Mitsipa yeropa iri mumutsipa wako yakavharwa here? Ngatidzidzei nezvekuvhiyiwa kweTCAR (Transcarotid Artery Revascularization)

Chiremba wako akakuudza here kuti tsinga huru yeropa mumutsipa wako yakavharwa uye kuti uri panjodzi huru yekubatwa nesitiroko? Zvakajairika kuti chero munhu atye zvishoma paanonzwa chimwe chinhu chakadai. "Ndichafanira kuvhiyiwa here? Inyaya hombe here?" Mibvunzo yakawanda ingangouya mupfungwa. Asi usazvidya mwoyo, nekuti sainzi yezvekurapa yafambira mberi, ikozvino kune nzira dzakachengeteka, dziri nyore uye dzinoshanda dzekurapa zvirwere zvakadaro. Nhasi tichataura nezveimwe yenzira itsva uye dzinobudirira zvikuru dzekurapa, TCAR.

Zvichitaurwa zviri nyore, chii chinonzi TCAR?

Zita rakazara reTCAR rinonzi Transcarotid Artery Revascularization . Zita iri rinonzwika serakaoma, handiti? Ngatizvichengetedze zviri nyore.

Kune mitsipa miviri mikuru yeropa kumativi ese emutsipa wedu inotakura ropa kuenda kuuropi. Tinoidaidza kuti mitsipa yeropa inonzi carotid . Iyi yakafanana nemapombi maviri makuru anounza mvura mumba medu. Nekufamba kwenguva, zvinhu zvakaita semafuta necholesterol zvinobva muzvikafu zvatinodya zvinoungana mukati memitsipa iyi yeropa, sengura inoungana mukati mepombi yemvura. Izvi zvinonzi 'plaque' mukurapa.

Sezvo jira iri re'plaque' richikura zvishoma nezvishoma, nzvimbo iri mukati metsinga yeropa inoderera, uye kufamba kweropa kunovharika. Chinhu chine njodzi zvikuru ndechekuti kana chidimbu chidiki chejira iri re'plaque' chikatyoka chikaenda kuuropi neropa, chinogona kuvhara tsinga yeropa muuropi uye kukonzera sitiroko .

Saka, kuvhurazve tsinga iyi yeropa yakavharika uye kudzoreredza kuyerera kweropa ndizvo zvatinodaidza kuti 'revascularization.' Kune nzira dzakawanda huru dzekuita izvi.

1. Carotid Endarterectomy (CEA): Uku kuvhiyiwa kwakavhurika kwechivanhu. Pakuita izvi, kucheka kudiki kunoitwa pamutsipa, tsinga yeropa inovhurwa, jira re'plaque' riri mukati rinobviswa, uye tsinga yeropa inosonwa pamwe chete.

2. Carotid Angioplasty uye Stenting (CAS): Chubhu yakatetepa zvikuru inopfuudzwa nemutsinga yeropa iri mudumbu kana muruoko yoendeswa kutsinga yeropa yakavharika iri mumutsipa. Nzvimbo yakavharika inobva yawedzerwa nechinhu chakaita sebharumu, uye 'stent' , chubhu diki ine mesh, inoiswa kudzivirira kuti isavhare zvakare.

3. TCAR (Transcarotid Artery Revascularization): TCAR inzira yakachengeteka uye yemazuva ano inosanganisa nzira dzakanakisisa pane dzese dziri mbiri. Inosanganisira kugadzira kucheka kudiki pamusoro pebhonzo remutsipa uye kuisa stent zvakananga mutsinga yeropa yakavharika.

Ndiani akakodzera kuvhiyiwa uku kweTCAR?

Nzira yeTCAR yakatanga kushandiswa muna 2015 kuvarwere vaiva panjodzi huru yekuvhiyiwa kwechivanhu (CEA). Izvi zvinoreva kuti:

• Kune vanhu vakuru .
• Kune avo vane chirwere chemwoyo kana mapapu .
• Kune avo vane mavanga kubva pakuvhiyiwa kwemutsipa kwakamboitwa kana kurapwa nemwaranzi.
• Kana tsinga yeropa yakavharwa panzvimbo yakaoma kuvhiyiwa, senge pasi peshaya.

Asi ikozvino nzira iyi yave kubudirira zvekuti kubvira muna 2022, kurapwa kweTCAR kwave kukurudzirwa kunyangwe kune varwere vane hutano hwakanaka, kureva avo vasina zvinhu zvakakosha zvine njodzi. Kusvika pari zvino, kuvhiyiwa kweTCAR kunopfuura 20,000 kwakaitwa muUnited States chete.

Unogadzirira sei usati wavhiyiwa?

Kana chiremba wako akasarudza kukuvhiya neTCAR, anofanira kuongororwa kakawanda nguva isati yasvika.

• Kuongororwa kweropa: Tsvaga nezveutano hwako uye kugona kwako kugayiwa kweropa.
• Kuongororwa kwetsinga dzeropa ne ultrasound: Ona kuti tsinga yeropa yakawanda sei yakavharwa.
• CT Angiogram: Wana mufananidzo wakajeka, une mativi matatu wetsinga dzeropa dziri mumutsipa nepfungwa.

Zvakare, chiremba achatanga newe mishonga yakasiyana-siyana kuti akugadzirire kuvhiyiwa.

