Ọkpụkpụ ọbara

Ọkpụkpụ ọbara na-ezo aka na clot (embolus) nke si n'akụkụ ọzọ nke ahụ pụta ma na-akpata nkwụsị mberede nke ọbara na-abanye na akụkụ ma ọ bụ akụkụ ahụ.

"Embolus" bụ nkedo ọbara ma ọ bụ mpempe akwụkwọ nke na-eme dị ka clot. Okwu a bu “Emboli” putara na onwere ihe kariri otu nkpu ma obu mpempe efere. Mgbe clot na-aga site na saịtị ebe ọ kpụrụ gaa ebe ọzọ na ahụ, a na-akpọ ya embolism.

Ọ bụ otu mgbochi ma ọ bụ karịa ka ọ pụrụ iji akpata nkwonkwo obi. Ihe mkpụkọ ahụ nwere ike ịrapara na akwara ma gbochie ọbara na-agba. Nchịkọta agụụ na-agụ anụ ahụ nke ọbara na oxygen. Nke a nwere ike ibute mmebi ma ọ bụ ọnwụ anụ ahụ (necrosis).

Arterial emboli na-emekarị na ụkwụ na ụkwụ. Emboli nke na-eme n’ụbụrụ na-akpata ọrịa strok. Ndị na-eme n’obi na-ebute nkụchi obi. Ebe ndị a na-anaghị ahụkebe gụnyere akụrụ, eriri afọ, na anya.

Ihe egwu maka arterial embolism gụnyere:

• Mmetụta obi na-adịghị mma dịka atr fibrillation
• Mmebi ma ọ bụ mmebi nke mgbidi akwara
• Ọnọdụ ndị na-eme ka mkpụkọta ọbara

Ọnọdụ ọzọ nke nwere nnukwu ihe ọghọm maka embolization (ọkachasị n'ụbụrụ) bụ mitral stenosis. Endocarditis (ọrịa nke obi) nwekwara ike ibute akwara.

Ihe na-esitekarị na embolus bụ site na mpaghara nke hardening (atherosclerosis) na aorta na nnukwu arịa ọbara ndị ọzọ. Mgbochi a nwere ike gbasaa ma gbadaa n'ụkwụ na ụkwụ.

Paradoxical embolization nwere ike ime mgbe akwa dị na akwara na-abanye n'aka nri nke obi ma gafere oghere n'ime akụkụ aka ekpe. Ihe mgbochi ahụ nwere ike ịkwaga na akwara ma gbochie ọbara na-abanye na ụbụrụ (ọrịa strok) ma ọ bụ akụkụ ndị ọzọ.

Ọ bụrụ na eriri na-agagharị ma na-abanye na akwara akwara na-ebute ọbara na ngụgụ, a na-akpọ ya akpa ume akpa ume.

May gaghị enwe ihe mgbaàmà ọ bụla.

Mgbaàmà nwere ike ịmalite ngwa ngwa ma ọ bụ nwayọ nwayọ dabere na nha nke embolus na ole ọ na - egbochi ọbara.

Mgbaàmà nke arterial embolism na ogwe aka ma ọ bụ ụkwụ nwere ike ịgụnye:

• Aka ma ọ bụ ụkwụ oyi
• Mbelata ma ọ bụ enweghị usu na ogwe aka ma ọ bụ ụkwụ
• Enweghị mmegharị na ogwe aka ma ọ bụ ụkwụ
• Mgbu na mpaghara emetụtara
• Ọnụ ọgụgụ na ịpị aka na ogwe aka ma ọ bụ ụkwụ
• Aka na-acha ncha ncha nke ogwe aka ma ọ bụ ụkwụ (pallor)
• Adịghị ike nke ogwe aka ma ọ bụ ụkwụ

Mgbaàmà ndị ọzọ:

• Blisters nke anụ nri site otite akwara
• Shedding (sloughing) nke anụ ahụ
• Sros ozi (ọnya)
• Onwu nke anụ ahụ (necrosis; anụ ahụ gbara ọchịchịrị ma mebie)

Mgbaàmà nke eriri dị na akụkụ ahụ dị iche na akụkụ ahụ metụtara mana ọ nwere ike ịgụnye:

• Mgbu dị n'akụkụ nke ahụ metụtara
• Nwa oge belatara ngwa ọrụ

Onye nlekọta ahụike nwere ike ịhụ mbelata ma ọ bụ enweghị usu, wee belata ma ọ bụ enweghị ọbara mgbali na ogwe aka ma ọ bụ ụkwụ. Enwere ike ịnwe ihe iriba ama nke anụ ahụ nwụrụ anwụ ma ọ bụ gangrene.

