Hiki ke pani hou ʻia kahi aʻa coronary ma hope o ke kau ʻia ʻana o kahi stent? (In-Stent Restenosis)

Ua kau ʻia anei kahi stent iā ʻoe a i ʻole kekahi āu i ʻike ai i loko o kahi aʻa coronary? Ma hope o ia ʻano lapaʻau, manaʻo pinepine mākou ua hoʻopau loa ʻia ka pilikia, ʻaʻole e ālai hou ʻia ke aʻa coronary. Eia nō naʻe, i kekahi manawa, hiki ke hana hou ʻia kahi ālai liʻiliʻi a i ʻole ka haiki ʻana ma kahi like i kau ʻia ai ka stent, ʻo ia hoʻi, ma ka ʻāpana like o ke aʻa i mālama ʻia. ʻO ia ka mea a nā kauka e kapa nei ʻo 'In-Stent Restenosis'. ʻOiai paha he paʻakikī iki ka inoa, he mea maʻalahi loa ia. E kamaʻilio kākou e pili ana i kēia me nā kikoʻī, ma ka ʻōlelo Sinhala hiki iā ʻoe ke hoʻomaopopo.

ʻO ka mea mua, e hoʻomaopopo kākou i kēia mau ʻōlelo, ʻeā?

Ma mua o ko mākou kamaʻilio ʻana e pili ana i ka 'in-stent restenosis', e hoʻomaopopo kākou i ke ʻano o kekahi mau huaʻōlelo. A laila e ʻoi aku ka maopopo iā ʻoe.

He aha ke ʻano o ka 'Stenosis'?

I ka ʻōlelo maʻalahi, ʻo ka 'stenosis' he ʻūmiʻi a i ʻole ka ʻūmiʻi ʻana o kahi kīʻaha koko i loko o ko kākou kino. E noʻonoʻo i ka hala ʻana o ka manawa, e hōʻiliʻili ana ka lepo a me ka ʻōpala i loko o kahi paipu wai, e ālai ana i ke kahe ʻana o ka wai.

No laila, he aha ka maʻi ʻaʻa coronary (CAD)?

Pono nō hoʻi ko kākou puʻuwai i ke koko e hana ai. ʻO nā aʻa nui e hoʻolako iā ia ua kapa ʻia ʻo nā aʻa coronary. ʻO ka CAD ka wā e hōʻiliʻili ai nā waihona momona i kapa ʻia ʻo ka plaque i loko o hoʻokahi a ʻoi aku paha o nā aʻa coronary, e hoʻohaiki ana i nā aʻa. Ua kapa ʻia hoʻi kēia he atherosclerosis. Ua kapa pū kekahi poʻe iā ia he "paʻakikī o nā aʻa." Hiki mālie kēia hōʻiliʻili momona, a ʻaʻole paha e hōʻike i kekahi mau hōʻailona i ka wā mua. Akā inā ʻaʻole mālama ʻia, hiki iā ia ke alakaʻi i nā kūlana koʻikoʻi e like me ka hōʻeha puʻuwai a me ka hāʻule ʻana o ka puʻuwai.

He aha nā ʻano o 'Angioplasty' a me 'Stent'?

ʻO kekahi o nā lāʻau lapaʻau nui a nā kauka e hoʻohana ai e wehe i nā aʻa coronary i paʻa ʻia ma muli o CAD ua kapa ʻia ʻo angioplasty. I kekahi manawa ua kapa ʻia hoʻi ʻo ia he percutaneous coronary intervention (PCI). Ma kēia, ua hoʻokomo ʻia kahi ʻōmole lahilahi (catheter) ma o kahi lua liʻiliʻi i loko o ka ʻili i loko o ke aʻa i paʻa ʻia. Hoʻopiha ʻia kahi mea liʻiliʻi e like me ka balloon ma ka hopena o ka ʻōmole, e hoʻonui ana i ke aʻa i paʻa ʻia. A laila, i mea e pale ai i ka hiolo hou ʻana o ke aʻa a e mālama pono i ke kahe ʻana o ke koko, ua kau ʻia kahi ʻōmole mesh liʻiliʻi - ʻo ia ke kumu o ka stent - i loko o ke aʻa i hoʻonui ʻia. A laila, kahe mālie hou ke koko.

ʻAe, he aha kēia 'In-Stent Restenosis'?

