Koj puas tau hnov tias cov hlab ntsha tseem ceeb tshaj plaws hauv peb lub cev tuaj yeem o zoo li lub npas? Qhov no yog qhov xwm txheej txaus ntshai heev. Tab sis tsis txhob txhawj, nrog kev nce qib ntawm kev kho mob, qhov no tam sim no tuaj yeem kho tau yooj yim yam tsis tas yuav phais loj. Hnub no peb yuav tham txog nws. Txoj kev no hu ua EVAR.
Hais yooj yim xwb, EVAR yog dab tsi?
Lub ntsiab lus tag nrho ntawm EVAR yog Endovascular Aneurysm Repair . Qhov no yog kev phais mob uas tsis tas phais ntau. Nws yog siv los kho cov aneurysms, lossis raws li peb hu lawv hauv cov lus kho mob , aneurysms , hauv aorta, cov hlab ntsha tseem ceeb hauv peb lub plab.
Xav txog tias cov hlab ntsha loj tshaj plaws hauv peb lub cev yog lub aorta. Qhov no yog qhov chaw uas cov ntshav faib los ntawm lub plawv mus rau tag nrho lub cev. Qee zaum, thaum ib qho chaw hauv phab ntsa ntawm cov hlab ntsha no qaug zog, qhov siab ntawm cov ntshav ua rau qhov chaw qaug zog ntawd nce tawm zoo li lub npas. Qhov ntawd yog qhov peb hu ua aneurysm.
Hauv kev kho mob EVAR, tsuas muaj ob lub qhov me me xwb uas ua rau ntawm ob sab ntawm cov leeg ntshav, thiab cov cuab yeej tshwj xeeb raug xa mus rau hauv lawv los kho cov hlab ntsha o los ntawm sab hauv.
Vim li cas peb thiaj xav tau kev kho mob EVAR no?
Lub hom phiaj tseem ceeb ntawm kev kho mob no yog tiv thaiv kom cov hlab ntsha zoo li lub npuas (aneurysm) tsis txhob tawg, vim tias yog nws tawg, nws yog qhov txaus ntshai rau lub neej.
Yog tias cov hlab ntsha tawg, kev los ntshav ntau dhau yuav pib tshwm sim hauv lub cev, uas tuaj yeem ua rau tuag taus hauv ob peb feeb xwb.
Hauv kev kho mob EVAR, cov kws kho mob muab ib lub raj tshwj xeeb (stent graft) ua los ntawm ntaub thiab hlau mesh rau hauv cov hlab ntsha o. Tom qab muab lub raj no tso rau hauv, cov ntshav ntws los ntawm lub raj tshiab no. Ces qhov siab ntawm cov ntshav tsis ntaus rau ntawm phab ntsa ntawm cov hlab ntsha o. Yog li ntawd, qhov kev pheej hmoo ntawm nws tawg yuav luag raug tshem tawm tag nrho.
Txoj kev kho mob EVAR no zoo tshaj plaws rau leej twg?
Yog koj muaj ib qho aortic aneurysm, qhov kev kho mob no yuav yog rau koj. Txawm li cas los xij, tsis yog txhua qhov aneurysms raug kho tib lub sijhawm. Koj tus kws kho mob yuav xav txog EVAR hauv cov xwm txheej hauv qab no:
- Yog tias koj lub aneurysm loj lossis yog tias nws me tab sis loj hlob sai .
- Yog tias koj lub cev tsis tuaj yeem zam kev phais qhib nrog qhov txiav loj.
- Yog tias cov hlab ntsha saum toj thiab hauv qab lub aneurysm noj qab nyob zoo .
Puas muaj lwm txoj kev zoo li EVAR? (FEVAR thiab TEVAR)
Yog, txoj kev kho mob no siv nrog kev hloov pauv me ntsis nyob ntawm qhov chaw ntawm lub aneurysm.
FEVAR yog dab tsi?
Xav txog peb lub aorta zoo li lub cev ntoo. Los ntawm lub cev no, cov ceg (cov hlab ntsha me me) uas nqa ntshav mus rau cov kabmob hauv peb lub plab (xws li lub raum thiab cov hnyuv) faib ua ob. Qee zaum ib qho aneurysm tsim nyob ze ntawm qhov chaw uas ib qho ntawm cov ceg no faib. Yog li ntawd, nws nyuaj rau ua EVAR ib txwm muaj.
