Atherosulinotic plaque mu carotid artery: ntchito ndi mtengo wa njirayi

Carotid atherosulinosis ndi matenda oopsa, osakhazikika nthawi yomwe malo omwe ma atherosocolotic amakaikidwa mu makhoma a mitsempha ya carotid.

Chifukwa chachikulu cha matenda awa ndi kuchuluka kwa cholesterol, makamaka yogwirizana ndi otsika osalimba a lipoprotein.

Chifukwa chiyani arteriosulinosis ya mitsempha ya carotid imabuka ndipo ndi owopsa?

Atherosulinosis ndi nthenda ya polyetiological. Pali zifukwa zambiri zomwe zimayambitsa matenda m'thupi la munthu. Pakati pazinthu zonse zomwe zimayambitsa matendawa, pali zingapo zomwe zimafala kwambiri.

Zomwe zimayambitsa matendawa ndi izi:

• Zaka zopitilira 40.
• Amuna amadwala chifukwa cha kupezeka kwa cholesterol plaque kanayi kuposa amayi.
• Kusuta kumatsogolera ku kuwonongeka kwakanema chifukwa cha kusintha kwa kapangidwe ka makoma awo.
• Kunenepa kwambiri.
• Matenda a shuga, makamaka amtundu wachiwiri.
• Matenda a mahomoni, kuphatikizapo kuperewera kwa mahomoni a chithokomiro komanso kusamba kwa kusintha kwa msambo kwa akazi.
• Mowa.
• Udindo wofunikira umachitika ndi chibadwidwe.
• Mavuto apakati a kagayidwe ka lipid m'thupi.
• Kusowa kwa lipoproteins wapamwamba ("wabwino" cholesterol).
• Khalidwe labwino.
• Metabolic syndrome ndi mkhalidwe wapadera womwe umaphatikizapo kuwonetsedwa kwa matenda oopsa (kuthamanga kwa magazi), kunenepa kwambiri makamaka pamimba, triglycerides, komanso kulekerera kwa shuga.
• Kupsinjika pafupipafupi, kusakhazikika pamalingaliro.

Kuwonongeka kwa mitsempha ya carotid kumakhala kowopsa chifukwa cha kusokonezeka kwa magazi muubongo, chifukwa amakhala ndi magazi okhala ndi mpweya m'maselo ake ndi minyewa yake. Poyamba, zizindikiro zazing'ono zimatha kuwoneka, monga kuchepa kwa kukumbukira, kusinthasintha kwa mtima, kupweteka mutu, kuchepa kwa luntha, komanso kusakhazikika maganizo. Mtsogolomo, zomwe zimadziwika kuti ndizosachedwa kuwonongeka (TIAs) zimatha kuchitika - izi ndizovuta kwakanthawi (zosakhalitsa) zamatsenga zomwe zimatha osakwana tsiku limodzi. Amadziwika ndi matenda osiyanasiyana amtundu wamiyendo, kuwonongeka kwa mawonekedwe, ngakhale ziwalo zimatheka.

Ngati zizindikiro zomwe zimakhalapo pang'onopang'ono zovuta za ischemic sizitha maola 24, ndiye kuti mukupezanso matenda ena - stroko.

A sitiroko ndi necrosis yamitsempha yamaubongo. Itha kuchitika chifukwa cha hypoxia (kusowa kwa oxygen) yaubongo kapena chifukwa cha kutaya mtima kwambiri m'menemo.

Tissue hypoxia imatha kuchitika chifukwa cha matenda oopsa (mitsempha ya m'magazi ndi yopapatiza, ndipo magazi samayenda bwino) kapena atherosulinosis (zolembera za atherosulinotic zimatha kutuluka mu lumen ya chotengera ndikuchepetsa kuyenda kwamagazi kokhazikika). Pankhaniyi, sitiroko imatchedwa ischemic (ischemia - kusowa kwa magazi opatsa mpweya).

Ngati kukha magazi kumachitika m'mitsempha yaubongo, ndiye kuti chochititsa chachikulu kwambiri ndi mtima wauroma - kuwonda ndi kukulitsa khoma la chotengera, chifukwa chomwe chimataya kuyerekezera kwake ndikutha kupasuka mosavuta nthawi iliyonse chifukwa cha kuchuluka kapena kupsinjika. Aneurysm, ikhoza kukhazikika pamaso pa atherosulinosis. Kutupa kwa magazi m'mutu kumaonetsa kuti hemorrhagic stroke (hemorrhage - magazi).

