Ingabe kukhona ukugeleza kwegazi okunciphile ezingxenyeni zomzimba wakho? Ake sifunde nge-Ischemia!

Wake wezwa ngesimo lapho igazi lingahambi kahle ezindaweni ezithile zomzimba? Uma lokho kwenzeka, lezo zingxenye azitholi umoya-mpilo owanele, okungabangela izinkinga ezinkulu. Lokhu kungaba kubi kakhulu. Namuhla sizokhuluma ngalesi simo esibizwa ngokuthi ischemia. Ake sibheke ukuthi siyini ngempela, kungani senzeka, nokuthi yini ongayenza ngakho.

Iyini ngempela i-Ischemia?

Kalula nje, i-Ischemia yilapho ingxenye yomzimba wakho ingatholi igazi elanele. Manje usuyazi ukuthi igazi lethu lithwala umoya-mpilo kuwo wonke amaseli nezicubu zomzimba. Ngakho-ke lapho ukugeleza kwegazi kwehla, lokho kusho ukuthi inani lomoya-mpilo elilethwayo nalo liyancipha. Lena inkinga yangempela, ngoba amaseli ethu adinga umoya-mpilo ukuze aphile.

Ngokuvamile, lokhu kwenzeka ngenxa yomthambo omncane noma ukuvaleka komthambo wegazi.

Ngezinye izikhathi lesi simo se-ischemia singase singabi sibi kakhulu futhi singase singabangeli izinkinga ezinkulu. Kodwa-ke, ngokuhamba kwesikhathi, singaba sibi kancane kancane futhi sibe sibi kakhulu. Uma siba sibi kakhulu, okusho ukuthi amaseli amaningi ayafa, singaba yingozi empilweni. Ngakho-ke, kubaluleke kakhulu ukuqaphela lokhu.

Yiziphi izinhlobo eziyinhloko ze-ischemia?

I-Ischemia ingathinta izingxenye ezahlukene zomzimba. Siyihlukanisa ngokwendawo ethintekile. Kunezinhlobo eziningana eziyinhloko ezingabonakala:

• I-myocardial ischemia: Lesi yisimo esenzeka lapho ukunikezwa kwegazi emisipheni yenhliziyo kuncipha. Lesi yimbangela eyinhloko yokuhlaselwa yinhliziyo esesizwile sonke. Cabanga ngakho, inhliziyo ifana nephampu esebenza njalo. Kuthiwani uma ingatholi igazi elanele?
• I-Mesenteric ischemia: Lesi simo singase senzeke lapho imithambo yegazi ehlinzeka ngegazi ezingxenyeni zesimiso sokugaya ukudla, njengamathumbu ethu, ivaleka. Lokhu akuvamile, kodwa kungaba kubi futhi kungazelelwe.
• Ischemia engaphandle noma emilenzeni: Lokhu kwenzeka lapho kuncipha ukugeleza kwegazi ezingalweni noma emilenzeni. Ngezinye izikhathi imilenze iyabuhlungu uma uhamba, kodwa kuba ngcono kuphela uma ume isikhashana. Ezimweni ezimbi kakhulu, ingalo noma umlenze ungaze ukhubazeke.
• I-Ischemic stroke: Lesi isifo sohlangothi esithinta ubuchopho futhi senzeka lapho umthambo wegazi ohambisa igazi ebuchosheni uvalekile, okubangela umonakalo engxenyeni yobuchopho, entula umoya-mpilo. Lokhu kuyingozi kakhulu ngoba uma amangqamuzana obuchopho efa, awakwazi ukuphinda avuseleleke.
• Ukuhlaselwa kwe-ischemic okuhamba kancane (i-TIA): Lokhu futhi ukwehla kwesikhashana kokugeleza kwegazi kuya ebuchosheni. Nakuba izimpawu zifana neze-stroke, zivame ukuphela zingakapheli amahora angama-24, ngokuvamile zingakapheli imizuzu embalwa. Kodwa-ke, kuyisibonakaliso esiyisixwayiso sokuthi i-stroke enkulu iyeza! Ngakho-ke, uma une-TIA, kufanele ufune usizo lwezokwelapha ngokushesha.

Sivame kangakanani lesi simo esibizwa ngokuthi ischemia?

