Cabanga ukuthi bekuzokwenzekani uma ihlule legazi livimba ngokuzumayo umthambo omkhulu wegazi oholela enhliziyweni yakho, ebuchosheni, noma emaphashini? Lokhu kunganqamula ukugeleza kwegazi kulezo zitho zomzimba futhi kubangele umonakalo. Lesi yisimo esisongela ukuphila. Kusesimweni esiphuthumayo lapho odokotela basebenzisa khona ukwelashwa okukhethekile ukusindisa izimpilo. Namuhla, sikhuluma ngokwelashwa okuncibilikisayo nokususa lawo mahlule egazi, okubizwa ngokuthi 'Ukwelashwa Nge-Thrombolytic.'
Kalula nje, kuyini ukwelashwa nge-Thrombolytic?
Nakuba leli gama liyinkimbinkimbi kancane, lo mqondo ulula kakhulu. Kalula nje, lokhu kuhilela ukusebenzisa uhlobo olukhethekile lomuthi ukuze kuncibilikiswe futhi kususwe amahlule egazi ayingozi akheke emithanjeni yegazi emizimbeni yethu. Kufana nokuncibilikisa nokususa isithiyo epayipini lamanzi ngekhemikhali.
Umgomo oyinhloko walokhu kwelashwa ukubuyisela ukugeleza kwegazi okuvinjelwe yi-clot yegazi. Lokhu kunganciphisa umonakalo ezithweni zomzimba (njengenhliziyo nobuchopho) ezinikezwa yilowo mthambo wegazi. Lokhu ukwelashwa okunikezwa ezimweni eziphuthumayo. Lokhu kwelashwa kungasindisa impilo, ikakhulukazi ezimweni ezifana nokuhlaselwa yinhliziyo (`(Myocardial Infarction)`), isifo sohlangothi esibangelwa ukuvaleka komthambo wegazi ebuchosheni (`(Ischemic Stroke)`), noma i-clot yegazi emaphashini (`(Pulmonary Embolism)`).
Into ebaluleke kakhulu ukuqala lolu hlobo lokwelashwa ngokushesha okukhulu. Uma ukwelashwa kuqala ngokushesha ngemva kokuqala kwezimpawu, imiphumela iba ngcono.
Ubani odinga lokhu kwelashwa? Futhi ubani okungafanele akuthole?
Lokhu akuyona indlela yokwelapha enganikezwa wonke umuntu. Odokotela bacabangela izici eziningi ngaphambi kokunikeza othile lokhu kwelashwa. Ngoba kunezingozi ezithile. Ake sibone ukuthi lokhu kwelashwa kufanele nini nokuthi kungafanele nini.
| Izimo lapho ukwelashwa kungadingeka khona | Ezimweni lapho ukwelashwa kungafanele kunikezwe khona (ngenxa yengozi ephezulu) |
|---|---|
| Uma umthambo omkhulu wegazi (umthambo noma umthambo) uvaleka ngokuzumayo ngenxa yokuqhekeka kwegazi. | Uma sekuvele kukhona ukopha okusebenzayo emzimbeni. |
| Ezimweni ezifana ne-deep vein thrombosis (DVT) kanye ne-pulmonary embolism (PE), okungenakukwazi ukulawulwa ngemithi ejwayelekile yokunciphisa igazi (ama-anticoagulant). | Uma usanda kuba nokopha ebuchosheni (Intracranial Hemorrhage). |
| Emahoreni ambalwa okuqala ngemva kokuhlaselwa yinhliziyo noma isifo sohlangothi. | Uma usanda kwenziwa ukuhlinzwa kobuchopho noma komgogodla. |
| Uma kwenzeka isimo esiphuthumayo ngenxa yokuvaleka kwemithambo yegazi ezithweni (i-Peripheral Arterial Disease - PAD). | Uma unomfutho wegazi ophakeme ongalawuleki (umfutho wegazi ophakeme). |
| Uma i-catheter efakwe emzimbeni ivinjwa yi-blood clot. | Uma unesifo sezinso esibi kakhulu. |
| Uma usanda kulimala kakhulu ekhanda. |
Ngaphezu kwalokho, odokotela bakhathazeke kakhulu ngengozi yezinkinga lapho benikeza lokhu kwelashwa komama abakhulelwe kanye nabantu asebekhulile.
Yiziphi izinhlobo eziyinhloko zalokhu kwelashwa?
Kunezindlela eziningana zokunikeza lo muthi wokugoqa igazi. Udokotela uzokhetha indlela efanele kakhulu ngokusekelwe esimweni sesiguli kanye nendawo lapho igoqa igazi likhona.
1. I-Thrombolysis Ehlelekile
Lena yindlela evame ukusetshenziswa kakhulu. Lapha, ithubhu ye-IV ifakwa emthanjeni engalweni, njenge-saline drip, bese umuthi unikezwa ngayo. Lo muthi uhamba kulo lonke uhlelo lokujikeleza kwegazi, lapho uncibilikisa khona i-blood clot. Le ndlela ivame ukusetshenziswa ezimweni eziphuthumayo ezifana nokuhlaselwa yinhliziyo, isifo sohlangothi, kanye nama-blood clots emaphashini.
