I-Thromboangiitis obliterans

I-Thromboangiitis obliterans yisifo esingajwayelekile lapho imithambo yegazi yezandla nezinyawo ivinjelwa khona.

I-Thromboangiitis obliterans (Isifo i-Buerger) ibangelwa yimithambo yegazi emincane evuvukala ivuvuke. Imithambo yegazi bese iyancipha noma ivinjwe amahlule egazi (thrombosis). Imithambo yegazi yezandla nezinyawo ithinteka kakhulu. Imithambo yegazi iyathinteka kakhulu kunemithambo. Isilinganiso seminyaka yobudala lapho kuqala izimpawu cishe singama-35. Abesifazane nabantu abadala bayathinteka kaningi.

Lesi simo sithinta kakhulu izinsizwa ezineminyaka engama-20 kuya kwengama-45 ezibhemayo kakhulu noma ezihlafuna ugwayi. Abesifazane ababhemayo nabo bangathinteka. Lesi simo sithinta abantu abaningi eMiddle East, e-Asia, eMedithera naseMpumalanga Yurophu. Abantu abaningi abanale nkinga banempilo engeyinhle yamazinyo, ngokunokwenzeka ngenxa yokusebenzisa ugwayi.

Izimpawu zivame ukuthinta izitho ezi-2 noma ngaphezulu futhi zingafaka:

• Iminwe noma izinzwane ezibonakala ziphaphathekile, zibomvu, noma ziluhlaza okwesibhakabhaka futhi zizizwa zibandayo kulokho okuthintwayo.
• Ubuhlungu obukhulu ngokungazelelwe ezandleni nasezinyaweni. Ubuhlungu bungazizwa njengokushisa noma ukuhayiza.
• Ubuhlungu ezandleni nasezinyaweni ezivame ukwenzeka lapho uphumule. Ubuhlungu bungaba bukhulu lapho izandla nezinyawo kubanda noma ngesikhathi sokucindezeleka ngokomzwelo.
• Ubuhlungu emilenzeni, emaqakaleni, noma ezinyaweni lapho uhamba (ukuhlukaniswa okuphakathi). Ubuhlungu buvame ukutholakala enyaweni yonyawo.
• Izinguquko zesikhumba noma izilonda ezincane ezibuhlungu eminweni noma ezinzwaneni.
• Kwesinye isikhathi, isifo samathambo esihlakaleni noma emadolweni siyakhula ngaphambi kokuba imithambo yegazi ivinjwe.

Ukuhlolwa okulandelayo kungakhombisa ukuvinjelwa kwemithambo yegazi ezandleni noma ezinyaweni ezithintekile:

• I-Ultrasound yemithambo yegazi ekugcineni, ebizwa nge-plethysmography
• I-Doppler ultrasound yomkhawulo
• I-arteriogram esekwe ku-catheter

Ukuhlolwa kwegazi kwezinye izimbangela zemithambo yegazi evuvukile (i-vasculitis) nokuvimba (ukuvalwa) kwemithambo yegazi kungenziwa. Lezi zimbangela zibandakanya isifo sikashukela, i-scleroderma, i-vasculitis, i-hypercoagulability, ne-atherosclerosis. Akukho ukuhlolwa kwegazi okuxilonga i-thromboangiitis obliterans.

I-echocardiogram yenhliziyo ingenziwa ukubheka imithombo yamahlule egazi. Ezimweni ezingavamile lapho ukuxilongwa kungacaci, kwenziwa i-biopsy yegazi.

Alikho ikhambi le-thromboangiitis obliterans. Inhloso yokwelashwa ukulawula izimpawu nokuvikela ukuthi lesi sifo singabi sibi kakhulu.

Ukuyeka ukusetshenziswa kogwayi kwanoma yiluphi uhlobo kuyisihluthulelo sokulawula lesi sifo. Izindlela zokubhema ukubhema zinconywa ngokuqinile. Kubalulekile futhi ukugwema ukushisa okubandayo nezinye izimo ezinciphisa ukugeleza kwegazi ezandleni nasezinyaweni.

Ukufaka imfudumalo nokwenza izivivinyo ezimnene kungasiza ekwandiseni ukusakazwa kwegazi.

I-aspirin nemithi evula imithambo yegazi (ama-vasodilators) kungasiza. Ezimweni ezimbi kakhulu, ukuhlinzwa ukusika izinzwa endaweni (i-upasuaji sympathectomy) kungasiza ekulawuleni ubuhlungu. Kuyaqabukela, ukuhlinzwa kokudlula kubhekwe kubantu abathile.

Kungadingeka ukuthi unqunywe iminwe noma izinzwane uma indawo itheleleka kakhulu futhi izicubu zifa.

Izimpawu ze-thromboangiitis obliterans zingaphela uma umuntu eyeka ukusebenzisa ugwayi. Abantu abaqhubeka nokusebenzisa ugwayi bangadinga ukunqunywa kaninginingi.

Izinkinga zifaka:

• Ukufa kwezicubu (ukubola)
• Ukunqunywa kweminwe noma izinzwane
• Ukulahleka kokugeleza kwegazi emlenzeni weminwe noma izinzwane ezithintekile

Shayela umhlinzeki wakho wezempilo uma:

• Unezimpawu ze-thromboangiitis obliterans.
• Une-thromboangiitis obliterans futhi izimpawu ziba zimbi kakhulu, noma ngabe ukwelashwa.
• Uba nezimpawu ezintsha.

Abantu abanomlando wesimo sikaRaynaud noma oluhlaza okwesibhakabhaka, iminwe ebuhlungu noma izinzwane, ikakhulukazi ezinezilonda, akufanele basebenzise noma yiluphi uhlobo lukagwayi.

Isifo se-Buerger

• AmaTriterangiangiites obliterans
• Uhlelo lokujikeleza kwegazi

I-Akar AR, Inan B. Thromboangiitis obliterans (Isifo se-Buerger). Ku: Sidawy AN, Perler BA, ama-eds. Rutherford’s Vascular Surgery and Endovascular Therapy. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2019: isahluko 138.

UGupta N, uWahlgren CM, u-Azizzadeh A, uGewertz BL. Isifo sikaBugerger (iTromboangiitis obliterans). Ku: UCameron JL, uCameron AM, ama-eds. Ukwelashwa Kwamanje. Umhlaka 13. IPhiladelphia, PA: Elsevier; 2020: 1054-1057.

UJaff MR, uBartheolomew JR. Ezinye izifo ezisemaphethelweni zemithambo yegazi. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 72.