Kukonza kwa aortic aneurysm - endovascular

Kukonzekera kwam'mimba m'mimba mwa aortic aneurysm (AAA) ndi opaleshoni yokonza malo okulitsidwa mu aorta yanu. Izi zimatchedwa aneurysm. Aorta ndi mtsempha wamagazi waukulu womwe umanyamula magazi kupita nawo kumimba, m'chiuno, ndi miyendo.

Aortic aneurysm ndipamene gawo la mtsempha wamagazi limakhala lokulirapo kapena mabaluni akunja. Zimachitika chifukwa cha kufooka kwa khoma la mtsempha wamagazi.

Njirayi imachitika mchipinda chogwiririra, mu dipatimenti ya radiology ya chipatalacho, kapena labu ya catheterization. Mudzagona pa tebulo lokutidwa. Mutha kulandira anesthesia wamba (mukugona komanso opanda ululu) kapena matenda opatsirana kapena msana. Pochita izi, dokotalayo:

• Pangani kudula pang'ono pafupi ndi kubuula, kuti mupeze mtsempha wamafuta.
• Ikani stent (chitsulo chachitsulo) ndi zomangira zopangidwa ndi anthu (zopangira) kudzera mumalowo.
• Kenako gwiritsani ntchito utoto kuti mufotokoze kukula kwa aneurysm.
• Gwiritsani ntchito ma x-ray kuti muwongolere kulumikizana kwa stent mpaka mu aorta yanu, kupita komwe kuli aneurysm.
• Kenaka tsegulani stent pogwiritsa ntchito njira yonga masika ndikuyiyika kukhoma la aorta. Matenda anu am'madzi amatha kuzungulirazungulira.
• Pomaliza gwiritsani ntchito ma x-ray ndi utoto kuti muwonetsetse kuti stent ili pamalo oyenera ndipo aneurysm yanu sikutuluka magazi mthupi lanu.

EVAR yachitika chifukwa chakuti matenda a aneurysm ndi akulu kwambiri, akukula msanga, kapena akutuluka kapena akutuluka magazi.

Mutha kukhala ndi AAA yomwe siyimayambitsa zizindikiro kapena mavuto. Wothandizira zaumoyo wanu atha kukhala kuti adapeza vutoli mutakhala ndi ultrasound kapena CT scan pazifukwa zina. Pali chiopsezo kuti matendawa amatha kutuluka (osaphulika) ngati mulibe opaleshoni kuti mukonze. Komabe, opaleshoni yokonzanso matenda a aneurysm amathanso kukhala owopsa. Zikatero, EVAR ndi njira ina.

Inu ndi omwe akukuthandizani muyenera kusankha ngati chiopsezo chochitidwa opaleshoni imeneyi ndi chochepa kuposa chiopsezo chotuluka ngati simukuchitidwa opaleshoni kuti mukonze vutoli. Woperekayo akuyenera kulangiza kuti muchitidwe opaleshoni ngati aneurysm ndi:

• Chachikulu (pafupifupi mainchesi awiri kapena masentimita 5)
• Kukula mofulumira kwambiri (osakwana 1/4 inchi pa miyezi 6 mpaka 12 yapitayi)

EVAR ali ndi chiopsezo chochepa chokhala ndi zovuta poyerekeza ndi opaleshoni yotseguka. Omwe amakuthandizani amatha kunena zakukonzekera ngati muli ndi mavuto ena azachipatala kapena okalamba.

Zowopsa za opaleshoni iliyonse ndi izi:

• Magazi amatundikira m'miyendo yomwe imatha kupita kumapapu
• Mavuto opumira
• Kutenga, kuphatikiza m'mapapu, kwamikodzo, ndi m'mimba
• Matenda a mtima kapena sitiroko
• Zomwe zimachitika ndi mankhwala

Zowopsa za opaleshoniyi ndi izi:

• Kuthira mozungulira kumtengowu komwe kumafunikira opaleshoni yambiri
• Kuthira magazi musanachitike kapena mutatha
• Kutsekedwa kwa stent
• Kuwonongeka kwa mitsempha, kuyambitsa kufooka, kupweteka, kapena kufooka mwendo
• Impso kulephera
• Magazi osakwanira m'miyendo yanu, impso zanu, kapena ziwalo zina
• Mavuto kupeza kapena kusunga erection
• Opaleshoni siyabwino ndipo muyenera opaleshoni yotseguka
• Stent imazembera
• Kutuluka kwamphamvu kumafuna opaleshoni yotseguka

Wopezayo amakupimitsani ndikuyitanitsa mayeso musanachite opareshoni.

