He aha te Carotid Angioplasty me te Stenting? Te Whāinga, te Hātepe me ngā Hua

Ko te carotid angioplasty me te stenting he hātepe iti nei te whakaeke e whakatuwhera ana i ngā uaua carotid kua aukatia i tō kaki kia whakahokia mai te rere o te toto ki tō roro. Whakaarohia me te mea e hanga ana i tētahi ara mārama kia tae atu ai te toto ki tō roro i te wā kua tino whāiti te huarahi nui.

Ko ō uaua carotid he rite ki ngā huarahi nui e kawe ana i te toto whai hāora mai i tō ngākau ki tō roro. I te wā ka aukatia ēnei uaua e te pākirikiri, ka puta he whiu roro, he raruraru nui rānei. Mā tēnei hātepe e ārai ana i aua tūponotanga e mōrearea ana te ora mā te pupuri i tō roro kia pai te tuku toto.

He aha te carotid angioplasty me te stenting?

Ko te carotid angioplasty me te stenting e whakakotahi ana i ngā tikanga e rua hei rongoā i ngā uaua carotid kua aukatia. I te wā o te angioplasty, ka pupuhi tō tākuta i tētahi pōtae iti i roto i te uaua kua whāiti hei pana i te pākirikiri ki ngā pakitara o te uaua.

Ko te wāhanga stenting e whai pānga ana ki te whakatakoto i tētahi ngongo mātiti iti e kīia ana he stent kia tūwhera tonu te uaua. Ko tēnei ngongo mātiti e mahi ana hei āwhina, e tautoko ana i ngā pakitara o te uaua me te ārai i a rātou kia kaua e whāiti anō.

Ka mahia te hātepe katoa mā tētahi werohanga iti i tō tūtae, i tō ringaringa rānei, he rite ki te mahi o te catheterization ngākau. Ka ārahi tō tākuta i ngā ngongo angiangi, ngāwari mā roto i ō uaua toto kia tae atu ki te uaua carotid kua aukatia i tō kaki.

He aha te take e mahia ai te carotid angioplasty me te stenting?

Ka mahia tēnei hātepe i te tuatahi hei ārai i te whiu roro i te wā kua tino aukatia ō uaua carotid. E whakarato ana ō uaua carotid i te tata ki te 80% o te toto ki tō roro, nō reira he mōrearea te aukati.

Ka tūtohu pea tō tākuta i tēnei hātepe mēnā he mate uaua carotid nui tō, te tikanga i te wā he 70% neke atu rānei te aukati. Ka whakaarohia hoki i te wā i pā mai ngā tohumate pēnei i ngā whiu roro iti, i te wā rānei kei te tūpono nui koe ki te pokanga.

I ētahi wā ka whiriwhiria e ngā tākuta tēnei huarahi i runga i te pokanga carotid tuku iho i te wā e pā ana ētahi atu āhuatanga hauora e nui ake ai te tūponotanga o te pokanga tuwhera. Ko ēnei pea ko te mate ngākau, ngā raruraru pūkahukahu, ki te mea rānei i pokangia tō kaki i mua, i whakawāhia rānei.

He aha te tikanga mō te angioplasty carotid me te stenting?

Ko te tikanga e 1-2 hāora te roa, ā, ka mahia i roto i tētahi ruma motuhake e kīia ana he taiwhanga catheterization. Ka oho koe engari ka whakangāwarihia, ā, ka noho humārie koe, ka pai hoki i te wā o te tukanga.

Ka whai te rōpū hauora i ēnei mahi tūpato hei whakarite i tō haumaru:

1. Ka werohia tētahi wāhi iti i roto i tō uaua tūāwhiorangi, i tō uaua pūwaha rānei
2. Ka ārahina tētahi ngongo angiangi, ngāwari e kīia ana he catheter mā roto i ō uaua toto ki te uaua carotid kua aukatia
3. Ka whakatakotoria tētahi pūrere whakamarumaru ki tua atu i te aukati hei hopu i ngā otaota
4. Ka pupuhihia tētahi pōro i roto i te aukati hei whakatuwhera i te uaua
5. Ka whakatakotoria tētahi stent hei pupuri i te uaua kia tuwhera tonu
6. Ka tangohia te pūrere whakamarumaru me te catheter

He mea nui te pūrere whakamarumaru nā te mea he rite ki te marara iti, e hopu ana i ngā matūriki pōkai ka ngaro pea i te wā o te tukanga. Mā tēnei ka ārai i ngā otaota kia kaua e haere ki tō roro, kia kore ai e pā te whiu.

Ka taea e te nuinga o te tangata te hoki ki te kāinga i te rā kotahi, i muri rānei i te noho pō. Ka tino aroturukihia koe i te wā o te tukanga, i muri hoki, hei whakarite kia pai ngā mea katoa.

