Wake wacabanga ukuthi imithambo yegazi engaphakathi kwemizimba yethu ifana namapayipi amanzi endlini? Njengoba nje ngokuhamba kwesikhathi, ukungcola nokugqwala kwakheka ngaphakathi kwamapayipi amanzi futhi kuvimbele ukugeleza kwamanzi, izinto ezifana namafutha namafutha nazo zingakhiwa ngaphakathi kwemithambo yegazi yethu futhi zivimbele ukugeleza kwegazi. Yilokho esikubiza ngokuthi 'i-Endarterectomy', inqubo yokuhlinzwa yokuhlanza umthambo wegazi onjalo ovinjiwe. Namuhla, sizokhuluma ngalokhu ngamagama alula.
Kalula nje, kuyini i-Endarterectomy?
I-Endarterectomy (ebizwa ngokuthi: en-da-te-rek-to-me) inqubo yokuhlinzwa yokuvula kabusha imithambo yegazi evalekile noma enciphile. Kule nqubo, odokotela basusa i-plaque , ungqimba olukhulu lwamafutha, i-calcium, kanye ne-plaque eqongeleleke ngaphakathi kwemithambo yegazi yakho.
Njengokuhlanza ukungcola ngaphakathi kwepayipi lamanzi nokuvumela amanzi ukuthi ageleze kahle futhi, ngemva kwalokhu kuhlinzwa, ukujikeleza kwegazi emithanjeni yegazi kuyabuyiselwa. Lokhu kunciphisa kakhulu ingozi yezimo eziyingozi njengezinhlayiya zegazi kanye nesifo sohlangothi .
Lokhu kuhlinzwa kuvame ukwenziwa njengokwelashwa kwesimo esibizwa ngokuthi i-atherosclerosis. Lokhu kwenzeka lapho i-plaque inqwabelana ngaphakathi kwemithambo yegazi, okwenza iqine kancane kancane futhi ibe mncane. Lokhu kuhlinzwa kuvame ukunconywa ezimweni ezinezimpawu, ezinzima ngokwesilinganiso zemithambo evalekile.
Kunezimo ezimbili eziyinhloko eziphathwa ngalokhu kuhlinzwa:
- Isifo Semithambo Engasogwini (i-PAD): Lokhu kuwukunqwabelana kwe-plaque emithanjeni enikeza igazi emilenzeni noma ezingalweni zakho. Lokhu kungabangela imilenze yakho ukuba ibuhlungu uma uhamba, amanxeba aphole kancane, futhi ngezinye izikhathi ngisho nokufa kwezicubu (i-gangrene).
- Isifo Semithambo Ye-Carotid: Lesi yisimo esibi kakhulu. Sibangelwa ukwakheka kwe-plaque emithanjeni emibili eyinhloko entanyeni ethwala igazi liye ebuchosheni. Uma ingelashwa, ingaholela ekushayweni yisifo sohlangothi noma ekuhlaselweni yi-ischemic okwesikhashana (TIA).
Yiziphi izinhlobo zokuhlinzwa kwe-endarterectomy?
Uhlobo lokuhlinzwa luyahlukahluka kuye ngokuthi umthambo wegazi uvalekile kuphi emzimbeni wakho. Bheka ithebula elingezansi ukuze lokhu kube lula kuwe.
| Uhlobo lokuhlinzwa | Ukuhlanza imithambo yegazi kanye nencazelo |
|---|---|
| Ukuhlinzwa kwe-Carotid Endarterectomy | Ukuhlanza imithambo yegazi ethwala igazi lisuka ezinhlangothini zombili zentamo liya ebuchosheni. Lolu uhlobo oluvame kakhulu. |
| Ukususwa Kwe-Endarter Yesifazane | Ukuhlanza imithambo emikhulu (imithambo ye-femoral) egijima kusukela endaweni yesinqe kuya emilenzeni. |
| Ukuhlinzwa kwe-Aortic kanye ne-Iliac Endarterectomy | Ukuhlanza imithambo yegazi emikhulu esiswini (esiswini) nasezindaweni ze-pelvic (ezinqeni). |
| Ukuhlinzwa kwe-Endarter kwe-Coronary | Ukuhlanza imithambo yenhliziyo ehambisa igazi enhliziyweni uqobo. |
| Ukuhlinzwa Kwe-Endarter Yephaphu | Ukususa amahlule egazi amadala emithanjeni ethwala igazi liye emaphashini. Lokhu kuvame ukwenziwa kaningi. |
Kufanele ngilungiselele kanjani ngaphambi kokuhlinzwa?
