Lapho welapha i-atherosclerosis yemikhumbi yemikhawulo engezansi, zombili izindlela zokwelashwa ezisiza ngosizo lwemithi nokuhlinzwa zingasetshenziswa.
Kungukungabikho komphumela omuhle ovela ekusetshenzisweni kwemithi okuyisibonakaliso sokusetshenziswa kokungenelela kokuhlinzwa.
Ukungenelela kokuhlinzwa kwenziwa esikhathini sekwedlule isikhathi, lapho ukwelashwa kwezidakamizwa kungalethi umphumela omuhle ofunekayo. Ezigabeni zakamuva zokukhula kwalesi sifo, izicubu ezithambile ziyafa bese kuba nenqubo yobugebengu.
Udokotela ohlinzayo we-vascular, ohlelweni lokungenelela kokuhlinzwa, wenza i-excision yezindawo zezicubu eziqhutshwa yi-necrotization. Izindawo ezenziwa ukuhlinzwa zimbozwe ngocingo lwesikhumba.
Ukuhlinzwa kwe-atherosclerosis yemikhawulo engezansi esigabeni sokugcina sokuthuthuka kungasiza kakhulu ekuthuthukiseni impilo kanye nekhwalithi yempilo yesiguli.
Kunezindlela ezahlukahlukene zokungenelela kokuhlinzwa. Izindlela ezivame kakhulu yilezi zindlela ezilandelayo:
- Ukuhlinzwa kweBypass - ukuhlinzwa kuqukethe ukudala indlela eyengeziwe yokuhamba kwegazi esizeni somonakalo.
- I-balloon angioplasty ukusetshenziswa kwebhaluni elikhethekile elihlikihla isitsha esisetshenziswayo lapho kwenziwa inqubo.
- I-Arterial stenting - ukubekwa ku-artery ye-stent ekhethekile egcina ububanzi besikebhe esingaguquki ezingeni elifunekayo.
- I-Endarterectomy - ukususwa kwengxenye eyonakalisiwe yomkhumbi ne-atherosclerotic plaque equkethe kuyo.
- I-Autodermoplasty uhlobo lokungenelela kokuhlinzwa okusetshenziswa ekwelapheni izilonda ze-trophic, okunzima ukwelapha ngemithi. Ukuhlinzwa kusiza ukuvikela ukukhula kwenqubo yeziqhumane kwezicubu zomkhawulo ophansi.
- I-Prosthetics - inqubo yokufaka esikhundleni somkhumbi ongazenzakaleli noma owenziwe ngengxenye yombhede wezinzwa ohlupheka ngenxa yokuqhubeka kokuqothula i-atherosulinosis. Indlela yokuhlinzwa ikuvumela ukuthi ubuyisele ukuhambisa kwegazi endaweni elimele.
- Ukunqunywa - inqubo yokususa ingxenye ye-necrotic yomlenze, kulandelwa yi-prosthetics.
Ukukhethwa kwendlela yokungenelela kokuhlinzwa kuya ngezinga lomonakalo wezicubu zomlenze nezimpawu zomzimba wesiguli ngamunye. Ukuzikhethela kwendlela yokwelashwa kwenziwa ngudokotela ohlinzayo wemithambo owenza ukwelashwa.
Ngemuva kokuhlinzwa, isiguli sizodinga ukwenza inkambo ende yokuvuselela kanye nokwelashwa ngezidakamizwa ukuze sibuyisele indlela ejwayelekile.
Lapho welapha isifo sokuqina kwemithambo yegazi emithanjeni esezingeni eliphansi, udokotela, lapho ekhetha indlela yokwelashwa, unquma ukubekezela kwenqubo kanye nokuthi kungenzeka ukuthi ukusebenza okuningi kusiza kanjani ukuthuthukisa isimo sesiguli ngaphandle kokusebenzisa ezinye izindlela zokungenelela.
Izici zezinhlobo ezahlukene zokwelashwa okuhlinzwa
I-Balloon angioplasty iyindlela yokwelashwa okuhlinza efaka ukwethula embhedeni we-vascular endaweni yokunciphisa i-catheter ekhethekile enebhaluni elikhethekile elikhulayo ekugcineni.
Ngemuva kokufakwa kwe-catheter, i-balloon iqala ukuvuvukala ngaphansi kwengcindezi yokucindezela, okuholela ekunwetshisweni kwezindonga zesitsha kanye nokubuyiselwa kwendlela yokuthuthwa kwegazi.
Uma ukubuyiselwa kokugeleza kwegazi kungenzeki, kufakwa uhlaka olukhethekile emkhakheni womonakalo esitsheni. Inhloso yalolu hlaka ukugcina ubuningi bomkhumbi endaweni yomonakalo ezingeni elamukelekayo. Uhlaka lokwethula ngesikhathi senqubo lwenziwe nge-alloy ekhethekile.
