Carotid endarterectomy: nāʻikepili, postoperative complications, hoʻohana nāʻana, pros a me ka hooluolu

Ua noa ike i ka hahauʻana ua manaoia kekahi o ka loa e like me ka kumu o ka make i waena o ka heluna o ka Honua holoʻokoʻa. Keia maʻi ia lŘlŘ me ka like alapine (frequency) i loko o nā'āina o ko ke ao nei. Pinepine i ka cerebral holo hele aku ai i lōlō a me ka paresis, ma o na la? Aiaiiuo a me ka mau kīnā o ke kino. E pale i ka hooulu ana o keia maʻi, manawa e diagnose hahau hoowalewale mai la ia aʻe, a no ka hana ana me ia oe e pono ai. I ka papa kuhikuhiE kumu o ka mapuna hoe - ka atherosclerosis o na arteries o ka ai a me ke poo. embolism ma ka waena a me ka wa elemakule, he mea aneane a pau. Ka hapanui o kanaka ma luna o 60 makahiki mohai 'inikua Kāohiʻana o ka atherosclerosis. Ma kekahi mau hihia, lāʻau lapaʻau ua ole me ka mea i makemake ia. A laila, i hōʻikeʻoki kino - carotid endarterectomy. Kēia kaʻina hana komo ai i ka wehe 'ana o ka moku hapa poino ma ka atherosclerosis.

No ke aha la i kaupaona aku carotid endarterectomy?

Krovosnabzhnenie lolo hilinaʻi nui ma luna o ka carotid arteries. Mau moku, he mau lala o ka aorta. Ka mea, i hoonohonoho symmetrically ma na aoao a elua o ka'ā'ī. Komo i loko o ka cranial lua, e māheleʻia carotid arteries i uuku lala lolo. Ma nā mea maʻi pilikia mai atherosclerosis, he pilikia kiʻekiʻe o ke koko clots i loko o kēia mau moku. Ka mea, i haku o ka naʻokoko plaques a me fibrous'aʻaʻa. A hiki i ke koko, mea ulu ma ka carotid thrombus ke uhai aku, mai ka moku paia, a komo i ka lolo. E like me ka hopena, ka mea, i ischemia - muli o ka oxygen lako i na nā'aʻaʻa. Oia cerebral koko hiki aku ai i ka weliweli ka hopena. E pale aku hahauʻana, carotid endarterectomy ua hana. Ua kōkua pale hahauʻana a me kona hopena.

ke kaʻina hana no Overview

Carotid endarterectomy - kaʻoki kino, i mea no ka hoʻomaʻemaʻeʻiaʻana o ka pā, ahu iho o ka moku ma ka atherosclerotic plaque. Ua ua hana i ka hihia ma ka lapaʻauʻia ka powerless paha pilikia o ka mapuna hoe muli o kona kiʻekiʻe. Ai 'mea e hiki i ka hoʻolako i ka makemake ia ka wā atherosclerotic plaque ninoaaeyao oi ma mua o ka hapalua o ke anawaena o ka carotid artery. A ina o ka naʻokoko pani ka lumen o ka moku, mai kekahi mauʻaoʻao ka poʻe. Eia hou, i ka pilikia o ka mapuna hoe maoli me ka nui loa i loko o ke alo o ke kipi hypertension. Ma keia hihia, atheroma e i kekahi manawa i ka endothelium, nānā 'ole o kona nui. Ka hopena paha e ole ka loa blockage o ka carotid artery a me kona mau lālā e hānai i ka lolo. E like me ka hopena o ka ulu ischemic hahau ana.

Nāʻikepili no ka carotid endarterectomy

ʻoki kino (carotid endarterectomy) ua lawe mai,ʻaʻole no ka kela mea keia mea. Mea i haawi mai ai i ke kauka ae no kaʻoki kino, pono e hoʻoponopono hoike. Pinepine ka hana ua hana i loko o nā mea maʻi me ka mōʻaukala ano ua hoololiia ka cerebral holo. No laila, i loko o kekahi mau hihia hoomaikai aku la lakou carotid endarterectomy? Nāʻikepili no ka mea kēia:

1. Ke anawaena o ka moku ua paa hou mai la ka atherosclerotic plaque ma oi ma mua o ka hapalua o.
2. Hai hahau ana ma ka mōʻaukala.
3. I ka hoʻohuiʻia o ka hypertension (ka ukuʻanuʻu) a me atherosclerosis o ka carotid arteries.

Contraindications no kaʻoki kino

I loko nō o ka pomaikai o kaʻoki kino, ma kekahi hihia, ka mea hiki ole ke lawe mai. E like me nā hana, ka mea, ua contraindications a me carotid endarterectomy. Reviews o nā mea maʻi me ka atherosclerosis,ʻo ia ka mea ike i ka helu ana i okoa ana hana muaʻoki kino. Wale nō ma hope o ke kauka mea māʻona i loaʻa nā ole contraindications, ke hoʻomanawanui hoʻomaka e hoomakaukau ai no ka hana. Carotid endarterectomy ua papa ia ma ke kēia hihia.

