Thaum tham nrog tsev neeg hais txog kev npaj ua haujlwm, nws tau tshaj tawm tias cov lus cog tseg rau lub cev tuag tau hais tias yog "lub sijhawm tawg" ntawm WeChat. Nws ua rau kuv ceeb heev. Txij li thaum qhia tawm ntawm txoj kev kho cov hlab ntshav stent thaum xyoo 1980, nws tau dhau los ua kab mob plawv. Cov qauv kev kho mob yog tus sawv cev ntawm kev phais neeg thoob ntiaj teb. Ntau cov pov thawj hauv kev kho mob thoob ntiaj teb qhia tau hais tias cov mob hlab ntsha hlwb ntau txhim kho txoj kev muaj sia nyob ntawm cov neeg mob myocardial infarction thiab tsis khov kho lub siab lub ntsws pectoris, thiab txhim kho lub neej zoo ntawm cov neeg mob plawv mob rau lub plawv ntau lub neej ntawm cov neeg mob. Cov kev tshaj tawm dhau los tau dhau los rau qee qhov xwm txheej tom qab stent cog, yog li muaj "lub sij hawm foob pob", uas yog qhov muaj kev ntxub ntxaug tiag tiag. Hauv qab no, Kuv yuav ua ib qho kev ntsuam xyuas tshwj xeeb ntawm ntau qhov kev txi ntawm kev mob ntshav ntawm txoj hlab ntshav txhawm rau saib nws.
1. Cia li tuag sai sai tom qab stent?
Ua ntej txhua yam, qhov no yog ib daim ntawv tshaj tawm, tsawg tsawg, thiab yog vim li cas yuav tsum tau ntsib ob qho tib lub sijhawm: ib qho yog stent tso rau sab laug pob tw (qhov chaw nyob ntawm lub cev qhov chaw), thiab lwm qhov yog mob siab occlusion. nyob rau hauv stent (feem ntau yog thrombosis). Cov laj thawj tseem ceeb rau stent thrombosis cuam tshuam nrog kev kho mob tsis zoo ntawm qhov tsis tuaj. Cov laj thawj muaj raws li nram no: Ua ntej, qee tus neeg mob tsis ua raws li kws kho mob cov lus qhia, tsis txhob muab cov tshuaj tiv thaiv ob leeg (tshuaj aspirin + clopidogrel) uas tsis muaj kev tso cai, lossis xav tau kev phais mob kev kuaj mob, tsis tau tso tseg cov tshuaj antiplatelet raws li cov kws kho mob tshwj xeeb; qhov thib ob, qee tus neeg mob tau teb tsis zoo rau cov tshuaj, tshwj xeeb tshaj yog clopidogrel yog ib qho tshuaj tiv thaiv, hauv qee cov neeg mob muaj kev tawm tsam, ua rau muaj teebmeem antiplatelet zoo thib peb yog qhov teeb meem ntawm stent technology thiab kev paub. Cov teeb meem saum toj no yog tam sim no zoo tiv thaiv nyob rau hauv cov kev mob plawv. Sab laug lub ntsiab stenting tsis yog thaj chaw txwv nyob rau hauv lub qhov muag ntawm kev paub txog kev cuam tshuam ntawm cov kws kho mob. Intravascular ultrasound (IVUS) zoo li lub qhov muag uas kws kho mob ncab mus rau hauv cov hlab ntshav, uas tuaj yeem txiav txim siab qhov loj me, kev ua raws, thiab kev cais tawm ntawm sab laug lub ntsiab stent. Rau cov neeg mob nrog clopidogrel tsis kam, kev tshuaj ntsuam zoo tuaj yeem ua los ntawm kev ua kom muaj zog thromboelastography, kev siv tshuaj tua kab mob thiab lwm yam, thiab kev tsis txaus los ntawm cov tshuaj tiv thaiv kab mob tuaj yeem tiv thaiv tau zoo los ntawm kev muab ob npaug tshuaj lossis hloov nws nrog lwm cov tshuaj xws li ticagrelor.
Yog li, rau qhov txhab mob txhab xws li sab lauj rov qab, nws yog qhov yuav tsum tau mus ntsib kws kho mob plawv los tsim kho hom phiaj xwm kho mob. Cov neeg mob yuav tsum tau saib qhov tseem ceeb rau lawv thiab ua raws nraim li kws kho mob tau txiav txim kom tiv thaiv qhov tshwm sim ntawm kev tuag sai sai tom qab stent.
