Mwina mwangobwera kumene kuchokera ku opaleshoni yayikulu. Mwina mukumva bwino kwambiri komanso kumasuka. Koma kodi dokotalayo anakuuzani za chinthu chonga 'endoleak'? Kapena anakuuzani kuti chinthu chonga chimenecho chingachitike mukabwera kudzayezetsa mtsogolo? Ndizachibadwa kumva mantha pang'ono komanso nkhawa mukamva mawu awa. Koma musadandaule. Lero, tikambirana mwachidule, kuti ndi chiyani, chifukwa chake zimachitika, komanso ngati muyenera kuopa.
Mwachidule, kodi endoleak iyi ndi chiyani?
Kuti timvetse izi, choyamba tiyeni tikukumbutseni pang'ono za opaleshoni yomwe mudachita. Mtsempha waukulu kwambiri wamagazi m'thupi lathu, aorta, uli ngati chitoliro chachikulu chamadzi m'nyumba mwathu. Nthawi zina, malo pakhoma la chitolirochi amakhala ofooka ndikutupa ngati baluni. Ndicho chimene timachitcha
aneurysm . Chifukwa izi zitha kukhala zoopsa, madokotala amaika mtsempha wopangira magazi, wotchedwa
stent graft, mu chitolirocho. Taganizirani ngati kuyika chubu chatsopano, cholimba kudzera mu chitoliro chakale, chofooka. Tsopano magazi amangoyenda kudzera mu stent yatsopano. Kenako, palibe kukakamiza pakhoma lakale, lofooka, kotero palibe chiopsezo choti liphulike. Koma, pakapita
nthawi yochepa kwambiri, magazi pang'ono amayamba kutuluka pakati pa
stent yatsopano ndi khoma la mtsempha wakale wamagazi. Zili ngati madzi pang'ono akutuluka m'mbali mwa chubu chatsopano.
Kutuluka kwa magazi kumeneko ndi komwe timatcha azachipatala kuti 'endoleak'. Ngati endoleak iyi ichitika mkati mwa masiku 30 kuchokera pa opaleshoni, imatchedwa "endoleak yoyambirira." Ngati izi zitachitika patatha masiku 30, zimatchedwa "late endoleak."
Kodi izi zimachitikira anthu ambiri? Kodi ndi chinthu choopera?
Ndipotu,
pafupifupi munthu m'modzi mwa anayi omwe amachitidwa opaleshoni yokonzanso aneurysm (monga EVAR kapena TEVAR) ali ndi mwayi wopeza endoleak iyi. Choncho si zachilendo. Koma chofunika ndichakuti,
si endoleak zonse zomwe ndi zoopsa. Mitundu ina ya endoleaks imatha kuchira yokha patatha miyezi ingapo popanda chithandizo chilichonse. Dokotala amangoyang'anira pogwiritsa ntchito ma scan . Komabe, mitundu ina ndi yoopsa kwambiri. Ingayambitse aneurysm kukula kachiwiri ndikuwonjezera kuthamanga kwa magazi, kotero iyenera kuchiritsidwa mwachangu.
Chifukwa chake, kuopsa kwake kumatsimikiziridwa ndi mtundu ndi malo a izi.
Kodi mitundu ikuluikulu ya endoleaks ndi iti?
Pali mitundu ikuluikulu isanu ya ma endoleak. Iliyonse ya iyo ili ndi chifukwa chosiyana. Tsopano, chifukwa cha kubwera kwa ukadaulo watsopano wa stent, kuchuluka kwa mitundu ina kwachepa kwambiri. Tiyeni tiwone mitundu iyi.
