Wake wezwa ngesifo sohlangothi? Yisimo esibi kakhulu esethusa abantu abaningi futhi esingashintsha izimpilo zabo. Ngakho-ke isizathu esiyinhloko salesi sifo sohlangothi ukuvaleka kwemithambo yegazi eyinhloko ethwala umoya-mpilo nezakhamzimba ebuchosheni bethu. Kufana nepayipi eliyinhloko elivalekile elithwala amanzi ensimini. Namuhla sizokhuluma ngendlela yokwelapha ebaluleke kakhulu evula kabusha le mithambo yegazi evalekile, ivumele ukugeleza kwegazi okuhle ebuchosheni, futhi inciphise ingozi yesifo sohlangothi.
Kalula nje, kuyini i-Carotid Artery Stenting?
Ake sithi sinemithambo emibili emikhulu ezinhlangothini zombili zentamo yethu enikeza igazi ebuchosheni bethu, ebusweni, nasentanyeni. Lokhu yilokho esikubiza ngokwezokwelapha ngokuthi i-Carotid Arteries . Ngokuhamba kwesikhathi, ama-fat deposits, ikakhulukazi i-cholesterol (odokotela abakubiza ngokuthi 'i-plaque'), aqala ukwakheka ezindongeni zale mithambo yegazi. Kufana nokugqwala okwakheka ngaphakathi kwepayipi lamanzi. Kancane kancane, la ma-deposits ayakhula futhi umthambo wegazi uyancipha, ngezinye izikhathi uwuvimbele ngokuphelele. Lesi simo sibizwa ngokuthi i-Carotid Artery Stenosis .
Yilapho kufakwa khona ipayipi lensimbi elincane kakhulu, elifana ne-mesh endaweni evinjiwe bese umthambo wegazi oncishisiwe uvulwa futhi. Yilokhu esikubiza ngokuthi i-carotid artery stent .
Le stent ifana nebhuloho eliqinile. Ifakwa unomphela ngaphakathi komthambo wegazi, futhi ivulwa ngaphandle kokuncipha futhi. Ngemva kwamasonto ambalwa, udonga lomthambo wegazi luyaphola luzungeze le stent, bese iba yingxenye yomzimba.
Lokhu kwelashwa kwenziwa ochwepheshe abaqeqeshwe ngokukhethekile, njengodokotela wenhliziyo osebenzayo, udokotela ohlinzayo wemithambo yegazi, noma udokotela wezinzwa we-Endovascular.
Ubani ngempela odinga lokhu kwelashwa?
Ngaphambi kokuba udokotela wakho akuncome lokhu kwelashwa, ngokuvamile uzokwenza i-ultrasound scan, i-CT scan, noma i-MRI scan yemithambo yegazi yakho entanyeni ukuze abone ukuthi ivimbeke kangakanani. Lokhu kwelashwa kuvame ukudingwa kubantu aba:
- Labo ababonise izimpawu zesifo sohlangothi noma i-ministroke futhi abanomthambo we-carotid oqinisekisiwe ukuthi uvalwe ngaphezu kuka-50% yizikena.
- Kulabo abangenazo izimpawu, kodwa abanomthambo we-carotid ovalwe ngaphezu kuka-70% kuma-scan.
Ngingalungiselela kanjani ngaphambi kokwelashwa?
Nakuba lokhu kungekona okukhulu njengokuhlinzwa, kudinga ukulungiselela okuthile. Udokotela wakho cishe uzosho okulandelayo:
- Ama-Anticoagulant: Ungase ucelwe ukuthi uqale ukuthatha i-aspirin kanye neminye imithi efanayo (isib. i-Clopidogrel, i-Ticagrelor) ezinsukwini ezintathu kuya kwezinhlanu ngaphambi kokwelashwa kwakho. Kubalulekile ukuthatha le mithi njengoba nje udokotela wakho ekutshelile, njengoba kuyalelwe. Ukwehluleka ukwenza kanjalo kungabangela ukuthi ukwelashwa kwakho kubambezeleke.
- Ukudla Nokuphuza: Uzocelwa ukuba uzile ukudla amahora ambalwa ngaphambi kokwelashwa. Udokotela wakho uzokunikeza imiyalelo eqondile ngalokhu.
