Kodi mudamvapo kuti mtsempha wofunika kwambiri m'thupi mwathu ukhoza kutupa ngati baluni? Izi ndi zoopsa kwambiri. Koma musadandaule, chifukwa cha kupita patsogolo kwa sayansi ya zamankhwala, izi zitha kuchiritsidwa mosavuta popanda kudula kwambiri. Lero tikambirana za izi. Njira iyi imatchedwa EVAR.
Mwachidule, kodi EVAR ndi chiyani?
Tanthauzo lonse la EVAR ndi Endovascular Aneurysm Repair . Iyi ndi opaleshoni yochepa kwambiri. Imagwiritsidwa ntchito pochiza aneurysms, kapena monga momwe timawatchulira m'mawu azachipatala , aneurysms , mu aorta, mtsempha waukulu wamagazi m'mimba mwathu.
Tangoganizani kuti mtsempha waukulu kwambiri m'thupi mwathu ndi aorta. Apa ndi pomwe magazi amafalikira kuchokera mumtima kupita ku thupi lonse. Nthawi zina, pamene malo pakhoma la mtsempha uwu wamagazi afooka, kuthamanga kwa magazi kumapangitsa kuti malo ofookawo atuluke ngati buluni. Ndicho chimene timachitcha aneurysm.
Mu chithandizo cha EVAR, mabowo awiri ang'onoang'ono okha ndi omwe amapangidwa mbali zonse ziwiri za mtsempha, ndipo zida zapadera zimadutsamo kuti akonze mtsempha wamagazi wotupa kuchokera mkati.
Nchifukwa chiyani tikufunika chithandizo cha EVAR ichi?
Cholinga chachikulu cha chithandizochi ndikuletsa kuti mtsempha wamagazi wonga baluni (aneurysm) usaphulike, chifukwa ngati utaphulika, ndi chiopsezo chachikulu pa moyo.
Ngati mtsempha wamagazi waphulika, kutuluka magazi ambiri kumayamba kuchitika m'thupi, zomwe zingakhale zoopsa pasanathe mphindi zochepa.
Mu chithandizo cha EVAR, madokotala amaika chubu chapadera (stent graft) chopangidwa ndi nsalu ndi ulusi wachitsulo mu mtsempha wamagazi wotupa. Chubu ichi chikayikidwa, magazi amatuluka mu chubu chatsopanochi. Kenako kuthamanga kwa magazi sikufika pakhoma lofooka la mtsempha wamagazi wotupa. Chifukwa chake, chiopsezo choti chiphulike chimatha pafupifupi kwathunthu.
Kodi chithandizo cha EVAR ichi ndi choyenera kwa ndani?
Ngati muli ndi aneurysm ya aorta, chithandizochi chingakhale choyenera kwa inu. Komabe, si aneurysm zonse zomwe zimachiritsidwa nthawi imodzi. Dokotala wanu angaganizire za EVAR pazochitika zotsatirazi:
- Ngati aneurysm yanu ndi yayikulu kapena yaying'ono koma ikukula mofulumira .
- Ngati thupi lanu silingathe kupirira opaleshoni yotseguka yokhala ndi chotupa chachikulu.
- Ngati mitsempha yamagazi yomwe ili pamwamba ndi pansi pa aneurysm ili bwino .
Kodi pali njira zina monga EVAR? (FEVAR ndi TEVAR)
Inde, njira yochizira iyi imagwiritsidwa ntchito mosiyana pang'ono kutengera malo omwe ali ndi aneurysm.
Kodi FEVAR ndi chiyani?
Taganizirani za mtsempha wathu wamagazi ngati thunthu la mtengo. Kuchokera pa thunthu ili, nthambi (mitsempha yaying'ono) yomwe imanyamula magazi kupita ku ziwalo za m'mimba mwathu (monga impso ndi matumbo) imagawikana. Nthawi zina aneurysm imapanga pafupi ndi pomwe nthambi imodzi imagawikana. Zikatero, zimakhala zovuta kuchita EVAR yachizolowezi.