Uma umphumela oyifunayo ungatholakalanga, khona-ke udokotela oholayo uzonquma ngokusetshenziswa kwendlela evulekile ye-shunt.
Ezimweni eziningi, i-balloon angioplasty ingabuyisela ukujikeleza kwegazi futhi igweme ukusetshenziswa kokungenelela okubanzi nokuhlukumezanayo.
Ukusetshenziswa kokungenelela kokuqina kokubeletha kwenza ukuba kwenzeke, uma kukhona ukuxilongwa okufana ne-Lerish's syndrome, ukuthuthukisa kakhulu impilo yempilo yeziguli. Ngemuva kokungenelela, isimo sokuphuma kwegazi emithanjeni yamaphethelo aphansi sithuthuka kakhulu.
Ukuhlinzwa ngepulasitiki kwe-Vascular kanye ne-stinging okwenziwe embhedeni we-vascular we-artery engaphezulu yensimbi engaphezulu kungasusa lesi simo esikhona ebusweni bokuntuleka kwemithambo okwenzeka ngemuva kokuvaleka kokukhanya kwesitsha ngethambo legazi.
Iningi lemitholampilo ehamba phambili emhlabeni ebandakanyeka ekuhlinzweni ngamathambo lithanda indlela ye-balloon angioplasty.
Kaningi, le ndlela isetshenziselwa ukubuyisa ubunikazi bemithambo ye-popliteal.
Indlela ye-balloon angioplasty ihlolwe muva nje.
Kwi-balloon angioplasty, amasilinda ane-coating izidakamizwa ebusweni asetshenziswa.
Izidakamizwa ezingena odongeni lwebhaluni zidonswa odongeni lwe-vascular futhi zivimbele ukuqhubeka kwesifo.
Izinzuzo zesicelo sebhaluni
Ukuhlinzwa kwe-balloon ukuhlinzwa kwepulasitiki kunohlu lonke lwezinzuzo, okukuvumela ukuthi kusetshenziselwe ukwelashwa ezimweni eziningi zokungenelela kokuhlinzwa.
Ukwelashwa kokuhlinzwa kwenziwa ngaphandle kokwenza izehlakalo ezinkulu zesikhumba.
Ukuze wenze inqubo, ukubhoboza okuncane kwenziwa esikhunjeni. Esigabeni, kufakwa idivaysi ekhethekile lapho okokufaka kwamathuluzi kwenziwa, kanye nokwenziwa okukhohlisayo okudingekayo.
Ngaphezu kwalokho, ukusetshenziswa kwe-balloon angioplasty kunikeza izinzuzo ezilandelayo:
- i-anesthesia ejwayelekile ayidingeki;
- ukungasebenzi isikhathi eside kwesiguli akudingekile, isiguli singasukuma sihambahamba usuku ngemuva kwenqubo;
- inani eliphansi lezinkinga liqhathaniswa nenqubo evulekile;
- inqubo ithatha isikhathi esincane uma kuqhathaniswa nezinye izindlela;
Ngaphezu kwalokho, nge-revascularization, ingozi yokutheleleka kwesibili incane.
Ukwethulwa kwe-balloon ku-lumen yomkhumbi kuvimbela ukukhula kwenqubo yokuvuvukala futhi kumise ukukhula kwe-endological ye-endothelium odongeni lwe-vascular.
Imiphumela Yepulasitiki ye-Balloon
Ukuthuthuka okujwayelekile kokugeleza kwegazi ngomkhumbi osetshenziswayo ngemuva kokuhlinzwa kwepulasitiki emithanjeni kugcinwa iminyaka emihlanu esigabeni esikhulu seziguli.
Imininingwane etholakele ngesikhathi sokuhlolwa kweziguli inika amandla udokotela ohambelayo ukubhalisa izibonakaliso zokuqala zokuwohloka okuphindaphindekayo esimweni sempilo futhi, uma kunesidingo, enze ukulungiswa kwayo.
Ukuqapha isimo sezempilo, isiguli sinconywa okungenani kabili ngonyaka ukuba sihlolwe umzimba usebenzisa i-dopplerography ye-ultrasound kanye kanye ngonyaka ukwenza ukuhlolwa nge-computer tomography.
Uma isiguli sibhekene nokuqashwa ngokomtholampilo nokulungiswa kwesikhashana kwesimo sayo sezempilo ngokuchayeka kwezidakamizwa zokwelapha, umsebenzi wokuhamba wesiguli uyagcinwa kuyo yonke inkathi yokuphila.
