Kodi mitsempha yamagazi m'khosi mwanu yatsekedwa? Tiyeni tiphunzire za opaleshoni ya TCAR (Transcarotid Artery Revascularization)

Kodi dokotala wanu wakuuzani kuti mtsempha waukulu wamagazi m'khosi mwanu watsekedwa ndipo muli pachiwopsezo chachikulu chogwidwa ndi sitiroko? Ndizachilendo kuti aliyense achite mantha pang'ono akamva chinthu chonga ichi. "Kodi ndiyenera kuchitidwa opaleshoni? Kodi ndi nkhani yaikulu?" Mafunso ambiri mwina amabwera m'maganizo. Koma musadandaule, chifukwa sayansi ya zamankhwala yapita patsogolo, tsopano pali njira zotetezeka, zosavuta komanso zothandiza pa matenda otere. Lero tikambirana za imodzi mwa njira zatsopano komanso zopambana kwambiri, TCAR.

Mwachidule, kodi TCAR ndi chiyani?

Dzina lonse la TCAR ndi Transcarotid Artery Revascularization . Chabwino, dzinali likumveka lovuta pang'ono, sichoncho? Tiyeni tisunge mosavuta.

Pali mitsempha ikuluikulu iwiri yamagazi mbali zonse ziwiri za khosi lathu yomwe imanyamula magazi kupita ku ubongo. Mitsempha iyi timaitcha kuti mitsempha ya carotid . Iyi ili ngati mapaipi awiri akuluakulu omwe amabweretsa madzi m'nyumba mwathu. Pakapita nthawi, zinthu monga mafuta ndi cholesterol kuchokera muzakudya zomwe timadya zimasonkhana mkati mwa mitsempha iyi yamagazi, monga dzimbiri lomwe limasonkhana mkati mwa chitoliro chamadzi. Izi zimatchedwa 'plaque' m'mawu azachipatala.

Pamene gawo la 'plaque' ili likukulirakulira pang'onopang'ono, malo omwe ali mkati mwa mtsempha wamagazi amachepa, ndipo kuyenda kwa magazi kumatsekeka. Choopsa kwambiri ndichakuti ngati chidutswa chaching'ono cha gawo la 'plaque' ili chikasweka ndikupita ku ubongo ndi magazi, chikhoza kutseka mtsempha wamagazi muubongo ndikuyambitsa sitiroko .

Kotero, kutsegulanso mtsempha wamagazi wotsekedwawu ndikubwezeretsa kuyenda kwa magazi ndiko komwe timatcha 'kubwezeretsa magazi m'thupi.' Pali njira zingapo zazikulu zochitira izi.

1. Carotid Endarterectomy (CEA): Iyi ndi opaleshoni yachikhalidwe yotseguka. Pa opaleshoniyi, kudula pang'ono kumapangidwa pakhosi, mtsempha wamagazi umatsegulidwa, wosanjikiza wa 'plaque' mkati umachotsedwa, ndipo mtsempha wamagazi umasokedwa pamodzi.

2. Carotid Angioplasty ndi Stenting (CAS): Chubu chopyapyala kwambiri chimadutsa m'mitsempha yamagazi m'mimba kapena m'dzanja ndikutsogoleredwa ku mtsempha wamagazi wotsekedwa m'khosi. Kenako malo otsekedwawo amakulitsidwa ndi chinthu chonga baluni, ndipo 'stent' , chubu chaching'ono cha maukonde, chimayikidwa kuti chisatsekedwenso.

3. TCAR (Transcarotid Artery Revascularization): TCAR ndi njira yotetezeka komanso yamakono yomwe imagwiritsa ntchito njira zonse ziwiri zabwino kwambiri. Imafuna kudula pang'ono pamwamba pa khosi la khosi ndikuyika stent mwachindunji mu mtsempha wamagazi wotsekedwa.

Kodi opaleshoni ya TCAR iyi ndi yoyenera kwa ndani?

Njira ya TCAR idayambitsidwa koyamba mu 2015 kwa odwala omwe anali pachiwopsezo chachikulu cha opaleshoni yachikhalidwe yotseguka (CEA). Izi ndi izi:

• Kwa anthu okalamba .
• Kwa iwo omwe ali ndi matenda a mtima kapena mapapo .
• Kwa iwo omwe ali ndi zipsera zomwe adachitidwa opaleshoni ya khosi kapena chithandizo cha radiation.
• Ngati mtsempha wa magazi watsekedwa pamalo pomwe opaleshoni ndi yovuta, monga pansi pa nsagwada.

Koma tsopano njira iyi yapambana kwambiri kotero kuti kuyambira mu 2022, chithandizo cha TCAR chakhala chikulangizidwa ngakhale kwa odwala omwe ali ndi thanzi labwinobwino, kutanthauza omwe alibe zoopsa zapadera. Pakadali pano, maopaleshoni opitilira 20,000 a TCAR achitika ku United States kokha.

Kodi mumakonzekera bwanji musanachite opaleshoni?

Ngati dokotala wanu asankha kukupangirani opaleshoni ya TCAR, adzafunika kukuyesani kangapo pasadakhale.

• Kuyezetsa magazi: Dziwani za thanzi lanu lonse komanso momwe magazi anu amagwirira ntchito.
• Kujambula kwa ultrasound kwa mitsempha ya carotid: Onani kuchuluka kwa mtsempha wamagazi komwe kwatsekeka.
• CT Angiogram: Pezani chithunzi chomveka bwino cha mitsempha yamagazi m'khosi ndi muubongo.

Komanso, dokotala adzayamba kumwa mankhwala angapo kuti akukonzekeretseni opaleshoni.

