I-CAD, I-Triple Vessel Disease (TVD) Akusho ukuthi Isiguli Sizodinga Ukuhlinzwa Ngokuphambene Nomthetho

I-Triple Vessel Disease yisimo esibucayi senhliziyo. Iwuhlobo lwe-Coronary Artery Disease (CAD) evalekile kuyo yomithathu imithambo yegazi emikhulu ehlinzeka inhliziyo ngegazi.  

I-TVD empeleni ibangelwa ukuqina noma ukuvaleka kwemithambo ngenxa yesimo esibizwa ngokuthi i-atherosclerosis. Lokhu kungenzeka ngenxa yemikhuba engemihle yokuphila okuhlanganisa ukungazivocavoci, ukungadli kahle, ukukhuluphala ngokweqile, isifo sikashukela, ukubhema, njll.

Izimpawu ze-TVD

Izimpawu ze-triple isitsha se-coronary artery disease zilingisa lezo ze-CAD, njenge:

• Ukukhathala: Ukukhathala okuqhubekayo noma ukungabi namandla.
• Ukudideka: Ubunzima bokugxila noma ukucabanga kahle.
• Ubunzima bokuphefumula: Ukuphelelwa umoya, ikakhulukazi phakathi nomsebenzi womzimba noma uphumule.
• Ubuhlungu Besifuba: Ukungakhululeki noma ukucindezela esifubeni okungase kukhanye emahlombe, izingalo, intamo, umhlathi, noma emuva.
• Ukushaya Kwenhliziyo Okungavamile: Ukushaya kwenhliziyo noma ukuqaphela ukushaya kwenhliziyo okungavamile.
• Isilungulela: Ukuzwa ukushisa esifubeni noma ngaphezulu kwesisu.
• Ukuzwa Ukuklinywa: Ukuzwa ukuqina noma ukuqina endaweni emphinjeni or isifuba.
• Isicanucanu: Ukuzizwa uguliswa yisisu noma uququda.
• Ukuphalaza: Ukukhipha isisu ngomlomo.
• Isiyezi: Ukuzizwa unekhanda elilula noma ungaqinile.
• Ukungakhululeki Emhlane, Entanyeni, Ezingalo, Emahlombe, Noma Emhlathini: Ubuhlungu, ukucindezela, noma ubuhlungu kulezi zindawo, kuvame ukuhlotshaniswa nokungakhululeki kwesifuba.

Ukutholwa kwe-TVD

I-TVD ingatholwa ngokuhlolwa okuhlukahlukene. Lokhu kufaka phakathi:

• I-catheterization yenhliziyo (i-coronary angiography)
• I-CT Coronary Angiogram

Indlela Yokwelapha

Ukwelashwa kuhloswe ukuthuthukisa ukugeleza kwegazi, ukunciphisa ubunzima benhliziyo, nokumisa noma ukubuyisela ukwakheka koqweqwe lwemithambo yegazi.

Ukwelashwa kwakho okuqondile kuzoncika ezintweni ezifana nempilo iyonke, imithi esetshenziswa kanyekanye, kanye nokusabela ekwelashweni. Izindlela ezijwayelekile zifaka:

• Ama-Beta-blockers noma ama-calcium channel blockers okulawula umfutho wegazi.
• Ama-Vasodilators anciphisa izindonga ze-artery.
• Izinqubo ezifana nebhaluni angioplasty noma i-coronary artery bypass grafting ukuvula imithambo evalekile.
• Ukwamukela izinguquko zendlela yokuphila njengokuzivocavoca njalo, ukudla okunempilo, ukubhema ukuyeka, nokugcina isisindo esinempilo.

I-CABG noma i-Angioplasty yezifo ze-Triple Vessel?

Uma umuntu kutholakala ukuthi une-Triple Vessel Disease, akusho ukuthi i-CABGs iyindlela yokwelapha eyelulekwayo. Odokotela bangakhetha i-angioplasty noma i-CABG kuye ngenani nendawo yokuvinjwa kwenhliziyo namandla okumpompa kwenhliziyo. 

Amaphuzu aziwa ngokuthi amaphuzu e-syntax asetshenziswa odokotela benhliziyo njengethuluzi lokuhlola ubunkimbinkimbi bezilonda zemithambo yenhliziyo. Uma amaphuzu e-syntax engaphansi okusho ukuthi ukuvinjelwa kulula, i-angioplasty ingasebenza ngokulinganayo njenge-CABGs. Kodwa-ke, uma kunamabhulokhi ayinkimbinkimbi, ama-CABG asebenza kangcono kune-angioplasty.

Ucwaningo lwakamuva lubonise ukuthi iziguli ezine-Triple Vessel Disease akudingeki ukuthi zidlule kuma-CABG. I-PTCA noma i-CABGs ingalulekwa njengendlela yokwelapha kuye ngesimo ngasinye seziguli. 

Ubani osengcupheni yalesi sifo?