2. Puas yog qhov ncauj ntshaus dua ib zaug ntxiv tom qab lub cev qaug zog thiab tsis tuaj yeem kho tom qab qhov mob tshwm sim?
Nov yog qhov teeb meem qub. Hauv lub caij nyoog ntawm cov hlau liab stents nyob hauv lub xyoo pua xeem, qhov feem pua ntawm qhov rov ua dua yog li 30%. Hauv kev teb rau cov teeb meem ntawm kev khawb lub taub hau, qhov tshwm sim ntawm kev quav yeeb tshuaj-nyob hauv 2000 tau muaj txiaj ntsig zoo daws cov teeb meem ntawm kev txwv. Kev siv tshuaj yeeb-tshuaj yog txheej txheem nrog tshuaj tiv thaiv endothelial antitumor (rapamycin lossis paclitaxel) rau ntawm qhov chaw ntawm cov hlau tsis muaj zog, uas tuaj yeem tswj tau qhov tshwm sim ntawm-stent restenosis. Tam sim no, qhov rov khi ntawm kev siv tshuaj kho mob thaum muaj kev tswj hwm ntawm 5%, qhov xwm txheej tseem tsawg heev, thiab tsis tas yuav txhawj txog ntau dhau; ib zaug kev kho mob tshwm sim nyob rau hauv lub stent, cov kev paub txog lub plawv tuaj yeem tshawb xyuas cov teeb meem tshwj xeeb thiab paub qhov laj thawj, xws li kev muaj feem yuav tswj tau, cov tshuaj tiv thaiv kab mob tiv thaiv kab mob, yug menyuam tshiab rau atherosclerosis, stent thev naus laus zis, hlau ua xua, thiab lwm yam. yam sib txawv. Peb cov txheej txheem kev cuam tshuam muaj xws li: kev sib tw siab sib zog siab zais pa nthuav dav, txiav pob zais kev nthuav dav, tshuaj-eluting stent implantation, zais pa tshuaj, thiab lwm yam, raws li qhov peb ntxiv dag zog rau kev tswj hwm ntawm cov kev pheej hmoo (saib "Cov neeg zoo li cas tau yooj yim" Yuav ua li cas kom tsis txhob mob plawv coronary? "), Kho cov tshuaj tiv thaiv kab mob hauv lub plawv, thiab lwm yam, cov neeg mob feem ntau tuaj yeem tswj tau qhov rov qab mob hauv lub plab, thiab rau cov neeg tsawg heev ntawm cov tsis tshua raug tswj tau mob (xws li tshuaj tiv thaiv hlau, mob rau cov leeg ntshav) aneurysm-zoo li nthuav dav) Etc.), koj tuaj yeem xaiv cov kev phais plawv rau kev phais mob.
3. Puas muaj kev pheej hmoo lossis kev mob loj thaum phais mob?
Tam sim no qhov feem cuam tshuam ntawm kev phais stent (PCI) tsawg dua 1%, thiab nws tseem qis dua hauv cov chaw mob plawv. Kev phais mob nruj tsuas yog siv cov tshuaj loog hauv zos, thiab tus neeg mob tsaug zog thaum ua haujlwm tag nrho. Tam sim no, ntau dua 95% ntawm cov neeg mob hauv peb qhov chaw ua haujlwm los ntawm caj npab radial leeg leeg mus kom ze nrog lub siab zoo. Me, rov qab sai tom qab kev phais, tag nrho xav txog cov yam ntxwv ntawm kev phais me me.
4. Kuv puas yuav tsum tau noj tshuaj rau lub neej tom qab stent?
Tom qab lub cev qaug lawm, koj yuav tsum tau noj tshuaj rau lub neej, tab sis tsis yog vim koj muaj lub stent, tab sis vim tias koj muaj kab mob plawv, uas yog mob ntsws ntev, xws li ntshav siab thiab ntshav qab zib, koj yuav tsum noj tshuaj rau lub neej. Kev sib raug zoo ncaj qha yog tias ob npaug tshuaj tiv thaiv kab mob (tshuaj aspirin + clopidogrel) tsis tuaj yeem nres yam tsis tau tso cai nyob rau hauv ib xyoos tom qab tso lub stent. Kuv feem ntau ceeb toom cov neeg mob tias thaum lub xyoo, ob pluag mov tuaj yeem noj tau tsawg dua, tab sis cov tshuaj tiv thaiv kab mob tsis txhob tso tseg! Qhov txaus ntshai tau sib tham txog hauv Tshooj 1.
