Masifunde ngakumbi ngeVenous Thromboembolism (VTE) ngoko nangoko.

Ngaba wakha wazibuza ukuba igazi elihamba ngemithambo yethu ngamanye amaxesha linokunamathela njani kwindawo enye lize lenze amahlwili? Oku kusenokuvakala kuyoyikisa, kodwa kubaluleke kakhulu ukukwazi oku. Kuba kulapho kuphela apho sinokuthatha khona amanyathelo ngokukhawuleza ukuba kuyimfuneko. Namhlanje sithetha ngehlwili legazi emthanjeni, imeko oogqirha abayibiza ngokuba yi-`(Venous Thromboembolism - VTE)`.

Yintoni i-Venous Thromboembolism (VTE)?

Ngamafutshane, `(I-Venous Thromboembolism)` kuxa ihlwili legazi lenzeka ngaphakathi komthambo emzimbeni wethu, uhlobo lomthambo oluthwala igazi elingcolileyo ukuya entliziyweni, luthintela ukuhamba kwegazi. Apha, igama elithi "Thrombo" lithetha ihlwili legazi. Igama elithi "Embolism" lithetha xa ihlwili legazi elinjalo lihamba ngemithambo yegazi lize libambeke ndaweni ithile. Igama elithi "Venous" lithetha emithanjeni.

Xa oogqirha bethetha nge-VTE, bathetha kakhulu ngeentlobo ezimbini zamahlwili egazi:

1. I-Deep Vein Thrombosis (DVT): Oku kwenzeka xa igazi liqhekeka kwimithambo enzulu ehamba ngemisipha, ngaphakathi emzimbeni.

2. I-Pulmonary Embolism (PE): Oku kwenzeka xa igazi liphuma kwi-DVT okanye i-blood clot evela kwenye indawo iphuma ize ihlale emthanjeni emaphashini.

Cinga nje, le mithambo ibuyisela igazi entliziyweni isuka kwiindawo ezikude zomzimba wethu, njengeengalo zethu. Ngoko ke, xa umthambo uvalwa lihlwili legazi, igazi liqala ukuhlangana ngasemva kwendawo evalekileyo. Emva koko loo ndawo inokudumba ize ivuvuke. Kwakhona, iiseli eziphambi kwendawo evalekileyo azifumani ioksijini kunye nezondlo ezizidingayo. Oku kunokubangela umonakalo omkhulu kwimithambo, kwizicubu, kwanakwizitho zomzimba. Kwezinye iimeko, umzekelo, ukuba umthambo othwala igazi emiphungeni uvalwa yi-"VTE", unokuba yingozi ebomini .

Kwenzeka njani ukuba amahlwili egazi avele kwimithambo enje?

Enyanisweni, ukujiya kwegazi yindlela eqhelekileyo nesempilweni yomzimba wethu. Ungacinga ngayo njengerhashalala eyenzeka xa inxeba elincinci phezu kolusu lwethu loma kwaye igazi elincinci liphuma. Yiyo loo nto. Xa kukho ukwenzakala emzimbeni, nokuba lusulelo, igazi liyaqina kancinci ukuze lithintele ukuphuma kwegazi. Nokuba lolusulelo, ulwelo lomthambo wegazi luphathwa ngokungathi lulinxeba.

Ngokwesiqhelo, xa inxeba okanye usulelo luqala ukuphola, ihlwili legazi liyanyibilika. Kodwa ngamanye amaxesha, oko akwenzeki . Okanye, amahlwili egazi anokwakheka ngaphandle kokwenzakala. Oku kunokubangelwa zizinto ezininzi. Kwiimeko ezinjalo, ukuba ihlwili legazi likhulu ngokwaneleyo, linokuvala ngokupheleleyo umthambo.

La mahlwili egazi achaphazela njani umzimba wakho?

Abantu abaninzi bacinga ukuba xa becinga nge-blood clot, kuthetha i-blood clot ebangela "i-Heart Attack" okanye "i-Stroke." Nangona kunjalo, i-"VTE" ayilohlobo lwe-blood clot oluhlala luvela kwimithambo yegazi (imithambo ethwala igazi lisuka entliziyweni liye emzimbeni wonke). Nangona kunjalo, inokuba yingozi efanayo .

