Ingabe izinso zakho zingathinta umfutho wegazi lakho? Ake sixoxe nge-Renovascular Hypertension!

Umfutho wegazi ophakeme, noma njengoba sonke sazi, "umfutho wegazi," kuyinkinga abantu abaningi ababhekene nayo kulezi zinsuku. Kodwa bewazi ukuthi ngezinye izikhathi izinso zakho nazo zingaba imbangela yalo mfutho wegazi ophakeme? Yebo, kuyiqiniso. Lesi simo somfutho wegazi ophakeme esenzeka ezinso sibizwa nangokuthi `(Renovascular Hypertension)` noma `(Renal Hypertension)`. Ake sixoxe ngalokhu ngokuningiliziwe nangokulula namuhla.

Kungani lokhu kwandisa ingcindezi ezinso? (Kuyini i-Renovascular Hypertension?)

Kalula nje, lesi simo senzeka lapho imithambo yegazi eyinhloko enikeza igazi ezinso zakho (esizibiza ngokuthi "i-Renal Arteries") ivalekile. Cabanga ngakho njengepayipi lamanzi elivalekile, okunciphisa ukugeleza kwamanzi. Lapho le mithambo yegazi ivalekile, inani legazi elifinyelela ezinso liyancipha.

Kwenzekani-ke? Izinso ziyaqaphela ukuthi azitholi igazi elanele. Ngenxa yalokho, izinso zivuselela uhlelo olukhethekile lwama-hormone nezinye izinto. Lokhu kubizwa ngokuthi `(RAAS - Renin-Angiotensin-Aldosterone System)`. Uma lolu hlelo `(RAAS)` lusebenza, luphakamisa umfutho wegazi womzimba wonke. Kunjengokungathi izinso zithumela isignali zithi, "Asitholi igazi elanele, khulisa umfutho wegazi ngokushesha!"

Umfutho wegazi ophakeme we-Renovascular uhlobo oluvamile lomfutho wegazi ophakeme wesibili. Okungukuthi, umfutho wegazi ophakeme obangelwa esinye isimo sezokwelapha. Ngezinye izikhathi, kungaba futhi imbangela yomfutho wegazi ophakeme okunzima ukuwulawula naphezu kwemithi (umfutho wegazi ophakeme omelana nawo). Ngakho-ke, ukwazi ukuthi umfutho wegazi wakho uhlobene nezinso zakho kungasiza udokotela wakho ukuthi akutholele ukwelashwa okufanele.

Ziyini izimpawu zalesi simo? (Izimpawu ze-Renovascular Hypertension)

Esikhathini esiningi, ungase ungabi nazo izimpawu ezithile kulesi simo '(se-Renal Hypertension)'. Yilokho okwesabisayo kancane. Kodwa-ke, odokotela bazothola izinkomba emlandweni wakho wezokwelapha kanye nokuhlolwa ukuze basole lesi simo.

Nazi ezinye zezeluleko ezinjalo:

• Ukuqala ngokuzumayo komfutho wegazi ophakeme ngaphambi kweminyaka engama-30 noma ngemva kweminyaka engama-50. Cabanga ngakho, kuyamangaza kancane ukuba nomfutho wegazi ophakeme ngokuzumayo ngemva kwesikhathi eside ngaphandle kwezinkinga, ngaphambi nje kweminyaka lapho umfutho wegazi uvame ukukhula khona, akunjalo?
• Ukwanda okungazelelwe komfutho wegazi okwakulawulwa kahle ngaphambilini. Kungenzeka ukuthi ubulokhu uphuza imithi yomfutho wegazi iminyaka eminingi futhi ibilokhu ilawulwa kahle. Kodwa uma imithi iyeka ukusebenza ngokuzumayo futhi umfutho wegazi wakho ukhuphuka ngokuzumayo, kuyinto okufanele uyikhathazeke ngayo.
• Umfutho wegazi wakho awunciphi naphezu kokusebenzisa izinhlobo eziningana zemithi yokwelapha umfutho wegazi wakho. Uma umfutho wegazi wakho unciphi naphezu kokuthatha imithi udokotela wakho ayikuyalelayo, kungase kube nenye imbangela eyinhloko.
• Ukuba nezinkinga eziningi zomfutho wegazi ophakeme. Lezi yizikhathi lapho umfutho wegazi ukhuphuka khona ngokuzumayo ube sezingeni eliyingozi.
• Kungaba khona i-edema yamaphaphu engazelelwe (i-flash pulmonary edema). Lokhu kungabangela ubunzima obungazelelwe bokuphefumula.
• Ukuba nomlando wokunqwabelana kwama-plaque kweminye imithambo yegazi emzimbeni, njengenhliziyo, intamo, kanye nemilenze. Lokhu kubizwa nangokuthi i-atherosclerosis.
• Ubuhlungu besifuba buvela ngaphandle kokufakwa kwamafutha amaningi emithanjeni yenhliziyo.
• Ukwehluleka kwezinso ngaphandle kwesizathu esibonakalayo.
• I-Breathing ilapho udokotela ebeka i-stethoscope esiswini sakho bese ezwa umsindo othi "swoo... swoo...". Lona umsindo ongajwayelekile owenziwa lapho igazi ligeleza emthanjeni wegazi.

Khumbula, lezi yizimpawu odokotela abasola ukuthi zikhona. Ukuthi nje unesinye noma ezimbili zalezi akusho ukuthi une-Renovascular Hypertension. Kodwa-ke, uma unezinye zalezi zimpawu, kuwukuhlakanipha ukubona udokotela.

Yini ebangela lokhu? (Izimbangela Zokucindezeleka Kwegazi Okusha Kwemithambo Yegazi)

Imbangela eyinhloko yalesi simo `(Renovascular Hypertension)` ukuncipha kwemithambo yegazi ethwala igazi ezinso (Renal Artery Stenosis) . Kungaba nezizathu eziningana zalokhu kuncipha kwemithambo yegazi:

1. I-Atherosclerosis: Lena yimbangela evame kakhulu. Njengoba nje ukungcola nokugqwala kwakheka ngaphakathi kwamapayipi amanzi, i-cholesterol namanye amafutha akheka ngaphakathi kwemithambo yegazi, okunciphisa ukugeleza kwegazi. Lokhu kungenzeka ngokuguga, ngenxa yemikhuba yokudla engafanele, isifo sikashukela, nokubhema.

2. I-Fibromuscular Dysplasia (FMD): Lesi yisimo esingavamile njenge-Atherosclerosis. Sibonakala ngokukhula okungavamile kwamaseli emisipha kanye nezicubu ezixhumeneyo odongeni lwemithambo yegazi, okungaholela ekuncipheni kwemithambo yegazi. Lesi simo sivame kakhulu kwabesifazane abasebasha.

Ngaphezu kwalezi zizathu ezimbili eziyinhloko, kunezinye izizathu ezingavamile kakhulu:

• Ukuvuvukala kwemithambo yegazi (i-Vasculitis)
• I-Aneurysm ye-Renal Artery
• Ukucindezela kwe-tumor emthanjeni wezinso noma wezinso
• I-Fibrosis ebangelwa ukwelashwa ngemisebe

Yiziphi izinkinga ezingaba khona ngenxa yalokhu? (Izinkinga ze-Renovascular Hypertension)

Noma yiluphi uhlobo lomfutho wegazi ophakeme, okuhlanganisa nomfutho wegazi ophakeme we-renovascular, lungaholela ezinkingeni ezahlukahlukene uma lungelashwa kahle. Okubaluleke kakhulu, umfutho wegazi ophakeme wesikhathi eside ungalimaza inhliziyo. Lokhu kubizwa ngokuthi isifo senhliziyo esinomfutho wegazi ophakeme .