Ule iji chọpụta ọrịa embolism ma ọ bụ gosipụta isi iyi nke emboli nwere ike ịgụnye:

• Angiography nke akụkụ ma ọ bụ akụkụ ahụ metụtara
• Doppler ultrasound nke ule
• Duplex Doppler ultrasound nke ule nke ngwụcha
• Ihe omumu
• MRI nke ogwe aka ma ọ bụ ụkwụ
• Myocardial iche echocardiography (MCE)
• Plethysmography
• Nnyocha transpranial Doppler nke akwara na ụbụrụ
• Transesophageal echocardiography (TEE)

Ọrịa a nwekwara ike imetụta nsonaazụ nke ule ndị a:

• D-dimer
• Ihe nyocha nke asatọ
• Ọmụmụ ihe ọmụmụ banyere akụkụ ahụ metụtara
• Ọrụ Plasminogen activator-1 (PAI-1)
• Nlekọta mkpokọta platelet
• Levelsdị anụ ahụ nke ụdị plasminogen activator (t-PA)

Ọrịa arterial chọrọ ọgwụgwọ ngwa ngwa n'ụlọ ọgwụ. Ebumnuche nke ọgwụgwọ bụ ịchịkwa mgbaàmà na iji meziwanye usoro mgbasa ọbara na-adịghị akwụsị n'akụkụ nke ahụ. Ihe kpatara nkedo, ọ bụrụ na achọtara ya, kwesịrị ịgwọ ya iji gbochie nsogbu ndị ọzọ.

Ọgwụ gụnyere:

• Anticoagulants (dị ka warfarin ma ọ bụ heparin) nwere ike igbochi mkpụkọ ọhụrụ ịmalite
• Antiplatelet ọgwụ (dị ka aspirin ma ọ bụ clopidogrel) nwere ike igbochi mkpụkọ ọhụrụ ịkpụ
• A na-enye ọgwụ mgbu site na akwara (site na IV)
• Thrombolytics (dị ka streptokinase) nwere ike igbari mkpụkọ

Needfọdụ ndị chọrọ ịwa ahụ. Usoro gụnyere:

• Uzo nke akwara (uzo uzo) iji meputa uzo ozo nke obara
• Nwepu akwa site na catheter balloon etinyere n'ime akwara emetụtara ma ọ bụ site na ịwa ahụ na-emeghe na akwara (embolectomy)
• Imepe akwara akwara na balloon catheter (angioplasty) ma obu na enweghi stent

Etu mmadụ si eme nke ọma dabere n’ebe ọnọdụ mkpụkọ ọbara dị na etu ọbara ahụ gbochiri ọbara si aga yana ogologo oge mgbochi a dị. Ọkpụkpụ akwara nwere ike ịdị oke njọ ma ọ bụrụ na anaghị agwọ ya ozugbo.

Mpaghara emetụtara nwere ike imebi kpamkpam. Mbepu chọrọ na ihe ruru 1 na 4 ikpe.

Arterial emboli nwere ike ịlaghachi azụ ma ọgwụgwọ gwọchara ya.

Nsogbu nwere ike ịgụnye:

• Nnukwu MI
• Ofufe Ọrịa na-emetụta anụ ahụ
• Septic ujo
• Mkpọnwụ (CVA)
• Nwa oge ma ọ bụ na-adịgide adịgide mbelata ma ọ bụ ọnwụ nke ọrụ ndị ọzọ
• Nwa oge ma ọ bụ na-adịgide adịgide akụrụ odida
• Ọkpụkpụ anụ ahụ (necrosis) na gangrene
• Mwakpo ọgụ na-aga agha (TIA)

Gaa na ụlọ mberede ma ọ bụ kpọọ nọmba ihe mberede mpaghara (dịka 911) ma ọ bụrụ na ị nwere mgbaàmà nke embolism arterial.

Mgbochi na-amalite site na ịchọta isi mmalite nke ọnya ọbara. Onye na-enye gị ọrụ nwere ike ịkọwa ihe ga-eme ka ndị na-egbu ọbara (dị ka warfarin ma ọ bụ heparin) gbochie mkpụkọ mkpụkọ. A pụkwara ịchọ ọgwụ mgbochi ọrịa.

Have nwere nnukwu atherosclerosis na mkpụkọ ma ọ bụrụ na ị:

• Anwụrụ ọkụ
• Mee obere mmega ahụ
• Nwee ọbara mgbali elu
• Nwee ogo cholesterol dị iche iche
• Nwee ọrịa shuga
• Ndi buru oke ibu
• Na-enwe nrụgide

• Ọkpụkpụ ọbara
• Sistemụ nrugharị

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Gerhard-Herman MD, Gornik HL, Barrett C, et al. Ntuziaka 2016 AHA / ACC banyere njikwa nke ndị ọrịa nwere ọrịa akwara akụkụ ala: nchịkọta nchịkọta: akụkọ nke American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. Ọrịa. 2017; 69 (11): 1465-1508. PMID: 27851991 pubmed.ncbi.nlm.nih.gov/27851991/.

Goldman L. Agakwuru onye ọrịa nwere ọrịa obi nwere ike. Na: Goldman L, Schafer AI, eds. Ọgwụ Goldman-Cecil. Nke 26th. Philadelphia, PA: Elsevier; 2020: isi 45.

Kline JA. Pulmonary embolism na miri emi akwara thrombosis. Na: Mgbidi RM, Hockberger RS, Gausche-Hill M, eds. Ngwọta Mberede nke Rosen: Echiche na usoro ọgwụgwọ. Agba nke 9. Philadelphia, PA: Elsevier; 2018: isi 78.

Wyers MC, Martin MC. Nnukwu ọrịa ọbara na-efe efe. Na: Sidawy AN, Perler BA, eds. Herwa Ahụ nke Vascular Rutherford na ọgwụgwọ Endovascular. Agba nke 9. Philadelphia, PA: Elsevier; 2019: isi 133.