Imiphumela etholwe kusetshenziswa i-balloon angioplasty noma i-stenting emithanjeni yabesifazane iyaqhathaniswa nemiphumela etholakele lapho kudlula ingxenye yesitho sangasese sowesifazane wesistimu ye-vascular isebenzisa i-prosthesis yomkhumbi wokufakelwa.
Ngokwezibalo zezokwelapha, kuma-80% eziguli ezenziwa ngokuhlinzwa ngopulasitiki, ubunikazi bembhede yemithambo buhlala okungenani iminyaka emithathu. Uma isiguli sizibandakanye njalo ekuhambeni okwelashwa, khona-ke isidingo sokusebenza kabusha asiveli.
Ukuhlinzwa ngopulasitiki kususa ingozi yezicubu ze-necrotization nokubukeka kwezinkinga. Le ndlela ivimbela ukuthuthukiswa kwezinkinga zezigelekeqe.
Ukusetshenziswa kokuhlinzwa kwe-aortic femoral bypass
Izinkomba eziphambili zokuhlinzwa kwe-aortic-femoral bypass ukuhlinzwa kwe-occlusion embhedeni we-aorta wesisu ngokuqala nokwanda kokuntuleka kwe-aortic.
Ngaphezu kwalokho, le ndlela isetshenziswa ukuthola ukuqhekeka kombhede we-vascular echibini le-aral echibini, inqobo nje uma kungenakwenzeka ukwenza ukuhlinzwa kwepulasitiki okungapheli.
Futhi, le ndlela iboniswa isetshenziswa ekuboneni i-aneurysms yodonga lwe-aortic lwesisu.
Ukuhlinzwa kwe-aorto-femoral bypass njengamanje kuyindlela evamile kakhulu futhi ebabazekayo yokuvimbela ukuthuthukiswa kwezinhlobo ezinzima zesifo se-ischemic kanye nokuqunjelwa kwamalungu esigweni sikashukela.
Ngokuhambisana nezibalo zamanje zezokwelapha, ukulahleka kwemilenze phakathi kweziguli ezinesilonda sohlelo lwe-vascularalunga lezinyawo cishe kungama-20% azo zonke izimo ze-pathological ezibhalisiwe.
Ngokungenelela okwenziwe kahle kwi-aorta yesisu, ubungozi bezinkinga eziholela ekunqunyweni kwezitho zomzimba buncishiselwe ku-3% wamacala.
Isu Lokungenelela
Izincazelo zokungenelela kokuhlinzwa kokuhlinzwa kwe-atherosulinosis yemikhumbi emaphethelweni aphansi kuncishiswa ekwabiweni kwengxenye ye-aorta ebekwe ngaphezu kwendawo ethinteke yi-cholesterol deposits.
Ngesikhathi senqubo, i-incision yenziwa endaweni engemuva yesisu kanye nengxenye ephezulu yesifunda sowesifazane. Ngemuva kwalokhu, kukhethwa isigaba se-aorta lapho kungatholwa khona ama-atherosulinotic amana. Kulesi siza, umkhumbi wokufakelwa uvuthelwa ku-aorta. Izinto ezisetshenziswayo ekwakhiweni komkhumbi azithathi hlangothi ngokwemvelo futhi azivusi ukuphendula kokuzivikela komzimba. Ukuphela kwamahhala komkhumbi wokufakelwa okulethwa kulethwa ezingxenyeni ezikhululiwe zemithambo yensimbi yabesifazane futhi kwaqondiswa kubo.
Ukuthungatha kungaba yimbumba eyodwa noma eyodwa.
I-Arterial artery bypass grafting inqubo eyinkimbinkimbi. Lokhu kungenxa yokuthi izindonga ze-aorta zivame ukuba nezinguquko eziqinile, ezingavusa ukubukeka kokuphuma kwegazi ngesikhathi senqubo.
Ukubuyisela ukuphakelwa kwegazi kuyindlela kuphela yokulondolozwa kwesitho esigulini esiguliswa uhlobo olunzima lwe-atherosclerosis.
Ngemuva kwenqubo, ezimweni ezingavamile, ukuthuthukiswa kwengqungquthela enjalo njengokuvuselelwa kwe-prosthesis kungenzeka. Yini engadala ukubonakala kokopha.
Ukuhlinzwa kweBypass kanye ne-angioplasty kungukungenelela okuphezulu kobuchwepheshe; izindleko zokwelashwa okunjalo ziyisilinganiso esikhulu, esingahlukahluka ekuxakaneni kwenqubo nendawo yokungenelela kokuhlinzwa.
Ungayelapha kanjani i-atherosclerosis yemilenze uzotshela uchwepheshe kule vidiyo ekulesi sihloko.
