Carotid endarterectomy: zvairatidza, postoperative matambudziko, vakavhura wongororo, zvayakanakira nezvayakaipira

Munhu wose anoziva kuti sitiroko anonzi chimwe chezvinhu zvakafanana zvinokonzera rufu pakati Vagari yose nyika. chirwere ichi kunoitika pamwe maitikiro vakaenzana zvose kunyika zvenyika. Kazhinji cerebral riparadzirwe kunotungamirira nourema uye paresis, zvichikonzera pfupi kana zvachose urema. Kuti tidzivise kukura chirwere ichi, unofanira nguva rokuongorora sitiroko wakatsamwiswa zvinhu uye kubata navo. The chikuru chinokonzera sitiroko - ndiko atherosclerosis of arteries kwemitsipa uye musoro. embolism mu pakati uye kukwegura pane anenge munhu wose. Vanhu Most makore 60 kupa vezvokurapa kudzivirira atherosclerosis. Mune zvimwe zviitiko, zvinodhaka kurapwa haisi kuva zvinozoita. Zvino akaratidza Kuvhiya - carotid endarterectomy. nzira iyi inosanganisira kubviswa ngarava mugove damage atherosclerosis.

Sei kupedza carotid endarterectomy?

Krovosnabzhnenie uropi kunobva carotid arteries. midziyo ava mapazi yeropa. Vari vakaronga symmetrically kumativi maviri mumutsipa. Vachipinda cranial mhango, carotid arteries akakamurwa mapazi madiki uropi. In varwere vanenge atherosclerosis, yakakwirira mukana ropa clots mumidziyo izvi. Ivo rinoumbwa remafuta akawandisa plaques uye fibrous tishu. Kana BP kuwedzera carotid thrombus anogona kutyora kubva mudziyo parusvingo uye kupinda uropi. Somugumisiro, vanovakonzera ischemia - kushaya okisijeni wedzerai munyama. ropa kuyerera chepfungwa kwakadaro kunotungamirira migumisiro yakaipisisa. Kudzivirira sitiroko, carotid endarterectomy rinoitwa. Zvinobatsira kudzivirira sitiroko uye nemigumisiro yayo.

nzira Overview

Carotid endarterectomy - iri kuvhiyiwa, rinova kucheneswa yomukati rukoko ari mudziyo pedyo atherosclerotic Dombo. It rinoitwa muzviitiko apo mushonga simba kana mukana sitiroko hahusvikirwi. Drugs havagoni kupa zvinozoita apo atherosclerotic Dombo anopindura inopfuura hafu dhayamita yacho carotid tsinga. Kana remafuta akawandisa anovhara lumen ari mudziyo kubva kumativi akawanda panguva imwe chete. Uyezve, mukana sitiroko kunowedzera yekudyidzana pamberi unotungidzwa neBP. Muchiitiko chino, atheroma angabvuma chero nguva kubva endothelium, zvisinei ukuru hwaro. Zvingaguma kwete zvikuru blockage pamusoro carotid tsinga uye awo kuti zvokudya uropi. Somugumisiro dzichiri ischemic sitiroko.

Zvairatidza kuti carotid endarterectomy

Surgery (carotid endarterectomy) rinoitwa kwete vose. Kuti chiremba akapa mvumo kunorapwa, anofanira kuva zvakakomba uchapupu. Kazhinji kuvhiyiwa rinoitwa pavarwere vane nhoroondo kare ave akatamisira chepfungwa riparadzirwe. Saka, mune zvimwe zviitiko wakarurama carotid endarterectomy? Zvairatidza kuti zvinotevera:

1. The dhayamita ngarava rinovharwa ne atherosclerotic Dombo neinopfuura hafu.
2. Akadzokorora Kurohwa munhau.
3. Tikafunga neBP (muripo danho) uye atherosclerosis yacho carotid arteries.

