Zvidzidzo Zviratidzei Murairo weNzira Yakakurumbira
Kana iwe kana munhu waunoda akawanikwa ane coronary artery chirwere (CAD) , unogona kuiswa nechisarudzo cheitiro inonzi inonzi percutaneous coronary intervention (PCI). ICPI inosanganisira nzira mbiri dzakasiyana:
- Angioplasty, iyo iyo tube inoshandiswa mukati meyeri uye inokonzerwa kuti iwedzere mudziyo uye kuwedzera kubuda kweropa
- Kuiswa kwe stent, mesh mesh tube iyo inobata mudziyo wakazaruka uye inodzivisa kubviswa kubva pakugadzirisa zvakare.
Kunyange zvazvo nzira yacho yakajeka chaizvo uye iri nyore kunzwisisa, inogona here kuwedzera tariro yeupenyu kana kuvandudza mukana wekupona?
Chidzidzo cheKliniki Chinounza Zviitiko Zvinoshamisa
Mukupindura kumubvunzo uyu-wakabvunzwa, boka rinotsvakurudza raibhadharwa neVeteran Administration's Reseach uye Development Unit rakaenzanisa migumisiro kune vanhu vakagadzirirwa zvakanakisisa kurapwa kwemaawa (OMT) kuti vabate CAD yavo kune avo vakagadziridzwa maWTT nePCI.
Yakabatwa neCOURAGE (Clinical Outcomes Uchishandisa Revascularization uye Aggressive Drug Evaluation) kuongororwa, svondo ra2007 rakagumisa kuti vanhu vakapiwa OMT voga vakanga vasina dambudziko guru rekurwadziwa kwemoyo kana kufa kunze kweivo vakapa OMT nePCI. Uyezve, PCI haina kupa chero ruzivo pane OMT mukuderedza zviratidzo zve angina .
Mutevedzeri muna 2015 unosimbisa zvakare izvi.
Kutsanangura Migumisiro
Zvigumisiro zvaishamisika kune vakawanda vari munharaunda yezvokurapa avo vakanga vagara vachifunga kuti PCI inobatsira avo vane chirwere chakanyanya kuvhara.
Yakanga ichangobva kuongorora mafambiro evarwere-uyewo kukwana kwebato racho-izvo vatsvakurudzi vakakwanisa kutsanangura zvinowanikwa.
Pakati pezvavakagumisa:
- Vanhu vakawana PCI kazhinji vakadzokera kune maitiro avo okutanga aive pamba (kusanganisira kunyanya kudyiwa nyama yakatsvuka uye mafuta asina kunaka ).
- ICPI pachayo inowanzokuvadza rusvingo rwemitare uye kuwedzera njodzi yekudzivirirwa kwechipiri. Zvechokwadi, 21 kubva muzana yeboka rePCI raida imwe shent mukati pemwedzi mitanhatu, asi 60 muzana yemidziyo yakarapwa yaida kudzokorora.
- Nzira yePCI yaibatanidzawo nengozi yakakura yekubuda ropa, kurwadziwa kwemwoyo, nekurova, nekubudirira kubvisa zvizhinji zvezvibereko zvekurapa.
Chimwe chinhu chinokosha ndechekuti mabheti anotarirwa muPCI haasi iyo inowanzokonzera chirwere chemwoyo kana kurohwa. Pane kudaro, zvinetso izvi zvakabatana zvikuru kune zvisiri izvo zvinopesana nezvivharo zvakashata, zvisinganyatsogadzikane, uye zvakanyanya kupera.
Kunyange zvazvo angioplasty uye kushivirira kunogona kupa ruregerero rwemazuva mashoma, mutoro mukuru wechirwere ichi unoramba wakanyatsogadzikana uyewo njodzi yezviitiko zvepamwoyo yemangwana.
Chirapa Inoshanda Pasi Pokuongororwa
Kukanganisa kunowedzera kune zvekurapa. A 2010 kuongorora kwechirongwa cheCOURAGE chakataura kuti vashoma vanopfuura 45 muzana yevarwere vane CAD vakawana kuongororwa kwepfungwa vasati vasarudza PCI. Zvinorehwa izvi ndezvokuti vanachiremba vazhinji vakakundikana kutarisa zvimwe zvinogadziriswa zvinhu, zvakadai sekudya uye maitiro, zvisati zvambopa nzira.
Nemhaka yeizvi, vanhu vazhinji vangangodaro vasina kunyatsoziva nezvekudikanwa kwekuchinja maitiro, kusanganisira kupera kwekusvuta , kana vachinge vasunungurwa kubva mukuchengetwa.
Izvi Zvinotitaurira
Somugumisiro wekutongwa kweCOURAGE, American Heart Association neAmerican College of Cardiology yakabudisa mazano anotsanangura kushandiswa kwakakodzera kwePCI kune vanhu vane chirwere chepfungwa. Vanosimbisa kuchinja mararamiro uye kushandiswa kwakakodzera kwemishonga mumutambo wekutanga-mutsara apo mwoyo wemamiriro acho akasimba.
Aya mazano anotsigirawo kudiwa kwekuona kuti munhu anonyatsoteerera kurapwa asati afungisisa PCI. Mune zviitiko zvizhinji, kuvandudzwa kwekuteerera kunonyatsoenderana nekuvandudzika kana kusimbiswa kwemamiriro emwoyo.
Kumugumo uyu, kana une chirwere chemwoyo, haufaniri kumboona PCI se "kurumidza kugadzirisa." Chirwere chinogara kwenguva refu chichagara chiri chiito chekuita muviri , kudya kwakanyatsonaka, kwakaderera-mafuta , uye kunyatsoteerera kumishonga yako isingaperi.
> Sources:
> Boden, W .; O'Rourke, R .; Teo, K. et al. "Kurapa kwakanaka kwechiremba kana kuti pasina PCI yezvirwere zvakasimba zvakasimba." N Engl J Med. 2007, 356: 1503-16. DOI: 10.1056 / NEJMoa070829.
> Desai, N .; Bradley, S ;; Parzynski, C. et al. "Kushandisa Zvakakodzera Criteria for Coronary Revascularization uye Matanho Emashandisirwo, Kurapa Kwevarwere, uye Kufanirwa kwePerccutary Coronary Intervention." JAMA. 2015; 314: 2045-53. DOI: 10.1001 / jama.2015.13764.
> Finn, A .; Nakano, M .; Narula, J. et al. "Chirevo chekunetseka / chisina kugadzikana." Arterioscler Thromb Vasc Biol . 2010; 30: 1282-92. DOI: 10.1161 / ATVBAHA.108.179739.
> Levine, G .; Mabhangi, E .; Kubwinya, J .; et al. "2015 ACC / AHA / SCAI Inotarisa Kuvandudzwa kweKunyanzvi yeCononary Coronary Intervention yevarwere ne ST-Elevation Myocardial Infarction .." Circulation. 2015; 87 (6): 1001-19. DOI: 10.1161 / CIR.0000000000000336.
> Sedlis, S ;; Hartigan, P .; Teo, K. et al. "Migumisiro yeCPI paKupona Kwemazuva Akareba Muvarwere vane Stable Ischemic Heart Disease." N Engl J Med . 2015; 373: 1937-46. DOI: 10.1056 / NEJMoa1505532.