Khawucinge ukuba bekuya kwenzeka ntoni ukuba ihlwili legazi livale ngequbuliso umthambo omkhulu wegazi okhokelela entliziyweni yakho, ebuchotsheni, okanye emiphungeni? Oku kuya kuyithintela indlela igazi elihamba ngayo kuloo malungu omzimba kwaye kubangele umonakalo. Le yimeko esongela ubomi. Kukwimeko engxamisekileyo apho oogqirha basebenzisa unyango olukhethekileyo ukusindisa ubomi. Namhlanje, sithetha ngonyango olunyibilikisa luze lususe loo mahlwili egazi, olubizwa ngokuba yi-'Thrombolytic Therapy.'
Ngamafutshane, yintoni iThrombolytic Therapy?
Nangona eli gama liyinkimbinkimbi kancinci, le ngcamango ilula kakhulu. Ngamafutshane, oku kuquka ukusebenzisa uhlobo oluthile lonyango ukunyibilikisa nokususa amahlwili egazi ayingozi asele enziwe kwimithambo yegazi emizimbeni yethu. Kufana nokunyibilikisa nokususa isiciko kumbhobho wamanzi ngekhemikhali.
Injongo ephambili yolu nyango kukubuyisela ukuhamba kwegazi okuvalwe yi-blood clot. Oku kunokunciphisa umonakalo kwizitho zomzimba (ezifana nentliziyo nengqondo) ezinikezelwa yiloo mthambo wegazi. Olu lunyango olunikezelwa kwiimeko ezingxamisekileyo. Olu nyango lunokusindisa ubomi, ingakumbi kwiimeko ezifana nokuhlaselwa yintliziyo (`(Myocardial Infarction)`), istroke esibangelwa kukuvaleka komthambo wegazi engqondweni (`(Ischemic Stroke)`), okanye i-blood clot emiphungeni (`(Pulmonary Embolism)`).
Eyona nto ibalulekileyo kukuqala olu nyango ngokukhawuleza. Unyango luqala ngokukhawuleza emva kokuba iimpawu ziqalile, kokukhona iziphumo zingcono.
Ngubani ofuna olu nyango? Kwaye ngubani ongafanele alufumane?
Olu asilonyango olunokunikwa wonke umntu. Oogqirha baqwalasela izinto ezininzi ngaphambi kokuba banike umntu olu nyango. Kuba lunemingcipheko ethile. Makhe sibone ukuba olu nyango lufanelekile nini kwaye alufanelekanga nini.
| Iimeko apho unyango lunokufuneka khona | Amatyala apho unyango lungafanele lunikwe (ngenxa yomngcipheko omkhulu) |
|---|---|
| Ukuba umthambo omkhulu wegazi (umthambo okanye umthambo) uvalwe ngequbuliso lihlwili legazi. | Ukuba sele kukho ukopha okusebenzayo emzimbeni. |
| Kwiimeko ezifana ne-deep vein thrombosis (DVT) kunye ne-pulmonary embolism (PE), ezingenakulawulwa ngee-blood thinners eziqhelekileyo (i-anticoagulants). | Ukuba kutshanje ukhe wopha ubuchopho (Intracranial Hemorrhage). |
| Kwiiyure zokuqala emva kokuhlaselwa yintliziyo okanye isifo sohlangothi. | Ukuba usandul’ ukwenziwa utyando lobuchopho okanye lomqolo. |
| Ukuba kwenzeka imeko engxamisekileyo ngenxa yokuvaleka kwemithambo yegazi emalungeni (iPeripheral Arterial Disease - PAD). | Ukuba une-high blood pressure engalawulekiyo (uxinzelelo lwegazi oluphezulu). |
| Ukuba i-catheter efakwe emzimbeni ivalwe lihlwili legazi. | Ukuba unesifo sezintso esinzulu. |
| Ukuba usandul’ ukwenzakala entloko kakhulu. |
Ukongeza, oogqirha baxhalabile ngakumbi ngomngcipheko weengxaki xa benika olu nyango koomama abakhulelweyo nakubantu abadala.
Ziziphi iintlobo eziphambili zolu nyango?
Kukho iindlela ezahlukeneyo zokunika eli yeza lokuqunjelwa kwegazi. Ugqirha uya kukhetha eyona ndlela ifanelekileyo ngokusekwe kwimeko yesigulana kunye nendawo apho iqunjelwe khona igazi.
1. I-Systemic Thrombolysis
Le yeyona ndlela isetyenziswa kakhulu. Apha, ityhubhu ye-IV ifakwa emthanjeni osengalweni, njenge-saline drip, kwaye iyeza linikwa ngayo. Eli yeza lihamba kuyo yonke inkqubo yokujikeleza kwegazi, apho linyibilikisa khona ihlwili legazi. Le ndlela idla ngokusetyenziswa kwiimeko ezingxamisekileyo ezifana nokuhlaselwa yintliziyo, istroke, kunye namahlwili egazi emiphungeni.
