Cardiosulinosis ndi kusintha kwamomwe munjira ya minofu ya mtima ndikuyimitsidwa ndi minyewa yolumikizana, kumachitika pambuyo pa matenda opatsirana - myocarditis, endocarditis yotupa, pambuyo poyambira. Atherosulinosis imathandizanso kuti pakhale mtima, kusintha kwa m'mitsempha kumachitika chifukwa cha minyewa ya ischemia komanso kuchepa kwa magazi. Vutoli limachitika nthawi zambiri mwa achikulire kapena okalamba, limodzi ndi matenda monga angina pectoris ndi matenda oopsa.
Mtima wamatenda amtundu wa cell atos kachitidwe.
Amuna amatha kukhala ndi atherosulinosis, monga mahomoni ogonana achikazi, monga estrogen, amatha kuteteza pazitseko zamitsempha yamagazi ndikuletsa kupangidwe kwa zolembera. Amayi amakhala ndi matenda a mtima komanso matenda opatsirana, koma patatha zaka 45 - 50 atasiya kusamba. Izi zimayambitsa kuphipha ndikuchepetsa mphamvu ya ziwongolero za m'matumbo am'mimba, ischemia ndi hypoxia ya myocyte, kuchepa kwawo ndi kuwonekera kwawo.
Poyerekeza ndi kuchepa kwa oxygen, ma fibroblasts amayambitsidwa, ndikupanga ma collagen ndi zotanuka m'malo m'malo owonongeka a minofu ya mtima. Pang'onopang'ono maselo amisempha amasinthidwa ndi minyewa yolumikizana, yomwe singagwire ntchito za contractile ndi conduction. Ndi kukula kwa matendawa, minyewa yambiri yowonjezereka komanso kufooka, zomwe zimapangitsa kuti pakhale kupendekeka kwamanzere kwamitsempha yamagazi, moyo wowopsa, monga mtima wamitsempha, kulephera kwamtima, komanso kulephera kwa magazi.
Kugawidwa kwa atherosulinosis ndi matenda a mtima ofanana ndi ICD 10
Atherosulinotic mtima mu ICD 10 si nosology yodziimira payekha, koma ndi imodzi mwazomwe zimachitika ndi matenda a mtima.
Kuti athandizire kuzindikira zamtunduwu, ndichizolowezi kuganizira matenda onse malinga ndi gulu la ICD 10.
Amapangidwa ngati chikwatu ndi gulu la alphanumeric, pomwe gulu lililonse la matenda limapatsidwa khodi yakeyake.
Matenda a mtima wamtima amasonyezedwa ndi ma I00 kudzera I90.
Matenda a mtima a ischemic, malinga ndi ICD 10, ali ndi mitundu iyi:
- I125.1 - Atherosclerotic matenda am'mitsempha yamagazi.
- I125.2 - Myocardial infarction yapitayi yomwe imapezeka ndi zizindikiro zamankhwala ndi maphunziro owonjezera - ma enzymes (ALT, AST, LDH), mayeso a troponin, ECG.
- I125.3 - Aneurysm of the heart or aorta - ventricular or wall.
- I125.4 - Chidziwitso cha mtsempha wamagazi ndi kayendedwe kazinthu, kamene kali ndi fistula ya corterary arteriovenous fistula.
- I125.5 - Ischemic cardiomyopathy.
- I125.6 - Asymptomatic myocardial ischemia.
- I125.8 - Mitundu ina yamatenda a mtima.
- I125.9 - Matenda a mtima osadziwika osadziwika.
Diffuse cardiosclerosis imasiyananso chifukwa cha kuthekera ndi kuchuluka kwa ndondomekoyi - minofu yolumikizika imakhala chimodzimodzi myocardium, ndipo kakhalira kapena malo owoneka bwino - malo owopsa amakhala osapindika ndipo amakhala m'malo akulu.
Mtundu woyamba umachitika pambuyo pa matenda opatsirana kapena chifukwa cha ischemia yayikulu, chachiwiri - pambuyo poti myocardial infarction ikupezeka pamalo a necrosis a minofu ya mtima.
Zowonongeka zonsezi zimachitika nthawi imodzi.
Matenda akuwonetsa matendawa
Zizindikiro za matendawa zimawonekera pokhapokha pakuwunika kwa ziwiya ndi myocardial ischemia, kutengera kufalikira ndi kutukuka kwa njira ya pathological.
Mawonetsero oyamba a matendawa ndi kupweteka kwakanthawi kumbuyo kwa sternum kapena kumverera kosasangalatsa m'derali pambuyo pa kupsinjika kwakuthupi kapena kwamalingaliro, hypothermia. Ululu ndiwachilengedwe, kupweteka kapena kusoka, limodzi ndi kufooka, chizungulire, ndi thukuta lozizira.
