Egazi emiphungeni. Embolism pulmonary: oonobangela, iimpawu, iziphumo, unyango

sifo ezisongela ubomi yi Embolism pulmonary (eBhayi). Sithetha malunga egazi kwakhiwa. Phakathi kwazo zonke izinto ezimbi of Embolism yemiphunga uyakhululwa manani ezothusayo. egazi emiphungeni bayakwazi ngalo naliphi na ixesha ukuvala umthambo. Ngelishwa, ngokufuthi lelibulalayo. Phantse isinye kwisithathu zonke izigulane ngokufa ngesiquphe kwenzeka ngenxa ukuvaleka kwemithambo pulmonary yi ihlwili legazi.

Iimpawu zesi sifo

PE ayikho sisifo elizimeleyo. Njengoko igama libonisa, oku ngenxa thrombosis.

Blood ihlwili, wakhangela phezulu ukusuka kwindawo yakhe imfundo, baqhubeka ngenkqubo yegazi. Amaxesha amaninzi, egazi igazi kwenzeka yesiqephu asezantsi. Maxa wambi eyendayo entliziyweni ekunene. A ihlwili legazi udlula intendelezo ekunene, ventricle kunye kungena ejikeleza miphungeni. Yena edakasa omnye kwimithambo umphunga umzimba kunye negazi lwemithambo - lung.

Travelling ihlwili ubizwa ngokuba embolus. Yena Lisuka emiphungeni. Le yinkqubo kakhulu yingozi. A ihlwili legazi emiphungeni ukuze ngesiquphe ukuvala amasebe umthambo. Ezi iimpahla lokuphalala ngenani. Noko ke, ubukhulu babo kunciphisa. Kanye impahla adlule apho ihlwili legazi ayinako le ndebe ukudlula, oko flow iibhloko kwegazi. Yiloo nto kaninzi ekhokelela ekufeni.

Ukuba isigulane awaphule ihlwili legazi kwi kwemiphunga, imiphumo ixhomekeka koko yaba ukuba kucocwe isitya. Embolus kuphazamisa igazi unikezelo eqhelekileyo ancedisana ithuba kunaniselwano igesi kwinqanaba amasebe ezincinane, okanye imithambo enkulu. Isigulane ivela hypoxia.

Ebukhulwini sifo

amahlwili egazi kwemiphunga ezibangelwa iingxaki ukugula ngokwasemzimbeni emva iimeko ekubelekeni kunye zokusebenza. Yokufa kwesi sifo iphezulu kakhulu. Yeyona 3 ephambili unobangela wokufa, eyesibini kuphela izifo sentliziyo kunye nesifo somhlaza.

Namhlanje PE iqulunqwa ikakhulu kwisiqalo kwezi zinto zilandelayo:

• zokugula kakhulu;
• utyando ezinzima;
• ukulimala.

Esi sifo sizibonakalisa ngokuthi kakhulu, iintlobo iimpawu saa, ukuphelelwa loxilongo, kukho umngcipheko ophezulu yokufa. Iinkcukacha-manani zibonisa, ngenxa yokuba uviwo post-wokufa, egazi kwegazi emiphungeni engakange ngexesha ukuxilongwa phantse 50-80% yabemi wafa ngenxa Embolism miphungeni.

Isifo kwenzeka ngokukhawuleza kakhulu. Yiyo loo nto kubalulekile ukuba ngokukhawuleza nangokuchanekileyo nokuxilonga ezingaqhelekanga. Njengoko ngokunjalo unyango olufanelekileyo ukuba unako ukusindisa ubomi babantu.

Xa kwakukho ngexesha ibhaqe i igazi ihlwili kwi kwemiphunga, ipesenti ukusinda inyuswe kakhulu. Izinga lokufa phakathi izigulane abafumana unyango kuyimfuneko, yi-10%. Ngaphandle isifo kwaye afumane unyango olufanelekileyo, lufikelela 40-50%.

Ezibangela isifo

A ihlwili legazi emiphungeni, ifoto apho ibekwe kweli nqaku ngenxa yokuba:

• deep vein thrombosis kweqondo asezantsi;
• ukuyilwa ihlwili igazi ngayo nayiphi na indawo kwinkqubo lwemithambo.

Kakhulu ngaphantsi rhoqo, le ngezifo nga eyendayo ngemithambo le peritoneum, okanye iziphelo ephezulu.

