Igazi Eliminyene (Hypercoagulability)

-Delile

• Ziyini izimpawu zegazi elijiyile?
• Ziyini izimbangela zegazi elijiyile?
• Litholakala kanjani igazi elijiyile?
• Yiziphi izindlela zokwelapha zegazi elijiyile?
• I-Polycythemia vera
• Ukwelashwa kwezimo ezithinta ukujiya kwegazi
• Ziyini izinkinga zegazi elijiyile?
• Uyini umbono walesi simo?

Liyini igazi elijiyile?

Ngenkathi igazi lomuntu lingabukeka lifana, lenziwe ngenhlanganisela yamaseli ahlukene, amaprotheni, nezakhi ezijiyisayo, noma izinto ezisiza ukujiya.

Njengezinto eziningi emzimbeni, igazi lithembela kubhalansi ukugcina ukungaguquguquki okujwayelekile. Uma ukungalingani kumaprotheni namaseli abhekene negazi nokuvimba kwegazi kukhula, igazi lakho lingaba likhulu kakhulu. Lokhu kwaziwa ngokuthi yi-hypercoagulability.

Izici eziningana zingadala igazi elijiyile, njenge:

• amaseli egazi amaningi ngokweqile
• izifo ezithinta ukujiya kwegazi
• amaprotheni amaningi okujiya egazini

Ngoba kunezimbangela eziningi ezingaba khona zegazi elijiyile, odokotela abanayo incazelo ejwayelekile yegazi elijiyile. Kunalokho bayichaza ngesimo ngasinye esiholela egazini elijiyile.

Izinkinga zokuvala igazi ezibangela igazi elijiyile zivame ukuba zincane. Okunye okuvame kakhulu kufaka phakathi i-factor V Leiden, okulinganiselwa kumaphesenti ama-3 kuye kwayi-7 wabantu abaningi abanayo. Lesi simo asisho ukuthi igazi lomuntu lizoba likhulu kakhulu, kepha ukuthi bathambekele ekubeni negazi elijiyile.

Kubo bonke abantu abenegazi emithanjeni yabo, bangaphansi kwamaphesenti ayi-15 ngenxa yesimo esidala igazi elijiyile.

Ziyini izimpawu zegazi elijiyile?

Abaningi abanazo izimpawu zegazi elijiyile kuze kube yilapho behlangabezana negazi. Ukuqaqeka kwegazi kuvame ukuvela emthanjeni womuntu, okungadala izinhlungu futhi kuthinte ukujikeleza ngaphakathi nangaseduze kwendawo lapho kwenzeka khona ihlule.

Abanye bayazi ukuthi banomlando womndeni wokuphazamiseka kwegazi. Lokhu kungabakhuthaza ukuthi bahlolelwe izinkinga zokuvala igazi ngaphambi kokuvela.

Ukuba namaseli egazi amaningi kungaholela ezimpawu ezahlukahlukene. Izibonelo zalokhu zifaka:

• ukungaboni kahle
• isiyezi
• ukulinyazwa okulula
• ukopha ngokweqile kokuya esikhathini
• ukuvuvukala
• ikhanda
• umfutho wegazi ophakeme
• ukuluma kwesikhumba
• ukungabi namandla
• ukuphelelwa umoya

Uma uhlangabezana nenye yalezi zimpawu, kufanele ubone udokotela wakho ukuze avivinye igazi elijiyile:

• enegazi elinemvelaphi engaziwa
• ukuphindaphinda amahlule egazi ngaphandle kwesizathu esaziwayo
• ukuthola ukulahleka kokukhulelwa okuphindaphindiwe (ukulahlekelwa kokukhulelwa okungaphezu kokuthathu kokuqala kwe-trimester)

Udokotela wakho angalawula izivivinyo ezahlukahlukene zokuhlolwa kwegazi uma unalezi zimpawu ngaphezu komlando womndeni wegazi elijiyile.

Ziyini izimbangela zegazi elijiyile?

