Imishanguzo iyimithwalo yegazi lapho igazi elicebile ne-oxygen elicebile ligeleza ezihlotsheni ezinjengezinso, inhliziyo, nobuchopho. I-oksijeni nezakhi zomzimba zibalulekile ekusindeni kwazo zonke izitho emzimbeni.
Imishanguzo esemqoka eyenza igazi ebuchosheni yi-artery carotid ne-vertebral. Noma yikuphi inkinga ngegazi ukugeleza kulezi zithandane kungabangela ukushaywa.
Uhlobo olungavamile kakhulu lwesifo se-arteries, olubizwa ngokuthi i-dissection yamagciwane, lungabangela isifo.
Kuyini ukuhlukaniswa kwamagciwane?
Ukuphazamiseka kwamagciwane kubhekisela ekungajwayelekile, futhi ngokuvame ukonakala, ukwakheka kwezinyembezi ngaphakathi kodonga lwangaphakathi lomthambo. Njengoba izinyembezi ziba zikhulu, zakha isikhwama esincane odokotela ababiza ngokuthi "i-lumen yamanga." Igazi elibuthela ngaphakathi kwalokhu lumen lamanga lingabangela ukushaywa yilezi zindlela ezilandelayo:
- Amachibi egazi ngaphakathi kwodonga lwe-artery aze aqale ukuvimbela ukugeleza kwegazi. I-pool ekhulayo yegazi emdongeni we-artery ibizwa ngokuthi "i-pseudoaneurysm." Amapseudoaneurysms angabangela izimpawu zokushaywa ngokucindezela izakhiwo zobuchopho eziseduze. Kungase futhi kuqhume futhi kubangele ukuphuma kwegazi okukhulu ebuchosheni (imivimbo enzima). Uma lokhu kwenzeka, i-pseudoaneurysm ibizwa ngokuthi "i-dissecting aneurysm" noma "i-dissecting pseudoaneurysm."
- Igazi ngaphakathi kwe-lumen engamanga lingagubuzela futhi lande kancane endaweni lapho igazi livame ukugeleza khona. Lokhu kunganciphisa noma kuphazamise ngokuphelele ukugeleza kwegazi engxenyeni yobuchopho.
- Izingcezu ezincane ezivela egazini legazi elikhulayo likwazi ukuphuma, ligeleza phezulu, futhi ziboshwe ngaphakathi kwe-artery encane ebuchosheni. Lo mcimbi waziwa ngokuthi "i-artery-to-artery thromboembolism."
Ukuphazamiseka kwamagciwane kubhekene namaphesenti angaphansi kuka-2 kuwo wonke ama-stroke. Kodwa-ke, ama-akhawunti e-dissection e-arterial for a quarter-quarter of all stroke kubantu abasha nabangaphakathi.
Unyaka ngamunye e-United States, abantu abaphakathi kuka-12 000 no-15,000 bathinteka ngokungaxhunywanga kwamakhemikhali e-carotid noma e-vertebral.
Izimpawu
Izimpawu ezijwayelekile zifaka:
- Ubuhlungu komunye owodwa noma zombili izinhlangothi entanyeni, ubuso, noma ikhanda
- Ubuhlungu beso, noma umfundi oyedwa ongavamile
- Ijwabu leso lesikhumba noma umbono ophindwe kabili
- Ukungakwazi ukuvala iso elilodwa
- Ukushintsha okungazelelwe kokukwazi ukunambitha ukudla
- Ukukhala ezindlebeni, isizungu noma vertigo
- Ukukhubazeka kwanoma yimiphi imisipha yentamo futhi ubheke ngakolunye uhlangothi
Izimpawu zokuhlaselwa kwesisu noma ukuphela kwesinye isikhathi kungenzeka ezinsukwini ezimbalwa kuya kwamasonto ambalwa emva kokuqala kwezimpawu ezichazwe ngenhla.
Izimbangela
Imithambo ye-carotid ne-vertebral ingonakaliswa ukulimala kwentamo noma ngisho nokunyakaza kwentamo eqinile. Lokhu okulandelayo yizinye izimo eziye zahlotshaniswa ne-dissection ye-artibral ne-vertebral arteries:
- Isandiso sezintambo ngesikhathi sokuhlanza izinwele endaweni enhle
- Ukuphathwa kwe-Chiropractic yentamo
- Ukulimala kwe-Whiplash
- Ukuhlukumezeka okulimazayo entanyeni
- Ukwandiswa kwentanyeni enkulu ngesikhathi se-yoga
- Ukudweba ugwayi
- Ukuhlunga, ukuhlanza nokweqa
- Ukwandiswa kwemikhanda ngenkathi uthola umlomo ngomlomo ngesikhathi sokuvuselela i-cardiopulmonary (CPR)
Ukuphazamiseka okungajwayelekile kwamathambo e-carotid ne-vertebral kuyimbangela evamile kakhulu yokushaywa yisifo.
