Cabanga nje ukuthi othile oseduze nawe uzwa ubuhlungu esifubeni ngokuzumayo, ujuluka ngenxa yobunzima bokuphefumula. Noma ngokuzumayo uvuvukele umlomo, ingalo engezwani, futhi akakwazi ukukhuluma. Ziyigugu kangakanani umzuzwana ngamunye esikhathini esinjengalesi? Namuhla sikhuluma ngokwelashwa okukhethekile, okunamandla okungasindisa impilo ngokuncibilikisa amahlule egazi ayingozi abangela izimo eziphuthumayo ezisongela ukuphila njengalezi.
Kalula nje, kuyini lokhu kwelashwa?
Lokhu kubizwa ngokuthi ukwelashwa nge-fibrinolytic noma i-thrombolytic. Nakuba amagama eyinkimbinkimbi kancane, inqubo ilula kakhulu. Kufana noketshezi esilusebenzisayo ukuhlanza ipayipi elivalekile ekhaya lethu.
Uma kwenzeka ihlule legazi eliyingozi ngaphakathi komthambo wegazi emzimbeni wethu, livimba ukugeleza kwegazi kuwo. Ngenxa yalokho, izitho ezibalulekile njengobuchopho nenhliziyo ezinikezwa igazi yilowo mthambo ziqala ukufa ngaphandle kokuthola umoya-mpilo. Lokhu kuyimbangela yokuhlaselwa yinhliziyo nokushaywa yisifo sohlangothi okuningi.
Ngakho-ke lokhu kwelashwa okwenziwa yikufaka umuthi onamandla kakhulu emzimbeni, oncibilikisa futhi ususe lelo hlwili legazi eliyingozi. Lokhu kuvula kabusha umthambo, kubuyisele ukugeleza kwegazi. Lokho kusho ukuthi kungasindisa impilo.
Kukuziphi izimo lapho lokhu kwelashwa kudingeka khona?
Lokhu akuyona indlela yokwelapha evamile. Inikezwa ezimweni eziphuthumayo nalapho kukhona ingozi empilweni. Odokotela bacabangela le ndlela yokwelapha ikakhulukazi ezimweni ezilandelayo:
| Isimo sezokwelapha | Incazelo elula |
|---|---|
| Isifo senhliziyo | Ukuvaleka komthambo wenhliziyo ohlinzeka ngegazi enhliziyweni ngehlule legazi. |
| Isifo Sohlangothi (Ischemic Stroke) | Ihlule legazi livimba umthambo ohambisa igazi ebuchosheni. |
| I-Pulmonary Embolism | Ihlule legazi livimba umthambo othwala igazi liye emaphashini. |
| Amahlule egazi emithanjeni ejulile yomlenze (i-Acute Deep Vein Thrombosis) | Kuvela ihlule legazi emthanjeni ojulile, ngokuvamile emilenzeni. |
| I-Acute Arterial Thrombosis (I-Acute Arterial Thrombosis) | Ihlule legazi livimba umthambo othwala igazi liye emilenzeni. |
| Ezinye izithiyo | Ukuvaleka kwama-catheter, amashubhu e-dialysis, noma amashubhu e-bypass abekwe ngokuhlinzwa ngenxa yokuqhekeka kwegazi. |
Lo muthi unikezwa kanjani emzimbeni?
Kunezindlela ezimbili zokukunikeza lokhu.
1. Ngomugqa we-IV: Lena yindlela esetshenziswa kakhulu. Umuthi ufakwa ngqo egazini lakho nge-cannula (umugqa we-IV) efakwe emthanjeni engalweni yakho.
2. Nge-catheter: Ngezinye izikhathi, ikakhulukazi lapho umuthi udinga ukulethwa ngqo endaweni lapho igazi liqhekekile khona, odokotela bafaka ithubhu elincane (i-catheter) ngomthambo wegazi bese befaka umuthi ngqo endaweni lapho igazi liqhekekile khona.
Isikhathi sibaluleke kangakanani? - Umzuzwana ngamunye uyigugu!
Isikhathi sibaluleke kakhulu kulokhu kwelashwa. Njalo ngomzuzwana lapho ihlule legazi linamathela, amangqamuzana obuchopho noma amangqamuzana emisipha yenhliziyo ayafa. Ngakho-ke, kubalulekile ukuqala ukwelashwa ngokushesha okukhulu .
Ikakhulukazi uma kwenzeka isifo sohlangothi, imiphumela iba yimpumelelo enkulu uma lokhu kwelashwa kunganikezwa zingakapheli amahora amathathu kuya kwangu-4.5 kusukela ekuqaleni kwezimpawu. Uma lo muthi unganikezwa zingakapheli imizuzu engama-30 kusukela ungeniswe esibhedlela, umonakalo ungancishiswa kakhulu.
Ngakho-ke, uma ubona izimpawu zokuhlaselwa yinhliziyo noma isifo sohlangothi, ungazami ukuzelapha ekhaya noma ulinde. Thatha isiguli uye e -Emergency Treatment Unit (ETU) yesibhedlela ngokushesha okukhulu.
Ingabe zikhona izimo lapho lokhu kwelashwa kungenakutholakala khona?
Yebo. Lona umuthi onamandla kakhulu, ngakho awukwazi ukunikezwa wonke umuntu. Ngoba uncibilikisa amahlule egazi futhi wandisa ingozi yokopha emzimbeni. Ngakho-ke, ukunikeza abanye abantu lokhu kwelashwa kungaba yingozi.
