Isitho esiyinhloko sohlelo lokujikeleza kwenhliziyo. It, enciphisa, idlulisela igazi kuwo wonke izicubu zomzimba, iwagcwalise nomoya-mpilo. Inikeza ukubuya kwe-venous kwegazi ukuze iphinde igcwaliswe kabusha ngezinto eziwusizo. Kungakho isimo sempilo senhliziyo nemithambo yegazi sibaluleke kakhulu kubantu.
Lapho kunezici zobungozi, izifo zesistimu yezinhliziyo ezinjengesifo sokuhlasela kwenhliziyo, imivimbo, i-pulmonary embolism ne-thrombosis, zingakhula. Zonke zikhula ngenxa yesifo esibi - isifo sokuqina kwemithambo yegazi.
Umqondo onjengokuthi isifo sokuqina kwenhliziyo asisetshenziswa kwezokwelapha zesimanje. Lokhu kungenxa yokuthi i-atherosclerosis ithinta imithambo yegazi, futhi inhliziyo iyisicubu. Igama elithi "isifo sokuqina kwenhliziyo" lisho ukunqotshwa kwemithambo yenhliziyo. Banesibopho sokulethwa komoya-mpilo myocardium nangokuncipha kwabo, kubulawa yindlala yomoya.
Izigaba zokukhula kwe-pathology
I-atherosclerosis yemithambo yenhliziyo ayiqali ngokungazelelwe. Le yinqubo engahlala iminyaka, ukuqala isencane. Kubangelwa ukuqongelela ngokweqile kwe-cholesterol emzimbeni nokufakwa kwayo odongeni lwe-vascular.
Ukunqotshwa kwemithambo ye-coronary kwenzeka ngezigaba eziningana:
- Ukwanda kwenani lamazinga aphansi we-lipoprotein egazini. Lokhu kungenxa yendlela yokuphila engafanele, ukudla okungenamsoco, ukungasebenzi ngokomzimba. Emithanjeni ngalesi sikhathi akunakwenzeka ukubona noma yiziphi izinguquko - izindonga zemikhumbi zisalokhu zibushelelezi, yize ukuhlolwa ngemicroscopic kwembula i-edema yamaseli e-endothelial kumasenti angama-60;
- Isigaba esilandelayo sibonisa ngokubonakala kwama-lipid band odongeni lomkhumbi. Abangeni ku-lumen of the artery futhi abaphazamisi ukuhamba kwegazi, ngakho-ke kulesi sigaba abavami ukusithola isifo;
- Ngemuva kokufakwa kwegazi nge-lipids, i-atherosulinotic plaque iqala ukukhula. Kubonakala emikhunjini ethintekile, futhi eheha izindlela ezisebenza nge-thrombotic. I-Fibrinogen namaplatelethi nayo inamathisela kuma-lipids, asheshisa ukunciphisa i-lumen yemithambo yegazi.
Isinyathelo sokugcina ukuthuthukiswa kwezinkinga. Lokhu kufaka hlangana ukugcwala kosawoti kanye nokugqabhuka kwe-plaque. Esimweni sokuqala, ukuguquguquka kodonga lomkhumbi kuqashelwa ngenxa yokutholwa kwethala lokuxinana kwamatshe, noma, njengoba ibizwa nangokuthi, ukubekwa phansi kwezandla. Esimweni sesibili, izinhlayiya ze-atherosselotic ziqala ukuhlakazeka futhi izingxenye zegazi ezihlanganisiwe zisakazeke emzimbeni wonke, zivale ama-arterioles nama-capillaries.
Ngokuya ngosayizi wezinhlayiya, izinga lomonakalo linqunywa - ngamasayizi amakhulu, inkambo iyasinda. Lokhu kungenxa yokuthi izingxenye ezinkulu zembobo yemithambo ye-caliber enkulu, eziyilimaza kakhulu emzimbeni.
Izilonda ezijwayelekile ze-vascular
I-Atherossteosis inezinketho eziningana zokuthuthuka.
Kuya ngendawo nesivinini sentuthuko.