Ngaphambi kwalokhu kuhlinzwa, udokotela uzokwenza izivivinyo eziningana ukuze athole ukuthi umthambo wakho wegazi uvalekile kangakanani.
- I-Doppler Ultrasound: Lokhu kusebenzisa amaza omsindo ukubona ukuthi imithambo yegazi ivinjiwe kuphi kanye nenani legazi eligeleza.
- I-CT Angiography: Kulokhu, kufakwa uketshezi olukhethekile (udayi wokungafani) emthanjeni osengalweni yakho, bese kusetshenziswa i-CT scan ukuthatha isithombe semithambo yegazi yakho esinezinhlangothi ezintathu (3D).
- I-Angiography: Kule nqubo, uketshezi olukhethekile lufakwa ngqo emithanjeni yegazi bese kuthathwa izithombe ze-X-ray.
- I-Magnetic Resonance Angiography (MRA): Isebenzisa omayibuthe namagagasi omsakazo ukuthatha izithombe zemithambo yegazi.
Ngaphezu kwalokho, udokotela wakho uzokunikeza imiyalelo yokuthi ungalungiselela kanjani ukuhlinzwa. Ungase ucelwe ukuthi uyeke okwesikhashana ukuthatha imithi ethile, njengemithi yokunciphisa igazi (ama-anticoagulant). Ngezinye izikhathi, ungase ucelwe ukuthi uqale ukuthatha imithi efana ne-aspirin.
Kuzodingeka futhi uzile ukudla amahora ambalwa ngaphambi kokuhlinzwa. Ithimba le-anesthesiology lizokutshela ngqo ukuthi wenzeni. Ungase futhi wenze izivivinyo ezifana ne-'Echocardiogram' noma i-'Stress Test' ukuze uhlole impilo yenhliziyo yakho.
Ubani ongeke ahlinzwe kanje?
Abanye abantu abanezimo ezithile zezokwelapha basengozini enkulu yalokhu kuhlinzwa, ngakho odokotela abakuncomi kubo. Isibonelo:
- Uma unesifo senhliziyo esibi kakhulu esingalawuleki (ukwehluleka kwenhliziyo okubangelwa ukuminyana).
- Uma usanda kuba nokuhlaselwa yinhliziyo.
- Uma unezimpawu zesifo senhliziyo ezingelapheki.
- Uma unesifo esibi samaphaphu njenge-emphysema noma i-COPD.
- Uma uke wathola ukwelashwa ngemisebe endaweni lapho ukuhlinzwa kuzokwenziwa khona.
- Uma kukhona ukutheleleka kuleyo ndawo.
Kodwa ungakhathazeki. Ngisho nakumuntu onjalo, udokotela ngezinye izikhathi uzozama ukususa ukuvaleka ngokufaka i-stent ngaphakathi kwemithambo yegazi, njengokuhlinzwa kwe-atherectomy.
Kwenziwa kanjani ukuhlinzwa?
Uzonikezwa i-anesthesia ukuze ungezwa ubuhlungu ngesikhathi sokuhlinzwa. Ngokuvamile, uzonikezwa i-anesthesia ejwayelekile. Lokhu kusho ukuthi uzobe ungazi lutho. Kodwa-ke, kwezinye izimo, ikakhulukazi lapho uhlanza imithambo yegazi entanyeni yakho (carotid endarterectomy), ungase uhlale uphapheme futhi uzizwe ungaphilile kuleyo ndawo (i-anesthesia yendawo) ngesikhathi sokuhlinzwa ngoba kuyadingeka ukuqapha umsebenzi wobuchopho bakho.
Ngesikhathi sokuhlinzwa, udokotela:
1. Ukusikwa kwenziwa ngokusika isikhumba phezu komthambo wegazi ovalekile.
2. Umthambo wegazi uyavulwa bese ungqimba lwe-'plaque' olungaphakathi lususwa ngokucophelela.
3. Umthambo wegazi uyathungwa uhlanganiswe ndawonye bese uvalwa. Ngezinye izikhathi, ukuze kuvinjwe indawo ukuthi inganciphi futhi, kusetshenziswa i-'patch' yokwenziwa (i-patch) noma ucezu lomthambo ophilile oluthathwe kwenye ingxenye yomzimba wakho ukuze kwandiswe indawo kancane.
