Uma isiguli ngendlela ebaluleke kakhulu futhi ethuthukile ye-atherosclerosis yamaphethelo aphansi sitholakala, kwezinye izimo ayikho enye indlela ephumelelayo ekwelashweni njengokunqunywa kwemikhawulo engezansi.
Ukwehlukanisa i-atherosclerosis yamaphethelo aphansi yisifo se-vascular esingapheli esiqhubekayo sangaphakathi nesikhulukazi, sikhula ngenxa yokuhlanganiswa kwe-dyslipidemia yesikhathi eside kanye nomonakalo odongeni olungaphandle, lapho kungekho ukwelashwa okufanele kuholela ezinkingeni nokukhubazeka.
Izizathu zokuthuthuka kwe-atherosulinosis NK
Kunezizathu eziningi zokuthuthuka kwezinguquko ze-atherosclerotic emikhunjini yamalungu.
Izimbangela eziholela ekuthuthukisweni kwe-atherossteosis zingahlukaniswa ngamaqembu amabili.
Amaqembu anjalo wezimbangela yizinto ezinegalelo ekwandeni kwezinga lama-cholesterol aphelele kanye nezingxenyana zawo kwiplasma yegazi nezinto ezenzo zawo ziholele ekulimaleni kwemithambo yegazi.
Iqembu lokuqala lifaka:
- Imbangela evame kakhulu yokwanda kwe-cholesterol ayilandeli ukudla okunengqondo - ukudla amafutha amaningi ezilwane nokudla okune-cholesterol, kanye nokudla okuthosiwe emafutheni amaningi kawoyela, obhemayo, ekudleni okunosawoti nokudla okusheshayo. Okubaluleke kakhulu ukuncishiswa kokudla kwemithombo ye-fiber - imifino eluhlaza, izithelo, okusanhlamvu nemidumba, ukungahambisani nombuso wokuphuza, ukusetshenziswa kwenamba kashukela omnandi, ikofi, itiye.
- Ukuqina komndeni nakho kubalulekile - kuzo zombili izifo zesistimu yezinhliziyo, ukukhuluphala, i-metabolic syndrome, ezinye izindlela ze-endocrine, kanye ne-dyslipidemia yomndeni, i-homocysteinemia, nezinye izifo zokuphazamiseka komzimba.
Izizathu zeqembu lesibili zifaka:
- imikhuba emibi - ukuphuza ngokweqile nokubhema kuthinta ungqimba lwangaphakathi lodonga lomkhumbi, konakalise ukwakheka kwalo futhi kudale izimo zokunameka kwezixuku ze-atheromatous kanye nokugoqwa kwegazi;
- ukuntuleka kokuzivocavoca ngokomzimba - ngezinga eliphansi lokuzivocavoca nokuphila kokuhlala phansi, kunokuthambekela kokuqina kwegazi emithanjeni yemikhawulo ephansi, kwandise ingcindezi futhi kulimaze ne-endothelium;
- ukusebenza ngokweqile komzimba, ukusebenza kanzima - kuholela kuma-microtrauma emisipha yemilenze futhi, ngokufanelekile, imikhumbi yabo, ukudala izimo zokuthuthukiswa kwama-cholesterol plaques;
- ukulimala kanye ne-hypothermia yemikhawulo - kuholela ekuphazamisekeni kokujikeleza kwegazi ezindaweni ezilimele zemilenzeni, ischemia;
- ukwenzeka kwe-atherosulinosis kuthinteka yi-concomitant pathologies - izifo ezi-thrombotic noma i-thromboembolic, ukusetshenziswa kwemithi ethile - izindlela zokuvimbela inzalo zomlomo ezihlanganisiwe, ama-glucocorticosteroids.
Ezinye izinto zifaka iminyaka yobudala (i-vascular elasticity iyancipha kubantu asebekhulile) kanye nobulili (imvamisa lesi sifo sikhula emadodeni, njengoba ama-hormone abesifazane besifazane eba nomthelela ovikela i-endothelium).
Izinhlobo zezilonda nezimpawu
Imvamisa, lezi zinhlobo zezilonda zamathambo zitholakala - ngokwengxenye noma nge-stenosis - ububanzi be-artery abuvinjelwe ngokuphelele. Ngasikhathi sinye, ukugeleza kwegazi akusiyo inkimbinkimbi, akubangeli zimpawu nezimpawu ezibalulekile, kungenzeka kalula ngezindlela zokwelashwa ezivumayo.
Uhlobo lwesibili - i-occlusion - i-lumen ivinjelwe ngaphezulu kwesigamu, ukugeleza kwegazi kukhubazekile noma akukho ngokuphelele, kubangela izimpawu eziphindaphindayo nezinkinga, kudinga ukwelashwa okuhlinzwa, futhi kungaholela ekukhubazekeni.
