Ingabe umthambo wenhliziyo ungavimbeka futhi ngemva kokufakwa kwe-stent? (In-Stent Restenosis)

Ingabe wena noma othile omaziyo wake wafakwa i-stent emthanjeni wenhliziyo? Ngemva kokwelashwa okunjalo, sivame ukucabanga ukuthi manje inkinga isixazululekile ngokuphelele, ukuthi umthambo wenhliziyo ngeke uphinde uvaleke. Kodwa-ke, ngezinye izikhathi, ukuvaleka okuncane noma ukuncishiswa kungaphinde kwenzeke endaweni efanayo lapho kwafakwa khona i-stent, okungukuthi, engxenyeni efanayo yomthambo owelashwe. Yilokho odokotela abakubiza ngokuthi 'In-Stent Restenosis'. Nakuba igama lingase lizwakale liyinkimbinkimbi kancane, empeleni lilula kakhulu. Ake sixoxe ngalokhu ngokuningiliziwe, ngesiSinhala ongakuqonda.

Okokuqala, ake siqonde la mazwi, akunjalo?

Ngaphambi kokuba sikhulume 'ngokuphumula okujulile', ake siqonde incazelo yamagama ambalwa. Khona-ke kuzocaca kuwe.

Kuyini 'i-Stenosis'?

Kalula nje, 'i-stenosis' iwukuncipha noma ukuncipha komthambo wegazi emzimbeni wethu. Cabanga ukuthi ngokuhamba kwesikhathi, ukungcola nokugqwala kwakheka ngaphakathi kwepayipi lamanzi, kuvimbele ukugeleza kwamanzi.

Ngakho-ke, siyini isifo semithambo yenhliziyo (CAD)?

Inhliziyo yethu nayo idinga igazi ukuze isebenze. Imithambo emikhulu eyinikezayo ibizwa ngokuthi imithambo yenhliziyo. I-CAD yilapho ama-fatty deposits abizwa ngokuthi i-plaque enqwabelana ngaphakathi kwemithambo yenhliziyo eyodwa noma ngaphezulu, okunciphisa imithambo yenhliziyo. Lokhu kubizwa nangokuthi i-atherosclerosis. Abanye abantu bakubiza nangokuthi "ukuqina kwemithambo yenhliziyo." Lokhu kwakheka kwamafutha kwenzeka kancane kancane, futhi kungase kungakhombisi zimpawu ekuqaleni. Kodwa uma kungelashwa, kungaholela ezimweni ezibucayi njengokuhlaselwa yinhliziyo kanye nokwehluleka kwenhliziyo.

Kuyini 'i-Angioplasty' kanye 'ne-Stent'?

Enye yezindlela zokwelapha eziyinhloko ezisetshenziswa odokotela ukuvula imithambo yenhliziyo evalekile ngenxa ye-CAD ibizwa ngokuthi i-angioplasty. Ngezinye izikhathi ibizwa nangokuthi i-percutaneous coronary intervention (PCI). Kulokhu, kufakwa ithubhu elincane (i-catheter) ngembobo encane esikhumbeni iye emthanjeni ovalekile. Idivayisi encane efana nebhaluni ekugcineni kwethubhu iyavuvukala, ikhulise umthambo ovalekile. Bese, ukuze kuvinjwe umthambo ukuthi ungaphinde udilike futhi kugcinwe igazi ligeleza kahle, ithubhu encane ene-mesh - yilokho okwenziwa yi-stent - ifakwa ngaphakathi komthambo ovalekile. Bese, igazi ligeleza kahle futhi.

Kulungile, manje kuyini lokhu 'Ukuqina Kwe-In-Stent'?

