Umthambo wegazi omkhulu, omkhulu kunayo yonke othwala igazi emzimbeni wethu yi-aorta, noma i-aorta. Cabanga ngayo njengepayipi lamanzi eliyinhloko eliletha amanzi endlini yethu. Kwenzekani uma olunye lwezindonga zalo mbhobho luba buthakathaka endaweni eyodwa bese luqala ukukhukhumala ngaphansi kwengcindezi yamanzi? Yilokho i-Thoracic Aortic Aneurysm eyikho. Okwenzekayo kulokhu ukuthi udonga lwengxenye ye-aorta oludlula esifubeni sethu luba buthakathaka futhi lukhukhumala njengebhaluni ngaphansi kwengcindezi yegazi. Namuhla, sizokhuluma ngalesi simo, esivame ukwenzeka ngaphandle kwezimpawu, ngaphakathi emzimbeni.
Iyini ngempela i-Thoracic Aortic Aneurysm?
Kalula nje, lokhu ukuvuvukala noma ukuvuvukala (i-aneurysm) ku-aorta, umthambo omkhulu odlula esifubeni sethu (esifubeni). Le aorta ifana nepayipi. Kodwa lapho kwakheka i-aneurysm, isimo saleyo payipi siyashintsha, bese indawo eyodwa ivuvukala njengebhaluni. Ngokuvamile, odokotela babiza lesi simo ngokuthi i-aneurysm lapho leyo ngxenye yomthambo iba nobubanzi okungenani obungu-50% kunobubanzi bayo obujwayelekile.
Lolu hlobo lwe-aneurysm lungakheka noma kuphi ku-aorta yethu. Kodwa luvame kakhulu ukwenzeka esiswini. Silubiza ngokuthi yi-Abdominal Aortic Aneurysm. Kodwa cishe i-aneurysm eyodwa kwezine ezakhekayo zenzeka esifubeni. Silubiza ngokuthi yi-Thoracic Aortic Aneurysm.
Uma une-aneurysm encane kanje, ingase ingadingi ukwelashwa okuningi. Ngesikhathi uphuza imithi yokulawula izinto ezifana nomfutho wegazi ophakeme, udokotela wakho uzokuskena njalo ukuze abone ukuthi iyakhula yini. Kodwa uma i-aneurysm inkulu, noma ikhula ngokushesha, kungase kudingeke ukuhlinzwa ngaphambi kokuba kuvele izinkinga ezinkulu nezisongela ukuphila.
Sivame kangakanani lesi simo?
Ngokwezibalo, lesi simo sithinta abantu abaphakathi kuka-6 no-10 kwabangu-100,000. Kodwa-ke, inani langempela lingase libe phezulu. Lokhu kungenxa yokuthi abantu abaningi ababonisi zimpawu futhi baphila ngaphandle kokwazi ukuthi banalesi simo. Cishe ama-20% eziguli ezitholakale zinamalungu omndeni anaso, okusho ukuthi singase sibe yifa.
Ziyini izimpawu zalokhu?
Ingozi enkulu yalesi simo ukuthi isikhathi esiningi azikho izimpawu. Kodwa-ke, ngezinye izikhathi, lapho i-aneurysm ikhula kakhulu futhi icindezela izitho ezizungezile, ezinye izimpawu zingase zivele.
| Isibonakaliso | Isizathu |
|---|---|
| Ubuhlungu emhlathini, entanyeni, esifubeni, noma emhlane ongaphezulu. | Ngenxa yengcindezi evela ku-aneurysm. |
| Ubunzima bokugwinya noma ubuhlungu lapho ugwinya. | I-aneurysm ibangelwa ukuvuvukala komphimbo. |
| Ukuhosha kwezwi. | Ngenxa yokucindezelwa kwemizwa elawula izwi. |
| Ukukhwehlela noma ubunzima bokuphefumula. | I-aneurysm ibangelwa ukucindezelwa kwe-trachea. |
Izimpawu eziphuthumayo ezenzekayo uma i-aneurysm iqhuma (iqhuma) noma iqhuma (iqhuma)
Lesi yisigaba esiyingozi kakhulu salesi sifo. Udonga lwe-aneurysm lungaba buthaka futhi luqhume ngokuzumayo (luqhekeke) noma ludabule izingqimba ezimbili zodonga (ukuqhekeka). Lesi yisimo esiphuthumayo kakhulu, esisongela ukuphila. Lezi zimpawu zivame ukuvela ngokuzumayo futhi zibe nzima kakhulu.
