Ingabe imithambo yegazi entanyeni yakho ivaliwe? Ake sifunde ngokuhlinzwa kwe-TCAR (i-Transcarotid Artery Revascularization)

Ingabe udokotela wakho ukutshelile ukuthi umthambo wegazi omkhulu entanyeni yakho uvaliwe nokuthi usengozini enkulu yokuba nesifo sohlangothi? Kuvamile ukuthi noma ubani esaba kancane uma ezwa into efana naleyo. "Ingabe kuzodingeka ngihlinzwe? Ingabe kuyinto enkulu?" Imibuzo eminingi cishe ifika engqondweni. Kodwa ungakhathazeki, ngoba isayensi yezokwelapha isithuthukile, manje kunezindlela zokwelapha eziphephile kakhulu, ezilula nezisebenzayo zezimo ezinjalo. Namuhla sizokhuluma ngenye yezindlela zokwelapha ezintsha neziphumelelayo kakhulu, i-TCAR.

Kalula nje, iyini i-TCAR?

Igama eliphelele le-TCAR yi- Transcarotid Artery Revascularization . Kulungile, leli gama lizwakala liyinkimbinkimbi kancane, akunjalo? Masiligcine lilula.

Kunemithambo yegazi emibili emikhulu ezinhlangothini zombili zentamo yethu ethwala igazi liye ebuchosheni. Lokhu sikubiza ngokuthi imithambo ye-carotid . Lena ifana namapayipi amabili amakhulu aletha amanzi endlini yethu. Ngokuhamba kwesikhathi, izinto ezifana namafutha kanye ne-cholesterol ekudleni esikudlayo ziyanqwabelana ngaphakathi kwale mithambo yegazi, njengokugqwala okwakheka ngaphakathi kwepayipi lamanzi. Lokhu kubizwa ngokuthi 'i-plaque' ngokwezokwelapha.

Njengoba lolu ngqimba 'lwe-plaque' lukhula kancane kancane, isikhala ngaphakathi komthambo wegazi siyancipha, futhi ukugeleza kwegazi kuyavaleka. Into eyingozi kakhulu ukuthi uma ingxenye encane yalolu ngqimba 'lwe-plaque' iphuka futhi ihambe iye ebuchosheni negazi, ingavimba umthambo wegazi ebuchosheni futhi ibangele isifo sohlangothi .

Ngakho-ke, ukuvula kabusha lo mthambo wegazi ovinjiwe nokubuyisela ukugeleza kwegazi yilokho esikubiza ngokuthi 'ukuvuselela imithambo yegazi.' Kunezindlela eziningana eziyinhloko zokwenza lokhu.

1. Ukuhlinzwa kwe-Carotid Endarterectomy (CEA): Lokhu kuyindlela yokuhlinzwa evamile evulekile. Kulokhu, kwenziwa ukusikwa okuncane entanyeni, kuvulwe umthambo wegazi, kususwe ungqimba 'lwe-plaque' ngaphakathi, bese kuthi umthambo wegazi uthungwe ndawonye.

2. I-Carotid Angioplasty kanye ne-Stenting (CAS): Ipayipi elincane kakhulu lidlula emthanjeni wegazi esinqeni noma engalweni bese liqondiswa emthanjeni wegazi ovalekile entanyeni. Indawo evalekile ibe isinwetshwa ngento efana nebhaluni, bese kufakwa 'i-stent' , ipayipi elincane eline-mesh, ukuze livinjwe lingaphinde livaleke.

3. I-TCAR (i-Transcarotid Artery Revascularization): I-TCAR iyindlela ephephile nesimanje ehlanganisa izindlela zombili ezinhle kakhulu. Ihilela ukwenza ukusika okuncane kakhulu ngaphezu kwethambo lentamo bese kufakwa i-stent ngqo emthanjeni wegazi ovalekile.

Ubani lo kuhlinzwa kwe-TCAR okufanelekelayo?

Indlela ye-TCAR yethulwa okokuqala ngo-2015 ezigulini ezazisengozini enkulu yokuhlinzwa okuvulekile kwendabuko (i-CEA). Lokho kusho ukuthi:

• Kwabantu abadala .
• Kulabo abanesifo senhliziyo noma samaphaphu .
• Kulabo abanezibazi ezivela ekuhlinzweni kwentamo kwangaphambilini noma ekwelashweni ngemisebe.
• Uma umthambo wegazi uvalekile endaweni lapho ukuhlinzwa kunzima khona, njengangaphansi komhlathi.

Kodwa manje le ndlela isiphumelele kakhulu kangangokuthi kusukela ngo-2022, ukwelashwa kwe-TCAR kuye kwanconywa ngisho nasezigulini ezinempilo ejwayelekile, okungukuthi, lezo ezingenazo izici ezikhethekile zengozi. Kuze kube manje, kwenziwe ukuhlinzwa kwe-TCAR okungaphezu kuka-20,000 e-United States kuphela.

Uzilungiselela kanjani ngaphambi kokuhlinzwa?

Uma udokotela wakho enquma ukukuhlinza nge-TCAR, kuzodingeka enze izivivinyo eziningana kusengaphambili.

• Ukuhlolwa kwegazi: Thola ngempilo yakho jikelele kanye nekhono lakho lokujiya kwegazi.
• Ukuskena kwe-ultrasound kwe-carotid artery: Bona ukuthi ingakanani imithambo yegazi evalekile.
• I-CT Angiogram: Thola isithombe esicacile, esinobukhulu obuthathu semithambo yegazi entanyeni nasebuchosheni.

Futhi, udokotela uzoqala ngemithi eminingana ukuze akulungiselele ukuhlinzwa.