Abantu abasengozini ye-CAD (Coronary Artery Disease) kanye ne-Triple Vessel Disease (TVD) bahlanganisa:

• Labo abanakho nomfutho wegazi ophezulu
• Abantu abanomlando womndeni wesifo senhliziyo
• Ababhemayo
• Abantu abakhuluphele noma abakhuluphele ngokweqile
• Labo abaphila impilo yokunganyakazi
• Abantu abanesifo sikashukela noma insulin Ukumelana

Izindlela Zokuthola Izifo Zemikhumbi Ezintathu

Ukuthola isifo se-coronary artery kuhlanganisa:

• I-Coronary Angiography: Isebenzisa udayi nama-X-ray ukuze ubuke ukuvaleka kwemithambo yenhliziyo.
• Ukuhlolwa Kwengcindezi: Ihlola ukusebenza kwenhliziyo ngesikhathi sokuzivocavoca noma ngemithi.
• I-Electrocardiogram (ECG): Irekhoda umsebenzi kagesi wenhliziyo ngokungahambi kahle.
• I-Echocardiography: Isebenzisa amaza omsindo ukwenza izithombe zenhliziyo.
• I-CT Angiography: Ama-X-ray namakhompyutha enza izithombe ezinemininingwane yenhliziyo nemithambo yegazi.
• I-MRI: Isebenzisa omazibuthe namaza omsakazo ukuze kuhlolwe inhliziyo enemininingwane.
• I-Fractional Flow Reserve (FFR): Ikala ukugeleza kwegazi emithanjeni ethile yenhliziyo ngesikhathi se-angiography.

Isiphetho

I-Triple Vessel Disease yisimo sezempilo esibucayi futhi uhlobo oludlulele lwe-Coronary Artery Disease. Kodwa-ke, kungenzeka ukunciphisa ubungozi futhi uvimbele izifo ezinjalo ngokukhetha indlela yokuphila enempilo. 

Uma kwenzeka isiguli sinezimpawu ezibalulwe ngenhla, kufanele sibonane nodokotela wenhliziyo futhi sihlole izinketho zazo. Uma kutholakala ukuthi une-TVD nanoma yiluphi olunye uhlobo lwe-CAD, ukukhetha phakathi kwe-CABG ne-Angioplasty kuyingxenye yomphumela wesifo. Ikakhulukazi ukukhetha kuncike ezintweni eziningi futhi ngentuthuko yakamuva yobuchwepheshe ama-CABG ahlaselayo angase angadingeki noma aze alulekwe. Ukuzikhethela kuzoncika kakhulu kulokho okuthandwa udokotela wenhliziyo nesiguli kanye nesimo sesiguli. Lokhu kufaka phakathi isifo sikashukela, ukwehluleka kwenhliziyo ngokuncipha kwemithambo, ukuba nokwenzeka kokuvuselelwa kabusha kwemithambo, njll.

Ekuphetheni, udokotela wenhliziyo uzosihlola ngokucophelela isiguli futhi enze ukukhetha okunolwazi. Nakuba i-CABG ingase ibe inkambo yokwelashwa ezigulini eziningi, ingase ingabekwa njalo futhi inkambo yokwelashwa ingaba nge-Angioplasty futhi.

Imibuzo Evame Ukubuzwa

1. Siyini isifo semikhumbi emithathu? 

Isifo semikhumbi emithathu (i-TVD) sibhekisela esimweni lapho yomithathu imithambo emikhulu ye-coronary enikeza igazi enhliziyweni incisha noma ivinjwe, inciphisa ukugeleza kwegazi futhi okungase kuholele ebuhlungwini besifuba (angina) noma ukuhlaselwa yinhliziyo.

2. Ingabe isifo semikhumbi emithathu singafakwa? 

Yebo, isifo semikhumbi emithathu singelashwa nge-stenting. Lokhu kuhilela ukufaka ishubhu elincane elinenetha (i-stent) emithanjeni yenhliziyo emincane noma evalekile ukuze kubuyiselwe ukugeleza kwegazi. Ama-stents angafakwa ngesikhathi sezinqubo ezifana ne-percutaneous coronary intervention (PCI).

3. Umuntu angaphila isikhathi esingakanani enesifo semikhumbi emithathu? 

Ubude besikhathi sokuphila komuntu onesifo semikhumbi emithathu sincike ezicini ezihlukahlukene ezihlanganisa impilo yonke, izinga lesifo se-coronary artery, ukwelashwa okutholiwe, kanye nokuhambisana neseluleko sezokwelapha. Ngokwelashwa okufanele kanye nokuguqulwa kwendlela yokuphila, abantu abaningi bangaphila impilo egcwele naphezu kokuba nesifo semikhumbi emithathu.

4. Selashwa kanjani isifo semikhumbi emithathu? 

Ukwelashwa kungase kuhlanganise imithi yokulawula izimpawu nokunciphisa ukwakheka kwama-plaque, ukushintsha indlela yokuphila (ukudla, ukudla, Ukuvivinya, ukuyeka ukubhema), izinqubo ezifana ne-stenting noma i-CABG yokuthuthukisa ukugeleza kwegazi, kanye nokuphathwa kwezokwelapha okuqhubekayo ukuvimbela izinkinga.

5. Ingabe isifo semikhumbi emithathu singelapheka ngaphandle kokuhlinzwa? 

Nakuba isifo semikhumbi emithathu singeke "selapheka" ngomqondo wendabuko, singaphathwa ngendlela efanele futhi selashwe ngaphandle kokuhlinzwa ngoshintsho lwendlela yokuphila, imithi, kanye nezinqubo ezihlasela kancane ezifana ne-stenting. Ukuhlinzwa okufana ne-CABG kungase kudingeke ezimweni ezimbi kakhulu.

6. Kuyini ukudla kwesifo semikhumbi emithathu? 

Ukudla okunempilo kwenhliziyo kwesifo semikhumbi emithathu ngokuvamile kuhlanganisa:

• Inala yezithelo nemifino
• Ukudla okuphelele
• Amaprotheni angenalutho (njengezinhlanzi, izinkukhu, ubhontshisi namantongomane)
• Imikhiqizo yobisi enamafutha amancane
• Ukunciphisa amafutha agcwele, amafutha e-trans, cholesterol, i-sodium, noshukela owengeziwe
• Ukugwema ukudla okugayiwe kanye nosawoti oweqile