Usenokuba uzibuza ukuba isifo sohlangothi sibi kangakanani na. Isizathu esiphambili sale nto kukuba umthambo obalulekileyo (umthambo we-carotid) kumacala omabini entamo yethu othwala igazi ukuya engqondweni uvalwa ngamanqatha. Kufana nokugqwala okwakheka ngaphakathi kumbhobho wamanzi uze uwuvale kancinci kancinci. Kodwa ungakhathazeki, ngoku kukho unyango oluphambili nolulula loku. Yiloo nto sithetha ngayo namhlanje.
Yintoni le nto kuthiwa lunyango lwe-TFCAS?
Ngamafutshane, iTransfemoral Carotid Artery Stenting (TFCAS) yinkqubo engaphantsi kakhulu esetyenziselwa ukuvula kwakhona umthambo we-carotid ovalekileyo entanyeni. Ibandakanya ukufaka ityhubhu encinci kakhulu efana ne-mesh, ebizwa ngokuba yi-stent, kumthambo ovalekileyo ukuze ivulwe kwakhona.
Cinga nje, imithambo ye-carotid emacaleni omabini entamo yethu yimithambo emibini ephambili ethwala ioksijini kunye nezondlo ebuchotsheni bethu, ebusweni, nasentanyeni. Ekuhambeni kwexesha, i-cholesterol kunye namafutha avela ekutyeni esikutyayo aqala ukuqokelelana eludongeni lwale mithambo. Siyibiza ngokuba yi-plaque. Oku kwakheka kwe-plaque kubangela ukuba iindonga zemithambo ye-artery ziqine kwaye zibe lukhuni (atherosclerosis). Ekugqibeleni, imithambo yegazi iyancitshiswa (stenosis). Xa oku kuhamba kwegazi kuthintelwe, ukuhanjiswa kwegazi ebuchotsheni kuncipha, okwandisa kakhulu umngcipheko we-stroke.
Kwi-TFCAS unyango, kufakwa ityhubhu ekhethekileyo (i-catheter) ngomngxuma omncinci kakhulu emqolo okanye engalweni yakho ize ikhokelwe kumthambo ovalekileyo entanyeni yakho. Emva koko kufakwa i-stent nge-catheter ukuze kuvulwe kwakhona umthambo. I-stent, njengepali yentente, inceda ukugcina umthambo ungaphinde udilike. Oku kubuyisela ukuhamba kwegazi ukuya engqondweni, kunciphisa umngcipheko we-stroke.
Ngubani ofuna olu nyango?
Olu nyango lunokucetyiswa ukuba ugqirha wakho ufumanise ukuba unesifo semithambo yegazi ebuhlungu. Ngamanye amaxesha usenokungabi nazimpawu konke konke. Nangona kunjalo, abanye abantu banokufumana iimpawu ezifana ne-mini-stroke (okanye i-transient ischemic attacks - ii-TIAs).
Kukho iindlela ezahlukeneyo zonyango lwe-carotid artery stenosis. Ugqirha wakho uya kukhetha unyango olukulungeleyo ngokusekwe kwimeko yakho yempilo, imilo ye-artery, kunye nendawo ekuyo i-stenosis.
Eyona nto ibalulekileyo kukuxoxa nogqirha wakho ukuba loluphi unyango olulungele wena.
| Indlela yonyango | Kwenzeka ntoni nje | Ingcali ekhethekileyo |
|---|---|---|
| I-TFCAS (indlela ekuxoxwe ngayo kweli nqaku) | Ukufaka i-stent emthanjeni osentanyeni kusetyenziswa ityhubhu efakwe ngaphakathi kwesisu okanye engalweni. | Akukho monakalo mkhulu. Ixesha lokuphiliswa lifutshane. |
| Utyando lweCarotid Endarterectomy (CEA) | Kwenziwa ukusika entanyeni, umthambo uyavulwa, kwaye umaleko wamafutha (i-plaque) oqokelelene apho uyasuswa. | Utyando lwesintu lwenziwa kubantu abaninzi. |
| I-Transcarotid Stenting (TCAR) | Kwenziwa umngxuma omncinci entanyeni ngaphezulu nje kwe-collarbone kwaye i-stent ifakwe ngqo kumthambo. | Ezinye izifundo zibonise ukuba inobungozi obuphantsi bokuhlaselwa sistroke kune-TFCAS. |
Ngubani unyango lwe-TFCAS olufaneleke kakhulu kuye?
Unyango lwe-TFCAS lunokuba ngcono kuwe kunotyando lwe-CEA ukuba unezi zinto zibalulekileyo:
- Ukuba umthambo uvalekile kwindawo engenakufikelelwa lula ngotyando.
- Ukuba unezinye iingxaki zempilo (iimeko ezingaqhelekanga) ezifana nesifo sentliziyo, isifo semiphunga, okanye ukutyeba kakhulu.
- Ukuba unezicwili entanyeni yakho ngenxa yotyando lwangaphambili okanye unyango lwemitha.
- Ukuba iintambo zakho zelizwi zonakele.
Uzilungiselela njani ngaphambi kotyando?
Ngaphambi kolu tyando, ugqirha wakho angakucela ukuba:
- Yenza uvavanyo lwegazi kunye nolunye uvavanyo lwempilo.
- Yenza uvavanyo lwe-echocardiogram okanye uvavanyo loxinzelelo ukuze ujonge ukusebenza kwentliziyo.
- Yenza uvavanyo lomfanekiso olufana ne-`carotid angiography`, `vascular ultrasound`, okanye `MRA` ukuze ubone apho umthambo uvalekile khona.
- Nika uluhlu lwamayeza kunye nezongezo ozisebenzisayo.