Manje usuyaqonda ukuthi kungani futhi kanjani ukufakwa kwe-stent. Ngemva kokufakwa kwe-stent futhi ukugeleza kwegazi kubuyiselwe emthanjeni wenhliziyo, ngezinye izikhathi umthambo uqala ukuncipha futhi lapho ukufakwa kwe-stent kwafakwa khona, okungukuthi, ngaphakathi kwe-stent. Yingakho sikubiza ngokuthi 'In-Stent Restenosis'. Igama elithi 'Re' lisho "futhi", kanti elithi 'stenosis' lisho "ukuncipha". Ngakho-ke, lokhu kusho "ukuncipha futhi ngaphakathi kwe-stent".

Sivame kangakanani lesi simo?

Manje ungase uzibuze ukuthi lokhu kuyinto ehlukile yini kubo bonke abathola ama-stents.Cha, lokhu akwenzeki kuwo wonke umuntu one-stent. Kodwa-ke, uma sikhuluma nje, cishe umuntu oyedwa kwabane abane -stent banethuba lokuthola lesi simo esibizwa ngokuthi 'In-Stent Restenosis'. Lokhu kuvame ukwenzeka zingakapheli izinyanga ezintathu kuya kweziyisithupha kusukela kufakwe i-stent.

Okubalulekile: Uma une-balloon angioplasty ngaphandle kokuhlinzwa, ingozi ye-restenosis iphakeme nakakhulu. Abantu abangaba ngu-4 kwabayi-10 bazophinde bavalwe umthambo wabo.

Kungani kwenzeka 'ukuphumula kwe-in-stent'?

Umbuzo othakazelisayo ngempela. Ngemva kokufakwa kwe-stent, umzimba wethu uzama "ukuyelapha". Okusho ukuthi, ungqimba olusha lwamaseli ("ulwelwesi olusha") lukhula phezu kwe-stent, okwenza ingaphakathi lomthambo libe bushelelezi futhi. Lokhu empeleni kuyinto enhle, ngoba-ke igazi lingageleza kalula ngaphandle kokujiya.

Kodwa-ke, ngezinye izikhathi, ngaphansi kwalolu ngqimba olusha lwamaseli, oluzungeze i-stent, kukhula izicubu ezincane zesibazi . Uma lesi zicubu sesibazi sikhula kakhulu, ulwelwesi lwangaphakathi lomthambo luyaqina, lunciphise ukugeleza kwegazi futhi. Lena imbangela eyinhloko ye-'In-Stent Restenosis'.

Khumbula, lokhu kuvame ukwenzeka zingakapheli izinyanga ezintathu kuya kweziyisithupha zokusebenzisa i-stenting. Ngemva kwalokho, ingozi yokwakheka kwezicubu zesilonda nokuvimba umthambo iphansi kakhulu.

Ubani osengozini enkulu yokuthola 'i-in-stent restenosis'?

Nakuba noma ubani ofakelwe i-stent ye-CAD angaba nalesi simo esibizwa ngokuthi i-'In-Stent Restenosis', abanye abantu basengozini enkulu kancane. Ake sibheke ukuthi bangobani:

• Kubantu abanamazinga aphezulu e-cholesterol egazini. (Yilokhu okubangela izifo eziningi zenhliziyo!)
• Kulabo abanesifo sezinso .
• Kulabo ababhemayo. (Lokhu kuyinto okufanele uyeke ukuyenza!)
• Kulabo abanesifo sikashukela esingalawulwa kahle.
• Kulabo abanomfutho wegazi ophakeme ongalawuleki (umfutho wegazi ophakeme).

Uma unezimo ezinjengalezi, kubaluleke kakhulu ukukhuluma nodokotela wakho bese ubalawula.

Yiziphi izimpawu 'zokuphumula okunamandla'?

Esikhathini esiningi, abantu abane-'In-Stent Restenosis' ababonisi zimpawu zangaphandle. Yingakho kubaluleke kakhulu ukubona udokotela wakho ngezikhathi ezithile bese wenza izivivinyo ezidingekayo ngemuva kokufakwa kwe-stent.

