Nika ingqalelo kwinqanaba lokupheliswa kwe-thrombus

I-thrombectomy yokuhlinzwa yindlela enokususa ngokukhawuleza i-thrombus ngexesha elifutshane.Emva kokuba i-thrombus ihlanjululwe, i-vein evaliweyo iya kubuyela kwi-patency, kwaye i-prognosis engcono yexesha elide inokufezekiswa ngokucoca ngokupheleleyo i-thrombus ngokuhlinzwa.Ngenxa yokwenzakala okukhulu, ukopha kunye neengxaki zotyando, azikho izibhedlele ezininzi ezenza uphando lwezonyango.

Kwiminyaka yakutshanje, ukusetyenziswa kweziyobisi ze-thrombolytic kunye nophuhliso olukhawulezayo lwetekhnoloji ye-intravascular yenza ingcamango "ye-thrombus clearance" ibekho.Ngokwesiseko sonyango lwe-anticoagulation, unyango lwe-thrombolytic lunokuthathwa njengokhetho olusebenzayo nolusebenzayo, olufanelekileyo kwizigulane ze-DVT ezingabandakanyi ukuchasana kwe-thrombolytic.

Okwangoku, i-urokinase (e-UK) kunye ne-alteplase zezona ziqhelekileyo zisetyenziswa kwi-fibrinolytic agents kwi-DVT yonyango lwe-thrombolytic lweklinikhi ekhaya nakwamanye amazwe.Unyango lwe-Thrombolytic lunokukhawulezisa ukuvuselelwa kwe-thrombolytic, ukukhusela ukusebenza kwevalvu, ukunciphisa izehlo ze-PTS, kwaye ukuphuculwa komgangatho wobomi bezigulane kuhambelana ngokufanelekileyo neqondo le-thrombolysis.Unyango lwe-Thrombolytic lunokwahlulwa lube yi-peripheral thrombolysis (i-systemic thrombolysis) kunye ne-catheter eqondiswe kwi-thrombolysis (CDT).

Ngokuphuculwa kwezixhobo zokungenelela kunye nobuchwepheshe, i-CDT ineenzuzo ezicacileyo kunyango lwe-DVT.Iqhagamshelana ngokuthe ngqo ne-thrombus yendawo kunye neziyobisi ze-thrombolytic, ezonyusa kakhulu ukuxinana kweziyobisi ze-thrombolytic malunga ne-thrombus.Indawo yoqhagamshelwano phakathi kwamachiza e-thrombolytic kunye ne-thrombus inkulu kakhulu kune-peripheral thrombolysis ye-venous.Unyango lwe-CDT lunyusa kakhulu inani leziyobisi ezisebenza kwi-thrombus, kwandisa kakhulu isantya sokuvuselelwa kwemithambo emva kwe-thrombolysis, kwaye umphumo wonyango ungcono kakhulu kune-peripheral thrombolysis ye-venous.

I-CDT ibe yeyona ndlela ixhaphakileyo esetyenziswayo ngoku ye-thrombolytic, enokunciphisa ngokufanelekileyo iingxaki zokopha ngelixa inyusa i-thrombolysis.I-Pharmaceutical mechanical thrombectomy (PMCT) sisixhobo esijikelezayo ekupheleni kwentloko, esinokukrazula i-thrombus kwaye siyifunxe kwi-catheter ngoxinzelelo olubi, kwaye emva koko idibanise ne-CDT yendabuko, enokunciphisa umthamo wamachiza e-thrombolytic kunye nexesha lonyango malunga 50%.

Impembelelo ye-thrombus clearance ye-PMCT kunye ne-CDT iyafana, kodwa i-PMCT ikhuselekile, ikhawulezisa i-thrombus recanalization, iyanciphisa ixesha lokunyanga, iyanciphisa ukusetyenziswa kweziyobisi ze-thrombolytic kunye neengxaki zokuphuma kwegazi, ukunciphisa iziganeko ze-PTS, ukunciphisa inani leentsuku esibhedlele kwaye kunciphisa i-PTS. iindleko zokulaliswa esibhedlele.

Uphononongo lweCavent luphononongo olulawulwa ngokungahleliwe lonyango oluqhelekileyo lwe-anticoagulant oludityaniswe ne-CDT kunye nonyango oluqhelekileyo lwe-anticoagulant kwi-acute iliofemoral deep vein thrombosis, eyafumana izigulane ezivela kwizibhedlele ze-20 kuMntla-ntshona weNorway.

Iziphumo zolu phononongo zibonisa ukuba xa kuthelekiswa nonyango lwe-anticoagulant yodwa, unyango oludityanisiweyo lwe-CDT lunokunciphisa kakhulu umngcipheko we-PTS, kodwa kwandisa kancinane umngcipheko wokuphuma kwegazi.Noko ke, xa kuthelekiswa ne-systemic thrombolysis, le ngozi yokopha ibonakala yamkelekile.

Esi siphumo sixhasa isincomo sezikhokelo zamva nje ezidityanisiweyo zonyango lwe-CDT zinokuqwalaselwa kwizigulane ezine-proximal deep vein thrombosis kunye nengozi ephantsi yokopha.