Koj puas tau muab stent tso rau koj tus mob plawv? Tej zaum koj yuav tau xav tias koj zoo siab heev tom qab ua li ntawd. Tej yam xws li mob hauv siab thiab ua tsis taus pa tau ploj mus lawm, thiab tej zaum koj yuav xav tias koj muaj lub neej tshiab. Tab sis, yog tias, tom qab ib pliag, ob peb lub hlis, tus kab mob qub ntawd pib rov tshwm sim dua? Yuav ua li cas yog tias koj lub hauv siab pib mob dua? Yuav ua li cas yog tias koj ua tsis taus pa? Muaj ntau tus neeg txhawj xeeb lub sijhawm no. Lawv xav tias, "Vim li cas qhov no thiaj tshwm sim txawm tias tau muab stent tso rau?" Cov lus teb rau lo lus nug ntawd yog tus mob uas peb tab tom tham txog hnub no, hu ua 'In-Stent Restenosis'.
Hais yooj yim xwb, In-Stent Restenosis yog dab tsi?
Yuav kom nkag siab qhov no, cia peb pib ntawm qhov pib.
Hais yooj yim xwb, 'Stenosis' txhais tau hais tias ib yam dab tsi zoo li peb cov hlab ntsha raug thaiv lossis nqaim. Thaum cov hlab ntsha hauv lub plawv uas muab ntshav mus rau lub plawv raug thaiv vim muaj cov rog ntau (peb hu qhov no ua Atherosclerosis ) peb hu nws ua Coronary Artery Disease (CAD) . Angioplasty yog ib txoj kev kho mob uas cov kws kho mob siv los qhib cov hlab ntsha uas raug thaiv no dua.
Hauv qhov no, ib lub npas me me raug ntxig rau hauv qhov chaw uas raug txhaws thiab ua kom cov hlab ntsha dav dua. Tom qab ntawd, kom tiv thaiv qhov chaw dav dua kom tsis txhob tawg thiab kaw dua, ib lub raj me me zoo li daim ntaub mesh (qhov no yog qhov peb hu ua stent ) raug muab tso rau hauv cov hlab ntsha. Qhov no ua rau cov ntshav rov qab ntws tau.
Zoo, tam sim no koj nkag siab lawm. 'Restenosis' yog ib lo lus uas muaj cov lus 're' (dua) thiab 'stenosis' (blockage). Nws txhais tau tias, rov thaiv dua . Yog li, In-Stent Restenosis yog thaum cov hlab ntsha uas tau muab stent tso rov qab raug thaiv dua, qhov chaw uas stent nyob. Txawm hais tias qhov no ua rau kuv chim siab heev, nws tseem ceeb heev uas yuav tsum paub tias vim li cas qhov no thiaj tshwm sim.
Vim li cas cov hlab ntsha thiaj li raug thaiv dua tom qab muab stent tso rau?
Qhov no tsis yog vim muaj teeb meem nrog lub stent. Nov yog li cas peb lub cev teb. Xav txog thaum koj raug mob ntawm koj lub cev, ib qho caws pliav tshwm sim thaum nws kho, puas yog? Qhov ntawd yog qhov tshwm sim ntawm no.
Ib lub stent yog ib yam dab tsi uas los ntawm sab nraud peb lub cev. Yog li ntawd, lub cev kho nws zoo li 'qhov txhab' thiab sim kho nws. Thaum lub sijhawm no, ib txheej tshiab ntawm cov hlwb loj hlob hla lub stent. Qhov no yog qhov ib txwm muaj. Cov txheej tshiab ntawm cov hlwb no ua rau lub stent yog ib feem ntawm phab ntsa ntawm cov hlab ntsha, ua kom cov ntshav ntws zoo.
Txawm li cas los xij, qee tus neeg lub cev ua rau qhov no ntau dhau. Tom qab ntawd cov txheej ntawm cov hlwb uas tsim los saum lub stent, hu ua cov nqaij caws pliav, yuav tuab dua li qhov xav tau . Ib yam li cov nyom loj hlob hauv cov kav dej thiab txhaws lub qhov hauv cov kav dej, cov nqaij tuab no ua rau txoj kev ntshav nqaim dua. Qhov ntawd yog qhov peb hu ua In-Stent Restenosis.
Qhov tseem ceeb tshaj plaws, qhov mob no feem ntau tshwm sim 3 txog 6 lub hlis tom qab muab stent tso rau.Lub sijhawm no. Tom qab ib xyoos lossis ob xyoos, qhov muaj feem yuav tshwm sim no tsawg heev.
Leej twg muaj feem yuav mob no tshaj?