5. Lub stent yog lub cev txawv teb chaws uas cuam tshuam los yog pleev xim rau lub cev?
Lub stent yog hlau lub cev txawv teb chaws, tab sis nws tsis muaj antigenicity. Tsis zoo li kev hloov raum thiab hloov pob txha, nws tsis tas yuav noj mov tiv thaiv kab mob thiab tsis muaj kev xyeej pov tseg. Cov tshuaj noj-ua kom tiav feem ntau them rau vascular endothelial cov pob txha tsis pub dhau 6 lub hlis txog 1 xyoos, dhau los ua "cov pob txha" hauv cov hlab ntshav thiab ua ib feem ntawm lub cev. Qhov nqus tau ruaj khov, uas tseem nyob hauv chav kuaj mob hauv chav kho mob, tuaj yeem ua kom tiav cov dej thiab cov pa carbon dioxide tsis pub dhau ob xyoos. Qhov no kuj yog qhov taw qhia ntawm kev txhim kho tom ntej ntawm lub stent. Nyob rau tam sim no, peb lub chaw tau tsim ib ntu II kev soj ntsuam kev kawm txog lub stent absorbent. Cov neeg mob siab nyiam Koj tuaj yeem sab laj rau peb sab laj.
6. Lub bracket muaj lub neej ntev, pes tsawg xyoo nws tsuas yog siv tau?
Lub stent tsis muaj lub neej pab tau zoo. Raws li tau hais hauv Tshooj 5, tom qab stent raug them los ntawm vascular endothelial hlwb, nws dhau los ua ib feem ntawm lub cev. Yog tsis muaj lub neej pab tau. Tsuav yog tsis muaj kev kho mob tshiab lossis mob atherosclerosis hauv stent, nws tuaj yeem siv rau lub neej. Cov.
7. Puas yog lub stent yuav hloov chaw thaum lub zog ua si?
Lub stents yog lub cim kev alloys tso tawm los ntawm lub zais pa nthuav dav, thiab qhov tso tawm tso tawm lub zog feem ntau siab tshaj 10 atmospheres (atm), yog li lub stent tau ntim rau hauv cov hlab ntsha phab ntsa thiab tsis tuaj yeem hloov chaw tau tom qab tso tawm tiav. Kuv feem ntau qhia rau cov neeg mob tias lawv yuav koom nrog bungee stent Tsis tuaj yeem txav mus, tsis txhob hais txog kev ya, kev ua kis las thiab lwm yam dej num.
8. Tsis tuaj yeem ua cov khoom sib nqus pev tom qab stent?
Qhov no yog ib qho teeb meem uas tau ntsib dua tom qab phais mob siab. Cov stent tam sim no feem ntau nickel-chromium lossis platinum-chromium alloy cov ntaub ntawv, nyob rau hauv uas cov hlau cov ntsiab lus me me thiab yuav tsis txav mus rau hauv cov chaw sib nqus. Ntau lub stent cov lus qhia kom meej meej qhia tias qhov sib nqus resonance tuaj yeem ua kom ruaj ntseg li ntawm 1 lub lis piam tom qab stent. kuaj mentsis.
Hauv cov ntsiab lus, qhov kev sib cav hais tias lub cev muaj zog stent yog "lub sij hawm foob pob" yog qhov tsis meej kiag li. Qhov tseem ceeb tshaj plaws yog txhawm rau txhawm rau txhawm rau txhawm rau txheeb xyuas cov stent implantation, kev tswj nruj nkag, nruj ntsuas qhov kev pheej hmoo-txiaj ntsig, thiab tsim qauv rau cov tib neeg rau cov neeg mob sib txawv. Txhawm rau kom tus neeg mob tau txais txiaj ntsig zoo, txoj kev npaj kho mob tus kheej tuaj yeem ua tiav.