Imiba yomngcipheko, exela uphuhliso Embolism yemiphunga yomguli ezi-3 imeko kwaqala. Bebizwa ngokuba 'oneziqu Virchow. " Ezi zinto zibandakanya:

1. Ukucutheka kwamanzi kwegazi Velocity kwinkqubo lwemithambo. Mihla le nangenxa yokudodobala nasezimpahleni. flow kwegazi Slow.
2. Le olungaka landa thrombosis. igazi Gipersvertyvaemost.
3. Ngokonzakala okanye konakalise udonga lwemithambo.

Ngoko ke, kukho iimeko ezithile apho bawaphikise zizathu zikhankanywe ngasentla, ethi ibonise ngenxa ihlwili kwi kwemiphunga. Kusenokwenzeka ukuba efihliweyo phantsi kwezi meko zilandelayo.

Xa zokunciphisa yokumpompoza kwegazi lwemithambo kungabangela:

• uhambo olude, ukuhamba, ngenxa yokuba umntu anayo ixesha elide ukuba ahlale moya, imoto uloliwe,;
• esibhedlele apho alale ezifunekayo ixesha elide.

Ngegazi gipersvertyvaemosti kungabangela:

• ukutshaya;
• ukusebenzisa iipilisi zokulawula inzala, estrogen;
• yofuzo;
• Oncology;
• polycythemia - inani elikhulu iiseli ezibomvu;
• utyando;
• ukukhulelwa.

Ukuze a lwemithambo udonga ukwenzakala lead:

• thrombosis ndlela obukhulu;
• ukwenzakala umlenze basekhaya;
• utyando kwezi nemilenze.

ubungozi

Amagqirha ezi zinto zilandelayo predisposing apho ihlwili legazi ubuninzi afunyanwa rhoqo kwi emiphungeni. Imiphumo sifo ziyingozi kakhulu. Ngoko kuyimfuneko ukuba banikele ingqalelo impilo abo bantu abubonileyo ezi zinto zikhankanywe ngezantsi apha:

• kwanciphisa ukusebenza komzimba;
• yobudala ngaphezu kweminyaka engama-50;
• zokugula oncologic;
• utyando;
• ukusilela intliziyo, engabalulekanga;
• ukulimala ebuhlungu;
• ngemithambo varicose;
• sebenzisa lokucwangcisa hormone;
• iingxaki zokubeleka;
• erythremia;
• luphele;
• yemfuzo;
• lupus zomzimba systemic.

Ngamanye amaxesha ukuba yintoni na unobangela egazi kwegazi emiphungeni abafazi kokuba luzelwe, ingakumbi abo enzima. Njengomgaqo, kwimeko enjalo landulelwa ukuyilwa ihlwili ethangeni okanye ithole. Yena ngokwayo ubuhlungu, ifiva, ububomvu okanye ukudumba kwenza. Malunga esi sifo kufuneka sixelwe kugqirha ngokukhawuleza, ukuze mandundu inkqubo sifo.

Zimpawu uphawu

Ukwenzela ukufumanisa igazi ihlwili emiphungeni, iimpawu sifo kufuneka icace. Kufuneka uqaphele kakhulu kuphuhliso kwesi sifo kunokwenzeka. Ngelishwa, umfanekiso bezonyango belo Embolism yemiphunga kakhulu ezahlukahlukeneyo. Ixhomekeka ubungqongqo ngezifo, umyinge kophuhliso kunye notshintsho iimpawu pulmonary esi sifo engundoqo nomsindo yile ingxaki.

Ukuba kukho ihlwili legazi emiphungeni, iimpawu (zihlolwe) in a isigulane ilandelayo:

1. Ukuphelelwa umoya, i ngequbuliso ngaphandle kwesizathu.
2. Kukho ukunyuka izinga lentliziyo (per omnye ngomzuzu imivimbo ezingaphezu kwe-100).
3. isikhumba sakuba kunye ithinti kuphawu engwevu.
4. Iintlungu, lwenzeke kwiindawo ezahlukeneyo kwentamo.
5. kwesisu motility kwamehlo.
6. Sharp emithanjeni hyperemia intamo le plexus welanga, waphawula equmbile zabo, pulsation obubonakalayo aorta.
7. peritoneum axakane - udonga na ixesha ngokwaneleyo, kukho intlungu imvakalelo esuswini.
8. luyambombozela Heart.
9. nzima sinciphile.

