Mtsempha waukulu kwambiri m'thupi mwathu ndi aorta, yomwe timaitcha "Aorta" mu Chingerezi. Taganizirani ngati chitoliro chachikulu cha madzi m'thupi mwathu. Ndi ichi chomwe chimagawa magazi kuchokera mumtima kupita ku thupi lonse. Nthawi zina, khoma la mtsempha uwu limafooka ndikuyamba kuphulika ngati baluni. Ichi ndi chomwe timachitcha "Aneurysm" mu zamankhwala. Choopsa kwambiri ndichakuti kuphulika kumeneku kumawonjezeka ndipo pali mwayi woti kungaphulike mwadzidzidzi. Chifukwa chake lero tikambirana za njira yamakono yochizira yomwe ingapewe vutoli popanda kupanga ming'alu yayikulu m'thupi komanso popanda khama lalikulu.
Mwachidule, kodi EVAR ndi chiyani?
Tanthauzo lonse la EVAR ndi `(Endovascular Aneurysm Repair)`. Mu Chisinhala, ndi kukonzanso komwe kumachitika mkati mwa mtsempha wamagazi. Iyi si opaleshoni yayikulu . Izi zikutanthauza kuti m'malo mochita opaleshoni yayikulu podula mimba, chithandizochi chimachitika pogwiritsa ntchito dzenje laling'ono kwambiri.
Tangoganizani kuti chitoliro chakale chamadzi chatupa ndipo chatsala pang'ono kuphulika. M'malo modula chitolirocho ndikuchichotsa, zomwe zikuchitika apa zikufanana ndi kuchikonza poika chitoliro chopyapyala komanso cholimba mkati mwake. Madokotala amaika chubu chopangidwa mwapadera (Stent Graft) mu mtsempha wamagazi wotupa. Izi zili ngati nsalu yapadera yopangidwa ndi nsalu ndi ukonde wachitsulo. Izi zikalowetsedwa, magazi amatuluka mu chubu chatsopanocho. Kenako, palibe kupanikizika komwe kumayikidwa pakhoma lofooka, lotupa. Chifukwa chake, chiopsezo choti chiphulike chimachotsedwa kwathunthu.
Nchifukwa chiyani tikufunika chithandizo cha EVAR?
Cholinga chachikulu komanso chokhacho cha izi ndikuletsa kuti Aneurysm ya m'mimba isasweke . Chifukwa ngati zimenezo zitachitika, ndi vuto lomwe lingayambitse imfa komanso imfa.
Khoma la mtsempha wamagazi likafooka, kuthamanga kwa magazi komwe kumabwera ndi kugunda kwa mtima kulikonse kumapangitsa kuti malo ofookawo atukuke. Zimakhala ngati thovu mu tayala. Sizingakulire kwamuyaya. Nthawi ina, zimaphulika. Ngati zimenezo zitachitika, magazi ambiri amatha kulowa m'thupi, ndipo imfa imatha kuchitika mkati mwa mphindi zochepa.
Kotero chomwe chithandizo cha EVAR chimachita ndi kuyika ``(Stent Graft)`` imeneyo, kusintha kayendedwe ka magazi, ndikuchepetsa kupanikizika pakhoma lotupa. Zimenezo zimaletsa chiopsezo cha kuphulika.
Mwachidule, izi zili ngati kutseka bomba. Mumachotsa ngoziyo isanaphulike.
Kodi chithandizo cha EVAR ichi n'choyenera kwa ndani?
Chithandizochi sichichitika nthawi yomweyo kwa aliyense amene ali ndi aneurysm ya m'mimba. Dokotala wanu adzayang'ana zinthu zingapo kuti adziwe ngati chithandizochi chili choyenera kwa inu.
- Ngati aneurysm yanu ndi yayikulu mokwanira , kapenaNgati ma scan akusonyeza kuti ikukula mofulumira mkati mwa nthawi yochepa.
- Ngati simungathe kupirira chiopsezo cha opaleshoni yayikulu monga gastric bypass chifukwa cha matenda ena (monga matenda a mtima kapena matenda a m'mapapo).
- Ngati mitsempha yamagazi yomwe ili pamwamba ndi pansi pake ili yathanzi komanso yolimba (chifukwa pakufunika kukhala malo abwino oti muyikemo chubu chatsopano).
Dokotala akaganizira zinthu ngati izi, amasankha kuti chithandizo cha EVAR ndi chabwino kwa inu.
Kodi njira yapadera yotchedwa FEVAR ndi iti?
Mtsempha waukulu wa m'mimba mwathu uli ngati thunthu la mtengo. Umafalikira m'mitsempha yaying'ono yamagazi yomwe imanyamula magazi kupita ku ziwalo za m'mimba mwathu (monga impso ndi matumbo). Nthawi zina aneurysm imapanga pafupi kwambiri ndi komwe nthambizo zimafikira. Zikatero, chubu cholunjika chomwe chimagwiritsidwa ntchito mu EVAR yachizolowezi sichingaikidwe, chifukwa kuchita izi kungalepheretse kuyenda kwa magazi kupita ku nthambizo.
