Uzwa ubuhlungu obukhulu noma ukuqina emilenzeni yakho, ikakhulukazi emathangeni nasemaqakaleni, uma uhamba ibanga elifushane? Ubuhlungu buyaphela ngemva kwesikhashana, kodwa buyabuya uma uqala ukuhamba futhi? Noma ingabe uthola amanxeba emilenzeni yakho ngaphandle kwesizathu esicacile futhi athatha isikhathi eside ukuphola? Uma unalezi zimpawu, udokotela wakho kungenzeka ukuthi ukhulume nawe ngokuhlinzwa. Kungenzeka ukuthi wesaba kancane lapho uzwa igama. Namuhla sikhuluma ngalokho, ukuhlinzwa okubizwa ngokuthi i-Aortobifemoral Bypass. Ungakhathazeki, ake sikuchaze kalula lokhu.
Kalula nje, iyini i-Aortobifemoral Bypass?
Cabanga nje ukuthi umgwaqo omkhulu edolobheni uvaliwe ngokuphelele ngenxa yethrafikhi. Ayikho indlela yokuthi izimoto zidlule. Wenzani-ke? Siyayigwema leyo ndawo evinjiwe bese sakha umgwaqo omusha 'wokudlula' ukuze sifike kolunye uhlangothi, akunjalo? Yilokho okwenziwa yilolu hlinzo.
I-Aortobifemoral bypass iwukuhlinzwa okubandakanya imithambo yegazi emzimbeni wethu. Kulokhu, odokotela abahlinzayo bakha umzila omusha, obizwa ngokuthi i-bypass , wokudlula izindawo ezivinjiwe noma ezincishisiwe zemithambo yegazi eyinhloko esiswini sethu. Lokhu kubuyisela ukugeleza kwegazi emilenzeni yethu.
Kulokhu kuhlinzwa, odokotela basebenzisa umthambo wegazi wokwenziwa, obizwa ngokuthi i -graft . Lokhu kuvame ukwenziwa ngezinto ezifana ne-polyester. Ake siqonde ukuthi yathola kanjani igama layo:
- Igama elithi "Aorto" libhekisela emthanjeni wegazi omkhulu kunayo yonke emzimbeni wethu, i-aorta . Liqala enhliziyweni bese lidlula esifubeni liye esiswini.
- Igama elithi "Femoral" libhekisela emithanjeni ye-femoral, eqala ezinqeni zethu futhi igijime emathangeni ethu iye ngemuva kwamadolo ethu.
- Igama elithi "Bi" lisho 'okubili'. Lokho kusho ukuthi lesi sitho sixhumanisa nemithambo yomibili ye-femoral emilenzeni yakho yomibili.
Le graft ibukeka njenge-"Y" ebheke phansi. Isiphetho esisodwa phezulu sixhunywe engxenyeni engezansi ye-aorta esiswini. Imilenze emibili ye-Y ixhunywe emithanjeni ye-femoral emilenzeni. Ngale ndlela, igazi lingadlula ukuvaleka futhi ligeleze kalula liye emilenzeni.
Kungani sidinga lolu hlobo lokuhlinzwa?
Lokhu kuhlinzwa kwenziwa ikakhulukazi njengokwelashwa kwesimo esibizwa ngokuthi isifo esibizwa ngokuthi i-Aortoiliac occlusive disease . Nakuba igama lingase lizwakale liyinkimbinkimbi kancane, indaba ilula kakhulu. Okwenzekayo ukuthi i-cholesterol kanye nezinye izinsalela zamafutha (i-plaque) zinqwabelana ngokuhamba kwesikhathi emithanjeni yegazi eyinhloko esiswini nasesinqeni sethu. Imithambo yegazi eyinhloko ethintekile ngale ndlela yile:
- I-aorta yesisu: Lena yingxenye ye-aorta eyehla isuka ngaphakathi esiswini sethu.
- Imithambo ye-Iliac:Lezi ziqala eduze kwe-groin, lapho i-aorta ihlukana khona kabili. Lezi yizo ezihamba ziye endaweni ye-groin bese ziba yimithambo ye-femoral.
Uma i-plaque inqwabelana ngaphakathi kwale mithambo yegazi futhi iyincipha, izingxenye ezingezansi zomzimba wethu, njengemilenze, izinyawo, nezinye izitho ezisesinqeni, azitholi inani elidingekayo legazi elinomoya-mpilo. Uma lesi simo siba sibi kakhulu, kungaba nezinkinga ezahlukahlukene.
