Kukurumidza kunyunguduka kweropa kunonyanya kukonzerwa nekurapwa nemishonga. Mune zvimwe zviitiko, kuvhiyiwa kwekubvisa ropa kunoshandiswawo.

Zvinotevera ndizvo zvinotsanangurwa zvakadzama:

1 Kubviswa kweropa muropa nemushonga

1.1 Mishonga inowanzoshandiswa

Urokinase: enzyme yechisikigo inotorwa kubva muweti yemunhu kana kugadzirwa nemasero eitsvo. Inogona kushanda zvakananga pahurongwa hwe fibrinolytic hwe endogen, kumutsa plasminogen kuita plasmin, uye nokudaro kunyungudutsa mabundu eropa.

Streptokinase: puroteni inotorwa kubva mumvura inoyerera kubva mu hemolytic streptococci. Inogona kusunganidza ku plasminogen kuti iite complex, kukurudzira kushandurwa kwe plasminogen kuita plasmin, uye yobva yanyungudutsa ropa rakagwamba.

Recombinant tissue plasminogen activator (rt-PA): glycoprotein inogona kumutsa plasminogen uye ine hukama hwakakura nefibrin. Inogona kushanda pa fibrin mumagwamba eropa kuti iparadze uye iwane chinangwa chekunyungudutsa magwamba eropa. Kana ichienzaniswa ne urokinase ne streptokinase, rt-PA ine thrombolytic efficiency yakakura uye ine matambudziko mashoma ekubuda ropa.

1.2 Nguva yekurapwa

Pazvirwere zvakaita se acute myocardial infarction uye cerebral infarction, nguva yekurapa thrombolytic yakakosha zvikuru. Kazhinji, varwere vane acute myocardial infarction vanofanira kugamuchira thrombolytic therapy mukati memaawa gumi nemaviri mushure mekutanga, zviri nani mukati memaawa matatu kusvika matanhatu; varwere vane acute cerebral infarction vari munguva yakanaka ye thrombolysis mukati memaawa mana nehafu kusvika matanhatu mushure mekutanga.

2 Kuvhiyiwa kwekubvisa thrombectomy nekuvhiyiwa kwethrombectomy

2.1 Kuvhiyiwa kwekubvisa thrombectomy

Ichitungamirirwa ne digital subtraction angiography (DSA), mudziyo wekubvisa thrombectomy unotumirwa kunzvimbo ye thrombus kuburikidza ne catheter kuti ubvise thrombus zvakananga. Nzira iyi ine zvakanakira zvekusava nekukuvara kushoma uye kupora nekukurumidza, uye yakakodzera kune vamwe varwere vasingagoni kushivirira thrombolysis yemishonga kana kuti vane mhedzisiro yakaipa ye thrombolysis yemishonga.

2.2 Kuvhiyiwa kwekubvisa thrombectomy

Cheka mitsipa yeropa zvakananga kuburikidza nekuvhiyiwa kubvisa thrombus. Nzira iyi inowanzo shandiswa mumamiriro ezvinhu enjodzi apo thrombolysis yemishonga uye interventional thrombectomy haigone kuitwa kana mhedzisiro yacho isina kunaka, senge acute lower limb artery embolism. Kuvhiyiwa thrombectomy kunogona kukurumidza kudzorera kuyerera kweropa, asi kukuvara kwekuvhiyiwa kwakakura uye kune mamwe matambudziko akawanda mushure mekuvhiyiwa.

Pasinei nekuti ndeipi nzira inosarudzwa, kurapwa kwemunhu mumwe nemumwe kunodiwa pasi pekutungamirirwa nachiremba zvichienderana nemamiriro ezvinhu emurwere, akadai senzvimbo, saizi, nguva yekuumbwa kwethrombus, uye mamiriro emuviri wemurwere. Panguva imwe chete, mushure mekubviswa kweropa kana kubviswa kweropa, kurapwa kunotevera kwekudzivirira ropa kuvhara, antiplatelet nedzimwe nzira dzekurapa zvinodiwa kudzivirira kuumbwazve kwethrombus.