Ungase uzibuze ukuthi isifo sohlangothi sibi kangakanani. Isizathu esiyinhloko salokhu ukuthi umthambo obaluleke kakhulu (umthambo we-carotid) ohlangothini ngalunye lwentamo yethu othwala igazi uye ebuchosheni uvinjelwa yizinqwaba zamafutha. Kufana nokugqwala okwakheka ngaphakathi kwepayipi lamanzi bese ulivala kancane kancane. Kodwa ungakhathazeki, manje kunezindlela zokwelapha ezithuthukisiwe kakhulu nezilula zalokhu. Yilokho esikhuluma ngakho namuhla.
Iyini le ndlela yokwelapha ebizwa ngokuthi i-TFCAS?
Kalula nje, i-Transfemoral Carotid Artery Stenting (TFCAS) inqubo engangenisi kakhulu esetshenziselwa ukuvula kabusha umthambo we-carotid ovalekile entanyeni. Kuhilela ukufaka ithubhu elincane kakhulu elifana ne-mesh, elibizwa ngokuthi i-stent, emthambo ovalekile ukuze liphinde livuleke.
Cabanga ngakho, imithambo ye-carotid ezinhlangothini zombili zentamo yethu iyimithambo emibili eyinhloko ethwala umoya-mpilo nezakhamzimba ebuchosheni bethu, ebusweni, nasentanyeni. Ngokuhamba kwesikhathi, i-cholesterol namafutha avela ekudleni esikudlayo aqala ukwakheka ezindongeni zale mithambo. Sibiza lokhu ngokuthi i-plaque. Lokhu kwakheka kwe-plaque kubangela ukuthi izindonga zemithambo ziqine futhi zibe lukhuni (i-atherosclerosis). Ekugcineni, imithambo yegazi iba mincane (i-stenosis). Lapho lokhu kugeleza kwegazi kuvimbekile, ukunikezwa kwegazi ebuchosheni kwehla, okwandisa kakhulu ingozi yokushaywa yisifo sohlangothi.
Ekwelashweni kwe-TFCAS, kufakwa ithubhu ekhethekile (i-catheter) ngomsikelo omncane kakhulu embotsheni yakho noma engalweni bese iqondiswa emthanjeni ovalekile entanyeni yakho. I-stent ifakwa nge-catheter ukuze kuvulwe kabusha umthambo. I-stent, njengenduku yetende, isiza ukuvimbela umthambo ukuthi ungaphinde udilike. Lokhu kubuyisela ukugeleza kwegazi ebuchosheni, kunciphisa ingozi yokushaywa yisifo sohlangothi.
Ubani odinga lokhu kwelashwa?
Lokhu kwelashwa kunganconywa uma udokotela wakho ethola ukuthi unesifo semithambo yegazi ye-carotid. Ngezinye izikhathi ungase ungabi nazimpawu nhlobo. Kodwa-ke, abanye abantu bangase babe nezimpawu ezifana nokuhlaselwa yisifo sohlangothi okuncane (noma ukuhlaselwa yi-ischemic okufushane - ama-TIA).
Ngokuvamile kunezindlela eziningana zokwelapha i-carotid artery stenosis. Udokotela wakho uzokhetha ukwelashwa okukulungele kangcono kuye ngesimo sakho sempilo, ukuma kwe-artery, kanye nendawo ye-stenosis.
Into ebaluleke kakhulu ukuxoxa nodokotela wakho ukuthi yikuphi kwalokhu kwelashwa okungcono kakhulu kuwe.
