Ake sifunde kabanzi nge-Venous Thromboembolism (VTE) ngokushesha.

Wake wazibuza ukuthi igazi eligeleza emithanjeni yethu lingabhajwa kanjani endaweni eyodwa futhi lakhe amahlule? Lokhu kungase kuzwakale kuyesabisa kancane, kodwa empeleni kubaluleke kakhulu ukuqaphela lokhu. Ngoba yilapho kuphela lapho singathatha khona isinyathelo ngokushesha uma kudingeka. Namuhla sikhuluma ngehlule legazi emithanjeni, isimo odokotela abasibiza ngokuthi `(Venous Thromboembolism - VTE)`.

Kuyini i-Venous Thromboembolism (VTE)?

Kalula nje, `(I-Venous Thromboembolism)` yilapho kwakheka ihlule legazi ngaphakathi komthambo emzimbeni wethu, uhlobo lomthambo oluthwala igazi elingcolile liye enhliziyweni, luvimbele ukugeleza kwegazi. Lapha, elithi "Thrombo" lisho ihlule legazi. Igama elithi "Embolism" lisho lapho ihlule legazi elinjalo lihamba emthanjeni wegazi bese libhajwa ndawana thile. Igama elithi "Venous" lisho emithanjeni.

Uma odokotela bekhuluma nge-VTE, bakhuluma kakhulu ngezinhlobo ezimbili zamahlule egazi:

1. I-Deep Vein Thrombosis (DVT): Lokhu kwenzeka lapho kwakheka amahlule egazi emithanjeni ejulile edlula emisipheni, ngaphakathi emzimbeni.

2. I-Pulmonary Embolism (PE): Lokhu kwenzeka lapho ihlule legazi elivela ku-DVT noma ihlule legazi elivela kwenye indawo liqhuma bese lihlala emthanjeni emaphashini.

Cabanga ngakho, le mithambo ibuyisela igazi enhliziyweni lisuka ezingxenyeni ezikude zomzimba wethu, njengezitho zethu. Ngakho-ke, lapho umthambo uvinjwa yi-blood clot, igazi liqala ukuhlangana ngemuva kwendawo evinjiwe. Ngemuva kwalokho leyo ndawo ingavuvukala futhi ivuvuke. Futhi, amaseli aphambi kwendawo evinjiwe awatholi umoya-mpilo nezakhamzimba azidingayo. Lokhu kungabangela umonakalo omkhulu emithanjeni, ezicutshini, ngisho nasezithweni zomzimba. Kwezinye izimo, isibonelo, uma umthambo othwala igazi emaphashini uvinjwa yi-"VTE", kungaba yingozi empilweni .

Kwenzeka kanjani ukuthi amahlule egazi avele emithanjeni kanje?

Empeleni, ukujiya kwegazi kuyindlela evamile nenempilo yomzimba wethu. Ungakucabanga njengoqweqwe oluvela lapho inxeba elincane ebusweni besikhumba sethu loma futhi igazi elincane liphuma. Kunjalo-ke. Uma kukhona ukulimala emzimbeni, kungakhathaliseki ukuthi ukutheleleka, igazi liyaqina kancane ukuze livimbe igazi ukuthi lingaphumi. Ngisho noma lokhu kungukutheleleka, ulwelwesi lomthambo wegazi luphathwa njengokungathi luyisilonda.

Ngokuvamile, lapho inxeba noma ukutheleleka kuqala ukuphola, ihlule legazi liyancibilika. Kodwa ngezinye izikhathi, lokho akwenzeki . Noma, amahlule egazi angakheka ngaphandle kokulimala. Lokhu kungabangelwa izinto eziningana. Ezimweni ezinjalo, uma ihlule legazi likhulu ngokwanele, lingavimba ngokuphelele umthambo.

La mahlule egazi awuthinta kanjani umzimba wakho?

