I-vein thrombosis enzulu

I-vein thrombosis enzulu (i-DVT) yimeko eyenzeka xa i-clot yegazi yenzeka kumthambo ngaphakathi ngaphakathi kwinxalenye yomzimba. Ichaphazela ikakhulu imithambo enkulu emlenzeni nasethangeni elisezantsi, kodwa inokwenzeka kwezinye iimithambo ezinzulu, ezinjengeengalo kunye nesinqe.

I-DVT ixhaphake kakhulu kubantu abadala abangaphezu kweminyaka engama-60. Kodwa inokwenzeka nakweyiphi na iminyaka. Xa iqabaka liqhekeka lize lihambe ngokuhamba kwegazi, ibizwa ngokuba yi-embolism. I-embolism inokubambeka kwimithambo yegazi kwingqondo, imiphunga, intliziyo, okanye enye indawo, ekhokelela kumonakalo omkhulu.

Amahlwili egazi anokuvela xa kukho into ecothayo okanye etshintsha ukuhamba kwegazi emithanjeni. Izinto zomngcipheko zibandakanya:

• I-catheter ye-pacemaker eye yadlula emthanjeni kwi-groin
• Ukuphumla kwebhedi okanye ukuhlala kwindawo enye ixesha elide, njengokuhamba ngenqwelomoya
• Imbali yosapho yamahlwili egazi
• Ukuqhekeka kwesinqe okanye imilenze
• Ukuzala phakathi kweenyanga ezi-6 ezidlulileyo
• Ukukhulelwa
• Ukutyeba kakhulu
• Utyando lwamva nje (ixhaphake kakhulu inyonga, idolo, okanye utyando lwabasetyhini)
• Zininzi iiseli zegazi ezenziwe ngumongo wethambo, zibangela ukuba igazi lijiye ngakumbi kunesiqhelo (polycythemia vera)
• Ukuba ne-catheter yokuhlala ixesha elide kwindawo yegazi

Igazi kunokwenzeka ukuba ligubungele umntu oneengxaki okanye iingxaki ezithile, ezinje:

• Umhlaza
• Ezinye iingxaki zomzimba, ezifana ne-lupus
• Ukutshaya icuba
• Iimeko ezenza ukuba kube lula ukuphuhlisa amahlwili egazi
• Ukuthatha ii-estrogens okanye iipilisi zokulawula ukuzalwa (lo mngcipheko uphezulu ngokutshaya)

Ukuhlala ixesha elide xa uhamba kunokunyusa umngcipheko we-DVT. Oku kunokwenzeka xa unenye okanye ezingaphezulu kwezinto ezinobungozi ezidweliswe apha ngasentla.

I-DVT ichaphazela ikakhulu imithambo emlenzeni nasemathangeni asezantsi, amaxesha amaninzi kwicala elinye lomzimba. Ihlwili linokuthintela ukuhamba kwegazi kwaye libangele:

• Utshintsho kumbala wesikhumba (ubomvu)
• Intlungu yomlenze
• Ukudumba komlenze (i-edema)
• Ulusu oluziva lufudumele xa uchukumiseka

Umboneleli wakho wezempilo uya kwenza uvavanyo lomzimba. Uviwo lunokubonisa bomvu, ukudumba, okanye umlenze wethenda.

Ezi mvavanyo zimbini zihlala zisenziwa kuqala ukufumanisa i-DVT zezi:

• Uvavanyo lwegazi lwe-D-dimer
• Uvavanyo lweDoppler ultrasound lwendawo echaphazelekayo

I-MRI ye-pelvic inokwenziwa ukuba i-clot yegazi ikwisinqe, nasemva kokukhulelwa.

Uvavanyo lwegazi lunokwenziwa ukukhangela ukuba unethuba elongezelelekileyo lokujiya kwegazi, kubandakanya:

• Ukusebenza kweprotein C esebenzayo (ukukhangela i-Factor V Leiden mutation)
• Amanqanaba eAntithrombin III
• Iintsholongwane ze-Antiphospholipid
• Gcwalisa ubalo lwegazi (CBC)
• Ukuvavanywa kwemfuza ukukhangela utshintsho olwenzela ukuba ube nakho ukukhula amahlwili egazi, njenge-prothrombin G20210A mutation
• ILupus anticoagulant
• Amanqanaba eProtheni C kunye neeprotein S

Umboneleli wakho uya kukunika iyeza lokunciphisa igazi lakho (elibizwa ngokuba yi-anticoagulant). Oku kuyakugcina amahlwili ngakumbi ekwenzeni okanye amadala ekubeni makhulu.

IHeparin ihlala iyeza lokuqala oza kulifumana.

• Ukuba i-heparin inikwa ngomthambo (IV), kufuneka uhlale esibhedlele. Nangona kunjalo, uninzi lwabantu lunokunyangwa ngaphandle kokuhlala esibhedlele.
• Ubunzima beemolekyuli obuphantsi bunokunikwa ngenaliti phantsi kolusu lwakho kube kanye okanye kabini ngemini. Kusenokungabikho mfuneko yokuba uhlale esibhedlele ixesha elide, okanye konke konke, ukuba umiselwe olu hlobo lweeparpar.

