Ukuqina Kwezinhlanzi Ezijulile Yini? Izimpawu, Izimbangela, Nokwelapha

Ukuqina kwezinhlanzi ezijulile (DVT) yisigaxa segazi esakheka kwenye yezinhlanzi ezijulile emzimbeni wakho, ikakhulukazi ezinyaweni zakho. Cabanga ngakho njengokuthi igazi lakho liqina futhi lenze isigaxa esiqinile ngaphakathi kwezinhlanzi, esikhona ezihlangeni zakho, kunokuba eduze kwesikhumba sakho.

Nakuba lokhu kungase kuzwakale kukhathaza, i-DVT iyimo elilawuleka uma itholakala ngokushesha futhi iphelelwe ngokufanele. Ukuqonda izimpawu nokwazi ukuthi nini kufanele ufuna usizo kungenza umehluko omkhulu ekuphileni kwakho nasempilweni yakho yesikhathi eside.

Ziyini izimpawu zokuqina kwezinhlanzi ezijulile?

Izimpawu ze-DVT zingase zibe zingekho ngokusobala ekuqaleni, futhi abanye abantu bangase bangaziboni nhlobo izimpawu. Izimpawu ezivamile zithinta umlenze lapho isigaxa sakhiwe khona, nakuba zingase zihluke kumuntu nomuntu.

Nazi izimpawu eziyinhloko okumele uzilandele:

• Ukuvuvukala kwenye inyawo, ikhanda, noma unyawo olungafani nolunye uhlangothi
• Ubuhlungu noma ukuhlunguluka emilenzeni yakho okungase kuzwakale njengokuqina noma ukudabuka
• Ukushisa endaweni ethintekayo lapho uyithinta
• Isikhumba esibomvu noma esishintshile umbala, ngokuvamile sinombala oluhlaza okwesibhakabhaka
• Ubuhlungu benyawo obukhulu uma uqengqeleka unyawo lwakho phezulu
• Ukuzwa okukhulu noma okuhlunguluka emilenzeni ethintekayo

Ngezinye izikhathi i-DVT ingase ibe khona ngaphandle kwezimpawu ezicacile, yingakho ngokuvamile ibizwa ngokuthi “imo ethule.” Umzimba wakho ungase usebenze ukuqothula izigaxa ezincane ngokwemvelo, noma isigaxa singase singavimbeli ukugeleza kwegazi ngokwanele ukubangela izinguquko ezibonakalayo.

Ezimeni ezingavamile, ungase ube nezimpawu ezandleni zakho uma isigaxa sakhiwa ezinhlanzini zezandla. Lokhu kungenzeka ngemva kokwelashwa kwezokwelapha okuhilela izinhlanzi zezandla noma ngenxa yokuphindaphinda kokunyakaza kwezandla emisebenzini ethile noma ezemidlalo.

Yini ebangela ukuqina kwezinhlanzi ezijulile?

I-DVT kwenzeka lapho ukugeleza kwegazi kwakho okuvamile kuphazanyiswa, okuholela ekwakheni isigaxa. Igazi lakho ngokwemvelo lifuna ukuqhubeka ligeleza ngokulinganayo ngezinhlanzi zakho, kodwa izimo ezithile zingaphazanyiswa le nqubo.

Izici eziyinhloko ezifaka isandla ekukhuleni kwe-DVT zihlanganisa:

• Ukungabi namandla isikhathi eside ngenxa yokuhamba ngezindiza isikhathi eside, ukuphumula embhedeni, noma ukuhlala isikhathi eside
• Ukuhlinzwa, ikakhulukazi ukuhlinzwa okukhulu okuhilela imilenze, izihlalo, noma isisu
• Ukulimala noma ukulimala kwezinhlanzi zakho ngenxa yezingozi noma izinqubo zezokwelapha
• Imithi ethile njengezithombe zokulawula ukubeletha noma ukwelashwa kwe-hormone
• Ukukhulelwa nesikhathi emva kokubeletha ngenxa yokwanda kokucindezeleka nokushintsha kwe-hormone
• Umshuza nokwelashwa komdlavuza okuthinta ukuqina kwegazi
• Isimo sokuqina kwegazi esidluliselwa ezindlelweni

Igazi lakho liqukethe ibhalansi ebucayi yezinto zokwenza isigaxa ezivikelayo ngokwemvelo kokubili ukuphulukana negazi okukhulu nokwenza isigaxa okungafuneki. Uma le bhalansi ishintsha, igazi lakho lingase libe nokwenza izigaxa ngisho noma kungekho ukulimala okudinga ukululama.

