Ngaba umthambo wentliziyo ungaphinda uvaleke emva kokuba kufakwe i-stent? (In-Stent Restenosis)

Ngaba wena okanye umntu omaziyo ukhe wafakwa i-stent kwi-coronary artery? Emva konyango olunjalo, sihlala sicinga ukuba ngoku ingxaki isonjululwe ngokupheleleyo, ukuba i-coronary artery ayisayi kuphinda ivalwe. Nangona kunjalo, ngamanye amaxesha, ukuvaleka okuncinci okanye ukuncitshiswa kunokuphinda kwenzeke kwindawo enye apho i-stent yayibekwe khona, oko kukuthi, kwindawo efanayo ye-artery eyayinyangiwe. Yiloo nto oogqirha bayibiza ngokuba yi-'In-Stent Restenosis'. Nangona igama lisenokuvakala liyinkimbinkimbi kancinci, lilula kakhulu. Makhe sithethe ngale nto ngokweenkcukacha, ngesiSinhala onokuyiqonda.

Okokuqala, masiqonde la mazwi, akunjalo?

Ngaphambi kokuba sithethe 'nge-in-stent restenosis', masiqonde amagama ambalwa. Emva koko kuya kucaca kuwe.

Yintoni i-'Stenosis'?

Ngamafutshane, 'i-stenosis' kukuncitshiswa okanye ukuncitshiswa komthambo wegazi emzimbeni wethu. Khawuthelekelele ukuba ngokuhamba kwexesha, ukungcola kunye nomhlwa kwakheka ngaphakathi kombhobho wamanzi, okuthintela ukuhamba kwamanzi.

Ngoko ke, yintoni isifo semithambo yegazi yentliziyo (CAD)?

Intliziyo yethu ikwafuna igazi ukuze isebenze. Imithambo ephambili eyinika igazi ibizwa ngokuba yimithambo yentliziyo. I-CAD kuxa amanqatha abizwa ngokuba yi-plaque eqokelelana ngaphakathi kwenye okanye ngaphezulu kwemithambo yentliziyo, nto leyo enciphisa imithambo. Oku kukwabizwa ngokuba yi-atherosclerosis. Abanye abantu bakubiza ngokuba "kukuqina kwemithambo." Oku kwakheka kwamafutha kwenzeka kancinci kancinci, kwaye kusenokungabonakalisi zimpawu ekuqaleni. Kodwa ukuba akunyangwa, kunokukhokelela kwiimeko ezinzulu ezifana nokuhlaselwa yintliziyo kunye nokusilela kwentliziyo.

Yintoni 'i-Angioplasty' kunye 'ne-Stent'?

Enye yeendlela eziphambili zonyango ezisetyenziswa ngoogqirha ukuvula imithambo yentliziyo evalekileyo ngenxa ye-CAD ibizwa ngokuba yi-angioplasty. Ngamanye amaxesha ikwabizwa ngokuba yi-percutaneous coronary intervention (PCI). Kule meko, kufakwa ityhubhu encinci (i-catheter) ngomngxuma omncinci eluswini ukuya kwimithambo evalekileyo. Isixhobo esincinci esifana nebhaluni esisekupheleni kwetyhubhu siyavuthelwa, sikhulise imithambo evalekileyo. Emva koko, ukuze imithambo ingawi kwakhona kwaye kugcinwe igazi lihamba kakuhle, ityhubhu encinci ye-mesh - yiloo nto i-stent isetyenziselwa yona - ifakwa ngaphakathi kwemithambo evalekileyo. Emva koko, igazi lihamba kakuhle kwakhona.

Kulungile, ngoku yintoni le 'In-Stent Restenosis'?

Ngoku uyaqonda ukuba kutheni kwaye i-stent ifakwa njani. Emva kokuba i-stent ifakiwe kwaye ukuhamba kwegazi kubuyiselwe kwi-coronary artery, ngamanye amaxesha i-artery iqala ukuncipha kwakhona kanye apho i-stent ibekwe khona, oko kukuthi, ngaphakathi kwi-stent. Yiyo loo nto siyibiza ngokuba yi-'In-Stent Restenosis'. Igama elithi 'Re' lithetha "kwakhona", kwaye elithi 'stenosis' lithetha "ukuncipha". Ngoko ke, oku kuthetha "ukuncipha kwakhona ngaphakathi kwi-stent".

Ixhaphake kangakanani le meko?

Ngoku usenokuba uzibuza ukuba ngaba oku kuyinto eyahlukileyo kubo bonke abantu abafumana ii-stents.Hayi, oku akwenzeki kubo bonke abantu abane-stent. Nangona kunjalo, xa sithetha nje, malunga nomntu omnye kwaba-4 abane-stent banethuba lokufumana le meko ibizwa ngokuba yi-'In-Stent Restenosis'. Oku kwenzeka rhoqo kwiinyanga ezintathu ukuya kwezintandathu emva kokuba i-stent ifakiwe.