- Amayeza anjenge-aspirin anokumiselwa ukuthintela ukuqhekeka kwegazi.
- Musa ukutya okanye ukusela (ngokuzila ukutya) iiyure ezimbalwa ngaphambi kotyando.
Lwenziwa njani utyando? Inyathelo ngenyathelo
Olu tyando ludla ngokuthatha ngaphantsi kweeyure ezimbini kwaye lwenziwa liqela loogqirha abaqeqeshwe ngokukodwa.
| Amanyathelo | Kwenzekani? |
|---|---|
| 1. I-Anesthesia | Uhlala unikwa i-anesthesia epheleleyo. Unganikwa neyeza elincinci ukuze uthomalalise umsindo ngelixa uvukile. |
| 2. Ukufaka i-catheter | Ityhubhu ekhethekileyo (i-catheter) ikhokelwa ngomngxuma omncinci owenziwe emqolo ukuya kumthambo we-carotid entanyeni ngoncedo lwe-X-ray. |
| 3. Ukufaka isihluzi | Isihluzo esincinci sibekwa ngaphaya nje kokuvaleka ukuze kubanjwe nayiphi na iplaque enokuqhekeka ngelixa umthambo ukhuliswa. Oku kunciphisa umngcipheko westroke. |
| 4. Ukusebenzisa ibhaluni | Ibhaluni encinci ifakwa kwindawo evalekileyo ize ivuthe, nto leyo ecinezela umaleko wamafutha eludongeni lomthambo kwaye iwenze wande umthambo. Emva koko ibhaluni iyasuswa. |
| 5. Ukubeka i-stent | Ngoku, kufakwa i-stent ezikhulisayo kwindawo ebanzi. Oku kunceda ukugcina umthambo uvulekile. |
| 6. Ukugqiba | Isihluzo kunye ne-catheter ziyasuswa, kwaye umngxuma osesinqeni uvalwa ngesixhobo esikhethekileyo. |
Kwenzeka ntoni emva kotyando?
Emva kotyando, uza kubekwa esweni kwigumbi lokuchacha iiyure ezininzi. Emva koko kuya kufuneka uhlale esibhedlele ubusuku bonke.
- Uza kunikwa amayeza okuthomalalisa iintlungu ngenxa yokungonwabi onokuba nako.
- Ugqirha wakho uza kukuxelela ukuba uthathe amayeza okunciphisa iiplatelet (umz., i-Aspirin, i-Clopidogrel) ubomi bakho bonke ukuthintela ukuqhekeka kwegazi kwindawo ye-stent.
Uninzi lwabantu lunokubuyela ekhaya bevela esibhedlele emva kweeyure ezingama-24. Kunokubakho imikrwelo, ukudumba, kunye nentlungu encinci kwindawo yokusikwa kangangeentsuku ezimbalwa.
Ziziphi iingenelo kunye neengozi zale ndlela yonyango?
Iinzuzo
- Umngcipheko wesifo sohlangothi onciphileyo: Njengoko ukuhamba kwegazi engqondweni kubuyiselwa, umngcipheko wesifo sohlangothi uncitshiswa kakhulu.
- Ukusikwa okuncinci: Akukho kusikwa okukhulu, ngoko ke iintlungu azinciphi, umngcipheko wosulelo, kunye namanxeba.
- Ukuchacha ngokukhawuleza: Ungaqhubeka nemisebenzi yakho yesiqhelo kwiintsuku ezimbalwa.
Iingozi
Njengakwezinye iintlobo zotyando, kukho umngcipheko omncinci, kodwa umngcipheko weengxaki ezinkulu ungaphantsi kwe-3%.
- I-Restenosis: Kunqabile kakhulu ukuba izicubu ezibomvu zikwazi ukwakheka phantsi kwe-stent kwaye zinciphise umthambo kwakhona.
- Istroke: Ngexesha lotyando, iziqwenga zamafutha zinokuqhekeka zize zivale umthambo wemithambo-luvo engqondweni. Nangona kunjalo, le ngozi incitshiswa kakhulu sisihluzo esixoxe ngaso ngaphambili.
- Ukuhlaselwa yintliziyo
- Ukopha okanye usulelo
Udinga nini ukubona ugqirha?
Ukuba ufumana naziphi na ezi mpawu xa ubuyela ekhaya emva kotyando , fowunela ugqirha wakho ngoko nangoko.
- Ukuba uziva umkhuhlane okanye umkhuhlane
- Ukuba isicaphucaphu nokuhlanza kuphelile
- Ukuba indawo eqatywe kuyo ibomvu, idumbile, okanye ikhupha ulwelo olumthubi (iimpawu zosulelo)
Okubaluleke kakhulu: Ukuba ufumana iimpawu zestroke, ezifana nokuthetha okungacacanga, ubuthathaka kwelinye icala lomzimba, ukugoba kobuso, okanye utshintsho embonweni, yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele ngokukhawuleza ngaphandle kokulibazisa.
Umyalezo Wokuya Ekhaya
- I-TFCAS yinkqubo ephucukileyo nengenabungozi kangako esetyenziselwa ukuvula imithambo evalekileyo entanyeni nokunciphisa umngcipheko westroke.
- Olu nyango alufanelekanga kuye wonke umntu. Xoxa nogqirha wakho ukuba loluphi unyango olulungele wena.
- Kubaluleke kakhulu ukugcina indlela yokuphila esempilweni (ukutya okunempilo, ukuzilolonga, kunye nokuyeka ukutshaya) kwaye uthabathe amayeza akho owanikwe ngugqirha njengoko uyalelwe emva kotyando.
- Ukuqaphela iimpawu ezilumkisayo ezinokwenzeka emva kotyando, ingakumbi iimpawu zestroke, kunokunceda ukusindisa ubomi bakho.
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