I-dissection yokuzenzekelayo ibhekisela ekuchasheni okuphazamisayo okungenayo imbangela ebonakalayo ngokushesha. Ukuxoshwa kwemithambo ye-carotid ne-vertebral kungenzeka futhi ngokuzenzekelayo ngokuhambisana nezifo ezilandelayo:
- I-Marfan's syndrome
- Isifo sezinso ze-Polycystic
- Osteogenesis imperfecta
- Dysplasia ye-fibromuscular
Ukuxilongwa
Isivivinyo esivame kakhulu ukusetshenziselwa ukuxilonga ukuxubana kwe-carotid noma umthambo we-vertebral ingumdwebo we-angiogram. Kulesi sivivinyo, idayisi yokuphambene ifakwe ngaphakathi ngaphakathi komunye wemithwalo yegazi eyenza igazi ebuchosheni. I-x-ray isetshenziselwa ukubheka ukuma kwe-carotid ne-vertebral arteries njengoba idayisi ihamba ngayo (bheka isithombe).
I-dissection ikhonjwa uma i-angiogram ibonisa umshini obonakala uhlukaniswa zibe izingxenye ezimbili ezihlukene, enye yawo ichazwa ngokuthi 'i-lumen yamanga' (echazwe ngezansi.) Uma ukuxubana komzimba kunzima kangangokuthi kuvimbela ukuthi igazi ligeleza phakathi kwabathintekayo i-artery, idayi igxuma futhi iphela lapho iphutha livalwa ngokuphelele. Uma i-dissection ibangela i-pseudoaneurysm, i-angiogram ibonisa ukuqoqwa kwedayi ngaphakathi kwodonga lwe-artery ehlukanisiwe.
Okunye ukuhlolwa okusetshenziselwa ukuxilongwa kwe-carotid ne-dissection ye-vertebral kubandakanya i-magnesium resonance angiography (MRA), ne-duplex ultrasound.
Ukwelapha
I-carotid ne-vertebral artery dissection ingase iphathwe i-heparin, imithi evimbela ukwandiswa kwe-clot yegazi endaweni ye-dissection. I-Heparin iyimithi e-intravenous. Uma sekuyisikhathi sokushiya esibhedlela, i-Coumaden (i-warfarin) i-blood thinner engathathwa ngomlomo.
Ngokuvamile, umuntu ophulukisayo kusuka ekuhlaselweni kwamagciwane kulindeleke ukuthi athathe abathintekayo begazi abangezinyanga ezintathu kuya kwezi-6. Kodwa-ke, uma ukuhlolwa okulandelwayo kungabonakali ukuthuthukiswa okukhulu ngemva kwezinyanga ezingu-6, imithi inqunywe isikhathi eside. Uma kungabikho ukuthuthukiswa, ukuhlinzwa noma ibhaluni ye-percutaneous angioplasty ne-stenting kungaba enye indlela.
Ukubuyisela
Iningi labantu abanobuhlungu obuhlobene nokuphazamiseka kwamagciwane ukutholwa okuhle. Eqinisweni, abangaphansi kuka-5% kulabo abanesifo se-dissection arterial bafa ngenxa yomcimbi. Amacala angaphezulu kuka-90% lapho umthambo we-carotid uyancipha khona, futhi amacala angaphezu kuka-66% lapho evinjelwe khona ngokuphelele yi-dissection, ukuxazulula ezinyangeni ezimbalwa zokuqala ngemuva kokuba izimpawu zihlangene. Kwezinye izimo, ikhanda eliphikisanayo lingase lihlale amasonto ambalwa noma izinyanga ezimbalwa.
Ama-Aneurysms ahlobene nokusekelwa kwe-dissection cishe awakhuphuki, kodwa angaholela ekwakheni i-blood clots ne- stroke ye-thromboembolic ezimweni ezingavamile.
Izwi elivela
Ukuphazamiseka kwamagciwane kuyinkinga enzima kakhulu. Kodwa ngokuphathwa kwezokwelapha, abantu abaningi abanenkinga yokusinda baphila futhi baqhubeka benza kahle. Uma wena noma othandekayo uye waba nesifo esiwumshayabhuqe esibangelwa ukuphazamiseka kwamagciwane, nawe uzodinga isikhathi esithile sokuphinda uphinde uhlaselwe isifo. Ukuvuselelwa kwesisindo ngokuvamile kudinga ukuhlanganyela okubambe iqhaza, futhi kungase kube ukukhathala, kodwa uzobona ukutakula nokuthuthukiswa njengoba isikhathi siqhubeka.
> Imithombo:
> Ukuhlukaniswa kwe-septum yangaphakathi: Izici ze-Echocardiographic, i-Gu X, i-Y, i-Luan S, iZhao Y, i-Sun L, i-Zhang H, i-Nixon JV, i-Medicine (i-Baltimore). 2017 Mar; 96 (10): e6191