Uma wena noma omunye umuntu eba nanoma yiziphi zalezi zimpawu, ungalibali ngisho nomzuzu. Yiya e-Emergency Treatment Unit (ETU) yesibhedlela ngokushesha. Umzuzwana ngamunye ubalulekile ukuze usindise impilo.
| Izimpawu ezidinga usizo oluphuthumayo lwezokwelapha | |
|---|---|
| Ubuhlungu obukhulu | Ubuhlungu obungazelelwe, obungabekezeleleki, obuhlabayo, obuhlabayo esifubeni noma emhlane. |
| Isiyezi | Ukuzungeza, ukubona okufiphele, noma ukuquleka. |
| Ubunzima bokuphefumula | Ukuzwa ngokuzumayo kokuphelelwa umoya. |
| Ukushaya kwenhliziyo | Ukuzizwa sengathi inhliziyo yakho ishaya ngokushesha. |
| Ukujuluka ngokweqile | Ukujuluka ngokweqile ngaphandle kwesizathu. |
| Ezinye izici | Ukudideka, ubunzima bokukhuluma, ukulahlekelwa umbono, ukuba ndikindiki noma ubuthakathaka ohlangothini olulodwa lomzimba. |
Kungani kwenzeka into efana nale?
Izindonga zemithambo yethu ngokuvamile ziqinile futhi ziguquguquka. Kufanele zikwazi ukufinyela nokwelula ngaphansi kwengcindezi yegazi elifika ngokushaya kwenhliziyo ngakunye. Kodwa uma lezi zindonga ziba buthakathaka, azikwazi ukubhekana nengcindezi bese ziqala ukukhukhumala.
Imbangela eyinhloko yalokhu yisimo esibizwa ngokuthi i-Atherosclerosis . Kalula nje, izinto ezinamafutha njenge-cholesterol zifakwa ngaphakathi kwemithambo yegazi (siyibiza ngokuthi i-plaque), kancane kancane ziqina futhi zenze buthaka izindonga zemithambo yegazi. Njengoba nje ukugqwala kwakheka ngaphakathi kwepayipi lamanzi elidala. Lokhu kwenza buthaka izindonga zemithambo yegazi futhi kwandisa amathuba okuba ne-aneurysm.
Yiziphi izinto ezandisa ingozi?
Ngaphezu kwe-atherosclerosis, noma yini eyenza buthaka izindonga ze-aorta yandisa ingozi yokuba ne-aneurysm.
| Isici sengozi | Incazelo |
|---|---|
| Umfutho wegazi ophakeme | Ihlala ibeka ingcindezi eyengeziwe ezindongeni zemithambo yegazi. |
| Ukubhema nokusetshenziswa kukagwayi | Kulimaza ngqo izindonga zemithambo yegazi futhi kusheshise ukwakheka kwe-atherosclerosis. |
| Umlando womndeni | Uma othile emndenini wakho oseduze eye waba ne-aneurysm, nawe usengozini enkulu. |
| Ukuguga | Ngokuvamile, abantu abangaphezu kweminyaka engama-65 basengozini enkulu. |
| Ezinye izimo zofuzo | Izimo ezifana ne-Marfan syndrome, i-Loeys-Dietz syndrome, i-Vascular Ehlers-Danlos syndrome, kanye ne-Turner syndrome zandisa ingozi ngoba zibuthakathaka izicubu zomzimba ezixhumeneyo. |
| Ezinye izimo zezokwelapha | Izimo ezifana ne-aortitis (ukuvuvukala kwe-aorta), isifo se-bicuspid aortic valve (isifo se-valve yenhliziyo), kanye nesifo se-coronary artery (CAD). |
Odokotela bakuthola kanjani lokhu?
Esikhathini esiningi, lokhu kutholakala ngengozi. Sikubiza ngokuthi "ukuxilongwa okungahleliwe." Okusho ukuthi, lapho kwenziwa i-X-ray yesifuba ngesizathu esithile, udokotela angase aqaphele ukuthi ingxenye ephakathi yesifuba (i-mediastinum) ibanzi kunokujwayelekile. Yilapho kusolwa khona ukuthi kukhona i-aneurysm.
Uma kuvela ukusola okunjalo, udokotela uzoyala ukuhlolwa okufana nalokhu ukuze akuqinisekise:
- I-computed tomography (CT) angiogram: Lokhu kungaveza izithombe ezicacile kakhulu ze-aorta.
- I-Echocardiogram (echo): I-ultrasound scan ukuze kubhekwe ukusebenza kwenhliziyo kanye nengxenye yokuqala ye-aorta.
- I-Magnetic resonance angiogram (MRA): Ukuhlolwa okufana ne-CT scan, kodwa ngaphandle kokusebenzisa imisebe.
- I-ultrasound yesisu: Abantu abane-aneurysm yesifuba bangase babe ne-aneurysm yesisu, ngakho-ke hlola nalokho.
Yiziphi izindlela zokwelapha ezitholakalayo?
Ukwelashwa okuwukuphela kweqiniso kwe-thoracic aortic aneurysm ukuhlinzwa. Kodwa-ke, nini futhi hlobo luni lokuhlinzwa okwenziwayo kuncike kubukhulu be-aneurysm, indawo ekuyo, ukuthi ikhula ngokushesha kangakanani, kanye nempilo yakho iyonke.
Kunini lapho kudingeka khona ukuhlinzwa?
Uma i-aneurysm incane, udokotela angase anqume ukulinda ngaphandle kokuhlinzwa. Lokhu sikubiza ngokuthi "ukulinda okuqaphile." Lokhu kusho ukuthi bazohlola i-aneurysm njalo ezinyangeni eziyi-6 kuya kweziyi-12 ukuze babone ukuthi iyakhula yini, futhi bazokunikeza imithi yokulawula umfutho wegazi lakho.
