Umthambo wegazi oyinhloko othwala igazi lisuka enhliziyweni yakho liye emzimbeni wakho wonke, i-aorta, ufana nombhobho oyinhloko ophuma ethangini lethu lamanzi ekhaya. Ngezinye izikhathi lo mbhobho uba buthakathaka bese uqala ukukhukhumala njengebhaluni elidala. Kwezokwelapha, lokhu sikubiza ngokuthi i-aneurysm. Ikakhulukazi uma ingxenye eseduze nenhliziyo, i-ascensing aorta, ikhukhumala kanje, kungaba yinto engathí sina. Namuhla sizokhuluma ngokuhlinzwa okwenziwa kulesi simo.
Lokhu kuhlinzwa kwenziwa kanjani?
Kalula nje, lesi simo silungiswa ngokuhlinzwa okuvulekile kwendabuko. Udokotela wakho wenhliziyo ususa ingxenye ebuthaka nevuvukele ye-aorta yakho bese eyishintsha ngethubhu elenziwe ngezinto zokwenziwa, elibizwa ngokuthi i-graft. Le graft isebenza njengolwelwesi olusha lwe-aorta yakho. Igazi libe seligeleza kuyo ngaphandle kokuvinjelwa. Lokhu kuhlinzwa kwenziwa egumbini lokuhlinza esibhedlela.
Ubani odinga lokhu kuhlinzwa?
Uma i-aneurysm ku-aeroscending aorta yakho iqhuma noma ihlukana , kuyisimo esiphuthumayo. Lokhu sikubiza ngokuthi ukuhlukaniswa kohlobo A. Lokhu ukuhlinzwa okuphuthumayo okumele kwenziwe ngokushesha ukuze kusindiswe impilo yakho.
Futhi, uma une-aneurysm esengozini yokuqhuma noma ukuqhekeka, kungadingeka ukuthi wenze lokhu kuhlinzwa. Udokotela wakho uzokwenza izivivinyo ze-imaging (ezifana ne-CT scans, i-MRI scans) kanye noma kabili ngonyaka ukuhlola isimo sayo. Ngezinye izikhathi, uma i-aneurysm incane kakhulu noma ikhula kancane, ukuhlinzwa kungase kungadingeki isikhashana. Kodwa-ke, uma inkulu noma ibonisa izimpawu zokukhula ngokushesha , kungadingeka ukuthi ilungiswe ngokuhlinzwa ngaphambi kokuba iqhume noma iqhume.
Kalula nje, uma izingozi zokulibazisa ukwelashwa zingaphezu kwezingozi zokuhlinzwa, udokotela wakho uzoncoma ukuhlinzwa.
Yisiphi isikhathi esingcono kakhulu sokuhlinzwa?
Izici eziningana zinquma isikhathi esingcono kakhulu sokwenza lokhu kuhlinzwa. Okubaluleke kakhulu kulezi ukuthi unazo yini izimpawu. Ngaphezu kwalokho, izici ezifana nosayizi we-aneurysm, ukuthi ikhula ngokushesha kangakanani, usayizi womzimba wakho, nanoma yiziphi ezinye izimo zezokwelapha ongase ube nazo nazo zidlala indima.
Izimpawu ezidinga ukuhlinzwa okuphuthumayo
Uma uzwa ubuhlungu esifubeni, kungaba uphawu lokuthi i-aneurysm isizoqhuma. Ezimweni ezinjalo, kudingeka ukuhlinzwa okuphuthumayo.
| Izimpawu eziphuthumayo - hamba esibhedlela ngokushesha! | |
|---|---|
| Ubuhlungu obungazelelwe, obukhulu | Ubuhlungu obukhulu esifubeni noma emhlane ongaphezulu ozwakala sengathi kukhona okudabukayo ngaphakathi. |
| Ubuhlungu besifuba | Noma yiluphi uhlobo lobuhlungu besifuba. |
| Izinguquko zesikhumba | Isikhumba siyanamathela, sijuluke. |
| Ubunzima bokuphefumula | Ukukhwehlela, ukushaqeka, noma ubunzima bokuphefumula. |
| Ezinye izici | Ukujuluka, ukuquleka, ukushaya kwenhliziyo okusheshayo, isicanucanu nokuhlanza, ukuphelelwa umoya. |
Uma uhlangabezana nanoma yiziphi zalezi zimpawu, ungalibali. Shayela ngokushesha isevisi ye-ambulensi ka-1990 noma uye e-Emergency Treatment Unit (ETU) yesibhedlela esiseduze.
