Wake wezwa ukuthi umthambo wegazi obaluleke kakhulu emzimbeni wethu ungavuvukala njengebhaluni? Lesi yisimo esesabekayo ngempela. Kodwa ungakhathazeki, ngokuthuthuka kwesayensi yezokwelapha, lokhu manje sekungelashwa ngendlela elula kakhulu ngaphandle kokwenza i-incision enkulu. Namuhla sizokhuluma ngakho. Le ndlela ibizwa ngokuthi i-EVAR.
Kalula nje, iyini i-EVAR?
Incazelo ephelele ye-EVAR i- Endovascular Aneurysm Repair . Lokhu kuyindlela yokuhlinzwa engangenisi kakhulu. Isetshenziselwa ukwelapha ama-aneurysm, noma njengoba siwabiza ngamagama ezokwelapha , ama-aneurysm , ku-aorta, umthambo wegazi oyinhloko esiswini sethu.
Cabanga ukuthi umthambo wegazi omkhulu kunayo yonke emzimbeni wethu yi-aorta. Yilapho igazi lisakazwa khona lisuka enhliziyweni liye kuwo wonke umzimba. Ngezinye izikhathi, lapho indawo odongeni lwalo mthambo wegazi iba buthakathaka, ukucindezela kwegazi kubangela ukuthi leyo ndawo ebuthakathaka iqhume njengebhaluni. Yilokho esikubiza ngokuthi i-aneurysm.
Ekwelashweni kwe-EVAR, kwenziwa izimbobo ezimbili ezincane kakhulu kuzo zombili izinhlangothi zomthambo, futhi kudluliswa amathuluzi akhethekile kuzo ukulungisa umthambo wegazi ovuvukele ngaphakathi.
Kungani sidinga lolu hlobo lokwelashwa lwe-EVAR?
Umgomo oyinhloko walokhu kwelashwa ukuvimbela ukuqhuma komthambo wegazi ofana nebhaluni (i-aneurysm), ngoba uma kwenzeka, kuwusongo olukhulu empilweni.
Uma umthambo wegazi uqhuma, ukuphuma kwegazi ngokweqile kuqala ukwenzeka emzimbeni, okungaba yingozi empilweni ngemizuzu embalwa.
Ekwelashweni kwe-EVAR, odokotela bafaka ithubhu ekhethekile (i-stent graft) eyenziwe ngendwangu kanye ne-mesh yensimbi emthanjeni wegazi ovuvukile. Ngemva kokufakwa kwaleli thubhu, igazi ligeleza ngaleli thubhu elisha. Khona-ke ukucindezela kwegazi akushayi odongeni olubuthakathaka lomthambo wegazi ovuvukile. Ngakho-ke, ingozi yokuqhuma kwayo cishe iqedwe ngokuphelele.
Ubani lokwelashwa kwe-EVAR okufanelekela kangcono?
Uma une-aneurysm ye-aorta, lokhu kwelashwa kungase kukufanele. Kodwa-ke, akuzona zonke i-aneurysm eziphathwa ngesikhathi esisodwa. Udokotela wakho angase acabangele i-EVAR ezimweni ezilandelayo:
- Uma i-aneurysm yakho inkulu noma incane kodwa ikhula ngokushesha .
- Uma umzimba wakho ungakwazi ukubekezelela ukuhlinzwa okuvulekile okune-incision enkulu.
- Uma imithambo yegazi engaphezulu nangaphansi kwe-aneurysm iphilile .
Zikhona yini ezinye izindlela ezifana ne-EVAR? (FEVAR kanye ne-TEVAR)
Yebo, le ndlela yokwelapha isetshenziswa ngokushintshashintsha okuncane kuye ngokuthi i-aneurysm ikuphi.
Kuyini i-FEVAR?
Cabanga nge-aorta yethu njengesiqu somuthi. Kusukela kulesi siqu, amagatsha (imithambo emincane) athwala igazi aya ezithweni ezisesiswini sethu (njengezinso namathumbu) ayahlukana. Ngezinye izikhathi kwakheka i-aneurysm eduze kwendawo lapho elinye lala magatsha lihlukana khona. Kuleso simo, kunzima ukwenza i-EVAR evamile.