Eyona ngxaki inzima kukuba xa i-VTE, okanye ihlwili legazi, liphuma kwindawo elivela kuyo, lihamba ngegazi, lize lihlale emithanjeni yemiphunga . Oku kubizwa ngokuba yi-Pulmonary Embolism (PE). I-PE ithintela ukuhamba kweoksijini negazi ukuya emiphungeni. Kwangaxeshanye, uxinzelelo lwegazi kwimithambo luyanda. Le meko ibizwa ngokuba yi-Pulmonary Hypertension. Ukuba oku kuyaqhubeka, ukusilela kwentliziyo kunye nokufa kunokwenzeka.

I-VTE idla ngokuvela kwimithambo enzulu yomzimba wethu, ingakumbi emilenzeni okanye ezingalweni okanye kwimithambo engaphakathi kwimisipha. Xa ihlwili legazi lenzeka kwimithambo enzulu, libizwa ngokuba yi-Deep Vein Thrombosis (DVT). Xa i-DVT ivala umthambo, inokubangela ukudumba, ukudumba, kunye nokubomvu, okunokonakalisa umthambo kwixesha elide. Oku kunokukhokelela kwimeko ebizwa ngokuba yi-Chronic Venous Insufficiency okanye i-Post-thrombotic Syndrome. Ayizizo zonke ii-DVT ezivala umthambo, kodwa ziyakwazi, ngoko ke zihlelwa njenge-Venous Thromboembolic Disease. Kubalulekile ukukhumbula ukuba ukuba ihlwili legazi liyaqhekeka lize liye emiphungeni, linokubangela i-PE.

Yintoni umahluko phakathi kwe-'Thrombosis' (ihlwili legazi) kunye ne-'Thromboembolism' (ukuvaleka kwehlwili legazi kwi-circulation yegazi)?

Ngamafutshane, `(Thrombosis)` ithetha ihlwili legazi. `(Thromboembolism)` ithetha ihlwili legazi elihamba ngegazi lize libambeke ndaweni ithile, lithintele ukuhamba kwegazi. `(Deep Vein Thrombosis - DVT)` kunye `(Pulmonary Embolism - PE)` zombini ziwela phantsi kwesambulela `(Venous Thromboembolic Disease)`. Kuba zombini ezi zinto zinokuthintela ukuhamba kwegazi kwimithambo yegazi.

I-superficial venous thrombosis (SVT) yi-blood clot eyenzeka kwimithambo emincinci, engaphezulu kufutshane nomphezulu wolusu, kwaye ayinakwenzeka ukuba ibangele iingxaki ezinkulu. Nangona malunga nesiqingatha se-DVTs zingabangela iingxaki, kufuneka ziqwalaselwe kuba zinokubangela iingxaki kwaye zingumngcipheko kwi-PE.

Ixhaphake kangakanani le meko ibizwa ngokuba yi-`VTE`?

Kwanakwamanye amazwe aphuhlileyo ehlabathini, `(VTE)` sesona sifo sesithathu esixhaphakileyo semithambo yegazi emva kwe`(Heart Attack)` kunye`(Stroke)`. Oku kuthetha ukuba le meko ichaphazela malunga nomntu omnye kwabayi-1000 ngonyaka. Malunga nesiqingatha sabo baphuhlisa `(VTE)` nabo baphuhlisa `(Pulmonary Embolism - PE)`. Kwakhona, malunga nama-25% abo baphuhlisa `(PE)` bayafa. Kuthiwa kwakhona umngcipheko wophuhlisa `(VTE)` uphindaphindeka kabini rhoqo emva kweminyaka engama-40 .

Ngubani osengozini enkulu yokuphuhlisa i-VTE?

