Wake wacabanga ngomthambo wegazi omkhulu kunayo yonke emzimbeni wethu? Njengepayipi lamanzi eliyinhloko eliletha amanzi endlini yethu, umthambo wegazi oyinhloko othwala igazi kuzo zonke izitho kanye namaseli emzimbeni wethu yi -aorta, noma njengoba sikubiza kanjalo, i-aorta . Lona umthambo oqinile kakhulu. Kodwa ngezinye izikhathi, njengoba nje uhlangothi lwethayi lemoto elidala luba buthakathaka futhi luqhume njengebhamuza, udonga lwalo mthambo wegazi lungabuye lube buthakathaka futhi luqhume endaweni eyodwa. Noma ungqimba lwalo lwangaphakathi lungaze luqhume. Lezi yizimo eziyingozi kakhulu. Kodwa ungakhathazeki, ngokuthuthuka kwesayensi yezokwelapha, manje sekukhona izindlela zokwelapha eziphumelela kakhulu zalokhu. Yilokho esikhuluma ngakho namuhla.
Kuyini lokhu kuhlinzwa kwe-TEVAR?
Kalula nje, i-TEVAR (Thoracic Endovascular Aortic Repair) inqubo yokuhlinzwa engangenisi kakhulu esetshenziselwa ukulungisa umonakalo ku-thoracic aorta.
Cabanga ukuthi lolu hlobo lwesifo lwaluphathwa kanjani esikhathini esidlule. Odokotela kwadingeka bavule isifuba ngokuphelele futhi benze ukuhlinzwa okukhulu ukuze kulungiswe lo monakalo. Kwakuyinkimbinkimbi kakhulu, kwathatha isikhathi eside ukuphulukiswa, futhi kwakuyingozi kakhulu.
Kodwa ngendlela ye-TEVAR, ukusikwa okukhulu kangaka akwenziwa. Esikhundleni salokho, kwenziwa ukusikwa okuncane kakhulu embotsheni, kufakwa ipayipi elincane (i-catheter) ngalo, bese kudluliswa idivayisi ekhethekile kulelo payipi ukulungisa ingxenye ebuthakathaka ye-aorta. Lokhu kufana nendlela ipayipi elihamba ngaphakathi kodonga lwendlu eliphuka ngayo bese kufakwa ipayipi elincane ngaphakathi kwepayipi ngaphandle kokuphula udonga. Lokhu kuphumela esikhathini esifushane kakhulu sokuphulukiswa, ubuhlungu obuncane, kanye nengozi encane.
Kukuziphi izimo lapho kudingeka khona ukuhlinzwa kwe-TEVAR?
Odokotela basebenzisa kakhulu lolu hlinzo ukwelapha izimo eziningana ezingathi sína ezenzeka ku-aorta. Ake sibheke ukuthi ziyini.
| Isimo sezokwelapha | Kuchazwe kalula |
|---|---|
| I-Thracic Aortic Aneurysm | Yilokhu ebengikhuluma ngakho ngaphambili, indawo ebuthakathaka odongeni lwe-aorta evuvukala njengebhaluni. Ingakhula kancane kancane futhi ekugcineni iqhume. Uma lokho kwenzeka, kungaba yingozi enkulu empilweni. |
| Ukusikwa kwe-Aortic | Yilapho ungqimba lwangaphakathi lodonga lwe-aorta ludabuka khona. Igazi libe selivuza phakathi kwezingqimba ezimbili zodonga, lihlukanise izingqimba ezimbili. Lesi futhi yisimo esibi esidinga ukwelashwa okuphuthumayo. |
| Ukuhlinzwa kwe-Aorta | Ukulimala okukhulu esifubeni, njengengozi yemoto, kungabangela ukuthi i-aorta idabuke noma iqhume. |
Into ebalulekile ukuthi, nakuba lezi zimo ziyingozi kakhulu, izindlela zokwelapha zesimanje ezifana ne-TEVAR sezisindise izimpilo eziningi.
Uzilungiselela kanjani ngaphambi kokuhlinzwa?
Uma unquma ukwenza lolu hlobo lokuhlinzwa, udokotela wakho uzokuchazela ngokucacile ukuthi udinga ukululungiselela kanjani. Ngokuvamile ungase ucelwe ukuba wenze izinto ezinjengalezi:
- Ukulawulwa komfutho wegazi kanye ne-cholesterol: Unganikezwa imithi yokulawula lokhu kahle.
