Embolism Embolism Embolism

Ihlule legazi elingena emthanjeni wakho wamaphaphu lingabangela i-pulmonary embolism ngokuvimba ukugeleza kwegazi okubalulekile. Izinga lokusinda liphathelene - umuntu oyedwa kwabathathu ongaxilongiwe futhi welashwe akaphumeleli. Izindaba ezinhle ukuthi ukuhlonzwa okusheshayo kanye nokwelashwa kuthuthukisa kakhulu lezi zingqinamba.

Iziguli eziningi ziba nokuphelelwa umoya kungazelelwe njengophawu lwazo oluyinhloko, nakuba ezinye izimpawu zingahluka kumuntu nomuntu. Izinto ezinciphisa igazi, noma ama-anticoagulant, zisebenza njengenketho yokwelapha eyinhloko. Amathuba akho okusinda anda kakhulu uma uzazi izici zobungozi, ubona izimpawu kusenesikhathi, futhi uthole usizo lwezokwelapha ngokushesha.

Iyini i-Pulmonary Embolism?

Lesi simo senzeka lapho amahlule egazi egqashuka emithanjeni ejulile yomlenze (deep vein thrombosis noma i-DVT) futhi azihlalele emithanjeni emincane yamaphaphu. Ukuvinjelwa kwemithambo yegazi ngezinye izikhathi kungase kubangele amabhamuza omoya, amafutha, uketshezi lwe-amniotic, noma amaseli esimila, nakuba lezi zimo zingavamile.

Izimpawu ze-Pulmonary Embolism

Ubukhulu behlule kanye nendawo yamaphaphu ethintekile inquma ukuthi izimpawu ze-pulmonary embolism zivela kanjani. Abantu bajwayele ukuzwa:

• Ubunzima bokuphefumula kungazelelwe (uphawu oluvame kakhulu)
• ezinzima ubuhlungu besifuba lokho kuba kubi nakakhulu ngenkathi uphefumula
• Iziqephu zokukhwehlela, ngezinye izikhathi ngegazi
• Ukuphefumula okusheshayo nokushaya kwenhliziyo okuphakeme

Ezinye iziguli zingase zizwe zinesiyezi, zikhathazekile, noma ziquleke. Bangase futhi babe nokujuluka okukhulu futhi babone izindebe zabo noma izinzipho ziba luhlaza okwesibhakabhaka.

Izimbangela ze-Pulmonary Embolism

Ukuhlinzwa, ukuhlukunyezwa, izifo, noma ukulimala kungalimaza imithambo futhi kubangele amahlule egazi. Igazi livamise ukuhlangana futhi lenze amahlule phakathi nezikhathi ezinde ngaphandle komnyakazo.

Izingozi ze-Pulmonary Embolism

Abantu babhekana nezingozi eziphezulu ze-PE uma:

• Udlule iminyaka engu-60
• Muva nje uhlinzwe, ikakhulukazi ukushintshwa okuhlangene.
• Phila nomdlavuza noma wamukele imiphumela emibi yokwelashwa ngamakhemikhali
• Experience ukukhulelwa noma ukubeletha kwakamuva
• Thatha imithi esekelwe ku-hormone
• Yiba nezihlobo ezinomlando wehlule legazi
• Hlala unganyakazi phakathi nohambo olude

Izinkinga ze-Pulmonary Embolism

Ukwelashwa okubambezelekile kungaholela kokuthi:

• Umfutho wegazi ophezulu emithanjeni yamaphaphu (i-pulmonary hypertension)
• Ukuhluleka kwenhliziyo ohlangothini lwesokudla ngenxa yokucindezeleka ngokweqile
• Izicubu zamaphaphu ezifile (i-pulmonary infarction)
• Ukuqoqa uketshezi emaphashini (i-pleural effusion)

Sifo

Izinyathelo zokuqala zikadokotela zihlanganisa ukuhlolwa ngokomzimba kanye nokubuyekezwa komlando wakho wezokwelapha. Bahlola imilenze yakho ukuze bathole izimpawu ze-deep vein thrombosis— befuna izindawo ezivuvukele, ezithambile, ezibomvu, noma ezifudumele. 

Ukuhlolwa kwegazi okulinganisa amazinga e-D-dimer kusiza ukuthola ukwakheka kwehlule, futhi amazinga aphezulu angase akhombe amahlule egazi. 