Ndi pa milandu yovuta ngati imeneyi pomwe njira yapadera yotchedwa FEVAR (Fenestrated Endovascular Aneurysm Repair) imagwiritsidwa ntchito. Chomera cha stent chomwe chimagwiritsidwa ntchito pano chili ndi mabowo ang'onoang'ono (fenestrations) opangidwa kuti agwirizane ndi nthambi zomwe zimagawikana. Kudzera m'mabowo amenewo, ma stents ang'onoang'ono osiyana amatha kuyikidwa pa nthambi zimenezo. Monga chubu chopangidwira kuti chigwirizane ndi thunthu ndi nthambi za mtengo.
Kusiyana pakati pa EVAR ndi TEVAR
Izi n'zosavuta kwambiri.
- EVAR imachitika pa aneurysms m'mimba (m'mimba) .
- Kukonza kwa TEVAR (Tháracic Endovascular Aneurysm Repair) kumachitika pa aneurysms m'chifuwa (chifuwa) .
TEVAR nthawi zambiri imakhala yothandiza kwambiri pa aneurysms m'mitsempha yayikulu yomwe imadutsa pachifuwa, kutali pang'ono ndi mtima. Komabe, pa aneurysms yomwe ili pafupi kwambiri ndi mtima, opaleshoni yotseguka nthawi zambiri imafunika.
| Ubwino waukulu wa chithandizo cha EVAR | |
|---|---|
| Ubwino | Kufotokozera |
| Chiwerengero cha masiku omwe munthu amakhala kuchipatala chachepa. | Mukhoza kupita kunyumba msanga kuposa opaleshoni yotseguka. |
| Kuchepa kwa magazi | Popeza palibe kudulidwa kwakukulu, kuchuluka kwa magazi omwe amatuluka m'thupi ndi kochepa kwambiri. |
| Kupweteka kochepa panthawi yochira | Popeza palibe kuvulala kwakukulu, ululu ndi kusasangalala ndizochepa. |
| Mukhale bwino msanga | Mukhoza kubwerera ku zochita zanu zachizolowezi nthawi yomweyo. |
| Nthawi ya opaleshoni ndi yochepa. | Opaleshoniyo imatha kuchitika munthawi yochepa kuposa opaleshoni yotseguka. |
Kodi pali zoopsa zilizonse ndi chithandizochi?
EVAR ndi mankhwala otetezeka kwambiri komanso opambana kwambiri, koma monga opaleshoni iliyonse, pali mwayi wochepa wa zovuta.
- Magazi Oundana: Nthawi zina magazi amaundana m'mitsempha yakuya ya miyendo. Timatcha izi kuti Deep Vein Thrombosis (DVT) .
- Endoleak: Ngakhale stent ikayikidwa, magazi ochepa amatuluka pakati pa stent ndi khoma la mitsempha yamagazi ndipo amalowa mu aneurysm.
- Matenda: Matenda pamalo pomwe pavulala.
- Kulephera kwa impso
- Matenda amtima
- Kutuluka magazi kwambiri
Zoopsa zimenezi n'zochepa kwambiri. Dokotala wanu adzakufotokozerani zonsezi musanachite opaleshoni.
Kodi opaleshoniyi imachitidwa bwanji?
Chabwino, tsopano tiyeni tiwone njira zomwe zingagwiritsidwe ntchito pa opaleshoni iyi.
1. Choyamba, mudzapatsidwa mankhwala oletsa ululu kuti mugone kapena kugona pang'ono. Kuti musamve kupweteka kulikonse.
2. Kenako, dokotala adzatsegula aneurysm m'mimba mwanu kudzera m'mitsempha ya femoral yomwe ili m'mimba mwanu.
3. Pogwiritsa ntchito singano ziwiri zoonda kwambiri, catheter , chubu chopyapyala komanso chosinthasintha, imayikidwa mu mitsempha iwiri iyi. Cholumikizira cha stent chomwe tatchula kale chimapindidwa mkati mwa catheter iyi.
