Dzimwe nguva unonzwa kurwadziwa pachipfuva, kana kunzwa kupera simba mushure mekushanda nesimba, wobva washamisika kuti, "Pane kuvharika kwetsinga dzangu dzemwoyo here?" Kana uine kusava nechokwadi kwakadaro, chiremba anogona kukukumbira kuti uite coronary angiogram, inova bvunzo inosanganisira catheterization yemwoyo. Inogona kutarisa chero kuvharika kana stenosis mutsinga dzemwoyo dzinopa ropa kumoyo. Asi dzimwe nguva, kunyangwe mushure mekuona kuvharika uku, zvakaoma kuziva chaizvo kana kwakanyanya zvakakwana kuti kuda stent kana kuti kunogona kudzorwa nemishonga chete. Apa ndipo panobatsira bvunzo iyi inonzi Fractional Flow Reserve kana FFR.
Zvichitaurwa zviri nyore, chii chinonzi FFR iyi?
Fungidzira kuti kune pombi yemvura, uye pane chidimbu chidiki chevhu chakanamira pakati pepombi. Zvino, kumanikidzwa kwemvura inoyerera nemupombi kwakasiyana zvishoma isati yavharika uye mushure mekuvharika, handiti? Bvunzo yeFFR inoita chimwe chinhu chakafanana.
Zvichitaurwa zviri nyore, FFR inzira yekuyera kuti ropa rakawanda sei rinoenda kutsandanyama yemwoyo riri kuvharika nekuda kwekuvharika kuri mutsinga dzemwoyo. Muizvi, kumanikidzwa kweropa kunoyerwa kumativi ese ekuvharika. Nekuenzanisa kukosha kwekumanikidzwa uku, chiremba anoona kana kuvharika kwacho kuchikuvadza tsandanyama yemoyo kana kwete.
Kuongororwa uku inzira isinganyanyi kukuvadza muviri inoitiswa panguva yekuisa catheter mumoyo.
Kuongororwa kweFFR kunodiwa rini?
Havasi vese vanoda bvunzo iyi. Chiremba anowanzo sarudza kuita bvunzo yeFFR mumamiriro ezvinhu anotevera:
- Kuvharika kwepakati: Kana angiogram ichiratidza kuvharika kwetsinga iri pakati pe50% ne70%, zvakaoma kutaura chokwadi kana stent ichidiwa. Muzviitiko zvakadaro, FFR inoyera kuti kuvharika kwacho kuri kudzivirira kufamba kweropa zvakadii.
- Kana paine kuvharika kwakawanda: Dzimwe nguva munhu anogona kunge aine kuvharika kudiki diki mutsinga dzake. FFR inogona kubatsira kuona kuti kuvharika kupi kuri kukanganisa kuyerera kweropa zvakanyanya, pasina kuisa stents mune imwe neimwe.
- Mushure mekunge stent yaiswa: Dzimwe nguva mushure mekunge stent yaiswa, bvunzo yeFFR inogona kuitwa kuti ive nechokwadi chekuti iri kushanda nemazvo uye kuti kuyerera kweropa kwadzokera pakare.
Zvisinei, kana kuvharika kwetsinga kuri pasi pe30% (zvichireva kuti hapana kuvharika kukuru) kana kupfuura 90% (zvichireva kuti pane kuvharika kwakakomba kunoda kurapwa), bvunzo yeFFR haiwanzodiwi. Nekuti panguva iyoyo, sarudzo yekurapwa inogona kuitwa kubva paangiogram pachayo.
Chii chiri musiyano uripo pakati peFFR neiFR?
Ungave wakambonzwawo nezve iFR (instant wave-free ratio). Zvese izvi zvinoyera kuoma kwekuvharika kwetsinga. Musiyano mukuru ndewekuti muFFR test, mushonga wakakosha, wakadai se adenosine, unopihwa kuti ropa rifambe zvakanaka kuenda kumoyo. Muif yeiFR test, pachinzvimbo chekupa mushonga wakadaro, kumanikidzwa kunoyerwa panguva chaiyo mukurova kwemoyo. Chiremba wako ndiye achasarudza kuti ndeipi yenzira mbiri idzi yakakunakira.
Unofanira kugadzirira sei bvunzo isati yaitwa?
Chiremba wako achakupa mimwe mirairo yakakosha usati waongororwa, uye zvakakosha kuti uitevere.
- Ruzivo nezvemishonga: Ungangokumbirwa kuti urege kutora mimwe mishonga, kunyanya mishonga inobvisa ropa mumuviri, mazuva mashoma bvunzo isati yaitwa. Iva nechokwadi chekuudza chiremba wako nezvemishonga yese yauri kutora.
- Zvekudya Nekunwa: Uchaudzwa kuti usadye kana kunwa chero chinhu mushure mehusiku husiku husati hwaitwa bvunzo.
- Mubatsiri: Sezvo ucharapwa panguva yebvunzo, zvakakosha kuti uve nemumwe munhu anokutora kuenda newe kumba mushure mebvunzo.
Chii chinoitika panguva yebvunzo?
Kana ukangoita bvunzo yeFFR chete, zvinotora maminetsi asingasviki makumi matanhatu. Zvisinei, kana ukasarudza kuisa stent ipapo ipapo zvichibva pane zvabuda, zvinotora nguva yakati rebei. Maitiro ese anoenda seizvi:
1. Kusanzwa: Kutanga, jekiseni diki remushonga wekunzwa kusanzwa rinopinzwa mutsinga iri muruoko rwako, pahudyu, kana mumutsipa umo catheter ichaiswa.
2. Kuisa catheter: Zvadaro, chubhu yakatetepa (catheter) inopinzwa nepanzvimbo isina chinhu ichipinda mune imwe yetsinga dzeropa.
