Pochiza atherosclerosis ya ziwiya zam'munsi, onse othandizira pochiritsa mothandizidwa ndi mankhwala komanso opaleshoni angagwiritsidwe ntchito.
Ndiko kusapezeka kwa zotsatira zabwino kuchokera kumagwiritsidwe ntchito a mankhwala omwe ali chisonyezo chogwiritsa ntchito opaleshoni yothandizira.
Kuthandizira opaleshoni kumachitika kumapeto kwa nthawi, pamene mankhwala osokoneza bongo samabweretsa zotsatira zabwino. Pakapita nthawi matendawa atakula, minofu yofewa imamwalira ndipo zimayamba kukhala zigawenga.
Dokotala wochita opaleshoni, pakuthandizira opaleshoni, amachita zotupa za malo a minofu omwe akuchitika. Madera omwe adachitidwa opaleshoni adaphimbidwa ndi chikwama cha chikopa.
Kuchita opaleshoni ya atherosulinosis ya malekezero otsika kumapeto kwa kusuntha kungathandize kwambiri kukonza thanzi la wodwalayo ndi moyo wake.
Pali njira zingapo zopangira opaleshoni. Njira zodziwika bwino ndi izi:
- Opaleshoni ya Bypass - opareshoni imapangidwa kuti apange njira yowonjezerapo yoyenda magazi mozungulira malo owonongeka.
- Balloon angioplasty ndikugwiritsa ntchito putala wapadera yemwe akutsitsa chotengera cham'kati pamachitidwe.
- Arterial stenting - kuyikika mu artery of stent yapadera yomwe imapitilizabe kupendekera kwamatumbo nthawi zonse pamlingo womwe mukufuna.
- Endarterectomy - kuchotsa kwa gawo lowonongeka la chotengera ndi zolembera za atherosrance?
- Autodermoplasty ndi mtundu wa njira zopangira opaleshoni zomwe zimagwiritsidwa ntchito pochiza zilonda zam'mimba, zomwe zimakhala zovuta kuthana ndi mankhwala. Kuchita opareshoni kumathandiza kupewa kukulira kwa gangrenous ndondomeko mu minofu ya m'munsi malekezero.
- Prosthetics - njira yosinthira chotengera chachilendo kapena chopanga ndi gawo la bedi lamitsempha lomwe limavutika chifukwa cha kupitilira kwa kufalikira kwa atherosulinosis. Njira yochitira opaleshoni imakupatsani mwayi wobwezeretsa magazi kumalo owonongeka.
- Kucheka - njira yochotsa mbali ya mwendo, ndikutsatira ma prosthetics.
Kusankha kwa njira yochitira opaleshoni kumadalira kuchuluka kwa kuwonongeka kwa ziwalo zam'manja ndi machitidwe a thupi la wodwalayo. Kusankha kwa njira yochizira kumachitidwa ndi dotolo wamankhwala ochita operekera mankhwalawa.
Pambuyo pakuchita opaleshoni, wodwala adzafunika kuchita njira yayitali ndikukonzanso mankhwala osokoneza bongo kuti abwezeretsenso moyo wake.
Pochiza matenda a atherosulinosis a ziwiya zamagawo am'munsi, dokotala, posankha njira yothandizira, amazindikira zakutsogolo kwa njirayi komanso kuchuluka kwa momwe ntchitoyo imathandizira kusintha mkhalidwe wa wodwalayo popanda kugwiritsa ntchito njira zina zolowererapo.
Zina za mitundu yosiyanasiyana ya mankhwala othandizira opaleshoni
Balloon angioplasty ndi njira yothandizira opaleshoni yomwe imaphatikizira kuyambitsa bedi lamitsempha pamalowo pakuchepetsa kwa catheter wapadera wokhala ndi baluni yapadera pamapeto.
Pambuyo pokhazikitsa catheter, balloon imayamba kututira mokakamizidwa, zomwe zimapangitsa kukulitsa makhoma a chotengera ndi kubwezeretsanso njira yotumiza magazi.
Ngati kubwezeretsanso kwa kayendedwe ka magazi sikutheka, chimango chapadera chimayambitsidwa m'gawo la kuwonongeka kwa chotengera. Cholinga cha ndalamayi ndikuwonetsetsa kuti chombocho chikhale pamalo owonongeka pamalo ovomerezeka. Choyimira kukhazikitsa munthawi ya njirayi chimapangidwa ndi aloyi yapadera.
