Isifo sikashukela sivame ukunika izinkinga emilenzeni. Izinkinga ezinyaweni kuyo yonke impilo zenzeka ku-25-35% wabo bonke abanesifo sikashukela. Futhi lapho isiguli siguga, kulapho amathuba okuba khona kwawo. Izifo zemilenze ezinesifo sikashukela ziletha inkathazo enkulu ezigulini nakodokotela. Imilenze ilimala nesifo sikashukela - ngeshwa, isisombululo esilula kule nkinga asikabikho. Kuzofanele ngenze konke okusemandleni ukuze ngilashwe. Ngaphezu kwalokho, udinga ukwelashwa kuphela ngudokotela ochwepheshe, futhi akunakuthi "amakhambi abantu". Kulesi sihloko, uzofunda okufanele ukwenze. Izinjongo zokwelashwa:
- Dambisa izinhlungu emilenzeni, futhi okungcono - uyiqede ngokuphelele;
- Gcina amandla okuhamba "uwedwa."
Uma ungakunaki ukuvimba kanye nokwelashwa kwezifo zikashukela emilenzeni, isiguli singalahlekelwa izinzwani noma izinyawo ngokuphelele.
Manje imilenze yesiguli ayilimazi, ngoba ukuhlinzekwa kokunwebeka kwezikhanyisi emithanjeni kuthuthukise ukuhamba kwegazi kuzo, nezicubu zemilenze ziyema ukuthumela amasiginali ezinhlungu
Isifo sikashukela, imilenze ilimele, ngoba i-atherossteosis ishiya ingcosana emithanjeni yegazi. Izicubu zomlenze azitholi igazi elanele, “i-suffocate” futhi ngenxa yalokho zithumela izimpawu zobuhlungu. Ukuhlinzwa ukubuyisa ukugeleza kwegazi emithanjeni yamaphethelo aphansi kungadambisa izinhlungu futhi kuthuthukise ikhwalithi yempilo yesifo sikashukela.
Kunezimo ezimbili eziyinhloko zezinkinga zomlenze onesifo sikashukela:
- Ushukela wegazi ophakeme ngokungamahlalakhona uthinta imicu yezinzwa, futhi bayeka ukuqhuba umfutho. Lokhu kubizwa ngokuthi yi-neuropathy yesifo sikashukela, futhi ngenxa yako, imilenze ilahlekelwa umuzwa wayo.
- Imithambo yegazi eyondla imilenze ivalekile ngenxa ye-atherosulinosis noma ukwakheka kwejazi legazi (i-damu). Ischemia eba - ukubulawa yindlala komoya we-tishu. Kulokhu, imilenze ihlala ilimala.
Isifo sikashukela sonyawo sikashukela
Umonakalo wezinzwa ngenxa ye-glucose ephezulu yegazi ubizwa ngokuthi yi-diabetesic neuropathy. Le nkinga yesifo sikashukela iholela eqinisweni lokuthi isiguli siphelelwa amandla okuzwa ukuthinta imilenze yakhe, izinhlungu, ingcindezi, ukushisa nokubanda. Manje uma alimala umlenze wakhe, ngeke ayizwe. Iningi labanesifo sikashukela abakulesi simo banezilonda emilenzeni nasezinyaweni zezinyawo, ezipholisa isikhathi eside futhi zilukhuni.
Uma izinzwa zemilenze zibuthakathaka, khona-ke amanxeba nezilonda akubangeli buhlungu. Noma ngabe kukhona ukuhlakazeka noma ukwaphuka kwamathambo onyawo, khona-ke cishe kuzoba buhlungu. Lokhu kubizwa ngokuthi yi-diabetesic foot syndrome. Njengoba iziguli zingezwa zinhlungu, eziningi zazo zivila kakhulu ukulandela izincomo zikadokotela. Ngenxa yalokhu, amagciwane ayanda ezilondeni, futhi ngenxa ye-gangrene, umlenze uvame ukunqunywa.