Ngokungavamile, i-DVT ingase ibe yimbangela yizimo ezingavamile njenge-May-Thurner syndrome, lapho inhlanzi icindezelwa yi-artery, noma ngenxa yokutheleleka okungavamile okuthinta izinhlanzi zakho ngokuqondile.

Nini kufanele ubona udokotela ngokuqina kwezinhlanzi ezijulile?

Kufanele uxhumane nodokotela wakho ngokushesha uma uqaphela ukuvuvukala okungazelelwe, ubuhlungu, noma ukushintsha kombala emilenzeni yakho. Lezi zimpawu zidinga ukunakekelwa kwezokwelapha ngokushesha ngoba ukwelashwa okusheshayo kungavimbela izinkinga ezinzima.

Funani ukunakekelwa kwezokwelapha okusheshayo uma uhlangabezana nezibonakaliso zokuthi isigaxa singase siye emaphashini akho, isimo esibizwa ngokuthi i-pulmonary embolism. Lezi zimpawu ezicasulayo zihlanganisa ukuphefumula okungazelelwe, ubuhlungu besifuba obukhulu uma uphefumula, ukushaya kwenhliziyo okusheshayo, ukukhokha igazi, noma ukuzwa ubuthakathaka.

Ungalindi uma uhlangabezana nalezi zibonakaliso zezexwayiso, ngisho noma awuqiniseki ukuthi zihlangene ne-DVT. Iqembu lakho lezempilo lingathanda kakhulu ukukuhlola ngokushesha futhi lingatholi lutho olukhulu kunokuba ulibambezele ukwelashwa kwesimo esingase sibe yingozi ekuphileni.

Ziyini izinto ezingase zikubangele ukuqina kwezinhlanzi ezijulile?

Ukuqonda izinto ezingase zikubangele ukuqina kwezinhlanzi ezijulile kungakusiza ukuthi uthathe izinyathelo zokuvimbela futhi uqonde ukuthi nini ungase ube sengozini enkulu yokuthola i-DVT. Ezinye izinto ezingase zikubangele ukuqina kwezinhlanzi ezijulile ungazilawula, kanti ezinye ziyisigaba semlando wakho wezokwelapha noma i-genetics.

Izinto ezivamile ezingase zikubangele ukuqina kwezinhlanzi ezijulile zihlanganisa:

• Iminyaka engaphezu kuka-60, nakuba i-DVT ingase ibe khona kunoma iyiphi iminyaka
• Ukuba ngumuntu omkhulu noma olukhulu, okubekela ukucindezeleka okukhulu ezinhlanzini zezinyawo
• Ukubhema, okuthinta ukugeleza kwegazi nokuqina
• Ukuhlala noma ukuphumula phansi isikhathi eside njalo
• Ukuba uke waba ne-DVT noma i-pulmonary embolism ngaphambili
• Umlando womndeni wezifo zokwenza isigaxa
• Ukuhlinzwa kwamuva noma ukungena esibhedlela
• Umshuza noma ukwelashwa komdlavuza

Abanye abantu banezinto eziningi ezingase zibabangele ukuqina kwezinhlanzi ezijulile, okuyanda amathuba abo okuthola i-DVT. Noma kunjalo, ukuba nezinto ezingase zikubangele ukuqina kwezinhlanzi ezijulile akusho ukuthi uzokwenza isigaxa ngokuqinisekile. Abantu abaningi abanezinto eziningi ezingase zibabangele ukuqina kwezinhlanzi ezijulile abazange babe ne-DVT, kanti abanye abanezinto ezimbalwa ezingase zibabangele ukuqina kwezinhlanzi ezijulile bangase basathuthukise le simo.