Txawm hais tias tus mob no tuaj yeem tshwm sim rau txhua tus neeg uas muaj stent, qee tus neeg muaj kev pheej hmoo siab dua. Xyuas seb koj puas muaj cov mob no.
| Qhov ua rau muaj kev pheej hmoo | Kev piav qhia |
|---|---|
| Kab mob ntshav qab zib | Cov neeg uas tsis tswj tau tus kab mob ntshav qab zib zoo yog cov uas muaj feem yuav muaj mob ntau dua. Cov ntshav qab zib ntau dhau tuaj yeem ua rau cov nqaij loj hlob tsis zoo. |
| Kab mob raum | Qhov kev pheej hmoo no kuj tseem siab rau cov neeg uas muaj kab mob raum ntev. |
| Cov roj cholesterol ntau | Rau cov neeg uas muaj cov roj cholesterol ntau hauv cov ntshav. |
| Ntshav siab (Tshuaj ntshav siab) | Kev tsis tswj tau ntshav siab kuj yog ib qho kev pheej hmoo. |
| Haus luam yeeb | Kev haus luam yeeb ua rau muaj kev pheej hmoo ntau ntxiv vim nws ua rau cov hlab ntsha puas tsuaj thiab cuam tshuam rau txoj kev kho mob. |
Muaj ob peb yam ntxiv...
Tsis tas li ntawd xwb, qhov kev pheej hmoo no yuav nce ntxiv yog tias cov hlab ntsha uas raug thaiv me me heev lossis yog tias qhov kev thaiv ntev heev . Tsis tas li ntawd, yog tias cov hlab ntsha raug nthuav dav nrog lub npas tsis muaj stent (Balloon Angioplasty), qhov kev pheej hmoo ntawm kev rov thaiv dua yuav siab dua.
Cov tsos mob ntawm qhov no yog dab tsi?
Ib qho teeb meem loj tshaj plaws ntawm no yog tias feem ntau cov neeg uas muaj In-Stent Restenosis tsis muaj tsos mob dab tsi . Tej zaum koj yuav tsis hnov dab tsi txog thaum cov hlab ntsha nqaim heev. Yog vim li ntawd nws thiaj li tseem ceeb uas yuav tsum mus kuaj xyuas tsis tu ncua raws li koj tus kws kho mob hais tom qab muaj stent.
Txawm li cas los xij, qee tus neeg muaj cov tsos mob uas zoo ib yam li cov tsos mob ntawm tus kab mob plawv (CAD) uas koj muaj ua ntej koj muaj stent.
- Mob hauv siab los yog tsis xis nyob (Angina): Ib qho kev xav tias lub hauv siab nruj los yog nqaim. Qhov no yuav hnyav dua thaum koj ua si nawv los yog nce ntaiv.
- Ua tsis taus pa: Ua pa nyuaj txawm tias siv zog me ntsis los xij.
- Xav tias nkees heev: Xav tias nkees heev uas koj ua tsis tau tej yam uas koj tau ua yooj yim yav dhau los.
- Mob xub pwg lossis mob caj npab: Mob hauv siab nrog rau qhov mob kis mus rau sab laug xub pwg lossis caj npab.
- Tej zaum yuav muaj cov tsos mob xws li kiv taub hau, tawm hws, thiab xeev siab .
Qhov tseem ceeb tshaj plaws: Yog tias koj rov qab muaj cov tsos mob no dua tom qab muaj stent, tsis txhob hnov qab tias nws yuav yog lwm yam . Qhia rau koj tus kws kho mob tam sim ntawd.
Kuv yuav ua li cas thiaj paub tias qhov no muaj?
Thaum koj qhia peb txog koj cov tsos mob, tus kws kho mob yuav qhia ntau yam kev kuaj mob kom paub meej.
- Kev Ntsuas Kev Nyuaj Siab Thaum Ua Si (Kev Ntsuas Treadmill): Koj raug ua kom taug kev lossis khiav ntawm lub treadmill thiab ECG siv los saib xyuas seb koj lub plawv ua haujlwm li cas thaum koj ntxhov siab.
- Kev Siv Tshuaj Rau Lub Plawv (Angiogram): Qhov no yog qhov kev kuaj mob uas paub tseeb tshaj plaws. Ib yam li kev muab stent tso rau, ib lub raj me me raug xa mus rau hauv lub plawv los ntawm cov hlab ntsha, ib qho xim tshwj xeeb raug txhaj rau hauv, thiab ib daim duab X-ray raug thaij los saib seb puas muaj qhov thaiv hauv lub stent.
- Lwm yam kev kuaj: Qee zaum, cov txheej txheem scanning xws li Intravascular Ultrasound (IVUS) tuaj yeem siv los saib sab hauv cov hlab ntsha thiab ntsuas qhov dav ntawm qhov kev thaiv kom raug.
Yuav kho li cas?
