Ingabe uzizwa ubuhlungu obukhulu noma umuzwa wokucasuka emilenzeni yakho uma uhamba ibanga elifushane? Ingabe kuyaphela ngemva kokuma nokuphumula isikhashana, bese ubuhlungu buphinde buvele uma uqala ukuhamba futhi? Lena inkinga abantu abaningi abanayo. Imbangela enkulu yalokhu kungaba ukuvaleka kwemithambo yegazi eyinhloko ethwala igazi elinomoya-mpilo emilenzeni yakho. Namuhla, sikhuluma ngokuhlinzwa okubaluleke kakhulu, okukhulu okwenziwa esimweni esinjalo.
Kuyini i-Aortobifemoral Bypass?
Kalula nje, lokhu ukuhlinzwa okwenziwa odokotela abahlinzayo esiswini sakho (esiswini). Njengoba nje umgwaqo uvaliwe, kwakhiwa umgwaqo omusha, obizwa ngokuthi umgwaqo 'odlulayo', lokhu kuhlinzwa kudala umzila omusha wokudlula imithambo yegazi evalekile noma enciphile emzimbeni wakho. Lokhu kuvumela igazi ukuthi ligeleze kahle liye emilenzeni yakho futhi.
Kule nqubo, udokotela ohlinzayo ufaka umthambo wegazi wokwenziwa, obizwa ngokuthi i-graft, esiswini sakho bese ewuxhumanisa nomthambo wegazi ovalekile. Lo mthambo wegazi wokwenziwa uvame ukwenziwa ngezinto ezifana ne-polyester. Igama elithi "aortobifemoral" ngokwalo lisikisela lokhu.
- "I-Aorto" iwumthambo wegazi omkhulu kunayo yonke emzimbeni wethu, i-aorta . Iqala enhliziyweni bese idlula esifubeni iye esiswini.
- Igama elithi "Femoral" libhekisela emithanjeni esemathangeni akho . Le mithambo iqala endaweni yesisu bese yehlela emuva kwedolo.
- Igama elithi "Bi" lisho "okubili." Lokho kusho ukuthi lo mthambo wegazi wokwenziwa uxhumeka kuzo zombili imithambo ye-femoral emilenzeni yakho yomibili.
Cabanga ngalesi sixhumo, ``(i-Graft),'' njengo-"Y" obheke phansi. Ingxenye eyodwa engenhla yaso ixhuma kwi-aorta esiswini, kanti amagatsha amabili e-"Y" axhuma kwimithambo ye-femoral emilenzeni.
Lolu hlobo lokuhlinzwa lwenzelwa isimo esinjani?
Lokhu kuhlinzwa kwenziwa ikakhulukazi ukwelapha isimo esibizwa ngokuthi isifo sokuvaleka kwemithambo yegazi esibizwa ngokuthi i-aortoiliac occlusive disease . Lokhu kwenzeka lapho amafutha nezinye izinto (njenge-plaque) zakheka ezindongeni zangaphakathi zemithambo yegazi emikhulu esiswini sakho nasesinqeni ngokuhamba kwesikhathi. Lokhu sikubiza ngokuthi `(i-plaque)`. Lokhu kwakheka kwenzeka ngezindlela ezilandelayo:
- I-aorta yesisu: Lena yingxenye ye-aorta eyehla ngesisu.
- Imithambo ye-Iliac: Lena imithambo ephuma e-aorta enkabeni (umbilicus) bese iya emilenzeni.
Uma imithambo yegazi incipha noma ivalwe ngokuphelele yilokhu kuhlanganiswa koketshezi, umzimba wakho ongezansi, ikakhulukazi imilenze yakho, izinyawo, kanye nezitho zangasese, kuncishwa igazi elicebile ngomoya-mpilo elidingekayo. Lokhu kungaholela ezinkingeni ezinkulu.
Nakuba lokhu kuhlinzwa kungeke kuphulukise lesi sifo ngokuphelele, kungabuyisela ukujikeleza kwegazi okuhle emilenzeni, kulawule izimpawu, futhi kunciphise kakhulu ingozi yezinkinga ezinkulu.
| Izinkinga ezibangelwa ukwehla kokugeleza kwegazi |
|---|
| Ubuhlungu emilenzeni uma uhamba (Intermittent claudication) |
| Ubuhlungu obukhulu emilenzeni ngisho nalapho uphumule |
| Ukufa kwezicubu emlenzeni (i-Gangrene) |
| Ukunqunywa kwesisu |
Ingabe lokhu ukuhlinzwa okukhulu? Ingabe zikhona ezinye izindlela?
