Umfutho wegazi ophezulu wamaphaphu 

I-PH emele i-Pulmonary Hypertension isifo esibucayi se-hypertension emithanjeni yamaphaphu. Imithambo ihambisa igazi eline-oksijini eliphansi emaphashini ukusuka kwesokudla inhliziyo. Umfutho wegazi ophakeme wamaphaphu wehlisa inani legazi elifika enhliziyweni nasenhliziyweni amaphaphu, futhi lesi isizathu kuyisifo esibi. Uma iyekwa ingahloliwe, i-PH ingase ibangele ukwehla okuqhubekayo kwenhliziyo futhi iphumele ekuthuthukisweni kwezinkinga ezengeziwe ezihlanganisa wonke umzimba. Uma sitholakala kusenesikhathi, lesi sifo singelashwa ngaphandle kwalokho singaholela ezimweni ezibulalayo. 

Iyini i-Pulmonary Hypertension? 

Ifomu eliphezulu ukushaya kwegazi ebizwa ngokuthi i-pulmonary high blood pressure ilimaza imithambo emaphashini kanye nohlangothi lwesokudla lwenhliziyo. Umfutho ongaphakathi emithanjeni emincane emaphashini uyakhuphuka lapho uminyene noma uvaleka, okwenza kube nzima kakhulu ngegazi ukudlula kuwo. Uma lokhu kucindezela kungalawuleki kahle, kungase kugcine kuphoqe i-ventricle elungile yenhliziyo ukuthi ishaye kakhulu, okungase kubangele ukwehluleka kwenhliziyo. Umfutho wegazi ophakeme wamaphaphu udinga ukunakekelwa nokwelashwa okuqhubekayo, ngokungafani nomfutho wegazi ophakeme wamaphaphu, okungase kube ukusabela kwesikhashana ekucindezelekeni noma kwezinye izimo. 

Izinhlobo ze-Pulmonary Hypertension

I-Hypertension yamaphaphu ihlukaniswe ngezinhlobo ezinhlanu ngokuya ngezimbangela zayo: 

• I-Pulmonary Arterial Hypertension (PAH): Lolu wuhlobo lokuncipha noma ukuvaleka kwemithambo yamaphaphu ngenxa yezici ezihlukahlukene ezihlanganisa lezo zofuzo noma ezinye izimbangela ezingaziwa. 
• I-Pulmonary Hypertension ngenxa ye-Left Heart Disease: Lolu hlobo luvela emiphumeleni yezifo zenhliziyo kwesokunxele njengesifo se-mitral valve, noma imiphumela yesikhathi eside yomfutho wegazi ophezulu emithanjeni yamaphaphu. 
• I-Hypertension ye-Pulmonary ngenxa yezifo zamaphaphu: Izimo ezihlala isikhathi eside njenge-COPD noma isifo se-interstitial lung zingabangela lolu hlobo. 
• I-Chronic Thromboembolic Pulmonary Hypertension (CTEPH): Lolu wuhlobo olungavamile lwe-pulmonary hypertension olubangelwa amahlule egazi emaphashini angaxazululi futhi ngaleyo ndlela aqhubeke evimbela ukugeleza okuvamile ngokuqhubekayo. 
• I-Pulmonary Hypertension ngenxa ye-Multifactorial Mechanisms: Lolu hlobo luhlanganisa izici eziningi, okuhlanganisa ukuphazamiseka kwesistimu, izifo ze-metabolic, noma ezinye izimo ezithinta kanyekanye amaphaphu nenhliziyo. 

Izimpawu ze-Pulmonary Hypertension 

Uphawu lokuqala lwe-pulmonary hypertension luwuphawu ukuphelelwa umoya, obungazizwa lapho wenza imisebenzi yansuku zonke, njengokugibela izitebhisi noma ukuyothenga igilosa. Ungase futhi uhlangabezane nokuphelelwa umoya ngesikhathi Ukuvivinya. Ekuqaleni kwe-hypertension yamaphaphu, awubonisi noma yiziphi izimpawu. Kamuva, uyothola ukuthi izimpawu ezinjalo zikhona nokuthi zingaba mnene. Kodwa-ke, izimpawu ze-PH ziba zimbi ngokuhamba kwesikhathi, okwenza imisebenzi evamile yansuku zonke ibe nzima kakhulu ukuyenza. 