Ngaphezu kwalokho, umfutho wegazi ophakeme ongalashwanga ungabangela izinkinga ezifana nalezi:

• Isifo Sezinso: Akumangalisi, akunjalo? Ngenxa yokuthi inkinga yaqala ngezinso, zingalimala kakhulu.
• Isifo Se-Retinal: Ukulimala kwemithambo yegazi ebucayi emehlweni kungaholela ekulahlekelweni kokubona.
• Isifo sohlangothi
• Isifo senhliziyo

Yingakho kubaluleke kakhulu ukulawula umfutho wegazi lakho ngendlela efanele.

Odokotela bakuthola kanjani lesi simo?

Odokotela abaxilongi i-Renovascular Hypertension ngokuhlolwa okukodwa nje. Bafinyelela esiphethweni ngokuhlanganisa izinkomba ezahlukene, njengomseshi. Lezi zinkomba ziyabafikela:

• Ngokukuhlola ngokomzimba: Isibonelo, izinto ezifana nomsindo othi 'Bruit' oshiwo ngenhla ozizwayo nge-stethoscope esiswini sakho.
• Ngokubukeza umlando wakho wezokwelapha: imininingwane efana nokugula kwangaphambilini, ukugula komndeni, kanye nemithi oyiphuzayo.
• Ngokwenza izivivinyo ezikhethekile.

Nazi ezinye izinhlobo zokuhlolwa ongazenza:

• Ukuhlolwa Kwegazi: Hlola izinto ezifana nokusebenza kwezinso kanye namazinga e-cholesterol.
• Ukuhlolwa Komchamo: Hlola ukuthi izinto ezifana namaprotheni ziyakhishwa yini ezinso.
• I-ultrasound yezinso kanye nezinye izivivinyo ze-radiological ezibonisa ukugeleza kwegazi emithanjeni yezinso: Lokhu kungabonisa usayizi nesimo sezinso nokuthi imithambo yegazi ivaliwe yini. I-scan ekhethekile ebizwa ngokuthi i-Doppler ultrasound ingalinganisa izinto ezifana nesivinini sokugeleza kwegazi. Kungadingeka futhi wenze izivivinyo ezifana ne-CT Angiogram noma i-MR Angiogram.
• Ukuhlolwa kwe-X-ray okubonisa ukugeleza kwegazi kwezinye izingxenye zomzimba, isibonelo, imithambo ye-carotid entanyeni: Lokhu kuhlola izinkinga ngemithambo yegazi kwenye indawo emzimbeni.

Iphathwa Kanjani I-Renovascular Hypertension?

Umgomo oyinhloko wokwelashwa ukwehlisa umfutho wegazi lakho nokuthuthukisa ukugeleza kwegazi ezinso zakho. Esikhathini esiningi , lokhu kungalawulwa ngemithi. Kodwa-ke, kwezinye izimo, inqubo ekhethekile noma ukuhlinzwa kunganconywa ukuthuthukisa ukugeleza kwegazi ezinso zakho.

Imithi

Into eyinhloko ukwehlisa ingcindezi. Uma une-`(Umfutho Wegazi Wezinso)`, lezi zinhlobo ezimbili zemithi ikakhulukazi zingasebenza kahle kakhulu:

• Ama-inhibitor e-Angiotensin-Converting Enzyme (ACE)
• Ama-Angiotensin Receptor Blockers (ARBs)

Yomibili le mithi isebenza ohlelweni lwe-``(RAAS)`` olushiwo ngaphambilini. Okusho ukuthi, ilawula umfutho wegazi ngokunciphisa umsebenzi wohlelo lwe-hormone olwenyusa umfutho wegazi.