Me pēhea te whakarite mō tō angioplasty carotid me te stenting?

Ko te whakarite mō tēnei tikanga e whai ana i ētahi mahi nui hei āwhina i tō haumaru me te angitu. Ka hoatu e tō tākuta ngā tohutohu motuhake i runga i ō hiahia hauora takitahi.

Koinei te mea ka taea e koe te tūmanako i ngā rā e tata ana ki tō tikanga:

• Whakamutua ētahi rongoā pērā i ngā rongoā whakaheke toto i runga i ngā tohutohu a tō tākuta
• Whakaritea tētahi tangata hei taraiwa i a koe ki te kāinga i muri i te tikanga
• Kaua e kai, e inu rānei i tētahi mea i muri i te pō waenganui i mua i tō tikanga
• Tangohia ngā rongoā i whakaritea me te wai iti mō te inu ki te tohutohu
• Whakamōhio atu ki tō tākuta mō ō mate pāwera, ina koa ki te waikano rerekē, ki te iodine rānei
• Whakamōhio atu ki tō rōpū hauora mō ngā tohu makariri, rewharewha, kirika rānei

Ka tono pea tō tākuta i ngā whakamātautau i mua i te tikanga pērā i te mahi toto, i ngā rangahau whakaahua rānei. Ka āwhina ēnei i tō rōpū hauora ki te whakamahere i te huarahi haumaru mō tō āhuatanga motuhake.

He mea noa te āwangawanga i mua i te tikanga. Kaua e whakaroa ki te pātai ki tō tākuta, ki tō nēhi rānei i ngā pātai e pā ana ki ngā mea e tūmanakohia ana.

Me pēhea te pānui i ngā hua o tō angioplasty carotid me te whakauru stent?

Ka inea te angitu o tō tikanga mā te pai o te whakahoki mai i te rere o te toto ki tō roro. Ka whakamahi tō tākuta i ngā whakamātautau whakaahua i te wā o te tikanga, i muri hoki i te tikanga hei arotake i ngā hua.

I muri tonu i te tikanga, ka tirohia e tō tākuta te tūnga tika o te stent me te whānui o te uaua. Ko ngā hua pai e whakaatu ana i te uaua e tuwhera ana ki te whānui tata ki te whānui noa me te rere toto māeneene.

Ko te aroturuki whakaahua i ngā marama e whai ake nei ka aroturuki i te pai o te mahi tonu a te stent. Ka titiro tō tākuta ki ngā tohu o te whāiti anō o te uaua, e puta ana i roto i te 5-10% o ngā keehi.

Ka aroturukihia hoki koe mō ngā tohu neurological kia mōhio ai kei te whiwhi tō roro i te nui o te toto. Ko te nuinga o ngā tāngata ka pai ake, ka pūmau rānei ngā tohu i muri i te whakaurunga stent angitu.

He aha te putanga pai rawa atu mō te angioplasty carotid me te whakauru stent?

Ko te putanga pai rawa atu ko te whakahoki mai i te rere o te toto i roto i tō uaua carotid me te kore he raruraru. Ko te tikanga ka whiwhi tō roro i te hāora me ngā matūkai e tika ana, e tino whakaiti ana i tō tūponotanga ki te whiu.

He tino whakahihiri ngā reiti angitu mō tēnei tikanga, neke atu i te 95% o ngā keehi i tutuki ai te angitu hangarau. Ko te nuinga o ngā tāngata ka pai ake ā rātou tohumate, ka ārai rānei i ngā whiu ā muri ake nei.

Ko te hua pai ko te roa o te ora o te stent. E whakaatu ana ngā rangahau, he maha ngā tau e tuwhera ana, e mahi ana te nuinga o ngā stent, he iti tonu te reiti whaiti anō.

I tua atu i te angitu hangarau, ko te hua pai rawa atu ko te hoki ki ō mahi noa me te māia, me te mōhio kua tino whakahekehia tō tūponotanga whiu.

He aha ngā āhuatanga tūpono mō te hiahia ki te angioplasty me te stenting carotid?

He maha ngā āhuatanga ka whakanui ake i tō tūponotanga ki te whakawhanake i te mate o te uaua carotid e hiahia ana ki tēnei tikanga. Mā te māramatanga ki ēnei āhuatanga tūpono ka āwhina koe ki te mahi tahi me tō tākuta i ngā rautaki ārai.

