Uzizwa sengathi ukugeleza kwegazi lakho kunciphile engalweni yakho? Ake sixoxe ngalokhu (Subclavian Artery Stenosis)!

Ingabe ngezinye izikhathi uzizwa ukhathele, ubuhlungu, noma ungezwani uma usebenzisa ingalo yakho noma uphakamisa into esindayo? Noma ingabe ingalo eyodwa izizwa ibanda kunenye? Lokhu kungaba izimpawu zokuthi umthambo omkhulu wegazi ohambisa igazi engalweni yakho unciphile. Namuhla sizokhuluma ngesinye isimo esinjalo, esibizwa ngokuthi `(Subclavian Artery Stenosis)`.

Kuyini ``(Subclavian Artery Stenosis)``? Masikuqonde kalula!

Kalula nje, `(I-Subclavian Artery Stenosis)` ukuncipha, okungukuthi, isimo esifana nokuvaleka komthambo wegazi oyinhloko (siwubiza ngokuthi `(I-Subclavian Artery)`) onikeza igazi engalweni yakho. Cabanga sengathi ukungcola kuqongelelene ngaphakathi kwepayipi lamanzi bese kuncipha kancane kancane. Bese ijubane lamanzi liyehla, akunjalo? Yilokho okwenzekayo ngalokhu. Esikhathini esiningi, lokhu kuncipha kwenzeka lapho izinto ezinamafutha (esizibiza ngokuthi `(i-plaque)`) zifakwa ngaphakathi kwalo mthambo wegazi. Kodwa kungaba nezinye izizathu futhi. Kufana `(i-speed bump)` emgwaqweni, okunciphisa ukugeleza kwegazi kancane.

Kungenzeka ukuthi uke wezwa ngesimo esibizwa ngokuthi i-Peripheral Artery Disease (PAD), esibangela ukuncipha kwemithambo yegazi emilenzeni. Lesi simo, esenzeka emithanjeni yegazi engalweni, sibizwa ngokuthi i-Subclavian Artery Stenosis.

Abantu abaningi banalesi simo kodwa ababonisi zimpawu. Lokho kungenxa yokuthi yonke imithambo yegazi yomzimba wethu isebenza kahle kakhulu. Uma umthambo wegazi owodwa uvalekile, eminye imithambo yegazi izama ukugcwalisa isikhala. Okusho ukuthi, izama ukunikeza igazi elidingwa yingalo ngandlela thile.

Esikhathini esiningi, lesi simo se-`(Subclavian Artery Stenosis)` senzeka emthanjeni ohambisa igazi engalweni yesobunxele . Ngoba, i-`(Subclavian Artery)` engakwesobunxele ihlukaniswe ngokuqondile ne-`(Aorta)`, umthambo wegazi omkhulu kunayo yonke ovela enhliziyweni yethu. Ngakho-ke, kunethuba elikhulu lezinkinga ngawo. Ongakwesokunene uvela komunye umthambo wegazi. Kodwa akuvamile kakhulu, lesi simo singabonakala kokubili ezingalweni zesobunxele nesokudla.

Sivame kangakanani lesi simo?

Uma ubheka izibalo ezweni elifana neMelika, ngokuvamile phakathi kuka-2% no-7% banalesi simo. Kodwa-ke, phakathi kwalabo asebevele benesifo "se-Peripheral Vascular Disease" (ukuncipha kwemithambo yegazi), leli nani licishe libe ngu-19%. Kuthiwa futhi lesi simo sivame kakhulu kwabesifazane .

Yiziphi izimpawu ze-`(Subclavian Artery Stenosis)`?

