Ingabe unomthambo wegazi omkhulu ovuvukele esiswini sakho? (I-Abdominal Aortic Aneurysm) - Masiqaphele lokhu!

Wake wezwa ngomthambo omkhulu wegazi esiswini sakho ovuvukala njengebhaluni? Lokhu kungase kuzwakale kuyesabisa, kodwa uma ukwazi, ungalawula izinto eziningi. Namuhla sizokhuluma ngesimo esinjalo, esibizwa ngokwezokwelapha ngokuthi `(Abdominal Aortic Aneurysm)` noma `(AAA)`. Kalula nje, ingxenye yodonga olukhulu lwesisu (i-Aorta) iba buthakathaka futhi ivuvuke.

Iyini le-Abdominal Aortic Aneurysm?

Kulungile, ake siqale sibone ukuthi le `(Abdominal Aortic Aneurysm)` iyini kalula. Umthambo wegazi omkhulu kunayo yonke emzimbeni wakho yi-aorta, noma `(Aorta)`. Cabanga ngayo njengepayipi eliyinhloko elithwala amanzi esuka ethangini lamanzi liye endlini yonke. Igazi elimpontshwa yinhliziyo yethu lisakazwa kuwo wonke umzimba ngale `(Aorta)`. Ingxenye yale `(Aorta)` edlula esiswini ibizwa ngokuthi `(Abdominal Aorta)`.

Manje, ku-`(Abdominal Aortic Aneurysm)`, indawo ebuthakathaka odongeni lwe-aorta yesisu iyavuvukala, njengebhaluni eliqhumayo. Ngokuvamile, izindonga ze-`(Aorta)` yethu ziqinile kakhulu futhi ziyaguquguquka. Yenzelwe ukumelana nokucindezeleka kwegazi okuvela enhliziyweni.

Kodwa-ke, njengoba siguga, ngenxa yezici ezifana nokusetshenziswa kukagwayi (njengokubhema ugwayi), kanye nezimo ezithile zezokwelapha, udonga lwale `(Aorta)` lungaba buthakathaka. Uma luba buthakathaka, alukwazi ukumelana nokucindezela kwegazi, futhi `(Aorta)` iqala ukukhukhumala kusukela kuleyo ndawo ebuthakathaka. Lokhu kukhukhumala kuyakhula kancane kancane ngokuhamba kwesikhathi.

Odokotela banquma ukuthi une-AAA uma ingxenye ye-aorta inkulu okungenani ngo-50% kunokuvamile. Kubantu abaningi, lokhu kusho ukuvuvukala okungaba amasentimitha amathathu ububanzi.

Into ebaluleke kakhulu ukuthi njengoba lokhu kuvuvukala (`Aneurysm`) kukhula, ingozi yokuqhuma kwayo (`Rupture`) iyanda. Uma lokho kwenzeka, kungabangela ukopha ngokweqile emzimbeni futhi kube yingozi empilweni. Le ngozi iphakeme kakhulu kwi-`Aneurysm`` engaphezu kwamasentimitha angu-5.0 kwabesifazane kanye namasentimitha angu-5.5 kwabesilisa.

Ngokuvamile, i-AAA ayibonisi zimpawu kuze kube yilapho isizoqhuma. Yingakho kubaluleke kakhulu ukwazi ukuthi unezici eziyingozi yini zokuthuthukisa i-AAA bese usebenzisana nodokotela ukuze uziphathe.

Isimo esiphuthumayo!

Uma uzwa ubuhlungu obukhulu esiswini sakho noma emhlane ongezansi ngokuzumayo, kungaba uphawu lwe-AAA esizoqhuma. Ungase futhi ube nobunzima bokuphefumula, isiyezi, nokuhlanza. Uma lokhu kwenzeka , kufanele ushayele u-911 noma uye esibhedlela esiseduze ngokushesha.

Kuvame kangakanani lokhu `(Abdominal Aortic Aneurysm)`?

Empeleni lesi akusona isimo esingavamile njengoba ungase ucabange.

