Shin wannan kyakkyawan farfado ne don restenosis?
Cutar tawaye da ciwon zuciya sun canza yadda za su magance cututtukan cututtuka , amma waɗannan maganin sun bullo da sababbin matsala a cikin mahaɗin. Wannan shi ne matsala na restenosis - sake maimaitawa a shafin yanar gizo. A farkon shekarun 2000, farfadowa, ko maganin jinin jini, ya zama sabon sabbin maganin maganin tsabtace jiki.
Amma yayin da brachyrapy ya kasance (kuma har yanzu) yana da tasiri ga restenosis, yanzu ya zama mafi yawan maye gurbin da amfani da maganin miyagun ƙwayoyi stents .
Saukewa bayan angioplasty ko tsutsawa ya haifar da ci gaba mai girma akan nama a shafin yanar gizo. Ana haifar shi ne ta hanyar maganin warkarwa mai yawa, yana haifar da yaduwar kwayoyin "endothelial" wanda ke danganta da jini. Wannan ci gaban nama zai iya saukewa a hankali.
Brachytherapy zai iya magance tsabtace jiki ta hanyar kashe kwayoyin wuce haddi da kuma hana ci gaban karuwa.
Ta yaya ake amfani da Brachytherapy?
An yi amfani da Brachytherapy a lokacin ƙwaƙwalwar zuciya. Rawanin kanta kanta yana fitowa ne ta hanyar nau'i na musamman na catheter wanda aka tsara don amfani da radiation daga cikin maganin na jijiyoyin jini. Kwancen ya shigo cikin suturar jini da kuma fadin rikici wanda aka haifar da restenosis. Da zarar catheter ta "ƙulla" ta hanyar da aka yi niyya, ana amfani da radiation.
Hanyoyin radiation guda biyu za a iya amfani dashi: radiation gamma da radiation beta. Dukkan nauyin rashawa suna da mahimmanci don yin amfani da su, kuma suna buƙatar samun kayan aiki na musamman a cikin lakabi, yin amfani da hanyoyi na musamman, da kuma horarrun mutane, yawanci ciki har da mai ilimin likita.
Masu likitan zuciya wadanda suka yi amfani da brachytherapy sun yarda da cewa babbar hanyar samun nasara shine kwarewar mai aiki. Wadannan hanyoyi ne masu ban sha'awa wadanda suke buƙatar fiye da kwarewa na yau da kullum na magungunan kwakwalwa.
Amfani
Nazarin na asibitoci sun nuna cewa maganin ƙwaƙwalwa na aiki yana da kyau wajen kawar da restenosis a cikin jigilar jini, da kuma rage haɗarin haɗakarwa. Bugu da ƙari, nazarin yana nuna cewa marasa lafiya suna da haɗarin haɗari - irin su mutanen da ke da ciwon sukari - suna samun mafi amfani daga farfadowar radiation.
Matsaloli
Brachytherapy ba kyauta ba ne. Ɗaya daga cikin matsala ta musamman da aka gani tare da farfadowa da ƙwarewa ya kasance "sakamako mai zurfi" - bayyanar sababbin yankuna a kowane gefen filin radiation (yankin da ake bi da shi tare da radiation). Wannan kututturewar lalacewa, wadda take ɗaukar kamfani ko kuma "candy-wrapper" lokacin da aka gani tare da angiogram, yana da sakamako mai mahimmanci wanda ya fi wuya a bi da. Wadannan raunin sakamako ne na iya haifar dashi ta hanyar sanyawa a karkashin jagorancin kullun lokacin da suke jagorancin kwarewa.
Har ila yau, marasa lafiya da aka bi da maganin ƙwaƙwalwar ƙwayar cuta sun kasance suna da haɗari ga ƙwayar katakon maganin jini na jini.
Yawanci, idan thrombosis na faruwa bayan angioplasty ko stenting, yakan kasance a cikin kwanaki 30 na hanya. Amma marigayi thrombosis (yana faruwa a bayan kwanaki 30 na farko) an gani a kusan kashi 10 cikin dari na marasa lafiya da ke samun karfin jini. Wannan marigayi marigayi yana da alaƙa da infarction na katako (ciwon zuciya ) ko angina maras kyau . Don taimakawa rage wannan haɗari, ana bada shawara ga masu zubar da jini don akalla shekara guda bayan farfadowa.
Me ya Sa ake amfani da Brachytherapy a yau?
Maimaitawa shine babbar matsalar da ba a warware ta ba a farkon kwanakin angioplasty da stenting, kuma don shekaru da dama brachytherapy ya kasance kamar hanyar da za a yi amfani da shi don magance restenosis.
Duk da haka, ana amfani dasu yanzu kawai.
Harsar maganin maganin maganin ƙwayoyin cuta yana da sauri ya sa tsaka-tsakin ƙarfe ya yi kusan bace. Nazarin kai tsaye kwatanta aminci da tasiri na farfadowa da maganin maganin maganin maganin maganin maganin maganin maganin maganin ƙwayoyi yana nuna kyakkyawan tabbacin cewa stent ya ba da kyakkyawan sakamako. Bugu da ƙari kuma, masu kwakwalwa suna jin dadi suna sanya stents, kuma kwayoyi ba su buƙatar abubuwan da ba su da komai, kwarewa, da kuma ƙwarewa na musamman da ake bukata ta hanyar ƙwarewa. Bai yi jinkiri ba don farfadowa da yawa don sauke taswira.
Duk da haka, farfadowa mai tasiri yana da inganci kuma yana da aminci kuma an yarda da ita don amfani da Abinci da Drug Administration. Ƙananan cibiyoyi na musamman suna ba da shi a matsayin wani zaɓi don zalunta restenosis.
A yau, yawancin magungunan ƙwayoyin cuta ne kawai ana daukar su ne kawai ga marasa lafiya wadanda suka sake yin gyaran ƙyama bayan bin hankali, kuma a cikin wanda kwayoyi masu yaduwar kwayoyi sun kasa magance matsalar. Don samun karfin gwadawa wadannan marasa lafiya ya kamata a kira su daya daga cikin 'yan cibiyoyin har yanzu suna bada irin wannan farfadowa.
Sources:
Salon farko na PS, Massullo V, Jani S, et al. Shekaru uku na asibiti da kuma bayanan angiographic bayan radiation na intracoronary: sakamakon binciken gwaji na asibiti. Yanayin 2000; 101: 360.
Sapirstein W, Zuckerman B, Dokar Dillard J. FDA ta amincewa da maganin jinin jini. N Engl J Med 2001; 344: 297.
Holmes DR Jr, Teirstein PS, Satler L, et al. Shekaru 3 na SISR (Sirolimus-Eluting Stents Versus Vascular Brachytherapy for In-Stent Restenosis) gwaji. JACC Cardiovasc Interview 2008; 1: 439.