Embolism Embolism Embolism

Ukwelashwa Kwehlule Legazi Emaphaphu e-Hyderabad, India

Kunezinhlobo ezikhethekile zemithambo emizimbeni yethu eyaziwa ngokuthi imithambo yamaphaphu. Uma ukuvaleka kwakheka komunye wemithambo yamaphaphu emaphashini akho, lokhu kwaziwa ngokuthi yi-pulmonary embolism. I-pulmonary embolism ngokuvamile ibangelwa lapho ihlule legazi elakheke emithanjeni yakho ejulile lisuka lapho liya emaphashini. Le mithambo ejulile ngokuvamile isemilenzeni. Ezimweni ezingavamile, imithambo ejulile ikwezinye izingxenye zomzimba. Lawa mahlule egazi emithanjeni ejulile aziwa ngokuthi i-deep vein thrombosis.  

I-pulmonary embolism ingaba yingozi empilweni ngoba amahlule egazi avimba ukugeleza kwegazi emaphashini akho. Uma ukwelashwa kwalokhu kushesha kakhulu, khona-ke ingozi iyancipha kakhulu. Futhi, uma uthatha izinyathelo ezifanele zokuvimbela amahlule egazi ekukhuleni emilenzeni yakho, khona-ke ingozi yokuthola i-pulmonary embolism iyancipha. 

Izimbangela ze-Pulmonary Embolism 

Izimbangela ze-pulmonary embolism zingabandakanya:

• Ukunqwabelana kwegazi engxenyeni ethile yomzimba, ngokuvamile ingalo noma umlenze, ngokuvamile kulandela izikhathi ezinwetshiwe zokungasebenzi njengokululama ngemva kokuhlinzwa, ukuphumula kombhede isikhathi eside, noma izindiza ezinde.
• Ukulimala kwemithambo, kuvame ukuhlotshaniswa nokuphuka noma izinqubo zokuhlinzwa, ikakhulukazi ezifundeni ze-pelvis, i-hip, idolo, noma imilenze.
• Izimo zezokwelapha eziyisisekelo ezifana nezifo zenhliziyo (okuhlanganisa ukuhluleka kwenhliziyo eqinile, i-atrial fibrillation, isifo senhliziyo, noma isifo sohlangothi).
• Ukungalingani ezicini zokujiya kwegazi, okunamazinga aphakeme okungenzeka axhunyaniswe nomdlavuza othile noma abantu abasebenzisa ukwelapha okubuyisela amahomoni noma izivimbelinzalo ezithathwa ngomlomo. Ngakolunye uhlangothi, izinto ezingavamile noma ukushiyeka ezicini zokujiyisa kungase kuphakame ngenxa yokuphazamiseka kokujiyisa kwegazi.

Izimpawu Zesifo

Kunezimpawu eziningana ezihlukahlukene ze-pulmonary embolism. Izimpawu ziyahlukahluka kuye ngengxenye yephaphu lakho elihilelekile. Kubuye kuncike ekutheni isiguli sesivele sinaso yini isifo senhliziyo namaphaphu.  

Ezinye izimpawu ezivamile kanye nezimpawu ze-pulmonary embolism: -

• Ungase ubhekane nokuphelelwa umoya kungazelelwe okuyoba kubi nakakhulu uma uzikhandla. 

• Ungase uzwe ubuhlungu besifuba obungase uzwe sengathi unesifo senhliziyo. Lobu buhlungu buhlale bubukhali kakhulu futhi buzozwakala uma uphefumulela phezulu. Ubuhlungu bungase bukuvimbe ukuthi uphefumule kakhulu. Uma ukhwehlela, ugoba noma ugoba, ubuhlungu buyozwakala kahle. 

• Uma ukhwehlela, ungase ukhiphe isikhwehlela esinegazi noma esinegazi. 

• Ukushaya kwenhliziyo okukhulu noma ukushaya kwenhliziyo okungajwayelekile. Isiyezi noma ikhanda elilula. 

• Ukujuluka kakhulu. 

• Imfiva Emaphakathi noma Ephakeme

• Ukuvuvukala nobuhlungu emlenzeni, ikakhulukazi enkonyaneni. Lokhu kubangelwa i-deep vein thrombosis. 

• Isikhumba singashintsha umbala noma sibe clammy. Lokhu kwaziwa ngokuthi yi-cyanosis. 