1. Kipi lapaau (decompensated) hypertension.
2. Nui huʻi ischemic hahau ana.
3. He hu wale angina a me kāu mau myocardial infarction.
4. Huʻi naʻau ole.
5. Recent hahau ana.
6. Maʻi circulatory insufficiency 2 a me 3 degere.
7. Alzheimer ka maʻi.
8. Cancer a me ka loa.

Makaukau no ka carotid endarterectomy

Mua hana carotid endarterectomy mea pono e hoʻomaka like ana. Ka mua hōʻike heʻelua papa ultrasound o na moku o ke poo a me ka ai. A me keia hana i ke kauka ke hoʻoponopono i ka degere o ka panina o ka lumen o na arteries o atherosclerotic plaques. I kekahi manawa, he vascular angiography. Kēia like o ka pōkole i loko o ke koko Akä naÿe agena ukali ma ka X-Ray hooponopono. A oi pololei iaoia mea HI angiography. Ua apono 'oe i ka loiloi i ke kinona, ka nui a me ka IIeEeAIEUAA o ka naʻokoko mea e hoouhi ia ma luna o ka endothelium. Inā ke kauka hāʻupu ischemia kekahi māhele o ka lolo, hoʻokōʻume mākenēki resonance kiʻi. I ka wa a ke kauka i hoike mai i na nāʻikepili no kaʻoki kino, ka mea, Ua pono, e kikoo aku i ka hopena e pili ana i ka mau ana o ka hoʻomanawanui. E hana i kēia i loko o ke alo o ka carotid endarterectomy hana ECG, KLA, kekahi koko kemika a me ka coagulation. Inā ka hoʻomanawanui i nā maʻi, e mea pono e kukakuka hoʻomalu (endocrinologist, cardiologist).

Kahua o ka hoʻonaʻauao o ka carotid endarterectomy

Ka mua kahua o kaʻoki kino ka anesthesia. Ke koho ana o ka anesthesia hilinaʻi nui ma luna o ka manao o ke kauka, a pēlā hoʻi me ka makemake o ka hoʻomanawanui. Ua hiki ke hana kūloko anesthesia a mau anesthesia. Mahope, i ka surgeon i ka incision i loko o ke kahi o ka hopena o ka ultrasound paha angiography ka naʻokoko plaques. I kekahiʻanuʻu e ka hopuʻana ipu. Eia, ke oki ua i ma luna o ka hapanui o ka carotid artery. Ma hope o ke kauka e visually loiloi i ka nui a me ka palena o atherosclerotic plaque, oia manao i ke ala ma ka a, e hoʻomau i ka hana. Aia i kekahi mau 'ana i kūpono. Pinepine Hawaii e wehe endarterectomy. Ma keia mea i manaoia he lonikū incision o ka moku, a "hamoʻia" naʻokoko mea e hoouhi ia. Ma hope o ia, ma ka wahi o ka poino endothelium ua noi "one." Kekahi iaoia - keia eversion endarterectomy. No keia mea i ka moku ua huli maloko mai, a ua holoiʻia o atherosclerotic me ka. Inā ka lesion o ka carotid artery mea nui, kona hope ua hana i loko o ka ua wahi. No keia mea, kemikala fabrics. I ka hope loa kahua o ka carotid endarterectomy mea he ahu-stitching.

Pehea o ke kia-operative manawa?

Ma hope o carotid endarterectomy i manawa e hoihoi mai i ke koko pele. Ua lawe he mau pule. Mai ka incision i loko o ka'ā'ī o kaʻuʻuku nui, kaheaia iki ola ka waiʻona ma ke. Aka hoi, analgesics i ke koi 'ia i ka lā mua. Oe i hiki ole ke eaʻe mea kaumaha i, a me ka hana i kekahi mau pule ma hope, e like me ka carotid endarterectomy i hanaia. Ke postoperative papa ua maikai, ina a pau o ko ke kauka i ka kuhikuhi,ʻaʻole wale ana i loko o ka haukapila, akā, i ka wā o ka hoʻomanawanui ua hookuu. i wehe 7-10 lā ma hope oʻoki kino Sutures.

Complications o carotid endarterectomy

Ua hoʻomanaʻoʻia ai ia i kekahiʻoki kino kŰia kamepiula. No koe a me ka carotid endarterectomy. Complications ma hope o kēia hana e pohihihi keia, ma kahi o 3% o ka hihia. Aka hoi, ua loaa ia lakou, a me ka hoʻomanawanui pono e ao e pili ana i keia.

