Umbungu wamaphaphu

Umbungu wamaphaphu ukuvaleka komthambo emaphashini. Isizathu esivame kakhulu sokuvinjelwa kwegazi.

Umbungu wamaphaphu uvame ukubangelwa ihlule legazi elivela emthanjeni ongaphandle kwamaphaphu. Isigaxa segazi esivame kakhulu ngesinye esisemthanjeni ojulile wethanga noma okhalweni (endaweni yesinqe). Lolu hlobo lwe-clot lubizwa nge-deep vein thrombosis (DVT). Ukuqhuma kwegazi kuyaphuka bese kuya emaphashini lapho ihlala khona.

Izimbangela ezingejwayelekile zivame ukufaka amabhamuza omoya, amaconsi amafutha, i-amniotic fluid, noma ama-clumps ama-parasites noma ama-tumor cells.

Kungenzeka ukuthi uthole lesi simo uma wena noma umndeni wakho ninomlando wamahlule egazi noma ukuphazamiseka okuthile kokunqandeka. Umbungu wamaphaphu ungavela:

• Ngemuva kokubeletha
• Ngemuva kokuhlaselwa yinhliziyo, ukuhlinzwa kwenhliziyo, noma isifo sohlangothi
• Ngemuva kokulimala kanzima, ukusha, noma ukuphuka okhalweni noma ethangeni
• Ngemuva kokuhlinzwa, imvamisa ukuhlinzwa kwamathambo, okuhlangene noma kobuchopho
• Ngesikhathi noma ngemuva kwendiza ende noma ukuhamba ngemoto
• Uma unomdlavuza
• Uma uthatha amaphilisi okulawula ukubeletha noma i-estrogen therapy
• Ukuphumula kombhede wesikhathi eside noma ukuhlala endaweni eyodwa isikhathi eside

Ukuphazamiseka okungaholela kumahlule egazi kufaka:

• Izifo zesimiso sokuzivikela ezifweni ezenza kube nzima ngegazi ukujiya.
• Ukuphazamiseka okuzuzwe njengefa okwenza ukuthi igazi lize likwazi ukujiya. Esinye sezifo ezinjalo ukuntuleka kwe-antithrombin III.

Izimpawu eziyinhloko ze-embolism ye-pulmonary zifaka ubuhlungu besifuba okungenzeka kube okunye kwalokhu okulandelayo:

• Ngaphansi kwethambo lesifuba noma ohlangothini olulodwa
• Cijela noma ugwaze
• Ukushisa, ukuqaqamba, noma ukuzwa okuncane, okunzima
• Imvamisa kuba kubi ngokuphefumula okujulile
• Ungagoba noma ubambe isifuba sakho uphendula ubuhlungu

Ezinye izimpawu zingafaka:

• Isiyezi, ikhanda elikhanyayo, noma ukuquleka
• Izinga le-oxygen ephansi egazini (i-hypoxemia)
• Ukuphefumula okusheshayo noma ukuphefumula
• Ukushaya kwenhliziyo okusheshayo
• Ukuzizwa ngikhathazekile
• Ubuhlungu bomlenze, ubomvu, noma ukuvuvukala
• Umfutho wegazi ophansi
• Ukukhwehlela okungazelelwe, mhlawumbe ukukhwehlela igazi noma amafinyila anegazi
• Ukuphefumula okuqala ngokuzumayo ngesikhathi sokulala noma ekusebenzeni
• Umkhuhlane webanga eliphansi
• Isikhumba se-Bluish (i-cyanosis) - esingandile kakhulu

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba abuze ngezimpawu zakho nomlando wezokwelapha.

Ukuhlolwa okulandelayo kwebhu kungenziwa ukubona ukuthi amaphaphu akho asebenza kanjani kahle:

• Imithambo yegazi yegazi
• Pulse oximetry

Ukuhlolwa okulandelayo kwe-imaging kungasiza ekunqumeni ukuthi i-clot yegazi ikuphi:

• I-x-ray yesifuba
• I-CT angiogram yesifuba
• I-pulmonary ventilation / perfusion scan, ebizwa nangokuthi ukuskena kwe-V / Q
• I-CT angiogram yamaphaphu

Olunye uvivinyo olungenziwa lubandakanya:

• Isikena se-CT esifubeni
• Ukuhlolwa kwegazi kwe-D-dimer
• Ukuhlolwa kwe-Doppler ultrasound kwemilenze
• I-Echocardiogram
• ECG

Ukuhlolwa kwegazi kungenziwa ukubheka ukuthi unamathuba amaningi okwanda kwegazi, kufaka phakathi:

• Amasosha omzimba we-Antiphospholipid
• Ukuhlolwa kofuzo ukubheka izinguquko ezikwenza ube sethubeni elikhulu lokuthola amahlule egazi
• I-Lupus anticoagulant
• Amaprotheni C namazinga wamaprotheni S

Umbungu wamaphaphu udinga ukwelashwa ngokushesha. Ungadinga ukuhlala esibhedlela:

• Uzothola imishanguzo yokwehlisa igazi futhi wenze kube mancane amathuba okuthi igazi lakho lakhe amahlule amaningi.
• Ezimweni ze-embolism ye-pulmonary enamandla, esongela impilo, ukwelashwa kungabandakanya ukuncibilikisa ihlwili. Lokhu kubizwa ngokuthi ukwelashwa kwe-thrombolytic. Uzothola imithi yokuqeda ihlwili.