2. I-Thrombolysis eqondiswa yi-Catheter
Le ndlela ihlukile kancane. Lapha, kufakwa ithubhu elincane kakhulu, elide (lokhu kubizwa ngokuthi i-catheter) emzimbeni ngomthambo osesinqeni, entanyeni, noma engalweni. Bese, kusetshenziswa inqubo efana ne-X-ray, isihloko sale catheter siqondiswa endaweni eqondile yehlule legazi. Bese, esikhundleni sokunikeza umuthi wonke umzimba, ufakwa ngqo ehluleni legazi nge-catheter. Lokhu kuvumela umuthi ukuthi unikezwe ngendlela egxile kakhulu, ngqo kumuntu ohlosiwe. Le ndlela ivame ukusetshenziswa kakhulu ezimweni ezifana ne-DVT ne-PAD. Lokhu kuvame ukwenziwa kusenesikhathi.
3. Ukususwa Kwemithambo Yezitho Zomzimba
Kulesi simo, ngaphezu kokunikeza imithi, ihlule legazi liyaqhekeka bese lisuswa ngomshini. Idivayisi ekhethekile (idivayisi edlidliza, ejikeleza, noma emunca ihlule legazi) ekugcineni kwe-catheter isetshenziselwa ukuqhekeza ihlule legazi bese ilisusa libe yizicucu. Ngezinye izikhathi le ndlela isetshenziswa kanye nendlela eqondiswa yi-catheter.
Kwenzekani ngesikhathi sokwelashwa nangemva kwalokho?
Indlela lokhu kwelashwa okwenziwa ngayo izohluka kuye ngohlobo olutholayo.
Uma kwenzeka isimo esiphuthumayo
Uma unesimo esiphuthumayo, njengokuhlaselwa yinhliziyo noma isifo sohlangothi, odokotela bazozama ukuqala ukwelashwa ngokushesha okukhulu ngemuva kokungeniswa e-Emergency Treatment Unit (ETU) yesibhedlela. Ukuze uthole imiphumela emihle kakhulu, kubalulekile ukuqala ukwelashwa zingakapheli amahora amabili kusukela ekuqaleni kwezimpawu, noma zingakapheli imizuzu engama-30 kusukela ufike esibhedlela.
Indlela yokwelashwa eyenziwa ngayo
Ake sibone ukuthi kwenzekani kulezi zindlela ezimbili eziyinhloko.
| Ukuhlolwa kwe-thrombosis yesistimu (ngokusebenzisa i-IV) | I-thrombolysis eqondiswa yi-catheter (nge-catheter) |
|---|---|
| Lokhu kuvame ukwenziwa egunjini lokunakekela abagula kakhulu (ICU). | Lokhu futhi kuyinto eyenziwa eyunithi ekhethekile ngaphakathi esibhedlela. |
| Bazokunikeza umuthi wokudambisa ukuze uthule. Bazoqeda ubuhlungu endaweni lapho kufakwe khona i-IV. | Uzonikezwa umuthi wokudambisa ukuze uzole. Indawo lapho kuzofakwa khona i-catheter (ingquza, ingalo) izobe ingasasebenzi kahle. |
| Ipayipi le-IV lifakwa emthanjeni osengalweni bese umuthi uthunyelwa emzimbeni ngalo. | Kwenziwa ukusikwa okuncane, kufakwa i-catheter emthanjeni, bese kuthi ihlule legazi liyiswe endaweni lapho ihlule likhona. |
| Umuthi uhamba emzimbeni wonke negazi bese ufinyelela ekwandeni kwegazi. | Umuthi ufakwa ngqo ehlwini legazi. Ngezinye izikhathi ihlwili liyaqhekeka ngedivayisi yomshini. |
| Le nqubo ivame ukuthatha cishe ihora. | Kungathatha amahora angama-48 (izinsuku ezimbili) ukuthi ihlule legazi lincibilike ngokuphelele. Phakathi naleso sikhathi, uzoqashwa esibhedlela. |
Ngesikhathi sokwelashwa, ithimba lezokwelapha lizoqhubeka nokuqapha izinto ezifana nokushaya kwenhliziyo yakho, ukusebenza kwamaphaphu, kanye nomfutho wegazi.
Ngemva kokwelashwa
Udokotela uzokwenza izivivinyo eziningana ukuze abone ukuthi ihlule legazi selincibilike ngokuphelele.