Kungase kudingeke ukuhlolwa kwezithombe ezimbalwa:

• I-CT pulmonary angiography (indlela evame kakhulu)
• I-Ultrasound yemilenze ukuthola amahlule
• Ukuskena kwe-Ventilation-perfusion (V/Q).
• I-Echocardiogram ukuhlola ukusebenza kwenhliziyo
• I-angiography yamaphaphu ukuqinisekisa ukuxilongwa ezimweni ezingacacile

Ukwelashwa Kwe-Pulmonary Embolism

Umgomo oyinhloko wokwelashwa kwe-pulmonary embolism ukumisa ukukhula kwamahlule nokuvimbela amasha ukuba akheke. 

Ama-blood thiners (ama-anticoagulant) ayindlela yokwelapha evamile. Le mithi ivumela umzimba wakho ukuthi uphule amahlule akhona ngokwemvelo esikhundleni sokuwahlakaza ngokuqondile. 

Odokotela bangase basebenzise i-thrombolytics (izincibiliki zehlule) ezimweni ezisongela ukuphila, nakuba lezi zinengozi enkulu yokopha.

Izimo ezibucayi zingadinga ukungenelela kokuhlinzwa ngokukhipha ihlule elisizwa yi-catheter noma ukubekwa kwesihlungi se-vena cava esivimba amahlule ukuthi afinyelele emaphashini.

Uzoyibona Nini Udokotela

Udinga usizo lwezokwelapha ngokushesha uma uba nobunzima bokuphefumula obungachazeki, ubuhlungu besifuba, noma ukuquleka. 

Iziguli ezithatha imithi enciphisa igazi kufanele zithinte udokotela wazo uma zibona indle emnyama, ikhanda elibuhlungu, noma imihuzuko ekhulayo—lokhu kungase kubonise ukuphuma kwangaphakathi.

Prevention

Ungathatha izinyathelo ezimbalwa ukuvimbela i-pulmonary embolism:

• Ukuhamba njalo, ikakhulukazi phakathi nohambo olude 
• Ukugqoka amasokisi okucindezela ukuze kuthuthukiswe ukugeleza kwegazi 
• Ukuhlala ungenawo amanzi futhi unciphise ukuphuza utshwala 
• Ukuhlala kude ugwayi 
• Ukugcina isisindo esinempilo 
• Ukuphakamisa imilenze yakho imizuzu engu-30 kabili ngosuku

Iziguli ezihlinzwayo zivame ukuthola imithi enciphisa igazi ngaphambi nangemva kwezinqubo zokunciphisa ingozi yokuba namahlule.

Isiphetho

I-pulmonary embolism yisimo sezempilo esibucayi. Wena kanye nodokotela wakho ningakwazi ukukulawula uma kutholakala kusenesikhathi. Ukuqonda lesi simo kungasiza iziguli nemindeni yazo ukuthi zithathe izinyathelo ezifanele, nakuba ukuxilongwa kwasekuqaleni kungase kusabise. Umzimba wakho uzothumela izimpawu eziyisixwayiso ngezinkinga zokuphefumula okungazelelwe noma ubuhlungu besifuba. Ukusabela okusheshayo kulezi zimpawu kungasindisa impilo yakho.

Izinto eziyingozi zithinta abantu ngezindlela ezahlukene ngokusekelwe eminyakeni yabo yobudala, umlando wezokwelapha, nokukhetha indlela yokuphila. Izikhathi ezinde ngaphandle kokunyakaza zandisa ingozi, ikakhulukazi ngemva kokuhlinzwa noma phakathi nohambo olunwetshiwe. Ubungozi bakho bukhuphuka nokukhulelwa, imishanguzo yehomoni, nomlando womndeni - konke lokhu kudlala indima ebalulekile.

Abantu abaningi bangazuza kumasu okuvimbela. Ubuchwepheshe bezithombe obuthuthukisiwe, obuhlanganiswe nokwelashwa okufana nama-anticoagulant, bunikeza ithemba ezigulini ezinezimo ezinzima. Intuthuko yezokwelapha ithuthukisa imiphumela unyaka ngamunye. Ukungenelela okusheshayo kunikeza iziguli ithuba elingcono kakhulu lokusinda futhi eziningi zibuyela empilweni enempilo ngemva kokwelashwa.

