Nj\u00eb nga simptomat m\u00eb t\u00eb zakonshme q\u00eb kan\u00eb pacient\u00ebt me s\u00ebmundje malinje t\u00eb lokalizuar n\u00eb abdomen esht\u00eb dhimbja e vazhdueshme dhe e padurueshme n\u00eb pjes\u00ebn e sip\u00ebrme t\u00eb barkut dhe t\u00eb shpin\u00ebs. Dhimbja e cila nuk ndalon, \u00ebsht\u00eb nj\u00eb problem serioz i cili d\u00ebmton dhe ndikon n\u00eb cil\u00ebsin\u00eb e jet\u00ebs tek k\u00ebta pacient\u00eb. Prof. Dr. Zoran Trajkovski , specialist n\u00eb radiologji, shpjegon n\u00eb lidhje me procedur\u00ebn e nuroliz\u00ebs e cila p\u00ebrdoret p\u00ebr trajtimin e dhimbjeve tek pacient\u00ebt me s\u00ebmundje malinje.<\/p>\n

\u00a0\u00c7far\u00eb \u00ebsht\u00eb neuroliza?<\/span><\/p>\n

Metoda neuroliza ka nj\u00eb histori shum\u00ebvje\u00e7are t\u00eb aplikimit e cila fillon q\u00eb nga viti 1914. Pleksusi celiak ose p\u00ebrzierja e nervore ganglione gjendet e fshehur n\u00eb bark para aort\u00ebs, n\u00ebn en\u00ebt e gjakut t\u00eb zorr\u00ebve dhe mbi en\u00ebt e gjakut mezenteriale. Me pozit\u00ebn e vet anatomike ajo p\u00ebrb\u00ebn nj\u00eb sfid\u00eb p\u00ebrsa i p\u00ebrket trajtimit, prandaj k\u00ebrkon shum\u00eb sakt\u00ebsi\u00a0 p\u00ebr kryerjen e intervenimit.\u00a0<\/p>\n

\u00a0Kur b\u00ebhet neuroliza?<\/span><\/p>\n

Neuroliza b\u00ebhet n\u00ebse pacienti ka dhimbje t\u00eb vazhdueshme e cila nuk mund t\u00eb trajtohet n\u00eb m\u00ebnyr\u00eb tjet\u00ebr. Shkaqet m\u00eb t\u00eb shpeshta jan\u00eb pankreasi, stomaku, ezofagu, malinja e cila vjen nga pema e t\u00ebmthit ose tumore malinje t\u00eb cilat gjenden tek nyjet limfatike. Kjo procedur\u00eb nuk duhet t\u00eb kryhet n\u00ebse pacienti nuk ka rrjedhje t\u00eb mir\u00eb t\u00eb gjakut apo reduktim t\u00eb numrit t\u00eb trombociteve, p\u00ebr shkak t\u00eb rrezikut t\u00eb lart\u00eb t\u00eb gjakderdhjes. Por, edhe n\u00ebse pacienti ka aneuriz\u00ebm t\u00eb aort\u00ebs ose deg\u00ebzim t\u00eb pazakont\u00eb t\u00eb artereve celiake.<\/p>\n

\u00a0Kryerja e procedur\u00ebs<\/span><\/p>\n

Procedura kryhet me nj\u00eb p\u00ebrgatitje t\u00eb m\u00ebparshme dhe studim anatomik t\u00eb zon\u00ebs nga ku duhet t\u00eb shpohet me ndihm\u00eb t\u00eb tomografis\u00eb kompjuterike. Pozicioni i gjilp\u00ebr\u00ebs kontrollohet nga skanimi KT. Si nj\u00eb mjet terapeutik neurolitik, zakonisht p\u00ebrdoret alkooli absolut. Me nj\u00eb gjilp\u00ebr\u00eb t\u00eb holl\u00eb futet n\u00eb zon\u00ebn anatomike nd\u00ebrmjet en\u00ebve\u00a0 t\u00eb gjakut celiake (t\u00eb zorr\u00ebs), en\u00ebve mezenterike dhe aort\u00ebs. Si fillim pacienti nuk duhet t\u00eb ket\u00eb ngr\u00ebn\u00eb dhe nuk duhet t\u00eb marr\u00eb terapi antikoagulante. Zona n\u00eb t\u00eb cil\u00ebn kryhet procedura, mpihet n\u00eb m\u00ebnyr\u00eb q\u00eb pacienti t\u00eb mos ndjej\u00eb dhimbje dhe monitorohen funksionet vitale. Intervenimi mund t\u00eb kryhet n\u00eb pjes\u00ebn e p\u00ebrparme dhe t\u00eb pasme p\u00ebr punksion. Pozicioni i gjilp\u00ebr\u00ebs kontrollohet me rregjistrime t\u00eb p\u00ebrs\u00ebritura. Para se t\u00eb aplikohet mjeti terapeutik jepet kontrast p\u00ebr doktorin q\u00eb ai t\u00eb jet\u00eb i sigurt\u00eb se ku ndodhet gjilp\u00ebra. M\u00eb pas aplikohet 20 deri n\u00eb 80 ml alkool absolut. Efekti i nd\u00ebrhyrjes ndihet menj\u00ebher\u00eb.<\/p>\n

