Ukunyibilika ngokukhawuleza kwamahlwili egazi kuxhomekeke kakhulu kunyango ngamayeza. Kwezinye iimeko, kusetyenziswa i-thrombectomy yotyando.

Oku kulandelayo yintshayelelo eneenkcukacha:

1 Ukususwa kwe-thrombolysis yamayeza

1.1 Amayeza asetyenziswa rhoqo

I-Urokinase: yi-enzyme yendalo ekhutshwa kumchamo womntu okanye eyenziwe ziiseli zezintso. Ingasebenza ngokuthe ngqo kwinkqubo ye-fibrinolytic ye-endogen, isebenze i-plasminogen ibe yi-plasmin, ngaloo ndlela inyibilikise amahlwili egazi.

I-Streptokinase: yiproteni ekhutshwe kulwelo lwe-culture lwe-hemolytic streptococci. Ingabopha kwi-plasminogen ukuze yenze i-complex, ikhuthaze ukuguqulwa kwe-plasminogen ibe yi-plasmin, ize emva koko inyibilikise amahlwili egazi.

I-recombinant tissue plasminogen activator (rt-PA): i-glycoprotein enokwenza i-plasminogen isebenze kwaye inobuhlobo obuphezulu ne-fibrin. Ingasebenza ngokukhetha kwi-fibrin kwi-blood clots ukuze yonakalise kwaye ifezekise injongo yokunyibilikisa amahlwili egazi. Xa ithelekiswa ne-urokinase kunye ne-streptokinase, i-rt-PA isebenza kakuhle kwi-thrombolytic kwaye inengxaki ezimbalwa zokopha.

1.2 Ixesha lonyango

Kwizifo ezifana ne-acute myocardial infarction kunye ne-cerebral infarction, ixesha lonyango lwe-thrombolytic libaluleke kakhulu. Ngokubanzi, izigulane ezine-acute myocardial infarction kufuneka zifumane unyango lwe-thrombolytic kwiiyure ezili-12 emva kokuqala, kungcono kwiiyure ezi-3-6; izigulane ezine-acute cerebral infarction zikwixesha legolide le-thrombolysis kwiiyure ezi-4.5-6 emva kokuqala.

2 Ukususwa kwe-thrombectomy kunye nokususwa kwe-thrombectomy ngotyando

2.1 Utyando lwe-thrombectomy olungenelelayo

Phantsi kwesikhokelo se-digital subtraction angiography (DSA), isixhobo se-thrombectomy sithunyelwa kwindawo ye-thrombus nge-catheter ukuze kususwe ngqo i-thrombus. Le ndlela ineengenelo zokulimala okuncinci kunye nokuchacha ngokukhawuleza, kwaye ifanelekile kwezinye izigulana ezingakwaziyo ukunyamezela i-thrombolysis yamayeza okanye ezineziphumo ezimbi ze-thrombolysis yamayeza.

2.2 Utyando lokususa i-thrombectomy

Sika imithambo yegazi ngokuthe ngqo ngotyando ukuze ususe i-thrombus. Le ndlela isetyenziswa rhoqo kwiimeko ezingxamisekileyo apho i-thrombolysis yamayeza kunye ne-thromboectomy yokungenelela ingenakwenziwa okanye isiphumo sibi, njenge-acute lower limb artery embolism. I-thrombectomy yotyando inokubuyisela ukuhamba kwegazi ngokukhawuleza, kodwa ukwenzakala kotyando kukhulu kwaye kukho iingxaki ezininzi emva kotyando.

Nokuba yeyiphi na indlela ekhethiweyo, unyango lomntu ngamnye lufuneka phantsi kwesikhokelo sikagqirha ngokusekelwe kwimeko ethile yesigulana, njengendawo, ubungakanani, ixesha lokwakheka kwe-thrombus, kunye nemeko yomzimba yesigulana iyonke. Kwangaxeshanye, emva kwe-thrombolysis okanye i-thrombectomy, unyango olulandelayo lwe-anticoagulation, i-antiplatelet kunye nolunye unyango luyafuneka ukuthintela ukwakheka kwakhona kwe-thrombus.