Ingabe ngezinye izikhathi uzizwa ukuqina noma ubuhlungu esifubeni sakho uma ukhathele kancane, noma uma ukhuphuka izitebhisi? Noma ingabe unenkinga yokuphefumula? Lokhu kungaba ukukhathala okuvamile, kodwa ngezinye izikhathi kungaba yinkinga ngomthambo othwala igazi enhliziyweni yethu. Namuhla sizokhuluma ngesimo esingathi sína, kodwa kubaluleke kakhulu ukuqaphela. Leso yisimo esibizwa ngokuthi i-CTO, noma i-Chronic Total Occlusion.
Kalula nje, iyini i-CTO (Chronic Total Occlusion)?
Ake sithi unepayipi eliyinhloko eliletha amanzi endlini yakho. Ngokuhamba kwesikhathi, leli payipi livaleka ngokugqwala nokungcola, futhi ekugcineni livaleke ngokuphelele, livimbele ngisho nethonsi lamanzi ukuthi ligeleze.
Kwenzeka into efanayo nasezinhliziyweni zethu. Sinemithambo yegazi (esiyibiza ngokuthi imithambo yenhliziyo) enikeza igazi elihlanzekile ezinhliziyweni zethu. Uma izinto ezifana namafutha ne-cholesterol zifakwa ngaphakathi kwale mithambo isikhathi esithile, bese umthambo uvaleka ngokuphelele (100%), okusho ukuthi uma lokhu kuvimbeka kuqhubeka isikhathi esingaphezu kwezinyanga ezintathu , sibiza leso simo ngokuthi yi-Chronic Total Occlusion (CTO) .
Uma umthambo uvaleka ngokuphelele ngale ndlela, ingxenye yenhliziyo ethintekile ayitholi umoya-mpilo nezakhamzimba ezidingayo. Lokhu kungabangela izimpawu ezifana nobuhlungu besifuba nobunzima bokuphefumula. Kwezinye izimo, lokhu kungaba kubi kakhulu, kuze kuholele nasekuhlaselweni yinhliziyo.
Ubani osengozini enkulu yokuthola lesi simo se-CTO?
I-CTO ivame ukubonakala kubantu abanesifo senhliziyo, ikakhulukazi isifo semithambo yegazi yenhliziyo (CAD). Kulinganiselwa ukuthi cishe umuntu oyedwa kwabathathu abane-CAD angase abe ne-CTO.
Izinto ezifanayo eziyingozi ezivame ukuba nomthelela ezifweni zenhliziyo nazo zinegalelo ku-CTO. Bheka ukuze ubone ukuthi unazo yini lezi zinto.
| Isici sengozi | Incazelo elula |
|---|---|
| Ukubhema | Lesi yisitha esikhulu. Ukubhema konakalisa imithambo yegazi futhi kusheshise ukwakheka kwama-depositi ngaphakathi kuyo. |
| Umfutho wegazi ophezulu (i-Hypertension) | Njengoba ukucindezeleka kukhuphuka, izindonga zemithambo yegazi ziyalimala futhi amathuba okufakwa kwe-cholesterol ayanda. |
| I-cholesterol ephezulu (i-Hyperlipidemia) | Uma inani le-cholesterol embi (LDL) egazini landa, liqala ukunamathela ngqo ezindongeni zemithambo yegazi. |
| Isifo sikashukela | Uma amazinga kashukela engalawulwa, kulimaza imithambo yegazi futhi kwandisa ukwakheka kwalezi zinsalela. |
| Ukukhuluphala ngokweqile | Isisindo somzimba sihlotshaniswa nesifo senhliziyo. I-BMI engaphezu kuka-30 isengozini enkulu. |
| Umlando womndeni wesifo senhliziyo | Uma umama wakho, ubaba, noma izingane zakini zinesifo senhliziyo, nawe ungase ube sengozini. |
| Ukuntuleka kokuzilolonga | Ukungawugcini umzimba wakho usebenza kufana nokufaka isandla esifweni senhliziyo. |
| Ukuhlaselwa yinhliziyo kwangaphambilini noma ukuhlinzwa kwe-bypass | Uma uke wahlaselwa yinhliziyo noma wahlinzwa nge-bypass ngaphambilini, usengozini yokuthola i-CTO komunye umthambo. |
Into ebaluleke kakhulu ukuthi ingozi yokuthola i-CTO iyanda njengoba sikhula. Ngakho-ke, sidinga ukunakekela inhliziyo yethu kakhudlwana njengoba siguga.
