Izifo zemithambo yegazi - imilenze

Isifo se-artery peripheral (PAD) yimeko yemithambo yegazi ebonelela ngemilenze neenyawo. Kwenzeka ngenxa yokunciphisa imithambo emilenzeni. Oku kubangela ukwehla kwegazi, elinokwenzakalisa imithambo-luvo kunye nezinye izicwili.

I-PAD ibangelwa yi-atherosclerosis. Le ngxaki ivela xa izinto ezinamafutha (i-plaque) zisakha phezu kweendonga zemithambo yakho kwaye ziyenze icuthe. Iindonga zemithambo nazo ziba lukhuni kwaye azinako ukwandisa (ukuxanda) ukuvumela ukuhamba kwegazi okukhulu xa kufuneka njalo.

Ngenxa yoko, izihlunu zemilenze yakho azinakufumana gazi laneleyo kunye neoksijini xa zisebenza nzima (njengokuzilolonga okanye ukuhamba). Ukuba i-PAD iba nzima, kungabikho gazi laneleyo kunye neoksijini, kwanaxa izihlunu ziphumlile.

I-PAD sisifo esiqhelekileyo. Ihlala ichaphazela amadoda angaphezu kweminyaka engama-50, kodwa abasetyhini banokuba nayo. Abantu basemngciphekweni omkhulu ukuba banembali:

• I-cholesterol engaqhelekanga
• Seswekile
• Isifo sentliziyo (isifo semithambo)
• Uxinzelelo lwegazi (uxinzelelo lwegazi)
• Isifo sezintso esibandakanya i-hemodialysis
• Ukutshaya
• Ukubetha (isifo se-cerebrovascular)

Iimpawu eziphambili ze-PAD ziintlungu, ukudinwa, ukudinwa, ukutshisa, okanye ukungonwabi kwiimisipha zeenyawo zakho, amathole, okanye amathanga. Ezi mpawu zihlala zibonakala ngexesha lokuhamba okanye lokuzilolonga, kwaye uhambe emva kwemizuzu yokuphumla.

• Ekuqaleni, ezi zimpawu zinokubonakala kuphela xa usenyuka intaba, uhamba ngokukhawuleza, okanye uhamba imigama emide.
• Kancinci, ezi zimpawu zenzeka ngokukhawuleza kwaye zinokuzilolonga kancinci.
• Imilenze okanye iinyawo zakho zinokuziva zindindisholo xa uphumle. Imilenze nayo inokuziva ipholile xa uyichukumisa, kwaye ulusu lungajongeka lumbala.

Xa i-PAD iba nzima, unokuba:

• Ukungabi namandla
• Intlungu kunye necramp ebusuku
• Intlungu okanye ukurhawuzelela iinyawo okanye iinzwane, ezinokuba nzima kangangokuba nobunzima bempahla okanye beebhedi buhlungu
• Ubuhlungu obubi ngakumbi xa uphakamisa imilenze yakho, kwaye uyaphucuka xa uyikrwitsha imilenze yakho ecaleni kwebhedi
• Ulusu olujongeka lumnyama kwaye luhlaza okwesibhakabhaka
• Izilonda ezingapholiyo

Ngexesha loviwo, umboneleli wezempilo unokufumana:

• Isandi esingxolayo xa i-stethoscope ibanjwe ngaphezulu komthambo (iarterial bruits)
• Ukucutha uxinzelelo lwegazi kwilungu elichaphazelekayo
• Imiphetho ebuthathaka okanye engekhoyo kwilungu lomlenze

Xa i-PAD inzima ngakumbi, iziphumo zinokubandakanya:

• Izihlunu zethole ezithi zinciphe (zibune okanye zibethe)
• Ukulahleka kweenwele ngaphezulu kwemilenze, iinyawo kunye neenzwane
• Izilonda ezibuhlungu, ezingophiyo ezinyaweni okanye ezinzwaneni (zihlala zimnyama) ezikhawulezayo ukuphola
• Umbala wolusu okanye umbala oluhlaza okwesibhakabhaka ezinzwaneni okanye ezinyaweni (cyanosis)
• Isikhumba esikhanyayo, esiqinileyo
• Iinzipho ezishinyeneyo

Uvavanyo lwegazi lunokubonisa i-cholesterol ephezulu okanye isifo seswekile.