Ukuphelelwa umoya kuzovama njengoba i-PH yakho iba yimbi, ngisho noma unganyakazi. Izimpawu ezengeziwe nezimpawu zihlanganisa: 

• Ukuphefumula, ikakhulukazi ngesikhathi sokusebenza ngokomzimba 
• Ukukhathala nokubuthakathaka 
• ubuhlungu besifuba noma ingcindezi 
• Ukuvuvukala emaqakaleni, emilenzeni, ekugcineni nasesiswini 
• Umbala oluhlaza ezindebeni nasesikhumbeni (cyanosis) 
• Ukushaya kwenhliziyo okusheshayo noma ukushaya kwenhliziyo 
• Isiyezi noma ukuquleka 
• Ukuba nokuncane ukudla kunokujwayelekile
• Ubuhlungu besisu sakho esingenhla kwesokudla

Izimbangela Ze-Hypertension Yamaphaphu

I-hypertension yamaphaphu ingaba nezimbangela ezihlukahlukene, kuye ngohlobo lwayo:

• Ukuguqulwa kofuzo 
• Izimo ezifana nesifo se-valve yenhliziyo noma umfutho wegazi ophakeme wesikhathi eside ohlangothini lwesobunxele lwenhliziyo
• Isifo se-Chronic obstructive pulmonary (COPD), i-interstitial isifo samaphaphu, noma ukuphelelwa umoya
• Amahlule egazi emaphashini 
• Izifo ezizimele, izifo zesibindi, nemithi ethile noma umuthi ukusetshenziswa

Sifo

Okokuqala, uzoba nokuhlolwa ngokomzimba ukuze uhlole izimpawu ezivamile ze-hypertension yamaphaphu, kanye nezinye izinkinga zenhliziyo noma zamaphaphu. Okunye ukuhlola kungenziwa ngemva kokuhlolwa kwakho komzimba ukuze ubone ukuthi unayo yini i-PH. Lezi zivivinyo zihlanganisa: 

• Ukuhlolwa Kwegazi: Lokhu kungaxilonga noma yisiphi isifo esingase sibangele i-PH. 
• I-Echocardiogram: I-echocardiogram isebenzisa amaza omsindo ukwenza izithombe nevidiyo yokuthi inhliziyo isebenza kanjani nokuthi ukwakheka kwenhliziyo nemithambo yamaphaphu kunjani. 
• I-X-ray yesifuba: Ibonisa ukuthi i-ventricle yakho yangakwesokudla noma i-pulmonary arteries mikhulu kunalokho okufanele ibe yikho. 
• I-Chest CT scan: Ibheka izifo zamaphaphu ezingase zibe zimbi noma zidale umfutho wegazi ophakeme wamaphaphu, njengamahlule egazi. 
• Izivivinyo Zokusebenza Kwephaphu: Ihlola ukuthi amaphaphu asebenza kahle kangakanani. 
• I-Right Heart Catheterization: Lokhu kuhlola kukala ingcindezi emithanjeni yakho yamaphaphu futhi kunamandla okunquma igazi inhliziyo yakho engalimpompa ngomzuzu. 

Ukwelashwa kwe-Hypertension ye-Pulmonary 

Izinkinga zakho zezempilo eziwumsuka kanye nohlobo lwe-PH onalo kuzonquma ukuthi umfutho wegazi ophezulu wamaphaphu wakho welashwa kanjani. Ithimba lakho lezokwelapha lizokwenza ngendlela oyifisayo ukwelashwa kwalo ukuze lihlangabezane nezidingo zakho ezihlukile. I-pulmonary arterial hypertension (PAH) iphathwa ngokulandelayo: 

• Imithi: Lokhu kungase kuhlanganise ama-vasodilator, ama-anticoagulant, ama-diuretics, nokwelashwa komoyampilo. 
• Ukuhlinzwa: Ukuhlinzwa kungase kuphakanyiswe uma imithi ingasebenzi ekulawuleni izimpawu ze-pulmonary hypertension. Lokhu kuhlinzwa nokuhlinzwa okulandelayo kungasetshenziswa ukwelapha i-pulmonary hypertension:
  • I-Atrial septostomy 
  • Ukufakelwa kwamaphaphu noma inhliziyo-amaphaphu 
• Ukushintsha indlela yokuphila: Ukudla ukudla okunempilo, ukuzivocavoca njalo, nokugwema ukuphakama okuphezulu. 
• Ukuvuselelwa Kwephaphu: Uhlelo lokuzivocavoca, imfundo, nokusekelwa ukusiza iziguli ukuphatha isimo sazo. 

Izingozi Zengozi Ye-Hypertension Yamaphaphu 

Abantu abaningi abanomfutho wegazi ophezulu wamaphaphu batholakala bephakathi kweminyaka engama-30 kuya kwengama-60 ubudala. I-PAH yesizathu esingaziwa ivame kakhulu kubantu abadala abasebasha. 

Ezinye izinto ezingandisa ingozi ye-pulmonary hypertension zihlanganisa: 

• Umlando womndeni 
• Ukukhuluphala 
• Ukukhubazeka kwenhliziyo yokuzalwa. 
• Ezinye izimo zezempilo ezifana nesifo senhliziyo, isifo samaphaphu, kanye ne-autoimmune 
• ukuphazamiseka. 
• Imithi kanye nokusetshenziswa kwezidakamizwa 
• Ukuchayeka kwe-asbestos. 
• Ukuhlala endaweni ephakeme. 