4. Ekugcineni, ukunqunywa kwesikhumba kuyavalwa futhi kuthungwe.
Izinzuzo, izingozi, kanye nesikhathi sokululama
Inzuzo eyinhloko yalokhu kuhlinzwa ukuthi kuvula umthambo wegazi ovalekile futhi kubuyisele ukuhamba kwegazi. Lokhu kunciphisa kakhulu ubuhlungu bemilenze, amanxeba angapholi, futhi ikakhulukazi ingozi yokushaywa yisifo sohlangothi. Imiphumela yalokhu kuhlinzwa ivame ukuhlala iminyaka eminingi.
Njenganoma yikuphi ukuhlinzwa, kunezingozi ezithile ezihilelekile , kodwa amathuba okuba lokhu kwenzeke mancane.
- Ukopha
- Isifo senhliziyo, njengokuhlaselwa yinhliziyo
- Izifo
- Ukulimala kwemizwa (ngokuvamile okwesikhashana)
- Ukuncishiswa komthambo ofanayo nalowo owahlinzwa
- `Isifo sohlangothi`
Into ebaluleke kakhulu ukuqonda ukuthi udokotela wakho uncoma lokhu kuhlinzwa ngoba izinzuzo zokuhlinzwa zidlula kakhulu izingozi.
Kuthatha isikhathi esingakanani ukuphulukiswa?
Ubude besikhathi ozohlala esibhedlela buxhomeke ohlotsheni lokuhlinzwa okwenziwe.
- Ukuhlinzwa kwe-Carotid (intamo): cishe usuku.
- Ngokuhlinzwa kwe-femoral (umthambo womlenze): Cishe izinsuku ezimbili kuya kwezine.
- Ukuhlinzwa kwe-Aortic (i-abdominal artery): cishe isonto.
Uzocelwa ukuthi uze uzolandelelwa cishe amasonto amane ngemva kokuhlinzwa. Iningi labantu lingabuyela emsebenzini ngemva kwalokhu kulandelela. Kodwa-ke, uma unomsebenzi odinga ukuthwala izinto ezisindayo, kungathatha inyanga noma ezimbili ukuthi ululame ngokugcwele.
Ngingashayela nini udokotela ucingo?
Uma uhlangabezana nanoma yiziphi izimpawu ezingezansi ngemva kokuhlinzwa kwakho, kufanele ushayele udokotela wakho ucingo ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze nawe.
- Ubuhlungu besifuba
- Ubunzima bokuphefumula
- Uma uzizwa ushisa noma umkhuhlane
- Uma uzizwa ungenamizwa noma ubuthakathaka endaweni yokusikwa
- Uma kukhona ukuvuvukala, ukubomvu, noma uketshezi olufana nobomvu oluzungeze indawo yokusikwa
- Izinguquko embonweni, inkulumo engacacile, noma ukugoba kolunye uhlangothi lobuso
- Uma kuvela isicanucanu noma ukuhlanza
Umlayezo Wokuya Nawe Ekhaya
- I-Endarterectomy inqubo yokuhlinzwa esusa i-plaque (ama-fat deposits) ngaphakathi komthambo wegazi futhi ihlanze umthambo wegazi.
- Lokhu kuhlinzwa kunganciphisa kakhulu ingozi yezimo ezibucayi ezifana nesifo sohlangothi.
- Ngaphambi kokuhlinzwa, kwenziwa izivivinyo eziningana ukuze kutholakale ukuthi ukuvaleka kwenhliziyo yakho kungakanani kanye nempilo yayo.
- Nakuba lokhu kuyindlela yokuhlinzwa enkulu, kuyindlela yokwelapha enemiphumela ephumelelayo futhi ehlala iminyaka.
- Kuthatha isikhathi ukululama ngemva kokuhlinzwa. Phakathi naleso sikhathi, kubaluleke kakhulu ukulandela imiyalelo kadokotela ngqo.
- Uma kuvela izimpawu eziyingozi ngemva kokuhlinzwa, funa iseluleko sezokwelapha ngokushesha.
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