Uke waba nokuhlaselwa yinhliziyo, noma wake wafakwa i-stent, noma mhlawumbe wahlinzwa nge-bypass, futhi udokotela wakho ekuyalele ukuthi uphuze imithi emibili ngesikhathi esisodwa? Abantu abaningi bakhathazekile kancane ngalokhu. Kuyinto evamile ukuba kuvele imibuzo efana nokuthi "Kungani nginikwe imithi emibili?" kanye nokuthi "Ingabe lokhu kuzobangela izinkinga?". Ngakho-ke, namuhla sizokhuluma ngale ndlela yokwelapha imithi, okuyi-Dual Antiplatelet Therapy (DAPT).
Kalula nje, iyini i-DAPT?
I-DAPT iyindlela yokwelapha ehlanganisiwe esebenzisa izinhlobo ezimbili zemithi yokunciphisa igazi. Ngokukhethekile, unikezwa i-aspirin kanye nomunye umuthi obizwa ngokuthi i-P2Y12 inhibitor .
Manje bheka, uma silimala ndawana thize emzimbeni wethu, ukuphuma kwegazi kuyayeka ngoba amahlule egazi futhi inxeba liyavaleka. Lokho kuyinto enhle. Kodwa, kwenzekani uma amahlule egazi akheka emithanjeni yethu yegazi ngaphandle kwesizathu? Cabanga ngokuminyana kwezimoto emgwaqweni, njengezimoto ezinamathelene, la mahlule egazi anganamathela emithanjeni yethu yegazi. Uma ihlule legazi elinjalo linamathela emithanjeni yegazi eliholela enhliziyweni, kuvela ukuhlaselwa yinhliziyo. Uma linamathela emithanjeni yegazi eliholela ebuchosheni, kuvela isifo sohlangothi.
Ngakho-ke lokhu kwelashwa kwe-DAPT okwenziwayo ukuvimbela ama-platelet, amaseli amancane egazini lethu, ukuthi anganamatheli ndawonye futhi ajiye. Ngale ndlela, lokhu kwelashwa kungamisa ukwakheka kwama-blood clots ayingozi (i-thrombosis).
Ubani odinga ukwelashwa kwe-DAPT kakhulu?
Odokotela bavame ukunikeza lokhu kwelashwa ngemva kwesigameko sezempilo kanye nakubantu abasengozini yokuthi kwenzeke futhi. Bheka ithebula elingezansi.
| Uma kudingeka ukwelashwa | Incazelo elula |
|---|---|
| Ngemva kokuhlaselwa yinhliziyo (i-Myocardial Infarction) | Ukuvimbela izinkinga ezibangelwa ukuhlaselwa yinhliziyo noma ukuqhekeka kwegazi futhi. |
| Ngemva kokuhlaselwa yisifo sohlangothi noma i-TIA ('isifo sohlangothi esincane') | Ukunciphisa ingozi yokuba nesinye isifo sohlangothi. I-TIA yisimo sesikhashana lapho izimpawu zifika ziphinde ziphele khona. |
| Ngemva kokufakwa kwe-stent | Lokhu kubalulekile ukuvimbela ukwakheka kwamahlule egazi ngaphakathi kwale divayisi encane efana ne-mesh ebekwe ukugcina imithambo yegazi yenhliziyo ivulekile. |
| Ngemva kwe-Angioplasty | Uma umthambo wegazi ovalekile unwetshwa ngento efana nebhaluni, kuvimbela ukwakheka kwamahlule egazi futhi kuleyo ndawo. |
| Ngemva Kokuhlinzwa Kwe-Coronary Artery Bypass | Ukuvimbela ukwakheka kwamahlule egazi emithanjeni yegazi esanda kuhlanganiswa ngemva kokuhlinzwa. |
Yiziphi izinzuzo nezingozi zokwelashwa kwe-DAPT?
Njenganoma yikuphi ukwelashwa, lokhu kunezinzuzo kanye nezingozi ezithile.
Into ebaluleke kakhulu ukuthi udokotela ukunikeze lokhu kwelashwa ngoba izinzuzo zidlula kakhulu izingozi.
- Inzuzo eyinhloko: Ngokuvimbela amahlule egazi, ingozi yokuba nokuhlaselwa yinhliziyo noma isifo sohlangothi incishiswa kakhulu . Lo muthi usindisa impilo, ikakhulukazi kumuntu oke wafakwa i-stent.
- Ingozi Eyinhloko: Ngenxa yokuthi le mithi ivimbela ukujiya kwegazi, kunengozi yokopha.
- Uphawu oluvame kakhulu ukopha kwamathumbu .
- Ngisho nesilonda esincane noma ukusikeka kungabangela ukopha okuningi kunokujwayelekile.
- Akuvamile kakhulu ukuthi kube nezimo ezingathi sína njengokuphuma kwegazi ngaphakathi ebuchosheni.
