Dziwani zambiri zokhudza kukonza ndi opaleshoni ya Ascending Aortic Aneurysm

Mtsempha waukulu wamagazi womwe umanyamula magazi kuchokera mumtima mwanu kupita ku thupi lanu lonse, aorta, uli ngati chitoliro chachikulu chomwe chimachokera mu thanki yathu yamadzi kunyumba. Nthawi zina chitolirochi chimakhala chofooka ndikuyamba kutuluka ngati baluni yakale. Mu zamankhwala, timatcha izi kuti aneurysm. Makamaka ngati gawo lapafupi ndi mtima, aorta yokwera, litatuluka motere, lingakhale lalikulu pang'ono. Lero tikambirana za opaleshoni yomwe imachitika pa vutoli.

Kodi opaleshoni iyi imachitidwa bwanji?

Mwachidule, vutoli limakonzedwa ndi opaleshoni yachikhalidwe yotseguka. Dokotala wanu wa mtima amachotsa gawo lofooka komanso lotupa la mtsempha wanu wamagazi ndikuliyika m'malo mwake ndi chubu chopangidwa ndi zinthu zopangidwa, chotchedwa graft. Graft iyi imagwira ntchito ngati chingwe chatsopano cha mtsempha wanu wamagazi. Kenako magazi amatulukamo popanda choletsa chilichonse. Opaleshoni iyi imachitikira m'chipinda chochitira opaleshoni kuchipatala.

Ndani akufunika opaleshoni iyi?

Ngati aneurysm mu mtsempha wanu wokwera ikuphulika kapena kusweka , ndi ngozi. Timatcha izi kuti kusweka kwa Mtundu A. Iyi ndi opaleshoni yadzidzidzi yomwe iyenera kuchitika nthawi yomweyo kuti mupulumutse moyo wanu.

Komanso, ngati muli ndi aneurysm yomwe ili pachiwopsezo chophulika kapena kuphulika, mungafunike opaleshoni iyi. Dokotala wanu adzachita mayeso ojambulira zithunzi (monga CT scans, MRI scans) kamodzi kapena kawiri pachaka kuti awone momwe zilili. Nthawi zina, ngati aneurysm ndi yaying'ono kwambiri kapena ikukula pang'onopang'ono, opaleshoni singafunike kwa kanthawi. Komabe, ngati ndi yayikulu kapena ikuwonetsa zizindikiro zakukula mofulumira , ingafunike kukonzedwa opaleshoni isanaphulike kapena kuphulika.

Kodi nthawi yabwino yochitira opaleshoni ndi iti?

Zinthu zingapo zimatsimikiza nthawi yabwino yochitira opaleshoniyi. Chofunika kwambiri mwa izi ndi ngati muli ndi zizindikiro. Kuphatikiza apo, zinthu monga kukula kwa aneurysm, kukula kwake mwachangu, kukula kwa thupi lanu, ndi matenda ena aliwonse omwe mungakhale nawo nawonso amachitapo kanthu.

Zizindikiro zomwe zimafuna opaleshoni yadzidzidzi

Ngati mukumva kupweteka pachifuwa, kungakhale chizindikiro chakuti aneurysm yatsala pang'ono kuphulika. Zikatero, opaleshoni yadzidzidzi imafunika.

Ngati mukukumana ndi zizindikiro izi, musazengereze. Imbani nthawi yomweyo ku ambulansi ya 1990 kapena pitani ku Chipatala cha Emergency Treatment Unit (ETU) chapafupi.

Kukula kwa aneurysm

Kukula kwa aneurysm ndi chinthu chofunikira kwambiri pokonzekera opaleshoni. Opaleshoni ingakhale yofunikira ikafika kukula kotsatira:

• Avereji: 5.5 masentimita
• Kwa iwo omwe ali ndi matenda monga Marfan syndrome: 4.5 cm
• Kwa iwo omwe ali ndi matenda monga Loeys-Dietz syndrome: 4.0 masentimita

Liwiro limene aneurysm imakula

Ngakhale aneurysm ili yochepera masentimita 5.5, ngati ikukula mofulumira, opaleshoni idzafunika posachedwa.

