Carotid endarterectomy: egosi, postoperative nsogbu, ejikwara reviews, uru na ọghọm

Onye ọ bụla maara na a ọrịa strok na-atụle otu n'ime ihe ndị kasị akpata ọnwụ n'etiti ndị bi na nke dum planet. Nke a na ọrịa emee na hà ugboro ole na obodo nile nke ụwa. Ọtụtụ mgbe nke akụkụ ụbụrụ mgbasa na-eduga ná mkpọnwụ na paresis, na-eme nwa oge ma ọ bụ nkwarụ. Iji zere na mmepe nke ọrịa a, i kwesịrị oge nchọpụta ọrịa strok nkpasu-iwe ihe na-emeso ha. The isi kpatara ọrịa strok - bụ atherosclerosis nke akwara nke n'olu na isi. embolism na n'etiti na agadi e fọrọ nke nta ka onye ọ bụla. Ọtụtụ ndị mmadụ karịrị afọ 60 na àjà ọgwụ mgbochi nke atherosclerosis. Mgbe ụfọdụ, ya ọgwụgwọ na-adịghị enwe ezi mmetụta. Mgbe ahụ gosiri ịwa - carotid endarterectomy. Nke a na usoro-agụnye mwepụ nke arịa òkè mebiri site atherosclerosis.

Gịnị mere eji carotid endarterectomy?

Krovosnabzhnenie ụbụrụ na-adabere na carotid akwara. Ndia nile bụ alaka nke aorta. Ha na-mere ndokwa symmetrically na abụọ nke n'olu. Abanye n'ime cranial uji eze, carotid akwara na-ekewa n'ime nta alaka ụbụrụ. Na ọrịa na-ata ahụhụ site na atherosclerosis, a elu n'ihe ize ndụ egbochi mkpụkọ nke ọbara na arịa ndị a. Ha na-ekewet nke cholesterol mbadamba nkume ndị e na fibrous anụ ahụ. Mgbe ọbara mgbali na-abawanye na carotid thrombus nwere ike kewapụta si arịa mgbidi na-abanye na ụbụrụ. Dị ka a N'ihi ya, ha ime ka ischemia - enweghị oxygen ọkọnọ na arọ. Ndị dị otú ahụ-arịa ọrịa ọbara na-eduga ná egwu na ya pụta. Iji gbochie ọrịa strok, carotid endarterectomy a rụrụ. Ọ enyere aka igbochi ọrịa strok na ya pụta.

usoro Isi

Carotid endarterectomy - bụ ịwa ahụ, nke bụ ọcha nke n'ime oyi akwa nke arịa site atherosclerotic e dere ede. Ọ na-rụrụ ke otu ebe ọgwụ enweghị ike ma ọ bụ ihe ize ndụ nke ọrịa strok dị elu. Ọgwụ ọjọọ abụghị ike inye ezi mmetụta mgbe atherosclerotic e dere ede enyene ihe karịrị ọkara n'obosara nke carotid akwara. Ma ọ bụ ọ bụrụ na cholesterol emechi lumen nke arịa ọtụtụ n'akụkụ n'out oge. Ke adianade do, ihe ize ndụ nke ọrịa strok enwekwu budata na ọnụnọ nke na-achịkwaghị achịkwa ọbara mgbali. Na nke a, atheroma nwere ike mgbe ọ bụla anya na endothelium, n'agbanyeghị ya size. N'ihi nwere ike ghara ịbụ ndị kasị mkpọchi nke carotid akwara na alaka ya na-eri nri ụbụrụ. Dị ka a N'ihi nke na-emepe emepe ischemic ọrịa strok.

Egosi maka carotid endarterectomy

Surgery (carotid endarterectomy) a rụrụ abụghị maka mmadụ nile. Na dọkịta nyere ikike maka ịwa ahụ, ga-abụ oké njọ na-egosi. Ọtụtụ mgbe, ndị ọrụ a rụrụ na ọrịa na a akụkọ ihe mere eme ugbua nwere bufee ụbụrụ mgbasa. Ya mere, n'ọnọdụ ụfọdụ, n'onye ezi omume carotid endarterectomy? Egosi maka ndị na-esonụ:

1. Na dayameta nke arịa a na-emechi site na atherosclerotic e dere ede site karịrị ọkara.
2. Ugboro ugboro strok n'akụkọ ihe mere eme.
3. The Nchikota ọbara mgbali (ụgwọ nzọụkwụ) na atherosclerosis nke carotid akwara.

