Thaum koj taug kev luv luv, koj puas hnov mob lossis nruj heev rau koj ob txhais ceg, tshwj xeeb tshaj yog rau ntawm koj ob txhais ceg thiab koj lub pob tw? Qhov mob yuav ploj mus tom qab ib pliag, tab sis rov qab los thaum koj rov qab taug kev dua? Los yog koj puas muaj cov qhov txhab rau ntawm koj ob txhais ceg yam tsis muaj laj thawj thiab lawv siv sijhawm ntev los kho? Yog tias koj muaj cov tsos mob no, koj tus kws kho mob yuav tau tham nrog koj txog kev phais. Tej zaum koj yuav ntshai me ntsis thaum koj hnov lub npe. Hnub no peb tab tom tham txog qhov ntawd, kev phais hu ua Aortobifemoral Bypass. Tsis txhob txhawj, cia peb piav qhia qhov no yooj yim heev.
Hauv lwm lo lus, Aortobifemoral Bypass yog dab tsi?
Xav txog tias txoj kev loj hauv nroog raug thaiv tag nrho vim muaj tsheb coob. Tsis muaj txoj kev rau cov tsheb hla mus tau. Yog li ntawd, koj yuav ua li cas? Peb zam qhov chaw uas raug thaiv ntawd thiab tsim txoj kev 'bypass' tshiab kom mus rau sab tod, puas yog? Qhov ntawd yog qhov kev phais no ua.
Kev phais plawv Aortobifemoral bypass yog ib qho kev phais uas siv cov hlab ntsha hauv peb lub cev. Hauv qhov no, cov kws phais tsim ib txoj kev tshiab, hu ua bypass , los hla cov chaw uas cov hlab ntsha tseem ceeb hauv peb lub plab raug thaiv lossis nqaim. Qhov no ua rau cov ntshav rov qab mus rau peb ob txhais ceg.
Hauv kev phais no, cov kws kho mob siv cov hlab ntsha cuav, hu ua graft . Qhov no feem ntau yog ua los ntawm cov khoom siv zoo li polyester. Cia peb nkag siab tias nws tau txais nws lub npe li cas:
- "Aorto" yog hais txog cov hlab ntsha loj tshaj plaws hauv peb lub cev, lub aorta . Nws pib ntawm lub plawv thiab tom qab ntawd mus dhau lub hauv siab thiab mus rau hauv plab.
- "Femoral" yog hais txog cov hlab ntsha femoral, uas pib hauv peb lub qhov ncauj thiab khiav raws peb lub duav mus rau tom qab peb lub hauv caug.
- "Bi" txhais tau tias 'ob'. Qhov ntawd txhais tau tias qhov graft no txuas rau ob lub femoral artery hauv koj ob txhais ceg.
Qhov kev cog hniav no zoo li tus "Y" tig rau sab saud. Ib kawg ntawm sab saud txuas nrog rau sab qis ntawm lub aorta hauv plab. Ob txhais ceg ntawm Y txuas nrog cov hlab ntsha femoral hauv ob txhais ceg. Ua li no, cov ntshav tuaj yeem hla qhov txhaws thiab ntws mus rau ob txhais ceg yooj yim dua.
Vim li cas peb thiaj xav tau hom kev phais mob no?
Qhov kev phais no feem ntau yog ua los kho tus mob hu ua Aortoiliac occlusive disease . Txawm hais tias lub npe yuav zoo li nyuaj me ntsis, zaj dab neeg yooj yim heev. Qhov tshwm sim yog tias cov roj cholesterol thiab lwm cov rog (plaque) sib sau ua ke raws sijhawm hauv cov hlab ntsha tseem ceeb hauv peb lub plab thiab lub duav. Cov hlab ntsha tseem ceeb uas cuam tshuam rau txoj kev no yog:
- Lub plawv aorta hauv plab: Qhov no yog ib feem ntawm lub plawv aorta uas nqes los ntawm sab hauv peb lub plab.
- Cov hlab ntsha Iliac:Cov no pib ze ntawm lub puab tais qhov twg lub aorta faib ua ob. Cov no yog cov uas mus rau thaj tsam lub puab tais thiab dhau los ua cov hlab ntsha femoral.
Thaum cov quav hniav sib sau ua ke hauv cov hlab ntsha no thiab ua rau lawv nqaim, cov qhov qis ntawm peb lub cev, xws li ob txhais ceg, taw, thiab lwm yam kabmob hauv lub duav, yuav tsis tau txais cov ntshav uas muaj oxygen txaus. Thaum qhov mob no hnyav zuj zus, ntau yam teeb meem tuaj yeem tshwm sim.
