Carotids bụ akwara na-enye ụbụrụ, olu na ihu. Carotid stenosis bụ isi pathology na-atụ egwu. N'ihe na-adịkarị na afọ, ọ nwere ike ma ọ bụ ọ gaghị eduga na ọrịa strok na-adịte aka.

A na-enye ụbụrụ site na akwara dị iche iche: akwara carotid abụọ n'ihu na akwara vertebral abụọ n'azụ. Ọwara akwara anọ ndị a na-ezukọ n'okpuru okpokoro isi iji mepụta ihe a na-akpọ Polygon nke Willis.

Ihe a na-akpọ isi ma ọ bụ akwara carotid nkịtị na-esi na aorta na-arịgo n'olu. Ọ na-ekewa n'ogo nke etiti olu n'ime akwara abụọ: carotid n'ime na carotid mpụga. A na-akpọ mpaghara nkwụsịtụ a carotid bifurcation.

Akwara carotid dị n'ime na-enye ụbụrụ ụbụrụ, ebe akwara carotid dị n'èzí na-ebuga n'olu na ihu. Ya mere, ndị a bụ akwara dị oke mkpa.

Carotid stenosis bụ isi ọnya na-atụ egwu na akwara carotid.

Ọ dabara na mbelata dayameta nke akwara carotid, na-esochi nguzobe nke plaque atheromatous (nkwado nke cholesterol, fibrous na calcareous tissues) n'ime akwara. N'ọtụtụ ọnọdụ (90%), a na-ahụta stenosis a n'ogo nke carotid bifurcation cervical.

Ihe ize ndụ bụ na akwara carotid ga-ejedebe na-egbochi ya site na plaque atheroma ma ọ bụ na ọ ga-agbaji. Mwakpo ischemic na-agafe agafe (TIA) nwere ike ime nke na-alaghachi na-enweghị sequelae n'ime ihe na-erughị awa 24, ma ọ bụ ihe mberede cerebrovascular (AVC) ma ọ bụ infarction ụbụrụ, nke nwere ọtụtụ ma ọ bụ dị njọ.

Carotid stenosis bụ ihe a na-ahụkarị na afọ: dị ka Haute Autorité de Santé si kwuo, 5 ruo 10% nke ndị mmadụ karịrị 65 nwere stenosis karịa 50%. A na-eche na carotid stenosis na-akpata ihe dị ka otu ụzọ n'ụzọ anọ nke ọrịa strok.

Nlekọta nke carotid stenosis na-adabere na ọgwụgwọ ọgwụ, ịchịkwa ihe ize ndụ nke vaskụla na ụfọdụ ndị ọrịa usoro revascularization.

N'ihe gbasara ọgwụgwọ ọgwụ, a na-edekọta ụdị ọgwụ atọ ọnụ: onye na-ahụ maka antiplatelet iji mee ka ọbara dị nro, statin na-ebelata mmepe nke plaques atheroma na ACE inhibitor (ma ọ bụ beta blocker n'ọnọdụ ụfọdụ).

Banyere revascularization, French National Authority for Health ewepụtala ndụmọdụ ndị akọwapụtara maka ngosipụta ịwa ahụ dịka ogo akara carotid stenosis:

• n'etiti 70 na 99% nke stenosis, a na-egosi ịwa ahụ na uru dị ịrịba ama nke nwoke na nwanyị;
• n'etiti 50 na 69% stenosis, enwere ike igosi ịwa ahụ mana uru dị ntakịrị, karịsịa na ụmụ nwanyị;
• n'etiti 30 na 49%, ịwa ahụ adịghị aba uru;
• n'okpuru 30%, ịwa ahụ na-emebi emebi na ekwesighi ime ya.

Mgbe egosiri revascularization, ịwa ahụ ka bụ ọkọlọtọ ọla edo. A na-emekarị usoro a, nke a na-akpọ carotid endarterectomy, n'okpuru nchịkwa izugbe. Dọkịta na-awa ahụ na-eme mbepụ n'olu, na-amachi akwara akwara atọ wee bepụ akwara carotid n'ogo nke stenosis. Mgbe ahụ, ọ na-akpachara anya wepụ ihe atherosclerotic plaque na irighiri ihe ndị dị na ya, wee jiri waya mara mma mechie akwara ahụ.

Achọpụtaghị angioplasty nwere stent dị ka ọgwụgwọ nke mbụ. A na-enye ya naanị n'ọnọdụ ụfọdụ akọwapụtara nke contraindication maka ịwa ahụ.

N'ihe banyere asymptomatic carotid stenosis:

• karịa 60%: revascularization site na ịwa ahụ carotid nwere ike igosi dabere na ihe ụfọdụ (atụmatụ ndụ, ọganihu nke stenosis, wdg);
• Ọ bụrụ na stenosis na-erughị 60%, a naghị egosi ịwa ahụ.

Tinyere ọgwụgwọ ọgwụ na ịwa ahụ, ọ dị mkpa iji nyochaa ụzọ ndụ gị iji belata ihe ize ndụ: ọbara mgbali elu, ụtaba, hypercholesterolemia na ọrịa shuga.

Carotid stenosis nwere ike asymptomatic ma chọpụta ya n'oge nyocha ahụike site n'aka onye ọkachamara n'ozuzu gị ma ọ bụ ọkachamara, ma ọ bụ n'oge ultrasound nke thyroid dịka ọmụmaatụ. Ọnụnọ nke ntamu nke carotid na auscultation kwesịrị iduga na ndenye ọgwụ carotid doppler ultrasound iji chọpụta ihe nwere ike ime ka ọkpụkpụ carotid ma chọpụta ọnụego nkwụsị. Dabere na nsonaazụ ya, a ga-edenye MRI angiography, CT angiography ma ọ bụ dijitalụ carotid angiography. Ọ na-eme ka o kwe omume ikpebi ebe, morphology na ndọtị nke plaque, na iji nyochaa mgbasa nke atheroma na axes ndị ọzọ na karịsịa ndị ọzọ carotid artery.

Mgbe mgbaàmà na-egosi, ihe ịrịba ama nke carotid stenosis bụ nke ọgụ ischemic transient (TIA) na ọrịa strok. Ma ọ bụ, dabere na mpaghara ụbụrụ emetụtara:

• mmebi anya (ọnwụ mberede na enweghị mgbu nke ọhụụ n'otu anya ma ọ bụ amaurosis na-agafe agafe);
• mkpọnwụ n'otu akụkụ nke ahụ, ma ọ bụ mkpokọta ma ọ bụ njedebe na akụkụ elu na / ma ọ bụ ihu (hemiparesis, mkpọnwụ ihu);
• ọnwụ nke okwu (aphasia).

Iche ihu akara ngosi ndị a, ọ dị mkpa ịkpọtụrụ 15.