Izinkinga ze-Pulmonary Embolism 

I-pulmonary embolism ingase ibangele:

• I-Cyanosis (ukushintsha umbala oluhlaza okwesibhakabhaka kwesikhumba ngenxa yokuntuleka komoyampilo).
• I-Myocardial infarction (isifo senhliziyo).
• Ingozi ye-Cerebrovascular (stroke).
• I-hypertension ye-pulmonary (umfutho wegazi ophakeme emaphashini).
• Ukushaqeka kwe-Hypovolemic (ukwehla okukhulu kwevolumu yegazi nomfutho wegazi).
• I-Pulmonary infarction (ukufa kwezicubu zamaphaphu ngenxa yokuntuleka kwegazi).

Izingozi Ezihlobene Nesifo

Esikhathini esiningi, cishe amaphesenti angama-90 wesikhathi, i-pulmonary embolism ivela ku-proximal leg deep vein thrombosis noma i-pelvic vein thrombosis. 

Ake sibheke izinto ezimbalwa ezingase zikhulise ingcuphe yakho ye-PE:- 

• Ukungasebenzi noma ukungakwazi ukuhamba isikhathi eside kakhulu. 

• Izimo ezithile ezizuzwe njengefa njenge-factor V Leiden nezinye iziyaluyalu zokujiya kwegazi zisengozini enkulu ye-PE. 

• Noma ubani ohlinziwe noma ohlushwa ithambo eliphukile. Ingozi inkulu ngemva kwamasonto okuhlinzwa noma okulimala. 

• Uhlushwa umdlavuza unomlando womndeni womdlavuza, noma welashwa ngamakhemikhali. 

• Ukukhuluphala ngokweqile noma ukukhuluphala ngokweqile. 

• Ukuba obhema ugwayi. 

• Ukubeletha emasontweni ayisithupha adlule noma ukhulelwe. 

• Ukuthatha njalo amaphilisi okulawula inzalo (izivimbela-nzalo ezithathwa ngomlomo) noma ukwelashelwa ukushintshwa kwamahomoni. 

• Uhlushwa noma unomlando wezifo ezifana nokukhubazeka, unhlangothi, umfutho wegazi ophakeme, noma isifo senhliziyo esingamahlalakhona. 

• Ukulimala kwakamuva noma ukuhlukumezeka kunoma yimuphi umthambo kungase kwandise ingozi ye-pulmonary embolism. 

• Ukuthola ukulimala kanzima, ukuphuka kwethambo lethanga noma amathambo e-hip, noma ukusha. Ukuba ngaphezu kweminyaka engama-60.

Uma unanoma iyiphi yalezi zici eziyingozi futhi unehlule legazi, kufanele uthintane nomhlinzeki wakho wezempilo ngokushesha. Uma izinyathelo ezifanele zithathwa ngesikhathi esifanele, khona-ke ingozi ye-pulmonary embolism ingagwenywa. 

Ukuvimbela I-Pulmonary Embolism 

Izinyathelo zokuvimbela i-pulmonary embolism zihlanganisa:

• Ukuzivivinya umzimba njalo. Uma ukuhamba kulinganiselwe, yenza izivivinyo zengalo, umlenze, nonyawo njalo ngehora. Ngokuhlala isikhathi eside noma ukuma, cabanga ukugqoka amasokisi amasokisi ukuze uthuthukise ukujikeleza kwegazi.
• Ukugcina i-hydration ngokudla uketshezi olwanele ngenkathi unciphisa utshwala ne-caffeine.
• Ukugwema ukusebenzisa ugwayi.
• Ukugwema ukweqa imilenze nokugwema izingubo ezimpintshayo.
• Ukuzuza isisindo esinempilo.
• Ukuphakamisa izinyawo imizuzu engu-30 kabili ngosuku.
• Ukuxoxa ngamasu okunciphisa ubungozi nomhlinzeki wezempilo, ikakhulukazi uma kunomlando womuntu siqu noma womndeni wamahlule egazi.
• Kucatshangelwa ukusetshenziswa kwesihlungi se-vena cava ngokubonisana nomhlinzeki wezempilo.

Indlela Yokuhlonza Isifo?

