Malire a zotumphukira zimadutsa - mwendo

Mitsempha yam'mbali imadutsa ndikuchita opaleshoni kuti mubwezeretse magazi mozungulira mtsempha wotsekedwa m'miyendo mwanu. Madontho a mafuta amatha kukulira mkati mwa mitsempha ndikutchingira.

Kuphatikizika kumagwiritsidwa ntchito m'malo kapena kudutsa gawo lotsekeka la mtsempha wamagazi. Kukhomerera kumatha kukhala chubu cha pulasitiki, kapena mwina chotengera magazi (mtsempha) chotengedwa m'thupi lanu (nthawi zambiri mwendo wosiyana) panthawi ya opaleshoni yomweyo.

Mitsempha ya m'mitsempha yodutsa opaleshoni imatha kuchitika m'modzi kapena angapo amitsempha yamagazi yotsatirayi:

• Mitsempha (mtsempha waukulu womwe umachokera mumtima mwanu)
• Mitsempha m'chiuno mwako
• Mitsempha mu ntchafu yako
• Mitsempha kumbuyo kwa bondo lanu
• Mitsempha pamunsi mwako
• Mitsempha m'khwapa mwanu

Pochita opaleshoni yodutsa mitsempha iliyonse:

• Mudzalandira mankhwala (anesthesia) kuti musamve kuwawa. Mtundu wa mankhwala oletsa ululu omwe mumalandila umadalira mtsempha womwe ukuthandizidwa.
• Dokotala wanu adzadula mbali ya mtsempha womwe watsekedwa.
• Pambuyo pochotsa khungu ndi minofu panjira, dokotalayo amaika zolumikizana kumapeto kulikonse kwa mtsempha wamagazi. Kumtengako kumasulidwa m'malo mwake.
• Dokotalayo adzaonetsetsa kuti magazi anu akuyenda bwino kumapeto kwanu. Ndiye kudula kwanu kudzatsekedwa. Mutha kukhala ndi x-ray yotchedwa arteriogram kuti muwonetsetse kuti utengowo ukugwira ntchito.

Ngati mukuchita opaleshoni kuti muchiritse mitsempha yanu ya aorta ndi iliac kapena aorta yanu ndi mitsempha yonse yachikazi (aortobifemoral):

• Mutha kukhala ndi anesthesia wamba. Izi zidzakupangitsani inu kukomoka ndikulephera kumva ululu. Kapena, mutha kukhala ndi matenda opatsirana kapena operewera m'malo mwake. Adokotala akubaya msana wanu ndimankhwala kuti akupangitseni kufooka kuchokera m'chiuno mpaka pansi.
• Dokotala wanu adzadula pakati pa mimba kuti akafike ku mitsempha ya aorta ndi iliac.

Ngati mukuchita opareshoni yothandizira phazi lanu lakumunsi (femoral popliteal):

• Mutha kukhala ndi anesthesia wamba. Mudzakomoka ndipo simungamve kuwawa. Mutha kukhala ndi matenda opatsirana kapena operewera. Adokotala akubaya msana wanu ndimankhwala kuti akupangitseni kufooka kuchokera m'chiuno mpaka pansi. Anthu ena ali ndi mankhwala oletsa ululu am'deralo komanso mankhwala owapumulitsira. Anesthesia am'deralo amangokhala malo omwe akugwiritsidwapo ntchito.
• Dokotala wanu adzadula mwendo wanu pakati pa kubuula kwanu ndi bondo. Idzakhala pafupi ndi kutseka kwamitsempha yanu.

Zizindikiro za mtsempha wotsekedwa wotsekemera ndi kupweteka, kupweteka, kapena kulemera mwendo wanu womwe umayamba kapena kukulirakulira mukamayenda.

Simungafunike kuchitidwa opaleshoni ngati mavutowa amachitika pokhapokha mukuyenda kenako ndikupita mukamapuma. Simungafunike opaleshoniyi ngati mungathe kuchita zambiri tsiku lililonse. Dokotala wanu akhoza kuyesa mankhwala ndi mankhwala ena poyamba.

Zifukwa zochitira opaleshoni yodutsa mwendo ndi izi:

• Muli ndi zizindikiro zomwe zimakulepheretsani kuchita ntchito zanu za tsiku ndi tsiku.
• Zizindikiro zanu sizikhala bwino ndi mankhwala ena.
• Muli ndi zilonda za pakhungu (zilonda) kapena mabala pa mwendo wanu zomwe sizichira.
• Muli ndi matenda kapena chilonda m'miyendo mwanu.
• Mukumva kupweteka mwendo kuchokera kumitsempha yanu yocheperako, ngakhale mutapuma kapena usiku.

Musanachite opareshoni, dokotala wanu adzachita mayeso apadera kuti awone kukula kwa kutsekeka.

Zowopsa za anesthesia iliyonse ndi opaleshoni ndi izi:

• Thupi lawo siligwirizana ndi mankhwala
• Mavuto opumira
• Magazi amatundikira m'miyendo yomwe imatha kupita kumapapu
• Mavuto opumira
• Matenda a mtima kapena sitiroko

Zowopsa za opaleshoniyi ndi izi:

• Kulambalala sikugwira ntchito
• Kuwonongeka kwa mitsempha yomwe imapweteka kapena kufooka mwendo wanu
• Kuwonongeka kwa ziwalo zapafupi m'thupi
• Kuwonongeka kwa matumbo panthawi yochita opaleshoni ya aortic
• Kutaya magazi kwambiri
• Infection mu kudula kwa opaleshoni
• Kuvulaza mitsempha yapafupi
• Mavuto azakugonana omwe amayamba chifukwa cha kuwonongeka kwa mitsempha pa opaleshoni ya aortofemoral kapena aortoiliac
• Opaleshoni yomwe imatsegulidwa
• Kufunika kwa opaleshoni yachiwiri yolambalala kapena kudula mwendo
• Matenda amtima
• Imfa

Mukayezetsa thupi komanso kuyezetsa mankhwala ambiri.