Contraindications maka ịwa ahụ

N'agbanyeghị na uru nke ịwa ahụ, mgbe ụfọdụ, ha nwere ike ghara rụrụ. Dị ka ndị ọzọ arụmọrụ, ya nwere contraindications na carotid endarterectomy. Nyocha nke ọrịa na atherosclerosis, na-eme ka o doo anya na a ọnụ ọgụgụ nke dị iche iche nyocha rụrụ tupu ịwa ahụ. Nanị mgbe dọkịta bụ na afọ ojuju nke na-enweghị contraindications, onye ọrịa na-amalite iji kwadebe maka ọrụ. Carotid endarterectomy na-aju na-esonụ mgbe:

1. Achịkwaghị achịkwa ọgwụ (decompensated) ọbara mgbali.
2. Ọtụtụ nnukwu ischemic ọrịa strok.
3. Ejighị n'aka rịaworo ma ọ bụ na-adịbeghị anya myocardial infarction.
4. Nnukwu obi ọdịda.
5. Adịbeghị anya ọrịa strok.
6. Adịghị ala ala ọbara insufficiency 2 na 3 degrees.
7. Ọrịa Alzheimer.
8. Cancer na oké.

Nkwadebe maka carotid endarterectomy

Tupu na-eme carotid endarterectomy dị mkpa iji na-eduzi dị iche iche nyocha. The mbụ na-egosi na a duplex ultrasound arịa nke isi na olu. Na usoro a na dọkịta nwere ike ikpe ikpe na ogo nke mmechi nke lumen nke akwara nke atherosclerotic mbadamba nkume ndị e. Mgbe ụfọdụ, a vaskụla angiography. Nke a na-amụ bụ iwebata n'ime n'ọbara iche gị n'ụlọnga sochiri X-ray akara. A ihe ezi usoro bụ CT angiography. Ọ-enye gị ohere iji chọpụta ihe ndị udi, size na orunótu nke cholesterol machite na endothelium. Ọ bụrụ na dọkịta kwo ischemia akụkụ ụfọdụ nke ụbụrụ, rụrụ magnetik resonance Onyonyo. Mgbe dọkịta kpughere na-egosi maka ịwa ahụ, ọ dị mkpa ka a ọgwụgwụ banyere izugbe ala nke onye ọrịa. Iji mee nke a n'ihu carotid endarterectomy eme ECG, KLA, rue ọbara onwu na coagulation. Ọ bụrụ na onye ọrịa nwere ọrịa ndị ọzọ, ọ dị mkpa iji ịkpọ ọkachamara (endocrinologist, cardiologist).

Nkebi nke carotid endarterectomy

The mbụ ogbo ịwa ahụ bụ ná Nkụnwụ. Oke nke ná Nkụnwụ na-adabere na uche nke dọkịta, nakwa dị ka njikere nke onye ọrịa. Ọ nwere ike na-rụrụ obodo Nkụnwụ ma ọ bụ ofụri ofụri ná Nkụnwụ. Mgbe nke ahụ gasịrị, ndị dọkịta na-awa na-eme ka ihe mbepụ ke ebe ebe ahụ pụta ihe ultrasound ma ọ bụ angiography bụ cholesterol mbadamba nkume ndị e. Nzọụkwụ na-esonụ na-clamping akpa. Ọzọkwa, ịkpụ na-mere na ọtụtụ n'ime ndị na carotid akwara. Mgbe dọkịta anya inwale size na n'ókè nke atherosclerotic ihe e dere ede, ọ na-ekwubi na ụzọ nke na-anọgide na-arụ ọrụ. E nwere ọtụtụ usoro. Ọtụtụ mgbe na-amalite na-emeghe endarterectomy. Site na nke a pụtara a longitudinal mbepụ nke arịa na "ịkpụcha" cholesterol machite. Mgbe ahụ, na ebe nke mebiri emebi endothelium etinyere "kwachie." Ọzọ usoro - a eversion endarterectomy. N'ihi nzube a ka arịa na-tụgharịa ntughari na kpochara nke atherosclerotic wt. Ọ bụrụ na ndị lesion nke carotid akwara bụ nnukwu, ya nnọchi a rụrụ n'ime otu ebe. N'ihi nke a, sịntetik akwa. Ikpeazụ ogbo nke carotid endarterectomy bụ a oyi akwa-kpachie.

Olee otú bụ post-ịkpa oge?

Mgbe carotid endarterectomy na-ewe oge iji weghachi ọbara. Ọ na-ewe a izu ole na ole. Ebe ọ bụ na mbepụ na olu nke a obere size, kwupụtara na ubé na-egbu mgbu sensations. O sina dị, analgesics nwere ike a chọrọ, n'ụbọchị mbụ. Ị na-ike iweli arọ ihe, na-egosipụta a izu ole na ole ebe ọ bụ na, dị ka carotid endarterectomy e rụrụ. The postoperative N'ezie bụ ihe ọma, ma ọ bụrụ na niile nke ndenye ọgwụ nke dọkịta, ọ bụghị nanị mgbe n'ụlọ ọgwụ, ma mgbe onye ọrịa atara. Isi agịga Ma do na-ewepụ 7-10 ụbọchị mgbe ịwa ahụ.

Nsogbu nke carotid endarterectomy

Ọ ga-eti na ọ bụla ịwa ahụ na-agụnye ihe ize ndụ. Ọ dịghị ma e wezụga na carotid endarterectomy. Nsogbu mgbe a na ime bụ obere, banyere 3% nke ikpe. O sina dị, ha na-hụrụ, na-enwe ndidi ga-dọrọ aka ná ntị banyere nke a.

