Kungenzeka ukuthi uke wakuzwa ukungakhululeki kanye nobuhlungu besifuba obuhambisana nokungafiki kwegazi elanele enhliziyweni yakho. Kungenzeka ukuthi wesaba ngisho nokuhlaselwa yinhliziyo. Imbangela eyinhloko yalokhu ukuvaleka kwemithambo yegazi ehambisa igazi enhliziyweni. Ngenhlanhla, namuhla kunezindlela zokwelapha ezithuthukisiwe ezingavula kabusha le mithambo yegazi evalekile futhi zivumele igazi ukuthi ligeleze kahle enhliziyweni. Namuhla, sikhuluma ngalezi zindlela zokwelapha ezingavuselela inhliziyo.
Kuyini 'i-Coronary Revascularization'?
Kalula nje, lolu uhlobo lokwelashwa olusetshenziswa ukubuyisela ukugeleza kwegazi emisipheni yenhliziyo yakho lapho ingatholi igazi eliyidingayo. Lesi simo ngokwezokwelapha sibizwa ngokuthi "i-Ischemia". Lokhu kwelashwa kungasiza ekuvimbeleni ukuhlaselwa yinhliziyo ngemva kokuba sekwenzekile, kanye nakubantu abasengozini enkulu yokuba naso.
Sikhuluma kakhulu ngezindlela ezimbili zokwelapha ngezansi:
- Ukungenelela Kwenhliziyo Okuhamba Ngesicubu (PCI): Lokhu akusikho ukuhlinzwa. Kuyinqubo lapho kufakwa khona ipayipi elincane emthanjeni wegazi bese lisetshenziselwa ukwandisa indawo evinjiwe kusukela ngaphakathi, ukubuyisela ukugeleza kwegazi. Abantu abaningi bazi lokhu ngokuthi 'ukuphunga'.
- I-Coronary Artery Bypass Grafting (CABG): Lokhu ukuhlinzwa okudala 'i-bypass' entsha, noma umzila oseceleni, ukuze igazi ligeleze eduze komthambo ovinjiwe enhliziyweni.
Kungani kusetshenziswa lezi zindlela zokwelapha?
Njengoba nje imisele yethu yesinki ivaleka ngamafutha nokungcola ngokuhamba kwesikhathi, into efana ne-wax efana namafutha iqala ukuqoqana emithanjeni yegazi yenhliziyo yethu. Siyibiza ngokuthi i-plaque . Lesi yisimo lapho i-plaque iqoqana khona ngaphakathi kwemithambo yegazi bese iyincipha, okubizwa ngokuthi "i-Atherosclerosis." Lesi yisibonakaliso esikhulu sesifo semithambo yegazi yenhliziyo.
Ngokuhamba kwesikhathi, lawa ma-deposit angaba mancane kakhulu emithanjeni yegazi. Ngezinye izikhathi, uma enye yala ma-deposit iqhuma, i-blood clot ingakheka futhi ivimbe ngokuphelele i-vascular. Lokhu kubangela ukuthi ingxenye yenhliziyo ilahlekelwe yigazi, futhi amaseli akuleyo ngxenye aqale ukufa. Lokhu kubizwa ngokuthi ukuhlaselwa yinhliziyo .
Into ebalulekile ukuthi uma amangqamuzana emisipha yenhliziyo efa, umonakalo uhlala unomphela. Kodwa-ke, uma ukugeleza kwegazi kubuyiselwa ngokushesha okukhulu, lomonakalo ungancishiswa noma uvinjelwe ngokuphelele.
Lokhu kwelashwa kuyadingeka kunoma yisiphi isifo senhliziyo esiwela ngaphansi kwesigaba se-"Acute Coronary Syndrome". Isibonelo:
- Isifo senhliziyo
- I-angina ezinzile - ubuhlungu besifuba obuqedwa ukuphumula futhi bube bubi kakhulu ngokuzivocavoca umzimba
- I-angina engazinzile - Ubuhlungu besifuba obungalindelekile obuvela ngisho nalapho uphumule
Kwenzekani ngaphambi kokwelashwa?