Izigulane abaye bafumana ihlwili igazi kwemiphunga, ezi mpawu zingasentla akhoyo ngokuyimfuneko. Noko ke, akukho nalunye kwezi mpawu akufuneki ezinxulumene ngqo.

Ukongeza iimpawu ezingundoqo, ithi zilandelayo ukwakha:

• umkhuhlane;
• sifo kukukhohlela igazi;
• niphele;
• intlungu kwentamo;
• ukuphalaza;
• umsebenzi kuhluthwe izinto;
• elulwelo kwentamo;
• isiqaqa.

Ikhosi ye sifo

Ekubeni ngezifo ibhekisela izifo eziyingozi kakhulu, hayi ngaphandle ukufa, kufuneka kuqwalaselwe iinkcukacha ezivela zesifo.

Ekuqaleni, lo isiguli nokubamba-bamba umphefumlo. isahlakalo awo akasayi landulelwa naziphi na iimpawu. Izizathu ukutyhileka iimpawu ixhala bengekho ngokupheleleyo. Ukuphelelwa umoya ivela kwi siphefumla. Lubonakala yi isandi cwaka, ilandelwe umthunzi lenzwinini. Noko ke, ukuba usoloko ekhona.

Ngaphandle kwakhe, PE sikhatshwa ukunyuka kweqondo intliziyo. Yasentabeni ukusuka phezulu ibetha 100 ngomzuzu.

Lo msebenzi osemqoka ebalulekileyo elandelayo kukuhla elibukhali kwi uxinzelelo lwegazi. The degree of ukuncitshiswa inkomba bomzimba ngokomlinganiselo ubungqongqo sifo. Le amathontsi umfutho, ezitshangubeni enzulu baphambana PE.

Intlungu kuxhomekeke ubungqongqo esi sifo, kwaye isixa ukuphazamiseka ezimashakeleyo ezinemigca kwinqanaba ibakho umzimba:

1. Intlungu emva breastbone, leyo ebukhali, umlinganiswa discontinuous. Le ukuqaleka luphawulwa Umthambo ukuvaleka. Iziphumo buhlungu luvo ucinezelo eludongeni inqanawa.
2. ubuhlungu Stenokardicheskie. Ntlungu ngokuveza umlinganiswa. Elime kule ngingqi kwentliziyo. Amaxesha amaninzi Nonika igxalaba, ingalo.
3. kuyaphela Ebuhlungu yonke kwentamo. Le ngezifo uyakwazi ukuchaza ingxaki - iposi miphungeni. Ukuqaleka bazimisela kakhulu xa nayiphi na intshukumo - ukuphefumla nzulu, ekhohlela, nangokuthimla.
4. Intlungu phantsi ezimbanjeni kwi ekunene. Kakhulu kuyaphela ngaphantsi kungenziwa kwindawo kwesibindi, ukuba ogulayo egazi kwegazi emiphungeni.

flow igazi elanele iqatshelwe isitya. Oku kungabangela isigulane:

• hiccups buhlungu;
• imimoya eludongeni esiswini;
• paresis yethumbu;
• ewayo of yegazi omkhulu entanyeni kunye nemilenze.

Umphezulu isikhumba uba umbala okhanyayo. Bavame tide ashy okanye hina. Kamva, mhlawumbi wokujoyina imilebe blue. Eyona nkalo yokugqibela icebisa a Embolism omkhulu.

Ngamanye amaxesha isigulane ukuva yambombozela intliziyo iimpawu, arrhythmia ibanjiwe. Kwimeko ka-pulmonary iqhosha kungase hemoptysis, kudityaniswe ziintlungu elibukhali kwi esifubeni, yaye iqondo sezingeni eliphezulu. Komzimba kunokwenzeka iintsuku eziliqela, maxa wambi ngeveki kunye nesiqingatha.

Xa izigulane awanikeleyo thrombus kungena emiphungeni, inokubonakalisa Kukwaphula ejikeleza ebuchotsheni. Ezi zigulane badla khona:

• niphele;
• yombono;
• nesiyezi;
• coma;
• hiccups.

