Carotid endarterectomy: alamomi, postoperative rikitarwa, sarrafa da sake dubawa, ribobi da fursunoni

Kowa ya sani cewa a bugun jini an dauki daya daga cikin na kowa Sanadin mutuwa a tsakanin yawan jama'a da dukan duniya. Wannan cuta na faruwa a tare da daidaita mita a duk ƙasashe na duniya. Sau da yawa da cerebral wurare dabam dabam take kaiwa zuwa inna da kuma paresis, haddasa wucin gadi ko m tawaya. Don kauce wa ci gaban da wannan cuta, kana bukatar lokaci don gane asali bugun jini tsokanar dalilai da kuma magance su. Babban dalilin da bugun jini - shi ne atherosclerosis daga cikin jijiyoyi na cikin wuyansa, kuma kai. embolism a tsakiyar da kuma tsufa akwai kusan kowa da kowa. Mafi yawan mutane a kan shekaru 60 da miƙa likita rigakafin atherosclerosis. A wasu lokuta, miyagun ƙwayoyi jiyya ba da ciwon da ake so sakamako. Sa'an nan ya nuna tiyata - carotid endarterectomy. Wannan hanya ya shafi kau da jirgin ruwa rabo lalace ta atherosclerosis.

Me ciyar carotid endarterectomy?

Krovosnabzhnenie kwakwalwa dogara a kan carotid jijiyoyi. Waɗannan kwanoni ne rassan da lakã. Suna shirya symmetrically a garesu na wuyansa. Shiga girman kwanyar rami, carotid arteries kasu kashi karami rassan kwakwalwa. A marasa lafiya fama da atherosclerosis, wani babban hadarin da jini clots a wadannan tasoshin. Suna hada da cholesterol plaques kuma fibrous nama. Lokacin da jini karuwa a carotid thrombus iya karya daga jirgin ruwa bango da kuma shiga cikin kwakwalwa. A sakamakon haka, da suka sa ischemia - rashin oxygen samar da kyallen takarda. Irin wannan cerebral jini ya kwarara take kaiwa zuwa tsanani sakamakon. Don hana bugun jini, carotid endarterectomy aka yi. Yana taimaka hana bugun jini da kuma da nasa sakamakon.

hanya Overview

Carotid endarterectomy - shi ne tiyata, wanda shi ne tsarkakewa daga ciki Layer da jirgin ruwa da atherosclerotic plaque. An yi a lokuta inda magani ne m, ko hadarin bugun jini ne da muni. Kwayoyi ba su iya samar da ake so sakamako a lokacin da atherosclerotic plaque mamaye fiye da rabin diamita daga cikin carotid jijiya. Ko idan cholesterol rufe da lumen na jirgin ruwa daga dama bangarorin lokaci guda. Bugu da kari, hadarin bugun jini qara muhimmanci a gaban uncontrolled hauhawar jini. A wannan yanayin, atheroma yiwu a kowane lokaci kashe endothelium, ko da kuwa ta size. A sakamakon iya zama ba mafi blockage na carotid jijiya da kuma rassansa da cewa ciyar da kwakwalwa. A sakamakon tasowa ischemic bugun jini.

Alamomi ga carotid endarterectomy

Surgery (carotid endarterectomy) ne da za'ayi ba ga kowa da kowa. Wannan likita Yã yi izni a gare tiyata, dole ne tsanani shaida. Sau da yawa aiki yana yi a marasa lafiya tare da wani tarihin riga ya canjawa wuri da cerebral wurare dabam dabam. Saboda haka, a wasu lokuta wajaba carotid endarterectomy? Alamomi ga wadannan:

1. A diamita da jirgin ruwa da aka rufe ta atherosclerotic plaque da fiye da rabin.
2. Maimaita shanyewar jiki a tarihi.
3. A hade da hauhawar jini (diyya mataki) da kuma atherosclerosis na carotid jijiyoyi.