Kungamacala ayinkimbinkimbi kangaka lapho kusetshenziswa khona indlela ekhethekile ebizwa ngokuthi i-FEVAR (Fenestrated Endovascular Aneurysm Repair) . I-stent graft esetshenziswa lapha inezimbobo ezincane (ama-fenestrations) ezenzelwe ukulingana lapho amagatsha ehlukana khona. Ngalezo zimbobo, kungafakwa ama-stent amancane ahlukene kulawo magatsha. Njengepayipi eklanyelwe ukulingana kokubili isiqu namagatsha esihlahla.
Umehluko phakathi kwe-EVAR ne-TEVAR
Lokhu kulula kakhulu.
- I-EVAR yenziwa nge-aneurysms esiswini (esiswini) .
- I-TEVAR (Ukulungiswa kwe-Thoracic Endovascular Aneurysm) yenziwa nge-aneurysms esifubeni (esifubeni) .
I-TEVAR ivame ukuphumelela kakhulu kuma-aneurysms emithanjeni emikhulu egeleza esifubeni, kude kancane nenhliziyo. Kodwa-ke, kuma-aneurysms aseduze kakhulu nenhliziyo, ukuhlinzwa okuvulekile kuvame ukudingeka.
| Izinzuzo eziyinhloko zokwelashwa kwe-EVAR | |
|---|---|
| Inzuzo | Incazelo |
| Inani lezinsuku esibhedlela linciphile. | Ungaya ekhaya ngokushesha kunokuba uhlinzwe ngokuhlinzwa okuvulekile. |
| Ukopha okuncane | Njengoba kungekho ukusikeka okukhulu, inani legazi eliphuma emzimbeni lincane kakhulu. |
| Ubuhlungu obuncane ngesikhathi sokuphulukiswa | Njengoba kungekho ukulimala okukhulu, ubuhlungu nokungakhululeki kuncane kakhulu. |
| Uphole ngokushesha | Ungabuyela emisebenzini evamile ngokushesha. |
| Isikhathi sokuhlinzwa sincane. | Ukuhlinzwa kungaqedwa ngesikhathi esingaphansi kokuhlinzwa okuvulekile. |
Ingabe zikhona izingozi ngalokhu kwelashwa?
I-EVAR iyindlela yokwelapha ephephile kakhulu futhi ephumelela kakhulu, kodwa njenganoma yikuphi ukuhlinzwa, kunethuba elincane lezinkinga.
- Amahlule Egazi: Ngezinye izikhathi amahlule egazi angakheka emithanjeni ejulile yemilenze. Lokhu sikubiza ngokuthi i -Deep Vein Thrombosis (DVT) .
- I-Endoleak: Ngisho nangemva kokufakwa kwe-stent, inani elincane legazi liyavuza phakathi kwe-stent nodonga lomthambo wegazi bese lijoyina i-aneurysm.
- Ukutheleleka: Ukutheleleka endaweni yokulimala.
- Ukwehluleka kwezinso
- Isifo senhliziyo
- Ukopha ngokweqile
Lezi zingozi ziphansi kakhulu. Udokotela wakho uzokuchazela konke lokhu ngaphambi kokuhlinzwa.
Kwenziwa kanjani ukuhlinzwa?
Kulungile, manje ake sibheke izinyathelo ezihilelekile kulokhu kuhlinzwa.
1. Okokuqala, uzonikezwa i-anesthesia ukuze ulale noma ulale kancane. Ngakho ngeke uzwe ubuhlungu.
2. Okulandelayo, udokotela uzofinyelela i-aneurysm esiswini sakho ngemithambo ye-femoral esesinqeni sakho.
3. Kusetshenziswa izinaliti ezimbili ezincane kakhulu, kufakwa i-catheter , ipayipi elincane neliguquguqukayo, kule mithambo emibili. I-stent graft esikhulume ngayo ekuqaleni igoqwe ngaphakathi kwale catheter.