Izimo ezingavamile ze-genetic njenge-Factor V Leiden mutation noma i-protein C deficiency zingase zikwenze kube lula ukwenza isigaxa. Lezi zifo eziwumfuzo zithinta indlela igazi lakho eliqina ngayo futhi zingase zidinga ukulandelelwa okukhethekile ekuphileni kwakho konke.

Ziyini izinkinga ezingase zenzeke ngenxa yokuqina kwezinhlanzi ezijulile?

Nakuba abantu abaningi abane-DVT baphila ngokuphelele ngokwelashwa okufanele, kubalulekile ukuqonda izinkinga ezingase zenzeke ukuze ukwazi ukuqaphela izibonakaliso zezexwayiso futhi ufuna ukunakekelwa okufanele uma kudingeka.

Inkinga enkulu kakhulu eyenzeka ngokushesha yi-pulmonary embolism, eyenzeka lapho ingxenye yesigaxa segazi iphula futhi iye emaphashini akho. Lokhu kungavimba ukugeleza kwegazi ezihlangeni zakho zephunga futhi kube yingozi ekuphileni uma kungelashwa ngokushesha.

Ezinye izinkinga ezingase zenzeke zihlanganisa:

• I-Post-thrombotic syndrome, ebangela ubuhlungu obuhlala njalo emilenzeni nokuvuvukala
• Ukwehluleka kwezinhlanzi ezingapheli, lapho izinhlanzi zezinyawo zingasebenzi kahle
• Ukushintsha kwesikhumba nama-ulcers endaweni ethintekayo
• Iziqephu ze-DVT eziphindaphindayo esikhathini esizayo
• Ukunciphisa ukunyakaza nokuphuza impilo ngenxa yezimpawu eziqhubekayo

I-Post-thrombotic syndrome ithonya cishe u-20-30% wabantu abake baba ne-DVT, ngokuvamile ithuthuka ezinyangeni kuya eminyakeni ngemva kwesigaxa sokuqala. I-valves yezinhlanzi ezilimele ayikwazi ukupompa igazi emuva enhliziyweni yakho ngokuphumelelayo, okuholela ekuvuvukaleni okuhlala njalo nokungakhululeki.

Ngokungavamile, i-DVT enkulu ingabangela ukuvuvukala okukhulu okuvimba ukugeleza kwegazi ezihlangeni zakho, isimo esibizwa ngokuthi i-phlegmasia cerulea dolens. Leli bhubhane lezokwelapha lidinga ukungenelela okusheshayo ukusindisa uhlangothi.

Ukuqina kwezinhlanzi ezijulile kungavikeleka kanjani?

Izindaba ezinhle ukuthi izimo eziningi ze-DVT zingavikeleka ngokwenza izinguquko ezilula zokuphila nokuqaphela izinto ezingase zikubangele ukuqina kwezinhlanzi ezijulile. Ukuvimbela kugxile ekuqondeni ukugeleza kwegazi lakho ngokulinganayo nokugcina ukugeleza kwegazi okuhle.

Uma usengozini enkulu noma ubhekene nezimo ezikhuphula amathuba e-DVT, nazi izindlela zokuvimbela eziphumelelayo:

• Nyakaza njalo ngesikhathi sokuhamba okuningi noma isikhathi sokuhlala
• Gqoka izokisi zokucindezela njengoba kunconywe udokotela wakho
• Hlala unamanzi amaningi, ikakhulukazi ngesikhathi sokuhamba
• Gcina isisindo esinempilo ngokudla nokwenza umsebenzi
• Yekela ukubhema ukuthuthukisa ukugeleza kwegazi
• Thatha izithombe zokuncela igazi njengoba kunconywe
• Phakamisa imilenze yakho uma uphumula uma kungenzeka

Ngesikhathi sokungena esibhedlela noma ngemva kokuhlinzwa, iqembu lakho lezempilo lingase lisebenzise izindlela ezengeziwe zokuvimbela njengezinto zokucindezela okulandelanayo noma izithombe zokuncela igazi ezivikela. Lezi zingenelelo zilungiselelwe izinga lakho elikhethekile lengozi nesimo sakho sezokwelapha.