Ngati zotsatira zomwe mukufuna sizinachitike, dokotala yemwe akupezekapo adzaganiza zogwiritsa ntchito njira yotseguka ya shunt.
Nthawi zambiri, balloon angioplasty imatha kubwezeretsa magazi komanso kupewa kugwiritsa ntchito njira zowonjezera komanso zoopsa.
Kugwiritsira ntchito kolowerera mosalekeza kumapangitsa kuti zitheke, ngati pali matenda monga a Lerish's syndrome, kusintha kwambiri moyo wa wodwala. Pambuyo pa kulowererapo, mkhalidwe wamagazi amayenda mumitsempha yam'munsi yam'munsi imakhala bwino.
Opaleshoni ya pulasitiki ya mtima ndi kununkha yomwe imagwiritsidwa ntchito pamitsempha ya zotumphukira zotupa za akazi imatha kuthetseratu zinthu zomwe zimachitika pamaso pa mtima.
Ambiri mwa zipatala zotsogola padziko lapansi zomwe zimachitidwa opaleshoni ya mtima imakonda njira ya balloon angioplasty.
Nthawi zambiri, njirayi imagwiritsidwa ntchito pobwezeretsa patency yamitsempha yama popliteal.
Njira ya balloon angioplasty ayesedwa posachedwa.
Kwa balloon angioplasty, masilindala okhala ndi zokutira pansi pamanja amagwiritsidwa ntchito.
Mankhwala omwe amalowetsa khoma la balloon amalowetsedwa kukhoma lamitsempha ndikutchinga kuti matenda awonjezeke.
Ubwino wazowerengera
Kugwiritsa ntchito opaleshoni yapulasitiki yokhala ndi balloon kuli mndandanda wonse wazabwino, zomwe zimaloleza kuti azitha kugwiritsidwa ntchito pochiza nthawi zambiri.
Chithandizo cha opaleshoni chimachitika popanda kuchita zowopsa pakhungu.
Kuti achite njirayi, kupuma pang'ono kumapangidwa pakhungu. Gawoli, pulogalamu yapadera imakhazikitsidwa pomwe kuyika kwa zida kumachitika, komanso zofunikira zimachitika.
Kuphatikiza apo, kugwiritsa ntchito balloon angioplasty kumapereka zotsatirazi:
- opaleshoni wamba safunikira;
- kulimbitsa thupi kwa nthawi yayitali sikufunika, wodwalayo amatha kudzuka ndikuyendayenda tsiku litatha;
- kuchuluka kwapakati pamavuto poyerekeza ndi njira yotseguka;
- njirayi imatenga nthawi yochepa poyerekeza ndi njira zina;
Kuphatikiza apo, ndi revascularization, chiopsezo chokhala ndi vuto lachiwiri ndilochepa.
Kukhazikitsidwa kwa balloon mu lumen kwa chotengera kumalepheretsa kukula kwa kutupa ndikuyimitsa kukula kwa endothelium khoma lamitsempha.
Zotsatira Zapulasitiki
Kupititsa patsogolo kwabwinobwino kwa magazi kudzera mu chotengera chogwiriridwa pambuyo pa opaleshoni yapulasitiki pamitsempha yam'mimba imasungidwa kwa zaka zisanu odwala ambiri.
Zambiri zomwe zimapezeka pakuwunika kwa odwala zimathandizira adokotala kuti azilembera panokha zizindikiro zoyambirira za kusokonekera kwa thanzi ndipo ngati pakufunika kutero, azikonza.
Kuti muwone momwe thanzi limakhalira, wodwalayo amalimbikitsidwa osachepera pachaka kuti ayesedwe thupi pogwiritsa ntchito ultrasound dopplerography ndipo kamodzi pachaka kukaunikira pogwiritsa ntchito tomography.
Wodwala akakhala akuyang'aniridwa ndikusamalidwa kwakanthawi kovomerezeka chifukwa chakuwonekera kwa mankhwala othandizira, kayendedwe ka wodwalayo kamasungidwa nthawi yonse ya moyo wake.
