Opaleshoni ya Aortobifemoral Bypass: Njira yodutsa magazi yooneka ngati 'Y' yomwe imapereka magazi kupita ku miyendo

Kodi mumamvanso kupweteka kwambiri kapena kumva kuwawa m'miyendo yanu mukayenda mtunda waufupi? Kodi kumachepa mukayima ndikupumula kwakanthawi, kenako ululuwo umabwereranso mukayambanso kuyenda? Ili ndi vuto lomwe anthu ambiri ali nalo. Chifukwa chachikulu cha izi chikhoza kukhala kutsekeka kwa mtsempha waukulu wamagazi womwe umanyamula magazi ochulukirapo kumiyendo yanu. Lero, tikulankhula za opaleshoni yofunika kwambiri, yayikulu yomwe imachitika mumkhalidwe wotere.

Kodi Aortobifemoral Bypass ndi chiyani?

Mwachidule, iyi ndi opaleshoni yomwe madokotala ochita opaleshoni amachita pamimba panu (m'mimba). Monga momwe msewu umatsekeredwa, msewu watsopano umapangidwa, wotchedwa msewu wa 'bypass', opaleshoniyi imapanga njira yatsopano yodutsa mitsempha yamagazi yotsekedwa kapena yopapatiza (mitsempha) m'thupi lanu. Izi zimathandiza kuti magazi ayende bwino kupita ku miyendo yanu kachiwiri.

Mu njira imeneyi, dokotalayo amaika mtsempha wopangira magazi, wotchedwa graft, m'mimba mwanu ndikuulumikiza ku mtsempha wotsekeka wa magazi. Mtsempha wopangira magazi uwu nthawi zambiri umapangidwa ndi zinthu monga polyester. Mawu akuti "aortobifemoral" amatanthauza izi.

• "Aorto" ndi mtsempha waukulu kwambiri wamagazi m'thupi lathu, aorta . Umayamba kuchokera pamtima ndikudutsa pachifuwa mpaka pamimba.
• "Femoral" amatanthauza mitsempha ya m'ntchafu zanu . Mitsempha iyi imayambira m'mimba mwanu ndikutsikira kumbuyo kwa bondo.
• "Bi" amatanthauza "ziwiri." Izi zikutanthauza kuti mtsempha wamagazi wopangidwawu umalumikizana ndi mitsempha yonse iwiri ya femoral m'miyendo yanu yonse.

Tangoganizirani za graft iyi, ``(Graft),'' ngati "Y" yozikidwa mozondoka. Gawo limodzi lapamwamba limalumikizana ndi aorta m'mimba, ndipo nthambi ziwiri za "Y" zimalumikizana ndi mitsempha ya femoral m'miyendo.

Kodi opaleshoniyi imachitika chifukwa cha matenda amtundu wanji?

Opaleshoni iyi imachitika makamaka pochiza matenda otchedwa aortoiliac occlusive disease . Apa ndi pamene mafuta ndi zinthu zina (monga plaque) zimasonkhana pa makoma amkati mwa mitsempha yayikulu yamagazi m'mimba ndi m'chiuno mwanu pakapita nthawi. Timatcha izi `(Plaque)`. Kuwonjezeka kumeneku kumachitika m'njira zotsatirazi:

• Mtsempha wa m'mimba: Iyi ndi gawo la mtsempha wa m'mimba lomwe limatsikira m'mimba.
• Mitsempha ya Iliac: Iyi ndi mitsempha yomwe imatuluka kuchokera ku aorta pa navel (umbilicus) ndikupita ku miyendo.

Mitsempha yamagazi ikachepa kapena kutsekedwa kwathunthu ndi madzi ochulukirapowa, thupi lanu la pansi, makamaka miyendo yanu, mapazi, ndi ziwalo za m'chiuno, zimasowa magazi okwanira okosijeni omwe amafunikira. Izi zingayambitse mavuto aakulu.

Kodi opaleshoni imeneyi ndi yaikulu? Kodi pali njira zina?

Inde, opaleshoni imeneyi imaonedwa kuti ndi yaikulu chifukwa imafuna kuduladula kwakukulu m'mimba.

Koma pali njira ina yochepetsera kufalikira kwa magazi yotchedwa aortoiliac stenting yokhala ndi bifurcation reconstruction (AISBR) . Izi zimaphatikizapo kuyika chubu chaching'ono chotchedwa stent mkati mwa mtsempha wotsekeka ndikuchidzaza kuti chitsegulenso mtsempha. Kafukufuku wina wasonyeza kuti njira imeneyi ili ndi zovuta zochepa komanso imakhala nthawi yochepa kuchipatala.

Dokotala wanu adzasankha ngati opaleshoni yotseguka kapena stent ndi yoyenera kwa inu. Ngakhale kuti stent nthawi zambiri imaperekedwa kwa anthu omwe sangathe kulekerera opaleshoni yayikulu, chifukwa cha kupita patsogolo kwa ukadaulo, tsopano imagwiritsidwa ntchito nthawi zambiri m'malo mwa opaleshoni yotseguka. Komabe, nthawi zina, ngati stent si njira yabwino kwa inu, kapena ngati stent yakale yalephera, opaleshoni yotseguka ingafunike.