Contraindications for tiyata

Duk da amfanin tiyata, a wasu lokuta, su ba za a iya za'ayi. Kamar yadda sauran aiki, shi yana da contraindications da carotid endarterectomy. Reviews da marasa lafiya da atherosclerosis, ya sa ya bayyana a fili cewa da dama daban-daban safiyo yi kafin tiyata. Kawai bayan likita ya gamsu da cewa babu contraindications, da mãsu haƙuri a fara shirya domin aiki. Carotid endarterectomy da aka haramta a cikin wadannan lokuta:

1. Uncontrolled magunguna (decompensated) hauhawar jini.
2. M m ischemic bugun jini.
3. M angina ko kwanan nan tsokar zuciya infarction.
4. M zuciya rashin cin nasara.
5. Recent bugun jini.
6. Kullum Sistem insufficiency 2 da kuma 3 digiri.
7. Alzheimer ta cutar.
8. Cancer da kuma tsanani.

Shiri for carotid endarterectomy

Kafin yin carotid endarterectomy wajibi ne a gudanar da daban-daban safiyo. A farko ya nuna wani Duplex duban dan tayi na tasoshin da kai da wuya. Tare da wannan Hanyar likita zai iya yin hukunci da mataki na ƙulli daga cikin lumen na arteries na atherosclerotic plaques. A wasu lokuta, a jijiyoyin bugun gini angiography. Wannan binciken shi ne gabatarwar a cikin jini bambanci wakili bi ta X-ray iko. A mafi m Hanyar ne CT angiography. Yana ba ka damar kimanta da siffar, size da kuma sarrafawa da cholesterol overlays a kan endothelium. Idan likita ake zargi ischemia wasu sassa na kwakwalwa, ya yi Magnetic rawa Dabarar. Lokacin da likita saukar da alamomi na tiyata, shi ne zama dole zana a ƙarshe game da janar jihar na haƙuri. Don yin wannan, a gaban carotid endarterectomy yi ECG, KLA, wuce jini sunadarai da coagulation. Idan haƙuri yana da sauran cututtuka, shi wajibi ne don tuntubar kwararru (endocrinologist, likitan zuciyar).

Akayi na carotid endarterectomy

A mataki na farko na tiyata ne maganin sa barci. A zabi na maganin sa barci dogara a kan ra'ayi na likita, kazalika da shirye na haƙuri. Yana za a iya yi maganin sa barci ko janar maganin sa barci. Bayan nan, Likita sa wani incision a yankin inda sakamakon wani duban dan tayi ko angiography ne cholesterol plaques. A mataki na gaba da aka clamping ganga. Bugu da ari, da yanke aka sanya a kan mafi yawansu, da carotid jijiya. Bayan likita ya gani kimanta da size da kuma nisan da atherosclerotic plaque, ya ƙarasa da cewa, hanyar da ake so a ci gaba da aiki. Akwai da dama dabaru. Sau da yawa Resort bude endarterectomy. By wannan yake nufi a tsaye incision na jirgin ruwa da kuma "scraping" cholesterol overlays. Bayan haka, a wurin da lalace endothelium ne amfani "faci." Wani Hanyar - wannan eversion endarterectomy. A saboda wannan dalili da jirgin ruwa da aka juya daga cikin da kuma tsabtace na atherosclerotic wt. Idan rauni na carotid jijiya ne manyan, ta maye da aka yi a wannan yanki. A saboda wannan dalili, roba yadudduka. A karshe mataki na carotid endarterectomy ne a Layer-stitching.

Ta yaya ne post-dau lokaci?

Bayan carotid endarterectomy daukan lokaci don mayar da jini ya kwarara. Yana daukan 'yan makonni. Tun da incision a cikin wuyansa na karamin size, ya nuna dan kadan m majiyai. Duk da haka, analgesics iya da ake bukata a rana ta farko. Za ka kuma ba zai iya dauke nauyi abubuwa, da yin aiki da 'yan makonni tun, kamar yadda carotid endarterectomy da aka yi. A postoperative Hakika yana da kyau, idan duk da ganin likita, ba kawai yayin da a asibiti, amma kuma a lokacin da haƙuri da aka dakatar. Sutures an cire 7-10 kwanaki bayan tiyata.

Matsalolin carotid endarterectomy

Ya kamata a tuna da cewa duk wani tiyata ya shafi hadarin. Babu togiya da carotid endarterectomy. Matsalolin bayan wannan aiki ne rare, game da 3% na lokuta. Duk da haka, an same su, da mãsu haƙuri dole ne a yi musu gargaɗi game da wannan.

