I-Thoracic ne-Thoracoabdominal Aortic Aneurysm

Ukwelashwa kwe-Thoracic and Thoracoabdominal Aortic Aneurysm e-Hyderabad, India

I-Aorta iwumkhumbi oyinhloko womzimba womuntu owuphakelayo futhi unikeze igazi elinomoya-mpilo ezithweni nakwezinye izingxenye. Isimo lapho siba buthakathaka, igazi elingaphakathi lingakwazi ukusunduza udonga lwe-arterial futhi libangele ukwakheka okufana nesakhiwo. Lesi simo saziwa ngokuthi i-thoracic aortic aneurysm. Iqhubu yi-aneurysm ebangelwa ngaphakathi kwe-aorta.

I-aorta ingahlukaniswa ngenxa ye-thoracic aortic aneurysm noma i-thoracic aneurysm. Indawo lapho i-aorta ibuthakathaka khona ithola igama elithi horacic (amaphaphu) noma i-thoracoabdominal (isifuba nesisu).

Ukopha kwangaphakathi kungaba yingozi uma i-aorta ehlanjululwe ingelashwa ngesikhathi. Lawa ma-aneurysm makhulu futhi akhula ngokushesha ukuze aqhume. Nakuba ama-aneurysm amancane mancane amathuba okuthi aqhume futhi alapheke kalula. 

Isimo esiphuthumayo sihlelwa ngokuya ngendawo, ubukhulu, ubunzima be-aneurysm. Izinga lokukhula nalo lingahluka futhi uma likhula ngokushesha, kunconywa ukuhlinzwa. 

Odokotela ezibhedlela ze-CARE basebenza kuphela ukuxilonga nokwelapha izimo ezifana ne-thoracic aortic aneurysms. 

Izimpawu 

I-aneurysm ingakhula kancane ngaphandle kwanoma yiziphi izimpawu. Ezinye ze-thoracic aortic aneurysms zincane futhi zihlose ukuhlala zincane ngaphandle kokudala umonakalo omkhulu emzimbeni. 

Lawa ma-aneurysm e-thoracic aortic angase angalokothi aqhume futhi ahlale endaweni eyodwa njengeqhubu elincane kodwa angakhula uma engelashwa. Kunzima ukubikezela isivinini sokukhula kwe-thoracic aortic aneurysm. 

Ngokukhula kwe-thoracic ne-thoracoabdominal aortic aneurysm, umuntu angase abe nezimpawu ezilandelayo-

• Ubumnene esifubeni
• Ubuhlungu esifubeni 
• Ukuhlungu obusemhlane
• Ukuthuthumela
• Isikhukhula
• Ukuphelelwa umoya

Lezi zingathuthuka noma yikuphi nge-aorta; kusukela enhliziyweni kuya esifubeni kuya esiswini. Ama-aneurysms esifuba abizwa ngokuthi i-thoracic aortic aneurysms futhi lawo ahlobene nesisu abizwa ngokuthi i-thoracoabdominal aortic aneurysms.

Izimbangela

I-thoracic aortic aneurysm iqhuma noma ibhaluni odongeni lwe-aorta, umkhumbi wegazi omkhulu othwala igazi elinomoya-mpilo lisuka enhliziyweni liyise kuwo wonke umzimba. Kunezici eziningana ezingaba nomthelela ekuthuthukisweni kwe-thoracic aortic aneurysm, futhi lezi zingabandakanya:

• I-Atherossteosis: Isizathu esivame kakhulu se-thoracic aortic aneurysms i-atherosclerosis, isimo esibonakala ngokunqwabelana kwe-plaque ezindongeni zangaphakathi zemithambo. Ngokuhamba kwesikhathi, lokhu kungenza buthaka udonga lwe-aortic, kwenze kube lula ukuthola i-aneurysm.
• Izakhi zofuzo: Kukhona isakhi sofuzo ekuthuthukisweni kwe-aortic aneurysms. Abantu abanomlando womndeni we-aortic aneurysms basengozini eyengeziwe, futhi izifo ezithile zofuzo, njenge-Marfan syndrome kanye ne-Ehlers-Danlos syndrome, zingabeka abantu phambili ekwakhekeni kwe-aneurysm.
• I-Connective Tissue Disorders: Izimo ezithinta izicubu ezixhumeneyo, njenge-Marfan syndrome, i-Ehlers-Danlos syndrome, ne-Loeys-Dietz syndrome, zingenza buthaka izindonga ze-aorta futhi zibe nomthelela ekwakhekeni kwama-aneurysms.
• Umfutho Wegazi Ophakeme (Hypertension): Umfutho wegazi ongapheli ungabeka ingcindezi eyengeziwe ezindongeni ze-aorta, okungase kuholele ekuthuthukisweni kwe-aneurysm ngokuhamba kwesikhathi.
• Izifo Ezivuthayo: Izimo ezivuvukalayo, njenge-giant cell arteritis noma i-Takayasu arteritis, zingabangela ukuvuvukala kwemithambo yegazi, zenze buthaka izindonga zemithambo yegazi futhi zandise ingozi yokwakheka kwe-aneurysm.
• Amagciwane: Izifo ezithinta i-aorta, njenge-syphilis noma izifo ze-mycotic, zingaholela ekuvuvukeni futhi zenze buthaka izindonga zomkhumbi, zibe nomthelela ekuthuthukiseni i-aneurysm.
• Ukuhlukumezeka noma Ukulimala: Ukuhlukumezeka kwe-aortic, njengokuhlukumezeka okufiphele noma ukulimala, kungalimaza i-aorta futhi kuyibeke ngaphambili ekwakhekeni kwe-aneurysm. Lokhu kuvame ukuhlotshaniswa nokulimala okubuhlungu kunokuthuthukiswa kwe-aneurysm okuzenzakalelayo.
• Ubudala nobulili: Ukuguga kuyisici esiyingozi se-aortic aneurysms, futhi ingozi iyanda njengoba abantu bekhula. Abesilisa nabo bavame ukuthinteka kakhulu kunabesifazane.