Eqinisweni, le ischemia ivame kakhulu kunalokho ongakucabanga. Cabanga nje, isifo senhliziyo siyimbangela ehamba phambili yokufa emhlabeni. Futhi uma kukhulunywa ngesifo sohlangothi, iningi laso liyisifo sohlangothi esibangelwa yi-ischemic. Isibonelo, ezweni elifana neMelika, kuthiwa othile uba nesifo sohlangothi njalo ngemizuzwana engama-40.

Abantu abangaphezu kwezigidi ezingu-200 emhlabeni wonke bahlushwa yisifo semithambo yegazi engaphandle (i-PAD). Cishe u-11% walaba bantu bane-ischemia engapheli esongela izitho.

Kodwa-ke, i-mesenteric ischemia eshiwo ngenhla ayivamile. Ibonakala kakhulu ezigulini ezigula kakhulu e-Intensive Care Unit (ICU).

Ziyini izimpawu ze-Ischemia?

Izimpawu ze-ischemia ziyahlukahluka kuye ngokuthi igazi lishoda kuphi emzimbeni. Okusho ukuthi, akuzona izimpawu ezenzeka lapho inhliziyo ishoda igazi, kodwa izimpawu ezenzeka lapho imilenze ishoda igazi. Ake sibheke ezinye zezimpawu ezivamile:

• I-Angina, okuwubuhlungu besifuba noma ukuqina: Lolu uphawu olukhulu lwe-ischemia ye-myocardial. Kungazwakala sengathi kukhona ingcindezi noma isisindo esibekwa esifubeni sakho. Ngezinye izikhathi, lobu buhlungu bungadlulela engalweni yakho yesobunxele, entanyeni, noma emhlathini.
• Ukuphefumula kanzima: Ungase ube nokuphefumula kanzima, ngisho noma ukhathele kancane.
• Ukuzizwa ukhathele noma udidekile: Umuzwa wokujikeleza, ukuba buthakathaka, noma ukuquleka.
• Ubunzima bokukhuluma: Ukukhuluma amagama angacacile, ukungakwazi ukukhuluma ngokucacile, kanye nokungaqondwa abanye. Lokhu ikakhulukazi uphawu lokuntuleka kwegazi ebuchosheni.
• Ukulahlekelwa ukuhambisana komzimba: Ukukhubeka ngenkathi uhamba, ukulahlekelwa yibhalansi ngokuzumayo, ubunzima bokubamba izinto.
• Ubuhlungu engalweni noma emlenzeni: Ubuhlungu bungase buvele ngokuzumayo, noma bungase buvele lapho wenza okuthile (isib. ubuhlungu emlenzeni wakho lapho uhamba). Lobuhlungu bungase buphele ngemva kwesikhathi esifushane sokuphumula, kodwa bungabuya uma uqhubeka nomsebenzi.
• Isandla noma umlenze uba mhlophe noma ubanda: Leso sandla/umlenze uzizwa ubanda kakhulu kunolunye uhlangothi, bese umbala ushintsha, mhlawumbe uze uphenduke ube luhlaza okwesibhakabhaka.
• Ukuba ndikindiki noma ukuqaqamba engalweni noma emlenzeni (Paresthesia): Kuzwakala sengathi kuyizikhonkwane nezinaliti, noma indawo ayindindi noma inzima.
• Ubuhlungu obukhulu besisu (isisu): Ubuhlungu besisu obungazelelwe, obungabekezeleleki. Lokhu kungaba uphawu lwe-mesenteric ischemia.
• Ukuqunjelwa okukhulu: Umuzwa wokuqunjelwa okukhulu, njengokungathi isisu sigcwele igesi.
• Uhudo: Uhudo ngezinye izikhathi lungase luhambisane negazi.
• Isisu esibuhlungu, isicanucanu, nokuhlanza.

Uma unesinye noma ngaphezulu salezi zimpawu, ungazinaki. Kungcono ukufuna iseluleko sezokwelapha ngokushesha. Ikakhulukazi uma unezimpawu ezifana nobuhlungu besifuba noma ubunzima bokukhuluma, kufanele uye esibhedlela ngokushesha.

Ziyini izimbangela ze-ischemia?

