Ake sixoxe ngomthambo wegazi omkhulu nobaluleke kakhulu emzimbeni wakho. Siwubiza ngokuthi "i-aorta." Cabanga ngawo njengepayipi eliyinhloko elithwala amanzi lisuka ethangini lamanzi liye ekhishini nasendlini yokugezela endlini yethu. Kungale aorta lapho igazi elihlanzekile, elinomoya-mpilo lisakazeka khona emzimbeni wonke. Kodwa ngezinye izikhathi lo mthambo oyinhloko ungaba nezinkinga. Izindonga zawo zingaba buthakathaka futhi zivuvuke njengebhaluni, noma ungaqhuma ngokuzumayo. Yilapho odokotela bekhuluma khona ngokuhlinzwa "kwe-aorta". Leli gama lizwakala lithusa kancane, kodwa masiliqonde kalula.
Kuyini Ukuhlinzwa Kwe-Aorta?
Kalula nje, ukuhlinzwa kwe-aorta bypass kuyindlela yokulungisa iphutha noma umonakalo kulo mthambo wegazi omkhulu emzimbeni wakho. Uxhuma enhliziyweni, ugeleze kusukela lapho ngesifuba uye esiswini, bese ungena emithanjeni ehambisa igazi emilenzeni.
Uma izindonga zale aorta ziba buthakathaka ngesizathu esithile, ingcindezi yegazi iyayelula kancane kancane bese iqala ukukhukhumala njengebhaluni . Kwezokwelapha, lokhu sikubiza ngokuthi i-aneurysm . Ngezinye izikhathi, ulwelwesi olungaphakathi kodonga lwemithambo yegazi lungadabuka, futhi igazi lingavuza phakathi kwezingqimba ezimbili. Lokhu sikubiza ngokuthi ukuqhekeka . I-aorta evuvukele noma edabukile ngale ndlela ingaqhuma ngokuzumayo (ukuqhekeka) . Uma lokho kwenzeka, kuyisimo esiyingozi kakhulu empilweni. Ngakho-ke umgomo oyinhloko walokhu kuhlinzwa ukulungisa le nkinga ngaphambi kokuba kwenzeke ingozi enjalo.
Kukuziphi izimo lapho lolu hlobo lokuhlinzwa ludingeka khona?
Udokotela wakho uzoncoma lolu hlobo lokuhlinzwa uma i-aneurysm inkulu kunosayizi othile, noma uma ikhula ngokushesha kunokujwayelekile. Lobukhulu bunqunywa ngokulinganisa ngokucophelela izingozi zokuhlinzwa kanye nomonakalo ongaba khona wokungahlinzwa. Isimo sevalvu yenhliziyo, ikakhulukazi uma i-aorta ivuvukala eduze kwenhliziyo, sithinta nalesi sinqumo.
Into ebaluleke kakhulu ukuhlinzwa ngaphambi kokuba kube nengozi yokuqhuma kwe-aorta.
Kunezizathu eziningana zokuthi kungani i-aorta ingavuvukala noma iqhume ngale ndlela:
- Ukuqina nokuqina kwezindonga zemithambo yegazi: Lokhu sikubiza ngokuthi 'i-Atherosclerosis'.
- Umfutho wegazi ophakeme: Lokho kusho ukuthi 'Umfutho wegazi ophakeme'.
- Izifo zezicubu ezixhumeneyo: Isibonelo, izimo ezifana ne-'Marfan Syndrome'.
- Ukulimala okubangelwa izingozi.
Ama-Aneurysm ahlukaniswe ngezinhlobo eziningana kuye ngokuthi atholakala kuphi.
| Uhlobo lwe-Aneurysm | Indawo |
|---|---|
| I-Aneurysm ye-Aortic yesisu | Ukwenzeka engxenyeni edlula endaweni yesisu. |
| I-Thracic Aortic Aneurysm | Kwenzeka endaweni yesifuba. Lokhu kungaba empandeni ye-aorta, i-ascending aorta, i-aorta arch, noma i-descending aorta. |
| I-Thoracoabdominal Aortic Aneurysm | Ukusabalala kokubili esifubeni nasesiswini. |
Kubaluleke kangakanani ukuhlinzwa kwe-aorta?
