Ukudityaniswa kwemithambo

I-Arterial embolism ibhekisa kwi-clot (embolus) eye yavela kwelinye ilungu lomzimba kwaye ibangela ukuphazamiseka ngesiquphe kokuhamba kwegazi kwilungu okanye kwilungu lomzimba.

I "embolus" ligazi okanye iqhekeza leplagi elisebenza njengehlwili. Igama "emboli" lithetha ukuba kukho ngaphezulu kwehlwili elinye okanye iqhekeza leplagi. Xa iqokobhe lihamba lisuka kwindawo elakheka kuyo laya kwenye indawo emzimbeni, libizwa ngokuba kukuqina.

I-embolism ye-arterial inokubangelwa lilungu elinye okanye nangaphezulu. Amahlwili anokubambeka kwimithambo kwaye avimbe ukuhamba kwegazi. Ukuvalwa kulamba izicwili zegazi kunye neoksijini. Oku kunokubangela ukonakala okanye ukubulawa kwethishu (necrosis).

I-Arterial emboli ihlala ivela emilenzeni nasezinyaweni. I-Emboli eyenzeka kwingqondo ibangela ukubetha. Ezo zenzeka entliziyweni zibangela isifo sentliziyo. Iindawo ezincinci eziqhelekileyo zibandakanya izintso, amathumbu kunye namehlo.

Izinto ezinobungozi kwi-embolism ye-arterial zibandakanya:

• Iingqungquthela zentliziyo engaqhelekanga ezifana ne-atrial fibrillation
• Ukonzakala okanye ukonakala kudonga lwemithambo
• Iimeko ezonyusa ukujiya kwegazi

Enye imeko ebeka umngcipheko omkhulu wokudibanisa (ngakumbi kwingqondo) yi-mitral stenosis. I-Endocarditis (usulelo lwangaphakathi lwentliziyo) kunokubangela ne-arterial emboli.

Umthombo oqhelekileyo wombumba uvela kwiindawo zokuqina (i-atherosclerosis) kwi-aorta nakweminye imithana yegazi emikhulu. La mahlule anokuqhawuka kwaye ahle aye emilenzeni nasezinyaweni.

Ukudibanisa okungahambelaniyo kunokwenzeka xa ihlwili emthanjeni lingena kwicala lasekunene lentliziyo kwaye lidlula emngxunyeni kwicala lasekhohlo. Ihlwili linokuhamba liye emithanjeni lize livimbe ukuhamba kwegazi liye kwingqondo (stroke) okanye amanye amalungu.

Ukuba iqokobhe lihamba kwaye lingena kwimithambo ebonelela ngokuhamba kwegazi ukuya emiphungeni, ibizwa ngokuba yi-pulmonary embolus.

Awunakho ukuba naziphi na iimpawu.

Iimpawu zingaqala ngokukhawuleza okanye ngokuthe chu kuxhomekeka kubungakanani bembumba kunye nokuba ibhloka kangakanani ukuhamba kwegazi.

Iimpawu ze-arterial embolism ezingalweni okanye emilenzeni inokubandakanya:

• Ingalo ebandayo okanye umlenze
• Ukuhla okanye ukungabikho kwempumlo engalweni okanye emlenzeni
• Ukungabikho kokuhamba engalweni okanye emlenzeni
• Intlungu kwindawo echaphazelekayo
• Ukuba ndindisholo kunye nokutswina engalweni okanye emlenzeni
• Umbala opholileyo wengalo okanye womlenze (pallor)
• Ubuthathaka bengalo okanye umlenze

Iimpawu kamva:

• Amadyungudyungu kulusu olondliwe ngumthambo ochaphazelekayo
• Ukuchithwa (ukutyibilika) kwesikhumba
• Ukhukuliseko lolusu (isilonda)
• Ukufa kwethishu (necrosis; ulusu lumnyama kwaye lonakele)

Iimpawu zegalelo kwilungu emzimbeni ziyahluka kwilungu elibandakanyekayo kodwa linokubandakanya:

• Intlungu kwilungu lomzimba elibandakanyekayo
• Ukunciphisa okwethutyana ukusebenza kwamalungu

Umboneleli wezempilo unokufumana ukwehla okanye ukungabikho kwempembelelo, kunye nokunciphisa okanye akukho xinzelelo lwegazi engalweni okanye emlenzeni. Kusenokubakho iimpawu zokufa kwethishu okanye ukubola.

