Yini i-Coronary Angioplasty kanye ne-Stents? Inhloso, Inqubo & Imiphumela

I-Coronary angioplasty iyinqubo encane engahlaseli evula imithambo yenhliziyo evaliwe noma encishisiweyo isebenzisa ibhaluni elincane. Ngesikhathi senqubo, odokotela bavame ukufaka ishubhu elincane elinenetha elibizwa nge-stent ukuze bavule umthambo isikhathi eside. Lokhu kwelapha kusiza ukubuyisela ukugeleza kwegazi emsipheni wenhliziyo yakho, kunciphisa ubuhlungu besifuba futhi kunciphisa ingozi yakho yokuhlaselwa yinhliziyo.

Yini i-coronary angioplasty?

I-Coronary angioplasty yinqubo ekhulisa imithambo yenhliziyo encishisiwe ngaphandle kokuhlinzwa okuvulekile. Udokotela wakho ufaka ishubhu elincanyana elinebhaluni eliqediwe ekugcineni kwalo ngomthambo wegazi esihlakaleni sakho noma emgodini. Ibhaluni libe selikhukhumezwa endaweni evaliwe ukuze licindezele amafutha odongeni lomthambo, okwenza indawo eyengeziwe yokuthi igazi ligeleze.

Igama lezokwelapha lale nqubo lithi percutaneous coronary intervention, noma i-PCI ngamafuphi. Cabanga ngayo njengokuhlanza ipayipi elivaliwe, ngaphandle kokuthi

Njengoba sesishilo lokho, udokotela wakho wenhliziyo uzocabangela izinto eziningana ngaphambi kokuncoma i-angioplasty:

• Indawo nokujiya kokuvinjelwa kwakho
• Ukusebenza kwenhliziyo yakho kanye nempilo yakho iyonke
• Ukuthi usabela kanjani emithini
• Izimpawu zakho kanye nekhwalithi yempilo yakho
• Noma ngabe unesifo senhliziyo esisebenzayo

Ezimweni eziphuthumayo njengokuhlaselwa yinhliziyo, i-angioplasty ingasindisa impilo ngokushesha ngokuvula kabusha umthambo ovinjelwe ngokuphelele. Ezimweni ezinzile, kuvame ukucatshangelwa lapho imithi kanye nezinguquko zokuphila zinganikezi ukukhululeka okwanele ezimpawini.

Yini inqubo ye-coronary angioplasty?

Inqubo ye-angioplasty ngokuvamile ithatha imizuzu engama-30 kuya emahoreni ama-2, kuye ngobunzima bokuvinjelwa kwakho. Uzobe uvukile kodwa ubuthuntu ngesikhathi senqubo, ulele etafuleni elikhethekile elise-cardiac catheterization lab elihlonyiswe ngemishini ye-X-ray.

Ithimba lakho lezokwelapha lizoqala ngokubulala indawo lapho lizofaka khona i-catheter, ngokuvamile isihlakala sakho noma ithanga eliphezulu. Ngemuva kokwenza umgodi omncane, bazofaka ngentambo ithumbu elincanyana, eliguquguqukayo elibizwa nge-catheter ngemithambo yakho yegazi kuze kufike enhliziyweni yakho. Umbala okhethekile ufakwa nge-catheter ukuze imithambo yakho ivele ngokusobala ezithombeni ze-X-ray.

Ake sihlukanise ukuthi kwenzekani ngokulandelayo ngesikhathi se-angioplasty yangempela:

1. Udokotela wakho uqondisa i-balloon catheter endaweni evaliwe
2. I-balloon iyakhukhuliswa ukuze icindezele i-plaque odongeni lomthambo
3. I-balloon iyakhukhuliswa futhi ingase ikhukhuliswe futhi uma kudingeka
4. I-stent ngokuvamile ibekwa ukuze igcine umthambo uvulekile
5. Yonke imishini isuswa ngokucophelela
6. Kufakwa ingcindezi ukuvala indawo yokufaka

Ngesikhathi sokukhukhumala kwebhaluni, ungase uzwe ukucindezela esifubeni noma ukuphatheka kabi imizuzwana embalwa. Lokhu kuvamile futhi kusho ukuthi inqubo iyasebenza ekuvuleni umthambo wakho. Ithimba lakho lezokwelapha lizobheka ukushaya kwenhliziyo yakho nomfutho wegazi kuyo yonke inqubo.