Empeleni, lokhu kuwukuhlinzwa okungathi sína . Ngoba i-aorta iwukuhlinzeka kwegazi okuyinhloko emzimbeni wonke. Uma ukusebenza kwayo kuyeka ngisho kancane, umzimba wonke uzosebenza kabi.
Kodwa kukhona into ebaluleke kakhulu okufanele uyiqonde lapha. Impumelelo nokuphepha kokuhlinzwa okukhethwayo, okuhlelwe futhi kulungiselelwe kusengaphambili, kuphakeme kakhulu kunokuhlinzwa okuphuthumayo, okwenziwa lapho i-aneurysm isizoqhuma. Labo abahlinzwa ngaphambi kokuba kuqhume banethuba elikhulu lokusindisa izimpilo zabo.
Ukuhlinzwa kwenziwa kanjani? Yiziphi izindlela?
Kuye ngesimo sakho, udokotela unezindlela eziningana eziyinhloko zokwenza lokhu kuhlinzwa.
1. Ukuhlinzwa Okuvulekile: Kulokhu, ukuhlinzwa kwenziwa ngokusika phakathi kwesifuba (sternotomy), ngokuvula isifuba phakathi kwezimbambo ezimbili (thoracotomy), noma ngokusika isisu. Lena yindlela yendabuko.
2. Indlela Engangeni Kakhulu Noma Engena Emikhunjini:Lena inqubo entsha. Akukho ukusikwa okukhulu. Kunalokho, kwenziwa imbobo encane ngomthambo wegazi esinqeni, bese kufakwa idivayisi ebizwa ngokuthi i-stent graft ngokusebenzisa yona kusetshenziswa i-catheter endaweni yenkinga yomthambo.
Cabanga ngakho njengokulungisa ipayipi lamanzi elidala ngokufaka elisha ngaphakathi. Le stent iyipayipi elenziwe nge-mesh yensimbi kanye nendwangu ekhethekile. Uma ifakwa ngaphakathi kwe-aneurysm, igazi ligeleza ngaleli payipi elisha. Khona-ke ukucindezela kwegazi akushayi odongeni olubuthakathaka obelulokhu luvuvukala. Ngakho-ke, kuyayeka ukuqhuma.
Yiziphi izinzuzo zendlela ye-endovascular?
- Isikhathi esichithwa esibhedlela sifushane.
- Lena inketho engcono kulabo abangakwazi ukuthwala ingozi yokuhlinzwa okuvulekile.
- Njengoba kungekho ukusikwa okukhulu, isikhathi sokuphulukiswa sifushane kakhulu.
Uzilungiselela kanjani ngaphambi kokuhlinzwa?
Kunezinto ezimbalwa okudingeka uzenze ngaphambi kokuhlinzwa.
- Tshela udokotela wakho ngayo yonke imithi oyithathayo (ngisho naleyo ongayinikwanga udokotela). Eminye imithi ingadinga ukuthi uyeke ukuyithatha ezinsukwini ezimbalwa ngaphambi kokuhlinzwa.
- Thola zonke izivivinyo kanye nokuhlolwa kwegazi okwenziwa udokotela wakho, njenge-EKG kanye ne-CT scans, ngesikhathi.
- Hlela ukuthi othile akusize ufike esibhedlela futhi ubuya kuso. Kungumqondo omuhle futhi ukuba nomuntu ozokusiza ezinsukwini ezimbalwa zokuqala ngemva kokuhlinzwa lapho ufika ekhaya.
- Buza udokotela wakho ukuthi kufanele uyeke nini ukudla nokuphuza ngobusuku bangaphambi kokuhlinzwa.
Kwenzekani ngesikhathi sokuhlinzwa nangemva kwalokho?
Uhlobo lokuhlinzwa luzohluka kuye ngenkinga ye-aorta yakho kanye nohlobo lokuhlinzwa. Ngokuvamile, udokotela ohlinzayo uzosusa ingxenye eyonakele, evuvukele yomthambo bese eyishintsha nge -graft eyenziwe ngezinto zokwenziwa ezifana ne-Dacron .