Isifo se-aripheral artery isifo sikashukela
Uma ubunikazi bemithambo yegazi bawa, khona-ke izicubu zemilenze ziqala 'ukubulawa yindlala "futhi zithumele amasiginali wezinhlungu. Ubuhlungu bunokwenzeka ekuphumuleni noma kuphela lapho uhamba. Ngomqondo othile, uma imilenze yakho ilimala ngesifo sikashukela mihle kakhulu. Ngoba izinhlungu emilenzeni zivuselela onesifo sikashukela ukubona udokotela futhi elashwa ngamandla akhe onke. Esihlokweni sanamuhla, sizocubungula nje isimo esinjalo.
Izinkinga ngemithambo yegazi ephakela imilenze ibizwa nge- “peripheral artery isifo”. I-Peripheral - isho kude nesikhungo. Uma i-lumen emikhunjini incishisiwe, khona-ke imvamisa ngesifo sikashukela, i-claudication eyenzeka ngezikhathi ezithile. Lokhu kusho ukuthi ngenxa yobuhlungu obukhulu emilenzeni, isiguli kufanele sihambe kancane noma siyeke.
Uma isifo se-artery sangaphakathi sihambisana ne-neuropathy yesifo sikashukela, khona-ke izinhlungu zingaba mnene noma zingabikho ngokuphelele. Ukuhlanganiswa kokuvaleka kwemithambo kanye nokulahleka kokuzwela kobuhlungu kukhulisa kakhulu amathuba okuba onesifo sikashukela kuyodingeka ukuthi anqume imilenze eyodwa noma yomibili. Ngoba izicubu zemilenze ziyaqhubeka nokuwohloka ngenxa “yokubulawa yindlala,” noma isiguli singabuzwa ubuhlungu.
Yikuphi ukuvivinya okwenzayo uma imilenze yakho ilimala ngesifo sikashukela
Kuyadingeka ukuhlola ngokucophelela imilenze nezinyawo zakho nsuku zonke, ikakhulukazi ekugugeni. Uma ukuhamba kwegazi emithanjeni kuphazamisekile, khona-ke ungaziqaphela izimpawu zokuqala zangaphandle zalokhu. Izimpawu zesigaba sokuqala sesifo se-artery yangaphakathi:
- isikhumba emilenzeni siyoma;
- mhlawumbe luzoqala ukuphuma, luhlanganiswe nokuwohloka;
- i-pigmentation noma i-depigmentation ingavela esikhunjeni;
- emadodeni, izinwele emlenzeni ongezansi ziba mpunga bese ziphuma;
- isikhumba singaba mnyama njalo sibande lapho sithintwa;
- noma okuphambene nalokho, ingafudumala futhi ithole umbala we-cyanotic.
Udokotela onolwazi angahlola ngokuthinta ukuthi uluhlobo luni lokudonsa isiguli olunalo emithanjeni eyondla izicubu zemilenze. Le ndlela ithathwa njengeyona elula futhi ebiza kakhulu yokuthola ukuphazamiseka kokujikeleza kwegazi. Ngesikhathi esifanayo, i-pulsation ku-artery iyama noma incipha kakhulu kuphela lapho i-lumen yayo incishiswe ngama-90% noma ngaphezulu. Isikhathi sekwephuze kakhulu ukuvikela "ukulamba" kwezicubu.
Ngakho-ke, basebenzisa izindlela zocwaningo olubucayi kakhulu besebenzisa imishini yezokwelapha yesimanje. Bala isilinganiso sokucindezela kwe-systolic ("ephezulu") emithanjeni yomlenze ophansi kanye ne-brachial artery. Lokhu kubizwa ngokuthi yi-ankle-brachial index (LPI). Uma kuluhlu lwe-0.9-1.2, khona-ke ukuhamba kwegazi emilenzeni kubhekwa njengokujwayelekile. Ukucindezela kwe-artery yeminwe nakho kuyalinganiswa.
Inkomba ye-ankle-brachial inikeza imininingwane engamanga uma ngabe imikhumbi ithinteka yi-atherosulinosis yeMenkeberg, okungukuthi, imbozwe “ngezinga” lokungena ngaphakathi. Ezigulini esezikhulile, lokhu kwenzeka kaningi. Ngakho-ke, izindlela ziyadingeka ezinikeza imiphumela efanelekile futhi ezinzile. Lokhu kubaluleke kakhulu lapho kuhlinzwa ukuhlinzwa okubuyiselwe ekubuyiselweni kokuqina kwemithambo ukuze imilenze ingabe isalimala.