Ngamanye amaxesha Iimpawu ezichazwe bangazibandakanya iimpawu ukusilela kwezintso, uhlobo oyingozi.

iingxaki Embolism pulmonary

Oku ezimbi kakhulu iyingozi ngokwendawo apho ihlwili igazi emiphungeni. Imiphumo ukuba umzimba zinokohluka. Oku kugqiba ekuhambeni iingxaki esi sifo, umgangatho kunye nobude bobomi malunga nesigulane eso.

Iziphumo eziphambili PE zezi:

1. Enelungu kwaphakanyiswa uxinzelelo nasezimpahleni miphungeni.
2. iqhosha miphungeni.
3. Embolism ngamazwi kwi izitya isangqa esikhulu.

Noko ke, asingabo bonke ibuhlungu kangaka, ukuba ngexesha sifo egazi kwegazi emiphungeni. Limi njengoko kuchazwe ngasentla, oko kukholekileyo, ukuba isigulane ziya kufumana unyango olufanelekileyo. Kulo mzekelo, ithuba iphezulu ukunciphisa umngcipheko nesohlwayo.

Apha ngezantsi kukho izifo eziziintloko oogqirha kwafunyaniswa ngenxa iingxaki Embolism pulmonary:

• unepleurisy;
• iqhosha pulmonary;
• pneumonia;
• empyema;
• ithumba lung;
• ukusilela kwezintso;
• pneumothorax.

Embolism nezolo pulmonary

Le ngezifo uyakwazi mayiphindwe izigulane izihlandlo eziliqela ubomi. Kulo mzekelo, kuba luhlobo thromboembolism nezolo. Malunga nama-10-30% ezigulane emva omnye sifo, ezithandwa ngeziqendu nezolo of Embolism miphungeni. Esinye isigulane inokuba inani bahlaselwe ezahlukeneyo. Kwi-avareji, inani labo iyahluka ukusuka-2 ukuya 20. iziqephu ngezifo abaninzi bafudukela imele ukuvaleka kumasebe amancinci. Kamva lo ngezifo kukhokelela embolization umthambo omkhulu. Kuye kwasekwa a Embolism omkhulu miphungeni.

Ubangelwa Iifom nezolo ingaba:

• izifo ezingapheliyo le wokuphefumla kunye neenkqubo sentliziyo;
• izifo oncologic;
• ungenelelo zoqhaqho kule ndawo esiswini.

Le fomu akukho imiqondiso ecacileyo clinical. Lubonakala yi umehluko phezu. Kakuhle ixilonge le meko kunzima kakhulu. Ngokufuthi iimpawu engavezwanga iphutha ukuba iimpawu zezinye izifo.

Embolism nezolo pulmonary kunokwenzeka le miqathango ilandelayo:

• inyumoniya emizamweni, kwenzeka ngaphandle kwesizathu;
• niphele;
• unepleurisy ziyenzeka phezu iintsuku ezimbalwa;
• somoya;
• ekuweni yegazi;
• ukuphelelwa umoya;
• izinga intliziyo ukwanda;
• fever, aluyiphelisi amachiza antibacterial;
• senhliziyo, isifo esinganyangekiyo xa engekho kwemiphunga okanye intliziyo.

Isifo kunokubangela iingxaki zilandelayo:

• emphysema ;
• pulmonary abanesigulo - izihlunu lung luthathelwa nokuqina;
• Ukungaphumeleli intliziyo;
• BP miphungeni.

Embolism nezolo pulmonary kuyingozi kuba naliphi episode elandelayo kunokuphumela ekufeni.

isifo izifo

Ezi mpawu zingentla, njengoko sele kuchaziwe, ayikho ezithile. Ngoko ke, ngokusekelwe kwezi miqondiso ayikwazi unesifo. Noko ke, xa kufike ukugonyamela kwakhe ngokuyimfuneko phambi uphawu uphawu 4:

• ukuphelelwa umoya;
• tachycardia - ukunyusa izinga intliziyo;
• ubuhlungu esifubeni;
• uphelelwa umoya.

Ukuba isigulana akukho umqondiso ezine, ngoko ke akukho thromboembolism.