Ziyini izimpawu ze-CTO?
Izimpawu ze-CTO zingahluka kumuntu nomuntu. Abanye abantu bangase bangabi nazo nhlobo izimpawu. Kodwa-ke, izimpawu ezivame kakhulu yilezi:
- Ubuhlungu besifuba, ukuqina, noma ingcindezi: Kungase kuzwakale sengathi othile ucindezela isifuba sakho.
- Ubunzima bokuphefumula (i-Dyspnea):Ukuzizwa uphelelwa umoya uma uzikhandla, njengalapho uhamba ibanga elifushane noma ukhuphuka izitebhisi.
- Ukukhathala okukhulu: Ukuzizwa ukhathele ngaso sonke isikhathi, ngisho noma ungenzi msebenzi.
- Ukuzizwa unesizungu.
- Ukushaya kwenhliziyo okungajwayelekile.
- Isicanucanu.
- Ubuhlungu engalweni engenhla: ikakhulukazi engalweni yesobunxele.
Into ebalulekile ukuthi lezi zimpawu zivame kakhulu uma ukhathele. Ziyaphela uma uphumula. Kodwa-ke, ngezinye izikhathi lezi zimpawu zingavela ngisho noma ungakhathele nhlobo.
Udokotela ukuthola kanjani lokhu?
Uma unalezi zimpawu, kufanele nakanjani ubonane nodokotela. Uzokuhlola futhi, uma kudingeka, akuthumelele ukuhlolwa okuningana.
Ukuhlolwa okuyinhloko ukuqinisekisa ukuthi une-CTO yini i-coronary angiogram . Kulokhu, ithubhu elincane kakhulu lidluliselwa emthanjeni ongalweni noma emlenzeni wakho liye emithanjeni yenhliziyo, bese kufakwa uketshezi olukhethekile (udayi ohlukile). Ngemuva kwalokho, kuthathwa i-X-ray ukuze kubonwe ukuthi lolu ketshezi lugeleza kanjani emithanjeni yenhliziyo. Uma kukhona ukuvaleka emthanjeni, lolu ketshezi alukwazi ukugeleza kude, ngakho luzobonakala kahle.
Ngaphezu kwalokho, udokotela angase ancome ezinye izivivinyo ezifana nalezi:
- I-ECG (i-Electrocardiogram): Buka umsebenzi kagesi wenhliziyo.
- I-Echocardiogram (Echo): Iskeni sokubheka ukusebenza kwenhliziyo kanye nokugeleza kwegazi.
- Ukuhlolwa Kokucindezeleka: Bona ukuthi inhliziyo yakho isabela kanjani uma uzikhandla kancane (njengokugijima ku-treadmill).
- I-MRI Yenhliziyo: Thola isithombe esicacile sesakhiwo senhliziyo kanye nokugeleza kwegazi.
Yiziphi izindlela zokwelapha i-CTO?
Uma kutholakale ukuthi une-CTO, ungesabi. Manje kunezindlela eziningi zokwelapha ezisebenzayo zalokhu. Uhlelo lokwelapha luzoncika ebunzimeni bezimpawu zakho, indawo yomthambo ovalekile, kanye nempilo yakho iyonke. Kunezinhlobo ezimbili eziyinhloko zokwelapha.
1. Ukungenelela Kwenhliziyo Ehamba Ngesinqe (PCI)
Lolu uhlobo lokwelashwa oluvame ukusetshenziswa kakhulu, olungadingi ukuhlinzwa. Lwenziwa ngendlela efanayo ne-angiogram.
