Kodi mtsempha wa mtima ungatsekekenso pambuyo poti stent yaikidwa? (In-Stent Restenosis)

Kodi inuyo kapena munthu wina amene mumamudziwa anaikidwapo stent mu mitsempha ya mtima? Pambuyo pa chithandizo chotere, nthawi zambiri timaganiza kuti tsopano vutoli lathetsedwa kwathunthu, kuti mitsempha ya mtima sidzatsekekanso. Komabe, nthawi zina, kutsekeka pang'ono kapena kucheperako kungabwerenso pamalo omwewo pomwe stent inayikidwa, kutanthauza, mbali yomweyo ya mitsempha yomwe inachiritsidwa. Ndicho chimene madokotala amatcha 'In-Stent Restenosis'. Ngakhale dzinalo lingamveke lovuta pang'ono, kwenikweni ndi losavuta. Tiyeni tikambirane za izi mwatsatanetsatane, mu Chisinhala chomwe mungamvetse.

Choyamba, tiyeni timvetse mawu awa, sichoncho?

Tisanalankhule za 'in-stent restenosis', tiyeni timvetse mawu ochepa. Kenako zidzamveka bwino kwa inu.

Kodi 'Stenosis' ndi chiyani?

Mwachidule, 'stenosis' ndi kuchepa kapena kuchepa kwa mtsempha wamagazi m'thupi lathu. Tangoganizani kuti pakapita nthawi, dothi ndi dzimbiri zimasonkhana mkati mwa chitoliro cha madzi, zomwe zimaletsa kuyenda kwa madzi.

Ndiye, kodi matenda a mitsempha ya mtima (CAD) ndi chiyani?

Mtima wathu umafunikanso magazi kuti ugwire ntchito. Mitsempha ikuluikulu yomwe imapereka magazi imatchedwa mitsempha ya mtima. CAD ndi pamene mafuta osungidwa otchedwa plaque amasonkhana mkati mwa mitsempha imodzi kapena zingapo za mtima, zomwe zimapangitsa kuti mitsemphayo ikhale yopapatiza. Izi zimatchedwanso atherosclerosis. Anthu ena amatchanso kuti "kuuma kwa mitsempha." Kuchulukana kwa mafuta kumeneku kumachitika pang'onopang'ono, ndipo sikungasonyeze zizindikiro poyamba. Koma ngati sikuchiritsidwa, kungayambitse matenda aakulu monga matenda a mtima ndi kulephera kwa mtima.

Kodi 'Angioplasty' ndi 'Stent' ndi chiyani?

Chimodzi mwa njira zazikulu zomwe madokotala amagwiritsa ntchito potsegula mitsempha ya mtima yotsekeka chifukwa cha CAD chimatchedwa angioplasty. Nthawi zina chimatchedwanso percutaneous coronary intervention (PCI). Mu izi, chubu chopyapyala (catheter) chimayikidwa kudzera mu dzenje laling'ono pakhungu kulowa m'mitsempha yotsekeka. Chipangizo chaching'ono chonga baluni kumapeto kwa chubu chimadzazidwa, ndikukulitsa mitsempha yotsekeka. Kenako, kuti mitsempha isagwerenso ndikusunga magazi bwino, chubu chaching'ono cha mesh - ndicho chomwe stent imagwiritsa ntchito - chimayikidwa mkati mwa mitsempha yotsekeka. Kenako, magazi amayenda bwino kachiwiri.

Chabwino, tsopano 'In-Stent Restenosis' iyi ndi chiyani?

Tsopano mukumvetsa chifukwa chake komanso momwe stent imayikidwira. Pambuyo poti stent yayikidwa ndipo magazi abwerera m'thupi, nthawi zina mitsempha imayamba kucheperanso pomwe stent idayikidwa, kutanthauza mkati mwa stent. Ndicho chifukwa chake timayitcha 'In-Stent Restenosis'. 'Re' amatanthauza "kachiwiri", ndipo 'stenosis' amatanthauza "kuchepera". Chifukwa chake, izi zikutanthauza "kucheperanso mkati mwa stent".

Kodi vutoli ndi lofala bwanji?

Tsopano mwina mukudabwa ngati izi ndi zosiyana kwa aliyense amene amalandira stents.Ayi, izi sizichitika kwa aliyense amene ali ndi stent. Komabe, mwachidule, munthu m'modzi mwa anayi aliwonse omwe ali ndi stent ali ndi mwayi wopeza vutoli lotchedwa `In-Stent Restenosis`. Izi nthawi zambiri zimachitika mkati mwa miyezi itatu kapena isanu ndi umodzi kuchokera pamene stent yaikidwa.

