Kev yaj cov ntshav txhaws sai sai feem ntau yog nyob ntawm kev kho mob nrog tshuaj. Qee zaum, kev phais mob thrombectomy kuj siv tau.

Cov hauv qab no yog cov lus qhia ntxaws ntxaws:

1 Kev tshem cov tshuaj thrombolysis

1.1 Cov tshuaj siv ntau

Urokinase: ib qho enzyme ntuj tsim los ntawm cov zis tib neeg lossis tsim los ntawm cov qe ntshav hauv lub raum. Nws tuaj yeem ua haujlwm ncaj qha rau ntawm lub cev fibrinolytic endogenous, ua kom plasminogen ua plasmin, thiab yog li ntawd yaj cov ntshav txhaws.

Streptokinase: ib qho protein uas tau rho tawm los ntawm cov kua dej ntawm cov kab mob hemolytic streptococci. Nws tuaj yeem khi rau plasminogen los ua ib qho complex, txhawb kev hloov pauv ntawm plasminogen mus rau plasmin, thiab tom qab ntawd yaj cov ntshav txhaws.

Recombinant tissue plasminogen activator (rt-PA): ib hom glycoprotein uas tuaj yeem ua kom plasminogen ua haujlwm tau thiab muaj kev sib raug zoo rau fibrin. Nws tuaj yeem xaiv ua haujlwm rau fibrin hauv cov ntshav txhaws kom rhuav tshem nws thiab ua tiav lub hom phiaj ntawm kev yaj cov ntshav txhaws. Piv nrog urokinase thiab streptokinase, rt-PA muaj kev ua haujlwm thrombolytic zoo dua thiab muaj teeb meem los ntshav tsawg dua.

1.2 Lub sijhawm kho mob

Rau cov kab mob xws li mob plawv nres thiab mob hlwb, lub sijhawm rau kev kho mob thrombolytic yog qhov tseem ceeb heev. Feem ntau, cov neeg mob uas mob plawv nres yuav tsum tau txais kev kho mob thrombolytic hauv 12 teev tom qab pib mob, zoo dua yog hauv 3-6 teev; cov neeg mob uas mob hlwb nres yog lub sijhawm zoo tshaj plaws rau kev kho mob thrombolytic hauv 4.5-6 teev tom qab pib mob.

2 Kev phais mob thrombectomy thiab kev phais mob thrombectomy

2.1 Kev phais tshem cov ntshav txhaws tawm

Nyob rau hauv kev taw qhia ntawm digital subtraction angiography (DSA), lub cuab yeej thrombectomy raug xa mus rau qhov chaw thrombus los ntawm lub catheter kom ncaj qha tshem tawm cov thrombus. Txoj kev no muaj qhov zoo ntawm kev raug mob tsawg dua thiab rov zoo sai dua, thiab nws tsim nyog rau qee tus neeg mob uas tsis tuaj yeem ua siab ntev rau kev siv tshuaj thrombolysis lossis muaj cov teebmeem thrombolysis tshuaj tsis zoo.

2.2 Kev phais tshem cov ntshav txhaws

Txiav cov hlab ntsha ncaj qha los ntawm kev phais kom tshem tawm cov thrombus. Txoj kev no feem ntau yog siv rau hauv cov xwm txheej ceev uas cov tshuaj thrombolysis thiab kev kho thrombectomy tsis tuaj yeem siv tau lossis cov txiaj ntsig tsis zoo, xws li mob hlab ntsha ntawm ceg qis. Kev phais thrombectomy tuaj yeem kho cov ntshav kom rov qab tau sai, tab sis qhov kev raug mob phais loj heev thiab muaj cov teeb meem tom qab phais ntau dua.

Txawm xaiv txoj kev twg los xij, kev kho mob rau tus kheej yuav tsum tau ua raws li tus kws kho mob qhia, raws li tus neeg mob qhov xwm txheej, xws li qhov chaw, qhov loj me, lub sijhawm tsim cov ntshav txhaws, thiab tus neeg mob lub cev tag nrho. Tib lub sijhawm, tom qab thrombolysis lossis thrombectomy, tom qab ntawd yuav tsum tau siv tshuaj anticoagulation, antiplatelet thiab lwm yam kev kho mob kom tiv thaiv kev tsim cov ntshav txhaws dua.