Njengoba sishilo ngaphambili, akuwona wonke umuntu ozobhekana nezimpawu. Kodwa uma zibonakala, zingase zibukeke kanje:

• Ukuqaqamba kwemisipha uma usebenzisa ingalo ethintekile. Cabanga ukuthi uma uphakamisa into esindayo noma wenza okuthile ngesandla sakho, imisipha engalweni yakho iyaqina futhi izwakale sengathi iyaqaqamba.
• Ubuhlungu noma ukuqina kwesandla uma usebenzisa isandla esithintekile.
• Ukuba ndikindiki noma ukulahlekelwa umuzwa esandleni esithintekile (lokhu sikubiza ngokuthi "i-Paresthesia"). Kunjengokungathi isandla siyandindi kakhulu.
• Isiyezi - Lokhu kuyinto engavamile.
• Ukuquleka - Lokhu nakho akuvamile kakhulu.
• I-Vertigo - Lona umuzwa wokuzungeza nxazonke zakho. Lokhu nakho akuvamile.

Abantu abaningi ababonisi zimpawu ngoba igazi elingangeni linikezwa eminye imithambo yegazi. Izimpawu ziqala ukuvela ngemva kokuba umthambo wegazi unciphile cishe ngo-50% . Ngezinye izikhathi, isimo esibizwa ngokuthi ``Steal Syndrome'' singabangela ezinye izimpawu. Sizoxoxa ngalokho kamuva.

Yiziphi izimbangela ze-`(Subclavian Artery Stenosis)`?

Imbangela eyinhloko yalesi simo "i-Atherosclerosis". Okusho ukuthi, amafutha (njenge-cholesterol) afakwa ngaphakathi kwemithambo yegazi, anciphise kancane kancane imithambo yegazi . Njengoba nje ukhula epayipini lamanzi. Lena yimbangela evame kakhulu.

Ngaphandle kwalokho, kungaba nezinye izizathu eziningana:

• I-Vasculitis: Isimo sokuvuvukala okwenzeka emithanjeni yegazi.
• Ukwelashwa ngemisebe: Uma uke welashwa ngemisebe ngento efana nomdlavuza esifubeni.
• I-Thoracic Outlet Syndrome: Ukucindezelwa kwemithambo yegazi kanye nemizwa egijima kusukela esifubeni esingaphezulu kuya entanyeni nasengalweni.
• (I-Takayasu's Arteritis): Isimo sokuvuvukala esithinta imithambo yegazi emikhulu, ikakhulukazi kwabesifazane abasebasha.
• I-Fibromuscular Dysplasia: Ukuncipha kwemithambo yegazi ngenxa yokukhula okungavamile kwemisipha kanye nezicubu ezixhumeneyo ezindongeni zemithambo yegazi.
• I-Neurofibromatosis: Isimo sofuzo esibangela ukwakheka kwezimila ohlelweni lwezinzwa.

Yiziphi izinto ezibangela lokhu? Ngubani okufanele aqaphele kakhulu?

Abanye abantu banamathuba amaningi okuthola i-``(Subclavian Artery Stenosis)``. Bheka ukuthi lezi zici eziyingozi ziyasebenza yini kuwe:

• Ukuba phakathi kweminyaka engu-50-60 ubudala.
• Ukuba nomfutho wegazi ophezulu (i-Hypertension). Yilokhu esikubiza ngokuthi "umfutho wegazi ophezulu".
• Ukuba nesifo sikashukela (i-Diabetes Mellitus / Diabetes). Sibizwa nangokuthi "isifo sikashukela", akunjalo?
• Amazinga e-cholesterol egazini akhuphukile.
• Ukudla ukudla okunamafutha agcwele kanye namafutha e-trans amaningi (njengebhotela, i-margarine, ukudla okunamafutha, ukudla okusheshayo)
• Ukusetshenziswa kwemikhiqizo kagwayi (njengokubhema, ukuhlafuna i-betel nut).
• Ukuhlala endaweni eyodwa isikhathi eside kakhulu futhi ungazivivinyi.
• Inkomba yesisindo somzimba (i-BMI) engaphezu kuka-25 isho ukuthi ukhuluphele kakhulu uma kuqhathaniswa nobude bakho.
• Ukuba nesifo semithambo yegazi engaphandle (i-PAD).
• Ukuba nalesi simo (i-Takayasu's Arteritis).

Yiziphi izinkinga ezingaba khona ze-`(Subclavian Artery Stenosis)`?