• Imithi yohlobo lwe-statin ehlisa i-cholesterol.
• Imithi efana ne -aspirin ne- clopidogrel evimbela ukujiya kwegazi.

Uzokwaziswa ukuthi ungadli noma uphuze lutho ngemva kwamabili ngobusuku bangaphambi kokuhlinzwa.

Indlela yokuhlinzwa: isinyathelo ngesinyathelo

Lokhu kuhlinzwa kuzothatha cishe ihora nesigamu. Ake sibheke ngokushesha ukuthi kwenzekani egumbini lokuhlinza.

1. I-Anesthesia: Ukuze uvimbele ukuthi ungezwa ubuhlungu, indawo ezungeze intamo yakho izoncishiswa (i-anesthesia yendawo) noma uzonikezwa i-anesthesia ngokuphelele (i-anesthesia ejwayelekile) .

2. Ukusikwa okuncane: Ukusikwa okuncane kakhulu kwenziwa entanyeni, ngaphezu nje kwethambo lentamo, cishe amasentimitha angu-1-1.5.

3. Ukuguqulwa Kokugeleza: Lesi yisinyathelo esibaluleke kakhulu nesiphephe kakhulu enkambisweni ye-TCAR.

• Ipayipi elincane lifakwa emthanjeni osesinqeni (umthambo we-femoral).
• Elinye ipayipi lifakwa emthanjeni we-carotid ovalekile ngokusebenzisa ukusikwa kwentamo.
• Manje, la mapayipi amabili axhunywe emshinini onesihlungi esikhethekile. Ngemva kwalokho, ukugeleza kwegazi kuya ebuchosheni kuyamiswa okwesikhashana, bese igazi elivela emthanjeni osentanyeni liphuma ngaleyo payipi, lihlanzwe yisihlungi, bese libuyela emzimbeni ngepayipi elisesinqeni.
• Kuleli qophelo, igazi elidingwa ubuchopho bakho livela emthanjeni we-carotid ngakolunye uhlangothi lwentamo yakho kanye nemithambo yomgogodla ngemuva kobuchopho bakho.Iyatholakala ngaphandle kwesithiyo.

4. Ukuvula indawo evalekile: Ucingo oluncane lusetshenziswa ukuze kudlule indawo evalekile futhi kwandiswe indawo ngebhaluni elincane.

5. Ukubekwa kwe-stent: Okulandelayo, kufakwa ithubhu elincane lensimbi, elibizwa ngokuthi i-stent , endaweni evalekile. Lokhu kugcina umthambo wegazi uvulekile futhi kubambe i-plaque odongeni.

6. Isiphetho: Bese kuthi wonke amapayipi asuswe, bese kuthi imbobo encane emthanjeni wegazi kanye nokusika entanyeni kuthungwe.

Kwenzekani ngemva kokuhlinzwa?

Ngemva kokuhlinzwa kwe-TCAR, kuzodingeka uhlale esibhedlela cishe ubusuku obubodwa . Odokotela nabahlengikazi bazoqapha impilo yakho njalo. Njengoba lokhu kuyindlela elula kakhulu yokuhlinzwa, ukululama nakho kuyashesha kakhulu.

Yiziphi izingozi nezinkinga?

Njenganoma yikuphi ukwelashwa kwezokwelapha, i-TCAR ingaba nezingozi ezincane kakhulu. Kodwa-ke, amathuba okuba lokhu kwenzeke mancane kakhulu.

• Ukopha noma ukuvuvukala okuvela endaweni yokusikwa.
• Ukutheleleka kwesilonda.
• Umonakalo omncane emsipheni entanyeni.
• Isifo sohlangothi.
• Isifo senhliziyo.

Udokotela wakho uzokuchazela kabanzi ngalezi zingozi. Khumbula ukuthi kuthathwa izinyathelo ezikhethekile zokunciphisa lezi zingozi ngesikhathi senqubo ye-TCAR.

Ukululama nokuphila nge-stent

I-TCAR inqubo eshesha kakhulu ngoba ayikho i-incision enkulu.

• Gwema ukuphakamisa izinsimbi isonto elilodwa noma amabili.
• Hlola ukusikwa entanyeni yakho nsuku zonke ukuze uqiniseke ukuthi kuhlanzekile futhi azikho izimpawu zokutheleleka.
• Buza udokotela wakho ukuthi ungabuyela nini emsebenzini wakho nakweminye imisebenzi yansuku zonke.

Ngemva kokufakwa kwe-stent, kukuwe ukuvimbela ukuthi umthambo wegazi ungaphinde uvaleke. Ukuze wenze lokhu, kufanele wenze lezi zinto.

• Uma ubhema, yeka ngokushesha.
• Vivinya umzimba njalo.
• Yamukela ukudla okunempilo okunamafutha agcwele aphansi.
• Thatha umuthi wokunciphisa igazi kanye nomuthi wokwehlisa i-cholesterol onikezwe udokotela wakho ngesikhathi esifanele.

Kufanele ngimbone nini udokotela?

Uma ubona izimpawu zokutheleleka endaweni yokusikwa, shayela udokotela wakho ngokushesha.

• Imfiva
• Uma uzizwa ubanda
• Uma kukhona ukubomvu nokuvuvukala okuzungeze indawo yokusikwa
• Uma into efana noketshezi iphuma esikiweni

Udokotela wakho uzonquma ukuthi yikuphi ukwelashwa okukulungele. Xoxa naye nganoma yimiphi imibuzo, ukukhathazeka, noma ukungabaza onakho. Umgomo wakhe ukukunikeza ukwelashwa okufanele nokuphephile kakhulu.