Izingozi 

Kunezici eziningi eziyingozi ezihambisana ne-thoracic aortic aneurysms okudingeka zithathwe ngokungathí sina.

• Iminyaka yobudala- uma umuntu esengaphezu kweminyaka engama-65, uthambekele kakhulu kwi-thoracic kanye namanye ama-aortic aneurysms.

• Ukusebenzisa ugwayi- kungenye yezinto eziyingozi ezihamba phambili ezihlobene ne-thoracic kanye ne-aortic aneurysms ehlobene.

• Umfutho wegazi ophakeme - Umfutho wegazi ophezulu ungalimaza imithambo yegazi futhi ube nomthelela ku-thoracic kanye ne-aortic aneurysms ehlobene.

• I-Plague buildup- Amafutha nezinye izinto zinganqwabelana emithanjeni yegazi futhi zilimaze ulwelwesi lwazo. Kuvamile kubantu asebekhulile futhi kubangela i-thoracic aortic aneurysm.

• Izakhi zofuzo zomndeni kanye nomlando- Abantu abasha bangathola futhi i-thoracic aneurysms ye-aortic ehlobene uma benomlando womndeni ofanayo.

• I-Marfan syndrome nezici ezihlobene- izimo ezinjenge-Loeys-Dietz syndrome, i-Marfan syndrome noma i-vascular Ehlers-Danlos syndrome ingaba nomthelela ofanayo.

• I-Bicuspid aortic valve- uma une-cusps engu-2 esikhundleni sika-3, uzothambekela ekubeni ne-thoracic kanye ne-aortic aneurysms ehlobene.

Sifo 

• Ukuhlolwa kwezokwelapha okuhlanganisa ukuhlolwa ngokomzimba, ukuhlolwa okujwayelekile, ama-ultrasound, ama-CT scan, nama-X-ray scan kungathola i-thoracic aneurysms ye-aorta ehlobene.

• Umuntu uzodingeka ukuthi atshele umlando wezokwelapha kanye nemithi yangaphambilini uma ethathwe. Umlando womndeni nawo uhlolwa ngendlela efanayo.

• Uma ukuhlolwa kokuqala kuqinisekisa ukuba khona kwe-thoracic kanye ne-aortic aneurysms ehlobene, odokotela bazohlola ukuhlolwa kwesibili ukuze banikeze ukwelashwa okufanele.

Ukuhlola ukuhlolwa 

• I-Echocardiogram- i-aorta ekhuphukayo nenhliziyo itholakala ngosizo lwamaza omsindo asetshenziswa ku-echocardiogram. Kwenziwa ukwazi nokuxilonga ukusebenza kwamagumbi enhliziyo namavalvu. Ingakwazi futhi ukuhlola amalungu omndeni futhi ihlonze i-thoracic kanye ne-aortic aneurysms ehlobene. I-transoesophageal echocardiogram nayo ingatholwa uma udokotela efuna isithombe esifanele se-aorta. 

• I-Computed tomography noma i-CT- ingxenye yomzimba kanye nemifanekiso ye-aorta yenziwa ngosizo lwe-X-ray kusetshenziswa ama-CT scan. Ubukhulu kanye nendawo ye-aneurysm ihlulelwa ngalokhu. Uzolala etafuleni lapho inqubo iqhutshwa khona, udayi ungase futhi ujovwe ngaphakathi emithanjeni ukuze wazi i-aorta ngokucacile. Uma umuntu ene-Marfan syndrome, banikezwa ukwelashwa ngemisebe nsuku zonke ukuze bazi isimo se-aneurysms.

• I-Magnetic resonance imaging noma i-MRI- izithombe zomzimba zenziwa kusetshenziswa amaza omsakazo kanye nenkundla kazibuthe. Ingakwazi ukuxilonga i-thoracic kanye ne-aorta aneurysms ehlobene, ubukhulu bayo nezindawo. I-Magnetic resonance angiography ingasetshenziswa futhi ukwazi isimo se-aorta.

• Ukuhlolwa kofuzo- uma umuntu enomlando womndeni we-thoracic kanye ne-aorta aneurysms ehlobene nanoma iyiphi enye i-markup yofuzo; kuzodingeka ukuthi bahlolwe ukuze bazi ubungozi bokuthuthukiswa okuqhubekayo. 