Izimpawu zokuqothula i-atherosclerosis yamaphethelo aphansi ziyehluka futhi zixhomekeke ebangeni lokuqhubeka kwezifo.
Izimpawu ezivame kakhulu yilezi:
- Ukusinda nokungakhululeki emilenzeni, kuze kube buhlungu, ngemuva kokuzivocavoca umzimba, ukuhamba ibanga elide.
- Ukwephulwa kokuzwela okushisayo - umuzwa ongaguquki owenziwa izinyawo ezibandayo.
- Ukwephulwa kokuzwela okubucayi nobuhlungu bendawo eyonakele.
- Ukuhamba okunzima, lapho kufakwa khona i-atherosclerotic plaque endaweni yokufakelwa kwe-aortic emithanjeni yemithambo ye-iliac - ukubonisana ngezikhathi ezithile.
- I-Pain syndrome - kusukela ekubonakaleni kobuhlungu enkomeni noma emisipheni yabesifazane ngemuva kokuzivocavoca okukhulu noma ukuhamba isikhathi eside, kugijimela ebuhlungwini obungapheli, ngisho nasekuphumuleni noma ebusuku. Ngenxa yohlobo lobuhlungu ku-atherosulinosis, imvamisa okuhlala kungakhanyi, hhayi okukhulu, kungakhula ngesikhathi sokuzivocavoca komzimba.
- Ukwephulwa kwe-trophism yesikhumba nokwenziwa kwayo, izicubu - ukuncipha kanye nokuqina kwesikhumba, ukushintshwa kombala waso (kusuka kuphuzi lapho izigaba zokuqala zesifo ziphenduke zibe nsomi nokumnyama ngokwakhiwa kwe-gangrene kanye ne-tis necrosis), ukulahleka kwezinwele ezindaweni ezithintekile, ukuqina, izipikili ezibunjiwe, izicubu zomsipha, kubambezele ukuphulukiswa kwamanxeba esikhunjeni sezinyawo, ukwakheka kwezilonda ezinamahlwili, i-necrosis yesikhumba nezicubu ezithambile.
Isibonakaliso Injongo yokuphazamiseka kokujikeleza kwemilenze ukungabikho kokushayeka emithanjeni ye-distal - i-popliteal, imithambo yethambo, nethanga. Lolu phawu lubaluleke kakhulu ekuxilongeni kokuqala nasekuzixilongeni kwe-atherosclerosis.
Izigaba ze-Atherosulinosis NK
Lesi sifo sihlukaniswa ngokuya ngezigaba lapho amanye amaqhinga okuthola ukwelashwa ancike khona - ukukhethwa kukadokotela noma amaqhinga okulondolozwa, noma ukusetshenziswa kwezindlela zokuhlinzwa.
Isigaba sokuqala sitholakala lapho izinhlungu zenzeka kuphela ngemuva kokuzivocavoca okukhulu ngokomzimba, ukuhamba ibanga elingaphezu kwekhilomitha elilodwa akunabuhlungu. Kulesi sigaba, isiguli sidinga ukwelashwa okulondoloziwe - ukuguqulwa kwendlela yokuphila, nezinkomba - ukwelashwa ngezidakamizwa.
Isigaba sesibili sibonisa ngokuncipha kokubekezelela umsebenzi womzimba, ukwenzeka kobuhlungu emisipha yemilenze lapho uhamba ibanga ukusuka kumamitha angama-250 ukuya kwekhilomitha elilodwa. Ezigulini ezinjalo, irejimeni yokwelashwa iqukethe ukusetshenziswa kwezindlela ezingezona izidakamizwa nezidakamizwa.
Isigaba sesithathu ibanga lokuhamba kobuhlungu kusuka kumamitha angama-50 kuye kwangama-250, ezinye izinkomba zikhona - ukukhohlakala, ukuzwela okungahambi kahle, izinhlungu ziyenzeka ebusuku nasekuphumuleni. Ezigulini ezinjalo, kuyadingeka ukuhlanganisa izindlela zokwelapha ezingejwayelekile nezingahlaseli.
Isigaba sesine sinezimpawu zonke zesithathu, kepha singezelelwa ngokwenzeka kwezinkinga ze-ischemic - trophic ulcers, gangrene. Njengomthetho, izindlela zokwelapha ezihlinzwa zisetshenziselwa iziguli ezinje, ngoba kulesi sigaba amathuba okukhubazeka kwesiguli ngokuphathwa okungafanele futhi okungafanele kube sezingeni eliphakeme.