Abantu abaningi bacabanga ukuthi uma becabanga ngehlule legazi, kusho ihlule legazi elibangela "ukuhlaselwa yinhliziyo" noma "uhlangothi." Kodwa-ke, "i-VTE" akuyona uhlobo lwehlule legazi oluvame ukwakheka emithanjeni (imithambo ethwala igazi lisuka enhliziyweni liye emzimbeni wonke). Kodwa-ke, lingaba yingozi ngendlela efanayo .

Inkinga enkulu kakhulu yilapho i-VTE, noma ihlule legazi, liphuma endaweni yalo yokuqala, lihamba ngegazi, bese lihlala emithanjeni yamaphaphu . Lokhu kubizwa ngokuthi i-Pulmonary Embolism (PE). I-PE ivimbela ukugeleza komoya-mpilo negazi emaphashini. Ngesikhathi esifanayo, umfutho wegazi emithanjeni uyakhuphuka. Lesi simo sibizwa ngokuthi i-Pulmonary Hypertension. Uma lokhu kuqhubeka, ukwehluleka kwenhliziyo ngisho nokufa kungenzeka.

I-VTE ivame ukwenzeka emithanjeni ejulile yomzimba wethu, ikakhulukazi emilenzeni noma ezingalweni noma emithanjeni engaphakathi kwemisipha. Lapho kwakheka ihlule legazi emthanjeni ojulile, libizwa ngokuthi i-Deep Vein Thrombosis (DVT). Uma i-DVT ivimba umthambo, ingabangela ukuvuvukala, ukuvuvukala, kanye nokubomvu, okungalimaza umthambo isikhathi eside. Lokhu kungaholela esimweni esibizwa ngokuthi i-Chronic Venous Insufficiency noma i-Post-thrombotic Syndrome. Akuwona wonke ama-DVT avimba umthambo, kodwa angakwenza, ngakho-ke ahlukaniswa njenge-Venous Thromboembolic Disease. Kubalulekile futhi ukukhumbula ukuthi uma ihlule legazi liphuma futhi liye emaphashini, lingabangela i-PE.

Uyini umehluko phakathi kwe-'Thrombosis' (ihlule legazi) kanye ne-'Thromboembolism' (ukuvaleka kwehlule legazi emjikelezweni wegazi)?

Kalula nje, `(Thrombosis)` kusho ihlule legazi. `(Thromboembolism)` kusho ihlule legazi elihamba egazini bese libhajwa ndawana thize, livimbele ukugeleza kwegazi. `(Deep Vein Thrombosis - DVT)` kanye `(Pulmonary Embolism - PE)` zombili ziwela ngaphansi kwesambulela `(Venous Thromboembolic Disease)`. Ngoba zombili lezi zingavimbela ukugeleza kwegazi emithanjeni.

I-superficial venous thrombosis (SVT) iyi-blood clot eyakheka emithanjeni emincane, engaphezulu eduze kobuso besikhumba, futhi cishe ayinazo izinkinga ezinkulu. Nakuba cishe ingxenye ye-DVTs ingabangeli izinkinga, kufanele icatshangelwe ngoba ingabangela izinkinga futhi iyisici esiyingozi se-PE.

Sivame kangakanani lesi simo esibizwa ngokuthi `i-VTE`?

Ngisho nakwamanye amazwe athuthukile emhlabeni, i-`(VTE)` iyisifo sesithathu esivame kakhulu semithambo yegazi ngemva kwe-`(Heart Attack)` kanye ne-`(Stroke)`. Lokhu kusho ukuthi lesi simo sithinta cishe umuntu oyedwa kwabayi-1000 ngonyaka. Cishe ingxenye yalabo abathola i-`(VTE)` nabo bathola i-`(Pulmonary Embolism - PE)`. Futhi, cishe ama-25% alabo abathola i-`(PE)` bayafa. Kuthiwa futhi ingozi yokuthola i-`(VTE)` iphindwe kabili njalo eminyakeni eyishumi ngemva kweminyaka engama-40 .

Ubani osengozini enkulu yokuthola i-VTE?