Into ebaluleke kakhulu ukuthi lokhu kuhlinzwa akukwazi ukwelapha lesi sifo ngokuphelele. Kodwa-ke, kuyasiza ukulawula izimpawu nokuvimbela izinkinga ezinkulu.
| Inkinga | Kuchazwe kalula |
|---|---|
| Ubuhlungu bomlenze lapho uhamba (i-Intermittent claudication) | Ubuhlungu obukhulu noma ukuqina okwenzeka lapho imisipha ingatholi igazi elidingekayo lapho uhamba. Buyaphela ngokuphumula. |
| Ubuhlungu obukhulu obuvela ngisho nalapho uphumule | Ukujikeleza kwegazi kuphansi kangangokuthi imilenze iyabuhlungu ngisho noma ungenzi lutho, ikakhulukazi ebusuku. |
| I-gangrene | Ukunikezwa kwegazi ezicutshini kunyamalala ngokuphelele, okubangela ukuba zife. Lokhu kubangela ukuthi izingxenye zonyawo zibe mnyama. |
| Ukunqunywa kwesisu | Uma isilonda singenakulawuleka, ingxenye yomlenze kungadingeka isuswe ngokuhlinzwa ukuze kusindiswe impilo. |
Ingabe lokhu ukuhlinzwa okukhulu? Ingabe zikhona ezinye izindlela?
Yebo, i-aortobifemoral bypass iwukuhlinzwa okuvulekile okwenziwa ngokusikwa okukhulu esiswini. Ngakho-ke, kubhekwa njengokuhlinzwa okukhulu, noma okukhulu.
Kodwa kulezi zinsuku, ngokuthuthuka kobuchwepheshe, kunezindlela zokwelapha ezihlukile zalokhu. Enye yezindlela eziyinhloko yindlela ebizwa ngokuthi i-aortoiliac stenting ene-bifurcation reconstruction (AISBR) . Lokhu kungokwesigaba sokuhlinzwa kwe-endovascular .
Kalula nje, lokhu kuhilela ukufaka i-cannula emthanjeni wegazi ngembobo encane e-groin, ukuya endaweni evinjiwe, bese ufaka ipayipi elincane elifana ne-mesh (i-stent) kuyo ukuze unwebe umthambo wegazi futhi. Le ndlela inezinkinga ezimbalwa zokuhlinzwa kanye nokuhlala isikhathi esifushane esibhedlela.
Udokotela wakho uzonquma ukuthi iyiphi inketho engcono kakhulu kuwe. Ngokuvamile, ukuthungwa nge-stenting kunconywa kubantu abasengozini enkulu yokuhlinzwa okukhulu ngenxa yezinye izimo zezokwelapha. Kodwa-ke, ngezinye izikhathi, kuye ngokuthi ukuvaleka kwale nqubo kungakanani, ukuhlinzwa okuvulekile kungadingeka. Ngakho-ke khuluma nodokotela wakho ngezinketho zakho kanye nezinzuzo nezingozi.
Silungiselela kanjani ngaphambi kokuhlinzwa?
Ukuhlinzwa okukhulu okufana nalokhu kudinga ukulungiselela okuningi. Ithimba lakho lezokwelapha lizokunikeza imiyalelo edingekayo. Ngokuvamile, kufanele unakekele lezi zinto.
- Ukuyeka ukubhema: Uma ubhema, kufanele uyeke ngokuphelele okungenani amasonto ama-3-4 ngaphambi kokuhlinzwa. Ukuyeka ukubhema kubaluleke kakhulu empumelelweni yokuhlinzwa, kanye nempilo yenhliziyo yakho kanye nemithambo yegazi kamuva.
- Tshela udokotela wakho nganoma yimiphi imithi oyithathayo: Uma uthatha imithi yezinto ezifana nesifo sikashukela noma umfutho wegazi ophakeme, kufanele utshele udokotela wakho ngayo. Eminye imithi kungadingeka iyekwe noma kushintshwe umthamo ngaphambi kokuhlinzwa.
- Ukuzila ukudla ngaphambi kokuhlinzwa: Uzoyalwa ukuba ugweme ukudla noma ukuphuza ngemva kwamabili ebusuku ngaphambi kokuhlinzwa. Landela le miyalelo kahle.
- Ukuthola izivivinyo ezidingekayo: Kuzodingeka wenze izivivinyo eziningana ukuqinisekisa impilo yakho ngaphambi kokuhlinzwa.
- Inkomba ye-Ankle-brachial (ABI): Ukuhlolwa okulinganisa umfutho wegazi emilenzeni.