Kodwa,
- Uma i-aneurysm ingamasentimitha angu-2 (cishe amasentimitha angu-5.5) noma ngaphezulu,
- Uma i-aneurysm ikhula ngokushesha kuno-0.5 cm ngonyaka ,
- Uma i-aneurysm ibangela izimpawu ,
Ukuhlinzwa kuvame ukunconywa ngoba uma i-aneurysm inkulu, kulapho ingozi yokuqhuma kwayo inkulu khona.
Izinhlobo eziyinhloko zokuhlinzwa
Kunezinhlobo eziningana eziyinhloko zokuhlinzwa ezisetshenziswayo njengamanje.
1. Ukuhlinzwa okuvulekile kwendabuko: Kwenziwa isilonda phakathi kwesifuba, kususwe ingxenye ebuthakathaka ye-aorta ene-aneurysm, bese kufakwa i-graft endaweni yayo.
2. Ukulungiswa kwe-aorta yesifuba (i-TEVAR): Lena inqubo engangenisi kakhulu. Kwenziwa ukusikwa okuncane embotsheni, bese kufakwa i-stent graft ngokusebenzisa ukusikwa kusetshenziswa i-catheter eya ku-aneurysm bese ivalwa ngaphakathi.
3. Ukufakwa esikhundleni kwezimpande ze-aorta: Lokhu kuhlinzwa kwenziwa uma i-aneurysm itholakala empandeni ye-aorta, exhumanisa nenhliziyo. Kungadingeka futhi ukufaka esikhundleni se-valve yenhliziyo.
Udokotela wakho uzonquma ukuthi iyiphi indlela yokwelapha engcono kakhulu kuwe.
Ingabe lokhu akunakuvinjelwa ukuthi kwenzeke?
Ayikho indlela yokuvimbela ngokuphelele ukuthuthukiswa kwe-aneurysm. Kodwa-ke, ukulawula imbangela eyinhloko, i-atherosclerosis, kunganciphisa kakhulu ingozi.
- Lawula umfutho wegazi lakho kanye namazinga e-cholesterol ngokuthatha imithi udokotela wakho ayinikezayo.
- Yamukela indlela yokudla enempilo yenhliziyo, njengeMediterranean Diet.
- Yeka ukubhema kanye nayo yonke imikhiqizo kagwayi ngokuphelele.
- Ukuzivocavoca. Yenza umsebenzi womzimba olinganiselayo, njengokuhamba, okungenani imizuzu eyi-150 ngesonto. Kodwa khuluma nodokotela wakho ngaphambi kokuqala uhlelo olusha lokuzivocavoca.
- Yenza ukuhlolwa kwezokwelapha minyaka yonke.
Uma unalesi simo, uzinakekela kanjani?
Uma udokotela wakho ekutshela ukuthi une-thoracic aortic aneurysm, ungesabi. Uzokunikeza iseluleko sokuthi ungazinakekela kanjani ngenkathi uphila nayo.
- Gwema izinto ezifana nokuphakamisa izinsimbi kanye nokuqeqeshwa kwezikhawu eziphakeme (HIIT). Lokhu kungabeka ingcindezi engadingekile ku-aorta. Buza udokotela wakho ukuthi yikuphi ukuzivocavoca okufanele wena.
- Gwema ukusebenzisa ugwayi ngokuphelele.
- Nciphisa usawoti ekudleni.
- Thatha umuthi onikezwe udokotela ngesikhathi esifanele.
- Gwema izidakamizwa ezikhulisa ukushaya kwenhliziyo (i-cocaine, ama-amphetamine) kanye nezinye izimila.
- Hlala uxhumana nodokotela wakho njalo. Uma uthola izimpawu ezintsha noma uhlangabezana nanoma yimiphi imiphumela emibi evela emithini yakho, mtshele ngokushesha.
Umlayezo Wokuya Nawe Ekhaya
- I-Thoracic Aortic Aneurysm iyisiqhubu esifana nebhaluni emthanjeni wegazi oyinhloko esifubeni.
- Esikhathini esiningi, ayinazo izimpawu, ngakho-ke uma unezici eziyingozi (umfutho wegazi ophakeme, ukubhema, umlando womndeni), qaphela lokho.
- Ubuhlungu obungazelelwe, obukhulu esifubeni noma emhlane, ubunzima bokuphefumula, noma ukuquleka kuyisimo esiphuthumayo esibi kakhulu. Yiya eMnyangweni Wezimo Eziphuthumayo wesibhedlela (ETU) ngokushesha.
- Uma i-aneurysm incane, ingaphathwa ngemithi kanye nokuhlolwa njalo. Uma inkulu, ingelashwa ngokuhlinzwa.
- Ngokwelashwa okufanele kwezokwelapha kanye nokushintsha indlela yokuphila, ungaphila impilo ende nenempilo naphezu kwalesi simo. Landela njalo iseluleko sikadokotela wakho.
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