Kanye nomuthi wokuvimbela i-ACE noma i-ARB, ungadinga eminye imithi. Isibonelo:

• ``(Statins)`` yokwehlisa i-cholesterol
• ` (Abavimbeli Beziteshi Ze-Calcium)`
• Ama-diuretics (abizwa nangokuthi "amaphilisi amanzi")

Udokotela uzokuchazela kahle ukuthi umuthi owudingayo, ungakanani, nokuthi kungani. Ungalokothi uyeke ukuthatha umuthi wakho noma ushintshe umthamo ngaphandle kweseluleko sikadokotela.

Izinqubo

Ngezinye izikhathi, odokotela batusa inqubo ebizwa ngokuthi i-Renal Artery Angioplasty (ngezinye izikhathi ene-stenting) ukwelapha i-Renal Hypertension. Lokhu kwenziwa ezimweni ezilandelayo:

• Uma une-`(Umfutho Wegazi Ophakeme Wezinso)` ngenxa ye-`(I-Fibromuscular Dysplasia - FMD)`.
• Uma ungakwazi ukulawula umfutho wegazi lakho ngemithi yodwa.
• Uma uhlaselwa ukwehluleka kwenhliziyo noma ukuvuvukala kwamaphaphu ngaphandle kwesizathu esibonakalayo.

I-Angioplasty ihilela ukufaka ibhaluni elincane emthanjeni wegazi ovalekile, okwandise umthambo wegazi. Ngezinye izikhathi, kufakwa i-stent, ipayipi elincane eline-mesh, ukuze kuvinjelwe indawo evalekile ukuthi ingaphinde ivaleke.

Ukwelashwa okusha okusanda kuvunyelwa ukususwa kwemisipha yezinso . Le nqubo isebenzisa amandla okushisa noma e-ultrasound ukunciphisa umsebenzi weziphetho zezinzwa emithanjeni yezinso. Lokhu kungasiza futhi ekunciphiseni umfutho wegazi.

Ngaphambi kokwenza noma iyiphi inqubo, udokotela uzokuchazela konke, okuhlanganisa izinzuzo nezingozi, isikhathi sokululama, njll. Ukuze ukwazi ukuqonda konke kahle futhi wenze isinqumo.

Ukuhlinzwa

Ukuhlinzwa akukhuthazwa kakhulu ngenxa yokucindezeleka kwezinso. Lokhu kubizwa ngokuthi i-Surgical Renal Revascularization noma i-Renal Bypass Surgery .

Kule nqubo, udokotela ohlinzayo uthatha ingxenye yomunye umthambo wegazi emzimbeni wakho, noma ipayipi lokwenziwa, bese eyixhumanisa ne-aorta yakho kanye nezinso zakho. Lokhu kudala umzila omusha wegazi ukuze ligeleze liye ezinso zakho, lidlule umthambo wezinso ovalekile. Kufana nokuthatha umzila ohlukile lapho umgwaqo uvalekile.

Ukuhlinzwa kuyingozi kakhulu kune-angioplasty, ngakho odokotela bakusebenzisa kuphela ezimweni ezikhethekile. Isibonelo:

• Uma une-anatomy eyinkimbinkimbi yemithambo yezinso, okusho ukuthi imithambo yakho ivalekile ngendlela eyenza kube nzima ukufaka i-stent.
• Uma izindlela ezishiwo ngaphambilini ze-"Minimally Invasive" (njenge-angioplasty) zingaphumeleli.
• Uma udinga ukuhlinzwa e-aorta yakho eduze komthambo wezinso.

Kufanele Ngimbone Nini Umhlinzeki Wami Wezempilo?

Uma usuthole ukuthi unalesi simo, udokotela wakho uzokutshela ukuthi kufanele ubuye kangaki uzombona. Lokhu kuhlangana kokulandelela kubaluleke kakhulu ngoba yisikhathi lapho udokotela wakho engenza khona lokhu:

• Hlola umfutho wegazi lakho ukuze ubone ukuthi ukwelashwa kuphumelele kangakanani.
• Hlola ukusebenza kwezinso zakho.
• Shintsha uhlelo lwakho lokwelashwa uma kudingeka.