Uvavanyo lwe-PAD lubandakanya:

• I-Angiography yemilenze
• Uxinzelelo lwegazi olulinganiswe ezingalweni nasemilenzeni yokuthelekisa (iqatha / isalathiso se-brachial, okanye i-ABI)
• Uvavanyo lwe-Doppler ultrasound yesiphelo
• I-Magnetic resonance angiography okanye i-CT angiography

Izinto onokuzenza ukulawula i-PAD zibandakanya:

• Ukulinganisela umthambo kunye nokuphumla. Hamba okanye wenze omnye umsebenzi ukuya kwindawo yentlungu kwaye uyitshintshe ngamaxesha okuphumla. Ixesha elingaphezulu, ukujikeleza kwakho kunokuphucuka njengefom entsha, yegazi elincinci. Soloko uthetha nomboneleli ngaphambi kokuqala inkqubo yokuzilolonga.
• Yeka ukutshaya. Ukutshaya kunciphisa imithambo, kunciphisa amandla egazi okuphatha ioksijini, kwaye kwandisa umngcipheko wokwenza amahlwili (thrombi kunye ne-emboli).
• Khathalela iinyawo zakho, ngakumbi ukuba unesifo seswekile. Nxiba izihlangu ezikulingana kakuhle. Nika ingqalelo nakuphi na ukusika, ukukrwela, okanye ukonzakala, kwaye ubone umboneleli wakho kwangoko. Izicubu ziyaphola kancinci kwaye kunokwenzeka ukuba bosulelwe xa kuncipha ukujikeleza.
• Qinisekisa ukuba uxinzelelo lwegazi lulawulwa kakuhle.
• Ukuba utyebe kakhulu, nciphisa ubunzima bakho.
• Ukuba icholesterol yakho iphezulu, yitya ukutya okune-cholesterol esezantsi kunye nokutya okunamafutha asezantsi.
• Jonga eswekile yegazi lakho ukuba unesifo seswekile, kwaye usigcine phantsi kolawulo.

Amayeza anokufuneka ukulawula isifo, kubandakanya:

• I-Aspirin okanye iyeza elibizwa ngokuba yi-clopidogrel (Plavix), eligcina igazi lakho lingazenzi amahlwili kwimithambo yakho. SUKUYEKE ukuthatha la mayeza ungakhange uqale uthethe nomboneleli wakho.
• I-Cilostazol, iyeza elisebenza ukwandisa (ukunciphisa) i-artery echaphazelekayo okanye iirriyiti zamatyala amodareyithayo ukuya kwinto enzima anganyanzelekanga ukuba enze utyando.
• Iyeza lokunceda ukunciphisa i-cholesterol yakho.
• Ukuphelisa iintlungu.

Ukuba uthatha amayeza oxinzelelo lwegazi oluphezulu okanye isifo seswekile, wathabathe njengoko kumiselwe ngumboneleli wakho.

Utyando lunokwenziwa ukuba imeko inzima kwaye ichaphazela amandla akho okusebenza okanye ukwenza imisebenzi ebalulekileyo, unentlungu yokuphumla, okanye unezilonda okanye izilonda emlenzeni wakho ezingapholiyo. Iinketho zezi:

• Inkqubo yokuvula imithambo yegazi emxinwa okanye evaliweyo ehambisa igazi kwimilenze yakho
• Ugqirha lokuhambisa kwakhona igazi xa ujikeleze umthambo

Abanye abantu abane-PAD banokufuna ukuba umlenze ususwe (unqunyulwe).

Uninzi lweziganeko ze-PAD yemilenze zinokulawulwa ngaphandle kotyando. Nangona utyando lubonelela ngesiqabu esihle seempawu kwiimeko ezinzima, iinkqubo ze-angioplasty kunye ne-stenting ziyasetyenziswa endaweni yotyando rhoqo nangakumbi.

