I-thrombosis ye-venous engaphezulu, evame ukubizwa ngokuthi i-paraphlebitis, ibhekisela ekuvinjweni komthambo ngehlule legazi. Kuyisifo esivamile futhi esithambile, esilashwa kalula. Ziyini izimpawu ? Kwenziwa kanjani ukuxilongwa?

I-phlebitis (i-venous thrombosis) yigama elidala futhi lisasetshenziswa ngokujwayelekile ukuchaza ihlule legazi elithi “thrombus” elakheka futhi elivimba kancane noma livimbe ngokuphelele umthambo ojulile noma ongaphezulu. Izinhlobo ezimbili zamanethiwekhi e-venous zihlala ndawonye: inethiwekhi ye-venous ejulile kanye nenethiwekhi ye-venous engaphezulu. 

Uma kubonakala emithanjeni ye-varicose ebonakala ngaphansi kwesikhumba, khona-ke singakhuluma "nge-superficial venous thrombosis". I-phlebitis ekha phezulu ayibucayi uma ihlukanisiwe, kodwa njengoba amanethiwekhi exhumana, ingasakazeka futhi ibe yinkimbinkimbi yi-deep vein thrombosis.

Izimbangela ezahlukene ziyizi: 

• Ku-paraphlebitis, ihlule lingadalwa emthanjeni ongaphezulu, umthambo omncane ophakathi kwesikhumba nemisipha (i-saphenous vein). I-saphenous veins iyingxenye yenethiwekhi engaphezulu yemithambo etholakala ngaphansi kwesikhumba futhi okungaba indawo yemithambo ye-varicose. Imithambo ye-Varicose ibonakala ngokuzenzakalelayo noma lapho kukhona izinto eziyingozi futhi ihlala iyimbangela evame kakhulu ye-paraphlebitis emilenzeni;
• I-Paraphlebitis ephakama emithanjeni “enempilo” ngokuvamile iyisici sesimo esiyisisekelo esifana nesici sofuzo noma esitholiwe ekuhlulekeni kwegazi, umdlavuza, noma isifo semithambo esivuthayo esingavamile (isifo sika-Behçet, isifo sika-Burger);
• Isibonakaliso sokuntuleka kwe-venous kungase kube inkomba yokufika kwe-paraphlebitis.

Ngeshwa, izimpawu azihlali zinembile kakhulu. Nokho, kubangela ukwenzeka kobuhlungu obuhlabayo obungathatha izinsuku ezimbalwa. Umthambo we-varicose ube usubonakala uvuvukele, ubomvu, ushisayo, ujiyile futhi uqinile uma uthintwa okubangela ukungakhululeki ekusebenzeni. Ukwengeza, kubaluleke kakhulu ukuhlala uqaphile uma kwenzeka kuba nezingozi ezihlobene.

Uma kwenzeka i-phlebitis ekha phezulu, ukuxilongwa kwenziwa ngesikhathi sokuhlolwa, kodwa i-Doppler ultrasound ye-venous iyasiza ukuze kukhishwe ubukhona be-phlebitis ejulile ehlobene, ekhona kanye kwezine.

Umgomo wokwelashwa kuzoba ukunciphisa igazi. Ngempela, kuyadingeka ukugwema ukukhuphuka nokunwetshwa kwehlule okungase:

• Ukuqhubekela phambili kunethiwekhi ye-venous ejulile bese kuholela ku-phlebitis noma i-deep vein thrombosis;
• Thuthela enhliziyweni futhi ubangele i-pulmonary embolism ngokuvala imithambo esemaphashini.

Ezimweni eziningi, uma ukwelashwa kuqala, ihlule linamathela odongeni futhi alisaqhubeki ngenxa yokwelashwa kwe-anticoagulant noma amasokisi okucindezela.

Ukwelashwa kwe-Anticoagulant

Njengokukhetha kokuqala, ama-anticoagulants omlomo oqondile (DOA) asetshenziselwa izinhlobo eziningi ze-thrombosis kuye ngokuthi izimpawu nezimpawu ezitholakala ngesikhathi sokuhlolwa: indawo, ubukhulu kanye nokwandiswa kwehlule. Kulula ukuzisebenzisa, aziphazamisi kakhulu ukudla noma ezinye izindlela zokwelapha futhi azidingi ukuqapha njalo ngokuhlolwa kwegazi. 

Ukucindezela amasokisi

Ngaphezu kokwelashwa kwezidakamizwa, ukucindezelwa kwesokisi kungase kubekwe esigabeni sokuqala. Bazosiza ukukhulula i-edema emlenzeni futhi banciphise ubuhlungu. Kungenzeka nokuthi benza ngokwengxenye ekubuyiselweni kwehlule. Amasokisi okucindezela kufanele agqokwe kuphela phakathi nosuku futhi isikhathi eside.

Kunamakilasi ahlukene kodwa ikilasi lesi-3 lizokhonjiswa kakhulu (kunezigaba ezi-4 zamandla acindezelayo akhulayo). Lokhu kucindezela kuzoqinisekisa ukwelashwa kwemithambo ye-varicose.

Okokugcina, i-paraphlebitis eyenzeka emithanjeni ye-varicose ingxabano yokwelapha i-varicose veins ukuze ivimbele ukuthi ingaphindeki kamuva. Ukwenza lokho, kuzocelwa izivivinyo zokuthola imbangela. Phakathi kwalokhu kuhlolwa, kukhona ukuhlolwa kwe-radiological, noma ukuhlolwa kwegazi okuzobhekwa, isibonelo, ukungavamile kwegazi lomndeni noma ufuzo, okukhuthaza ingozi ye-phlebitis.

Ngokuya ngemiphumela, ukwelashwa kwe-anticoagulant kungase kunwetshwe.

Izimo ezilandelayo zingavuna ukuvela kwe-phlebitis:

• I-venous stasis (igazi liyashona emithanjeni, ngenxa yokulala isikhathi eside noma ukuma okunganyakazi. Lesi yisici esibaluleke kakhulu);
• Isifo sokopha (igazi lakho libopha kalula ngenxa yokugula noma ukwelashwa);
• Ukuguqulwa kodonga lwe-vein (uma ukumnika kufakwa emthanjeni isikhathi eside, udonga lomthambo lungalimala futhi lungavinjelwa);
• Uneminyaka engaphezu kwengu-40;
• Ukukhuluphala;
• Ukubhema;
• Immobilization (uplastiki, ukukhubazeka, uhambo olude);
• Ukukhulelwa, ukuvimbela inzalo noma ukwelashwa kwe-hormone ye-menopausal equkethe i-estrogen;
• Umlando we-phlebitis;
• Umdlavuza, ukwelashwa komdlavuza (chemotherapy);
• Isifo sokuvuvukala esingapheli;
• Izifo zofuzo zebhayoloji, ezikhonjwa ngokuhlolwa kwegazi.

Imithetho ejwayelekile futhi iyasiza ekuvimbeleni i-phlebitis:

• Ukuhlanganisa imisipha yakho ngokuhamba kanye nokuzivocavoca kwemisipha;
• Ukuphakama kwezinyawo zombhede;
• Ukucindezelwa kwe-venous ngamasokisi agqokwa emini;
• Ukucindezelwa kwe-venous kuyanconywa phakathi nokuhamba emoyeni.