Qhov tseem ceeb tshaj plaws yog tias qhov kev phais mob no tsis tuaj yeem kho tau tus kab mob tag nrho. Txawm li cas los xij, nws pab tswj cov tsos mob thiab tiv thaiv cov teeb meem loj.
| Kev nyuaj siab | Piav qhia yooj yim xwb |
|---|---|
| Mob ceg thaum taug kev (Intermittent claudication) | Mob hnyav heev los yog nruj thaum cov leeg tsis tau txais cov ntshav txaus thaum taug kev. Nws ploj mus thaum so. |
| Mob hnyav heev uas tshwm sim txawm tias thaum so | Cov ntshav ncig tsis zoo ua rau ob txhais ceg mob txawm tias koj tsis ua dab tsi los xij, tshwj xeeb tshaj yog thaum hmo ntuj. |
| Gangrene | Cov ntshav uas mus rau cov nqaij tsis muaj zog lawm, ua rau lawv tuag. Qhov no ua rau qee qhov ntawm ko taw dub. |
| Kev txiav tes txiav taw | Yog tias tsis tuaj yeem tswj tau qhov mob gangrene no, ib feem ntawm ceg yuav tsum tau phais tshem tawm kom cawm tau txoj sia. |
Qhov no puas yog ib qho kev phais loj heev? Puas muaj lwm txoj kev xaiv?
Yog, aortobifemoral bypass yog ib qho kev phais qhib uas ua los ntawm kev phais loj hauv plab. Yog li ntawd, nws suav tias yog ib qho kev phais loj, lossis loj.
Tab sis niaj hnub no, nrog kev nce qib ntawm thev naus laus zis, muaj lwm txoj kev kho mob rau qhov no. Ib qho ntawm cov tseem ceeb yog ib txoj kev hu ua aortoiliac stenting nrog bifurcation reconstruction (AISBR) . Qhov no yog ib feem ntawm pawg ntawm kev phais mob endovascular .
Hais yooj yim xwb, qhov no yog muab ib lub cannula ntxig rau hauv cov hlab ntsha los ntawm ib lub qhov me me hauv qhov ncauj, mus rau thaj chaw uas raug thaiv, thiab muab ib lub raj me me zoo li lub mesh (stent) tso rau hauv nws kom nthuav cov hlab ntsha dua. Txoj kev no muaj tsawg dua qhov teeb meem phais thiab luv dua nyob hauv tsev kho mob.
Koj tus kws kho mob yuav txiav txim siab seb qhov kev xaiv twg zoo tshaj plaws rau koj. Feem ntau, kev siv stenting raug pom zoo rau cov neeg uas muaj feem yuav phais loj vim yog lwm yam mob. Txawm li cas los xij, qee zaum, nyob ntawm qhov hnyav ntawm qhov kev thaiv, kev phais qhib yuav tsim nyog. Yog li ntawd, nrog koj tus kws kho mob tham txog koj cov kev xaiv thiab qhov zoo thiab qhov tsis zoo.
Peb yuav npaj li cas ua ntej phais?
Kev phais loj zoo li no yuav tsum tau npaj ntau yam. Koj pab neeg kho mob yuav muab cov lus qhia tsim nyog rau koj. Feem ntau, koj yuav tsum ua tib zoo saib xyuas cov no.
- Tso kev haus luam yeeb: Yog tias koj haus luam yeeb, koj yuav tsum tso tag nrho tsawg kawg yog 3-4 lub lis piam ua ntej phais. Tso kev haus luam yeeb yog qhov tseem ceeb heev rau kev ua tiav ntawm kev phais, nrog rau kev noj qab haus huv ntawm koj lub plawv thiab cov hlab ntsha tom qab.
- Qhia rau koj tus kws kho mob txog cov tshuaj uas koj noj: Yog tias koj noj tshuaj rau tej yam xws li ntshav qab zib lossis ntshav siab, koj yuav tsum qhia rau koj tus kws kho mob txog qhov ntawd. Tej zaum yuav tsum tsis txhob noj qee cov tshuaj lossis hloov cov tshuaj noj ua ntej phais.
- Kev yoo mov ua ntej phais: Koj yuav raug qhia kom tsis txhob noj lossis haus tom qab ib tag hmo hmo ua ntej phais. Ua raws li cov lus qhia no kom meej.
- Tau txais kev kuaj mob tsim nyog: Koj yuav tsum tau kuaj ntau zaus kom paub meej tias koj txoj kev noj qab haus huv ua ntej phais.
- Kev ntsuas qhov siab ntawm pob luj taws thiab pob tw (ABI): Ib qho kev ntsuas uas ntsuas ntshav siab hauv ob txhais ceg.
