Stenting ntawm cov hlab ntsha hauv lub plawv

Rau cov kev kho mob ntawm coronary mob plawv, uas yog raws li nyob rau hauv lub narrowing ntawm lub coronary hlab ntsha (lawv pub rau cov myocardium), nyob rau hauv 1977 zais pa angioplasty ntawm cov hlab ntsha tau ua rau cov thawj lub sij hawm. Nyob rau hauv feem ntau tus neeg mob, qhov ua rau narrowing ntawm cov hlab ntsha yog roj deposits rau cov intima ntawm cov hlab ntsha, uas leads mus rau ib tsis txaus mov ntawm oxygen mus rau lub cardiomyocytes. Raws li ib tug tsim nyog tau, tsim angina thiab myocardial infarction.

Zais pa angioplasty txheej txheem yog raws li nyob rau hauv lub fact tias rau ntawm lub plawv los ntawm cov femoral leeg noj catheter rau nws kawg nyob ib cuff (zais pa deflated). Nyob rau hauv X-ray tswj catheter yog noj ncaj qha mus rau qhov chaw ntawm lub narrowing, thiab ces lub zais pa yog inflated - leeg txhab. Cov kev qhia tau zoo, tab sis feem ntau relapse (artery re-narrows, thiab ho).

Nyob rau hauv kev txiav txim mus cuag cov hauj lwm zoo ntawm zais pa angioplasty, cov kws kho mob tau tsim ib tug tshiab txoj kev - mob vascular stenting. Ib tug stent yog ib tug nws yog xim hlau tubular mesh, ib yam ntawm cov stainless steel ncej. Hauv lub artery, nws expands, tsis uas nws spasm. Lub plawv vascular stenting yog ua los ntawm ntaub ntawv sib txawv uas muaj ntau zog. Ntawm loj tshaj kev txaus siab yog stents uas yog coated nrog polymeric cov ntaub ntawv thiab lam tshuaj (e.g., cytotoxic anticancer yeeb siv tshuaj). Stenting ntawm cov hlab ntsha hauv lub plawv xws catheters yuav txo tau tus nqi ntawm tsim ntawm atherosclerotic plaques. Tab sis nws yog tsim nyog nco ntsoov tias los ntawm kev siv cov stents tus nqi ntawm kev kho neeg mob ntawm lub puab phab ntsa ntawm cov hlab ntsha decreases, uas yog ib qhov zoo tshaj ntawm thrombosis uas muaj feem yuav.

Stenting ntawm cov hlab ntsha ntawm lub plawv nyob rau hauv raws nraim tib txoj kev raws li zais pa angioplasty. Nws muaj tsuas yog ib tug txawv ntawm lub zais pa stent hnav khaub ncaws, coated plhaub. Thaum qhia ib catheter rau hauv lub coronary artery sheath yog muab tshem tawm, thiab ces ntxiv pa rau lub zais pa, lub stent rau wires qhov chaw uas ib leeg yog roj. Yog li, lub txhab leeg phab ntsa yog muaj zog thiab tam ntawm sab hauv.

Thaum lub tam sim no theem ntawm lub plawv stents - cawm coronary artery bypass grafting. Nws yuav tsum tau muab sau tseg lwm zoo nam ntawm stenting: lub spasm ntawm lub coronary hlab ntsha thaum lub sij hawm zais pa angioplasty yuav tsim ib tug myocardial infarction, uas yuav zam tau los ntawm kev siv ib tug stent. Stenting ntawm cov hlab ntsha ntawm lub plawv tam sim no - ib tug lwm txoj txoj kev coronary artery bypass grafting. Nyob rau hauv tas li ntawd, yog hais tias nyob rau thaum kawg ntawm lub lag luam kev zais pa angioplasty coronary artery spazmiruyutsya, nws yog tau txoj kev loj hlob ntawm myocardial infarction, thiab stent nyob rau hauv qhov teeb meem no yuav pab kom tsis txhob no loj yam tab kaum. Thaum coronary artery bypass phais ib nrab ntawm cov neeg mob tsim stenosis ntawm lub shunt. Nws stenting yog ib tug zoo lwm txoj rau rov coronary bypass. Tsis tas li ntawd plawv stents - ib tug lwm txoj rau thrombolysis thiab qhov zoo tshaj plaws technology rau cov kev kho mob ntawm mob myocardial infarction ncaj qha nyob rau hauv thawj lub sij hawm ntawm nws txoj kev loj hlob.

Txawm li cas los, muaj contraindications rau txoj kev ua no. Stent kev tso kawm yog tsis tau nrog diffuse narrowing ntawm lub coronary hlab ntsha. Tsis tas li ntawd, ib tug insurmountable chaw khuam siab yog me me (tsawg tshaj li 2.8 hli) txoj kab uas hla ntawm lub roj leeg.

Rau kev tiv thaiv ntawm thrombotic txheej xwm txoj kev ua no yog ua nyob rau tom qab ntawm anticoagulants.

Tom qab xws li ib lub lag luam, tus neeg mob nyob rau hauv lub tsev kho mob rau 5-7 hnub nyob ib ncig ntawm lub moos kho mob saib xyuas. Postoperatively tseem antiplatelet thiab anticoagulation txoj kev kho.