Iingxaki zinokubandakanya:

• Amahlwili egazi okanye ama-emboli athintela imithambo encinci
• Imithambo yegazi
• Ukungabi namandla
• Izilonda ezivulekileyo (izilonda zeschemic kwimilenze esezantsi)
• Ukufa kwamathambo (ukubola)
• Umlenze okanye unyawo oluchaphazelekayo lusenokufuna ukunqunyulwa

Fowunela umnikezeli wakho ukuba unayo:

• Umlenze okanye unyawo oluya lupholile xa uchukumisa, luthuthu, luhlaza okwesibhakabhaka, okanye lindindisholo
• Intlungu yesifuba okanye ukuphefumla kancinci ngentlungu yomlenze
• Intlungu yomlenze engahambiyo, nokuba awuhambi okanye ushukuma (ekuthiwa yintlungu yokuphumla)
• Imilenze ebomvu, eshushu, okanye edumbileyo
• Izilonda ezintsha / izilonda
• Iimpawu zosulelo (umkhuhlane, ubomvu, ukugula ngokubanzi)
• Iimpawu ze-arteriosclerosis yeziphelo

Akukho luvavanyo lokuvavanywa olucetyiswayo lokuchonga i-PAD kwizigulana ezingenazo iimpawu.

Eminye yemingcipheko yesifo semithambo onokuthi uyitshintshe yile:

• Akatshayi. Ukuba uyatshaya, yeka.
• Ukulawula i-cholesterol yakho ngokutya, ukuzivocavoca kunye namayeza.
• Ukulawula uxinzelelo lwegazi oluphezulu ngokutya, ukuzilolonga, kunye namayeza, xa kufuneka njalo.
• Ukulawula isifo seswekile ngokutya, ukuzilolonga, kunye namayeza, xa kufuneka njalo.
• Ukuzivocavoca ubuncinci imizuzu engama-30 ngosuku.
• Ukugcina ubunzima obusempilweni ngokutya ukutya okusempilweni, ukutya kancinci, kunye nokujoyina inkqubo yokwehla kobunzima, ukuba ufuna ukunciphisa umzimba.
• Ukufunda iindlela ezisempilweni zokumelana noxinzelelo kwiiklasi ezizodwa okanye iinkqubo, okanye izinto ezinje ngokucamngca okanye ngeyoga.
• Ukunciphisa usela utywala obuninzi obuselayo kwitywala e-1 ngosuku kwabafazi kunye ne-2 ngemini yamadoda.

Isifo peripheral semithambo; PVD; IPAD; Iimpawu ze-Arteriosclerosis; Ukuvaleka kwemithambo yemilenze; Ukuchithwa; Ukuchaphazeleka okungapheliyo; Isifo se-Vaso-esiqhelekileyo semilenze; Ukungabikho komzimba kwimilenze; Iintlungu ezixhaphakileyo zomlenze kunye necramping; Intlungu yenkomo kunye nokuzilolonga

• I-angioplasty kunye nokubekwa ngokuqinileyo-imithambo yendlela-yokukhutshwa
• Iziyobisi Antiplatelet - P2Y12 inhibitors
• Cholesterol kunye nendlela yokuphila
• Kuchazwe amafutha ezempilo
• Iingcebiso zokutya okukhawulezayo
• Ukunqunyulwa kweenyawo - ukukhutshwa
• Ufunda njani iilebheli zokutya
• Ukunqunyulwa umlenze - ukubhobhoza
• Ukunqunyulwa komlenze okanye unyawo - ukunxiba
• Ukutya kweMeditera
• Umda we-peripheral artery-umlenze-ukukhutshwa

• I-atherosclerosis yeziphelo
• Uluhlu lwe-Arterial yokuhamba ngomlenze

ILungu lePalamente leBonaca, iCreager MA. Imithambo yegazi lomda. 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 64.

Ridker PM, Libby P, Buring JE. Iimpawu zomngcipheko kunye nothintelo lokuqala lwezifo zentliziyo. 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 45.

I-Simons JP, iRobinson WP, iSchanzer A. Isifo esiphantsi kwesifo: ulawulo lwezonyango kunye nokwenza izigqibo. Ku: Sidawy AN, Perler BA, ii-eds. Utshintsho lukaRutherford lweeVascular and Therapy ze-Endovascular Therapy. Umhla we-9. IPhiladelphia, PA: Elsevier; I-2019: isahluko 105.

Umsebenzi woKhuseleko kwi-US, Curry SJ, Krist AH, Owens DK, et al. Ukuvavanywa kwesifo se-artery kunye nokuvavanywa komngcipheko wesifo sentliziyo kunye nesalathiso se-ankle-brachial: I-US Preventive Services Task Force Statement. JAMA. 2018; 320 (2): 177-183. IINKCUKACHA: 29998344 pubmed.ncbi.nlm.nih.gov/29998344/.

I-CJ emhlophe. Isifo se-atherosclerotic isifo se-arterial. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahl. 71.