Ukuxilongwa kwe-atherosclerosis yamaphethelo aphansi
Isinyathelo sokuqala kulokhu kutholwa ngumlando ophelele wempilo (izifo ezedlule nezingamahlalakhona, ukuhlinzwa, ukulimala, ukuthambekela komndeni, indlela yokuphila, ukondliwa, imikhuba emibi).
Umlando walesi sifo nawo ubalulekile (ukuqala, izimbangela ezingakhona, izimpawu zokuqala, isikhathi sesifo, ukukhula kwaso, ukwelashwa kwangaphambilini, imiphumela yaso).
Izindlela ezilandelayo zingakhethwa, ziyadingeka ukuze kuqinisekiswe ukutholwa.
Lokhu kufaka phakathi ukuhlolwa kwelabhoratri:
- Ukubala kwegazi eliphelele, i-urinalysis ejwayelekile.
- Iglucose yegazi (ukuxilongwa kwesifo sikashukela kanye nokufakwa ngaphandle kwe-angiopathy yesifo sikashukela).
- Ukuhlolwa kwegazi kwe-biochemical - nquma ukuhlolwa kwe-lipid (izinga le-cholesterol ephelele, indawo ephakeme nephansi ye-lipoproteins, i-triglycerides), isibindi (i-AlAT, i-AcAT, i-alkaline phosphatase nayo ibalulekile - ama-statins aphikisanwe nokwanda kwalezi zinhlaka) nokuhlolwa kwe-renal (creatinine, urea).
Ukuxilongwa kokugcina kunqunywa ngemuva kokuba kwenziwe izindlela zokwengeza zokuhlola izinsiza, ezikuvumela ukunquma izinga lomonakalo, ububanzi bokuqina komkhumbi futhi ubone ngamehlo ukuphuma kwegazi.
Lokhu kufaka phakathi:
- i-angiography ingenye yezindlela ezilula futhi ezingabizi kakhulu zokuxilonga, ngokususelwa ekungenisweni kwe-ejenti le-X-ray emikhunjini nezithombe ze-X-ray zezitho;
- i-multispiral computed tomography kanye ne-magnetic resonance imaging kuyizindlela zokucwaninga ezifundisayo ezisiza ukubona ngeso lengqondo izinga lokuvinjwa kwemithambo;
- ukuskena kwe-duplex ultrasound kuyindlela esezingeni legolide yokuxilongwa kokuqothuka kwe-atherosulinosis, kwenza sikwazi ukulandelela ukuhamba kwegazi endaweni eyonakele, ukubona ngamehlo engqondo imithambo yempahla ebambisene.
Futhi ekubhekaneni nezindlela zokuxilonga kufaka ukulinganisa umfutho wegazi ezingalweni nasemilenzeni, ukubala inkomba ye-ankle-brachial.
Ukwelashwa okujwayelekile kwe-atherosclerosis yamaphethelo aphansi
Ukwelashwa kuya ngezimpawu zesifo, isigaba saso, futhi kufaka phakathi ukuguqulwa kwendlela yokuphila yesiguli, imithi nezindlela zokuhlinzwa.
Ukwelashwa kwezigaba zokuqala kungenziwa ngokuqapha, isiguli sinikezwa izincomo ngokudla, ukuvivinya umzimba ngokulinganisela, nokunakekelwa kwezinyawo.
Ukudla kokwelashwa kwe-atherosclerosis kufanele kube ngokulinganayo, ngokufakwa ekudleni kwemifino nezithelo, okusanhlamvu, izinhlobo ezinamafutha amancane enyama nezinhlanzi, uhlobo olwanele lokuphuza.
Njengomthombo wamaprotheni, inyama yenkukhu, inhlanzi enamafutha aphansi, i-legumes, i-soy, amaprotheni amaqanda enkukhu afanele.
Ukudla okunothe kakhulu akukhishwe ngokuphelele - amasoseji, udoti, izikhupha, ukudla okusheshayo, ukudla okulula.
Ukunakekelwa kwezinyawo okufanele nakho kubalulekile - ukugwema i-hypothermia, ukugqoka izicathulo ezintofontofo, hhayi eziseduze, noma zamathambo uma kungenzeka, ukwenza izinyawo ngokufanele, ukuphatha amanxeba amancane esikhunjeni nge-antiseptics.
Kuyalule futhi ukuthi usebenzise izinyawo zokugeza ezingefani nge-decoctions yamakhambi noma usawoti, i-massage.