Monga momwe mumadziwonera nokha, atherosulinosis ya mitsempha ya carotid imatha kukhala zotsatirapo zomvetsa chisoni. Ndipo koposa zonse, palibe amene anganeneretu momwe sitirayo idzadziwonekera. Ngati simupereka chithandizo chamankhwala munthawi yake, ndiye kuti munthu akhoza kukhala wolemala kwathunthu kapena kufa kumene.

Ndiye chifukwa chake, ngati atapezeka ndi chotupa cha ma cell a carotid, njira imodzi mwanjira yomwe amathandizira ndi kuchitidwa opaleshoni.

Kodi opaleshoni ndiyofunikira?

Kuchita chithandizo cha opaleshoni kumachitika pokhapokha kuwulula za matendawo.

Kuphatikiza apo, opareshoni imachitika ndi mphamvu yotsika ya mankhwalawa omwe amagwiritsidwa ntchito, omwe sangathe kukhazikika pansi thanzi.

Kuchitapo kanthu pochizira opaleshoni ya carotid arteriosulinosis kumakhala ndi malingaliro angapo osatsimikizika.

Zizindikiro ndi stenosis (kupapatiza) kwa lumen kwa chotupa cha carotid kumakhala kwamphamvu kuposa 70%, kuphatikiza milandu yomwe kulibe mawonetseredwe azachipatala; stenosis ya carotid artery imakhala yoposa theka ngati pali zizindikiro za matenda amiseche, ndipo m'mbuyomo wodwalayo adakumana ndi vuto losakhalitsa la ubongo (TIA) kapena stroke.

Komanso, opaleshoni imalembedwa ngati pali kufupika kwa lumen kosakwana theka ngati milandu ya TIA ndi stroko zidawonedwa kale; kusweka kwadzidzidzi kwa ntchito zaubongo kapena kupita patsogolo kwa matenda amiseche; kuwonongeka kwa kumanzere ndi kumanzere kwa carotid mitsempha; munthawi yomweyo kuwonongeka kwa carotid, vertebral ndi subclavian mitsempha.

Palinso zolakwika zambiri pakuchita opareshoni, chifukwa nthawi zambiri anthu achikulire amakumana ndi mavuto omwewo.

Kwa iwo, zochitika ngati izi ndizopweteka kwambiri, motero pamakhala zotsutsana pamakhalidwe awo:

1. matenda opatsirana a mtima, bronchopulmonary dongosolo ndi impso nthawi yakukokoka - ndiye vuto loyamba, chifukwa thupi lomwe limayendetsedwa ndi opaleshoni ya m'mimba silingathe;
2. kupsinjika kwakukulu kwa chikumbumtima, mpaka kukomoka;
3. pachimake gawo la sitiroko;
4. hemorrhage mu ubongo minofu ndi concomitant foci wa ischemia.

Chinanso chomwe chikuyambitsa cholakwika ndicho kufa kwathunthu kwa maselo aubongo omwe amatuluka kwambiri m'mitsempha yama carotid.

Zosiyanasiyana maopareshoni yama carotid

Madokotala asanadziwe mtundu wa opareshoni yomwe adzagwire ntchito m'dipatimenti yopanga opaleshoni, odwala amafunika kuyesedwa: magazi ndi mkodzo poyesa, kuyezetsa magazi osiyanasiyana, kupatula mtima (kupatula matenda amtima), fluorography (mayeso ofunikira chifuwa chachikulu), coagulogram (kutsimikiza kwa magazi kuundana).

Njira zowonjezera pakufufuzira pankhaniyi, zomwe tikulingalira, zikuphatikiza ma carotid artery angiography (angiography ndikusanthula kwa mitsempha yamagazi pogwiritsa ntchito njira yosiyanitsa), mitsempha yamagazi obwereza, compact tomography (CT), kapena maginito a resonance imaging (MRI).

Mitundu itatu yayikulu ya njira zochitira opaleshoni yamitsempha yama carotid imasiyanitsidwa: carotid endarterectomy, stenting stelling, vascular prosthetics.