4. Poyang'ana chithunzi chapadera chonga X-ray, dokotalayo amatsogolera catheter iyi m'mitsempha yamagazi kupita komwe kuli aneurysm.
5. Ikafika pamalo oyenera, chubu cha stent chomwe chili mkati mwa catheter chimakulitsidwa. Kenako chimakulitsidwa mkati mwa mtsempha wamagazi, ndikupanga njira yatsopano komanso yolimba yoti magazi aziyenda.
6. Chubu cha stent ichi chimalumikizidwa mwamphamvu kukhoma la mtsempha wamagazi, zomwe zimaletsa magazi kulowa mu aneurysm.
7. Pambuyo pomaliza opaleshoni, catheter imachotsedwa mosamala. Mabowo ndi ang'onoang'ono kwambiri kotero kuti sipakufunika kusoka. Pulasitiki yaying'ono imayikidwa pabala kuti lichiritse.
Kodi nthawi yochira imakhala bwanji pambuyo pa opaleshoni?
Nthawi zambiri zimatenga masiku angapo mpaka mwezi kuti muchiritse bwino.
- Uyenera kukhala m'chipatala kwa masiku awiri kapena atatu.
- Mukhoza kuyamba kudya ndi kumwa nthawi yomweyo mutatha kugonekedwa ndi mankhwala oletsa ululu.
- Mungathenso kudzuka pabedi ndikuyenda mothandizidwa ndi anamwino.
- Mungamve kutopa pang'ono komanso kupweteka kwa masiku angapo mutabwerera kunyumba. Muyenera kugwiritsa ntchito bwino mankhwala ochepetsa ululu omwe mwapatsidwa.
- Pewani kuyendetsa galimoto mpaka mutamwa mankhwala ochepetsa ululu.
- Anthu ambiri amatha kubwerera kuntchito mkati mwa mwezi umodzi.
- Muyenera kupewa kunyamula zinthu zolemera kwa milungu inayi mpaka isanu ndi umodzi.
| Ngati muli ndi zizindikiro izi, pitani kwa dokotala nthawi yomweyo. | |
|---|---|
| Khalidwe | Kufotokozera |
| Kutupa kwa miyendo, kupweteka | Izi zitha kukhala zizindikiro za matenda a deep vein thrombosis (DVT) m'miyendo. Izi zikuphatikizapo khungu lozizira m'miyendo. |
| Chizungulire kapena kukomoka | Kungakhale chizindikiro cha vuto linalake mkati. |
| Kupweteka msana, pachifuwa, kapena m'mimba | Izi zitha kukhala vuto ndi stent kapena aneurysm. |
| Kugunda kwa mtima | Kugunda kwa mtima mofulumira kwambiri (Heart Palpitations). |
| Kufiira kapena kupweteka m'mimba | Kungakhale chizindikiro cha matenda m'malo ochitira opaleshoni. |
Uthenga Wopita Nawo Kunyumba
- EVAR ndi njira yabwino kwambiri komanso yosavulaza kwambiri m'malo mwa opaleshoni yachikhalidwe yotseguka.
- Mukalandira chithandizochi, mudzachira msanga ndipo mudzatha kupita kunyumba mwachangu.
- Ngakhale mutachira, muyenera kusamalira mtima wanu ndi mitsempha yamagazi. Zinthu monga kuchita masewera olimbitsa thupi komanso kuchepetsa mchere muzakudya zanu zingathandize kupewa mavuto amtsogolo.
- Chofunika kwambiri ndikuwonananso ndi dokotala panthawi yomwe yakonzedwa kuti akayesedwenso. Mwanjira imeneyi, mutha kuwona ngati stent yomwe mudayika ikugwira ntchito bwino komanso ngati pali mavuto ena.
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