Ese imitsi y'umutima ishobora kongera gufunga nyuma yo gushyirwaho stent? (In-Stent Restenosis)

Ese wowe cyangwa umuntu uzi wigeze ashyirwamo stent mu mitsi ifata umutima? Nyuma yo kuvurwa gutyo, akenshi dutekereza ko ikibazo cyakemutse burundu, ko imitsi ifata umutima itazongera gufunga. Ariko, rimwe na rimwe, kuziba gato cyangwa gufunga bishobora kongera kubaho ahantu hamwe na hamwe stent yashyizwe, ni ukuvuga mu gice kimwe cy'imitsi yavuwe. Ibyo ni byo abaganga bita 'In-Stent Restenosis'. Nubwo izina rishobora kumvikana nk'irigoye, mu by'ukuri ni ryoroshye cyane. Reka tubiganireho birambuye, mu rurimi rwa Sinhala ushobora gusobanukirwa.

Ubwa mbere, reka dusobanukirwe aya magambo, si byo se?

Mbere yuko tuvuga ku byerekeye 'in-stent restenosis', reka dusobanukirwe amagambo make. Hanyuma bizakunogera neza.

'Stenose' ni iki?

Mu magambo make, 'stenosis' ni ukugabanuka cyangwa kugabanuka k'imitsi y'amaraso mu mubiri wacu. Tekereza ko uko igihe kigenda gihita, umwanda n'ingese byiyongera mu muyoboro w'amazi, bigahagarika amazi atemba.

None se, indwara y'imitsi ifata umutima (CAD) ni iki?

Umutima wacu nawo ukeneye amaraso kugira ngo ukore. Imitsi y'ingenzi iwutanga yitwa imitsi y'umutima. CAD ni igihe ibinure byibumbiye mu mitsi imwe cyangwa myinshi y'umutima, bigafunga imitsi. Ibi kandi byitwa atherosclerosis. Hari n'abantu babyita "gukomera kw'imitsi." Uku kwiyongera kw'ibinure bigenda buhoro buhoro, kandi bishobora kutagaragaza ibimenyetso mu ntangiriro. Ariko iyo bitavuwe, bishobora gutera indwara zikomeye nko kurwara umutima no kunanirwa k'umutima.

'Angioplasty' na 'Stent' ni iki?

Bumwe mu buryo bw'ingenzi abaganga bakoresha mu gufungura imitsi y'umutima yazibye bitewe na CAD ni uburyo bwitwa angioplasty. Hari igihe bwitwa kandi percutaneous coronary intervention (PCI). Muri ibi, umuyoboro muto (catheter) winjizwa mu mwobo muto uri mu ruhu ujya mu mitsi yazibye. Agakoresho gato kameze nk'agapira kari ku mpera y'umuyoboro karabyimbye, kagakura umuyoboro wazibye. Hanyuma, kugira ngo umuyoboro muto udasubira kugwa no kugira ngo amaraso akomeze gutembera neza, umuyoboro muto w'amaraso - ni cyo stent ikora - ushyirwa mu muyoboro wagutse. Hanyuma, amaraso arongera atembera neza.

None se, iyi 'In-Stent Restenosis' ni iki?

Noneho usobanukiwe impamvu n'uburyo stent ishyirwamo. Nyuma yo gushyirwamo stent no gusubirana amaraso mu mitsi y'umutima, rimwe na rimwe imitsi itangira kugabanuka aho stent yashyizwe, ni ukuvuga imbere muri stent. Niyo mpamvu tuyita 'In-Stent Restenosis'. 'Re' bivuga "agashya", naho 'stenosis' bivuga "kugabanuka". Ibi rero bivuze "kongera kugabanuka muri stent".

Iyi ndwara ikunze kugaragara gute?

Ubu ushobora kwibaza niba ibi ari ibintu bitandukanye kuri buri wese ufata stent.Oya, ibi ntibibaho kuri buri wese ufite stent. Ariko, mu buryo bw'ikigereranyo, umuntu umwe kuri bane bafite stent afite amahirwe yo kurwara iyi ndwara yitwa 'In-Stent Restenosis'. Ibi akenshi biba mu mezi atatu kugeza kuri atandatu nyuma yo gushyirwaho stent.

Icy'ingenzi: Niba ufite angioplasty ya balloon udafite stent, ibyago byo kurwara restenosis biba byinshi kurushaho. Abantu bagera kuri 4 kuri 10 bazongera gufunga imitsi yabo.