• Anthu ambiri amafunika kuyeza mtima ndi mapapu awo asanadutse mtsempha wamagazi.
• Ngati muli ndi matenda ashuga, muyenera kukaonana ndi omwe amakuthandizani kuti akuthandizeni.

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

Pakati pa masabata awiri musanachite opareshoni:

• Mutha kupemphedwa kuti musiye kumwa mankhwala omwe amalepheretsa magazi anu kuphimba. Izi zimaphatikizapo aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), naprosyn (Aleve, Naproxen), ndi mankhwala ena ofanana nawo.
• Funsani omwe amakupatsani mankhwala omwe muyenera kumwa patsiku la opareshoni yanu.
• Mukasuta, muyenera kusiya. Funsani omwe akukuthandizani kuti akuthandizeni.
• Nthawi zonse muziwuza omwe akukuthandizani za chimfine, chimfine, malungo, herpes breakout, kapena matenda ena omwe mungakhale nawo musanachite opareshoni.

Musamwe chilichonse pakati pausiku usiku usanachitike opaleshoni yanu, kuphatikizapo madzi.

Patsiku la opareshoni yanu:

• Tengani mankhwala omwe wothandizirayo adakuwuzani kuti mutenge ndi madzi pang'ono.
• Wothandizira anu adzakuuzani nthawi yoti mufike kuchipatala.

Mukangochitidwa opareshoni, mupita kuchipatala, komwe anamwino amakakuyang'anirani. Pambuyo pake mupita kuchipatala cha anthu odwala mwakayakaya (ICU) kapena kuchipatala chanthawi zonse.

• Mungafunike kugona masiku 1 kapena awiri ngati opaleshoniyi ikukhudza mtsempha waukulu womwe uli m'mimba mwanu wotchedwa aorta.
• Anthu ambiri amakhala mchipatala masiku 4 mpaka 7.
• Pambuyo popita pachimake chachikazi, mudzakhala nthawi yocheperako kapena kusakhala ndi nthawi ku ICU.

Wothandizira anu akanena kuti zili bwino, mudzaloledwa kudzuka pabedi. Mudzawonjezera pang'onopang'ono momwe mungayendere. Mukakhala pampando, khalani ndi miyendo yanu pampando kapena pampando wina.

Kutentha kwanu kumayang'aniridwa pafupipafupi mukatha opaleshoni. Mphamvu yamphamvu yanu idzawonetsa momwe kulumikiza kwanu kwatsopano kukugwirira ntchito. Mukakhala mchipatala, muuzeni omwe akukuthandizani nthawi yomweyo ngati mwendo womwe wachitidwa opaleshoni umamva bwino, ukuwoneka wotuwa kapena pinki, ukuchita mantha, kapena ngati muli ndi zizindikiro zina zatsopano.

Mukalandira mankhwala opweteka mukawafuna.

Kuchita opaleshoni yolambalala kumathandizira kuthamanga kwa magazi m'mitsempha ya anthu ambiri. Mwina simudzakhalanso ndi zizindikilo, ngakhale mukuyenda. Ngati mudakali ndi zizindikiro, muyenera kuyenda kutali kwambiri asanayambe.

Ngati muli ndi zotchinga m'mitsempha yambiri, zizindikilo zanu sizingasinthe kwambiri. Kulosera kwake kuli bwino ngati matenda ena monga matenda ashuga amayendetsedwa bwino. Ngati mumasuta, ndikofunikira kuti musiye.

Kulambalala kwa aortobifemoral; Ukazi wamkazi; Zachikazi popliteal; Kulambalala kwa bortemoral; Kulambalala Axillo-bifemoral; Kulambalala Ilio-bifemoral; Chachikazi-chachikazi kulambalala; Kudutsa mwendo wakutali

• Angioplasty ndi stent mayikidwe - zotumphukira mitsempha - kutulutsa
• Mankhwala osokoneza bongo - P2Y12 inhibitors
• Aspirin ndi matenda amtima
• Cholesterol ndi moyo
• Cholesterol - mankhwala osokoneza bongo
• Kulamulira kuthamanga kwa magazi
• Malire a zotumphukira zimadutsa - mwendo - kutulutsa

MP wa Bonaca, Creager MA. Matenda a mtsempha wamagazi. 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: chap 64.

Kinlay S, Bhatt DL. Chithandizo cha matenda osakanikirana ndi mitsempha. 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: chap 66.

Sosaiti ya Opaleshoni ya Mitsempha Yotsika Kwambiri Malangizo Olemba Gulu; Conte MS, Pomposelli FB, ndi al. Malangizo a Society for Vascular Surgery othandizira matenda opatsirana a atherosclerotic omwe amapezeka kumapeto kwenikweni: kasamalidwe ka matenda asymptomatic ndi claudication. J Vasc Opaleshoni. 2015; 61 (3 Suppl): 2S-41S. PMID: 25638515 www.ncbi.nlm.nih.gov/pubmed/25638515. (Adasankhidwa)

Mamembala a Komiti Yolemba, Gerhard-Herman MD, Gornik HL, et al. Malangizo a 2016 AHA / ACC pakuwongolera odwala omwe ali ndi vuto la mitsempha yotsika kwambiri: chidule chachikulu. Vasc Med. Chizindikiro. 2017; 22 (3): NP1-NP43. PMID: 28494710 www.ncbi.nlm.nih.gov/pubmed/28494710. (Adasankhidwa)