• Cishe u-1.4% wabantu abadala abaneminyaka ephakathi kuka-50 no-84 e-United States banalesi simo. Labo cishe abantu abayizigidi ezingu-1.1.
• Kuthinta phakathi kuka-1% no-2% wamadoda angaphezu kweminyaka engu-65. Ingozi yokuthola i-AAA iphindwe kabili njalo eminyakeni eyishumi ubudala.
• Amadoda anamathuba aphindwe kane okuthola lokhu kunabesifazane.
• Kuvela cishe ku-1% wabesifazane abangaphezu kweminyaka engu-70 abanomlando wokubhema.

Ucwaningo luye lwathola ukuthi:

• Nakuba lokhu `(Aneurysm)` (ukuvuvukala) kungenzeka noma kuphi ku-`(Aorta)` kuvame ukwenzeka esifundeni sesisu. Ama-75% azo zonke `(Aortic Aneurysm)` yi-`(Abdominal Aortic Aneurysm)`.
• `(AAA)` ivame kakhulu kwabamhlophe, abamnyama, kanye nabantu base-Asia.
• Lokhu kuvame ukwenzeka kwabesilisa. Kodwa-ke, uma kwenzeka kowesifazane, kunethuba elikhulu lokuthi kuqhume, noma ngabe kuncane. Kungase kwenzeke nakwamanye amalungu omndeni.

Yiziphi izimpawu ze-Abdominal Aortic Aneurysm?

Iningi labantu alibi nazo izimpawu kuze kube yilapho i-"AAA" isizoqhuma. Kodwa-ke, uma isizoqhuma, ungase ubhekane nalokhu okulandelayo:

• Ubuhlungu obuqhubekayo, obujulile emhlane noma esiswini.
• Ubuhlungu emlenzeni, embotsheni, noma endaweni ye-pelvic.
• Ukushaya kwenhliziyo okuzwakala njengokushaya kwenhliziyo esiswini. (Lokhu kungase kuzwakale kwabanye abantu abancane, kodwa uma kuyinto entsha, kufanele ukhathazeke).

I-AAA ephukile iyisimo esiphuthumayo sezokwelapha! Izimpawu zingaqala ngokuzumayo:

• Ubuhlungu obukhulu esiswini, emhlane ongezansi, noma emilenzeni.
• Ubunzima bokuphefumula.
• Isilinganiso senhliziyo siyanda.
• Umfutho wegazi ophansi.
• Ukuzizwa unesizungu noma ukulahlekelwa ukwazi.
• Ukucanuzela noma ukuhlanza.
• Isikhumba siyanamathela futhi siyajuluka.

Uma uhlangabezana nalezi zimpawu, ungalibali umzuzwana, hamba uye esibhedlela ngokushesha!

Yiziphi izimbangela ze-Abdominal Aortic Aneurysm?

Kalula nje, i-AAA ibangelwa ubuthakathaka odongeni lwe-aorta. Lobu buthakathaka bubangelwa ukuhlanganiswa kwezici zemvelo nezakhi zofuzo. Okwenzekayo akukaqondakali ngokugcwele okwamanje.

Isibonelo, ukusetshenziswa kukagwayi kungalimaza amaprotheni akha udonga lwe-aorta, okwenza lungaqini. Futhi, i-aorta ingaba buthakathaka ngenxa yokugcwala kwamafutha emithanjeni yegazi (i-atherosclerosis). Lapho lokhu kugcinwa kwamafutha kwakheka ngokuhamba kwesikhathi, ukuvuvukala nokufa kwamangqamuzana kungenzeka ezingqimbeni zodonga lwemithambo yegazi. Lapho izingxenye zesakhiwo se-aorta ziwohloka, i-aorta iba buthakathaka futhi ingavuvukala kalula ngendlela engavamile.

Ubani osengozini enkulu yokuthola i-"Abdominal Aortic Aneurysm"?

