Cabanga nje ukuthi uhlelo lwemithambo yegazi lomzimba wethu lufana nenethiwekhi yemigwaqo edolobheni elimatasa. Igazi lihamba ngale migwaqo njalo ukuze londle zonke izitho zethu zomzimba, njengenhliziyo yethu, ubuchopho namaphaphu. Ngakho-ke, kwenzekani uma lo mgwaqo omkhulu, okungukuthi, umthambo wegazi, uvalwa ngokuzumayo yi-blood clot enkulu? Njengengozi enkulu emgwaqweni kanye nokuminyana kwezimoto, ukuhlinzekwa kwegazi ezithweni zethu kungayeka, okuholela esimweni esiyingozi kakhulu njengokuhlaselwa yinhliziyo noma isifo sohlangothi. Namuhla, sikhuluma ngokwelashwa okubaluleke kakhulu odokotela abakusebenzisayo ukuncibilikisa i-blood clot esongela ukuphila nokubuyisela ukugeleza kwegazi.
Kalula nje, kuyini ukwelashwa nge-Thrombolytic?
Lokhu kusho 'ukwelashwa kokuncibilikisa amahlule egazi' ngesiSinhala. Kalula nje, lokhu kuhilela ukunikeza imithi enamandla kakhulu (i-thrombolytics) emzimbeni ukuze kuncibilikiswe amahlule egazi ayingozi anamathele emithanjeni yegazi. Uma ihlule selincibilikile, umthambo wegazi ovalekile uyavuleka futhi ukugeleza kwegazi esithweni esithintekile kuyabuyiselwa. Lokhu kuyindlela yokwelapha esindisa impilo esetshenziswa ezimweni eziphuthumayo kakhulu . Uma lokhu kwelashwa kuqala ngokushesha, kulapho kungenzeka khona ukuthi kuphumelele.
Ubani odinga lokhu kwelashwa futhi kuziphi izimo?
Odokotela bavame ukucabangela lokhu kwelashwa ezimweni ezibucayi neziphuthumayo njengalezi ezilandelayo.
- Ukuhlaselwa yinhliziyo: Lapho ihlule legazi livimba umthambo wenhliziyo ohambisa igazi enhliziyweni, ikakhulukazi uma kungekho ukufakwa kwe-stent noma ukuhlinzwa okutholakalayo ngokushesha.
- I-Ischemic Stroke: I-stroke ebangelwa ukuqhekeka kwegazi okuvalekile emthanjeni ohambisa igazi ebuchosheni.
- I-Pulmonary Embolism: Lapho ihlule legazi elakheka kwenye indawo emzimbeni (ngokuvamile emilenzeni) liqhuma bese lihlala emthanjeni emaphashini.
- I-Deep Vein Thrombosis (DVT): Amahlule amakhulu egazi, ikakhulukazi emithanjeni ejulile yemilenze, abangela izinkinga ezifana nokuba luhlaza okwesibhakabhaka kwemilenze, ubuhlungu obukhulu, futhi awasabeli emithini evamile yokunciphisa igazi (ama-anticoagulants).
- Ukuvaleka Kwemithambo Emikhulu Ye-Peripheral: Ihlule legazi livimba umthambo omkhulu engalweni noma emlenzeni .
Ingabe bakhona abantu okungafanele bathole lokhu kwelashwa?
Yebo, impela. Njengoba ingozi enkulu yalokhu kwelashwa ukopha, akunikelwa kwezinye iziguli. Ngoba kubo, umonakalo ovela ekwelashweni ungase ube ngaphezu kwenzuzo.
| Izimo eziyinhloko lapho ukwelashwa nge-Thrombolytic kunganikezwa khona | |
|---|---|
| Isimo | Incazelo |
| Ukopha okusebenzayo | Uma usuvele uphuma igazi endaweni ethile emzimbeni (isib. emathunjini). |
| Ukopha kobuchopho kwakamuva | Uma usanda kuba nokuqhuma komthambo wegazi ebuchosheni (isifo sohlangothi esihambisana nokopha). |
| Ukuhlinzwa kwamuva nje | Ikakhulukazi uma kungakapheli isikhathi eside kusukela kwahlinzwa ubuchopho noma umgogodla. |
| Umfutho wegazi ophakeme ongalawuleki | Umfutho wegazi ophakeme ongenakukwazi ukulawulwa ngisho nangemithi. |
| Isifo sezinso esibi kakhulu | Ukusebenza kwezinso kubi kakhulu. |
| Ukulimala ekhanda kwakamuva | Uma kungakapheli isikhathi eside kwenzeke ukulimala okukhulu ekhanda. |
Ngaphezu kwalokho, odokotela bacabanga kabili ngalokhu ngoba omama abakhulelwe kanye nabantu asebekhulile basengozini enkulu yezinkinga.
Lokhu kwelashwa kwenziwa kanjani?
Kunezindlela ezimbili eziyinhloko zokwelapha, kuye ngesimo sakho kanye nokuphuthuma.
1. I-Thrombolysis Ehlelekile
Lena yindlela evame ukusetshenziswa ezimweni eziphuthumayo (ukuhlaselwa yinhliziyo, unhlangothi).
- Lokhu kuhilela ukunikeza umuthi oqeda amahlule egazi ngqo egazini nge- IV cannula efakwe emthanjeni engalweni.
- Lomuthi uhamba negazi, uye endaweni lapho igazi liqhekeke khona, bese uqala ukulincibilikisa.