Kodwa-ke, abanye abantu bangase babe nezimpawu. Uma bezithola, izimpawu zivame ukufana neze-CAD esezikhona. Lezi zimpawu zifaka:

• Umuzwa wobuhlungu, ukuqina, noma ukungakhululeki esifubeni. Lokhu sikubiza ngokuthi "i-angina." Lobuhlungu esifubeni bungase bube bubi kakhulu uma uzivocavoca, ukhuphuka izitebhisi, noma ukhathala kancane.
• Ukujuluka okubandayo.
• Ukuzizwa unesizungu, ikhanda elibuhlungu, noma ukuzizwa uphelelwe amandla.
• Ukukhathala ngokweqile kanye nobuthakathaka.
• Ukuzwa ukushaya kwenhliziyo okungavamile (`Ukushaya kwenhliziyo okungavamile`).
• Isicanucanu.
• Ukuphefumula kanzima, ngezinye izikhathi ngisho noma uhamba ibanga elifushane.
• Ubuhlungu ehlombe noma engalweni (ikakhulukazi engalweni yesobunxele).

Uma unalezi zimpawu, kufanele ubonane nodokotela ngaphandle kokuchitha isikhathi.

Itholakala kanjani i-'in-stent restenosis'?

Njengoba ngishilo ngaphambili, njengoba i-'In-Stent Restenosis' ingabonisi izimpawu ngaso sonke isikhathi, kubalulekile ukubona udokotela wakho njalo ngemva kokufakwa kwe-stent. Ngemuva kwalokho, ukuhlolwa okudingekayo kungenziwa.

Uma unezimpawu, udokotela wakho angase akuncomele ukuhlolwa okufana nalokhu:

• Ukuhlolwa kokucindezeleka kokuzivocavoca : Lokhu kuhlolwa kulinganisa indlela inhliziyo yakho epompa ngayo igazi futhi kubheka izinguquko ku-ECG yakho njengoba uhamba nge-treadmill noma ugibela ibhayisikili.
• Ukuhlolwa kwe-catheterization yenhliziyo kanye ne-angiogram : Lokhu kwenziwa ngaphambi kokuba i-stent ibekwe. Lokhu kungenziwa futhi ukuze kubonakale ukuthi kukhona yini ukuvaleka ngaphakathi kwe-stent.
• I-Coronary computed tomography angiogram (CCTA): Lokhu kufana ne-CT scan. Kufakwa idayi ekhethekile enhliziyweni ukuze kudalwe izithombe ze-3D zemithambo yenhliziyo.
• I-Fractional flow reserve (FFR): Lokhu kungenziwa ngesikhathi esifanayo ne-angiogram. Intambo ekhethekile ifakwa emthanjeni bese kulinganiswa umfutho wegazi kuzo zombili izinhlangothi zokuvaleka ukuze kubonakale ukuthi ukuvaleka kukhulu kangakanani.
• I-ultrasound ye-Intravascular (IVUS): Lokhu kungenziwa ngesikhathi esifanayo ne-angiogram. I-probe encane ye-ultrasound idluliselwa emthanjeni, okuvumela ingaphakathi lodonga lwemithambo kanye ne-stent ukuthi kubonakale ngokucacile.

Yiziphi izindlela zokwelapha 'i-in-stent restenosis'?

Udokotela wakho uzonquma ukwelashwa okufanele kakhulu kuwe ngokusekelwe ebunzimeni be-In-Stent Restenosis yakho, okungukuthi, ukuthi umthambo unciphile kangakanani, kanye nempilo yakho iyonke. Kungafaka phakathi okunye kokwelashwa okulandelayo:

• Imithi: Ukuze kulawulwe izimpawu ezifana ne-angina ebangelwa yi-In-Stent Restenosis, umthamo wemithi yamanje ungase wande noma kwengezwe imithi emisha.
• I-angioplasty ephindaphindayo: Umthambo ovalekile uyavulwa futhi ngebhaluni, futhi ngezinye izikhathi kufakwa elinye i-stent. Ngezinye izikhathi kungasetshenziswa ibhaluni elimbozwe umuthi.
• Ukuhlinzwa kwe-heart bypass:Lokhu kubizwa nangokuthi 'ukufakelwa kwe-Coronary artery bypass' noma 'i-CABG'. Lokhu kuyindlela enkulu yokuhlinzwa. Okwenzayo ukudala indlela entsha yokuthi igazi ligeleze endaweni evinjiwe. Okusho ukuthi, uthatha ucezu lomthambo kwenye ingxenye yomzimba wakho (njengomlenze wakho, isifuba) bese uwuxhuma endaweni evinjiwe kanye nomhlane.
• Ukwelashwa nge-Vascular brachytherapy: Lokhu kuyindlela yokwelapha ehluke kancane. Njengokwelashwa ngemisebe okusetshenziselwa ukubulala amangqamuzana omdlavuza, lokhu kuhilela ukunikeza inani elincane lemisebe isikhathi esifushane ku-stent ukuze kuvinjelwe izicubu zesilonda ukuthi zingakhuli. Lokhu kubizwa nangokuthi i-coronary brachytherapy.

Ingabe zikhona izindlela zokuvimbela 'ukuphumula okubangelwa yi-in-stent'?

Yebo, izindaba ezinhle ukuthi ingozi ye-'In-Stent Restenosis' ingancishiswa. Enye yezindlela eziyinhloko zokwenza lokhu ukusebenzisa ama-stent asebenzisa izidakamizwa ('DES').

Lawa ma-'DES' ahlukile kuma-stents ensimbi angenalutho (i-BMS). Ane-coating encane yomuthi kuwo. Uma i-stent isifakwe emthanjeni, umuthi ukhishwa kancane kancane, ulawula ukwakheka kwezicubu zesilonda kanye nokukhula kwamaseli.

Eminyakeni edlule, kwakukhulunywa ngengozi yokuqhekeka kwegazi ngalezi 'DES'. Kodwa-ke, isizukulwane esisha sama-stent asusa izidakamizwa siphephile kakhulu futhi sisebenza kahle kakhulu. Uma usebenzisa lezi 'DES', ingozi ye-'In-Stent Restenosis' incishiswa kakhulu. Uma sikhuluma nje, 'abantu abangaphansi koyedwa kwabayi-10' bahlakulela i-'In-Stent Restenosis'.

Ngakho-ke, uma uzofakwa i-stent, khuluma nodokotela wakho ukuze anqume ukuthi yiluphi uhlobo lwe-stent olufanele wena.

Uyini umbono womuntu 'onokukhubazeka okubangelwa yi-in-stent restenosis'?

Uma uthola i-'In-Stent Restenosis', ungase ube namathuba amancane okubhekana nezimo zenhliziyo ezingasongela ukuphila, njenge-'angina engazinzile', i-'acute coronary syndrome', kanye ne-'heart attacks'.

Ngenhlanhla, lezi zingozi zincishiswe kakhulu ngokufika kwama-stent amasha (ikakhulukazi ama-DES) kanye namasu okubeka ama-stent athuthukisiwe. Ngaphezu kwalokho, manje sekukhona ukwelashwa okuphumelelayo kwe-In-Stent Restenosis.

Uma une-CAD, kufanele ulandele imiyalelo kadokotela wakho ngqo ukuze uvimbele i-In-Stent Restenosis futhi uvikele inhliziyo yakho iyonke. Lokho kusho ukuthi:

• Nciphisa usawoti owudlayo bese uthatha imithi oyinikezwe udokotela wakho (ikakhulukazi leyo yomfutho wegazi, i-cholesterol, kanye nokujiya kwegazi) ngesikhathi esifanele.
• Nciphisa ukuphuza kwakho utshwala. Uma uluthekile, funa usizo lokulunqoba.
• Ukudla okunempilo kwenhliziyoYidla "ukudla okunempilo kwenhliziyo." Yidla amafutha amancane, ushukela, nofulawa, kanye nemifino eminingi, izithelo, kanye nokudla okucebile nge-fiber.
• Qaphela izinhlobo zamafutha owadlayo. Nciphisa ukudla kwakho okunamafutha amaningi agcwele kanye nama-trans (ukudla okusheshayo, ukudla okuthosiwe, ukudla okupakishwe) ngangokunokwenzeka.
• Gcina isisindo esinempilo. Vivinya umzimba nsuku zonke.
• Uma unesifo sikashukela, silawule kahle.
• Uma ubhema, zama ukuyeka namuhla. Kunezindlela zokuthola usizo.

Kufanele ngishayele nini udokotela ucingo?

Uma ucabanga ukuthi unesifo senhliziyo (izimpawu ezifana nobuhlungu obukhulu besifuba, ukuphelelwa umoya, ukujuluka), shayela i-Suwaseriya Ambulance Service ka-1990 ngokushesha.

Uma uke wafakwa i-stent ngaphambili futhi lezi zimpawu ziphinde zibuye, bheka udokotela wakho wenhliziyo ngokushesha:

• Ubuhlungu besifuba (i-angina), ukuqina, ingcindezi, ubuhlungu engalweni noma ehlombe.
• Ukujuluka okubandayo.
• Ubunzima bokuphefumula, ukukhwehlela.
• Ukukhathala ngokweqile noma ubuthakathaka ngaphandle kwesizathu.

Yini okufanele ngiyibuze udokotela wami?

Uma uhlangana nodokotela, ungabuza imibuzo efana nale ukuze uthole ukuqonda okucacile ngesimo sakho:

• Kungani ngithole lokhu 'ukuphumula'? Yiziphi izinto ezingibeka engcupheni?
• Ngingaphinde ngithole i-restenosis? Yini okufanele ngiyenze ukuze ngiyivimbele?
• Iyiphi indlela yokuphila okufanele ngiyilandele ukuze ngivikele inhliziyo yami?
• Yiziphi izimpawu zezinkinga okufanele ngiziqaphele?
• Yikuphi ukwelashwa okungcono kakhulu kimi?

Ekugcineni, yini okufanele uyikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ngakho into ebaluleke kakhulu okudingeka uyikhumbule kulokho esikhulume ngakho yilokhu. I-Angioplasty kanye ne-stenting kuyizindlela ezimbili zokwelapha ezibaluleke kakhulu nezisindisa impilo zesifo senhliziyo. Lezi zindlela zokwelapha zithuthukisa ukugeleza kwegazi enhliziyweni yakho, zinciphise izimpawu ze-CAD, futhi zithuthukise ikhwalithi yokuphila kwakho.

Kodwa-ke, uma izimpawu ezifana nokukhathala, ubuhlungu besifuba, kanye nokuphelelwa umoya ziphinde zivele ngemva kokufakwa kwe-stent, kungaba uphawu lwe-'In-Stent Restenosis. ' Uma lokho kwenzeka, ungesabi noma ulibale, kodwa qiniseka ukuthi ubona udokotela wakho ukuze uthole iseluleko.

Ngenhlanhla, ama-stents amasha, aphephile futhi angenazo izidakamizwa atholakalayo namuhla anciphise kakhulu ingozi yokuthola i-In-Stent Restenosis. Kukhona futhi izindlela zokwelapha ezinhle zalokhu. Kungcono ukukhuluma nodokotela wakho mayelana nokuthi hlobo luni lwe-stent kanye nokwelashwa okufanele wena. Nakekela inhliziyo yakho!

Ama - stents, i-in-stent restenosis, isifo senhliziyo, i-angioplasty, isifo semithambo yenhliziyo, isifo semithambo yenhliziyo, ukuhlaselwa yinhliziyo