Cabanga nje uyinsizwa ephilile edlala ikhilikithi, izivocavoca kanzima ejimini. Kodwa kungazelelwe ingalo yakho iqala ukuqaqamba, ivuvukale, futhi ibukeke iluhlaza okwesibhakabhaka. Ngokuvamile kucatshangwa ukuthi kufana nokucindezeleka kwemisipha. Kodwa lokhu kungaba yisimo esibi kakhulu, kodwa esingelapheka kakhulu. Namuhla sikhuluma ngesinye salezo zimo, 'i-Axillo-Subclavian Vein Thrombosis' noma i-ASVT ngamafuphi.
Kalula nje, iyini le ASVT?
Kalula nje, i-ASVT ukwakheka kwehlule legazi emthanjeni ojulile engalweni yakho engenhla, njengomthambo we-axillary noma umthambo we-subclavian. Lokhu kuvame ukwenzeka ngemva kokulimala engalweni yakho noma uma usebenzisa ingalo yakho kakhulu futhi wenza into efanayo ngokuphindaphindiwe. Lesi simo sibizwa nangokuthi i-Paget-Schroetter syndrome kanye ne-thrombosis ebangelwa umzamo.
Ingabe nalokhu uhlobo lwe-DVT? Uyini umehluko?
Yebo, i-ASVT nayo uhlobo lwe-deep vein thrombosis (DVT). Kodwa uma sivame ukuzwa nge-DVT, sizwa ngamahlule egazi akhiwa emilenzeni. Kubangelwa izinto ezifana nokuhlala endaweni efanayo isikhathi eside, ukukhuluphala ngokweqile, nokuguga. Kodwa lesi simo esibizwa nge-ASVT sihluke kakhulu kunalokho.
Ungawuqonda kalula lo mehluko kusukela kuthebula elingezansi.
| Isici | I-DVT evamile esiyaziyo | I-ASVT (i-DVT engalweni) |
|---|---|---|
| Isizathu | Ukungakwazi ukwenza lutho, ukukhuluphala, ukuguga, ngemva kokuhlinzwa. | Ukulimala esandleni, ukucindezeleka ngokweqile esandleni (ezemidlalo, emsebenzini). |
| Indawo ethintekile | Ngokuvamile imithambo emilenzeni. | Imithambo engxenyeni engenhla yengalo, ekhwapheni, kanye nasehlombe. |
| Abantu abathintekile | Ngokuvamile abantu abadala, abangasebenzi kahle. | Intsha enempilo, esebenzayo, neyasezemidlalo ephakathi kweminyaka eyi-15-45 . |
Ubani onamathuba amaningi okuthola lesi simo?
Nakuba lokhu kungase kubonakale kumangalisa, i-ASVT ivame kakhulu ukuvela kubantu abaphilile ngokomzimba, abanempilo, nabakhuthele , ikakhulukazi labo abaneminyaka ephakathi kwengu-15 no-45.
Cabanga ngabantu abanjengalaba:
- Abantu abahlanganyela ekuzivocavoceni okuphindaphindiwe noma kwezemidlalo ezihilela ukuphakamisa izingalo zabo, njengokubhowula okusheshayo ekhilikithi, ukudlala i-volleyball, ukubhukuda, noma ukuphakamisa izinsimbi.
- Abantu abasebenza emisebenzini yezandla, njengabapendi kanye nochwepheshe bezogesi.
- Abantu abanezinkinga zokujiya kwegazi nabo basengozini.
Ziyini izimpawu zalesi simo?
Izimpawu ze-ASVT zivame ukuvela ngokuzumayo. Izimpawu eziyinhloko yilezi:
- Ubuhlungu esandleni.
- Imithambo esezandleni iyavuvukala futhi ibonakale ngokucacile.
- Ukushintsha kombala wesikhumba sezandla (i-Cyanosis).
- Umuzwa wokusinda noma ukukhathala esandleni.
- Ukuvuvukala kwesandla ngokuzumayo (lesi yisibonakaliso esivame kakhulu).
Okuthile okufanele ukuqaphele! Ngezinye izikhathi leli qhubu legazi lingaphuma emthanjeni bese libhajwa emaphashini. Lokhu sikubiza ngokuthi i -Pulmonary Embolism (PE) . Lesi yisimo esiyingozi kakhulu, esisongela ngisho nokuphila. Ngakho-ke, uma uzwa ukuvuvukala engalweni yakho, ubunzima bokuphefumula, noma ubuhlungu besifuba , hamba uye eMnyangweni Wezimo Eziphuthumayo wesibhedlela (ETU) ngokushesha.
Iyini imbangela yangempela ye-ASVT?
Nansi indlela esebenza ngayo. Cabanga ngomthambo wegazi (umthambo) ehlombe lakho ofana nombhobho wamanzi. Kuzo zombili izinhlangothi zalo mbhobho, ubambo nomsipha kuboshwe ngokuqinile. Uma wenza umsebenzi ohilela ukuphakamisa ingalo yakho, umthambo uyacindezelwa phakathi kwalowo msipha nobambo, okubangela ukuba ulimale.
Ngokuhamba kwesikhathi, izicubu zesilonda zakheka endaweni yokulimala, okwenza umthambo unciphe kakhulu. Lokhu kuvimbela ukugeleza kwegazi. Yilapho-ke kuqala ukwakheka amahlule egazi. Isimo esiyisisekelo esibangela ukuthi lomthambo uvaleke sibizwa ngokuthi i-thoracic outlet syndrome (TOS).
Ukuthola kanjani lokhu, Dokotela?
