Koj puas muaj ib txoj hlab ntsha hauv koj lub caj dab uas raug txhaws? Cia peb kawm txog Carotid Artery Stenting, uas tiv thaiv kev mob stroke.

Koj tus kws kho mob puas tau hais rau koj tias cov hlab ntsha loj hauv koj lub caj dab raug thaiv thiab koj muaj feem yuav mob stroke? Nws yog ib qho ib txwm muaj uas yuav ntshai me ntsis thaum koj hnov ​​​​​​ib yam dab tsi zoo li no. Tab sis tsis txhob txhawj. Niaj hnub no, kev kho mob tau nce qib heev. Muaj kev kho mob zoo heev los kho cov kev thaiv no thiab txo qhov kev pheej hmoo ntawm mob stroke. Niaj hnub no peb tab tom tham txog ib qho kev kho mob zoo heev thiab tsis nyuaj heev: qhov chaw ntawm carotid stent.

Hauv lwm lo lus, carotid stenting yog dab tsi?

Zoo, cia peb pib los ntawm kev piav qhia yooj yim. Peb muaj ob txoj hlab ntsha tseem ceeb ntawm ob sab ntawm peb lub caj dab uas muab ntshav rau peb lub hlwb, lub ntsej muag, thiab caj dab. Cov no yog yam peb hu ua Carotid Arteries . Raws li lub sijhawm dhau mus, cov khoom xws li cov rog thiab cov roj cholesterol los ntawm cov khoom noj uas peb noj pib sib sau ua ke ntawm phab ntsa ntawm cov hlab ntsha no. Peb hu qhov no ua 'plaque' . Nws zoo li xeb sib sau ua ke hauv cov kav dej.

Cov plaque no sib sau ua ke thiab ua rau txoj kev hla hauv cov hlab ntsha nqaim, qee zaum thaiv nws tag nrho. Qhov mob no hu ua carotid artery stenosis . Thaum qhov no tshwm sim, cov ntshav ntws mus rau lub hlwb raug txo qis, uas yog ib qho ua rau mob stroke.

Yog li, carotid stenting yog ib txoj kev kho mob uas qhib cov hlab ntsha uas raug thaiv. Ntawm no, tus kws kho mob muab ib lub stent , ib lub raj hlau me me zoo li lub mesh, ntxig rau hauv thaj chaw uas raug thaiv thiab ua kom nws nthuav los ntawm sab hauv. Cov hlab ntsha uas raug thaiv ces rov qhib dua, rov qab tau cov ntshav ntws. Lub stent no raug muab tso rau hauv cov hlab ntsha tas mus li. Nws zoo li ib lub prop tiv thaiv phab ntsa uas yuav vau, pab cov hlab ntsha kom tsis txhob nqaim dua.

Leej twg xav tau kev kho mob no?

Feem ntau tus kws kho mob yuav pom zoo kom kho qhov no tom qab kuaj xyuas koj cov hlab ntsha carotid seb puas muaj kev thaiv. Qhov no yuav suav nrog kev kuaj xws li carotid ultrasound , CT scan , lossis MRI . Kev kho no feem ntau xav tau rau:

• Rau cov neeg uas tau muaj cov tsos mob ntawm tus mob stroke me me lossis mob stroke thiab uas cov hlab ntsha raug thaiv ntau dua 50%.
• Rau cov neeg uas tsis muaj tsos mob tab sis lawv cov hlab ntsha raug thaiv ntau dua 70%.

Koj tus kws kho mob yuav txiav txim siab seb qhov kev kho mob no puas tsim nyog rau koj tus mob, lossis seb puas yog phais lwm yam (Carotid Endarterectomy) puas tsim nyog.

Npaj thiab ua qhov kev kho mob

Koj tus kws kho mob yuav pib noj qee cov tshuaj uas ua rau cov ntshav nyias nyias rau koj ob peb hnub ua ntej koj txoj kev kho mob, xws li aspirin thiab clopidogrel .

Kev kho mob ua li cas?

Qhov no yog ua los ntawm ib tug kws kho mob tshwj xeeb uas tau txais kev cob qhia tshwj xeeb rau lub hom phiaj no. Koj yuav tau txais tshuaj kom tsis txhob mob thaum lub sijhawm kho mob. Muaj ntau txoj hauv kev tseem ceeb rau kev ntxig lub stent.

Koj tus kws kho mob yuav txiav txim siab seb txoj kev twg zoo tshaj plaws rau koj. Tag nrho cov txheej txheem yuav siv sijhawm li ib teev lossis ob teev. Txawm li cas los xij, koj yuav tsum nyob hauv tsev kho mob ib hnub, vim tias nws yuav siv sijhawm ntau teev rau kev npaj thiab kev soj ntsuam tom qab.