Ukuzivocavoca okulula njengokupompa imilenze, ukuphakamisa ama-calf, nokuhamba ibanga elifushane kungathuthukisa kakhulu ukugeleza kwegazi emilenzeni yakho. Ngisho nokunyakaza okuncane njalo ngehora kungenza umehluko obalulekile ekuvimbeleni ukwakheka kwesigaxa.

Ukuqina kwezinhlanzi ezijulile kunqunywa kanjani?

Ukuqonda i-DVT ngokuvamile kuhilela ukuxubana kokuhlolwa komzimba, ukubuyekezwa komlando wezokwelapha, nezivivinyo ezithile zokubona ukugeleza kwegazi ezinhlanzini zakho. Udokotela wakho uzoqala ngokubuza ngezimpawu zakho nokucwaninga indawo ethintekayo.

Ivivinyo elivamile lokuqonda yi-duplex ultrasound, esebenzisa amaza omsindo ukwenza izithombe zokugeleza kwegazi ezinhlanzini zakho. Leli vivinyo elingenabuhlungu lingabonisa ukuthi isigaxa sikho yini futhi lisize ukuqonda usayizi nendawo yaso.

Ezinye izivivinyo udokotela wakho angase azincoma zihlanganisa:

• I-D-dimer blood test ukuhlola imikhiqizo yokwahlukaniswa kwesigaxa
• I-Venography esebenzisa i-contrast dye ukubona izinhlanzi ku-X-ray
• I-CT noma i-MRI scans ezimweni eziyinkimbinkimbi noma lapho i-ultrasound ingaqiniseki
• Izivivinyo zegazi ukuhlola izifo zokwenza isigaxa

I-D-dimer test ilinganisa izinto ezikhishwa lapho izigaxa zegazi ziqothuka. Nakuba amazinga aphezulu angase abonise ukwakheka kwesigaxa, leli vivinyo lodwa alianele ukuqonda i-DVT ngoba izimo eziningi zingabangela amazinga aphezulu e-D-dimer.

Ezimeni ezingavamile lapho izivivinyo ezivamile zingaqiniseki, udokotela wakho angase a-ode i-imaging ekhethekile njenge-magnetic resonance venography noma i-computed tomography venography ukuthola isithombe esicacile sesakhiwo sakho sezinhlanzi nokugeleza kwegazi.

Ukwelashwa kokuqina kwezinhlanzi ezijulile kuyini?

Ukwelashwa kwe-DVT kugxile ekuvimbeleni isigaxa ukukhula, ukunciphisa ingozi yakho ye-pulmonary embolism, nokunciphisa izinkinga zesikhathi eside. Abantu abaningi bangaphelelwa ngokuphumelelayo ngemithi, nakuba ezinye izimo zingase zidinga ukungenelela okwengeziwe.

Indlela eyinhloko yokwelapha ihilela imithi ye-anticoagulant, evame ukubizwa ngokuthi izithombe zokuncela igazi. Le mithi ayiqinisi igazi lakho kodwa ivikela izigaxa ezintsha ukuba zingakhi futhi isize umzimba wakho ukuqothula izigaxa ezikhona ngokwemvelo.

Izindlela zokwelapha ezivamile zihlanganisa:

• I-Heparin injections yokuncela igazi ngokushesha
• Amapilisi e-Warfarin okuncela igazi isikhathi eside
• Izithombe zokuncela igazi ezintsha njenge-rivaroxaban noma i-apixaban
• Izokisi zokucindezela ukunciphisa ukuvuvukala nokwenza ukugeleza kwegazi kube ngcono
• I-Thrombolytic therapy ukuqothula izigaxa ezinkulu ezimweni ezinkulu

Isikhathi sokwelashwa sivame ukuba izinyanga ezintathu kuya kweziyisithupha, nakuba abanye abantu bengase badinge ukuncela igazi isikhathi eside kuye ngezinto ezingase zibabangele ukuqina kwezinhlanzi ezijulile nokuthi lokhu kuyisiqephu sabo sokuqala se-DVT.

Ezimeni ezingavamile ezihilela izigaxa ezinkulu noma ingozi enkulu ye-pulmonary embolism, udokotela wakho angase ancome ukwelashwa okunamandla njenge-catheter-directed thrombolysis noma i-surgical thrombectomy ukususa isigaxa ngokomzimba.