4. Ngesikhathi ebheka isikrini esikhethekile esifana ne-X-ray, udokotela uqondisa le catheter emthanjeni wegazi ukuya endaweni lapho kukhona khona i-aneurysm.
5. Uma isisendaweni efanele, ithubhu le-stent elingaphakathi kwe-catheter liyanwebeka. Libe selinwebeka ngaphakathi kwemithambo yegazi, lidale indlela entsha neqinile yokugeleza kwegazi.
6. Leli payipi le-stent linamathele ngokuqinile odongeni lomthambo wegazi, livimbela igazi ukuthi lingangeni ku-aneurysm.
7. Ngemva kokuba inqubo isiqediwe, i-catheter isuswa ngokucophelela. Amanxeba mancane kangangokuthi akudingeki ngisho nokuthungwa. Kufakwa iplasta encane enxebeni ukuze liphole.
Sinjani isikhathi sokululama ngemva kokuhlinzwa?
Ngokuvamile kuthatha izinsuku ezimbalwa kuya enyangeni ukuze ululame ngokugcwele.
- Kuzodingeka uhlale esibhedlela izinsuku ezimbili noma ezintathu.
- Ungaqala ukudla nokuphuza ngokushesha ngemva kokuhlinzwa.
- Ungavuka ngisho embhedeni uhambe ngosizo lwabahlengikazi.
- Ungase uzizwe ukhathele futhi udabukile kancane izinsuku ezimbalwa ngemva kokubuyela ekhaya. Kufanele usebenzise imithi yobuhlungu oyinikezwe ngendlela efanele.
- Gwema ukushayela uze uthathe imithi yokudambisa izinhlungu.
- Iningi labantu lingabuyela emsebenzini kungakapheli inyanga.
- Kufanele ugweme ukuphakamisa noma yiziphi izinto ezisindayo amasonto amane kuya kwayisithupha.
| Uma unalezi zimpawu, bona udokotela wakho ngokushesha. | |
|---|---|
| Isici | Incazelo |
| Ukuvuvukala kwemilenze, ubuhlungu | Lokhu kungaba izimpawu ze-deep vein thrombosis (DVT) emilenzeni. Lokhu kufaka phakathi isikhumba esibandayo emilenzeni. |
| Isiyezi noma ukuquleka | Kungaba uphawu lwenkinga ethile ngaphakathi. |
| Ubuhlungu emhlane, esifubeni, noma esiswini | Lokhu kungaba yinkinga nge-stent noma i-aneurysm. |
| Ukushaya kwenhliziyo | Ukushaya kwenhliziyo okusheshayo ngendlela engavamile (Ukushaya kwenhliziyo okusheshayo). |
| Ubomvu noma ubuhlungu endaweni yesisu | Kungaba uphawu lokutheleleka endaweni yokuhlinzwa. |
Umlayezo Wokuya Nawe Ekhaya
- I-EVAR iyindlela engcono kakhulu, engangenisi kakhulu ukuhlinzwa okujwayelekile.
- Ngemva kwalokhu kwelashwa, uzolulama ngokushesha futhi ukwazi ukuya ekhaya ngokushesha.
- Ngisho nangemva kokuba usululame, kufanele unakekele inhliziyo yakho kanye nemithambo yegazi. Izinto ezifana nokuzivocavoca umzimba nokunciphisa usawoti ekudleni kwakho kungasiza ekuvimbeleni izinkinga zesikhathi esizayo.
- Into ebaluleke kakhulu ukubona udokotela futhi ngesikhathi esibekiwe ukuze kuhlolwe okulandelayo. Ngaleyo ndlela, ungahlola ukuthi i-stent oyifakile isebenza kahle yini nokuthi ngabe kukhona yini ezinye izinkinga.
💬 Comments (0)
Awekho amazwana athunyelwe okwamanje. Faka amazwana akho lapha okokuqala ngqa.
Engeza amazwana akho