Ukunyanyiswa kukubangela umngcipheko wokwehluleka kwentliziyo ukwenzela ukuba ukunciphisa umzimba kusenokuba nako kunokukunceda ukukhusela ukukhubazeka kwentliziyo kamva. Kodwa kuthekani malunga neendlela zokugaya ukulahleka kwesisindo, njengophando lwe-bariatric (utyando lokulahleka kwesisindo) kunye nezixhobo zokulahlekelwa kwesisindo somzimba ? Ngaba abo banokuthintela ukuhluleka kwentliziyo? Uphando lubonisa ukukhanya oku.
Ukunyaniseka kunye neengqondo zeNtliziyo
Ubukhulu bexinzelelo kunye nokugqithisa ngokweemeko ziimeko, ngethuba, iziganeko zobungozi bokuphuhliswa kweentlobo ezahlukeneyo zesifo se-cardiovascular ziquka ukunyuka kwengcinezelo yegazi, ukuhlaselwa yintliziyo, ukuphefumula kwegazi , ukuphazamiseka kwesifo, kunye nokuhluleka kwentliziyo.
Ukunyameka kweso sizathu esaziwayo kakuhle solu hlobo lwesifo sikashukela , esikuyo kwaye sisona sengozi esichengeni sesifo senhliziyo. Yaye ukunyanya kunobangela we-cholesterol ephezulu, eyona nto ibangelwa izifo zentliziyo.
Ukongezelela, ukukhuluphala kunomngcipheko weengcamango ezingenangqondo ezibizwa ngokuba yi-fibrillation ye-atrial, kwaye abantu abane-fibrillation ye-atrial basengozini yokubetha. Ukunyaniseka kunokuchaphazela iinkalo ezininzi ze-cardiovascular system.
Njengoko kuphawuliwe ngasentla, kukho iindlela ezininzi ezithintekayo ukubeka iziganeko ezihlukeneyo zesifo senhliziyo, kodwa kubalulekile ukuba ukhumbule ukuba ukukhuluphala kunyusela ukuvuvukala emzimbeni wonke, kwaye ukuvuvukala kungadlala indima kwi-heart disease coronary.
Ukunyaniseka kunye nokungaphumeleli kwentliziyo
Okokuqala, yintoni ukuhluleka kwentliziyo? Ukubeka nje, kukho ezimbini iintlobo eziphambili zokwahluleka kwentliziyo : ukuhluleka kwentliziyo ye- systolic kunye nokuhluleka kwentliziyo ye-diastolic.
Kwi-systolic heart failure, intliziyo ihluleka ukupompa ngokuqhelekileyo; oku kudibene necandelo elincinci le- ejection (umlinganiselo wendlela yokupompa).
Ukuhluleka kwentliziyo ye-diastolic (ngoku kutshatyalaliswa kwaso njengokwehluleka kwentliziyo kunye necatshulwa elondoloziwe), inxalenye ye-ejection iyinto eqhelekileyo, kodwa intliziyo ayifuni ukuqhuma ngokuqhelekileyo ngenxa yesisu senhliziyo esomelele.
Bobabini ukuhluleka kwentliziyo ye-systolic kunye ne-diastolic banezizathu ezinobangela, kwaye banokwabelana ngezizathu ezithile, ezifana nokunyuswa kwengcinezelo yegazi, isifo se-coronary disease kunye nokukhuluphala .
Naluphi na uhlobo lokuhluleka kwentliziyo lungakhokelela kwiimpawu zento eyaziwa njenge-congestive heart failure, apho i-fluid iqokelela kwimiphunga, yenza kube nzima ukuphefumula; Umkhuhlane unakho ukuqokelela emilenzeni, okwenza ukuvuvukala kunye nokuphazamiseka.
Ngoko, ekuphelelweni kwentliziyo, intliziyo ayikwazi ukupompa ngokuqhelekileyo okanye ngokufanelekileyo ukugcina ukujikeleza okwaneleyo kuwo wonke umzimba.
Ngoko ukunyanyeka kukuthini ukusilela kwintliziyo? Kwisikhokelo sokusilela kwintliziyo ekhishwe ngo-2013 yi-American College of Cardiology Foundation kunye ne-American Heart Association, ukunyanya kuninzi kuthathwa njengento yokuqala yokusilela intliziyo.
Esi sikhokelo sichaza ukukhuluphala njengempilo yonyango eyayiza kubeka umntu kwiSigaba A sokwehluleka kwentliziyo. Isigaba A, njengoko kuchazwe kwesi sikhokelo sikazwelonke, siquka bonke "abasengozini enkulu yokungaphumeleli kwintliziyo kodwa bengenazo izifo zentliziyo okanye iimpawu zentliziyo yokuhluleka." Oku kuthetha ukuba, nangona umntu enesisindo angenayo nayiphi impawu okanye iimpawu zentliziyo engaphumeleli, zisacingwa ukuba zisekuqaleni kwintsilelo yokuphelelwa yintliziyo ngenxa yokunyanyisa.