Izimo eziholela egazini elijiyile zingazuzwa njengefa noma zitholwe ngokuhamba kwesikhathi, njengoba kuvame ukwenzeka kumdlavuza. Okulandelayo yisampula elincane lezimo eziningi ezingadala igazi elijiyile:

• umdlavuza
• i-lupus, ebangela umzimba wakho ukuthi ukhiqize ama-antibodies e-antiphospholipid, angadala ukujiya
• ukuguqulwa kwesici V
• i-polycythemia vera, ebangela ukuthi umzimba wakho wenze amaseli abomvu amaningi kakhulu, okuholela egazini elijiyile
• ukuntuleka kwamaprotheni C
• ukuntuleka kweprotheni S
• prothrombin 20210 ukuguqulwa
• ukubhema, okungadala ukulimala kwezicubu kanye nokunciphisa ukukhiqizwa kwezinto ezinciphisa amahlule egazi

Kubalulekile ukuqonda ukuthi izimo ezidala ukujiya kwegazi, futhi kwesinye isikhathi ukujiya kwegazi, akuzona kuphela izimbangela zamahlule egazi.

Isibonelo, umuntu angahlaselwa yisifo senhliziyo ngoba igazi lakhe lahlangana ne-plaque emithanjeni yakhe, okwenza ukuba kuvele ihlwili. Labo abane-circulation engafanele nabo bathambekele kakhulu kumahlule egazi ngoba igazi labo alihambi nasemizimbeni yabo. Lokhu akubangelwa ukuqina kwegazi. Esikhundleni salokho, imithambo nemithambo yalaba bantu ilimele, ngakho igazi alikwazi ukuhamba ngokushesha njengokujwayelekile.

Litholakala kanjani igazi elijiyile?

Udokotela wakho uzoqala inqubo yokuxilonga ngokuthatha umlando wakho wezokwelapha. Bazobuza imibuzo nganoma yiziphi izimpawu ongahle ubhekane nazo kanye nomlando wezempilo.

Udokotela wakho kungenzeka a-oda ukuhlolwa kwegazi, kepha imvamisa ngezigaba. Isizathu salokhu ukuthi ukuhlolwa okuningi kwegazi eliwugqinsi kuyabiza futhi kucaciswe kakhulu. Ngakho-ke bazoqala ngokuhlolwa okuvamile, bese be-oda okuthe xaxa uma kunesidingo.

Isibonelo sokuhlolwa kwegazi okusetshenzisiwe uma udokotela wakho ecabanga ukuthi ungaba negazi elijiyile kufaka:

• Qedela ukubalwa kwegazi: Lesi sivivinyo sihlola ukutholakala kwamaseli abomvu egazi namaplatelets egazini. Amazinga aphezulu we-hemoglobin ne-hematocrit angakhombisa ukuba khona kwesimo esinjenge-polycythemia vera.
• Kuvulwa ukumelana kwamaprotheni C: Lokhu kuhlolwa kobukhona besici V Leiden.
• Ukuhlolwa kwezinguquko kwe-Prothrombin G20210A: Lokhu kunquma ukutholakala kwe-antithrombin, amaprotheni C, noma amaprotheni S okungajwayelekile.
• Antithrombin, protein C, noma protein protein S amazinga: Lokhu kungaqinisekisa ubukhona be-lupus anticoagulants.

Umtholampilo waseCleveland uncoma ukuthi ukuhlolwa kwegazi elijiyile kwenzeke okungenani emavikini amane kuya kwayisithupha ngemuva kokuba unegazi. Ukuhlola maduze kungaholela emiphumeleni engeyinhle ngenxa yokuba khona kwezakhi zokuvuvukala egazini kusuka ehluleni.

Yiziphi izindlela zokwelapha zegazi elijiyile?

Ukwelashwa kwegazi elijiyile kuncike embangela.

I-Polycythemia vera

Ngenkathi odokotela bengakwazi ukwelapha i-polycythemia vera, bangancoma ukwelashwa ukuthuthukisa ukugeleza kwegazi. Umsebenzi womzimba ungasiza ukukhuthaza ukuhamba kwegazi okufanele emzimbeni wakho. Ezinye izinyathelo okufanele zithathwe zifaka:

• ukwelula njalo, ikakhulukazi imilenze nezinyawo zakho ukukhuthaza ukugeleza kwegazi
• ukugqoka izingubo zokuzivikela, ikakhulukazi ezandleni nasezinyaweni zakho, ebusika
• ukugwema ukushisa okweqile
• ukuhlala unamanzi amaningi futhi uphuza uketshezi oluningi
• ukuthatha okugeza isitashi ngokungeza uhhafu webhokisi lesitashi emanzini okugeza afudumele, angadambisa isikhumba esivame ukulunywa esihambisana ne-polycythemia vera

Udokotela wakho angancoma indlela yokwelashwa ebizwa nge-phlebotomy, lapho befaka khona umugqa we-intravenous (IV) emthanjeni ukuze kususwe inani elithile legazi.