Kwi-Intanethi ungathola izibuyekezo ezinhle ngemiyalelo yesintu yokwelashwa, lokhu kufaka hlikihla isikhumba ngamafutha omnqumo noma olwandle, ama-decoctions of ash ash noma dill. Kodwa kufanele kukhunjulwe ukuthi kuyadingeka ukusebenzisa izindlela ezinjalo zokupheka kuhlangene nolunye ukwelashwa futhi kungabikho mibango.
Ukwelashwa kwezidakamizwa ze-atherosulinosis:
- Ama-Hypolipidemic agents - Atorvastatin, Rosuvastatin, Simvastatin, fibrate, nicotinic acid.
- Ama-Antispasmodics - uNo-shpa, uDrotaverin, uPapaverin.
- Izidakamizwa ze-Vasoactive - Vazoprostan, Trental, Curantil, Cilostazol.
- Ama-antiplatelet agents kanye nama-anticoagulants - u-Aspirin, uCardiomagnyl, uMagnikor, uFraksiparin, uHeparin, u-Enoksiparin, uClopidogrel.
Ngaphezu kwalokho, kusetshenziswa ama-Vitamin therapy kanye ne-physiotherapy enqubweni yokwelashwa.
Ukwelashwa kokuhlinzwa kwe-atherosclerosis
Ukubuyisa ukugeleza kwegazi esigabeni sokuqala nesesibili, kusetshenziswa imithambo ye-low-invasive endovascular - i-stenting, surgepp, i-balloon angioplasty, i-thrombendarteriectomy, i-angioplasty nge-alloprosthetics noma i-autoprosthetics.
Ukwelashwa kwesigaba sesithathu nesine se-atherossteosis, kusetshenziswa ukwelashwa okuyinkimbinkimbi, okubandakanya izincomo ezijwayelekile ngendlela yempilo nokudla, ukwelashwa ngezidakamizwa nokuhlinzwa.
Ezigulini ezine-ischemia ebucayi, akunakwenzeka ukwenza ukuhlinzwa okungajwayelekile, ngoba ukuphuma kwegazi kuphazamisekile kakhulu, futhi kwenzeka izinguquko ezingaphenduki ze-ischemic necrotic.
Kwesinye isikhathi okuwukuphela kwendlela yokuphuma ezimeni ezinjalo, phambi kwenqwaba enkulu yezicubu ze-necrotic, ukulimala hhayi kuphela ezithambile kodwa futhi nezicubu zamathambo, ukunqunywa kwendawo ethintekile.
Lokhu kungenye yezindlela ezindala kakhulu zokuhlinzwa, umongo wayo ukukhipha ingxenye yesilungu eduze kwethambo, ukunqunywa kwamalungu aphansi nge-atherossteosis kusetshenziswa kuphela ezimweni lapho kungenzeki khona ukusindisa izicubu ezinesifo.
Ngokuya ngezinga le-vaslation occlusion nezinguquko ezindaweni eziseduze, ukunqunywa okuphezulu nokuphansi kuyahlukaniswa.
Ukuqunjelwa okukhulu kubizwa lapho umlenze unqunywe ngenhla kwedolo, uphansi - ngokuhlelwa kabusha kweminwe, unyawo, umlenze ophansi.
Ukukhishwa kuhlukaniswe phakathi kokuyinhloko nokwelesibili.
Izinkomba zokusetshenziswa - i-occlusion ephelele ye-vascular, ehambisana nobuhlungu obukhulu, ukushoda komphumela kusuka ekwelashweni okulondoloziwe, ushintsho lwe-necrotic esikhunjeni kanye nemisipha.
Ukuhlinzwa ngokuxhamazela kuvimbela ukuvela kwezinkinga - i-sepsis, ukutheleleka kwesibili kwezinye izitho.
Kumele kukhunjulwe ukuthi ngemuva kokunqunywa, ukwelashwa kulesi sigaba akupheli, ngoba i-atherosclerosis imvamisa i-multifocal, futhi ngokushesha isimo sokuwohloka kwegazi okungahambi kahle singase siphinde sibuye.
Ngemuva kokuhlinzwa okukhulu, izinyathelo zokubuyiselwa ziyadingeka - ukuhlinzwa okudlula noma ukuhlikihla, i-prosthetics of the okuhlangene okuhlanganisiwe.
Ukuvimbela ukuqeda i-atherosulinosis kuqeda ngokusebenza ngokomzimba, ukugcina ukudla okunengqondo, ukuyeka ukubhema nokusebenzisa kabi utshwala, ukubheka ngezikhathi ezithile i-cholesterol kanye nezinye izingxenyana ze-lipid, umfutho wegazi, ukwelashwa okufika ngesikhathi kwama-pathologies ahambisanayo.
Ukuthi i-atherossteosis yelashwa kanjani ichazwa kuvidiyo kule ngxenye.