Ukulungiswa kwe-aortic aneurysm esiswini - vula

Ukulungiswa kwesisu kwe-aortic aneurysm (AAA) kungukuhlinzwa ukulungisa ingxenye enwetshiwe ku-aorta yakho. Lokhu kubizwa nge-aneurysm. I-aorta ingumthambo omkhulu ohambisa igazi ulibhekise esiswini sakho (esiswini), okhalweni nasemilenzeni.

I-aortic aneurysm yilapho ingxenye yalo mthambo iba nkulu kakhulu noma ibhaluni ngaphandle.

Ukuhlinzwa kuzokwenzeka egumbini lokuhlinzwa. Uzonikezwa i-anesthesia ejwayelekile (uzobe ulele futhi ungenazinhlungu).

Udokotela wakho ohlinzayo uvula isisu sakho bese efaka i-aortic aneurysm ngento eyenziwe ngabantu, efana nendwangu.

Nakhu ukuthi kungenziwa kanjani:

• Ngendlela eyodwa, uzolala ngomhlane. Udokotela ohlinzayo uzosika maphakathi nesisu sakho, kusuka ngezansi nje kwethambo lesifuba kuya ngezansi kwenkinobho yesisu. Imvamisa, ukusika kudlula esiswini.
• Kwenye indlela, uzolala utshekise kancane ohlangothini lwakho lokunene. Udokotela ohlinzayo uzokwenza ukusika okungu-5- to 6-intshi (13 kuye ku-15 centimeters) ukusuka ohlangothini lwesobunxele esiswini sakho, kuphele kancane ngaphansi kwenkinobho yesisu sakho.
• Udokotela wakho ohlinzayo uzothatha indawo ye-aneurysm ngeshubhu ende eyenziwe ngendwangu eyenziwe ngezinto ezenziwe ngabantu. Ithungwe ngemithungo.
• Kwezinye izimo, imikhawulo yale tube (noma i-graft) izohanjiswa ngemithambo yegazi emgodini ngamunye bese inamathiselwa kulabo abasemlenzeni.
• Lapho ukuhlinzwa sekwenziwe, kuzohlolwa imilenze yakho ukuze kuqinisekiswe ukuthi kukhona ukushaya kwenhliziyo. Imvamisa ukuhlolwa kwedayi kusetshenziswa ama-x-ray kwenziwa ukuqinisekisa ukuthi kukhona ukuhamba kwegazi okuhle emilenzeni.
• Ukusikwa kuvaliwe ngama-sutures noma okuyisisekelo.

Ukuhlinzwa kokushintshwa kwe-aortic aneurysm kungathatha amahora amabili kuya kwangu-4. Iningi labantu liyalulama egumbini labagula kakhulu (i-ICU) ngemuva kokuhlinzwa.

Ukuhlinzwa okuvulekile ukulungisa i-AAA kwesinye isikhathi kwenziwa njengenqubo ephuthumayo lapho kuphuma ukopha ngaphakathi emzimbeni wakho kusuka ku-aneurysm.

Ungaba ne-AAA engabangeli zimpawu noma izinkinga. Umhlinzeki wakho wezokunakekelwa kwempilo kungenzeka ukuthi uyitholile inkinga ngemuva kokuthi wenze i-ultrasound noma i-CT scan eyenziwe ngesinye isizathu. Kunobungozi bokuthi le aneurysm ingahle ivele ivuleke ngokungazelele uma ungahlinzekwanga ukuyilungisa. Kodwa-ke, ukuhlinzwa ukulungisa i-aneurysm nakho kungaba yingozi, kuya ngempilo yakho yonke.

Wena nomhlinzeki wakho kufanele ninqume ukuthi ngabe ingozi yokwenza lokhu kuhlinzwa incane yini kunengozi yokuqhekeka. Ukuhlinzwa kungenzeka kuphakanyiswe uma i-aneurysm ingu:

• Okukhulu (cishe ngamasentimitha amabili noma ama-5 cm)
• Ukukhula ngokushesha okukhulu (ngaphansi kuka-1/4 intshi ngaphezulu kwezinyanga eziyi-6 kuya kwezingu-12 ezedlule)

Izingozi zalokhu kuhlinzwa ziphakeme uma une:

• Isifo senhliziyo
• Ukuhluleka kwezinso
• Isifo samaphaphu
• Unhlangothi odlule
• Ezinye izinkinga ezinkulu zezokwelapha

Izinkinga nazo ziphakeme kubantu abadala.