Ungalungiselela kanjani i-coronary angioplasty yakho?

Ukulungiselela i-angioplasty kuvame ukuqala ezinsukwini ezimbalwa ngaphambi kwenqubo yakho. Udokotela wakho uzobuyekeza imithi yakho futhi angase akucele ukuthi uyeke ukuthatha izinciphisi zegazi ezithile noma imithi yesifo sikashukela okwesikhashana. Uzodinga futhi ukuhlela ukuthi othile akuqhubele ekhaya ngemva kwalokho, njengoba ngeke ukwazi ukuqhuba okungenani amahora angu-24.

Ngosuku olwandulela inqubo yakho, ngokuvamile uzodinga ukuyeka ukudla nokuphuza ngemva kwamabili. Ithimba lakho lezokwelapha lizokunikeza imiyalelo ethile mayelana nemithi okufanele uyithathe ngamanzi amancane ekuseni kwenqubo yakho. Uma unesifo sikashukela, udokotela wakho uzohlinzeka ngesiqondiso esikhethekile mayelana nokuphatha ushukela wakho wegazi.

Nakhu ongakulindela ngosuku lwe-angioplasty yakho:

• Fika esibhedlela amahora angu-1-2 ngaphambi kwesikhathi sakho esihleliwe
• Guqela engubeni yesibhedlela futhi ususe ubucwebe
• Hlangana nodokotela wakho we-anesthesiologist kanye ne-cardiologist
• Faka umugqa we-IV wemithi kanye noketshezi
• Thola ukuthuliswa okuncane ukukusiza ukuthi uphumule

Ithimba lakho lezokwelapha lizophinda ligunde futhi lihlanze indawo lapho lizofaka khona i-catheter. Ungakhathazeki ngokuzizwa ukhathazekile - lokhu kuvamile ngokuphelele, futhi abahlengikazi bakho banolwazi ekusizeni iziguli ukuthi zizizwe zikhululekile futhi zinolwazi kuyo yonke inqubo.

Ungawafunda kanjani imiphumela yakho ye-coronary angioplasty?

Imiphumela yakho ye-angioplasty ngokuvamile ilinganiswa ngempumelelo inqubo evule ngayo imithambo yakho evaliwe. Odokotela bahlose ukunciphisa ngaphezu kuka-20% ngemuva kwenqubo, okusho ukuthi umthambo wakho kufanele uvuleke okungenani ngo-80%. Udokotela wakho wenhliziyo uzokukhombisa izithombe zangaphambi nangemva ezibonisa ngokusobala ukuthuthuka kokugeleza kwegazi.

Amanani empumelelo ye-angioplasty ngokuvamile akhuthaza kakhulu. Inqubo eningi izuza impumelelo yezobuchwepheshe ngokushesha, okusho ukuthi ukuvaleka kuvulwa ngempumelelo futhi ukuhamba kwegazi kubuyiselwa. Udokotela wakho uzophinda alinganise into ebizwa ngokuthi i-TIMI flow, ehlola ukuthi igazi lihamba kahle kangakanani emthanjeni wakho esikalini esingu-0 kuya ku-3, lapho u-3 kuyisijwayelekile.

Ngakho lokhu kusho ukuthini kuwe? Nawa amakhomba abalulekile iqembu lakho lezokwelapha elizowaqapha:

• Ukuqeda ngokushesha ubuhlungu besifuba noma ukucindezela
• Ukugeleza kwegazi okuthuthukisiwe okubonakala ezithombeni ze-X-ray
• Isigqi senhliziyo esizinzile ngesikhathi nangemva kwenqubo
• Umfutho wegazi ojwayelekile kanye namazinga omoya-mpilo
• Ukubekwa kwe-stent okuphumelelayo uma kwakusetshenziswa eyodwa

Udokotela wakho wenhliziyo uzoxoxa ngemiphumela nawe ngokushesha ngemuva kwenqubo. Bazochaza ukuthi izithombe zikhombisani nokuthi ukwelashwa kufanele kuthuthukise kanjani izimpawu zakho nempilo yenhliziyo yesikhathi eside. Iziguli eziningi zibona ukukhululeka kwezimpawu phakathi nezinsuku kuya emavikini ngemuva kwe-angioplasty ephumelelayo.