- I-Angiogram
- Ukuskena kwe-CT
- I-Echocardiogram
Ngemva kokwelashwa, kuzodingeka uhlale egunjini lokunakekelwa okujulile (ICU) cishe usuku lonke. Ngemva kwalokho, kuzodingeka uhlale esibhedlela olunye usuku olulodwa kuya kwezintathu uqashwe. Ngisho nangemva kokuba usubuyele ekhaya, kuzodingeka uqhubeke nokuthatha imithi yokunciphisa igazi ukuze uvimbele ukwakheka kwamahlule egazi futhi.
Yiziphi izinzuzo nezingozi zalokhu kwelashwa?
Njenganoma yiluphi uhlobo lokwelashwa, lolu lunezinzuzo kanye nezingozi.
Izinzuzo eziyinhloko:
- Amandla okusindisa impilo: Lena inzuzo enkulu kunazo zonke. Lokhu kwelashwa kungasiza ekuvimbeleni ukufa ezimweni ezifana nokuhlaselwa yinhliziyo kanye nohlangothi.
- Ukuvimbela ukukhubazeka okungapheli: Ngokunciphisa umonakalo ebuchosheni, kungenzeka ukuvimbela ubunzima bokukhuluma kanye nokulahlekelwa yizitho zomzimba ngemva kokuhlaselwa yisifo sohlangothi.
- Ukuvimbela ukunqunywa kwethambo: Uma umthambo omkhulu engalweni noma emlenzeni uvaleka, leyo ngxenye yomzimba ingafa ngaphandle kokugeleza kwegazi. Lokhu kwelashwa kunciphisa leyo ngozi.
Izingozi Eziyinhloko:
Ingozi enkulu nenkulu kakhulu yalokhu kwelashwa ukuthi kungenzeka ukuthi igazi liphume ngaphakathi emzimbeni.
- Ukopha ebuchosheni: Lena inkinga eyingozi kakhulu. Cishe u-1% wabantu abathola lokhu kwelashwa bangase babe nesifo sohlangothi ngenxa yokopha ebuchosheni.
- Okunye ukopha: Ungase uphume ekhaleni, ngendle yakho, noma ngomchamo wakho. Ungase ube nokuklwebheka noma ukopha lapho kufakwe khona i-IV noma i-catheter.
- Ezinye izingozi:
- Ukusabela kokungezwani komzimba
- Ukulimala kwezinso (ikakhulukazi kubantu abanesifo sikashukela)
- Umfutho wegazi ophansi (`(Hypotension)`)
- Ihlule legazi liyaphuka bese liya kwenye indawo bese libhajwa.
- Ukuphazamiseka kwesigqi senhliziyo (`(Ventricular arrhythmia)`)
Ngenxa yalezi zingozi, odokotela bacabangela izici eziningi ngaphambi kokunikeza othile lokhu kwelashwa.
Kufanele ngimbone nini udokotela ngemva kokwelashwa?
Uma usufikile ekhaya, kubalulekile ukuqaphela izimpawu ezithile. Uma uhlangabezana nanoma yiziphi izimpawu ezingezansi, kufanele wazise udokotela wakho ngokushesha.
| Izimpawu okufanele uziqaphele | Incazelo |
|---|---|
| Ubuhlungu besifuba | Ubuhlungu besifuba obungazelelwe noma obukhulayo. |
| Izinguquko ekubekweni kwe-IV/catheter | Uma indawo iqhubeka nokopha noma ukuphuma kwegazi, iba bomvu, izwa ukushisa, noma inokuvuvukala/ubuhlungu obandayo. |
| Imfiva | Uma uthola umkhuhlane ngaphandle kwesizathu. |
| Ikhanda elibuhlungu noma isicanucanu | Uma unekhanda elibuhlungu elibi kakhulu noma isicanucanu. |
| Ukuba ndikindiki ezithweni zomzimba | Uma uzizwa uqhaqhazela noma ungenamizwa ezandleni noma emilenzeni. |
Lezi zimpawu zingase zibonise inkinga, ngakho ungazinaki.
Umlayezo Wokuya Nawe Ekhaya
- Ukwelashwa nge-Thrombolytic kuyindlela ebaluleke kakhulu yokwelapha engasindisa izimpilo ngokuncibilikisa amahlule egazi ezimweni eziphuthumayo njengokuhlaselwa yinhliziyo kanye nohlangothi.
- Isikhathi sibaluleke kakhulu empumelelweni yalolu hlobo lokwelashwa. Ukuya esibhedlela ngokushesha nje lapho izimpawu zivela kungathuthukisa kakhulu imiphumela.
- Njengoba ingozi enkulu yalokhu iwukuphuma kwegazi, odokotela bazonquma ukukunikeza lokhu kwelashwa kuphela ngemva kokuhlola ngokucophelela isimo sakho.
- Ngemva kokwelashwa, kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo, ikakhulukazi ukuthatha imithi yokunciphisa igazi, ukuze kuvinjelwe ukuqhekeka kwegazi esikhathini esizayo.
- Uma usuya ekhaya ngemva kokwelashwa, yazisa udokotela wakho ngokushesha nganoma yiziphi izimpawu ezingavamile ozizwayo.
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