I-Ischemia yenzeka lapho okuthile kuvimbela ukugeleza kwegazi ngemithambo yegazi kuya ezicutshini. Ngezinye izikhathi, uma kunomfutho wegazi ophansi noma amazinga omoya-mpilo aphansi emzimbeni wonke isikhathi eside, isimo esibizwa ngokuthi "i-global ischemia" singavela.

Izimbangela eziyinhloko ze-ischemia yilezi:

• I-atherosclerosis: Lena imbangela eyinhloko. Kalula nje, ukuqongelela kwamafutha (esikubiza ngokuthi i-cholesterol) kwakheka ngaphakathi kwemithambo yegazi, kwenze izindonga zemithambo yegazi zibe lukhuni futhi kunciphise izikhala. Lokhu kuvimbela igazi ekugelezeni kahle.
• Amahlule egazi: Ihlule legazi lingakheka ngaphakathi komthambo wegazi futhi livale umthambo. Leli hlule legazi lingakheka kwenye indawo, lihambe negazi, bese lihlala emthanjeni.
• Ukuklinywa kwe-hernia yesisu: Ngezinye izikhathi ingxenye yamathumbu ingaklinywa ngaphakathi kwe-hernia, kuvimbele ukugeleza kwegazi kuyo.
• Umfutho wegazi ophansi kakhulu: Uma umfutho wegazi wehla kakhulu, inhliziyo iba nobunzima bokupompa igazi liye ezingxenyeni zomzimba, ikakhulukazi izingxenye ezikude.
• I-Vasculitis: Lokhu ukuvuvukala kwemithambo yegazi. Lokhu kungabangela nokuthi imithambo yegazi inciphe.
• Amadivayisi ezokwelapha: Ngesikhathi sokuhlinzwa okuthile, uma kuxhunywe emishinini esindisa impilo, noma ngenxa yamadivayisi afakwe emithanjeni yegazi, ukuhamba kwegazi ngezinye izikhathi kungavimbeka.

Yiziphi izinto ezandisa ingozi yokuthola ischemia?

Abanye abantu banamathuba amaningi okuthola i-ischemia kunabanye. Ake sibheke ukuthi bayini:

• Uma sekuvele kukhona ischemia kwenye ingxenye yomzimba.
• Umfutho wegazi ophezulu noma umfutho wegazi ophansi.
• Izinga le-cholesterol ephezulu egazini.
• Isifo Sikashukela (i-Diabetes Mellitus).
• Ukuntuleka komsebenzi womzimba.
• Ukukhuluphala ngokweqile kusho ukukhuluphala ngokweqile.
• Isifo Sezinso Esingapheli (CKD).
• Ukusetshenziswa kwemikhiqizo kagwayi (ukubhema, ugwayi ongenantuthu).
• Uma uke waba nokuhlaselwa yinhliziyo ngaphambilini.
• Uma uke waba nesifo sohlangothi ngaphambilini.
• Ukuphefumula komoya.
• Izinkinga zokujiya kwegazi.
• Eminye imithi, isibonelo, amaphilisi okuvimbela inzalo.

Uma unesinye noma ngaphezulu salezi zici eziyingozi, ukuzilawula kubaluleke kakhulu ukuvimbela ischemia.

Yiziphi izinkinga ezingaba khona ngenxa ye-ischemia?

Uma i-ischemia ingelashwa kahle, ingaholela ezinkingeni ezinkulu ngoba amangqamuzana aqala ukufa ngaphandle komoya-mpilo.

• Ukuhlaselwa yinhliziyo: Lokhu kwenzeka lapho igazi eliya emisipheni yenhliziyo liyeka ukunikezwa.
• I-critical limb ischemia: Isimo lapho igazi elingangeni noma emlenzeni lincipha kakhulu, okubangela ukuba ingxenye ife. Kungase kudingeke ngisho nokunqunywa.
• Isifo sohlangothi: Lapho ukugeleza kwegazi kuya ebuchosheni kunqamuka.
• Ukuhlaselwa kwe-ischemic okufushane (i-TIA).
• Ukubhoboka kwamathumbu akho amancane: Uma amathumbu engatholi igazi elanele, udonga lwamathumbu lungaba buthaka futhi lubhoboka.
• I-Gangrene, isimo lapho izicubu zifa futhi zibole: Lokhu kungabuye kuhambisane nokutheleleka.

