Phlebitis

I-thrombophlebitis yisimo esenza ukuba kube khona isilayidi legazi elivalayo elivala inhlamba eyodwa noma ngaphezulu, ngokuvamile ezinyaweni. Ku-thrombophlebitis ebonakalayo, inhlamba iseduze nobuso bolusu. Ku-deep vein thrombosis noma i-DVT, inhlamba ijule ngaphakathi emsisipha. I-DVT iyakwandisa ingozi yezinkinga zempilo ezingathi sína. Zombili izinhlobo ze-thrombophlebitis zingaphathwa ngemithi yokuncipha kwegazi.

Izimpawu ze-thrombophlebitis ebushelelezi zihlanganisa ukushisa, ukuhlunguluka, nobuhlungu. Ungase ube nobomvu nokuvuvukala futhi ubona intambo ebomvu, eqinile ngaphansi nje kwesikhumba sakho ebuhlungu uma uyithinta. Izimpawu ze-thrombosis ye-deep vein zihlanganisa ukuvuvukala, ukuhlunguluka, nobuhlungu emilenzeni yakho.

Bona udokotela wakho ngokushesha uma une-vein ebomvu, ebuhlungu noma ebuhlungu - ikakhulukazi uma unezinye zezingozi ze-thrombophlebitis.

Shaya u-911 noma inombolo yakho yokuphuthuma kwendawo uma:

• Ukukhula kwe-vein nobuhlungu kunzima
• Uphinde ube nomoya ophezulu noma ubuhlungu ebeleni, uphuza igazi, noma unezinye izimpawu ezingase zibonise ukuthi igazi lihamba liya emaphashini akho (pulmonary embolism)

Cela umuntu akukhiphe ku dokotela wakho noma ekamelweni lokuphuthuma, uma kungenzeka. Kungase kube nzima kuwe ukuqhuba, futhi kuwusizo ukuba nomuntu ongahamba nawe ukuze akusize ukukhumbula ulwazi olukufumanayo.

I-thrombophlebitis ibangelwa yisigaxa legazi. Isigaxa legazi singakha ngenxa yokulimala kwe-vein noma ngokuba nesifo esidluliselwa ezizukulwaneni esithinta indlela igazi lakho eliqina ngayo. Ungase futhi uthole isigaxa legazi ngemva kokungasebenzi isikhathi eside, njengasesikhathini sokugula esibhedlela noma ekuphulukiseni ekwlimala.

Ubungozi bakho be-thrombophlebitis bukhulu uma ungasebenzi isikhathi eside noma une-catheter emithanjeni ephakathi ukuze welaphe isimo. Ukuba nemithambo yezinhlungu noma i-pacemaker kungandisa nebungozi bakho. Abafazi abakhulelwe, abasanda kubeletha, noma abaphuza amaphilisi okuvimbela ukukhulelwa noma ukwelashwa kwe-hormone bangase babe sengozini enkulu. Ezinye izimbangela zengozi zihlanganisa umlando womndeni wesifo sokuhlanganiswa kwegazi, ukuthambekela kokwakha ama-clots egazi, nokuhlushwa yi-thrombophlebitis ngaphambili. Ubungozi bakho bungase bukhulu uma uke waba nokushaya kwengqondo, uneminyaka engaphezu kuka-60, noma unesisindo esingaphezulu. Ukuba nomdlavuza nokubhema kuwonawo ama-risk factors.

Izinkinga ezivela ku-thrombophlebitis ebushelelezi zingezona ezivamile. Kodwa-ke, uma uthuthukisa i-deep vein thrombosis (DVT), ingozi yezinkinga ezingathi sína iyanda. Izinkinga zingafaka:

• I-blood clot emaphashini (i-pulmonary embolism). Uma ingxenye ye-clot ejulile ye-vein ihlukana, ingaya emaphashini akho, lapho ingavimba khona i-artery (i-embolism) futhi ibe yingozi eyingozi ebomini.
• Ubuhlungu obuhlala njalo omunyameni nokukhuluphala (i-post-phlebetic syndrome). Lesi simo, esaziwa nangokuthi i-post-thrombotic syndrome, singathuthuka ngezinyanga noma ngeminyaka ngemva kokuba uthole i-DVT. Ubuhlungu bungase bukhubaze.