Ungayigcina kanjani impilo yakho yenhliziyo ngemuva kwe-angioplasty?

Ukugcina impilo yakho yenhliziyo ngemuva kwe-angioplasty kudinga inhlanganisela yemithi, izinguquko zendlela yokuphila, nokunakekelwa okuqhubekayo. Udokotela wakho uzonikeza imithi yokunciphisa igazi ukuvimbela ukwakheka kwamahlule egazi azungeze i-stent yakho, futhi lokhu kubalulekile ekuphepheni kwakho. Ungayeki le mithi ngaphandle kokubonisana nodokotela wakho wenhliziyo kuqala.

Ukushintsha indlela yokuphila kudlala indima ebaluleke ngokulinganayo empumelelweni yakho yesikhathi eside. Inhliziyo yakho izozuza ekudleni okunothe ngemifino, izithelo, okusanhlamvu okuphelele, namaprotheni anciphile ngenkathi kukhawulwa amafutha agcwele, i-sodium, nokudla okucutshungulwayo. Ukuzivocavoca umzimba njalo, njengoba kuvunywe udokotela wakho, kusiza ukuqinisa inhliziyo yakho futhi kuthuthukise ukujikeleza kwegazi emzimbeni wakho wonke.

Ake sihlukanise izinyathelo ezibalulekile zokululama okuphelele nempilo yesikhathi eside:

1. Thatha yonke imithi ebekiwe ngqo njengoba uqondisiwe
2. Hambela wonke ama-aphoyintimenti okulandelayo nodokotela wakho wenhliziyo
3. Landela uhlelo lokudla okunempilo enhliziyo
4. Kancane kancane wandise ukuzivocavoca umzimba njengoba kunconywe
5. Yeka ukubhema ngokuphelele uma ungakayeki
6. Lawula ukucindezeleka ngezindlela zokuphumula noma ukwelulekwa
7. Qapha futhi ulawule umfutho wegazi, i-cholesterol, nesifo sikashukela

Ithimba lakho lezokwelapha lizosebenza nawe ukudala uhlelo olwenzelwe wena olungena endleleni yakho yokuphila nezidingo zempilo. Iziguli eziningi zithola ukuthi izinhlelo zokuvuselelwa kwenhliziyo zinikeza ukwesekwa okuhle kakhulu nesiqondiso ngesikhathi sokululama kwazo.

Ziyini izici eziyingozi zokudinga i-coronary angioplasty?

Izici eziningana eziyingozi zikhuphula amathuba akho okuthuthukisa isifo semithambo yenhliziyo esingase sidinge i-angioplasty. Ezinye zalezi zici ungalawula ngokukhetha indlela yokuphila, kanti ezinye zihlobene nezakhi zofuzo noma izimo zezokwelapha ozalwa nazo. Ukuqonda lezi zingozi kukusiza ukuthi wenze izinqumo ezinolwazi mayelana nempilo yenhliziyo yakho.

Izici eziyingozi ezingashintshwa yizona onamandla okuwaguqula noma ukuwathuthukisa. Umfutho wegazi ophezulu, i-cholesterol ephezulu, isifo sikashukela, ukubhema, ukukhuluphala, nendlela yokuphila yokuhlala nje konke kunomthelela ekwakhekeni kwe-plaque emithanjeni yakho. Ukucindezeleka okungapheli kanye nemikhuba emibi yokulala nakho kungathinta impilo yenhliziyo yakho ngokuhamba kwesikhathi.

