Ho buuoa ka methapo ea Carotid - ho bulehile

Ho buuoa ka methapo ea Carotid ke mokhoa oa ho phekola lefu la methapo ea carotid.

Mothapo oa carotid o tlisa mali a hlokahalang bokong le sefahlehong sa hau. U na le e 'ngoe ea methapo ena ka lehlakoreng le leng la molala oa hau. Phallo ea mali mothapong ona e ka koaloa kapa ea koaloa ka botlalo ke mafura a bitsoang plaque. Sena se ka fokotsa phepelo ea mali bokong ba hau mme sa baka stroke.

Ho buuoa ka methapo ea Carotid ho etsoa ho khutlisetsa phallo e nepahetseng ea mali bokong. Ho na le mekhoa e 'meli ea ho phekola methapo ea carotid e nang le leqhoa ho eona. Sengoliloeng sena se bua haholo ka opereishene e bitsoang endarterectomy. Mokhoa o mong o bitsoa angioplasty e nang le stent placement.

Nakong ea endarterectomy ea carotid:

• U fumana thethebatso e akaretsang. O robetse mme ha o na bohloko. Lipetlele tse ling li sebelisa anesthesia ea lehae. Ke karolo ea 'mele oa hau e sebetsoang feela e thatafalitsoeng ke moriana hore o se utloe bohloko. Hape o fuoa moriana ho u thusa ho phutholoha.
• U robala ka mokokotlo tafoleng ea ts'ebetso hlooho e shebile ka lehlakoreng le leng. Lehlakore leo mothapo oa hau oa carotid o koetsoeng o lutse lifahleho holimo.
• Ngaka e buoang e seha molala oa hau holim'a methapo ea hau ea carotid. Phala e tenyetsehang (catheter) e kenngoa mothapong. Mali a phalla ka har'a catheter ho potoloha sebaka se koetsoeng nakong ea ts'ebetso.
• Mothapo oa hau oa carotid oa buloa. Ngaka e buoang e tlosa lejoe le ka har'a mothapo.
• Ka mor'a hore letlapa le tlosoe, mothapo o koaloa ka lithupa. Mali hona joale a phalla ka har'a mothapo ho ea bokong ba hau.
• Mosebetsi oa hau oa pelo o tla shebeloa haufi-ufi nakong ea ho buuoa

Ho buuoa ho nka lihora tse ka bang 2. Kamora ts'ebetso, ngaka ea hau e ka etsa tlhahlobo ho netefatsa hore mothapo o butsoe.

Tsamaiso ena e etsoa haeba ngaka ea hau e fumane ho khutsufala kapa ho koala methapong ea hau ea carotid. Mofani oa hao oa tlhokomelo ea bophelo o tla be a entse tlhahlobo e le 'ngoe kapa tse' maloa ho bona hore na mothapo oa carotid o koetsoe hakae.

Phekolo ea ho tlosa sehahi ka har'a mothapo oa hau oa carotid e kanna ea etsoa haeba mothapo o patisane ka ho feta 70%.

Haeba u kile ua ba le setorouku kapa kotsi ea nakoana ea boko, mofani oa hau o tla nahana hore na ho phekola methapo ea hau e koetsoeng ka ho buuoa ho bolokehile ho uena.

Mekhoa e meng ea kalafo eo mofani oa hau a tla e tšohla le uena ke:

• Ha ho kalafo, ntle le liteko tsa ho hlahloba methapo ea hau ea carotid selemo se seng le se seng.
• Meriana le lijo ho theola k'holeseterole ea hau.
• Meriana e fokotsang mali ho theola menyetla ea ho tšoaroa ke setorouku. E meng ea meriana ena ke aspirin, clopidogrel (Plavix), dabigatran (Pradaxa), le warfarin (Coumadin).

Carotid angioplasty le stenting li kanna tsa sebelisoa ha carotid endarterectomy e sa bolokehe.

Likotsi tsa anesthesia ke:

• Matšoao a alejiki meriana
• Mathata a phefumolohang

Likotsi tsa ho buuoa ka carotid ke:

• Ho koala mali kapa ho tsoa mali bokong
• Tšenyo ea boko
• Lefu la pelo
• Thibelo e eketsehileng ea mothapo oa carotid ha nako e ntse e tsamaea
• Ho oa
• Leqeba
• Ho ruruha haufi le tsela ea hau ea moea (tube eo u phefumolohang ka eona)
• Tšoaetso

Mofani oa hau o tla etsa tlhahlobo e phethahetseng ea 'mele le ho odara liteko tse' maloa tsa bongaka.

Bolella mofani oa hau hore na ke meriana efe eo u e nkang, esita le meriana, litlatsetso, kapa litlama tseo u li rekileng ntle le lengolo la ngaka.

Nakong ea libeke tse 2 pele u etsoa opereishene:

• Matsatsi a 'maloa pele ho opereishene, ho ka' na ha hlokahala hore u khaotse ho sebelisa lithethefatsi tse fokotsang mali. Tsena li kenyelletsa aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), naprosyn (Aleve, Naproxen), le lithethefatsi tse ling tse kang tsena.
• Botsa mofani oa hau hore na ke meriana efe eo u lokelang ho e nka ka letsatsi la ts'ebetso ea hau.
• Haeba u tsuba, u lokela ho emisa. Botsa mofani oa hau thuso ea ho tlohela.
• Bolella mofani oa hau ka sefuba, feberu, feberu, lefu la herpes, kapa bokuli bo bong boo u ka bang le bona pele u etsoa opereishene.

Latela litaelo tsa hore na u khaotse ho ja le ho noa neng pele u etsoa opereishene.

Letsatsing la ho buuoa:

• Nka meriana efe kapa efe eo mofani oa hau a u laetseng eona ka ho noa metsi hanyane.
• Latela litaelo tsa hore na u fihle sepetlele neng. Etsa bonnete ba hore o fihla ka nako.

U kanna ua ba le sekotlo molaleng oa hau se kenang molemong oa hau. E tla tsoa mokelikeli o hahang sebakeng seo. E tla tlosoa pele ho letsatsi.

Kamora ho buuoa, mofani oa hau a ka batla hore u lule sepetlele bosiu bo le bong e le hore baoki ba ka o shebella bakeng sa matšoao afe kapa afe a ho tsoa mali, ho hlaseloa ke lefu, kapa phallo e mpe ea mali bokong ba hau. U kanna oa khona ho khutlela hae ka lona letsatsi leo haeba ts'ebetso ea hau e entsoe hoseng 'me u ntse u sebetsa hantle.

Latela litaelo tsa hore na u ka itlhokomela joang lapeng.

Ho buuoa ka methapo ea Carotid ho ka thusa ho theola monyetla oa ho ba le stroke. Empa o tla hloka ho etsa liphetoho tseleng eo u phelang ka eona ho thusa ho thibela ho bokellana ha lejoe, ho koaloa ha mali le mathata a mang methapong ea hau ea carotid ha nako e ntse e tsamaea. U kanna ua hloka ho fetola tsela eo u jang ka eona 'me u qale lenaneo la boikoetliso, haeba mofani oa hau au joetsa hore boikoetliso bo bolokehile bakeng sa hau. Ho bohlokoa hape ho emisa ho tsuba.

Carotid endarterectomy; Ho buuoa ka CAS; Carotid artery stenosis - ho buuoa; Endarterectomy - mothapo oa carotid

• Ho beoa ha Angioplasty le stent - mothapo oa carotid - ho tsoa
• Lithethefatsi tsa antiplatelet - P2Y12 inhibitors
• Aspirin le lefu la pelo
• Botoro, majarine le oli ea ho pheha
• Ho buuoa ka methapo ea Carotid - ho tsoa
• Cholesterol le mokhoa oa bophelo
• Cholesterol - kalafo ea lithethefatsi
• Ho laola khatello ea mali e phahameng
• Ho hlalositsoe mafura a phepo
• Malebela a lijo tse potlakileng
• Mokhoa oa ho bala mangolo a lijo
• Lijo tsa Mediterranean
• Stroke - ho tsoa
• Tlhokomelo ea leqeba la ho buoa - e bulehile

• Carotid stenosis - X-ray ea methapo ea letsohong le letšehali
• Carotid stenosis - X-ray ea mothapo o nepahetseng
• Ho lla ha methapo ea methapo ea ka hare ea carotid
• Atherosclerosis ea methapo ea ka hare ea carotid
• Ho haha ​​matlapa
• Ho buuoa ka methapo ea Carotid - letoto la lihlooho

Arnold M, Perler BA. Carotid endarterectomy. Ka: Sidawy AN, Perler BA, bahlophisi. Rutherford's Vasculry and Endovascular Therapy. La 9th. Philadelphia, PA: Elsevier; 2019: khaolo ea 91.

Moahloli J, Ruland S, Schneck MJ. Lefu la Ischemic cerebrovascular. Ho Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, lingoloa. Neurology ea Bradley ho Tloaelo ea Bongaka. La 7th. Philadelphia, PA: Elsevier; 2016: khaolo ea 65.

Brott TG, Halperin JL, Abbara S, le al. 2011 ASA / ACCF / AHA / AANN / AANS / ACR / ASNR / CNS / SAIP / SCAI / SIR / SNIS / SVM / SVS tataiso mabapi le taolo ea bakuli ba nang le lefu la methapo ea methapo ea methapo ea methapo: kakaretso ea phethahatso: tlaleho ea Amerika College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines, le American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, Mokhatlo oa Amerika oa Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Ho nahanisisa le ho Thibela, Mokhatlo oa Phekolo ea Metsing le Mekhoa ea Metsing, Mokhatlo oa Radiology ea Ts'ebetso, Mokhatlo oa NeuroInterventional Surgery, Mokhatlo oa Vascular Medicine le Mokhatlo oa Phekolo ea Vascular. E thehiloe ka ts'ebelisano le American Academy of Neurology le Society of Cardiovascular Computed Tomography. Catheter Cardiovasc Nako. 2013; 81 (1): E76-E123. PMID: 23281092 phatlalalitsoe.ncbi.nlm.nih.gov/23281092/.

Brott TG, Howard G, Roubin GS le ba bang. Liphetho tsa nako e telele tsa stenting le endarterectomy bakeng sa carotid-artery stenosis. N Engl J Med. 2016; 374 (11): 1021-1031. PMID: 26890472 e fetotsoe.ncbi.nlm.nih.gov/26890472/.

Holscher CM, Abularrage CJ. Carotid endarterectomy. Ka: Cameron AM, Cameron JL, bahlophisi. Phekolo ea Hajoale ea Ts'ebetso. 13th ed. Philadelphia, PA: Elsevier; 2020: 928-933.