Kodi tiyenera kudziwa bwino za mankhwala awiriwa omwe amaperekedwa pambuyo poika stent pa matenda a mtima? (Chithandizo cha Antiplatelet Chachiwiri)

Kodi mwakhala ndi vuto la mtima posachedwapa? Kapena mwakhala ndi stent mumtsempha wamagazi mumtima mwanu? Dokotala wanu mwina anakupatsani mitundu iwiri ya mankhwala. Limodzi likhoza kukhala aspirin. Lina likhoza kukhala piritsi lokhala ndi dzina lina. Chifukwa chake mwina mukudabwa kuti, "N'chifukwa chiyani ndikupatsidwa mankhwala awiri osiyana a vuto lomweli?" Ili ndi funso lomwe anthu ambiri ali nalo. Lero, tikulankhula za DAPT, kapena Dual Antiplatelet Therapy, yomwe ndi mankhwala ofunikira komanso opulumutsa moyo kwa ambiri a inu.

Kodi DAPT ndi chiyani? Tiyeni timvetse mosavuta.

Kuti timvetse izi, choyamba tiyenera kudziwa pang'ono za magazi athu. Magazi athu ali ndi maselo ofiira a magazi, maselo oyera a magazi, ndi tinthu tina tating'ono ta maselo. Izi zimatchedwa ma platelet . Ntchito yayikulu ya ma platelet awa ndikuletsa kutuluka magazi pakavulala kwinakwake m'thupi lathu, ndipo amathamangira pamalopo, amamatirana, ndikupanga ulusi kuti aletse kutuluka magazi. Zili ngati kuika pulasitala mwachangu pa chitoliro chosweka. Izi ndi zomwe timatcha magazi kuundana . Iyi ndi njira yofunika kwambiri populumutsa miyoyo yathu. Komabe, vuto limayamba pomwe magazi kuundana sikuyenera kuchitika, ndiko kuti, ngati kuchitika mkati mwa mitsempha yathu imodzi yamagazi. Tangoganizirani zomwe zimachitika ngati magazi kuundana apanga m'mitsempha yomwe imanyamula magazi kupita kumtima? Mitsempha yamagazi imeneyo yatsekedwa, kuletsa kuyenda kwa magazi kupita kumtima ndikuyambitsa matenda amtima (Myocardial Infarction) . Komanso, ngati magazi kuundanawa apita ku ubongo, angayambitse sitiroko . Chifukwa chake, Dual Antiplatelet Therapy (DAPT) ndi chithandizo chomwe chimaletsa magazi kuundana koopsa kuti asapangidwe mkati mwa mitsempha. Mu izi, mitundu iwiri ya mankhwala otchedwa "Antiplatelet" imaperekedwa pamodzi. Antiplatelet ndi mankhwala omwe amaletsa ma platelet kuti asamamatire pamodzi, zomwe zikutanthauza kuti amaletsa magazi kuundana. "Dual" amatanthauza awiri. Chifukwa chake, izi zimatchedwa Dual Antiplatelet Therapy chifukwa mitundu iwiri ya mankhwala imaperekedwa pamodzi.

Ndani akufunikira chithandizo cha DAPT ichi?

Madokotala sapereka chithandizo ichi kwa aliyense. Chimaperekedwa kwa anthu okhawo omwe ali pachiwopsezo chachikulu chokhala ndi magazi oundana m'mitsempha yawo. Chithandizochi nthawi zambiri chimaperekedwa pazochitika zotsatirazi:

Ndi mankhwala ati omwe amaperekedwa kwa DAPT?

Timanena kuti mitundu iwiri ya mankhwala imaperekedwa pamodzi mu chithandizo cha DAPT. Mitundu iwiri ya mankhwala ndi iyi: 1. Aspirin: Iyi ndi mankhwala omwe ambiri mwa inu mwamvapo. Ngakhale kuti nthawi zambiri amagwiritsidwa ntchito pa mlingo waukulu ngati mankhwala ochepetsa ululu, amaperekedwa pa mlingo wochepa kwambiri kuti ateteze magazi kuundana mwa odwala a mtima. 2. Mankhwala omwe ali m'gulu la P2Y12 Inhibitor: Iyi ndi mankhwala achiwiri. Pali mitundu ingapo ya mankhwala omwe ali m'gululi.

• Clopidogrel
• Prasugrel
• Ticagrelor

Dokotala wanu adzasankha mankhwala atatu awa omwe akupatseni komanso mlingo wake.Zimatengera zinthu zambiri, monga matenda anu, zaka, komanso ngati muli ndi matenda ena.

Kodi ubwino ndi zoopsa za chithandizo cha DAPT ndi ziti?

Monga momwe zimakhalira ndi chithandizo chilichonse, chithandizo cha DAPT chili ndi ubwino ndi zoopsa zina. Ndikofunikira kudziwa zonse ziwiri.

Zambiri zokhudza chiopsezo cha kutuluka magazi...

Musachite mantha mukamva mawu akuti "chiopsezo cha kutuluka magazi." Izi zingatanthauze chilichonse kuyambira zinthu zazing'ono mpaka zinthu zazikulu.

