Carotid endarterectomy: ezibonisa, iingxaki postoperative, utyando ncomo, nobubi

Wonke umntu uyazi ukuba nobetho njengenye yezinto ezingunobangela eqhelekileyo ukufa phakathi abemi ehlabathini lonke. Esi sifo kwenzeka rhoqo ngokulinganayo kuwo onke amazwe ehlabathini. Amaxesha amaninzi kuye kwasasazwa yobuchopho ikhokelela ekukhubazekeni kunye paresis, ibangela ukukhubazeka okwethutyana okanye ngokusisigxina. Ukunqanda uphuhliso esi sifo, udinga ixesha ukuxilonga stroke izinto Ngokuqunjiswa ojamelana nazo. Oyena nobangela ngesibetho - na yamafutha kwemithambo entanyeni kunye nentloko. Embolism ebudaleni phakathi nabadala kukho phantse wonke umntu. Abantu abaninzi ngaphezu kweminyaka engama-60 ezifundisa zonyango yokuthintela yegazi. Kwezinye iimeko, unyango ichiza ungabinayo yifuna. Emva koko kuboniswe utyando - endarterectomy carotid. Le nkqubo iquka ukususwa kwenxalenye inqanawa zonakaliswe yi yegazi.

Yini na ukuba nilinganisele endarterectomy carotid?

Krovosnabzhnenie ingqondo kuxhomekeke imithambo carotid. Ezi iimpahla amasebe aorta. Bona amalungiselelo symmetrically kumacala omabini entanyeni. Ningena kwisisu cranial, nemithambo carotid yahlulwe yangamacandelo ezincinane engqondweni. Xa izigulana yegazi, basengozini ephezulu egazi igazi kwezi mpahla. Ziye ke yakhiwa umonakalo cholesterol okanye izityalo ezinezikhondo. Ekwandeni wegazi carotid thrombus bangazilahla udonga isitya kwaye ngenisa ingqondo. Ngenxa yoko, ukuba ischemia - yokunqongophala kwe-oksijini ubonelelo emzimbeni. Ezo flow igazi ebuchotsheni ikhokelela imiphumo ebuhlungu. Ukuthintela stroke, carotid endarterectomy olwenziweyo. Kuyanceda ukunqanda stroke kunye neziphumo zawo.

inqubo Overview

Carotid endarterectomy - na uqhaqho, nto angahlanjululwa ngayo umaleko engaphakathi nqanawa nge uqweqwe atherosclerotic. Oku kwenziwa kwiimeko apho imithi engenamandla okanye amathuba okuba nestroke uphezulu kakhulu. Machiza akanako ukunika isiphumo efunekayo xa nebhodi atherosclerotic lubaluleke ngaphezu kwesiqingatha ubukhulu kwemithambo carotid. Okanye ukuba cholesterol ivale mithambo benqanawa evela kumacala eziliqela ngaxeshanye. Ukongeza, amathuba okuba nestroke kuphula phambi nomfutho olungalawulwayo. Kulo mzekelo, ngalo naliphi na ixesha ngaphandle endothelium atheroma, nokuba ubukhulu balo. Isiphumo ibe hayi ukuvaleka inkoliso kwemithambo carotid amasebe awo, ukuba ukondla ingqondo. Ngenxa yokuba zokuphuhlisa stroke kobuchopho.

Ubungqina obubonakalayo buxela ukuba carotid endarterectomy

Surgery (carotid endarterectomy) ikhutshwa phandle hayi ukuba wonke. Ukuba ugqirha unike imvume kutyando, kufuneka kubekho ubungqina kakhulu. Amaninzi umsebenzi lwenziwa izigulane yimbali sele igxalaba kwegazi lobuchopho. Ngoko ke, kwezinye iimeko igwetyelwe carotid endarterectomy? Izinto ezibonisa oku kulandelayo:

1. Le bepali nganye inqanawa yavalwa nebhodi atherosclerotic ngaphezu kwesiqingatha.
2. Izibetho iyaphindwa kwimbali.
3. Iindibaniso lwegazi (compensation inqwanqwa) kunye yamafutha kwemithambo carotid.

