Ni iki Angioplasty ya Koronari na Stents? Intego, Uburyo & Ibivamo

Angioplasty ya koronari ni uburyo butagoye bwo gufungura imitsi y'umutima yazibye cyangwa yagabanutse ikoresheje agasimba gato. Mu gihe cy'ubwo buryo, abaganga bakunze gushyiraho agati gato k'umuyoboro witwa stent kugira ngo bagumane umuyoboro ufunguye igihe kirekire. Ubu buvuzi bufasha gusubiza amaraso mu mikaya y'umutima wawe, kugabanya ububabare mu gituza no kugabanya ibyago byo guhura n'umutima.

Ni iki angioplasty ya koronari?

Angioplasty ya koronari ni uburyo bwagura imitsi y'umutima yagabanutse idakoresheje kubaga. Muganga wawe ashyiraho umuyoboro muto ufite agasimba katuzuye ku mpande zawo unyuze mu muyoboro w'amaraso mu kuboko kwawe cyangwa mu gatuza. Agasimba noneho karuzurwa ahantu hazibye kugira ngo gashyireho ibinure ku rukuta rw'umuyoboro, bikongera umwanya w'amaraso yo gutembera.

Ijambo ry'ubuvuzi ry'ubu buryo ni percutaneous coronary intervention, cyangwa PCI muri make. Tekereza nk'uko usukura umuyoboro wazibye, usibye ko

Nubwo bimeze bityo, muganga wawe w’umutima azatekereza ibintu byinshi mbere yo kugusaba gukorerwa angioplasty:

• Aho ibiziba byawe biherereye n'uburemere bwabyo
• Imikorere y'umutima wawe muri rusange n'ubuzima bwawe
• Uburyo witwara ku miti
• Ibimenyetso byawe n'imibereho yawe
• Niba urimo kugira umutima utera cyane

Mu bihe by'ubutabazi nk'uko umutima utera cyane, angioplasty ishobora kurokora ubuzima mu buryo bwo gufungura vuba umutsi wazibye rwose. Ku bibazo bitajegajega, akenshi bitekerezwa iyo imiti n'imibereho y'ubuzima idatanga ihumure rihagije ku bimenyetso.

Ni iki angioplasty ikora ku mutima?

Uburyo bwa angioplasty busanzwe bufata iminota 30 kugeza ku masaha 2, bitewe n'uburyo ibiziba byawe bikomeye. Uzaba uri maso ariko waruhutse mu gihe cy'uburyo, uryamye ku meza yihariye mu laboratori ya catheterization y'umutima ifite imashini za X-ray.

Itsinda ryawe ry'abaganga rizatangira no gukubita agace aho bazashyira catheter, akenshi urushyi rwawe cyangwa itako ryawe ryo hejuru. Nyuma yo gukora umwobo muto, bazashyira umuyoboro woroshye, woroshye witwa catheter mu mitsi yawe y'amaraso ukageza ku mutima wawe. Irangi ryihariye riterwa muri catheter kugira ngo imitsi yawe igaragarire neza ku mashusho ya X-ray.

Reka dusobanure ibizaba bikurikira muri angioplasty nyayo:

1. Muganga wawe ayobora catheter ya balloon ahantu hazibye
2. Balloon irahaguruka kugira ngo ikande plaque ku rukuta rw'umutsi
3. Balloon iramanuka kandi ishobora kongera guhaguruka niba bibaye ngombwa
4. Stent akenshi ishyirwaho kugira ngo umutsi ugume ufunguye
5. Ibikoresho byose bikurwaho neza
6. Igitsure gishyirwaho kugira ngo gishimangire ahantu hashyizweho

Mugihe cyo kuzamura baluni, ushobora kumva umuvumo mu gituza cyangwa kutumva neza mu masegonda make. Ibi ni ibisanzwe kandi bivuze ko uburyo burimo gukora kugirango bukingure umutsi wawe. Itsinda ryawe ry’abaganga rizakurikirana umuvuduko w'umutima wawe n'umuvuduko w'amaraso mu gihe cyose cy'inzira.

Ni gute witegura angioplasty yawe ya koronari?

Kwitegura angioplasty mubisanzwe bitangira iminsi mike mbere y'inzira yawe. Muganga wawe azasuzuma imiti yawe kandi ashobora kukubwira guhagarika gufata imiti imwe n'imwe ituma amaraso atinda cyangwa imiti ya diyabete by'agateganyo. Uzakenera kandi gutegura umuntu uzakugeza mu rugo nyuma, kuko ntuzashobora gutwara imodoka byibuze amasaha 24.

