Ingaba imithambo yegazi entanyeni yakho ivaliwe? Masifunde ngotyando lwe-TCAR (iTranscarotid Artery Revascularization)

Ngaba ugqirha wakho ukuxelele ukuba umthambo wegazi omkhulu entanyeni yakho uvalekile kwaye usemngciphekweni omkhulu wokuba nestroke? Kuqhelekile ukuba nabani na othuka kancinci xa esiva into efana naleyo. "Ngaba kuya kufuneka ndityandwe? Ingaba yinto enkulu?" Imibuzo emininzi isenokufika engqondweni. Kodwa ungakhathazeki, kuba isayensi yezonyango ihambele phambili, ngoku kukho unyango olukhuselekileyo, olulula nolusebenzayo lweemeko ezinjalo. Namhlanje siza kuthetha ngolunye lonyango olutsha noluphumeleleyo, i-TCAR.

Ngamafutshane, yintoni i-TCAR?

Igama elipheleleyo le-TCAR yiTranscarotid Artery Revascularization . Kulungile, eli gama livakala linzima kancinci, akunjalo? Masiligcine lilula.

Kukho imithambo yegazi emibini ephambili kumacala omabini entamo yethu ethwala igazi liye ebuchotsheni. Le siyibiza ngokuba yimithambo ye-carotid . Le ifana nemibhobho emibini ephambili ezisa amanzi endlwini yethu. Ekuhambeni kwexesha, izinto ezifana namafutha kunye ne-cholesterol ezivela ekutyeni esikutyayo ziyaqokelelana ngaphakathi kwezi mithambo yegazi, njengokugqwala okwakheka ngaphakathi kombhobho wamanzi. Oku kubizwa ngokuba yi -'plaque' ngokwezonyango.

Njengoko olu 'lwe-plaque' lukhula kancinci kancinci, indawo engaphakathi komthambo wegazi iyancipha, kwaye ukuhamba kwegazi kuyavalwa. Eyona nto iyingozi kukuba ukuba iqhekeza elincinci lalo 'lwe-plaque' liyaqhekeka lize lihambe liye engqondweni kunye negazi, linokuvala umthambo wegazi engqondweni lize libangele isifo sohlangothi .

Ngoko ke, ukuvula kwakhona le mthambo wegazi uvalekileyo nokubuyisela ukuhamba kwegazi yinto esiyibiza ngokuba yi -'revascularization.' Kukho iindlela ezininzi eziphambili zokwenza oku.

1. I-Carotid Endarterectomy (CEA): Olu lutyando oluvulekileyo lwendabuko. Kulo, kwenziwa umngxuma omncinci entanyeni, umthambo wegazi uyavulwa, kususwe umaleko 'weplaque' ngaphakathi, kwaye umthambo wegazi uthungwe ndawonye.

2. I-Carotid Angioplasty kunye ne-Stenting (CAS): Ityhubhu encinci kakhulu idluliselwa kwimithambo yegazi ekwisinqe okanye engalweni ize ikhokelwe kwimithambo yegazi evaliweyo entanyeni. Indawo evaliweyo iyandiswa ngento efana nebhaluni, kwaye kufakwa 'i-stent' , ityhubhu encinci ye-mesh, ukuze ingayivali kwakhona.

3. I-TCAR (iTranscarotid Artery Revascularization): I-TCAR yindlela ekhuselekileyo neyanamhlanje edibanisa ezona ndlela zibalaseleyo kuzo zombini. Ibandakanya ukwenza umsikelo omncinci kakhulu ngaphezulu nje kwe-collarbone entanyeni kunye nokufaka i-stent ngqo kumthambo wegazi ovalekileyo.

Ngubani ofanelekileyo kakhulu kolu tyando lwe-TCAR?

Indlela ye-TCAR yaqalwa ukwaziswa ngo-2015 kwizigulane ezazisengozini enkulu yotyando lwendabuko oluvulekileyo (CEA). Oko kukuthi:

• Kwabantu abadala .
• Kwabo banesifo sentliziyo okanye semiphunga .
• Kwabo banezicwili zesilonda ezivela kutyando lwentamo lwangaphambili okanye unyango lwemitha.
• Ukuba umthambo wegazi uvalekile kwindawo apho utyando lunzima khona, njengaphantsi komhlathi.

Kodwa ngoku le ndlela iphumelele kakhulu kangangokuba ukusukela ngo-2022, unyango lwe-TCAR luye lwacetyiswa nakwizigulana ezisempilweni eqhelekileyo, oko kukuthi, ezo zingenazo izinto ezikhethekileyo ezinobungozi. Okwangoku, utyando lwe-TCAR olungaphezulu kwama-20,000 lwenziwe eMelika kuphela.

Uzilungiselela njani ngaphambi kotyando?

Ukuba ugqirha wakho ugqiba ekubeni akwenzele utyando lwe-TCAR, kuya kufuneka enze uvavanyo oluninzi kwangaphambili.

• Uvavanyo lwegazi: Fumanisa ngempilo yakho ngokubanzi kunye nokukwazi kwakho ukujiya kwegazi.
• Iskeni ye-ultrasound yemithambo yegazi ye-carotid: Jonga ukuba ingakanani na imithambo yegazi evalekileyo.
• I-CT Angiogram: Fumana umfanekiso ocacileyo nonobukhulu obuthathu wemithambo yegazi entanyeni nasebuchotsheni.

Kwakhona, ugqirha uza kukuqalisa amayeza aliqela ukuze akulungiselele utyando.

