Kuyini Ukucindezeleka Kwegazi Kwephaphu Nokuthi Ungakwelapha Kanjani
I-Pendahuluan
Umfutho wegazi ophezulu wamaphaphu yisimo esibucayi sezokwelapha lapho umfutho wegazi emithanjeni yamaphaphu uphakeme ngendlela engavamile. Lesi simo sibangela ukuthi uhlangothi lwesokudla lwenhliziyo lusebenze kanzima kunokujwayelekile futhi, uma lungelashwa, lungabangela ukwehluleka kwenhliziyo. Umfutho wegazi ophezulu wamaphaphu ungathinta noma ubani, kusukela ezinganeni kuya kubantu abadala, kungakhathaliseki ubulili noma uhlanga.
Ukuqonda Umfutho Wegazi Ophakeme Wephaphu
Umfutho wegazi ophezulu wamaphaphu yisifo esithinta imithambo yamaphaphu kanye nohlangothi lwesokudla lwenhliziyo. Imithambo yamaphaphu yimithambo yegazi ethwala igazi lisuka enhliziyweni liye emaphashini ukuze lithathe umoya-mpilo. Kubantu abane-hypertension yamaphaphu, izindonga zale mithambo ziba zijiyile, ziqine, futhi zivinjwe amangqamuzana angavamile. Ngenxa yalokho, imithambo yegazi iyancipha futhi umfutho wegazi emaphashini uyanda kakhulu.
Izinhlobo ze-Pulmonary Hypertension
Umfutho wegazi ophezulu wamaphaphu ungahlukaniswa ngezigaba ezilandelayo:
1. Umfutho wegazi ophezulu wemithambo yamaphaphu (i-PAH): Lolu uhlobo oluvame kakhulu lomfutho wegazi ophezulu wamaphaphu futhi indlela olusebenza ngayo ihilela ukuncishiswa kwemithambo yamaphaphu okuthinta ukugeleza kwegazi.
2. Umfutho wegazi ophezulu wamaphaphu obangelwa yisifo senhliziyo esihlangothini lwesobunxele: Lesi simo sibangelwa yizifo ezithinta uhlangothi lwesobunxele lwenhliziyo, njengesifo senhliziyo noma i-cardiomyopathy.
3. Umfutho wegazi ophezulu wamaphaphu obangelwa yisifo samaphaphu: Izimbangela zingase zihlanganise i-Chronic Obstructive Pulmonary Disease (COPD), i-pulmonary fibrosis, noma ezinye izifo zamaphaphu ezithinta izicubu kanye nesakhiwo samaphaphu.
4. Umfutho wegazi ophakeme obangelwa amahlule egazi angapheli (CTEPH): Okubangelwa amahlule egazi aphindaphindayo noma angapheli emaphashini.
5. Umfutho wegazi ophezulu wamaphaphu onezici eziningi: Izimo zezokwelapha ezahlukahlukene eziyinkimbinkimbi nazo zingabangela umfutho wegazi ophezulu wamaphaphu.
Izimpawu Zomfutho Wegazi Ophakeme Wephaphu
Izimpawu zomfutho wegazi ophezulu emaphashini zivame ukungabonakali kuze kube yilapho lesi sifo sesisesigabeni saso esiphambili. Kodwa-ke, ezinye izimpawu ezivamile zifaka:
- Ukuphefumula okunzima kakhulu uma usebenza
- Ukukhathala
- Ubuhlungu besifuba
– Ukuzizwa unesizungu noma ukuphelelwa yithemba
– Ukuvuvukala (i-edema) emaqakaleni, ezinyaweni noma esiswini
– Izindebe nesikhumba esiluhlaza okwesibhakabhaka (i-cyanosis)
- Ukushaya kwenhliziyo okusheshayo noma okushaya ngamandla
Izimbangela Zokucindezeleka Kwegazi Emaphaphu
Imbangela eqondile yomfutho wegazi ophezulu wamaphaphu ivame ukungaziwa futhi ingaba yinto engavamile. Kodwa-ke, izimo eziningana zezokwelapha kanye nezici ezaziwayo ezibangela umfutho wegazi ophezulu wamaphaphu zifaka:
– Isifo senhliziyo esizalwa naso: Abanye abantu bazalwa benezinkinga zesakhiwo senhliziyo ezingaholela ekucindezelekeni kwegazi emaphashini ngokuhamba kwesikhathi.
– Isifo samaphaphu: Njenge-COPD, i-pulmonary fibrosis, noma i-sleep apnea.
– Isifo sesibindi: Njenge-cirrhosis.
– Izidakamizwa nobuthi: Ukusetshenziswa kwezidakamizwa ezithile, njenge-methamphetamine noma i-cocaine, kanye neminye imithi yokwehlisa isisindo.
– Izimo zokuzivikela komzimba: Njenge-lupus noma i-scleroderma.
– Ukuthambekela kwezakhi zofuzo: Ukuguquka kwezakhi zofuzo ezithile kungandisa ingozi yomuntu yokuba nomfutho wegazi ophakeme emaphashini.