Usayizi we-aneurysm
Ubukhulu be-aneurysm buyisici esibalulekile ekuhleleni ukuhlinzwa. Ukuhlinzwa kungadingeka uma kufinyelela osayizi abalandelayo:
- Isilinganiso: 5.5 amasentimitha
- Kulabo abanezimo ezifana ne-Marfan syndrome: 4.5 cm
- Kulabo abanezimo ezifana ne-Loeys-Dietz syndrome: 4.0 amasentimitha
Isivinini lapho i-aneurysm ikhula khona
Ngisho noma i-aneurysm ingaphansi kwamasentimitha angu-5.5, uma ikhula ngokushesha, kuzodingeka ukuhlinzwa maduze.
- Ngokwesilinganiso: 1 cm ngonyaka noma 0.5 cm ezinyangeni eziyisithupha.
- Kubantu abanezimo ezithile (isib. i-bicuspid aortic valve): Uma ikhula ngo-0.5 cm ngonyaka.
Izinto ezikhethekile kuwe
Udokotela wakho uzocabangela nosayizi womzimba wakho kanye nezinye izimo zezokwelapha. Isibonelo, i-aneurysm encane kumuntu omncane ingaba yingozi, noma ngabe incane. Futhi, uma wenza olunye ukuhlinzwa kwenhliziyo, udokotela wakho angancoma ukuthi ulungise i-aneurysm ngesikhathi esifanayo nalolo kuhlinzwa. Lokhu kungasiza ekuvimbeleni ukuhlinzwa kwesikhathi esizayo.
Ingabe ezinye izindlela (endovascular) azikwazi ukusetshenziswa kulokhu?
Ukulungiswa kwe-aortic ye-thoracic endovascular (TEVAR) inqubo esetshenziselwa ukulungisa ama-aneurysms ku-aorta ye-thoracic eyehlayo. Kodwa-ke, le nqubo ayivamile ukusetshenziswa ku-aorta ekhuphukayo, umthambo oqala enhliziyweni. Lokhu kungenxa yokuthi isakhiwo kanye nomfutho wegazi walezi zingxenye ezimbili kuhlukile.
Kodwa-ke, ezimweni eziphuthumayo, i-TEVAR isetshenziswe ukusindisa impilo yesiguli esibuthakathaka kakhulu ukuba sihlinzwe ngendlela yendabuko. Abacwaningi okwamanje bathuthukisa amadivayisi amasha afanelana ne-ascending aorta. Ngakho-ke le ndlela ingase ivame kakhulu esikhathini esizayo. Kodwa okwamanje, ukwelashwa okungcono kakhulu nokujwayelekile ukuhlinzwa okuvulekile.
Kwenzekani ngaphambi kokuhlinzwa?
Kuzodingeka ubone udokotela wakho amasonto ambalwa ngaphambi kokuhlinzwa. Impilo yakho izohlolwa futhi kuzokwenziwa izivivinyo ezithile ezidingekayo.
Ukuhlolwa okwenziwa njalo:
- Ukuhlolwa kwegazi: Hlola ukusebenza kwezinso.
- I-CT noma i-Heart MRI: Ihlola zonke izingxenye ze-aorta. Uma kunenkinga nge-aorta valve, ingalungiswa futhi phakathi nalokhu kuhlinzwa.
- I-Coronary angiography: Ukuhlola ukugcinwa kwamafutha (i-atherosclerosis) emithanjeni ehambisa igazi enhliziyweni.
- I-Duplex ultrasound: Ihlola isimo semithambo yegazi entanyeni (imithambo ye-carotid). Izinkinga ngalezi zingandisa ingozi yokushaywa yisifo sohlangothi ngesikhathi sokuhlinzwa.
Izinto okufanele uzixoxe nodokotela:
- Imithi oyithathayo: Kufanele utshele udokotela wakho ngayo yonke imithi, amavithamini, kanye nemithi yamakhambi oyithathayo. Eminye imithi ingadinga ukuthi uyeke ukuyithatha ngaphambi kokuhlinzwa.