• Kutuluka magazi pang'ono: Kutuluka magazi m'kamwa mukamatsuka mano, kutuluka magazi m'mphuno, komanso kusanduka buluu msanga mutavulala pang'ono ndi zofala.
• Kutuluka magazi kwambiri: Ngakhale kuti n’kosowa kwambiri, kutuluka magazi m’mimba kapena m’matumbo ( kutuluka magazi m’mimba) kungachitike. Izi zingayambitse magazi m’chimbudzi kapena kupangitsa chimbudzi kukhala chakuda. Komanso, kutuluka magazi m’kati mwa ubongo kungachitike kawirikawiri.

Zotsatirapo zoyipa ndi kuyanjana ndi mankhwala ena

Anthu ena omwe amatenga DAPT akhoza kukhala ndi zotsatirapo zazing'ono.

• Kuvuta kupuma
• Magazi mu mkodzo (Haematuria)
• Kutupa
• Kuchepa kwa kuchuluka kwa ma platelet m'magazi ( Thrombocytopenia )
• Ma polyps a m'mphuno
• Kutuluka magazi m'mphuno (Epistaxis)

Komanso, mukamamwa DAPT, muyenera kuuza dokotala wanu za mankhwala ena omwe mukumwa. Chifukwa mankhwala ena amatha kusokoneza mphamvu ya DAPT. Samalani kwambiri ndi mankhwalawa.

• Mankhwala ena ochepetsa magazi ( Anticoagulants ): Ngati mukumwa mankhwala monga Warfarin, chiopsezo chotuluka magazi chimakhala chachikulu kwambiri.
• Mankhwala Ochepetsa Ululu (NSAIDs): Kugwiritsa ntchito mankhwala monga Ibuprofen ndi Diclofenac pafupipafupi kungapangitse kuti magazi azituluka m'mimba.
• Mankhwala ena ochepetsa kuvutika maganizo (Antidepressants).
• Mankhwala a gastritis (Proton Pump Inhibitors): Mankhwala monga Omeprazole.

Choncho, musaiwale kuuza dokotala wanu za chilichonse chomwe mumamwa, kuphatikizapo mapiritsi, mavitamini, ndi mankhwala achikhalidwe.

Ndiyenera kumwa mankhwalawa kwa nthawi yayitali bwanji?

Izi ndi vuto kwa anthu ambiri. Nthawi yogwiritsira ntchito DAPT si yofanana kwa aliyense. Imasiyana malinga ndi munthu.

• Anthu ena angapereke kwa kanthawi kochepa, monga mwezi umodzi kapena iwiri.
• Anthu ambiri amamwa mowa kwa chaka chimodzi kapena kuposerapo.
• Ngakhale mutasiya kumwa mankhwala a DAPT, dokotala wanu angakuuzeni kuti mumwe aspirin yokha kwa moyo wanu wonse.

Nthawi ino imasankhidwa ndi dokotala wanu. Pali zinthu zingapo zomwe zimakhudza izi:

• N’chifukwa chiyani munayamba kumwa DAPT (matenda a mtima? Chifukwa chakuti munaikidwa stent?).
• Zaka zanu ndi thanzi lanu lonse.
• Kodi muli ndi chiopsezo chotani chotaya magazi?
• Chiwopsezo chokhala ndi matenda ena a mtima kapena sitiroko mtsogolo.

Kodi muyenera kuchita chiyani kuti mudziteteze mukamamwa DAPT?

Muyeneranso kuganizira za chitetezo chanu pamene mukulandira chithandizochi. Nazi zinthu zosavuta zomwe mungachite kuti zikuthandizeni.

• Imwani mankhwala anu pa nthawi yake: Imwani mankhwala anu monga momwe dokotala wanu wanenera, osadumpha tsiku lililonse . Ngati mwaphonya mlingo, ukhoza kuyambitsa magazi kuundana. Musasiye kumwa mankhwala anu popanda kufunsa dokotala wanu.
• Valani khadi la ID yachipatala:Ngati n'kotheka, nthawi zonse nyamulani chibangili kapena khadi lolembedwa kuti mukumwa DAPT. Pakagwa ngozi, izi zithandiza omwe akukuthandizani kudziwa kuti mukumwa mankhwala ochepetsa magazi.
• Uzani madokotala anu onse: Ngakhale mukupita kwa dokotala wa mano kapena kuchitidwa opaleshoni ina iliyonse, muyenera kuwauza kuti mukugwiritsa ntchito DAPT, chifukwa opaleshoni zina zimafuna kuti musiye kumwa mankhwalawa kwakanthawi.

Kodi zizindikiro zomwe zimafunika thandizo lachipatala mwamsanga ndi ziti?

Ngati mukukumana ndi zizindikiro izi, zingakhale chizindikiro cha kutuluka magazi ambiri. Choncho, musachedwe kuyimbira dokotala nthawi yomweyo kapena pitani ku Dipatimenti Yoona za Zadzidzidzi (ETU) ya chipatala chapafupi. Komanso, ngati mukuganiza kuti mwamwa mankhwala ochulukirapo, imbani dokotala wanu nthawi yomweyo. Kupanda kutero,Muthanso kuyimbira National Poison Information Center ku Colombo National Hospital kuti mupeze upangiri. DAPT, Chithandizo Chachiwiri Choletsa Kutsekeka kwa Magazi, Kutseka Magazi, Kuukira kwa Mtima, Kufa kwa Mimba, Kutupa kwa Magazi, aspirin, clopidogrel, Clopidogrel, Matenda a Mtima, Kuchepetsa Magazi