Ko ngā āhuatanga tūpono noa e whai wāhi ana ki te whaiti o te uaua carotid ko:

• Neke atu i te 65 tau te pakeke, i te mea ka kaha ake te hanga o te pānga ki ngā uaua
• Te toto tiketike e whakangaro ana i ngā pakitara uaua i te roanga o te wā
• Ngā taumata cholesterol tiketike e whai wāhi ana ki te hanga pānga
• Te mate huka, e whakatere ana i te atherosclerosis
• Te kai paipa, e whakangaro ana i ngā oko toto me te whakatairanga i te hanga toto
• Te hītori o te whānau mō te whiu, te mate rānei o te ngākau me ngā oko toto
• Te momomo me te kore mahi tinana
• Te whakaeke ngākau o mua, te mate rānei o te uaua taha

Ko ētahi āhuatanga tūpono pēnei i te pakeke me te ira tangata e kore e taea te huri, engari he maha ētahi atu ka taea te whakahaere mā te whakarerekē i te oranga me te rongoā. Ka taea e tō tākuta te āwhina i a koe ki te whakawhanake i tētahi mahere hei whakatika i ngā āhuatanga tūpono ka taea te huri.

Ko te whai i ngā āhuatanga tūpono maha ka tino whakanui ake i ō tūponotanga ki te whakawhanake i te mate o te uaua carotid. Heoi, ahakoa ko ngā tāngata whai āhuatanga tūpono maha ka whai hua mai i ngā tikanga ārai.

He pai ake te angioplasty me te stenting carotid, te pokanga rānei?

Ko te whakatau i waenga i te angioplasty me te stenting carotid me te pokanga carotid tuku iho e pa ana ki ō āhuatanga me ō āhuatanga tūponotanga. He whai hua ngā tikanga e rua ki te ārai i te whiu, engari he painga ō ia mea i roto i ngā āhuatanga rerekē.

He pai ake pea te angioplasty me te stenting carotid mō koe mēnā he nui te tūponotanga pokanga nā ētahi atu āhuatanga hauora. Kei roto i tēnei ko te mate ngākau, ngā raruraru pūkahukahu, mēnā kua pokangia tō kaki i mua, kua whakawāhi rānei.

He pai ake pea te pokanga carotid tuku iho mēnā he tamariki koe, he āhuatanga uaua ō te pāti, he āhua ō te tinana e uaua ai te stenting. He raraunga wā roa hoki te pokanga e whakaatu ana i te roa pai.

Ka whakaarohia e tō tākuta ngā āhuatanga pēnei i tō tau, te hauora whānui, te āhua o te tinana, me ngā āhuatanga o tō aukati i te wā e whakatau ana i tēnei tohutohu. Ko te whāinga ko te whiriwhiri i te kōwhiringa haumaru me te whai hua mō tō āhuatanga motuhake.

He aha ngā raruraru ka puta mai i te angioplasty me te stenting carotid?

Ahakoa te haumaru o te angioplasty me te stenting carotid, pērā i ngā tikanga rongoā katoa, he tūponotanga kei roto. Mā te māramatanga ki ēnei raruraru ka āwhina koe ki te whakatau i tētahi whakatau mā te tākuta.

Ko ngā raruraru tino nui engari he onge ko:

• Te whiu i te wā, i muri tata rānei i te tikanga (ka puta i roto i te 2-4% o ngā keehi)
• Te whakaeke ngākau nā te pēhanga o te tikanga
• Te toto i te wāhi whakauru catheter
• Te urupare pānga ki te waikano rerekē e whakamahia ana i te wā o te whakaahua
• Ngā raruraru tākihi mai i te waikano rerekē
• Te hanga o ngā toto toto i runga i te stent
• Te pakaru, te tūhau rānei o te uaua (he tino onge)
• Te mate i te wāhi werohanga

Ko te nuinga o ngā raruraru he wā poto, ā, ka taea te whakahaere whai hua e tō rōpū rongoā. He onge ngā raruraru nui, ka puta i roto i te iti iho i te 5% o ngā tikanga.

He maha ngā tūpato ka mahia e tō tākuta hei whakaiti i ēnei tūponotanga, tae atu ki te whakamahi i ngā pūrere whakamarumaru me te āta aroturuki i a koe i te wā o te tikanga. Ko ngā painga o te aukati i te whiu i te nuinga o te wā ka nui ake i ēnei tūponotanga mō te nuinga o ngā tūroro.

Āhea au e kite ai i te tākuta mō ngā āwangawanga e pā ana ki te uaua carotid?

Me whakapā atu koe ki tō tākuta tonu mēnā ka pā ki a koe ētahi tohumate e tohu ana i ngā raruraru o te uaua carotid, i ngā raruraru rānei i muri i te tikanga. Mā te mōhio wawe me te rongoā i ēnei tohumate ka ārai i ngā raruraru nui.