Kubalulekile: Ukuba une-balloon angioplasty ngaphandle kokwenza i-stenting, umngcipheko we-restenosis uphezulu nangakumbi. Malunga nabantu abane kwabalishumi baya kuphinda bavalwe umthambo wabo.

Kutheni kukho 'ukungaphumli kakuhle'?

Ngumbuzo onomdla ngokwenene. Emva kokuba i-stent ifakiwe, umzimba wethu uzama "ukuyiphilisa". Oko kukuthi, umaleko omtsha weeseli ("ulwelo olutsha") ukhula phezu kwe-stent, okwenza ingaphakathi lomthambo lithambe kwakhona. Oku kuyinto elungileyo, kuba ke igazi linokuhamba ngokulula ngaphandle kokujiya.

Nangona kunjalo, ngamanye amaxesha, phantsi kolu maleko lutsha lweeseli, olujikeleze i-stent, kukhula izicubu ezincinci kakhulu . Xa ezi zicubu zikhula kakhulu, ulwelo lwangaphakathi lwemithambo yegazi luyaqina, lunciphise ukuhamba kwegazi kwakhona. Le yeyona nto iphambili ebangela i-'In-Stent Restenosis'.

Khumbula, oku kwenzeka rhoqo kwiinyanga ezintathu ukuya kwezintandathu emva kokutshiswa yi-stenting. Emva koko, umngcipheko wokwakheka kwezicubu ezibomvu nokuvala umthambo uphantsi kakhulu.

Ngubani osengozini enkulu yokuba ne-'in-stent restenosis'?

Nangona nabani na ofakelwe i-stent ye-CAD angafumana le meko ibizwa ngokuba yi-'In-Stent Restenosis', abanye abantu basengozini enkulu kancinci. Makhe sijonge ukuba bangoobani:

• Kubantu abanezinga eliphezulu le-cholesterol egazini. (Yile nto ibangela izifo ezininzi zentliziyo!)
• Kwabo banesifo sezintso .
• Kwabo batshayayo. (Oku ngokuqinisekileyo yinto ekufuneka uyeke ukuyenza!)
• Kwabo banesifo seswekile esingalawulekiyo kakuhle.
• Kwabo banoxinzelelo lwegazi olungalawulekiyo (uxinzelelo lwegazi oluphezulu ).

Ukuba uneemeko ezinje, kubaluleke kakhulu ukuthetha nogqirha wakho uze umlawule.

Zithini iimpawu 'zokuhlala uphumle'?

Ixesha elininzi, abantu abane-'In-Stent Restenosis' ababonisi zimpawu zangaphandle. Yiyo loo nto kubaluleke kakhulu ukubona ugqirha wakho rhoqo kwaye wenze uvavanyo olufunekayo emva kokufakwa kwe-stent.

Nangona kunjalo, abanye abantu banokuba neempawu. Ukuba benjenjalo, iimpawu zihlala zifana nezo ze-CAD esele ikho. Ezi ziquka:

• Ukuziva intlungu, ukuqina, okanye ukungakhululeki esifubeni. Oku sikubiza ngokuba yi "angina." Le ntlungu esifubeni inokuba mandundu xa uzilolonga, unyuka izinyuko, okanye udinwa kancinci.
• Ukubila okubandayo.
• Ukuba nesiyezi, ukuba nentloko ende, okanye ukuziva utyhafile.
• Ukudinwa kakhulu kunye nobuthathaka.
• Ukuva isantya sentliziyo esingaqhelekanga (`Intliziyo ibetha ngamandla`).
• Isicaphucaphu.
• Ukuphefumla kancinci, ngamanye amaxesha nokuba uhamba umgama omfutshane.
• Intlungu egxalabeni okanye engalweni (ingakumbi engalweni yasekhohlo).

Ukuba unale mpawu, kufuneka ubone ugqirha ngaphandle kokuchitha ixesha.

Ifunyaniswa njani i-'in-stent restenosis'?

Njengoko benditshilo ngaphambili, ekubeni i-'In-Stent Restenosis' ingabonisi zimpawu rhoqo, kubalulekile ukubona ugqirha wakho rhoqo emva kokuba i-stent ifakiwe. Emva koko, uvavanyo olufunekayo lunokwenziwa.

