Ake sifunde ngokuhlinzwa kwemithambo yegazi ngendlela elula.

Umzimba wethu ufana nomuzi omatasa. Lo muzi unesimiso semigwaqo ethwala izinto ezibalulekile, njengomoya-mpilo nezakhamzimba, kuzo zonke izingxenye zawo. Le migwaqo yilokho esikubiza ngokuthi "imithambo yegazi" noma "imithambo yegazi." Ngezinye izikhathi le migwaqo iyalimala, ivaleke, noma ibe buthaka futhi icishe iqhume. Yilapho-ke sidinga khona usizo lochwepheshe ukulungisa le migwaqo. Kwezokwelapha, insimu ebhekene nalo msebenzi ibizwa ngokuthi i-Vascular Surgery.

Kalula nje, kuyini ukuhlinzwa kwemithambo yegazi?

Ukuhlinzwa Kwemithambo yegazi akuyona into eyodwa. Yigama elijwayelekile lezinhlobo ezahlukene zokuhlinzwa kanye nokwelashwa okubandakanya imithambo yegazi emzimbeni wethu, okungukuthi imithambo yegazi (imithambo yegazi ethwala igazi lisuka enhliziyweni), imithambo yegazi (imithambo yegazi ebuyisela igazi lisuka emzimbeni liye enhliziyweni), kanye nama-capillary (imithambo yegazi emincane kakhulu) .

Ngezinye izikhathi lezi zimo zingaphathwa ngokushintsha indlela yokuphila kanye nemithi, kodwa kwezinye izimo, ukuhlinzwa kuyadingeka ukuze kuvinjelwe isimo ukuba singabi sibi kakhulu.

Kunezinhloso ezintathu eziyinhloko zokuhlinzwa kwemithambo yegazi:

• Ukulungisa umonakalo emithanjeni yegazi.
• Ukunciphisa ingozi yezinkinga eziyingozi ezibangelwa yilezi zifo.
• Ukulungiselela izindlela zokufinyelela emithanjeni yegazi zokwelapha njenge-dialysis yeziguli zezinso.

Yiziphi izimo ezidinga ukuhlinzwa kwemithambo yegazi?

Uma unesinye noma ngaphezulu kwalezi zimo ezilandelayo, ungase udinge ukuhlinzwa kwemithambo yegazi. Kungenzeka ukuthi uke wezwa ngezinye zalezi zimo.

• I-Aortic aneurysm: Umthambo omkhulu kunayo yonke emzimbeni wethu (i-aorta) uyabuthaka futhi uqhume njengebhaluni.
• Amahlule egazi: Amahlule egazi, ikakhulukazi emithanjeni ejulile yemilenze (Deep Vein Thrombosis - DVT).
• Isifo semithambo ye-carotid: Ama-fat deposits avimba imithambo entanyeni ehambisa igazi ebuchosheni.
• Imithambo ye-Varicose: Imithambo eluhlaza okwesibhakabhaka evuvukele emilenzeni ebonakala ngaphezu kwesikhumba.
• Isifo semithambo yegazi engaphandle (i-PAD): Ukuvaleka okubangelwa ukugcwala kwamafutha emithanjeni yegazi enikeza igazi ezingalweni ikakhulukazi emilenzeni.
• I-stenosis yemithambo yezinso.
• Ukusungula indlela yokufinyelela i-dialysis.

Udokotela ohlinzayo wemithambo yegazi uzohlola isimo sakho bese enquma ukuthi yikuphi ukwelashwa okukulungele.

Yiziphi izinhlobo eziyinhloko zokuhlinzwa kwemithambo yegazi?

Kunezinhlobo eziningi ezahlukene zokuhlinzwa ezisetshenziswa ukwelapha izimo zezokwelapha ezahlukene. Ake sibheke ezinye zezindlela zokuhlinzwa ezivame ukwenziwa.

Ukuhlinzwa kwe-Aortic Aneurysm

Uma i-aneurysm iba nkulu kakhulu, noma uma kunengozi yokuthi iqhume, kwenziwa ukuhlinzwa.

• Ukuhlinzwa Kwe-Open Aneurysm: Kwenziwa i-incision esifubeni noma esiswini, ingxenye eyonakele yomthambo wegazi iyasuswa, bese kufakwa ipayipi lokwenziwa (i-graft) endaweni yalo.
• Ukulungiswa Kwe-Endovascular Aneurysm (EVAR): Lokhu ukuhlinzwa okwenziwa ngokusikwa okuncane. Ipayipi elincane (i-catheter) lifakwa nge-groin, lapho ipayipi lokwenziwa elifana nohlaka lwensimbi (i-stent graft) lidluliselwa khona endaweni evuvukele, kuqiniswe umthambo ovela ngaphakathi.

Ukwelashwa Kwesifo Semithambo Engasogwini (i-PAD)

Lokhu kwelashwa kusetshenziswa uma uzwa ubuhlungu obuhambisana nokujikijeleka (ubuhlungu obuzwakala sengathi uyagingqika uma uhamba) ngenxa yokuncipha kwemithambo yegazi emilenzeni yakho, noma uma amanxeba akho engakapholi.