- Ipayipi elincane kakhulu (i-catheter) lidluliselwa ngemithambo engalweni noma emlenzeni liye enhliziyweni lapho kukhona khona umthambo ovalekile.
- Ibhaluni elincane lidlula kulelo payipi bese lifuthwa lapho kuvimbeke khona. Ungqimba lwamafutha oluqongeleleke ngaphakathi komthambo lucindezelwa emaceleni, luvule umthambo.
- Ngemuva kwalokho, kufakwa ithubhu elincane elinoxhumano olubizwa ngokuthi i-stent phezu komgodi. I-stent isiza ukugcina umthambo uvulekile futhi ivimbele ukuthi ungaphinde uvaleke.
Izifundo zikhombisile ukuthi le ndlela iphumelela cishe ku-86% weziguli.
2. Ukuhlinzwa Kokuhlinzwa Kwemithambo Yenhliziyo (i-CABG)
Lokhu ukuhlinzwa kwenhliziyo okuvulekile. Kunconywa kuphela uma imithambo eminingi ivaliwe, noma uma ukuvaleka kuyinkimbinkimbi kakhulu ukuba kungavulwa nge-PCI.
Kalula nje, lokhu kuhilela ukudala "indlela yokudlula" yomthambo ovinjiwe. Okusho ukuthi, kuthathwa ingcezu yomthambo evela kwenye ingxenye yomzimba wakho (ngokuvamile esifubeni noma emlenzeni) bese kwakheka indlela entsha yokuthi igazi ligeleze lizungeze ingxenye evinjiwe.
Lokhu kuhlinzwa kuveza imiphumela ephumelelayo cishe ku-60% weziguli.
Udokotela wakho wenhliziyo uzochaza ngokuningiliziwe ukuthi iyiphi indlela yokwelapha efaneleka kakhulu kuwe.
Imibuzo okufanele uyibuze udokotela wakho
Uma kutholakale ukuthi une-CTO, kuvamile ukuba nemibuzo eminingi engqondweni yakho. Ungesabi noma ungabaze ukubuza le mibuzo kudokotela wakho.
- "Dokotela, yiziphi izimpawu zokuqala zale CTO?"
- "Yiziphi izivivinyo okudingeka ngizenze ukuze ngiqinisekise lokhu?"
- "Yiziphi izinguquko okudingeka ngizenze endleleni yami yokuphila ukuze ngivimbele lesi simo ukuba singenzeki?"
- "Yiziphi izindlela zokwelapha enginazo? Yini engcono kakhulu kimi?"
- "Ngemva kokwelashwa, amathuba okuba lesi simo siphinde sivele angakanani?"
Umlayezo Wokuya Nawe Ekhaya
- I-CTO (Chronic Total Occlusion) yisimo esibi lapho umthambo wegazi ohambisa igazi enhliziyweni uvaleka ngokuphelele (100%) izinyanga ezingaphezu kwezintathu.
- Isizathu esiyinhloko salokhu ukubekwa kwezinto ezifana ne -cholesterol namafutha ezindongeni zemithambo yegazi.
- Ukubhema, umfutho wegazi ophakeme, isifo sikashukela, kanye ne-cholesterol ephezulu yizinto eziyinhloko eziyingozi. Kubaluleke kakhulu ukulawula lokhu.
- Uma unezimpawu ezifana nobuhlungu besifuba, ubunzima bokuphefumula, noma ukukhathala okukhulu , ungazinaki futhi funa iseluleko sezokwelapha ngokushesha.
- Ungakhathazeki, manje kunezindlela zokwelapha eziphumelela kakhulu njenge-PCI (ukubekwa kwe-stent) kanye ne-CABG (ukuhlinzwa kwe-bypass).
- Indlela yokuphila enempilo (ukudla okuhle, ukuvivinya umzimba) kanye nokuthatha imithi oyinikezwe udokotela wakho kuzosiza kakhulu ekulawuleni lesi simo.
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