3. Kufamba uchienda kumoyo: Catheter iyi inotungamirirwa nokungwarira kutsinga yemoyo uchishandisa tekinoroji yeX-ray (fluoroscopy).
4. Jekiseni reDye: Tevere, dhayi yakakosha (contrast media) inopinzwa mutsinga kuburikidza nechubhu iyi. Mukati metsinga munogona kuonekwa zvakajeka paX-ray.
5. Waya yePressure: Apa ndipo panotanga basa chairo . Waya yakatetepa kwazvo ine masensa inopfuudzwa nepa catheter yoiswa mutsinga yakavharika.
6. Kuyera kumanikidzwa: Waya iyi inoshandiswa kuyera kumanikidzwa kweropa tsinga isati yavharika uye mushure mekunge yavharika.
7. Kupa mushonga:Kuti uwane kuverenga kwakarurama, unofanirwa kuwedzera kuyerera kweropa kuenda kumoyo wako. Kuti uite izvi, uchapihwa mushonga unonzi adenosine. Paunopihwa mushonga uyu, unogona kurwadziwa zvishoma pachipfuva uye kuoma kufema kweinenge miniti. Izvi zvakajairika, usazvidya moyo. Izvi zvinoreva kuti mushonga uri kushanda uye ikozvino ndiyo nguva yakakodzera yekuverenga.
8. Sarudzo yeKurapwa: Mushure mekugamuchira kukosha kweFFR, chiremba achasarudza kana uchida kuiswa stent kana kwete. Kana zvichidikanwa, stent inogona kuiswa pakarepo mushure mekuita angioplasty.
9. Kuguma: Kana basa rapera, catheter inobviswa, kumanikidzwa kunoiswa panzvimbo inopinzwa, uye plaster inoiswa.
Nzira yekunzwisisa sei mhedzisiro?
Mhedzisiro yebvunzo yeFFR inouya nenhamba. Nhamba iyi iri nyore kunzwisisa.
| Mhedzisiro yeFFR | Zvinorevei? |
|---|---|
| 0.94 kusvika 1.0 (yakajairika) | Zvakanaka! Kuyerera kweropa remwoyo wako kwakanaka kwazvo. Kuvharika kunoonekwa mutsinga yeropa hakusi kukonzera kukanganiswa kukuru kwekuyerera kweropa. Kazhinji stent haidiwi, uye chirwere ichi chinogona kurapwa nemishonga. |
| Kana iri pasi pe0.80 | Panyaya iyi, huwandu hweropa rinoyerera kuenda kutsandanyama yemwoyo hwakaderera zvakanyanya nekuda kwekutetepa kwetsinga dzeropa. Chiremba anogona kusarudza kuita kurapwa kwakadai sekuisa stent (angioplasty). |
| Muenzaniso: Ko kana kukosha kweFFR kuri 0.75? | Izvi zvinoreva kuti BP yadzikira ne25% nekuda kwekuoma kwetsinga dzeropa. Izvi zvinoreva kuti pane kuvharika kweropa ne25% mutsandanyama yemwoyo. |
Chii chekutarisira mushure mekuongororwa?
Matambudziko makuru haawanzoitika mushure mekuongororwa kweFFR.
- Kudzokera kumba:Kana stent isina kuiswa, unokwanisa kuenda kumba mushure memaawa mashoma uchiongororwa. Kana stent ikaiswa, ungangoda kugara muchipatara husiku ihwohwo.
- Zorora: Zvakanaka kuzorora kwezuva rimwe kana maviri mushure mekuenda kumba. Panogona kunge paine maronda uye kurwadziwa pakaiswa catheter.
- Migumisiro: Zvinhu zvakaita sekurwadziwa kwechipfuva kunokonzerwa nemushonga weadenosine zvinopera zvachose mukati memaminitsi mashoma.
Kana ukaona zviratidzo izvi, fonera chiremba wako nekukasika.
Kana ukaona chimwe chezviratidzo zvinotevera mushure mekudzokera kumba kubva kunoongororwa, zivisa chiremba wako nekukasika. Kana zvichidikanwa, enda kuEmergency Department (ETU) yechipatara chiri pedyo.
- Kurwadziwa kwakanyanya pachipfuva
- Kuoma kufema
- Kupindwa nechando
- Kubuda ropa, kuzvimba, kana kurwadziwa kwakanyanya panzvimbo inopinzwa catheter
- Dzungu
- Kuchinja kusingajairika kwekurova kwemoyo (kurova kwemoyo)
FFR bvunzo yakakosha zvikuru mukurapa chirwere chemwoyo. Inobatsira vanachiremba kuona kuoma kwekuvharika kwetsinga, kudzivirira kuiswa kwestent zvisina kufanira, uye kusarudza mushonga wakanakira iwe, pane kungovimba nezvinoonekwa paangiogram chete. Saka, kana chiremba wako akakurudzira bvunzo iyi, usatya kubvunza chero mibvunzo yaungave nayo.
Mharidzo Yekuenda Nayo Kumba
- FFR (Fractional Flow Reserve) inzira yakakosha yekuyedza kudzika kwetsinga yemwoyo.
- Izvi zvakakosha zvikuru pakuona kana stent ichidikanwa kana kuti kwete kuti pave nechikamu chepakati (50%-70%) chekuvhara kwemasero (angiogram).
- Kuongororwa uku kunoitwa panguva yekuisa catheter mumoyo.
- Kana mhedzisiro iri pasi pe0.80, zvinoratidza kuti kuvharika kuri kukonzera kuvharika kukuru kweropa uye kungada kurapwa.
- Kuongororwa uku kunobvumira vanachiremba kuderedza kuiswa kwestent zvisina kufanira uye kupa murwere kurapwa kwakakodzera.
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