Ingabe imithambo yegazi ethwala igazi ezinso zakho inciphile? (I-Renal Artery Stenosis) Ake sixoxe ngalokhu!

Izinso zingenye yezitho ezibaluleke kakhulu emzimbeni wethu. Zifana nesihlungi esihlanza imfucuza emzimbeni wethu. Kodwa ngezinye izikhathi, ngaphandle kokwazi kwethu, imigudu eyinhloko ehambisa igazi ezinso, okungukuthi imithambo yezinso, ingavinjelwa. Lokhu yilokho esikubiza ngokwezokwelapha ngokuthi 'i-Renal Artery Stenosis' (RAS) noma isifo semithambo yezinso. Lokhu kungaba yisimo esibi kakhulu, njengoba kungaholela ezimweni ezifana nomfutho wegazi ophakeme (umfutho wegazi ophakeme) , isifo sezinso esingamahlalakhona (isifo sezinso esingamahlalakhona), kanye nokwehluleka kwezinso ekugcineni. Ngakho-ke, kubaluleke kakhulu ukuqaphela lokhu.

Ubani osengozini enkulu yokuthola lesi sifo?

Kalula nje, nakuba lesi simo singakhula kunoma ubani, abanye abantu basengozini enkulu. Abantu abane -atherosclerosis basengozini enkulu. I-atherosclerosis yisimo lapho izinto ezinamafutha njenge-cholesterol kanye ne-plaque ziqoqana khona ezindongeni zemithambo yegazi yethu, okungaholela ekuvinjweni. Cabanga ngakho njengepayipi lamanzi elivalekile ngothuli ngokuhamba kwesikhathi.

Ngakho-ke, uma unezinye zezinto ezibangela ingozi ezingezansi, kuwumqondo omuhle ukuba uqaphele kakhudlwana:

• Uma unesifo sikashukela .
• Uma othile emndenini enesifo senhliziyo (okungukuthi, isixhumanisi sofuzo).
• Uma une -high blood pressure .
• Uma unezinga eliphezulu le-cholesterol egazini .
• Ukukhuluphala ngokweqile kusho ukuba nesisindo somzimba esiningi kakhulu.
• Ingozi iyanda ngokuguga (amadoda angaphezu kweminyaka engu-45 ubudala, abesifazane abangaphezu kweminyaka engu-55 ubudala).
• Ukudla okungekuhle , okusho ukudla njalo ukudla okunosawoti omningi, uwoyela kanye noshukela.
• Uma ubhema , lokhu kuyingozi ezintweni eziningi.

Buyini ubudlelwano phakathi kwe-stenosis yemithambo yezinso nesifo semithambo eseceleni?

Nansi enye into ebalulekile. Le stenosis yemithambo yezinso (i-RAS) ithinta imithambo ethwala igazi ezinso. Kodwa kunesinye isimo esibizwa ngokuthi 'i-Peripheral Artery Disease' (i-PAD) . Kulokhu, imithambo ethwala igazi lisuka enhliziyweni liya ezingalweni nasemilenzeni iyavaleka. Cabanga nje, uma uhamba, uzwa ubuhlungu emilenzeni yakho, futhi ngemva kwesikhashana ungahamba futhi, ungabona izimpawu zale PAD.

Imbangela eyinhloko ye-RAS kanye ne-PAD ivame ukuba yi-atherosclerosis okukhulunywe ngayo ngenhla . Izifundo zibonise ukuthi phakathi kuka-14% no-35% wabantu abane-PAD bangase babe ne-RAS. Lokhu kusho ukuthi kukhona ukuxhumana okuqinile phakathi kwalokhu okubili.

Ngaphezu kwalokho, abantu abanesifo sezinso esingamahlalakhona, esingabangelwa yi-RAS, kutholakale ukuthi basengozini enkulu yokuthola i-PAD. Umuntu onazo zombili lezi zimo usengozini enkulu kakhulu yokuthola izinkinga ezinkulu zempilo, njengokuhlaselwa yinhliziyo, isifo sohlangothi, kanye nokulahlekelwa yimilenze . Ngakho-ke, kubalulekile ukuqaphela lezi zinto.

