Zofufuza Zimasonyeza Kulephereka kwa Njira Zowonekera
Ngati inu kapena wokondedwa wanu mwapezeka kuti muli ndi matenda odwala matenda oopsa (CAD) , mungaperekedwe ndi mwayi wa njira yotchedwa percutaneous coronary intervention (PCI). PCI imaphatikizapo njira ziwiri zosiyana:
- Angioplasty, imene chubu imalowetsedwa mu mitsempha ndipo imakhudzidwa kuti yowonjezera chotengeracho ndikuwonjezera kuuluka kwa magazi
- Kuikidwa kwa tizilombo tomwe timakhala tomwe timagwiritsa ntchito sitima yotseguka ndikulepheretsanso kutseka.
Ngakhale kuti njirayi ndi yosavuta kumvetsa komanso yosavuta kumvetsa, ingathe kuwonjezera chiyembekezo cha moyo kapena kusintha mwayi wopulumuka?
Kuphunzira Zipatala Kumapangitsa Zotsatira Zodabwitsa
Poyankha funso lofunsidwa kwambiri, gulu lofufuza kafukufuku lomwe linalipidwa ndi Veteran Administration's Reseach and Development Unit linagwirizanitsa zotsatira mwa anthu omwe anapatsidwa mankhwala opatsirana bwino (OMT) kuti athetsere CAD awo omwe apatsidwa onse a OMT ndi PCI.
Kuphatikizidwa ndi COURAGE (Pulojekiti ya Kugwiritsa Ntchito Revascularization ndi Kugonjetsa Mankhwala Osokoneza Bongo), phunziro la 2007 linatsimikizira kuti anthu omwe anapatsidwa OMT okha analibe chiopsezo chachikulu cha matenda a mtima kapena imfa kusiyana ndi omwe anapatsidwa OMT ndi PCI. Komanso, PCI siidapindulepo kuposa OMT pochepetsa zizindikiro za angina .
Kutsatira mu 2015 kunatsimikiziranso zotsatirazi.
Kufotokozera Zotsatira
Zotsatira zake zinali zodabwitsa kwa anthu ambiri m'magulu a zachipatala omwe akhala akuganiza kuti PCI ili yopindulitsa kwa iwo omwe ali ndi vuto loopsa lakuteteza.
Pambuyo pofufuza zoyenera za odwala-komanso zolephera zazomwezo-omwe ochita kafukufuku adatha kufotokoza zomwe adapezazo.
Zina mwazifukwazo:
- Anthu omwe anali ndi PCI nthawi zambiri ankabwerera ku zizolowezi zawo zam'mbuyomu kamodzi pakhomo (kuphatikizapo kudya mofiira nyama ndi mafuta osasamala ).
- PCI yokha imayesa kuvulaza khoma la mitsempha ndi kuonjezera chiopsezo chachiwiri. Ndipotu, 21 peresenti ya gulu la PCI inkafuna kuti likhale lolimba mkati mwa miyezi isanu ndi umodzi, pamene 60 peresenti ya zitsulo zothandizira zinkasintha.
- Ndondomeko ya PCI inalinso ndi chiopsezo chochulukirapo cha magazi, matenda a mtima, ndi kupwetekedwa, kupyolera bwino mapindu ambiri a chithandizo.
Chinthu china chofunikira ndi chakuti mapuloteni omwe amachitikitsidwa mu PCI si omwe angayambitse matenda a mtima kapena kupwetekedwa mtima. M'malo mwake, nkhaŵazo zimagwirizana kwambiri ndi zopanda zolepheretsa zomwe ziri zochepetsetsa, zosasunthika, komanso zochepa kwambiri.
Ngakhale kuti angioplasty ndi stenting zimapereka mpumulo wa nthawi yayitali, vuto lalikulu la matendawa limakhalabe losagwirizana komanso kuti pangakhale zochitika za mtsogolo za mtima.
Zochita zachipatala Poganiziridwa
Zolakwitsa zimaphatikizanso kuzochitika zamankhwala. Kuyesedwa kwa 2010 kwa mlandu wa COURAGE kunanena kuti oposa 45 peresenti ya odwala omwe ali ndi CAD anayesedwa kupanikizika musanakhale PCI yosankha. Izi zikutanthauza kuti madokotala ambiri alephera kuthana ndi zinthu zina zosinthika, monga chakudya ndi masewera olimbitsa thupi, asanayambe kupereka njirayi.
Chifukwa cha ichi, anthu ambiri sankadziwa kuti akufunika kusintha khalidwe, kuphatikizapo kutha kwa kusuta , atatulutsidwa ku chisamaliro.
Zimene Izi Zikutiuza
Chifukwa cha kuyesedwa kwa COURAGE, American Heart Association ndi American College of Cardiology zinalemba ndondomeko yonena za kugwiritsa ntchito koyenera kwa PCIs kwa anthu omwe ali ndi matenda a mtima. Amatsindika kusintha kwa moyo ndi kugwiritsa ntchito mankhwala oyenera pa mankhwala oyamba omwe mtima ulibe.
Zolangizizi zimatsimikiziranso kufunika koonetsetsa kuti munthu akutsatira chithandizo asanayambe kuganizira za PCI. Nthawi zambiri, kusintha kwa kutsata molunjika kumagwirizana ndi kusintha kapena kukhazikika kwa mtima.
Pofika pamapeto pake, ngati muli ndi matenda a mtima, simuyenera kuwona PCI ngati "kukonzekera msanga." Njira yothetseratu nthawi zonse idzakhala yochita masewera olimbitsa thupi , chakudya chabwino, chochepa kwambiri cha mafuta , komanso kumatira kwambiri mankhwala anu opatsirana.
> Zotsatira:
> Boden, W .; O'Rourke, R .; Teo, K. et al. "Opaleshoni yabwino kwambiri yachipatala ndi kapena popanda PCI kwa matenda okhazikika a coronary." N Engl J Med. 2007, 356: 1503-16. DOI: 10.1056 / NEJMoa070829.
> Desai, N .; Bradley, S .; Parzynski, C. et al. "Njira Zoyenera Zogwiritsira Ntchito Coronary Revascularization ndi Trends of Use, Kusankha Odwala, ndi Kuvomerezeka kwa Kuperewera kwa Coronary Intervention." JAMA. 2015; 314: 2045-53. DOI: 10.1001 / jama.2015.13764.
> Finn, A .; Nakano, M .; Narula, J. et al. "Chidziwitso cha chiopsezo chosasunthika / chosasunthika." Arterioscler Thromb Vasc Biol . 2010; 30: 1282-92. DOI: 10.1161 / ATVBAHA.108.179739.
> Levine, G ;; Mabanki, E .; Blankenship, J .; et al. "2015 ACC / AHA / SCAI Kukonzekera Kwambiri pa Kufunika Kwambiri kwa Coronary kwa Odwala Ndi ST-Elevation Myocardial Infarction .." Circulation. 2015; 87 (6): 1001-19. DOI: 10.1161 / CIR.0000000000000336.
> Sedlis, S .; Hartigan, P .; Teo, K. et al. "Zotsatira za PCI pa Kukhalitsa Kwambiri Kwambiri kwa Odwala Ndi Matenda Ovuta a Ischemic Heart." N Engl J Med . 2015; 373: 1937-46. DOI: 10.1056 / NEJMoa1505532.