- Gwema ukubhema: Uma ubhema, kudingeka uyeke ngokuphelele.
- Ukushintsha imithi: Ungase ucelwe ukuthi uyeke noma ushintshe eminye yemithi oyithathayo okwamanje isikhashana ngaphambi kokuhlinzwa.
- Ukuhlolwa okukhethekile: Udokotela kuzodingeka enze ukuhlolwa okuningana ukuze ahlele ukuhlinzwa.
Ukuhlolwa kwangaphambi kokuhlinzwa
Okubaluleke kakhulu kulezi zivivinyo yi- CT Angiogram . Lokhu kuyi-CT scan ekhethekile. Ingabona kahle ubukhulu nesimo se-aorta yakho kanye neminye imithambo yegazi esetshenziselwa ukuhlinzwa.
Cabanga nje, ipayipi lokuhlinza lifakwa ngomthambo wegazi esinqeni. Uma lowo mthambo wegazi umncane kakhulu, noma uma uvinjiwe yizinsalela ze-cholesterol, ipayipi alikwazi ukudlula. Lokhu kuskena kusiza ukuthola izinto ezinjalo kusenesikhathi.
Futhi, izilinganiso ezivela kulokhu kuskena zibaluleke kakhulu ekukhetheni i-stent graft yosayizi ofanele yendawo eyonakele ku-aorta yakho.
Kuyini i-stent graft?
Lona iqhawe lalo msebenzi wokuhlinzwa. I-stent graft iyipayipi elenziwe ngezinto ezifana nendwangu. Ine-mesh yensimbi ngaphakathi. Iyagoqwa bese idlula ku-aorta. Uma ifika endaweni efanele, ivuleka njengesiphethu bese inamathela ngokuqinile odongeni lwe-aorta.
Okwenzekayo ukuthi igazi ligeleza ngaleli payipi elisha. Udonga olubuthakathaka noluvuvukele lwe-aorta alunawo umfutho wegazi. Ngakho-ke luyeka ukukhukhumala. Kufana nokufaka ulwelwesi olusha ngaphakathi kwe-aorta.
Kwenziwa kanjani ukuhlinzwa?
Kumelwe ukuba unesithakazelo esikhulu ngalokhu. Ake sibheke izinyathelo ezilula ezihilelekile ekuhlinzeni.
1. Ukupholisa: Okokuqala, uzofakwa ngaphansi kwe-anesthesia ejwayelekile, noma indawo lapho ukuhlinzwa kuzokwenziwa khona kuphela ezoncishiswa, futhi uzonikezwa imithi yokuphumula.
2. Ukusikwa okuncane: Okulandelayo, kwenziwa ukusikwa okuncane esikhumbeni, ngokuvamile endaweni ye-groin, bese kuthi umthambo wegazi (umthambo we-femoral) okhona lapho ufinyelelwe.
3. Ucingo oluqondisayo: Ucingo oluncane (ucingo oluqondisayo) ludluliselwa kulo mthambo wegazi, ludlule endaweni eyonakele ye-aorta, bese lumiswa.
4. I-catheter kanye ne-stent: Bese kuba khona ithubhu (i-catheter) edluliselwa ngocingo. I-stent graft egoqiwe ingaphakathi kwaleli thubhu. Konke lokhu kwenziwa ngaphansi kwesiqondiso somshini okhethekile we-X-ray (i-fluoroscopy).
5. Ukubekwa kwe-stent: Uma ipayipi selisendaweni efanele, udokotela uzofaka ngokucophelela i-stent graft. Izobe isinwebeka ngokuzenzakalelayo bese inamathela odongeni lwe-aorta.
6. Ukuqeda: Ngemva kwalokho, ipayipi kanye nocingo kuyakhishwa, bese ukusika okuncane okwenziwe esinqeni kuvalwa ngezitishi.
Ngokuvamile, yonke le nqubo ithatha cishe amahora amabili.
Yiziphi izinzuzo nezingozi zokuhlinzwa kwe-TEVAR?
