Isifo semithambo yeCarotid

Isifo semithambo seCarotid senzeka lapho imithambo ye-carotid incipha noma ivinjiwe.

Imithambo ye-carotid inikeza ingxenye yegazi eliyinhloko ebuchosheni bakho. Zitholakala ohlangothini ngalunye lwentamo yakho. Ungakuzwa ukushaya kwenhliziyo ngaphansi komhlathi wakho.

Isifo semithambo seCarotid senzeka lapho okunamafutha okubizwa ngokuthi i-plaque kuyanda ngaphakathi kwemithambo. Lolu qweqwe olwakhiwe lubizwa ngokuthi ukuqina kwemithambo (i-atherosclerosis).

Lolu qweqwe lungavimba noma linciphise umthambo we-carotid kancane. Noma kungadala ukuthi ihlwili lakheke kungazelelwe. Ihlwili elivimba ngokuphelele umthambo lingaholela ekushayweni unhlangothi.

Izici zobungozi bokuvaleka noma ukunciphisa imithambo zifaka:

• Ukubhema (abantu ababhema iphakethe elilodwa ngosuku baphinda ubungozi bokushaywa unhlangothi)
• Isifo sikashukela
• Umfutho wegazi ophezulu
• I-cholesterol ephezulu ne-triglycerides
• Ukuguga
• Umlando womndeni wesifo sohlangothi
• Ukusetshenziswa kotshwala
• Ukusetshenziswa kwezidakamizwa zokuzijabulisa
• Ukuhlukumezeka endaweni yentamo, okungadala izinyembezi emthanjeni we-carotid

Ekuqaleni, ungahle ungabi nazimpawu. Ngemuva kokuthi uqweqwe lukhuphuke, izimpawu zokuqala zesifo semithambo ye-carotid kungaba isifo sohlangothi noma ukuhlaselwa yischemic (TIA). I-TIA yisifo sohlangothi esincane esingabangeli noma yimuphi umonakalo ohlala njalo.

Izimpawu zokushaywa unhlangothi ne-TIA zifaka:

• Ukubona okufiphele
• Ukudideka
• Ukulahleka kwenkumbulo
• Ukulahlekelwa umuzwa
• Izinkinga ngokukhuluma nolimi, kufaka phakathi ukulahleka kwenkulumo
• Ukulahleka kombono (ukungaboni okuyingxenye noma okuphelele)
• Ubuthakathaka engxenyeni eyodwa yomzimba wakho
• Izinkinga ngokucabanga, ukucabanga, nokukhumbula

Umhlinzeki wakho wokunakekelwa kwezempilo uzokwenza ukuhlolwa komzimba. Umhlinzeki wakho angasebenzisa i-stethoscope ukulalela ukugeleza kwegazi entanyeni yakho ngomsindo ongajwayelekile obizwa nge-bruit. Lo msindo ungaba uphawu lwesifo somthambo we-carotid.

Umhlinzeki wakho naye angathola amahlule emithanjeni yegazi yeso lakho. Uma uke wahlaselwa yisifo sohlangothi noma i-TIA, ukuhlolwa kwesistimu yezinzwa (izinzwa) kuzobonisa ezinye izinkinga.

Ungase futhi ube nokuhlolwa okulandelayo:

• Ukuhlolwa kwe-cholesterol yegazi ne-triglycerides
• Ukuhlolwa koshukela wegazi (glucose)
• I-Ultrasound yemithambo ye-carotid (carotid duplex ultrasound) ukubona ukuthi igazi ligeleza kahle kangakanani ngomthambo we-carotid

Ukuhlolwa kwe-imaging okulandelayo kungasetshenziswa ukuhlola imithambo yegazi entanyeni nasebuchosheni:

• I-Cerebral angiography
• I-CT angiography
• MR angiography

Izinketho zokwelashwa zifaka:

• Imithi yokuncipha igazi efana ne-aspirin, i-clopidogrel (i-Plavix), i-warfarin (i-Coumadin), i-dabigatran (i-Pradaxa), noma eminye ukwehlisa ubungozi bokushaywa unhlangothi
• Izinguquko kwezokwelapha nokudla ukwehlisa i-cholesterol yakho noma umfutho wegazi
• Akukho ukwelashwa, ngaphandle kokubheka umthambo wakho we-carotid minyaka yonke

Ungahle ube nezinqubo ezithile zokwelapha umthambo we-carotid omncane noma ovinjiwe:

• I-Carotid endarterectomy - Lokhu kuhlinzwa kususa ukwakheka kocwecwe emithanjeni ye-carotid.
• I-Carotid angioplasty kanye ne-stenting - Le nqubo ivula umthambo ovinjiwe bese ifaka i-wire mesh (stent) encane emthanjeni ukuyigcina ivulekile.

