Ingabe ngezinye izikhathi uzizwa ukuqina noma ubuhlungu esifubeni sakho? Noma ingabe ukuthola kunzima ukuphefumula uma ukhathele kancane? Lezi zinto zingaba izimpawu zemithambo yegazi enhliziyweni yethu (imithambo ye-coronary) evaleka kancane kancane. Kufana nodaka oluqoqana ngaphakathi kwepayipi lamanzi endlini yethu bese luvaleka kancane kancane. Uma lokhu kungelashwa, kungaholela ngisho nasekuhlaselweni yinhliziyo. Kodwa ungakhathazeki, imithi yesimanje inezindlela zokwelapha ezisebenza kahle kakhulu kulokhu. Namuhla sizokhuluma ngendlela yokwelapha engavuselela inhliziyo enjalo.
Kuyini lokhu kuvuselelwa kwemithambo yegazi ye-coronary?
Lokhu kungase kuzwakale njengegama elide nelingavamile, kodwa incazelo yalo ilula kakhulu. Igama elithi "Coronary" libhekisela emithanjeni yegazi exhumanisa nenhliziyo. Igama elithi "Revascularization" lisho "ukuvuselela ukugeleza kwegazi." Ngakho-ke, ngamazwi alula, i-Coronary Revascularization iyindlela yokwelapha ebuyisela ukugeleza kwegazi enhliziyweni lapho imisipha yenhliziyo ingatholi igazi elilidingayo (isimo esisibiza ngokuthi i-ischemia kwezokwelapha) . Kungaba ngokuvula kabusha umthambo wegazi ovalekile noma ngokudala umzila omusha ozungeze ukuvaleka.
Lokhu kwelashwa kunganciphisa umonakalo enhliziyweni yakho ngemva kokuhlaselwa yinhliziyo, futhi kungakuvimbela uma usengozini enkulu yokuba nokuhlaselwa yinhliziyo.
Sikhuluma kakhulu ngezindlela ezimbili zokwelapha ngaphansi kwalokhu:
1. Ukungenelela Kwenhliziyo Okuhamba Ngesicubu (PCI): Yilokhu abantu abaningi abakubiza ngokuthi "ukubekwa kwe-stent." Lokhu kuhilela ukungena ngaphakathi kwemithambo yegazi, ukususa ukuvaleka, nokudala indlela yokugeleza kwegazi, ngaphandle kokuhlinzwa.
2. I-Coronary Artery Bypass Grafting (CABG): Lokhu kwaziwa nangokuthi "Ukuhlinzwa Kokudlula." Lokhu kuhilela ukudala indlela entsha (bypass) ezungeze umthambo wegazi ovinjiwe kusetshenziswa ucezu lomthambo wegazi oluthathwe kwenye ingxenye yomzimba.
| Indlela yokwelapha | Kalula nje... |
|---|---|
| I-PCI (ukubekwa kwe-stent) | Kufana nokufaka ucingo ngaphakathi kwepayipi elivalekile, uligcwalise ngamanzi, bese ulungisa umgwaqo. Akukho ukunqamuka okukhulu. |
| I-CABG (Ukuhlinzwa Kokudlula) | Njengokwakha indlela entsha yokudlula umgwaqo omatasa, umthambo wegazi omusha uyatshalwa ukuze udlule umthambo wegazi ovinjiwe. Lokhu ukuhlinzwa. |
Ubani odinga lokhu kwelashwa?
Noma ubani onenkinga yokugeleza kwegazi okuya enhliziyweni angazuza kulezi zindlela zokwelapha. Imbangela eyinhloko yalokhu isifo semithambo yegazi yenhliziyo . Ingozi yalesi simo iyanda njengoba iminyaka ikhula. Ngakho-ke, abantu abangaphezu kweminyaka engu-65 ubudala ngokuvamile yibona abadinga kakhulu lezi zindlela zokwelapha.
Cabanga nje, into ejiyile eyenziwe ngamafutha kanye ne-cholesterol (esiyibiza ngokuthi i-plaque) iyanda kancane kancane ngaphakathi kwemithambo yegazi yethu. Le nqubo ibizwa ngokuthi i-atherosclerosis . Kufana namafutha abhajwa epayipini lesinki lasekhishini bese evaleka. Ngokuhamba kwesikhathi, le mfucuza inciphisa umthambo wegazi. Uma ngelinye ilanga le mfucuza iqhuma, ihlule legazi lingakheka kuleyo ndawo futhi livimbe ngokuphelele umthambo wegazi. Yilapho ingxenye yenhliziyo iyeka ukuthola igazi, okubangela ukuhlaselwa yinhliziyo.