Yingakho kubalulekile ukufuna iseluleko sezokwelapha ngokushesha nje lapho kuvela izimpawu ze-ischemia.

Uyibona kanjani i-ischemia?

Uma unezimpawu ze-ischemia, uma ubona udokotela, uzokubuza ngezimpawu zakho kanye nanoma yiziphi izifo oye wabhekana nazo ngaphambilini. Uzobe esekwenza ukuhlolwa ngokomzimba, ebheka ngqo indawo lapho unenkinga khona. Ngaphezu kwalokho, uzoyala ukuhlolwa okuthile ukuze kutholakale lesi sifo. (Kulungiswe igama elithi 'நிரணய' ngesiSinhala elifana nelithi "தணரு").

Kubuyekezwe: Ngaphezu kwalokho, kungase kudingeke ukuthi kuhlolwe ezinye izivivinyo ukuqinisekisa ukuxilongwa.

Yiziphi izivivinyo ezenziwayo ukuze kutholakale lokhu?

Kunezinhlobo ezahlukene zokuhlolwa ezingasetshenziswa ukuthola ukuthi i-ischemia ikhona yini, ukuthi imbi kangakanani, nokuthi itholakala kuphi. Ezinye zazo zifaka:

• Ukuhlolwa kwegazi: Hlola umonakalo wenhliziyo, amazinga e-cholesterol, kanye nesifo sikashukela.
• Ukuhlolwa kwe-Ankle-brachial index: Ukuhlolwa okulula ukuhlola ukugeleza kwegazi okubi emilenzeni.
• I-Doppler ultrasound: Lokhu kungasetshenziswa ukubona ukuthi igazi ligeleza kanjani emithanjeni yegazi nokuthi kukhona yini ukuvinjelwa.
• I-Echocardiogram: Ukuhlolwa kwe-ultrasound ukuhlola ukusebenza kwenhliziyo, okuhlanganisa amakamelo enhliziyo nama-valve.
• I-Angiogram: Kufakwa uketshezi olukhethekile emithanjeni yegazi bese kuthathwa i-X-ray ukuze kutholakale indawo eqondile lapho kuvimbeke khona kanye nokuvaleka kwemithambo yegazi.
• Isikeni se-MRI (Magnetic Resonance Imaging).
• Iskeni se-CT (Computed Tomography).
• Ukuhlolwa kokucindezeleka kokuzivocavoca:Babheka indlela inhliziyo yakho esabela ngayo lapho uzivocavoca.
• I-Electrocardiogram (EKG/ECG): Iqopha umsebenzi kagesi wenhliziyo.
• I-PET scan (i-Positron Emission Tomography scan): Ingabona izinto ezifana nenani legazi eligeleza ezicutshini.

Udokotela uzonquma ukuthi enzeni ngalezi zivivinyo ngokusekelwe esimweni sakho.

Iphathwa kanjani i-Ischemia?

Umgomo oyinhloko wokwelapha i-ischemia ukubuyisela ukugeleza kwegazi okwanele engxenyeni yomzimba engenawo umoya-mpilo. Lokhu kungafezwa ngemithi, izinguquko zendlela yokuphila, kanye nezinqubo ezithile zezokwelapha noma ukuhlinzwa.

Imithi

• Umuthi wokwehlisa umfutho wegazi: Uma unengcindezi ephezulu yegazi.
• Umuthi wokwehlisa i-cholesterol: Lawula i-atherosclerosis.
• Ama-anticoagulant - Ama-blood thinner: Avimbela ukwakheka kwama-blood clots futhi avimbele ama-clots akhona ukuthi abe makhudlwana.
• Ama-antiplatelet: Lolu uhlobo lomuthi onciphisa ukwakheka kwamahlule egazi (isib. i-aspirin).
• I-Thrombolytics - Imithi yokuncibilikisa amahlule egazi: Le mithi inikezwa lapho umthambo wegazi uvalwa ngokuzumayo yihlule legazi (isib. ukuhlaselwa yinhliziyo, isifo sohlangothi).
• Ama-antibiotic uma kukhona ukutheleleka.