Izilonda zenhliziyo ezivame kakhulu ku-atherossteosis zifaka: i-cardiossteosis, i-angina pectoris, kanye nokuhlaselwa yisifo senhliziyo.
I-Cardiossteosis yisifo se-myocardial esibonakaliswa ngokufakwa kwezicubu ezijwayelekile zemisipha ngezicubu zesilonda. Lokhu kungenxa yokugcwala komoya ophelele, okuholela ekufeni kwamaseli emisipha. Njengomphumela walokhu, i-hypertrophy iba khona - lokhu kungukuthuthuka ngokweqile kwezicubu namaseli ezinempilo esele. Kodwa-ke, lo mbuso awukwazi ukuhlala isikhathi eside, amagumbi enhliziyo ayanda, futhi ngeke esakwazi ukupompela igazi. Lokhu kufaka ukwehluleka kwe-valve, okuholela ekuhlulekeni kwenhliziyo nokufa.
Ngokuya ngezinga lomonakalo emithanjeni ye-coronary, izinhlobo ezimbili ze-cardiosclerosis ziyahlukaniswa - zigxile futhi zisehlukanisa. I-Diffuse ibhekwa njengento enzima ngokugeleza, ngoba ithwebula iningi le-myocardium, isatshalaliswa ngokulinganayo. I-Focal cardiossteosis ibonakala ngokwakhiwa kwezilonda ezincane kuyo yonke inhliziyo. Nge-atherossteosis, i-diffuse uhlobo lwe-cardiossteosis iyisici esithe xaxa. Ezigulini, izibonakalisa ngezimpawu ezinjengalezi - izinhliziyo zenhliziyo, ukubukeka kokuphefumula kokuphumula naphakathi kokuzivocavoca, ukuthuthukiswa kokuvuvukala kwemilenze. Izinkinga zithathwa njenge-endocarditis exudative, i-myocarditis nama-ascites, ngenxa yokuqongelela ngokweqile koketshezi emzimbeni nokungakwazi ukukususa emzimbeni.
Ukulimala kwensiza ye -vvular kubonakaliswa ukuthuthukiswa kokutholwa kokutholwa kwenhliziyo. Lokhu kufaka phakathi ukuthuthukiswa kokunganele kwe-aortic noma mitral valve. Ngenxa yalokhu, umsebenzi we-ventricles kanye ne-atria yenhliziyo uyaqina futhi nokuhluleka kwenhliziyo kuyakhula. Ngenxa yendlala ye-oksijini yezakhi zenhliziyo, kutholakala iziphazamiso kuma-pacemaker enhliziyo - okuwukuthi, izinhlaka ezibhekele ukulawulwa nokukhiqizwa kwethonya lezinzwa zokuqothuka kwenhliziyo ziyathinteka. Lokhu kuholela ku-arrhythmias - lokhu ukwehluleka kwesigqi senhliziyo, kanye nama-extrasystoles - ukungezelelwa kokuqanjwa kwamanga kwenhliziyo.
Izimpawu zingahluka - kusuka ekudluliseleni ezinhlungwini enhliziyweni kuya ekuthuthukisweni kwe-fibrillation. Konke kuya ngesilinganiso somonakalo emithanjeni ye-coronary kanye nesikhathi sokwelashwa.
Kuhle ukukhumbula ukuthi ukwelashwa kwe-atherosclerosis kusebenza kakhulu ezigabeni zokuqala. Ngemuva kokuthuthukiswa kwe-plaque, ukwelashwa kuqukethe ekugcineni ukuzinza kwesimo.
Yini i-angina pectoris?
I-Angina pectoris iyinkimbinkimbi yezimpawu ezibonakala ngenxa yokunciphisa imithambo ye-coronary of etiologies ehlukahlukene.
Ngokwesiko kubizwa ngokuthi "angina pectoris," ngenxa yesimo sokuzwa kwengcindezi ngemuva kwe-sternum.
Ubuhlungu buvame ukubonakala ngokuzumayo, ngaphandle kwesikhathi se-prodromal, akuxhomeki kumjikelezo wokuvuka. Inganikeza izindawo ezingomakhelwane - isibambo esingaphezulu, i-scapula noma intamo.
