Ingabe udokotela wakho ukutshelile ukuthi umthambo wegazi omkhulu entanyeni yakho uvaliwe nokuthi usengozini yokuba nesifo sohlangothi? Kuvamile ukuzizwa wesaba kancane uma uzwa into efana nale. Kodwa ungakhathazeki. Namuhla, ezokwelapha sezithuthuke kakhulu. Kunezindlela zokwelapha eziphumelela kakhulu zokwelapha ukuvinjelwa okunjalo nokunciphisa ingozi yokuhlaselwa yisifo sohlangothi. Namuhla sikhuluma ngenye yezindlela zokwelapha eziphumelela kakhulu futhi ezingeyona inkimbinkimbi: ukufakwa kwe-stent ye-carotid.
Kalula nje, kuyini i-carotid stenting?
Kulungile, ake siqale ngokukuchaza kalula. Sinemithambo yegazi emibili emikhulu kuzo zombili izinhlangothi zentamo yethu enikeza igazi ebuchosheni bethu, ebusweni, nasentanyeni. Lokhu yilokho esikubiza ngokuthi i-Carotid Arteries . Ngokuhamba kwesikhathi, izinto ezifana namafutha kanye ne-cholesterol ekudleni esikudlayo ziqala ukwakheka ezindongeni zale mithambo. Lokhu sikubiza ngokuthi 'i-plaque' . Kufana nokugqwala okwakheka ngaphakathi kwepayipi lamanzi.
Le plaque iyanqwabelana futhi inciphise indlela engaphakathi kwemithambo yegazi, ngezinye izikhathi iyivimbe ngokuphelele. Lesi simo sibizwa ngokuthi i-carotid artery stenosis . Uma lokhu kwenzeka, ukugeleza kwegazi kuya ebuchosheni kuyancipha, okuyimbangela enkulu yesifo sohlangothi.
Ngakho-ke, i-carotid stenting iyindlela yokwelapha evula kabusha umthambo ovalekile. Lapha, udokotela ufaka i -stent , ithubhu elincane lensimbi elibunjwe njenge-mesh, endaweni evalekile bese eyifutha ngaphakathi. Umthambo ovalekile bese uyanda futhi, ubuyisele ukugeleza kwegazi. Le stent ifakwa unomphela ngaphakathi komthambo. Ifana ne-prop ebhekene nodonga oluzodilika, isize umthambo ukuthi uyeke ukuncipha futhi.
Ubani odinga lokhu kwelashwa?
Udokotela uvame ukuncoma lokhu kwelashwa ngemva kokuhlola umthambo wakho we-carotid ukuze abone ukuthi awuvalekile yini. Lokhu kungafaka ukuhlolwa okufana ne-carotid ultrasound , i-CT scan , noma i-MRI . Lokhu kwelashwa kuvame ukudingeka ku:
- Kulabo abaye baba nezimpawu ze-ministroke noma i-stroke futhi abanomthambo wabo ovalekile ngaphezu kuka-50%.
- Kulabo abangenazo izimpawu kodwa abanomthambo wabo ovalekile ngaphezu kuka-70%.
Udokotela wakho uzonquma ukuthi lokhu kwelashwa kufaneleka yini esimweni sakho, noma ukuthi ukuhlinzwa okuhlukile (i-Carotid Endarterectomy) kufanelekile.
Ukulungiselela nokwenza ukwelashwa
Udokotela wakho cishe uzokuqala ngemithi yokunciphisa igazi ezinsukwini ezimbalwa ngaphambi kokuhlinzwa kwakho, njenge -aspirin ne-clopidogrel .
Kubalulekile ukuthatha le mithi njengoba nje udokotela wakho ekutshelile. Ngaphandle kwalokho, ukwelashwa kwakho kungase kudingeke kuhlehliswe. Udokotela wakho uzokwazisa nokuthi kufanele ugweme ukudla noma ukuphuza isikhathi esingakanani ngaphambi kokwelashwa kwakho.
Kwenziwa kanjani ukwelashwa?
Lokhu kwenziwa udokotela ochwepheshe othole ukuqeqeshwa okukhethekile ngale njongo. Uzonikezwa imithi yokugwema ubuhlungu ngesikhathi sokwelashwa. Kunezindlela eziningana eziyinhloko zokufaka i-stent.
| Indlela yokwelapha | Indawo yokufaka i-Stent (Indawo Yokufinyelela) |
|---|---|
| Indlela ye-Transfemoral | Kusukela emthanjeni wemithambo yegazi kuya embotsheni yomlenze. |
| Indlela ye-Transradial | Kusukela emthanjeni kuya esihlakaleni . |
| Indlela ye-Transcarotid (TCAR) | Kwenziwa ukusika okuncane entanyeni ngaphezu nje kwethambo lentamo, ngqo ngaphezu komthambo we-carotid. |
Udokotela wakho uzonquma ukuthi iyiphi indlela engcono kakhulu kuwe. Yonke inqubo ithatha cishe ihora noma amabili. Kodwa-ke, kuzodingeka uhlale esibhedlela usuku lonke, njengoba kuzothatha amahora amaningana ukuze ulungiselele futhi uqaphe ngemva kwalokho.
Kwenzekani ngemva kokwelashwa?