Contraindications kunorapwa

Pasinei kubatsira kuvhiyiwa, mune zvimwe zviitiko, havagoni kuitwa. Sezvo vamwe kushandiswa, rine contraindications uye carotid endarterectomy. Reviews varwere atherosclerosis, rinojekesa kuti vanoverengeka kuongorora siyana anoitwa asati kuvhiya. Chete pashure chiremba ndiko kugutsikana kuti hapana contraindications, murwere anotanga kugadzirira oparesheni. Carotid endarterectomy hakubvumidzwi anotevera nyaya:

1. Dzisingadzorwi mishonga (decompensated) neBP.
2. Kukuru chenjera ischemic sitiroko.
3. Kusagadzikana angina kana achangopfuura myocardial infarction.
4. Chenjera mwoyo kutadza.
5. Recent sitiroko.
6. Chirwere kweropa insufficiency 2 uye 3 madhigirii.
7. chirwere cheAlzheimer.
8. Kenza uye chakakomba.

Kugadzirira carotid endarterectomy

Asati kuita carotid endarterectomy zvakakodzera kuita ongororo siyana. Wokutanga inoratidza duplex Ultrasound rwengarava musoro uye mutsipa. With nzira iyi chiremba anogona kutonga mwero kuvhara zviri lumen pakati arteries ose atherosclerotic plaques. Mune zvimwe zviitiko, rimwe vascular angiography. kudzidza Ndiyo sumo kupinda muropa musiyano mumiririri zvichiteverwa X-ray kuzvidzora. A nzira neyakarurama ndiye CT angiography. Kunoitawo kuti kuyera chimiro, ukuru uye localization kuti remafuta akawandisa overlays pamusoro endothelium. Kana chiremba ari kufungidzira ischemia zvimwe zvikamu uropi, akaita simba rinonzi magnetic resonance kuri. Kana chiremba akaratidza zvairatidza kuti kuvhiyiwa, zvakakodzera tigumise pamusoro mukuru mamiriro murwere. Kuti vaite izvi pamberi carotid endarterectomy kuita ECG, KLA, kupfuura ropa kemisitiri uye coagulation. Kana murwere ane zvimwe zvirwere, zvakakodzera kubvunza unyanzvi (endocrinologist, cardiologist).

Zvokukura carotid endarterectomy

Danho rokutanga kuvhiya ndiyo yokutindivadza. Pakusarudza yokutindivadza kunoenderana maonero chiremba, uyewo kuda murwere. It kunogona kuitwa dzeko yokutindivadza kana mukuru yokutindivadza. Zvadaro, chiremba inoita incision munzvimbo migumisiro Ultrasound kana angiography ndiyo remafuta akawandisa plaques. Danho iri clamping mudziyo. Uyezve, akachekwa chinoitwa pamusoro akawanda carotid tsinga. Mushure chiremba nemaziso kuongorora kukura uye rwakadini atherosclerotic Dombo, akapedzisa kuti nzira iri kuramba nokushanda. Pane nzira dzakawanda. Kazhinji kushandisa kuvhura endarterectomy. By izvi zvaireva longitudinal incision ngarava uye "tichibvisa" remafuta akawandisa overlays. Pashure paizvozvo, panzvimbo ukama endothelium rinoshandisirwa "chigamba." Imwe nzira - ichi eversion endarterectomy. Nokuda kwaizvozvi mudziyo dzikava mukati kunze uye ndaichenesa kubva atherosclerotic wt. Kana lesion pamusoro carotid tsinga yakakura, yokutsiva rayo rinoitwa neimwe nzvimbo. Nokuti chinangwa ichi, micheka chakaita zvokugadzirwa. Kwokupedzisira pavaipfuura carotid endarterectomy ndiyo marongera-stitching.

Sei post-kushanda nguva?

Pashure carotid endarterectomy zvinotora nguva rokudzorera ropa riyerere. Zvinotora shomanana. Sezvo incision iri mutsipa duku saizi, akaratidza zvishoma dzinorwadza nezvekufadza. Kunyange zvakadaro, analgesics kungadiwa nezuva rokutanga. Newewo unogona harungazosimudziri inorema zvinhu, uye kushandisa shomanana kubva, sezvo carotid endarterectomy chakaitwa. The postoperative kosi yakanaka, kana zvose chiremba mushonga, kwete chete pavaiva muchipatara, asiwo kana murwere pauri. Sutures vanobviswa mazuva 7-10 pashure kuvhiyiwa.

Matambudziko carotid endarterectomy

Zvinofanira kurangarirwa kuti chero kuvhiya kunosanganisira ngozi. No kunze uye carotid endarterectomy. Matambudziko avhiyiwa ichi hadziwanzowaniki, vanenge 3% nyaya. Kunyange zvakadaro, havana dzinowanikwa, uye murwere inofanira kuyambirwa pamusoro ichi.