Pas intervenimit<\/h2>\n

Pacienti duhet t\u00eb q\u00ebndroj shtrir\u00eb pas intervenimit\u00a0 8 deri n\u00eb 12 or\u00eb dhe duhet t\u00eb jet\u00eb n\u00ebn mbikqyrje t\u00eb vazhdueshme t\u00eb funksioneve vitale dhe t\u00eb presionit t\u00eb gjakut pasi ekziston rrezik n\u00ebse pacienti ngrihet dhe presioni i gjakut bie. Ndiqet edhe funksioni i zemr\u00ebs dhe i frym\u00ebmarrjes. Mund\u00ebsia e komplikimeve \u00ebsht\u00eb m\u00eb e vog\u00ebl se 2 %. Si komplikimi m\u00eb i shpesht\u00eb q\u00eb mund t\u00eb shfaqet \u00ebsht\u00eb dhimbja e p\u00ebrkoh\u00ebshme e cila mund t\u00eb kontrollohet me analgjetik\u00eb,\u00a0 i cili jepet menj\u00ebher\u00eb pas intervenimit. Gjithashtu, nj\u00eb komplikim tjet\u00ebr i mundsh\u00ebm \u00ebsht\u00eb dhe r\u00ebnia e presionit t\u00eb gjakut. N\u00ebse ndiqen benefitet e metod\u00ebs, suksesi \u00ebsht\u00eb nga 70% deri n\u00eb 90% n\u00eb p\u00ebrputhje me standardet bot\u00ebrore dhe n\u00eb m\u00ebnyr\u00eb t\u00eb konsiderueshme reduktohet p\u00ebrdorimi i mjeteve klasike p\u00ebr leht\u00ebsimin e dhimbjeve. Vet\u00eb intervenimi \u00ebsht\u00eb i mjaftuesh\u00ebm p\u00ebr t\u00eb leht\u00ebsuar pacientin nga gjendja e pak\u00ebndshme e cila\u00a0 reduktimin e cil\u00ebsis\u00eb s\u00eb jet\u00ebs. Trajtimi kryhet vet\u00ebm nj\u00eb her\u00eb dhe efekti \u00ebsht\u00eb i p\u00ebrhersh\u00ebm.<\/p>\n

\n","protected":false},"excerpt":{"rendered":"

Nj\u00eb nga simptomat m\u00eb t\u00eb zakonshme q\u00eb kan\u00eb pacient\u00ebt me s\u00ebmundje malinje t\u00eb lokalizuar n\u00eb abdomen esht\u00eb dhimbja e vazhdueshme dhe e padurueshme n\u00eb pjes\u00ebn e sip\u00ebrme t\u00eb barkut dhe t\u00eb shpin\u00ebs. Dhimbja e cila nuk ndalon, \u00ebsht\u00eb nj\u00eb problem serioz i cili d\u00ebmton dhe ndikon n\u00eb cil\u00ebsin\u00eb e jet\u00ebs tek k\u00ebta pacient\u00eb. Prof. Dr. Zoran Trajkovski , specialist n\u00eb radiologji, shpjegon n\u00eb lidhje me procedur\u00ebn e nuroliz\u00ebs e cila p\u00ebrdoret p\u00ebr trajtimin e dhimbjeve tek pacient\u00ebt me s\u00ebmundje malinje.<\/p>\n","protected":false},"author":2,"featured_media":4875,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[367],"tags":[],"doktori":[],"class_list":["post-3157","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-kancer-sq"],"acf":[],"_links":{"self":[{"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/posts\/3157","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/comments?post=3157"}],"version-history":[{"count":0,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/posts\/3157\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/media\/4875"}],"wp:attachment":[{"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/media?parent=3157"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/categories?post=3157"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/tags?post=3157"},{"taxonomy":"doktori","embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/doktori?post=3157"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}