2. I-Thrombolysis elawulwa yiCatheter
Le ndlela yahlukile kancinci. Apha, kufakwa umbhobho omncinci kakhulu, omde (oku kubizwa ngokuba yi-catheter) emzimbeni ngomthambo osesinqeni, entanyeni, okanye engalweni. Emva koko, kusetyenziswa indlela efana ne-X-ray, incam yale catheter ikhokelwa kwindawo echanekileyo apho igazi liqhekeka khona. Emva koko, endaweni yokunika iyeza kuwo wonke umzimba, lifakwa ngqo kwi-blood clot nge-catheter. Oku kuvumela ukuba iyeza linikwe ngendlela exineneyo, ngqo kwindawo ekujoliswe kuyo. Le ndlela isetyenziswa kakhulu kwiimeko ezifana ne-DVT kunye ne-PAD. Oku kudla ngokwenziwa kwangaphambili.
3. Utyando lweThrombectomy yoMechanical
Kule meko, ukongeza ekunikezeni amayeza, ihlwili legazi liyaqhekeka lize lisuswe ngoomatshini. Isixhobo esikhethekileyo (isixhobo esingcangcazelayo, esijikelezayo, okanye esifunxa ihlwili legazi) esisekupheleni kwe-catheter sisetyenziselwa ukuqhekeza ihlwili legazi size silisuse libe ziingceba. Ngamanye amaxesha le ndlela isetyenziswa kunye nendlela elawulwa yi-catheter.
Kwenzeka ntoni ngexesha nasemva konyango?
Indlela olu nyango oluqhutywa ngayo iya kwahluka ngokuxhomekeke kuhlobo olufumanayo.
Kwimeko yongxamiseko
Ukuba unemeko engxamisekileyo, efana nokuhlaselwa yintliziyo okanye isifo sohlangothi, oogqirha baya kuzama ukuqala unyango ngokukhawuleza emva kokuba ungeniswe kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele. Ukuze ufumane iziphumo ezilungileyo, kubalulekile ukuqala unyango kwiiyure ezimbini emva kokuba iimpawu ziqalile, okanye kwimizuzu engama-30 emva kokufika esibhedlele.
Indlela unyango olwenziwa ngayo
Makhe sibone ukuba kwenzeka ntoni kwezi ndlela zimbini ziphambili.
| I-systemic thrombolysis (nge-IV) | I-thrombolysis ekhokelwa yi-catheter (nge-catheter) |
|---|---|
| Oku kudla ngokwenziwa kwiyunithi yokhathalelo oluphezulu (ICU). | Oku kukwayinto eyenziwa kwicandelo elikhethekileyo ngaphakathi esibhedlele. |
| Baza kukunika isithomalalisi esincinci ukuze uzole. Baza kuyivala indawo apho kufakwe khona i-IV. | Uza kunikwa iyeza lokuthomalalisa umsindo. Indawo apho kuza kufakwa khona i-catheter (ingqumbo, ingalo) iza kuba ne-numbness. |
| Ityhubhu ye-IV ifakwa kumthambo osengalweni kwaye iyeza lithunyelwa ngayo emzimbeni. | Kwenziwa ukusika okuncinci, kufakwa i-catheter emthanjeni, kwaye ihlwili legazi likhokelwa kwindawo apho ihlwili likhona. |
| Eli yeza lihamba emzimbeni wonke kunye negazi lize lifikelele kwihlwili legazi. | Eli yeza lifakwa ngqo kwihlwili legazi. Ngamanye amaxesha ihlwili liyaqhekeka ngesixhobo somatshini. |
| Le nkqubo idla ngokuthatha malunga neyure. | Kungathatha ukuya kuthi ga kwiiyure ezingama-48 (iintsuku ezimbini) ukuba ihlwili legazi linyibilike ngokupheleleyo. Ngeli xesha, uza kubekwa esweni esibhedlele. |
Ngexesha lonyango, iqela lezonyango liza kuqhubeka nokujonga izinto ezifana nesantya sentliziyo yakho, ukusebenza kwemiphunga, kunye noxinzelelo lwegazi.
Emva konyango
Ugqirha uza kwenza iimvavanyo ezininzi ukuze abone ukuba ihlwili legazi linyibilike ngokupheleleyo na.
- I-Angiogram
- Iskeni ye-CT
- I-Echocardiogram
Emva konyango, kuya kufuneka uhlale kwigumbi labagula kakhulu (ICU) kangangeentsuku ezimalunga ne-1. Emva koko, kuya kufuneka uhlale esibhedlele olunye usuku ukuya kwezintathu phantsi koqwalaselo. Nokuba sele ubuyele ekhaya, kuya kufuneka uqhubeke nokusela amayeza okunciphisa igazi ukuthintela ukwakheka kwamahlwili egazi kwakhona.