• Mankhwala a statin omwe amachepetsa cholesterol.
• Mankhwala monga aspirin ndi clopidogrel omwe amaletsa magazi kuundana.

Mudzalangizidwa kuti musadye kapena kumwa chilichonse pambuyo pa pakati pausiku usiku woti opaleshoni ichitike.

Momwe opaleshoni imachitikira: sitepe ndi sitepe

Opaleshoni iyi itenga pafupifupi ola limodzi ndi theka. Tiyeni tiwone mwachidule zomwe zimachitika mchipinda chochitira opaleshoni.

1. Mankhwala Oletsa Kupweteka: Kuti musamve ululu uliwonse, dera lozungulira khosi lanu lidzatsekedwa (local anesthesia) kapena mudzapatsidwa mankhwala oletsa kupweteka kwathunthu (general anesthesia) .

2. Kucheka pang'ono: Kucheka pang'ono kwambiri kumapangidwa pakhosi, pamwamba pa khosi, pafupifupi mainchesi 1-1.5.

3. Kubwerera M'mbuyo kwa Mayendedwe: Iyi ndi sitepe yofunika kwambiri komanso yotetezeka kwambiri mu njira ya TCAR.

• Chubu chopyapyala chimayikidwa mu mtsempha m'mimba (mtsempha wa femoral).
• Chubu china chimayikidwa mu mtsempha wa carotid wotsekedwa kudzera mu kudula kwa khosi.
• Tsopano, machubu awiriwa alumikizidwa ku makina okhala ndi fyuluta yapadera. Pambuyo pake, kuyenda kwa magazi kupita ku ubongo kumayimitsidwa kwakanthawi, ndipo magazi ochokera mumtsempha wa m'khosi amatuluka kudzera mu chubucho, amatsukidwa ndi fyulutayo, ndikubwerera m'thupi kudzera mu chubu cha m'mimba.
• Pa nthawiyi, magazi omwe ubongo wanu umafunikira amachokera ku mitsempha ya carotid yomwe ili mbali ina ya khosi lanu ndi mitsempha ya vertebral yomwe ili kumbuyo kwa ubongo wanu.Ikupezeka popanda choletsa chilichonse.

4. Kutsegula chotchinga: Waya woonda umagwiritsidwa ntchito kupitirira chotchingacho ndikukulitsa malowo ndi baluni yaying'ono.

5. Kuika stent: Kenako, chubu chaching'ono chachitsulo chotchedwa stent chimayikidwa mu chotsekacho. Izi zimasunga mtsempha wamagazi wotseguka ndikugwirizira plaque kukhoma.

6. Mapeto: Kenako, machubu onse amachotsedwa, ndipo dzenje laling'ono mu mtsempha wamagazi ndi chotupa cha pakhosi zimasokedwa.

Kodi chimachitika ndi chiyani pambuyo pa opaleshoni?

Mukamaliza opaleshoni ya TCAR, muyenera kukhala m'chipatala kwa usiku umodzi . Madokotala ndi anamwino adzayang'anira thanzi lanu nthawi zonse. Popeza opaleshoniyi ndi yosavuta, kuchira kumachitika mwachangu kwambiri.

Kodi zoopsa ndi zovuta zake ndi ziti?

Monga momwe zimakhalira ndi chithandizo chilichonse chamankhwala, TCAR ikhoza kukhala ndi zoopsa zazing'ono kwambiri. Komabe, mwayi woti izi zichitike ndi wochepa kwambiri.

• Kutuluka magazi kapena kutupa kuchokera pamalo odulidwa.
• Matenda a chotupacho.
• Kuwonongeka pang'ono kwa mitsempha pakhosi.
• Stroke.
• Matenda amtima.

Dokotala wanu adzakufotokozerani zoopsa izi mwatsatanetsatane. Kumbukirani kuti njira zapadera zimatengedwa kuti zichepetse zoopsazi panthawi ya opaleshoni ya TCAR.

Kuchira ndikukhala ndi stent

Njira ya TCAR ndi yachangu kwambiri chifukwa palibe kudula kwakukulu.

• Pewani kunyamula zolemera kwa sabata imodzi kapena ziwiri.
• Yang'anani khosi lanu tsiku lililonse kuti muwonetsetse kuti ndi loyera komanso palibe zizindikiro za matenda.
• Funsani dokotala wanu nthawi yomwe mungabwerere kuntchito yanu ndi zochita zina za tsiku ndi tsiku.

Pambuyo poti stent yaikidwa, ndi udindo wanu kuteteza kuti mtsempha wamagazi usatsekekenso. Kuti muchite izi, muyenera kuchita izi.

• Ngati mukusuta, siyani nthawi yomweyo.
• Kuchita masewera olimbitsa thupi nthawi zonse.
• Khalani ndi zakudya zabwino zokhala ndi mafuta ochepa.
• Imwani mankhwala ochepetsa magazi ndi mankhwala ochepetsa mafuta m'thupi omwe dokotala wanu wakupatsani panthawi yake.

Ndiyenera kupita kwa dokotala liti?

Ngati mukuona zizindikiro za matenda pamalo odulidwa, imbani dokotala nthawi yomweyo.

• Malungo
• Ngati mukumva kuzizira
• Ngati pali kufiira ndi kutupa kuzungulira chotupacho
• Ngati chinthu chonga madzi chatuluka m'chidutswacho

Dokotala wanu adzasankha chithandizo chomwe chili chabwino kwa inu. Kambiranani naye mafunso, nkhawa, kapena kukayikira kulikonse komwe muli nako. Cholinga chake ndikukupatsani chithandizo choyenera komanso chotetezeka kwambiri.