Eqinisweni, noma ubani angathola i-VTE. Kodwa-ke, kunezici ezithile ezandisa ingozi. Cabanga ukuthi cishe u-25% kuya ku-50% wamacala e-VTE ayenzeka ngaphandle kwesizathu esibonakalayo. Amanye u-20% ahlobene nomdlavuza. Amanye u-20% ahlobene nokuhlinzwa. Futhi, abanye abantu banezinkinga zokujiya kwegazi, okwenza kube nokwenzeka kakhulu ukuthi babe namahlule egazi.

Yiziphi izimbangela ze-VTE?

Kunezizathu eziningi ezenza ukuthi amahlule egazi akheke. Kodwa-ke, kunzima ukusho ngokuqinisekile ukuthi amahlule egazi azokhula ngokwanele yini ukuvimba umthambo noma aphuke bese eya emaphashini. Abantu abathola i-VTE bavame ukuba nezinto ezingaphezu kweyodwa eziyingozi.

Abanye abantu banokungalingani kwamaprotheni egazini labo okusiza ukujiya kwegazi (`(Thrombophilia)`). Lokhu kungabangela ukuthi igazi labo lijiye kalula futhi kwenze kube lula ukuncibilikisa amajiye akhekile. Lokhu kungaba yifa, noma kungaba umphumela wesinye isimo sezokwelapha.

Ngezinye izikhathi, uma umzimba ungahambi, okungukuthi, uma unganyakazi , ukugeleza kwegazi emithanjeni kuyehla futhi kungakheka amahlule egazi. Cabanga nje, uma usohambweni olude, uma usesimeni esifanayo amahora amaningi ebhasini noma esitimeleni, noma uma uhleli esihlalweni usuku lonke ehhovisi, noma uma ugula futhi uvaleleke embhedeni, le ngozi ikhona.

Imbangela evame kakhulu yokuqhekeka kwegazi ukulimala noma ukutheleleka. Ngezinye izikhathi, lokhu kulimala kubangelwa ukwelashwa kwezokwelapha. Isibonelo, kungenzeka ngesikhathi sokuhlinzwa, ukwelashwa ngamakhemikhali komdlavuza, noma lapho kufakwa umugqa we-IV (intravenous liquid) engalweni noma kufakwa i-catheter. Abantu abahlala esibhedlela isikhathi eside basengozini enkulu yokuqhekeka kwegazi. Lokhu kungenxa yokuthi bayalulama ekulimaleni noma ekuthelelekeni, baphathwa ngokwelashwa okunamandla, futhi bachitha isikhathi esiningi embhedeni wesibhedlela.

Yiziphi izinto ezandisa ingozi ye-VTE?

Nazi ezinye izinto ezingandisa ingozi yakho yokuthola i-VTE:

• Ukulimala emthanjeni ngenxa yokuphuka noma ukuhlinzwa.
• Izimo ezithathelwanayo.
• Ukuncipha kokujikeleza kwegazi ngenxa yokuhlala ungashukumi endaweni eyodwa isikhathi eside kakhulu.
• Izimo zofuzo ezidluliselwa ezizukulwaneni ngezizukulwane kanye nomlando womndeni we-VTE.
• Amazinga akhuphukile e-hormone `(Estrogen)` ngenxa yokukhulelwa, ukusetshenziswa kwamaphilisi okuvimbela inzalo, noma ukwelashwa kokushintsha ama-hormone (`(Ukwelashwa Kokushintsha Ama-hormone)`).
• Izifo zokujiya kwegazi, isibonelo `(Isifo se-Factor V Leiden)`, `(I-Polycythemia Vera)` kanye `(Isifo se-Sickle Cell)`.
• Ezinye izifo ezingamahlalakhona, isibonelo umdlavuza, isifo senhliziyo, kanye ne-Inflammatory Bowel Disease (IBD).
• Izici zendlela yokuphila, okungukuthi, ukubhema, ukukhuluphala ngokweqile, kanye nokuntuleka kokuvivinya umzimba.
• Ubudala (i-VTE ivame kakhulu kubantu abadala. Lokhu kungase kube ngenxa yokusabalala kwezifo ezihambisana nalesi sifo kanye nezici ezingezinhle zendlela yokuphila phakathi kwabo).