Ukuba uneempawu, ugqirha wakho unokucebisa iimvavanyo ezifana nezi:

• Uvavanyo loxinzelelo lokuzilolonga : Olu vavanyo lulinganisa indlela intliziyo yakho epompa ngayo igazi kwaye lujonga utshintsho kwi-ECG yakho njengoko uhamba kwi-treadmill okanye ukhwela ibhayisekile.
• Ukuhlolwa kwe-catheterization yentliziyo kunye ne-angiogram : Oku kwenziwa ngaphambi kokuba i-stent ibekwe. Oku kungenziwa kwakhona ukuze kubonwe ukuba kukho na ukuvaleka ngaphakathi kwe-stent.
• I-Coronary computed tomography angiogram (CCTA): Oku kufana ne-CT scan. Idayi ekhethekileyo ifakwa entliziyweni ukwenza imifanekiso ye-3D yemithambo yentliziyo.
• Ugcino lokuhamba kwenxalenye (FFR): Oku kungenziwa ngexesha elinye ne-angiogram. Intambo ekhethekileyo ifakwa emthanjeni kwaye uxinzelelo lwegazi lulinganiswa kumacala omabini okuvaleka ukuze kubonwe ukuba uvalekile kangakanani.
• I-ultrasound yemithambo yegazi (IVUS): Oku kungenziwa ngaxeshanye ne-angiogram. I-probe encinci ye-ultrasound idluliselwa kwimithambo yegazi, nto leyo evumela ukuba ingaphakathi lodonga lwemithambo yegazi kunye ne-stent zibonakale ngokucacileyo.

Ziziphi iindlela zonyango 'zokuhlala ixesha elide'?

Ugqirha wakho uza kumisela unyango olufanelekileyo kuwe ngokusekelwe kubukhali be-In-Stent Restenosis yakho, oko kukuthi, ukuba umthambo unciphile kangakanani, kunye nempilo yakho iyonke. Ingabandakanya olunye lonyango lulandelayo:

• Amayeza: Ukulawula iimpawu ezifana ne-angina ebangelwa yi-In-Stent Restenosis, umthamo wamayeza akhoyo unokwandiswa okanye kongezwe amayeza amatsha.
• I-angioplasty ephindaphindayo: Umthambo ovalekileyo uyavulwa kwakhona ngebhaluni, kwaye ngamanye amaxesha kufakwa enye i-stent. Ngamanye amaxesha kungasetyenziswa ibhaluni egqunywe ngamayeza.
• Utyando lokungena kwentliziyo:Oku kukwabizwa ngokuba yi-'Coronary artery bypass grafting' okanye i-'CABG'. Olu lutyando olukhulu kancinci. Okwenzayo kukudala indlela entsha yokuba igazi lijikeleze indawo evalekileyo. Oko kukuthi, uthatha iqhekeza le-artery kwenye indawo yomzimba wakho (njengomlenze wakho, isifuba) uze ulidibanise nendawo evalekileyo kunye nomqolo.
• I-Vascular brachytherapy: Olu lonyango olwahlukileyo kancinci. Ngokufana nonyango lwe-radiation olusetyenziselwa ukubulala iiseli zomhlaza, oku kuquka ukunika ubungakanani obuncinci be-radiation ixesha elifutshane kwi-stent ukuthintela izicubu zesilonda ukuba zingakhuli kwakhona. Oku kukwabizwa ngokuba yi-coronary brachytherapy.

Ngaba zikho iindlela zokuthintela 'ukungaphumli kakuhle'?

Ewe, iindaba ezimnandi zezokuba umngcipheko we-'In-Stent Restenosis' ungancitshiswa. Enye yeendlela eziphambili zokwenza oku kukusebenzisa ii-stent ezisebenzisa amayeza ('DES').

Ezi 'DES' zahlukile kwii-stents zesinyithi ezingenanto (i-BMS). Zine-coating encinci yeyeza kuzo. Nje ukuba i-stent ifakwe emthanjeni, iyeza likhutshwa kancinci kancinci, lilawula ukwakheka kwezicubu ezibomvu kunye nokukhula kweeseli.

Kwiminyaka eyadlulayo, bekukho intetho malunga nomngcipheko wokuqhekeka kwegazi ngezi 'DES'. Nangona kunjalo, isizukulwana esitsha see-stent ezisusa amayeza sikhuselekile kakhulu kwaye sisebenza kakuhle. Xa kusetyenziswa ezi 'DES', umngcipheko we 'In-Stent Restenosis' uncitshiswa kakhulu. Xa sithetha nje, 'abantu abangaphantsi komnye kwabalishumi' banesifo se 'In-Stent Restenosis'.

Ngoko ke, ukuba uza kufakwa i-stent, thetha nogqirha wakho ukuze agqibe ukuba loluphi uhlobo lwe-stent olulungele wena.

Iyintoni imbono yomntu 'onoxinzelelo olungapheliyo'?

Ukuba ufumana i-'In-Stent Restenosis', usenokuba nethuba elincinci lokufumana iimeko zentliziyo ezisongela ubomi, ezifana ne-'angina engazinzile', i-'acute coronary syndrome', kunye ne-'heart attacks'.

