Stents, bypass kubagwa byerekana ko nta nyungu zigaragara ku rupfu rw’indwara z'umutima ku barwayi bahamye

16 Ugushyingo 2019 - Na Tracie White

ikizamini
David Maron

Abarwayi bafite uburwayi bukomeye ariko butajegajega bavurwa hakoreshejwe imiti ndetse n’inama z’ubuzima bonyine ntibagifite ibyago byo guhitanwa n’umutima cyangwa urupfu kurusha ababazwe uburyo bwo kubaga ibitero, nk'uko byagaragajwe n’ikigereranyo kinini, cyatewe inkunga na federasiyo kiyobowe n’abashakashatsi bo muri Stanford Ishuri ry'ubuvuzi n'ishuri ry'ubuvuzi rya kaminuza ya New York.

Ubushakashatsi bwerekanye ariko ko mu barwayi barwaye indwara zifata imitsi na bo bafite ibimenyetso bya angina - ububabare bwo mu gatuza buterwa no gutembera kw'amaraso mu mutima - kuvura hakoreshejwe uburyo butera, nka stent cyangwa kubagwa bypass, byagize akamaro kanini mu kugabanya ibimenyetso no kuzamura imibereho.

David Maron, MD, umwarimu w’ubuvuzi w’ubuvuzi akaba n’umuyobozi ushinzwe indwara z'umutima zikumira indwara mu ishuri ry’ubuvuzi rya Stanford, yagize ati: "Ku barwayi bafite uburwayi bukomeye ariko butajegajega badashaka kunyura muri ubwo buryo butera, ibisubizo biraduhumuriza cyane." bafatanije kuyobora iburanisha, ryiswe ISCHEMIYA, kugira ngo bige ku rwego mpuzamahanga rw’ubuzima bugereranije n’ubuzima bwiza hamwe n’ubuvuzi.

Maron, akaba n'umuyobozi w'ikigo cy’ubushakashatsi cyo gukumira Stanford, yongeyeho ati: "Ibisubizo ntibisobanura ko bagomba gukurikiza inzira kugira ngo birinde indwara z'umutima."

Ibikorwa byubuzima byapimwe nubushakashatsi birimo urupfu rwindwara zifata umutima, indwara z'umutima, ibitaro bya angina idahindagurika, ibitaro kubera kunanirwa k'umutima no kuzura nyuma yo gufatwa k'umutima.

Ibyavuye mu bushakashatsi byitabiriwe n’abantu 5.179 ku mbuga 320 zo mu bihugu 37, byatanzwe ku ya 16 Ugushyingo mu ishyirahamwe ry’imitima ry’Abanyamerika ry’umutima ryabereye i Philadelphia.Judith Hochman, MD, umuyobozi mukuru wungirije ushinzwe ubumenyi bw’ubuvuzi mu ishuri ry’ubuvuzi rya NYU Grossman, yari umuyobozi w’urubanza.Ibindi bigo byagize uruhare mu gusesengura ubushakashatsi ni Saint Luke's Mid America Heart Institute na Duke University.Ikigo cy’igihugu cy’umutima, ibihaha, n’amaraso cyashoye miliyoni zirenga 100 z’amadolari muri ubu bushakashatsi, bwatangiye kwandikisha abitabiriye mu 2012.

'Kimwe mu bibazo nyamukuru'
Ati: “Iki ni kimwe mu bibazo nyamukuru by’ubuvuzi bw’umutima n’umutima kuva kera: Ubuvuzi bwonyine bwonyine cyangwa ubuvuzi buvurwa hamwe n’uburyo busanzwe bwo gutera indwara ari bwo buryo bwiza bwo kuvura iri tsinda ry’abarwayi bafite umutima uhamye?”nk'uko byatangajwe n’umushakashatsi w’ubushakashatsi Robert Harrington, MD, umwarimu akaba n’umuyobozi w’ubuvuzi muri Stanford na Arthur L. Bloomfield Umwarimu w’ubuvuzi.Ati: "Njye mbona ibi ari ukugabanya umubare w’ibikorwa byo gutera."

ikizamini
Robert Harrington

Ubushakashatsi bwakozwe hagamijwe kwerekana imikorere yubuvuzi iriho, aho abarwayi bafite ubumuga bukabije bwimitsi yabo bakunze kubagwa angiogramu no kuvugurura imitsi hamwe no kubagwa stent cyangwa kubagwa.Kugeza ubu, nta bimenyetso bike bya siyansi byemeza niba ubwo buryo bukora neza mu gukumira indwara mbi z'umutima kuruta kuvura abarwayi bafite imiti nka aspirine na statine.