Chofunika: Ngati mwachitidwa opaleshoni ya balloon angioplasty popanda kuchitidwa stenting, chiopsezo cha restenosis chimakhala chachikulu kwambiri. Pafupifupi anthu anayi pa anthu 10 aliwonse adzatsekedwanso ndi mitsempha yawo yamagazi.

Nchifukwa chiyani 'kupumula kwamkati mwa stent' kumachitika?

Ndi funso losangalatsa kwambiri. Pambuyo poika stent, thupi lathu limayesetsa "kulichiritsa". Izi zikutanthauza kuti, maselo atsopano ("chiwalo chatsopano" chimakula pamwamba pa stent, zomwe zimapangitsa mkati mwa mtsempha kukhala wosalala kachiwiri. Ichi ndi chinthu chabwino, chifukwa magazi amatha kuyenda mosavuta popanda kuuma.

Komabe, nthawi zina, pansi pa maselo atsopanowa, kuzungulira stent, minofu yochulukirapo imakula. Minofu iyi ikakula kwambiri, mkati mwa mitsempha yamagazi mumakhuthala, zomwe zimapangitsa kuti magazi ayambe kuyenda pang'onopang'ono. Ichi ndiye chifukwa chachikulu cha `In-Stent Restenosis`.

Kumbukirani, izi nthawi zambiri zimachitika mkati mwa miyezi itatu kapena isanu ndi umodzi mutagwiritsa ntchito stent. Pambuyo pake, chiopsezo cha minofu ya zipsera ndikupanga ndikutseka mtsempha chimakhala chochepa kwambiri.

Ndani ali pachiwopsezo chachikulu chotenga 'in-stent restenosis'?

Ngakhale kuti aliyense amene ali ndi stent yoikidwa pa CAD akhoza kukhala ndi vutoli lotchedwa `In-Stent Restenosis`, anthu ena ali pachiwopsezo chachikulu pang'ono. Tiyeni tiwone omwe ali:

• Kwa anthu omwe ali ndi cholesterol yambiri m'magazi. (Izi ndi zomwe zimapangitsa kuti matenda ambiri a mtima ayambe!)
• Kwa iwo omwe ali ndi matenda a impso .
• Kwa iwo amene amasuta. (Ichi ndi chinthu chomwe muyenera kusiya!)
• Kwa iwo omwe ali ndi matenda a shuga osalamulirika bwino.
• Kwa iwo omwe ali ndi kuthamanga kwa magazi kosalamulirika (kuthamanga kwa magazi).

Ngati muli ndi matenda ngati amenewa, ndikofunikira kwambiri kulankhula ndi dokotala wanu ndikuwayang'anira.

Kodi zizindikiro za 'in-stent restenosis' ndi ziti?

Nthawi zambiri, anthu omwe ali ndi `In-Stent Restenosis` sasonyeza zizindikiro zilizonse zakunja. Ichi ndichifukwa chake ndikofunikira kwambiri kukaonana ndi dokotala nthawi ndi nthawi ndikuyesedwa kofunikira mutayikidwa stent.

Komabe, anthu ena akhoza kukhala ndi zizindikiro. Ngati atatero, zizindikirozo nthawi zambiri zimakhala zofanana ndi za CAD yomwe inalipo kale. Izi zikuphatikizapo:

• Kumva kupweteka, kupsinjika, kapena kusasangalala pachifuwa. Timatcha izi kuti "angina." Kupweteka pachifuwa kumeneku kumatha kukulirakulira mukamachita masewera olimbitsa thupi, kukwera masitepe, kapena kutopa pang'ono.
• Thukuta lozizira.
• Chizungulire, mutu wopepuka, kapena kumva kukomoka.
• Kutopa kwambiri ndi kufooka.
• Kumva kugunda kwa mtima kosazolowereka (`kugunda kwa mtima`).
• Kusanza.
• Kupuma movutikira, nthawi zina ngakhale mutayenda mtunda waufupi.
• Kupweteka pa phewa kapena mkono (makamaka mkono wakumanzere).

Ngati muli ndi zizindikiro izi, muyenera kuonana ndi dokotala popanda kutaya nthawi.

Kodi 'in-stent restenosis' imapezeka bwanji?

Monga ndanenera kale, popeza `In-Stent Restenosis` siimasonyeza zizindikiro nthawi zonse, ndikofunikira kuonana ndi dokotala nthawi zonse mukayika stent. Kenako, mayeso ofunikira akhoza kuchitidwa.

