Koj puas muaj tej lub sij hawm koj hnov mob lossis mob hauv koj lub hauv siab thaum koj qaug zog me ntsis, lossis thaum koj nce ntaiv? Los yog koj puas ua pa nyuaj? Tej no yuav yog qaug zog ib txwm muaj, tab sis tej lub sij hawm lawv tuaj yeem yog teeb meem nrog cov leeg ntshav uas nqa ntshav mus rau peb lub plawv. Hnub no peb yuav tham txog ib qho mob uas loj me ntsis, tab sis nws yog ib qho tseem ceeb heev uas yuav tsum paub txog. Qhov ntawd yog ib qho mob hu ua CTO, lossis Chronic Total Occlusion.
Hais yooj yim xwb, CTO (Chronic Total Occlusion) yog dab tsi?
Xav txog koj muaj ib lub yeeb nkab loj uas coj dej los rau hauv koj lub tsev. Raws li lub sijhawm dhau mus, lub yeeb nkab no yuav txhaws nrog xeb thiab av, thiab thaum kawg yuav txhaws tag, txawm tias ib tee dej los tsis ntws los xij.
Tib yam no tshwm sim hauv peb lub plawv. Peb muaj cov hlab ntsha (peb hu cov hlab ntsha no ua cov hlab ntsha hauv lub plawv) uas muab cov ntshav huv rau peb lub plawv. Yog tias cov khoom xws li roj thiab cov roj cholesterol tau tso rau hauv cov hlab ntsha no ib ntus, thiab cov hlab ntsha raug thaiv tag nrho (100%), txhais tau tias yog qhov kev thaiv no tseem nyob ntev tshaj peb lub hlis , peb hu qhov mob ntawd ua Chronic Total Occlusion (CTO) .
Thaum cov hlab ntsha raug thaiv tag li no, qhov ntawm lub plawv uas raug cuam tshuam yuav tsis tau txais cov pa oxygen thiab cov as-ham uas nws xav tau. Qhov no tuaj yeem ua rau muaj cov tsos mob xws li mob hauv siab thiab ua pa nyuaj. Qee zaum, qhov no tuaj yeem hnyav heev, txawm tias ua rau mob plawv nres.
Leej twg muaj feem yuav mob CTO no tshaj?
Feem ntau pom muaj CTO rau cov neeg uas muaj kab mob plawv, tshwj xeeb yog kab mob plawv coronary artery (CAD). Kwv yees li ntawm ib ntawm peb tus neeg uas muaj CAD kuj muaj CTO.
Cov yam uas ua rau muaj kab mob plawv kuj ua rau muaj CTO thiab. Saib seb koj puas muaj cov no thiab.
| Qhov ua rau muaj kev pheej hmoo | Piav qhia yooj yim |
|---|---|
| Haus luam yeeb | Qhov no yog tus yeeb ncuab tseem ceeb. Kev haus luam yeeb ua rau cov hlab ntsha puas tsuaj thiab ua rau cov pob zeb hauv lawv sai dua. |
| Ntshav siab (Tshuaj ntshav siab) | Thaum lub siab nce ntxiv, cov phab ntsa ntawm cov hlab ntsha yuav puas tsuaj thiab qhov muaj feem yuav muaj cov roj cholesterol ntau ntxiv. |
| Cov roj cholesterol ntau (Hyperlipidemia) | Thaum cov roj cholesterol phem (LDL) hauv cov ntshav nce ntxiv, nws pib tso ncaj qha rau ntawm phab ntsa ntawm cov hlab ntsha. |
| Kab mob ntshav qab zib | Yog tias cov piam thaj tsis raug tswj, nws yuav ua rau cov hlab ntsha puas tsuaj thiab ua rau cov pob zeb no ntau ntxiv. |
| Kev rog dhau | Qhov hnyav ntawm lub cev muaj feem cuam tshuam nrog kab mob plawv. Yog tias BMI ntau dua 30 ces muaj feem yuav mob ntau dua. |
| Keeb kwm tsev neeg ntawm tus kab mob plawv | Yog koj niam, txiv, lossis cov kwv tij neej tsa muaj kab mob plawv, koj kuj yuav muaj feem yuav muaj kab mob no thiab. |
| Tsis muaj kev tawm dag zog | Tsis ua kom koj lub cev nquag ua haujlwm zoo li ua rau muaj kab mob plawv. |
| Kev phais plawv lossis bypass yav dhau los | Yog tias koj tau muaj mob plawv lossis phais bypass yav dhau los, koj muaj feem yuav tsim CTO hauv lwm cov hlab ntsha. |
Qhov tseem ceeb tshaj plaws yog tias qhov kev pheej hmoo ntawm kev mob CTO nce ntxiv thaum peb laus zuj zus. Yog li ntawd, thaum peb laus zuj zus, peb yuav tsum tau saib xyuas peb lub siab ntau dua.
