Ukulungiswa kwe-aortic aneurysm - endovascular

Ukulungiswa kwe-Endovascular besisu aortic aneurysm (AAA) ukuhlinzwa ukulungisa indawo enwetshiwe ku-aorta yakho. Lokhu kubizwa nge-aneurysm. I-aorta ingumthambo omkhulu othwala igazi ulibhekise esiswini sakho, okhalweni nasemilenzeni.

I-aortic aneurysm yilapho ingxenye yalo mthambo iba nkulu kakhulu noma ibhaluni ngaphandle. Kwenzeka ngenxa yobuthakathaka odongeni lomthambo.

Le nqubo yenziwa egumbini lokuhlinza, emnyangweni we-radiology wesibhedlela, noma ebhodini le-catheterization. Uzolala etafuleni eligwedwe. Ungathola i-anesthesia ejwayelekile (ulele futhi awunazinhlungu) noma i-epidural noma i-anesthesia yomgogodla. Ngesikhathi senqubo, udokotela wakho ohlinzayo uzo:

• Yenza ukusika okuncane okuhlinza eduze kwesibungu, ukuthola umthambo wabesifazane.
• Faka i-stent (ikhoyili yensimbi) kanye nokuxhunyelelwa okwenziwe ngabantu (okwenziwe) ngokusebenzisa ukusika emthanjeni.
• Bese usebenzisa udayi ukucacisa ubukhulu be-aneurysm.
• Sebenzisa ama-x-ray ukuqondisa ukufakelwa kwe-stent ku-aorta yakho, lapho kutholakala khona i-aneurysm.
• Okulandelayo vula i-stent usebenzisa indlela efana nentwasahlobo bese uyinamathisela ezindongeni ze-aorta. I-aneurysm yakho ekugcineni izoncipha izungeze yona.
• Okokugcina sebenzisa ama-x-ray nedayi futhi ukuze uqiniseke ukuthi i-stent isendaweni efanele futhi i-aneurysm yakho ayophi ngaphakathi emzimbeni wakho.

I-EVAR yenziwa ngoba i-aneurysm yakho inkulu kakhulu, ikhula ngokushesha, noma iyavuza noma yopha.

Ungaba ne-AAA engabangeli zimpawu noma izinkinga. Umhlinzeki wakho wokunakekelwa kwezempilo kungenzeka ukuthi uthole le nkinga ngenkathi une-ultrasound noma i-CT scan ngesinye isizathu. Kukhona ubungozi bokuthi le aneurysm ingavuleka (iqhume) uma ungenakho ukuhlinzwa ukuyilungisa. Kodwa-ke, ukuhlinzwa ukulungisa i-aneurysm nakho kungaba yingozi. Ezimweni ezinjalo, i-EVAR iyinketho.

Wena nomhlinzeki wakho kufanele ninqume ukuthi ngabe ingozi yokwenza lokhu kuhlinzwa incane yini kunengozi yokuphuka uma ungenakho ukuhlinzwa ukulungisa inkinga. Umhlinzeki kungenzeka ancome ukuthi uhlinzwe uma i-aneurysm ingu:

• Okukhulu (cishe ngamasentimitha amabili noma amasentimitha ama-5)
• Ukukhula ngokushesha okukhulu (ngaphansi kuka-1/4 intshi ngaphezulu kwezinyanga eziyi-6 kuya kwezingu-12 ezedlule)

I-EVAR inobungozi obuphansi bokuba nezinkinga uma kuqhathaniswa nokuhlinzwa okuvulekile. Umhlinzeki wakho kungenzeka aphakamise lolu hlobo lokulungiswa uma unezinye izinkinga ezinkulu zezokwelapha noma ungabantu abadala.

Izingozi zanoma yikuphi ukuhlinzwa yilezi:

• Amahlule egazi emilenzeni angahamba aye emaphashini
• Izinkinga zokuphefumula
• Ukutheleleka, kufaka phakathi amaphaphu, umgudu wokuchama kanye nesisu
• Isifo senhliziyo noma isifo sohlangothi
• Ukusabela emithini

Izingozi zalokhu kuhlinzwa yilezi:

• Ukopha ngokuzungeza ubumbano oludinga ukuhlinzwa okwengeziwe
• Ukopha ngaphambi noma ngemuva kwenqubo
• Ukuvalwa kwe-stent
• Ukulimala kwesibindi, okubangela ubuthakathaka, ubuhlungu, noma ukuphazamiseka emlenzeni
• Ukuhluleka kwezinso
• Ukunikezwa kwegazi okungafanele emilenzeni yakho, izinso zakho, noma ezinye izitho
• Izinkinga zokuthola noma ukugcina ukwakhiwa
• Ukuhlinzwa akuphumelelanga futhi udinga ukuhlinzwa okuvulekile
• Istent siyashelela
• Ukuvuza okunamandla futhi kudinga ukuhlinzwa okuvulekile

Umhlinzeki wakho uzokuhlola futhi a-oda izivivinyo ngaphambi kokuhlinzwa.