The sosai farko postoperative wahala ne dinki gazawar. Tare da wannan aiki, shigar azzakari cikin farji daga kwayoyin cuta a cikin rauni ne sosai a kawo hadari ga haƙuri da rai, kamar yadda da yanke kai tsaye, a kan jijiyoyin bugun gini gado. Wannan wahala iya faruwa saboda ba yarda da dokoki na magunguna iri iri.

Wani hatsari yanayin dangantaka da CEA, shi ne wani zagi. Cerebrovascular hatsari na iya faruwa a sakamakon atherosclerotic plaque gutsure rabuwa a lokacin aiki da kuma ta kai a lamba tare da tasoshin. Wannan wahala ne m, a 2-3% na lokuta.

Bugu da kari, wani lokacin tiyata ne lura wucin gadi cuta daga murya da hadiya. Wannan ake dangantawa da lalacewar da jijiya endings located a cikin wuyansa.

Late rikitarwa na carotid endarterectomy restenosis an dauke. Wannan yana nufin sake takaita da jirgin ruwa lumen. Mafi sau da yawa restenosis auku a marasa lafiya da suke ba cika tare da likita ya umarta.

Rigakafin postoperative rikitarwa

Matsalolin kamar bugun jini da kuma lalacewar da jijiyoyi na wuyansa, kada ya dogara ne a kan haƙuri, kamar yadda suka bayyana a cikin shakka daga tiyata. Duk da haka, rigakafin wasu yanayi ne kawai zai yiwu godiya ga hada aikin likita da kuma haƙuri. Musamman ta shafi batun sake faru na atherosclerotic plaques. Da zarar aiki ne a kan, da mãsu haƙuri dole ne a kullum lura da wani gwani. Bugu da kari ga diagnostic hanya, da likita ya ba da haƙuri da wani amfani shawarwarin. A musamman wannan ya shafi salon: da mãsu haƙuri dole ne a daina shan taba da kuma shan barasa amfani, rage cin abinci (ci low-mai abinci). Har ila yau, domin rigakafin restenosis wajabta magani. A haƙuri kamata kullum dauki sia-ragewan kwayoyi ( "atorvastatin" miyagun ƙwayoyi), antiplatelet jamiái ( "Cardiomagnyl" kwamfutar hannu "Clopidogrel").

Operation "carotid endarterectomy": ribobi da fursunoni

Kamar yadda da dukan m hanyoyin, wannan aiki yana da biyu amfani ko rashin amfani. Wasu likitoci ba su bayar da shawarar carotid endarterectomy muddin atherosclerosis za a iya bi conservatively, da kuma marasa lafiya basu da na asibiti manifestations cuta. Sauran likitoci yi imani da cewa tiyata wajibi ne tare da wani gagarumin takaita da lumen na jijiya, ko da kuwa ko cututtuka su ne ba, ko ba a cikin haƙuri. A amfani da wannan hanya ne tsaftace da jirgin ruwa daga cholesterol, inganta jini ya kwarara. The aiki iya rage hadarin bugun jini. Duk da haka endarterectomy bai da garantin cewa jirgin ruwa ba za a lalace sake. Har ila yau, a lokacin tiyata rikitarwa zai iya ci gaba kamar yadda wani jijiya rauni ko bugun jini. Mai likitoci sanyã wannan ga mun gwada m magudi da kuma hanyoyin da sakamakon an dauke su da ma'ana.

Carotid endarterectomy: reviews na sarrafa mutane

Tabbatacce kuma korau ra'ayin ci karo a cikin tattaunawa na wani m magani. Babu togiya da carotid endarterectomy. Reviews sarrafa mutane ne daban-daban. A mafi yawan lokuta, mutane gamsu da aiki. Godiya ta, ne bayyanar cututtuka na ischemia (sosai da hankali, memory, barci), da inganta sakamakon da binciken da kuma janar yanayin. Wasu marasa lafiya lura da wani canji a cikin murya, hadiya cuta bayan endarterectomy. A mafi yawan lokuta, wadannan cututtuka dade game da wata, sa'an nan gaba daya bace.