Kumurongo w'umunsi mbere y'inzira yawe, mubisanzwe uzakenera guhagarika kurya no kunywa nyuma ya saa sita z'ijoro. Itsinda ryawe ry’abaganga rizagutanga amabwiriza yihariye yerekeye imiti yo gufata hamwe n'amazi make mu gitondo cy'inzira yawe. Niba ufite diyabete, muganga wawe azatanga ubuyobozi bwihariye bwo gucunga isukari yo mu maraso yawe.

Ibi nibyo ushobora kwitega kumunsi wa angioplasty yawe:

• Gusohoka mu bitaro isaha 1-2 mbere y'igihe cyagenwe
• Kwambara ikanzu y'ibitaro no gukuramo imitako
• Guhererana n'umuganga wawe w'ibijyanye n'uburwayi bw'umutima
• Gushyiraho umurongo wa IV kubijyanye n'imiti n'amazi
• Guhabwa imiti yoroheje kugirango igufashe kuruhuka

Itsinda ryawe ry’abaganga rizogosha kandi risukure ahantu bazashyira catheter. Ntugire impungenge zo kumva uhangayitse - ibi ni ibisanzwe rwose, kandi abaforomo bawe bafite uburambe bwo gufasha abarwayi kumva bameze neza kandi bamenyeshejwe mu gihe cyose cy'inzira.

Ni gute usoma ibisubizo byawe bya angioplasty ya koronari?

Ibyavuye mu gikorwa cyo gukora angioplasty bikunze gupimwa hashingiwe ku buryo icyo gikorwa cyagutse imitsi yawe yari yazibye. Abaganga bagamije kugira ngo nyuma y'igikorwa, imitsi itazibwa ku kigero cya 20%, bivuze ko umutsi wawe ukwiye kuba ufunguye nibura ku kigero cya 80%. Muganga wawe w'umutima azakwereka amashusho yerekana mbere na nyuma y'igikorwa, agaragaza neza uko imikorere y'amaraso yateye imbere.

Urwego rwo gutsinda rwa angioplasty muri rusange rurashimishije cyane. Ibikorwa byinshi bigeraho intsinzi yihuse mu by'ikoranabuhanga, bivuze ko iziba rifungurwa neza kandi imikorere y'amaraso igasubizwa. Muganga wawe azapima kandi ikintu cyitwa TIMI flow, gipima uko amaraso atembera neza mu mutsi wawe ku gipimo kuva kuri 0 kugeza kuri 3, aho 3 ari imikorere isanzwe.

None se ibi bisobanuye iki kuri wowe? Dore ibimenyetso by'ingenzi ikipe yawe y'abaganga izakurikiza:

• Kuvana vuba mu gituza cyangwa umuvundo
• Imikorere y'amaraso yateye imbere igaragara ku mashusho ya X-ray
• Umutima ukora neza mu gihe cy'igikorwa no nyuma yacyo
• Umubare usanzwe w'amaraso na ogisijeni
• Gushyirwaho neza kwa stent niba yakoreshejwe

Muganga wawe w'umutima azaganira kuri ibi byavuye mu gikorwa nawe nyuma gato y'igikorwa. Bazagusobanurira icyo amashusho agaragaza n'uburyo ubuvuzi bugomba guteza imbere ibimenyetso byawe n'ubuzima bw'umutima bw'igihe kirekire. Abarwayi benshi bamenya ko ibimenyetso bigabanuka mu minsi cyangwa mu byumweru nyuma ya angioplasty yagenze neza.

Ni gute wakomeza ubuzima bw'umutima wawe nyuma ya angioplasty?

Gukomeza ubuzima bw'umutima wawe nyuma ya angioplasty bisaba uruvange rw'imiti, impinduka mu mibereho, n'ubuvuzi buhoraho. Muganga wawe azandika imiti igabanya amaraso kugira ngo yirinde ko amaraso avurirana akora hafi ya stent yawe, kandi ibi ni ngombwa ku mutekano wawe. Ntukigere uhagarika iyi miti utabanje kubaza muganga wawe w'umutima.

Impinduka mu mibereho bifite uruhare rungana mu kugera ku ntego yawe y'igihe kirekire. Umutima wawe uzungukirwa n'imirire yuzuye imbuto, imboga, ibinyampeke byuzuye, na poroteyine zidakungahaye ku mavuta mu gihe ugabanya amavuta yuzuye, umunyu, n'ibiryo bitunganyirijwe mu nganda. Imyitozo ngororamubiri ya buri gihe, nk'uko byemejwe na muganga wawe, bifasha gukomeza umutima wawe no kunoza imikorere y'amaraso mu mubiri wawe.