• I-Angioplasty kanye ne-stenting: I-catheter ifakwa emthanjeni ovalekile, ivuvuke, bese ukuvaleka kuyanwebeka. Bese kufakwa idivayisi efana ne-mesh (i-stent) ukuze kuvinjelwe ukuvaleka kungaphindi kwenzeke.
• Ukuhlinzwa kokudlula kwemithambo yegazi engaphandle: Njengoba nje umgwaqo uvaliwe, kwakhiwa umzila omusha wokudlula umthambo wegazi ovaliwe. Lokhu kwenziwa kusetshenziswa omunye umthambo ophilile noma ithubhu lokwenziwa elingaphakathi emzimbeni.

Ukuhlinzwa kwezinkinga ngemithambo ye-carotid

Lokhu kuvinjelwa komthambo wegazi kuyisici esikhulu esiyingozi sokuhlaselwa yisifo sohlangothi.

• Ukususwa kwe-carotid endarterectomy: Kwenziwa ukusikwa okuncane entanyeni, umthambo uyavulwa, bese ungqimba olunamafutha (i-plaque) oluqongeleleke ngaphakathi lususwa ngokuhlinzwa.
• I-Carotid angioplasty kanye ne-stenting: Njengoba kushiwo ngaphambili, ibhaluni kanye ne-stent kusetshenziswa ukwandisa umthambo ovalekile.

Ukwelashwa kwezifo ezihlobene nemithambo yegazi

Uma ama-valve emithanjeni emilenzeni eba buthakathaka, igazi liyahlangana emilenzeni esikhundleni sokubuyela enhliziyweni. Lokhu kubangela ukuvuvukala, ubuhlungu, kanye nemithambo evuvukalayo.

• Ukubopha nokususa imithambo: Ukwelashwa okuvamile kwemithambo ekhuphukile. Kule nqubo, umthambo onesifo ususwa ngokuphelele ngokuhlinzwa.
• Ukususwa kokushisa okungaphakathi: Ngaphandle kokusikwa okukhulu, kusetshenziswa i-laser noma amaza omsakazo asezingeni eliphezulu ukushisa nokuvala umthambo onesifo ngaphakathi. Lokhu-ke kumisa ukugeleza kwegazi emthanjeni.
• Ukwelashwa nge-Sclerotherapy: Ukwelashwa kwemithambo emincane evuvukele kanye nemithambo yesicabucabu. Isixazululo samakhemikhali sifakwa emthanjeni bese sivalwa.

Kwenzekani ngaphambi, ngesikhathi nangemva kokuhlinzwa?

Ngaphambi kokuhlinzwa, udokotela wakho uzokwenza ukuhlolwa okuphelele, enze noma yikuphi ukuhlolwa kwegazi okudingekayo, ama-scan (njenge-Doppler ultrasound, i-CT angiogram), futhi akunikeze imiyalelo yalokho okudingeka ukwenze ukuze ulungiselele ukuhlinzwa.

• Ungase ucelwe ukuthi uyeke okwesikhashana ukuthatha imithi ethile (ikakhulukazi imithi yokunciphisa igazi ).
• Uzocelwa ukuba uzile ukudla kusukela ngobusuku bangaphambi kokuhlinzwa.
• Uma ubhema, kubaluleke kakhulu ukuyeka ngokuphelele amasonto ambalwa ngaphambi kokuhlinzwa.

Kunezinhlobo ezimbili eziyinhloko zokuhlinzwa. Udokotela wakho uzokhetha indlela efanele wena.

Isikhathi sokululama ngemva kokuhlinzwa sincike ohlotsheni lokuhlinzwa okwenziwe. Ezinye izinhlinzeko ezinkulu zingadinga izinsuku ezimbalwa egunjini lokunakekelwa okujulile (ICU). Ngemva kwenqubo encane efana ne-sclerotherapy, ungase ukwazi ukuya ekhaya ngalolo suku.

Yiziphi izinzuzo nezingozi zalokhu kuhlinzwa?

Izinzuzo eziyinhloko:

• Ezinye zalezi zihlinza ezisindisa impilo .
• Kuthuthukisa kakhulu ikhwalithi yempilo yakho (isib., ukukwazi ukuhamba ngaphandle kobuhlungu).
• Izinkinga eziyingozi ezifana nesifo sohlangothi kanye nokuhlaselwa yinhliziyo zingavinjelwa .

Izingozi ezingaba khona:

• Ukungezwani komzimba ne-anesthesia noma amadayi asetshenzisiwe.
• Ukopha.
• Amahlule egazi.
• Ukutheleleka endaweni yokuhlinzwa.
• Ukulimala kwemizwa.

Ingozi ingahluka kuye ngezici ezifana neminyaka yakho, ukuba khona kwezinye izimo zezokwelapha (isifo sikashukela, isifo sezinso), njll. Udokotela wakho uzoxoxa nawe ngazo zonke lezi zinto ngokucacile ngaphambi kokuhlinzwa.

Kufanele ubonane nini nodokotela ngemva kokuhlinzwa?

Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo ngesikhathi ululama ngemva kokuhlinzwa, yazisa udokotela wakho ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) esibhedlela esiseduze.

• Ukopha noma ubomvu obuvela enxebeni lokuhlinzwa, ukubomvu nokuvuvukala, kanye nobuhlungu obukhulu.
• Imfiva.
• Ukuba ndikindiki noma ubuhlungu obukhulu noma ukuvuvukala ezingalweni noma emilenzeni.
• Ubuhlungu obukhulu esifubeni, esiswini, noma emhlane.
• Ukukhwehlela igazi noma ulwelwesi oluluhlaza/oluphuzi.
• Ubunzima bokubona noma ukukhuluma.