Uma lesi simo singelashwa kahle noma singalawulwa, kungase kube nezinkinga ezithile.

• (Isifo Sokubamba I-Subclavian):Lesi yisimo esikhethekile kancane. Okwenzekayo lapha ukuthi ngenxa yokuthi ukugeleza kwegazi ezandleni kuyancipha, elinye igazi eliya ebuchosheni lidonswa "ngokunyenyeza" ezandleni lapho lisebenza ngazo. Bese inani legazi eliya ebuchosheni liyancipha, okungabangela izinto ezifana nesiyezi namehlo aluhlaza okwesibhakabhaka.
• I-Coronary Steal Syndrome: Lokhu kufana neyokuqala, kodwa lapha elinye igazi eliya enhliziyweni lidluliselwa engalweni. Lokhu akuvamile kakhulu, ikakhulukazi kubantu abaye bahlinzwa nge-bypass.
• Ucezu lwe-fatty plaque olufakwe emthanjeni wegazi luyaqhekeka bese lubhajwa emthanjeni omncane wegazi eduze kweminwe. Lokhu kungavimba ukugeleza kwegazi eminweni, okubangela ukuba ibe buhlungu futhi ibe nezilonda.
• Ukuncipha kokugeleza kwegazi enhliziyweni, ebuchosheni, noma ezandleni.
• (TIA - Ukuhlaselwa Kwe-Ischemic Okwesikhashana): Lokhu kufana ne-mini `(stroke)`. Izimpawu ezinjengokwehla kokugeleza kwegazi kuya ebuchosheni isikhathi esifushane, ukungakwazi ukukhuluma, kanye nokulahlekelwa yizitho zomzimba kuyafika kudlule. Kodwa-ke, lokhu kungaba yimbangela ye-`(stroke)` enkulu.

Odokotela bayixilonga kanjani le nkinga (i-Subclavian Artery Stenosis)?

Uma unezimpawu ezishiwo ngenhla, uma ubona udokotela, uzokuhlola kuqala. Lokhu kubizwa ngokuthi "ukuhlolwa ngokomzimba".

• Lapho, bazohlola ukushaya kwenhliziyo yakho kanye nomfutho wegazi .
• Mhlawumbe uhlola ukuthi isandla esisodwa sibanda yini kunesinye.
• Hlola ukuthi kukhona yini amanxeba ezandleni zombili, nokuthi awapholi yini (amanxeba athatha isikhathi eside ukuphola ngenxa yokungahambi kahle kwegazi).
• Ungahlola futhi ukuthi ukushaya kwenhliziyo engalweni eyodwa kubuthakathaka yini.

Okukhethekile ukuthi, ngokungafani nokuhlolwa okuvamile, udokotela uzolinganisa umfutho wegazi lakho ezingalweni zombili . Lokhu kwenzelwa ukuqhathanisa `(ingcindezi)` ezingalweni zombili. Uma umfutho we-`(systolic)` (inombolo ephezulu) engalweni eyodwa uphakeme ngamamilimitha ayi-10-15 `(mmHg)` kunenye ingalo, kungaba uphawu lwesimo esibizwa ngokuthi `(Subclavian Artery Stenosis)`. `(ingcindezi)` iphakeme engalweni ethola igazi elivela emthanjeni wegazi ophilile.

Ngaphezu kwalokho, uma udokotela wakho ezwa umsindo othi "swoosh" (obizwa ngokuthi "bruit") lapho elalele imithambo yegazi yakho entanyeni yakho nge-stethoscope, lokhu kungaba uphawu lokuncipha kwemithambo yegazi.

Akuvamile ukuthi abantu abathola lesi simo ngenxa yezinye izimbangela bangase babonise nezimpawu ezihlobene nalezo zifo ezihlobene.

Yiziphi ezinye izivivinyo ezenziwayo ukuqinisekisa?

Uma udokotela wakho esola ukuthi une-Subclavian Artery Stenosis, angase aqale acele i-ultrasound. Lokhu kungahlola isivinini sokugeleza kwegazi kanye nesimo semithambo yegazi.