Ngakho-ke, kubantu abanalolu hlobo lokuvaleka, lokhu kwelashwa kusetshenziselwa ukubuyisela ngokushesha ukugeleza kwegazi ngaphambi kokuba amangqamuzana enhliziyo afe.
Yiziphi izimo eziphathwa ngalezi zindlela zokwelapha?
Lokhu kwelashwa kusetshenziselwa kakhulu izimo eziwela ngaphansi kwesigaba se-acute coronary syndrome. Okungukuthi:
- Ukuhlaselwa yinhliziyo: Ukulimala kwemisipha yenhliziyo ngenxa yokuvaleka komthambo wegazi ngokuzumayo.
- I-Stable Angina: Isimo lapho ubuhlungu besifuba buvela khona ngesikhathi sokuzikhandla, njengalapho ukhuphuka izitebhisi, futhi buphele lapho uphumula.
- I-Angina Engazinzile: Isimo esiyingozi esibonakala ngobuhlungu besifuba obuba bubi nakakhulu ngisho nalapho uphumule.
Kwenzekani ngaphambi kokwelashwa?
Uma usunqume ukwenza okunye kwalokhu kwelashwa, odokotela bazokwenza izivivinyo eziningana ukuze bahlole ngokunembile isimo sakho futhi bahlele inkambo engcono kakhulu yokwelashwa.
| Ukuhlolwa | Yini nje oyenzayo? |
|---|---|
| I-Electrocardiogram (ECG noma EKG) | Umsebenzi kagesi wenhliziyo uyahlolwa. |
| I-Echocardiogram | Kufana nokuskena, ukuhlola ukusebenza kanye nosayizi wenhliziyo. |
| Ukufakwa kwe-catheter kwenhliziyo / i-Angiogram | Kufakwa uketshezi olukhethekile emithanjeni yegazi bese kuthathwa i-X-ray ukuze kubonakale ukuthi ivinjiwe kuphi nokuthi ingakanani. |
| I-CT scan angiography | I-CT scan ibheka ukuvaleka kwemithambo yegazi. |
| Ukuhlolwa kwegazi | Izinto ezifana nama-enzyme kanye namazinga e-cholesterol ziyahlolwa ukuze kubonakale ukuthi inhliziyo yonakele yini. |
Ngaphandle kokuthi kuyisimo esiphuthumayo, kuzodingeka uzile ukudla cishe amahora angu-8 ngaphambi kwenqubo. Ngaphambi kokuba inqubo iqale, kuzofakwa umugqa we-IV (ithubhu elikunikeza usawoti) emthanjeni ongalweni yakho. Yilapho imithi edingekayo kanye noketshezi kuzonikezwa khona emzimbeni wakho. Nge-PCI, uzonikezwa umuthi wokudambisa. Ngokuhlinzwa kwe-CABG bypass, uzofakwa ngaphansi kwe-anesthesia ejwayelekile.
Kwenzekani ngesikhathi sokwelashwa?
Nakuba umgomo wezinqubo ze-PCI kanye ne-CABG ufana, indlela ezenziwa ngayo ihluke kakhulu.
Inqubo ye-PCI (ukubekwa kwe-stent)
Lapha, udokotela ufaka ipayipi elincane kakhulu neliguquguqukayo (i-catheter) emthanjeni wegazi omkhulu, kungaba ngesihlakala sakho noma ngesinqe. Ipayipi libe seliqondiswa emthanjeni wegazi ovalekile enhliziyweni yakho ngaphansi kwesiqondiso se-X-ray.
Okulandelayo, ibhaluni elincane ekugcineni kwepayipi liyafuthwa endaweni lapho kuvimbeke khona. Lokhu kubangela ukuthi umthambo wegazi oncishisiwe wande kusukela ngaphakathi. Lokhu kubizwa ngokuthi i-balloon angioplasty .
Cabanga nje, okwenzekayo lapha kufana nokufaka ibhaluni ngaphakathi kwepayipi elivalekile bese ulifutha, usunduze uthuli olungaphakathi kwepayipi lube nhlangothi zombili, kudaleke umgwaqo.
