Clip okanye Coil?
Igama elithi aneurysm lithetha ukuhlengahlengiswa, okanye ukwandisa, kwesitya segazi. I-Berry aneurysms, eyaziwa ngokuba yi-aneurysms ye-sacular, ibhalloon-like outouchings of art in the brain. Udonga lwe-artery lubuthathaka kulezi zine-aneurysms, oko kuthetha ukuba phantsi kweemeko ezithile, njengomxhesho ophezulu wegazi (uxinzelelo lwegazi) , udonga lwesitya lunokudiliza kwaye luvumela igazi ukuba luqhubekele kwisithuba esinqununu phakathi kwe-arachnoid mater kunye ne-mater.
Ukuphuma kwegazi, okubizwa ngokuba yi- subarachnoid , kunokubangela ukufa okanye ukukhubazeka okukhulu.
Oko kwathiwa, abaninzi abantu baneenerysms ezinobuninzi ezingapheliyo. Ukugqithisa okwenziweyo kubantu abafayo ngezizathu ezahlukahlukeneyo bafumene ukuba malunga nama-5% abantu banaloo-aneurysm. Nangona kunjalo, ngokwenene, i-aneurysms ezininzi zifunyenwe emva kokuba kwenzeke into ethile, njengokwenyuka kwegazi, okukhokelela oogqirha ukuba babone isizathu.
Emva kweemvula eziphambeneyo, kukho umngcipheko omkhulu wokubuyiselwa kwisayithi ephuliweyo. Igazi elinjalo lithwala kakhulu. Abantu abangama-70% abantu bafa ngenxa yokubuyiselwa kwe-aneurysmal. Ngesi sizathu, i-aneurysms ezinjalo azikwazi ukushiywa yedwa. Ukunyanzeliswa okanye ukuxhaswa kwamathambo kuyimfuneko.
Iziphi iiAn Aneurysms ezifuna Unyango?
Akukho mbuzo ukuba i-berry infurred aneurysm idinga unyango, kwaye ngokukhawuleza, bhetele. Umngcipheko wokuguqulwa uphezulu ngokukhawuleza emva kwexesha lokuqala lokuqhwala kwesisu.
Kodwa kuthekani ukuba uvavanyo lwezithombe ezifana ne-MRI lubonisa i-aneurysm engaphuli? Ngaba inkqubo ye-neurosurgical isadingeka? Impendulo ixhomekeka kwiimpawu ezithile ze-aneurysm.
- Ubukhulu: Izikhulu ezinamandla ezinamandla zinokukhubeka. Nangona kunjalo, kukho impikiswano malunga nokuba lukhulu kangakanani ne-aneurysm ekufuneka lube nayo ukuze kunconywe ukungenelela njengokwenziwa kotyando. Esinye sifundo esikhulu esoloko sikhokela unyango siye sacebisa ukuba i-cutoff yama-millimitha ayi-7. Kwakhona, ukuba ubukhulu buba bunkulu, unyango kufuneka luqwalaselwe.
- Indawo: I- Aneurysms kwimibhobho engemuva kwengqondo ayinayo yonke into ephantsi, kodwa inomngcipheko ophezulu wokuphuka kunama-aneurysms ngaphambili kwengqondo.
- Ixesha elidlulileyo lokumisa isisu: Umngcipheko ophezulu wokuphuma kumntu obesele aphuma kwi-aneurysm ehlukeneyo angabonisa imilambo yegazi engafanelekanga ngokubanzi.
- Imbali yentsapho: Ngokufanayo, abantu abaneenkcukacha zentsapho ye-aneurysms bavame ukuphazamiseka kwiminyaka emncinci kunye nobuncinci obukhulu be-aneurysm, mhlawumbi ngenxa yegazi elithwalwe ngumthwalo. Abantu abanamalungu amabini okanye ngaphezulu entsapho abane-aneurysms kufuneka bacinge ukuba bahlolwe ukuba babone ukuba bane-aneurysms ngokwabo.
Kungakhathaliseki ukuba kungenjalo ukungenelela kungathi kuyimfuneko kuxhomekeke ekudibaniseni zonke izinto ezilapha ngasentla. Kukho ezimbini iindlela eziphambili zokungenelela.