Ngaphambi kokuthola lolu hlobo lokwelashwa, odokotela bazokwenza izivivinyo eziningana ukuze bahlole ngokunembile isimo sakho bese bekhetha ukwelashwa okufanele kakhulu kuwe. Ezinye zazo zifaka:
- I-ECG (i-Electrocardiogram): Ukuhlola ukusebenza kukagesi kwenhliziyo.
- I-Echocardiogram: Ukuskena kwenhliziyo.
- I-Catheterization Yenhliziyo (i-Angiogram): Inqubo lapho kufakwa khona idayi emithanjeni yegazi yenhliziyo bese kusetshenziswa i-X-ray ukuhlola ukuvaleka.
- I-X-ray Angiography noma i-CT Angiography: Ukuhlolwa kwemithambo yegazi kusetshenziswa i-computer tomography scan.
- Ukuhlolwa kwegazi: I-Complete Blood Count, ama-Enzyme enhliziyo, njll.
Uma inqubo ingeyona into ephuthumayo, udokotela wakho uzokweluleka ukuthi uzile ukudla amahora ambalwa ngaphambi kwenqubo. Futhi, ngaphambi kokuba inqubo iqale, kuzofakwa umugqa we-IV engalweni yakho ukuze ukwazi ukunikeza kalula imithi edingekayo kanye noketshezi. Ngesikhathi se-PCI, uzonikezwa imithi yokukulalisa kancane, kanti ngesikhathi sokuhlinzwa kwe-CABG, uzonikezwa umuthi wokubulala izinzwa ojwayelekile.
Kwenzekani ngesikhathi sokwelashwa?
Nakuba i-PCI ne-CABG zinenhloso efanayo, indlela ezenziwa ngayo ihluke ngokuphelele. Ake sibheke ukuthi kanjani.
| Indlela yokwelapha | Okwenzekayo kulula. |
|---|---|
| I-PCI (ukubekwa kwe-stent) | Udokotela ufaka ipayipi elincane kakhulu (i-catheter) esihlakaleni sakho noma embotsheni yegazi enkulu. Ngemuva kwalokho, kusetshenziswa isikrini se-X-ray, ipayipi liqondiswa emthanjeni wegazi ovalekile enhliziyweni yakho. Okulandelayo, ibhaluni elincane ekugcineni kwepayipi liyavuvukala (i-Balloon Angioplasty) ukuze kwandiswe indawo evalekile. Ngokuvamile, idivayisi efana ne-mesh (i-stent) ifakwa unomphela ngaphakathi kwendawo evalekile ukuze ivimbele ukuthi ingaphinde ivaleke. |
| I-CABG (Ukuhlinzwa Kokudlula) | Lena inqubo yokuhlinzwa. Kule nqubo, udokotela ohlinzayo uqala ngokuthatha ingxenye yomthambo wegazi ophilile kwenye ingxenye yomzimba wakho (ngokuvamile emlenzeni wakho, engalweni, noma esifubeni). Bese, kungaba ngokuhlinzwa okuvulekile noma ngokusika okuncane (ukuhlinzwa okungenangozi kakhulu), udokotela ohlinzayo usebenzisa ingxenye yomthambo wegazi ukudala indlela entsha (yokudlula) ukuze igazi ligeleze emthanjeni ovimbekile enhliziyweni yakho. Kufana nokuthatha umgwaqo oseceleni ukuze ugweme ithrafikhi. |
Kwenzekani ngemva kokwelashwa?
Uzodinga isikhathi sokululama ngemva kwenqubo. Lesi sikhathi sincike ohlotsheni lwenqubo oyenzile, impilo yakho iyonke, nokuthi ngabe kwakuyisimo esiphuthumayo yini. Ngokuvamile, kuthatha izinsuku ezimbalwa kuphela ukululama kusuka ku-PCI. Kodwa-ke, kungathatha amasonto noma izinyanga ukululama ngokuphelele kusukela ekuhlinzweni kwe-CABG.
