Kuvhiya kana stenting ye carotid artery chirwere? Mubvunzo unoramba uripo
Kuvhiya kana stenting ye carotid artery chirwere? Mubvunzo unoramba uripo
Anonim

Ongororo yezvidzidzo zvesainzi inoenzanisa marapirwo maviri ekudzivirira sitiroko nekuda kwechirwere checarotid artery chinopa hapana mhinduro yakajeka pamusoro pekuti kurapwa kupi kuri nani, chiremba weUT Southwestern Medical Center anoshuma mupepeti mune yanhasi chinyorwa cheArchives of Internal Medicine.

"Nyaya ichangobva kuitika pamusoro pezvisarudzo zvekurapa kwechirwere checarotid artery inoramba ichisanganiswa nemashoko akanaka uye akaipa," akadaro Dr. Ethan Halm, mukuru weWilliam T. uye Gay F. Solomon Division yeGeneral Internal Medicine kuUT Southwestern.

Iyo carotid arteries, iyo inomhanya kurudyi nekuruboshwe kumberi kwemutsipa, maviri etsinga ina mikuru yeropa inopa oxygen kuuropi. Idzi tsinga dzinogona kudzikiswa nemafuta ane cholesterol deposits, kana plaque. Kana zvidimbu zveplaque zvikasununguka, zvinogona kugara muuropi, zvichikonzera sitiroko.

Tsvagiridzo zhinji pamusoro pechirwere checarotid artery chinotarisa pakurapa kuviri kudzivirira sitiroko. Mushonga wakanyanya kusimbiswa ndeyekuvhura tsinga uye kubvisa plaque nekuvhiya. Imwe nzira ichangoburwa, inonzi carotid stenting, inosanganisira kuisa mesh chubhu kuti tsinga irambe yakavhurika. Iyo chubhu, kana kuti stent, inopinzwa kuburikidza nechidya.

"Kune mapoka maviri akasiyana evarwere avo vanogona kuvhiyiwa kana stenting," akadaro Dr. Halm. "Vanhu vazhinji vakave nesitiroko kana 'kurova kwenguva pfupi' nekuda kwechirwere checarotid mumwedzi gumi nemiviri yapfuura vanobatsirwa zvakanyanya nerevascularization kana vakakwanisa kushivirira maitiro. Vanofanira kuita sarudzo ine ruzivo navanachiremba vavo pamusoro pezvakanakira nekukuvadza kwezvose zvavanosarudza pakurapwa, kungave kuvhiyiwa, kupinza kana mushonga."

Stenting inopokana nekuti zvishoma zvinozivikanwa nezve kuchengetedzwa kwayo kwenguva refu uye kushanda zvakanaka kana zvichienzaniswa nekuvhiya. Medicare inodzikamisa kubhadharwa kwemaitiro kune akasarudzwa mamiriro. Chikumbiro che stenting ndechekuti haidi kuti anesthesia, haisiye vanga remutsipa, inoda kugara muchipatara kwenguva pfupi uye inogona kuitwa nevavhiyi, cardiologists, radiologists uye neurologists. Zvese stenting uye kuvhiyiwa zvinogona kukonzera rufu kana sitiroko.

Chinyorwa chaDr. Halm chinoperekedza chidzidzo mujenari rimwechete rakanyorwa nemunyori anotungamirira Dr. Manesh Patel weDuke Clinical Research Institute. Chidzidzo chePatel chakaongorora dhata renyika pamusoro pekushandiswa uye mhedzisiro yekuvhiya uye stenting muhuwandu hweMedicare. Vatsvakurudzi vakaona kuti kubva muna 2003 kusvika muna 2006, kushandiswa kwe stenting kwakawedzera 33 muzana, asi mazinga ekuvhiyiwa kwechinyakare akaderera ne19 muzana. Chidzidzo chacho chakarondedzerawo kusiyana kwakakura kwenzvimbo mukushandiswa kwemaitiro.

"Tichifunga nezvegwaro renyika kufarira kudzora kukwira kwemitengo yehutano, chokwadi chekuti kwaunogara kunogona kukanganisa kuwanda uye rudzi rwekutarisira kwaunowana sekurwara kwaunoita kwakaunza kufarira kukuru," Dr. Halm akadaro. "Kukwira kwekushandiswa kwe stenting kungangodaro kunokonzerwa nekuti inogona kuitwa neboka rakakura kwazvo renyanzvi zvichienzaniswa nekuvhiyiwa chete, uye stenting haina kunyanyisa, saka vanhu vazhinji vangazvida."

Nekudaro, "jury richiri padanho rakakodzera rekuita uye kungwarira kwakakodzera nekuda kwezvikonzero zvakati," akadaro. Semuenzaniso, zvidzidzo zvakagara zvichiratidza kuti kuvhiyiwa kuri nani pane stenting muvarwere 70 uye vakuru (boka guru rine chirwere checarotid). Uye kunyangwe 70 muzana kusvika 90 muzana yevarwere vekuUS vanovhiyiwa kana stenting vari asymptomatic, zvinoramba zvisina kuratidzwa kuti kana revascularization zano riri pamusoro perudzi rweyakanyanya njodzi yekudzikisa iyo ikozvino inogoneka nepamusoro-simba mishonga yekudzikisa cholesterol, kudzivirira ropa. magwamba uye kudzora BP.

"Zvidzidzo zvechirwere checarotid zvakaratidza kuti vanachiremba vanowanzotaura njodzi yekusaita chirongwa kakawanda kupfuura njodzi dzemaitiro acho pachayo, saka varwere vangave vasiri kuwana ruzivo rwakanyanya nezvezvavanosarudza," akadaro Dr. Halm, uyo iri kugadzira zvedzidzo yemurwere uye chirongwa chekombuta chinodyidzana chakagadzirirwa kubatsira varwere kunzwisisa zviri nani zvakanakira nekuipira pakuvhiya, stenting uye kurapwa.

Anopa mazano anotevera kuvarwere vane chirwere checarotid: "Bvunza chiremba wako nezvezvinobatsira uye njodzi dzecarotid maitiro akapiwa mamiriro ako. Kana usati wambova nechirwere checarotid, saka mabhenefiti erevascularization idiki, uye anogona kunge asiri nani pane aggressive medical therapy. chirwere che carotid hachisi chekukurumidzira, saka une nguva yekuwana chokwadi pamusoro pezvakanakira nekuipira zvese zvitatu zvingasarudzwa - kuvhiyiwa, stenting, kurapwa kwega."

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