Reka dusesengure intambwe z'ingenzi zo gukira neza no kugira ubuzima bwiza bw'igihe kirekire:

1. Fata imiti yose wandikiwe neza nk'uko byategetswe
2. Witabe gahunda zose zo gukurikiranwa na muganga wawe w'umutima
3. Kurikiza gahunda y'imirire yita ku mutima
4. Wongere buhoro buhoro imyitozo ngororamubiri nk'uko byasabwe
5. Reka itabi burundu niba utararireka
6. Gucunga umunabi ukoresheje uburyo bwo kuruhuka cyangwa kujya inama
7. Gukurikirana no kugenzura umuvuduko w'amaraso, kolesteroli, na diyabete

Itsinda ryawe ry'abaganga rizakorana nawe kugira ngo bakore gahunda yihariye ijyanye n'imibereho yawe n'ibyo ukeneye mu buzima. Abarwayi benshi basanga gahunda zo kuvura indwara z'umutima zitanga ubufasha n'ubuyobozi bwiza mu gihe cyo gukira kwabo.

Ni ibihe bintu byongera ibyago byo gukenera coronary angioplasty?

Ibintu byinshi byongera ibyago byo kurwara indwara z'imitsi y'umutima bishobora gusaba angioplasty. Bimwe muri ibyo bintu ushobora kubicunga ukoresheje amahitamo yawe mu mibereho, mu gihe ibindi bifitanye isano n'imiterere yawe cyangwa indwara uvukanye. Kumva ibyo byago bifasha gufata ibyemezo bifitiye akamaro ku buzima bw'umutima wawe.

Ibintu byongera ibyago bishobora guhinduka ni byo ufite ubushobozi bwo guhindura cyangwa kunoza. Umuvuduko mwinshi w'amaraso, kolesteroli nyinshi, diyabete, kunywa itabi, umubyibuho ukabije, n'imibereho idakora imyitozo ngororamubiri byose bituma habaho kwiyongera kw'ibice by'amavuta mu miyoboro y'amaraso yawe. Umunabi uhoraho n'imico mibi yo gusinzira na byo bishobora kugira ingaruka ku buzima bw'umutima wawe uko igihe kigenda.

Dore ibintu byongera ibyago by'ingenzi muganga wawe azatekereza:

• Amateka y'umuryango y'indwara z'umutima, cyane cyane mbere y'imyaka 65
• Umubyimba mwinshi w'amaraso (140/90 mmHg cyangwa hejuru)
• Urugero rwo hejuru rwa cholesterol ya LDL (irenze 100 mg/dL)
• Indwara ya diyabete cyangwa mbere ya diyabete
• Umunywi w'itabi cyangwa wahoze urinywa
• Umubyibuho ukabije, cyane cyane hafi y'ikibuno
• Imyaka (abagabo barengeje 45, abagore barengeje 55)
• Indwara ya kronike y'impyiko
• Amateka y'izindi ndwara z'imitsi

Kugira kimwe cyangwa byinshi mu bintu biteza ibyago ntibisobanura ko uzakenera angioplasty, ariko byongera amahirwe yo kurwara indwara y'imitsi y'umutima. Inkuru nziza ni uko gukemura ibintu biteza ibyago bishobora guhinduka bishobora kugabanya cyane ibyago byawe kandi bishobora kwirinda gukenera uburyo nk'ubwa angioplasty.

Ni izihe ngaruka zishobora guterwa na coronary angioplasty?

Nubwo coronary angioplasty muri rusange itekanye kandi ikora neza, kimwe n'ubundi buryo bwo kuvura, ifite ibyago bimwe. Ibyago bikomeye ni bikeya, bibaho muri 2% by'uburyo bukoreshwa, ariko ni ngombwa gusobanukirwa icyashobora kubaho. Itsinda ryawe ry'abaganga rifata ingamba zikomeye zo kugabanya ibyo byago.

Ingaruka ntoya zisanzwe zirimo kuva amaraso cyangwa gukomeretsa ahantu hashyizweho catheter, akenshi bikemuka mu minsi mike. Abantu bamwe barwara ibibazo by'igihe gito cyangwa kubabara aho catheter yashyizwe. Mu buryo butavugwa, abarwayi bashobora kugira allergie ku rangi rikoreshwa mugihe cyo kuvura.

Dore ingaruka zishobora kubaho, kuva ku ntoya kugeza ku zikomeye:

• Kuva amaraso cyangwa hematoma ahantu hashyizweho
• Gukomeretsa cyangwa kubabara bimara iminsi myinshi
• Allergie ku rangi rikoreshwa
• Ibibazo by'impyiko by'igihe gito biturutse ku rangi rikoreshwa
• Ukwangirika cyangwa gutoboka kw'umutsi mugihe cyo kuvura
• Amabara y'amaraso akora hafi ya stent
• Umutima guhagarara gukora mugihe cyo kuvura (gake cyane)
• Umutsi wo mu bwonko (gake cyane)
• Gukenera kubagwa byihutirwa (birenze 1%)

Itsinda ryawe ry'abaganga rigukurikiranira hafi mu gihe cy'igikorwa no nyuma yacyo kugira ngo bamenye ibibazo byose hakiri kare. Abantu benshi ntibagira ibibazo na gato kandi barakira neza. Niba ugize ibimenyetso bidasanzwe nyuma y'igikorwa cyawe, ntugatinye guhita uvugana n'umuganga wawe.

Ni ryari nkwiriye kubona umuganga nyuma yo gukorerwa angioplasty ya coronary?

Ugomba guhita uvugana n'umuganga wawe niba wumva ububabare mu gituza bumeze nk'ubwo wari ufite mbere ya angioplasty yawe. Nubwo kutumva neza guto ahantu bashyizeho ibikoresho bisanzwe, ububabare bushya cyangwa bukomeye mu gituza bushobora kwerekana ikibazo kuri stent yawe cyangwa inzitizi nshya. Ntuzategereze ngo urebe niba ibimenyetso bizivana.

Ibindi bimenyetso byo kwitondera bisaba ubufasha bwihuse bw'abaganga, cyane cyane mu byumweru bike bya mbere nyuma y'igikorwa cyawe. Ibi birimo guhumeka nabi bidasanzwe, kuribwa umutwe, kugwa igihumure, cyangwa umutima utera cyane. Ibibazo ahantu bashyizeho ibikoresho, nk'amaraso menshi, ububabare bukomeza, cyangwa ibimenyetso by'ubwandu, nabyo bisaba isuzuma ryihuse.

Vugana n'umuganga wawe ako kanya niba wumva kimwe muri ibi bimenyetso:

• Ububabare mu gituza cyangwa umuvundo bimara iminota irenga mike
• Kutumva neza mu guhumeka gushya cyangwa gukomeza
• Kuribwa umutwe, kumva umutwe cyangwa kugwa igihumure
• Umutima utera cyane cyangwa utagenda neza
• Urugimbu cyangwa kuruka hamwe no kutumva neza mu gituza
• Ububabare bugera mu kuboko kwawe, mu ijosi cyangwa mu ruhanga
• Amara akomeye ava ahantu bashyizeho ibikoresho
• Ibimenyetso by'ubwandu nk'umuriro, umutuku, cyangwa gushyuha
• Ububabare bukomeye cyangwa kubyimba ahantu bashyizeho catheter

Kugira ngo ukurikiranwe buri gihe, umuganga wawe w'umutima azagusura mu cyumweru kimwe cyangwa bibiri nyuma y'igikorwa cyawe. Izi gahunda ni ngombwa kugira ngo ukurikirane imikoreshereze yawe no guhindura imiti niba bibaye ngombwa. Kugenzura buri gihe bifasha kureba ko stent yawe ikora neza kandi umutima wawe ugakomeza kugira ubuzima bwiza mu gihe kirekire.

Ibibazo bikunze kwibazwa ku bijyanye na angioplasty na stents ya coronary

Q.1 Ese angioplasty ya coronary ni nziza mu gukumira indwara z'umutima?

Yego, angioplasty ya coronary ishobora kugira akamaro kanini mu gukumira indwara z'umutima, cyane cyane mu bihe bimwe na bimwe. Niba urwaye indwara y'umutima ikomeye, angioplasty yihutirwa ishobora kurokora ubuzima mu buryo bwo gufungura vuba umutsi wazibye no kugabanya kwangirika kw'imitsi y'umutima wawe. Ubushakashatsi bwerekana ko ubu buvuzi bwihutirwa butuma ubuzima bwiyongera cyane kandi imikorere y'umutima igahoraho.

Ku ndwara ya coronary artery idahinduka, angioplasty ifasha cyane mu kugabanya ibimenyetso nk'ububabare mu gituza no guhumeka bigoranye. Nubwo bishobora kugabanya ibyago byo kurwara indwara z'umutima mu gihe kizaza, cyane cyane niba ufite inzitizi zikomeye, ubu buryo bukora neza iyo buhuriye n'imiti no guhindura imibereho. Muganga w'umutima wawe azagufasha kumenya niba angioplasty ari uburyo bwiza bwo gukumira indwara mu bihe byawe byihariye.

Q.2 Ese kugira stent bitera ingaruka zirambye?

Abantu benshi bafite stents babaho ubuzima busanzwe, bwiza nta ngaruka zirambye. Stents zigezweho zitanga imiti zagenewe guhuza neza n'urukuta rw'umutsi wawe kandi zigabanya cyane ibyago byo kongera kwaguka kw'umutsi. Imiti ikora kuri izi stents ifasha gukumira uruhu rwo mu mubiri rwohereza imbere y'igikoresho.

Ariko, uzakenera gufata imiti ituma amaraso ataguma, mubisanzwe byibuze umwaka umwe nyuma yo gushyiraho stent. Mu buryo butavugwa, abarwayi bamwe bashobora guteza in-stent restenosis, aho umutsi wongera kwaguka imbere cyangwa hirya ya stent. Ibi bibaho munsi ya 10% by'ibihe hamwe na stents zigezweho kandi mubisanzwe birashobora kuvurwa neza niba bibaye.

Q.3 Stents za coronary zimara igihe kingana iki?

Utwuma twa koronari bigenewe kuba turambye kandi akenshi tumara ubuzima bwose iyo dushyizwe neza. Utwuma twinjira mu rukuta rw'umutsi wawe mu mezi make, mu by'ukuri bigahinduka igice cy'iteka ry'imitsi yawe y'amaraso. Bitandukanye n'ibikoresho bimwe na bimwe by'ubuvuzi, utwuma ntigashira cyangwa ngo dusimburwe mu bihe bisanzwe.

Ibyo bivuzwe, indwara ya koronari irashobora gukomeza mu tundi duce tw'imitsi y'amaraso y'umutima wawe. Mugihe ahantu hashyizwe utwuma akenshi haguma hafunguye, inzitizi nshya zirashobora kuza mu bice bitandukanye nyuma y'igihe. Iyi niyo mpamvu gukomeza imiti, impinduka z'imibereho, no kwitabwaho buri gihe bikomeza kuba by'ingenzi mu buzima bwawe bwose.

Q.4 Nshobora gukora imyitozo isanzwe nyuma yo gushyirwaho utwuma?

Yego, abantu benshi barashobora gusubira mu myitozo isanzwe n'ibikorwa bya fisik nyuma yo gukira gushyirwaho utwuma. Mubyukuri, gukora imyitozo ngororamubiri buri gihe birashishikarizwa cyane nk'igice cy'imibereho yawe ifitiye umutima ubuzima bwiza. Abarwayi benshi basanga bashobora gukora cyane nyuma ya angioplasty kuko imiyoborere yabo y'amaraso yateye imbere igabanya kubabara mu gituza no guhumeka nabi mugihe cy'imyitozo.

Muganga wawe azatanga amabwiriza yihariye yerekeye igihe n'uburyo bwo gusubukura imyitozo, akenshi batangira n'ibikorwa byoroheje muminsi mike hanyuma bakagenda bongera imbaraga nyuma y'ibyumweru byinshi. Abarwayi benshi bungukira muri gahunda za reabilitasiyo y'umutima, zitanga imyitozo yagenzurwa n'uburezi bujyanye n'imibereho ifitiye umutima ubuzima bwiza ahantu hizewe kandi hagenzurwa.

Q.5 Nzakeneye kongera gukora angioplasty mu gihe kizaza?

Abarwayi benshi ntibakeneye kongera gukora angioplasty ahantu hamwe hashyizwe utwuma. Utwuma twa none dutanga imiti twagabanije cyane gukenera kongera gukora imirimo, hamwe n'amanota yo gutsinda akomeza kuba hejuru nyuma y'imyaka myinshi yo gushyirwaho. Ariko, indwara ya koronari irashobora gukomeza nyuma y'igihe, ishobora gusaba kuvura inzitizi nshya mumitsi itandukanye.

Uburyo wifata mu gihe kizaza biterwa cyane n'uburyo ucunga ibintu byongera ibyago nyuma yo gukorerwa angioplasty. Gufata imiti uko yategetswe, kugira imibereho myiza y'umutima, kugenzura umuvuduko w'amaraso na kolesteroli, no kwirinda itabi bifasha mu kwirinda ko ubundi buziba bushya. Kuguma ukurikirana na muganga wawe w'umutima bifasha kumenya ibibazo bishya hakiri kare igihe byoroshye kuvurwa.