Noma ngabe udinga ukuhlala esibhedlela noma cha, kuzodingeka ukuthi uphuze imithi ekhaya ukunciphisa igazi:

• Unganikezwa amaphilisi ozowaphuza noma ungahle uzidinge ukujova.
• Kweminye imithi, uzodinga ukuhlolwa kwegazi ukuqapha umthamo wakho.
• Udinga ukuthi uthathe isikhathi esingakanani le mithi incike kakhulu kwisizathu nosayizi wegazi lakho.
• Umhlinzeki wakho uzokhuluma nawe ngengozi yezinkinga zokopha uma uthatha le mithi.

Uma ungakwazi ukuthatha izinciphisi zegazi, umhlinzeki wakho angaphakamisa ukuhlinzwa ukuze kubekwe idivaysi ebizwa nge-inferior vena cava filter (IVC filter). Le divayisi ibekwe emthanjeni omkhulu esiswini sakho. Kugcina amahlule amakhulu angangeni emithanjeni yegazi yamaphaphu. Kwesinye isikhathi, isihlungi sesikhashana singabekwa futhi sisuswe ngokuhamba kwesikhathi.

Kungaba nzima ukubikezela ukuthi umuntu ululama kahle kanjani embunjini wamaphaphu. Kuhlala kuncike ku:

• Yini ebangele inkinga kwasekuqaleni (isibonelo, umdlavuza, ukuhlinzwa okukhulu, noma ukulimala)
• Usayizi wehlule legazi emaphashini
• Uma i-clot yegazi ichitheka ngokuhamba kwesikhathi

Abanye abantu bangaba nezinkinga zesikhathi eside zenhliziyo namaphaphu.

Ukufa kungenzeka kubantu abane-pulmonary embolism enzima.

Iya egumbini lezimo eziphuthumayo noma ushayele inombolo yendawo ephuthumayo (efana ne-911), uma unezimpawu zombungu we-pulmonary.

Abanciphisa igazi bangabekwa ukusiza ukuvimbela i-DVT kubantu abasengozini enkulu, noma labo abahlinzwa kakhulu.

Ukube ubune-DVT, umhlinzeki wakho uzonquma amasokisi amasheya. Gqoka njengokuyalelwa. Zizothuthukisa ukugeleza kwegazi emilenzeni yakho futhi zinciphise ubungozi bamahlule egazi.

Ukuhambisa imilenze yakho kaningi phakathi nohambo olude lwendiza, ukuhamba ngezimoto, nezinye izimo lapho uhleli khona noma ulele phansi isikhathi eside nakho kungasiza ekuvimbeleni i-DVT. Abantu abasengozini enkulu kakhulu yamahlule egazi bangadinga isibhamu segazi elibizwa nge-heparin lapho bethatha indiza ehlala isikhathi eside kunamahora ama-4.

Ungabhemi. Uma ubhema, yeka. Abesifazane abathatha i-estrogen kumele bayeke ukubhema. Ukubhema kwandisa ingozi yokuba namahlule egazi.

I-venous thromboembolism; Isilonda segazi semiphunga; Ihlwili legazi - amaphaphu; Embolus; Isimila embolus; Embolism - yamaphaphu; I-DVT - embolism yamaphaphu; Thrombosis - embolism yamaphaphu; I-thromboembolism yamaphaphu; PE

• I-vein thrombosis ejulile - ukukhipha
• Ukuthatha i-warfarin (Coumadin, Jantoven) - okufanele ubuze udokotela wakho
• Ukuthatha i-warfarin (Coumadin)

• Amaphaphu
• Uhlelo lokuphefumula
• Umbungu wamaphaphu

IGoldhaber SZ. I-embolism yamaphaphu. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Izifo Zenhliziyo zeBraunwald: Incwadi Yemithi Yezinhliziyo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 84.

UKline JA. I-embolism ye-pulmonary kanye ne-vein thrombosis ejulile. Ku: Walls RM, Hockberger RS, Gausche-Hill M, ama-eds. Imithi Ephuthumayo yaseRosen: Imiqondo kanye Nokuzijwayeza Komtholampilo. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 78.

UMorris TA, uFedullo PF. I-pulmonary thromboembolism. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, abakwa-eds. Incwadi kaMurray neNadel Yemithi Yokuphefumula. Umhlaka 6. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 57.