Ngoba azikho izimpawu, ungahle ungazi ukuthi unesifo somthambo we-carotid uze ube nesifo sohlangothi noma i-TIA.

• I-Stroke iyimbangela ehamba phambili yokufa e-United States.
• Abanye abantu abanesifo sohlangothi balulama kakhulu noma yonke imisebenzi yabo.
• Abanye babulawa yisifo sohlangothi uqobo noma ngenxa yezinkinga.
• Cishe isigamu sabantu abanesifo sohlangothi banezinkinga zesikhathi eside.

Izinkinga ezinkulu zesifo semithambo ye-carotid yilezi:

• Ukuhlaselwa kweschemic kwesikhashana. Lokhu kwenzeka lapho i-blot clot ivimba kafushane isitsha segazi ebuchosheni. Kubangela izimpawu ezifanayo nokushaywa unhlangothi. Izimpawu zihlala kuphela imizuzu embalwa kuya ehoreni noma amabili, kepha azidluli amahora angama-24. I-TIA ayidali umonakalo ongapheli. Ama-TIA awuphawu lokuxwayisa ukuthi kungenzeka isifo sohlangothi esikhathini esizayo uma kungenziwa lutho ukusivimba.
• Unhlangothi. Lapho ukunikezwa kwegazi ebuchosheni kuvinjwe ngokwengxenye noma ngokuphelele, kubangela isifo sohlangothi. Imvamisa, lokhu kwenzeka lapho ihlule legazi livimba umthambo wegazi uye ebuchosheni. Isifo sohlangothi singenzeka futhi lapho umthambo wegazi uqhekeka uvuleka noma uvuza. Ukushaywa unhlangothi kungadala ukulimala kobuchopho isikhathi eside noma ukufa.

Iya egumbini lezimo eziphuthumayo noma ushayele inombolo yendawo ephuthumayo (efana ne-911) ngokushesha lapho izimpawu zivela. Ngokushesha uthola ukwelashwa, kuba ngcono ithuba lakho lokululama. Ngokushaywa unhlangothi, umzuzwana wokubambezeleka ungadala ukulimala okungaphezulu kobuchopho.

Nakhu ongakwenza ukusiza ukuvimbela isifo semithambo ye-carotid nesifo sohlangothi:

• Yeka ukubhema.
• Landela ukudla okunempilo, okunamafutha amancane okunemifino nezithelo eziningi ezintsha.
• Ungaphuzi iziphuzo ezidakayo ezingaphezu kwe-1 kuye kwezi-2 ngosuku.
• Ungazisebenzisi izidakamizwa zokuzijabulisa.
• Ukuzivocavoca okungenani imizuzu engama-30 ngosuku, izinsuku eziningi zesonto.
• Hlola i-cholesterol yakho njalo eminyakeni emihlanu. Uma welashelwa i-cholesterol ephezulu, udinga ukuthi ihlolwe kaningi.
• Yenza umfutho wegazi lakho uhlolwe njalo eminyakeni engu-1 kuya kwemibili. Uma unesifo somfutho wegazi ophakeme, isifo senhliziyo, isifo sikashukela, noma uke washaywa unhlangothi, kudingeka ukuthi uhlolwe kaningi. Buza umhlinzeki wakho.
• Landela izincomo zokwelashwa komhlinzeki wakho uma unengcindezi ephezulu yegazi, isifo sikashukela, i-cholesterol ephezulu, noma isifo senhliziyo.

I-carotid stenosis; I-stenosis - i-carotid; Stroke - umthambo we-carotid; I-TIA - umthambo we-carotid

• Ukubekwa kwe-Angioplasty kanye ne-stent - umthambo we-carotid - ukukhishwa
• Ukuhlinzwa komthambo weCarotid - ukukhipha
• I-cholesterol - ukwelashwa kwezidakamizwa
• Ukuthatha i-warfarin (Coumadin)

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UMeschia JF, uKlaas JP, uBrown RD Jr, uBrott TG. Ukuhlolwa nokuphathwa kwe-atherosclerotic carotid stenosis. IMayo Clin Proc. 2017; 92 (7): 1144-1157. I-PMID: 28688468 www.ncbi.nlm.nih.gov/pubmed/28688468.