Futhi, le mihlangano iyithuba elihle lokuthi ubuze udokotela imibuzo futhi wabelane ngezinkinga zakho.

Ingabe Ukucindezeleka Kwegazi Kwezinso Kungelapheka?

Umfutho wegazi ophakeme ovuselelwa kabusha uyisifo somfutho wegazi ophakeme esingelapheka. Lokhu kusho ukuthi umfutho wegazi wakho ungancishiswa ube sezingeni elinempilo ngemithi kanye nezinye izindlela zokwelapha. Udokotela wakho uzokutshela okwengeziwe ngalokho ongakulindela ngokusekelwe esimweni sakho.

Into ebaluleke kakhulu ukuphuza imithi njengoba nje udokotela esho, nokulandela imiyalelo enikeziwe.

Ngokuvamile, kubaluleke kakhulu ukunakekela lezi zinto:

• Thatha yonke imithi oyinikezwe udokotela ngesikhathi esifanele.
• Landela iseluleko sikadokotela wakho mayelana nokudla nokuzivocavoca. (Bangase batuse uhlelo lokudla olukhethekile njenge-DASH Diet. Lokhu kusho ukudla ukudla okunosawoti omncane kanye nezithelo nemifino eminingi.)
• Khuluma nodokotela wakho mayelana nenani lomsebenzi womzimba ofanele wena.

Uma usutholakale une-Renovascular Hypertension, ungase ukwazi ukuchaza ezinye zezimpawu oye wabhekana nazo muva nje. Mhlawumbe umfutho wegazi wakho ukhuphuke ngokuzumayo ngemva kokuba ujwayelekile iminyaka eminingi. Noma mhlawumbe imithi yakho evamile yomfutho wegazi ayisasebenzi.

Kungakhathaliseki ukuthi isimo sakho sinjani, ukwazi ukuthi izinso zakho zithinta kanjani umfutho wegazi lakho kungasiza udokotela wakho ukuthi ahlele ukwelashwa okufanele. Uma unemibuzo mayelana nemithi yakho noma ukuthi ungayiphatha kanjani isimo sakho, qiniseka ukuthi ubuza udokotela wakho.

Umyalezo Ofanele Uwuthathe Ekhaya (Izinto Ezibaluleke Kakhulu Okufanele Uzikhumbule)

Kulungile, ake sifingqe ezinye zezinto okudingeka uzikhumbule kulokho esikhulume ngakho:

• Umfutho wegazi ophakeme wegazi (Renovascular hypertension) yisimo somfutho wegazi ophezulu esibangelwa ukuvaleka kwemithambo yegazi ethwala igazi liye ezinso.
• Lokhu kungase kungabi nezimpawu ezithile, kodwa odokotela basola ukuthi kusekelwe emibonweni ethile.
• Izimbangela eziyinhloko ukugcwala kwamafutha emithanjeni yegazi (i-Atherosclerosis) kanye ne-Fibromuscular Dysplasia (FMD).
• Lokhu kungalawulwa ngemithi. Ngezinye izikhathi, izinqubo ezifana ne-"Angioplasty" zingadingeka.
• Kubaluleke kakhulu ukulandela imiyalelo kadokotela ngqo nokubona udokotela ngesikhathi.
• Lesi yisimo esingalawuleka. Ngakho-ke, kubalulekile ukungesabi bese ufuna ukwelashwa okufanele.

Uma ucabanga ukuthi unenkinga efanayo, ungangabazi ukubona udokotela bese uthola iseluleko. Hlala uphilile!

'Umfutho wegazi ophezulu wezinso, Umfutho wegazi ophakeme wemithambo yegazi, i-Renal Artery Stenosis, ingcindezi, umfutho wegazi ophezulu, isifo sezinso