Zotsatira zomwe zimapezeka pogwiritsira ntchito balloon angioplasty kapena kuluma m'mitsempha yachikazi ndizofanana ndi zotsatira zomwe zimapezeka mukadutsa gawo la femal-popliteal la mtima wamankhwala pogwiritsa ntchito zida zapachiberekero.
Malinga ndi ziwerengero zamankhwala, mu 80% ya odwala omwe amachitidwa opaleshoni ya pulasitiki, mphamvu ya kama yogona imakhalapo kwa zaka zosachepera zitatu. Ngati wodwalayo amatenga nawo mbali pafupipafupi pakuyenda, ndiye kuti kufunika kogwirizananso sikukuchitika.
Opaleshoni yapulasitiki imathetsa chiopsezo cha minofu necrotization ndi mawonekedwe a zovuta. Njirayi imalepheretsa kukula kwamavuto.
Kugwiritsa ntchito opaleshoni ya aortic femoral bypass
Chizindikiro chachikulu cha opaleshoni ya aortic-femoral bypass ndi ma occlusion mu kama wa m'mimba ndi kumayambira ndi kuwonjezeka kwa msempha kusakwanira.
Kuphatikiza apo, njirayi imagwiritsidwa ntchito kuti ipeze njira yodulitsira bedi la wodwala mu dziwe la eleal artery, malinga ndi momwe sizingatheke kuchitira opaleshoni ya pulasitiki yamkati.
Komanso, njirayi imawonetsedwa kuti igwiritsidwe ntchito kuzindikira aneurysms ya m'mimba aortic khoma.
Opaleshoni ya aorto-femoral bypass pakadali pano ndi njira yofala kwambiri komanso yodalirika yopewera kukula kwa mitundu yayikulu ya matenda a ischemic ndikudulidwa kwamiyendo mu matenda ashuga.
Malinga ndi ziwerengero zamankhwala zaposachedwa, kutayika kwa miyendo pakati pa odwala omwe ali ndi zotupa zam'magazi a miyendo ndi pafupifupi 20% ya mitundu yonse yovomerezeka ya pathological.
Ndi kuchitapo kanthu koyenda bwino pamimba, msempha, chiopsezo cha zovuta zomwe zimadulidwa maliseche zimachepetsedwa mpaka 3% ya milandu.
Njira Yachitetezo
Tanthauzo la opaleshoni yolumikizira mafupa a ziwongo za m'munsi yam'munsi imatsitsidwa kuti ikhale gawo limodzi la msempha womwe uli pamwamba pa malo okhudzidwa ndi ma cholesterol amana.
Pakati pa njirayi, kuyamwa kumachitika pakatikati pamimba ndi kumtunda kwa chigawo chachikazi. Pambuyo pa izi, gawo la aorta limasankhidwa momwe madongosolo atherosulinotic samapezeka. Patsamba lino, zombo zokumbira zimakola kwa aorta. Zinthu zomwe zimagwiritsidwa ntchito popanga sitimayi sizimatenga nthawi iliyonse ndipo sizimapangitsa kuti chitetezo cha mthupi chitetezeke. Kutha kwaulere kwa chiwiya chochita kupanga kumabwera kumagawo omasulidwa a mitsempha yachikazi ndikuwakweza.
Shuting ikhoza kukhala yamtundu umodzi kapena umodzi.
Kutsetsereka kwa mitsempha yozungulira mwa njirayi ndi njira yovuta kwambiri. Izi ndichifukwa choti makoma a aorta nthawi zambiri amasintha mwamphamvu, zomwe zimatha kupangitsa kuti magazi aziwoneka munthawi ya njirayi.
Kubwezeretsanso magazi ndi njira yokhayo yosungiramo miyendo mwa wodwala yemwe akuvutika kwambiri chifukwa cha kufafaniza kwa mitsempha.
Pambuyo pa ndondomekoyi, nthawi zina, kukula kwa kuphatikizika kwa zinthu zoterezi kumapitilira. Zomwe zimapangitsa kuti magazi ayambe kutuluka.
Opaleshoni ya Bypass ndi angioplasty ndi njira zapamwamba zamankhwala opangira opaleshoni; mtengo wa chithandizo chotere ndi kuchuluka kwakukulu, komwe kumatha kuyambira pakuvuta kwa njirayi komanso malo othandizira opaleshoni.
Momwe mungagwiritsire matenda a atherosclerosis a miyendo auzeni katswiri mu kanema nkhaniyi.