Oku kwenza inkcazelo enamandla malunga nokubaluleka kokuphatha ukunyanya ukukhusela ukuphelelwa yintliziyo.
I-Bariatric Surgery Ifunyenwe Ukukhusela Ukungaphumeleli Kwintliziyo
Ngenhlanhla, iinzame zokulahleka kwemilinganiselo zihlawulela, kwaye ukuba unesisindo senza uncedo olukhulu ukukhusela isifo senhliziyo, kuquka ukuhluleka kwentliziyo, ngokulahlekelwa ngumzimba. Nangona ulahleko oluthile lokunciphisa umzimba, kwi-five percent ukuya kwi-10 ekhulwini lokunciphisa umzimba, lunokwenza umehluko omkhulu.
Kwaye ngoku iziphumo ziye zafumanisa ukuba ukulahleka kwesisindo ngokuhlinzwa, kubandakanywa iinkqubo ezifana ne- gastric bypass , sleeve gastrectomy, kunye ne -banding banding , kunokukhusela isifo senhliziyo njengesifo senhliziyo.
Ngonyaka we-2016 we-American Heart Association uScientific Sessions, abaphandi abakhokelwa ngumongameli omkhulu uJohn Sundstrom, MD, PhD, uprofesa we-epidemiology e-Uppsala University yaseSweden, wabonisa iziphumo zesifundo esikhulu (malunga nama-40,000 izigulane ezipheleleyo) ezifumene ukuba izigulane ukunyamezela okwakusenokuba utyando lwe-bariatric kwakungenakwenzeka kakhulu ukuhlakulela ukukhubazeka kwentliziyo kunabo abangazange baqhutywe ukuhlinzwa kodwa kunoko bazama ukuguquka kwendlela yokuphila njengento yokutya kunye nokuzivocavoca.
Abaphandi bacacisa ukuba impembelelo ephawulekayo yokuhlinzwa ngonyango ingabangelwa yimiphumo eyaziwayo yokuhlinzwa ngokubhekiselele kwimingcipheko yokunqongophala kwentliziyo, njengesifo sikashukela, uxinzelelo lwegazi oluphezulu kunye ne-fibrillation ye-atrial.
Ngokomzekelo, kwiphononongo eyenziwe nguJamaly kunye noogxa kunye nepapashwe kwi- Journal ye-American College of Cardiology ngoDisemba 2016, abalobi bafumene ukuba "xa kuthelekiswa nokunyamekela okuqhelekileyo, ukulahleka kwesisindo ngokusebenzisa uphando lwe-bariatric kunciphise umngcipheko we-fibrillation ye-atrial phakathi kwabantu unyangwa ngenxa yokunyanya kakhulu. "Okuthakazelisayo kukuba, le ncitshiswa yokunciphisa umngcipheko ibonakala kakhulu kubantu abancinci nakubantu abaneengxaki eziphezulu zegazi.
Kuyafaneleka ukuba uqaphele ukuba utyando lwama-baratric lungabangela ukulahlekelwa bunzima kwexesha elifutshane, njengoko kuboniswe kwisifundo sikaDkt. Sundstrom, apho, emva konyaka emva kokuhlinzwa, izigulane zalahlekelwa ngumyinge wama-pounds angaphezu kwama-41 ngaphezu kwabo ukuguquka kwendlela yokuphila kuphela (kodwa akukho uphando).
Inxalenye enkulu ngenxa yelo hlobo lokulahleka kwesisindo ngokukhawuleza kwixesha elifutshane, ukuhlinzwa ngokugqithisileyo kuye kwafunyanwa kwizifundo ezininzi ukuze kubangele ukuncipha okukhulu kwizinga leeswekile zesifo kunye nokunyuswa kwengcinezelo yegazi, ekunciphiseni ingozi yesifo senhliziyo ( ekubeni isifo sikashukela kunye nokunyuswa kwengcinezelo yegazi zizinto ezinobungozi zesifo senhliziyo).
Ngaba Ungumviwa weBatric Surgery?
Ngoko, unokuzibuza ukuba ungumgqatswa wokutyunjwa kwe-bariatric. Hlalani nikhumbule ukuba kukho iintlobo ezininzi ezahlukeneyo zokunyusa ukulahlekelwa kwemithwalo, kodwa ezininzi zezi nkqubo zinemfuneko efanayo yokufaneleka.
Ngokwezihlandlo zakutshanje zokunyamezela ezikhutshwe yi-American Heart Association (AHA), i-American College of Cardiology (ACC), kunye ne-Obesity Society (TOS), ukuhlinzwa ngonyango kungabakho ukhetho kwizigulane zabantu abadala abahlangabezana nemigangatho ethile.
Le miqathango ichaza isalathisi somzimba we-mass (i-BMI) engama-40 okanye ngaphezulu, okanye i-BMI engama-35 okanye ngaphezulu kwisigulane esinezinye izimo zonyango (ezibizwa ngokuba yi "imeko ezixhatshazwayo") ezibangelwa ukukhuluphala. Ikomidi lokubhala ngokunyamezela ukunyamezela akufumananga ubungqina obaneleyo bokunconywa ngokugqithiswa kwezigulane ezine-BMIs eziwela ngaphantsi kwezi nqununu.