Enyanisweni, nabani na unokufumana i-VTE. Nangona kunjalo, kukho izinto ezithile ezonyusa umngcipheko. Cinga ukuba malunga ne-25% ukuya kwi-50% yeemeko ze-VTE zenzeka ngaphandle kwesizathu esicacileyo. Ezinye i-20% zinxulumene nomhlaza. Ezinye i-20% zinxulumene notyando. Kwakhona, abanye abantu baneengxaki zokujiya kwegazi, ezenza ukuba babe namathuba amaninzi okuba negazi elijiyileyo.

Zithini izizathu ze-VTE?

Zininzi izizathu zokuba kwenzeke amahlwili egazi. Nangona kunjalo, kunzima ukutsho ngokuqinisekileyo ukuba ihlwili legazi liya kukhula ngokwaneleyo ukuvala umthambo okanye liqhekeke lize liye emiphungeni. Abantu abafumana i-VTE badla ngokuba nezinto ezingaphezu kwesinye ezinokubangela umngcipheko.

Abanye abantu banokungalingani kweeproteni egazini labo ezinceda ukujiya kwegazi (`(Thrombophilia)`). Oku kunokubangela ukuba igazi labo lijiye lula kwaye kwenze kube nzima ukunyibilikisa amahlwili asele enziwe. Oku kunokuba yimfuza, okanye kungaba yimpembelelo embi yesinye isifo.

Ngamanye amaxesha, xa umzimba ungashukumi, oko kukuthi, xa ungashukumi , ukuhamba kwegazi emithanjeni kuyehla kwaye kunokwenziwa amahlwili egazi. Khawucinge nje, xa useluhambeni olude, xa ukwindawo efanayo iiyure ezininzi ebhasini okanye kuloliwe, okanye xa uhleli esitulweni imini yonke eofisini, okanye xa ugula kwaye ulele ebhedini, le ngozi ikhona.

Eyona nto ixhaphakileyo ebangela ukuqhekeka kwegazi kukwenzakala okanye usulelo. Ngamanye amaxesha, oku kwenzakala kubangelwa lunyango lwezonyango. Umzekelo, kunokwenzeka ngexesha lotyando, i-chemotherapy yomhlaza, okanye xa kufakwa umgca we-IV (intravenous liquid) engalweni okanye kufakwa i-catheter. Abantu abahlala esibhedlele ixesha elide basengozini enkulu yokuqhekeka kwegazi. Oku kungenxa yokuba bayaphola emva kokwenzakala okanye usulelo, bafumana unyango oluqatha, kwaye bachitha ixesha elininzi ebhedini yesibhedlele.

Zeziphi izinto ezonyusa umngcipheko we-VTE?

Nazi ezinye izinto ezinokunyusa umngcipheko wakho wokufumana i-VTE:

• Ukulimala emthanjeni ngenxa yokuphuka okanye utyando.
• Iimeko ezibangela usulelo.
• Ukujikeleza kwegazi okunciphileyo ngenxa yokuhlala ungashukumi kwindawo enye ixesha elide.
• Iimeko zemfuza ezidluliselwa kwizizukulwana ngezizukulwana kunye nembali yosapho ye-VTE.
• Amanqanaba aphezulu ehomoni `(i-Estrogen)` ngenxa yokukhulelwa, ukusetyenziswa kweepilisi zokulawula ukuzalwa, okanye unyango lokutshintshwa kweehomoni (`(uNyango loTshintsho lweeHormone)`).
• Izifo zokuqunjelwa kwegazi, umzekelo `(Isifo seFactor V Leiden)`, `(I-Polycythemia Vera)` kunye `(Isifo seSickle Cell)`.
• Ezinye izifo ezingapheliyo, umzekelo umhlaza, isifo sentliziyo, kunye neSifo sokudumba kwamathumbu (IBD).
• Izinto ezibangela indlela yokuphila, oko kukuthi, ukutshaya, ukutyeba kakhulu, kunye nokungazilolongi.
• Ubudala (i-VTE ixhaphake kakhulu kubantu abadala. Oku kusenokubangelwa kukuxhaphaka kwezifo ezihambisana noko kunye nezinto ezingalunganga kwindlela yokuphila phakathi kwabo).

Zithini iimpawu ze-`VTE`?