Hlala utshela umhlinzeki wakho ukuthi yiziphi izidakamizwa oziphuzayo, ngisho nezidakamizwa, izithasiselo, noma amakhambi owathengile ngaphandle kwencwadi kadokotela.

Uma ubhema, kufanele uyeke. Umhlinzeki wakho angasiza. Nazi ezinye izinto ozodinga ukuzenza ngaphambi kokuhlinzwa kwakho:

• Cishe amasonto amabili ngaphambi kokuhlinzwa kwakho, uzovakashela umhlinzeki wakho ukuqinisekisa ukuthi noma yiziphi izinkinga zezokwelapha, ezinjengesifo sikashukela, umfutho wegazi ophakeme, nezinkinga zenhliziyo noma zamaphaphu, ziphathwa kahle.
• Ungacelwa futhi ukuthi uyeke ukuthatha izidakamizwa ezenza kube nzima ngegazi lakho ukuminyana. Lokhu kufaka phakathi i-aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), warfarin (Coumadin), ne naprosyn (Aleve, Naproxen).
• Buza ukuthi imiphi imishanguzo okufanele usayiphuza ngosuku lokuhlinzwa kwakho.
• Njalo utshele umhlinzeki wakho uma uthola umkhuhlane, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, noma okunye ukugula ngaphambi kokuhlinzwa kwakho.

Kusihlwa ngaphambi kokuhlinzwa kwakho:

• UNGAPHUZI lutho ngemuva kwamabili, kufaka phakathi amanzi.

Ngosuku lokuhlinzwa kwakho:

• Thatha noma imiphi imithi udokotela wakho akutshele ukuthi uyiphuze ngesiphuzo esincane samanzi.
• Uzotshelwa ukuthi ufika nini esibhedlela.

Iningi labantu lihlala esibhedlela izinsuku ezimbalwa ngemuva kwalokhu kuhlinzwa, kuya ngohlobo lwenqubo ababenayo. Imvamisa, ukululama kule nqubo kushesha futhi kubuhlungu kancane kunokuhlinzwa okuvulekile. Futhi, ngokunokwenzeka uzokwazi ukuya ekhaya ngokushesha.

Ngesikhathi sokuhlala esibhedlela, unga:

• Yiba egumbini labagula kakhulu (i-ICU), lapho uzobhekwa khona kakhulu ekuqaleni
• Yiba nepayipi lomchamo
• Unikezwe imithi yokwehlisa igazi lakho
• Khuthazeka ukuthi uhlale eceleni kombhede wakho bese uhamba
• Gqoka amasokisi akhethekile ukuvikela amahlule egazini emilenzeni yakho
• Thola umuthi wezinhlungu emithanjeni yakho noma esikhaleni esizungeze umgogodla wakho (i-epidural)

Ukubuyiselwa emuva kokulungiswa kwe-endovascular kuyashesha ezimweni eziningi.

Uzodinga ukubukwa futhi uhlolwe njalo ukuze uqiniseke ukuthi i-aortic aneurysm yakho ayivuzi igazi.

I-EVAR; Ukulungiswa kwe-endovascular aneurysm - aorta; Ukulungiswa kwe-AAA - i-endovascular; Ukulungisa - i-aortic aneurysm - endovascular

• Ukulungiswa kwe-aortic aneurysm - endovascular - discharge

IBraverman AC, iSchemerhorn M. Izifo ze-aorta. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 63.

I-Brinster CJ, iSternbergh WC. Amasu wokulungisa i-endovascular aneurysm. Ku: Sidawy AN, Perler BA, ama-eds. Rutherford’s Vascular Surgery and Endovascular Therapy. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2019: isahluko 73.

UTracci MC, uCherry KJ. I-aorta. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; I-2017: isahluko 61.