Ithimba lezokwelapha lizonquma ukuthi uyakufanelekela yini lokhu kwelashwa ngemva kokuhlolwa okumbalwa okusheshayo. Lokhu kwelashwa ngokuvamile akunikezwa abantu abanezimo ezilandelayo:
- Uma uneminyaka engaphezu kuka-75 ubudala.
- Uma uke wopha ubuchopho ngaphambili.
- Uma usebenzisa imithi yokunciphisa igazi njengamanje.
- Uma uke waba nesifo sohlangothi ezinyangeni ezi-3 ezedlule.
- Uma uphuma igazi emzimbeni noma usanda kuhlinzwa/ukulimala okukhulu.
- Uma wazi ukuthi unesimila sobuchopho.
- Uma ukhulelwe.
- Uma une-high blood pressure lokho akunakulawulwa.
- Uma unezifo zamehlo ezibangelwa isifo sikashukela.
- Uma inani lamaplatelet liphansi kakhulu.
Lolu hlu aluphelele. Isinqumo sokugcina sizokwenziwa udokotela wakho okwelaphayo ngokusekelwe esimweni sakho esithile.
Indlela yokwelapha eyenziwa ngayo isinyathelo ngesinyathelo
Ngaphambi kokwelashwa
Ngenxa yokuthi lesi yisimo esiphuthumayo, uzongeniswa ngqo e-Intensive Care Unit (ICU) , lapho amaqembu ezokwelapha nabahlengikazi ezoqapha khona yonke into kusukela ekushayeni kwenhliziyo yakho, umfutho wegazi, kanye namazinga omoya-mpilo.
Ngesikhathi sokwelashwa
Njengoba kushiwo ngaphambili, umuthi uzofakwa emzimbeni nge-IV line noma i-catheter. Ngesikhathi sokwelashwa, kuzosetshenziswa izivivinyo ezifana ne -CT scans noma i-MRI scans ukuze kubonakale ukuthi ihlule legazi liyancibilika yini.
Kwezinye izimo, ngaphezu kwalomuthi noma esikhundleni sawo, kungenziwa i-mechanical thrombectomy . Lokhu kuhilela ukusebenzisa i-catheter ukuze kufinyelelwe endaweni yehlule, kuliqhekeze libe yizicucu ezincane, bese kususwa ngomchamo .
Ngemva kokwelashwa
Ngemva kokwelashwa, odokotela bahlola ukuze babone ukuthi kukhona yini izingcezu zegazi ezisele. Kungase kudingeke ukwelashwa okwengeziwe. Isibonelo, ukuphonswa nge-stenting , i-balloon angioplasty , noma ukuhlinzwa okuvulekile kungadingeka ukuze kugcinwe umthambo uvuleke isikhathi eside.
Futhi, odokotela bazokweluleka ukuthi uqhubeke uthatha imithi yokunciphisa igazi (ama-anticoagulant) , njenge-Warfarin noma i-Heparin, ukuze uvimbele ukwakheka kwamahlule egazi esikhathini esizayo.
Ziyini izingozi nemiphumela emibi yalokhu?
Ingozi eyinhloko nevame kakhulu yalokhu kwelashwa ukopha . Lokhu kuvamile.
- Ukopha kungase kwenzeke endaweni lapho i-cannula ikhona khona.
- Ukulimala kwamuva nje kungase kophe futhi.
- Kungase kube nokopha ekhaleni.
- Kungase kube negazi emchameni.
- Kungase kube negazi esitulweni.
- Abesifazane bangase baphuze kakhulu isitho sangasese sowesifazane.
- Ingozi engavamile kakhulu, kodwa eyingozi kakhulu, ukopha kobuchopho .
Naphezu kwalezi zingozi, kubantu abaningi inzuzo yalokhu kwelashwa, okusho ukusindisa izimpilo, idlula kakhulu lezi zingozi. Yingakho odokotela behlola konke ngaphambi kokwenza lesi sinqumo.
Kufanele ngiphinde ngimbone nini udokotela?
Ngemva kokubuyela ekhaya ngemva kokwelashwa, uma kuvela izinkinga, kufanele wazise udokotela ngokushesha.
- Uma kukhona ukopha ngokweqile .
- Uma uzwa ubuhlungu obungabekezeleleki .
- Uma uhlaselwa umkhuhlane .
Uma kwenzeka into efana nale, shayela udokotela wakho ngokushesha. Uzobona imbangela bese ekunikeza ukwelashwa okudingekayo.
Umlayezo Wokuya Nawe Ekhaya
- Lolu uhlobo lokwelashwa oluphuthumayo olusetshenziswa ezimweni ezisongela ukuphila njengokuhlaselwa yinhliziyo kanye nohlangothi.
- Isikhathi sibaluleke kakhulu empumelelweni yalolu hlobo lokwelashwa. Kubalulekile ukuya e-Emergency Treatment Unit (ETU) yesibhedlela ngokushesha nje lapho kuvela izimpawu.
- Lokhu kubangela ukuthi ihlule legazi elivimba umthambo wegazi lincibilike.
- Lokhu kwelashwa akufaneleki kubo bonke abaguli. Udokotela uzonquma ngalokhu ngemva kokucabangela izingozi.
- Ingozi enkulu yalokhu kwelashwa ukopha, kodwa izinzuzo zokwelashwa zivame ukwedlula kakhulu izingozi.
- Ngisho nangemva kokwelashwa, kubaluleke kakhulu ukulandela imiyalelo yezokwelapha nokuphuza imithi oyinikezwe udokotela.
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