I-pulmonary embolism iyisifo esinzima ngempela ukusixilonga. Lokhu kuyiqiniso ikakhulukazi kubantu asebevele benesifo samaphaphu esingaphansi noma senhliziyo. Uma uvakashela udokotela we-pulmonary embolism, khona-ke uzobuzwa nakanjani ngomlando wakho wezokwelapha. Ngemva kwalokhu, uzohlolwa ngokomzimba ngaphambi kokuba wenze noma yiziphi ezinye izinqubo zokuxilonga. Ezinye izinqubo zokuxilonga zimi kanje:- 

• Ukuhlolwa kwegazi- Iphrotheni ebizwa ngokuthi i-D dimer ibandakanyeka ekwakhekeni kwegazi. Uma le phrotheni isegazini lakho emazingeni aphezulu, kusho ukuthi usengozini enkulu yokuba namahlule egazi. Ukuhlolwa kwegazi kwenziwa ukuhlola amazinga e-D dimer egazini lakho. Inani le-oxygen noma i-carbon dioxide nalo likalwa ngokuhlolwa kwegazi. Izinga le-oxygen liyehla lapho wenza ihlule legazi emaphashini akho. Ngaphandle kwalokho, ukuhlolwa kwegazi kuyenziwa futhi ukuze kutholakale ukuthi unomlando womndeni we-clotting disorders. 
• I-X-ray yesifuba- Lokhu ukuhlola okungahlanyisi. Kulesi sivivinyo, izithombe zenhliziyo namaphaphu akho zibonakala efilimini. Ama-X-ray akushiwo ukuthi akwazi ukuxilonga i-pulmonary embolism. Zingase zibonakale zivamile nakuba isiguli siphethwe yi-pulmonary embolism. Kodwa ngosizo lwe-X-ray, izimo ezilingisa lesi sifo zingakhishwa ukuze ukuxilonga kungenziwa kahle ngemva kwalokho.  
• I-Ultrasound - Lokhu futhi ukuhlolwa okungahlanyisi. Lokhu kwaziwa nge-duplex ultrasonography futhi ngezinye izikhathi kubizwa ngokuthi yi-duplex scan noma i-compression ultrasonography. Le ndlela isetshenziselwa ukuskena imithambo yedolo lakho, ithole, ithanga, futhi ngezinye izikhathi, izingalo. Lokhu kwenzelwa ukuhlola imithambo yegazi. I-transducer iyithuluzi elimise okwe-wand elinyakaziswa phezu kwesikhumba. Lokhu kukhipha amaza omsindo we-ultrasonic emithanjeni ehlolwayo. Lawa magagasi aboniswa emuva kudivayisi futhi isithombe esinyakazayo senziwa esikrinini sekhompyutha. Uma amahlule ekhona, khona-ke ukwelashwa okusheshayo kuzobekwa. 
• I-CT pulmonary angiography I-CT scan yindlela lapho ama-x ray enziwa khona ukukhiqiza izithombe ezihlukene zomzimba. Ucwaningo lwe-CT pulmonary embolism, olwaziwa nangokuthi i-CT pulmonary angiography. Le ndlela yakha isithombe se-3D esisetshenziselwa ukutadisha okungavamile ezithweni. Le ndlela isetshenziselwa ukuhlola izimpawu ze-pulmonary embolism emithanjeni yamaphaphu emaphashini akho. Kwezinye izimo, udayi ofakwa emthanjeni uyajova ukuze kufundwe kahle izithombe zemithambo nemithambo. 
• Ukuskena kwe-Ventilation-perfusion (i-V/Q scan)- Lena indlela esetshenziswa ngezikhathi lapho kunesidingo sokugwema ukuchayeka emisebeni. Lokhu kuphinda kusetshenziswe ezikhathini lapho udayi wokuqhathanisa we-CT scan ungeke usetshenziselwe izimo zokwelapha ezikhona. Ngale ndlela, i-tracer ijovwa engalweni yomuntu ozohlolwa. Ukugeleza kwegazi kuhlolwa ngosizo lwale tracer futhi kuhlolwa nokugeleza komoya. Ngale ndlela, ukutholakala kwamahlule emithanjeni nasemithanjeni kutholwa. 
• I-MRI- Indlela yezokwelapha yokuthwebula lapho kusetshenziswa khona amandla kazibuthe kanye namaza omsakazo akhiqizwa ikhompuyutha asiza ekwakheni izithombe ezinemininingwane yezitho nezicubu ezingaphakathi emzimbeni womuntu. 

Izibhedlela ze-CARE zinodokotela abaqeqeshwe kahle futhi zisebenzisa ubuchwepheshe obuphambili ukwelapha i-pulmonary embolism. Ukuze uthole okwengeziwe, xhumana nathi namuhla!

Ukungenelela kwezokwelapha okufika ngesikhathi kungasindisa ukuphila.