Isifo semithambo yeCarotid

Isifo somthambo weCarotid senzeka xa imithambo ye-carotid incitshisiwe okanye ivaliwe.

Imithambo ye-carotid ibonelela ngenxalenye yegazi eliphambili elinikezela kwingqondo yakho. Zibekwe kwicala ngalinye lentamo yakho. Unokuziva ukubetha kwawo phantsi komhlathi wakho.

Isifo semithambo seCarotid senzeka xa izinto ezinamafutha ezibizwa ngokuba yiplaque zisakha ngaphakathi kwimithambo. Eli litye libizwa ngokuba lukhuni kwemithambo (atherosclerosis).

Iqweqwe lisenokucothisa okanye licothise umthambo wecarotid. Okanye kunokubangela ukuba ihlwili lenze ngesiquphe. Ihlwili elithintela ngokupheleleyo umthambo kungakhokelela kwistroke.

Imiba yomngcipheko wokuvaleka okanye ukunciphisa imithambo ibandakanya:

• Ukutshaya (abantu abatshayayo ipakethi enye ngosuku baphinde babe semngciphekweni wokubethwa)
• Seswekile
• Igazi elonyukayo
• I-cholesterol ephezulu kunye ne-triglycerides
• Ukwaluphala
• Imbali yosapho yokubetha
• Ukusetyenziswa kotywala
• Ukusetyenziswa kweziyobisi ngokuzonwabisa
• Umothuko ukuya kwindawo yentamo, enokubangela ukothuka kwimithambo ye-carotid

Kumanqanaba okuqala, usenokungabi nazimpawu. Emva kokuba i-plaque iyakha, iimpawu zokuqala zesifo se-carotid isifo okanye isifo esisisigxina se-ischemic (TIA). I-TIA sisibetho esincinci esingabangeli monakalo ongapheliyo.

Iimpawu zokubetha kunye ne-TIA zibandakanya:

• Umbono omfiliba
• Ukudideka
• Ukuphulukana nenkumbulo
• Ukuphulukana nemvakalelo
• Iingxaki ngentetho nolwimi, kubandakanya ukulahleka kwentetho
• Ukulahleka kombono (ukungaboni okanye ukungaboni ngokupheleleyo)
• Ubuthathaka kwilungu elinye lomzimba wakho
• Iingxaki ngokucinga, ukuqiqa kunye nememori

Umboneleli wakho wezempilo uya kwenza uvavanyo lomzimba. Umboneleli wakho unokusebenzisa i-stethoscope ukumamela ukuhamba kwegazi entanyeni yakho kwisandi esingaqhelekanga esibizwa ngokuba yi-bruit. Esi sandi sinokuba luphawu lwesifo semithambo.

Umboneleli wakho naye unokufumana amahlwili kwimithambo yegazi yamehlo akho. Ukuba uye wabethwa sistroke okanye i-TIA, inkqubo yeemvakalelo (yemithambo-luvo) iya kubonisa ezinye iingxaki.

Unako ukufumana ezi mvavanyo zilandelayo:

• Uvavanyo lwe-cholesterol yegazi kunye novavanyo lwe-triglycerides
• Uvavanyo lweswekile yegazi (iswekile)
• I-Ultrasound ye-carotid arteries (carotid duplex ultrasound) ukubona ukuba igazi lihamba kakuhle kangakanani kumthambo we-carotid

Ezi mvavanyo zilandelayo zinokusetyenziselwa ukuvavanya imithambo yegazi entanyeni nengqondo:

• I-angiography yeCerebral
• I-CT angiography
• UMnu angiography

Izinketho zonyango zibandakanya:

• Amayeza okucoca igazi njenge-aspirin, i-clopidogrel (i-Plavix), i-warfarin (i-Coumadin), i-dabigatran (i-Pradaxa), okanye abanye ukunciphisa umngcipheko wesifo
• Amayeza kunye notshintsho kwindlela yokunciphisa i-cholesterol okanye uxinzelelo lwegazi
• Akukho lunyango, ngaphandle kokujonga umthambo we-carotid unyaka nonyaka

Unokuba neenkqubo ezithile zokuphatha i-carotid encinci okanye evaliweyo:

• I-Carotid endarterectomy-Olu tyando lususa i-plaque buildup kwimithambo ye-carotid.
• I-Carotid angioplasty kunye ne-stenting -Le nkqubo ivula umthambo ovalelweyo kwaye ibeke ucingo oluncinci (i-stent) kwimithambo ukuze ihlale ivulekile.

