).
- Emva koko, xa ujonga indawo echanekileyo, i-stent iyandiswa.
- Xa umsebenzi ugqityiwe, ityhubhu kunye nocingo ziyakhutshwa kwaye ibhandeji elincinci libekwa phezu kwendawo yokufaka kwi-groin.
Kwenzeka ntoni emva kotyando?
Ixesha lokuchacha emva kotyando liyahluka ngokuxhomekeke kuhlobo lotyando.
- Emva kotyando oluvulekileyo: Uza kungeniswa ngqo kwigumbi lokhathalelo olunzulu (ICU) . Uza kuhlala apho usuku olunye okanye ezimbini. Emva koko uza kudluliselwa kwigumbi eliqhelekileyo kwaye kusenokufuneka uhlale esibhedlele malunga neentsuku ezili-10.
- Emva kotyando lwe-TEVAR: Ixesha lokuhlala esibhedlele lidla ngokuba lifutshane, malunga neentsuku ezintathu. Kunokubakho ukukruquka kunye nentlungu emqolo. Ugqirha uza kukunika amayeza okudambisa iintlungu afunekayo.
Ixesha elithathwayo ukubuyela kubomi obuqhelekileyo liyahluka. Kungathatha iinyanga ezimbini ukuya kwezintathu ukuze uphile ngokupheleleyo emva kotyando oluvulekileyo. Kungcono ukuphepha ukuphakamisa izinto ezinzima kwiiveki zokuqala ezi-4-6. Nangona ungabuyela kwimisebenzi eqhelekileyo malunga neeveki ezimbini emva kotyando lwe-TEVAR, kungcono ukuphepha imisebenzi enzima malunga neeveki ezine.
Zithini iingozi zolu tyando?
Nangona olu lutyando olusindisa ubomi, njengalo naluphi na utyando olukhulu, kukho iingozi ezithile ezibandakanyekileyo.
Kodwa khumbula into enye: Oogqirha bacebisa olu tyando kuphela xa umngcipheko wokufa ngenxa yokungatyandwa uphezulu kakhulu kunomngcipheko wotyando.
Ezinye zeengxaki ezinokubakho zezi:
- Ukopha kakhulu
- Ukuphazamiseka kokunikezelwa kwegazi kumqolo
- Ukuhlaselwa yintliziyo
- Iimeko ezichaphazelayo
- Ukusebenza kwezintso okungasebenzi kakuhle
- Iingxaki zokuphefumla ezifana ne-pneumonia
- Imeko efana nestroke
- Ubuthathaka kwimilenze
Zombini ezi ndlela zotyando ziphumelela kakhulu. Ingakumbi kwimeko yotyando lwe-TEVAR, izinga lempumelelo lokufakelwa kwe-stent liphezulu njenge-99%.
Kufuneka ndidibane nogqirha nini emva kotyando?
Emva kokuba ubuyele ekhaya, kufuneka wazise ugqirha wakho ngoko nangoko ukuba kukho naziphi na iimpawu zosulelo okanye iingxaki. Qaphela ngakumbi ezi mpawu zilandelayo.
| Uphawu ekufuneka luqwalaselwe | Inkcazo |
|---|---|
| Ifiva | Ukuba ubushushu bomzimba buyi-100.4 Fahrenheit (100.4°F) okanye ngaphezulu. |
| Utshintsho kwindawo yokusikwa | Ubomvu obugqithisileyo, ukudumba, okanye amaqhubu ajikeleze indawo etyumkileyo. |
| Intlungu engapheliyo | Intlungu ebuhlungu engapheziyo nangona usela amayeza okudambisa iintlungu. |
| Ukudumba | Ukudumba okungaqhelekanga kwindawo yotyando okanye emilenzeni. |
Ukuba unayo nayiphi na kwezi mpawu, musa ukuzityeshela kwaye funa ingcebiso kagqirha ngoko nangoko.
Umyalezo Wokuya Ekhaya
- I-aneurysm yesifuba yi-bulge efana nebhaluni ebangelwa kubuthathaka komthambo wegazi oyintloko womzimba.
- Injongo ephambili yolu tyando kukuthintela imiphumo esongela ubomi yokuqhekeka.
- Kukho iindlela ezimbini eziphambili zonyango: utyando oluvulekileyo kunye notyando lwe-TEVAR olungenasithintelo kangako.
- Iqela lezonyango liza kugqiba ukuba loluphi utyando olulungele wena.
- Ixesha lokuchacha emva kotyando liyahluka ngokuxhomekeke kuhlobo lotyando, kwaye kubaluleke kakhulu ukulandela imiyalelo yezonyango ngononophelo.
- Ukuba ufumana naziphi na iimpawu ezingaqhelekanga emva kotyando, yazisa ugqirha wakho ngoko nangoko.
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