Ngati muli ndi zizindikiro, dokotala wanu angakulangizeni mayeso monga awa:

• Kuyesa kupsinjika maganizo : Kuyesa kumeneku kumayesa momwe mtima wanu umapopera magazi ndikuyang'ana kusintha kwa ECG yanu pamene mukuyenda pa treadmill kapena kukwera njinga.
• Kuyeza magazi m'mitsempha ya mtima ndi angiogram : Izi zimachitika stent isanayikidwe. Izi zitha kuchitikanso kuti muwone ngati pali chotchinga mkati mwa stent.
• Coronary computed tomography angiogram (CCTA): Izi zikufanana ndi CT scan. Utoto wapadera umalowetsedwa mumtima kuti upange zithunzi za 3D za mitsempha ya mtima.
• Kusunga kwa fractional flow reserve (FFR): Izi zitha kuchitika nthawi yomweyo ndi angiogram. Waya wapadera umayikidwa mumtsempha ndipo kuthamanga kwa magazi kumayesedwa mbali zonse ziwiri za kutsekeka kuti aone momwe kutsekekako kulili koopsa.
• Kujambula kwa ultrasound m'mitsempha (IVUS): Izi zitha kuchitikanso nthawi imodzi ndi angiogram. Chofufuzira chaching'ono cha ultrasound chimalowetsedwa mumtsempha, zomwe zimathandiza kuti mkati mwa khoma la mtsempha ndi stent ziwonekere bwino kwambiri.

Kodi mankhwala a 'in-stent restenosis' ndi ati?

Dokotala wanu adzasankha chithandizo choyenera kwambiri kwa inu kutengera kuopsa kwa In-Stent Restenosis yanu, kutanthauza kuti, mtsempha wamagazi wachepa bwanji, komanso thanzi lanu lonse. Chingaphatikizepo chimodzi mwa mankhwala otsatirawa:

• Mankhwala: Pofuna kuchepetsa zizindikiro monga angina zomwe zimayambitsidwa ndi In-Stent Restenosis, mlingo wa mankhwala omwe alipo ungawonjezedwe kapena mankhwala atsopano angawonjezedwe.
• Kubwerezabwereza angioplasty: Mitsempha yotsekeka imakulitsidwanso ndi baluni, ndipo nthawi zina stent ina imayikidwa. Nthawi zina baluni yokhala ndi mankhwala ingagwiritsidwe ntchito.
• Opaleshoni ya mtima wodutsa:Izi zimatchedwanso `Coronary artery bypass grafting` kapena `CABG`. Iyi ndi opaleshoni yayikulu pang'ono. Chomwe mumachita ndikupanga njira yatsopano yoti magazi aziyenda mozungulira malo otsekeka. Izi zikutanthauza kuti, mumatenga chidutswa cha mtsempha kuchokera ku gawo lina la thupi lanu (monga mwendo wanu, chifuwa) ndikuchilumikiza ku malo otsekeka ndi kumbuyo.
• Chithandizo cha mitsempha yamagazi: Ichi ndi chithandizo chosiyana pang'ono. Mofanana ndi chithandizo cha radiation chomwe chimagwiritsidwa ntchito kupha maselo a khansa, izi zimaphatikizapo kupereka radiation yochepa kwa kanthawi kochepa ku stent kuti minofu ya chilonda isamerenso. Izi zimatchedwanso coronary brachytherapy.

Kodi pali njira zopewera 'kupumula kwa stent'?

Inde, nkhani yabwino ndi yakuti chiopsezo cha `In-Stent Restenosis` chingachepe. Njira imodzi yayikulu yochitira izi ndikugwiritsa ntchito ma stenti oletsa mankhwala (`DES`).

`DES` izi ndi zosiyana ndi ma stenti achitsulo opanda kanthu (BMS). Ali ndi utoto wochepa wa mankhwala. Stent ikangolowetsedwa mumtsempha, mankhwalawo amatulutsidwa pang'onopang'ono, zomwe zimawongolera kupangika kwa minofu ya zipsera ndi kukula kwa maselo.

Zaka zapitazo, panali nkhani yokhudza chiopsezo cha magazi kuundana ndi `DES` izi. Komabe, mbadwo watsopano wa ma stent oletsa kugwiritsa ntchito mankhwala ndi otetezeka kwambiri komanso ogwira mtima kwambiri. Pogwiritsa ntchito `DES` izi, chiopsezo cha `In-Stent Restenosis` chimachepa kwambiri. Mwachidule, `osakwana munthu m'modzi pa anthu 10 aliwonse` amakhala ndi `In-Stent Restenosis`.

Choncho, ngati mukufuna kuika stent, lankhulani ndi dokotala wanu kuti mudziwe mtundu wa stent womwe uli wabwino kwa inu.

Kodi chiyembekezo cha munthu amene ali ndi 'in-stent restenosis' ndi chotani?

Ngati mutakhala ndi `In-Stent Restenosis`, mungakhale ndi mwayi woti mukumane ndi matenda a mtima omwe angawononge moyo wanu, monga `angina wosakhazikika`, `acute coronary syndrome`, ndi `heart attack`.