• Amayeza e-statin anciphisa i-cholesterol.
• Amayeza anjenge -aspirin kunye ne -clopidogrel athintela ukujiya kwegazi.

Uya kucetyiswa ukuba ungatyi okanye ungaseli nto emva kobusuku bobusuku ngaphambi kotyando.

Indlela yotyando olwenziwa ngayo: inyathelo ngenyathelo

Olu tyando luza kuthatha malunga neyure enesiqingatha. Makhe sijonge ngokukhawuleza okwenzekayo kwigumbi lotyando.

1. I-Anesthesia: Ukuze ungaziva iintlungu, nokuba indawo ejikeleze intamo yakho iya kuba ne-numbness (local anesthesia) okanye uya kuba ne-anesthesia epheleleyo (general anesthesia) .

2. Ukusikwa okuncinci: Kwenziwa ukusikwa okuncinci kakhulu entanyeni, ngaphezulu nje kwethambo lentamo, malunga ne-1-1.5 intshi.

3. Ukubuyela umva kokuhamba: Eli lelona nyathelo libalulekileyo nelikhuselekileyo kwinkqubo ye-TCAR.

• Ityhubhu encinci ifakwa kumthambo osesinqeni (umthambo we-femoral).
• Enye ityhubhu ifakwa kumthambo we-carotid ovalekileyo ngokusebenzisa umsikelo wentamo.
• Ngoku, ezi tyhubhu zimbini ziqhagamshelwe kumatshini onesihluzo esikhethekileyo. Emva koko, ukuhamba kwegazi ukuya ebuchotsheni kuyamiswa okwethutyana, kwaye igazi elivela kumthambo osentanyeni liphuma ngaloo tyhubhu, licocwe ngesihluzo, lize libuyele emzimbeni ngetyhubhu esesinqeni.
• Kule nqanaba, igazi elifunekayo yingqondo yakho livela kwi-carotid artery kwelinye icala lentamo yakho nakwi -vertebral arteries ngasemva kwengqondo yakho.Ifumaneka ngaphandle kwengxaki.

4. Ukuvula indawo evalekileyo: Kusetyenziswa ucingo olubhityileyo ukuze kudlule indawo evalekileyo kwaye kwandiswe indawo ngebhaluni encinci.

5. Ukubekwa kwe-stent: Okulandelayo, kufakwa ityhubhu encinci yesinyithi, ebizwa ngokuba yi-stent , kwindawo evalekileyo. Oku kugcina umthambo wegazi uvulekile kwaye kubambe i-plaque eludongeni.

6. Isiphelo: Emva koko, zonke iityhubhu ziyasuswa, kwaye umngxuma omncinci kwimithambo yegazi kunye nokusika entanyeni kuyathungwa.

Kwenzeka ntoni emva kotyando?

Emva kotyando lwe-TCAR, kuya kufuneka uhlale esibhedlele malunga nobusuku obunye . Oogqirha kunye nabongikazi baya kujonga impilo yakho rhoqo. Ekubeni olu lutyando olulula kakhulu, ukuchacha nako kuyakhawuleza kakhulu.

Zithini iingozi kunye neengxaki?

Njengakwezinye iindlela zonyango, i-TCAR inokuba neengozi ezincinci kakhulu. Nangona kunjalo, amathuba okuba ezi zinto zenzeke aphantsi kakhulu.

• Ukopha okanye ukudumba kwindawo yokusikwa.
• Usulelo lwenxeba.
• Umonakalo omncinci kumthambo entanyeni.
• Istroke.
• Ukuhlaselwa yintliziyo.

Ugqirha wakho uza kukuchazela ezi ngozi ngokweenkcukacha. Khumbula ukuba kuthathwa amanyathelo akhethekileyo ukunciphisa ezi ngozi ngexesha lenkqubo ye-TCAR.

Ukuchacha nokuphila nge-stent

I-TCAR yinkqubo ekhawulezayo kakhulu kuba akukho mingxunya mikhulu.

• Kuphephe ukuphakamisa iintsimbi kangangeveki okanye ezimbini.
• Jonga i-incision entanyeni yakho yonke imihla ukuqinisekisa ukuba icocekile kwaye akukho zimpawu zosulelo.
• Buza ugqirha wakho ukuba ungabuyela nini emsebenzini wakho nakweminye imisebenzi yemihla ngemihla.

Emva kokuba i-stent ifakiwe, kuxhomekeke kuwe ukuthintela ukuba umthambo wegazi ungavaleki kwakhona. Ukuze wenze oku, kufuneka wenze ezi zinto.

• Ukuba uyatshaya, yeka ngoko nangoko.
• Zilolonge rhoqo.
• Zama ukutya ukutya okunempilo okunamafutha agcweleyo aphantsi.
• Sela amayeza okunciphisa igazi kunye namayeza okunciphisa i-cholesterol achazwe ngugqirha wakho ngexesha elifanelekileyo.

Ndifanele ndimbone nini ugqirha?

Ukuba ubona iimpawu zosulelo kwindawo etyatyekwe kuyo, fowunela ugqirha wakho ngoko nangoko.

• Ifiva
• Ukuba uziva ubanda
• Ukuba kukho ukubomvu kunye nokudumba okujikeleze i-incision
• Ukuba into efana nolwelo iphuma kwi-cut

Ugqirha wakho uya kugqiba ukuba loluphi unyango olukulungeleyo. Xoxa naye ngayo nayiphi na imibuzo, iinkxalabo, okanye amathandabuzo onawo. Injongo yakhe kukubonelela ngonyango olufanelekileyo nolukhuselekileyo.