Izindlela zokwelapha eziningana zisiza ukususa enye yensimbi yomzimba wakho, enganciphisa ukukhiqizwa kwegazi.

Ezimweni ezingavamile, lapho isimo sidala izinkinga ezinkulu, njengokulimala komzimba, udokotela wakho angancoma imithi yokwelashwa ngamakhemikhali. Izibonelo zalokhu zifaka phakathi i-hydroxyurea (Droxia) ne-interferon-alpha. Lokhu kusiza ukumisa umnkantsha wakho ekukhiqizeni amaseli egazi amaningi. Ngenxa yalokho, igazi lakho liyajiya.

Ukwelashwa kwezimo ezithinta ukujiya kwegazi

Uma unesifo esibangela ukuthi igazi limboleke kalula (njengokuguquka kwezakhi ze-factor V), udokotela wakho angancoma ezinye zezindlela ezilandelayo zokwelapha:

• Ukwelashwa kwama-antiplatelet: Lokhu kufaka phakathi ukuthatha imishanguzo evimbela amangqamuzana egazi abhekene nokuqina, okubizwa ngama-platelets, ekuhlanganeni ndawonye ukuze abe yihlwili. Izibonelo zalokhu zingafaka i-aspirin (iBufferin).
• Ukwelashwa kwe-Anticoagulation: Lokhu kuhilela ukuthatha imishanguzo esetshenziselwa ukuvimbela amahlule egazi, njenge-warfarin (Coumadin).

Kodwa-ke, abantu abaningi abanezimo ezingenza igazi labo lijiye abakaze babhekane negazi. Ngalesi sizathu, udokotela wakho angaxilonga igazi elijiyile, kepha angakuniki umuthi ozowuphuza njalo ngaphandle kokuthi bakholelwa ukuthi usengozini yeqhwa.

Uma ujwayele amahlule egazi, kufanele uhlanganyele ezinyathelweni zokuphila ezaziwa ukunciphisa amathuba azo. Lokhu kufaka phakathi:

• ukuyeka ukubhema
• ukwenza umsebenzi ojwayelekile womzimba
• ukuthatha amathuba amaningi wokuzelula nokuhamba lapho uhamba amabanga amade endizeni noma ngemoto
• ukuhlala unamanzi amaningi

Ziyini izinkinga zegazi elijiyile?

Uma unegazi elijiyile, usengcupheni enkulu yamahlule egazi, emithanjeni yakho nasemithanjeni yegazi. Amahlule egazi emithanjeni yakho azothinta ukugeleza kwegazi liye ezindaweni ezibalulekile zomzimba wakho. Ngaphandle kokugeleza kwegazi okwanele, izicubu azikwazi ukusinda. Uma ucabanga ukuthi ungaba negazi, funa ukwelashwa ngokushesha.

Omunye wemiphumela engaba yingozi kakhulu yegazi elijiyile i-pulmonary emboli, okuyizigaxa zegazi ezivimba imithambo eyodwa noma ngaphezulu yamaphaphu emaphashini. Ngenxa yalokho, iphaphu alikwazi ukuthola igazi elinomoya-mpilo. Izimpawu zalesi simo zifaka ukuphefumula, izinhlungu esifubeni, nokukhwehlela okungase kube negazi. Kufanele ufune ukwelashwa okuphuthumayo uma ucabanga ukuthi ungaba ne-pulmonary emboli.

Uyini umbono walesi simo?

Ngokusho komtholampilo waseCleveland, okwamanje akukho datha ephakamisa ukuthi igazi elijiyile lithinta isikhathi sokuphila. Kodwa-ke, uma umndeni wakho unomlando waleso simo, ungahle uthande ukuxhumana nodokotela wakho mayelana nezingozi ezingaba khona.