I-Transcutaneous Oximetry
I-transcutaneous oximetry iyindlela engenabuhlungu ekuvumela ukuthi uhlole ukuthi izicubu zigcwele kahle kanjani i-oxygen. I-Transcutaneous isho “esikhunjeni.” Kusetshenziswa inzwa ekhethekile ebusweni besikhumba, okwenza isilinganiso.
Ukunemba kokuhlola kuya ngezinto eziningi:
- isimo sohlelo lwamaphaphu lwesiguli;
- izinga le-hemoglobin yegazi nokukhishwa kwenhliziyo;
- i-oxygen oxygen emoyeni;
- ubukhulu besikhumba okufakwa kuyo inzwa;
- ukuvuvukala noma ukuvuvukala endaweni yokulinganisa.
Uma inani elitholile lingaphansi kuka-30 mm RT. Ubuciko., Khona-ke ischemia (indlala yomoya-mpilo) yemilenze iyatholakala. Ukunemba kwendlela ye-transcutaneous oximetry akuyona ephezulu. Kepha isasetshenziswa, ngoba ibhekwa njengeyofundisayo futhi ayizidali izinkinga iziguli.
I-Ultrasound yemithambo enikeza igazi emilenzeni
Ukuskena i-Duplex (i-ultrasound) yemithambo yemikhawulo engezansi - isetshenziselwa ukuhlola isimo sokuphuma kwegazi ngaphambi nangemva kokwenza ukuhlinzwa emithanjeni. Le ndlela inyusa amathuba wokuthi izokwazi ngesikhathi esifanele ukuthola ukuthikamezwa kwe-artery yi-thrombus noma ukuphindwa okunciphisiwe kwe-lumen emikhunjini ngemuva kokuhlinzwa (restenosis).
I-Ultrasound yemithambo yegazi ikuvumela ukuba ufunde izindawo ezinenkinga, okungukuthi, izingxenye “ezivaliwe” emthanjeni wegazi ngenxa yokuqalwa kwesifo. Usebenzisa le ndlela, ungabheka kahle isimo semikhumbi bese uhlela kusengaphambili kokusebenza ukuze ubuyisele ubunikazi babo.
Ukukhunjulwa kwesiguli esinesifo sikashukela sohlobo 2, esivele sanyamalala izinkinga zomlenze ngemuva kokuba ushukela wegazi sithuthukile ...
Ishicilelwe nguSergey Kushchenko Disemba 9, 2015
I-angiography ephikisana ne-X-ray
I-X-ray umehluko we-angiography kuyindlela yokuhlola lapho umenzeli ophikisayo afakwa khona egazini, bese kuthi ke nemikhumbi "idlulele" ngama-x-ray. I-Angiography isho "ukuhlolwa kwemithambo yegazi". Le ndlela iyindlela yokufundisa kunazo zonke. Kepha akumjabulisi isiguli, futhi okubaluleke kakhulu - ukuthi umphikisi ongafani naye angalimaza izinso. Ngakho-ke, kunconywa ukuyisebenzisa kuphela lapho kunqunywa impikiswano yokuhlinzwa ukuze kubuyiswe i-patency ye-vascular.
Izigaba zesifo sikashukela emilenzeni
Kunama-degree ama-3 wokuphazamiseka kwegazi okujikelezayo ezigulini ezinesifo sikashukela mellitus.
I-1st degree - azikho izimpawu nezimpawu zesifo segazi sezinsimbi emilenzeni:
- imizwa ye-arterial pulsation izwakala;
- inkomba ye-ankle-brachial 0.9-1.2;
- inkomba ehlombe lomunwe> 0,6;
- isilinganiso se-transcutaneous oximetry> 60 mmHg. Ubuciko.
I-2nd degree - kunezimpawu noma izimpawu, kepha azisekho indlala ebalulekile yomoya-mpilo wezicubu:
- ukubuyiswa kwezindebe ngezikhathi ezithile (imilenze ebuhlungu);
- i-ankle-brachial index <0.9, enengcindezi ye-systolic emithanjeni yomlenze ophansi ngenhla kuka-50 mm RT. st.;
- inkomba ehlombe lomunwe ka-30 mm RT. st.;
- transcutaneous oximetry 30-60 mm RT. Ubuciko.