Kusankhidwa kwa njira yochita opaleshoni mwachindunji kumadalira kuchuluka kwa kuvulala kwamitsempha, pa zaka komanso zikhalidwe la wodwalayo, komanso ku chipatala komwe mchitidwewo udzachitidwira.

• Carotid enadarterectomy ndichomwe chimagwira ntchito kwambiri pamwambapa. Muli ndi kuchotsedwa kwathunthu kwa cholesterol plaque kuchokera khoma la chotengera, zomwe zimapangitsa kuti zibwezeretsedwe kwathunthu. Nthawi zambiri imachitika pogwiritsa ntchito mankhwala opha ululu, koma nthawi zina kwanuko kumatha. Amachitika ndi atherosulinosis ndi carotid artery thrombosis, momwe mumanenedwa matenda akuwonekera kwa ngozi yamitsempha, kapena asymptomatic atherosclerosis, koma ndi mtima wamphamvu wa stenosis. Pa opaleshoniyo, khungu limapangika kumbuyo kwa auricle 2 cm pansi pamphepete mwa nsagwada yam'munsi; imapitilizidwa limodzi ndi minofu ya sternocleidomastoid masentimita khumi. Kenako khungu ndi subcutaneous mafuta minofu timatulutsa. Zitachitika izi, kuchuluka kwakweko (chotupa) cha chotupa cha carotid chimayesedwa ndipo chamkati chimapezeka. Chingwe cha atherosulinotic limodzi ndi zinthu zosinthika za khoma lamkati limachotsedwa kwathunthu ku lumen. Kenako malowa amatsukidwa ndi njira yothandizira ya sodium chloride. Khoma lamitsempha limakulungidwa pogwiritsa ntchito chigamba chapadera. Itha kupangidwa kuchokera ku zinthu zopangidwa kapena kuchokera ku minofu ya wodwalayo. Pamapeto pa opareshoni, chilondacho chimasokonekera m'magulu, ndikusiya drainage (chubu) m'chigawo chotsikira kuti utulutse madzi.
• Ndikuluma - pakadali pano, opaleshoni iyi imakondedwa kwambiri, chifukwa mwachilengedwe imakhala yovuta, ndipo, motero, sizivuta anthu. Kwa stenting, kuyang'anira pafupipafupi kwa x-ray ndikofunikira, momwe woperekera zosiyanazo amatumizidwa mchombo ndikugawa kuyang'aniridwa. Kuchita opareshoni kumachitika pansi pa mankhwala oletsa ululu. Choyamba, kupyoza (kupyoza) kwa chotupa cha carotid kumachitika. Kenako, motsogozedwa ndi X-ray, balloon yapadera imayambitsidwa mkati mwake, yomwe imakulitsa kuwunikira kwa chotengera pamalo ofunikira. Pambuyo pa izi, stent imayikika - kasupe wachitsulo, amene amasunga nthawi yomweyo chilolezo. Pamapeto pa opareshoni, baluniyo imachotsedwa. Mukakhala ndi kununkha, zovuta monga kuwonongeka kwa zolengeza, carotid artery thrombosis imatha kuonedwa.
• Prosthetics mwina ndi njira yovuta kwambiri kuchitira opaleshoni nthawi yayitali. Amagwiritsidwa ntchito pakuwonjezera zotupa za atherosselotic, kuyika kwamchere kwa khoma la chotengera, komanso pamaso pa kukwiya kapena kuchuluka kwa mtsempha. Pa ma prosthetics, chotupa chamkati cha carotid chimadulidwa, malo omwe akhudzidwa amachotsedwa kwathunthu, zotengera zimatsukidwa m'malo omwe adasungidwa, ndipo gawo lotsala la mkati mwa carotid limaphatikizidwa ndi chotupa wamba cha carotid. Cholumikizira ndi kuphatikizika kwa zinthu zopangidwa koyenerana ndi ma diameter a ziwiya. Gawo lomaliza ndikukhazikitsa ngalande zotulutsira madzi.

Nthawi yokonzanso pambuyo pochita opaleshoni ya zolembera zam'mimba mu carotid artery samapitilira sabata. Mavuto amakula nthawi zambiri. Zotsatira za opaleshoniyo nthawi zambiri zimakhala zabwino. Ndemanga za ntchito ili pamwambapa ndizabwino.

Carotid arteriosulinosis akufotokozedwa mu kanema munkhaniyi.