Ziziphi iingenelo kunye neengozi zale ndlela yonyango?
Njengalo naluphi na unyango lwezonyango, olu lunezibonelelo kunye neengozi.
Iingenelo eziphambili:
- Amandla okusindisa ubomi: Le yeyona nzuzo inkulu. Olu nyango lunokunceda ekuthinteleni ukufa kwiimeko ezifana nokuhlaselwa yintliziyo kunye nokubetha kwentliziyo.
- Ukuthintela ukukhubazeka okusisigxina: Ngokunciphisa umonakalo engqondweni, kunokwenzeka ukuthintela ubunzima bokuthetha kunye nokulahlekelwa ngamalungu omzimba emva kwestroke.
- Ukuthintela ukunqunyulwa kwethambo: Ukuba umthambo omkhulu engalweni okanye emlenzeni uvalekile, loo nxalenye yomzimba inokufa ngaphandle kokuhamba kwegazi. Olu nyango lunciphisa loo mngcipheko.
Iingozi eziphambili:
Eyona ngozi inkulu neyona inzima yolu nyango kukuba kungenzeka ukuba igazi liphume ngaphakathi emzimbeni.
- Ukopha kwegazi ebuchotsheni: Le yeyona ngxaki iyingozi kakhulu. Malunga ne-1% yabantu abafumana olu nyango banokufumana isifo sohlangothi ngenxa yokopha kwegazi ebuchotsheni.
- Okunye ukopha: Usenokopha empumlweni, ngendle yakho, okanye ngomchamo wakho. Usenokopha okanye ukopha apho kufakwe khona i-IV okanye i-catheter.
- Ezinye iingozi:
- Iimpendulo ze-allergy
- Ukonakala kwezintso (ingakumbi kubantu abanesifo seswekile)
- Uxinzelelo lwegazi oluphantsi (`(Hypotension)`)
- Ihlwili legazi liyaqhekeka lize liye kwenye indawo lize libhajwe.
- Ukuphazamiseka kwesantya sentliziyo (`(Ventricular arrhythmia)`)
Ngenxa yezi ngozi, oogqirha baqwalasela izinto ezininzi ngaphambi kokuba banike umntu olu nyango.
Ndifanele ndimbone nini ugqirha emva konyango?
Wakuba ubuyele ekhaya, kubalulekile ukuba uqaphele iimpawu ezithile. Ukuba ufumana naziphi na iimpawu ezingezantsi, kufuneka wazise ugqirha wakho ngoko nangoko.
| Iimpawu ekufuneka uziqaphele | Inkcazo |
|---|---|
| Iintlungu zesifuba | Intlungu yesifuba ekhawulezileyo okanye eyandayo. |
| Utshintsho kwindawo yokufaka i-IV/catheter | Ukuba indawo iyaqhubeka nokopha okanye ukuphuma kwegazi, iba bomvu, ivakala ishushu, okanye idumbile/intlungu eyandayo. |
| Ifiva | Ukuba ufumana umkhuhlane ngaphandle kwesizathu. |
| Intloko ebuhlungu okanye isicaphucaphu | Ukuba intloko yakho iya isiba mandundu, ibuhlungu kakhulu okanye isicaphucaphu. |
| Ukungabi nangqondo kwamalungu | Ukuba uziva urhawuzelelwa okanye ungenamthungo ezandleni okanye emilenzeni. |
Ezi mpawu zinokubonisa ingxaki, ngoko ke musa ukuzityeshela.
Umyalezo Wokuya Ekhaya
- Unyango lwe-Thrombolytic lunyango olubaluleke kakhulu olunokusindisa ubomi ngokunyibilikisa amahlwili egazi kwiimeko ezingxamisekileyo ezifana nokuhlaselwa yintliziyo kunye nokubetha kwentliziyo.
- Ixesha libaluleke kakhulu kwimpumelelo yolu nyango. Ukuya esibhedlele kwangoko nje xa iimpawu zibonakala kunokuyiphucula kakhulu imiphumo.
- Ekubeni ingozi enkulu yoku kukuphuma kwegazi, oogqirha baya kugqiba ekubeni bakunike olu nyango kuphela emva kokuba behlolisise imeko yakho ngononophelo.
- Emva konyango, kubaluleke kakhulu ukulandela imiyalelo kagqirha wakho ngokuchanekileyo, ingakumbi ukuthatha amayeza okunciphisa igazi, ukuthintela ukuqhekeka kwegazi kwixesha elizayo.
- Xa ubuyela ekhaya emva konyango, yazisa ugqirha wakho ngoko nangoko ngazo naziphi na iimpawu ezingaqhelekanga ozifumanayo.
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