- Le nqubo ivame ukwenziwa egunjini lokunakekelwa okujulile (ICU) . Yonke inqubo ingathatha cishe ihora.
2. I-Thrombolysis eqondiswa yi-Catheter
Le ndlela ivame ukusetshenziswa ekwelashweni okuhleliwe kusengaphambili njenge-DVT noma i-PAD.
- Kule nqubo, kwenziwa imbobo encane esikhumbeni se-groin, intamo, noma ingalo, bese kufakwa ipayipi elincane kakhulu, elide elibizwa ngokuthi i-catheter ngalo emthanjeni wegazi.
- Kusetshenziswa ubuchwepheshe obufana ne-X-ray, isihloko sale catheter siqondiswa ngqo endaweni lapho igazi liqhekekile khona.
- Ngemuva kwalokho, umuthi ufakwa ngqo ehlwini legazi nge-catheter. Ngezinye izikhathi, ithuluzi elikhethekile ekugcineni kwe-catheter lingasetshenziswa ukuphula ihlwili legazi (i-mechanical thrombectomy).
- Le ndlela ingathatha amahora angama-48 (izinsuku ezi-2) ukuthi ihlule legazi lincibilike ngokuphelele. Phakathi nalesi sikhathi, uzogcinwa esibhedlela futhi uqashwe yithimba lezokwelapha.
Yiziphi izingozi nezinkinga zokwelashwa?
Njenganoma yikuphi ukwelashwa kwezokwelapha, kunezingozi ezithile.
Ingozi enkulu nenkulu kakhulu yalokhu kwelashwa ukopha kwangaphakathi , ikakhulukazi uma kwenzeka ebuchosheni, okungaholela ekushayweni yisifo sohlangothi.
Ngaphezu kwale ngozi enkulu, kunethuba elincane lokuthi izinto ezilandelayo zizokwenzeka:
- Ukusabela kokungezwani komzimba nomuthi.
- Ukopha noma ukuphuka lapho kufakwe khona i-cannula noma i-catheter.
- Umfutho wegazi ophansi (hypotension).
- Ucezu oluncane lwehlule legazi elincibilikayo luyaphuka bese lubhajwa komunye umthambo wegazi.
- Ukulimala kwezinso (ikakhulukazi kubantu abanesifo sikashukela).
- Igazi elincane eliphuma ekhaleni, ngendle, noma ngomchamo.
Udokotela wakho uzochaza lezi zingozi kuwe noma kubanakekeli bakho ngaphambi kokwelashwa.
Ngemva kokwelashwa nokululama
Ngemva kokwelashwa, udokotela uzokwenza izivivinyo eziningana, njenge-angiogram kanye ne-CT scan, ukuze abone ukuthi ihlule legazi selincibilike ngokuphelele.
Kuzodingeka uhlale egunjini lokunakekelwa okujulile (ICU) okungenani usuku olulodwa, kulandele olunye usuku olulodwa kuya kwezintathu uqashwe egunjini elijwayelekile.
Ngemva kokubuyela ekhaya, udokotela wakho cishe uzokunikeza imithi yokunciphisa igazi ukuvimbela ukwakheka kwamahlule egazi futhi . Kubaluleke kakhulu ukulandela le miyalelo ngqo.
Izimpawu eziyisixwayiso zokuthi kufanele ubonane nodokotela ngemva kokuya ekhaya
Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo,Yazisa udokotela wakho ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
| Isibonakaliso | Incazelo |
|---|---|
| Ubuhlungu besifuba | Ubuhlungu besifuba obungazelelwe noma obukhulayo. |
| Ukopha okuqhubekayo | Ukopha okuqhubekayo noma uketshezi oluphuma endaweni ye-cannula/catheter. |
| Imfiva | Umkhuhlane ngaphandle kwesizathu. |
| Ikhanda elibuhlungu noma isicanucanu | Ukwanda kancane kancane kwekhanda, ukuhlanza, noma isicanucanu. |
| Ukuba ndikindiki emilenzeni | Ukuba ndikindiki noma ukuqaqamba ezandleni noma ezinyaweni. |
| Ukuvuvukala/ukubomvu kwesilonda | Ubuhlungu, ukuvuvukala (i-edema), ukubomvu, noma umuzwa wokufudumala endaweni yomjovo. |
Umlayezo Wokuya Nawe Ekhaya
- Ukwelashwa nge-Thrombolytic kuyindlela ebaluleke kakhulu, esindisa impilo encibilikisa amahlule egazi emithanjeni yegazi ezimweni eziphuthumayo ezifana nokuhlaselwa yinhliziyo kanye nohlangothi.
- Uma lokhu kwelashwa kuqalwa ngokushesha, imiphumela izoba yimpumelelo kakhulu. Yingakho kubalulekile ukulaliswa esibhedlela ngokushesha nje lapho izimpawu ziqala.
- Ingozi enkulu yalokhu kwelashwa ukopha ngaphakathi emzimbeni.Lokhu kunjalo. Ngakho-ke, lokhu kwelashwa akufanele wonke umuntu.
- Ngemva kokwelashwa, kubalulekile ukuthatha imithi enqunywe udokotela ngesikhathi esifanele ukuvimbela ukwakheka kwamahlule egazi futhi.
- Uma uba nanoma yiziphi izimpawu eziyisixwayiso ngemva kokubuyela ekhaya, funa iseluleko sezokwelapha ngokushesha.
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