Tus kws kho mob yuav txiav txim siab seb yuav kho qhov twg zoo tshaj plaws raws li qhov kev txhaws thiab koj tus mob.
| Txoj kev kho mob | Dab tsi tab tom ua |
|---|---|
| Cov tshuaj | Tej zaum koj yuav tau hloov qhov ntau npaum li cas ntawm koj cov tshuaj tam sim no lossis ntxiv cov tshuaj tshiab. |
| Rov ua dua Angioplasty | Qhov no yog kev kho mob uas siv ntau tshaj plaws. Muab lub balloon ntxiv rau hauv lub stent uas raug thaiv kom nws dav dua, thiab qee zaum muab lwm lub stent tso rau hauv. |
| Kev phais plawv bypass (CABG) | Yog tias qhov kev txhaws hnyav heev lossis muaj teeb meem nrog ntau cov hlab ntsha, koj yuav raug xa mus rau kev phais Coronary Artery Bypass Grafting (CABG). Qhov no suav nrog kev hla qhov chaw uas raug txhaws thiab tsim ib txoj hlab ntsha tshiab siv cov hlab ntsha coj los ntawm lwm thaj chaw. |
| Kev Kho Mob Hluav Taws Xob (Kev Kho Mob Hluav Taws Xob Rau Cov Hlab Ntsws) | Qhov no yog ib qho kev kho mob uas tsis tshua muaj. Hauv qhov no, yuav muab ib qho me me ntawm cov hluav taws xob rau hauv lub stent kom tiv thaiv kev tsim cov nqaij caws pliav. |
Puas tsis muaj txoj hauv kev los tiv thaiv qhov no?
Nov yog cov xov xwm zoo tshaj plaws. Yog lawm, qhov no feem ntau tiv thaiv tau.
Qhov laj thawj rau qhov no yog ib hom stent tshiab hu ua Drug-Eluting Stents (DES) . Cov no tsis yog tsuas yog cov hlau mesh xwb. Cov stents no muaj cov tshuaj tshwj xeeb uas tswj kev tsim cov nqaij caws pliav uas peb tau tham txog. Tom qab muab lub stent ntxig rau hauv lub cev, cov tshuaj no maj mam tso tawm, tiv thaiv cov cell kom tsis txhob loj hlob yam tsis tsim nyog.
Piv rau cov stents hlau qub, qhov kev pheej hmoo ntawm kev rov qab stenosis hauv-stent yog qis heev thaum siv cov stents no. Txawm tias nyob hauv Sri Lanka niaj hnub no, hom stent tshiab no feem ntau siv.
Txawm li cas los xij, muaj qee yam uas koj yuav tsum ua rau koj tus kheej.
- Noj koj cov tshuaj raws li tau qhia: Noj cov tshuaj uas koj tus kws kho mob tau qhia, tshwj xeeb tshaj yog cov uas tiv thaiv cov ntshav txhaws (piv txwv li, Aspirin, Clopidogrel), raws nraim li tau qhia, tsis txhob ncua ib hnub.
- Hloov koj txoj kev ua neej: Yog tias koj haus luam yeeb, tsum tam sim ntawd.Tswj koj cov roj cholesterol, ntshav qab zib, thiab ntshav siab. Noj zaub mov zoo uas tsis muaj roj, ntsev, thiab qab zib ntau, thiab muaj txiv hmab txiv ntoo thiab zaub ntau. Ua si nawv raws li koj tus kws kho mob qhia.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kev Rov Qis Dua Hauv Stent yog qhov uas cov hlab ntsha rov qab nqaim dua tom qab muab stent tso rau vim yog cov nqaij caws pliav loj hlob. Qhov no feem ntau tshwm sim hauv 3-6 lub hlis ntawm kev kho mob.
- Yog tias koj muaj cov tsos mob zoo ib yam li yav dhau los, xws li mob hauv siab lossis ua tsis taus pa , tom qab muaj stent, tsis txhob tsis quav ntsej. Mus ntsib koj tus kws kho mob tam sim ntawd.
- Feem ntau, tus mob no yuav tsis ua rau muaj tsos mob dab tsi . Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum nrhiav kev kho mob thaum lub sijhawm tsim nyog, raws li koj tus kws kho mob pom zoo.
- Qhov kev pheej hmoo ntawm tus mob no tau raug txo qis heev vim yog kev siv cov tshuaj Drug-Eluting Stents (DES) tam sim no.
- Qhov tseem ceeb tshaj plaws uas koj ua tau ntawm koj ib feem yog noj koj cov tshuaj raws li tau qhia, tsis txhob haus luam yeeb, thiab ua kom koj lub neej noj qab nyob zoo . Cov no tuaj yeem tiv thaiv koj lub plawv mus ntev.
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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