Koj puas tau hnov txog mob stroke? Nws yog ib qho mob hnyav uas ua rau ntau tus neeg ntshai thiab hloov lawv lub neej. Yog li ntawd, qhov laj thawj tseem ceeb rau mob stroke no yog kev thaiv cov hlab ntsha tseem ceeb uas nqa oxygen thiab cov as-ham mus rau peb lub hlwb. Nws zoo li lub yeeb nkab tseem ceeb uas nqa dej mus rau lub vaj. Hnub no peb yuav tham txog ib txoj kev kho mob tseem ceeb heev uas rov qhib cov hlab ntsha uas raug thaiv, ua rau cov ntshav ntws mus rau lub hlwb zoo, thiab txo qhov kev pheej hmoo ntawm mob stroke.
Hauv lwm lo lus, Carotid Artery Stenting yog dab tsi?
Xav txog tias peb muaj ob lub "arteries" tseem ceeb nyob rau ob sab ntawm peb lub caj dab uas muab ntshav rau peb lub hlwb, lub ntsej muag, thiab caj dab. Cov no yog yam uas peb hu ua Carotid Arteries . Raws li kev kho mob, cov rog, tshwj xeeb tshaj yog cholesterol (uas cov kws kho mob hu ua 'plaque'), pib sib sau ua ke ntawm phab ntsa ntawm cov hlab ntsha no. Nws zoo li xeb sib sau ua ke hauv cov yeeb nkab dej. Maj mam, cov khoom no sib sau ua ke thiab cov hlab ntsha nqaim, qee zaum thaiv nws tag nrho. Qhov mob no hu ua Carotid Artery Stenosis .
Qhov no yog qhov uas ib lub raj hlau me me, zoo li daim ntaub mesh raug ntxig rau hauv qhov chaw uas raug thaiv thiab cov hlab ntsha uas nqaim lawm raug nthuav dav dua. Qhov no yog qhov peb hu ua carotid artery stent .
Lub stent no zoo li ib lub choj ruaj khov. Nws raug muab tso rau hauv cov hlab ntsha tas mus li, thiab nws qhib yam tsis rov qab ntsws dua. Ob peb lub lis piam, cov phab ntsa ntawm cov hlab ntsha kho tau zoo nyob ib puag ncig lub stent no, thiab nws dhau los ua ib feem ntawm lub cev.
Kev kho mob no yog ua los ntawm cov kws tshwj xeeb uas tau kawm tshwj xeeb, xws li tus kws kho mob plawv Interventional, kws phais mob hlab ntsha, lossis kws phais mob Endovascular Neurosurgeon.
Leej twg xav tau kev kho mob no tiag?
Ua ntej koj tus kws kho mob pom zoo kom siv txoj kev kho mob no, feem ntau lawv yuav ua qhov kev kuaj ultrasound, CT scan, lossis MRI scan ntawm koj cov hlab ntsha caj dab kom pom tias lawv raug thaiv npaum li cas. Kev kho mob no feem ntau xav tau rau cov neeg uas:
- Cov neeg uas tau pom cov tsos mob ntawm tus mob stroke lossis ministroke thiab lawv cov hlab ntsha carotid tau raug kuaj xyuas tias raug thaiv ntau dua 50% .
- Rau cov neeg uas tsis muaj tsos mob, tab sis lawv cov hlab ntsha carotid raug thaiv ntau dua 70% thaum lub sijhawm luam theej duab.
Kuv yuav tsum npaj li cas ua ntej kho mob?
Txawm hais tias qhov no tsis loj npaum li kev phais, nws yuav tsum tau npaj me ntsis. Koj tus kws kho mob yuav hais li no:
- Cov Tshuaj Tiv Thaiv Kev Ntshav Ntshav: Tej zaum koj yuav raug hais kom pib noj tshuaj aspirin thiab lwm yam tshuaj zoo sib xws (piv txwv li, Clopidogrel, Ticagrelor) peb txog tsib hnub ua ntej koj txoj kev kho mob. Nws yog ib qho tseem ceeb uas yuav tsum noj cov tshuaj no raws nraim li koj tus kws kho mob qhia rau koj, raws li tau sau tseg. Yog tsis ua li ntawd yuav ua rau koj txoj kev kho mob qeeb.
- Khoom Noj thiab Dej Haus: Koj yuav raug hais kom yoo mov ob peb teev ua ntej kev kho mob. Koj tus kws kho mob yuav muab cov lus qhia tshwj xeeb rau koj txog qhov no thiab.