Imiphumela emibi nezinkinga ngeminye imithi
Imiphumela emibi evame ukubonwa
Abanye abantu bangase babhekane nalokhu okulandelayo ngenkathi bethatha lo muthi:
- Ubunzima bokuphefumula
- Igazi emchameni (i-Hematuria)
- Ukuphuka okungachazeki emzimbeni
- Ukopha Kwekhala (i-Epistaxis)
- Ukwehla kwenani lamaplatelet egazini (i-Thrombocytopenia)
- Ama-polyp ekhala
Uma lokhu kuqhubeka, khuluma nodokotela wakho.
Eminye imithi engase ihlangane nalo muthi
Uma uthatha i-DAPT, kudingeka uqaphele kakhulu lapho uthatha eminye imithi, ikakhulukazi le:
- Ama-anticoagulant (ezinye izidakamizwa zokunciphisa igazi):Imithi efana neWarfarin ne-Apixaban. Uma lezi zithathwa ndawonye, ingozi yokopha iphezulu kakhulu.
- Ama-NSAID (ama-painkiller): Imithi efana ne-Ibuprofen, i-Diclofenac, ne-Mefenamic Acid esivame ukuyithatha ngenxa yekhanda elibuhlungu kanye nobuhlungu bomzimba. Lokhu kwandisa ingozi yokopha esiswini uma kuhlanganiswa ne-DAPT.
- Ama-antidepressant: Eminye imithi isetshenziswa ukucindezeleka.
- Ama-Proton Pump Inhibitors (PPI): Imithi efana ne-Omeprazole esivame ukuyisebenzisa kwe-gastritis.
Ngakho-ke, kubalulekile ukutshela udokotela wakho ngayo yonke imithi oyithathayo (ngisho nomuthi wokuqeda izinhlungu owuthenga ekhemisi).
Kufanele kuthathwe isikhathi esingakanani i-DAPT?
Lokhu akufani kuwo wonke umuntu. Udokotela wakho uzonquma ukuthi udinga i-DAPT isikhathi esingakanani. Kunezici eziningana ezithinta lokhu:
- Ubudala bakho kanye nempilo yakho iyonke.
- Iyini ingozi yakho yokopha?
- Ingozi yokuba nokuhlaselwa yinhliziyo noma isifo sohlangothi.
- Isizathu sokuqala i-DAPT kwasekuqaleni (ngenxa ye-stent? ngenxa yokuhlaselwa yinhliziyo?).
Nakuba abanye abantu bengase badinge lokhu kwelashwa inyanga eyodwa noma ezimbili, abanye abaningi bangase bakudinge unyaka noma ngaphezulu . Udokotela wakho angase akuncome ukuthi uthathe i-aspirin impilo yakho yonke, ngisho nangemva kokuyeka i-DAPT.
Isikhathi sokuthola iseluleko sezokwelapha ngokushesha
Njengoba umuntu othatha i-DAPT esengozini yokopha, kufanele uqaphele kakhulu ngalezi zimpawu ezilandelayo. Uma unanoma yiziphi zalezi zimpawu, bona udokotela ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
| Izimpawu Zesexwayiso | |
|---|---|
| Ukuhlanza ngegazi | Ukuhlanza igazi elibomvu noma umchamo onsundu ofana nekhofi eligayiwe. |
| Ushintsho esitulweni | Indle emnyama noma igazi esitulweni. |
| Ikhanda elibuhlungu elinzima ngokuzumayo | Ikhanda elibuhlungu elingabekezeleleki elingakaze libonwe ngaphambili. |
| Ezinye izici | Ubuhlungu obukhulu besisu, ubuhlungu besifuba, ukulahlekelwa ukwazi, isiyezi esikhulu, ukudideka. |
Umlayezo Wokuya Nawe Ekhaya
- I-DAPT iyindlela yokwelapha esindisa impilo ehlanganisa i-aspirin kanye nomunye umuthi wokuvimbela ukuhlaselwa yinhliziyo kanye nohlangothi.
- Ungayeki ukuthatha lo muthi ngaphandle kweseluleko sikadokotela wakho nganoma yisiphi isizathu . Ukuphuthelwa ngisho nosuku olulodwa kwandisa kakhulu ingozi yokuba nehlule legazi.
- Ingozi enkulu yalokhu kwelashwa ukopha, ngakho-ke qaphela njalo izimpawu eziyisixwayiso (indle emnyama, ukuhlanza igazi).
- Kungakhathaliseki ukuthi uya kudokotela wamazinyo noma omunye udokotela, mtshele kuqala ukuthi uthatha i-DAPT.
- Kungase kudingeke uyeke okwesikhashana ukuthatha lo muthi ngaphambi kokuhlinzwa noma ukukhishwa kwezinyo, kodwa lokhu kufanele kwenziwe kuphela ngaphansi kweseluleko sikadokotela wakho wenhliziyo.
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