Kugwetsa ma atherosulinosis ndi njira yovuta kwambiri yamitsempha yama mtima, yomwe imadziwonekera yokha pakuwonekera kwa lumen ya ziwiya za zotanuka ndi mtundu wa minofu yokhala ndi magazi, odzaza ndi mapuloteni olowetsedwa ndi mafuta, maselo.
Izi zimabweretsa kuwonongeka kwa trophism ya dera lomwe limayendetsedwa ndi mtsempha wamafunde. Odwala amakumana ndi kusapeza kwakukulu ndi mitundu ya atherosulinosis yam'munsi yam'munsi.
Pankhaniyi, kufalikira kwa minofu kumachepetsedwa kwambiri, lactic acid ndi metabolites amachotsedwedwa pang'onopang'ono, kotero kuti kupweteka kosalephera kumachitika. Ganizirani za etiology ndi pathogenesis a matenda.
Zolinga ndi makina otukuka
Pali zifukwa zambiri zoyambitsa matendawa. Makina oyambitsa matenda a atherosulinosis sanaphunziridwe, koma muzolemba zamakono zopangidwa ndi umboni, magulu owopsa a matendawa amapangidwa. Izi zikutanthauza kuti ngati wodwalayo ali ndi chilichonse mwa mfundo zotsatirazi, ndiye kuti mwayi wa kusintha kwa atherosclerotic ukuwonjezeka.
Izi ndi monga:
- Kunenepa kwambiri. Anthu onenepa kwambiri amakonda kwambiri kudwala chifukwa cha kusokonezeka m'njira zingapo zama metabolic. Monga mafuta aufulu amamangidwa mu minofu ya adipose, ma triglycerides omwewo, cholesterol, zinthu za lipid zimatha kudutsa maselo a endothelial a khoma lamitsempha. Ku gulu lomweli lomwe langozi lingatchulidwe kuti kunanenepetsa mafuta ambiri, zakudya zamafuta ophatikiza ndi ophatikizika ndi enzyme.
- Zaka, jenda Amayi sakhala otetezedwa ku atherosulinosis chifukwa cha kupezeka kwa estrogen, komwe kumalepheretsa kusintha kwa membrane wa khungu. Amuna amadwala kasanu. Komanso, anthu atatha zaka 40 atenga matendawa chifukwa cha kuwonongeka kwachilengedwe kwa collagen khoma la mtima komanso kuchepa kwa mphamvu zawo.
- Kusuta. Nikotini ndi magawo ena a utsi wa fodya amachititsa kupindika kwamitsempha yamagazi, yomwe imafooketsa pakapita nthawi. Ndikosavuta kulowa mu khoma la cholesterol chotere kuposa lina lofunikira.
- Matenda a shuga. Mwakutero, lipid oxidation siyidutsa mpaka kumapeto, ndipo zinthu zosakongoletsedwa zimayenera kuyendayenda momasuka m'magazi, momwe zimadutsa m'matumbo awo otentha.
Kuthamanga kwa magazi, kukhala moyo wongokhala, komanso cholowa monga kupezeka kwa matenda amtima m'magazi sikutali ndi mndandanda wathunthu wa zinthu zomwe zimatsogolera ku atherosulinosis.
Kodi chimachitika ndi chiyani m'thupi? Poyamba, zosinthazi ndizosafunikira, zimatha kupezeka ndi njira ya biochemical yokha. Cholesterol m'thupi imanyamulidwa m'mayendedwe amtundu wambiri komanso wotsika kwambiri. Yoyamba ndi cholesterol yotchedwa "yothandiza", mumtunduwu imayendetsedwa chifukwa cha kuphatikiza kwa mahomoni ndi kayendedwe ka membrane, komanso kutaya. Mtundu wachiwiri ndi cholesterol transporter yosungira. Nthawi zambiri, ziyenera kukhala zochepa kuwirikiza koyamba, koma nthawi zina zimakhala bwino. Kenako kulowa kwa mafuta kumayamba. Izi zimatchedwa gawo la dolipid.
Pali magawo angapo a momwe matenda amathandizira
- Gawo Limodzi - Lipoidosis. Pakadali pano, pali ma spid okhazikika ndi ma lipid okha omwe ali chizindikiro choyamba cha atherosclerosis.
- Atheromatosis - zolengeza zimakulirakulira, kutseka lumen kwambiri, kumakuliratu ndi capillaries ndi fibrin. Zizindikiro zoyambirira za matendawa zikuwonekera kale.