Nthawi zonse muuzeni omwe akukuthandizani mankhwala omwe mukumwa, ngakhale mankhwala, zowonjezera, kapena zitsamba zomwe mwagula popanda mankhwala.

Ngati mumasuta, muyenera kusiya. Wopereka wanu atha kuthandiza. Nazi zina zomwe muyenera kuchita musanachite opaleshoni yanu:

• Pafupifupi milungu iwiri musanachite opareshoni, mudzapita kwa omwe amakuthandizani kuti muwonetsetse kuti zovuta zilizonse zamankhwala, monga matenda ashuga, kuthamanga kwa magazi, komanso mavuto amtima kapena mapapo, zithandizidwa bwino.
• Inunso mungafunsidwe kuti musiye kumwa mankhwala omwe amalepheretsa magazi anu kuphimba. Izi zimaphatikizapo aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), warfarin (Coumadin), ndi naprosyn (Aleve, Naproxen).
• Funsani mankhwala omwe muyenera kumwa patsiku la opareshoni yanu.
• Nthawi zonse muuzeni omwe akukuthandizani ngati mukudwala chimfine, malungo, malungo, kapena matenda ena musanachite opareshoni.

Madzulo asanafike opaleshoni yanu:

• Musamwe chilichonse pakati pausiku, kuphatikizapo madzi.

Patsiku la opareshoni yanu:

• Tengani mankhwala aliwonse omwe dokotala wanu adakuwuzani kuti mutenge ndi madzi pang'ono.
• Mudzauzidwa nthawi yobwera kuchipatala.

Anthu ambiri amakhala mchipatala masiku angapo pambuyo pa opaleshoniyi, kutengera mtundu wa njira zomwe anali nazo. Nthawi zambiri, kuchira pantchitoyi kumachitika mwachangu komanso mopweteka pang'ono kuposa opaleshoni yotseguka. Komanso, mudzatha kupita kunyumba posachedwa.

Mukakhala kuchipatala, mutha:

• Khalani m'chipinda cha anthu odwala mwakayakaya (ICU), komwe mungamayang'anitsidwe koyambirira
• Khalani ndi patheter yamikodzo
• Apatsidwe mankhwala ochepetsa magazi anu
• Limbikitsidwa kukhala pambali pa kama wako ndikuyenda
• Valani masitonkeni apadera oteteza magazi kuundana m'miyendo mwanu
• Landirani mankhwala opweteka m'mitsempha yanu kapena m'malo ozungulira msana wanu (epidural)

Kuchira pambuyo pakukonzanso kwam'mimba kumafulumira nthawi zambiri.

Muyenera kuyang'aniridwa ndikuwunikidwa pafupipafupi kuti muwonetsetse kuti aortic aneurysm yanu sikutuluka magazi.

ZOTSATIRA; Kukonza kwamitsempha yamagazi - aorta; AAA kukonza - endovascular; Kukonza - aortic aneurysm - endovascular

• Kukonza kwa aortic aneurysm - endovascular - kutulutsa

Braverman AC, Schemerhorn M. Matenda a aorta. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: mutu 63.

Brinster CJ, Sternbergh WC. Njira zothetsera matenda a endovascular aneurysm. Mu: Sidawy AN, Perler BA, olemba. Rutherford Opaleshoni ya Mitsempha ndi Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019: mutu 73.

Tracci MC, Cherry KJ. Mortal. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Buku Lopanga Opaleshoni. Wolemba 20th. Philadelphia, PA: Elsevier; 2017: mutu 61.