Ukudlula emthanjeni wokudlula - umlenze

Ukudlula komthambo wokuzungeza kungukuhlinzekwa kokuphindisela ukunikezwa kwegazi ezungeze umthambo ovinjiwe komunye wemilenze yakho. Ama-fatty deposits angakha ngaphakathi kwemithambo futhi ayivimbe.

Kuxhunyelelwa kusetshenziselwa ukufaka noma ukweqa ingxenye evinjiwe yomthambo. Ukuxhunyelelwa kungaba yishubhu lepulasitiki, noma kungaba ngumthambo wegazi (umthambo) othathwe emzimbeni wakho (imvamisa umlenze ophambene) ngesikhathi sokuhlinzwa okufanayo.

Ukuhlinzwa komthambo wokujikeleza okwedlula lapho kungenziwa komunye noma ngaphezulu kwemithambo yegazi elandelayo:

• I-aorta (umthambo oyinhloko oqhamuka enhliziyweni yakho)
• Umthambo okhalweni lwakho
• Umthambo ethangeni lakho
• Umthambo ngemuva kwedolo lakho
• Umthambo emlenzeni wakho ongezansi
• Umthambo ekhwapheni lakho

Ngesikhathi sokuhlinzwa okudlula noma yimuphi umthambo:

• Uzothola umuthi (i-anesthesia) ukuze ungabuzwa ubuhlungu. Uhlobo lwe-anesthesia olutholayo luzoncika kulokho okwelashwa ngomthambo.
• Udokotela wakho ohlinzayo uzosika ingxenye yomthambo ovinjiwe.
• Ngemuva kokuhambisa isikhumba nezicubu endleleni, udokotela ohlinzayo uzobeka izibopho ekugcineni ngakunye kwengxenye yomthambo evinjiwe. Ukuxhunyelelwa kuthungelwe endaweni.
• Udokotela ohlinzayo uzoqinisekisa ukuthi unegazi elihle ekugcineni kwakho. Ngemuva kwalokho ukusika kwakho kuzovalwa. Ungaba ne-x-ray ebizwa nge-arteriogram ukwenza isiqiniseko sokuthi ukuxhumeka kuyasebenza.

Uma uhlinzwa ngokudlula ukwelapha umthambo we-aorta ne-iliac noma i-aorta yakho nayo yomibili imithambo yabesifazane (aortobifemoral):

• Cishe uzoba ne-anesthesia ejwayelekile. Lokhu kuzokwenza uquleke futhi ungakwazi ukuzwa ubuhlungu. Noma, ungahle ube ne-epidural noma i-spinal anesthesia esikhundleni salokho. Udokotela uzokujova umgogodla wakho ngomuthi ukuze ube ndikindiki kusuka okhalweni lwakho kuye phansi.
• Udokotela wakho ohlinzayo uzosika phakathi nesisu ukuze afinyelele emithanjeni ye-aorta ne-iliac.

Uma uhlinzwa ngokudlula ukwelapha umlenze wakho ongezansi (i-femal popliteal):

• Ungaba ne-anesthesia ejwayelekile. Uzoquleka futhi ungakwazi ukuzwa ubuhlungu. Kungenzeka ube ne-anesthesia ye-epidural noma yomgogodla. Udokotela uzokujova umgogodla wakho ngomuthi ukuze ube ndikindiki kusuka okhalweni lwakho kuye phansi. Abanye abantu bane-anesthesia yendawo kanye nomuthi wokubakhulula. I-anesthesia yendawo iyindikindiki nje indawo okusetshenzelwa kuyo.
• Udokotela wakho ohlinzayo uzosika umlenze wakho phakathi kokugaya kwakho nedolo. Kuzoba eduze nokuvinjelwa emthanjeni wakho.

Izimpawu zomthambo womngcele ovinjiwe ubuhlungu, ubuhlungu, noma isisindo emlenzeni wakho esiqala noma sibe sibi kakhulu uma uhamba.

Ungahle ungadingi ukuhlinzwa ngokudlula uma lezi zinkinga zenzeka kuphela uma uhamba bese ziyahamba lapho uphumula. Ungahle ungadingi lokhu kuhlinzwa uma usengakwazi ukwenza imisebenzi yakho yansuku zonke. Udokotela wakho angazama imithi nezinye izindlela zokwelashwa kuqala.

Izizathu zokuhlinzwa okudlula emlenzeni yilezi:

• Unezimpawu ezikugcina ekwenzeni imisebenzi yakho yansuku zonke.
• Izimpawu zakho azibangcono ngeminye imishanguzo.
• Unezilonda zesikhumba (izilonda) noma amanxeba emlenzeni wakho angapholi.
• Unesifo noma isibazi emlenzeni wakho.
• Unobuhlungu emlenzeni wakho kusuka emithanjeni yakho emincane, noma ngabe uphumule noma ebusuku.

Ngaphambi kokuhlinzwa, udokotela wakho uzokwenza izivivinyo ezikhethekile ukubona ubukhulu bokuvinjelwa.

Izingozi zanoma iyiphi i-anesthesia nokuhlinzwa yilezi:

• Ukungezwani komzimba nemithi
• Izinkinga zokuphefumula
• Amahlule egazi emilenzeni angahamba aye emaphashini
• Izinkinga zokuphefumula
• Isifo senhliziyo noma isifo sohlangothi

Izingozi zalokhu kuhlinzwa yilezi:

• I-Bypass ayisebenzi
• Ukulimala kwenzwa ebangela ubuhlungu noma ukuphazamiseka emlenzeni wakho
• Ukulimala kwezitho zomzimba eziseduze
• Ukulimala kwamathumbu ngesikhathi sokuhlinzwa kwe-aortic
• Ukopha ngokweqile
• Ukutheleleka ekusikeni kokuhlinzwa
• Ukulimala kwezinzwa eziseduze
• Izinkinga zocansi ezibangelwa ukulimala kwenzwa ngesikhathi sokuhlinzwa kwe-aortofemoral noma i-aortoiliac bypass
• Ukusika kokuhlinzwa okuvula
• Isidingo sokuhlinzwa okwesibili kokudlula noma ukunqunywa umlenze
• Isifo senhliziyo
• Ukufa

Uzoba nokuhlolwa ngokomzimba nokuhlolwa okuningi kwezokwelapha.