Ukulungiswa kwe-Aneurysm neurosurgical
Ekubeni i-aneurysms ezininzi ze-cerebral zidonsa iinqanawa eziphambili njengebholethi, zinokuthi zingabandakanywa kuyo yonke indawo yesitya ngokubeka i-clip entsimbi entanyeni ye-aneurysm.
Kule nkqubo, i-gawu ivuliwe ukuvumela i-neurosurgeon ukuba ifinyelele ingqondo kwaye ifumene indlela eya kwisitya segazi. Nangona ubunzima bokusebenza okunjalo, kwisifundo esinye, izigulane ezingama-94% zineziphumo eziphambili zokupasa.
Njengoko kudla njalo, amathuba okufumana umphumo ongcono ngakumbi xa abagqirha kunye nabasebenzi abongezelelweyo banamava kakhulu kwinkqubo.
Ingozi ekhoyo yenkqubo ibandakanya umonakalo ophezulu wengqondo okanye ukuphuma kwegazi. Nangona kunjalo, le mingcipheko ixhomekeke kwimiphumo eyingozi kakhulu yecalachnoid hemorrhage.
Ukulungiswa kwe-Endovascular Aneurysm
Ekuqaleni kwee-1990s, kwafakelwa isixhobo esivumelekileyo ukuba senze i-catheter emancinci ukuba ikhuphe emithanjeni yegazi yomzimba ukuya kwisiza se-aneurysm, apho iiplatinum zifakwe kwi-sac ye-aneurysm. Izakhelo zakhiwe ngeenxa zonke ezi ngqekembe, ngokucwangcisa i-aneurysm ukusuka kuwo wonke umzimba.
Le ndlela yokwenziwa kwe-radiological isetyenziswa ngokuqhelekileyo ngokuthi "ukubola," nangona njengoko ixesha lidlulile, ezinye iindlela zokutywinwa kwiinermsms, ezifana ne-polymers, ziye zaqala ukusebenza.
Ngokuqhelekileyo, iziphumo ze-endovascular repair aneurysm zibonakala zifaniswa nemigangatho yendlela yokucima i-neurosurgical, kodwa oku kuyahluka. Kwisifundo esinye, ukubola kwakunxulumene neziphumo ezingcono kumqolo wengqondo, kwaye ukucima kwakungcono ngaphambili. Ubukhulu kunye nesimo se-aneurysm sinokunciphisa ukhetho lwenyango, kuba intamo emininzi okanye i-aneurysm enkulu ingaphenduli kakuhle. Ngokuqhelekileyo, ukubola kubonakala kunemiphumo engcono ngokubanzi, ngaphandle kokuba kukho ithuba eliphezulu le-aneurysm ebuyela kwi-coil kune-clipping.
Ezinye izinto, ezinjengobunzima beempazamo eziphantsi komhlaba kunye nentsholongwane yempilo kunye neminyaka yesigulane, nazo zinokudlala indima ekunqumeni indlela yokuphatha i-aneurysm. Mhlawumbi into ebalulekileyo ekunqumeni ukuba i-clip okanye ibhoyili i-aneurysm yikhono kunye namava oogqirha abaya kwenza le nkqubo.
Imithombo:
Broderick JP, Brown RD Jr, uSerberbeck L, et al. Ukwehla komngcipheko omkhulu kumakhaya xa kuthelekiswa neenvermsms ezingenakonakaliswa. Stroke 2009; 40: 1952.
McLaughlin N, uBojanowski MW. Iingxaki ezinxulumene nokuhlinzwa ngokukhawuleza emva kwe-aneurysm ukufakwa kwesimboli: uhlalutyo lwezizathu kunye neziphumo zesigulane. J Neurosurg 2004; 101: 600.
I-Wiebers YENZA, i-Whisnant JP, i-Huston J 3rd, ne-al. Iimpawu zomoya ezinobungozi ezingekho phantsi: imbali yemvelo, umphumo wekliniki, kunye neengozi zokunyangwa nokugonywa kwe-endovascular. Lancet 2003; 362: 103.