Kodwa hayi yonke kulula. ngezifo uphethwe nzima kakhulu. Ukuze ingakrokreleka PE kufuneka sihlalutye indlela yokuphuhlisa sifo. Ngoko ke, ugqirha ekuqaleni utsalela ingqalelo imiba ingozi: ubukho ngenxa yesifo sentliziyo, thrombosis, uqhaqho. Oku kukuvumela ukuba ukukhangela unobangela sifo, ummandla apho ihlwili kwi emiphungeni.

uphando olufunekayo ukuze bhaqo okanye ngaphandle Embolism yemiphunga zezi zifundo zilandelayo:

1. ECG. indlela ulwazi kakhulu kokuxilongwa. Electrocardiogram kunika uluvo lokuba iqondo ubungnqongqo sifo. Ukuba bayixuba le nkcazelo kwimbali sifo, Embolism yemiphunga unesifo ngobuciko eliphezulu.
2. X-ray. Olu phando ekuveliseni PE uphethwe uninformative. Noko ke, kunokwenzeka ukuba ukwahlula sifo kwezinye ezimbi ezininzi ukuba babe iimpawu ezifanayo. Hi xikombiso, yi nenyumoniya lobar, unepleurisy, pneumothorax, kwemithambo aortic, pericarditis.
3. Echocardiography. Uphononongo ityhila indawo ngqo ze-thrombus, uhlobo, ubungakanani, umthamo.
4. Lung scintigraphy. Le ndlela inika ugqirha a 'umfanekiso' iimpahla miphungeni. Yena ephawulwe ngokucacileyo indawo nokuhamba kwegazi aphazamiseka. Kodwa ukufumana indawo apho yaba egazi emiphungeni, akunakwenzeka. Uphononongo has a Ixabiso eliphezulu diagnostic kuphela xa ngezifo enkulu nemithambo. Chonga iingxaki emasebeni encinane ngoncedo le ndlela akunakwenzeka.
5. Ultrasonography of emithanjeni umlenze.

Ukuba kukho imfuneko, kufuneka isigulane eyabelwe iindlela ezongezelelweyo zophando.

uncedo olungxamisekileyo

Khumbula, xa uthe weza bucala igazi ihlwili emiphungeni, iimpawu ze isigulane lisenokuba kwi ngesantya esiphezulu. Kanye njengokuba ngokukhawuleza kukhokelela ekufeni. Ngoko ke, ukuba kukho ubungqina Embolism yemiphunga kufuneka kunikwa isigulane xa ekuphumleni oko, ngoko nangoko umnxeba zentliziyo "zezigulane." Isigulane wamkelwa kwicandelo labagula kakhulu.

Emergency Care isekelwe ezi ziganeko zilandelayo:

1. Emergency ndlela central catheter nokungena iziyobisi "Reopoligljukin" okanye umxube iswekile-novocaine.
2. Alawulwa ngurhulumente iziyobisi yegazi elawulwayo "lweeHedfowuni", "dalteparin", "Enoxaparin".
3. ukusebenza Ebuhlungu bayiyeka analgesics ezidakumbisayo, ezifana "Promedol," "Fentanyl", "Morin," "Leksir", "Droperidol".
4. Oxygen therapy.
5. Isigulane ilawulwa thrombolytics: lithetha "Streptokinase", "Urokinase".
6. Kwiimeko of arrhythmia elidityaniswe zilandelayo iziyobisi: "wemagniziyam Sulfate", "digoxin", "ATP", "Ramipril", "Panangin".
7. Ukuba isigulane ilawulwa Njengokungeniswa reaction kuyo "Prednisolone" okanye "Hydrocortisone", kunye antispasmodics, "akukho-zefula", "Eufillin", "papaverine".

Iindlela zokusingatha PE

Ebomini loo mntu ukubuyisela ukuhamba kwegazi emiphungeni, ukuthintela uphuhliso nokudumba kwindawo nomonde, kwakunye ukukhusela ngokuchasene ukuyilwa nomfutho miphungeni.

Noko ke, emva kokuba zoncedo lokuqala umguli abadinga unyango okuqhubekayo. ngezifo ekulweni ijonge ekuthinteleni ukwenzeka sifo, resorption ngokupheleleyo ihlwili legazi.

Ukuza kuthi ga ngoku, kukho iindlela ezimbini ukususa egazi kwegazi emiphungeni. Iindlela zonyango le ezimbi zilandelayo:

• therapy thrombolytic;
• uqhaqho.

therapy thrombolytic

unyango ngamachiza isekelwe amayeza afana:

• "LweeHedfowuni";
• "Streptokinase";
• "Fraksiparin";
• ijwabu plasminogen isilumeki;
• "Urokinase."

nemithi iyanyibilika egazi igazi nokuthintela ukuyilwa egazi ezintsha.