- Gawo lotsiriza ndi fibrosis kapena calcization. Chipilalachi chitha kusinthidwa ndi minofu yolumikizika, kapena kuwiluka ndi mchere ndikuumitsa, komwe kumachepetsa njira zamankhwala kuti zithandizidwe.
Kodi pali mitundu iti ya atherosulinosis?
Atherosulinosis imatha kukhudza ziwiya zilizonse zazikulu kapena zapakati thupi lonse.
Mitundu yoipa ndiyoti - coronary (blockage of the shipping that feed the heart), chithokomiro (chogwiritsira ntchito cha brachiocephalic thunthu ndi wamba carotid artery beseni), malekezero apansi (kuwonongeka kwa mtsempha wamagololo wamkazi kutalika kwake konse).
Kugawika kwa atherosulinosis obliterans a m'munsi malekezero amachitika malinga ndi zinthu zingapo - Zizindikiro, zovuta zamagulu ndi zizindikiro za morphological.
Mfundo zazikuluzikulu ziyenera kukumbukiridwa:
Ntchito yolakwika:
- 1 - munthu samva kuwawa akamayenda ngakhale mtunda woposa kilomita imodzi. Mwinanso kupezeka kwa zowawa kwambiri. Mwa zisonyezo zowonjezereka, kumangika kwa zala, kumverera kuzizira kwa malekezero, kuchepa kwa khungu kumapazi, dzanzi ndikotheka.
- 2a - ululu umawonekera mtunda wa 1 km. Zala zamtundu zimatenga kuwala kosalala chifukwa cha kusayenda kwa magazi m'mitsempha, hyperkeratosis (khungu louma), misomali yophimba. Pakadali pano, sizothekanso kudziwa kutumphuka kwa ziwiya za distal pamiyendo.
- 2b - wodwalayo sangathe kuyenda 250 m pamapazi osayima chifukwa cha ululu womwe umachitika pambuyo pakupuma pang'ono.
- 3 - kupweteka kumangochitika mwadzidzidzi, ndipo wodwalayo samadutsa mita 50 osayima. Kalasi iyi ikufanana ndi kutsekeka kwathunthu kwa lumen ya chombo. Tsitsi lomwe limakhazikitsidwa pamwendo limatsika, chifukwa chakudya sichikhala chokwanira. Ming'alu imawonekera pakhungu, imakhala yocheperapo ndipo imatenga mtundu wa nsangalabwi.
- 4 - mawonetseredwe azizindikiro zakunja mu mawonekedwe a zilonda zam'mapazi ndi foci ya necrosis. Ichi ndi chiopsezo chodzala ndi chilema. Gawo lazovuta kwambiri limadziwikanso ndi zowawa za usiku zomwe sizitha kupumula ndi ma pinkiller. Zala zake zimasanduka zofiira, ndipo phazi limatupa.
Malinga kutengera kwawuniyo:
- Mchitidwewo umakhudza mitsempha ya mitsempha ya m'mimba ndi m'mimba.
- Ndi chitukuko chowonjezerapo, chotupa cha akazi ndi nthambi zoyamba za popliteal zimaphatikizidwa.
- Mitsempha yotsatira ya popliteal ndi ziwiya za gawo la tibial zimakhudzidwa.
- Kugonjetsedwa kovuta kwa magawo pamwambapa.
- Multifocal matenda - pali zofunika zambiri mthupi lonse, mawonekedwe.
Atherosulinosis ya m'munsi yotsikirako imayang'anidwanso molingana ndi kuchuluka kwa matendawa (matenda owopsa komanso osachiritsika), kuchuluka kwa kusungidwa kwa magazi ozungulira (kulipidwa, kulipidwa, kuwongoleredwa).
Momwe mungadziwire matendawa nthawi?
Kuzindikira kulikonse kumayambira ndikuwunika koyesa, ndiye kuti, ndikudandaula kwa odwala.
Monga anamnestic mawonekedwe a atherosulinosis am'munsi malekezero amaphatikizapo pachimake, kupweteka koyenda mukamayenda m'munsi mwendo (ndi kuwonongeka kwa m'mimba msempha, kupweteka kumbuyo ndi matako, komanso kusabala kwa milandu ya 50%), kupsa mphamvu, dzanzi la miyendo, kuchepa mphamvu kwa khungu la miyendo, kusintha mitundu yawo, kufalikira kwa zimachitika.
