Inzululwazi yezonyango sele iqaphele ukuba isele ihlala emva kweSigaba seNqanaba leNkcenkcesho ye-Elevator Myocardial Infarction (STEMI) (ukuhlaselwa kwintliziyo) ngumngcipheko omkhulu wokufa kwangaphambili. Abantu ababandakanyeka kwiiprogram zokulungiswa kwenhliziyo emva kokuhlaselwa kwintliziyo, baze baqhubeke beqhuba emva kokuba iprogram yesiqhelo esisemthethweni isiphelile, yaziwa ukuba yenze ngcono kakhulu ixesha elide kunabantu abahlala (okanye ba) bengasebenzi.
Yingakho uqeqesho oluqhelekileyo lugxininiswa oogqirha abaphatha izigulane nge- coronary disease (CAD) .
Iingcamango zokuba kukho into enjengokuthi "kakhulu kakhulu" emva kokuhlaselwa kwentliziyo yinto entsha. Okanye, yinto entsha yokwakhiwa kwengcamango endala - iminyaka engama-50 edlulileyo ixhoba lokuhlaselwa yintliziyo yayiphathwe rhoqo ngeeveki zokulala, kwaye ngenxa yeso sihlandlo saba yinto engapheliyo. Ukuze kubekho into enjengokuzivocavoca kakhulu emva kokuhlaselwa kwintliziyo ephakanyisiwe kwiphepha lokuphanda elibonakala ngoAgasti 2014 kwiMayo Clinical Proceedings . Eli phepha libonisa ukuba, ngelixa usebenziso oluqhelekileyo emva kokuhlaselwa kwentliziyo kwaye kunciphisa kakhulu umngcipheko wokufa, iinzuzo zokuzilolonga zingase ziqale ukujika emva kokuba umda othile ufikeleleke.
Ngokucacileyo, abalobi bacetyisa, abasindileyo be-heart survivors abaqhuba ngaphezulu kweekhilomitha ezili-31 ngeveki, okanye bahamba ngokukhawuleza malunga neekhilomitha ezili-46 ngeveki, banomngcipheko ophezulu wokufa kuneemgijimi (okanye abahambahambayo) abasebenzisa ngaphantsi kwezi zixa .
(Nangona kunjalo, basengcono kakhulu kunokuba bahlaselwe yintliziyo abasindayo.)
Ubu bungqina boKhuselo lokuSebenza
Olu bungqina luvela kwiSizwe soPhulo lwezeMpilo kaZwelonke kunye neSizwe seZifundo sezeMpilo zeSizwe. Ezi zifundo zifunyenwe abangaphezu kwe-100,000 abathathi-nxaxheba, abazalise uluhlu lweemibuzo malunga nembali yabo yezonyango kunye nemikhwa yokuzilolonga.
Kulaba bathathi-nxaxheba, abali-924 abesilisa kunye nabesifazane abangama-631 babika ukuba babenokuhlaselwa kwentliziyo, kwaye aba bantu babandakanywa kwisifundo esixubushayo.
Nantsi abaphandi abakufumene. Emva kokulandelwa malunga neminyaka eyi-10, abathathi-nxaxheba abagijimela ukuya kwii-8 ngeekhilomitha okanye bahamba ukuya kwii-12 eziliekhilomitha ngeliveki (okukude umgama umntu oza kuwufumana olandela iinjongo ezilandelelanayo zokuhlaselwa kwenhliziyo), banciphisa isifo sabo senhliziyo -unxulumene nokufa kwabantu ngo-21%, xa kuthelekiswa nabasindayo bentliziyo. Ukufa kwancitshiswa ngama-24% ngabantu abagijimitha ezili-8 ukuya ku-16 okanye bahamba ngeekhilomitha ezingama-12 ukuya kwi-2; ngama-50% abo bahamba ngamamayela angama-16 ukuya ku-24 okanye bahamba ngeekhilomitha ezili-23 ukuya kuma-24 ngeveki; kwaye ngo-63% ngabantu abahamba ngeekhilomitha ezili-24 ukuya ku-31 okanye bahamba ngeekhilomitha ezingama-34 ukuya kuma -6 ngeveki.
Nangona kunjalo, ekuhlaselweni kweentliziyo ezithintele ekusebenziseni umsebenzi wabo, kangangokuba baqhuma ngaphezu kweekhilomitha ezingama-31 okanye bahamba ngaphezu kweeyure ezingama-46 ngeveki, kuphela ukunciphisa oku-12% ekufeni kwafunyanwa-okuyi-half half benefit benefit abantu "nje" balandele izikhokelo zoqeqesho ngoku. Ngoko, kulesi sifundo, kubonakala ukuba usebenziso oluninzi emva kokuhlaselwa kwentliziyo inzuzo enkulu-ukuya kwindawo. Kodwa ngaphaya kwelo nqanaba - xa kufikelelwe umyinge wokuzivocavoca ufikeleleko - inzuzo yokufa komsebenzi ngokuqinisekileyo uqala ukuguquka.
Ababhali be-editorial avela kwimiba efanayo ye- Mayo Clinical Proceedings baqikelele ukuba mhlawumbi kukho into efana nokulimala kwenhliziyo, "apho umzimba omkhulu unganciphisa impilo empilweni (mhlawumbi ngokuvelisa izicubu ezinqabileyo entliziyweni kwaye ngoko i- cardiomyopathy ). Ukuba kunjalo, ngoko kubekho into enokuthi "yinto eninzi", ubuncinane kubantu abaye bahlaselwa yintliziyo.