Lezi zici eziyingozi zinomthelela omkhulu ekuthuthukisweni kwe-`(AAA):

• Ukuba nomlando wokusebenzisa ugwayi:Abacwaningi bathi ukubhema okungenani ugwayi abayi-100 empilweni yakho kuyisici esiyingozi. Ingozi iyahlukahluka kuye ngokuthi usebenzise ugwayi ongakanani (uma usebenzise kakhulu, ingozi iba nkulu).
• Ukukhula kweminyaka: Ingozi yokuthola i-AAA iyanda njengoba ukhula (ngemuva kweminyaka engu-50 kwabesilisa, ngemuva kweminyaka engu-65 kwabesifazane).
• Ubulili ekuzalweni: Abesilisa banamathuba amaningi okukhula `(AAA)`.
• Ukuba nomlando womndeni we-(AAA): Lokhu kubalulekile futhi. Uma omunye wezihlobo zakho zezinga lokuqala (abazali, izingane, abafowenu nodadewenu) enayo i-(AAA), nawe usengozini yokuba nayo engu-10% kuya ku-20%. Lokhu kuhlangana kuphezulu kakhulu phakathi kwabafowethu nodadewethu besilisa.

Ezinye izinto ezingaba yingozi:

• Umfutho wegazi ophezulu.
• Ukuba nohlobo oluthile lwesifo senhliziyo nemithambo yegazi esibangelwa yi-atherosclerotic (ASCVD). Lokhu kufaka phakathi isifo semithambo yenhliziyo (CAD) kanye nesifo semithambo yegazi engaphandle (PAD).
• Ukuba nesifo esizuzwe njengefa esibangelwa yi-vascular connective tissue.

Yiziphi izinkinga ezingaba khona ze-`(AAA)`?

Inkinga evame kakhulu ukuqhekeka kwe-aneurysm. Lokhu kubangela ukufa kwabantu abaphakathi kuka-150,000 no-200,000 emhlabeni wonke minyaka yonke. I-AAA eqhekekile ingabangela ukopha kwangaphakathi okusongela impilo. Ingozi iyanda njengoba i-aneurysm ikhula.

Ungayithola kanjani i-`(Abdominal Aortic Aneurysm)`?

Ngenxa yokuthi ama-AAA ngokuvamile awabangeli izimpawu, odokotela bavame ukuxilonga ama-AAA angaphazamiseki ngesikhathi sokuhlolwa kwezinye izimo zempilo. Uma udokotela wakho esola ukuthi une-AAA ngokusekelwe emiphumeleni yokuhlolwa noma ezinye izizathu, angenza lezi zivivinyo ezilandelayo:

• I-ultrasound yesisu esiphindwe kabili: Lokhu ukuhlolwa okwenziwa kakhulu, okungenabuhlungu, futhi okulula.
• I-CT Angiogram (i-angiogram ye-computed tomography - CTA): Lokhu kuvumela umbono onemininingwane eminingi.

Ukuhlolwa kwe-Abdominal Aortic Aneurysm

Odokotela batusa ukuthi abantu abasengozini yokuthola i-AAA bahlolwe nge-ultrasound. Lokhu ukuhlolwa okulula, okungenabuhlungu. Kungahlola ukuthi kukhona i-AAA. Uma ikhona, udokotela wakho uzo-oda ama-ultrasound engeziwe ngezikhathi ezijwayelekile (ngokuvamile njalo ezinyangeni eziyi-6 kuya kweziyi-12) ukuze ayiqaphe. Uma iba nkulu kakhulu noma uma kunezinye izici eziyingozi zokuqhekeka, kunganconywa ukuhlinzwa.

Iphathwa kanjani i-Abdominal Aortic Aneurysm?

Ukwelashwa kuncike kubukhulu be-aneurysm, njengoba lokhu kuyisici esiyinhloko esinquma ingozi yokuqhekeka. Ama-aneurysm amancane angase angadingi ukwelashwa okusheshayo.Kunalokho, udokotela uzoqapha i-aneurysm nge-ultrasound ejwayelekile noma nge-CT scan. Lokhu kubizwa ngokuthi ukubhekwa . Ama-aneurysm amakhulu angadinga ukuhlinzwa.