Mwamwayi, zoopsazi zachepa kwambiri chifukwa cha kubwera kwa ma stent atsopano (makamaka ma DES) ndi njira zabwino zoyika ma stent. Kuphatikiza apo, tsopano pali mankhwala othandiza a In-Stent Restenosis.

Ngati muli ndi CAD, muyenera kutsatira malangizo a dokotala wanu kuti mupewe In-Stent Restenosis ndikuteteza mtima wanu wonse. Izi zikutanthauza:

• Chepetsani kumwa mchere ndipo imwani mankhwala omwe dokotala wanu wakupatsani (makamaka omwe amachepetsa kuthamanga kwa magazi, cholesterol, ndi magazi kuundana) nthawi yake komanso moyenera.
• Chepetsani kumwa mowa. Ngati muli ndi vuto la kumwa mowa, funani thandizo kuti muthetse vutoli.
• Zakudya zopatsa thanzi pamtimaIdyani "zakudya zopatsa thanzi pamtima." Idyani mafuta ochepa, shuga, ndi ufa, komanso ndiwo zamasamba zambiri, zipatso, ndi zakudya zokhala ndi ulusi wambiri.
• Dziwani mitundu ya mafuta omwe mumadya. Chepetsani kudya zakudya zokhala ndi mafuta ambiri okhuta komanso osinthika (chakudya chofulumira, zakudya zokazinga, zakudya zopakidwa m'matumba) momwe mungathere.
• Khalani ndi kulemera koyenera. Chitani masewera olimbitsa thupi tsiku lililonse.
• Ngati muli ndi matenda a shuga, samalani bwino.
• Ngati mukusuta, yesani kusiya lero. Pali njira zopezera thandizo.

Kodi ndiyenera kuyimbira dokotala liti?

Ngati mukuganiza kuti muli ndi vuto la mtima (zizindikiro monga kupweteka kwambiri pachifuwa, kupuma movutikira, thukuta), imbani 1990 Suwaseriya Ambulance Service nthawi yomweyo.

Ngati mudayikidwapo stent kale ndipo zizindikirozi zikubwereranso, pitani kwa dokotala wa mtima nthawi yomweyo:

• Kupweteka pachifuwa (angina), kufinya, kupanikizika, kupweteka m'dzanja kapena phewa.
• Thukuta lozizira.
• Kuvuta kupuma, kupuma movutikira.
• Kutopa kwambiri kapena kufooka popanda chifukwa.

Kodi ndiyenera kufunsa dokotala wanga chiyani?

Mukakumana ndi dokotala, mutha kufunsa mafunso ngati awa kuti mumvetse bwino za matenda anu:

• N’chifukwa chiyani ndinapeza 'restenosis' iyi? Kodi zinthu zomwe zingandibweretsere mavuto ndi ziti?
• Kodi ndingathe kupezanso restenosis? Kodi ndiyenera kuchita chiyani kuti ndipewe vutoli?
• Kodi ndi moyo wotani umene ndiyenera kutsatira kuti nditeteze mtima wanga?
• Ndi zizindikiro ziti za mavuto zomwe ndiyenera kuyang'anitsitsa?
• Kodi chithandizo chabwino kwambiri kwa ine ndi chiti?

Pomaliza, zomwe muyenera kukumbukira (Uthenga Wopita Nawo Kunyumba)

Chabwino, chinthu chofunikira kwambiri chomwe muyenera kukumbukira kuchokera pa zomwe takambiranazi ndi ichi. Angioplasty ndi stenting ndi njira ziwiri zofunika kwambiri komanso zopulumutsa moyo wa matenda a mtima. Mankhwalawa amathandiza kuti magazi aziyenda bwino mumtima mwanu, amachepetsa zizindikiro za CAD, komanso amapangitsa kuti moyo wanu ukhale wabwino.

Komabe, ngati zizindikiro monga kutopa, kupweteka pachifuwa, ndi kupuma movutikira zibwereranso pambuyo poti stent yaikidwa, ikhoza kukhala chizindikiro cha `In-Stent Restenosis`. Ngati zimenezo zitachitika, musachite mantha kapena kuchedwa, koma pitani kwa dokotala wanu kuti akupatseni upangiri.

Mwamwayi, ma stents atsopano komanso otetezeka omwe amapezeka masiku ano achepetsa kwambiri chiopsezo chokhala ndi In-Stent Restenosis. Palinso mankhwala abwino ochizira izi. Ndi bwino kulankhula ndi dokotala wanu za mtundu wa stent ndi chithandizo chomwe chili choyenera kwa inu. Samalani mtima wanu!

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