Muaj dab tsi tshwm sim thaum lub sijhawm kho mob?
Muaj ob txoj hauv kev tseem ceeb los ntxig lub stent rau hauv cov hlab ntsha hauv koj lub caj dab. Koj tus kws kho mob yuav txiav txim siab seb txoj kev twg zoo tshaj plaws rau koj.
| Hom txheej txheem | Qhov chaw ntxig rau ntawm lub stent (Access Point) |
|---|---|
| Txoj kev Transfemoral lossis Transradial | Ib lub raj me me (catheter) raug ntxig los ntawm ib txoj hlab ntsha hauv qhov chaw mos ntawm ceg lossis dab teg , thiab lub stent raug coj los ntawm nws mus rau ntawm cov hlab ntsha jugular. |
| Kev Kho Dua Tshiab ntawm Cov Ntshav Qab Zib Transcarotid (TCAR) | Hauv txoj kev no, ib qho kev phais me me yog ua rau hauv caj dab, nyob rau saum lub pob txha caj dab, thiab lub stent raug ntxig ncaj qha rau hauv cov hlab ntsha carotid. |
Thaum lub sijhawm kho mob no, koj yuav tau txais tshuaj xws li heparin los tiv thaiv cov ntshav txhaws. Feem ntau, tag nrho cov txheej txheem yuav siv sijhawm ib lossis ob teev. Txawm li cas los xij, koj yuav tsum nyob hauv tsev kho mob ib hnub, suav nrog lub sijhawm npaj thiab kev soj ntsuam tom qab.
Tom qab kho mob tas lawm, muaj dab tsi tshwm sim?
Tom qab muab lub stent tso rau hauv lub plawv lawm, pab neeg kho mob yuav ua cov hauv qab no:
- Yuav ua ib qho kev kuaj xws li angiogram kom pom seb lub stent puas dav txaus thiab seb cov ntshav ntws zoo.
- Tag nrho cov catheter raug tshem tawm. Lub stent yuav nyob hauv qhov chaw tas mus li.
- Koj yuav tau txais cov tshuaj tsim nyog los txo qhov tsis xis nyob uas koj hnov.
- Cov txiaj ntsig ntawm kev kho mob yuav raug piav qhia rau koj thiab koj tsev neeg.
- Tom qab koj mus tsev lawm, lawv yuav qhia koj txog kev noj tshuaj, yuav noj dab tsi, thiab yuav ua li cas tawm dag zog. Qhov tseem ceeb, lawv yuav qhia koj kom txuas ntxiv noj tshuaj aspirin thiab lwm yam tshuaj uas ua rau cov ntshav nyias.
Tseem ceeb heev: Tsis txhob tsum noj cov tshuaj uas koj tus kws kho mob tau sau tseg, tshwj xeeb tshaj yog cov uas tiv thaiv cov ntshav txhaws, txawm yog vim li cas los xij, yam tsis tau nrog nws tham. Feem ntau cov no yuav tsum tau noj tsawg kawg yog ib hlis, thiab feem ntau yog 6 lub hlis lossis ntau dua.
Cov txiaj ntsig thiab kev pheej hmoo ntawm kev kho mob no yog dab tsi?
Muaj ntau qhov zoo ntawm stenting piv rau cov carotid endarterectomy ib txwm muaj.
Cov txiaj ntsig tseem ceeb
- Tsis tas yuav phais loj: Qhov no yog ib txoj kev uas muaj kev cuam tshuam tsawg dua rau lub cev.
- Kev phais me me los yog tsis muaj kev phais: Hauv qee txoj kev, tsuas muaj ib qho chaw tho qhov xwb.
- Txo qhov kev pheej hmoo ntawm kev puas tsuaj rau cov hlab ntsha hauv caj dab.
- Txo qhov mob tom qab kho mob.
Tej Yam Yuav Ua Tau (Teeb Meem)
Ib yam li txhua yam kev kho mob, muaj qee qhov kev pheej hmoo. Tab sis cov no tsis tshwm sim rau txhua tus.
- Ntshav siab txo qis ('Hypotension') los yog nce ('Hypertension').
- Lub plawv dhia qeeb (Bradycardia).
- Los ntshav ntawm qhov chaw uas tau ntxig lub raj.
- Ntshav txhaws.
- Mob stroke: Muaj ib qho kev pheej hmoo me me ntawm mob stroke los ntawm cov ntshav me me uas mus rau lub hlwb thaum lub sijhawm lossis tom qab kev kho mob.
