Stenting ziwiya za mtima

Zochizira matenda a mitima, ozikidwa pa kuchepetsa wa mitsempha inatsekeratu (iwo kudyetsa myocardium), mu 1977 zibaluni angioplasty ziwiya izi chitachitidwa kwa nthawi yoyamba. Nthawi zambiri, chifukwa kuchepetsa wa mitsempha ndi mafuta madipoziti pa intima ziwiya, imbaenda ku kotunga osakwanira kwa mpweya cardiomyocytes lapansi. Motero, kukhala angina ndi m'mnyewa wamtima infarction.

njira zibaluni angioplasty zachokera chakuti mtima kudzera ku femoral mtsempha wamagazi kudyetsedwa catheter pa mapeto ake ali pamtunda wa khafu (zibaluni ataphwetsedwa). Mu X-ray ulamuliro catheter akudyetsedwa mwachindunji malo kuchepetsa, kenako zibaluni ndi mpweya - mtsempha wamagazi ndi kukodzedwa. njira amapereka zotsatira zabwino, koma nthawi zambiri muyambirenso (mtsempha wamagazi kukonzanso ukuning'a, ndipo kwambiri).

Pofuna kuwonjezera mphamvu ya zibaluni angioplasty, madokotala apanga njira yatsopano - mtima mtima stenting. stent ndi zachitsulo tubular mauna, mtundu wa chimango zosapanga dzimbiri. Mkati mtsempha wamagazi, ndi zambiri, osalola kuti kuphipha. Mtima mtima stenting imagwiridwa ndi zinthu zosiyanasiyana zimene katundu osiyana. Chidwi kwambiri ndi stents amene TACHIMATA ndi zipangizo polymeric ndi zinthu mankhwala (mwachitsanzo, cytotoxic anticancer mankhwala). Stenting ziwiya za mtima catheters amenewa akhoza kuchepetsa mlingo wa mapangidwe mipukutuyi atherosclerotic. Koma M'pofunikanso kukumbukira kuti pogwiritsa ntchito stents izi mlingo wa machiritso a malinga lamkati la mitsempha ya amachepetsa, umene ndi chinthu cha thrombosis chiopsezo.

Stenting ziwiya za mtima chimodzimodzi monga momwe zibaluni angioplasty. Pali kusiyana kumodzi kokha pa zibaluni stent atavala, lokutidwa chipolopolo. Potchula mawu catheter mu wa koronare mtsempha wamagazi m'chimake chikutha ndipo kenako zingakweze ndi zibaluni, ndi stent kwa kuwongola malo mtsempha wamagazi inayake mwapang'ono. Choncho, kukodzedwa mtsempha wamagazi khoma umalimba ndi kumakula kwa mkati.

Pa gawo lino la stents mtima - njira zina kuti inatsekeratu mtsempha wamagazi kulambalala kumezetsanitsa. Tikumbukenso ina zabwino stenting: ndi kuphipha ya mitsempha inatsekeratu pa zibaluni angioplasty akhoza kukhala infarction m'mnyewa wamtima, zomwe zikhoza kupewedwa pogwiritsa ntchito stent. Stenting ya mitsempha ya mtima tsopano - njira zina za inatsekeratu mtsempha wamagazi kulambalala kumezetsanitsa. Komanso, ngati mu njira ya ntchito zibaluni angioplasty inatsekeratu mtsempha wamagazi spazmiruyutsya, n'zotheka chitukuko cha infarction m'mnyewa wamtima, ndi stent imeneyi zimathandiza kupewa vuto lofunika kwambiri. Pamene inatsekeratu mtsempha wamagazi kulambalala opaleshoni theka la odwala anayamba stenosis wa shunt lapansi. stenting wake ndi wabwino njira kuti mobwerezabwereza inatsekeratu kulambalala. stents Komanso mtima - njira ina thrombolysis ndi luso zabwino zochizira pachimake m'mnyewa wamtima infarction mwachindunji mu maola woyamba wa chitukuko.

Komabe, pali contraindications kwa njirayi. Stent Kusinthaku sizingatheke ndi akakufunsani kuchepetsa wa mitsempha inatsekeratu. Komanso, chopinga chachikulu ndi yaing'ono (zosakwana 2.8 mm) awiri a mtsempha wamagazi ndi mwapang'ono.

Pakuti kupewa zochitika thrombotic njirayi amachitidwa pa maziko a anticoagulants.

Pambuyo opareshoni zimenezi, wodwalayo amakhalabe chipatala kwa masiku 5-7 padziko koloko achipatala. Postoperatively akupitiriza antiplatelet ndi anticoagulation mankhwala.