Kodi mumakonzekera bwanji musanachite opaleshoni?

Gulu lanu lachipatala lidzakupatsani malangizo a momwe mungakonzekere opaleshoni. Izi ndi zinthu zomwe muyenera kuzisamalira nthawi zambiri.

• Siyani kusuta fodya kwathunthu: Kusiya kusuta fodya milungu itatu kapena inayi musanachite opaleshoni kungakuthandizeni kupeza zotsatira zabwino kwambiri. Ndikofunikira kupitiriza kusiya kusuta fodya mutachita opaleshoni kuti mtima wanu ndi mitsempha yamagazi zikhale bwino.
• Lankhulani ndi dokotala wanu za mankhwala: Muyenera kuuza dokotala wanu za mankhwala aliwonse omwe mukumwa panopa. Iye angakufunseni kuti musiye kumwa mankhwala ena kapena kusintha mlingo musanachite opaleshoni.
• Kusala Kudya: Mudzalangizidwa kuti musadye kapena kumwa kuyambira pakati pausiku tsiku lisanafike opaleshoni.
• Mayeso azachipatala: Mudzapemphedwa kuti muyesedwe kangapo musanachite opaleshoni.
• Chizindikiro cha bondo ndi brachial
• Ultrasound ya mitsempha yamagazi (ultrasound scan ya mitsempha yamagazi)
• Ma scan omwe amafufuza thanzi la mtima ndi mitsempha ya mtima.

Kodi chimachitika ndi chiyani panthawi ya opaleshoni?

Opaleshoniyo ingatenge maola awiri kapena asanu ndi limodzi. Zotsatirazi zimachitika panthawiyi.

1. Mudzapatsidwa mankhwala oletsa ululu kuti mugone mokwanira.

2. Kuduladula kwakukulu (laparotomy) kumachitika m'mimba mwanu kuti dokotala wa opaleshoni afike pa mtsempha wamagazi.

3. Mabala awiri amapangidwa m'mimba zonse ziwiri kuti afike ku mitsempha ya femoral.

4. Mtsempha wamagazi wopangidwa ndi mawonekedwe a "Y" womwe watchulidwa kale umayikidwa, gawo lapamwamba limalumikizidwa ndi dera lotsekedwa la mtsempha wamagazi kuchokera pamwamba, ndipo magawo awiri apansi amalumikizidwa ndi madera otsekedwa a mitsempha iwiri ya femoral kuchokera pansi, ndipo amasokedwa pamodzi.

5. Pomaliza, mabala m'mimba ndi m'mimba amatsekedwa ndi ma stitches kapena staples.

Kodi chimachitika ndi chiyani mukatha opaleshoni komanso mukapita kunyumba?

Mudzayenera kukhala m'chipatala kwa masiku pakati pa 4 ndi 7. Panthawiyi, gulu lachipatala lidzakusamalirani bwino. Komanso, zingatenge miyezi iwiri kapena itatu kuti muchire bwino. Komabe, patatha milungu pafupifupi 4 mpaka 6, mudzatha kuyambiranso pang'onopang'ono zochita zanu zachizolowezi.

Samalirani zinthu izi mukafika kunyumba.

• Imwani mankhwala onse ochepetsa ululu ndi mankhwala ena omwe dokotala wanu wakupatsani pa nthawi yake.
• Sungani mabala oyera ndipo muwasamalire monga momwe dokotala wanenera.
• Kuchita masewera olimbitsa thupi monga momwe dokotala wanu wanenera. Kuwonjezera pang'onopang'ono mtunda womwe mumayenda kumathandiza kuti munthu achire. Koma musapitirire.
• Funsani dokotala wanu za nthawi yabwino yoyambiranso kuchita zinthu monga kuyendetsa galimoto, kupita kuntchito, ndi kunyamula zolemera.

Nthawi yoti mukaonane ndi dokotala nthawi yomweyo ndikupita ku Emergency Treatment Unit (ETU)

Ndikofunikira kwambiri kukhala maso ngati pali vuto lililonse lomwe lingabuke panthawi yochira.

Ngati zizindikiro za matenda a mtima kapena sitiroko zikuwonekera, imbani nthawi yomweyo ambulansi yadzidzidzi kapena pitani ku chipatala chapafupi cha Emergency Treatment Unit (ETU).

Zizindikiro za matenda a mtima:

• Kupweteka pachifuwa kapena kusasangalala
• Kuvuta kupuma
• Kusanza, kusasangalala m'mimba
• Kugunda kwa mtima
• Chizungulire (vertigo) kapena kukomoka

Zizindikiro za sitiroko:

• Kufooka kapena kusawona bwino mbali imodzi ya thupi
• Kuvuta kulankhula (Aphasia) kapena chibwibwi
• Kutaya mphamvu ya minofu mbali imodzi ya nkhope
• Kutaya mwadzidzidzi kapena kusawona bwino kapena kumva