- Ntshav ntws mus rau hauv lub hlwb.
Qhov kev pheej hmoo no yuav txawv nyob ntawm koj lub hnub nyoog, seb koj puas muaj lwm yam mob, thiab qhov loj ntawm qhov txhaws hauv cov hlab ntsha. Yog li, qhib siab txog qhov no nrog koj tus kws kho mob thiab nug txhua yam koj muaj.
Koj yuav tsum ua li cas thiaj li tau txais cov txiaj ntsig zoo tshaj plaws?
Tus mob uas ua rau cov hlab ntsha txhaws (atherosclerosis) tom qab muab stent tso rau hauv yuav tsis kho tau tag nrho. Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum hloov koj txoj kev ua neej kom tiv thaiv cov teeb meem zoo sib xws kom tsis txhob tshwm sim yav tom ntej.
- Tsis txhob haus luam yeeb kiag li: Tsis yog tsuas yog luam yeeb, bidis, thiab cigars xwb, tab sis txawm tias 'vaping' yuav tsum raug tso tseg.
- Noj koj cov tshuaj kom raug: Noj cov tshuaj uas koj tus kws kho mob tau sau tseg rau lub sijhawm raug thiab noj kom raug.
- Tswj koj qhov hnyav kom noj qab nyob zoo.
- Kev tawm dag zog tsis tu ncua: Txawm tias taug kev li 30 feeb hauv ib hnub los kuj zoo.
- Ua raws li kev noj zaub mov zoo rau lub plawv: noj roj, ntsev, thiab qab zib tsawg dua, thiab noj txiv hmab txiv ntoo thiab zaub ntau dua.
- Tswj lwm yam kab mob:Yog koj muaj ntshav qab zib, ntshav siab, lossis roj cholesterol, tswj kom zoo (piv txwv li, tswj ntshav siab kom qis dua 130, LDL roj cholesterol qis dua 70, thiab HbA1c qis dua 7).
- Mus kuaj mob tom qab: Nco ntsoov mus ntsib kws kho mob rau hnub uas nws hais kom koj tuaj kuaj xyuas seb lub stent puas zoo.
Lub sijhawm rov zoo yog dab tsi thiab kuv yuav tsum hu rau kws kho mob thaum twg?
Koj yuav tsum tau so me ntsis rau thawj lub lim tiam tom qab mus tsev.
- Tsis txhob tsa cov khoom hnyav (ntau tshaj 10 kg).
- Tsis txhob muab qhov chaw ntxig rau hauv dej (piv txwv li, da dej, ua luam dej) rau ib lub lim tiam. Kev da dej tsis yog teeb meem.
- Yog koj nce ntaiv, nce qeeb me ntsis.
Cov xwm txheej uas xav tau kev saib xyuas tam sim ntawd:
Yog tias koj muaj cov tsos mob ntawm kev tuag tes tuag taw uas koj muaj ua ntej kev kho mob (xws li poob ntawm ib sab ntawm koj lub ntsej muag, nyuaj hais lus, lossis tsis muaj kev xav hauv caj npab lossis ceg), mus rau chav kho mob ceev (ETU) ntawm tsev kho mob tam sim ntawd yam tsis muaj kev ncua.
Tsis tas li ntawd, yog tias qhov chaw ntawm lub raj txuas ntxiv los ntshav, o, lossis muaj kua qaub, hu rau koj tus kws kho mob tam sim ntawd.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Carotid stenting yog ib txoj kev kho mob zoo heev rau kev tshem tawm cov kev thaiv hauv cov hlab ntsha hauv caj dab uas muab ntshav mus rau lub hlwb thiab txo qhov kev pheej hmoo ntawm kev mob stroke.
- Qhov no muaj kev cuam tshuam tsawg dua rau lub cev dua li kev phais mob ib txwm muaj, tab sis tseem muaj qee qhov kev pheej hmoo.
- Qhov kev kho mob zoo tsis yog nyob ntawm seb koj muab lub stent tso rau qhov twg xwb, tab sis kuj nyob ntawm seb koj hloov koj txoj kev ua neej thiab noj koj cov tshuaj kom raug li cas .
- Nws yog ib qho tseem ceeb heev uas yuav tsum paub txog cov cim ceeb toom ntawm tus mob stroke thiab ua ib yam dab tsi sai li sai tau thaum koj pom cov tsos mob zoo li no.
- Yog koj muaj lus nug, kev ntshai, lossis kev tsis ntseeg txog kev kho mob no, nrog koj tus kws kho mob tham.
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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