Ziyini izimpawu? Sikubona kanjani lokhu?

Ngokuvamile, lolu hlobo lwe-renal artery stenosis (RAS) alubonisi zimpawu ezigabeni zokuqala. Kufana nokuthi luyakucashela futhi lwenze lesi sifo sibe sibi kakhulu. Izinkinga, njengomfutho wegazi ophezulu kanye nokwehluleka kwezinso, ziqala ukuvela kuphela uma lesi sifo sibi kakhulu. Uma izinso zingasebenzi kahle, lezi zimpawu zingavela. Bheka ukuthi unazo yini lezi:

• Ingabe unenkinga yokugxila noma uzizwa udidekile ?
• Awukwazi ukulala? (Ubunzima bokulala)
• Ingabe zikhona izindawo zomzimba wakho ezivuvukele ngamanzi? (Ukuvuvuka), ikakhulukazi emilenzeni nasemaqakaleni.
• Ingabe uzizwa ukhathele ngaso sonke isikhathi ? Ingabe uyakhathala ngisho nangemva kokwenza umsebenzi omncane?
• Ingabe uvame ukuba nekhanda elibuhlungu ?
• Ingabe uphelelwa yisifiso sokudla ?
• Ingabe uzwa ubuhlungu bemisipha noma izinhlungu ?
• Ingabe unesicanucanu nokuhlanza ?
• Ingabe uzizwa uphelelwa umoya (dyspnea) ? Ingabe uzizwa uphelelwa umoya ngisho nangemva kokuhamba isikhashana?
• Izinguquko zesikhumba - izinto ezifana nesikhumba esomile, ukulunywa, noma ukuba mnyama kwesikhumba.
• Ingabe wehlisa isisindo ngaphandle kwesizathu? (Ukwehlisa isisindo ngendlela engachazeki)
• Ingabe uchama kaningi noma kancane kunokujwayelekile?

Ukuthi unesinye noma ezimbili zalezi zimpawu akusho ukuthi unesifo. Kodwa-ke, uma unezinye zalezi zimpawu, kuwukuhlakanipha ukufuna iseluleko sezokwelapha.

Kungani le mithambo yezinso ivaleka? Ziyini izimbangela?

Kunezizathu ezimbili eziyinhloko zalokhu.

1. Ngokwezinga elikhulu, phakathi kuka-60% no-90% wamacala e-RAS abangelwa yisimo esikhulume ngaso ngaphambilini , i-atherosclerosis . Lokhu kuwukuqongelela kwamafutha (i-plaque) ezindongeni zemithambo yegazi, okuyenza inciphe kancane kancane. Lena yimbangela evame kakhulu.

2. Amacala asele avame ukubangelwa yisimo esibizwa ngokuthi 'i-Fibromuscular dysplasia' . Lokhu kuhlukile kancane. Yilapho amangqamuzana asezindongeni zemithambo yegazi ekhula khona ngendlela engajwayelekile futhi abangele ukuthi imithambo yegazi inciphe. Lokhu akusikho ukugcwala kwamafutha. Lesi simo sivame kakhulu kwabesifazane. Kucatshangwa ukuthi sibangelwa izakhi zofuzo noma ama-hormone.

Yimiphi imiphumela emibi engaba khona (izinkinga) zalokhu?

I-stenosis yemithambo yezinso akuyona into elula. Uma ingaphathwa kahle, ingaholela kwezinye izinkinga eziningi. Isibonelo:

• Isifo sezinso esingamahlalakhona: Ukwehla kancane kancane kokusebenza kwezinso.
• Isifo semithambo yenhliziyo: Ukuvaleka okufanayo kungenzeka emithanjeni ehambisa igazi enhliziyweni.
• Ukuwohloka kwezinso: Ubukhulu bezinso bungase bunciphe.
• Ukwehluleka kwezinso: Ekugcineni, izinso zingayeka ukusebenza ngokuphelele, kudingeke i-dialysis noma ukufakelwa izinso.
• Isifo semithambo yegazi engaphandle: Ukuvaleka kwemithambo yegazi ethwala igazi iye ezithweni.
• Umfutho wegazi ophezulu wezinso: Umfutho wegazi ophezulu emithanjeni yezinso.