Uvavanyo lokufumanisa isifo se-embolism okanye ukuveza umthombo we-emboli unokubandakanya:

• I-Angiography yomda ochaphazelekayo okanye ilungu
• Uvavanyo lwe-Doppler ultrasound yesiphelo
• I-Duplex Doppler ultrasound yovavanyo lokuphela
• Echocardiogram
• I-MRI yengalo okanye umlenze
• Umahluko we-myocardial echocardiography (MCE)
• Imvelaphi
• Uvavanyo lweTranscranial Doppler lweemithambo zengqondo
• I-transesophageal echocardiography (TEE)

Esi sifo sinokuchaphazela iziphumo zolu vavanyo lulandelayo:

• I-D-dimer
• Into ye-VIII yovavanyo
• Isotope yokufunda kwilungu elichaphazelekayo
• Umsebenzi wePlasminogen inhibitor-1 (PAI-1)
• Uvavanyo lokuhlanganiswa kweplatelet
• Uhlobo lweethishu plasminogen activator (t-PA) amanqanaba

I-arterial embolism ifuna unyango olukhawulezileyo esibhedlele. Iinjongo zonyango kukulawula iimpawu kunye nokuphucula ukuhamba kwegazi okuphazamisayo kwindawo echaphazelekayo yomzimba. Unobangela wehlwili, ukuba lifunyenwe, kufuneka inyangwe ukuthintela ezinye iingxaki.

Amayeza afaka:

• I-Anticoagulants (njenge-warfarin okanye i-heparin) inokuthintela amahlwili amatsha ekubeni abumbe
• Amayeza e-antiplatelet (njenge-aspirin okanye i-clopidogrel) anokuthintela amahlwili amatsha ukuba angabikho
• Iipilisi zentlungu ezinikezwe ngomthambo (ngo-IV)
• I-Thrombolytics (enje nge-streptokinase) inokunyibilikisa amahlwili

Abanye abantu bafuna utyando. Iinkqubo zibandakanya:

• Dlula i-artery (ngokudlula kwimithambo) ukwenza umthombo wesibini wonikezelo lwegazi
• Ukususwa kwengubo nge-catheter yebhaluni ebekwe kumthambo ochaphazelekayo okanye ngotyando oluvulekileyo kwilitha (embolectomy)
• Ukuvulwa komthambo ngebhaluni yecatheter (angioplasty) kunye okanye ngaphandle kwestent

Ukusebenza kakuhle komntu kuxhomekeke kwindawo ekuyo iqhekeza nokuba lingakanani na eliathintele ukuphuma kwegazi kunye nokuba ixesha elingakanani ubukho. I-arterial embolism inokuba yinto enzulu kakhulu ukuba ayinyangwa ngokukhawuleza.

Indawo echaphazelekayo inokonakaliswa ngokusisigxina. Ukukhutshwa kwamalungu kuyadingeka ukuya kuthi ga kumatyala ama-4.

I-Arterial emboli ingabuya nasemva konyango oluyimpumelelo.

Iingxaki zinokubandakanya:

• MI efanelekileyo
• Usulelo kwizicubu ezichaphazelekayo
• Ukutshatyalaliswa kwe-Septic
• Ukubetha (CVA)
• Ukuhla okwethutyana okanye ngokusisigxina okanye ukulahleka kweminye imisebenzi yelungu
• Ukungaphumeleli okwethutyana okanye okusisigxina kwezintso
• Ukufa kwamathambo (necrosis) kunye nokulimala
• Ukuhlaselwa kweschemic okwethutyana (TIA)

Yiya kwigumbi likaxakeka okanye fowunela inombolo yongxamiseko yendawo (enje nge-911) ukuba uneempawu zembonakalo yomzimba.

Uthintelo luqala ngokufumana imithombo yegazi. Umboneleli wakho unokumisela abancinci begazi (njenge-warfarin okanye i-heparin) ukuthintela amahlwili ekubunzeni. Amachiza antiplatelet nawo anokufuneka.

Unomngcipheko ophezulu we-atherosclerosis kunye namahlwili ukuba:

• Umsi
• Musa ukwenza umthambo omncinci
• Yiba noxinzelelo lwegazi oluphezulu
• Unamanqanaba angaqhelekanga e-cholesterol
• Unesifo seswekile
• Batyebile
• Ngaba uxinezelekile

• Ukudityaniswa kwemithambo
• Inkqubo yokujikeleza

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