Nthawi zina wodwalayo amapweteketsa madera ena - chakumanzere tsamba kapena mkono, phewa. Kutalika kwa ululu m'matumbo a mtima kumachokera pa mphindi ziwiri mpaka zitatu mpaka theka la ora, kumatsika kapena kuima mutapuma, mutatenga Nitroglycerin.
Ndi kukula kwa matendawa, zizindikiro za kulephera kwa mtima zimawonjezeredwa - kupuma movutikira, kutupa kwa mwendo, khungu la khungu, kutsokomola pachimake kwamanzere kwamitsempha, kukulitsa chiwindi ndi ndulu, tachycardia kapena bradycardia.
Kupuma pang'ono kumachitika pafupipafupi pambuyo pa kupsinjika kwakuthupi ndi kwamalingaliro, m'malo apamwamba, kumachepetsa kupumula, kukhala. Ndi chitukuko cha kupweteka kwapanja kumanzere kwamitsempha, kupuma movutikira kumakulirakulira, chifuwa chowuma, chopweteka chikujowina.
Edema ndi chizindikiro cha kuwonongeka kwa kulephera kwa mtima, kumachitika pamene ma venous m'miyendo atadzaza ndimagazi ndipo kupopa kwa mtima kumachepa. Kumayambiriro kwa matendawa, edema ya miyendo ndi miyendo yokha imawonedwa, ndikudutsa momwe amafalikira, ndipo amatha kuwonekera pankhope ndi pachifuwa, pericardial, m'mimba.
Zizindikiro za ischemia ndi hypoxia ya ubongo zimawonedwanso - mutu, chizungulire, tinnitus, kukomoka. Ndi kusintha kwakanthawi kwa myocyte ya conduction ya mtima ndi minyewa yolumikizika, kusokonezeka kwadzimadzi - blockages, arrhythmias, kumatha kuchitika.
Pang'onopang'ono, arrhythmias imatha kuwonetsedwa ndi kusokonezeka kwa ntchito ya mtima, kusakhazikika kwake kapena kuchepa kwapang'onopang'ono, kumverera kwa palpitations. Poyerekeza ndi mtima wamtima, machitidwe ngati tachycardia kapena bradycardia, blockade, atrrophtosis atria, kapena ma cyricular fibrillation amatha kuchitika.
Cardiosclerosis ya atherosulinotic chiyambi ndi matenda omwe akupita pang'onopang'ono omwe amatha kuchitika ndikuwonjezereka.
Njira zodziwira matenda a mtima
Kuzindikira matendawa kumakhala ndi zowerengetsa zamankhwala - nthawi yoyamba matendawa, zizindikiro zoyambirira, chibadwa chawo, nthawi yayitali, matenda ndi chithandizo. Komanso, pakuwonetsetsa, ndikofunikira kudziwa mbiri ya wodwala m'moyo - matenda akale, ma opaleshoni ndi kuvulala, zizolowezi zabanja pamatenda, kupezeka kwa zizolowezi zoipa, moyo wanu, akatswiri.
Zizindikiro zamankhwala ndizofunikira kwambiri pakuwunika kwa atherosulinotic cardiosclerosis, ndikofunikira kufotokoza bwino zomwe zikupezeka, momwe zimachitikira, mphamvu zake pakadutsa matenda onse. Onjezani zidziwitsozo pogwiritsa ntchito njira zothandizira ngati ntchito.
Gwiritsani ntchito njira zowonjezera:
- Kusanthula kwa magazi ndi mkodzo - ndimatenda ofatsa, mayesowa sangasinthidwe. Mu hypoxia yayikulu kwambiri, kuchepa kwa hemoglobin ndi erythrocyte ndi kuwonjezeka kwa SOE kumawonedwa poyesa magazi.
- Kuyesedwa kwa magazi kwa glucose, kuyesa kwa kulolera kwa glucose - kupatuka kumangopezeka ndi concomitant shuga mellitus ndi kulolerana kwa shuga.
- Kuyesa kwa magazi a biochemical - kudziwa mtundu wa lipid, wokhala ndi atherosulinosis, cholesterol yathunthu imakwezedwa, kutsika kwambiri komanso ochepa kwambiri lipoproteins, triglycerides, lowensens lipoproteins amachepetsa.
Potsatira mayesowa, kuyezetsa kwa hepatic ndi aimpso kumatsimikizidwanso, komwe kungawonetse kuwonongeka kwa ziwalo izi nthawi yayitali ischemia.