Ngenxa yokuba akukho zimpawu, unokungazi ukuba unesifo se-carotid uze ube nesifo okanye i-TIA.

• IStroke ngoyena nobangela wokufa eMelika.
• Abanye abantu abanesifo sokubethwa ngumoya bafumana uninzi lwayo okanye yonke imisebenzi yabo.
• Abanye babulawa sisibetho ngokwabo okanye ngenxa yeengxaki.
• Phantse isiqingatha sabantu abane-stroke baneengxaki zexesha elide.

Iingxaki ezinkulu zesifo se-carotid isifo:

• Uhlaselo lwexeshana lweschemic. Oku kwenzeka xa iblot clot ibhloka ngokufutshane isitya segazi kwingqondo. Ibangela iimpawu ezifanayo nokubetha. Iimpawu zihlala kuphela kwimizuzu embalwa ukuya kwiyure okanye ezimbini, kodwa hayi ngaphezulu kweeyure ezingama-24. I-TIA ayibangeli monakalo ungapheliyo. Ii-TIAs luphawu lwesilumkiso lokuba ukubetha kungabakho kwixesha elizayo ukuba akukho nto yenziweyo ukusithintela.
• Ukubetha. Xa ukunikezelwa kwegazi kwingqondo kuvaliwe okanye ngokupheleleyo, kubangela ukubetha. Rhoqo, oku kwenzeka xa iqabunga legazi livimba isitya segazi kwingqondo. Ukubethwa sisifo kuyenzeka kwakhona xa umthambo wegazi uvuleka okanye uvuza. Ukubetha kungabangela ukonakala kwengqondo ixesha elide okanye ukufa.

Yiya kwigumbi likaxakeka okanye fowunela inombolo yongxamiseko yendawo (enje nge-911) kwakamsinya emva kokuba iimpawu zenzekile. Ngokukhawuleza ufumana unyango, ngcono amathuba okuba uphinde uchache. Ngesibetho, yonke imizuzwana yokulibaziseka kunokubangela ukonzakala kwengqondo okungaphezulu.

Nantsi into onokuyenza ukunceda ukuthintela isifo somthambo we-carotid kunye nokufa icala:

• Yeka ukutshaya.
• Landela ukutya okusempilweni, okunamafutha asezantsi kunye nemifuno emitsha kunye neziqhamo.
• Musa ukusela ngaphezulu kwe-1 ukuya kwezi-2 iziselo ezinxilisayo ngosuku.
• Sukusebenzisa iziyobisi zokuzonwabisa.
• Zilolonge ubuncinci imizuzu engama-30 ngosuku, uninzi lweentsuku zeveki.
• Fumana i-cholesterol yakho ihlolwe rhoqo kwiminyaka emi-5. Ukuba unyangwa i-cholesterol ephezulu, kufuneka uhlolwe rhoqo.
• Fumana uxinzelelo lwegazi luhlolwe rhoqo kwiminyaka emi-1 ukuya kwezi-2. Ukuba unoxinzelelo oluphezulu lwegazi, isifo sentliziyo, isifo seswekile, okanye ukhe wabethwa yistroke, kufuneka uyokuhlolwa rhoqo. Buza umboneleli wakho.
• Landela iingcebiso zonyango lwakho ukuba unoxinzelelo lwegazi oluphezulu, isifo seswekile, icholesterol ephezulu, okanye isifo sentliziyo.

Isifo seCarotid; Stenosis - icarotid; Stroke - carotid umthambo; I-TIA - umthambo weCarotid

• I-Angioplasty kunye nokubekwa kwindawo entle-umthambo we-carotid-ukukhutshwa
• Utyando lweCarotid-ukukhutshwa
• Cholesterol - unyango lweziyobisi
• Ukuthatha warfarin (Coumadin)

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UMeschia JF, uBushnell C, uBoden-Albala B, et al. Izikhokelo zothintelo lokuqala lwe-stroke: ingxelo yabasebenzi bezempilo kwi-American Heart Association / American Association. Ukubetha. Ngo-2014; 45 (12): 3754-3832. IINKCUKACHA: 25355838 www.ncbi.nlm.nih.gov/pubmed/25355838.

UMeschia JF, uKlaas JP, uBrown RD Jr, uBrott TG. Uvavanyo kunye nolawulo lwe-atherosclerotic carotid stenosis. Ikliniki yaseMayo. Ngo-2017; 92 (7): 1144-1157. IINKCUKACHA: 28688468 www.ncbi.nlm.nih.gov/pubmed/28688468.