Njenganoma iyiphi inqubo yezokwelapha, kunezinzuzo nezingozi, kodwa izinzuzo zokuhlinzwa kwe-TEVAR zidlula kakhulu izingozi.
| Izinzuzo | Izingozi |
|---|---|
| Isikhathi sokululama sifushane. | Ukuvuza kwegazi eduze kwe-stent (i-Endoleak). |
| Inani lezinsuku ezichithwa esibhedlela liyancipha. | Ukutheleleka. |
| Kunobuhlungu obuncane kanye nokopha kwegazi okuncane. | I-stent iyasuka endaweni yayo. |
| Ngeke kushiye isilonda esikhulu. | Ukukhubazeka kwemilenze (ukukhubazeka kwemilenze) ngenxa yokuncipha kokugeleza kwegazi emgogodleni - lokhu akuvamile kakhulu. |
| Ingozi yezinkinga ezinkulu iphansi. | Ukuhlaselwa yinhliziyo noma isifo sohlangothi. |
Udokotela wakho uzokuchazela kahle lezi zingozi, futhi uzothatha zonke izinyathelo ezingenzeka ukuze azinciphise.
Sinjani isikhathi sokululama ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, uzogcinwa egunjini lokunakekelwa okujulile (ICU) ukuze uhlolwe usuku olulodwa noma ezimbili, bese udluliselwa egunjini elijwayelekile. Uma konke kuhamba kahle, uzokwazi ukuya ekhaya ezinsukwini ezimbalwa. Nazi ezinye izinto okufanele uzikhumbule ngemva kokubuyela ekhaya:
- Ukushayela: Gwema ukushayela isonto elilodwa kuya kwamabili.
- Ukugeza: Gwema ukucwilisa ebhavini lamanzi kuze kube yilapho inxeba lesisu selipholile. Ukugeza kulungile.
- Ukuphakamisa izinsimbi: Ungaphakamisi ngaphezu kwamakhilogremu angu-10 (cishe amakhilogremu angu-4.5) isonto elilodwa kuya kwamabili.
Ukulandelela impilo yonke kubalulekile!
Leli yiphuzu elibaluleke kakhulu . Ngemva kokuhlinzwa kwe-TEVAR, kubalulekile ukubona udokotela wakho ukuze ahlolwe impilo yakho yonke. Ngokuvamile,
- Inyanga eyodwa ngemuva kokuhlinzwa
- Bese kuthi ngemva kwezinyanga eziyisithupha (uma kube nenkinga ekuhlolweni kokuqala)
- Ngemva konyaka
- Bese kuba kanye ngonyaka
Kuzodingeka ukuthi uhlolwe. Lokhu kwenziwa ukuze kuhlolwe ukuthi i-stent isendaweni efanele yini, uma kukhona izinkinga ngayo, uma kukhona ukuvuza kwegazi. Ungakweqi lokhu. Lokhu kubaluleke kakhulu ekuphepheni kwakho.
Ngingashayela nini udokotela ucingo?
Uma unemibuzo noma ukukhathazeka mayelana nokwelashwa kwakho noma isikhathi sokululama, ungesabi ukukhuluma nodokotela wakho. Futhi, uma uhlangabezana nezimpawu ezisheshayo zokuhlaselwa yinhliziyo noma isifo sohlangothi (isib. ubuhlungu obukhulu besifuba, ukuphelelwa umoya, ubunzima bokukhuluma, noma ubuthakathaka ohlangothini olulodwa lomzimba), iya eMnyangweni Wezimo Eziphuthumayo wesibhedlela (ETU) ngokushesha.
I-TEVAR iyintuthuko emangalisayo kwezesayensi yezokwelapha. Isizile ekwelapheni izimo ezazisongela ukuphila, namuhla, ngengozi encane kakhulu futhi ngengozi encane kakhulu. Uma wena noma othile omaziyo enalesi simo, ungesabi ukukhuluma nodokotela bese unquma inketho yokwelashwa engcono kakhulu kuwe.
Umlayezo Wokuya Nawe Ekhaya
- I-TEVAR inqubo yokuhlinzwa yesimanje, engadingi ukungenelela okuningi elapha izimo ezibucayi njenge-aneurysms noma ukuqhekeka kwe-thoracic aorta.
- Lokhu akubuhlungu kakhulu, kunesikhathi esincane sokululama, futhi akunangozi kangako njengokuhlinzwa kwesifuba okujwayelekile.
- Ukuhlinzwa kwenziwa ngokufaka idivayisi ekhethekile ebizwa ngokuthi i-stent graft ngokusebenzisa i-incision encane eyenziwe e-groin.
- Nakuba ukululama ngemva kokuhlinzwa kushesha, ukuhlolwa kwezokwelapha kwaminyaka yonke kanye nokuskena kuyimpoqo kukho konke ukuphila .
- Ungalokothi unqikaze ukuxoxa nodokotela wakho nganoma yiziphi izinkinga noma ukukhathazeka onakho.
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