Njira zina zowonjezera
X-ray ya ziwalo zachifuwa - imapangitsa kudziwa mawonekedwe a mtima, kuchepa kwamitsempha, magazi m'mitsempha, edema. Angiography ndi njira yotsatsira, yomwe imagwiridwa ndi kuyambitsa kwa gawo losasiyanitsa lamitsempha yamagazi, magawo a magazi kumadera ena, chitukuko. Dopplerography yamitsempha yamagazi kapena kuwunika kwa maulendo atatu, omwe amagwiritsidwa ntchito pogwiritsa ntchito mafunde akupanga, amakupatsani mwayi kudziwa momwe magazi amayendera komanso kuchuluka kwa zoletsedwa.
Ma electrocardiography ayenera kuchitidwa - amawunika kukhalapo kwa arrhythmias, kumanzere kapena kumanzere kwamitsempha yamagazi, kukokoloka kwa mtima, kuyambika kwa myocardial infarction. Kusintha kwa Ischemic kumawonetsedwa pa electrocardiogram ndi kuchepa kwa mphamvu yamagetsi (kukula) kwa mano onse, kukhumudwa (kuchepa) kwa gawo la ST pansi pa contour, mawonekedwe olakwika a T.
ECG imathandizidwa ndi kafukufuku wa echocardiographic, kapena ultrasound yamtima - imayang'ana kukula ndi mawonekedwe, mgwirizano wamkati wamtima, kupezeka kwa malo osasunthika, kuwerengetsa, kugwira ntchito kwa mawonekedwe a valavu, kusinthika kwa metabolism kapena metabolic.
Njira yothandiza kwambiri yodziwira njira zamtundu uliwonse ndizodandaula - chithunzi chowoneka bwino cha kuphatikizika kwa magawo kapena ma isotopes olembedwa ndi myocardium. Nthawi zambiri, kufalitsidwa kwa chinthu kumakhala kofanana, popanda madera owonjezera kapena ochulukitsa. Minofu yolumikizika imatha kuchepetsa mphamvu, ndipo zigamba za sclerosis sizowoneka m'chifaniziro.
Pozindikira zotupa zam'malo zilizonse za dera lililonse, kusanthula kwa maginito, michere yamitundu yosiyanasiyana ndi njira yosankhira. Ubwino wawo ndi wofunikira kwambiri kuchipatala, kuthekera kowonetsera kuthekera kwapanthawi yomweyo.
Nthawi zina, kuti mupeze matenda olondola, kuyesedwa kwa mahomoni kumachitika, mwachitsanzo, kudziwa hypothyroidism kapena matenda a Itsenko-Cushing's.
Chithandizo cha matenda a mtima ndi mtima
Kuchiza ndi kupewa matenda a mtima a coronary kumayamba ndi kusintha kwa moyo - kutsatira kwambiri zakudya zopatsa mphamvu zopatsa mphamvu, kusiya zizolowezi zoipa, maphunziro olimbitsa thupi kapena kuchita masewera olimbitsa thupi.
Zakudya za atherosclerosis zimakhazikitsidwa pamkaka ndi zakudya zamasamba, kukana kwathunthu chakudya, mafuta ndi nyama yokazinga, zakudya zakonzedwe, nyama yamafuta ndi nsomba, confectionery, chokoleti.
Zakudya zimadyedwa makamaka - magwero a fiber (masamba ndi zipatso, chimanga ndi ma nyemba), mafuta osapatsa thanzi (mafuta a masamba, nsomba, mtedza), njira zophikira - kuphika, kuphika, kutsitsa.
Mankhwala omwe amagwiritsidwa ntchito kukweza cholesterol ndi matenda a mtima a coronary ndi nitrate yothetsa matenda a angina (Nitroglycerin, Nitro-long), othandizira antiplatelet othandizira kupewa thrombosis (Aspirin, Thrombo Ass), anticoagulants pamaso pa hypercoagulation (Heparin, Enoxyparin, Hypindia, ndi inhibitors) , Ramipril), okodzetsa (Furosemide, Veroshpiron) - kuti athetse kutupa.
Statins (Atorvastatin, Lovastatin) kapena fibrate, nicotinic acid amagwiritsidwanso ntchito kupewa matenda a hypercholesterolemia ndi kupitilira kwa matendawa.
Kwa arrhythmias, antiarimic drug (Verapamil, Amiodarone), beta-blockers (Metoprolol, Atenolol) ndi mankhwala, ndipo mtima glycosides (Digoxin) umagwiritsidwa ntchito pochiza kulephera kwa mtima.
Cardiossteosis akufotokozedwa mu kanema munkhaniyi.