I kēia manawa ua maopopo iā ʻoe ke kumu a pehea e kau ʻia ai kahi stent. Ma hope o ke kau ʻia ʻana o kahi stent a hoʻihoʻi ʻia ke kahe o ke koko i loko o ke aʻa coronary, i kekahi manawa hoʻomaka hou ke aʻa e haiki hou ma kahi i kau ʻia ai ka stent, ʻo ia hoʻi, i loko o ka stent. ʻO ia ke kumu a mākou e kapa ai iā ia ʻo 'In-Stent Restenosis'. ʻO 'Re' ke ʻano "hou", a ʻo 'stenosis' ke ʻano "hoʻohaiki". No laila, ʻo kēia ke ʻano "hoʻohaiki hou i loko o ka stent".

Pehea ka maʻamau o kēia ʻano?

I kēia manawa ke noʻonoʻo nei paha ʻoe inā he mea ʻokoʻa kēia no nā mea āpau e loaʻa ana nā stents.ʻAʻole, ʻaʻole kēia e hana i nā mea a pau me ka stent. Eia nō naʻe, ma ke ʻano maʻamau, ma kahi o 1 i loko o 4 mau kānaka me ka stent e loaʻa ana kekahi manawa e loaʻa ai kēia maʻi i kapa ʻia ʻo 'In-Stent Restenosis'. Hana pinepine kēia i loko o ʻekolu a ʻeono mahina o ke kau ʻia ʻana o ka stent.

He mea nui: Inā loaʻa iā ʻoe ka angioplasty balloon me ka ʻole o ka stenting, ʻoi aku ka kiʻekiʻe o ka pilikia o ka restenosis. Ma kahi o 4 i loko o 10 mau kānaka e pani hou ʻia ko lākou aʻa.

No ke aha e hana ʻia ai ka 'in-stent restenosis'?

He nīnau hoihoi maoli nō ia. Ma hope o ke kau ʻia ʻana o kahi stent, hoʻāʻo ko mākou kino e "ho'ōla" iā ia. ʻO ia hoʻi, ulu kahi papa hou o nā cell (kahi "ʻili hou") ma luna o ka stent, e hoʻomaʻemaʻe hou ana i loko o ke aʻa. He mea maikaʻi kēia, no ka mea, a laila hiki i ke koko ke kahe maʻalahi me ka ʻole o ka clotting.

Eia nō naʻe, i kekahi manawa, ma lalo o kēia papa hou o nā cell, a puni ka stent, ulu nui ka ʻiʻo ʻeha . Ke ulu nui kēia ʻiʻo ʻeha, mānoanoa ka uhi o loko o ke aʻa, e hoʻohaiki hou ana i ke kahe koko. ʻO kēia ke kumu nui o ka 'In-Stent Restenosis'.

E hoʻomanaʻo, hana pinepine kēia i loko o ʻekolu a ʻeono mahina o ke kau ʻana o ka stenting. Ma hope o kēlā, haʻahaʻa loa ka pilikia o ka hoʻokumu ʻana o nā ʻiʻo ʻeha a me ke ālai ʻana i ke aʻa.

ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i ka 'in-stent restenosis'?

ʻOiai hiki i kekahi mea i kau ʻia kahi stent no CAD ke loaʻa i kēia kūlana i kapa ʻia ʻo `In-Stent Restenosis`, aia kekahi poʻe i kahi pilikia kiʻekiʻe iki. E nānā kākou iā lākou:

• No nā kānaka me nā pae cholesterol koko kiʻekiʻe. (ʻO kēia ka mea e kōkua ai i nā maʻi puʻuwai he nui!)
• No ka poʻe me nā maʻi puʻupaʻa .
• No ka poʻe puhi paka. (He mea kēia e pono ai ʻoe e hoʻōki i ka hana ʻana!)
• No ka poʻe me ka maʻi diabetes i kāohi pono ʻole ʻia.
• No ka poʻe me ke koko kiʻekiʻe i kāohi ʻole ʻia (hypertension).

Inā loaʻa iā ʻoe nā maʻi e like me kēia, he mea nui loa e kamaʻilio me kāu kauka a e hoʻokele iā lākou.

He aha nā hōʻailona o ka 'in-stent restenosis'?

ʻO ka hapa nui o ka manawa, ʻaʻole hōʻike ka poʻe me ka `In-Stent Restenosis` i nā hōʻailona o waho. ʻO ia ke kumu he mea nui loa e ʻike i kāu kauka i nā manawa maʻamau a hana i nā hoʻokolohua e pono ai ma hope o ke kau ʻia ʻana o kahi stent.