Yebo, lokhu kubhekwa njengokuhlinzwa okukhulu ngoba kudinga ukusikwa okukhulu esiswini.
Kodwa kukhona enye indlela engasetshenziswa kakhulu ebizwa ngokuthi i-aortoiliac stenting ene-bifurcation reconstruction (AISBR) . Lokhu kuhilela ukufaka ithubhu elincane elibizwa ngokuthi i-stent ngaphakathi kwe-artery evalekile bese uyifutha ukuze uvule i-artery futhi. Ezinye izifundo zibonise ukuthi le ndlela inezinkinga ezimbalwa futhi ihlala isikhathi esifushane esibhedlela.
Udokotela wakho uzonquma ukuthi ukuhlinzwa okuvulekile noma ukufaka i-stenting kulungile yini kuwe. Nakuba ukufaka i-stenting kuvame ukugcinelwa abantu abangakwazi ukubekezelela ukuhlinzwa okukhulu, ngenxa yentuthuko kwezobuchwepheshe, manje kuvame ukusetshenziswa esikhundleni sokuhlinzwa okuvulekile. Kodwa-ke, ngezinye izikhathi, uma ukufaka i-stenting kungeyona inketho enhle kuwe, noma uma i-stent yangaphambilini yehlulekile, ukuhlinzwa okuvulekile kungadingeka.
Uzilungiselela kanjani ngaphambi kokuhlinzwa?
Ithimba lakho lezokwelapha lizokweluleka ngokuthi ungalungiselela kanjani ukuhlinzwa. Lezi yizinto okufanele uzinakekele ngokuvamile.
- Yeka ukubhema ngokuphelele: Ukuyeka ukubhema okungenani amasonto ama-3-4 ngaphambi kokuhlinzwa kungakusiza ukuthi uthole imiphumela emihle kakhulu. Kubalulekile ukuqhubeka nokuyeka ukubhema ngemva kokuhlinzwa ngenxa yempilo yenhliziyo yakho kanye nemithambo yegazi.
- Khuluma nodokotela wakho ngemithi: Kufanele utshele udokotela wakho nganoma yimiphi imithi oyithathayo njengamanje. Angase akucele ukuthi uyeke ukuthatha eminye imithi noma ushintshe umthamo ngaphambi kokuhlinzwa.
- Ukuzila Ukudla: Uzokwaziswa ukuthi ungadli noma uphuze kusukela phakathi kwamabili ngosuku olwandulela ukuhlinzwa.
- Ukuhlolwa kwezokwelapha: Uzocelwa ukuthi wenze izivivinyo eziningana ngaphambi kokuhlinzwa.
- Inkomba ye-Ankle-brachial
- I-Vascular ultrasound (ukuskena kwe-ultrasound kwemithambo yegazi)
- Ama-scan ahlola impilo yenhliziyo kanye nemithambo yenhliziyo.
Kwenzekani ngesikhathi sokuhlinzwa?
Ukuhlinzwa kungathatha amahora amabili kuya kwayisithupha. Izinyathelo ezilandelayo zenzeka phakathi nale nqubo.
1. Uzonikezwa i-anesthesia ejwayelekile ukuze ulale ngokuphelele.
2. Kwenziwa i-incision enkulu (i-laparotomy) eduze kwesisu sakho ukuze udokotela ohlinzayo akwazi ukufinyelela i-aorta.
3. Kwenziwa izimbobo ezimbili kuzo zombili izimbobo ukuze kufinyelelwe emithanjeni ye-femoral.
4. Kufakwa umthambo wegazi wokwenziwa omise okwe-"Y" obizwa ngokuthi "(Graft)` , ingxenye engenhla yawo ixhunywe endaweni evinjiwe ye-aorta evela phezulu, kanti izingxenye ezimbili ezingezansi zixhunywe ezindaweni ezivinjiwe zemithambo emibili ye-femoral evela ngezansi, futhi zithungwa ndawonye.
5. Ekugcineni, ukusikwa esiswini nasesinqeni kuvalwa ngezithungo noma ngezinti.
Kwenzekani ngemva kokuhlinzwa futhi uma ubuyela ekhaya?