• Pa avareji: 1 cm pachaka kapena 0.5 cm pa miyezi 6.
• Kwa anthu omwe ali ndi matenda enaake (monga bicuspid aortic valve): Ngati imakula kufika 0.5 cm pachaka.

Zinthu zapadera kwa inu

Dokotala wanu adzaganiziranso za kukula kwa thupi lanu ndi matenda ena. Mwachitsanzo, aneurysm yaying'ono mwa munthu wamng'ono ikhoza kukhala yoopsa, ngakhale itakhala yaying'ono. Komanso, ngati muchita opaleshoni ina ya mtima, dokotala wanu angakulangizeni kuti mukonze aneurysm nthawi yomweyo ndi opaleshoniyo. Izi zingathandize kupewa opaleshoni yamtsogolo.

Kodi njira zina (endovascular) sizingagwiritsidwe ntchito pa izi?

Kukonza mitsempha ya m'mimba yotchedwa Thoracic endovascular aortic repair (TEVAR) ndi njira yomwe imagwiritsidwa ntchito pokonza mitsempha ya m'mimba yomwe imatsika m'chifuwa. Komabe, njirayi siigwiritsidwa ntchito kawirikawiri mu mitsempha yokwezeka yomwe imayambira pamtima. Izi zili choncho chifukwa kapangidwe kake ndi kuthamanga kwa magazi a ziwalo ziwirizi ndizosiyana.

Komabe, pazochitika zadzidzidzi, TEVAR yagwiritsidwa ntchito kupulumutsa moyo wa wodwala yemwe ali wofooka kwambiri kuti asachite opaleshoni yachikhalidwe. Ofufuza akupanga zida zatsopano zomwe zimagwirizana ndi ascensing aorta. Chifukwa chake njira iyi ikhoza kukhala yofala kwambiri mtsogolo. Koma pakadali pano, chithandizo chabwino komanso chokhazikika ndi opaleshoni yotseguka.

Kodi chimachitika ndi chiyani opaleshoni isanachitike?

Mudzafunika kuonana ndi dokotala milungu ingapo opaleshoni isanachitike. Thanzi lanu lidzayesedwa ndipo mayeso ena ofunikira adzachitika.

Mayeso omwe amachitidwa kawirikawiri:

• Kuyezetsa magazi: Kuyezetsa momwe impso zimagwirira ntchito.
• CT kapena Heart MRI: Imafufuza mbali zonse za msempha wa magazi. Ngati pali vuto ndi valavu ya msempha wa magazi, ikhozanso kukonzedwa panthawi ya opaleshoniyi.
• Coronary angiography: Kuyang'ana mafuta omwe ali m'mitsempha yamagazi yomwe imapereka magazi kumtima.
• Duplex ultrasound: Imayang'ana momwe mitsempha yamagazi ilili m'khosi (mitsempha ya carotid). Mavuto ndi izi angapangitse kuti pakhale chiopsezo cha sitiroko panthawi ya opaleshoni.

Zinthu zoti mukambirane ndi dokotala:

• Mankhwala omwe mumamwa: Muyenera kuuza dokotala wanu za mankhwala onse, mavitamini, ndi mankhwala azitsamba omwe mumamwa. Mankhwala ena angafunike kuti musiye kumwa musanachite opaleshoni.
• Matenda ena: Ngati muli ndi matenda monga kuthamanga kwa magazi, ayenera kulamulidwa bwino musanachite opaleshoni.
• Momwe mukumvera: Uzani dokotala wanu ngati muli ndi matenda enaake, monga chimfine, chimfine, kapena herpes.
• Kusuta: Kusuta kuyenera kuimitsidwa kotheratu osachepera mwezi umodzi opaleshoni isanachitike .

Dokotala wanu adzakupatsani malangizo omveka bwino pa tsiku la opaleshoni yanu. Kutsatira malangizo amenewo n'kofunika kwambiri kuti opaleshoni yanu ipambane.

Kodi chimachitika ndi chiyani panthawi ya opaleshoni?