Ngemuva kwalokho, ukuze kuvikelwe ukuthi umthambo wegazi obanzi ungaphinde unciphe, kufakwa uhlaka lwensimbi oluncane olwenziwe njenge-mesh endaweni yalo. Yilokhu esikubiza ngokuthi i-stent . Amanye ama-stents anomuthi kuwo ovimbela umthambo wegazi ukuthi ungaphinde unciphe. Lawa abizwa ngokuthi ama-stent asebenzisa izidakamizwa . Ngemva kokuba umsebenzi usuqediwe, ipayipi liyakhishwa, kufakwa uthungo oluncane lapho lufakwe khona, bese ukwelashwa kuqedwa.
Indlela Yokuhlinzwa Kwe-CABG (Bypass)
Lena inqubo yokuhlinzwa. Udokotela ohlinzayo uqala ngokuthatha ucezu lomthambo wegazi ophilile kwenye indawo emzimbeni wakho (ngokuvamile emlenzeni wakho, engalweni, noma esifubeni sakho).
Ngemva kwalokho, inhliziyo ifinyelelwa ngezindlela ezimbili:
- Ukuhlinzwa okuvulekile: Kusikwa amasentimitha ambalwa phansi maphakathi nesifuba, kuvulwe ithambo lesifuba (sternum) ukuze kufinyelelwe enhliziyweni.
- Ukuhlinzwa Okungenazo Izinga Lokungena: Lokhu kuhilela ukwenza ukuhlinza okuncane okukodwa noma ngaphezulu esifubeni nokusebenzisa ikhamera namathuluzi akhethekile ukufinyelela inhliziyo ngezimbambo. Ngezinye izikhathi lokhu kwenziwa ngokusebenzisa ukuhlinzwa kwerobhothi.
Ngesikhathi sokuhlinzwa, inhliziyo ingase imiswe okwesikhashana bese ixhunywa emshinini we-heart -lung bypass ukuze yenze umsebenzi. Kodwa-ke, okunye ukuhlinzwa kwenziwa ngenkathi inhliziyo isashaya (off-pump bypass).
Udokotela ohlinzayo ube esesebenzisa umthambo wegazi osususiwe ngaphambilini ukudala indlela entsha ngokuxhuma umthambo wegazi ovinjiwe ngaphezulu nangaphansi kwawo. Kufana nokudala indlela entsha yokudlula umgwaqo omatasa. Lokhu kugwema ukuvaleka futhi kuvumela igazi ukuthi ligeleze liye emisipheni yenhliziyo endleleni entsha. Uma indlela yokudlula isiqediwe, isifuba siyavalwa, kuthungwe, bese ukuhlinzwa kuqediwe.
Kwenzekani ngemva kokwelashwa?
Uzodinga isikhathi sokululama ngemva kwenqubo. Lesi sikhathi sincike ohlotsheni lwenqubo oye wayenza (i-PCI noma i-CABG) kanye nempilo yakho iyonke. Ngokuvamile, uzobuyela esimweni esijwayelekile zingakapheli izinsuku ezimbalwa ngemva kwe-PCI. Kodwa-ke, kungathatha amasonto ambalwa noma ngisho nezinyanga ngemva kokuhlinzwa kwe-CABG.
Ngesikhathi sokululama kwakho, udokotela wakho angakudlulisela ohlelweni lokuvuselela inhliziyo . Kulezi zinhlelo, odokotela, abahlengikazi, abafundisi bokuzivocavoca, kanye nochwepheshe bezokudla basebenza ndawonye ukukusiza.
- Yimuphi umsebenzi wokuzivocavoca ofanelana nawe?
- Yikuphi ukudla okufanele ukudle?
- Ungayithatha kanjani imithi ngendlela efanele?
- Ungaphila kanjani impilo enempilo futhi?
Ngizokwazisa ngakho konke okushiwoyo.
Futhi, kubalulekile ukuya emihlanganweni yokulandelela ehlinzekwe udokotela. Ukuthatha imithi yakho ngesikhathi, ukulawula ukudla kwakho, nokulandela imiyalelo kadokotela wakho kubaluleke kakhulu ukuze kusheshiswe ukululama kwakho nokuvimbela ukuphinda kwalesi simo.
Yiziphi izinzuzo nezingozi zalokhu kwelashwa?