• Iningi labantu lidinga ukuhlolwa izinhliziyo namaphaphu ngaphambi kokuba kudlule umthambo wokuzungeza.
• Uma unesifo sikashukela, uzodinga ukubona umhlinzeki wakho wezempilo ukuze asihlole.

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

Phakathi namasonto ama-2 ngaphambi kokuhlinzwa kwakho:

• 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 ezifanayo.
• Buza umhlinzeki wakho ukuthi yiziphi izidakamizwa okufanele usaziphuza ngosuku lokuhlinzwa kwakho.
• Uma ubhema, udinga ukuyeka. Cela usizo kumhlinzeki wakho.
• Ngaso sonke isikhathi vumela umhlinzeki wakho azi nganoma yikuphi ukubanda, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, noma okunye ukugula ongaba nakho ngaphambi kokuhlinzwa kwakho.

UNGAPHUZI lutho ngemuva kwamabili ebusuku ngaphambi kokuhlinzwa kwakho, kufaka phakathi amanzi.

Ngosuku lokuhlinzwa kwakho:

• Thatha imithi umhlinzeki wakho akutshele ukuthi uyiphuze ngesiphuzo esincane samanzi.
• Umhlinzeki wakho uzokutshela ukuthi ufika nini esibhedlela.

Ngemuva nje kokuhlinzwa, uzoya egumbini lokutakula, lapho abahlengikazi bezokubuka khona eduze. Ngemuva kwalokho uzoya egumbini labagula kakhulu (i-ICU) noma egumbini lesibhedlela elijwayelekile.

• Ungadinga ukuchitha usuku olungu-1 noma 2 embhedeni uma ukuhlinzwa kubandakanya umthambo omkhulu esiswini sakho obizwa nge-aorta.
• Iningi labantu lihlala esibhedlela izinsuku ezi-4 kuya kwezi-7.
• Ngemuva kokudlula kwe-femur popliteal, uzochitha isikhathi esincane noma ungasichithi isikhathi e-ICU.

Lapho umhlinzeki wakho ethi kulungile, uzovunyelwa ukuphuma embhedeni. Uzokwengeza kancane ukuthi ungahamba ibanga elingakanani. Uma uhleli esihlalweni, gcina imilenze yakho iphakanyiswe esitulweni noma kwesinye isihlalo.

Ukushaya kwenhliziyo yakho kuzohlolwa njalo ngemuva kokuhlinzwa kwakho. Amandla we-pulse yakho azobonisa ukuthi i-graft yakho entsha isebenza kanjani. Ngenkathi usesibhedlela, tshela umhlinzeki wakho zisuka nje uma umlenze ohlinzwayo uzizwa upholile, ubukeka uphaphathekile noma ubomvana, uzizwa undikindiki, noma uma unezinye izimpawu ezintsha.

Uzothola umuthi wezinhlungu uma uwudinga.

Ukuhlinzwa nge-Bypass kuthuthukisa ukugeleza kwegazi emithanjeni yabantu abaningi. Kungenzeka ungabe usaba nezimpawu, noma uhamba. Uma usenezimpawu, kufanele ukwazi ukuhamba kude kakhulu ngaphambi kokuba ziqale.

Uma unama-blockages emithanjeni eminingi, izimpawu zakho kungenzeka zingathuthuki kangako. Isibikezelo singcono uma ezinye izimo zezokwelapha ezifana nesifo sikashukela zilawulwa kahle. Uma ubhema, kubaluleke kakhulu ukuyeka.

Ukudlula kwe-aortobifemoral; I-femoropopliteal; Ubuningi besifazane; Ukudlula kwe-aorta-bifemoral; Ukudlula kwe-Axillo-bifemoral; Ukudlula kwe-Ilio-bifemoral; Ukudlula kwabesifazane nabesifazane; Ukudlula komlenze okude

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• Ukudlula emthanjeni wokudlula - umlenze - ukukhishwa

ILungu lePhalamende laseBonaca, uCreager MA. Izifo zemithambo eseceleni. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 64.

IKinlay S, iBhatt DL. Ukwelashwa kwesifo semithambo esingavaleki kahle. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 66.

I-Society for Vascular Surgery I-Lower Extremity Guidelines Guidelines Group YokuBhala; IConte MS, iPomposelli FB, et al. I-Society for Vascular Surgery practice imihlahlandlela yesifo se-atherosclerotic esivela emaphethelweni aphansi: ukuphathwa kwesifo se-asymptomatic kanye ne-claudication. J Vasc Ukuhlinzwa. 2015; 61 (3 Suppl): 2S-41S. I-PMID: 25638515 www.ncbi.nlm.nih.gov/pubmed/25638515.

Amalungu eKomidi Lokubhala, uGerhard-Herman MD, uGornik HL, et al. Umhlahlandlela we-2016 AHA / ACC ekuphathweni kweziguli ezinesifo semithambo yegazi lomkhawulo ongaphansi: isifinyezo esiphezulu. IVasc Med. 2017; 22 (3): NP1-NP43. PMID: 28494710 www.ncbi.nlm.nih.gov/pubmed/28494710.