Yog rau cov teeb meem nyuaj heev uas siv txoj kev tshwj xeeb hu ua FEVAR (Fenestrated Endovascular Aneurysm Repair) . Lub stent graft siv ntawm no muaj cov qhov me me (fenestrations) ua kom haum rau qhov chaw uas cov ceg faib. Los ntawm cov qhov ntawd, cov stents me me sib cais tuaj yeem tso rau cov ceg ntawd. Ib yam li lub raj tsim los kom haum rau ob qho tib si lub cev thiab cov ceg ntawm tsob ntoo.
Qhov txawv ntawm EVAR thiab TEVAR
Qhov no yooj yim heev.
- EVAR yog ua rau cov aneurysms hauv plab (plab) .
- TEVAR (Kev Kho Mob Aneurysm Thoracic Endovascular) yog ua rau cov aneurysms hauv lub hauv siab (thorax) .
Feem ntau TEVAR ua tau zoo heev rau cov aneurysms hauv cov hlab ntsha loj uas khiav mus rau hauv lub hauv siab, me ntsis deb ntawm lub plawv. Txawm li cas los xij, rau cov aneurysms uas nyob ze rau lub plawv, feem ntau yuav tsum tau phais qhib.
| Cov txiaj ntsig tseem ceeb ntawm kev kho mob EVAR | |
|---|---|
| Qhov zoo | Kev piav qhia |
| Tus naj npawb ntawm hnub nyob hauv tsev kho mob raug txo qis. | Koj tuaj yeem mus tsev sai dua li phais qhib. |
| Los ntshav tsawg dua | Vim tsis muaj qhov txiav loj, cov ntshav uas tawm hauv lub cev thiaj li me me heev. |
| Tsawg dua qhov mob thaum lub sijhawm kho mob | Vim tsis muaj kev raug mob loj, qhov mob thiab tsis xis nyob yog tsawg heev. |
| Zoo sai sai no | Koj tuaj yeem rov qab mus ua tej yam li qub tam sim ntawd. |
| Lub sijhawm phais mob tsawg dua. | Qhov kev phais mob tuaj yeem ua tiav hauv lub sijhawm tsawg dua li kev phais qhib. |
Puas muaj kev pheej hmoo nrog kev kho mob no?
EVAR yog ib txoj kev kho mob uas muaj kev nyab xeeb thiab ua tau zoo heev, tab sis zoo li lwm yam kev phais mob, muaj feem me me uas yuav muaj teeb meem.
- Ntshav Txhaws: Qee zaum cov ntshav txhaws tuaj yeem tsim nyob rau hauv cov leeg ntshav tob ntawm ob txhais ceg. Peb hu qhov no tias Deep Vein Thrombosis (DVT) .
- Endoleak: Txawm tias tom qab muab lub stent tso rau hauv, me ntsis ntshav ntws ntawm lub stent thiab phab ntsa ntawm cov hlab ntsha thiab koom nrog aneurysm.
- Kev kis kab mob: Kev kis kab mob ntawm qhov chaw raug mob.
- Kev ua haujlwm tsis zoo ntawm lub raum
- Mob plawv nres
- Los ntshav ntau dhau
Cov kev pheej hmoo no tsawg heev. Koj tus kws kho mob yuav piav qhia txhua yam no rau koj ua ntej phais.
Yuav ua li cas thiaj phais tau?
Zoo, tam sim no cia peb saib cov kauj ruam koom nrog hauv kev phais no.
1. Ua ntej, koj yuav raug muab tshuaj loog kom koj tsaug zog lossis kom koj tsaug zog me ntsis. Yog li koj yuav tsis hnov mob dab tsi.
2. Tom ntej no, tus kws kho mob yuav nkag mus rau hauv lub aneurysm hauv koj lub plab los ntawm cov hlab ntsha femoral hauv koj lub qhov ncauj.
3. Siv ob rab koob nyias nyias, ib lub catheter , uas yog ib lub raj nyias nyias, thiab yoog tau, raug ntxig rau hauv ob lub hlab ntsha no. Lub stent graft uas peb tau hais ua ntej raug tais rau hauv lub catheter no.