Kwenzekani ngesikhathi sokwelashwa?
Kunezindlela ezimbili eziyinhloko zokufaka i-stent emthanjeni wegazi entanyeni yakho. Udokotela wakho uzonquma ukuthi iyiphi indlela engcono kakhulu kuwe.
| Uhlobo Lwenqubo | Indawo yokufaka i-Stent (Indawo Yokufinyelela) |
|---|---|
| Indlela ye-Transfemoral noma ye-Transradial | Ithubhu elincane (i-catheter) lifakwa ngomthambo osesiswini somlenze noma esihlakaleni , bese i-stent iqondiswa ngayo iye emthanjeni we-jugular. |
| Ukuvuselelwa Kwemithambo Ye-Transcarotid (TCAR) | Ngale ndlela, kwenziwa ukusika okuncane entanyeni, ngaphezu nje kwe-collarbone, bese i-stent ifakwa ngqo emthanjeni we-carotid. |
Phakathi nalokhu kwelashwa, uzonikezwa imithi efana ne-heparin yokuvimbela ukujiya kwegazi. Inqubo yonke ivame ukuthatha ihora noma amabili. Kodwa-ke, kuzodingeka uhlale esibhedlela usuku lonke, okuhlanganisa nesikhathi sokulungiselela kanye nokubhekwa ngemva kwalokho.
Kwenzekani ngemva kokwelashwa?
Ngemva kokufakwa kwe-stent ngempumelelo, ithimba lezokwelapha lizokwenza okulandelayo:
- Ukuhlolwa okufana ne-angiogram kwenziwa ukuze kubonakale ukuthi i-stent ibanzi ngokwanele nokuthi ukugeleza kwegazi kuhle yini.
- Zonke izicatheter ziyasuswa. I-stent ihlala endaweni yayo unomphela.
- Uzonikezwa imithi edingekayo ukuze unciphise ukungakhululeki okuzwayo.
- Imiphumela yokwelashwa izochazwa kuwe nomndeni wakho.
- Ngemva kokubuyela ekhaya, uzonikezwa imiyalelo yokuthi ungayithatha kanjani imithi yakho, ukuthi udle ini, nokuthi ungazivocavoca kanjani. Ikakhulukazi, uzotshelwa ukuthi uqhubeke nokuthatha i-aspirin kanye neminye imithi yokunciphisa igazi.
Kubaluleke kakhulu: Ungayeki ukuthatha noma yimiphi imithi oyinikezwe udokotela wakho, ikakhulukazi leyo evimbela ukuqhekeka kwegazi, nganoma yisiphi isizathu, ngaphandle kokukhuluma naye. Le mithi ngokuvamile idinga ukuthathwa okungenani inyanga, futhi ngokuvamile izinyanga eziyisithupha noma ngaphezulu.
Yiziphi izinzuzo nezingozi zalokhu kwelashwa?
Kunezinzuzo eziningana zokusebenzisa i-stenting uma kuqhathaniswa nokuhlinzwa kwe-carotid endarterectomy yendabuko.
Izinzuzo eziyinhloko
- Asikho isidingo sokuhlinzwa okukhulu: Lena indlela engenawo umthelela omkhulu emzimbeni.
- Ukusikwa okuncane noma ukungasikwa: Kwezinye izindlela, kunendawo yokubhoboza kuphela.
- Kuncishiswe ingozi yokulimala kwemizwa entanyeni.
- Ubuhlungu buyancipha ngemva kokwelashwa.
Izingozi ezingaba khona (Izinkinga)
Njengakuzo zonke izindlela zokwelapha, kunezingozi ezithile. Kodwa lokhu akwenzeki kuwo wonke umuntu.
- Umfutho wegazi ophansi (`Hypotension`) noma ophakeme (`Hypertension`).
- Isilinganiso senhliziyo esihamba kancane (i-Bradycardia).
- Ukopha okuvela endaweni lapho ipayipi lifakwe khona.
- Ukujiya kwegazi.
- Isifo sohlangothi: Kukhona ingozi encane yesifo sohlangothi esibangelwa ukuqhekeka kwegazi okuncane okuya ebuchosheni ngesikhathi noma ngemva kokwelashwa.
