Koj puas tau hnov txog kab mob plawv (coronary artery disease)? Peb coob leej ntau tus twb tau hnov txog nws lawm. Hauv kev kho mob, qhov no hu ua Kab Mob plawv ( COronary Artery Disease - CAD ). Hais yooj yim xwb, nws yog ib qho mob uas cov rog thiab cov roj cholesterol sib sau ua ke hauv cov hlab ntsha uas nqa cov ntshav mus rau lub plawv, ua rau cov ntshav ntws nqaim. Tab sis cov hlab ntsha no tuaj yeem raug thaiv ntau txoj kev sib txawv. Hnub no, peb yuav tham txog ib qho mob nyuaj me ntsis uas xav tau kev saib xyuas tshwj xeeb. Ntawd yog, thaum cov rog sib sau ua ke thiab thaiv cov hlab ntsha qhov twg cov hlab ntsha loj hauv lub plawv faib ua ib ceg me dua. Xav txog kev sib tsoo ntawm txoj kev Y, qhov chaw uas ob txoj kev sib faib. Cov kws kho mob hu qhov no ua 'Bifurcation Blockage'.
Qhov no hu ua Bifurcation Blockage yog dab tsi tiag?
Zoo, cia peb muab qhov no ua ib txoj kev yooj yim dua. Koj lub plawv yog ib cov leeg nqaij uas ua haujlwm tsis tu ncua. Nws tau txais lub zog thiab cov pa oxygen uas nws xav tau los ntawm cov hlab ntsha hu ua cov hlab ntsha hauv lub plawv. Cov hlab ntsha tseem ceeb no ceg tawm mus ua cov ceg me me kom nqa cov ntshav mus rau txhua qhov ntawm lub plawv.
Tam sim no, qhov Bifurcation Blockage no tshwm sim thaum muaj cov rog sib sau ua ke (peb hu ua plaque ) tsim qhov twg cov hlab ntsha loj faib ua ib ceg me dua, uas yog, ntawm Y-junction. Cov plaque no thaiv cov ntshav ntws. Cov kws kho mob hu cov ceg me no ua "side-branch vessel." Cov plaque no kuj hu ua "bifurcation lesion."
Thaj chaw no nyuaj me ntsis rau kev txhaws dua li lwm thaj chaw. Vim tias cov ntshav ntws thiab lub siab txawv ntawm no, muaj feem ntau dua uas cov quav hniav yuav tsim nyob rau hauv cov chaw no. Thiab nws tuaj yeem nyuaj me ntsis rau kev kho.
Puas muaj cov hom kev thaiv no tseem ceeb?
Yog, cov kws kho mob faib qhov kev thaiv no raws li qhov hnyav, uas yog, ntau npaum li cas ntawm cov hlab ntsha raug thaiv. Qhov no hu ua stenosis . Muaj ob hom tseem ceeb.
| Hom kev thaiv | Ib qho lus piav qhia yooj yim |
|---|---|
| Ib qho kev thaiv yooj yim | Qhov no yog thaum cov hlab ntsha raug thaiv tsawg dua 70%. Qhov no txhais tau tias tseem muaj chaw rau cov ntshav ntws. Qhov no yooj yim kho. |
| Kev thaiv teeb meem nyuaj | Ntawm no, cov hlab ntsha raug thaiv ntau dua 70%, uas txhais tau tias nws raug thaiv heev. Qee zaum yuav muaj ntau dua ib qho kev thaiv. Los yog qhov kev thaiv no tuaj yeem tshwm sim los ntawm cov ntshav txhaws lossis calcification. Lwm yam yog, qee zaum yog tias ceg me me ntawd tawg ntawm lub kaum ntse ntse heev (ntau dua 70 degrees), nws nyuaj heev rau ntxig cov cuab yeej thiab kho thaj chaw ntawd. |
Qhov teeb meem no muaj ntau npaum li cas hauv peb lub tebchaws?
Qhov no yog ib qho mob uas pom ntau heev. Kev kwv yees qhia tias ntawm 15% thiab 20% ntawm txhua tus neeg mob uas muaj kab mob plawv (CAD) uas xav tau kev kho mob poob rau hauv pawg no, hu ua bifurcation blockages. Hais yooj yim xwb, ntawm txhua 100 tus neeg mob uas tuaj rau tsev kho mob nrog lub plawv txhaws, kwv yees li 15-20 tus muaj qhov txhaws ntawm qhov sib tshuam no. Yog li, qhov no tsis yog ib yam dab tsi uas yuav tsum tau saib yooj yim.
Vim li cas qhov no thiaj tshwm sim? Qhov laj thawj tiag tiag rau qhov no yog dab tsi?
Qhov laj thawj tseem ceeb rau qhov no yog cov rog uas hu ua plaque uas peb tau tham txog ua ntej. Qhov no zoo li kev sib sau ua ke ntawm xeb thiab av hauv cov kav dej dhau sijhawm, ua rau muaj qhov hauv cov kav dej. Cov plaque no yog tsim los ntawm kev sib sau ua ke ntawm cov roj cholesterol, rog, thiab calcium hauv phab ntsa ntawm peb cov hlab ntsha. Dhau sijhawm, cov plaque no loj hlob tuaj thiab ua rau cov ntshav hla dhau cov leeg. Thaum kawg, lub plawv tsis tau txais cov ntshav txaus. Peb hu qhov mob no ua atherosclerosis . Bifurcation blockage kuj yog qhov tshwm sim ntawm qhov mob atherosclerosis no.
Leej twg muaj kev pheej hmoo tshaj plaws?
Txawm hais tias tus mob no tuaj yeem tshwm sim rau txhua tus neeg, qee tus neeg muaj feem yuav mob ntau dua. Yog tias koj muaj ib lossis ntau yam ntawm cov yam no, nws yog ib lub tswv yim zoo kom ceev faj ntxiv me ntsis.
| Qhov ua rau muaj kev pheej hmoo | Ib qho lus piav qhia yooj yim |
|---|---|
| Hnub nyoog thiab poj niam txiv neej | Qhov kev pheej hmoo siab dua rau cov poj niam tom qab lub sijhawm tas lawm thiab cov txiv neej hnub nyoog tshaj 45 xyoo. |
| Kab mob ntshav qab zib | Kab mob ntshav qab zib tuaj yeem ua rau cov hlab ntsha puas tsuaj, ua rau cov quav hniav yooj yim dua los sib sau ua ke. |
| Rog dhau los yog rog dhau | Thaum lub cev hnyav nce ntxiv, lwm yam kev pheej hmoo xws li cov roj cholesterol thiab ntshav siab kuj nce ntxiv. |
| Keeb kwm tsev neeg | Yog tias ib tug neeg hauv koj tsev neeg (niam, txiv, cov kwv tij neej tsa) muaj kab mob plawv, koj kuj muaj feem yuav muaj kab mob ntau dua. |
| Ntshav siab (Tshuaj ntshav siab) | Thaum muaj kev ntxhov siab ntau ntxiv, cov phab ntsa ntawm cov hlab ntsha yuav puas tsuaj thiab cov quav hniav tuaj yeem yooj yim tsim. |
| Cov roj cholesterol ntau | Qhov no yog cov khoom xyaw tseem ceeb rau kev tsim cov quav hniav. Qhov kev pheej hmoo siab dua yog tias muaj cov roj cholesterol phem (LDL) ntau hauv cov ntshav. |
| Tsis muaj kev tawm dag zog thiab kev noj zaub mov tsis zoo | Cov neeg uas tsis muaj zog thiab noj zaub mov uas muaj roj, qab zib, thiab ntsev ntau yuav muaj kev pheej hmoo ntau dua. |
| Haus luam yeeb | Kev haus luam yeeb ncaj qha ua rau cov hlab ntsha puas tsuaj thiab ua rau muaj kev pheej hmoo ntawm cov ntshav txhaws. |
Tej zaum koj yuav muaj cov tsos mob dab tsi?
Qhov kev thaiv ntawm cov hlab ntsha bifurcation yog ib hom kab mob ntawm cov hlab ntsha hauv lub plawv (CAD), yog li cov tsos mob zoo sib xws. Yog tias koj muaj ib lossis ntau yam ntawm cov tsos mob no, mus ntsib kws kho mob tam sim ntawd.
- Mob hauv siab los yog mob siab (Angina): Qhov no yog cov tsos mob tseem ceeb. Nws tuaj yeem zoo li raug nias los yog xav tias raug nias rau hauv nruab nrab ntawm lub hauv siab.
- Ua tsis taus pa: Ua tsis taus pa thaum koj nkees me ntsis, lossis thaum nce ntaiv.
- Xav tias nkees heev lossis tsis muaj zog yam tsis muaj laj thawj.
- Mob xub pwg lossis mob caj npab: Qhov mob uas kis mus rau sab caj npab sab laug, tshwj xeeb tshaj yog.
- Kiv taub hau (vertigo) lossis tsaus muag: Ib qho kev xav tias tig thiab sawv tsis taus.
- Xeev siab: Zoo li ntuav.
- Hnov txias thiab tawm hws.
- Kev hnov lub plawv dhia tsis zoo (Lub plawv dhia tsis xwm yeem).
Qhov tseem ceeb yog tias tsis yog txhua tus neeg yuav muaj tag nrho cov tsos mob no. Tej zaum qee tus neeg yuav muaj tus mob no yam tsis muaj tsos mob dab tsi li. Yog li ntawd, nws yog ib qho tseem ceeb kom mus kuaj mob tsis tu ncua yog tias koj muaj cov yam ntxwv ua rau muaj kev pheej hmoo.
Tus kws kho mob nrhiav tau qhov no li cas?
Thaum koj qhia rau koj tus kws kho mob txog cov tsos mob uas koj tau hais los saum toj no, nws yuav kuaj koj thiab xa koj mus kuaj ntau zaus kom paub meej tias muaj tus mob no.
- ECG (Electrocardiogram): Qhov no kuaj xyuas qhov ua haujlwm hluav taws xob ntawm lub plawv kom pom tias puas muaj kev puas tsuaj rau lub plawv.
- Kev Ntsuas Kev Nyuaj Siab: Yuav muaj kev ntsuas ECG thaum koj taug kev saum lub treadmill, saib seb koj lub plawv ua haujlwm li cas thaum koj ntxhov siab.
- Echocardiogram: Kev ntsuas ultrasound ntawm lub plawv.
- Kev Siv Tshuaj Rau Lub Plawv (Coronary Angiogram): Qhov no yog qhov kev kuaj tseem ceeb los saib seb puas muaj kev thaiv hauv koj cov hlab ntsha. Ib lub raj me me raug ntxig los ntawm koj ceg lossis caj npab, xov rau hauv cov hlab ntsha hauv koj lub plawv, thiab cov kua tshwj xeeb raug txhaj rau hauv, thiab cov duab X-ray raug thaij. Qhov no tso cai rau koj pom qhov twg ntawm kev thaiv kom meej.
- CCTA (Coronary Computed Tomography Angiogram): Qhov no zoo ib yam li angiogram, tab sis yog kev sim ua los ntawm kev siv lub tshuab CT scan yam tsis muaj ntxig lub raj rau hauv lub cev.
Cov kev kuaj no yuav cia koj tus kws kho mob txiav txim siab seb koj puas muaj qhov thaiv bifurcation thiab nws hnyav npaum li cas.
Cov kev kho mob rau qhov no yog dab tsi?
Kev kho qhov kev thaiv bifurcation yog qhov nyuaj dua me ntsis vim tias cov hlab ntsha ntawm sab ceg me dua, ua rau nws nyuaj dua rau kev kho nrog cov cuab yeej dua li cov hlab ntsha tseem ceeb.
Txoj kev kho mob tseem ceeb yog angioplasty thiab stenting . Qhov no tsis yog phais. Qhov no hu ua Percutaneous Coronary Intervention (PCI).
Nov yog qhov tshwm sim ntawm no:
1. Tus kws kho mob yuav ua kom daim tawv nqaij ntawm koj txhais caj npab lossis ceg loog, ua ib qho kev phais me me, thiab ntxig ib lub catheter rau hauv nws.Ib lub raj nyias nyias thiab yoog tau hu ua catheter raug ntxig rau hauv cov hlab ntsha.
2. Tom qab ntawd, thaum saib daim duab X-ray, lub raj xa dej yuav raug coj mus rau qhov chaw tseeb ntawm cov hlab ntsha uas raug thaiv hauv lub plawv.
3. Muaj ib lub npas me me nyob rau ntawm qhov kawg ntawm lub catheter. Thaum nws mus txog qhov txhaws, lub npas yuav nthuav dav. Tom qab ntawd cov plaque nias rau ntawm phab ntsa ntawm cov hlab ntsha, ua rau qhov kev txhaws qhib dua.
4. Tom qab ntawd, kom tsis txhob kaw qhov qhib dua, ib lub raj me me hu ua stent raug muab tso rau hauv qhov chaw ntawd.
Tom qab kho qhov no, koj tus kws kho mob yuav sau ntawv rau koj cov tshuaj tshwj xeeb (kev kho mob ob zaug antiplatelet) kom tiv thaiv cov ntshav txhaws hauv lub stent. Nws yog ib qho tseem ceeb uas koj noj cov tshuaj no rau lub sijhawm teem tseg.
Cov kev kho mob yog dab tsi?
Muaj ob txoj hauv kev tseem ceeb ntawm kev siv stenting los thaiv cov bifurcation.
- Kev Tso Stent Ib Ntus: Hauv txoj kev no, tus kws kho mob tsuas yog muab ib lub stent tso rau hauv cov hlab ntsha loj xwb. Cov ceg me me tsis raug tso. Koj tuaj yeem muab ib lub stent tso rau hauv cov ceg me me tom qab, tsuas yog tias koj muaj cov tsos mob dua.
- Cov Txheej Txheem Ob-Stent: Yog tias qhov kev thaiv yog qhov nyuaj heev, tus kws kho mob yuav txiav txim siab tso stents rau hauv ob qho tib si ntawm cov hlab ntsha tseem ceeb thiab cov ceg me me uas ceg tawm.
Puas muaj teeb meem dab tsi uas yuav tshwm sim tom qab kho mob?
Txawm hais tias angioplasty thiab stenting yog kev kho mob zoo, tab sis cov teeb meem tuaj yeem tshwm sim rau cov neeg tsawg heev .
| Kev nyuaj siab | Ib qho lus piav qhia yooj yim |
|---|---|
| Kev Rov Qab Los Ntawm Sab Hauv Stent | Qhov no txhais tau tias cov nqaij caws pliav tsim nyob rau hauv qab lub stent, ua rau cov hlab ntsha nqaim dua. Qhov no feem ntau tshwm sim hauv 6 lub hlis ntawm kev kho mob. Yog tias qhov no tshwm sim, koj yuav tsum tau muaj lwm txoj kev angioplasty lossis lwm yam kev kho mob. |
| Kev Mob Thrombosis ntawm Stent | Qhov no yog ib qho mob hnyav, tab sis tsis tshua muaj, uas cov ntshav txhaws hauv lub stent thiab ua rau cov hlab ntsha txhaws tam sim ntawd. Yuav kom tiv thaiv qhov no, koj yuav tsum noj tshuaj uas tiv thaiv cov ntshav txhaws kom zoo. |
Tsis tuaj yeem tiv thaiv qhov xwm txheej zoo li no tau?
Yeej muaj peev xwm ua tau li ntawd. Kab mob plawv feem ntau yog txuam nrog peb txoj kev ua neej. Yog li ntawd, kev ua neej kom lub plawv noj qab nyob zoo tuaj yeem txo qhov kev pheej hmoo ntawm kev mob no.
- Noj zaub mov kom zoo rau lub plawv. Txo cov khoom noj uas muaj roj, ntsev, thiab qab zib ntau li ntau tau. Noj txiv hmab txiv ntoo, zaub, taum pauv, ntses me, thiab cov nplej tag nrho rau hauv koj cov zaub mov.
- Yog koj haus luam yeeb, tsum tsis txhob haus hnub no. Kev haus luam yeeb yog ib qho ntawm cov yeeb ncuab loj tshaj plaws ntawm lub siab.
