Uxinzelelo lwegazi

Uxinzelelo lwegazi kwimiphunga luxinzelelo lwegazi oluphezulu kwimithambo yemiphunga. Yenza icala lasekunene lentliziyo lisebenze nzima kunesiqhelo.

Icala lasekunene lentliziyo lipompa igazi ngemiphunga, apho lithatha khona ioksijini. Igazi libuyela kwicala lasekhohlo lentliziyo, apho lifakwa khona emzimbeni wonke.

Xa imithambo encinci (yemithambo yegazi) yemiphunga iyancipha, ayinakuthwala igazi elininzi. Xa oku kusenzeka, uxinzelelo luyanda. Oku kubizwa ngokuba yi-pulmonary hypertension.

Intliziyo kufuneka isebenze nzima ukunyanzela igazi ngemithambo ngokuchasene nolu xinzelelo. Ixesha elingaphezulu, oku kubangela ukuba icala lasekunene lentliziyo likhulu. Le meko ibizwa ngokuba kukusilela kwentliziyo esecaleni, okanye i-cor pulmonale.

Uxinzelelo lwegazi lungabangelwa ngu:

• Izifo ezisebenza ngokuzenzekelayo ezonakalisa imiphunga, ezinje nge-scleroderma kunye ne-rheumatoid arthritis
• Iziphene zokuzalwa kwentliziyo
• Amahlwili egazi emiphungeni (pulmonary embolism)
• Ukumelwa yintliziyo
• Isifo sentliziyo sentliziyo
• Usulelo lwe-HIV
• Amanqanaba eoksijini asezantsi egazini ixesha elide (ezingapheliyo)
• Isifo semiphunga, esifana ne-COPD okanye i-pulmonary fibrosis okanye nayiphi na imeko engapheliyo yemiphunga
• Amayeza (umzekelo, amayeza athile okutya)
• Ukuphefumla kokulala okuthintelayo

Kwiimeko ezinqabileyo, unobangela wexinzelelo lwe-pulmonary hypertension awaziwa. Kule meko, imeko ibizwa ngokuba yi-idiopathic pulmonary arterial hypertension (IPAH). Idiopathic kuthetha ukuba unobangela wesifo awaziwa. I-IPAH ichaphazela abafazi abaninzi kunamadoda.

Ukuba uxinzelelo lwegazi kwimiphunga lubangelwa liyeza elaziwayo okanye imeko yezonyango, ibizwa ngokuba yi-secondary pulmonary hypertension.

Ukuphefumla kancinci okanye ukukhanya entloko ngexesha lomsebenzi kuhlala kuyinto yokuqala. Isantya sentliziyo esikhawulezayo (ukubetha kwentliziyo) sinokubakho. Ixesha elingaphezulu, iimpawu zenzeka ngokukhanya okuthe kratya okanye nokuba uphumla.

Ezinye iimpawu zibandakanya:

• Ukudumba kweqatha neenyawo
• Umbala oluhlaza okwesibhakabhaka wemilebe okanye ulusu (icyanosis)
• Intlungu yesifuba okanye uxinzelelo, rhoqo ngaphambili esifubeni
• Ukuba nesiyezi okanye ukuphelelwa ngamandla
• Ukudinwa
• Ukonyusa ubungakanani besisu
• Ubuthathaka

Abantu abane-pulmonary hypertension bahlala beba neempawu eziza kwaye zihambe. Zixela iintsuku ezintle neentsuku ezimbi.

Umboneleli wakho wezempilo uya kwenza uvavanyo lomzimba kwaye abuze malunga neempawu zakho. Uviwo lunokufumana:

• Intliziyo engaqhelekanga iyavakala
• Ukuziva ukubetha ngaphezulu kwesifuba
• Ukumbombozela kwentliziyo kwicala lasekunene lentliziyo
• Imithambo emikhulu kunesiqhelo entanyeni
• Ukudumba kwemilenze
• Ukudumba kwesibindi kunye nokudakumba
• Ukuphefumla okuqhelekileyo kuyavakala ukuba uxinzelelo lwegazi lwe-pulmonary yi-idiopathic okanye ngenxa yesifo sentliziyo
• Ukuphefumla okungaqhelekanga kuvakala ukuba uxinzelelo lwegazi kwimiphunga luvela kwesinye isifo semiphunga
  

Kumanqanaba okuqala esi sifo, uviwo lunokuba yinto eqhelekileyo okanye ephantse yesiqhelo. Le meko ingathatha iinyanga ezininzi ukufumanisa isifo. Isifo sombefu kunye nezinye izifo kunokubangela iimpawu ezifanayo kwaye kufuneka kugwetyelwe ngaphandle.