- Kev kuaj ultrasound ntawm cov hlab ntsha (Doppler scan): Kev kuaj xyuas kom meej txog kev ntws ntawm cov ntshav hauv cov hlab ntsha thiab tej yam uas thaiv.
- Cov kev kuaj xws li ECG thiab Echo uas kuaj xyuas kev noj qab haus huv ntawm lub plawv thiab cov hlab ntsha hauv lub plawv.
Muaj dab tsi tshwm sim tiag tiag thaum lub sijhawm ua haujlwm?
Koj yuav tsis hnov dab tsi thaum lub sijhawm phais, vim tias koj yuav raug siv tshuaj loog dav dav. Pawg neeg phais yuav ua raws li cov kauj ruam no:
1. Tshuaj loog: Koj raug muab tso rau hauv kev pw tsaug zog tob.
2. Ua qhov txiav: Ua ntej, yuav ua ib qho txiav loj (laparotomy) raws li qhov ntev ntawm lub plab kom mus txog rau ntawm lub aorta. Tom qab ntawd, yuav ua ob qhov txiav ntxiv rau saum lub puab tais kom mus txog rau ntawm cov hlab ntsha femoral.
3. Kev ntxig cov noob caj noob ces:Tus kws phais yuav siv cov hlab ntsha cuav uas zoo li tus "Y" thiab xaws qhov kawg sab saud ntawm nws saum qhov txhaws hauv aorta. Ob ceg hauv qab ntawm Y raug xaws hauv qab qhov txhaws hauv cov hlab ntsha femoral.
4. Kaw cov qhov txiav: Tom qab ua tiav txoj kev bypass tshiab, cov qhov txiav hauv plab thiab qhov chaw mos raug kaw nrog cov xov lossis cov staples.
Feem ntau, kev phais mob no yuav siv sijhawm li ntawm 2 txog 6 teev .
Tom qab phais tas, muaj dab tsi tshwm sim hauv tsev kho mob?
Tom qab phais tas, koj yuav tsum nyob hauv tsev kho mob li ntawm 4 txog 7 hnub. Lub sijhawm no, pab neeg kho mob yuav saib xyuas koj zoo heev.
- Koj yuav raug khaws cia rau hauv chav saib xyuas mob hnyav (ICU) lossis chav kho mob tshwj xeeb thiab yuav raug saib xyuas ze rau txhua yam teeb meem, tshwj xeeb tshaj yog kev kis kab mob.
- Kuv tsis tu ncua xyuas seb cov ntshav hauv koj ob txhais ceg puas ncig zoo.
- Lawv yuav pab koj maj mam taug kev. Ua ntej, taug kev luv luv, tom qab ntawd nce qhov kev taug kev txhua hnub.
- Cov tshuaj tua mob raug muab los tswj qhov mob.
Qhov kev phais no muaj kev vam meej thiab kev pheej hmoo li cas?
Qhov kev phais no ua tau zoo heev. Raws li cov ntaub ntawv txheeb cais, ntawm 80% thiab 95% ntawm kev phais ua tau zoo tswj cov ntshav ntws tau 5 xyoos. Thaum muaj 10 xyoos, qhov feem pua ntawm kev ua tiav yog ntawm 74% thiab 86%.
Ib yam li lwm yam kev phais loj, muaj tej yam txaus ntshai thiab teeb meem uas yuav tshwm sim tau. Ua ntej koj ntshai, nco ntsoov tias pab neeg kho mob yuav ua qhov zoo tshaj plaws los txo qhov uas yuav muaj tej no tshwm sim.
Tej yam teeb meem uas yuav tshwm sim tau:
- Mob plawv nres
- Mob stroke
- Los ntshav ntau dhau
- Cov ntshav txhaws
- Kev kis kab mob ntawm qhov txhab phais
- Kev kis kab mob ntawm cov khoom cog
- Kev ua haujlwm tsis zoo ntawm lub raum
- Kev ua tsis taus pa ntawm lub ntsws
Tham nrog koj tus kws kho mob txog cov kev pheej hmoo no ua ntej phais thiab nug txhua yam lus nug uas koj muaj.
Kev rov zoo thiab kev ceev faj tom qab mus tsev
Tej zaum yuav siv sijhawm 2 txog 3 lub hlis kom rov zoo tag nrho, tab sis koj yuav tsum maj mam rov qab ua tej yam li qub tau hauv 4 txog 6 lub lis piam.
Cov qhov txiav yuav mob rau ob peb lub lis piam thawj zaug. Siv cov tshuaj tua kab mob uas koj tus kws kho mob sau rau qhov no.
- Noj koj cov tshuaj raws nraim li tau qhia: Noj tag nrho cov tshuaj uas koj tus kws kho mob tau qhia rau lub sijhawm thiab raws li qhov ntau npaum li cas.