Ungayiphatha kanjani i-DVT ekhaya?

Nakuba ukwelashwa kwezokwelapha kubalulekile, kunezinto eziningi ongenza zona ekhaya ukuze usekele ukuphulukisa kwakho nokunciphisa ukungakhululeki. Lezi zinyathelo zokunakekela zisebenza kanye nemithi yakho eyalwe ukuze zikusize uphulukise ngokuphumelelayo.

Izindlela zokuphatha ubuhlungu nokuvuvukala zihlanganisa ukuphakamisa umlenze wakho othontekile ngaphezu kwesilinganiso senhliziyo uma kungenzeka, ukufaka izinto ezishisayo zokunethezeka, nokuthatha izithombe zokunciphisa ubuhlungu ezithengiswa ngaphandle komthetho njengoba kuvunyelwe udokotela wakho.

Izindlela ezibalulekile zokunakekela ekhaya zihlanganisa:

• Ukuthatha imithi njengoba kunconywe ngaphandle kokweqa izilinganiso
• Ukuqoba izokisi zokucindezela usuku lonke
• Ukuhlala usebenza ngokuhamba okulula njengoba ubekezelela
• Ukuqeda ukuhlala noma ukuqina isikhathi eside
• Ukulandelela izibonakaliso zezinkinga
• Ukugcina iziqukathi zokulandelela nodokotela wakho

Ukuzivocavoca okulula njengokuhamba kungasiza impilo yakho ngokuthuthukisa ukugeleza kwegazi nokunciphisa ubuthakathaka bemisipha. Qala kancane bese ukhulisa izinga lakho lomsebenzi njengoba izimpawu zakho ziqhubeka futhi udokotela wakho evuma.

Qaphela izibonakaliso zezexwayiso ezidinga ukunakekelwa kwezokwelapha okusheshayo, njengokwanda kobhlungu noma ukuvuvukala, ukuphefumula okungazelelwe, noma ukuphulukana negazi okungavamile ngenkathi uthatha izithombe zokuncela igazi.

Kufanele ulungiselele kanjani i-appointment yakho nodokotela?

Ukuba ulungile nge-appointment yakho kusiza ukuqinisekisa ukuthi uthola ukuxilongwa okuchane kakhulu nesiqondiso sokwelashwa esifanele. Udokotela wakho uzodinga ulwazi oluphelele ngezimpawu zakho, umlando wezokwelapha, nanoma iyiphi imithi oyithathayo.

Ngaphambi kokuya kwakho, bhala phansi ukuthi izimpawu zakho zaqala nini, yini eyenza zibe ngcono noma zimbi, nanoma yimiphi imisebenzi noma izenzakalo ezingase ziyibangele. Faka ulwazi ngokuhamba kwamuva, ukuhlinzwa, noma izikhathi zokungabi namandla.

Letha ulwazi olulandelayo ku-appointment yakho:

• Uhlu oluphelele lwemithi yamanje kanye nezinhlanganisela
• Umlando womndeni wezigaxa zegazi noma izifo zokwenza isigaxa
• Izinqubo zezokwelapha zamuva noma ukungena esibhedlela
• Noma yiziphi iziqephu zangaphambili ze-DVT noma i-pulmonary embolism
• Imibuzo mayelana nezindlela zokwelapha nokushintsha kokuphila

Unganqikazi ukubuza imibuzo mayelana nesimo sakho, izindlela zokwelapha, nokuthi yini okulindelekile ngesikhathi sokuphulukisa. Ukuqonda isiqondiso sakho sokwelashwa kukusiza ukuba usilekelele ngokuphumelelayo futhi uqonde ukuthi nini ungase udinga ukunakekelwa kwezokwelapha okwengeziwe.

Cabanga ngokuletha ilungu lomndeni noma umngani ukukusiza ukuba ukhumbule ulwazi olubalulekile futhi unikeze ukwesekwa ngesikhathi esingase sizwakale siwumthwalo omkhulu.

Iyini into ebalulekile mayelana nokuqina kwezinhlanzi ezijulile?