Uvavanyo olunoku-odolwa lubandakanya:

• Uvavanyo lwegazi
• Ukucinywa kwentliziyo
• I-x-ray yesifuba
• Ukuxilongwa kwe-CT kwesifuba
• Echocardiogram
• ECG
• Uvavanyo lomsebenzi wemiphunga
• Ukuskena kwemiphunga yenyukliya
• I-arteriogram yamapulmonary
• Uvavanyo lokuhamba lwemizuzu emi-6
• Ukulala ufunda
• Uvavanyo lokujonga iingxaki ezenzekelayo

Akukho unyango lwexinzelelo lwe-pulmonary. Injongo yonyango kukulawula iimpawu kunye nokuthintela ukonakala okungaphezulu kwemiphunga. Kubalulekile ukunyanga ukuphazamiseka kwezonyango okubangela uxinzelelo lwexinzelelo lwe-pulmonary, njengokuphazamiseka kokulala, iimeko zemiphunga kunye neengxaki zentliziyo yevalvu.

Zininzi iindlela zokhetho kunyango lwe-pulmonary arterial hypertension ezikhoyo. Ukuba unikwe amayeza, anokuselwa ngomlomo (ngomlomo), afunyanwe ngomthambo (efakwa ngaphakathi, okanye nge-IV), okanye aphefumlelwe (aphefumlelwe).

Umboneleli wakho uya kuthatha isigqibo sokuba leliphi iyeza elilungele wena. Uya kujongwa ngeliso elibukhali ngexesha lonyango ukuba ujonge iziphumo ebezingalindelekanga kwaye ubone ukuba uphendula njani kunyango. SUKUYEKE ukuthatha amayeza akho ungakhange uthethe nomboneleli wakho.

Olunye unyango lunokubandakanya:

• Abacoci begazi ukunciphisa umngcipheko wamahlwili egazi, ngakumbi ukuba une-IPAH
• Unyango lweoksijini ekhaya
• Imiphunga, okanye kwezinye iimeko, ukufakelwa kwentliziyo nemiphunga, ukuba amayeza awasebenzi

Ezinye iingcebiso ezibalulekileyo ekufuneka zilandelwe:

• Kuphephe ukukhulelwa
• Gwema imisebenzi enzima yomzimba kunye nokuphakamisa
• Gwema ukuhamba kwiindawo eziphakamileyo
• Fumana iyeza lokugonya lonyaka lomkhuhlane, kunye nezinye izitofu ezifana nokuthintela inyumoniya
• Yeka ukutshaya

Uqhuba kakuhle kangakanani kuxhomekeke kwinto ebangelwe yimeko. Amayeza e-IPAH anokunceda ukucothisa isifo.

Njengokuba ukugula kusiba kubi, kuyakufuneka wenze utshintsho ekhayeni lakho ukunceda ujikeleze indlu.

Fowunela umnikezeli wakho ukuba:

• Uqala ukuphefumla umoya omfutshane xa usebenza
• Ukuphefumla kancinci kuya kusiba mandundu
• Ukhula iintlungu esifubeni
• Uphuhlisa ezinye iimpawu

Uxinzelelo lwegazi lwe-pulmonary arterial; Ukuqala koxinzelelo lwe-pulmonary pulmonary; Uxinzelelo lwe-pulmonary primary uxinzelelo; Idiopathic pulmonary yegazi; Uxinzelelo lwegazi olusisiseko; I-PPH; Uxinzelelo lwegazi lwe-pulmonary yesibini; Cor pulmonale - uxinzelelo lwegazi kwimiphunga

• Inkqubo yokuphefumla
• Uxinzelelo lwegazi olusisiseko
• Ukufakelwa kwentliziyo nemiphunga - uthotho

UChin K, uChannick RN. Uxinzelelo lwegazi. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, ii-eds. Incwadi kaMurray kunye neNadel yeyeza lokuphefumla. Umhla wesi-6. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 58.

UMclaughlin VV, uHumbert M.Uxinzelelo lwegazi lwePulmonary. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 85.