Cov tsos mob ntawm CTO yog dab tsi?
Cov tsos mob ntawm CTO yuav txawv ntawm ib tus neeg mus rau ib tus neeg. Tej zaum ib txhia neeg yuav tsis muaj tsos mob li. Txawm li cas los xij, cov tsos mob feem ntau yog:
- Mob hauv siab, nruj, lossis muaj kev nyuaj siab: Tej zaum yuav zoo li muaj ib tug neeg tab tom zawm koj lub hauv siab.
- Ua pa nyuaj (Dyspnea):Thaum koj siv zog ua pa, xws li thaum taug kev luv luv lossis nce ntaiv.
- Qaug zog heev: Xav tias nkees txhua lub sijhawm, txawm tias tsis tau ua haujlwm dab tsi los xij.
- Hnov kiv taub hau.
- Lub plawv dhia tsis xwm yeem.
- Xeev siab.
- Mob sab caj npab sab saud: tshwj xeeb tshaj yog sab caj npab sab laug.
Qhov tseem ceeb yog tias cov tsos mob no feem ntau tshwm sim thaum koj nkees. Lawv ploj mus thaum koj so. Txawm li cas los xij, qee zaum cov tsos mob no tuaj yeem tshwm sim txawm tias koj tsis nkees kiag li.
Tus kws kho mob nrhiav tau qhov no li cas?
Yog koj muaj cov tsos mob no, koj yuav tsum mus ntsib kws kho mob. Nws yuav kuaj koj thiab, yog tias tsim nyog, xa koj mus kuaj ntau zaus.
Qhov kev kuaj tseem ceeb kom paub tseeb tias koj puas muaj CTO yog kev kuaj lub plawv (coronary angiogram ). Hauv qhov no, ib lub raj nyias nyias raug xa mus rau hauv cov hlab ntsha hauv koj txhais caj npab lossis ceg mus rau cov hlab ntsha ntawm lub plawv, thiab cov kua tshwj xeeb (contrast dye) raug txhaj tshuaj. Tom qab ntawd, kev thaij duab X-ray raug coj los saib seb cov kua no ntws li cas los ntawm cov hlab ntsha ntawm lub plawv. Yog tias muaj kev txhaws hauv cov hlab ntsha, cov kua no yuav pom tseeb vim tias nws yuav tsis ntws ntxiv lawm.
Ntxiv rau qhov ntawd, tus kws kho mob yuav pom zoo kom ua lwm yam kev kuaj xws li:
- ECG (Electrocardiogram): Saib qhov ua haujlwm hluav taws xob ntawm lub plawv.
- Echocardiogram (Echo): Ib qho kev ntsuas los saib lub plawv ua haujlwm thiab cov ntshav ntws.
- Kev Ntsuas Kev Nyuaj Siab: Saib seb koj lub plawv teb li cas thaum koj siv zog me ntsis (xws li khiav ntawm lub treadmill).
- MRI ntawm lub plawv: Tau txais daim duab meej dua ntawm lub plawv cov qauv thiab cov ntshav ntws.
Cov kev kho mob rau CTO yog dab tsi?
Yog tias koj raug kuaj pom tias muaj CTO, tsis txhob ntshai. Tam sim no muaj ntau txoj kev kho mob zoo rau qhov no. Txoj kev npaj kho mob yuav nyob ntawm seb koj cov tsos mob hnyav npaum li cas, qhov chaw ntawm cov leeg ntshav uas raug thaiv, thiab koj txoj kev noj qab haus huv tag nrho. Muaj ob hom kev kho mob tseem ceeb.
1. Kev Kho Mob Plawv Los Ntawm Txoj Hlab Ntsws (PCI)
Qhov no yog txoj kev kho mob uas siv ntau tshaj plaws, tsis tas phais. Nws ua tib yam li kev kuaj angiogram.