Ziyini izimpawu ze-`VTE`?

Uma umthambo uvaleka ngenxa ye-deep vein thrombosis (DVT), izimpawu zingase zivele endaweni lapho igazi liqhekeke khona. Lokhu kufaka phakathi:

• Ukuvuvukala (ikakhulukazi emlenzeni owodwa noma engalweni)
• Ububomvu
• Ukuzizwa ufudumele uma uthinta leyo ndawo
• Ubuhlungu (ikakhulukazi uma umi noma uhamba)

Izimpawu ze-``(PE)``, okungukuthi, ihlule legazi emaphashini, zingavela ngokuzumayo, ngezinye izikhathi ngaphandle kwezimpawu zangaphambili ze-``(DVT)``. Lezi zimpawu zifaka:

• Ubuhlungu besifuba (ikakhulukazi uma uphefumula kakhulu)
• Ubunzima bokuphefumula (ukuqala ngokuzumayo)
• Ukwanda kwesilinganiso senhliziyo
• Isilinganiso sokuphefumula esikhulayo
• I-Vertigo (ukuzizwa sengathi uyajikeleza)
• Ukulahlekelwa ingqondo
• Ukujuluka noma ukuzizwa ubanda
• Ukukhwehlela igazi

Okubalulekile: Uma unezinye zalezi zimpawu, kubaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha , njengoba lezi zingaba izimpawu zesimo esibucayi.

I-'VTE' ihlolwa kanjani?

Kunezinye izimo ezinezimpawu ezifana neze-DVT kanye ne-PE. Ukuze aqiniseke ukuthi unesifo se-Venous Thromboembolic Disease, udokotela wakho uzobuza ngomlando wakho wezokwelapha, athole izici eziyingozi ze-VTE, futhi akhiphe ezinye izimo. Bangase futhi benze ukuhlolwa kwegazi okuyisisekelo ukuze babheke izimpawu zamahlule egazi. Bazobe sebesebenzisa izivivinyo zezithombe, njengezikena, ukuthola indawo yamahlule.

Yiziphi izivivinyo ezisetshenziswa ukuxilonga i-'VTE'?

Kuhlolwa izivivinyo ezahlukene ukuze kutholakale `(DVT)` kanye `(PE)`.

Ukuhlolwa okuthola i-'DVT'

• Ukuhlolwa kwegazi: Kukhona ukuhlolwa kwegazi okubizwa ngokuthi ukuhlolwa kwe-D-dimer. Lokhu kulinganisa izinga lento ekhishwayo lapho amahlule egazi ephuka. Uma izinga lale nto liphezulu, kungaba uphawu lwehlule legazi. Ukuhlolwa kwegazi kungenziwa futhi ukuze kulinganiswe izinga lomoya-mpilo egazini kanye nokuhlola izinkinga zokugoba kwegazi ezizuzwe njengefa.
• I-Vascular ultrasound: Lokhu ukuhlolwa kwesithombe okungenabuhlungu. Ngokuvamile kuyisinqumo sokuqala ukubheka imithambo yegazi nokuthi igazi ligeleza kanjani kuyo. Ngezinye izikhathi kubizwa ngokuthi i-duplex ultrasound ngoba inezingxenye ezimbili. Engxenyeni yokuqala, udokotela usebenzisa idivayisi efana nenduku ukuqondisa amaza omsindo emithanjeni bese ethola izithombe esikrinini. Umthambo ungacindezelwa ukuze ubone ukuthi uyancipha yini ngokujwayelekile noma ukuthi uvinjiwe yi-blood clot. Engxenyeni yesibili, amaza omsindo aqondiswa ukubona ukuthi igazi ligeleza kanjani emthanjeni. Lapho igazi ligeleza ngokujwayelekile, amaza omsindo ayashintsha ngesenzakalo esibizwa ngokuthi i-Doppler effect.
• I-MR venography:Indlela ebizwa ngokuthi i-Magnetic Resonance Imaging (MRI) ingathembeka kakhulu kune-ultrasound yokuhlola imithambo ezindaweni ezifana nesisu, isifuba, kanye ne-pelvis. Ku-MR venography, amagagasi e-radiofrequency asetshenziswa ukuthola amahlule egazi. Lokhu kuhlolwa kudinga ukuthi ulale phansi ngaphakathi komshini ojwayelekile we-MRI. Ungase futhi unikezwe idayi ekhethekile ukusiza imithambo ivele ngokucacile.
• I-venography yokuqhathanisa: Lokhu ukuhlolwa kwe-X-ray okuvamile. Futhi, idayi yokuqhathanisa ifakwa emthanjeni ukuze imithambo ibonakale kakhulu ezithombeni. Nakuba ihlasela kancane kunezinye izivivinyo zezithombe, ibhekwa njengenembile kakhulu. Lokhu kungenziwa uma ezinye izivivinyo zingaphelele. Uchwepheshe we-X-ray ufaka ithubhu elincane komunye wemithambo yakho emikhulu, ayiqondise endaweni efanele, afake idayi yokuqhathanisa, bese ethatha i-X-ray.