Harrington, usanzwe abona abarwayi yagize ati: "Niba ubitekerezaho, hari ubushishozi bwerekana ko niba hari inzitizi mu mitsi hamwe n'ibimenyetso byerekana ko kuziba bitera ikibazo, gufungura iyo nzitizi bigiye gutuma abantu bamererwa neza kandi bakabaho igihe kirekire". n'indwara z'umutima n'imitsi kuri Stanford Health Care.Ati: “Ariko nta kimenyetso cyerekana ko byanze bikunze ari ukuri.Niyo mpamvu twakoze ubu bushakashatsi. ”

Ubuvuzi butera burimo catheterisiyoneri, uburyo bukoreshwa muburyo bwa catheter imeze nk'umuyoboro winjira mu mitsi mu muhogo cyangwa mu kuboko hanyuma ugahuzwa binyuze mu mitsi y'amaraso kugeza ku mutima.Ibi bikurikirwa no kuvugurura ibintu, nkuko bikenewe: gushyira stent, iyinjizwa muri catheter kugirango ifungure imiyoboro yamaraso, cyangwa kubaga umutima bypass, aho iyindi miyoboro cyangwa imitsi yongeye koherezwa kugirango irengere agace kahagaritswe.

Abashakashatsi bakoze ubushakashatsi ku barwayi b'umutima bari bameze neza ariko babana na ischemia itagereranywa kandi ikabije iterwa ahanini na aterosklerose - kubitsa plaque mu mitsi.Indwara z'umutima Ischemic, zizwi kandi nk'indwara zifata imitsi cyangwa indwara z'umutima, ni ubwoko bw'indwara z'umutima.Abarwayi bafite iyo ndwara bagabanije imiyoboro y'umutima iyo ihagaritswe burundu, itera indwara y'umutima.Ishyirahamwe ry’umutima ry’Abanyamerika rivuga ko Abanyamerika bagera kuri miliyoni 17,6 babana n’iki kibazo, bikaviramo abantu bagera ku 450.000 buri mwaka.

Ischemia, igabanya umuvuduko wamaraso, akenshi itera ibimenyetso byububabare bwo mu gatuza buzwi nka angina.Abagera kuri bibiri bya gatatu by'abo barwayi b'umutima biyandikishije mu bushakashatsi bagize ibimenyetso by'ububabare bwo mu gatuza.

Abashakashatsi bavuze ko ibyavuye muri ubu bushakashatsi bitareba abantu bafite ibibazo bikaze by’umutima, nk’abafite ikibazo cy’umutima.Abantu bahura nibibazo byumutima bikwiye guhita bashaka ubuvuzi bukwiye.

Kwiga byateganijwe
Kugira ngo hakorwe ubushakashatsi, abashakashatsi bagabanije abarwayi mu matsinda abiri.Amatsinda yombi yakiriye imiti ninama zubuzima, ariko rimwe muritsinda ryonyine ryakorewe inzira zitera.Ubushakashatsi bwakurikiranye abarwayi hagati yimyaka 1½ nimyaka irindwi, bugumisha ibisobanuro kubintu byose byumutima.

Ibisubizo byagaragaje ko abakorewe uburyo bwo gutera bari bafite igipimo cya 2% kiri hejuru y’indwara z'umutima mu mwaka wa mbere ugereranije n'iz'ubuvuzi bwonyine.Abashakashatsi bavuze ko ibyo byatewe n'ingaruka z'inyongera zizanwa no kugira inzira zitera.Umwaka wa kabiri, nta tandukaniro ryerekanwe.Umwaka wa kane, igipimo cyibyabaye cyari munsi ya 2% kubarwayi bavuwe nuburyo bwumutima kuruta kubuvura ninama zubuzima bwonyine.Abashakashatsi bavuze ko iyi myumvire yatumye nta tandukaniro rikomeye riri hagati y’ingamba zombi zo kuvura.

Mu barwayi batangaje ko ububabare bwo mu gatuza buri munsi cyangwa buri cyumweru batangiye ubushakashatsi, 50% by'abavuwe ku buryo budasubirwaho wasangaga nta angina bafite nyuma y'umwaka, ugereranije na 20% by'abavuwe bafite ubuzima n'imiti bonyine.

Maron yagize ati: "Dushingiye ku bisubizo byacu, turasaba ko abarwayi bose bafata imiti yagaragaye ko igabanya ibyago byo guhitanwa n'umutima, bagakora cyane, bakarya indyo yuzuye kandi bakareka itabi."Ati: “Abarwayi badafite angina ntibazabona iterambere, ariko abafite angina y'uburemere ubwo aribwo bwose bazagira iterambere ryinshi, rirambye mu mibereho yabo niba bafite inzira z'umutima zitera.Bagomba kuvugana n'abaganga babo kugira ngo bahitemo niba bazongera kubaho. ”

Abashakashatsi barateganya gukomeza gukurikirana abitabiriye ubushakashatsi indi myaka itanu kugirango bamenye niba ibisubizo bihinduka mugihe kirekire.

Ati: “Bizaba ngombwa gukurikirana kugira ngo turebe niba, igihe, hazabaho itandukaniro.Mu gihe twakurikiranye abitabiriye amahugurwa, nta kubaho rwose kwabayeho bivuye ku ngamba zo gutera ”, Maron.Ati: “Ntekereza ko ibisubizo bigomba guhindura imikorere y’ubuvuzi.Inzira nyinshi zikorwa kubantu badafite ibimenyetso.Biragoye gusobanura gushyira abarwayi mu gihagararo kandi nta bimenyetso bafite. ”