Ichiza "lweeHedfowuni" elawulwa kwisigulana butofelwe iintsuku 7-10. Kule alawulwe parameters of igazi ekunqandeni. Kangangeentsuku 3-7 phambi kokuba unyango isigulane nolwathi omnye amachiza zilandelayo azipilisi:

• "Warfarin";
• "Trombostop";
• "Cardiomagnyl";
• "ACC Thrombotic."

Ukulawulwa igazi ekunqandeni kuyaqhubeka. Ukufumana isabelo ihlala iipilisi (emva kokuba Embolism pulmonary) malunga nonyaka-1.

Imithi "Urokinase", "streptokinase" elawulwa yegazi emini. Le buqhinga iyaphindwa 1 xesha ngenyanga nganye. ukusetyenziswa efakwa kunye inyama plasminogen isilumeki. Ithamo single ukuba iphathwe iiyure eziliqela.

unyango Thrombolytic akwenziwanga emva kotyando. oko kwakhona akuvumelekanga kwimeko ezimbi, nabanako nzima ukopha. Umzekelo, isilonda Peptic. Ngenxa yokuba iziyobisi thrombolytic nga kwandisa ingozi ukopha.

unyango ngotyando

Loo umbuzo kuvuswa kuphela ngokoyiswa indawo enkulu. Kulo mzekelo, kufuneka sisusa ihlwili legazi lendawo apha emiphungeni. Unyango lo zilandelayo kuyacetyiswa. izixhobo Special liyasuswa thrombus isitya. Lo msebenzi ivumela ukuphelisa sisithintelo nokuphuma kwegazi endleleni.

ungenelelo Complex yotyando lwenziwa ukuba amasebe amakhulu okanye Umthambo buti. Kule meko kuyimfuneko ukubuyisela ukuhamba kwegazi phantse kuzo zonke iinkalo kwemiphunga.

Prevention of Embolism pulmonary

isifo thromboembolism has ukuthambekela kwikhondo nezolo. Ngoko ke, kubalulekile ukuba Ungalibali malunga namanyathelo ezikhethekileyo othintelo ukuba ukukhusela ngokuchasene ukwenzeka leengxaki kakhulu, lisibekele.

kubaluleke kakhulu ukuba abantu basengozini enkulu yokuba esi sifo manyathelo anjalo. Olu didi lubandakanya abantu:

• ezindala ngaphezu kweminyaka engama-40;
• Stroke okanye ukuhlaselwa yintliziyo;
• ukuba luphele;
• eliquka imbali isiqephu thrombosis ndlela nzulu okanye Embolism pulmonary;
• izalwe ukuhlinza esifubeni, imilenze, amalungu zangasese, isisu.

Nokuthintela iquka izenzo ebaluleke kakhulu:

1. Ultrasonography of emithanjeni umlenze.
2. elawulwa rhoqo phantsi amalungiselelo isikhumba "lweeHedfowuni", "Fraksiparin" okanye amayeza lesitofu Kwangale "Reopoligljukin".
3. Superimposition of iqhiya ngomkhala ezinyaweni zakhe.
4. Abenze cuffs mithambo ezizodwa ithole.
5. Liyenze unyawo mithambo ezinkulu.
6. Umzila okucoca Vena cava.

Le ndlela yokugqibela yeyona nokuthintela ogqwesileyo thromboembolism. iintlobo okucoca cava yenzelwe namhlanje:

• "Mobin-Uddin";
• "Gunther eTulip";
• "Greenfield";
• "Hourglass".

Ngelo xesha, khumbula ukuba lo matshini kunzima kakhulu ukuba kumiswe. Le cava filter engeyiyo kuphela ube nokuthintela enokuthenjwa, kodwa iyakwazi ukwenza ungcipheko ukwanda thrombosis ukubunjwa kunye nophuhliso koko Embolism miphungeni. Ngoko ke, lo msebenzi kufuneka kwenziwe kuphela kwiziko lezempilo kakuhle ngokwaneleyo, kuphela yi uchwepheshe abaqeqeshiweyo.