Isikhokelo esilandelayo siphakamisa oogqirha bokukhathalela abasemgangathweni kunye nabanye banakekela izigulane ezinobunene kakhulu nge-BMI ephezulu ukuba bazame "unyango lokuziphatha kunye okanye ngaphandle kwe-pharmotherapy" kuqala, kwaye ukuba oko akuzange kusebenze kunye nezinye iindlela zokutya kunye nokuphila ukuze kufezekiswe ukulahlekelwa kwesisindo esaneleyo, i-bariatric utyando lunokuqwalaselwa.
Ngoko kubalulekile ukuxoxa ngale ngogqirha wakho, ngubani onokukunceda ukuba unqume ukuba ngaba ungumgqatswa ofanelekileyo wokuhlinzwa ngonyango kwaye, ukuba ukhona, yintoni inqubo eya kulungile kuwe.
Ezinye iindlela zokuNciphisa ingozi yakho kwiintsholongwane zentliziyo
Ukongezelela ekulahlekeni kwesisindo, kukho ezinye iindlela ezininzi ezibalulekileyo apho unokunciphisa umngcipheko wesifo senhliziyo ngokubanzi kunye nentsilelo yokusilela ngokukodwa.
Okokuqala, yazi amanani akho. Oku kuthetha ukutshekishwa kwe-cholesterol yakho, uxinzelelo lwegazi lwakho luhlolwe, kunye neshukela lakho legazi lihlolwe isandulela seswekile okanye isifo sikashukela. Ukuthatha inkokhelo yempilo yakho kubandakanya ukwazi apho uqala khona, ngoko uyazi ukuba yiziphi izinto ezinobungozi obunayo kwaye ujongane nomnye ukunciphisa ingozi yakho yonke.
Njengoko kuvela, uninzi lweenguqulelo zokuphila ezigcina zonke izinto ezinobungozi kwi-check are similar, kwaye ziya kukunceda ugcine ubunzima obusempilweni, kwakhona. Ukuqala indlela yokuphila enempilo-ntliziyo kuthetha ukusetyenziswa rhoqo kwentsuku kunye nokulandela imikhuba yokutya enempilo .
Enye indlela yokutya, ngokukodwa, ibonisiwe, ngokuphindaphindiweyo, ngaphezu kweeminyaka zophando, ukukhusela isifo senhliziyo, kwaye yinto yokutya yaseMedithera.
Esikhundleni sokutya kwefadini ukuba umntu ukhetha kuphela iinjongo zexeshana zokulahleka kwesisindo, isidlo saseMedithera sisigqibo sokuphila, indlela yokutya ubomi bobomi bonke. Le ndlela yendalo yokutya ininzi yabemi belizwe elijikeleze uLwandle lweMeditera-ke igama.
Ukutya kweMedithera kugxininisa ukusetyenziswa kweziqhamo kunye nemifuno yonke, i-grains epheleleyo, iinqabunga zemithi, ioli ye-olive eyintombi, intlanzi kunye neenkukhu, newayini (ingakumbi iwayini ebomvu) ngokumodareyitha.
Njengebhonasi eyongeziweyo, isidlo saseMedithera siye safumanisa ukuba negalelo ekulahlekeni kwindleko kunye nomngcipheko omncinci wesifo somhlaza .
> Imithombo:
Estruch R, Ros E, Salas-Salvadó J, et al. Ukuthintelwa kweprayimari zesifo senhliziyo kunye nesidlo saseMedithera. N Engl J Med 2013; 368: 1279-1290.
> Jamaly S, uCarlsson L, uPeltonen M, Jacobson P, et al. Utyando lwe-Bariatric kunye nomngcipheko wokuhlaselwa kwe-atrial fibrillation kwizifundo zaseSweden ezigqithiseleyo. J Am Coll Cardiol. 2016; 68: 2497-2504.
> Jensen MD, Ryan DH, Apovian CM, et al. 2013 I-AHA / ACC / i-TOS isikhokelo sokulawulwa kokugqithisa nokugqithisa kubantu abadala: ingxelo ye-American College of Cardiology / American Heart Association Task Force kwi-Practice Guidelines kunye ne-Obesity Society [epapashwe kwi-intanethi ngoNovemba 27, 2013]. J Am Coll Cardiol.
> Sundstrom J, Bruze G, Ottosson J, uMarcus C, et al. I-American Heart Association yeNzululwazi yeeSeshoni 2016. I-Abstract (i-poster session) yaboniswa ngoNovemba 14, 2016.
> Yancy CW, Jessup M. Bozkurt B, Butler J, et al. 2013 ACCF / AHA isikhokelo sokulawulwa kwentliziyo: ingxelo ye-American College of Cardiology Foundation / i-American Heart Association Task Force kwi-Practice Guidelines. Ukujikeleza ngo-2013 Juni 5 [i-Epub phambi kokuprinta].