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

Ko te carotid endarterectomy he hātepe pokanga e tango ana i te hanga o te parataiao mai i ō uaua carotid. Koinei ngā uaua nui i tō kaki e kawe ana i te toto whai hāora ki tō roro. Ki te whāiti te parataiao i ēnei uaua, ka piki ake tō tūponotanga ki te whiu, ā, mā tēnei pokanga e āwhina te whakahoki i te rere toto tika hei tiaki i tō roro.

He aha te carotid endarterectomy?

Ko te carotid endarterectomy he pokanga ārai e horoi ana i ō uaua carotid. Whakaarohia me te mea e whakawātea ana i tētahi paipa kua purua - ka tango tō tākuta pokanga i ngā putunga momona me te parataiao kua hanga ki ngā pakitara uaua i te roanga o te wā.

E whāinga ana tēnei hātepe ki te carotid artery stenosis, arā, te whāititanga o ēnei uaua toto nui. E whai pānga ana te pokanga ki te hanga i tētahi tapahi iti i tō kaki, te whakatuwhera i te uaua mō tētahi wā, me te āta rakuraku i te hanga parataiao.

Ko te whāinga kia whānui anō te uaua ki tōna rahi noa kia rere noa ai te toto ki tō roro. Ka tino whakaiti tēnei i tō tūponotanga ki te whai whiu i pā mai i te aukati i te rere toto, i ngā wāhanga parataiao rānei e whati ana.

He aha te take e mahia ai te carotid endarterectomy?

E tūtohu ana tō tākuta i tēnei pokanga i te tuatahi ki te ārai i ngā whiu. Ki te tino whāiti ō uaua carotid - te tikanga e 70% neke atu rānei - ka tino piki ake te tūponotanga ki te whiu.

Ko te hātepe e mahia ana i te nuinga o te wā ki te whai koe i te mate uaua carotid nui engari kāore anō kia whai whiu nui. E tūtohu ana hoki ki te whai koe i ngā whiu iti (e kīia ana ko te whakaeke ischemic pāpaku rānei, TIAs) ki te whakaatu rānei ngā whakamātautau whakaahua i te hanga parataiao mōrearea.

I ētahi wā ka tūtohu ngā tākuta i tēnei pokanga ahakoa kāore ō tohumate, ina koa ki te whakaatu ngā whakamātautau i te whāititanga rawa. E mahi ana te pokanga hei mehua ārai, me te mea e whakatika ana i tētahi pāmu i mua i te whatinga, kaua ki te tatari mō te waipuke.

He aha te hātepe mō te carotid endarterectomy?

E 2-3 haora te roa o te pokanga, ā, ka mahia i raro i te rongoā whānui, nō reira ka moe katoa koe. Ka tūhau te tākuta i te 3-4 inihi te tapahi i te taha o tō kaki kia tae atu ki te uaua carotid.

Koinei ngā mea ka pā i ngā mahi matua o te tikanga:

1. Ka wehea e tō tākuta ngā uaua me ngā kiko kia tae atu ki te uaua carotid
2. Ka whakatakotoria e rātou ngā topenga rangitahi ki runga ake, ki raro i te wāhanga whāiti kia mutu te rere o te toto
3. Ka whakauruhia pea tētahi ngongo iti (shunt) hei pupuri i te rere o te toto ki tō roro i te wā o te tikanga
4. Ka whakatuwheratia te uaua i te roa, ā, ka tangohia mārire te pākirikiri i te wā kotahi ka taea
5. Ka katia te uaua ki ngā tūhono pai, i ētahi wā ka whakamahi i te papaki hei whānui
6. Ka whakahokia te rere o te toto, ā, ka katia te tapahi i ngā paparanga

Ka aroturukihia e tō rōpū pokanga te mahi o tō roro i te wā o te tikanga mā te whakamahi i ngā momo tikanga. Ka taea e te nuinga o ngā tūroro te hoki ki te kāinga i roto i te 1-2 rā i muri i te pokanga.

Me pēhea te whakarite mō tō carotid endarterectomy?

Ka tīmata tō whakarite i te wiki kotahi i mua i te pokanga me ngā tohutohu motuhake mai i tō rōpū hauora. Me whakamutu e koe ētahi rongoā, ina koa ngā whakaheke toto, i runga i te tohutohu a tō tākuta.

Ko tō whakarite i mua i te pokanga ko:

• Te whakamutu i te kai paipa i te iti rawa 2 wiki i mua i te pokanga kia pai ake te whakaora
• Te whakarite i tētahi tangata hei taraiwa i a koe ki te kāinga, me te noho ki a koe mō te 24 haora
• Te karo i te kai me te inu i muri i te pō i mua i tō rā pokanga
• Te tango i ngā rongoā kua tohua me te wai iti i runga i te tohutohu
• Te kawe mai i te rārangi o ō rongoā o nāianei ki te hōhipera
• Te mau i ngā kākahu pai, ngā kākahu wātea e kore e tika kia haere ki runga i tō upoko

Ka tono pea tō tākuta i ētahi atu whakamātautau pēnei i te mahi toto, i ngā rangahau whakaahua rānei kia mōhio ai koe kua rite koe mō te pokanga. Kaua e whakaroa ki te pātai pātai mō ngā mea katoa e pā ana ki a koe.