Ngokusekelwe ezimpawu zakho, uma udokotela wakho esola lokhu, uzoyala ukuhlolwa okuningana ukuqinisekisa isimo ngemuva kokuhlolwa ngokomzimba.
- I-Duplex ultrasound: Lolu uhlobo lokuhlola oluvame kakhulu. Lusebenzisa amaza omsindo ukubheka ukuthi igazi ligeleza kanjani ngaphakathi kwemithambo yegazi nokubona ukuthi kukhona yini amahlule egazi.
- I-venography eqondiswa yi-catheter: Ithubhu elincane (i-catheter) lifakwa emthanjeni, kufakwe idayi ekhethekile, bese kuthathwa i-X-ray ukuze kubonakale ukuthi ihlule legazi likuphi nokuthi imithambo ivimbeke kangakanani.
- I-CTA (i-computerized tomography angiography): I-CT scan ithatha izithombe ezinemininingwane zemithambo yegazi.
- I-MRA (i-magnetic resonance angiography): Ukuhlolwa kwemithambo yegazi kusetshenziswa i-MRI scan.
Yiziphi izindlela zokwelapha lokhu?
I-ASVT yisimo okumele selashwe. Ukulibazisa ukwelashwa akukuhle. Indlela eyinhloko yokwelapha i-'Thrombolysis'.
Izindlela zokwelapha
- I-Thrombolysis (ukuncibilika kwe-clot): Lokhu kuhilela ukunikeza umuthi oncibilikisa i-clot ngqo emthanjeni lapho i-clot itholakala khona ngethubhu efana ne-cannula (i-catheter).
- Ukususwa kwe-Thrombectomy (ukususwa kwe-blood clot): Ngezinye izikhathi odokotela basusa ngokoqobo leli hlwili legazi ngokuhlinzwa okuncane.
- Izinto zokunciphisa igazi: Ngemva kokususwa kwehlule legazi, uzonikezwa izinto zokunciphisa igazi izinyanga eziningana ukuze uvimbele ukwakheka kwamahlule egazi futhi.
Kanye nalokhu kwelashwa, udokotela uzokunikeza esinye iseluleko.
- Ukuphumula isandla kuze kube yilapho izimpawu ziphela.
- Ukuphakamisa ingalo kubizwa ngokuthi "ukuphakama kwengalo".
- Ukudluliselwa ekwelashweni ngokomzimba.
- Ukugqoka isembozo esikhethekile esifana nebhandishi (umkhono wokucindezela) engalweni.
Kwezinye izimo, ingcezu encane yomsipha noma ingcezu yombambo wokuqala ovimba umthambo isuswa ngokuhlinzwa ukuze umthambo ugeleze ngokukhululeka.
Sinjani isimo ngemva kokwelashwa?
Lokhu kuyinto ebaluleke kakhulu. Uma i-ASVT itholakala kusenesikhathi futhi ukwelashwa kuqalwe kusenesikhathi, imiphumela iba yimpumelelo enkulu. Izifundo zikhombisile ukuthi kunezinga lempumelelo eliphakathi kuka-90% no-95%.
Kodwa-ke, abanye abantu bangase babe nenkinga ebizwa ngokuthi 'i-post-thrombotic syndrome (PTS).' Lokhu kusho ukuthi izimpawu ezifana nobuhlungu, ukusinda, nokuvuvukala engalweni kuyaqhubeka ngisho nangemva kokwelashwa. Ngakho-ke, kubaluleke kakhulu ukulandela imiyalelo kadokotela ngqo.
Ingabe lesi simo singavinjelwa?
Nakuba kungenakuvinjelwa ngokuphelele, kunezinto eziningana ongazenza ukuze unciphise ingozi.
- Ungenzi izivivinyo ezinzima noma usebenze isikhathi eside, bese uthatha ikhefu phakathi kwazo.
- Yelula imisipha yakho ngaphambi nangemva kokuzivocavoca.
- Ungaphakamisi izinsimbi ezingenakukwazi ukuthwala imisipha yakho.
- Zama ukusebenzisa ingalo yakho engalawuleki noma nini lapho kungenzeka.
Kufanele ngimbone nini udokotela?
Bonana nodokotela ngokushesha lapho ubona izimpawu zokuqala ze-ASVT (ukuvuvukala okungazelelwe, ubuhlungu, ukuba luhlaza kwesandla). Futhi, uma kuvela izimpawu ezilandelayo, zibheke njengesimo esiphuthumayo bese uya e-Emergency Treatment Unit (ETU) yesibhedlela ngokushesha.
- Ubuhlungu besifuba
- Ubunzima bokuphefumula (ukuphelelwa umoya)
- Ukuba ndikindiki
Umlayezo Wokuya Nawe Ekhaya
- I-ASVT iyi-blood clot emthanjeni engalweni engenzeka ngisho nasebantwini abasha abanempilo futhi abakhuthele.
- Ukuvuvukala okungazelelwe, ubuhlungu, kanye nesikhumba esiluhlaza okwesibhakabhaka yizimpawu eziyinhloko. Uma ubona lokhu, ungazinaki.
- Uma izimpawu zengalo yakho zihambisana nobuhlungu besifuba noma ubunzima bokuphefumula, kungaba uphawu lwe- pulmonary embolism (PE) esongela impilo. Yiya ekamelweni eliphuthumayo ngokushesha.
- Lesi simo singelapheka ngempumelelo enkulu uma sitholakale futhi selashwa kusenesikhathi. Ngakho-ke, uma unokungabaza, bona udokotela wakho.
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