Ukuqedwa okusheshayo kwamahlule egazi kuncike kakhulu ekwelashweni ngemithi. Kwezinye izimo, kusetshenziswa nokuhlinzwa kwe-thrombectomy.

Okulandelayo isingeniso esinemininingwane:

1 Ukususwa kwe-thrombosis yemithi

1.1 Izidakamizwa ezisetshenziswa kakhulu

I-Urokinase: i-enzyme yemvelo ekhishwe emchameni womuntu noma eyenziwe ngamaseli ezinso. Ingasebenza ngqo ohlelweni lwe-fibrinolytic lwe-endogen, isebenze i-plasminogen ibe yi-plasmin, ngaleyo ndlela incibilikise amahlule egazi.

I-Streptokinase: iphrotheni ekhishwe kuketshezi lokukhula lwe-streptococci ye-hemolytic. Ingabopha ku-plasminogen ukuze yakhe i-complex, ikhuthaze ukuguqulwa kwe-plasminogen ibe yi-plasmin, bese incibilikisa amahlule egazi.

I-recombinant tissue plasminogen activator (rt-PA): i-glycoprotein engenza i-plasminogen isebenze futhi inamandla aphezulu e-fibrin. Ingasebenza ngokukhetha ku-fibrin emahlwini egazi ukuze iyibhubhise futhi ifeze injongo yokuncibilikisa amahlwili egazi. Uma kuqhathaniswa ne-urokinase kanye ne-streptokinase, i-rt-PA inamandla aphezulu e-thrombolytic kanye nezinkinga ezimbalwa zokopha.

1.2 Isikhathi sokwelashwa

Ezifweni ezifana ne-acute myocardial infarction kanye ne-cerebral infarction, isikhathi sokwelashwa nge-thrombolytic sibaluleke kakhulu. Ngokuvamile, iziguli ezine-acute myocardial infarction kufanele zithole ukwelashwa nge-thrombolytic zingakapheli amahora angu-12 ngemva kokuqala, okungcono zingakapheli amahora angu-3-6; iziguli ezine-acute cerebral infarction zisesimweni esihle kakhulu se-thrombolysis zingakapheli amahora angu-4.5-6 ngemva kokuqala.

2 Ukususwa kwe-thrombectomy okungenelelayo kanye nokususwa kwe-thrombectomy okuhlinzayo

2.1 Ukususwa kwe-thrombectomy okungenelele

Ngaphansi kwesiqondiso se-digital subtraction angiography (DSA), idivayisi yokukhipha i-thrombectomy ithunyelwa endaweni ye-thrombus nge-catheter ukuze kususwe i-thrombus ngqo. Le ndlela inezinzuzo zokulimala okuncane kanye nokululama okusheshayo, futhi ifanele ezinye iziguli ezingakwazi ukubekezelela i-thrombolysis yezidakamizwa noma ezinemiphumela emibi ye-thrombolysis yezidakamizwa.

2.2 Ukuhlinzwa kokususwa kwe-thrombectomy

Sika imithambo yegazi ngokuqondile ngokuhlinzwa ukuze ususe i-thrombus. Le ndlela ivame ukusetshenziswa ezimweni eziphuthumayo lapho i-thrombolysis yezidakamizwa kanye ne-thrombectomy yokungenelela ingenakwenziwa noma umphumela ungemuhle, njenge-acute lower limb artery embolism. I-thrombectomy yokuhlinzwa ingabuyisa ngokushesha ukugeleza kwegazi, kodwa ukulimala kokuhlinzwa kukhulu futhi kunezinkinga eziningi ngemva kokuhlinzwa.

Kungakhathaliseki ukuthi iyiphi indlela ekhethiwe, ukwelashwa komuntu ngamunye kuyadingeka ngaphansi kwesiqondiso sikadokotela ngokusekelwe esimweni esithile sesiguli, njengendawo, ubukhulu, isikhathi sokwakheka kwe-thrombus, kanye nesimo somzimba sesiguli sonke. Ngesikhathi esifanayo, ngemva kwe-thrombolysis noma i-thrombectomy, ukwelashwa okulandelayo kwe-anticoagulation, i-antiplatelet kanye nokunye kuyadingeka ukuvimbela ukwakheka kabusha kwe-thrombus.