Nazi izici eziyingozi ezibaluleke kakhulu udokotela wakho azozicabangela:

• Umlando womndeni wesifo senhliziyo, ikakhulukazi ngaphambi kweminyaka engama-65
• Umfutho wegazi ophezulu (140/90 mmHg noma ngaphezulu)
• Amazinga aphezulu e-cholesterol ye-LDL (ngaphezu kuka-100 mg/dL)
• Isifo sikashukela noma i-prediabetes
• Ukubhema kwamanje noma kwangaphambili
• Ukukhuluphala ngokweqile, ikakhulukazi okuzungeze okhalweni
• Ubudala (amadoda angaphezu kwama-45, abesifazane abangaphezu kwama-55)
• Isifo sezinso esingamahlalakhona
• Umlando wezinye izifo zemithambo yegazi

Ukuba nesici esisodwa noma ngaphezulu sokuthuthukisa isifo asiqinisekisi ukuthi uzodinga i-angioplasty, kodwa kwandisa amathuba akho okuthuthukisa isifo semithambo yenhliziyo. Izindaba ezinhle ukuthi ukubhekana nezici ezingashintshwa kunganciphisa kakhulu ingozi yakho futhi kungavimbela isidingo sezinqubo ezinjenge-angioplasty.

Ziyini izinkinga ezingase zibe khona ze-coronary angioplasty?

Ngenkathi i-coronary angioplasty ivikelekile futhi isebenza kahle, njenganoma iyiphi inqubo yezokwelapha, inezinye izingozi. Izinkinga ezinzima azivamile, zenzeka ngaphansi kuka-2% wezinqubo, kodwa kubalulekile ukuqonda ukuthi yini engase yenzeke. Ithimba lakho lezokwelapha lithatha izinyathelo eziningi zokunciphisa lezi zingozi.

Izinkinga ezincane ezivame kakhulu zihlanganisa ukopha noma ukuqaqamba endaweni yokufaka i-catheter, okuvame ukuxazululwa ezinsukwini ezimbalwa. Ezinye iziguli ziba nokungakhululeki okwesikhashana noma ubuhlungu lapho kufakwe khona i-catheter. Ngokuvamile, iziguli zingase zibe nokusabela komzimba emthunzini osetshenziswa ngesikhathi senqubo.

Nawa amathuba okuba khona kwezinkinga, kusukela ezincane kuya kwezinzima kakhulu:

• Ukuphuma igazi noma i-hematoma endaweni yokufaka
• Ukuqaqamba noma ubuhlungu obuhlala izinsuku eziningana
• Ukungezwani komzimba nomthunzi
• Izinkinga zesikhashana zezinso ezivela emthunzini
• Umonakalo wemithambo noma ukudabuka ngesikhathi senqubo
• Amaqhuqhuva egazi akheka ngase-stent
• Ukuhlaselwa yinhliziyo ngesikhathi senqubo (akuvamile kakhulu)
• Isitroko (akuvamile kakhulu)
• Isidingo sokuhlinzwa okuphuthumayo (ngaphansi kuka-1%)

Ithimba lakho lezokwelapha likuqapha eduze ngesikhathi nangemva kwenqubo ukuze libambe noma yiziphi izinkinga zisasekuqaleni. Iningi leziguli alitholi zinkinga nhlobo futhi lilulama kahle. Uma uhlangabezana nanoma yiziphi izimpawu ezingavamile ngemva kwenqubo yakho, unganqikazi ukuxhumana nomhlinzeki wakho wezempilo ngokushesha.

Kufanele ngibone nini udokotela ngemva kwe-coronary angioplasty?

Kufanele uthinte udokotela wakho ngokushesha uma uzwa ubuhlungu besifuba obuzizwa bufana nalobo obabunabo ngaphambi kwe-angioplasty yakho. Ngenkathi ukungakhululeki okuncane endaweni yokufaka kujwayelekile, ubuhlungu besifuba obusha noma obuqhubekayo bungabonisa inkinga nge-stent yakho noma ukuvaleka okusha. Ungalindi ukubona ukuthi izimpawu ziyathuthuka yini zodwa.