Kuki habaho 'in-stent restenosis'?

Ni ikibazo gishimishije cyane. Nyuma yo gushyiramo stent, umubiri wacu ugerageza "kuyikiza". Ni ukuvuga ko urwego rushya rw'uturemangingo ("ururabo rushya") rukura hejuru ya stent, bigatuma imbere mu mitsi yongera kuba nziza. Iki ni ikintu cyiza, kuko icyo gihe amaraso ashobora gutembera byoroshye adapfunditse.

Ariko, rimwe na rimwe, munsi y'uru rugingo rushya rw'uturemangingo, rukikije stent, havuka inkovu nyinshi cyane . Iyo uru rugingo rw'inkovu rukuze cyane, igice cy'imbere cy'imitsi kirabyimba, bigatuma amaraso yongera gutembera neza. Iyi ni yo mpamvu nyamukuru itera `In-Stent Restenosis`.

Wibuke ko ibi akenshi bibaho mu mezi atatu kugeza kuri atandatu nyuma yo gukaraba. Nyuma y'ibyo, ibyago byo kurema inkovu no kuziba imitsi biba bike cyane.

Ni nde uri mu kaga gakomeye ko kurwara 'in-stent restenosis'?

Nubwo umuntu wese ufite stent yashyizwemo CAD ashobora kurwara iyi ndwara yitwa `In-Stent Restenosis`, hari abantu bafite ibyago byinshi byo kurwara iyi ndwara. Reka turebe abo ari bo:

• Ku bantu bafite cholesterol nyinshi mu maraso. (Ibi nibyo bigira uruhare mu gutera indwara nyinshi z'umutima!)
• Ku bafite indwara z'impyiko .
• Ku banywa itabi. (Iki ni ikintu mukwiye kureka!)
• Ku bafite diyabete idacunzwe neza.
• Ku bafite umuvuduko ukabije w'amaraso (hypertension) udashobora kugenzurwa.

Niba ufite indwara nk'izi, ni ngombwa cyane kuvugana na muganga wawe no kumugenzura.

Ni ibihe bimenyetso bya 'in-stent restenosis'?

Akenshi, abantu bafite `In-Stent Restenosis` ntibagaragaza ibimenyetso byo hanze. Niyo mpamvu ari ingenzi cyane kujya kwa muganga buri gihe no gukorerwa ibizamini bikenewe nyuma yo gushyirwaho stent.

Ariko, hari abantu bashobora kugaragaza ibimenyetso. Iyo babibonye, ​​ibimenyetso akenshi bisa n'ibya CAD yari isanzweho. Ibi birimo:

• Kumva ububabare, gufungana, cyangwa kutamererwa neza mu gituza. Ibi tubyita "angina." Ubu bubabare bwo mu gituza bushobora kwiyongera iyo ukoze imyitozo ngororamubiri, uzamuka ingazi, cyangwa unaniwe gato.
• Ibyuya bikonje.
• Kuzunguruka, kugira isereri, cyangwa kumva nta cyo ushoboye.
• Umunaniro ukabije n'intege nke.
• Kumva umutima utera cyane (`Umutima utera cyane`).
• Isesemi.
• Guhumeka nabi, rimwe na rimwe ndetse no mu gihe ugenda n'amaguru intera ndende.
• Kubabara mu rutugu cyangwa ku kuboko (cyane cyane ukuboko kw'ibumoso).

Niba ufite ibi bimenyetso, ugomba kujya kwa muganga nta gupfusha ubusa.

Ni gute indwara ya 'in-stent restenosis' ipimwa?

Nkuko nabivuze mbere, kubera ko `In-Stent Restenosis` idahora igaragaza ibimenyetso, ni ngombwa kujya kwa muganga wawe buri gihe nyuma yo gushyirwaho stent. Hanyuma, ibizamini bikenewe birashobora gukorwa.