Ukuhlolwa okuthola i-'PE'

• I-pulse oximetry: Uma izimpawu zakho zibonisa ukuthi une-PE, udokotela wakho angase aqale alinganise izinga lomoya-mpilo egazini lakho ngokubeka inzwa ye-pulse oximetry esicongweni somunwe wakho. Uma izinga lomoya-mpilo liphansi, kungaba ngenxa ye-PE noma esinye isimo samaphaphu noma senhliziyo.
• I-X-ray yesifuba: Nakuba i-X-ray yesifuba ingenakukwazi ukuxilonga i-PE, ingahlonza ezinye izimo zamaphaphu noma zenhliziyo ezingase zibangele izimpawu zakho.
• I-CT pulmonary angiography (CTPA): Lolu ukuhlolwa okujwayelekile kokuxilonga i-PE. I-CT scan ikhiqiza izithombe ezinezinhlangothi ezintathu (3-D) zemithambo nemithambo emaphashini akho. Igama elithi "Pulmonary" lisho ukuthi lihlobene namaphaphu, kanti elithi "angiography" liyi-X-ray yemithambo yegazi. I-CTPA ayihlaseli, kodwa ingadinga ukufakwa kwedayi yokungafani emthanjeni.
• I-angiogram yamaphaphu: Uma ezinye izivivinyo zingaphelele, i-angiogram yamaphaphu yendabuko inganikeza imiphumela eqinisekile. Kodwa-ke, iyaphazamisa kancane. Kule angiogram, uchwepheshe we-X-ray ufaka ithubhu komunye wemithambo yakho emikhulu, ayifake esifubeni sakho, afake idayi yokungafani, bese ethatha i-X-ray.

Yiziphi izindlela zokwelapha i-VTE?

Izinketho zokwelapha `(I-Venous Thromboembolism)` zincike ekutheni ihlule legazi liyingozi kangakanani. Amanye amacala `(DVT)` angaphathwa ngemithi yomlomo. Kodwa-ke, amanye amacala `(PE)` kungadingeka asuswe ngokushesha . Udokotela wakho angasusa i-`(PE)` esongela impilo nge-catheter efakwe ngemithambo yegazi, noma angajova umuthi `(thrombolytic)` oqeda ngokushesha ihlule legazi. Kodwa-ke, ngenxa yezinkinga ezingase zenzeke, ukungenelela okunjalo kwenziwa kuphela ezimweni eziphuthumayo.