- I-Vascular ultrasound (i-Doppler scan): I-scan yokubheka ngokuseduze ukugeleza kwegazi ngaphakathi kwemithambo yegazi kanye nanoma yikuphi ukuvaleka.
- Ukuhlolwa okufana ne-ECG ne-Echo okuhlola impilo yenhliziyo kanye nemithambo yenhliziyo.
Kwenzekani ngempela ngesikhathi sokuhlinzwa?
Ngeke uzwe lutho ngesikhathi sokuhlinzwa, njengoba uzoba ngaphansi kwe-anesthesia ejwayelekile. Ithimba lokuhlinzwa lizolandela lezi zinyathelo:
1. Ukubulala izinzwa: Ulala ubuthongo obukhulu.
2. Ukwenza izimbobo: Okokuqala, kwenziwa isimbozo esikhulu (i-laparotomy) eduze kwesisu ukuze kufinyelelwe ku-aorta. Bese kuba nezimbobo ezimbili ezengeziwe phezulu kwe-groin ukuze kufinyelelwe emithanjeni ye-femoral.
3. Ukufakwa kwe-graft:Udokotela ohlinzayo uthatha umthambo wegazi owenziwe ngendlela "Y" bese ethunga ingxenye engenhla yawo ngaphezu kokuvaleka kwe-aorta. Imilenze emibili engezansi ye-Y ithungelwe ngaphansi kokuvaleka kwemithambo ye-femoral.
4. Ukuvala izimbobo: Ngemva kokwenziwa kwe-bypass entsha, izimbobo ezenziwe esiswini nasemaqakaleni zivalwa ngezithungo noma ngezinti.
Lonke lolu hlinzwa lungathatha amahora amabili kuya kwayisithupha .
Kwenzekani esibhedlela ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, kuzodingeka uhlale esibhedlela izinsuku eziphakathi kwezi-4 neziyi-7. Phakathi nalesi sikhathi, ithimba lezokwelapha lizokunakekela kahle kakhulu.
- Uzogcinwa egunjini lokunakekelwa okujulile (ICU) noma egunjini elikhethekile futhi uqashwe ngokucophelela ukuze kutholakale noma yiziphi izinkinga, ikakhulukazi izifo.
- Ngihlala ngihlola ukuthi ukujikeleza kwegazi emilenzeni yakho kulungile yini.
- Zizokusiza kancane kancane ukuhamba. Okokuqala ibanga elifushane, bese wandisa ibanga usuku nosuku.
- Ama-painkiller anikezwa ukulawula ubuhlungu.
Iyini impumelelo kanye nezingozi zalokhu kuhlinzwa?
Lokhu kuhlinzwa kuphumelele kakhulu. Ngokwezibalo, phakathi kuka-80% no-95% wokuhlinzwa kugcina ukugeleza kwegazi ngempumelelo iminyaka emi-5. Eminyakeni eyi-10, izinga lempumelelo liphakathi kuka-74% no-86%.
Njenganoma yikuphi ukuhlinzwa okukhulu, kunezingozi nezinkinga ezingase zenzeke. Ngaphambi kokuba wethuke, khumbula ukuthi ithimba lezokwelapha lizokwenza konke okusemandleni alo ukunciphisa amathuba okuba lokhu kwenzeke.
Izinkinga ezingaba khona:
- Isifo senhliziyo
- Isifo sohlangothi
- Ukopha ngokweqile
- Amahlule egazi
- Ukutheleleka kwamanxeba okuhlinzwa
- Ukutheleleka nge-graft
- Ukwehluleka kwezinso
- Ukwehluleka kwamaphaphu
Khuluma nodokotela wakho ngokukhululekile ngalezi zingozi ngaphambi kokuhlinzwa bese ubuza noma yimiphi imibuzo onayo.
Ukululama kanye nezinyathelo zokuphepha ngemva kokubuyela ekhaya
Kungathatha izinyanga ezimbili kuya kwezintathu ukululama ngokugcwele, kodwa kufanele ukwazi ukuqhubeka kancane kancane nemisebenzi evamile zingakapheli amasonto amane kuya kwayisithupha.
Ukusikwa kungase kube buhlungu emasontweni ambalwa okuqala. Sebenzisa imithi yokubulala ubuhlungu oyinikezwe udokotela wakho kulokhu.
- Phuza imithi yakho njengoba nje uyalelwe: Phuza yonke imithi oyinikezwe udokotela wakho ngesikhathi esifanele nangesilinganiso esifanele.
- Gcina amanxeba ehlanzekile: Landela imiyalelo kadokotela wakho ngokucophelela mayelana nokugeza nokusebenzisa imithi.