Ukuhlala isikhathi eside ohambweni lwenqola-moya noma emoyeni kungabangela ukuba izingalo zakho neenqindi ziqale ukuvuvukala futhi kukwandisa ingozi yokuthola i-thrombophlebitis. Ukuvimbela i-blood clot:

• Hamba-hamba. Uma uhamba ngenqola-moya noma nge-train noma ngebhasi, hamba phezulu naphansi emgwaqweni cishe njalo ngehora. Uma uqhuba, yima cishe njalo ngehora bese uhamba-hamba.
• Nyakaza imilenze yakho njalo. Goba izingalo zakho, noma ucindezele ngokucophelela izinyawo zakho phansi noma endaweni yokubeka izinyawo phambi kwakho okungenani izikhathi eziyi-10 njalo ngehora.
• Phuza amanzi amaningi noma ezinye izinto ezingena-uthakathaka ukuze ugweme ukuphelelwa amanzi.

Ukuthola i-thrombophlebitis, udokotela angase akusize mayelana nokuzwelwa ubuhlungu bakho futhi abuke imithambo yegazi ebonakalayo eduze kwesikhumba sakho. Ungase ube novivinyo lokwenza izithombe, njengolwemi-ultrasound, ukuhlola umlenze wakho ukuze ubone ukuthi une-thrombosis yemithambo yegazi ebonakalayo noma ejulile. Uvivinyo lwegazi lungabonisa ukuthi unezinga eliphezulu lesigaxa esichitha ama-clots. Lovivinyo lungabuye lukhiphe i-DVT futhi lubonise ukuthi uyingozi yokuba ne-thrombophlebitis ngokuphindaphindiwe.

Ukuthola i-thrombophlebitis, udokotela wakho uzokubuza ngokungakhululeki kwakho futhi abuke imithambo yegazi ebonakalayo eduze kwesikhumba sakho. Ukuze aqinisekise ukuthi une-thrombophlebitis ebonakalayo noma i-thrombosis yemithambo yegazi ejulile, udokotela wakho angase akhethe omunye walawa mavivinyo:

I-Ultrasound. Idivayisi efana nenduku (i-transducer) ehambiswa endaweni ebonakalayo yomlenze wakho ithumela amaza omsindo emilenzeni yakho. Njengoba amaza omsindo edlula esikhumbeni somlenze wakho futhi ebuyela emuva, ikhompyutha iguqula amaza abe yisithombe esihambayo esikrinini sevidiyo.

Lovivinyo lungaqinisekisa ukuxilongwa futhi luhlukanise phakathi kwe-thrombosis yemithambo yegazi ebonakalayo nejulile.

Uvivinyo lwegazi. Cishe wonke umuntu onama-clots egazi unezinga eliphezulu legazi lesigaxa esichitha ama-clots esiqinile, esibizwa nge-D dimer. Kodwa amazinga e-D dimer angaphakama nakwezinye izimo. Ngakho-ke ukuhlolwa kwe-D dimer akuyona into eqinisekile, kodwa kungabonisa isidingo sokuhlolwa okuqhubekayo.

Kuyasiza futhi ekususeni i-thrombosis yemithambo yegazi ejulile (DVT) nasekutholeni abantu abasezingozini zokuthuthukisa i-thrombophlebitis ngokuphindaphindiwe.

• I-Ultrasound. Idivayisi efana nenduku (i-transducer) ehambiswa endaweni ebonakalayo yomlenze wakho ithumela amaza omsindo emilenzeni yakho. Njengoba amaza omsindo edlula esikhumbeni somlenze wakho futhi ebuyela emuva, ikhompyutha iguqula amaza abe yisithombe esihambayo esikrinini sevidiyo.

  Lovivinyo lungaqinisekisa ukuxilongwa futhi luhlukanise phakathi kwe-thrombosis yemithambo yegazi ebonakalayo nejulile.

• Uvivinyo lwegazi. Cishe wonke umuntu onama-clots egazi unezinga eliphezulu legazi lesigaxa esichitha ama-clots esiqinile, esibizwa nge-D dimer. Kodwa amazinga e-D dimer angaphakama nakwezinye izimo. Ngakho-ke ukuhlolwa kwe-D dimer akuyona into eqinisekile, kodwa kungabonisa isidingo sokuhlolwa okuqhubekayo.

  Kuyasiza futhi ekususeni i-thrombosis yemithambo yegazi ejulile (DVT) nasekutholeni abantu abasezingozini zokuthuthukisa i-thrombophlebitis ngokuphindaphindiwe.