Me pēhea te pānui i ngā hua o tō carotid endarterectomy?

Ko te angitu i muri i te carotid endarterectomy ka inea e te pai ake o te rere o te toto me te whakaheke i te tūponotanga o te whiu. Ka whakamahi tō tākuta i ngā whakamātautau ultrasound hei tirotiro kei te tuwhera whānui tō uaua, ā, kei te rere mārire te toto.

I muri tonu i te pokanga, ka tūpono koe ki te pōhēhē me te kore e pai i te wāhi tapahi. Ka pōhēhē pea tō kaki, ka mōmona rānei mō ētahi wiki, he mea noa tēnei i te wā e ora ana ngā kiko.

He pai rawa ngā hua wā-roa - e whakaatu ana ngā rangahau ka whakaheke te pokanga i te tūponotanga o te whiu mā te 50% i roto i ngā kaitono e tika ana. Kāore te nuinga o te tangata e pā ana ki ngā tohumate e haere tonu ana, ā, ka hoki ki ā rātou mahi noa i roto i te 2-4 wiki.

Ka whakarite tō rōpū hauora i ngā whakaritenga whai-muri hei aroturuki i tō whakaora me te whakarite kia tuwhera tonu te uaua. He mea nui ēnei arowhai mō te pupuri i ō hua pai.

He aha ngā āhuatanga tūpono mō te hiahia ki te carotid endarterectomy?

He maha ngā āhuatanga ka whakanui i tō tūponotanga ki te whakawhanake i te mate uaua carotid e hiahia ana ki tēnei pokanga. Ko te pakeke te āhuatanga tino nui, me te piki haere o te tūponotanga i muri i te 65 tau.

Ko ngā āhuatanga tūpono tuatahi e whai wāhi ana ki te whāiti o te uaua carotid ko:

• Te toto tiketike e whakangaro ana i ngā pakitara uaua i te wā
• Ngā taumata cholesterol tiketike e arahi ana ki te hanganga o te pātai
• Te mate huka, e whakatere ana i te whakangaro uaua
• Te kai paipa, e rua ana i tō tūponotanga ki te mate uaua carotid
• Te hītori whānau o te mate ngākau, te whiu rānei
• Te whakaeke ngākau o mua, te mate uaua rānei o te taha
• Te momona me te noho noa

Ki te maha ngā āhuatanga tūpono ka piki ake te tūponotanga ki te whanake i te mate nui o te uaua carotid. Ko te rongo pai ko te nuinga o ēnei āhuatanga ka taea te whakahaere mā ngā huringa o te oranga me ngā rongoā.

He aha ngā raruraru ka puta mai i te carotid endarterectomy?

Ahakoa te haumaru o te carotid endarterectomy, pērā i ētahi atu pokanga, he tūponotanga kei roto. Ko te raruraru nui rawa atu ko te whiu, e puta ana i te 1-3% o ngā tūroro.

Ētahi atu raruraru ka puta, ahakoa he mea noa, kei roto:

• Te whakaeke ngākau nā te pēhanga o te pokanga
• Te toto, te hanga rānei o te pūhui toto i te wāhi pokanga
• Te mate i te tapahi, te nuinga ka taea te rongoā ki ngā paturopi
• Te kino o te io e pā ana ki ngā huringa reo rangitahi, tūturu rānei
• Te uaua ki te horo, te ngoikore rānei o te kanohi
• Ngā huringa toto e hiahia ana ki ngā whakatikatika rongoā

Ko te nuinga o ngā raruraru he rangitahi, ka ngaro i roto i ngā wiki ki ngā marama. Ka whai ngā tākuta pokanga i ngā whakatūpato nui hei whakaiti i ēnei tūponotanga, ā, ko ngā painga te nuinga ka nui ake i ngā raruraru ka puta.

Ngā raruraru onge pea kei roto ko ngā pūhihi, ngā huringa rānei o te hinengaro, engari e pā ana ēnei ki te iti iho i te 1% o ngā tūroro. Ka kōrero tō tākuta pokanga i tō kōtaha tūpono i mua i te mahi.

Āhea au e kite ai i te tākuta i muri i te carotid endarterectomy?

Me whakapā atu koe ki tō tākuta tonu mēnā ka pā ki a koe ētahi tohu whiu i muri i te pokanga. Kei roto i ēnei ko te ngoikore ohorere, te ngongo, te raruraru, te uaua ki te kōrero, te mamae nui rānei o te upoko.

Ētahi atu tohu whakatūpato e hiahia ana ki te āwhina hauora tonu kei roto:

• Te nui rawa o te toto, te pūhihi rānei i te wāhi tapahi
• Ngā tohu o te mate pērā i te kirika, te piki haere o te mamae, te pūhi rānei mai i te tapahi
• Ngā huringa ohorere i te tirohanga, te whanoke rānei
• Te uaua ki te hā, te mamae rānei o te uma
• Te mamae nui o te kaki, te mārō rānei
• Te ngongo hou, te ngā rānei i tō kanohi, i ō tūāwāhi rānei

Mō te aroturuki i ia rā, ka kite koe i tō tākuta i roto i te 1-2 wiki i muri i te pokanga. Ko ngā arowhai auau me ngā whakamātautau ultrasound ka whakaritea i te 6 marama, ā, ia tau ki te aroturuki i tō uaua.

Kaua e māharahara mō te mamae iti, te pānga, te pōhū rānei - he wāhanga noa tēnei o te whakaora. Ki te ruarua, he pai ake te waea atu ki tō rōpū hauora mō ngā pātai.

Ngā pātai auau mō te carotid endarterectomy

Q.1 He pai te carotid endarterectomy mō te ārai i te whiu?

Āe, he tino whai hua te carotid endarterectomy mō te ārai i te whiu mō ngā tāngata tika. E whakaatu ana ngā rangahau e whakaiti ana i te tūponotanga o te whiu mā te tata ki te 50% mō ngā tāngata e tino whāiti ana te uaua carotid.

He tino whai hua te pokanga mō ngā tāngata e 70% neke atu rānei te whāititanga o tō rātou uaua carotid, ina koa kua pā mai i a rātou ngā whiu iti. Mō ngā tāngata e whāiti ana (50-69%), he iti ake ngā painga engari he mea nui tonu i ētahi wā.

Q.2 Ka pā mai tonu ngā tohumate i te whāititanga o te uaua carotid?

Kāore, he maha ngā wā ka puta te whāititanga o te uaua carotid i te puku, kāore he tohumate e kitea ana. He maha ngā tāngata he nui ngā aukati ka kitea i te wā o ngā whakamātautau hauora auau, i ngā whakamātautau whakaahua rānei mō ētahi atu take.

Inā puta ngā tohumate, ko te tikanga ko ngā whiu iti me te ngoikore rangitahi, te ngaro o te rongo, te huringa o te tirohanga, te uaua rānei ki te kōrero. Heoi, ko te tohu tuatahi i ētahi wā he whiu nui, koinei te take he mea nui te tātari mō ngā tāngata e mōrearea ana.

Q.3 Kia pēhea te roa o te whakaora i muri i te carotid endarterectomy?

Ka taea e te nuinga o ngā tāngata te hoki ki ngā mahi māmā i roto i te wiki, me te hoki ki ngā mahi noa i roto i te 2-4 wiki. Ko te whakaora katoa o te tapahi ka roa te 4-6 wiki.

Me karo koe i te hiki taumaha (nui atu i te 10 pauna) mō te 2 wiki pea, ā, kaua e taraiwa kia whakaaetia koe e tō tākuta, ā, i roto i te wiki pea. Ka hoki te nuinga o te tangata ki ō rātou taumata pūngao noa i roto i te marama i muri i te pokanga.

Q.4 Ka hoki mai te mate o te uaua carotid i muri i te pokanga?

Ka hoki mai pea te mate o te uaua carotid, engari he mea noa i ngā tau tuatahi i muri i te pokanga. Tata ki te 10-20% o te tangata ka whai i tētahi āhua o te whāiti anō i roto i te 10-15 tau.

Koinei te take he mea nui ngā huringa o te noho me ngā rongoā hei whakahaere i ngā āhuatanga mōrearea pēnei i te toto tiketike me te cholesterol i muri i te pokanga. Ka āwhina te aroturuki auau me ngā whakamātautau ultrasound ki te hopu i ngā raruraru i te wā wawe.

Q.5 He aha ētahi atu huarahi kē atu i te carotid endarterectomy?

Āe, ko te carotid artery stenting tētahi atu tikanga e whakanohohia ai tētahi ngongo mata iti ki roto i te uaua kia tuwhera tonu ai. Ka mahia tēnei mā tētahi werohanga iti i tō pūwero, kaua i te pokanga kaki.

Ka whiriwhiria e tō tākuta i waenga i te pokanga me te stenting i runga i tō tau, te hauora whānui, te āhua o te tinana, me ngā āhuatanga mōrearea motuhake. He whai hua ngā tikanga e rua, engari ko te pokanga te mea e pai ana mō te nuinga o ngā tūroro, ina koa ko te hunga kei raro i te 75 tau te pakeke.