Qaphela ukuthi ukuphelelwa umoya, ubuhlungu besifuba, noma izimpawu ezingavamile zidinga ukunakekelwa kwezokwelapha ngokushesha. Ukuthatha isinyathelo namuhla kuvimbela izinkinga kusasa.

Imibuzo Evame Ukubuzwa

1. Iyini imbangela eyinhloko ye-pulmonary embolism?

Amahlule egazi akhula emithanjeni ejulile yomlenze (deep vein thrombosis noma i-DVT) abangela konke ngaphandle kweyodwa yalawa ma-pulmonary embolism. Igazi liyagcwala emithanjeni yakho ngezikhathi zokungasebenzi, ikakhulukazi ngemva kokuhlinzwa noma uhambo olude. Ezinye izinto zingavimba ukugeleza kwegazi ezimweni ezingavamile:

• Amafutha akhululwa ngemva kokuphuka kwethambo noma ukuhlukumezeka
• Amabhamuza omoya avela ekuhlinzweni noma ezinqubweni zezokwelapha
• Amaseli e-tumor avela kumdlavuza okhula ngokushesha
• Amniotic uketshezi

2. Ungakwazi yini ukululama embolism yamaphaphu?

Ukwelashwa okufanele kusiza abantu abaningi ukuthi balulame ngokuphelele. Ukululama kuthatha amasonto ambalwa noma izinyanga njengoba izimpawu ziba ngcono ngokwelashwa okuqhubekayo. Ezinye iziguli zizizwa zingcono uma ukwelashwa kuqala, nakuba izinkinga zokuphefumula noma ubuhlungu besifuba bungathatha amasonto. Ukwelashwa okusheshayo kusindisa izimpilo.

3. Yiziphi izimpawu eziyisixwayiso ze-pulmonary embolism?

Okulandelayo yizimpawu ezijwayelekile zokuxwayisa:

• Ngokuphazima kweso ukuphelelwa umoya (uphawu oluvame kakhulu)
• Ubuhlungu besifuba obubukhali buba bubi nakakhulu lapho uphefumula noma ukhwehlela
• Ukushaya kwenhliziyo okusheshayo noma ukushaya kwenhliziyo okungajwayelekile
• Ukukhwehlela igazi
• ukukhathazeka, ikhanda elilula, noma ukuquleka
• Izindebe eziluhlaza okwesibhakabhaka noma izinzipho ezimweni ezinzima

4. Ingabe i-pulmonary embolism ingelapheka?

Imithi enciphisa igazi isiza umzimba wakho ukuba uncibilikise ihlule ngokuhamba kwesikhathi, nakuba “ukwelapha” kungelona igama elingcono kakhulu. Iziguli eziningi zidinga ama-anticoagulant okungenani izinyanga ezintathu, kwesinye isikhathi isikhathi eside. Imithi yempilo yonke ingase isize abantu abasengozini enkulu yokuphinda. Isimo asivamile ukubuya uma ulandela izinyathelo ezifanele zokwelashwa nokuvimbela.

5. Ingabe i-ECG ingakwazi ukubona i-pulmonary embolism?

Odokotela abakwazi ukuxilonga i-pulmonary embolism nge-ECG kuphela. Izinguquko ze-ECG zivela ezimweni eziningi ze-PE, kodwa azicacile noma azibucayi ngokwanele ukuze zixilongwe. Noma kunjalo, ama-ECG asiza ekukhipheni ezinye izinkinga njengokuhlaselwa yinhliziyo. I-CT pulmonary angiography, ukuhlolwa kwegazi kwe-D-dimer, nezikena zamaphaphu kunikeza imiphumela ethembeke kakhulu.

6. Ingabe i-PE iwalimaza unomphela amalugi?

Iziguli eziningi aziwutholi umonakalo omkhulu wamaphaphu unomphela. Iqembu elincane lakha izicubu zezibazi emithanjeni yamaphaphu okuholela ku-chronic thromboembolic pulmonary hypertension (CTEPH). Lesi sibazi sithinta ukuphefumula. Kufanele ubuze udokotela wakho ngale nkinga engavamile uma usenenkinga yokuphefumula ezinyangeni eziyisithupha ngemva kokwelashwa.

UDkt. VNB Raju

I-MBBS, MD
CARE Hospitals, Banjara Hills, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

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