Ngaphezu kwalokho, kungenziwa izivivinyo ezilandelayo ukuze kubhekwe imithambo yegazi:

• (I-CT Angiogram - I-Computed Tomography Angiogram): Lolu uhlobo olukhethekile lwe-CT scan. Kufakwa uhlobo lwedayi ukuze kubonakale kahle imithambo yegazi.
• (MRA - Magnetic Resonance Angiogram): Lokhu kufana ne-MRI scan, kodwa kukhethekile ukubheka imithambo yegazi.
• I-Angiogram Yendabuko (Ehlaselayo):Kulokhu, kudluliswa ithubhu elincane emthanjeni wegazi, kufakwe idayi, bese kuthathwa i-"(X-ray)". Ngezinye izikhathi kusetshenziswa indlela ebizwa ngokuthi i-"(Digital Subtraction)". Lokhu kususa izinto ezifana namathambo futhi kuvumela imithambo yegazi kuphela ukuthi ibonakale kahle.

Yiziphi izindlela zokwelapha `(Subclavian Artery Stenosis)`?

Ukwelashwa kuncike ekutheni unezimpawu noma cha kanye nobunzima besimo.

Abantu abanezimpawu bangadinga ukwelashwa okufana nalokhu:

• (I-aspirin): Yehlisa ukujiya kwegazi futhi isiza ekunciphiseni igazi.
• Imithi yokwehlisa i-cholesterol: Yehlisa inani lamafutha aqongeleleka emithanjeni yegazi.
• Umuthi womfutho wegazi ophakeme .
• Uma imbangela kuyi-`(Vasculitis)`, khona-ke idinga imithi.
• I-Angioplasty: Kulokhu, kufakwa idivayisi encane efana nebhaluni emthanjeni wegazi ovinjiwe bese ivuvukala ukuze inwebe umthambo. Ngokuvamile, kufakwa i-stent (idivayisi encane efana ne-mesh) ukuze ingaphinde inciphe.
• Ukuhlinzwa Kokudlula Igazi: Lena inqubo engavamile kakhulu. Ihilela ukudlula umthambo wegazi ovalekile nokudala indlela entsha kusetshenziswa omunye umthambo wegazi (okungenzeka ukuthi uthathwe emlenzeni) noma owenziwe.

Ngisho noma ungenazo izimpawu, udokotela wakho cishe uzobheka ukuthi kukhona yini amafutha anqwabelene emithanjeni yakho yegazi (i-atherosclerosis). Lesi simo singathinta imithambo yegazi noma kuphi emzimbeni futhi singaholela "ekushayweni yisifo sohlangothi" noma "ekuhlaselweni yinhliziyo." Ngakho-ke, udokotela wakho cishe uzokutshela ukuthi:

• Zivocavoce ngokomzimba okungenani imizuzu engama-30 ngosuku, izinsuku eziningi zesonto. (Njengokuhamba, ukugijima, ukuzivocavoca)
• Gcina isisindo sakho siphilile.
• Gwema imikhiqizo kagwayi ngokuphelele.
• Yidla ukudla okunamafutha agcwele kanye namafutha e-trans aphansi (yidla imifino eminingi, izithelo, ubhontshisi kanye ne-fiber).

Ingabe kukhona izinkinga noma imiphumela emibi yokwelashwa?

Noma yimuphi umuthi ungabangela imiphumela emibi emincane. Uma uhlangabezana nanoma yimiphi imiphumela emibi ekhathazayo neqhubekayo ngenkathi uthatha umuthi wakho, khuluma nodokotela wakho.

Ngezinye izikhathi, ukuhlinzwa noma izinqubo ezifana ne-"Angioplasty" zingabangela izinkinga ezifana nalezi:

• Ukopha.
• Ukulimala emthanjeni wegazi.
• Amahlule egazi.
• I-stent efakiwe ayizange ikhule kahle noma yayingekho endaweni efanele.
• I-stent efakiwe iyaqhuma.
• Umthambo wegazi uvaliwe futhi.
• Akuvamile ukuthi kube nesifo sohlangothi ngemva kwe-angioplasty noma ukuhlinzwa.