| Mtundu wa Endolek | Zili bwanji? (Mwachidule) | Kuopsa |
|---|
| Mtundu 1 | Kutuluka kwa magazi chifukwa cha stent yosakwanira bwino pakhoma la mitsempha yamagazi pamwamba kapena pansi. | Zoopsa kwambiri. Pali chiopsezo chachikulu cha kuphulika kwa aneurysm. Chithandizo chachangu chikufunika. |
| Mtundu Wachiwiri | Kutuluka magazi m'magazi kuchokera ku mitsempha yaing'ono yamagazi yomwe imalumikizana ndi mitsempha yayikulu yamagazi. | Mtundu uwu ndi wofala kwambiri. Nthawi zambiri si woopsa. Pafupifupi 40% ya milandu imachira yokha mkati mwa miyezi 6. Madokotala amawayang'anira. |
| Mtundu 3 | Ngati stent ili ndi zigawo zingapo, kutuluka kwa magazi kungachitike chifukwa cha kulekana pakati pa zigawo ziwiri. | Zoopsa kwambiri. Monga mtundu woyamba, pali chiopsezo cha kuphulika. Chithandizo chachangu chikufunika. |
| Mtundu 4 | Magazi amatuluka kudzera m'mabowo abwino kwambiri a nsalu yomwe stent imapangidwa nayo. | Chosowa kwambiri. Vutoli silikuwoneka ngati limapezeka mu ma stents atsopano. |
| Mtundu 5 | Ma scan sakusonyeza kutuluka kwa magazi kulikonse, koma aneurysm ikupitirira kukula. Imatchedwanso "endotension." | Popeza chifukwa chake sichikudziwika bwino, madokotala akuyang'anira izi mosamala. |
Kodi zizindikiro za endoleak ndi ziti?
Ichi ndi chinthu chofunikira kwambiri chomwe muyenera kudziwa.
Nthawi zambiri, simudzamva zizindikiro zilizonse za endoleak. Simungamve kusintha kulikonse, kupweteka, kapena kusasangalala. Izi zimapezeka panthawi ya ma scan omwe amachitika panthawi
yokumana ndi dokotala pambuyo pa opaleshoni. Ichi ndichifukwa chake dokotala wanu amakuuzani kuti mubwere kudzajambula ma scan amenewo pa masiku omwe akupatsani. Musawaphonye.
Zadzidzidzi! Ngati mukumva zizindikiro izi, pitani ku ETU nthawi yomweyo!
Ngati aneurysm yakale yaphulika chifukwa cha endoleak, ndi vuto lachipatala. Ngati zizindikiro zotsatirazi zachitika mwadzidzidzi, musataye nthawi ndipo pitani
ku Dipatimenti Yothandiza Pangozi (ETU) ya chipatala chapafupi .
- Kupweteka kwadzidzidzi, kosapiririka, komanso koopsa m'mimba, msana, kapena miyendo.
- Kupweteka mwadzidzidzi komanso kopweteka pachifuwa kapena kumbuyo.
- Chizungulire ndi kukomoka.
- Kugunda kwa mtima mwachangu mwadzidzidzi.
- Kumva kuzizira komanso thukuta.
- Kusanza ndi kusanza .
- Kuvuta kupuma .
Kodi madokotala amazindikira bwanji izi?
Monga tanenera kale, izi zimapezeka pogwiritsa ntchito ma scan apadera. Mayesowa angachitike panthawi ya opaleshoni yanu, mutatha opaleshoni, komanso miyezi kapena zaka pambuyo pake. Izi zili choncho chifukwa ma endoleak ena ochedwa amatha kupangika patatha nthawi yayitali mutatha opaleshoni. Mayeso akuluakulu omwe amagwiritsidwa ntchito ndi awa:
- Kujambula kwa CT (Computed Tomography scans): Izi zimatha kujambula zithunzi zomveka bwino za mkati mwa thupi ndikuwona ngati magazi akutuluka.
- Doppler Ultrasound: Izi zimatha kuzindikira kutuluka kwa magazi poyang'ana momwe magazi amayendera komanso liwiro la kuyenda kwa magazi m'mitsempha yamagazi .
- Angiogram: Izi zimaphatikizapo kubaya utoto wapadera m'mitsempha yamagazi ndikujambula X-ray kuti muwone komwe magazi akutuluka.
Kodi mumachitira bwanji endoleak?
Chithandizo chimadalira mtundu wa endoleak yomwe muli nayo, komwe ili, komanso thanzi lanu lonse. Palibe chithandizo chimodzi choyenera onse. Pali njira zitatu zazikulu.