Izinguquko zendlela yokuphila

Lokhu kubaluleke kakhulu, ngoba imithi yodwa ayanele.

• Zivocavoce okungenani izinsuku ezinhlanu ngesonto, okungenani imizuzu engama-30 ngosuku.
• Ukugcina isisindo esinempilo.
• Ukugwema ngokuphelele imikhiqizo kagwayi.
• Yamukela ukudla okunomsoco: Yidla izithelo, imifino, imifino eluhlaza kanye nokudla okucebile nge-fiber. Nciphisa uwoyela, ushukela kanye nosawoti.

Ukuhlinzwa noma ezinye izinqubo zezokwelapha

Ngezinye izikhathi, uma imithi yodwa inganele, odokotela bangenza izinto ezinjengalezi:

• I-Angioplasty kanye ne-stenting: Umthambo wegazi oncishisiwe uvuvuzwa ngedivayisi efana nebhaluni, bese kufakwa idivayisi encane efana ne-mesh (i-stent) ukuze ungaphinde unciphe.
• Ukususwa kwe-Thrombectomy: Ukususwa kwehlule legazi emthanjeni wegazi.
• Ukuhlinzwa kwe-peripheral artery bypass: Umthambo omusha noma umthambo wokwenziwa uxhunywe kumthambo ovalekile ukuze kudalwe indlela entsha yokugeleza kwegazi.
• Ukususwa kwe-atherectomy: Kususa ama-fat deposits (i-plaque) aqongeleleke ngaphakathi kwemithambo yegazi.
• I-Coronary Artery Bypass Graft (CABG): Lokhu ukuhlinzwa kwe-bypass okwenziwa emithanjeni yegazi yenhliziyo.
• I-Endarterectomy: Ukuhlinzwa kokususa ungqimba olunamafutha ngaphakathi kwemithambo yegazi.
• Ukuhlinzwa kwe-Laparoscopic noma i-laparotomy: Lokhu ukuhlinzwa okwenziwa ezimweni ze-ischemic zesisu.

Kwenzekani uma ngine-ischemia?

I-Ischemia yanoma yiluphi uhlobo iyingozi empilweni yakho. Kusho ukuthi amangqamuzana akho awatholi umoya-mpilo awudingayo ukuze asinde. Isimo sawo wonke umuntu sihlukile. Kodwa-ke, uma uthola ukwelashwa ngokushesha, umphumela uba ngcono. Isibonelo, uma une-ischemia yemilenze engalweni noma emlenzeni, unethuba elingu-93% lokusindisa imilenze uma uhlinzwa ngokushesha. Kodwa uma uhlinzwa zingakapheli amahora angu-8 kusukela ekuqaleni kwe-ischemia, lelo phesenti lehla laya ku-78%.

Cabanga nje, uma ischemia ivele esithweni esibalulekile njengobuchopho noma inhliziyo, ukwelashwa okusheshayo kungaba umehluko phakathi kokuphila nokufa. Umzuzu ngamunye ubalulekile. Yilokho okunquma ubukhulu bomonakalo obangelwe yi-ischemia nokuthi uzothinta kanjani impilo yakho yonke.

Unganciphisa kanjani ingozi yokuthuthukisa ischemia?

Ngenhlanhla, kunezinto eziningi esingazenza ukunciphisa ingozi yethu yokuthola ischemia:

• Yidla ukudla okunomsoco: izinto ezifana nezithelo, imifino, ubhontshisi kanye nokolweni ophelele.
• Phuza amanzi anele: Gwema ukuphelelwa amanzi emzimbeni.
• Gwema imikhiqizo kagwayi ngokuphelele.
• Zivocavoce njalo.
• Phatha izimo ezifana nesifo sikashukela, umfutho wegazi ophakeme, kanye ne-cholesterol ephezulu engabangela ischemia.

Ngizinakekela kanjani?

Uma une-ischemia, kubaluleke kakhulu ukuphuza imithi yakho njengoba nje udokotela wakho ekuyalele, ngaphandle kokulahlekelwa yilodwa usuku. Uma ukhohlwa ukuphuza imithi yakho, setha i-alamu efonini yakho. Noma sebenzisa i-pill order ukuze ugcine imithi yakho ihlelekile emini.