Niba ufite ibimenyetso, muganga wawe ashobora kukugira inama yo gupima ibi bikurikira:

• Ikizamini cy'imihangayiko mu myitozo ngororamubiri : Iki kizamini gipima uburyo umutima wawe upompa amaraso kandi kigasuzuma impinduka muri ECG yawe mu gihe ugenda ku igare cyangwa ugendera ku igare.
• Gupima umutima na angiogramu : Ibi bikorwa mbere yuko stent ishyirwamo. Ibi bishobora kongera gukorwa kugira ngo harebwe neza niba hari stent yazibye.
• Angiogramu ya CT (angiogramu ya CT) ikoreshwa mu gupima umutima (coronary computed tomography angiogram ): Ibi bisa na CT scan. Irangi ryihariye rishyirwa mu mutima kugira ngo hakorwe amashusho ya 3D y'imitsi y'umutima.
• Uburyo bwo kubika ingano y'amaraso mu mitsi (FFR): Ibi bishobora gukorwa icyarimwe na angiogram. Insinga yihariye ishyirwa mu mitsi hanyuma umuvuduko w'amaraso ugapimwa ku mpande zombi z'aho yazibye kugira ngo harebwe ubukana bw'aho yazibye.
• Ultrasound yo mu mitsi (IVUS): Ibi bishobora kandi gukorwa icyarimwe na angiogram. Icupa rito rya ultrasound rishyirwa mu mitsi, bigatuma imbere mu rukuta rw'imitsi na stent bigaragara neza.

Ni ubuhe buryo bwo kuvura indwara ya 'in-stent restenosis'?

Muganga wawe azaguhitiramo uburyo bwiza bwo kuvura hashingiwe ku buremere bw'indwara yawe ya In-Stent Restenosis, ni ukuvuga uburyo imitsi y'amaraso yagabanutse, ndetse n'ubuzima bwawe muri rusange. Bishobora kuba birimo bumwe mu buryo bukurikira:

• Imiti: Kugira ngo hagenzurwe ibimenyetso nka angina iterwa na In-Stent Restenosis, ingano y'imiti iriho ishobora kongerwa cyangwa hakongerwamo indi miti mishya.
• Gusubiramo angioplasty: Imitsi yazibye yongera kwaguka hakoreshejwe ibara, rimwe na rimwe hagashyirwamo indi stent. Hari igihe hashobora gukoreshwa ibara ry’umuti.
• Kubagwa k'umutima:Ibi kandi byitwa `Coronary artery bypass grafting` cyangwa `CABG`. Ubu ni ukubaga gukomeye gato. Icyo ukora ni ugukora inzira nshya amaraso atembera mu gace kafunzwe. Ni ukuvuga ko ufata igice cy'imitsi mu kindi gice cy'umubiri wawe (nk'ukuguru kwawe, igituza) ukagihuza n'agace kafunzwe n'umugongo.
• Uburyo bwo kuvura imitsi ikoresha imitsi: Ubu buryo butandukanye gato. Kimwe n'uburyo bwo kuvura hakoreshejwe imirasire ikoreshwa mu kwica uturemangingo twa kanseri, ubu buryo bukubiyemo gutanga imirasire mike mu gihe gito ku gahu kugira ngo inkovu zihagarike kongera gukura. Ibi kandi byitwa brachytherapy y'umutima.

Ese hari uburyo bwo kwirinda 'in-stent restenosis'?

Yego, inkuru nziza ni uko ibyago byo kurwara `In-Stent Restenosis` bishobora kugabanuka. Bumwe mu buryo bw'ingenzi bwo kubikora ni ugukoresha ` drug-eluting stents` .

Izi 'DES' zitandukanye na stenti z'icyuma zidafite ubudodo (BMS). Zifite agahu gato k'umuti kuri zo. Iyo stent imaze gushyirwa mu mitsi, umuti urekurwa buhoro buhoro, ukagenzura ikorwa ry'inkovu n'ikura ry'uturemangingo.

Mu myaka yashize, havugwaga ku byago byo kuvura amaraso hakoreshejwe izi 'DES'. Ariko, stent nshya zikoresha imiti ni nziza cyane kandi zifite akamaro. Iyo ukoresheje izi 'DES', ibyago byo kurwara 'In-Stent Restenosis' biragabanuka cyane. Mu buryo bugaragara, 'umuntu umwe cyangwa icumi' arwara 'In-Stent Restenosis'.

Kubwibyo, niba ugiye gushyirwaho stent, vugana na muganga wawe kugira ngo agufashe guhitamo ubwoko bwa stent ikubereye.

Ni iki cyizere cy'umuntu ufite 'in-stent restenosis'?

Iyo urwaye indwara ya `In-Stent Restenosis`, ushobora kugira amahirwe make yo kurwara indwara z'umutima zishobora gushyira ubuzima bwawe mu kaga, nka `angina idahindagurika`, `syndrome y'umutima ikabije`, na `indwara z'umutima`.