Ubuhlungu bumiswa ngokuthatha izidakamizwa eqenjini lama-nitrate, umphumela wawo osezimeni ezinjalo:
- Ukuphumula kwe-coronary ngaphansi kwethonya lesiphepho se-guanylate cyclase. Lokhu kunomthelela ekwandeni kwe-Reflex kwemithambo ye-coronary, ngenxa yokuthi ukugeleza kwegazi kubuyiselwa, emva kwalokho indlala yomoya-mpilo iyema nobuhlungu bushabalale.
- Ukunciphisa umthwalo kwi-myocardium, esiza ukunciphisa isidingo se-oxygen;
- Imiphumela ethoni enozwela yemithambo yegazi nokuphumula kobuhlungu.
- Siza ekusatshalalisweni kwegazi, eligcwele i-oksijini phakathi kwezingxenye ezihlukene zomsipha, okuvimbela ukukhula kwe-necrosis noma i-myocardial infarction.
Ngaphandle kokuthi inqubo yokwenza ukuthuthukiswa kwe-angina iyefana, kunezinhlobo eziningi ze-angina pectoris ngokwe-ICD (ukuhlukaniswa kwezifo emhlabeni jikelele). Ziyahlukahluka ngokwazo ezingeni lomthwalo, okuholela ekuhlaselweni. Ukwazi lokhu kuvumela udokotela ukuthi akunikeze indlela yokwelashwa ephumelela kakhudlwana:
- I-angina pectoris ezinzile yiluhlobo oluvame kakhulu. Ikhula ngemuva kokuzivocavoca okuthile ngokomzimba. Leli fomu libonakaliswa ngokuhlaselwa okuhlala isikhathi esingadluli imizuzu eyishumi nanhlanu futhi kumiswe ngokuthatha izidakamizwa ze-nitrate;
- I-angina pectoris engasebenzi - ngokungafani nefomu elidlule, likhula kuphela ekuphumuleni. Lokhu okuhlukahlukene okuyingozi kwalesi sifo. Ukuhlaselwa kobuhlungu kungahlala isikhathi eside, akumiswa ngethebhulethi elilodwa le-nitroglycerin, okuletha isiguli ukuhlupheka.
Ukwelashwa kwe-angina pectoris ukwelapha isifo esiyisisekelo esithinta imithambo yegazi. Kulokhu, kusetshenziswe yonke inhlanganisela yezidakamizwa encibilikisa ama-atherosclerotic plaque, umfutho wegazi ophansi, isuse i-cholesterol emzimbeni, kanye noshukela wegazi ophansi.
Ngaphezu kwalokho, iziguli zikhonjiswa ukuguqulwa kwendlela yazo yokuphila, okubandakanya ukudla okuqinile ngaphandle kokudla okunamafutha amaningi ekudleni, ukwelashwa ngokomzimba nokwenqaba imikhuba emibi, njengokubhema nokuphuza utshwala. Ezimweni ezimbi kakhulu zalesi sifo, kwenziwa i-coronary artery bypass grafting, kuthathelwa indawo imithambo ethintekile ukufaka izimila ezinempilo.
I-acute myocardial necrosis
I-Myocardial infarction iyinkinga enzima ye-atherossteosis. Emhlabeni, ukushona kwalesi sifo kungamaphesenti angama-40, kaningi kubantu besilisa. Kuyisicucu sesifo senhliziyo esi-coronary kanye nesigaba saso esibuhlungu.
Ekukhuleni kwe-necrosis yemisipha yenhliziyo kuholela enkingeni efana nokubhema. Kuthuthukisa ukunqwabelana kwama-resin anobuthi odongeni lomkhumbi, lapho ama-lipid ne-fibrin anamathiselwe khona kalula, okwenza ukuqhekeka komkhumbi.