Izimo kutyando

Nangona kukho iinzuzo zotyando, kwezinye iimeko, abakwazi ukuba wenziwe. Neminye imisebenzi, iye Izimo kunye carotid endarterectomy. Izimvo kwezigulane yegazi, kwenza kucace ukuba inani iisaveyi ezahlukeneyo eyenziwa phambi uqhaqho. Kuphela emva kokuba ugqirha wanelisekile ukuba akukho Izimo, isigulane uqalisa ukulungiselela umsebenzi. Carotid endarterectomy akuvumelekanga kwezi meko zilandelayo:

1. amayeza ongalawulekiyo (decompensated) lwegazi.
2. Olubanzi stroke elibukhali kobuchopho.
3. angina obungazinzanga okanye iqhosha zakutshanje engabalulekanga.
4. senhliziyo olunamandla.
5. stroke yakutshanje.
6. Chronic insufficiency yegazi 2 kunye degrees-3.
7. isifo i-Alzheimer.
8. Umhlaza kunye kakhulu.

Ukulungiselela carotid endarterectomy

Ngaphambi kokuba carotid endarterectomy kuyimfuneko ukuqhuba iisaveyi ezahlukeneyo. Eyokuqala lubonisa kabini ultrasound iimpahla intloko kunye nentamo. Ngale ndlela ugqirha na onokubalawula iqondo ukuvalwa mithambo kwemithambo of umonakalo atherosclerotic. Kwezinye iimeko, umntu angiography nemithambo. Olu phando ukuqaliswa kwi-arhente umahluko yegazi kulandele ulawulo X-ray. A indlela echanileyo ngakumbi CT angiography. It ikuvumela ukuba nokuvavanya imilo, ubukhulu kunye zalapha ekhaya kwabo ngegolide cholesterol kwi endothelium. Ukuba ugqirha urhanela ischemia iinxalenye ezithile zobuchopho, wenza ngemagnethi ekuvakaleni kwelizwi umfanekiso. Xa ugqirha kutyhilwa Yayibubungqina kutyando, kuyimfuneko ukuba bazobe kwisigqibo malunga nemeko ngokubanzi malunga nesigulane eso. Ukwenza oku phambi endarterectomy carotid ukwenza ECG, pat, uwele chemistry igazi kunye coagulation. Ukuba isigulana abanezinye izifo, kuyimfuneko ukuba libonisane ziingcali (endocrinologist, cardiologist).

Izigaba carotid endarterectomy

Isigaba sokuqala sale ahlinzwe zomzimba. Ukhetho zomzimba kuxhomekeke ngokoluvo ugqirha, kwakunye ukuzimisela umguli. It zingenziwa zomzimba okanye Ukubulawa jikelele. Emva koko, lo gqirha yenza imbobo kwindawo apho iziphumo ultrasound okanye angiography na umonakalo cholesterol. Inyathelo olandelayo nokubotshwa isikhongozeli. Ngaphezu koko, lo cut senziwa ezininzi kwemithambo carotid. Emva kokuba ugqirha ukuba baphonononge abangaboniyo ubungakanani kunye nobungakanani ukubola atherosclerotic, uphetha ukuba indlela ukuqhubeka ukusebenza. Kukho iindlela ezininzi. Amaxesha amaninzi babhenela ukuvula endarterectomy. Xa oku kwakuthetha ukuba liqatywe longitudinal enqanaweni kunye 'sisusa "ngegolide cholesterol. Emva koko, endaweni endothelium umonakalo lisetyenziswa "isiziba." Enye indlela - eli eversion endarterectomy. Ukulungiselela le njongo isitya kuvuliwe ngaphakathi ngaphandle zicocwe of wt atherosclerotic. Ukuba sisilonda esidumbileyoesingaphakathi kwemithambo carotid mkhulu, indawo yayo lwenziwa kwindawo ethile. Ukulungiselela le njongo, amalaphu zokwenziwa. Inqanaba lokugqibela carotid endarterectomy yi umaleko-nemithungo.

Njani na ixesha post-operative?

Emva carotid endarterectomy kuthatha ixesha ukubuyisela ukuhamba kwegazi. Kuthatha iiveki ezimbalwa. Ekubeni liqatywe kwi intamo ubungakanani elincinane, wavakalisa ubuhlungu kancinane. Sekunjalo, analgesics kungafuneka ngosuku lokuqala. Kwakhona Awukwazi phakamisa izinto ezinzima, kwaye asebenzise kwiiveki ezimbalwa emva, njengoko senziwa carotid endarterectomy. Ikhosi postoperative kulungile, ukuba zonke lokumiselwa kagqirha, kungekuphela nje ngoxa esibhedlele, kodwa xa isigulane uthunyelwa. Sutures zisuswa kwiintsuku 7-10 emva kotyando.

Iingxaki carotid endarterectomy

Kufuneka kukhunjulwe ukuba ahlinzwe yingozi. Akukho ngaphandle kunye carotid endarterectomy. Iingxaki emva kwalo msebenzi zinqabile, malunga-3% amatyala. Noko ke, zifunyanwa, kwaye isigulane kufuneka balunyukiswe ngale nto.

