Ingabe uzizwa uphelelwa umoya noma uphefumula kanzima uma uzikhandla, ukhuphuka izitebhisi, noma wenza imisebenzi evamile? Ngezinye izikhathi imbangela yalokhu ingaba yi-blood clot endala ebilokhu iseziphashini zakho isikhathi eside. Ngokuvamile, noma uzama ukulawula lesi simo ngemithi, uma lokho kungasebenzi, odokotela bakudlulisela ekuhlinzweni okukhethekile okungasindisa impilo yakho. Namuhla sikhuluma ngalolo hlinzwa oluyinkimbinkimbi, kodwa olubaluleke kakhulu, i-PTE.
Kuyini lokhu kuhlinzwa kwe-PTE?
Kalula nje, i-PTE isifinyezo se- Pulmonary Thromboendarterectomy . Lena inqubo yokuhlinzwa esusa amahlule egazi amadala kanye nezicubu ezibomvu ezinamathele emithanjeni yegazi eyinhloko (imithambo yegazi yamaphaphu) emaphashini akho. Lena inqubo eyinkimbinkimbi edinga ulwazi olukhethekile. Kodwa ingazelapha ngokuphelele ezinye iziguli.
Yiziphi izimo eziphathwa ngokuhlinzwa kwe-PTE?
Lokhu kuhlinzwa kwenziwa ikakhulukazi ukwelapha isimo esibizwa ngokuthi i-CTEPH (Chronic Thromboembolic Pulmonary Hypertension) . Ungase ucabange, 'Lelo igama elide kakhulu,' akunjalo? Masikwenze kube lula.
Cabanga nje, othile une-blood clot emaphashini akhe. Sikubiza ngokuthi ``Pulmonary Embolism (PE)``. Esikhathini esiningi, la ma-blood clot ayancibilika uma enikezwa ama-blood thinner. Kodwa akuvamile kakhulu, kwabanye abantu, la ma-blood clot awancibiliki ngokuphelele, kodwa anamathela ezindongeni zemithambo yegazi emaphashini, futhi ngokuhamba kwesikhathi, aphenduke izicubu zesilonda.
Uma amahlule egazi amadala kanye nezicubu zesibazi kuvimbela imithambo yegazi emaphashini, umfutho wegazi ngaphakathi kwaleyo mithambo uba phezulu kakhulu. Yilokho esikubiza ngokuthi i-CTEPH.
Lokhu kubangela ukuthi uhlangothi lwesokudla lwenhliziyo lusebenze kanzima ukupompa igazi emaphashini. Ngokuhamba kwesikhathi, lokhu kungaholela ezimweni ezibucayi njengokwehluleka kwenhliziyo kanye nokulimala kwamaphaphu. Ukwelashwa okuwukuphela kwemithi engelapha i-CTEPH ukuhlinzwa kwe-PTE.
Ubani odinga lokhu kuhlinzwa? Ingabe wonke umuntu angakuthola?
Uma une-CTEPH, izici eziningana zizonquma ukuthi ungaba nokuhlinzwa kwe-PTE.
| Ukucabangela | Incazelo |
|---|---|
| Ubunzima bezimpawu | Ukuthi izimpawu zakho zimbi kangakanani, njengokuphelelwa umoya kanye nokuphefumula kanzima. |
| Indawo yamahlule egazi | Iqiniso lokuthi amahlule egazi kanye nezicubu zesibazi zitholakala ezindaweni lapho zingasuswa khona ngokuphepha ngokuhlinzwa. |
| Impilo yakho iyonke | Ubudala bakho, ukusebenza kwenhliziyo namaphaphu, nokuthi unezinye izimo zezokwelapha nakho kubalulekile. |
Akuzona zonke iziguli ze-CTEPH ezifanelekela lokhu kuhlinzwa. Cishe u-40% weziguli azifanelekeli lokhu kuhlinzwa. Isizathu salokhu ukuthi kuwukuhlinzwa okuyinkimbinkimbi kakhulu.
Kungani ukuhlinzwa kuyinkimbinkimbi kangaka?
Cabanga ukuthi ngesikhathi sokuhlinzwa, inhliziyo yakho namaphaphu kufakwa emshinini we-cardiopulmonary bypass ukuze kusize ngomsebenzi othile. Bese, ukuze udokotela ohlinzayo abone ngaphakathi kwamaphaphu akho, izinga lokushisa lomzimba wakho lehliswa libe yi-18 degrees Celsius (65°F), bese ukujikeleza kwegazi lakho kumiswe okwesikhashana. Lokhu kubizwa ngokuthi 'ukuboshwa kokujikeleza kwegazi okujulile.' Ungakhathazeki, le nqubo ivumela udokotela ohlinzayo ukuthi asuse amahlule egazi kanye nezicubu zesibazi ngokuhlanzekile ngenkathi evikela ubuchopho bakho kunoma yimuphi umonakalo.
Ungalungiselela kanjani ukuhlinzwa?