Ezinye izimpawu zokuxwayisa zidinga ukunakekelwa kwezokwelapha ngokushesha, ikakhulukazi emasontweni ambalwa okuqala ngemva kwenqubo yakho. Lokhu kufaka phakathi ukuphefumula okungavamile, isiyezi, ukuquleka, noma izinga lokushaya kwenhliziyo elisheshayo. Izinkinga endaweni yakho yokufaka, njengokopha okukhulu, ubuhlungu obanda, noma izimpawu zokutheleleka, nazo zidinga ukuhlolwa ngokushesha.

Xhumana nomhlinzeki wakho wezempilo ngokushesha uma uhlangabezana nanoma yiziphi zalezi zimpawu:

• Ubuhlungu besifuba noma ukucindezela okuhlala imizuzu engaphezu kwemihlanu
• Ukuphefumula okuncane okusha noma okuba kubi kakhulu
• Isiyezi, ukukhathala, noma ukuquleka
• Ukushaya kwenhliziyo okusheshayo noma okungajwayelekile
• Isicanucanu noma ukuhlanza ngokungakhululeki esifubeni
• Ubuhlungu obukhanyayo engalweni yakho, entanyeni, noma emhlathini
• Ukuphuma igazi okusebenzayo endaweni yokufaka
• Izimpawu zokutheleleka njengomkhuhlane, ububomvu, noma ukufudumala
• Ubuhlungu obukhulu noma ukuvuvukala endaweni ye-catheter

Ukuze uthole ukulandelela okuvamile, udokotela wakho wenhliziyo ngokuvamile uzokubona phakathi nesonto elilodwa kuya kwamabili ngemva kwenqubo yakho. Lawa ma-aphoyintimenti abalulekile ekuqapheni ukululama kwakho nokulungisa imithi uma kudingeka. Ukuhlolwa okuvamile kusiza ukuqinisekisa ukuthi i-stent yakho iyaqhubeka nokusebenza kahle futhi inhliziyo yakho ihlala iphilile isikhathi eside.

Imibuzo ebuzwa njalo nge-coronary angioplasty kanye nama-stents

Umbuzo 1. Ingabe i-coronary angioplasty ilungele ukuvimbela izifo zenhliziyo?

Yebo, i-coronary angioplasty ingasebenza kahle kakhulu ekuvikeleni izifo zenhliziyo, ikakhulukazi ezimweni ezithile. Uma unesifo senhliziyo esisebenzayo, i-angioplasty ephuthumayo ingasindisa impilo ngokushesha ngokuvula kabusha umthambo ovinjiwe futhi kunciphise umonakalo emisipheni yenhliziyo yakho. Ucwaningo lubonisa ukuthi lokhu kwelashwa okuphuthumayo kuthuthukisa kakhulu amazinga okuphila kanye nomsebenzi wenhliziyo wesikhathi eside.

Ngesifo somthambo we-coronary ozinzile, i-angioplasty ngokuyinhloko isiza ukukhulula izimpawu ezinjengobuhlungu besifuba nokuphefumula kanzima. Ngenkathi inganciphisa ingozi yakho yezifo zenhliziyo zesikhathi esizayo, ikakhulukazi uma unezithiyo ezinzima, le nqubo isebenza kahle kakhulu uma ihlanganiswe nemithi kanye nezinguquko zokuphila. Udokotela wakho wenhliziyo uzosiza ukunquma ukuthi i-angioplasty iyisu elifanele lokuvimbela isimo sakho esithile.

Umbuzo 2. Ingabe ukuba ne-stent kubangela izinkinga zesikhathi eside?

Abantu abaningi abane-stents baphila impilo ejwayelekile, enempilo ngaphandle kwezinkinga zesikhathi eside. Ama-stents anamuhla okhipha imithi aklanyelwe ukuhlanganisa ngokuphepha nodonga lomthambo wakho futhi anciphise kakhulu ingozi yokuthi umthambo unciphise futhi. Imithi ehlanganisa la ma-stents isiza ukuvimbela ukwakheka kwezicubu ezinamanxeba ezungeze le divayisi.