- Ezinye izifo: Uma unezifo ezifana nomfutho wegazi ophakeme, zidinga ukulawulwa kahle ngaphambi kokuhlinzwa.
- Indlela ozizwa ngayo: Tshela udokotela wakho uma unesifo esithile, njengomkhuhlane, umkhuhlane, noma i-herpes.
- Ukubhema: Ukubhema kufanele kuyekwe ngokuphelele okungenani inyanga eyodwa ngaphambi kokuhlinzwa.
Udokotela wakho uzokunikeza imiyalelo ecacile ngosuku lokuhlinzwa kwakho. Ukulandela leyo miyalelo kubaluleke kakhulu ukuze ukuhlinzwa kwakho kuphumelele.
Kwenzekani ngesikhathi sokuhlinzwa?
Ngesikhathi sokuhlinzwa, uzofakwa ngaphansi kwe-anesthesia ejwayelekile. Ngakho ngeke uzwe lutho. Udokotela ohlinzayo uzokwenza i-sternotomy ephakathi nendawo phakathi kwesifuba sakho, asuse ingxenye ebuthaka ye-aorta yakho, bese efaka i-graft esikhundleni sayo. Ngesinye isikhathi ngesikhathi sokuhlinzwa, uzoxhunywa emshinini we-cardiopulmonary bypass. Lokhu kuhlinzwa kuvame ukuthatha cishe amahora angu-3-4.
Kwenzekani ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, uzongeniswa egunjini lokunakekelwa okujulile (ICU). Lapho uzoqashwa izinsuku ezimbalwa. Ngemva kwalokho, uzodluliselwa egunjini elijwayelekile. Isikhathi sokuhlala esibhedlela singasukela ezinsukwini ezi-4 kuya kweziyi-10.
Ngesikhathi ngisesibhedlela,
- Uzofakwa i-catheter yomchamo.
- Imithi (ama-anticoagulant) inikezwa ukuvimbela ukujiya kwegazi.
- Kugqokwa amasokisi akhethekile okucindezela ukuze kuvinjelwe ukuqhekeka kwegazi emilenzeni.
- Ungase uxhunywe emshinini ukuze ukusize uphefumule.
- Kuzonikezwa ama-painkiller ukuze kuncishiswe ubuhlungu.
Udinga ukuqala ukuhamba kancane bese uthola amandla akho kabusha. Kodwa konke kufanele kwenziwe kancane, ngokwemiyalelo kadokotela. Njengoba ungakwazi ukushayela imoto endleleni eya ekhaya, kubalulekile ukuba nomuntu ozokuhamba nawe.
Izinzuzo, izingozi, kanye nesikhathi sokululama salokhu kuhlinzwa
| Ingxenye | Incazelo |
|---|---|
| Izinzuzo | Ukuhlinzwa okuhleliwe kungavimbela ukuqhuma noma ukuqhekeka kwe-aneurysm. Ukuhlinzwa okuphuthumayo kungasindisa impilo. |
| Izingozi | Njenganoma yikuphi ukuhlinzwa okukhulu, kunezingozi, njengokuphuma kwegazi, amahlule egazi, ukutheleleka, ukuhlaselwa yinhliziyo, isifo sohlangothi, kanye nokwehluleka kwezinso. Ingozi iphakeme kubantu abanezinye izimo zezokwelapha ezingathi sína. Udokotela wakho uzoxoxa ngezingozi zakho ngabanye. |
| Impumelelo nokuphila isikhathi eside | Ukuhlinzwa okuhleliwe (okukhethiwe) kuphumelele ngo-95% - 98%. Abantu abanjalo bangalindela ukuphila impilo efanayo neyabantu bonke. Kodwa-ke, izinga lempumelelo lokuhlinzwa okuphuthumayo liphansi kakhulu. Ngakho-ke, ukutholwa kusenesikhathi kanye nokwelashwa kubaluleke kakhulu. |
| Isikhathi sokutakula | Kungathatha amasonto angu-4-6 noma ngisho nezinyanga ukuze ululame ngokugcwele. Ngemva kokuphuma esibhedlela, ungabuyisa amandla ngokushesha ngokuhlanganyela ohlelweni lokuvuselela inhliziyo. |
Izinto okufanele uzilandele ngesikhathi sokululama
- Gwema ukushayela: Ungashayeli kuze kube yilapho udokotela wakho ekunike imvume.
