Kodi izi ndi mankhwala othandiza kuti pakhale kupuma?
Mankhwala a Angioplasty ndi otupa adasinthira momwe angachiritse matenda a mitsempha ya mitsempha , koma mankhwalawa adayambitsa mtundu watsopano wa vuto mukusakaniza. Ichi ndi vuto la kupumula - kubwereranso pakhomo la mankhwala. Kumayambiriro kwa zaka za 2000, matenda a brachytherapy, kapena mankhwala amtundu wa radiation, anakhala mankhwala atsopano othandizira kupuma.
Koma pamene brachytherapy inali (ndipo ilipo) yothandiza kwambiri kupuma, tsopano yayipidwa ndi kugwiritsa ntchito mankhwala osokoneza bongo .
Restenosis pambuyo pa angioplasty kapena kupweteka kumayambitsidwa ndi kukula kwa minofu pamalo a mankhwala. Zimayambitsidwa ndi machiritso ambiri, zomwe zimapangitsa kuti maselo a "endothelial" apitirize kufalikira mitsempha ya magazi. Izi zimakula pang'ono pang'ono.
Matenda a ubongo amatha kupweteka mwa kupha maselo ochulukirapo ndikuletsa minofu yowonjezera.
Kodi Brachytherapy Imagwiritsidwa Ntchito Bwanji?
Nthenda ya brachytherapy imayendetsedwa pamtundu wapadera wothandizira mtima. Dzuwa lokha limaperekedwa ndi catheter yapadera yomwe imagwiritsidwa ntchito kugwiritsa ntchito ma radiation kuchokera mkati mwa mitsempha yamakono. Catheter imadutsa mu mitsempha yowonongeka komanso kudutsa kwa chiwonongeko kumayambitsidwa ndi kupuma. Kamodzi kogwirizana ndi malowa ndi catheter, mazirawa amagwiritsidwa ntchito.
Mitundu iwiri ya ma radiation ingagwiritsidwe ntchito: gamma radiation ndi beta miyendo. Mitundu yonse ya ma radiation ndi yovuta kuigwiritsa ntchito, ndipo imafuna kukhalapo kwa zipangizo zamakono mu labata, kulandira njira zodzitetezera, ndi anthu ophunzitsidwa mwapadera, kawirikawiri kuphatikizapo a radiation oncologist.
Akatswiri a zamagetsi omwe agwiritsira ntchito brachytherapy amavomereza kuti chinsinsi cha kupambana ndicho chochitika cha wogwira ntchitoyo. Izi ndi njira zovuta zomwe zimakhala zofunikira kuposa momwe amachitira kawirikawiri katswiri wodziŵa matenda opatsirana.
Mphamvu
Kafukufuku wamakono awonetsetsa kuti brachytherapy imayesetsa kuthetsa kupuma kwa mitsempha yamakono, komanso kuchepetsa chiopsezo cha kupuma kwapadera. Kuonjezera apo, kafukufuku akuwoneka kuti amasonyeza kuti odwala omwe ali ndi chiopsezo chachikulu cha kupumula- (monga anthu omwe ali ndi matenda a shuga ) -kufuna kuti apindule kwambiri ndi mankhwala opatsirana.
Mavuto
Brachytherapy si vuto ayi. Vuto lina lapadera lomwe lawoneka ndi brachytherapy ndilo "pamphuno" - mawonekedwe atsopano m'mphepete mwa malo otentha kwambiri (malo omwe amachitilidwa ndi ma radiation). Mphuno yamtunduwu, yomwe imawoneka ngati mabulosi kapena "candy-wrapper" pamene imawonetsedwa ndi chidziwitso, ndizovuta kwambiri zomwe zimavuta kuchiza. Ziphuphu zoterezi zimapezeka chifukwa cha catheter pamene akupereka brachytherapy.
Komanso, odwala omwe amachiritsidwa ndi brachytherapy amawoneka kuti ali ndi chiopsezo chowonjezereka cha mitsempha yotchedwa coronary artery thrombosis (magazi clot).
Kawirikawiri, ngati thrombosis imachitika motsatira njira yotchedwa angioplasty kapena yopopera, imapezeka masiku osachepera 30. Koma kuchepa kwa thrombosis (komwe kumachitika pambuyo pa masiku 30 oyambirira) kumawonekera pafupifupi pafupifupi 10% mwa odwala omwe amalandira chithandizo cha brachytherapy. Matendawa amayamba kugwiritsidwa ntchito ndi matenda a mtima kapena angina osakhazikika . Pofuna kuchepetsa chiopsezo chimenechi, ochepa magazi amafunsidwa kwa zaka zosachepera chaka chimodzi chitatha chithandizo cha brachytherapy.
N'chifukwa Chiyani Brachytherapy Imagwiritsidwa Ntchito Masiku Ano Masiku Ano?
Restenosis inali vuto lalikulu lomwe silinathetsekedwe m'masiku oyambirira a angioplasty ndi stenting, ndipo kwa zaka zingapo brachytherapy inawoneka ngati njira yodalirika yothetsera kupuma.
Komabe, tsopano imagwiritsidwa ntchito kawirikawiri.
Maonekedwe a mankhwala osokoneza bongo amachititsa kuti brachytherapy ikhale yovuta. Zofukufuku mofanana poyerekeza ndi chitetezo ndi mphamvu ya brachytherapy kwa mankhwala osokoneza bongo chifukwa chochiritsa chiwonetsero chawonetsetsa bwino kwambiri kuti mphutsi zimapereka zotsatira zabwino. Komanso, akatswiri a cardiologists amakhala osasinthasintha, ndipo mpweya sumafuna kukhumudwa, kuwononga ndalama, komanso luso lapadera kwambiri lofunika ndi brachytherapy. Sizinatengere nthawi yaitali kuti munthu adwale kwambiri pamapu.
Komabe, brachytherapy ndi yothandiza ndipo imakhala yotetezeka ndipo yavomerezedwa kuti igwiritsidwe ntchito ndi Food and Drug Administration. Zigawo zingapo zapadera zimapereka izi ngati njira yosamalira kupuma.
Masiku ano, matenda a brachytherapy amagwiritsidwa ntchito ngati odwala omwe akhala akutsitsimutsa nthawi zonse, ndipo amene mankhwala osokoneza bongo amalephera kuthetsa vutoli. Pofuna kulandira brachytherapy odwalawa ayenera kutumizidwa ku malo amodzi omwe akupereka mankhwalawa.
Zotsatira:
Teirstein PS, Massullo V, Jani S, et al. Zotsatira zakale zam'chipatala ndi angiographic pambuyo pa mankhwala osagwira ntchito: zotsatira za mayesero ochizira odwala. Circulation 2000; 101: 360.
Sapirstein W, Zuckerman B, Dillard J. FDA akuvomerezedwa ndi coronary-artery brachytherapy. N Engl J Med 2001; 344: 297.
Holmes DR Jr, Teirstein PS, Satler L, et al. Kutsata kwa zaka zitatu za SISR (Sirolimus-Eluting Stents vs. Vascular Brachytherapy kwa In-Stent Restenosis). JACC Cardiovasc Interv 2008; 1: 439.