4. Thaum saib ib daim duab X-ray tshwj xeeb, tus kws kho mob yuav coj lub catheter no mus raws cov hlab ntsha mus rau qhov chaw ntawm lub aneurysm.
5. Thaum twg nyob rau qhov chaw zoo lawm, lub raj stent hauv lub catheter yuav nthuav dav. Tom qab ntawd nws yuav nthuav dav mus rau hauv cov hlab ntsha, tsim ib txoj kev tshiab thiab muaj zog dua rau cov ntshav ntws.
6. Lub raj stent no tau txuas ruaj khov rau ntawm phab ntsa ntawm cov hlab ntsha, tiv thaiv cov ntshav kom tsis txhob nkag mus rau hauv aneurysm.
7. Tom qab ua tiav cov txheej txheem, cov catheter yuav raug tshem tawm kom zoo. Cov qhov me me uas tsis tas yuav xaws. Muab ib daim plaster me me rau ntawm qhov txhab kom pab nws kho.
Lub sijhawm rov zoo tom qab phais mob yog li cas?
Feem ntau nws yuav siv sijhawm ob peb hnub mus rau ib hlis rau koj kom zoo tag nrho.
- Koj yuav tau nyob hauv tsev kho mob ob lossis peb hnub.
- Koj tuaj yeem pib noj thiab haus tam sim ntawd tom qab siv tshuaj loog.
- Koj tuaj yeem sawv ntawm txaj thiab taug kev nrog kev pab los ntawm cov kws tu mob.
- Tom qab koj mus tsev lawm, tej zaum koj yuav nkees thiab mob me ntsis rau ob peb hnub. Koj yuav tsum siv cov tshuaj tua kab mob uas tau muab rau koj kom raug.
- Tsis txhob tsav tsheb kom txog thaum koj noj cov tshuaj tua kab mob.
- Feem ntau cov neeg tuaj yeem rov qab mus ua haujlwm tau hauv ib hlis.
- Koj yuav tsum tsis txhob tsa tej yam hnyav rau 4 txog 6 lub lis piam.
| Yog koj muaj cov tsos mob no, mus ntsib koj tus kws kho mob tam sim ntawd. | |
|---|---|
| Yam ntxwv | Kev piav qhia |
| Ceg o, mob | Tej zaum cov no yog cov cim qhia tias muaj cov hlab ntsha hauv cov ceg (DVT). Qhov no suav nrog daim tawv nqaij txias ntawm ob txhais ceg. |
| Kiv taub hau los yog tsaus muag | Nws yuav yog ib qho cim qhia txog qee yam teeb meem sab hauv. |
| Mob nraub qaum, mob hauv siab, lossis mob plab | Qhov no yuav yog teeb meem nrog lub stent lossis lub aneurysm. |
| Lub plawv dhia ceev | Lub plawv dhia ceev dhau (Lub plawv dhia ceev dhau). |
| Liab los yog mob hauv thaj chaw qhov chaw mos | Nws yuav yog ib qho cim qhia txog kev kis kab mob hauv qhov chaw phais. |
Cov Lus Qhia Txog Kev Coj Mus Tsev
- EVAR yog ib txoj kev phais zoo dua, tsis tas yuav phais ntau dhau piv rau kev phais qhib ib txwm muaj.
- Tom qab kev kho mob no, koj yuav zoo sai sai thiab tuaj yeem mus tsev sai sai.
- Txawm tias tom qab koj zoo lawm los, koj yuav tsum saib xyuas koj lub plawv thiab cov hlab ntsha. Tej yam xws li kev tawm dag zog thiab txo cov ntsev hauv koj cov zaub mov noj tuaj yeem pab tiv thaiv cov teeb meem yav tom ntej.
- Qhov tseem ceeb tshaj plaws yog mus ntsib kws kho mob dua thaum lub sijhawm teem tseg rau kev kuaj mob tom qab. Ua li ntawd, koj tuaj yeem xyuas seb lub stent uas koj ntxig rau puas ua haujlwm zoo thiab puas muaj lwm yam teeb meem.
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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