Kuthatha isikhathi esingakanani ukululama kulezi zindlela zokwelapha?

Ngemva kwe-Angioplasty, kuzodingeka uphumule cishe usuku lonke. Uzokwazi ukushayela futhi uye emsebenzini zingakapheli isonto. Kodwa-ke, i-Bypass Surgery izothatha isikhathi eside ukululama. Udokotela wakho uzokutshela okwengeziwe ngalokhu kuye ngesimo sakho.

Kwenzekani uma ngine-`(Subclavian Artery Stenosis)`? Liyini ikusasa?

Uma unezimpawu, ukwelashwa kungasiza kakhulu ekuvuleni imithambo yegazi yakho nasekunciphiseni izimpawu zakho. Uma ungenazo izimpawu, ukwelashwa kungase kungadingeki.

Kodwa kungakhathaliseki ukuthi unezimpawu noma cha, i-Subclavian Artery Stenosis iyisibonakaliso esiyisixwayiso esivela emzimbeni wakho . Ngokuvamile, ibangelwa yi-Atherosclerosis (ukufakwa kwamafutha emithanjeni yegazi). Uma umthambo wegazi owodwa uvalekile, ungathinta neminye imithambo yegazi. Yingakho udokotela wakho ezokutshela ukuthi ulawule izici zakho eziyingozi zesifo senhliziyo .

Lokhu kufaka phakathi:

• Uma usebenzisa ugwayi, yeka ngokuphelele.
• Ukulawula umfutho wegazi ophakeme.
• Ukulawula i-cholesterol ephezulu.
• Ukulawula noma ukuvimbela isifo sikashukela.

I-Angioplasty isebenza kahle ngaphezu kwama-95% ekudambiseni izimpawu. Eminyakeni emihlanu ngemva kwe-angioplasty, cishe ama-90% emithambo yegazi eyayivinjiwe ngaphambili ahlala evulekile. Ukuhlinzwa okuvulekile kunganikeza imiphumela ehlala isikhathi eside nakakhulu.

Uma umthambo wakho wegazi uvalekile ngokuphelele, imiphumela ingase ingasebenzi kahle.

Ingabe i-Subclavian Artery Stenosis ingavinjelwa?

Yebo, ezimweni eziningi, ukugcwala kwamafutha emithanjeni yegazi (i-atherosclerosis) okubangela lokhu kungavinjelwa. Okudingeka ukwenze nje ukwenza izinguquko ezithile endleleni yakho yokuphila.

• Ukuzikhandla ngokomzimba.
• Ukulandela ukudla okunempilo (ukudla okunamafutha amancane, ushukela, usawoti, imifino nezithelo eziningi)
• Gwema ukubhema.
• Ukugcina isisindo esinempilo.

Kubalulekile futhi ukuphatha kahle noma yiziphi izimo zezokwelapha ongase ube nazo kakade, njenge:

• I-cholesterol ephezulu.
• Umfutho wegazi ophezulu (i-Hypertension).
• Isifo sikashukela.

Ngizinakekela kanjani?

Izinguquko ezimbalwa zendlela yokuphila ongazenza ukuvimbela i-Subclavian Artery Stenosis zizokusiza ngisho nangemva kokwelashwa. Imikhuba enempilo ingasiza ekuvimbeleni lesi simo ukuthi singaphinde sivele. Uma udokotela efaka i-stent emthanjeni wakho, cishe kuzodingeka uqhubeke nokuphuza imithi efana ne -aspirin ne-clopidogrel ukuze ingavaleki futhi.

Kufanele ngimbone nini udokotela?

Ngemva kokwelashwa, uzocelwa ukuthi ubonane nodokotela wakho cishe njalo ezinyangeni eziyisithupha eminyakeni emibili yokuqala. Bese kuba kanye ngonyaka. Lokhu kungahluka kuye ngesimo sakho nendawo olashwa kuyo. Ngakho-ke, landela imiyalelo kadokotela wakho ngqo.