Rapua tonu te āwhina hauora mēnā ka pā ki a koe ēnei tohu whakatūpato:

• Te ngoikore ohorere, te ngaro rānei o te mānawa i tō mata, tō ringa, i tō waewae rānei, ina koa i tētahi taha
• Te raruraru ohorere, te uaua rānei ki te kōrero, ki te mārama rānei ki te kōrero
• Ngā raruraru ohorere o te tirohanga i tētahi, i ngā kanohi e rua rānei
• Te mamae ohorere nui o te upoko kāore he take e mōhiotia ana
• Te uaua ohorere ki te haere, te whanoke, te ngaro rānei o te tauritenga
• Ngā wā poto o ēnei tohumate (ngā whiu iti, ngā TIA rānei)

I muri i tō tikanga, me whakapā atu anō koe ki tō tākuta mēnā ka kite koe i te toto, te pūpū, i te mamae rānei i te wāhi werohanga. Enei pea e tohu ana i ngā raruraru e hiahia ana kia rongoā wawe.

He mea nui ngā whakaritenga whai-whai tonu ahakoa e pai ana koe. Ka aroturukihia e tō tākuta tō stent me te hauora whānui o te uaua carotid kia tutuki ai te angitu i te wā roa.

Ngā pātai e pātai pinepine ana mō te carotid angioplasty me te stenting

Q.1 He pai te carotid angioplasty me te stenting mō te aukati i te whiu?

Āe, he tino whai hua te carotid angioplasty me te stenting ki te aukati i te whiu i roto i ngā tāngata he nui te aukati o te uaua carotid. E whakaatu ana ngā rangahau ka whakaiti i te tūponotanga o te whiu mā te 70-80% i te whakataurite ki te rongoā rongoā anake.

He tino whai hua te tikanga nei mō te hunga he aukati i te 70% neke atu rānei, mō te hunga kua pā i te whiu iti. Ka mahi mā te whakahoki i te rere toto noa ki tō roro, me te ārai i te pāti mai o te pākirikiri, ka puta he whiu.

Q.2 He raruraru roa pea ka puta mai i te whakanoho i te carotid stent?

Ko te nuinga o te hunga e whai carotid stent ana, e ora ana i te oranga noa, hauora, kāore he raruraru nui i te wā roa. Ka noho tō te stent hei wāhanga tūturu o tō uaua, ā, ka pai te urutau o tō tinana ki tērā.

Me tango koe i ngā rongoā whakaheke toto mō tētahi wā i muri i te tikanga, ā, me haere koe ki ngā tātari auau hei aroturuki i te stent. Ko ētahi tāngata ka pā i te whāiti anō o te uaua i te roanga o te wā, engari he mea kāore i te pāpā, ā, ka taea te rongoā ki te puta mai.

Q.3 Kia pēhea te roa o te whakaora i te angioplasty me te whakanoho stent carotid?

Ko te whakaora i te angioplasty me te whakanoho stent carotid he tere ake i te whakaora i te pokanga carotid tuku iho. Ka taea e te nuinga o te hunga te hoki ki ngā mahi noa i roto i ngā rā torutoru ki te wiki.

Me karo koe i te hiki i ngā mea taumaha mō te wiki pea, me te noho marie mō ngā rā tuatahi. Ko te wāhi werohanga i tō taha hope, i tō ringaringa rānei, ka ora i roto i ngā rā torutoru, ā, ka taea e koe te taraiwa i roto i te rā, e rua rānei, ki te kore koe e tango rongoā mamae kaha.

Q.4 Me tango rongoā au i muri i te whakanoho stent carotid?

Āe, me tango koe i ngā rongoā motuhake i muri i te whakanoho stent carotid hei ārai i te hanga o ngā pūtau toto ki runga i tō stent. Ko te tikanga, kei roto i tēnei ko te aspirin me tētahi atu rongoā anti-platelet pērā i te clopidogrel.

Ka tohutohu pea tō tākuta i ngā rongoā hei whakahaere i ō āhuatanga tūpono, pērā i ngā rongoā toto tiketike, ngā rongoā whakaheke cholesterol, me ngā rongoā mate huka ki te hiahiatia. He mea nui ēnei rongoā hei ārai i ngā raruraru ngākau i te wā anō.

Q.5 Ka hoki mai anō te aukati uaua carotid i muri i te whakanoho stent?

Ahakoa ka taea te hoki mai o te aukati i muri i te whakaurunga stent, he mea onge noa iho. Ka puta ano te whaiti (e kiia ana ko te restenosis) i roto i te 5-10% o nga keehi, i te nuinga o te wa i roto i te tau tuatahi i muri i te tikanga.

Mena ka puta ano te whaiti, ka taea te rongoa ki tetahi atu tikanga angioplasty. Ko te whai i nga tohutohu a to taakuta mo nga rongoa, nga huringa o te oranga, me nga aroturuki i nga wa katoa ka awhina i te whakaiti i te tupono ka hoki mai te aukati.