Udokotela wakho uzokunikeza yonke imiyalelo oyidingayo ngaphambi kokuhlinzwa. Ngokuvamile bazokutshela ukuthi unake lezi zinto:
- Imithi: Uzocelwa ukuthi uyeke ukuthatha imithi yokunciphisa igazi (njenge-aspirin ne-warfarin) kanye neminye imithi yokunciphisa ubuhlungu (ama-NSAID) ezinsukwini ezimbalwa ngaphambi kokuhlinzwa, njengoba lokhu kungandisa ingozi yokopha ngesikhathi sokuhlinzwa.
- Ukudla Nokuphuza: Uzocelwa ukuba uzile ukudla (ungadli noma uphuze) amahora ambalwa ngaphambi kokuhlinzwa. Kuphephile ukuba nesisu esingenalutho uma unikezwa umuthi wokubulala izinzwa.
- Ukubhema notshwala: Uma usebenzisa kokubili, kubaluleke kakhulu ukuyeka ngokuphelele ngaphambi kokuhlinzwa, njengoba kubambezela inqubo yokuphulukiswa futhi kwandisa ingozi yezinkinga.
Kwenzekani ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, uzolaliswa egunjini lokunakekela abagula kakhulu (ICU). Uzohlala lapho ngalobo busuku. Ngakusasa ekuseni, bazokuhlola ukuthi ungakwazi yini ukuphefumula wedwa bese bekhipha umshini wokuphefumula.
Ngokuvamile uzohlala esibhedlela izinsuku eziyi-7 kuya kweziyi-10. Phakathi nalesi sikhathi, uzoqala ukuhamba kancane kancane. Uzophinde uhlolwe ukuze ubone ukuthi udinga umoya-mpilo yini ngaphambi kokuba uye ekhaya. Lokhu kufana nokuhlangenwe nakho kokululama ekuhlinzweni kwenhliziyo okuvulekile.
Yiziphi izinzuzo nezingozi?
Njenganoma yikuphi ukuhlinzwa, i-PTE inezinzuzo kanye nezingozi.
| Izinzuzo | Izingozi |
|---|---|
| Amathuba okululama ngokuphelele kusuka ku-CTEPH. | Ingozi yokufa ngesikhathi sokuhlinzwa (manje iphansi njenge-1%). |
| Ukuthuthuka okukhulu ekuphefumuleni nasekuzivocavoceni. | Ingozi yokushaywa yisifo sohlangothi (1%-2%). |
| Ukubuyiselwa komonakalo ohlangothini lwesokudla lwenhliziyo. | Umfutho wegazi ophezulu wamaphaphu (i-PH) uhlala ezingeni elithile ngisho nangemva kokuhlinzwa. |
| Ikhono lokuphila impilo ende nenempilo ngemva kokuhlinzwa. | Ukuqongelela koketshezi oluzungeze inhliziyo (i-pericardial effusion). |
Isimo esiphuthumayo!
Uma uzwa ubuhlungu besifuba obungazelelwe, obukhulu, ukuphelelwa umoya okukhulu, noma uquleka ngemva kokuhlinzwa, hamba uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze ngokushesha. Futhi, uma uba nezimpawu ezifana nokuvuvukala, ukubomvu, ubomvu, noma umkhuhlane endaweni yokuhlinzwa, bona udokotela wakho ngokushesha.
Sinjani isikhathi sokululama?
Kuthatha cishe izinyanga ezintathu ukululama ngokuphelele.
- Amaviki okuqala ayisithupha: Akukho ukushayela, ukuya emsebenzini, noma ukuphakamisa isisindo esingaphezu kuka-4.5 kg (10 lbs).
- Amaviki 7 kuya ku-12: Ingaphakamisa isisindo esingafika ku-11 kg (25 lbs).
- Ngemva kwamasonto ayi-12: Ngokuvamile akukho mingcele.
Ikhono lakho lokuphefumula kanye nokuzivocavoca lingathuthuka kancane kancane kuze kube yiminyaka engu-4 ngemva kokuhlinzwa.
Umlayezo Wokuya Nawe Ekhaya
- Nakuba i-PTE iyindlela yokuhlinzwa eyinkimbinkimbi yokususa amahlule egazi amadala emaphashini, ingayelapha ngokuphelele inkinga ebizwa ngokuthi i-CTEPH.
- Lokhu kuhlinzwa akulona olwawo wonke umuntu. Udokotela wakho kanye nethimba lochwepheshe bazonquma ukuthi kulungile yini kuwe.
- Nakuba isikhathi sokululama siside kancane, izinga lempilo yakho, ikhono lokuphefumula, kanye nokuhamba kuzothuthuka kakhulu ngemva kokuhlinzwa.
- Ngemva kokuhlinzwa, kuzodingeka uthathe imithi yokuvimbela ukugabha kwegazi impilo yakho yonke ukuze uvimbele ukuqhekeka kwegazi ukuthi kuphinde kwakheke.
- Kubalulekile ukubona udokotela wakho ngesikhathi bese uhlolwa. Ungesabi ukukhuluma nodokotela wakho nganoma yikuphi ukungakhululeki okungenzeka ukuthi ubhekene nakho.
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