Wokutanga chaizvo postoperative kuomesa ndiyo suture kutadza. With mashandiro ichi, kuti kupinda utachiona kupinda ronda iri ngozi chaizvo nokuti murwere upenyu, sezvo chekawo kuitwa zvakananga pamusoro vascular panhovo. kuomesa Izvi zvinogona kuitika nokuda asiri zvaidiwa nemitemo antiseptics.

Chimwe ezvinhu ngozi chokuita CEA, ndiyo nokutuka. Cerebrovascular tsaona zvingaitika somugumisiro atherosclerotic Dombo zveMagwaro kuparadzana panguva oparesheni uye ayo musoro neVadzidzi nemidziyo. kuomesa Izvi kushoma, muna 2-3% nyaya.

Uyezve, kuvhiya dzimwe nguva vakachengeta kwenguva kukanganisika inzwi uye kumedza. Izvi Rinobatanidzwa kuchikuvadza etsinga harinzwi iri mumutsipa.

Late matambudziko anoitika carotid endarterectomy restenosis anonzi. Izvi zvinoreva apiwa aienda pamusoro mudziyo lumen. Kakawanda restenosis kunoitika Varwere vasingabvumi kutevedza chiremba mirairo.

Kudzivirira postoperative yematambudziko

Matambudziko akadai sitiroko uye kukuvadza utano hwake kwemitsipa, regai kuvimba murwere, sezvo ivo simuka mukufamba pakuvhiya. Kunyange zvakadaro, kudzivirira vamwe ezvinhu runobvira chete nemhaka basa akabatana chiremba uye murwere. Kunyanya nayo chokuita apiwa panowanikwa atherosclerotic plaques. Kamwe pokuvhiyiwa yapera, murwere anofanira kugara muonekwe nyanzvi. Kuwedzera kune chirwere nzira, chiremba anopa murwere yaibatsira kurumbidzwaka. Zvikurukuru ichi chinoshanda nemararamiro: murwere unofanira kurega kusvuta uye doro kushandiswa, kudya (kudya yakaderera-mafuta zvokudya). Uyewo kuti kudzivirira restenosis waakaudzwa mishonga. Murwere anofanira kutora daily zvinodhaka lipid-richikwidibira ( "atorvastatin" chinodhaka), antiplatelet vamiririri ( "Cardiomagnyl" piritsi "Clopidogrel").

Operation "carotid endarterectomy": zvayakanakira nezvayakaipira

Sezvo vose maoparesheni, kuvhiyiwa izvi zvichikanganisa zvakanakira nekuipira. Vamwe vanachiremba regai kuvakurudzira carotid endarterectomy chero atherosclerosis zvinogona kurapwa conservatively, uye varwere havana kurapwa kuratidzirwa chirwere. Vamwe vanachiremba vanodavira kuti kuvhiya chinodiwa ane chinokosha aienda pamusoro lumen ari tsinga, pasinei zviratidzo varipo kana kwete murwere. Kunakisa nzira iri wandei ari mudziyo kubva remafuta akawandisa, nani ropa riyerere. The oparesheni anogona kuderedza mukana sitiroko. Asi endarterectomy hakuvimbisi kuti ngarava rirege kukanganisa zvakare. Uyewo, pakuvhiya yematambudziko anogona kuva sechipiriso pakukuvara tsinga kana nevanga. vanachiremba Most vanoti izvi pfupi chisingakuvadzi bata pakati nzira uye migumisiro vanoonekwa kuti hunogutsa.

Carotid endarterectomy: wongororo kuti kuvhiyiwa vanhu

Positive uye nepfungwa nawo pakukurukura chero kuvhiya kurapwa. No kunze uye carotid endarterectomy. Reviews pakuvhiya vanhu zvakasiyana. Kazhinji, vanhu vanogutsikana oparesheni. Nemhaka yake, ndizvo zviratidzo ischemia (vasingadzoreki nzeve, ndangariro, hope), nani migumisiro kuongorora uye zvayo ezvinhu. Vamwe varwere akaona kuchinja inzwi, pakuparadza zvirwere pashure endarterectomy. Kazhinji, zviratidzo izvi rwakatora pamusoro mwedzi, uye ipapo anyangarika chose.