Ndi pa milandu yovuta ngati imeneyi pomwe njira yapadera yotchedwa FEVAR (Fenestrated Endovascular Aneurysm Repair) imagwiritsidwa ntchito. Mu `(Stent Graft)` yomwe imagwiritsidwa ntchito pano, mabowo ang'onoang'ono ofanana ndi mawindo amapangidwa kuti agwirizane ndi nthambi. Pambuyo poti chubu chachikulu chaikidwa, `(Stent)` yosiyana imayikidwa kudzera m'mawindo amenewo kupita m'mitsempha yamagazi yofanana ndi nthambi kuti zitsimikizire kuti magazi akuyenda bwino. Ngakhale izi ndi zovuta pang'ono, ndi mwayi waukulu kuchira `(Aneurysm)` m'malo ovuta ngati amenewa popanda kuchitidwa opaleshoni yayikulu.
Kodi kusiyana pakati pa EVAR ndi TEVAR ndi kotani?
Mankhwala onsewa ndi ofanana. Kusiyana kwake kuli pa malo omwe chithandizocho chachitikira.
- EVAR: Imachitika pa aneurysms ya m'mimba (m'mimba) .
- TEVAR (Kukonzanso kwa Thoracic Endovascular Aneurysm): imachitika pa aneurysms pachifuwa (chifuwa) .
Kodi ubwino wa chithandizo cha EVAR ndi wotani?
Poyerekeza ndi opaleshoni yayikulu, chithandizo cha EVAR chili ndi ubwino wambiri. Ndi njira yosavulaza kwambiri.
| Phindu | Mwachidule... |
|---|---|
| Nthawi yochepa kuchipatala | Ngakhale opaleshoni yaikulu imatenga pafupifupi sabata imodzi, opaleshoni iyi imatenga masiku awiri kapena atatu. |
| Kuchuluka kwa magazi omwe amatayika ndi kochepa. | Popeza palibe kuvulala kwakukulu, kutuluka magazi pang'ono kwambiri. |
| Kupweteka kochepa panthawi yochira | Popeza palibe kuvulala kwakukulu, ululu ndi wochepa kwambiri. Mankhwala opha ululu amafunikira kwa kanthawi kochepa chabe. |
| Mukhoza kubwerera ku moyo wabwinobwino mwachangu. | Mukhoza kubwerera kuntchito mkati mwa mwezi umodzi, popanda kudikira miyezi ingapo. |
| Zoopsa pa nthawi ya opaleshoni n'zochepa. | Chiwopsezo cha matenda a mtima kapena imfa panthawi ya opaleshoni n'chochepa poyerekeza ndi nthawi ya opaleshoni yaikulu. |
| Nthawi ya opaleshoni ndi yochepa. | Chithandizochi chingathe kuchitidwa munthawi yochepa kuposa opaleshoni yotseguka. |
Kodi pali zoopsa zilizonse ndi chithandizo cha EVAR?
Ngakhale kuti EVAR ndi mankhwala opambana kwambiri komanso otetezeka, monga momwe zimakhalira ndi njira ina iliyonse yachipatala, pali zoopsa zazing'ono zomwe zingachitike. Komabe, izi sizichitika kawirikawiri.
| Chiwopsezo | Kufotokozera |
|---|---|
| Kuundana kwa magazi | Pali chiopsezo cha magazi kuundana m'mitsempha yamagazi, makamaka m'mitsempha yakuya ya miyendo (Deep Vein Thrombosis - DVT). |
| Endoleak | Magazi ochepa kwambiri amatuluka pakati pa stent graft yatsopano ndi khoma la mtsempha wamagazi, zomwe zimapangitsa kuti aneurysm idzazenso ndi magazi. Ili ndiye vuto lalikulu lomwe lingachitike panthawi ya chithandizochi. |
| Mavuto ena | Matenda a mtima, matenda, kulephera kwa impso, ndi kutuluka magazi kwambiri zimatha kuchitika, koma izi zimachitika kawirikawiri. |
Kodi opaleshoni ya EVAR imachitika bwanji? Gawo ndi Gawo
Chabwino, tsopano tiyeni tiwone momwe chithandizochi chimachitikira. Mukamvetsetsa bwino izi, sipadzakhala mantha osafunikira.
1. Mankhwala Oletsa Kupweteka: Choyamba, mudzapatsidwa mankhwala oletsa kupweteka kuti muonetsetse kuti simukumva kupweteka kulikonse kapena kusasangalala. Mungathe kugona mokwanira, kapena mutha kukhala osazindikira bwino.
2. Kupeza: Dokotala adzagwiritsa ntchito mitsempha ikuluikulu yamagazi m'malo mwanu (Femoral Arteries). Pakhungu padzadulidwa pang'ono.