Yingakho kubaluleke kakhulu ukubona udokotela ngokushesha uma usola isimo esinjengalesi noma unezimpawu.

Lesi sifo sitholakala kanjani ngokunembile?

Ngezinye izikhathi, odokotela bathola ukuthi i-renal artery stenosis iyenzeka ngengozi. Okusho ukuthi, uma bekuhlola esinye isimo. Kodwa-ke, uma udokotela wakho esola ukuthi une-RAS, angenza ezinye izivivinyo, ezifana nalezi:

• Ukuhlolwa ngokomzimba: Okokuqala, uzohlolwa kahle. Umfutho wegazi wakho uzohlolwa. Kwabanye abantu, lesi simo singabangela umfutho wegazi ophezulu ongalawuleki. Bazobheka ukuvuvukala ezithweni zakho futhi balalele ukuphefumula kwakho. Udokotela angase abeke i-stethoscope phezu kwezinso zakho ukuze alalele ukugwinya kwegazi. Ungase uzwe umsindo 'wokukhwishiza' njengoba igazi ligeleza emthanjeni ovalekile. Isibonakaliso esiyinhloko se-RAS umfutho wegazi ophezulu ongachazeki .
• Ukuhlolwa kokusebenza kwezinso: Okulandelayo, kwenziwa ukuhlolwa kwegazi nomchamo ukuze kubonwe ukuthi izinso zakho zisebenza kahle kangakanani. Lokhu kuhlolwa kubheka amazinga aphezulu emikhiqizo yokungcola efana neprotheni, i-creatinine , ne-nitrogen emzimbeni wakho. Lezi yizinto izinso zakho ezidinga ukuzihlunga ziphume emzimbeni wakho. Uma ziphakeme, kusho ukuthi izinso zakho azihlungi kahle imikhiqizo yokungcola.
• Ukuskena izithombe: Ngaphezu kwalokho, kunezinhlobo ezahlukene zokuskena izithombe ezingasetshenziswa ukubona ukuthi izinso zakho zinkulu kangakanani nokuthi igazi ligeleza kahle kangakanani kuzo. Lokhu kungabonisa nokuthi imithambo yakho inciphile kangakanani. Udokotela wakho angase futhi akuncome ukuthiUngase ucelwe ukuthi wenze i-renal scan, i-duplex ultrasound, i-computerized tomographic angiography (CTA), noma i-magnetic resonance angiogram (MRA) . Lezi skeni zingakunikeza isithombe esicacile semithambo yezinso.

Yiziphi izindlela zokwelapha lokhu?

Izindlela zokwelapha eziyinhloko zalesi simo (i-RAS) ukushintsha indlela yokuphila kanye nemithi . Kokubili kufanele kusetshenziswe ndawonye. Kodwa-ke, uma imithambo yezinso incishisiwe kakhulu, kunengozi yokuvaleka kwemithambo, uma imithi ingakwazi ukulawula ingcindezi, noma uma ukusebenza kwezinso kuqhubeka nokwehla, kungase kudingeke ukuhlinzwa .

Lesi simo singalawulwa kanjani ngokushintsha indlela yokuphila?

Lokhu kubaluleke kakhulu. Ukuthatha imithi kuphela akwanele. Udokotela wakho uzokutusa ngokuqinisekile izinguquko ezithile zendlela yokuphila ezizosiza ukulawula lesi simo (RAS) nokwehlisa umfutho wegazi wakho ophezulu. Lezi ngokuqinisekile yizinto okufanele uzenze:

• Ukudla ukudla okunempilo: Yidla ukudla okunamafutha aphansi, i-cholesterol, usawoti (i-sodium), kanye noshukela. Lokhu kusho ukunciphisa ilayisi elithosiwe, ukudla okuthosiwe, iziphuzo ezinoshukela, kanye nokudla okulula okunamafutha. Faka imifino eminingi etshalwe ekhaya, izithelo, namantongomane ekudleni kwakho. Ngisho nezinguquko ezincane ezifana nalezi zingenza umehluko omkhulu.
• Ukuzivocavoca njalo: Yenza okuthile njengokuhamba noma ukugibela ibhayisikili okungenani imizuzu engama-30 ngosuku. Ukuzivocavoca akusho ukuthi uye ejimini.
• Ukwehlisa isisindo: Zama ukugcina isisindo esifanele ubude bakho.
• Ukuyeka ukubhema: Uma ubhema, yeka ngokushesha. Lokhu kungaba nzima, kodwa kunezindlela zokuthola usizo.

Yiluphi usizo olunikezwa yimithi?

Kanye nokushintsha indlela yokuphila, udokotela wakho angase akunikeze imithi eminingana ukusiza ukulawula umfutho wegazi ophakeme kanye nokumisa noma ukulawula ukuqhubeka kwesifo sezinso. Le mithi kufanele isetshenziswe njengoba nje udokotela wakho ekutshelile.

• Imithi efana ne -ACE inhibitors kanye ne-Angiotensin Receptor Blockers (ARBs) ivimba ama-hormone athile angavimba imithambo yegazi yakho.
• Ama-anticoagulant, njenge -aspirin , asiza igazi ukuthi ligeleze kalula emithanjeni.
• Ama-beta-blockers kanye nama-calcium channel blockers, anciphisa umfutho wegazi ophakeme.
• Ama-diuretics , aziwa nangokuthi 'amaphilisi amanzi', asebenza ngokusiza izinso zakho ukuthi zisuse amanzi amaningi nosawoti emzimbeni wakho, ehlisa umfutho wegazi lakho.
• Yehlisa amazinga e-cholesterol egaziniAma-statin.

Hlobo luni lokuhlinzwa olukhona kulokhu?

Uma isimo (i-RAS) sibi ngokwanele ukuthi singalawulwa ngemithi kanye nezinguquko zendlela yokuphila, njengalapho umthambo uvalekile ngaphezu kuka-70%, kungase kudingeke ukuhlinzwa. Kunezinhlobo ezintathu eziyinhloko zokuhlinzwa:

1. I-Angioplasty kanye ne-stenting: Lena inqubo evame kakhulu. Kule nqubo, udokotela ohlinzayo ufaka ithubhu elincane neliguquguqukayo (i-catheter) emthanjeni wakho wezinso ovalekile, kungaba nge-groin noma engalweni yakho. I-catheter ibe isifuthwa ngebhaluni elincane ekugcineni ukuze kwandiswe umthambo. I -stent (ithubhu elincane elifana ne-mesh) ibe isifakwa emthanjeni ukuze ingavaleki futhi futhi ivumele igazi ligeleze liye ezinso. Lena inqubo engangenisi kakhulu.

2. Ukudlula kwemithambo yezinso: Lokhu kuwukuhlinzwa okukhulu. Kufana nokudlula kwenhliziyo. Kule nqubo, udokotela ohlinzayo udala indlela entsha yokuthi igazi ligeleze liye ezinso, edlula umthambo wezinso ovalekile noma ovalekile. Lokhu kuvame ukuhilela ukusebenzisa i-graft evela emlenzeni wakho noma ipayipi lokwenziwa. Le graft noma ipayipi lixhunywe kumthambo ophilayo okhona, kanti elinye icala lixhunywe kumthambo ovalekile, phakathi nendawo yomthambo ovalekile nezinso.

3. Ukususwa kwe-renal endarterectomy: Kule nqubo, udokotela ohlinzayo uvula umthambo wezinso ovalekile bese esusa i-plaque nezinye izinto ezivimba ukugeleza kwegazi.

Udokotela wakho uzonquma ukuthi yikuphi kwalokhu kuhlinzwa okufanele wena.