Tom qab kho mob tas lawm, muaj dab tsi tshwm sim?

Tom qab kev kho mob tas, tus kws kho mob yuav ua angiogram los xyuas seb lub stent puas ua haujlwm zoo thiab seb cov ntshav ntws puas rov qab mus rau qhov qub. Tom qab ntawd, lub catheter thiab lwm yam khoom siv yuav raug tshem tawm thiab koj yuav tau txais cov tshuaj tua kab mob thiab lwm yam lus qhia uas koj xav tau.

Qhov tseem ceeb tshaj plaws yog koj yuav tsum tau noj koj cov tshuaj uas ua rau cov ntshav nyias (piv txwv li, Aspirin, Clopidogrel) txawm tias koj mus tsev lawm los xij. Tsis txhob tsum noj cov tshuaj no yam tsis tau nrog koj tus kws kho mob tham. Feem ntau koj yuav tsum tau noj cov tshuaj no rau ob peb lub hlis.

Lub sijhawm rov zoo tom qab mus tsev

• Tsis txhob nqa ib yam dab tsi hnyav dua 20 phaus (xws li ib thoob dej) rau ib lub lim tiam.
• Tsis txhob muab qhov chaw phais/tho qhov chaw txhaj tshuaj rau hauv dej (tsis txhob muab da dej, pas dej ua ke) rau ib lub lim tiam tom qab kho. Ua luam dej tau.
• Ua tib zoo me ntsis ntxiv thaum nce ntaiv.
• Maj mam li siv koj txoj kev ua neej niaj hnub hauv ib lub lim tiam.

Cov txiaj ntsig, kev pheej hmoo, thiab kev vam meej mus sij hawm ntev ntawm kev kho mob

Txoj kev kho mob no tsis tshua mob npaum li kev phais qhib ib txwm muaj, uas muaj ntau yam zoo. Cov qhov tseem ceeb yog cov qhov me me, txo qhov kev pheej hmoo ntawm kev puas tsuaj rau cov hlab ntsha hauv caj dab, thiab mob tsawg dua tom qab kho.

Tej yam uas yuav muaj feem cuam tshuam suav nrog kev los ntshav, ntshav siab qis/siab (Hypotension/Hypertension), lub plawv dhia qeeb (Bradycardia), ntshav txhaws, thiab tsis tshua muaj, mob hlwb. Koj tus kws kho mob yuav piav qhia txog tej yam no rau koj kom meej.

Qhov tseem ceeb yog tias kev kho mob no tsis kho tau tus kab mob tseem ceeb (atherosclerosis). Nws tsuas yog tshem tawm qhov kev thaiv uas twb muaj lawm. Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum hloov koj txoj kev ua neej kom tiv thaiv cov hlab ntsha kom tsis txhob raug thaiv dua.

• Tsum haus luam yeeb thiab vaping kiag li.
• Noj cov tshuaj uas tus kws kho mob tau sau tseg raws sijhawm.
• Tswj koj qhov hnyav kom noj qab nyob zoo.
• Ua si nawv tsis tu ncua.
• Noj zaub mov zoo rau lub plawv uas tsis muaj roj, ntsev, thiab qab zib ntau, thiab muaj txiv hmab txiv ntoo thiab zaub ntau.
• Tswj koj cov ntshav siab, roj cholesterol (LDL tsawg dua 70), thiab ntshav qab zib (HbA1c tsawg dua 7) kom zoo.
• Mus ntsib kws kho mob raws sijhawm teem tseg thiab kuaj xyuas.

Xwm txheej ceev! Yuav ua li cas yog tias koj muaj cov tsos mob no?

Qhov no tseem ceeb heev. Yog tias koj muaj ib qho ntawm cov tsos mob hauv qab no, hu rau 1990 Ambulance Service tam sim ntawd 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 tus mob stroke: poob ntawm ib sab ntawm lub ntsej muag, nyuaj hais lus lossis nkag siab cov lus, tsis hnov ​​​​​​lus lossis loog ntawm ib sab caj npab lossis ceg.
• Yog tias muaj ntshav ntau dhau los yog o ntawm qhov chaw uas tau ntxig lub stent (qhov chaw mos, caj npab, lossis caj dab).

Qee zaum cov hlab ntsha tuaj yeem nqaim dua vim yog cov nqaij rov loj hlob ntawm qhov chaw kho mob. Peb hu qhov no ua 'restenosis' . Yog vim li ntawd nws thiaj li tseem ceeb uas yuav tsum tau kuaj mob ultrasound tsis tu ncua.