Izinkinga ze-Pulmonary Hypertension

Uma ingelashwa, i-pulmonary hypertension ingaholela ezinkingeni ezinzima. Imiphumela emibi ye-pulmonary hypertension yile: 

• Ukuhluleka kwenhliziyo kwesokudla 
• Izinhliziyo ezingavamile 
• Ingozi eyengeziwe yamahlule egazi 
• ukopha emaphashini 
• ukukhulelwa izinkinga 

Uzoyibona Nini Udokotela

Uma kwenzeka umuntu enezimpawu ze-pulmonary hypertension, ikakhulukazi ukuphelelwa umoya, ubuhlungu besifuba, noma ukuvuvukala kwemilenze nasemaqakaleni, kubalulekile ukubonana nodokotela. Ukuxilongwa kusenesikhathi nokwelashwa kungavimbela ukuqhubeka kwesifo futhi kuthuthukise izinga lempilo. 

Isiphetho

I-pulmonary hypertension yisimo esibucayi okufanele sitholakale ngokushesha ngangokunokwenzeka futhi silashwe ngendlela efanele. Ngokuba nolwazi oluthile ngezimpawu, izimbangela, kanye nezigaba ezahlukene ze-pulmonary hypertension, labo abathintekile bangakwazi ukuthola usizo olufanele kusenesikhathi. Ukwelashwa okufanele kusetshenziswa izidakamizwa, ukuvivinya umzimba, nokungenelela ngezikhathi ezithile kokuhlinzwa kuzosiza ekulawuleni lesi sifo ukwandisa isikhathi sokuphila kwesiguli, futhi kuthuthukise impilo yabo yonke. 

Imibuzo Evame Ukubuzwa

Q1. Ngabe i-pulmonary hypertension iwuthinta kanjani umzimba wami?

Izimpendulo. Umfutho wegazi ophezulu wamaphaphu uphumela ekucindezelweni okuphezulu emithanjeni yamaphaphu kanye nokwanda kokucindezeleka ku-ventricle engakwesokudla yenhliziyo. Lokhu kungase kubangele ubunzima bokuphefumula, ukukhathala njalo, ubuhlungu besifuba, ukuhluleka kwenhliziyo, neminye imiphumela engathi sína. 

Q2. Ingabe i-hypertension yamaphaphu ingalapheka? 

Izimpendulo. Alikho ikhambi elaziwayo lomfutho wegazi ophakeme wamaphaphu; kodwa-ke, zonke izinhlobo ze-hypertension yamaphaphu ziyalawuleka ngemithi, izinguquko zokuphila, futhi ngezinye izikhathi, nokuhlinzwa. Ukwelashwa kwe-hypertension ye-pulmonary kuqala kusukela ngesikhathi lapho ukugula kutholakala khona futhi ukunakekelwa okuqhubekayo okusekelayo kunganciphisa izimpawu kanye nokubikezela. 

Q3. Iyini imbangela eyinhloko ye-pulmonary hypertension? 

Izimpendulo. Izimbangela ezivamile, kodwa eziguquguqukayo, ze-pulmonary hypertension zihlanganisa kwesokunxele inhliziyo isifo, esingamahlalakhona umphunga izifo, amahlule egazi emaphashini, nezici zofuzo. Zonke lezi zimo zandisa ingcindezi emithanjeni yamaphaphu. 

Q4. Ingabe i-pulmonary hypertension ingahlehla? 

Izimpendulo. Umfutho wegazi ophakeme wamaphaphu awukwazi ukuguqulwa, kodwa ukuxilongwa kusenesikhathi kanye nokwelashwa okufanele kukhona okunciphisa izimpawu nokuqhubekela phambili kancane. Kwezinye izimo, ukukhomba imbangela ye-causative kungasithuthukisa kakhulu isimo. 

Q5. Yiziphi izigaba ze-pulmonary hypertension? 

Izimpendulo. Izigaba ze-Pulmonary Hypertension yilezi: 

• Ikilasi I: Azikho izimpawu phakathi nomsebenzi ojwayelekile. 
• Ikilasi II: Izimpawu ezithambile phakathi nomsebenzi ojwayelekile. 
• Ikilasi III: Umkhawulo obonakalayo womsebenzi ngenxa yezimpawu. 
• Ikilasi IV: Ngisho ngenkathi uphumule, uthola izimpawu. Noma nini lapho uzama ukwenza noma yimuphi umsebenzi ojwayelekile, izimpawu ziba zimbi. 

CARE Medical Team

4