Udokotela wakho angase asikisele ukuthi uhlanganyele ohlelweni lokuvuselela inhliziyo . Kulezi zinhlelo, odokotela, abahlengikazi, abafundisi bokuzivocavoca, kanye nochwepheshe bezokudla basebenzisana ukukufundisa indlela yokuzivocavoca ngendlela efanele, ukulawula ukudla kwakho, kanye nokuphuza imithi yakho ngendlela efanele.
Futhi, kubalulekile ukuvakashela udokotela futhi ngesikhathi esibekiwe (ukuvakasha kokulandelela) bese uhlolwa. Ukulandela imiyalelo kadokotela ngqo kuzokusiza ukusheshisa ukululama kwakho.
Ziyini izinzuzo zalezi zindlela zokwelapha?
- Ukuvimbela ukuhlaselwa yinhliziyo: Uma isifo semithambo yenhliziyo sitholakala ngaphambi kokuba kuvele ukuhlaselwa yinhliziyo, lokhu kwelashwa kungakuvimbela.
- Ukusindisa impilo: Ukuhlaselwa yinhliziyo kuyisimo esiphuthumayo esisongela impilo. Ezimweni ezinjalo, lokhu kwelashwa kungasindisa impilo.
- Ukulondoloza ukusebenza kwenhliziyo: Ukwelashwa kusenesikhathi kungavimbela ukufa kwamaseli enhliziyo ngenxa ye-ischemia. Lokhu kunganciphisa umonakalo ohlala njalo enhliziyweni.
Ingabe zikhona izingozi kulezi zindlela zokwelapha?
Njenganoma yikuphi ukwelashwa kwezokwelapha, kunezingozi ezihilelekile, kuye ngesimo sakho sempilo kanye nokwelashwa okwenziwayo.
- Ku-PCI: Kungase kube nengozi encane yokulimala kwemithambo yegazi, ukushaya kwenhliziyo okungajwayelekile (ama-arrhythmia), amahlule egazi, isifo sohlangothi, noma ukopha.
- Nge-CABG: Ukuhlinzwa kuhambisana nengozi yobuhlungu, ukopha, kanye nokutheleleka.
Xoxa nganoma yimiphi imibuzo noma ukukhathazeka onakho ngalokhu nodokotela wakho. Uzochaza ngokucacile izingozi ezingase zivele kuye ngesimo sakho.
Kufanele uphinde uye kudokotela nini?
Ngemva kokwelashwa, uma izimpawu ezilandelayo ziphinde zibuya , bona udokotela wakho ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) .
- Ubuhlungu besifuba noma ukuqina (i-Angina)
- Ubunzima bokuphefumula (i-Dyspnea)
- Ukuzizwa unesizungu noma ubuthakathaka
- Ukuquleka
Kuvamile ukuzizwa wesaba futhi ukhathazekile uma ufunda ngesifo senhliziyo. Kodwa ngokuqonda izindlela zokwelapha ezithuthukisiwe ezifana nalezi, ungakunqoba lokho kwesaba, uthole ukwelashwa okudingekayo, futhi uphile impilo enempilo futhi.
Umlayezo Wokuya Nawe Ekhaya
- Ukuvuselelwa kwemithambo yegazi yenhliziyo kubhekisela ekwelashweni okuvula imithambo yegazi evalekile enhliziyweni futhi kubuyisele ukugeleza kwegazi.
- Ukubekwa kwe-stent (PCI) kanye nokuhlinzwa kwe-bypass (CABG) yizindlela ezimbili zokwelapha eziyinhloko.
- Lokhu kwelashwa kungavimbela ukuhlaselwa yinhliziyo futhi kusindise izimpilo uma kwenzeka ukuhlaselwa yinhliziyo.
- Ukwelashwa okufanele kakhulu kuwe kuzonqunywa udokotela wakho ngemva kokuhlola isimo sakho.
- Ukuze uthole imiphumela emihle kakhulu ngemva kokwelashwa, qiniseka ukuthi ulandela imiyalelo kadokotela wakho (imithi, ukudla okudlayo, ukuvivinya umzimba).
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