Eia nō naʻe, hiki i kekahi poʻe ke loaʻa nā hōʻailona. Inā loaʻa, ua like pinepine nā hōʻailona me nā CAD i loaʻa mua. ʻO kēia mau mea:

• He manaʻo ʻeha, paʻa, a ʻoluʻolu ʻole paha ma ka umauma. Kāhea mākou i kēia he "angina." Hiki ke ʻoi aku ka ʻeha o kēia ʻeha umauma ke hoʻoikaika kino ʻoe, piʻi i nā alapiʻi, a luhi iki paha.
• Hou anu.
• Ka poniuniu, ka māmā o ke poʻo, a i ʻole ka manaʻo nāwaliwali.
• Ka luhi nui a me ka nāwaliwali.
• Ke manaʻo nei i kahi puʻuwai puʻuwai ʻē aʻe ('Heart palpitations').
• Ka luaʻi.
• Ka pōkole o ka hanu, i kekahi manawa ʻoiai ke hele wāwae i kahi mamao pōkole.
• ʻEha ma ka poʻohiwi a i ʻole ka lima (ʻoi aku ka lima hema).

Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​pono ʻoe e ʻike i ke kauka me ka hoʻonele ʻole i ka manawa.

Pehea e ʻike ʻia ai ka 'in-stent restenosis'?

E like me kaʻu i ʻōlelo ai ma mua, ʻoiai ʻaʻole hōʻike mau ka 'In-Stent Restenosis' i nā hōʻailona, ​​​​he mea nui e ʻike pinepine i kāu kauka ma hope o ke kau ʻia ʻana o kahi stent. A laila, hiki ke hana ʻia nā hoʻokolohua e pono ai.

Inā loaʻa iā ʻoe nā hōʻailona, ​​​​hiki i kāu kauka ke kuhikuhi i nā hoʻokolohua e like me kēia:

• Hoʻāʻo koʻikoʻi hoʻoikaika kino : Ke ana kēia hoʻāʻo i ke ʻano o ka pamu ʻana o kou puʻuwai i ke koko a nānā i nā loli i kāu ECG i kou hele ʻana ma luna o ka treadmill a holo paikikala paha.
• ʻO ke catheterization cardiac a me ka angiogram : Hana ʻia kēia ma mua o ke kau ʻia ʻana o ka stent. Hiki ke hana hou ʻia kēia e ʻike pono inā he poloka i loko o ka stent.
• ʻO ka angiogram tomography computed coronary (CCTA): Ua like kēia me ka CT scan. Hoʻokomo ʻia kahi kala kūikawā i loko o ka puʻuwai e hana i nā kiʻi 3D o nā aʻa o ka puʻuwai.
• ʻO ka mālama kahe hapa (FFR): Hiki ke hana ʻia kēia i ka manawa like me ka angiogram. Hoʻokomo ʻia kahi uea kūikawā i loko o ke aʻa a ana ʻia ke kaomi koko ma nā ʻaoʻao ʻelua o ka mea i paʻa ai ke koko e ʻike i ke koʻikoʻi o ka mea i paʻa ai.
• ʻO ka ultrasound intravascular (IVUS): Hiki ke hana ʻia kēia i ka manawa like me ka angiogram. Hoʻokomo ʻia kahi probe ultrasound liʻiliʻi i loko o ke aʻa, e ʻae ana i ka ʻike maopopo ʻana o loko o ka paia aʻa a me ka stent.

He aha nā lāʻau lapaʻau no ka 'in-stent restenosis'?

E hoʻoholo kāu kauka i ka lāʻau kūpono loa nou ma muli o ke koʻikoʻi o kāu In-Stent Restenosis, ʻo ia hoʻi, pehea ka haiki o ke aʻa, a me kou olakino holoʻokoʻa. Hiki ke komo pū me kekahi o kēia mau lāʻau lapaʻau:

• Nā lāʻau lapaʻau: No ka kaohi ʻana i nā hōʻailona e like me ka angina i hoʻokumu ʻia e ka In-Stent Restenosis, hiki ke hoʻonui ʻia ka nui o nā lāʻau lapaʻau o kēia manawa a i ʻole e hoʻohui ʻia nā lāʻau lapaʻau hou.
• E hana hou i ka angioplasty: Hoʻonui hou ʻia ke aʻa i paʻa ʻia me kahi pōpō, a i kekahi manawa hoʻokomo ʻia kekahi stent. I kekahi manawa hiki ke hoʻohana ʻia kahi pōpō i uhi ʻia i ka lāʻau.
• ʻO ke ʻoki puʻuwai bypass:Ua kapa ʻia kēia ʻo 'Coronary artery bypass grafting' a i ʻole 'CABG'. He ʻano hana nui kēia. ʻO kāu hana, ʻo ia ke hana i ala hou no ke kahe ʻana o ke koko a puni ka wahi i ālai ʻia. ʻO ia hoʻi, lawe ʻoe i kahi ʻāpana o ke aʻa mai kahi ʻē aʻe o kou kino (e like me kou wāwae, umauma) a hoʻohui iā ia i ka wahi i ālai ʻia a me ke kua.
• ʻO ka brachytherapy vascular: He ʻano ʻokoʻa iki kēia o ka lāʻau lapaʻau. E like me ka radiation therapy i hoʻohana ʻia e pepehi i nā hunaola kanesa, pili kēia i ka hāʻawi ʻana i kahi liʻiliʻi o ka radiation no kahi manawa pōkole i ka stent e hoʻōki i ka ulu ʻana o ka ʻiʻo scar. Ua kapa ʻia hoʻi kēia he coronary brachytherapy.

Aia kekahi mau ala e pale aku ai i ka 'in-stent restenosis'?

ʻAe, ʻo ka nūhou maikaʻi, hiki ke hoʻemi ʻia ka pilikia o ka `In-Stent Restenosis`. ʻO kekahi o nā ala nui e hana ai i kēia, ʻo ia ka hoʻohana ʻana i nā stent drug-eluting (`DES`).

He ʻokoʻa kēia mau `DES` mai nā stent metala ʻole (BMS). He ʻāpana lahilahi ko lākou o ka lāʻau lapaʻau ma luna o lākou. Ke hoʻokomo ʻia ka stent i loko o ke aʻa, e hoʻokuʻu mālie ʻia ka lāʻau lapaʻau, e kāohi ana i ka hoʻokumu ʻia ʻana o nā ʻiʻo ʻeha a me ka ulu ʻana o nā cell.

I nā makahiki i hala aku nei, ua kamaʻilio ʻia e pili ana i ka pilikia o ke koko ʻana me kēia mau 'DES'. Eia nō naʻe, ʻo ka hanauna hou o nā stents e hoʻoheheʻe ʻia i nā lāʻau lapaʻau he palekana loa a he pono loa. Ke hoʻohana nei i kēia mau 'DES', ua emi nui ka pilikia o ka 'In-Stent Restenosis'. Ma ke ʻano maʻamau, 'ʻAʻole i hiki i ka 1 i loko o 10 mau kānaka' ke loaʻa i ka 'In-Stent Restenosis'.

No laila, inā e kau ʻia ana kahi stent, e kamaʻilio me kāu kauka e hoʻoholo i ke ʻano o ka stent kūpono loa iā ʻoe.

He aha ka manaʻo no kekahi me ka 'in-stent restenosis'?

Inā loaʻa iā ʻoe ka 'In-Stent Restenosis', ʻoi aku paha kou pilikia o ka loaʻa ʻana o nā maʻi puʻuwai e hoʻoweliweli ana i ke ola, e like me ka 'unstable angina', 'acute coronary syndrome', a me nā 'hoʻouka puʻuwai'.

ʻO ka mea pōmaikaʻi, ua hoʻemi nui ʻia kēia mau pilikia me ka hiki ʻana mai o nā stents hou (ʻoi aku hoʻi ʻo DES) a me nā ʻano hana hoʻokomo stent i hoʻomaikaʻi ʻia. Eia kekahi, aia i kēia manawa nā lāʻau lapaʻau kūpono no ka In-Stent Restenosis.

Inā loaʻa iā ʻoe ka CAD, pono ʻoe e hahai pololei i nā ʻōlelo a kāu kauka e pale aku i ka In-Stent Restenosis a pale i kou puʻuwai ma ke ʻano laulā. ʻO ia hoʻi:

• E hōʻemi i kāu ʻai paʻakai a lawe i nā lāʻau lapaʻau i kauoha ʻia e kāu kauka (ʻoi aku hoʻi nā mea no ke koko, ka cholesterol, a me ke kāpili ʻana o ke koko) me ka pololei a me ka manawa kūpono.
• E hōʻemi i kou inu ʻana i ka waiʻona. Inā ʻoe e hoʻopilikia nei i ka waiʻona, e ʻimi i ke kōkua e lanakila ai.
• ʻAi olakino puʻuwaiE ʻai i ka "ʻai olakino no ka puʻuwai." E ʻai iki i ka ʻaila, ke kō, a me ka palaoa, a e ʻai hou aku i nā mea kanu, nā huaʻai, a me nā meaʻai waiwai i ka fiber.
• E makaʻala i nā ʻano momona āu e ʻai ai. E hōʻemi i kāu ʻai ʻana i nā meaʻai kiʻekiʻe i nā momona saturated a me nā trans (meaʻai wikiwiki, nā meaʻai palai, nā meaʻai i hoʻopaʻa ʻia) i ka hiki.
• E mālama i ke kaumaha olakino. E hoʻoikaika kino i kēlā me kēia lā.
• Inā loaʻa iā ʻoe ka maʻi diabetes, e kaohi pono iā ia.
• Inā ʻoe e puhipaka ana, e hoʻāʻo e haʻalele i kēia lā. Aia nā ala e loaʻa ai ke kōkua.

Āhea wau e kāhea aku ai i ke kauka?

Inā manaʻo ʻoe e loaʻa ana iā ʻoe kahi hāʻule puʻuwai (nā hōʻailona e like me ka ʻeha nui o ka umauma, ka hanu pōkole, ka hou ʻana), e kāhea koke aku i ka 1990 Suwaseriya Ambulance Service.

Inā ua kau ʻia kahi stent ma mua a hoʻi hou kēia mau hōʻailona, ​​e ʻike koke i kāu cardiologist:

• ʻEha umauma (angina), ʻūmiʻi, kaomi, ʻeha ma ka lima a i ʻole ka poʻohiwi.
• Hou anu.
• Paʻakikī ka hanu ʻana, ka wheezing.
• Ka luhi nui a i ʻole ka nāwaliwali no ke kumu ʻole.

He aha kaʻu e nīnau aku ai i kaʻu kauka?

Ke hālāwai ʻoe me ke kauka, hiki iā ʻoe ke nīnau i nā nīnau e like me kēia e loaʻa ai kahi ʻike maopopo o kou kūlana:

• No ke aha i loaʻa ai iaʻu kēia 'restenosis'? He aha koʻu mau kumu pilikia?
• Hiki iaʻu ke loaʻa hou i ka restenosis? He aha kaʻu e hana ai e pale aku ai?
• He aha ke ʻano o ke ola e pono ai iaʻu e hahai ai e mālama i koʻu puʻuwai?
• He aha nā hōʻailona o nā pilikia e pono iaʻu e makaʻala?
• He aha ka lāʻau lapaʻau maikaʻi loa noʻu?

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

ʻAe, no laila ʻo ka mea nui loa āu e pono ai e hoʻomanaʻo mai kā mākou i kamaʻilio ai, ʻo ia kēia. ʻO Angioplasty a me stenting ʻelua o nā lāʻau lapaʻau koʻikoʻi a hoʻōla ola no ka maʻi puʻuwai. Hoʻomaikaʻi kēia mau lāʻau lapaʻau i ke kahe koko i kou puʻuwai, hoʻēmi i nā hōʻailona o CAD, a hoʻomaikaʻi i kou ʻano ola.

Eia nō naʻe, inā ʻike hou ʻia nā hōʻailona e like me ka luhi, ka ʻeha o ka umauma, a me ka pōkole o ka hanu ma hope o ke kau ʻia ʻana o kahi stent, he hōʻailona paha ia o ka 'In-Stent Restenosis. ' Inā hana ʻia kēlā, mai hopohopo a hoʻokaʻulua paha, akā e ʻike pono i kāu kauka no ka ʻōlelo aʻo.

ʻO ka mea pōmaikaʻi, ʻo nā stent hou a palekana hoʻi i loaʻa i kēia lā ua hōʻemi nui i ka pilikia o ka hoʻomohala ʻana i ka In-Stent Restenosis. Aia kekahi mau lāʻau lapaʻau maikaʻi no kēia. ʻOi aku ka maikaʻi o ke kamaʻilio ʻana me kāu kauka e pili ana i ke ʻano o ka stent a me ka lāʻau lapaʻau kūpono iā ʻoe. E mālama i kou puʻuwai!

ʻO nā stent, restenosis in-stent, maʻi puʻuwai, angioplasty, maʻi ʻaʻa coronary, maʻi ʻaʻa coronary, hōʻeha puʻuwai