- Ua si nawv tsis tu ncua. Ua ib yam dab tsi xws li taug kev lossis caij tsheb kauj vab tsawg kawg 30 feeb hauv ib hnub.
- Tswj koj qhov hnyav ntawm lub cev. Muaj ib qho hnyav uas haum rau koj qhov siab. Sim tswj nws kom ruaj khov.
- Yog koj muaj ntshav qab zib, ntshav siab, lossis roj cholesterol, tswj lawv los ntawm kev noj cov tshuaj uas koj tus kws kho mob sau ntawv kom noj.
- Txo kev ntxhov siab. Nws zoo heev rau kev koom nrog tej yam xws li yoga thiab kev xav.
- Txwv kev haus cawv.
Thaum twg koj yuav tsum mus ntsib kws kho mob tam sim ntawd?
Nco ntsoov qhov no: Yog tias koj muaj cov tsos mob ntawm kev mob plawv nres, xws li mob hauv siab sai sai, ua tsis taus pa, lossis tawm hws, tsis txhob ncua ib pliag. Hu rau 911 tam sim ntawd lossis coj tus neeg mob mus rau Chav Kho Mob Thaum Muaj Xwm Ceev (ETU) ntawm lub tsev kho mob ze tshaj plaws.
Ntxiv rau, yog tias koj ntsib cov tsos mob hauv qab no tas li, nco ntsoov mus ntsib kws kho mob kom tau txais lus qhia.
- Mob hauv siab (angina), mob caj npab lossis mob xub pwg
- Hnov txias thiab tawm hws
- Ua pa nyuaj
- Qaug zog lossis tsis muaj zog uas tsis paub meej
Cov lus nug uas yuav tsum nug koj tus kws kho mob
Thaum koj paub tias koj muaj tus mob no, nws yog ib qho ib txwm muaj ntau cov lus nug hauv koj lub siab. Tsis txhob zais dab tsi, nug koj tus kws kho mob thiab nrhiav seb puas muaj tseeb.
- Ua cas ua rau kuv xav tias kuv raug daig li no?
- Puas muaj kev pheej hmoo ntawm kev thaiv zoo sib xws hauv kuv lwm cov hlab ntsha?
- Puas yog angioplasty thiab stenting kho tau qhov kev thaiv no tag nrho?
- Koj pom zoo kom kuv siv hom stent twg?
- Kuv yuav tsum tau muab cov stents tso pes tsawg?
- Kuv yuav tsum ua li cas los tiv thaiv kuv lub siab?
- Kuv yuav tsum txhawj txog cov teeb meem dab tsi tom qab kho mob?
Vam tias cov ntaub ntawv no yuav pab koj nkag siab zoo dua txog qhov mob no. Nco ntsoov tias qhov no tsis yog ib yam dab tsi uas yuav tsum ntshai, tab sis yog ib yam dab tsi uas yuav tsum tau tswj kom zoo.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kev thaiv ob sab yog ib hom kev thaiv tshwj xeeb uas tshwm sim qhov twg cov hlab ntsha hauv lub plawv faib ua ceg. Qhov no nyuaj me ntsis dua li kev thaiv ib txwm muaj.
- Cov tsos mob zoo ib yam li cov mob plawv uas feem ntau pom. Mob hauv siab thiab ua tsis taus pa yog cov tsos mob tseem ceeb. Tsis txhob tsis quav ntsej txog cov no.
- Kev tso stent yog ib txoj kev kho mob zoo, tab sis nws xav tau kev pab los ntawm tus kws kho mob uas muaj kev paub dhau los.
- Qhov tseem ceeb tshaj li kev kho mob yog kev hloov koj txoj kev ua neej. Kev noj zaub mov kom zoo, kev tawm dag zog, thiab kev zam kev coj cwj pwm tsis zoo yog qhov tseem ceeb.
- Mob hauv siab hnyav yog qhov xwm txheej ceev. Mus rau chav kho mob ceev (ETU) ntawm tsev kho mob tam sim ntawd.
Kab Mob Plawv, Kev Thaiv Bifurcation, Kab Mob Coronary Artery, Stenting, Angioplasty, Mob Hauv Siab, Mob Plawv Attack
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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