Ingabe udokotela wake wakutshela noma umngane wakho ukuthi 'unenhliziyo evinjiwe'? Mhlawumbe wena ngokwakho uzizwa ukuqina esifubeni sakho, ubuhlungu, nobunzima bokuphefumula uma ukhuphuka izitebhisi noma uzikhandla kancane? Namuhla sizokhuluma ngokwelashwa odokotela abakubiza ngokuthi 'i-Angioplasty' noma 'i-PCI'. Ungesabi uma uzwa leli gama, lokhu akuyona indlela enkulu noma ehlaselayo njengoba ungase ucabange. Ake sixoxe ngakho konke kalula.
Kuyini i-PCI? Kalula nje...
Kalula nje, i-Percutaneous Coronary Intervention (PCI) inqubo esusa ukuvaleka kwemithambo yegazi ethwala igazi liye enhliziyweni (esikubiza ngokuthi imithambo yegazi yenhliziyo) futhi ivumele ukugeleza kwegazi kuqale kabusha. Cabanga ngakho njengepayipi lamanzi elinokuvimba futhi elingahambi kahle. I-PCI ifana nokususa ukuvaleka nokuhlanza ipayipi futhi.
Abantu abaningi bayazi ukuthi lokhu kwelashwa yi- angioplasty . Kungenzeka ukuthi wake wezwa ngakho ngaphambilini. Kuhilela ukufaka ipayipi elincane (i-catheter) ngomthambo ongalweni noma emlenzeni wakho uye emthanjeni onciphile enhliziyweni yakho, bese ufutha ibhaluni elincane ekugcineni kwepayipi ukuze kwandiswe indawo enciphile.
Ngemva kokuba umthambo usunwetshiwe, kufakwa ithubhu elincane elifana ne-mesh ukuze lingaliwi futhi. Lokhu yilokho esikubiza ngokuthi i-stent . Kufana nokusekela ngaphakathi komhubhe osuzowa.
Ama-stents amaningi amasha anomuthi kuwo onciphisa ingozi yokuthi umthambo uvaleke futhi. Siwabiza ngokuthi 'ama-stents angasebenzisi izidakamizwa'. Lokhu kuphumela emiphumeleni engcono nakakhulu.
Ubani odinga lokhu kwelashwa?
Ngokuhamba kwesikhathi, izinto ezifana namafutha kanye ne-cholesterol ziyanqwabelana emithanjeni yethu yegazi, zakha ungqimba olujiyile. Kufana nokugqwala okwakheka ngaphakathi kwepayipi lamanzi elidala. Kwezokwelapha, sibiza lolu ngqimba ngokuthi 'i-plaque. ' Isimo lapho la ma-plaque akheka khona emithanjeni, encipha futhi eqinisa izindonga, sibizwa ngokuthi i-atherosclerosis .
Lokhu kubangela ukuthi imithambo yegazi inciphe futhi inhliziyo ingatholi igazi elidingekayo. Yilapho:
- Uma uzikhandla kancane, ukhuphuka izitebhisi, noma uhamba ngokushesha, uzwa ubuhlungu noma ukuqina esifubeni sakho . Lokhu kubizwa ngokuthi i-angina .
- Sekunzima ukuphefumula, ngizizwa sengathi ngiyahlanya.
Kubantu abanalezi zimpawu, ukwelashwa kwe-PCI kwenziwa ukuze kususwe ukuvinjelwa nokubuyisela ukugeleza kwegazi.
Futhi, ukuhlaselwa yinhliziyo okungazelelweI-PCI iyindlela enkulu yokwelapha esindisa impilo yomuntu onesifo senhliziyo. Ukuhlaselwa yinhliziyo yilapho umthambo wegazi uvalekile ngokuphelele, kunqanyulwe ukugeleza kwegazi engxenyeni yenhliziyo. Ngemuva kwalokho, ukuvaleka kudinga ukuvulwa ngokushesha ngangokunokwenzeka futhi igazi lingapompelwa. I-PCI ingakwenza lokho ngokushesha futhi inciphise kakhulu umonakalo enhliziyweni.
Ingabe zikhona izimo lapho ukwelashwa kwe-PCI kungafanele kwenziwe?
Udokotela wakho wenhliziyo uzonquma ukuthi uyakudinga lokhu, ukuthi ungakwazi yini ukukulawula ngemithi yodwa, noma ukuthi udinga ukuhlinzwa okukhulu okubizwa ngokuthi i-coronary artery bypass graft (CABG). Lokhu kuhlukile kumuntu ngamunye.
Lapho ethatha leso sinqumo, udokotela ucabangela ngqo lezi zici:
- Zingaki imithambo yakho evalekile, ukuthi ivalekile kangakanani, nokuthi ikuphi.
- Ngaphandle kwesifo senhliziyo, ingabe unazo ezinye izifo ezifana nesifo sikashukela noma isifo sezinso?
- Isebenza kanjani imisipha yenhliziyo yakho, izinto ezifana nobudala bakho?
Ngakho-ke, udokotela uzokuchazela ukuthi yikuphi ukwelashwa okufanele kakhulu kuwe.
Yini okufanele uyenze ngaphambi kokwelashwa?
Ngaphandle kokuthi kube ukuhlaselwa yinhliziyo okungazelelwe, udokotela wakho uzokunikeza iseluleko sokuthi ungakulungiselela kanjani lokhu.
- Ukudla nokuphuza: Ngokuvamile uzocelwa ukuthi uyeke ukudla nokuphuza amahora angu-6-8 ngaphambi kokwelashwa.
- Imithi: Into ebaluleke kakhulu ukuthi uma uthatha imithi yokunciphisa igazi noma eminye imithi, kufanele utshele udokotela wakho. Bangase bakucele ukuthi uyeke ukuyithatha ezinsukwini ezimbalwa ngaphambi kokwelashwa kwakho. Ngaphandle kwalokho, ungase uzwe ukopha okukhulu ngesikhathi sokwelashwa. Kufanele wenze lokhu njengoba nje udokotela wakho ekutshelile. Ungalokothi uyeke noma ushintshe imithi yakho wedwa.
Kwenzekani ngesikhathi sokwelashwa?
Ungesabi uma uzwa lokhu, akuyona into enkulu njengoba ucabanga. Lokhu kwenziwa udokotela othole ukuqeqeshwa okukhethekile ekwelapheni izifo zenhliziyo (Interventional Cardiologist). Uzonikezwa umuthi wokubulala izinzwa olula ukuze uhlale uphumule futhi uzolile. Ngakho ngeke uzwe ubuhlungu, kodwa uzophaphama. Uzozwa ukuthi udokotela uthini.
Nazi izinyathelo ezilula zokwelashwa:
| Izinyathelo | Kwenzekani? |
|---|---|
| 1. Ukuthola ukufinyelela | Ipayipi elincane (umgobo) lifakwa emthanjeni omkhulu engalweni yakho, eduze kwesihlakala sakho (umthambo oqondile) noma esithweni sakho sangasese (umthambo we-femoral). Lokhu kufana nesango lapho kudlula khona ezinye izinto. |
| 2. Ukuthumela i-catheter | Ipayipi elincane kakhulu neliguquguqukayo (i-catheter) lidlula ngepayipi elalibekwe ngaphambili bese lingena emthanjeni wenhliziyo enhliziyweni. Ngeke uzizwe lokhu. |
| 3. Ukunakekela ibhlogo | Uketshezi olukhethekile (udayi ohlukile) oluvela ngokucacile ku-X-ray lufakwa emthanjeni nge-catheter. Udokotela angabe esebona kahle ukuthi umthambo ukuphi nokuthi uvalekile kangakanani kusikrini se-X-ray. |
| 4. Ukuvula umthambo | Okulandelayo, kudlula enye intambo encane enebhaluni ebhulokini, bese ibhaluni lifuthwa ukuze licindezele ungqimba lwegazi oluvalelekile odongeni lomthambo, okudala indlela yokugeleza kwegazi. |
| 5. Ukubeka i-stent | Ukuze kuvinjwe umthambo futhi, kufakwa i-stent bese ifakwa embotsheni. |
| 6. Ukuqeda | Uma umsebenzi usuqediwe, i-catheter kanye neminye imishini kuyasuswa, ingcindezi ifakwa endaweni lapho ipayipi lifakwe khona, bese kufakwa ibhandishi. |
Yonke inqubo ingathatha noma yikuphi kusukela kumaminithi angu-30 kuya cishe emahoreni amabili, kuye ngohlobo lokuvaleka kwemithambo yakho.
Kwenzekani ngemva kokwelashwa?
Ngemva kwe-PCI, uzogcinwa endaweni yokululama amahora ambalwa ukuze kuqashwe izinga lokushaya kwenhliziyo yakho kanye nomfutho wegazi. Kungase kube nokuklwebheka noma ubuhlungu lapho kufakwe khona i-catheter. Lokhu kuvamile futhi kuzophela ezinsukwini ezimbalwa. Ezimweni eziningi, uzokwazi ukuya ekhaya ngalobo busuku noma ngakusasa ekuseni.
Yiziphi izinzuzo nezingozi zalokhu kwelashwa?
Njenganoma yikuphi ukwelashwa, lokhu kunezinzuzo kanye nezingozi ezincane.