1. Kuyang'anitsitsa
Izi ndi zomwe zimachitika kawirikawiri pa matenda a endoleaks omwe si aakulu monga Type 2. Dokotala wanu adzakufunsani kuti muyesedwe miyezi 6 iliyonse. Izi zidzayang'ana ngati kutuluka kwa magazi kukuchoka kokha, ngati kukupitirirabe, kapena ngati aneurysm ikukulirakulira. Ngati aneurysm sikukulirakulira, ndibwino osachitapo kanthu ndikudikira.
2. Chithandizo cha Endovascular
Awa ndi maopaleshoni ang'onoang'ono omwe amachitidwa popanda kudula kwakukulu, pogwiritsa ntchito chinthu chonga singano kudutsa mtsempha wamagazi.
- Kutsekereza mitsempha yamagazi ing'onoing'ono yomwe imayambitsa kutuluka magazi pogwiritsa ntchito guluu wapadera kapena waya zazing'ono.
- Kukulitsa stent: Kukulitsa stent poika chidutswa china cha stent kuti chiphimbe kutuluka kwa madzi.
- Kugwiritsa ntchito guluu: Kutseka aneurysm poika chinthu chonga guluu pamalo pomwe magazi akutuluka.
3. Opaleshoni Yotseguka
Izi zimachitika kawirikawiri. Pokhapokha ngati njira zina zalephera kukonza endoleak, ndipo ngati njira yomaliza, opaleshoni yayikulu yokhudza kudula m'mimba imagwiritsidwa ntchito.
Mafunso oti mufunse dokotala wanu
Ndizachibadwa kukhala ndi mafunso okhudza matenda anu. Musazengereze kufunsa mafunso awa nthawi ina mukadzaonana ndi dokotala wanu.
- Ndi mavuto ena ati omwe angachitike pambuyo pa opaleshoni iyi?
- Kodi chiopsezo changa chotenga endoleak ndi chiyani?
- Kodi ndiyenera kubwera kangati kuti ndikaone ngati ndachira?
- Kodi ndi ma scan otani omwe ndiyenera kukhala nawo?
- Kodi ndiyenera kuchita chiyani kuti mtima wanga ndi mitsempha yamagazi zikhale zathanzi?
Kukonza aneurysm ndi njira yopulumutsa moyo. Chifukwa chake ndikwachibadwa kukhala ndi mavuto ang'onoang'ono ngati awa mutachita opaleshoni yotereyi. Nthawi zambiri, awa safunika kuchiritsidwa. Tsopano pali njira zamakono komanso zosavuta zomwe zilipo. Ngati mukumva kutopa kapena kutopa, lankhulani ndi dokotala wanu kapena abale anu za izi.
Uthenga Wopita Nawo Kunyumba
- Endoleak ndi vuto lofala kwambiri pambuyo pa opaleshoni ya aneurysm, koma nthawi zina si vuto loopsa.
- Matenda ambiri a endometritis sali ndi zizindikiro, choncho onetsetsani kuti mwapita kukayezetsanso monga momwe dokotala wanu wanenera.
- Matenda a endoleak a mtundu 1 ndi 3 ndi oopsa ndipo amafunika chithandizo chadzidzidzi. Matenda a endoleak a mtundu 2 omwe amapezeka nthawi zambiri amatha okha.
- Ngati muli ndi zizindikiro monga kupweteka kwadzidzidzi kwa m'mimba/pachifuwa, kukomoka, ndi zina zotero, izi zitha kukhala chizindikiro cha kuphulika kwa aneurysm . Pitani ku Dipatimenti Yodzidzimutsa ya Chipatala (ETU) nthawi yomweyo.
- Ngati muli ndi kukayikira kapena mafunso okhudza matenda anu, musaope kukambirana ndi dokotala wanu.
Endoleak, Aneurysm, Opaleshoni, Stent Graft, Kutuluka kwa Magazi, Aorta, EVAR, TEVAR, Matenda a Mtima
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