- Gwema ukuphakamisa izinsimbi: Ungaphakamisi ngaphezu kwamakhilogremu angu-4.5 (4.5 kg) amasonto angu-4-6.
- Ukuzivocavoca: Gwema ukuzivocavoca okunzima okukwenza uzizwe uphelelwa umoya. Buza udokotela wakho ukuthi yikuphi ukuzivocavoca okufanele.
- Ukunakekelwa Kokusikwa: Gcina isitho sihlanzekile. Sihlole nsuku zonke ukuze ubone izimpawu zokubomvu, ukuvuvukala, noma ubomvu. Ukubamba umcamelo esifubeni sakho uma ukhwehlela noma uthimula kuzosiza ekunciphiseni ubuhlungu.
Ingabe ngidinga ukushintsha indlela yami yokuphila ngemva kokuhlinzwa?
Yebo. Kubaluleke kakhulu ukwenza izinguquko ezithile endleleni yokuphila ukuze kuncishiswe ingozi yesifo senhliziyo esikhathini esizayo.
- Yidla ukudla okunempilo kwenhliziyo: ikakhulukazi nciphisa usawoti (i-sodium).
- Ukuzivocavoca: Buza udokotela wakho ngezivivinyo ezifanele wena.
- Uma ubhema, yeka ngokushesha: Ukubhema kubangela umonakalo omkhulu emithanjeni yakho yegazi.
- Lawula umfutho wegazi ophakeme, i-cholesterol kanye nesifo sikashukela.
Kufanele ngimbone nini udokotela?
Naka umzimba wakho ngesikhathi ululama. Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, shayela udokotela wakho ngokushesha.
| Izici okufanele uziqaphele | |
|---|---|
| Izinkinga zokusikwa | |
| - Ubomvu, ubuhlungu, ukufudumala, noma ukuvuvukala. - Igazi noma uketshezi olucacile oluphuma ngebhandishi. - Ukuphuma kobomvu okuluhlaza noma okuphuzi. - Ukuhlukaniswa komphetho endleleni yokusika. | |
| Ezinye izinkinga ezinkulu | |
| - Ubuhlungu esifubeni noma ukuphelelwa umoya ngisho noma uphumule. - Ukuvuvukala kwemilenze noma ukungakwazi ukuhambisa imilenze. - Ukuzumeka, ukuquleka, noma ukukhathala okukhulu. - Ukukhwehlela igazi, noma i-mucus ephuzi/eluhlaza okotshani. - Ukugodola noma umkhuhlane. - Igazi esitulweni. |
Kujwayelekile ukuba nemibuzo eminingi ngaphambi kokuba kwenziwe ukuhlinzwa okunje. Khuluma nodokotela wakho ngayo yonke ngokukhululekile. Uma udokotela encoma lokhu kuhlinzwa, bathi izingozi zokungakwenzi ukuhlinzwa ziphakeme kakhulu kunokukwenza. Abantu abalulama ekuhlinzweni okuhleliwe bayaqhubeka nokuphila impilo evamile. Ngakho-ke ngethimba lezokwelapha elifanele kanye nokunakekelwa okufanele, ungalulama ngokushesha futhi ubuyele empilweni yakho evamile.
Umlayezo Wokuya Nawe Ekhaya
- I-Aneurysm ye-Aortic ekhuphukayo iwukuvuvukala kwe-aorta yenhliziyo. Lesi yisimo esibucayi esidinga ukubhekwa ngokucophelela.
- Izinga lempumelelo lokuhlinzwa okukhethwayo liphezulu kakhulu. Ngakho-ke, ungakuhlehlisi ukuhlinzwa uma kukhona ingozi.
- Uma uzwa ubuhlungu obungazelelwe, obukhulu esifubeni noma emhlane, kungaba uphawu lokuqhuma kwe-aneurysm. Yiya eMnyangweni Wezimo Eziphuthumayo wesibhedlela (ETU) ngokushesha.
- Kuthatha isikhathi ukululama ngemva kokuhlinzwa. Landela imiyalelo kadokotela wakho ngqo.
- Ukulandela indlela yokuphila enempilo yenhliziyo ngemva kokuhlinzwa kubaluleke kakhulu empilweni yakho yesikhathi eside.
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