Kungakhathaliseki ukuthi unesifo sofuba esingakanani, ungazinakekela ngokushintsha imikhuba yakho yansuku zonke nokuphatha ezinye izimo ezingase zibangele isifo sofuba.

Kufanele ngimbone nini udokotela wami?

Ungaphuthelwa ama-aphoyintimenti akho okulandelela nodokotela wakho. Mtshele nganoma yiziphi izinkinga ezingapheli noma ezihlala zibuya. Mtshele nganoma yimiphi imiphumela emibi evela emithini yakho. Uma uke wahlinzwa noma ezinye izinqubo zezokwelapha, kufanele futhi uye kolandelelwa ukuze uhlole ukuthi uyalulama yini.

Kufanele ngiye nini e-Emergency Treatment Unit (ETU) ?

Funa usizo lwezokwelapha ngokushesha uma uhlangabezana nalezi zimpawu:

• Ubuhlungu besisu obungazelelwe, obukhulu.
• Izimpawu zokuhlaselwa yinhliziyo noma isifo sohlangothi: (isib. ubuhlungu obukhulu esifubeni, ubunzima bokuphefumula, ubunzima bokukhuluma, ukugoba kolunye uhlangothi lobuso, ukungazweli engalweni).
• Ubuhlungu obungabekezeleleki emlenzeni noma onyaweni.

Yimiphi imibuzo okufanele ngiyibuze udokotela?

Ungabuza udokotela wakho imibuzo efana nale:

• Ngidinga ukuthatha imithi engiyinikezwe udokotela isikhathi esingakanani?
• Iyini ingozi yami yokuthola olunye uhlobo lwe-ischemia?
• Ingabe izingane zami kanye namanye amalungu omndeni wami basengozini enkulu yokuthola ischemia ngenxa yokuxilongwa kwami?
• Kufanele ngikubone kangaki?

Uma uke wabhekana nesimo esiphuthumayo sezokwelapha esihlobene ne-ischemia, ungase uzibuze ukuthi yini ongayilindela ngokulandelayo. Udokotela wakho angakuqondisa ngezinyathelo ezilandelayo ekwelashweni kwakho. Kodwa kufanele futhi ucabangele ukuthi yiziphi izinguquko ozozenza empilweni yakho yansuku zonke - noma ngabe okwesikhashana nje. Lesi yisikhathi sokuqoqa abangani bakho nomndeni wakho eduze kwakho. Bangase bafune ukusiza, kodwa bangase bangazi ukuthi kanjani. Bacele ukuthi benze imisebenzi noma basize ngemisebenzi yasekhaya ngenkathi ululama. Abanye bangase bakwazi ukunciphisa ukwesaba kwakho futhi bakwenze uhleke. Ukusekelwa abanye kungaba usizo olukhulu ekululameni kwakho.

Isifinyezo (Umyalezo Wokuya Nawe Ekhaya)

Ngakho-ke, i-Ischemia, kafushane nje, yisimo lapho kunokuntuleka komoya-mpilo engxenyeni yomzimba wethu ngenxa yokuncipha kokugeleza kwegazi. Lokhu kungathinta noma iyiphi ingxenye yomzimba, okuhlanganisa inhliziyo, ubuchopho, izitho zangasese kanye namathumbu. Kubalulekile ukufuna usizo lwezokwelapha ngokushesha lapho kuvela izimpawu, njengoba ukwelashwa okusheshayo kungavimbela umonakalo omkhulu.

Ungakhathazeki, kunezindlela zokwelapha ezinhle ze-ischemia. Singavimbela lesi simo ngokwamukela indlela yokuphila enempilo nokulawula izici eziyingozi. Kubalulekile futhi ukulandela iseluleko sikadokotela wakho nokuya kohlolwa njalo. Awuwedwa, futhi baningi abantu abangakusiza kulolu hambo.

I- Ischemia, I-Ischemia, Ukujikeleza kwegazi, Ukuntuleka komoya-mpilo, Ukuhlaselwa yinhliziyo, Isifo sohlangothi, Izimpawu, Ukwelashwa, I-Atherosclerosis