3. Kuika catheter: Kenako, chubu chopyapyala kwambiri komanso chosinthasintha (catheter) chokhala ndi stent graft chimayikidwa kudzera m'bowo kupita mumtsempha wamagazi.
4. Malangizo: Catheter iyi iyenera kutsogozedwa m'mitsempha yamagazi, mpaka komwe kuli aneurysm m'mimba. Kuti aone izi bwino, dokotalayo amagwiritsa ntchito ukadaulo wapadera wojambulira zithunzi monga X-ray (Real-time imaging). Izi zikutanthauza kuti amachita izi poyang'ana catheter ikuyenda mkati mwa thupi.
5. Kuika Stent Graft: Akafika pamalo oyenera, dokotala adzakulitsa stent graft mkati mwa catheter. Kenako idzakula mkati mwa mtsempha wamagazi ndikudzilumikiza mwamphamvu ku makoma, ndikupanga njira yatsopano komanso yolimba yoti magazi ayende.
6. Kumaliza: `(Stent Graft)` ikayikidwa bwino, catheter imachotsedwa mosamala. Bowo lomwe lili m'mimba mwake ndi laling'ono kwambiri kotero kuti siliyenera kusokedwa . Mungagwiritse ntchito pulasitala yaying'ono ngati pulasitala.
Kodi zimatenga nthawi yayitali bwanji kuti munthu achire pambuyo pa opaleshoni?
Ngakhale kuti nthawi yochira ingasiyane malinga ndi munthu, izi ndi zomwe zimachitika nthawi zambiri.
- Uyenera kukhala m'chipatala kwa masiku angapo.
- Mukatha kupumula, mudzatha kudya ndi kumwa nthawi yochepa.
- Mothandizidwa ndi anamwino, amamuuza kuti adzuke pabedi mwamsanga ndikuyamba kuyenda.
- Mudzamva kutopa pang'ono kwa masiku oyamba mutabwerera kunyumba, ndipo mudzafunika kumwa mankhwala ochepetsa ululu. Ndi zachilendo zimenezo.
- Musayendetse galimoto mpaka mutamwa mankhwala ochepetsa ululu .
- Anthu ambiri amatha kubwerera kuntchito zawo mkati mwa mwezi umodzi .
- Muyenera kupewa kunyamula zolemera kwa milungu 4-6 .
Ngati muli ndi zizindikiro izi, pitani kwa dokotala nthawi yomweyo!
Mukapita kunyumba, ndikofunikira kusamala thupi lanu. Ngati muwona zizindikiro zilizonse zomwe zili pansipa, imbani dokotala nthawi yomweyo.
- Kutupa, kupweteka, kapena khungu lozizira m'miyendo, makamaka miyendo ya m'munsi (izi zitha kukhala zizindikiro za DVT).
- Ngati mukumva chizungulire kapena kukomoka .
- Ngati mukumva kupweteka kwambiri m'mimba, pachifuwa, kapena kumbuyo .
- Kugunda kwa mtima kumachitika pamene mukumva mtima wanu ukugunda mofulumira.
- Ngati mukumva kufiira m'mimba kapena kupweteka kwina kosazolowereka kwa mwendo .
Chithandizo cha EVAR ndi njira yabwino kwambiri komanso yosapweteka kwambiri m'malo mwa opaleshoni yachikhalidwe yotseguka. Mutha kuchira mwachangu ndikupita kunyumba. Komabe, simungaiwale kuti chithandizocho chinayenda bwino. Monga momwe dokotala akunenera, ndikofunikira kubweranso panthawi yomwe yakonzedwa ndikujambulanso. Umu ndi momwe mungayang'anire ngati `(Stent Graft)` yomwe idayikidwa ikugwira ntchito bwino komanso ngati pali mavuto ena monga `(Endoleak)`.
Uthenga Wopita Nawo Kunyumba
- EVAR ndi njira yamakono yochiritsira yomwe imagwiritsidwa ntchito poletsa kuphulika kwa aneurysm mu mtsempha waukulu wamagazi m'mimba, aorta.
- Apa, stent graft imayikidwa mu mtsempha wamagazi pogwiritsa ntchito chubu chopyapyala chotchedwa catheter, chomwe chimayikidwa kudzera m'mimba, popanda kudula kwakukulu.
- Kugona m'chipatala, ululu, ndi nthawi yochira ndizochepa kwambiri poyerekeza ndi opaleshoni yotseguka.
- Ngakhale mutalandira chithandizo, ndikofunikira kupitiriza kupita kukayezetsa monga momwe dokotala wanenera. Izi zithandiza kuzindikira mavuto omwe angakhalepo msanga.
- Ngati mukukumana ndi zizindikiro zachilendo (kutupa kwa miyendo, kupweteka kwambiri, chizungulire) mutachita opaleshoni, funsani upangiri wa dokotala nthawi yomweyo.
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