The nnọọ mbụ postoperative sikwuoro bụ agịga ọdịda. Na nke a ọrụ, ndị penetration nke bacteria n'ime ọnya dị nnọọ ize ndụ n'ihi ọrịa na-ndụ, dị ka ịkpụ rụrụ na na vaskụla bed. Nke a sikwuoro nwere ike ime n'ihi na ndị na-abụghị nnabata ya na iwu nke antiseptics.

Ọzọ ize ndụ ọnọdụ jikọtara CEA, bụ mkparị. Cerebrovascular mberede nwere ike ime ka a n'ihi nke atherosclerotic ihe e dere ede na ibe akwụkwọ nkewa n'oge ọrụ na ya na isi na kọntaktị na arịa. Nke a sikwuoro bụ obere, na 2-3% nke ikpe.

Ke adianade do, ịwa ahụ na-mgbe ụfọdụ hụrụ nwa oge aghara nke olu na-elo ihe. Nke a na-ejikọta ya na mmebi nke akwara endings dị na olu.

Mbubreyo nsogbu nke carotid endarterectomy restenosis a na-ewere. Nke a na-ezo aka re-ibelata nke arịa lumen. Ọtụtụ mgbe restenosis n'akparamagwa ọrịa ndị na-adịghị soro dọkịta iwu.

Prevention of postoperative nsogbu

Nsogbu ndị dị otú ahụ dị ka ọrịa strok na mmebi nke akwara nke n'olu, adịghị adabere na-enwe ndidi, dị ka ha na-adapụta na N'ezie nke ịwa ahụ. O sina dị, mgbochi nke ndị ọzọ ọnọdụ ekwe omume nanị ekele jikọtara ọrụ nke dọkịta na onye ọrịa. Karịsịa ya gbasara re-omume nke atherosclerotic mbadamba nkume ndị e. Ozugbo ọrụ dị n'elu, onye ọrịa a ga-mgbe niile hụ a ọkachamara. Na mgbakwunye na-achọpụta ọrịa usoro, ndị dibịa na-enye onye ọrịa a bara uru nkwanye. Akpan akpan nke a metụtara ndụ: onye ọrịa ga-akwụsị ịṅụ sịga na-aba n'anya eme ihe, nri (eri ala-abụba oriri). Ọzọkwa maka mgbochi nke restenosis kenyere ọgwụ. Onye ọrịa ga kwa ụbọchị iri lipid-ẹsụhọde ọgwụ ọjọọ ( "atorvastatin" ọgwụ), antiplatelet elekọta mmadụ ( "Cardiomagnyl" mbadamba "Clopidogrel").

Operation "carotid endarterectomy": uru na ọghọm

Dị ka niile usoro ịwa ahụ, a na ime nwere ma uru na ọghọm. Ụfọdụ ndị dọkịta adịghị ike ikwu carotid endarterectomy ka ogologo dị ka atherosclerosis nwere ike a na-emeso conservatively, na ọrịa na-adịghị na-adakarị ngosipụta nke ọrịa. Dọkịta ndị ọzọ kweere na ịwa ahụ dị mkpa na a ịrịba ibelata nke lumen nke akwara, n'agbanyeghị ma mgbaàmà ndị ugbu a ma ọ bụghị onye ọrịa. Ihe nke a usoro a ọma ihicha nke arịa si cholesterol, rụọ ọbara. The ime ihe nwere ike budata belata ihe ize ndụ nke ọrịa strok. Otú o sina endarterectomy anaghị ekwe nkwa ido na arịa na-agaghị mebiri emebi ọzọ. Ọzọkwa, n'oge ịwa ahụ nsogbu nwere ike ịzụlite dị ka a akwara mmerụ ahụ ma ọ ọrịa strok. Ọtụtụ ndị dọkịta na-ekwu nke a na adịchaghị njọ aghụghọ nke usoro na-arụpụta na-ahụta ka ndị bara uru.

Carotid endarterectomy: reviews nke ejikwara ndị mmadụ

Positive na-adịghị mma echiche okosobode ke nneme nke ọ bụla ịwa ahụ ọgwụgwọ. Ọ dịghị ma e wezụga na carotid endarterectomy. Nyocha ejikwara ndị mmadụ dị iche iche. Ọtụtụ mgbe, ndị mmadụ nwere afọ ojuju na-arụ ọrụ. N'ihi ya, bụ mgbaàmà nke ischemia (isi anya, na ebe nchekwa, na-ehi ụra), mma pụta nke nnyocha e mere na izugbe ọnọdụ. Ụfọdụ ọrịa kwuru a mgbanwe ke olu, ilo ọrịa mgbe endarterectomy. N'ọnọdụ ka ukwuu, a mgbaàmà kere ihe a ọnwa, na mgbe ahụ kpamkpam okụrede.