Ku bw'amahirwe, izi ngaruka zaragabanutse cyane bitewe no kuboneka kwa stent nshya (cyane cyane DES) no kunoza uburyo bwo gushyira stent. Byongeye kandi, ubu hari uburyo bwiza bwo kuvura In-Stent Restenosis.

Niba ufite CAD, ugomba gukurikiza amabwiriza ya muganga wawe neza kugira ngo wirinde In-Stent Restenosis no kurinda umutima wawe muri rusange. Ibyo bivuze:

• Gabanya umunyu unywa kandi ufate imiti wahawe na muganga wawe (cyane cyane iyo kuvura umuvuduko w'amaraso, cholesterol, no kuvura amaraso) neza kandi ku gihe.
• Gabanya kunywa inzoga. Niba waratwawe n'inzoga, shaka ubufasha bwo kuzitsinda.
• Indyo nziza ku mutimaKurya indyo "ifite ubuzima bwiza." Kurya amavuta make, isukari, n'ifu, n'imboga nyinshi, imbuto, n'ibiribwa bikungahaye kuri fibre.
• Menya ubwoko bw'ibinure urya. Gabanya kurya ibiryo birimo ibinure byinshi n'ibikomoka ku bimera (ibiryo byihuse, ibiryo bikaranze, ibiryo bipfunyitse) uko bishoboka kose.
• Komeza kugira ibiro byiza. Imyitozo ngororamubiri buri munsi.
• Niba urwaye diyabete, genzura neza.
• Niba unywa itabi, gerageza kurireka uyu munsi. Hari uburyo bwo kubona ubufasha.

Ni ryari ngomba guhamagara muganga?

Niba utekereza ko ufite indwara y'umutima (ibimenyetso nko kubabara cyane mu gatuza, guhumeka nabi, kubira ibyuya), hamagara serivisi y'abarwayi bakira indwara zo mu mutwe ya Suwaseriya yo mu 1990 ako kanya.

Niba warigeze gushyirwaho stent mbere hanyuma ibi bimenyetso bikagaruka, hita ubonana n'umuganga w'indwara z'umutima:

• Kubabara mu gituza (angina), gufungana, igitutu, ububabare mu kuboko cyangwa ku rutugu.
• Ibyuya bikonje.
• Kugorwa no guhumeka, guhumeka.
• Umunaniro ukabije cyangwa intege nke nta mpamvu.

Ni iki ngomba kubaza muganga wanjye?

Iyo uhuye na muganga, ushobora kubaza ibibazo nk'ibi kugira ngo usobanukirwe neza ikibazo cyawe:

• Kuki nagize iyi "restenosis"? Ni ibihe bintu bishobora kuntera ibyago?
• Ese nshobora kongera kurwara restenosis? Nkora iki kugira ngo mbyirinde?
• Ni iyihe mibereho ngomba gukurikiza kugira ngo nkingire umutima wanjye?
• Ni ibihe bimenyetso by'ingorane ngomba kwitondera?
• Ni ubuhe buryo bwiza bwo kuvura kuri njye?

Amaherezo, icyo ugomba kwibuka (Ubutumwa bwo kujyana mu rugo)

Yego, rero ikintu cy'ingenzi ugomba kwibuka mu byo twavuze ni iki. Angioplasty na stent ni bumwe mu buryo bw'ingenzi kandi burokora ubuzima bw'indwara z'umutima. Ubu buryo bwo kuvura butuma amaraso atembera neza mu mutima wawe, bugabanye ibimenyetso bya CAD, kandi bugatuma ubuzima bwawe burushaho kuba bwiza.

Ariko, niba ibimenyetso nk'umunaniro, ububabare mu gituza, no kubura umwuka bigarutse nyuma yo gushyirwaho stent, bishobora kuba ikimenyetso cya 'In-Stent Restenosis. ' Niba ibyo bibaye, ntugatinye cyangwa ngo utinde, ahubwo reba muganga wawe kugira ngo akugire inama.

Ku bw'amahirwe, stent nshya kandi zitekanye zikoresha imiti ziboneka muri iki gihe zagabanyije cyane ibyago byo kurwara In-Stent Restenosis. Hariho kandi uburyo bwiza bwo kuvura ibi. Ni byiza kuganira na muganga wawe ku bwoko bwa stent n'uburyo bwo kuvura bukubereye. Wite ku mutima wawe!

` Stents, in-stent restenosis, indwara z'umutima, angioplasty, indwara y'imitsi y'umutima, indwara y'imitsi y'umutima, indwara y'umutima