Nokho, uzodinga ukuthatha imithi yokunciphisa igazi, ngokuvamile okungenani unyaka owodwa ngemva kokufakwa kwe-stent. Ngokungavamile, ezinye iziguli zingase zithuthukise i-in-stent restenosis, lapho umthambo unciphisa futhi ngaphakathi noma ngaphandle kwe-stent. Lokhu kwenzeka ngaphansi kuka-10% wamacala ngama-stents anamuhla futhi ngokuvamile kungelashwa ngempumelelo uma kwenzeka.

Umbuzo 3. Ama-stents e-coronary ahlala isikhathi esingakanani?

Ama-stent e-coronary aklanyelwe ukuba ahlale unomphela futhi ngokuvamile ahlala impilo yonke uma efakwe kahle. I-stent ihlanganiswa odongeni lwakho lomthambo wemithambo yegazi eminyakeni eminingana, empeleni iba yingxenye ehlala unomphela yomthambo wakho wegazi. Ngokungafani namanye amadivayisi ezokwelapha, ama-stent awagugi noma adinge ukushintshwa ngaphansi kwezimo ezijwayelekile.

Lokho kusho, isifo semithambo ye-coronary singaqhubeka kwezinye izindawo zemithambo yegazi yenhliziyo yakho. Ngenkathi indawo ebekwe i-stent ngokuvamile ihlala ivulekile, ukuvaleka okusha kungase kuvele ezindaweni ezihlukene ngokuhamba kwesikhathi. Yingakho ukuqhubeka nemithi, izinguquko zokuphila, nokunakekelwa okuqhubekayo kubalulekile empilweni yakho yonke.

Umbuzo 4. Ngingakwazi yini ukuzivocavoca ngokujwayelekile ngemva kokufaka i-stent?

Yebo, abantu abaningi bangakwazi ukubuyela ekuzivocavoceni okuvamile nasemisebenzini yomzimba ngemva kokululama ekufakweni kwe-stent. Eqinisweni, ukuzivocavoca umzimba njalo kukhuthazwa ngokuqinile njengengxenye yokuphila kwakho okunempilo yenhliziyo. Iziguli eziningi zithola ukuthi zingase zikwazi ukuba matasa ngemva kwe-angioplasty ngoba ukugeleza kwegazi kwazo okuthuthukisiwe kunciphisa ubuhlungu besifuba nokuphefumula kanzima ngesikhathi sokuzikhandla.

Udokotela wakho uzonikeza imihlahlandlela ethile mayelana nokuthi nini nokuthi kanjani ukuqala kabusha ukuzivocavoca, ngokuvamile uqala ngemisebenzi elula phakathi nezinsuku ezimbalwa futhi wandise kancane kancane amandla emavikini ambalwa. Iziguli eziningi ziyazuza ezinhlelweni zokuvuselela inhliziyo, ezinikeza ukuqeqeshwa kokuzivocavoca okuqondisiwe kanye nemfundo mayelana nokuphila okunempilo yenhliziyo endaweni ephephile, eqashwe.

Umbuzo 5. Ngizodinga yini i-angioplasty ephindwayo esikhathini esizayo?

Iziguli eziningi azidingi i-angioplasty ephindwayo endaweni efanayo lapho kwafakwa khona i-stent. Ama-stent anamuhla akhishwa ngemithi anciphise kakhulu isidingo sezinqubo eziphindwayo, ngamanani empumelelo ahlala ephezulu iminyaka ngemva kokufakwa. Kodwa-ke, isifo semithambo ye-coronary singaqhubeka ngokuhamba kwesikhathi, okungenzeka sidinga ukwelashwa kokuvaleka okusha emithanjeni ehlukene.

Ingozi yakho yokudinga izinqubo zesikhathi esizayo incike kakhulu ekutheni uzilawula kanjani izinto eziyingozi ngemva kwe-angioplasty. Ukuthatha imithi njengoba kunqunyiwe, ukugcina indlela yokuphila enempilo yenhliziyo, ukulawula umfutho wegazi ne-cholesterol, nokugwema ukubhema konke kuyasiza ekuvikeleni ukuvela kwezithiyo ezintsha. Ukuqapha njalo nodokotela wakho wenhliziyo kusiza ukubamba noma yiziphi izinkinga ezintsha ekuqaleni lapho kulula ukuzelapha.