Iqiniso elithokozisayo ukuthi umuntu kungenzeka angazi nokuthi unesifo sokuqina kwemithambo yenhliziyo futhi ukuhlaselwa yisifo senhliziyo kuzoba wuphawu lwakhe lokuqala, oluzodinga ukwelashwa okungathi sína.
Ukuhlaselwa yinhliziyo kukhula ngejubane lombani, ngoba i-myocardium ingathola ngaphandle kwe-oksijini ngemizuzwana nje eyishumi nanhlanu.
Kungakapheli umzuzu, kuvela izimpawu zokuqala ze-necrosis, ngoba amaseli enhliziyo azwela kakhulu i-hypoxia.
Izimpawu eziphambili zokuhlaselwa yinhliziyo okuthuthukile yilezi:
- Ubuhlungu besifuba obukhulu. Ukhula ngokuxhamazela ngenxa yokuthi i-necrosis ibangela ukungena kwezinto ezinobuthi egazini. Futhi, izinhlungu zihlotshaniswa ne-spasm of imithambo yegazi eyayiphathwa i-thrombosis ne-ischemia. Uhlobo lobuhlungu buyasha, abubekezeleleki, iziguli ziyaqaphela ukuthi azange bezwe buhlungu obunamandla;
- Isiyezi sikhula ngenxa yokunikezwa okunganele kwe-oksijini kwezicubu zobuchopho, okuvela ngenxa yokwehla kwesilinganiso senhliziyo, ukwehla kokuphuma kwenhliziyo, kanye nokwehla kwemithambo ye-brachiocephalic. Ikholomu ye-brachiocephalic (BCC) izwela kakhulu amaconsi okucindezela. Ukukhishwa kwenhliziyo yinani legazi elifutha i-ventricle yangakwesobunxele enkingeni eyodwa. Uma lingekho igazi elanele, khona-ke alidaleli ukumelana okudingekile futhi nokucindezela kwehle;
- Ukuqhaqhaqeleka kanye nesicanucanu ngenxa yokucasuka kwesikhungo sokuhlanza ebuchosheni, kuvame ukungashadi, bese kunyamalala ngokushesha;
I-Pallor yesikhumba ivela ngenxa yokushintsha kwegazi kusuka esixekweni kuya esikhungweni, ukuze kugcinwe i-hemodynamics ejwayelekile yezitho zangaphakathi ezibaluleke kakhulu - ubuchopho nenhliziyo.
Ukwelashwa okujwayelekile kwalesi sifo
Konke ukwelashwa kwe-atherosclerosis kufanele kuqale ekuqaleni.
Esikhathini sokuqala, ingabuyiselwa emuva.
Esigabeni esibulalayo sokuthuthukiswa kwe-cholesterol plaque, umuthi kuphela ngeke usebenze.
Ezimweni ezinzima kakhulu zemitholampilo, ngokwesibonelo, nge-multifocal atherosclerosis, isiguli singalashwa ngokushesha.
Izincomo zendlela yokuphila ejwayelekile:
- Ukudla nge-predominance yokudla kwezitshalo. Kunamavithamini amaningi, i-fiber kanye nama-pectin emifino nasezithelo, ezinomphumela omuhle esimweni semithambo yemithambo yegazi, kunciphisa ukuthathwa kwe-lipid futhi kususe ama-lipoprotein aphezulu ngokweqile emzimbeni;
- Ukufakwa ngaphandle kokudla okunamafutha esikhundleni sawo nenkukhu nenhlanzi, ukunciphisa ukungena kwe-cholesterol emzimbeni;
- Ukuhambisana nohlelo lokuphuza - thatha okungenani amalitha nengxenye amanzi nsuku zonke. Lokhu kuzogcina ibhalansi yama-electrolyte ebaluleke kakhulu, ebaluleke kakhulu ekusebenzeni okufanele kombhede we-vascular futhi ibeke ingcindezi ngamanani ahlala njalo;
- Ukwanda kokuzivocavoca komzimba - kumuntu ngamunye, umthwalo kufanele ukhethwe ngudokotela ohambelayo ngokusezingeni lokuqina komzimba kanye nezinga lokulimala kwemithambo. Esigabeni sokuqala, abantu abaqeqeshwe kahle bazosebenzisa imidlalo eyinkimbinkimbi namandla amakhulu - egijima, izinhlobo ezahlukahlukene zokulwa, nezifundo ejimini. Kubantu abangalungiselelwe kangako, ukuvivinya umzimba ngokuzivocavoca, ukuhamba emoyeni omusha, ukubhukuda nokunye kufanelekile.