Ngemva kokwelashwa, udokotela uzokwenza i-angiogram ukuhlola ukuthi i-stent isebenza kahle yini nokuthi ukugeleza kwegazi sekubuyele esimweni esijwayelekile. Ngemuva kwalokho, i-catheter namanye amadivayisi azosuswa futhi uzonikezwa noma yimiphi imithi yobuhlungu kanye neminye imiyalelo ongayidinga.
Into ebaluleke kakhulu ukuthi kuzodingeka uqhubeke nokuthatha imithi yakho yokunciphisa igazi (isib. i-Aspirin, i-Clopidogrel) ngisho noma usubuyele ekhaya. Ungayeki ukuthatha le mithi ngaphandle kokukhuluma nodokotela wakho. Ngokuvamile kuzodingeka uthathe le mithi izinyanga eziningana.
Isikhathi sokululama ngemva kokubuyela ekhaya
- Ungaphakamisi lutho olusinda ngaphezu kwamakhilogremu angu-20 (njengebhakede lamanzi) isonto lonke.
- Ungacwilisi indawo yokusikwa/yokubhoboza emanzini (akukho zibhuku zokugeza, amachibi okubhukuda) isonto lonke ngemuva kokwelashwa. Ukubhukuda kulungile.
- Qaphela kancane uma ukhuphuka izitebhisi.
- Kancane kancane jwayela indlela yakho evamile yokusebenza zingakapheli isonto.
Izinzuzo, izingozi, kanye nempumelelo yesikhathi eside yokwelashwa
Lokhu kwelashwa akudingi ukuhlinzwa okujwayelekile, okunezinzuzo eziningana. Okuyinhloko ukusikwa okuncane, ingozi encishisiwe yokulimala kwemizwa entanyeni, kanye nobuhlungu obuncane ngemva kokwelashwa.
Njenganoma yikuphi ukwelashwa kwezokwelapha, kunezingozi ezingaba khona, futhi kubalulekile ukuzazi.
Izingozi ezingaba khona zifaka phakathi ukopha, umfutho wegazi ophansi/ophezulu (i-Hypotension/i-Hypertension), ukushaya kwenhliziyo okuhamba kancane (i-Bradycardia), ukuqhekeka kwegazi, kanye nokushaywa yisifo sohlangothi okungajwayelekile. Udokotela wakho uzokuchazela lezi zingozi ngokuningiliziwe.
Into ebalulekile ukuthi lokhu kwelashwa akusiqedi isifo esiyisisekelo (i-atherosclerosis). Kususa kuphela ukuvaleka okukhona. Ngakho-ke, kubalulekile ukushintsha indlela yakho yokuphila ukuze uvimbele ukuthi umthambo ungavaleki futhi.
- Yeka ukubhema nokuvama ngokuphelele.
- Thatha umuthi onikezwe udokotela ngesikhathi.
- Gcina isisindo esinempilo.
- Vivinya umzimba njalo.
- Yamukela ukudla okunempilo kwenhliziyo okunamafutha amancane, usawoti, noshukela, kanye nezithelo nemifino eminingi.
- Gcina umfutho wegazi lakho, i-cholesterol (i-LDL ngaphansi kuka-70), kanye nesifo sikashukela (i-HbA1c ngaphansi kuka-7) kulawulwa kahle.
- Bona udokotela ngesikhathi esibekiwe bese uhlolwa.
Isimo Esiphuthumayo! Yini okufanele uyenze uma unalezi zimpawu?
Lokhu kubaluleke kakhulu. Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, shayela i-1990 Ambulance Service ngokushesha ngaphandle kokulibala noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
- Izimpawu zesifo sohlangothi: ukugoba ohlangothini olulodwa lobuso, ubunzima bokukhuluma noma ukuqonda amagama, ukulahlekelwa umuzwa noma ukuba ndikindiki engalweni noma emlenzeni.
- Uma kukhona ukopha ngokweqile noma ukuvuvukala endaweni lapho i-stent ifakwe khona (ingquza, ingalo, noma intamo).
Ngezinye izikhathi umthambo ungancipha ngenxa yokukhula kabusha kwezicubu endaweni eselashwe kuyo. Lokhu sikubiza ngokuthi 'i-restenosis' . Yingakho kubalulekile ukwenza i-ultrasound njalo.
Umlayezo Wokuya Nawe Ekhaya
- Ukufaka i-carotid stent kuyindlela ephumelela kakhulu futhi ephephile yokunciphisa ingozi yokushaywa yisifo sohlangothi.
- Lokhu kulula kunokuhlinzwa kwendabuko futhi kunesikhathi esincane sokululama.
- Kubaluleke kakhulu empilweni yakho ukuthatha imithi yokunciphisa igazi enikezwa udokotela wakho ngemva nje kokwelashwa.
- Ukululama kwesikhathi eside kuncike ezinguqukweni endleleni yakho yokuphila. Ukuyeka ukubhema, ukudla ukudla okunempilo, kanye nokuzivocavoca umzimba kubalulekile.
- Khuluma nodokotela wakho ngokukhululekile nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho.
- Qaphela izimpawu eziphuthumayo zesifo sohlangothi futhi uthathe isinyathelo ngokushesha uma zenzeka.
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