Cishe uke wezwa udokotela ethi, "Umthambo wegazi omkhulu entanyeni yakho uvaliwe, futhi lokhu kwandisa ingozi yakho yokuba nesifo sohlangothi." Kuvamile ukuthi noma ubani azizwe esaba kancane uma ezwa into efana nale. Kodwa ungakhathazeki, ngoba isayensi yezokwelapha isithuthukile futhi manje kunezindlela eziphumelela kakhulu zokwelapha izimo ezinjalo. Namuhla sikhuluma nge-TCAR, indlela yokwelapha yesimanje nephephile esetshenziselwa ukunciphisa ingozi yokushaywa yisifo sohlangothi.
Kuyini i-TCAR? Ake sikuqonde kalula.
I-TCAR (i-Transcarotid Artery Revascularization) iyindlela ekhethekile yokwelapha elungisa ukuvaleka kwemithambo yegazi eyinhloko entanyeni yakho ebizwa ngokuthi i-Carotid Artery . Cabanga ukuthi kwenzeka into efanayo lapha, njengomsele ovalekile ekhaya lakho. Ngaphakathi kwale mithambo yegazi, izinto ezifana namafutha ne-cholesterol ziyaqoqana bese zakha ungqimba. Lokhu sikubiza ngokuthi 'i-Plaque' .
Lolu ngqimba lwe-plaque lunciphisa kancane kancane umthambo wegazi. Into eyingozi kakhulu ukuthi uma ingxenye yalolu qweqwe iphuka futhi ivimba umthambo wegazi ebuchosheni, noma uma lokhu kuvinjelwa kumisa ngokuphelele ukugeleza kwegazi, isifo sohlangothi singaba khona.
Ngakho-ke ukuze kuvinjelwe le ngozi, odokotela belapha lezi zithiyo ukuze bazisuse. Kunezindlela ezintathu eziyinhloko zalokhu:
1. Ukuhlinzwa kwe-Carotid Endarterectomy (CEA): Lokhu kuyindlela yokuhlinzwa evamile evulekile. Udokotela wenza i-incision entanyeni, avule umthambo wegazi, bese ekhuhla i-plaque ngesandla.
2. I-Carotid Angioplasty kanye ne-Stenting (CAS): Lokhu kuhilela ukudlulisa ipayipi elincane emthanjeni wegazi, ngokuvamile e-groin noma engalweni, liye endaweni evalekile entanyeni, bese kusetshenziswa into efana nebhaluni ukwandisa ukuvaleka. Ngemuva kwalokho, kufakwa idivayisi efana ne-mesh, ebizwa ngokuthi i-stent, ukuze kuvinjwe ukuthi umthambo ungaphinde uvaleke.
3. Ukwelashwa nge-TCAR: Lokhu kufana kancane nendlela ye-CAS, kodwa kuyindlela yesimanje futhi ephephile. Lapha, i-stent ifakwa ngokusikwa okuncane entanyeni, kunokuba idlule embotsheni. Sizoxoxa ngezici ezikhethekile zalokhu kamuva.
Umgomo oyinhloko wazo zonke izindlela ezintathu ukunciphisa ingozi yakho yokushaywa yisifo sohlangothi. Udokotela wakho uzonquma ukuthi iyiphi indlela engcono kakhulu kuwe ngokusekelwe esimweni sakho sezokwelapha, ubudala, kanye nezinye izinkinga zempilo.
Ukwelashwa kwe-TCAR kufanelekela bani ngokukhethekile?
I-TCAR yethulwa okokuqala ezigulini ezazisengozini enkulu yezinkinga ezivela ekuhlinzweni okuvulekile kwendabuko (i-CEA). Izici ezingase zandise le ngozi zifaka:
- Ukuguga.
- Ukuba khona kwesifo senhliziyo noma isifo samaphaphu.
- Ukuba nezicubu zesilonda entanyeni ngenxa yokuhlinzwa kwentamo kwangaphambilini noma ukwelashwa ngemisebe.
- Uma ukuvaleka kusendaweni enzima ukusebenza kuyo, njengangaphansi komhlathi.
Kodwa manje le ndlela isetshenziswa ngempumelelo nasezigulini ezinezinga elijwayelekile lengozi.
Uzilungiselela kanjani ngaphambi kokuhlinzwa?
Uma unquma ukuthola ukwelashwa kwe-TCAR, udokotela wakho uzoqala ngoku-oda ukuhlolwa okuningana.
- Ukuhlolwa kwegazi
- Ukuskena kwe-ultrasound kwemithambo ye-carotid entanyeni
- I-CT scan ekhethekile (i-CT Angiogram) ehlola imithambo yegazi entanyeni nasebuchosheni
Ngaphezu kwalokho, ungase uqalwe ngemithi eminingana yokukulungiselela ukuhlinzwa. Lokhu kungafaka phakathi imithi yokwehlisa i-cholesterol efana nama-statin kanye nemithi yokunciphisa igazi efana ne-aspirin.
Into ebaluleke kakhulu ukuthi udokotela uzokweluleka ukuthi ungadli noma uphuze lutho ngemva kwamabili ngobusuku bangaphambi kokuhlinzwa. Kubaluleke kakhulu ukulandela leyo miyalelo ngqo.
Kwenziwa kanjani ukuhlinzwa kwe-TCAR?
Lena inqubo emangalisayo ngempela, ethuthukisiwe kwezobuchwepheshe. Nakhu okwenzekayo egumbini lokuhlinza ngamagama alula:
1. I-Anesthesia: Lokhu kwenziwa ngokukulalisa ngokuphelele (i-General Anesthesia) noma ngokufaka izinzwa kuphela endaweni ezungeze intamo yakho (i-Local Anesthesia).