- Khaws cov qhov txhab kom huv: Ua raws li koj tus kws kho mob cov lus qhia kom zoo txog kev ntxuav thiab siv tshuaj.
- Kev Ua Si:Kev tawm dag zog zoo tshaj plaws rau cov theem pib yog kev taug kev. Maj mam nce qhov deb uas koj taug kev txhua hnub. Tab sis tsis txhob mus hnyav dua li koj tus kws kho mob pom zoo.
- Tsis txhob tsa cov hnyav: Tsis txhob tsa cov hnyav kiag li rau ob peb lub hlis.
Nug koj tus kws kho mob thaum twg koj mam li pib tsav tsheb dua, mus ua haujlwm, thiab ua kev tawm dag zog hnyav.
Kuv yuav tsum hu rau kws kho mob thaum twg?
Yog tias koj muaj ib qho ntawm cov tsos mob hauv qab no tom qab rov qab los tsev, hu rau koj tus kws kho mob lossis mus rau tsev kho mob tam sim ntawd .
| Cov tsos mob | Yuav tsum tau them sai sai rau dab tsi |
|---|---|
| Ua npaws | Tej zaum yuav yog ib qho cim qhia tias muaj kev kis kab mob hauv lub cev. |
| Cov teeb meem ntsig txog kev txiav | Liab ib ncig ntawm qhov txhab, o, mob heev, zoo li sov so, lossis kua dej zoo li kua qaub tawm ntawm qhov txhab. |
| Kev hloov pauv ceg | Ceg o, mob, loog, txias, ntsej muag daj ntseg, lossis xiav. |
| Ntuav thiab xeev siab | Xeev siab lossis ntuav tas li. |
Yuav ua li cas thaum muaj xwm txheej ceev? (Xwm txheej ceev)
Yog tias koj muaj ib qho ntawm cov tsos mob ntawm kev mob plawv lossis mob hlwb hauv qab no, hu rau 1990 lub tsheb thauj neeg mob yam tsis muaj kev ncua lossis mus rau Chav Kho Mob Thaum Muaj Xwm Ceev (ETU) ntawm lub tsev kho mob ze tshaj plaws.
Cov tsos mob ntawm kev mob plawv nres
- Mob, nruj, lossis tsis xis nyob hauv nruab nrab ntawm lub hauv siab.
- Ua pa nyuaj.
- Xeev siab, mob plab.
- Lub plawv dhia tsis xwm yeem.
- Qaug zog heev.
- Kiv taub hau, tsis nco qab.
- Tawm hws ntau dhau.
Cov tsos mob ntawm tus mob stroke
- Mob loog los yog tsis muaj zog ntawm ib sab ntawm lub cev (lub ntsej muag, caj npab, los yog ceg).
- Nyuaj hais lus los yog hais lus tsis meej.
- Tsis pom kev tam sim ntawd, ib lossis ob zaug pom kev.
- Mob taub hau loj heev tam sim ntawd.
- Nyuaj siab taug kev, poob qhov sib npaug.
Kev ntsib kev phais loj tuaj yeem ua rau koj ntxhov siab. Qhov ntawd yog ib txwm muaj. Tham txog koj qhov kev ntshai thiab kev txhawj xeeb nrog koj tsev neeg, nrog rau koj tus kws kho mob thiab pab pawg kho mob. Kev tau txais txhua yam ntaub ntawv uas koj xav tau thiab pib ua nrog kev npaj siab zoo yuav pab tau ntau yam nrog txoj kev kho mob.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kev phais plawv Aortobifemoral Bypass yog ib qho kev phais loj uas ua los kho cov ntshav ntws los ntawm kev hla cov kev thaiv hauv cov leeg ntshav tseem ceeb uas muab ntshav rau ob txhais ceg.
- Qhov kev phais no txo qhov mob thaum taug kev thiab tiv thaiv cov teeb meem loj xws li gangrene.
- Nws yog ib qho tseem ceeb heev uas yuav tsum tso kev haus luam yeeb ua ntej phais thiab ua raws li tus kws kho mob cov lus qhia.
- Txawm hais tias qhov no yog ib qho kev phais loj los xij, nws txoj kev vam meej yog siab heev.
- Thaum lub sijhawm rov zoo, nws yog ib qho tseem ceeb uas yuav tsum tau saib xyuas qhov txhab kom zoo, noj tshuaj raws li tau qhia, thiab ua raws li cov lus qhia ntawm kws kho mob.
- Yog tias koj muaj cov tsos mob thaum muaj xwm txheej ceev xws li mob hauv siab, ua pa nyuaj, lossis tsis nco qab ib sab ntawm lub cev, koj yuav tsum mus rau tsev kho mob tam sim ntawd.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus