I-carotid stenosis igxilile imishanguzo yangaphakathi ye-carotid, le mibhoshongo emibili entanyeni ehlinzeka ingxenye enkulu kunazo zonke zegazi ebuchosheni.
Izimpawu, Izimbangela Nokuxilongwa Kwe-Carotid Stenosis
I-carotid artery stenosis ingabangela ukuvinjelwa kwesikhashana kokugeleza kwegazi ezindaweni ezithile zobuchopho, kubonakale njengokushaywa kwe- mini noma ukuhlaselwa kwe-ischemic okungapheli (TIAs.) Nokho, iningi labantu abane-carotid stenosis abakutholi izimpawu ezivamile noma eziphindaphindiwe, futhi bangase babe engozini ukushaywa ngengozi ngaphandle kwesixwayiso.
Isizathu esivame kakhulu sokuthi i-carotid stenosis i-atherosclerosis, okuyinto enzima ye-arteries. Ukushisa ngokweqile kanye ne-cholesterol ephezulu kungabangela ukuqina kwe-atherosclerosis, nakuba abanye abantu bebhekene nalesi simo kunabanye.
Ukwehliswa kwe-artery carotid kutholakala ngezindlela eziningi, futhi isakhiwo esihle kakhulu i-carotid duplex ultrasound.
Ingabe Udinga Ukwelapha I-Carotid Stenosis?
Uma unomthamo we-carotid umthambo we-stenosis (50-69% ukutholakala kwemithambo ye-carotid) kudingeka uqiniseke ukuthi ulandela eduze nodokotela wakho ukuze uhlole ukuthi kungase kudingeke yini uthole ukwelashwa kokungenela ngesikhathi esithile. isinqumo sokuthi noma udinga ukwelashwa noma ukwelashwa kunzima kangakanani futhi sincike ezintweni eziningana, kuhlanganise nesimo se-arteries kanye nempilo yakho yonke.
Izinketho ezivamile kakhulu zokwelashwa kwe-carotid stenosis
I-Carotid Endarterectomy
Lena inqubo lapho udokotela ohlinzayo esusa khona i-plaque atherosclerotic ebangela ukunciphisa umthambo we-carotid futhi ivimbele ukugeleza kwegazi evamile ngaphakathi komshini we-carotid wangaphakathi ochaphazelekayo.
Izifundo eziningi zithole ukuthi lena yindlela ephephile kakhulu yokwelapha isifo se-carotid stenosis.
Izinkinga ezingenzeka zeCarotid Endarterectomy
Njengokuhlinzwa okuningi, i-carotid endarterectomy inomthelela omncane wegazi nokutheleleka. Ngenxa yokuthi ukuhlinzwa kwenziwa ngaphakathi kwezitsha eziletha igazi ebuchosheni, kukhona nengozi encane yokushaywa yisifo.
Kukhona futhi ingozi yokuba nesifo senhliziyo ngesikhathi noma emva kokuhlinzwa. Lezi zingozi zingaba kakhulu kubantu abathile abanezifo zenhliziyo eziphakeme noma ezinye izifo ezinkulu, ngakho-ke akuwona wonke umuntu omele ukhetho lwe-carotid endarterectomy.
Iningi lezingozi zokuhlinzwa liphansi, ikakhulukazi uma udokotela ohlinzayo ehlangene nalolu hlobo lokuhlinzwa.
Ukwelapha Okungapheli Kwe-Carotid Stenosis: Izinketho ezimbili
Kulolu hlobo lwenqubo, ucingo oluncane olubizwa ngokuthi i-catheter lwama-angiography lufakwe komunye wemithambo yegazi emikhulu emzimbeni futhi iqhubekela kancane emithanjeni yegazi eminingana yonke eya emthini we-carotid lapho i-stenosis, noma ilula khona khona. Lapho lapho, indawo encishisiwe inganconywa noma nge-angioplasty noma i-stenting.
Izinqubo ze-Percutanous zinezinzuzo ezithile ngaphezu kwe-carotid endarterectomy ngoba ayifuni kakhulu, futhi ngoba zingenziwa ngaphansi kwe-anesthesia yendawo. Kodwa-ke, ucwaningo oluningi lubonise ukuthi i-carotid endarterectomy iyindlela evikelekile yeziguli eziningi. Iziningi zezokwelapha zigcina ukwelashwa okungahambi kahle kwe-carotid artery stenosis yeziguli ezineengozi enkulu yokufa kusuka ekuhlinzeni i-carotid endarterectomy.
Iziguli okufanele zithole izindlela zokwelashwa ezihamba ngezinyawo esikhundleni sokuhlinzwa kwe-carotid endarterectomy zihlanganisa iziguli ezinezifo zenhliziyo eziphakeme noma eziye zathola ukwelashwa kwemisebe entanyeni ngesikhathi ukwelashwa komdlavuza.
Iziguli eziye zenziwa ukuhlinzwa kwentamo yangaphambilini zingacatshangelwa ngenqubo ye-percutaneous kune-carotid endarterectomy ukuhlinzwa. Kunezinyathelo ezimbili eziyinhloko zokungenelela okwenziwa okwamanje nge- carotid stenosis :
- I-Carotid Angioplasty : Kule nqubo, i-catheter ye-angiography ine-ballon encane ehlanjululwe ku-tip yayo. Uma i-catheter iqhubekela phambili endaweni yomshini we-carotid lapho i-stenosis ikhona khona, ibhaluni iyakhuphuka kancane futhi ibangele izingxenye ezincane zesitsha zande. Ngokuvamile i-carotid angioplasty yenziwa kanye nokubekwa kwe-stent .
- I-Carotid Ukuphoqa : I-carotid artery ehlabayo yinqubo engeyona iningi lapho i-stent (i-metal mesh-like tube) isetshenziswa njengomhubhe. I-stent ifakwa phezu kwe-plaque ye-atherosclerotic ukuze iqiniswe futhi ivumele ukugeleza kwegazi okungcono.
Izinkinga Ezenzekayo Zezokwelashwa Ngama- Percutaneous Izinqubo zemizi ngemizimba zingaphazamisa ngephutha izingcezu ze-plaque futhi zidale ukushaywa kwe-embolic. Ukukhwabanisa kwamakhemikhali kungaholela ekuqhekekeni komthambo futhi kubangele ukuphuma kwegazi okukhulu. Kukhona nengozi encane yokutheleleka.
I-angioplasty ye-Carotid inezinga eliphakeme kakhulu lokuphindaphinda okubikwe ngamaphesenti angu-15 abantu. Amaphesenti amahlanu abantu angase ahlushwe yi-carotid dissection. I-carotid artery stents ngezinye izikhathi ingabangela ukwakheka kwegazi. Kulezo zimo, i-endarterectomy ye-carotid kungenzeka ukuthi ayikwazi ukulungisa umonakalo. Ucwaningo olunzulu lwenziwa okwamanje ukuze kutholakale imishini namasu okugwema lezi zinkinga.
Izwi elivela
I-carotid artery stenosis ivame ukungabonakali futhi yatholakala ngokuzenzakalelayo. Lokhu kusho ukuthi kuvame ukutholakala ngokusekelwe ekuhlolweni kokuhlola ngaphambi kokuba kubangele imiphumela embi. Ukushaywa yisisu yisisusa esibaluleke kunazo zonke se-carotid artery stenosis.
Uma uthola ukuthi une-staroosis ye-carotid, kubalulekile ukungayinaki le nkinga. Ungadinga inqubo yokungenela ukunciphisa ingozi yokushaywa yisifo, noma ungadinga ukulandela okulandelayo nge-ultrasounds ngezikhathi ezithile ukuze uhlole ukuzinza kwesimo sakho ngokuhamba kwesikhathi.
> Ukufunda okuqhubekayo:
> I-carotid endarterectomy ye-carotid stenosis ye-carotid ephawulekayo, uBallotta E, Angelini A, Mazzalai F, Piatto G, Toniato A, Baracchini C, J Vasc Surg. 2014 Jan