I-vein thrombosis ejulile

I-vein thrombosis ejulile (i-DVT) yisimo esenzeka lapho amahlule egazi akha emthanjeni ojulile ngaphakathi kwengxenye yomzimba. Kakhulu kuthinta imithambo emikhulu emlenzeni nasethangeni elingezansi, kepha kungenzeka nakweminye imithambo ejulile, efana neyezingalo nokhalo.

I-DVT ivame kakhulu kubantu abadala abangaphezu kweminyaka yobudala engama-60. Kodwa kungenzeka nganoma yisiphi isikhathi. Lapho iqabunga liphuka futhi lihamba ngokuhamba kwegazi, kubizwa ngokuthi yi-embolism. I-embolism ingabambeka emithanjeni yegazi ebuchosheni, emaphashini, enhliziyweni, noma kwenye indawo, okuholele ekulimaleni okukhulu.

Amahlule egazi angakha lapho okuthile kuhamba kancane noma kushintsha ukugeleza kwegazi emithanjeni. Izici zobungozi zifaka:

• I-catheter ye-pacemaker edluliswe emthanjeni ku-groin
• Ukuphumula kombhede noma ukuhlala endaweni eyodwa isikhathi eside, njengokuhamba ngendiza
• Umlando womndeni wamahlule egazi
• Ukuphuka okhalweni noma emilenzeni
• Ukubeletha ezinyangeni eziyisithupha ezidlule
• Ukukhulelwa
• Ukukhuluphala ngokweqile
• Ukuhlinzwa kwakamuva (okuvamise ukuhlinzwa okhalweni, emadolweni, noma okhalweni lwabesifazane)
• Kunamaseli amaningi egazi enziwa ngomnkantsha, okwenza igazi libe mkhulu kunokujwayelekile (i-polycythemia vera)
• Ukuba ne-catheter yokuhlala (isikhathi eside) esitsheni segazi

Igazi kungenzeka livimbe umuntu onezinkinga noma ukuphazamiseka okuthile, okufana nalokhu:

• Umdlavuza
• Izinkinga ezithile ze-autoimmune, njenge-lupus
• Ukubhema ugwayi
• Izimo ezenza kube lula kakhulu ukuthuthukisa amahlule egazi
• Ukuphuza ama-estrogens noma amaphilisi okulawula ukubeletha (le ngozi iphakeme kakhulu ngokubhema)

Ukuhlala isikhathi eside lapho uhamba kungakhuphula ubungozi be-DVT. Lokhu kungenzeka kakhulu uma unesici esisodwa noma eziningi zobungozi ezibalwe ngenhla.

I-DVT ithinta kakhulu imithambo emikhulu emlenzeni nasethangeni elingezansi, imvamisa ohlangothini olulodwa lomzimba. Ihlwili lingavimba ukuhamba kwegazi futhi lidale:

• Izinguquko kumbala wesikhumba (ubomvu)
• Ubuhlungu bomlenze
• Ukuvuvukala komlenze (i-edema)
• Isikhumba esizizwa sifudumele uma usithinta

Umhlinzeki wakho wokunakekelwa kwezempilo uzokwenza ukuhlolwa komzimba. Ukuhlolwa kungakhombisa umlenze obomvu, ovuvukile, noma wethenda.

Izivivinyo ezimbili ezivame ukwenziwa kuqala ukuthola i-DVT yilezi:

• Ukuhlolwa kwegazi kwe-D-dimer
• Ukuhlolwa kwe-Doppler ultrasound kwendawo yokukhathazeka

I-MRI ye-pelvic ingenziwa uma i-clot yegazi isesinqeni, njengangemva kokukhulelwa.

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

• Kuvulwa ukumelana kwamaprotheni C (kuhlola ushintsho lweFactor V Leiden)
• Amazinga e-Antithrombin III
• Amasosha omzimba we-Antiphospholipid
• Qedela ukubalwa kwegazi (CBC)
• Ukuhlolwa kofuzo ukubheka ukuguquka kwezakhi ezikwenza ube sethubeni lokuthuthukisa amahlule egazi, njenge-prothrombin G20210A mutation
• I-Lupus anticoagulant
• Amaprotheni C namazinga wamaprotheni S

Umhlinzeki wakho uzokunika umuthi wokwehlisa igazi lakho (elibizwa ngokuthi i-anticoagulant). Lokhu kuzogcina amahlule amaningi angakhi noma amadala ekukhuleni.

IHeparin imvamisa umuthi wokuqala ozowuthola.

• Uma i-heparin inikezwa ngomthambo (IV), kufanele uhlale esibhedlela. Kodwa-ke, iningi labantu lingelashwa ngaphandle kokuhlala esibhedlela.
• I-heparin yesisindo esiphansi inganikezwa ngomjovo ngaphansi kwesikhumba sakho kanye noma kabili ngosuku. Ungahle ungadingi ukuhlala esibhedlela isikhathi eside, noma nhlobo, uma unqunyelwe lolu hlobo lwe-heparin.

Uhlobo olulodwa lomuthi wokunciphisa igazi obizwa nge-warfarin (i-Coumadin noma i-Jantoven) ungaqalwa kanye ne-heparin. IWarfarin ithathwa ngomlomo. Kuthatha izinsuku ezimbalwa ukusebenza ngokugcwele.