`(AAA)` Ukuqapha (`Ukuqapha`)

Ngokuvamile, kufanelekile ukuqapha i-AAA uma ububanzi bayo bungaphansi kuka-5.5 cm kwabesilisa kanye no-5.0 cm kwabesifazane. Futhi, i-aneurysm akufanele ibangele noma yiziphi izimpawu.

Kuye ngobukhulu be-aneurysm, kungadingeka ukuthi uhlolwe nge-ultrasound noma nge-CT scan njalo ngezikhathi ezithile. Ama-aneurysm amakhulu angadinga ukuhlolwa okuvamile. Uma ususondele esigabeni sokwelashwa, ungadinga i-CT scan esikhundleni se-ultrasound. Kufanele ulandelele nodokotela wakho ukuze uthole izivivinyo. Udokotela wakho uzokutshela futhi:

• Yiziphi izinguquko zendlela yokuphila okudingeka uzenze? Lokhu kuhlanganisa ukuyeka ngokuphelele ukubhema, ukudla ukudla okunempilo, kanye nokuzivocavoca umzimba.
• Yimiphi imithi okudingeka uyithathe ukuze ulawule izimo ezifana nomfutho wegazi ophakeme noma i-cholesterol ephezulu?

Ukushintsha indlela yokuphila kanye nemithi ngeke kuyinciphise i-aneurysm (okwamanje akukho ukwelashwa okungenza kanjalo). Kodwa-ke, lezi zinyathelo zingasiza ekunciphiseni izinga lapho i-aneurysm iba nkulu khona futhi kuncishiswe ingozi yezinye izinkinga zenhliziyo nemithambo yegazi. Abacwaningi basafuna imithi kanye nezinye izindlela zokwelapha ezinganciphisa noma zimise ukukhula kwe-AAA encane.

Ukuhlinzwa kwe-`(AAA)`

I-AAA yakho ingadinga ukuhlinzwa kulezi zimo:

• I-aneurysm ibhekwa njengobubanzi obungu-5.5 cm noma ngaphezulu kwabesilisa kanye no-5.0 cm noma ngaphezulu kwabesifazane. (Ezinye izikhungo ezikhethekile zingase zincome ukuhlinzwa kosayizi abancane, kuye ngempilo yakho iyonke, iphrofayili yengozi, nezinye izici.)
• Kungakhathaliseki ukuthi i-aneurysm ingakanani, uma ibangela izimpawu.
• Uma i-aneurysm iqhumile, kudingeka ukuhlinzwa okusheshayo ukuze kusindiswe impilo yakho.

Ukuhlinzwa kwenziwa ukuze kuncishiswe ingozi yokuqhuma kwe-aneurysm ngokususa ingxenye ebuthaka ye-aorta bese ifakwa ipayipi lokwenziwa (i-graft) noma ngokufaka ulwelwesi olusha (i-graft) ngaphakathi kwe-aorta. Kunezindlela ezimbili zokuhlinzwa zalokhu:

• Ukuhlinzwa okuvamile kokulungisa i-aneurysm evulekile: Lapha, isisu siyavulwa bese kuthi ingxenye eyonakele ye-aorta ishintshwe.
• Ukulungiswa kwe-Endovascular aneurysm (EVAR): Lokhu kuhilela ukwenza ukusika okuncane emlenzeni ongaphezulu nokufaka i-stent graft ku-aorta ukuze kufihlwe i-aneurysm. Lokhu akudingi ukusika okukhulu.