Kufanele ngiye nini e-Emergency Treatment Unit (ETU) ?

Abantu abane-Subclavian Artery Stenosis bangase babe nokugcwala kwamafutha kweminye imithambo yegazi emzimbeni. Lokhu kufaka phakathi imithambo enikeza igazi enhliziyweni yakho (imithambo yenhliziyo). Uma le mithambo ivalekile, ungaba nokuhlaselwa yinhliziyo. Uma unezimpawu zokuhlaselwa yinhliziyo , funa usizo lwezokwelapha ngokushesha.

Izimpawu zokuhlaselwa yinhliziyo zingafaka:

• Ubuhlungu besifuba noma ukuqina (lobuhlungu bungadlulela engalweni, entanyeni, noma emhlathini).
• Ubunzima bokuphefumula.
• Ukuzizwa unesizungu, uzizwa ukhululekile.
• Ukuzizwa sengathi inhliziyo yakho ishaya ngokushesha.
• Ukuphazamiseka kwesisu, isicanucanu, ukuhlanza.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma ubona udokotela wakho, ungabuza imibuzo efana nale:

• Ingabe ngidinga ukwelashwa?
• Yikuphi ukwelashwa okungcono kakhulu kwesimo sami?
• Zingaki izinhlobo zalezi zindlela zokwelapha ozenzayo esibhedlela/emtholampilo wakho ngonyaka?
• Ungangithumela kumuntu ongangisiza ngithuthukise imikhuba enempilo yenhliziyo? (isib., isazi sokudla okunempilo)

Ingabe i-`(Subclavian Artery Stenosis)` iyingozi?

Yebo, lokhu kungaba yingozi, ikakhulukazi uma kubangela isimo esibizwa ngokuthi "i-Steal Syndrome", okusho ukuthi igazi elincane liphampunwa liye ebuchosheni noma enhliziyweni, esikhundleni salokho liphambukiselwa ezingalweni. Into engcono kakhulu ongayenza ukuvimbela lezi zinkinga ukulandela iseluleko sikadokotela wakho mayelana nokudla okunempilo kanye nesimiso sokuzivocavoca.

Uma uthola ukuthi une-Subclavian Artery Stenosis, kungenzeka ukuthi kungokokuqala ngqa uzwa ngalowo mthambo wegazi. Kodwa, cabanga ngalokhu njengomyalezo ovela emzimbeni wakho: Une-Atherosclerosis. Uma isemzimbeni owodwa wegazi, ingaba semzimbeni owodwa futhi. Ngakho-ke, thatha izinyathelo manje zokugcina inhliziyo yakho nemithambo yegazi iphilile.

Ekugcineni, umyalezo okufanele uwuthathe uye nawo ekhaya

Kulungile, manje usuqonda kangcono lokho ebesikhuluma ngakho, ``(Subclavian Artery Stenosis)``. Ungakhathazeki , uma kutholakala kusenesikhathi futhi kuphathwa kahle, ungaba ngcono.

Into ebalulekile ukuthi lokhu kuvame ukuhlotshaniswa nendlela yethu yokuphila. Lokho kusho ukudla ukudla okunempilo, ukuzivocavoca njalo , ukugwema ukubhema, nokulawula izimo ezifana nesifo sikashukela, umfutho wegazi ophakeme kanye ne-cholesterol .

• Uma uvame ukuzwa ubuhlungu, ukungazweli, noma ukukhathala ezandleni zakho, ungakushayi indiva bese ucela iseluleko sezokwelapha.
• Landela ukwelashwa kukadokotela kanye nemiyalelo yakhe ngqo.
• Lokhu akuyona nje inkinga yesandla, kodwa kuyisibonakaliso sokuthi udinga ukunaka impilo yakho yonke yenhliziyo.

Lalela umzimba wakho bese uzama ukuhlala uphilile!

I- Subclavian Artery Stenosis, Ubuhlungu Bengalo, Ukungabi Nangqondo Kwengalo, Ukuncishiswa Kwemithambo Yegazi, I-Angioplasty, I-Stent, I-Atherosclerosis