Esinye isigaba sabanciphisi begazi sisebenza ngokuhlukile kune-warfarin. Izibonelo zalesi sigaba semithi, okuthiwa i-anticoagulants yomlomo eqondile (i-DOAC), ifaka i-rivaroxaban powder (i-Xarelto), i-apixaban (i-Eliquis), i-dabigatran (i-Pradax), ne-edoxaban (i-Savaysa). Le mithi isebenza ngendlela efanayo ne-heparin futhi ingasetshenziswa khona manjalo esikhundleni se-heparin. Umhlinzeki wakho uzonquma ukuthi imuphi umuthi ofanele wena.

Ngokuqinisekile uzothatha i-thinner yegazi okungenani izinyanga ezintathu. Abanye abantu bayithatha isikhathi eside, noma impilo yabo yonke, kuya ngengcuphe yokuthola elinye ihlwili.

Uma uthatha umuthi wokuncipha kwegazi, kungenzeka uphume, ngisho nasemisebenzini obuhlala uyenza. Uma uthatha i-thinner yegazi ekhaya:

• Thatha umuthi ngendlela umhlinzeki wakho akubeke ngayo.
• Buza umhlinzeki ukuthi enzeni uma uphuthelwa umthamo.
• Thola ukuhlolwa kwegazi njengoba welulekwe ngumhlinzeki wakho ukuqinisekisa ukuthi uthatha umthamo ofanele. Lezi zivivinyo zivame ukudingeka nge-warfarin.
• Funda ukuthi ungayisebenzisa kanjani eminye imithi nokuthi ungadla nini.
• Thola ukuthi ungazibheka kanjani izinkinga ezidalwa umuthi.

Ezimweni ezingavamile, ungadinga ukuhlinzwa esikhundleni noma ngaphezu kwama-anticoagulants. Ukuhlinzwa kungabandakanya:

• Ukubeka isihlungi emthanjeni omkhulu womzimba ukuvimbela amahlule egazi ekuhambeni ukuya emaphashini
• Ukususa ihlwili elikhulu legazi emthanjeni noma ukujova umuthi wokuqinisa amahlwili

Landela noma imiphi eminye imiyalo oyinikwa ukwelapha i-DVT yakho.

I-DVT ivame ukuhamba ngaphandle kwenkinga, kepha isimo singabuya. Izimpawu zingavela khona manjalo noma ungahle ungazikhulisi unyaka owodwa noma ngaphezulu ngemuva kwalokho. Ukugqoka amasheya wokucindezelwa ngesikhathi nangemva kwe-DVT kungasiza ukuvimbela le nkinga.

Izinkinga ze-DVT zingafaka:

• I-pulmonary embolism ebulalayo (amahlule egazi ethangeni kungenzeka ukuthi aqhekeke futhi ahambe aye emaphashini kunamahlule egazi emlenzeni ongezansi noma kwezinye izingxenye zomzimba)
• Ubuhlungu obuqhubekayo nokuvuvukala (i-post-phlebitic noma i-post-thrombotic syndrome)
• Imithambo ye-Varicose
• Izilonda ezingapholi (ezingavamile kakhulu)
• Izinguquko kumbala wesikhumba

Shayela umhlinzeki wakho uma unezimpawu ze-DVT.

Iya egumbini lezimo eziphuthumayo noma ushayele inombolo yendawo ephuthumayo (njenge-911) uma une-DVT futhi uthuthuka:

• Ubuhlungu besifuba
• Akhwehlele igazi
• Kunzima ukuphefumula
• Ukuquleka
• Ukulahlekelwa ukwazi
• Ezinye izimpawu ezinzima

Ukuvimbela i-DVT:

• Hambisa imilenze yakho kaningi phakathi nohambo olude lwendiza, uhambo lwemoto, nezinye izimo lapho uhleli khona noma ulele phansi isikhathi eside.
• Thatha imishanguzo yokuncipha igazi umhlinzeki ayinikezile.
• UNGABHALI. Khuluma nomhlinzeki wakho uma udinga usizo lokuyeka.

I-DVT; Ukujiya kwegazi emilenzeni; I-thromboembolism; Isifo se-post-phlebitic; Isifo se-post-thrombotic; I-Venous - DVT

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

• I-thrombosis ejulile ye-venous - iliofemoral
• Imithambo ejulile
• Igazi le-venous
• Imithambo ejulile
• I-venous thrombosis - uchungechunge

UKearon C, Akl EA, Ornelas J, et al. Ukwelashwa kwe-Antithrombotic yesifo se-VTE: Isiqondiso se-CHEST kanye nombiko wepaneli yochwepheshe. Isifuba. 2016; 149 (2): 315-352. I-PMID: 26867832 pubmed.ncbi.nlm.nih.gov/26867832/.

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ILockhart ME, Umphrey HR, Weber TM, Robbin ML. Imikhumbi eseceleni. Ku: Rumack CM, Levine D, eds. Ukuxilongwa kwe-Ultrasound. Umhlaka 5. IPhiladelphia, PA: Elsevier; 2018: isahluko 27.

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