I-3rd degree - i-oxygen esibucayi yindlala yezicubu (ischemia):
- ukucindezela kwe-systolic emithanjeni yomlenze ophansi <50 mm RT. Ubuciko. noma
- ingcindezi ye-artery yomunwe <30 mmHg. st.;
- i-transcutaneous oximetry <30 mm Hg. Ubuciko.
Yikuphi ukwelashwa uma imilenze ilimala nesifo sikashukela
Uma imilenze yakho ilimala ngesifo sikashukela, khona-ke ukwelashwa kwenziwa ngezindlela ezi-3:
- ukudalulwa kwezinto ezikhuthaza ukuthuthukiswa kwe-atherossteosis, kufaka phakathi imithambo yemilenze;
- ukuqaliswa ngokucophelela kwezincomo zokuvimbela nokwelashwa kwezinkinga zemilenze, okuxoxwa ngazo ngokuningiliziwe esihlokweni se- “Diabetesic foot syndrome”;
- Isixazululo senkinga yokuhlinzwa ukuze kubuyiselwe ukuhamba kwegazi emithanjeni
Kuze kube muva nje, esigabeni sokukhalinyelwa kwezikhathi ezithile, iziguli zazinikezwe umuthi i-pentoxifylline. Kepha ucwaningo luye lwabonisa ukuthi akukho nzuzo yangempela kwiziguli ezinesifo sikashukela esinesifo sokuwohloka kwengqondo.
Ngezinkinga zesifo sikashukela emilenzeni, ukuhlinzwa ukuze kubuyiswe ukuphuma kwegazi emithanjeni kungaba usizo olukhulu. Odokotela banquma umbuzo wokuziphatha kwayo nesiguli ngasinye, becabanga izinkomba zakhe zobungozi zokungenelela kokuhlinzwa.
Iziguli ezinobuhlungu bomlenze kushukela, njengomthetho, ziveze ukuphazamiseka kwe-carbohydrate metabolism (ushukela wegazi uphezulu kakhulu), isifo sikashukela sonyawo lwesifo sikashukela, kanye nokubonakaliswa kwezinye izinkinga zesifo sikashukela. Ukuze ubasize ngempela, udinga ukubandakanya iqembu labachwepheshe bezokwelapha ekwelashweni.
Ukwelashwa kwe-syndrome yonyawo lwesifo sikashukela kwenziwa ngudokotela wezilwane okhethekile (ukuze angadideki nodokotela wezingane). Okokuqala, ukwelashwa kokuhlinzwa kwamanxeba onyaweni kungadingeka ukuvikela i-gangrene, futhi kuphela lapho - ukubuyiselwa kokuqina kwemithambo yegazi.
Isifo sikashukela nezomlenze: Okutholakele
Siyethemba ukuthi le ndatshana ikuchazele ngemininingwane okufanele uyenze uma imilenze yakho ilimala nesifo sikashukela. Kuyadingeka ukushintshela empilweni enempilo ukuze ijwayele ushukela wegazi futhi uyeke ukuthuthukiswa kwe-atherosclerosis. Ngodokotela, uzokwazi ukunquma ngokuhlinzwa okuzobuyisa ubunikazi bemithambo yemilenze. Udinga nokuthi uhlolwe ukuze uthole ezinye izinkinga zesifo sikashukela bese uzelapha.
Uyacelwa ukuthi ungazami “ukudambisa” izinhlungu ezivela ku-lameness yangaphakathi ngosizo lwamaphilisi athile. Imiphumela yabo emibi ingasibhebhethekisa kakhulu isimo sakho kanye nesikhathi sakho sokuphila. Bonana nodokotela ofanelekayo. Esimweni sikashukela, kubalulekile ukukugcina ngokucophelela ukuhlanzeka kwezinyawo ukuze ukwazi ukukwazi ukuzihambisa “ngokwakho.”
Funda futhi izindatshana:
- Unganciphisa kanjani ushukela wegazi futhi uligcine livamile;
- Ukwelashwa kwesifo sikashukela sohlobo 2 yikhona okusebenzayo kakhulu;
- Ungawenza kanjani umjovo we-insulin ngaphandle kobuhlungu.