Ukuxilongwa Kwe-Hypertension Yamaphaphu
Ukuxilonga umfutho wegazi ophezulu wamaphaphu kudinga uchungechunge lokuhlolwa nokuhlolwa. Izinyathelo ezivamile zokuxilonga zifaka:
1. Ukuhlolwa ngokomzimba: Udokotela uzokwenza ukuhlolwa ngokomzimba futhi aqaphele noma yiziphi izimpawu.
2. Ukuhlolwa kwegazi: Ukuhlola izimpawu zesifo sokuzivikela komzimba, okungenani lezo ezingase zibonise ingozi yomfutho wegazi ophezulu emaphashini.
3. I-Echocardiogram: Isebenzisa amaza omsindo ukudala izithombe zenhliziyo nokubona ukuthi inhliziyo ipompa kanjani igazi futhi ibone ingcindezi emithanjeni yamaphaphu.
4. Ukuhlolwa kokusebenza kwamaphaphu: Kukala ukuthi amaphaphu asebenza kahle kangakanani.
5. I-Pulmonary angiography: Ukuhlolwa okukhethekile kokubona ukugeleza kwegazi emithanjeni yamaphaphu.
6. Ukufakwa kwe-catheter yenhliziyo kwesokudla: Le nqubo iyindinganiso yegolide yokuxilonga umfutho wegazi ophezulu wamaphaphu. I-catheter ifakwa emthanjeni wegazi bese iqondiswa ohlangothini lwesokudla lwenhliziyo ukuze kulinganiswe umfutho wegazi emithanjeni yamaphaphu.
Ukwelashwa Komfutho Wegazi Ophakeme Wephaphu
Imigomo yokwelashwa komfutho wegazi ophezulu emaphashini ukunciphisa izimpawu, ukuthuthukisa ikhwalithi yokuphila, kanye nokunciphisa ukuqhubeka kwesifo . Ukwelashwa kungabandakanya izindlela eziningana ezahlukene:
1. Imithi: Kunezinhlobo eziningana zemithi esetshenziselwa ukwelapha umfutho wegazi ophezulu emaphashini, okuhlanganisa:
– Ama-Vasodilator: Njenge-prostanoids, ama-endothelin receptor antagonists, kanye nama-phosphodiesterase-5 inhibitors, aphumuza futhi andise imithambo yegazi.
– Ama-anticoagulant: Ukunciphisa ingozi yokuqhekeka kwegazi.
– Ama-diuretics: Ukunciphisa ukunqwabelana koketshezi emzimbeni.
– I-Digitalis: Ukuqinisa umsebenzi wenhliziyo.
– Ukunikeza umoya-mpilo: Kungadingeka umoya-mpilo owengeziwe ukuze kusizwe ekuphefumulweni okunzima.
2. Indlela Yokuphila: Ukwamukela indlela yokuphila enempilo kungasiza ekulawuleni izimpawu zomfutho wegazi ophezulu emaphashini, okuhlanganisa:
- Yeka ukubhema
- Gwema imisebenzi enzima nokukhuphukela ezindaweni eziphakeme
- Yidla ukudla okunempilo nokunomsoco
- Qiniseka ukuthi uthola ukuphumula okwanele
- Phatha ukucindezeleka ngempumelelo
3. Izinqubo zezokwelapha: Ezinye izinqubo zingadingeka ukuze kuxazululwe izimo eziphuthumayo noma kulungiswe isakhiwo senhliziyo namaphaphu, njenge-atrial septostomy noma ukufakelwa kwamaphaphu/inhliziyo.
4. Ukuvuselelwa kwamaphaphu: Izinhlelo ezenzelwe ngqo iziguli ezinesifo samaphaphu zingasiza ekuthuthukiseni ukusebenza komzimba kanye nekhwalithi yokuphila.
5. Ukusekelwa ngokomzwelo nangokwengqondo: Ukuthola ukuxilongwa kwe-pulmonary hypertension kungaba yinto enzima. Ukusekelwa ngumeluleki, iqembu lokusekela, noma ukwelashwa kwengqondo kungaba usizo olukhulu ekubhekaneni nomthelela ngokomzwelo walesi simo.
Isiphetho
Umfutho wegazi ophezulu wamaphaphu yisifo esibi nesiqhubekayo esithinta imithambo yamaphaphu nenhliziyo. Nakuba okwamanje kungekho ukwelashwa komfutho wegazi ophezulu wamaphaphu, izindlela ezahlukene zokwelapha zinganciphisa izimpawu, zinciphise ukuqhubeka kwesifo, futhi zithuthukise ikhwalithi yokuphila. Kubalulekile ukuthi abantu ababhekene nezimpawu ezihlobene bafune ukunakekelwa kwezokwelapha okusheshayo ukuze kuqalwe ukuxilongwa okufanele nokwelashwa ngokushesha okukhulu. Ukusekelwa okuphelele kwezokwelapha kanye nokuzibophezela komuntu siqu endleleni yokuphila enempilo kubalulekile ekuphatheni umfutho wegazi ophezulu wamaphaphu.
