Ukulungiswa kwe-aortic aneurysm-endovascular

Ukulungiswa kwesisu esiswini se-aortic aneurysm (AAA) lutyando lokulungisa indawo ebanzi kwi-aorta yakho. Oku kubizwa ngokuba yi-aneurysm. I-aorta ngumthambo omkhulu ophethe igazi ulibeke esiswini sakho, kwiintsimbi kunye nasemilenzeni.

I-aortic aneurysm kuxa inxenye yalo mthambo iba nkulu kakhulu okanye iibhaluni ngaphandle. Kwenzeka ngenxa yobuthathaka eludongeni lomthambo.

Le nkqubo yenziwa kwigumbi lokusebenza, kwisebe le-radiology yesibhedlele, okanye kwilebhu ye-catheterization. Uya kulala etafileni enephedi. Unokufumana i-anesthesia jikelele (ulele kwaye ungenazintlungu) okanye i-epidural okanye i-anesthesia yomqolo. Ngexesha lenkqubo, ugqirha wakho wotyando uya:

• Yenza ukusika okuncinci kotyando kufutshane nomqala, ukufumana umthambo wobufazi.
• Faka i-stent (i-coil yesinyithi) kunye nokwenza okwenziwe ngumntu (okwenziweyo) ngokuncitshiswa komthambo.
• Emva koko sebenzisa idayi ukucacisa ubungakanani be-aneurysm.
• Sebenzisa i-x-ray ukukhokela ukufakelwa kwe-stent kwi-aorta yakho, apho kukho i-aneurysm.
• Emva koko vula i-stent usebenzisa indlela efana nentwasahlobo kwaye uyixhome kwiindonga ze-aorta. I-aneurysm yakho iya kuncipha ngeenxa zonke.
• Okokugqibela sebenzisa i-x-reyi kunye nedayi kwakhona ukuze uqiniseke ukuba i-stent ikwindawo elungileyo kwaye i-aneurysm yakho ayophisi ngaphakathi emzimbeni wakho.

I-EVAR yenziwe ngenxa yokuba i-aneurysm yakho inkulu kakhulu, ikhula ngokukhawuleza, okanye iyavuza okanye iyopha.

Unokuba ne-AAA engabangeli naziphi na iimpawu okanye iingxaki. Umboneleli wakho wezempilo unokufumana le ngxaki xa une-ultrasound okanye i-CT scan ngesinye isizathu. Kukho umngcipheko wokuba le aneurysm inokuvula (uqhekeko) ukuba awunayo utyando ukuyilungisa. Nangona kunjalo, utyando lokulungisa i-aneurysm lusenokuba yingozi. Kwiimeko ezinjalo, i-EVAR lukhetho.

Wena kunye nomboneleli wakho kufuneka uthathe isigqibo sokuba ngaba umngcipheko wokuba nolu tyando mncinci kunomngcipheko wokuqhekeka ukuba awunalo utyando ukulungisa ingxaki. Umboneleli kunokwenzeka ngakumbi ukuba acebise ukuba wenze utyando ukuba i-aneurysm yile:

• Enkulu (malunga nee-intshi ezimbini okanye iisentimitha ezi-5)
• Ukukhula ngokukhawuleza (ngaphantsi kwe-1/4 intshi ngaphezu kweenyanga ezi-6 ukuya kwezi-12 zokugqibela)

I-EVAR inomngcipheko ophantsi wokuphuhlisa iingxaki xa kuthelekiswa notyando oluvulekileyo. Umboneleli wakho kunokwenzeka ukuba acebise olu hlobo lokulungiswa ukuba unezinye iingxaki zonyango okanye abantu abadala.

Iingozi zalo naluphi na utyando zezi:

• Amahlwili egazi emilenzeni anokuhamba aye emiphungeni
• Iingxaki zokuphefumla
• Usulelo, kubandakanya imiphunga, indawo yokuchama kunye nesisu
• Ukuhlaselwa yintliziyo okanye ukubetha
• Impendulo kumayeza

Iingozi zolu tyando zezi:

• Ukopha ecaleni kwegrafti efuna utyando olungakumbi
• Ukopha ngaphambi okanye emva kwenkqubo
• Ukuvalwa kwe-stent
• Ukonakala kwimbilini, okubangela ubuthathaka, iintlungu, okanye ukuphazamiseka emlenzeni
• Ukungaphumeleli kwezintso
• Ukunikezelwa kwegazi okungalunganga kwimilenze yakho, izintso zakho, okanye amanye amalungu
• Iingxaki zokufumana okanye ukugcina ulwakhiwo
• Utyando aluphumelelanga kwaye kufuneka uqhaqho oluvulekileyo
• Isitayile siyatyibilika
• Ukuvuza kuvuza kwaye kufuna utyando oluvulekileyo

Umboneleli wakho uya kukuvavanya kwaye a-odole iimvavanyo ngaphambi kokuba wenze utyando.