• Mishonga yemhando yeStatin inoderedza cholesterol.
• Mishonga yakaita seaspirin neclopidogrel inodzivirira kuumbwa kweropa.

Uchaudzwa kuti usadye kana kunwa chero chinhu mushure mehusiku husiku hwakatangira kuvhiyiwa.

Kuvhiyiwa kunoitwa sei: nhanho nhanho

Kuvhiyiwa uku kuchatora awa imwe nehafu. Ngatimboongororai zvinoitika muimba yekuvhiyira.

1. Anesthesia: Kuti usanzwe kurwadziwa, nzvimbo yakatenderedza mutsipa wako inenge isina chinhu (local anesthesia) kana kuti uchanzwa anesthesia yakakwana (general anesthesia) .

2. Kuchekwa kudiki: Kuchekwa kudiki kunoitwa pamutsipa, pamusoro pebhonzo, anenge masendimita 1-1.5.

3. Kuchinja Kuyerera: Iri ndiro danho rakakosha uye rakachengeteka mukuita kweTCAR.

• Chubhu yakatetepa inopinzwa mutsinga iri mugotsi (femoral vein).
• Imwe chubhu inopinzwa mutsinga yeropa yakavharika kuburikidza nekucheka mutsipa.
• Zvino, machubhu maviri aya akabatana nemuchina une firita yakakosha. Mushure meizvozvo, kuyerera kweropa kuenda kuuropi kunomira kwenguva pfupi, uye ropa rinobva mutsinga iri mumutsipa rinobuda nepachubhu iyoyo, rocheneswa nefirita, rodzokera mumuviri nepachubhu iri muhudyu.
• Panguva ino, ropa rinodiwa neuropi hwako rinobva mutsinga yeropa iri kune rimwe divi remutsipa wako uye mutsinga dzemusana dziri kumashure kweuropi hwako.Inowanikwa pasina chipingamupinyi.

4. Kuvhura nzvimbo yakavharika: Waya yakatetepa inoshandiswa kupfuura nzvimbo yakavharika uye kuwedzera nzvimbo yacho nebharumu diki.

5. Kuiswa kweStent: Zvadaro, chubhu diki yesimbi inonzi stent inoiswa muvharo. Izvi zvinochengetedza tsinga yeropa yakavhurika uye zvinobata plaque pamadziro.

6. Kuguma: Zvadaro, machubhu ese anobviswa, uye buri diki riri mutsinga yeropa neburi riri mumutsipa zvinosonwa.

Chii chinoitika mushure mekuvhiyiwa?

Mushure mekuvhiyiwa kweTCAR, uchafanira kugara muchipatara kwehusiku humwe chete . Vanachiremba nevanamukoti vachagara vachitarisa hutano hwako. Sezvo uku kuri kuvhiyiwa kuri nyore, kupora kunokurumidzawo.

Ndezvipi njodzi nematambudziko?

Sekune chero kurapwa kupi zvako, TCAR inogona kuva nenjodzi diki diki. Zvisinei, mukana wekuti izvi zviitike wakaderera zvikuru.

• Kubuda ropa kana kuzvimba kubva panzvimbo yakachekwa.
• Kutapukirwa kweganda rakachekwa.
• Kukuvadzwa kudiki kwetsinga mumutsipa.
• Kurohwa nechirwere.
• Kumira kurova kwemoyo.

Chiremba wako achakutsanangurira nezvenjodzi idzi zvakadzama. Yeuka kuti matanho akakosha anotorwa kuderedza njodzi idzi panguva yeTCAR.

Kupora uye kurarama nestent

Kuvhiyiwa kweTCAR inzira inokurumidza zvikuru nekuti hapana kucheka kukuru.

• Dzivisa kusimudza zvinorema kwevhiki imwe kana maviri.
• Tarisa mutsipa wako zuva nezuva kuti uve nechokwadi chekuti wakachena uye hapana zviratidzo zvehutachiona.
• Bvunza chiremba wako kuti ungadzokera riini kubasa rako nemamwe mabasa ezuva nezuva.

Kana stent yaiswa, zviri kwauri kuti udzivise tsinga yeropa kuti isavharike zvakare. Kuti uite izvi, unofanira kuita zvinhu izvi.

• Kana ukasvuta, rega ipapo ipapo.
• Rovedza muviri nguva dzose.
• Tora chikafu chine hutano chine mafuta mashoma akawandisa.
• Inwa mushonga wekuderedza ropa uye mushonga wekuderedza cholesterol wawakanyorerwa nachiremba wako panguva chaiyo.

Ndinofanira kuona chiremba rini?

Kana ukaona zviratidzo zvehutachiona panzvimbo yakachekwa, fonera chiremba wako nekukasika.

• Kupindwa nechando
• Kana uchinzwa kutonhora
• Kana paine kutsvuka uye kuzvimba kwakakomberedza kukuvara
• Kana chimwe chinhu chakaita semvura chikabuda kubva pakachekwa

Chiremba wako ndiye achasarudza kuti ndeipi mishonga yakakunakira. Kurukura naye chero mibvunzo, zvinokunetsa, kana kusava nechokwadi kwaunako. Chinangwa chake ndechekukupa mushonga wakakodzera uye wakachengeteka.