Ngaba Ngokwenene Kuyi nyaniso?
Oku kunenyaniso ukuba ukwenza "kakhulu" emva kokuhlaselwa kwentliziyo kunokunciphisa inzuzo enkulu oyifumanayo ngokuziqhuba rhoqo. Nangona kunjalo, kukho imingcele ebalulekileyo kulolu cwaningo olufuna ukuba sibeke izigqibo zalo ngombono.
Okokuqala, olu phofu lwenziwa yimibuzo yodwa. Sifanele sithathe igama labathathi-nxaxheba ngenani lomsebenzi abenzileyo, kwaye mhlawumbi kubaluleke ngakumbi, ngenxa yokuba bahlaselwa yintliziyo. (Oogqirha ngamanye amaxesha basebenzisa igama elithi "ukuhlaselwa yintliziyo" ngokungahambi kakuhle nangokungahambi kakuhle , kwaye izigulane zabo zingabonakala ziphazamisekile.) Ngoko kwinqanaba elithile, ukuchaneka kwedatha ngokwayo kungathiwa. Oku, okokuthi, ukunciphisa okusemgangathweni kwanaluphi na uphando lwezokwelapha oluxhomekeke kuphela kwiingqinisombuzo zedatha yalo.
Mhlawumbi kubaluleke kakhulu ukufumanisa okubonakalayo xa umntu ebona itafile yedatha epapashwe kunye nento ngokwayo. Ukususela kuloo tafile, kuyacaca ukuba abasindileyo beentliziyo ezibaleka ngaphezu kweekhilomitha ezili-31 ngeliveki bekuncinane, baninzi kunabantu ababaleka ngaphantsi. Enyanisweni, babeneminyaka engama-51 kuphela ubudala. Kwaye, ngokucacileyo, babecala ukuba intliziyo yabo ihlasele iminyaka engama-13 ngaphambi kokuba ibhalise kule sifundo, okanye (ngokwemyinge) kwiminyaka engama-38. Ababhali beli nqaku ababhekiseli ngqo kwiimpembelelo zeli xesha.
Kodwa siyazi ukuba abantu abahlaselwa yintliziyo ebuntwaneni babesoloko benesimo esibi seCAD, kwaye isifo sabo seentliziyo sinokuqhubeka ngakumbi kwaye kunzima ukunyanga kunezigulane eziqhelekileyo ngeCAD. Ngoko, mhlawumbi ukwanda kokufa okubonwa kubantu abagijime ngaphezu kweekhilomitha ezili-31 ngeveki akubangelwa ngumsebenzi. Endaweni yoko, mhlawumbi oku kwakungabantu abahlukeneyo bezilwanyana ezihlaselwa yintliziyo.
Ngaphantsi
Iintloko ezazisasazwa ngokubanzi ngolu hlobo lwesifundo zithi "Ukuzivocavoca kakhulu emva kokuhlaselwa kwintliziyo kunokukubulala!" Nangona kunokwenzeka ukuba ukwenza umsebenzi omkhulu emva kokuhlaselwa kwentliziyo kunokunyanzelisa izibonelelo zomsebenzi , siya kufuneka ukuba sigcine izinto ezimbalwa engqondweni njengoko sicinga malunga nento ekuthethwa ngayo ngoku.
Okokuqala, olu cwaningo alubonakalisi nantoni na; ukungafezekanga isifundo sokwenza nantoni na ngaphezu kokuvelisa i-hypothesis entsha efuna ukuvavanywa kwiingxaki zeeklinikhi.
Okwesibini, "umyinge wokusebenza" owawucaciswe ngokucacileyo kulolu cwaningo, ngaphaya koko uqeqesho olunokuba lunobungozi emva kokuhlaselwa kwentliziyo, lukhulu kakhulu. Nabani oqhuba ngaphezulu kweekhilomitha ezingama-31 okanye ohamba ngaphezu kweeyure ezingama-46 ngeveki mhlawumbi uye wahlela kwakhona ubomi bawo bonke kwiindlela zabo zokuzilolonga. Abambalwa kakhulu abasinda kwiintliziyo zihlasela ngokungaqhelekanga kwindawo ephakamileyo apho kukho nasiphi isizathu sokukhathazeka.
Kwaye kubaluleke kakhulu, kungakhathaliseki ukuba kukho into efana "kakhulu kakhulu" emva kokuhlaselwa kwentliziyo, esi sifundo siqinisekisa kwakhona ukuba ukuzivocavoca rhoqo emva kokuhlaselwa kwentliziyo-nokuba ngamanqanaba okusebenzisa intliziyo kakhulu abasindileyo abayi kuzama ukugcina - inxulumene nokuphucula okukhulu kwiziphumo zengqondo. Ukuzivocavoca rhoqo, esi sifundo siyaqinisekisa, kubaluleke kakhulu kwimpilo yakho emva kokuhlaselwa kwentliziyo.
Imithombo:
Williams PT, Thompson PD. Ukwandisa izifo zesifo senhliziyo esishukumisayo kufana nokuzivocavoca ngokweqile kwiintsholongwane zentliziyo. I-Mayo Clin Proc 2014; INGXELO: 10.1016 / j.mayocp.2014.05.006.
UOeeefe JH, uFranklin B, uLavie CJ. Ukusebenzisa impilo kunye nokuphila ixesha elide nokusebenza komsebenzi wokuphakanyiswa kweentambo: Imimiselo eyahlukeneyo yeenjongo ezahlukeneyo. I-Mayo Clin Proc 2014; INGXELO: 10.1016 / j.mayocp.2014.07.007.