Kwezinye izimo eziyinkimbinkimbi, ikakhulukazi uma i-aneurysm isakazeke kusukela esifubeni kuya esiswini, kusetshenziswa amasu akhethekile njengenqubo yesigaba "sesiqu sendlovu" enezigaba ezimbili.
Ngemva kokuhlinzwa, uzoqala ukungeniswa egunjini lokunakekelwa okujulile (ICU) . Uma usuphinde waqaphela, ungase ube nepayipi lokuphefumula emphinjeni wakho. Lizokhishwa uma usukwazi ukuphefumula wedwa. Uzokwazi ukuqala ukuhamba kancane. Ngemuva kwalokho uzodluliselwa egunjini elivamile. Udokotela uzokutshela ukuthi usukulungele ukuya ekhaya.
Kuthatha isikhathi esingakanani ukululama? Yiziphi izingozi?
Isikhathi sokululama siyahlukahluka kuye ngohlobo lokuhlinzwa.
- Ngemva kokuhlinzwa okuvulekile: Ngokuvamile kuzodingeka uhlale esibhedlela cishe isonto lonke. Kungathatha cishe izinyanga ezimbili kuya kwezintathu ukuze ululame ngokugcwele.
- Ngemva Kokuhlinzwa Kwemithambo Yegazi: Udinga ukuhlala esibhedlela usuku olulodwa noma ezimbili kuphela. Isikhathi esifushane, cishe amasonto amabili kuya kwamathathu, sanele ukuze ululame ngokugcwele.
Njenganoma yikuphi ukuhlinzwa okukhulu, kunezingozi. Izinkinga ezifana nokopha, isifo sohlangothi, ukuhlaselwa yinhliziyo, ukwehluleka kwezinso, ukutheleleka, kanye nokuqhekeka kwegazi kungavela. Kodwa-ke, lezi zingozi zingancishiswa ngokuhlinzwa okuhlelwe kahle okwenziwa ngaphansi kokuqondisa kwethimba lezokwelapha elinekhono.
Uma uhlangabezana nezimpawu ezilandelayo ngemva kokuhlinzwa, kufanele wazise udokotela wakho ngokushesha .
| Isibonakaliso | Incazelo |
|---|---|
| Izinguquko endleleni yokusika | Ukubomvu, ukuvuvukala, noma uketshezi olufana nobovu oluphuma endaweni yokusikwa. |
| Imfiva | Uma uthola umkhuhlane ngaphandle kwesizathu. |
| Ubuhlungu besifuba | Ubuhlungu besifuba obungazelelwe. |
| Ubunzima bokuphefumula | Uma uzizwa uphelelwa umoya noma uphefumula kanzima. |
Ngemva kokuhlinzwa, uzoba nokuhlolwa njalo nodokotela wakho. Bazobe sebekwenza ukuhlolwa kwe-CT noma kwe-MRI ukuhlola isimo se-graft kanye nanoma yiziphi ezinye izinkinga nge-aorta.
Umlayezo Wokuya Nawe Ekhaya
- I-aorta iwumthambo wegazi oyinhloko emzimbeni wakho. Ifana nombhobho wamanzi oyinhloko endlini yakho.
- Izindonga zayo zingaba buthakathaka futhi zivuvukale njengebhaluni (i-aneurysm) noma ukudabuka (ukusikwa). Lezi zimo zingaba yingozi empilweni uma ziqhuma.
- Ukuhlinzwa kwe-aortic valve kungavimbela le ngozi. Kungasindisa impilo yakho.
- Ukuhlinzwa okuhleliwe kusengaphambili kuphephile kakhulu futhi kuphumelele kakhulu kunokuhlinzwa okuphuthumayo.
- Kunezinhlobo ezimbili eziyinhloko zokuhlinzwa: ukuhlinzwa okuvulekile kanye nokuhlinzwa kwe-endovascular okungangenisi kakhulu. Udokotela wakho uzonquma ukuthi iyiphi indlela engcono kakhulu kuwe.
- Kubaluleke kakhulu ukulandela imiyalelo efanele yezokwelapha nokuhlolwa njalo ngisho nangemva kokuhlinzwa.
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