Ni iki cyitwa Carotid Endarterectomy? Intego, Uburyo & Ibivamo

Carotid endarterectomy ni uburyo bwo kubaga bukuraho imyanda yiyongera mu miyoboro y'amaraso ya carotid. Iyi ni imiyoboro minini y'amaraso yo mu ijosi ryawe itwara amaraso yuzuye umwuka wa oxygène mu bwonko bwawe. Iyo imyanda yagabanije iyi miyoboro y'amaraso, bishobora kongera ibyago byo guhura n'indwara y'umutima, kandi iyi operasiyo ifasha gusubiza amaraso mu buryo bukwiye kugira ngo barengere ubwonko bwawe.

Ni iki cyitwa carotid endarterectomy?

Carotid endarterectomy ni operasiyo yo gukumira ikora isuku mu miyoboro yawe ya carotid. Bitekereze nk'uko usukura umuyoboro wazibye - umuganga ubaga akuraho ibinure n'imyanda byiyongereye ku nkuta z'umuyoboro w'amaraso uko igihe kigenda gihita.

Ubu buryo bugamije cyane carotid artery stenosis, bivuze kugabanuka kw'iyi miyoboro y'amaraso y'ingenzi. Iyi operasiyo ikubiyemo gukora agace gato mu ijosi ryawe, gufungura by'agateganyo umuyoboro w'amaraso, no gukuraho neza imyanda yiyongereye.

Intego ni ukwagura umuyoboro w'amaraso ukagaruka ku bunini busanzwe kugira ngo amaraso abashe gutembera neza mu bwonko bwawe. Ibi bigabanya cyane ibyago byo kugira indwara y'umutima iterwa no kuziba kw'amaraso cyangwa ibice by'imyanda biva.

Kuki carotid endarterectomy ikorwa?

Muganga wawe agushishikariza iyi operasiyo cyane cyane kugira ngo wirinde indwara z'umutima. Iyo imiyoboro yawe ya carotid igabanutse cyane - akenshi ku kigero cya 70% cyangwa kirenzeho - ibyago byo kurwara indwara y'umutima biriyongera cyane.

Ubu buryo bukunze gukorwa iyo ufite indwara ikomeye ya carotid artery ariko utaragira indwara y'umutima ikomeye. Biranashimwa niba waragize indwara ntoya z'umutima (zizwi nka transient ischemic attacks cyangwa TIAs) cyangwa niba ibizamini byerekana imyanda yiyongereye iteye akaga.

Rimwe na rimwe abaganga bashimira iyi operasiyo kabone niyo udafite ibimenyetso, cyane cyane niba ibizamini byerekana kugabanuka cyane. Operasiyo ikora nk'ingamba yo kurengera, nk'uko usana urugomero mbere y'uko rusenyuka aho gutegereza umwuzure.

Ni ubuhe buryo bwa carotid endarterectomy?

Kubaga bisanzwe bifata amasaha 2-3 kandi bikorwa hakoreshejwe imiti ituma umuntu asinzira, bityo uzaba usinziriye rwose. Muganga wawe akora urukanda rwa santimetero 7.5-10 ku ruhande rw'ijosi ryawe kugira ngo agere ku muyoboro w'amaraso wa carotid.

Ibi nibyo bibaho mu gihe cy'intambwe z'ingenzi z'iki gikorwa:

1. Muganga wawe atandukanya neza imitsi n'ibice by'umubiri kugira ngo agere ku muyoboro w'amaraso wa carotid
2. Bashyiraho ibikoresho by'agateganyo hejuru no hepfo y'igice cyagabanutse kugira ngo bahagarike urujya n'uruza rw'amaraso
3. Agatubuzo gato (shunt) gashobora gushyirwaho kugira ngo amaraso akomeze kujya mu bwonko bwawe mu gihe cy'iki gikorwa
4. Uyu muyoboro w'amaraso ufungurwa mu burebure, kandi plaque ikurwaho neza mu gice kimwe igihe bishoboka
5. Uyu muyoboro w'amaraso ufungwa hakoreshejwe imitsi mito, rimwe na rimwe hakoreshwa agapaki kugira ngo wagure
6. Urujyana n'uruzana rw'amaraso rugarurwa, kandi urukanda rufungwa mu byiciro

Itsinda ryawe ry'abaganga bakurikirana imikorere y'ubwonko bwawe mu gihe cy'iki gikorwa bakoresheje uburyo butandukanye. Abantu benshi barashobora gutaha mu rugo nyuma y'iminsi 1-2 nyuma yo kubagwa.

Ni gute wakitegura kubagwa carotid endarterectomy?

Imyiteguro yawe itangira hafi icyumweru mbere yo kubagwa hamwe n'amabwiriza yihariye ava mu itsinda ryawe ry'abaganga. Uzaba ukeneye guhagarika imiti imwe, cyane cyane imiti ituma amaraso atinda gupfa, nk'uko byategetswe na muganga wawe.

Imyiteguro yawe mbere yo kubagwa isanzwe irimo:

• Guhagarika itabi byibuze mu byumweru 2 mbere yo kubagwa kugira ngo wongere gukira
• Gutegura umuntu wo kukugeza mu rugo no kugumana nawe amasaha 24
• Kwanga kurya no kunywa nyuma ya saa sita z'ijoro mbere y'umunsi wo kubagwa kwawe
• Gufata imiti yose yategetswe hamwe n'agahinda gato k'amazi nk'uko byategetswe
• Kuzana urutonde rw'imiti yawe yose iriho mu bitaro
• Kwambara imyenda yoroshye, yagutse idakeneye kunyura mu mutwe wawe

Muganga wawe ashobora no gutuma bakora ibindi bizami nk'ibizamini by'amaraso cyangwa ibizamini by'amashusho kugira ngo barebe ko witeguye kubagwa. Ntuzatinye kubaza ibibazo ku kintu icyo aricyo cyose kikureba.

Ni gute usoma ibisubizo byawe byo kubagwa carotid endarterectomy?

Intsinzi nyuma ya carotid endarterectomy ipimwa no kunoza imikorere y'amaraso no kugabanya ibyago byo guhura n'indwara ya stroke. Muganga wawe azakoresha ibizamini bya ultrasound kugira ngo arebe ko umutsi wawe ubu ufunguye kandi amaraso atembera neza.

Nyuma y'ububagizi bw'ako kanya, ushobora kwitega kubyimba no kutamererwa neza ahantu hakorewe urubagizi. Ijosi ryawe rishobora kumva ryumye cyangwa ritagira ubwenge mu byumweru byinshi, ibyo bikaba bisanzwe rwose uko imitsi ikira.

Ibisubizo by'igihe kirekire muri rusange ni byiza cyane - ubushakashatsi bwerekana ko kubagwa kugabanya ibyago bya stroke ku kigereranyo cya 50% ku bantu babikwiriye. Abantu benshi ntibagira ibimenyetso bikomeza kandi bashobora gusubira mu bikorwa byabo bisanzwe mu byumweru 2-4.

Itsinda ryawe ry'abaganga rizagena gahunda yo gusuzuma kugira ngo bakurikirane imikoreshereze yawe kandi barebe ko umutsi ukomeza gufunguka. Ibi bizamini ni ngombwa kugira ngo ugumane ibisubizo byawe byiza.

Ni ibihe bintu byongera ibyago byo gukenera carotid endarterectomy?

Ibintu byinshi byongera amahirwe yawe yo kurwara indwara ya carotid artery ishobora gusaba ubu bubagizi. Imyaka ni ikintu cy'ingenzi, ibyago bikiyongera cyane nyuma y'imyaka 65.

Ibintu by'ibanze byongera umubyimbire wa carotid artery birimo:

• Umubyibuho w'amaraso mwinshi wangiza imitsi y'amaraso uko igihe kigenda
• Urugero rwo hejuru rwa cholesterol rutuma habaho imiterere ya plaque
• Diabetes, yihutisha kwangirika kw'imitsi y'amaraso
• Umunyonga, wongera ibyago byawe byo kurwara indwara ya carotid artery
• Amateka y'umuryango y'indwara y'umutima cyangwa stroke
• Umutima wabanje guhagarara cyangwa indwara ya peripheral artery
• Umubyibuho n'imibereho idakora imyitozo ngororamubiri

Kugira ibintu byinshi byongera ibyago byongera amahirwe yo kurwara indwara ikomeye ya carotid artery. Inkuru nziza ni uko ibyinshi muri ibyo bintu bishobora gucungwa hifashishijwe impinduka mu mibereho no gufata imiti.

Ni izihe ngaruka zishobora guterwa na carotid endarterectomy?

Nubwo carotid endarterectomy muri rusange itagira ingaruka, nk'uko bimeze ku kubagwa kwose, ifite ibyago bimwe na bimwe. Ingaruka ikomeye ishobora guterwa ni sitiroki, ibaho ku bagera kuri 1-3% b'abarwayi.

Izindi ngaruka zishobora guterwa, nubwo zitamenyerewe, zirimo:

• Umutima watewe n'umuvuduko wo kubagwa
• Gusohoka kw'amaraso cyangwa gukorwa kw'amaraso ahakorewe kubagwa
• Udukoko twateye igikomere, akenshi kivurwa na antibiyotike
• Ukwangirika kw'imitsi bitera impinduka z'ijwi ry'agateganyo cyangwa rihoraho
• Kugorana kw'agateganyo kumeza cyangwa intege nke mu maso
• Impinduka z'umuvuduko w'amaraso zisaba guhindura imiti

Inyinshi mu ngaruka ziba z'agateganyo kandi zikavaho mu byumweru cyangwa amezi. Itsinda ry'abaganga bakora kubagwa bafata ingamba zikomeye zo kugabanya ibyo byago, kandi inyungu zikunze kurenga kure ingaruka zishobora guterwa.

Ingaruka zitamenyerewe zirimo gufatwa n'ibihungabanyo cyangwa impinduka mu bitekerezo, ariko ibyo bigira ingaruka ku barenze 1% by'abarwayi. Umuganga ukubaga azaganira ku byago byawe byihariye mbere yo gukora icyo gikorwa.

Ni ryari nkwiriye kubona umuganga nyuma ya carotid endarterectomy?

Ugomba guhita uvugana n'umuganga wawe niba ubonye ibimenyetso bya sitiroki nyuma yo kubagwa. Ibyo birimo intege nke zidasanzwe, gucika intege, urujijo, kugorana kuvuga, cyangwa kubabara umutwe cyane.

Ibindi bimenyetso byo kwitondera bisaba ubufasha bwihuse bw'abaganga birimo:

• Gusohoka kw'amaraso cyangwa kubyimba cyane ahakorewe kubagwa
• Ibimenyetso by'indwara nka umuriro, kurushaho kubabara, cyangwa gushyira uruhu ku gikomere
• Impinduka zidasanzwe mu iyerekwa cyangwa isereri
• Kugorana guhumeka cyangwa kubabara mu gituza
• Kubabara cyane mu ijosi cyangwa gukakara
• Gucika intege gushya cyangwa kuribwa mu maso cyangwa mu ngingo zawe

Mugihe cyo gukurikiranwa buri gihe, mubisanzwe muzabona umuganga wabagishije mu gihe cy'icyumweru kimwe cyangwa bibiri nyuma yo kubagwa. Isuzuma risanzwe hamwe n'ibizamini bya ultrasound bikunze gutegurwa nyuma y'amezi 6, hanyuma buri mwaka kugirango hakurikiranwe imitsi yawe.

Ntimugahagarike umutima kubera kutumva neza, gukomeretsa, cyangwa kubyimba guto - ibi ni ibisanzwe mugihe cyo gukira. Mu gihe ushidikanya, burigihe biruta guhamagara ikipe yawe y'ubuvuzi ufite ibibazo.

Ibibazo bikunze kubazwa kuri carotid endarterectomy

Q.1 Ese carotid endarterectomy ni nziza mu gukumira sitiroko?

Yego, carotid endarterectomy ifite akamaro kanini mu gukumira sitiroko kubantu bakwiye. Ubushakashatsi burerekana ko bigabanya ibyago bya sitiroko nka 50% kubantu bafite imitsi ya carotid ifunganye cyane.

Kubagwa bifitiye akamaro kanini abantu bafite 70% cyangwa kurenza ifungana ry'imitsi ya carotid, cyane cyane niba baragize sitiroko ntoya. Kubantu bafite ifungana riringaniye (50-69%), inyungu ni ntoya ariko ziracyakomeye mubihe bimwe.

Q.2 Ese ifungana ry'imitsi ya carotid burigihe ritera ibimenyetso?

Oya, ifungana ry'imitsi ya carotid akenshi ritera ibimenyetso bitagaragara. Abantu benshi bafite ibibazo bikomeye bimenyekana gusa mugihe cyo gukorerwa ibizamini by'ubuvuzi bisanzwe cyangwa ibizamini byerekana impamvu zindi.

Iyo ibimenyetso bibayeho, mubisanzwe birimo sitiroko ntoya hamwe n'intege nke z'agateganyo, gucika intege, impinduka zo kureba, cyangwa kugorana kuvuga. Ariko, ikimenyetso cya mbere rimwe na rimwe gishobora kuba sitiroko ikomeye, niyo mpamvu gupima bifitiye akamaro abantu bafite ibyago byinshi.

Q.3 Bifatira igihe kingana iki gukira nyuma ya carotid endarterectomy?

Abantu benshi bashobora gusubira mubikorwa byoroheje muminsi mike kandi bagasubira mubikorwa bisanzwe muminsi 2-4. Gukira neza kw'igikomere mubisanzwe bifata ibyumweru 4-6.

Bizagusaba kwirinda kuzamura ibiremereye (birenze ibiro 4.5) mu byumweru 2 kandi ntugomba gutwara imodoka kugeza muganga abikwemereye, akenshi mu cyumweru kimwe. Abantu benshi bumva basubiye ku rwego rwabo rusanzwe rw'imbaraga nyuma y'ukwezi kumwe bavuye mu kubagwa.

Q.4 Ese indwara ya carotid artery ishobora kugaruka nyuma yo kubagwa?

Indwara ya carotid artery ishobora kugaruka, ariko ntibisanzwe mu myaka mike nyuma yo kubagwa. Abantu bagera kuri 10-20% bashobora kongera kugira ubugufi mu myaka 10-15.

Ibi nibyo bituma impinduka z'imibereho n'imiti yo kugenzura ibintu byongera ibyago nka umuvuduko ukabije w'amaraso na cholesterol ari ngombwa cyane nyuma yo kubagwa. Kugenzura buri gihe hamwe n'ibizamini bya ultrasound bifasha kumenya ibibazo hakiri kare.

Q.5 Ese hari ubundi buryo bwo kuvura carotid endarterectomy?

Yego, carotid artery stenting ni uburyo bundi aho umuyoboro muto w'urudodo ushyirwa imbere mu muyoboro w'amaraso kugirango ukomeze gufunguka. Ibi bikorwa binyuze mu gukomeretsa gato mu gatuza aho gukorerwa kubagwa mu ijosi.

Muganga wawe ahitamo hagati yo kubagwa na stenting bitewe n'imyaka yawe, ubuzima muri rusange, imiterere y'umubiri, n'ibintu byongera ibyago byihariye. Uburyo bwombi burakora neza, ariko kubagwa bikunda gukundwa nabantu benshi, cyane cyane abari munsi y'imyaka 75.