Njenganoma yikuphi ukwelashwa kwezokwelapha, lezi zindlela zinezinzuzo kanye nezingozi.
Yiziphi izinzuzo?
- Amandla okusindisa impilo: Lokhu kwelashwa kusindisa impilo ezimweni ezifana nokuhlaselwa yinhliziyo.
- Ukuvimbela ukuhlaselwa yinhliziyo: Uma ubona ukuvinjelwa emithanjeni yakho yegazi kusenesikhathi, ungakuvimbela ukuhlaselwa yinhliziyo ngokukwelapha ngaphambi kokuba kwenzeke.
- Ukuvikela ukusebenza kwenhliziyo: Uma kwelashwa ngokushesha, umonakalo emisipheni yenhliziyo ungavinjelwa ngokuphelele noma uncishiswe.
Yiziphi izingozi nezinkinga?
Ingozi incike ekwelashweni, eminyakeni yakho, kanye nezinye izimo zezokwelapha onazo (njengesifo sikashukela kanye nomfutho wegazi ophezulu).
| Indlela yokwelapha | Izingozi ezivamile |
|---|---|
| I-PCI (ukubekwa kwe-stent) | Ukulimala kwenhliziyo noma imithambo yegazi, ukushaya kwenhliziyo okungajwayelekile (i-arrhythmias) , ukuqhekeka kwegazi, isifo sohlangothi, noma ukopha. |
| I-CABG (Ukuhlinzwa Kokudlula) | Izingozi ezihambisana nokuhlinzwa. Isibonelo, ubuhlungu, ukopha ngokweqile, ukutheleleka kwenxeba. |
Kodwa ungesabi lezi zinto. Udokotela wakho uzokuchazela konke kahle futhi enze konke angakwenza ukuze anciphise izingozi zakho. Uma unemibuzo noma ukukhathazeka, buza udokotela wakho ngokushesha.
Kuzothatha isikhathi esingakanani ukululama? Kunini lapho kuzodingeka ngiphinde ngibone udokotela?
Nakuba ungabuyela empilweni evamile zingakapheli izinsuku ezimbalwa ngemva kwe-PCI, kungathatha izinyanga eziningana ukululama ngokuphelele ekuhlinzweni kwe-CABG. Udokotela wakho uzokutshela ukuthi udinga ukuphumula isikhathi esingakanani, yini ongayenza nengeke uyenze.
Ngemva kokwelashwa, uma kuvela izimpawu ezilandelayo, kufanele ubonane nodokotela ngokushesha .
- Ubuhlungu besifuba (i-Angina)
- Ubunzima bokuphefumula (i-Dyspnea)
- Ukuzizwa unesizungu noma uzizwa ukhululekile
- Ukulahlekelwa ingqondo
Kuvamile ukuzizwa wesaba futhi ukhathazekile uma uzwa ngenkinga yenhliziyo. Kodwa-ke, lokhu kwelashwa okubizwa ngokuthi i-Coronary Revascularization kungathuthukisa kakhulu izinkinga zenhliziyo futhi kuzivimbele ukuthi zingabi zimbi kakhulu. Into ebaluleke kakhulu ukuqonda lokhu kwelashwa kahle, ukuthola usizo lwezokwelapha oludingekayo ngaphandle kokwesaba, bese uzama ukuphila impilo enempilo nejabulisayo futhi.
Umlayezo Wokuya Nawe Ekhaya
- Ukuvuselelwa kwemithambo yegazi yenhliziyo kubhekisela ekwelashweni okubuyisela ukugeleza kwegazi emithanjeni yegazi evinjiwe enhliziyweni.
- I-PCI (ukubekwa kwe-stent) kanye ne-CABG (ukuhlinzwa kwe-bypass) yizona zindlela ezimbili eziyinhloko.
- Lokhu kwelashwa kungavimbela ukuhlaselwa yinhliziyo futhi kusindise izimpilo.
- Ngemva kokwelashwa, kubaluleke kakhulu ukulandela imiyalelo yezokwelapha ngqo, ukuphuza imithi, ukulawula ukudla kwakho, kanye nokuzivocavoca umzimba.
- Khuluma nodokotela wakho ngokukhululekile ngokuthi yikuphi ukwelashwa okungcono kakhulu esimweni sakho nokuthi yiziphi izinzuzo nezingozi.
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