Pa opaleshoni, mudzapatsidwa mankhwala oletsa ululu. Choncho simudzamva chilichonse. Dokotala wa opaleshoni adzakuchotsani sternotomy pakati pa chifuwa chanu, kuchotsa gawo lofooka la mtsempha wanu wamagazi, ndikuyikanso graft. Nthawi ina pa opaleshoni, mudzalumikizidwa ndi makina odulira mtima ndi mapapo. Opaleshoniyi nthawi zambiri imatenga maola 3-4.

Kodi chimachitika ndi chiyani pambuyo pa opaleshoni?

Pambuyo pa opaleshoni, mudzalowetsedwa mu chipinda chosamalira odwala kwambiri (ICU). Kumeneko mudzayang'aniridwa kwa masiku angapo. Pambuyo pake, mudzasamutsidwira ku chipinda chachikulu. Nthawi yonse yokhala kuchipatala ikhoza kukhala kuyambira masiku 4 mpaka 10.

Ndili kuchipatala,

• Mudzaikidwa catheter ya mkodzo.
• Mankhwala (anticoagulants) amaperekedwa kuti aletse magazi kuundana.
• Masokisi apadera opondereza amavalidwa kuti magazi asaundane m'miyendo.
• Mungathe kulumikizidwa ndi makina kuti akuthandizeni kupuma.
• Mankhwala ochepetsa ululu adzaperekedwa kuti achepetse ululu.

Muyenera kuyamba kuyenda pang'onopang'ono ndikuchira mphamvu zanu. Koma chilichonse chiyenera kuchitika pang'onopang'ono, malinga ndi malangizo a dokotala. Popeza simungathe kuyendetsa galimoto pobwerera kunyumba, ndikofunikira kukhala ndi munthu woti akutsatireni.

Ubwino, zoopsa, ndi nthawi yochira ya opaleshoni iyi

Zinthu zofunika kutsatira panthawi yochira

• Pewani kuyendetsa galimoto: Musayendetse galimoto mpaka dokotala atakupatsani chilolezo.
• Pewani kunyamula zolemera: Musanyamule zolemera zoposa makilogalamu 4.5 kwa milungu 4-6.
• Kuchita masewera olimbitsa thupi: Pewani kuchita masewera olimbitsa thupi omwe amakupangitsani kumva kuti mukulephera kupuma. Funsani dokotala wanu kuti ndi masewera olimbitsa thupi ati omwe ali oyenera kwa inu.
• Kusamalira Kuduladula: Sungani malo oduliramo ali oyera. Yang'anani tsiku lililonse ngati pali zizindikiro za kufiira, kutupa, kapena mafinya. Kugwira pilo pachifuwa chanu mukakosoza kapena kutsekula kungathandize kuchepetsa ululu.

Kodi ndiyenera kusintha moyo wanga nditachita opaleshoni?

Inde. Ndikofunikira kwambiri kusintha moyo wanu kuti muchepetse chiopsezo cha matenda a mtima mtsogolo.

• Idyani zakudya zopatsa thanzi pamtima: makamaka kuchepetsa mchere (sodium).
• Kuchita Masewera Olimbitsa Thupi: Funsani dokotala wanu za masewera olimbitsa thupi omwe ali oyenera kwa inu.
• Ngati mukusuta, siyani nthawi yomweyo: Kusuta kumabweretsa kuwonongeka kwakukulu kwa mitsempha yamagazi.
• Lamulirani kuthamanga kwa magazi, cholesterol ndi matenda a shuga.

Kodi ndiyenera kupita kwa dokotala liti?

Samalani thupi lanu pamene mukuchira. Ngati mukukumana ndi zizindikiro zotsatirazi, imbani dokotala nthawi yomweyo.

Ndizachilendo kukhala ndi mafunso ambiri musanachite opaleshoni ngati iyi. Lankhulani ndi dokotala wanu za mafunso onsewa momasuka. Dokotala akamalimbikitsa opaleshoni iyi, amanena kuti zoopsa zosachitidwa opaleshoniyi n'zambiri kuposa kuchita opaleshoniyi. Anthu omwe amachira pambuyo pa opaleshoni yomwe idakonzedwa amapitiliza kukhala ndi moyo wabwinobwino. Chifukwa chake ndi gulu loyenera lachipatala komanso chisamaliro choyenera, mutha kuchira mwachangu ndikubwerera ku moyo wanu wabwinobwino.