2. Uhlelo lokuhlunga igazi: Okulandelayo, kufakwa ipayipi elincane emthanjeni osesiswini sakho (umthambo we-femoral). Lokhu kube sekusetshenziswa ukubuyisela igazi elihlanziwe emzimbeni wakho.
3. Ukusikwa kwentamo: Ukusikwa okuncane, okungaba yi-intshi ubude, kwenziwa entanyeni, ngaphezu nje kwethambo lentamo, ohlangothini lokuvaleka.
4. Ukuguqula ukugeleza kwegazi: Manje into ebaluleke kakhulu iyenzeka. Elinye ipayipi lifakwa emthanjeni we-carotid ngaleyo mbobo encane, bese lelo payipi lixhunywe ethanjeni elisesinqeni ngesihlungi esikhethekile. Ngemuva kwalokho, ukugeleza kwegazi emthanjeni we-carotid kuphambukiswa okwesikhashana kusuka ohlangothini lobuchopho, kuye kwenye indlela!
5. Ukuphepha: Lokhu kusho ukuthi noma ngabe kukhona izingcezu ze-plaque eziphuka ngesikhathi senqubo, ngeke ziye ebuchosheni. Kunalokho, igazi liyahlungwa, libambe yonke imfucumfucu, bese kubuyiselwa igazi elihlanzekile kuphela emzimbeni ngomthambo osesinqeni. Lesi yisinyathelo esiyinhloko sokuphepha esivimbela ingozi yokushaywa yisifo sohlangothi.
6. Ukubekwa kwe-stent: Udokotela manje uzosebenzisa ucingo oluncane ukuze adlule ekuvinjweni, alunwebe ngebhaluni, bese efaka i -stent yensimbi efana ne-mesh. Lokhu kuzoqinisekisa ukuthi umthambo wegazi uhlala uvulekile.
7. Ukuqeda: Bese kususwa wonke amapayipi, bese kuthi ukubhoboka okuncane emthanjeni nasentanyeni kuthungwe kuvaliwe. Yonke inqubo ithatha cishe ihora nesigamu.
| Izinzuzo zokwelashwa kwe-TCAR | Izingozi zokwelashwa kwe-TCAR |
|---|---|
| Isilonda entanyeni sincane kakhulu. | Ukulimala kwemithambo ye-carotid. |
| Ingozi encane yokulimala kwemizwa kunokuhlinzwa okuvulekile (i-CEA). | Ukopha noma ukuvuvukala okuzungeze indawo yokusikwa. |
| Ukuba nohlelo olukhethekile lokuhlunga igazi olunciphisa ingozi yokushaywa yisifo sohlangothi ngesikhathi sokuhlinzwa. | Ukulimala kwemizwa (okungavamile). |
| Ukukwazi ukululama ngokushesha. | Uhlangothi, ukuhlaselwa yinhliziyo noma ukufa (okungavamile kakhulu). |
Ukwelashwa kanye nokunakekelwa kwesikhathi eside
Ngemva kokuhlinzwa kwe-TCAR, uzohlala esibhedlela cishe usuku lonke. Phakathi nalesi sikhathi, abasebenzi bezokwelapha bazohlala beqapha isimo sakho. Njengoba lokhu kuwukuhlinzwa okungangenisi kakhulu, akuthathi isikhathi eside ukuthi amanxeba aphole.
Ngemva kokubuyela ekhaya, kufanele ugweme ukuphakamisa izinto ezisindayo cishe isonto lonke. Khuluma nodokotela wakho ngokuthi ungabuyela nini emsebenzini. Kubalulekile futhi ukuhlola inxeba lakho lentamo njalo ukuqinisekisa ukuthi liyaphola kahle nokuthi libonisa izimpawu zokutheleleka.
Ukushayela nini udokotela ucingo
Uma unezinye zalezi zimpawu ezibonisa ukuthi inxeba lithelelekile, shayela udokotela wakho ngokushesha:
- Imfiva
- Ukuzizwa ubanda futhi uthuthumela
- Ubomvu obuzungeze inxeba
- Ukuphuma koketshezi oluvela enxebeni
Ngemva kokufakwa kwe-stent, unesibopho esikhulu sokuvikela imithambo yegazi yakho ukuthi ingaphinde ivaleke. Ukuze wenze lokhu, kufanele wenze okulandelayo:
- Yeka ukubhema ngokuphelele.
- Vivinya umzimba njalo.
- Yidla ukudla okunempilo okunamafutha agcwele angaphansi.
- Thatha imithi udokotela wakho ayinikezayo ukuze ulawule i-cholesterol kanye nokujiya kwegazi ngesikhathi.
Umlayezo Wokuya Nawe Ekhaya
- I-TCAR iyindlela yokwelapha ephephile, yesimanje, futhi engangenisi kakhulu esetshenziselwa ukunciphisa ingozi yokushaywa yisifo sohlangothi okubangelwa ukuvaleka kwemithambo yegazi eyinhloko entanyeni.
- Ngale ndlela, ukugeleza kwegazi ebuchosheni kuyaphambukiswa okwesikhashana ngesikhathi sokuhlinzwa, kuhlungwe, bese kubuyiselwa emzimbeni, kunciphisa ingozi yokushaywa yisifo sohlangothi.
- Izinzuzo eziyinhloko zale nqubo uma kuqhathaniswa nokuhlinzwa okuvulekile (i-CEA) amanxeba amancane, ukulimala okuncane kwemizwa, kanye nokululama okusheshayo.
- Kubaluleke kakhulu ukukhuluma nodokotela wakho bese unquma ukuthi iyiphi indlela yokwelapha engcono kakhulu kuwe.
- Ngisho nangemva kokuhlinzwa, kubalulekile ukulandela indlela yokuphila enempilo nokuphuza imithi njengoba nje udokotela ekuyalele.
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