Ukuqhekeka kwe-aortic

Ukuqhaqhaqhaqhaqhaqhaqhaqhaqhaqhaqhaqqqqqqqqqqqqqqqqqqwili xeshwethithi apho kukho iinyembezi eludongeni lomthambo omkhulu ophethe igazi eliphuma entliziyweni (aorta). Njengoko iinyembezi ziqhubeka kunye nodonga lwe-aorta, igazi linokuhamba phakathi kweendonga zodonga lomthambo wegazi (dissection). Oku kunokukhokelela ekuqhekekeni kwe-aortic okanye ekunciphiseni ukuhamba kwegazi (ischemia) kwizitho.

Xa ishiya intliziyo, i-aorta kuqala inyuka ngesifuba isiya entloko (i-aorta enyukayo). Emva koko iyagoba okanye iarches, kwaye ekugqibeleni ihle ngesifuba kunye nesisu (eyehla i-aorta).

Ukusasazeka kwe-aortic kuhlala kwenzeka ngenxa yeenyembezi okanye ukonakala kudonga lwangaphakathi lwe-aorta. Oku kuhlala kwenzeka esifubeni (thoracic) kwinxalenye yomthambo, kodwa kusenokwenzeka kwisisu se-aorta.

Xa iinyembezi zenzeka, zenza iindlela ezi-2:

• Enye apho igazi liyaqhubeka nokuhamba
• Elinye apho igazi lihlala lizolile

Ukuba itshaneli enegazi elingahambiyo iya isiba nkulu, inokutyhala kwamanye amasebe e-aorta. Oku kungawanciphisa amanye amasebe kwaye kunciphise ukuhamba kwegazi kuwo.

Ukuqhekeka kwe-aortic kunokubangela ukwandiswa ngokungaqhelekanga okanye ibhaluni ye-aorta (aneurysm).

Oyena nobangela awaziwa, kodwa umngcipheko oqhelekileyo uquka:

• Ukwaluphala
• I-atherosclerosis
• Ukuqaqanjelwa sisifuba, njengokushaya ivili lokuqhuba lemoto ngexesha lengozi
• Igazi elonyukayo

Eminye imingcipheko kunye neemeko ezinxulunyaniswa ne-aortic dissection zibandakanya:

• Ivalicic aortic ivelufa
• Ukudibanisa (ukunciphisa) i-aorta
• Ukuphazamiseka kwezicubu ezinxibelelanayo (ezinje ngeMarfan syndrome kunye ne-Ehlers-Danlos syndrome) kunye nokuphazamiseka okunqabileyo kwemfuzo
• Utyando lwentliziyo okanye iinkqubo
• Ukukhulelwa
• Ukudumba kwemithambo yegazi ngenxa yeemeko ezifana ne-arteritis kunye negcushuwa

Ukusasazeka kwe-aortic kwenzeka malunga nabantu aba-2 kwabali-10 000. Inokuchaphazela nabani na, kodwa ihlala ibonwa kumadoda aneminyaka engama-40 ukuya kuma-70.

Kwiimeko ezininzi, iimpawu ziqala ngequbuliso, kwaye zibandakanya iintlungu zesifuba. Intlungu inokuziva ngathi sisifo sentliziyo.

• Ubuhlungu bunokuchazwa njengobukhali, ukugwaza, ukukrazula, okanye ukukrazula.
• Livakala ngaphantsi kwethambo lesifuba, emva koko lihamba phantsi kwegxalaba okanye ngasemva.
• Ubuhlungu bunokuhamba egxalabeni, entanyeni, engalweni, emhlathini, esiswini, okanye esinqeni.
• Intlungu iyatshintsha indawo, ihlala isiya ezingalweni nasemilenzeni njengoko ukususwa kwe-aortic kusiba kubi.

Iimpawu zibangelwa kukuhla kwegazi eliqukuqela liye kuwo wonke umzimba, kwaye linokubandakanya:

• Ixhala kunye nemvakalelo yentshabalalo
• Ukuphelelwa ngamandla okanye isiyezi
• Ukujuluka okunzima (ulusu olunqabileyo)
• Isicaphucaphu nokugabha
• Ulusu oluthuthu (pallor)
• Ukukhawuleza, ukubetha okubuthathaka
• Ukuphefumla okufutshane kunye nengxaki yokuphefumla xa ulele (i-orthopnea)

Ezinye iimpawu zingabandakanya:

• Intlungu esiswini
• Iimpawu zestroke
• Ukuginya ubunzima kuxinzelelo kwi-esophagus

Umboneleli wezempilo uya kuthatha imbali yosapho lwakho kwaye ayimamele intliziyo yakho, imiphunga kunye nesisu esine-stethoscope. Uviwo lunokufumana:

• "Ukuvuthela" ukumbombozela malunga ne-aorta, ukumbombozela kwentliziyo, okanye esinye isandi esingaqhelekanga
• Umahluko kuxinzelelo lwegazi phakathi kweengalo zasekunene nezasekhohlo, okanye phakathi kweengalo nemilenze
• Uxinzelelo lwegazi oluphantsi
• Iimpawu ezifana nesifo sentliziyo
• Iimpawu zokothuka, kodwa ngoxinzelelo lwegazi oluqhelekileyo

Ukusasazeka kwe-aortic okanye i-aortic aneurysm kunokubonwa kwi:

• I-aortic angiography
• I-x-ray yesifuba
• I-MRI yesifuba
• Ukuxilongwa kwe-CT kwesifuba ngedayi
• I-Doppler ultrasonography (eyenziwa ngamanye amaxesha)
• Echocardiogram
• I-transesophageal echocardiogram (TEE)

Umsebenzi wegazi ukukhupha isifo sentliziyo uyafuneka.

Ukusasazeka kwe-aortic yimeko esongela ubomi kwaye kufuneka inyangwe kwangoko.

• Ukuphazamiseka okwenzeka kwinxalenye ye-aorta eshiya intliziyo (inyuka) iyanyangwa ngotyando.
• Ukwahlukana okwenzeka kwezinye iindawo ze-aorta (ukuhla) kunokulawulwa ngokuhlinzwa okanye amayeza.

Iindlela ezimbini zinokusetyenziselwa utyando:

• Umgangatho, utyando oluvulekileyo. Oku kufuna ukusikwa kotyando okwenziwe esifubeni okanye esiswini.
• Ukulungiswa kwe-aortic ye-Endovascular. Olu tyando lwenziwa ngaphandle kokuqhaqha okukhulu kotyando.

Iziyobisi ezinokuthi zinciphise uxinzelelo lwegazi. La machiza anokunikezwa nge-vein (ngaphakathi). I-Beta-blockers sisiyobisi sokuqala sokhetho. Ukunciphisa iintlungu ezinamandla zihlala zifuneka.

Ukuba ivelufa ye-aortic yonakele, kufuneka kufakelwe enye ivalve. Ukuba kubandakanyeka imithambo yentliziyo, ukwenziwa kwe-coronary bypass kuyenziwa.

Ukusasazeka kwe-aortic kusongela ubomi. Le meko inokulawulwa ngoqhaqho ukuba yenziwa ngaphambi kokuba i-aorta idilike. Ngaphantsi kwesiqingatha sabantu abane-aorta eqhekekileyo bayasinda.

Abo basindayo baya kudinga unyango, lobundlongondlongo lwexinzelelo lwegazi. Kuya kufuneka zilandelwe ngokuvavanywa kwe-CT rhoqo kwiinyanga ezimbalwa ukubeka esweni i-aorta.

Ukusasazeka kwe-aortic kunokunciphisa okanye kumise ukuhamba kwegazi kwiindawo ezahlukeneyo zomzimba. Oku kunokubangela iingxaki zexesha elifutshane okanye zexesha elide, okanye umonakalo kwi:

• Ingqondo
• Intliziyo
• Amathumbu okanye amathumbu
• Izintso
• Imilenze

Ukuba unempawu ze-aortic dissection okanye iintlungu zesifuba esibuhlungu, tsalela umnxeba ku-911 okanye inombolo yakho yongxamiseko yendawo, okanye uye kwigumbi likaxakeka ngokukhawuleza.

Amatyala amaninzi okusasazeka kwe-aortic awanakukhuselwa.

Izinto onokuzenza ukunciphisa umngcipheko zibandakanya:

• Ukunyanga kunye nokulawula ukuqina kwemithambo (atherosclerosis)
• Ukugcina uxinzelelo lwegazi phantsi kolawulo, ngakumbi ukuba usemngciphekweni wokuqhaqha
• Ukuthatha amanyathelo okhuseleko ukuthintela ukwenzakala okunokubangela ukuphazamiseka
• Ukuba ufumene ukuba une-Marfan okanye i-Ehlers-Danlos syndrome, uqinisekisa ukuba ulandela rhoqo umboneleli wakho

Aortic aneurysm - ukusasaza; Intlungu yesifuba - i-aortic dissection; I-aneurysm ye-aortic ye-Thoracic-dissection

• Ukuqhekeka kwe-aortic - i-x-ray yesifuba
• Aortic aneurysm
• Ukuqhekeka kwe-aortic

IBraverman AC, iShermerhorn M. Izifo ze-aorta. 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 63.

IConrad MF, iCambria RP. Ukusasazeka kwe-Aortic: i-epidemiology, i-pathophysiology, ukuboniswa kweklinikhi, kunye nolawulo lonyango kunye notyando. Ku: Sidawy AN, Perler BA, ii-eds. Utshintsho lukaRutherford lweeVascular and Therapy ze-Endovascular Therapy. Umhla we-9. IPhiladelphia, PA: Elsevier; I-2019: isahl. 81.

ILederle FA. Izifo ze-aorta. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 69.