Ngethamsanqa, le mingcipheko incitshiswe kakhulu ngokufika kwee-stent ezintsha (ingakumbi ii-DES) kunye neendlela eziphuculweyo zokubeka ii-stent. Ukongeza, ngoku kukho unyango olusebenzayo lwe-In-Stent Restenosis.

Ukuba une-CAD, kufuneka ulandele imiyalelo kagqirha wakho ngokuchanekileyo ukuze uthintele i-In-Stent Restenosis kwaye ukhusele intliziyo yakho ngokubanzi. Oko kuthetha ukuba:

• Nciphisa ukutya ityuwa kwaye usele amayeza owanikwe ngugqirha wakho (ingakumbi lawo oxinzelelo lwegazi, i-cholesterol, kunye nokugabha kwegazi) ngokuchanekileyo nangexesha elifanelekileyo.
• Nciphisa ukusela kwakho utywala. Ukuba ungumntu othanda utywala, funa uncedo lokuboyisa.
• Ukutya okunempilo kwentliziyoYitya "ukutya okunempilo kwentliziyo." Yitya ioyile encinci, iswekile, nomgubo, kunye nemifuno emininzi, iziqhamo, kunye nokutya okutyebileyo kwi-fiber.
• Lumka ngeentlobo zamafutha owatyayo. Nciphisa ukutya okunamafutha amaninzi agcweleyo kunye namafutha aguqulweyo (ukutya okukhawulezayo, ukutya okuqhotsiweyo, ukutya okupakishweyo) kangangoko unako.
• Gcina ubunzima bakho busempilweni. Zilolonge yonke imihla.
• Ukuba unesifo seswekile, silawule kakuhle.
• Ukuba uyatshaya, zama ukuyeka namhlanje. Zikho iindlela zokufumana uncedo.

Ndingambiza nini ugqirha?

Ukuba ucinga ukuba unesifo sentliziyo (iimpawu ezifana neentlungu eziqatha esifubeni, ukuphefumla kancinci, ukubila), fowunela i-1990 Suwaseriya Ambulance Service ngoko nangoko.

Ukuba ukhe wafakelwa i-stent ngaphambili kwaye ezi mpawu ziphinda zibuye, bona ugqirha wentliziyo ngokukhawuleza:

• Intlungu yesifuba (i-angina), ukuqina, uxinzelelo, intlungu engalweni okanye egxalabeni.
• Ukubila okubandayo.
• Ubunzima bokuphefumla, ukuphefumla kancinci.
• Ukudinwa kakhulu okanye ubuthathaka ngaphandle kwesizathu.

Ndimele ndibuze ntoni kugqirha wam?

Xa udibana nogqirha, ungabuza imibuzo efana nale ukuze ufumane ukuqonda okucacileyo ngemeko yakho:

• Kutheni ndifumene le 'restenosis'? Zithini izinto ezindibeka emngciphekweni?
• Ndingaphinda ndifumane i-restenosis? Ndingenza ntoni ukuze ndiyithintele?
• Yeyiphi indlela yokuphila endifanele ndiyilandele ukuze ndikhusele intliziyo yam?
• Zeziphi iimpawu zeengxaki ekufuneka ndiziqaphele?
• Yeyiphi indlela engcono yonyango kum?

Okokugqibela, yintoni ekufuneka uyikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ngoko ke eyona nto ibalulekileyo ekufuneka uyikhumbule kwinto esithethe ngayo yile. I-Angioplasty kunye ne-stenting zezona ndlela zimbini zibalulekileyo nezisindisa ubomi kwisifo sentliziyo. Ezi ndlela zonyango ziphucula ukuhamba kwegazi entliziyweni yakho, zinciphisa iimpawu ze-CAD, kwaye ziphucula umgangatho wobomi bakho.

Nangona kunjalo, ukuba iimpawu ezinje ngokudinwa, iintlungu zesifuba, kunye nokuphefumla okunzima ziphinda zivele emva kokufakwa kwe-stent, oko kungaba luphawu lwe-'In-Stent Restenosis. ' Ukuba oko kuyenzeka, musa ukoyika okanye ukulibazisa, kodwa ngokuqinisekileyo bonana nogqirha wakho ukuze akunike ingcebiso.

Ngethamsanqa, ii-stents ezintsha nezikhuselekileyo nezingenamachiza ezikhoyo namhlanje ziye zanciphisa kakhulu umngcipheko wokufumana i-In-Stent Restenosis. Kukwakho nonyango olufanelekileyo loku. Kungcono ukuthetha nogqirha wakho malunga nohlobo lwe-stent kunye nonyango olufanelekileyo kuwe. Nyamekela intliziyo yakho!

I- stents, i-in-stent restenosis, isifo sentliziyo, i-angioplasty, isifo se-coronary artery, isifo se-coronary artery, uhlaselo lwentliziyo