Sizivikela kanjani kulesi sifo? (Ukuvimbela)

Bathi, “Ukuvimbela kungcono kunokwelapha.” Ngakho-ke, nazi ezinye izinto ongazenza ukuze unciphise ingozi yakho yokuthola lesi simo (i-RAS):

• Yidla ukudla okunempilo .
• Vivinya umzimba njalo .
• Ukulawula umfutho wegazi lakho . Hlola umfutho wegazi lakho njalo.
• Ukugcina isisindo somzimba siphilile .
• Ungabhemi .

Ukwenza lezi zinto ngeke nje kuvimbele ukuvaleka kwemithambo yezinso, kodwa kungakuvikela nakwezinye izifo eziningi.

Uyini umbono womuntu onalesi sifo?

Isifo semithambo yezinso (i-RAS) yisimo esiqhubekayo esiba sibi ngokuhamba kwesikhathi. Umbono womuntu onalesi simo uncike ebunzimeni besifo, ukuthi sisheshe sitholakale kanjani, nokuthi usabela kahle kangakanani ekwelashweni.

Ucwaningo lukhombisile ukuthi abantu abangu-48% kuphela abanemithambo yezinso evalekile engu-95% noma ngaphezulu banesilinganiso sokusinda iminyaka emine. Lokho kusho ukuthi ingxenye kuphela yabantu abanezinkinga ezicishe ziphelele abasinda eminyakeni emine ngemva kokuxilongwa.Ngakho-ke, kubaluleke kakhulu ukuqaphela lesi simo kusenesikhathi bese ucela ukwelashwa. Uma sitholakala kusenesikhathi, umonakalo wezinso ungancishiswa futhi isikhathi sokuphila singandiswa.

Kufanele ngimbone nini udokotela ngalokhu?

Uma unesinye noma ngaphezulu kwalezi zimpawu ezilandelayo, bona udokotela ngokushesha . Lezi kungaba izimpawu zokusebenza kwezinso okuphansi kakhulu :

• Uma uzwa ukunambitheka kwensimbi emlonyeni wakho.
• Uma unezinhlungu esiswini .
• Uma unenkinga yokugxila, ukudideka noma izinkinga zokugxila .
• Uma inani lomchamo liphansi kakhulu (Umchamo ophumayo uphansi) .
• Uma isicanucanu nokuhlanza kuqhubeka.
• Uma unesifo sokuwa .
• Ukuvuvukala emilenzeni, ezingalweni noma ebusweni .

Ungazinaki lezi zinto. Uma uthola ukwelashwa ngokushesha, ungavimbela umonakalo omkhulu.

Okokugcina, izinto okudingeka uzikhumbule (Umyalezo Wokuya Ekhaya)

I-Renal Artery Stenosis (RAS) ukuncipha kwemithambo yegazi ehambisa igazi ezinso. Imbangela eyinhloko yalokhu ukugcinwa kwamafutha emithanjeni yegazi (i-atherosclerosis) . Lokhu kungaholela ezinkingeni ezinkulu zempilo ezifana nomfutho wegazi ophakeme, isifo sezinso esingamahlalakhona, kanye nokwehluleka kwezinso.

Khumbula, lokhu ngokuvamile akubonisi zimpawu ekuqaleni, kodwa kungaba yingozi uma kungelashwa kahle.

Izinguquko zendlela yokuphila (ukudla okuhle, ukuvivinya umzimba, nokuyeka ukubhema) kanye nemithi enikezwe udokotela wakho yizona zindlela zokwelapha eziyinhloko. Kwezinye izimo, kungase kudingeke ukuhlinzwa. Ngakho-ke, ukunaka izimpawu, ukulawula izici eziyingozi uma unazo, nokufuna iseluleko sezokwelapha ngesikhathi kubaluleke kakhulu ukugcina izinso zakho ziphilile. Nakekela umzimba wakho, ngoba impilo iyimpahla enkulu kakhulu!

I- Renal Artery Stenosis, Umfutho Wegazi Ophakeme, Isifo Sezinso, I-Atherosclerosis, I-Arterial Stenosis, Impilo Yezinso