Kuzodingeka uhlale esibhedlela izinsuku eziphakathi kwezi-4 neziyi-7. Phakathi nalesi sikhathi, ithimba lezokwelapha lizokunakekela kahle. Futhi, kungathatha cishe izinyanga ezi-2 kuya kwezi-3 ukuze ululame ngokugcwele. Kodwa-ke, ngemva kwamasonto angaba ngu-4 kuya ku-6, uzokwazi ukuqhubeka kancane kancane nemisebenzi yakho evamile.
Nakekela lezi zinto uma ufika ekhaya.
- Phuza zonke izidambisi-zinhlungu neminye imithi oyinikezwe udokotela wakho ngesikhathi.
- Gcina izimbobo zihlanzekile futhi uzinakekele njengoba udokotela eyalile.
- Ukuzivocavoca umzimba njengoba kuqondiswe udokotela wakho. Ukwandisa kancane kancane ibanga ohamba ngalo kusiza enkambisweni yokuphulukiswa. Kodwa ungaweqisi.
- Buza udokotela wakho ngesikhathi esingcono kakhulu sokuqhubeka nemisebenzi efana nokushayela, ukuya emsebenzini, nokuphakamisa izinsimbi.
Isikhathi sokubona udokotela ngokushesha bese uya e-Emergency Treatment Unit (ETU)
Kubaluleke kakhulu ukuqapha uma kuvela izinkinga ngesikhathi sokululama.
| Uma unalezi zimpawu, shayela udokotela wakho ngokushesha. | |
|---|---|
| Imfiva | Isicanucanu nokuhlanza |
| Ubuhlungu, ukubomvu, noma ukufudumala eduze kwezimbobo | Uketshezi oluphuma emanxebeni |
| Ubomvu noma ukuvuvukala endaweni yesinqe noma emlenzeni | Ubuhlungu bomlenze, ukungazweli, noma ukulahlekelwa umuzwa |
| Isikhumba esibandayo, esikhanyayo, noma esiluhlaza okwesibhakabhaka emilenzeni noma ezinyaweni | Amanxeba emilenzeni angapholi futhi abe mabi kakhulu |
Uma kuvela izimpawu zokuhlaselwa yinhliziyo noma isifo sohlangothi, shayela isevisi ye-ambulensi esiphuthumayo ngokushesha noma uye e-Emergency Treatment Unit (ETU) yesibhedlela esiseduze.
Izimpawu zokuhlaselwa yinhliziyo:
- Ubuhlungu besifuba noma ukungakhululeki
- Ubunzima bokuphefumula
- Isicanucanu, ukungakhululeki esiswini
- Ukushaya kwenhliziyo
- Isiyezi (vertigo) noma ukuquleka
Izimpawu zesifo sohlangothi:
- Ukuba ndikindiki noma ubuthakathaka ohlangothini olulodwa lomzimba
- Ubunzima bokukhuluma (i-Aphasia) noma ukungingiza
- Ukulahlekelwa ukulawula imisipha kolunye uhlangothi lobuso
- Ukulahlekelwa noma ukufiphala kombono noma ukuzwa ngokuzumayo
Umlayezo Wokuya Nawe Ekhaya
- I-Aortobifemoral Bypass iwukuhlinzwa okukhulu, kodwa okuphumelelayo kakhulu, okwenziwa lapho umthambo oyinhloko othwala igazi emilenzeni uvalekile kakhulu.
- Lokhu kuhlinzwa kuhilela ukudala indlela entsha kusetshenziswa umthambo wegazi wokwenziwa omise okwe-'Y' ukuze kudlule umthambo wegazi ovalekile.
- Amalungiselelo anjengokuyeka ukubhema ngaphambi kokuhlinzwa angenza imiphumela ibe yimpumelelo kakhulu.
- Kuthatha izinyanga eziningana ukululama ngokuphelele ngemva kokuhlinzwa, futhi kubaluleke kakhulu ukulandela imiyalelo yezokwelapha phakathi naleso sikhathi.
- Uma ubona noma yiziphi izimpawu ezingavamile ngesikhathi sokululama kwakho, njengomkhuhlane, ukutheleleka kwenxeba, noma ubuhlungu obukhulu emlenzeni, yazisa udokotela wakho ngokushesha.
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