Ukuba umthambo uvalekile ngenxa ye-deep vein thrombosis (DVT), iimpawu zinokuvela kwindawo apho igazi liqhekeke khona. Ezi ziquka:

• Ukudumba (ingakumbi emlenzeni okanye engalweni enye)
• Ububomvu
• Ukuziva ufudumele xa uchukumisa loo ndawo
• Intlungu (ingakumbi xa umi okanye uhamba)

Iimpawu ze-``(PE)``, oko kukuthi, ihlwili legazi emiphungeni, zinokuvela ngequbuliso, ngamanye amaxesha ngaphandle kweempawu zangaphambili ze-``(DVT)``. Ezi mpawu ziquka:

• Intlungu yesifuba (ingakumbi xa uphefumla nzulu)
• Ubunzima bokuphefumla (ukuqala ngequbuliso)
• Ukunyuka kwesantya sentliziyo
• Ukwanda kwesantya sokuphefumla
• I-Vertigo (ukuziva ngathi uyajikeleza)
• Ukulahlekelwa yingqondo
• Ukubila okanye ukuziva ubanda
• Ukukhohlela igazi

Kubalulekile: Ukuba unayo nayiphi na kwezi mpawu, kubaluleke kakhulu ukufuna ingcebiso kagqirha ngoko nangoko , kuba ezi zinokuba ziimpawu zesifo esinzulu.

Ifunyaniswa njani i-'VTE'?

Kukho ezinye iimeko ezineempawu ezifanayo neze-DVT kunye ne-PE. Ukuqinisekisa ukuba unesifo se-Venous Thromboembolic Disease, ugqirha wakho uya kukubuza ngembali yakho yezonyango, achonge izinto ezinokubangela i-VTE, aze akhuphe ezinye iimeko. Banokwenza uvavanyo olusisiseko lwegazi ukukhangela iimpawu zokuqhekeka kwegazi. Emva koko baya kusebenzisa iimvavanyo zomfanekiso, ezifana neeskeni, ukufumana indawo apho kuqhekeka khona igazi.

Zeziphi iimvavanyo ezisetyenziselwa ukuxilonga i-`VTE`?

Kwenziwa uvavanyo olwahlukeneyo ukuze kufunyaniswe `(DVT)` kunye `(PE)`.

Uvavanyo olufumanisa i-'DVT'

• Uvavanyo lwegazi: Kukho uvavanyo lwegazi olubizwa ngokuba luvavanyo lwe-D-dimer. Olu vavanyo lulinganisa inqanaba lento ekhutshwayo xa amahlwili egazi eqhekeka. Ukuba inqanaba lale nto liphezulu, linokuba luphawu lwehlwili legazi. Uvavanyo lwegazi lunokwenziwa ukuze kulinganiswe inqanaba leoksijini egazini kunye nokujonga iingxaki zokuqhekeka kwegazi ezizuzwe njengelifa.
• I-Vascular ultrasound: Olu luvavanyo lokujonga olungenabuhlungu. Ngokuqhelekileyo lukhetho lokuqala ukujonga imithambo kunye nendlela igazi elihamba ngayo kuyo. Ngamanye amaxesha ibizwa ngokuba yi-duplex ultrasound kuba inamacandelo amabini. Kwinxalenye yokuqala, ugqirha usebenzisa isixhobo esifana nenduku yokuqondisa amaza esandi kwimithambo kunye nokufumana imifanekiso kwiscreen. Umthambo ungacinezelwa ukuze ubone ukuba uyancipha ngokwesiqhelo okanye ukuba uvalwe lihlwili legazi. Kwinxalenye yesibini, amaza esandi aqondiswe ukuba abone indlela igazi elihamba ngayo kwimithambo. Xa igazi lihamba ngokwesiqhelo, amaza esandi ayatshintsha ngesiganeko esibizwa ngokuba yi-Doppler effect.
• I-MR venography:Indlela ebizwa ngokuba yiMagnetic Resonance Imaging (MRI) inokuthenjwa ngakumbi kune-ultrasound yokuvavanya imithambo kwiindawo ezifana nesisu, isifuba, kunye ne-pelvis. Kwi-MR venography, amaza e-radiofrequency asetyenziselwa ukubona amahlwili egazi. Kolu vavanyo, uya kulala phantsi kumatshini we-MRI oqhelekileyo. Unganikwa nedayi ekhethekileyo ukunceda imithambo ibonakale ngokucacileyo.
• I-venography yokwahlulahlula: Olu luvavanyo lwe-X-ray oluqhelekileyo. Kwakhona, idayi yokwahlulahlula ifakwa emthanjeni ukuze imithambo ibonakale ngakumbi kwimifanekiso. Nangona ingena kancinci kunezinye iimvavanyo zokuthatha imifanekiso, ithathwa njengechanekileyo ngakumbi. Oku kungenziwa ukuba ezinye iimvavanyo azinasiphumo. Ingcali ye-X-ray ifaka ityhubhu encinci kwenye yemithambo yakho emikhulu, iyikhokele kwicala elifanelekileyo, ifake idayi yokwahlulahlula, ize emva koko ithathe i-X-ray.

Uvavanyo olufumanisa i-'PE'

• I-pulse oximetry: Ukuba iimpawu zakho zibonisa i-PE, ugqirha wakho unokuqala ngokulinganisa inqanaba le-oksijini egazini lakho ngokubeka i-pulse oximetry sensor kwincam yeminwe yakho. Ukuba inqanaba le-oksijini liphantsi, kusenokwenzeka ukuba kungenxa ye-PE okanye enye imeko yemiphunga okanye yentliziyo.
• I-X-ray yesifuba: Nangona i-X-ray yesifuba ingenakukwazi ukufumanisa i-PE, inokuchonga ezinye iimeko zemiphunga okanye zentliziyo ezinokubangela iimpawu zakho.
• I-CT pulmonary angiography (CTPA): Olu luvavanyo oluqhelekileyo lokufumanisa i-PE. I-CT scan ivelisa imifanekiso ye-three-dimensional (3-D) yemithambo kunye nemithambo yegazi emiphungeni yakho. Igama elithi "Pulmonary" lithetha ukuba linxulumene nemiphunga, kwaye elithi "angiography" yi-X-ray yemithambo yegazi. I-CTPA ayihlaseli, kodwa inokufuna ukufakwa kwedayi yomahluko emthanjeni.
• I-angiogram yemiphunga: Ukuba ezinye iimvavanyo azinasiphumo, i-angiogram yendabuko yemiphunga inokubonelela ngeziphumo eziqinisekileyo. Nangona kunjalo, ingena kancinci. Kule angiogram, ingcali ye-X-ray ifaka ityhubhu kwenye yemithambo yakho emikhulu, iyifake esifubeni sakho, ifake idayi yokwahlulahlula, ize emva koko ithathe i-X-ray.

Ziziphi iindlela zonyango ze-VTE?

Iindlela zonyango lwe-`(Venous Thromboembolism)` zixhomekeke ekubeni ihlwili legazi liyingozi kangakanani. Ezinye iimeko ze-`(DVT)` zinokulawulwa ngamayeza omlomo. Nangona kunjalo, ezinye iimeko ze-`(PE)` zinokufuneka zisuswe ngokukhawuleza . Ugqirha wakho unokususa i-`(PE)` esongela ubomi nge-catheter efakwe ngemithambo, okanye angafaka iyeza le-`(thrombolytic)` eliyinyibilikisa ngokukhawuleza ihlwili legazi. Nangona kunjalo, ngenxa yeengxaki ezinokubakho, ukungenelela okunjalo kwenziwa kuphela kwiimeko ezingxamisekileyo.

Ukuba i-VTE ayisongeli ubomi ngoko nangoko, unyango lugxile ekuthinteleni amahlwili akhoyo ukuba angabi makhulu kwaye luthintele ukwakheka kwamahlwili amatsha. Olu hlobo lonyango lokuthintela luquka amayeza anciphisa igazi, angamayeza anciphisa igazi, kunye neesokisi zokucinezela, ezinceda ukugcina ukujikeleza kwegazi kakuhle. Kwiimeko ezinzima ngakumbi, ugqirha wakho unokucebisa ukuba kwenziwe ukungenelela ngokomzimba, njengokufaka isihluzo emthanjeni ukuthintela amahlwili egazi ukuba angahambi aye emiphungeni yakho.

Ungayithintela njani i-VTE?

Kukho izinto ezininzi ezibangela umngcipheko wokuba ne-venous thromboembolism, esingazilawula zonke. Nangona kunjalo, ngokubanzi, ukuhlala usebenza yeyona ndlela ilula yokuyithintela . Ekubeni uninzi lwee-DVTs zenzeka emilenzeni, ukugcina ukujikeleza kwegazi kakuhle emilenzeni kunokunciphisa kakhulu umngcipheko.

Ukuba uhleli ixesha elide, nokuba usemsebenzini okanye xa uhambahamba, qiniseka ukuba uvuka kwaye uhambahamba rhoqo kwaye uqeqeshe izihlunu zakho zemilenze. Oku kuya kunceda ukunciphisa ukuhlangana kwegazi. Nokuba uyagula okanye uyaphola emva kotyando, ukuvuka nokuhambahamba ngokukhawuleza kunokunceda ukunciphisa umngcipheko wakho wokuqhekeka kwegazi. Ukuzilolonga kunokunceda ukunciphisa uxinzelelo kunye nokugcina ubunzima obusempilweni . Ezi zezinye izinto ezinokubangela i-VTE.

Uzinyamekela njani emva kwe-VTE?

Ukuba uphuhlisa i-VTE, qaphela ezi zinto:

• Yiya kunyango olulandelelanayo rhoqo. Ugqirha wakho uza kujonga imeko yakho aze agqibe ukuba kufuneka uthathe ixesha elingakanani amayeza akho.
• Sela amayeza akho njengoko kuyalelwe. Nangona kunjalo, ukuba ufumana ukopha kakhulu (isiphumo esibi kakhulu sezinto ezinciphisa igazi), yeka ukuwasela amayeza ngoko nangoko kwaye uqhagamshelane nogqirha wakho.
• Qaphela iimpawu zokuqhekeka kwegazi, ingakumbi ukudumba emilenzeni kunye nentlungu xa uchukunyiswa.
• Ziqhelise indlela yokuphila esempilweni. Hlala usempilweni, sela amanzi amaninzi, lawula uxinzelelo, kwaye uyeke ukutshaya ukuba uyatshaya.

Khumbula, zininzi izizathu ezahlukeneyo ze-Venous Thromboembolism. Kusenokuba kukho izinto ezinobungozi ongazaziyo kwaye ongenakuzitshintsha.

Emva kwayo yonke le ntetho, nantsi into ekufuneka uyikhumbule!

Zininzi izinto ezinokubangela imeko ebizwa ngokuba yi-`(Venous Thromboembolism - VTE)`. Usenokuba nezinto ezinobungozi ongazaziyo, kwaye ezinye zazo asinakuzilawula. Nangona kunjalo, zininzi izinto onokuzenza ukuthintela i-`(VTE)` . Kwaye, ukuba ngelishwa iyenzeka, inokulawulwa ngempumelelo.

Ukuba uneengxaki malunga noku, thetha nogqirha wakho malunga nezinto ezithile ezikubangela umngcipheko kunye nendlela onokuthi unciphise ngayo umngcipheko wakho. Eyona nto ibalulekileyo kukufuna ingcebiso yezonyango ngokukhawuleza ukuba ubonakalisa iimpawu ze-"VTE". Sithatha onke amahlwili egazi, kokubini lawo unawo ngoku kunye nalawo onokuthi uwafumane kwixesha elizayo, nzulu kakhulu. Ngoko ke ungoyiki ukubona ugqirha kwangoko xa uneengxaki. Impilo yakho yeyona nto iphambili kuthi!

Ihlwili legazi , umthambo, i-DVT, i-PE, imiphunga, i-Venous Thromboembolism, i-VTE