Oyilwayo yokuqala postoperative ukwehluleka suture. Ngesi msebenzi, kwii-iintsholongwane enxebeni kuyingozi kakhulu ubomi yesigulane, njengoko cut wenziwe ngqo ebhedini nemithambo. Le kama kunokwenzeka ngenxa-non ukuthotyelwa kwemithetho ebulala.

Enye imeko eyingozi ezinxulumene BCEA, kusisithuko. ingozi Cerebrovascular ekunokwenzeka ngenxa nebhodi atherosclerotic ukungcola Isiqwenga ngexesha ukusebenza kunye nentloko yayo ukunxibelelana kunye neempahla. Le ingxaki kunqabile, ngo-2-3% yamatyala.

Ukongeza, utyando wambi waphawula disorder yelizwi kunye ligwinya okwethutyana. Oku yanxulunyaniswa nomonakalo kwi kwalapho akhiwe entanyeni.

iingxaki emva carotid endarterectomy restenosis uthathwa. Oku kubhekisela kwakhona licuthe le sayo isitya. Amaninzi restenosis kwenzeka xa izigulane abangawuthobeliyo ngemiyalelo kagqirha.

Uthintelo yobunzima postoperative

Iingxaki ezifana kobetho umonakalo luvo entanyeni, musa zixhomekeke kwisigulana, ngethuba utyando xabezikhona. Nakuba kunjalo, uthintelo kwezinye iimeko kunokwenzeka ngenxa kuphela kumsebenzi idibene logqirha kunye nomonde. Ingakumbi kumayelana kwakhona kukuvela umonakalo atherosclerotic. Wakuba lo msebenzi phezu, isigulane kufuneka rhoqo yabonwa ngabantu yincutshe. Ukongeza inkqubo zokuxilonga, ugqirha unika isigulane izincomo luncedo. Ingakumbi oku kusebenza yokuphila: isigulane kufuneka ayeke ukutshaya kunye notywala, ukutya (kutya ephantsi-fat). Kwakhona ukuze zokuthintela restenosis emiselweyo amayeza. Isigulana kufuneka athathe yonke imihla iziyobisi lipid-yandisa ( "atorvastatin" iziyobisi), ii-arhente antiplatelet ( "Cardiomagnyl" icwecwe "Clopidogrel").

Operation "carotid endarterectomy": nobubi

Njengazo zonke iinkqubo zotyando, lo msebenzi uye zombini ezilungileyo nezingalunganga. Abanye oogqirha azilukhuthazi carotid endarterectomy logama nje yamafutha sinokunyangwa ngokulumka, kwaye izigulane ukuba kubonakaliswa kwezonyango sifo. Ezinye oogqirha bakholelwa ukuba uqhaqho kuyimfuneko kunye exineneyo ebalulekileyo mithambo kwemithambo, kungakhathaliseki nokuba iimpawu akhoyo okanye hayi kwi kumguli. Abaxhamla kule nkqubo kukho ukucoca ngokucokisekileyo umkhumbi cholesterol, ukuphucula ukuhamba kwegazi. Lo msebenzi kakhulu ukunciphisa amathuba okuba nestroke. Kunjalo endarterectomy akuqinisekisi ukuba inqanawa akayi kuphinda yonakele. Kwakhona, ngexesha utyando ezinobuzaza ukuphuhlisa njengokonzakala luvo okanye icala. Oogqirha abaninzi bathi oku ukuphululwa engeyongozi ngokwentelekiso iinkqubo kwaye zithathwa kweziphumo ukuba abe luncedo.

Carotid endarterectomy: ncomo abantu abasebenza

izimvo akhabayo kunye navumelanayo nazo ekuxoxweni kwawo nawuphi na unyango ngotyando. Akukho ngaphandle kunye carotid endarterectomy. Ukuphonononga ezisetyenziswa abantu ezahlukeneyo. Kwiimeko ezininzi, abantu bonelisekile nokusebenza. Ngenxa yakhe, iimpawu ischemia (kakuhle ingqalelo, inkumbulo, ukulala), ziziphucule iziphumo zophando kunye nemeko ngokubanzi. Ezinye izigulane waphawula utshintsho ilizwi, yokuginya ukuphazamiseka emva endarterectomy. Kwiimeko ezininzi, ezi mpawu kwathatha malunga ngenyanga, uze emva koko wanyamalala ngokupheleleyo.