| Indlela yokwelapha | Kwenzekani nje | Okukhethekile |
|---|---|---|
| I-TFCAS (indlela okuxoxwe ngayo kulesi sihloko) | Ukufaka i-stent emthanjeni osentanyeni kusetshenziswa ipayipi elifakwe embotsheni noma engalweni. | Akukho ukugawula okukhulu. Isikhathi sokuphulukiswa sifushane. |
| Ukususwa Kwe-Carotid Endarterectomy (CEA) | Kwenziwa ukusika entanyeni, umthambo uyavulwa, bese kususwa ungqimba olunamafutha (i-plaque) oluqongeleleke lapho. | Ukuhlinzwa kwendabuko kwenziwa kubantu abaningi. |
| I-Transcarotid Stenting (TCAR) | Kwenziwa ukusika okuncane entanyeni ngaphezu nje kwethambo lentamo bese i-stent ifakwa ngqo emthanjeni. | Ezinye izifundo zibonise ukuthi inengozi ephansi yokushaywa yisifo sohlangothi kune-TFCAS. |
Ubani ukwelashwa kwe-TFCAS okufanelekela kangcono?
Ukwelashwa kwe-TFCAS kungaba ngcono kuwe kunokuhlinzwa kwe-CEA uma unalezi zici eziyingozi:
- Uma umthambo uvalekile endaweni engenakufinyelelwa kalula ngokuhlinzwa.
- Uma unezinye izinkinga zempilo (izifo ezibangelwa amagciwane) njengesifo senhliziyo, isifo samaphaphu, noma ukukhuluphala ngokweqile.
- Uma unezicubu zesilonda entanyeni yakho ngenxa yokuhlinzwa kwangaphambilini noma ukwelashwa ngemisebe.
- Uma izintambo zakho zezwi zonakele.
Uzilungiselela kanjani ngaphambi kokuhlinzwa?
Ngaphambi kwalokhu kuhlinzwa, udokotela wakho angakucela ukuthi:
- Hlola igazi kanye nezinye izivivinyo zempilo.
- Yenza i-echocardiogram noma ukuhlolwa kokucindezeleka ukuze uhlole ukusebenza kwenhliziyo.
- Yenza ukuhlolwa kwezithombe okufana ne-`carotid angiography`, `vascular ultrasound`, noma `MRA` ukuze ubone ukuthi umthambo uvalekile kuphi.
- Nikeza uhlu lwazo zonke izidakamizwa kanye nezithasiselo ozisebenzisayo.
- Imithi efana ne-aspirin ingase inikezwe ukuvimbela ukuqhekeka kwegazi.
- Gwema ukudla noma ukuphuza (ngokushesha) amahora ambalwa ngaphambi kokuhlinzwa.
Kwenziwa kanjani ukuhlinzwa? Isinyathelo ngesinyathelo
Lokhu kuhlinzwa kuvame ukuthatha isikhathi esingaphansi kwamahora amabili futhi kwenziwa yithimba lodokotela abaqeqeshwe ngokukhethekile.
| Izinyathelo | Kwenzekani? |
|---|---|
| 1. Ukubulala izinzwa | Uzovame ukulaliswa ngokuphelele. Ungase unikezwe nenani elincane lomuthi wokukuthulisa ngenkathi uphapheme. |
| 2. Ukufaka i-catheter | Ithubhu ekhethekile (i-catheter) iqondiswa ngembobo encane eyenziwe embotsheni iye emthanjeni we-carotid entanyeni ngosizo lwe-X-ray. |
| 3. Ukufaka isihlungi | Isihlungi esincane sibekwa ngale nje kokuvaleka ukuze kubanjwe noma iyiphi i-plaque engase iphuke ngenkathi umthambo unwetshwa. Lokhu kunciphisa ingozi yokushaywa yisifo sohlangothi. |
| 4. Ukusebenzisa ibhaluni | Ibhaluni elincane lifakwa endaweni evalekile bese livuvukala, elicindezela ungqimba olunamafutha odongeni lomthambo bese landisa umthambo. Ibhaluni liyasuswa bese lisuswa. |
| 5. Ukubeka i-stent | Manje, kufakwa i-stent ezikhulisayo endaweni evulekile. Lokhu kusiza ukugcina umthambo uvulekile. |
| 6. Ukuqeda | Isihlungi kanye ne-catheter kuyasuswa, bese imbobo e-groin ivalwa ngedivayisi ekhethekile. |
Kwenzekani ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, uzoqashwa egumbini lokululama amahora amaningana. Ngokuvamile kuzodingeka uhlale esibhedlela ubusuku bonke.
- Uzonikezwa imithi yobuhlungu nganoma yikuphi ukungakhululeki ongase ukuzwe.
- Udokotela wakho uzokunikeza imithi yokulwa nama-platelet (isib. i-Aspirin, i-Clopidogrel) impilo yakho yonke ukuze kuvinjelwe ukuqhekeka kwegazi endaweni ye-stent.
Iningi labantu lingaya ekhaya livela esibhedlela ngemva kwamahora angama-24. Kungase kube nokuklwebheka, ukuvuvukala, kanye nobuhlungu obuncane endaweni yokusikwa izinsuku ezimbalwa.
Yiziphi izinzuzo nezingozi zalokhu kwelashwa?
Izinzuzo
- Ingozi yokuhlaselwa yisifo sohlangothi incishisiwe: Njengoba ukugeleza kwegazi ebuchosheni kubuyiselwa, ingozi yokuhlaselwa yisifo sohlangothi incishiswa kakhulu.
- Ukusikwa okuncane: Akukho ukusikwa okukhulu, ngakho-ke ubuhlungu buncane, ingozi yokutheleleka, kanye nezibazi.
- Ukululama okusheshayo: Ungaqhubeka nemisebenzi evamile zingakapheli izinsuku ezimbalwa.
Izingozi
Njenganoma yikuphi ukuhlinzwa, kunengozi encane, kodwa ingozi yezinkinga ezinkulu ingaphansi kuka-3%.
- I-Restenosis: Akuvamile kakhulu ukuthi izicubu zesilonda zakheke ngaphansi kwe-stent bese zincipha umthambo futhi.
- Isifo Sohlangothi: Ngesikhathi sokuhlinzwa, izingcezu zamafutha zingaphuka futhi zivale umthambo wobuchopho. Kodwa-ke, le ngozi incishiswa kakhulu yi-filter esixoxe ngayo ekuqaleni.
- Isifo senhliziyo
- Ukopha noma ukutheleleka
Kunini lapho udinga ukubonana nodokotela?
Uma uhlangabezana nanoma yiziphi zalezi zimpawu lapho ubuyela ekhaya ngemva kokuhlinzwa , shayela udokotela wakho ngokushesha.
- Uma uzizwa ushisa noma umkhuhlane
- Uma isicanucanu nokuhlanza kuphelile
- Uma indawo yokusikwa ibomvu, ivuvukele, noma ikhipha uketshezi oluphuzi (izimpawu zokutheleleka)
Okubaluleke kakhulu: Uma uzwa izimpawu zesifo sohlangothi, njengokukhuluma okungacacile, ubuthakathaka ohlangothini olulodwa lomzimba, ukugoba kobuso, noma izinguquko embonweni, iya eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela ngokushesha ngaphandle kokulibala.
Umlayezo Wokuya Nawe Ekhaya
- I-TFCAS inqubo ethuthukisiwe, engangenisi kakhulu esetshenziswa ukuvula imithambo evalekile entanyeni nokunciphisa ingozi yokushaywa yisifo sohlangothi.
- Lokhu kwelashwa akufanele wonke umuntu. Xoxa nodokotela wakho ukuthi iyiphi indlela yokwelashwa engcono kakhulu kuwe.
- Kubaluleke kakhulu ukugcina indlela yokuphila enempilo (ukudla okuhle, ukuvivinya umzimba, nokuyeka ukubhema) futhi uphuze imithi oyinikezwe udokotela njengoba nje uyalelwe ngemva kokuhlinzwa.
- Ukuqaphela izimpawu eziyisixwayiso ezingase zenzeke ngemva kokuhlinzwa, ikakhulukazi izimpawu zesifo sohlangothi, kungasiza ekusindiseni impilo yakho.
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