Ukuqapha okungaphezulu kwesikhumba kungenziwa ngokufaka ubushushu endaweni ebuhlungu nokuphakamisa umlenze wakho. Ungase futhi uthathe imithi yokunciphisa ukukhuluphala nokuvuvukala bese ugqoka izokisi zokucindezela. Kusuka lapho, ngokuvamile kuyahamba ngokwalo. Ngokuqapha okungaphezulu nangaphakathi kwezinzwa, noma i-DVT, ungase uthathe imithi ehlanza igazi futhi ichithe ama-clot. Ungagqoka izokisi zokucindezela ezitholakala ngomyalelo wezokwelapha ukuvimbela ukukhuluphala nokuvimbela izinkinga ze-DVT. Uma ungakwazi ukuthatha abaphansi begazi, i-filter ingafakwa esinzweni elikhulu esiswini sakho ukuvimbela ama-clot ukuba angangeni emaphashini akho. Ngezinye izikhathi izinzwa zevaricose zisuswa ngokuhlinzwa.

Ngokuqapha okungaphezulu kwesikhumba, udokotela wakho angase akukhuthaze ukufaka ubushushu endaweni ebuhlungu, ukuphakamisa umlenze othoniwe, ukusebenzisa imithi engaphezu kokuthengiswa engaphezu kokuthengiswa (i-NSAID) futhi mhlawumbe ugqoke izokisi zokucindezela. Isimo ngokuvamile siyaphila ngokwalo.

Izokisi zokucindezela, ezaziwa nangokuthi izokisi zokusekela, zicindezela emilenzeni, zithuthukisa ukugeleza kwegazi. I-stocking butler ingasiza ekufakeni izokisi.

Udokotela wakho angase futhi akukhuthaze lezi zindlela zokwelapha zombili izinhlobo ze-thrombophlebitis:

• Imithi ehlanza igazi. Uma une-thrombosis yezinzwa ejulile, ukugxilwa kwemithi ehlanza igazi (i-anticoagulant), njenge-heparin enesisindo esincane, i-fondaparinux (Arixtra) noma i-apixaban (Eliquis), kungasiza ukuvimbela ama-clot ukuba akhule. Ngemva kokwelashwa kokuqala, cishe uzotshelwa ukuthi uthathe i-warfarin (Jantoven) noma i-rivaroxaban (Xarelto) izinyanga eziningi ukuqhubeka nokuvimbela ukukhula kwe-clot. Abaphansi begazi bangabangela ukuphuza igazi okukhulu. Landela imiyalo yodokotela wakho njalo ngokucophelela.
• Imithi ehlanza ama-clot. Ukwelashwa ngemithi ehlanza ama-clot kubizwa ngokuthi i-thrombolysis. Imithi i-alteplase (Activase) isetshenziswa ukuhlanza ama-clot egazi kubantu abane-DVT enkulu, kuhlanganise nalabo abane-clot egazi emaphashini (i-pulmonary embolism).
• Izokisi zokucindezela. Izokisi zokucindezela zamandla omthetho zisiza ukuvimbela ukukhuluphala nokunciphisa amathuba ezinkinga ze-DVT.
• I-Vena cava filter. Uma ungakwazi ukuthatha abaphansi begazi, i-filter ingafakwa esinzweni elikhulu esiswini (i-vena cava) ukuvimbela ama-clot ahlukana ezinzweni zezinyawo ukuba angangeni emaphashini. Ngokuvamile, i-filter isuswa uma ingasasebenzi.
• Ukususa izinzwa zevaricose. Udokotela angasusa izinzwa zevaricose ezibangela ubuhlungu noma i-thrombophlebitis ephindaphindayo. Le nqubo ihilela ukususa isinzi elide ngezinsimbi ezincane. Ukususa isinzi ngeke kuthonye ukugeleza kwegazi emilenzeni yakho ngoba izinzwa ezijulile emilenzeni zibheka amavolumu andisiwe egazi.

Ngaphezu kokwelashwa kwezokwelapha, izindlela zokunakekela uqobo zingasiza ekuthuthukiseni i-thrombophlebitis.

Uma une-thrombophlebitis ebonakalayo:

Xhumana nodokotela wakho uma uthatha olunye uhlangothi lwegazi, njenge-aspirin.

Uma une-thrombosis ye-deep vein:

• Sebenzisa i-washcloth efudumele ukufaka ubushushu endaweni ehilelekile izikhathi eziningi ngosuku

• Gcina umlenze wakho uphakanyisiwe uma uhleli noma ulele phansi

• Sebenzisa i-drug engapheli-inflammatory (NSAID), njenge-ibuprofen (Advil, Motrin IB, ezinye) noma i-naproxen sodium (Aleve, ezinye), uma kunconywe udokotela wakho

• Thatha imithi yokunciphisa igazi njengoba kunconywe ukuvimbela izinkinga

• Gcina umlenze wakho uphakanyisiwe uma uhleli noma ulele phansi uma uqengqelekile

• Gqoka izokisi zakho zokucindezela ezinamandla njengoba kunconywe