- Ib lub raj nyias heev (catheter) raug xa mus rau hauv cov hlab ntsha hauv caj npab lossis ceg mus rau lub plawv qhov chaw uas cov hlab ntsha raug thaiv.
- Muab ib lub npas me me tso rau hauv lub raj ntawd thiab muab cua rau ntawm qhov chaw uas raug txhaws. Cov roj uas tau sib sau ua ke hauv cov leeg ntshav ces raug nias rau ntawm ob sab, ua rau cov leeg ntshav qhib.
- Tom qab ntawd, muab ib lub raj me me hu ua stent tso rau saum qhov qhib. Lub stent pab kom cov hlab ntsha qhib thiab tiv thaiv nws kom tsis txhob raug thaiv dua.
Cov kev tshawb fawb tau qhia tias txoj kev no ua tiav rau kwv yees li 86% ntawm cov neeg mob.
2. Kev phais plawv (CABG)
Qhov no yog kev phais plawv qhib. Tsuas yog pom zoo kom ua yog tias muaj ntau txoj hlab ntsha raug thaiv, lossis yog tias qhov kev thaiv ntawd nyuaj dhau uas yuav siv PCI qhib tau.
Hais yooj yim xwb, qhov no yuav tsum tsim ib txoj kev "bypass" rau cov leeg ntshav uas raug txhaws. Uas yog, muab ib daim leeg ntshav los ntawm lwm qhov ntawm koj lub cev (feem ntau yog los ntawm koj lub hauv siab lossis ceg) thiab tsim ib txoj kev tshiab rau cov ntshav ntws ncig qhov uas raug txhaws.
Qhov kev phais mob no ua rau muaj txiaj ntsig zoo rau kwv yees li 60% ntawm cov neeg mob.
Koj tus kws kho mob plawv yuav piav qhia rau koj kom meej seb txoj kev kho mob twg zoo tshaj plaws rau koj.
Cov lus nug uas yuav tsum nug koj tus kws kho mob
Yog koj kuaj pom tias koj muaj CTO, nws yog ib qho ib txwm muaj ntau cov lus nug hauv koj lub siab. Tsis txhob ntshai lossis tsis txhob yig nug cov lus nug no rau koj tus kws kho mob.
- "Kws kho mob, cov tsos mob thaum ntxov ntawm tus CTO no yog dab tsi?"
- Kuv yuav tsum tau kuaj dab tsi los xyuas qhov no?
- Kuv yuav tsum hloov dab tsi hauv kuv txoj kev ua neej kom tiv thaiv qhov mob no kom tsis txhob tshwm sim?
- Kuv muaj cov kev kho mob twg? Yam twg zoo tshaj plaws rau kuv?
- Tom qab kho mob tas, muaj feem yuav muaj tus mob no dua li cas?
Cov Lus Qhia Txog Kev Coj Mus Tsev
- CTO (Chronic Total Occlusion) yog ib qho mob hnyav uas cov hlab ntsha uas muab ntshav mus rau lub plawv raug thaiv tag nrho (100%) rau ntau tshaj 3 lub hlis.
- Qhov laj thawj tseem ceeb rau qhov no yog qhov kev tso cov tshuaj xws li cov roj cholesterol thiab roj rau ntawm phab ntsa ntawm cov hlab ntsha.
- Haus luam yeeb, ntshav siab, ntshav qab zib, thiab roj cholesterol ntau yog cov yam tseem ceeb uas ua rau muaj kev pheej hmoo. Nws yog ib qho tseem ceeb heev uas yuav tsum tswj cov no.
- Yog koj muaj cov tsos mob xws li mob hauv siab, ua pa nyuaj, lossis qaug zog heev , tsis txhob tsis quav ntsej thiab nrhiav kev kho mob tam sim ntawd.
- Tsis txhob txhawj, tam sim no muaj kev kho mob zoo heev xws li PCI (stent placement) thiab CABG (bypass surgery).
- Kev ua neej noj qab haus huv (kev noj zaub mov zoo, kev tawm dag zog) thiab kev noj tshuaj uas koj tus kws kho mob tau sau tseg yuav pab tau koj tswj tau qhov teeb meem no.
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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