Bobabili odokotela abahlinzayo kanye neziguli ngokuvamile bakhetha inqubo ye-EVAR yokuhlinzwa okukhethwayo ngoba kulula ukululama kukho futhi kunethuba elingcono lokusinda esikhathini esifushane. Uma isakhiwo se-aorta sifanelekile, i-EVAR ingakunikeza ukulungiswa kwesikhathi eside. Kodwa-ke, kuzodingeka wenze i-ultrasound noma i-CT scan njalo ngonyaka ukuze uhlole ukulungiswa. Ukuhlinzwa okuvulekile kungaba yindlela ephephile ngenxa yezici ezithile (njengobudala bakho noma uhlobo lwe-aorta). Inqubo ngayinye inezinzuzo nezinkinga zayo. Udokotela wakho uzoxoxa nawe ngalokhu, futhi ndawonye ningenza isinqumo esingcono kakhulu.

I-aneurysm eqhumile idinga ukuhlinzwa okusheshayo ukuze inikwe ithuba lokusindisa impilo.

Yini engingayilindela uma nginalesi simo?

Umbono wakho uncike ezintweni eziningi, okuhlanganisa ubukhulu be-aneurysm, isikhathi esithathayo ukuze uthole ukwelashwa, kanye nempilo yakho iyonke. Udokotela wakho ungumuntu ongcono kakhulu ukukubuza ukuthi yini ongayilindela. Ukwazi kangcono wena nomlando wakho wezempilo.

Ingabe i-Abdominal Aortic Aneurysm ingavinjelwa?

Okwamanje ayikho indlela eqinisekisiwe yokuvimbela ukwakheka kwe-AAA. Kodwa-ke, uma unomzali, umfowenu noma ingane eye yaba ne-AAA, khuluma nodokotela wakho. Angase akuncomele ukuhlolwa kwe-ultrasound ukuhlola izimpawu ze-aneurysm.

Kungakhathaliseki ukuthi unomlando womndeni noma cha, ungathatha izinyathelo zokunciphisa ezinye izici eziyingozi futhi ulondoloze impilo yakho yonke yenhliziyo nemithambo yegazi. Khuluma nodokotela wakho ngalezi zinto:

• Ukuyeka kanjani ukubhema noma ukusebenzisa ugwayi?
• Uludala kanjani uhlelo lokuzivocavoca olukufanele?
• Ungalandela kanjani ukudla okunempilo kwenhliziyo?
• Ulawula kanjani umfutho wegazi lakho, i-cholesterol, kanye namazinga kashukela egazini?
• Unganciphisa kanjani ukusetshenziswa kotshwala?

Ngizinakekela kanjani?

Uma une-`(AAA)`, kubaluleke kakhulu ukulandela imiyalelo enikezwe udokotela wakho. Uzokweluleka ngokwezidingo zakho. Ngokuvamile, nanka amanye amathiphu:

• Yiba khona kuzo zonke izikhathi zakho zokubonana nodokotela kanye nokuhlolwa okulandelayo.
• Yenza izinguquko endleleni yokuphila ezisekela impilo yakho. Qala kancane bese uzibekela imigomo ongayifinyelela.
• Phuza imithi yakho njengoba nje udokotela wakho ekuyalele.
• Buza udokotela wakho uma udinga ama-antibiotic ngaphambi kwezinqubo ezithile zamazinyo noma zezokwelapha. Abanye abantu bayawadinga ukuvimbela ukutheleleka ngemva kokuhlinzwa kokulungisa i-aneurysm.

Kufanele ngimbone nini udokotela wami?

Shayela udokotela wakho uma unanoma yikuphi kwalokhu:

• Izimpawu ezintsha noma ezishintshayo.
• Imiphumela emibi evela emithini.
• Imibuzo noma ukukhathazeka ngesimo sakho noma uhlelo lokwelashwa.

Udokotela wakho uzokutshela ukuthi kufanele uze kangaki ngesikhathi sokuqokwa. Kuzodingeka ukuthi uhlolwe njalo ukuze uhlole lezi zinto:

• Ingabe i-`(AAA)` izokhula, noma ingabe kukhona ingozi yokuthi iqhume?
• Ingabe zikhona izinkinga ngemva kwe-EVAR, njenge-endoleak (ukuvuza kwegazi eduze kwe-graft), noma ingabe zikhona izimpawu zokuqhekeka kabusha?

Yiya kuzo zonke izikhathi zakho zokuqokwa ukuze udokotela wakho akwazi ukuqapha isimo sakho futhi akusize uhlale uphilile.

Kufanele ngiye nini egumbini lezimo eziphuthumayo?

Uma unezimpawu zokuqhuma kwe-AAA, njengobuhlungu obungazelelwe, obukhulu esiswini sakho noma emhlane ongezansi , shayela u-911 ngokushesha noma uye egumbini lezimo eziphuthumayo esibhedlela esiseduze.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Ungabuza udokotela imibuzo efana nale:

• Ingabe ngisengozini yokuthola i-`(AAA)`?
• Ingabe ngidinga ukuhlolwa kokuhlolwa kwe-`(AAA)`?
• Yiziphi izinguquko zendlela yokuphila okufanele ngizenze ukuze nginciphise ingozi yami?

Uma udokotela wakho ethola ukuthi une-`(AAA)`, angakubuza le mibuzo ukuze athole okwengeziwe:

• Ingakanani i-aneurysm?
• Ingabe uncoma ukubhekwa noma ukuhlinzwa?
• Iyiphi inqubo yokuhlinzwa engcono kakhulu kimi?
• Yiziphi izinzuzo kanye nokungalungi kokuhlinzwa?
• Kuzothatha isikhathi engingakanani ukuphola?
• Yiziphi izivivinyo zokulandelela engizodinga ukuzenza ngemva kokuhlinzwa?
• Ingabe kukhona emndenini wami okudingeka ahlolwe i-`(AAA)`?

Ukuthola ukuthi une-Abdominal Aortic Aneurysm kungaba yinto ekhungathekisayo futhi eyethusayo. Kodwa izindaba ezinhle ukuthi udokotela wakho uyazi ukuthi unayo. Ukwazi ukuthi unayo kuyisinyathelo sokuqala sokukugcina uphilile. Udokotela wakho uzoqapha isimo sakho futhi ancome ukwelashwa uma kudingeka. Uzokutshela nezinto ongazenza empilweni yakho yansuku zonke ukuvimbela i-aneurysm ukuthi ikhule noma iqhume.

Khumbula njengesifinyezo (Umyalezo Wokuya Ekhaya)

Kulungile, ake sibukeze amaqiniso abaluleke kakhulu nge-Abdominal Aortic Aneurysm noma i-AAA esikhulume ngawo namuhla.

• I-aortic aneurysm (AAA) iwukuba buthaka nokuvuvukala komthambo wegazi oyinhloko esiswini (i-aorta).
• Ngokuvamile, azikho izimpawu ezigabeni zokuqala.
• Amadoda amadala abhemayo asengozini enkulu. Uma othile emndenini enayo, kukhona ingozi.
• Ingozi enkulu ukuthi lokhu kungaqhuma (`Ukuqhekeka`) . Uma lokho kwenzeka, kungaba yingozi empilweni.
• Uma unobuhlungu obungazelelwe, obukhulu esiswini noma emhlane wakho, kanye nezinye izimpawu, kuyisimo esiphuthumayo. Yiya esibhedlela ngokushesha.
• Kubalulekile kulabo abanezici eziyingozi ukuthi bahlolwe njengoba beyalelwe udokotela.
• NjengokwelashwaKungase kwenziwe ukubhekwa noma ukuhlinzwa. Kuncike kubukhulu be-aneurysm nezinye izici.
• Ukuyeka ukubhema nokuphila impilo enempilo kubaluleke kakhulu.

Khumbula, kungcono ukwaziswa nokuthatha izinyathelo ezidingekayo kunokwesaba lokhu. Khuluma nodokotela wakho ngokukhululekile bese ukhetha ukwelashwa nendlela yokuphila ekufanele kakhulu.

I-Aneurysm ye-Aortic yesisu , i-AAA, Ukuvuvukala kwe-Aorta, Ukuqhuma kwemithambo yegazi, Ubuhlungu besisu, Isifo senhliziyo, Ukubhema