Pambuyo pa kafukufukuyu, mutha kupita kuchipatala chaku labotale:
- Kutsimikiza kwa ndulu-brachial index kuwunika kayendedwe ka magazi m'munsi. Amawerengeredwa ngati chiwopsezo cha kukakamiza kwakukulu mu tibial artery to the brachial artery. Nthawi zambiri zofanana ndi chimodzi.
- Kuyesa kwa Ultrasound. Kugwiritsa ntchito njirayi, mkhalidwe wamitsempha wofunikayo, kuchuluka kwa kutsekeka, komanso kuthamanga kwa magazi limodzi ndi zigawo zake za rheological - kachulukidwe, kubwezeretsanso kotheka kumatsimikiza. Iyi ndi njira yotsutsana.
- Angiografia - kuphatikiza ndi CT, imalola dokotalayo kuti azitha kuwona momwe magazi amayendera molondola komanso momwe angawonere dera lowonongeka. Zoyipa zake zimaphatikizira kuwononga, chifukwa pakuwunika kuyenera kukhazikitsa kusiyana pakati.
Kuti muwone momwe minofu yofewa imagwiritsidwira ntchito, MRI imagwiritsidwa ntchito ndipo kuvutikira kwa okosijeni kumayesedwa, ngati kuli koyenera, kuti mupeze madera omwe ndi othandiza komanso omwe akuyenera kuchotsedwa.
Chithandizo ndi kupewa matendawa
Pambuyo popanga matenda akachipatala, dokotalayo amapita ku kusankha kwa chithandizo chamankhwala.
Pankhani ya atherosulinosis, alipo awiri okha aiwo - othandizira (mankhwala) kapena opaleshoni.
Mukuyenera kumvetsetsa kuti njira yoyamba ndiyotheka pokhapokha ngati palibe njira zamatendawa, zomwe zitha kupulumutsidwa ndi akatswiri a pharmacological.
Mankhwalawa akuphatikizapo:
- Kugwiritsa ntchito ma antiplatelet agents (Dextran, Reopoliglyukin, Pentoxifylline (Trental), Aspirin, Ticlopidine) kuteteza maselo ofiira amwazi kumamatira pamodzi m'magawo ang'onoang'ono am'magazi - izi zikuwonjezera ischemia.
- Hypolipidemic mankhwala (kumwa Lovastatin, Simvastatin, Atorvastatin, Ciprofibrate, nicotinic acid).
- Antispasmodics (Drotaverin, No-Shpa, Papaverin) amagwiritsidwa ntchito kwakanthawi kusintha magazi m'malo omwe akukhudzidwa ndi minofu. Izi zimathandizanso kupweteka komanso kuonjezera nthawi yomwe matendawa amafalikira.
- Ndi chiwopsezo cha thromboembolism, thrombolytics ndi fibrinolytics (Streptokinase, Heparin, Urokinase) zimayendetsedwa pamitsempha.
- Opaleshoni imachitika mozungulira kapena paravertebrally.
Chithandizo chophatikizika chimaphatikizapo kugwiritsa ntchito njira za physiotherapeutic (electrophoresis, magnetotherapy), hyperbaric minofu oxygenation ndi ozoni.
Njira zogwiritsira ntchito pochizira atherosulinosis obliterans zokhala m'munsi zimaphatikizira kulowererapo kwa mtima - ichi ndi ntchito yomanganso, pomwe, poyang'aniridwa-ndi-kuyang'anira kwa zida za x-ray, adokotala amafika kumalo ochitikiridwayo ndikugwirira ntchito:
- Makina kuchepetsedwa kapena kukongoletsa kwa nthawi yayitali.
- Kuchotsa kwa magazi a magazi kapena khoma lotupa.
- Prosthetics ya chotengera chija.
- Kuyambitsidwa kwa balloon yaying'ono kuti athetse stenosis.
Njirazi ndi zamakono ndipo zimalandira ndemanga zabwino kuchokera kwa onse odwala ndi akatswiri, kusiyanitsa zomwe zidadulidwa kale.
Ntchito zotseguka pazotengera zam'munsi ndizachotsa zonse zomwe zakhudzidwazo, kusasinthika mosalunjika kapena kudulidwa.
Kuti mupewe matendawa, tikulimbikitsidwa kuti tizitsatira kudya mosamalitsa, kuwonjezera kuchuluka kwa magazi mokwanira ndi kuchita masewera olimbitsa thupi opindulitsa, pitani kutikita minofu ndikumapaka mafuta, idyani chakudya chochepa, momwe mumaphatikizira mafuta + owonjezera.
Momwe mungachiritsire atherosulinosis yamiyendo muuzeni katswiri mu kanemayu.
