Restenosis na-ezo aka na-adị nwayọọ na-agbatịghachi nke akwara akwara mgbe a na-emeso blockage na ọrịa angioplasty . Ọ bụrụ na restenosis emee, ọ na-emekarị n'ime 3 - 12 ọnwa nke usoro. N'ihi na restenosis na-eme ka akwara na-abawanye ọzọ, ihe mgbaàmà nke angina na -alaghachi.
A ghọtara Resenosis dịka nsogbu na mmalite nke ọrịa angioplasty, na - eme ihe dịka 40 - 50% nke ndị a na - agwọ ọrịa nanị.
N'ezie, ebumnuche ndị e mepụtara na mbụ bụ iji belata ntụgharị nke restenosis.
Ruo oke ogo, stents enwewo ihe ịga nke ọma n'ime otú ahụ. Ọbụna na ọgbọ mbụ nke stent metal stents (BMS), a na-ebelata ụba nke restenosis (ihe dịka 20 - 30% n'ime ọnwa 12). N'ikpeazụ, a na-emepụta stent (DD) ọgwụ-eluting stents iji gbalịa belata nkwụsịtụ ọbụna n'ihu. Na DES, a na-eji ọgwụ ọjọọ emechie stents ndị na-egbochi ahụ anụ ahụ nke na-eduba na restenosis.
Ọgbọ mbụ nke DES na-ebelata ụba restenosis ruo ihe dịka 15% na afọ ise. Ọhụụ ọhụrụ abaarala ọnụ ọgụgụ nke restenosis ọbụna n'ihu, ihe dịka 5 - 7% na afọ ise.
Kedu ihe na-akpata Restenosis?
Angioplasty (na stent placement, ebe ọ bụ na-esonyere ya na angioplasty) bụ ụdị nke anụ ahụ trauma. N'oge nkuku, a na-agafe otu catheter nke na-ebu balloon na-ekpuchi isi ihe atherosclerotic na akwara akwara, mgbe ahụ, a na-amụba balloon.
Onu ogugu nke balloon na-eme ka ihe akara a di na ya, si otú a na-emepe oghere nke ikuku. A na - agbasapụ stent - usoro nke obere nkwụsị - na saịtị nke angioplasty, iji mee ka okpukpu ahụ gbasaa ka ọ daa azụ. Mkpakọ (ma ọ bụ "ịkụda," ma ọ bụrụ na ịchọrọ) nke ihe akara a abụghị usoro dị nro, na ọ na-emekarị ka ọnya mgbochi ọbara dị.
A na-eme ka ahụ dịghachi na-apụta n'ihi uto anụ ahụ na saịtị nke ọgwụgwọ. Enwere ike iche na ọ bụ n'ihi usoro "ọgwụgwọ" na-esochi nsogbu nke ọrịa angioplasty. Mkpụrụ ndụ endothelial nke na-ejikarị eriri akwara ọbara na-amụba na saịtị nke trauma. Ọ bụrụ na ụbụrụ nke endothelial a na-aba ụba, mkpụrụ ndụ nwere ike igbochi arịa ọbara na saịtị ahụ.
Ndozigharị pụkwara ime n'ihi ntụgharị atherosclerosis na - agagharị - usoro nke mere ka akwara akwara na-ekpuchi na mbu. Restenosis kpatara site na atherosclerosis na - achọpụta ogologo oge mgbe usoro - otu afọ ma ọ bụ karịa. A na-ahụkarị ihe ndị ọzọ edozi, nke a na-ahụkarị n'ime ọnwa isii na ihe fọrọ nke nta ka ọ bụrụ n'ime ọnwa iri na abụọ na-esote usoro ahụ, na-emekarị ka uto nke anụ ahụ na-akpata.
Restenosis vs. Thrombosis
Ndochi ahụ abụghị otu ihe ahụ dị ka ọnyá thrombosis na-atụ ụjọ - nchịkọta mberede nke ụbụrụ site na e guzobere eriri ọbara. Ngwọrọgwu na-emekarị ka ọ bụrụ ọdachi, ebe ọ bụ na ọ na - emepụta mgbochi mberede na ngwụcha zuru oke nke akwara akwara. Ihe ize ndụ nke thrombosis bụ nke kachasị izu ole na ole mbụ ma ọ bụ ọnwa mgbe ọ na-etinye ego, ma a na-ebelata nke ukwuu site na iji ọgwụ na-emechi platelet .
Enwerekwa obere ihe ize ndụ nke strombosis na-egbu oge - thrombosis nke na-eme otu afọ ma ọ bụ karịa mgbe e debere ọgwụ ahụ - na afọ ndị na-adịbeghị anya, ọ pụtawo na a ghaghị ịnọgide na-eji ọgwụ ọjọọ eme ihe maka ọ dịkarịa ala otu afọ na ikekwe ogologo oge . Otú ọ dị, ụzọ kachasị mma iji gbochie ọnyá thrombosis ụbịa, na-anọgide na-arụrịta ụka.
Kedu Ka E Si Eme Ka Ndozigharị Nagide?
Mgbe ojiji nke DES na-eme ka ọnụ ọgụgụ nke stent restososis dị ukwuu, ọ kwụsịghị nsogbu ahụ.
Ọ bụrụ na restenosis emee ma na-emepụta ihe mgbaàmà nke angina, ọgwụgwọ na-agụnyekarị usoro imegharị - ya bụ, ịtinye nke abụọ stent na otu ọnọdụ.
Ọgwụgwọ ahụike (enweghị ọgwụ) maka angina bụkwa ihe ọzọ. Ịwa ahụ na-agwọ ọrịa ọbara na- agagharị bụ nhọrọ ọzọ maka ndị nwere ume ahụ ike, karịsịa ma ọ bụrụ na restenosis na-alaghachi mgbe ụdọ nke abụọ gasịrị.
Nchịkọta
Restenosis bụ mmalite njedebe kachasị n'iji angioplasty na stents maka ọrịa akwara obi. Ka nkà na ụzụ siri ike ka mma, restenosis ugbu a dị nnọọ oke dị ka nsogbu. Otú ọ dị, iji ihe eji eme ihe n'oge a emeela ka nsogbu ọzọ maka nlekọta maka nlekọta ọrịa ọrịa akwara ọbara - stent thrombosis. Ụzọ kacha mma iji belata nsogbu nke nsogbu ọhụrụ a ka na-arụ ọrụ.
> Isi mmalite:
> Dangas GD, Claessen BE, Caixeta A, et al. Akwụsịgwụ siri ike na Ọgwụ Ọjọọ-ọgwụ. J Am Coll Cardiol 2010; 56: 1897.
> Piccolo R, Stefanini GG, Franzone A, et al. Safety and Efficacy of Resolute Zotarolimus-eluting Ihe Ndị E Ji Nyere na Everolimus-eluting Stents: a Meta-analysis. Circ Cardiovasc abanye n'afọ 2015; 8.
> Räber L, Wohlwend L, Wigger M, et al. Afọ ise nke nyocha na nke Angiographic Mmeputara nke N'iji Ntuzi nke Sirolimus-eluting na Paclitaxel-eluting Stents: Ebube nke Sirolimus-Eluting Versus Paclitaxel-Eluting Stents for Coronary Revascularization Kwụsị ikpe. Oge 2011; 123: 2819.