- Ukopha okuya ebuchosheni.
Le ngozi ingahluka kuye ngeminyaka yakho, ukuthi unezinye izimo zezokwelapha, kanye nobukhulu bokuvimbeka kwemithambo yegazi. Ngakho-ke, khuluma nodokotela wakho ngalokhu futhi ubuze noma yimiphi imibuzo onayo.
Yini okufanele uyenze ukuze uthole imiphumela emihle kakhulu?
Isimo esibangele ukuvaleka kwemithambo yegazi (i-atherosclerosis) ngemva kokufakwa kwe-stent ngeke selapheke ngokuphelele. Ngakho-ke, kubaluleke kakhulu ukushintsha indlela yakho yokuphila ukuze uvimbele izinkinga ezifanayo ukuthi zenzeke esikhathini esizayo.
- Gwema ukubhema ngokuphelele: Akuyona nje ugwayi, ama-bidi, kanye nogwayi kuphela, kodwa ngisho ne-'vaping' kufanele iyekwe.
- Phuza imithi yakho ngendlela efanele: Phuza imithi oyinikezwe udokotela wakho ngesikhathi esifanele nangesilinganiso esifanele.
- Gcina isisindo esinempilo.
- Vivinya umzimba njalo: Ngisho nokuhamba imizuzu engama-30 ngosuku kuhle.
- Landela ukudla okunempilo kwenhliziyo: yidla amafutha amancane, usawoti, noshukela, kanye nezithelo nemifino eminingi.
- Lawula ezinye izifo:Uma unesifo sikashukela, umfutho wegazi ophakeme, noma i-cholesterol, zigcine zilawulwa kahle (isib., gcina umfutho wegazi ungaphansi kuka-130, i-LDL cholesterol ingaphansi kuka-70, kanye ne-HbA1c ingaphansi kuka-7).
- Hamba uyohlolwa ngokulandelayo: Qiniseka ukuthi uya kudokotela ngezinsuku akutshela zona ukuthi uze uzohlola isimo se-stent.
Isikhathi sokululama singakanani futhi kufanele ngishayele udokotela nini?
Udinga ukuphumula kancane isonto lokuqala ngemva kokubuyela ekhaya.
- Gwema ukuphakamisa izinto ezisindayo (ezingaphezu kuka-10 kg).
- Ungacwilisi indawo yokufaka emanzini (isib. ukugeza, ukubhukuda) isonto lonke. Ukugeza akuyona inkinga.
- Uma ukhuphuka izitebhisi, zikhuphuke kancane kancane.
Izimo ezidinga ukunakekelwa okusheshayo:
Uma uhlangabezana nanoma yiziphi izimpawu zokukhubazeka owawunazo ngaphambi kokwelashwa (njengokugoba kolunye uhlangothi lobuso bakho, ubunzima bokukhuluma, noma ukulahlekelwa umuzwa engalweni noma emlenzeni), hamba ngokushesha e-Emergency Treatment Unit (ETU) yesibhedlela ngaphandle kokulibala.
Futhi, uma indawo yepayipi iqhubeka nokopha, ukuvuvukala, noma ukuphuma kobomvu, shayela udokotela wakho ngokushesha.
Umlayezo Wokuya Nawe Ekhaya
- I-Carotid stent iyindlela yokwelapha ephumelela kakhulu yokususa ukuvaleka kwemithambo yegazi entanyeni ehambisa igazi ebuchosheni futhi inciphise ingozi yokushaywa yisifo sohlangothi.
- Lokhu akunamthelela omkhulu emzimbeni njengokuhlinzwa kwendabuko, kodwa kusenezingozi ezithile.
- Impumelelo yokwelashwa ayixhomekile nje kuphela ekubekweni kwe-stent, kodwa futhi nasekutheni ulungisa kanjani indlela yakho yokuphila futhi uphuze imithi yakho ngendlela efanele .
- Kubaluleke kakhulu ukuqaphela izimpawu eziyisixwayiso zesifo sohlangothi nokuthatha isinyathelo ngokushesha nje lapho ubona uphawu olunjalo.
- Uma unemibuzo, ukwesaba, noma unemibuzo mayelana nalokhu kwelashwa, xoxa ngakho ngokukhululekile nodokotela wakho.
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