Izinzuzo eziyinhloko
- Ukululama okusheshayo: Njengoba lokhu kungeyona indlela enkulu yokuhlinzwa, ungalulama futhi ubuyele empilweni evamile ngokushesha kunokuhlinzwa kwe-bypass.
- Ukuqeda izimpawu: Izinto ezifana nobuhlungu besifuba (i-angina) kanye nokuphelelwa umoya lapho uzikhandla (i-dyspnea) zincishisiwe kakhulu.
- Ukusindisa izimpilo: Lokhu kungasindisa izimpilo ngokunciphisa umonakalo enhliziyweni ngesikhathi sokuhlaselwa yinhliziyo.
Izingozi ezingaba khona
Nakuba i-PCI iyinqubo ephephile kakhulu , kunezinkinga ezimbalwa ezingavamile ezingaba khona.
- Ukopha noma ukutheleleka endaweni lapho ipayipi lifakwe khona.
- Amahlule egazi akha ngaphakathi kwe-stent (kunikezwe imithi yokuvimbela lokhu).
- Umthambo olashwe uvaleka futhi ngokuhamba kwesikhathi.
- Ukulimala kwezinso (ikakhulukazi kubantu abanesifo sezinso esivele sikhona).
- Akuvamile kakhulu ukuthi kube khona isifo sohlangothi.
Kodwa khumbula, uma odokotela besebenzisa i-stent engayisebenzisi imithi, amathuba okuthi umthambo uvaleke futhi angaphansi kuka-5%. Lokho kusho ukuthi ezimweni ezingu-95 kwezingu-100, inkinga ngeke ivele.
Kuthatha isikhathi esingakanani ukululama futhi yini okufanele ngikhathazeke ngayo?
Ngokuvamile ungabuyela emisebenzini yakho evamile zingakapheli isonto. Kodwa-ke, uma unomsebenzi odinga ukuthwala imithwalo enzima noma ukuzikhandla ngokomzimba, kungathatha isikhathi ngaphambi kokuba ubuyele emsebenzini. Khuluma nodokotela wakho ngalokhu.
Nansi into ebaluleke kakhulu:
Ngemva kokwelashwa, udokotela wakho uzokubhalela imithi yokuvimbela ukugabha kwegazi (njengeClopidogrel, Prasugrel, Ticagrelor). Kubalulekile ukuthatha le mithi njengoba kuyalelwe, ngaphandle kokulahlekelwa usuku olulodwa. Le mithi ivimbela ukwakheka kwamahlule egazi ngaphakathi kwe-stent. Ngakho-ke, landela imiyalelo kadokotela wakho ngqo.
Ngingaphinde ngimbone nini udokotela?
Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo ngemva kokuya ekhaya ngemva kokwelashwa, yazisa udokotela wakho ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
| Izimpawu okufanele uziqaphele |
|---|
| Kukhona ukopha okuqhubekayo, uketshezi olufana nobovu oluvuza endaweni lapho ipayipi lifakwe khona, noma ukuvuvukala okukhulu endaweni. |
| Ukuphinda kobuhlungu besifuba (i-angina) noma ukuphelelwa umoya njengangaphambi kokwelashwa. |
| Ukuzizwa ubanda futhi uphethwe umkhuhlane. |
| Ukuba ndikindiki noma ukubanda engalweni noma emlenzeni lapho kufakwe khona ipayipi. |
| Ukuzizwa unesizungu noma ukuphelelwa amandla (i-syncope). |
| Ukuqala okusha kobunzima bokuphefumula (ukuphelelwa umoya). |
Umlayezo Wokuya Nawe Ekhaya
- I-PCI iyindlela yokwelapha engadingi ukuhlinzwa, esebenza kahle kakhulu futhi ephephile yokuvula ukuvaleka kwemithambo yenhliziyo.
- Lokhu kunciphisa kakhulu izimpawu ezifana nobuhlungu besifuba kanye nokuphelelwa umoya. Kubalulekile futhi ekusindiseni izimpilo uma kwenzeka ukuhlaselwa yinhliziyo.
- Ngemva kokwelashwa, kubalulekile ukuthatha imithi yokunciphisa igazi enikezwe udokotela njengoba nje eyalelwe, ngaphandle kokulahlekelwa ngisho usuku olulodwa. Ibaluleke kakhulu empilweni yakho.
- Ngisho nangemva kokwelashwa, ukwamukela indlela yokuphila enhle (ukudla okulinganiselayo, ukuvivinya umzimba, ukugwema ukubhema notshwala, kanye nokunciphisa ukucindezeleka) kungasiza kakhulu ekuvimbeleni ukuthi imithambo yegazi ingaphinde ivaleke.
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