Ukwelashwa

Ukuhlinzwa kwe-aortic kuyindlela yokwelapha eqondile ye-thoracic aortic aneurysms, futhi izindlela ezihlukahlukene zokuhlinza zisetshenziswa:

• Ukuhlinzwa Okuvuliwe Kwendabuko:
  • Kubandakanya ukusika isifuba esiphakathi nendawo.
  • Ingxenye eyonakele ye-aorta iyasikwa, futhi ithubhu lendwangu (i-graft) ithatha indawo yayo.
  • Ifanele i-aneurysms ku-aorta ekhuphukayo kanye ne-aneurysms eyinkimbinkimbi esifubeni nasezifundeni zesisu.
• Ukulungiswa kwe-Thoracic Endovascular Aortic (TEVAR):
  • Inqubo ehlasela kancane ye-aneurysms ku-aorta eyehlayo.
  • Ukusikwa okuncane eduze kwe-groin kunikeza ukufinyelela kumthambo wesifazane.
  • I-catheter iqondisa i-graft endaweni ye-aneurysm, lapho isetshenziswa khona.
• Ukushintshwa kwe-Aortic Root:
  • Ikhuluma nge-aneurysms ezimpandeni ze-aorta, ezixhuma enhliziyweni.
  • Kungase kuhlanganise ukushintsha i-valve ye-aorta, noma izindlela zokulondoloza i-valve zingase zisetshenziswe ukuze kugcinwe i-valve yemvelo.
  • Odokotela abahlinzayo bangase basebenzise inhlanganisela yezindlela, njengengxube yokuhlinzwa okuvulekile nezindlela ze-endovascular, ngokusekelwe ezicini ezithile ze-aneurysm. Ukufuna ukunakekelwa esikhungweni esikhethekile se-aorta esigxile ekwelapheni izifo ze-aorta kunganikeza uhla lwezinketho futhi kuthuthukise umphumela wokwelapha jikelele.

Ukuqapha 

• Abaphathi kanye nokuhlolwa kwemithi nokuhlolwa kwe-imaging kuhlolwa odokotela ukuze belaphe i-thoracic kanye ne-aortic aneurysms ehlobene.

• Njalo ezinyangeni eziyisi-6 kwenziwa i-echocardiogram, i-MRI, ne-CT ukuze kwaziwe isimo se-thoracic kanye ne-aortic aneurysms ehlobene. Ukulandelela njalo kubalulekile ukwazi izinga lokukhula kwayo. 

Ukuhlinzwa 

• Uma i-thoracic kanye ne-aorta aneurysms ehlobene ithola cishe amayintshi angu-1.9 kuya kwangu-2.4, ukuhlinzwa kuyanconywa. Uhlobo lokuhlinzwa luzoncika esimweni, usayizi, kanye nohlobo lwe-aneurysms.

• Ukuhlinza isifuba- ishubhu lokwenziwa elibizwa ngokuthi i-graft lifakwa ngemva kokukhipha ingxenye eyonakele ye-aorta. Lokhu kuhlinzwa kubizwa ngokuthi ukuhlinzwa kwesifuba esivulekile. 

• Ukuhlinzwa kwe-Endovascular- kwenziwa ngokufaka i-graft ku-aorta. Yenziwa ngomlenze futhi ifakwe njengentambo phezulu ku-aorta. 

Prevention

Ukuvimbela lesi simo kuyinselele ngenxa yokungabikho kwezinyathelo ezithile; Nokho, kunezindlela zokunciphisa ingozi ye-aortic aneurysms, ikakhulukazi lezo ezibangelwa isifo sokuqina kwemithambo yegazi. Cabangela lezi zinyathelo ezilandelayo:

• Lawula umfutho wegazi futhi ulawule amazinga e-cholesterol.
• Yamukela ukudla okunempilo kwenhliziyo, njengokudla kwaseMedithera.
• Gwema yonke imikhiqizo kagwayi.
• Kancane kancane hlanganyela okungenani imizuzu engu-150 yokuzivocavoca okunamandla masonto onke, ngemva kokubonisana nomhlinzeki wakho wokunakekelwa kwezempilo mayelana nohlelo olusha lokuzivocavoca.
• Hlela ukuhlolwa kwaminyaka yonke nomhlinzeki wezempilo futhi uhambele zonke izikhathi zokulandelela.

Kungani ukhethe Izibhedlela ze-CARE eNdiya?

Ezibhedlela ze-CARE e-India, sizama ukuhlinzeka ngezinsizakalo eziseduze nasekhaya ezizuzisa wonke umphakathi. Sihlose ukuphatha umuntu ngamunye njengomuntu oyedwa, hhayi isiguli, ukugula, noma isikhathi esibekiwe - kuyisisekelo sakho konke esikwenzayo. Intshisekelo eyodwa iqhuba ukuzibophezela kwethu kwezemfundo, ucwaningo, kanye nabantu esibasebenzelayo: ukuxhumanisa iziguli zethu, amalungu eqembu, kanye nemiphakathi nempilo yabo.