Soloko uxelela umboneleli wakho ukuba zeziphi iziyobisi ozithathayo, nditsho neziyobisi, izongezo, okanye imifuno oyithengileyo ngaphandle kommiselo.

Ukuba uyatshaya, kuya kufuneka uyeke. Umboneleli wakho unokunceda. Nazi ezinye izinto ekufuneka uzenzile ngaphambi kotyando lwakho:

• Malunga neeveki ezimbini ngaphambi kotyando lwakho, uyakundwendwela umboneleli wakho ukuqinisekisa ukuba naziphi na iingxaki zonyango, ezinjengesifo seswekile, uxinzelelo lwegazi kunye neengxaki zentliziyo okanye zemiphunga ziphathwa kakuhle.
• Kananjalo unokucelwa ukuba uyeke ukuthatha iziyobisi ezenza kube nzima kwigazi lakho ukubambeka. Oku kubandakanya i-aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), warfarin (Coumadin), kunye ne naprosyn (Aleve, Naproxen).
• Buza ukuba zeziphi iziyobisi ekufuneka uzithathile ngosuku lotyando lwakho.
• Soloko uxelela umboneleli wakho ukuba ufumana ukubanda, umkhuhlane, umkhuhlane, ukuphuma kweherpes, okanye esinye isifo ngaphambi kotyando lwakho.

Ngokuhlwa ngaphambi kotyando lwakho:

• Sukusela nantoni na emva kobusuku, kubandakanya namanzi.

Ngomhla wotyando lwakho:

• Thatha nawaphi na amayeza ugqirha wakho akuxelele ukuba uwathabathe ngesiphuzo esincinci samanzi.
• Uzakuxelelwa ukuba ufike nini esibhedlele.

Uninzi lwabantu luhlala esibhedlele iintsuku ezimbalwa emva kolu tyando, kuxhomekeke kuhlobo lwenkqubo ababenayo. Rhoqo, ukubuyela kwimeko yesiqhelo kule nkqubo kukhawuleza kwaye kungabikho zintlungu zingaphantsi kotyando oluvulekileyo. Kananjalo uya kuba nakho ukubuyela ekhaya kwakamsinya.

Ngexesha lokuhlala esibhedlele, unga:

• Yiba kwigumbi labagula kakhulu (ICU), apho uza kujongwa kakhulu kuqala
• Yiba necatheter yomchamo
• Nikwa amayeza okunciphisa igazi lakho
• Khuthazwa ukuba uhlale ecaleni kwebhedi yakho uze uhambe
• Nxiba izitokhwe ezikhethekileyo ukunqanda amahlwili egazi emilenzeni yakho
• Fumana iyeza lentlungu kwimithambo yakho okanye kwindawo ejikeleze intambo yakho yomqolo (epidural)

Ukubuyiselwa emva kokulungiswa kwe-endovascular kukhawuleza kwiimeko ezininzi.

Kuya kufuneka ujongwe kwaye ujongisiswe rhoqo ukuze uqiniseke ukuba i-aortic aneurysm yakho ayivuzi gazi.

IVAR; Ukulungiswa kwe-endovascular aneurysm - aorta; Ukulungiswa kweAAA - i-endovascular; Ukulungisa-i-aortic aneurysm-endovascular

• Ukulungiswa kwe-aortic aneurysm-endovascular-discharge

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IBrinster CJ, iSternbergh WC. Iindlela ze-Endovascular aneurysm. Ku: Sidawy AN, Perler BA, ii-eds. Utshintsho lukaRutherford lweeVascular and Therapy ze-Endovascular Therapy. Umhla we-9. IPhiladelphia, PA: Elsevier; I-2019: isahluko 73.

UTracci MC, uCherry KJ. I-aorta. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, ii-eds. Incwadi yeSabiston yoNyango. Umhla we-20. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 61.