Izingozi zanoma yikuphi ukuhlinzwa yilezi:

• Amahlule egazi emilenzeni angahamba aye emaphashini
• Izinkinga zokuphefumula
• Isifo senhliziyo noma isifo sohlangothi
• Ukutheleleka, kufaka phakathi amaphaphu (i-pneumonia), umgudu wokuchama, nesisu
• Ukusabela emithini

Izingozi zalokhu kuhlinzwa yilezi:

• Ukopha ngaphambi noma ngemuva kokuhlinzwa
• Ukulimala kwesibindi, okubangela ubuhlungu noma ukuphazamiseka emlenzeni
• Ukulimala kwamathumbu akho noma ezinye izitho eziseduze
• Ukulahleka kokutholakala kwegazi engxenyeni yamathumbu amakhulu okubangela ukubambezeleka kokopha esitokisini
• Ukutheleleka ngokuxhunyelelwa
• Ukulimala kwe-ureter, ishubhu elithwala umchamo kusuka ezinso zakho uye esinyeni sakho
• Ukwehluleka kwezinso okungase kube unomphela
• Idrayivu yocansi ephansi noma ukungakwazi ukuthola ulwakhiwo
• Ukunikezwa kwegazi okungafanele emilenzeni yakho, izinso zakho, noma ezinye izitho
• Ukulimala komgogodla
• Kuvuleka amanxeba
• Ukutheleleka kwamanxeba

Uzohlolwa ngokomzimba bese uthola izivivinyo ngaphambi kokuhlinzwa.

Hlala utshela umhlinzeki wakho ukuthi yimiphi imithi oyisebenzisayo, ngisho nezidakamizwa, izithasiselo, noma amakhambi owathengile ngaphandle kwemithi kadokotela.

Uma ubhema, kufanele uyeke ukubhema okungenani amasonto ama-4 ngaphambi kokuhlinzwa kwakho. Umhlinzeki wakho angasiza.

Phakathi namasonto ama-2 ngaphambi kokuhlinzwa kwakho:

Uzoba nokuvakashelwa nomhlinzeki wakho ukuqinisekisa ukuthi izinkinga zezokwelapha ezifana nesifo sikashukela, umfutho wegazi ophakeme, nezinkinga zenhliziyo noma zamaphaphu zelashwa kahle.

• Ungacelwa ukuthi uyeke ukuthatha izidakamizwa ezenza kube nzima ngegazi lakho ukuminyana. Lokhu kufaka phakathi i-aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), naprosyn (Aleve, Naproxen), nezinye izidakamizwa ezifana nalezi.
• Buza ukuthi imiphi imishanguzo okufanele usayiphuza ngosuku lokuhlinzwa kwakho.
• Njalo utshele umhlinzeki wakho uma unomkhuhlane, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, noma okunye ukugula ngaphambi kokuhlinzwa kwakho.

UNGAPHUZI noma yini ngemuva kwamabili ngosuku olungaphambi kokuhlinzwa kwakho, kubandakanya namanzi.

Ngosuku lokuhlinzwa kwakho:

• Thatha izidakamizwa otshelwe ukuthi uziphuze ngophuzo oluncane lwamanzi.
• Uzotshelwa ukuthi ufika nini esibhedlela.

Iningi labantu lihlala esibhedlela izinsuku ezinhlanu kuya kweziyishumi. Ngesikhathi sokuhlala esibhedlela, uzo:

• Yiba egumbini labagula kakhulu (i-ICU), lapho uzobhekwa khona eduze kakhulu ngemuva kokuhlinzwa. Ungadinga umshini wokuphefumula phakathi nosuku lokuqala.
• Yiba nepayipi lomchamo.
• Yiba neshubhu elingena ngamakhala akho lingene esiswini sakho ukusiza ukukhipha uketshezi usuku olulodwa noma olungu-2. Uzoqala kancane ukuphuza, bese udla.
• Thola umuthi wokugcina igazi lakho lizacile.
• Khuthazeka ukuthi uhlale eceleni kombhede bese uhamba.
• Gqoka amasokisi akhethekile ukuvikela amahlule egazini emilenzeni yakho.
• Celwa ukuthi usebenzise umshini wokuphefumula ukusiza ukusula amaphaphu akho.
• Thola umuthi wezinhlungu emithanjeni yakho noma esikhaleni esizungeze umgogodla wakho (i-epidural).

Ukululama ngokugcwele kokuhlinzwa okuvulekile ukulungisa i-aortic aneurysm kungathatha izinyanga ezimbili noma ezintathu. Iningi labantu lilulama ngokugcwele kulokhu kuhlinzwa.

Abantu abaningi abane-aneurysm elungisiwe ngaphambi kokuba ivuleke (banemibhobho) banombono omuhle.

I-AAA - ivulekile; Ukulungisa - i-aortic aneurysm - evulekile

• Ukulungiswa kwe-aortic aneurysm esiswini - ukuvula - ukukhipha
• Ukuvuka embhedeni ngemuva kokuhlinzwa

ILancaster RT, iCambria RP. Vula ukulungiswa kwama-aortic aneurysms esiswini. Ku: UCameron JL, uCameron AM, ama-eds. Ukwelashwa Kwamanje. Umhla ka-12. IPhiladelphia, PA: Elsevier; 2017: 899-907.

UTracci MC, uCherry KJ. I-aorta. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; I-2017: isahluko 61.

I-Woo EY, iDamrauer SM. Ama-aneurysms esisu esiswini: ukwelashwa okuvulekile okuhlinzekwayo. Ku: Sidawy AN, Perler BA, ama-eds. Rutherford’s Vascular Surgery and Endovascular Therapy. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2019: isahluko 71.