Ukuqina kwezinhlanzi ezijulile kuyimo elibi kakhulu kodwa elilawuleka uma lixilongwa ngokushesha futhi lilawulwa ngokufanele. Into ebaluleke kakhulu okumele uyikhumbule ukuthi ukufuna ukunakekelwa kwezokwelapha ngokushesha uma uqaphela izimpawu kungavimbela izinkinga futhi kuholele emiphumeleni emihle.

Ngokwelashwa okufanele, abantu abaningi abane-DVT baphila ngokuphelele futhi babuyela emisebenzini yabo evamile. Nakuba abanye bengase babe nemiphumela yesikhathi eside, ukulandela isiqondiso sakho sokwelashwa nokwenza izinguquko zokuphila ezicelwe kunganciphisa kakhulu ingozi yakho yezinkinga.

Izindlela zokuvimbela njengokuhlala usebenza, ukugcina isisindo esinempilo, nokuqaphela izinto ezingase zikubangele ukuqina kwezinhlanzi ezijulile kungakusiza ukuzivikela ekwenzeni i-DVT esikhathini esizayo. Khumbula ukuthi ukuba nesigaba esisodwa akusho ukuthi uqondiswe ukuba ube nezinye, ikakhulukazi ngokuphathwa kwezokwelapha okufanele.

Imibuzo evamile ebuzwa mayelana nokuqina kwezinhlanzi ezijulile

Ingabe i-DVT ingase iphele yodwa ngaphandle kokwelashwa?

Nakuba izigaxa ezincane zingase ziqothuke ngokwemvelo, i-DVT idinga ukwelashwa kwezokwelapha ukuvimbela izinkinga ezinzima njenge-pulmonary embolism. Ukushiya i-DVT ingelashwa kukhuphula kakhulu ingozi yezinkinga ezingase zibe yingozi ekuphileni, ngakho kubalulekile ukufuna ukunakekelwa kwezokwelapha ngokushesha lapho izimpawu ziveleka.

Kuthatha isikhathi esingakanani ukuphulukisa i-DVT?

Abantu abaningi baqala ukuzizwa bekhulu ngemihla embalwa kuya emavikeni emva kokuqala ukwelashwa, nakuba ukuphulukisa okuphelele kungathatha izinyanga eziningi. Ngokuvamile uzodinga ukuthatha izithombe zokuncela igazi okungenani izinyanga ezintathu, futhi ezinye izimpawu njengokuvuvukala okuncane zingase zihlale isikhathi eside ngenkathi inhlanzi yakho iphulukisa.

Ngingazivocavoca yini nge-DVT?

Ukuhamba okulula kuvame ukukhuthazwa uma uqala ukwelashwa, njengoba kusiza ukuthuthukisa ukugeleza kwegazi nokunciphisa izinkinga. Noma kunjalo, kufanele ugweme imisebenzi enkulu noma imidlalo yokuqhakambisa ngenkathi uthatha izithombe zokuncela igazi. Landela njalo izincomo zakho zedokotela mayelana namazinga omsebenzi ngesikhathi sokwelashwa.

Ngingaphinde ngithole i-DVT esikhathini esizayo?

Ingozi yakho yokubuya kwe-DVT iyancika ezintweni eziningi, kufaka phakathi ukuthi yini ebangela isiqephu sakho sokuqala nezinto ezingase zikubangele ukuqina kwezinhlanzi ezijulile eziqhubekayo. Cishe u-10-30% wabantu baye baba ne-DVT enye phakathi kweminyaka eyi-10, kodwa ukulandela izindlela zokuvimbela nokuphatha izinto ezingase zikubangele ukuqina kwezinhlanzi ezijulile kunganciphisa kakhulu leli thuba.

Ingabe kukhona ukudla engingakufanele ngithathe izithombe zokuncela igazi?

Uma uthatha i-warfarin, uzodinga ukugcina ukudla kwe-vitamin K okuhlala njalo, okusho ukuba uqaphele imifino eluhlaza. Izithombe zokuncela igazi ezintsha ngokuvamile azinawo umkhawulo wokudla. Umhlinzeki wakho wezokwelapha uzokunika isiqondiso esikhethekile esisekelwe emithini yakho, futhi kubalulekile ukugwema ukusebenzisa utshwala ngokweqile nanoma iyiphi i-blood thinner.