Olunye uhlobo lweyeza lokucoca igazi elibizwa ngokuba yi-warfarin (Coumadin okanye iJantoven) linokuqalwa kunye neherparin. IWarfarin ithathwa ngomlomo. Kuthatha iintsuku ezininzi ukusebenza ngokupheleleyo.

Olunye udidi lwegazi elincinci lusebenza ngokwahlukileyo kune-warfarin. Imizekelo yolu didi lwamayeza, abizwa ngokuthe ngqo ii-anticoagulants zomlomo (i-DOAC), zibandakanya i-rivaroxaban powder (Xarelto), apixaban (Eliquis), dabigatran (Pradax), kunye ne-edoxaban (Savaysa). La machiza asebenza ngendlela efanayo neherparin kwaye anokusetyenziswa kwangoko endaweni yeheparin. Umboneleli wakho uya kuthatha isigqibo sokuba leliphi iyeza elilungele wena.

Uya kuthatha igazi elincinci kwiinyanga ezintathu ubuncinci. Abanye abantu bathatha ixesha elide, okanye ubomi babo bonke, kuxhomekeke kumngcipheko welinye ihlwili.

Xa uthatha iyeza lokucoca igazi, kunokwenzeka ukuba wophe, nakwizinto oqhele ukuzenza. Ukuba uthatha igazi elincinci ekhaya:

• Thatha iyeza kanye ngendlela umboneleli wakho akumisele ngayo.
• Buza umboneleli ukuba wenzeni ukuba uphoswa yidosi.
• Fumana uvavanyo lwegazi njengoko ucebise ngumboneleli wakho ukuqinisekisa ukuba uthatha idosi efanelekileyo. Ezi mvavanyo zihlala zifuneka nge-warfarin.
• Funda ngendlela yokuthatha amanye amayeza kunye nexesha lokutya.
• Fumanisa ukuba ungazijonga njani iingxaki ezibangelwa liyeza.

Kwiimeko ezinqabileyo, unokufuna utyando endaweni okanye ukongeza kwi-anticoagulants. Utyando lunokubandakanya:

• Ukubeka isihluzo kumthambo omkhulu womzimba ukuthintela amahlwili egazi ekuhambeni kwimiphunga
• Ukususa ihlwili elikhulu legazi emthanjeni okanye ukujova iyeza lokufaka intsholongwane

Landela nayiphi na eminye imiyalelo oyinikiweyo ukunyanga i-DVT yakho.

I-DVT ihlala ihamba ngaphandle kwengxaki, kodwa imeko inokubuya. Iimpawu zinokuvela kwangoko okanye ungangabuphuhlisi iminyaka eli-1 okanye nangaphezulu emva koko. Ukunxiba isitokhwe sokucinezelwa ngexesha nasemva kwe-DVT kunokunceda ukuthintela le ngxaki.

Iingxaki ze-DVT zinokubandakanya:

• I-pulmonary embolism ebulalayo (amahlwili egazi ethangeni kunokwenzeka ukuba aphule kwaye ahambe aye emiphungeni kunamahlwili egazi kumlenze ongezantsi okanye kwamanye amalungu omzimba)
• Intlungu eqhubekayo kunye nokudumba (post-phlebitic okanye post-thrombotic syndrome)
• Iimvumba ze-Varicose
• Izilonda ezinganyangekiyo (eziqhelekileyo)
• Utshintsho kumbala wesikhumba

Fowunela umboneleli wakho ukuba uneempawu ze-DVT.

Yiya kwigumbi likaxakeka okanye fowunela inombolo yongxamiseko yendawo (enje nge-911) ukuba une-DVT kwaye uyaphuhlisa:

• Iintlungu zesifuba
• Ukukhohlela igazi
• Kunzima ukuphefumla
• Ukufa isiqaqa
• Ukuphulukana nokuqonda
• Ezinye iimpawu ezinzima

Ukuthintela i-DVT:

• Hambisa imilenze yakho rhoqo ngexesha lokuhamba ngenqwelomoya, uhambo lwemoto, kunye nezinye iimeko ohleli kuzo okanye olele phantsi ixesha elide.
• Thatha amayeza okucoca igazi akunike umboneleli wakho.
• Musa ukutshaya. Thetha nomboneleli wakho ukuba ufuna uncedo lokuyeka.

I-DVT; Ihlwili legazi emilenzeni; ITromboembolism; Isifo seposi-phlebitic; Isifo se-post-thrombotic; Intsholongwane-i-DVT

• I-vein thrombosis enzulu - ukukhutshwa
• Ukuthatha i-warfarin (Coumadin, Jantoven) -ukubuza ugqirha wakho
• Ukuthatha warfarin (Coumadin)

• I-venous thrombosis-iliofemoral
• Imithambo enzulu
• Igazi elinemithambo yegazi
• Imithambo enzulu
• I-venous thrombosis - uthotho

UKearon C, Akl EA, Ornelas J, et al. Unyango lwe-Antithrombotic yesifo se-VTE: Isikhokelo se-CHEST kunye nengxelo yephaneli yengcali. Isifuba. Ngo-2016; 149 (2): 315-352. IINKCUKACHA: 26867832 pubmed.ncbi.nlm.nih.gov/26867832/.

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