Ka loa mua postoperative complication mea suture ole. Me keia hana, i ka anal o koʻohune i loko o kaʻeha ka loa pilikia no ke ahonui o ke ola, e like me ka mea e oki ai, lawe mai 'ana ma luna o ka vascular kahi moe. Kēia complication kānāwai ma muli o ke 'ole-kaʻaeʻana i nā rula o ka antiseptics.

Kekahi mea ano pili i CEA, o ka kūamuamu. Cerebrovascular ulia e hana ana i ka hopena o atherosclerotic plaque apana nahaha kaawale ana i ka hana a me kona poo ma ka hui 'ana me nā ipu. Kēia complication mea pohihihi keia, ma 2-3% o ka hihia.

Eia hou kekahi,ʻoki kino ua i kekahi manawa, malama? Aiaiiuie kāna hana o ka leo a me ka moni 'ia. Keia ua pili me ka poho i ke aʻalolo a hāʻule pahū wale aia i loko o ka'ā'ī.

Late complications o carotid endarterectomy restenosis ua noʻonoʻo pono. Ua pili ia i ka hou-hou ana o ka moku lumen. Loa pinepine restenosis ia lŘlŘ i loko o nā mea maʻi i e ole like me ke kauka mau kauoha.

Kāohiʻana o postoperative complications

Complications e like me hahauʻana a me ka poho ana i na nā aʻalolo o ka ai, mai hilinaʻi ma ka hoomanawanui, e like me ka mea, e ala aʻeʻoe i loko o ka papa o keʻoki kino. Aka hoi, Kāohiʻana o nā kūlana mea hiki wale nō i ke aloha a hiki i ka hui hana o ke kauka, a me ka hoʻomanawanui. No ka mea, pili ana i ka hou-hanana o atherosclerotic plaques. Once ka hana mea ma luna, i ka hoʻomanawanui pono e mau malama ma ka hoʻomalu. Ma waho aʻeo no ka lapaʻau 'ana i ke kaʻina hana, ke kahuna lapaau i hāʻawi mai i ka hoʻomanawanui he maikaʻi kēia hoike. Ma kekahi pili keia i ka I Aloha Hawaii: ke hoʻomanawanui, e hooki aku pūnuku puhi a me ka waiʻona ana,ʻai (ʻai haʻahaʻa-momonaʻai). Hoi kekahi poe kanaka no ka Kāohiʻana o ka restenosis hoakaka ia ka lapaʻauʻia. Ke hoomanawanui E kela la i keia lawe lipid-hookuu iho ai ' ( "atorvastatin" lāʻau), antiplatelet konohiki ( "Cardiomagnyl" papa "Clopidogrel").

Hana "carotid endarterectomy": pros a me ka hooluolu

E like me nā mea a pauʻoki lāʻau lapaʻau ke kaʻina hana, keia hana i nā pono a me nā keakea. Kekahi kauka mai e waiho aku carotid endarterectomy like loa me atherosclerosis hiki ke hana conservatively, a me nā mea maʻi e ole i lapaʻau hoikeana o ka maʻi. Other kauka manaʻo eʻoki kino mea pono me ka nui hou ana o ka lumen o ka artery, nānā 'ole o ka ina paha symptoms e noho paha,ʻaʻole i loko o ka hoʻomanawanui. Ka lanakila o kēia kaʻina hana o ka hoʻokolokolo pono, i ka hoʻomaʻemaʻe ana o ka moku mai ka naʻokoko, ka hoʻomaikaʻi koko. Ke hana ke me ka nui loa emi i ka pilikia o ka hahau ana. Akā, endarterectomy aʻole i kumu hoʻomalu i e ole ka moku e poino hou. No hoi, iʻoki kino complications ke hoʻomōhala me ke aʻalolo ino a me ka hahau ana. Ka hapanui o kauka ke kaila keia i ka kŘpa a kolohe ole nae manipulation o nā kaʻina hana, a me nā hopena i manaoia e e ka manaʻoi.

Carotid endarterectomy: hōʻike manaʻo o hoʻohana kanaka

Noke a me ka hopena maikaʻi 'manaʻo pilikia i loko o ke kūkā o kekahiʻoki lāʻau lapaʻau lapaau. No koe a me ka carotid endarterectomy. Reviews hoʻohana poʻe iʻokoʻa. Ma ka hapanui o na, kanaka i maona i ka hana. Mahalo iā ia,ʻo nā symptoms o ischemia (hihia hoʻi noonoo, hoomanao, hiamoe), hou hopena o ka anamanaʻo a me kekahi mau ano. Kekahi e hoomanawanui i kaulana i ka loli i ka leo, moni 'ia kāna hana ma hope o endarterectomy. Ma ka hapanui o na, mau symptoms mau ae la ia e pili ana i ka mahina, a laila, pau ka nalowale.