Uma i-VTE ingasongeli impilo ngokushesha, ukwelashwa kugxile ekuvimbeleni amahlule akhona ukuthi akhule futhi kuvimbele ukwakheka kwamahlule amasha. Ukwelashwa okunjalo okuvimbelayo kufaka phakathi ama-anticoagulant, okuyimithi enciphisa igazi, kanye namasokisi okucindezela, okusiza ukugcina ukujikeleza kwegazi okuhle. Ezimweni eziyinkimbinkimbi kakhulu, udokotela wakho angase asikisele ukungenelela ngokomzimba, njengokufaka isihlungi emthanjeni ukuze kuvinjelwe amahlule egazi ukuthi aye emaphashini akho.

Ungakuvimbela kanjani i-VTE?

Kunezici eziningi eziyingozi zokuthuthukisa i-venous thromboembolism, hhayi zonke esingazilawula. Kodwa-ke, ngokuvamile, ukuhlala usebenza kuyindlela elula yokukuvimbela . Njengoba ama-DVT amaningi enzeka emilenzeni, ukugcina ukujikeleza kwegazi okuhle emilenzeni kunganciphisa kakhulu ingozi.

Uma uhlala isikhathi eside, kungaba semsebenzini noma ngenkathi usohambweni, qiniseka ukuthi uvuka futhi uhambahamba njalo futhi uvocavoce imisipha yakho yemilenze. Lokhu kuzosiza ekunciphiseni ukuhlangana kwegazi. Kungakhathaliseki ukuthi uyagula noma uyalulama ekuhlinzweni, ukuvuka nokuhambahamba ngokushesha ngangokunokwenzeka kungasiza ekunciphiseni ingozi yakho yokuqhekeka kwegazi. Ukuzivocavoca umzimba kungasiza futhi ekunciphiseni ukucindezeleka nokugcina isisindo esinempilo . Lezi ezinye izici ezingaba nomthelela ku-VTE.

Uzinakekela kanjani ngemva kwe-VTE?

Uma uthuthukisa i-VTE, qaphela lezi zinto:

• Thola ukunakekelwa okulandelanayo okuvamile. Udokotela wakho uzoqapha isimo sakho futhi anqume ukuthi udinga ukuthatha isikhathi esingakanani imithi yakho.
• Phuza imithi yakho njengoba nje uyalelwe. Kodwa-ke, uma uzwa ukopha ngokweqile (umphumela omubi kakhulu wemithi yokunciphisa igazi), yeka ukuthatha imithi ngokushesha bese uthintana nodokotela wakho.
• Qaphela izimpawu zokuqhekeka kwegazi, ikakhulukazi ukuvuvukala emilenzeni kanye nobuhlungu lapho kuthintwa.
• Yamukela indlela yokuphila enempilo. Hlala umatasa, phuza amanzi amaningi, lawula ukucindezeleka, futhi uyeke ukubhema uma ubhema.

Khumbula, kunezimbangela eziningi ezahlukene ze-Venous Thromboembolism. Kungase kube nezici eziyingozi ongazazi futhi ongeke ukwazi ukuzishintsha.

Ngemva kwakho konke lokhu kukhuluma, nakhu okudingeka ukukhumbule!

Kunezici eziningi ezingaba nomthelela esimweni esibizwa ngokuthi `(Venous Thromboembolism - VTE)`. Ungase ube nezici eziyingozi ongazazi, futhi ezinye zazo esingenakuzilawula. Kodwa-ke, kunezinto eziningi ongazenza ukuvimbela `(VTE)` . Futhi, uma kwenzeka ngeshwa, kungaphathwa ngempumelelo.

Uma unenkinga ngalokhu, khuluma nodokotela wakho ngezinto ezithile ezikubangela ingozi nokuthi ungazinciphisa kanjani ingozi yakho. Into ebaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha uma uthola izimpawu ze-"VTE". Sithatha wonke amahlule egazi, kokubili lawo onawo manje nalawo ongase uwathole esikhathini esizayo, ngokungathi sína. Ngakho-ke ungesabi ukubona udokotela ngokushesha nje uma unezinkinga. Impilo yakho iyona nto eza kuqala kithi!

Igazi eliqhekekile, umthambo, i-DVT, i-PE, amaphaphu, i-Venous Thromboembolism, i-VTE