- Ukuzivocavoca:Ukuzivocavoca okungcono kakhulu ongakwenza ezigabeni zokuqala ukuhamba. Khulisa kancane kancane ibanga olihambayo nsuku zonke. Kodwa ungenzi kanzima kunalokho okunconywa udokotela wakho.
- Gwema ukuphakamisa izinsimbi: Gwema ukuphakamisa izinsimbi ngokuphelele izinyanga ezimbalwa.
Buza udokotela wakho ukuthi ungaqala nini ukushayela futhi, ukuya emsebenzini, nokwenza ukuzivocavoca okunzima.
Ngingashayela nini udokotela ucingo?
Uma uba nanoma yiziphi izimpawu ezilandelayo ngemuva kokubuyela ekhaya, shayela udokotela wakho noma uye esibhedlela ngokushesha .
| Isibonakaliso | Okufanele ukunake |
|---|---|
| Imfiva | Kungaba uphawu lokuthi kukhona ukutheleleka emzimbeni. |
| Izinkinga ezihlobene nokusika | Ukubomvu okuzungeze inxeba, ukuvuvukala, ubuhlungu obukhulu, umuzwa wokufudumala, noma uketshezi olufana nobovu oluphuma enxebeni. |
| Ukushintsha kwemilenze | Ukuvuvukala kwemilenze, ubuhlungu, ukungazweli, ukubanda, ukuphaphatheka, noma ukuba luhlaza okwesibhakabhaka. |
| Ukuhlanza kanye nesicanucanu | Ukucanuzela noma ukuhlanza okuqhubekayo. |
Yini okufanele uyenze uma kunesimo esiphuthumayo? (Isimo esiphuthumayo)
Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo zokuhlaselwa yinhliziyo noma isifo sohlangothi , shayela isevisi ye-ambulensi ka-1990 ngaphandle kokulibala noma uye e-Emergency Treatment Unit (ETU) yesibhedlela esiseduze.
Izimpawu zokuhlaselwa yinhliziyo
- Ubuhlungu, ukuqina, noma ukungakhululeki phakathi nesifuba.
- Ubunzima bokuphefumula.
- Isicanucanu, ukungakhululeki esiswini.
- Ukushaya kwenhliziyo.
- Ukukhathala okukhulu.
- Ukuzizwa unesizungu, ukulahlekelwa ukwazi.
- Ukujuluka ngokweqile.
Izimpawu zesifo sohlangothi
- Ukuba ndikindiki noma ubuthakathaka ohlangothini olulodwa lomzimba (ubuso, ingalo, noma umlenze).
- Ubunzima bokukhuluma noma ukugwinya amagama.
- Ukulahlekelwa umbono ngokuzumayo, umbono owodwa noma emibili.
- Ikhanda elibuhlungu kakhulu ngokuzumayo.
- Ubunzima bokuhamba, ukulahlekelwa yibhalansi.
Ukubhekana nokuhlinzwa okukhulu kungaba yinto ekucindezelayo ngokomzwelo. Lokho kuyinto evamile. Khuluma ngokwesaba kwakho nokukhathazeka kwakho nomndeni wakho, kanye nodokotela wakho kanye nethimba lezokwelapha. Ukuthola lonke ulwazi oludingayo nokulusebenzisa ngokulungiselela okuhle kwengqondo kuzosiza kakhulu ngenqubo yokuphulukiswa.
Umlayezo Wokuya Nawe Ekhaya
- I-Aortobifemoral Bypass iwukuhlinzwa okukhulu okwenziwa ukuze kubuyiselwe ukugeleza kwegazi ngokugwema ukuvaleka kwemithambo eyinhloko enikeza igazi emilenzeni.
- Lokhu kuhlinzwa kunciphisa ubuhlungu lapho uhamba futhi kuvimbela izinkinga ezinkulu ezifana ne-gangrene.
- Kubaluleke kakhulu ukuyeka ukubhema ngaphambi kokuhlinzwa bese ulandela imiyalelo kadokotela.
- Nakuba lokhu kuwukuhlinzwa okukhulu, izinga lempumelelo yakho liphezulu kakhulu.
- Ngesikhathi sokululama, kubalulekile ukunakekela inxeba kahle, uphuze imithi njengoba uyalelwe, futhi ulandele iseluleko sezokwelapha.
- Uma uzwa izimpawu eziphuthumayo njengobuhlungu besifuba, ubunzima bokuphefumula, noma ukulahlekelwa ukwazi kolunye uhlangothi lomzimba, kufanele uye esibhedlela ngokushesha.
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