Uma, ngemuva kwalezi zinyathelo, izinga le-cholesterol lingawi, ungasebenzisa umuthi wendabuko. Bangasebenza ngempumelelo ezigabeni zokuqala zesifo. Phakathi kokupheka okuningi ungahlala uthola okulungile:
- Hlanganisa izingxenye ezilinganayo zama-rhizomes amaqabunga ama-dandelion ajwayelekile namaqabunga akhula kancane, uwagcizelele amahora amabili emanzini abilayo. Phuza izingilazi ezimbalwa usuku lonke. Ukuze uthuthukise ukunambitheka, ungasebenzisa uju lwe-linden;
- Hlanganisa ama-rose okhalweni kanye nama-sitrobheli asendle ngesilinganiso esingu-1: 2, uthele amanzi abilayo. Vumela ukuma endaweni emnyama cishe amahora amathathu. Phuza ekuseni, uhhafu wengilazi ngaphambi kokudla kwasekuseni, cishe isigamu sehora ngaphambi kokudla;
- Hlanganisa ujusi we-anyanisi noju ngamanani alinganayo, thatha isigamu sezipuni kwasekuseni;
Ngaphezu kwalokho, ungasebenzisa ijusi le-anyanisi elihlanjululwe ngamanzi, libalwe njengamaconsi ama-3 kumamililitha amanzi ayi-100. Phuza ekuseni, mhlawumbe ngokudla, ukuze ujusi wesisu ungacasuli ulwelwesi lwe-mucous.
Le iresiphi i-contraindication kubantu abanezilonda ezi-ulcerative of the gastrointestinal gastitis kanye ne-hyperacid gastritis engamahlalakhona.
Ukwelashwa Okuqondile: Ukwelashwa noma Ukuhlinzwa
Ukwelashwa kwe-coronary stenosis kwenziwa ngokwelashwa nangokusebenza.
Izimiso eziyisisekelo zokwelashwa kwezidakamizwa ziyinkimbinkimbi futhi ziyasebenza.
Imithi kufanele ibe nomphumela ozuzisayo emithanjeni yegazi futhi ibe nemiphumela emincane okungenani.
Ukwelapha lesi sifo, kusetshenziswa ama-ejenti amaqembu e-pharmacological ahlukahlukene.
Amaqembu omkhiqizo amelelwa yizidakamizwa ezinjalo:
- Kwehlisa i-cholesterol - lokhu kufaka ama-statins nama-fibrate. Bathinta i-biosynthesis ye-cholesterol, bayiphazamisa esigabeni sokuqala. Zifanekiselwa izidakamizwa ezinjenge-atorvastatin kanye ne-hemifibrozil. Zingabizi kakhulu futhi zifakazele ukusebenza kahle ekwelashweni kwe-atherosulinosis;
- Ukunciphisa ingcindezi - lapha kuyadingeka ukuthi unake ukuthi yini ebangela ingcindezi ukuthi inyuke. Lokhu kungaba yimpendulo ekhanyayo kwe-stenosis, noma ukulimala kwemithambo ye-renal noma i-aortic defence. Udokotela kufanele acabangele idatha yezifundo zaselebhu kanye nezinsizakalo ukunquma ukwelashwa okwanele;
- Ezigulini ezinesifo sikashukela, kudalwa izidakamizwa ezinciphisa inani le-glucose egazini. Lokhu kufaka i-biguanides, isibonelo iMetformin Teva, iGlucophage, iMetformin Sandoz. Ibopha ngokweqile ushukela olula futhi iyisuse emzimbeni, evimbela ukulimala kwemithambo;
Ngaphezu kwalokho, kusetshenziswa i-Vitamin therapy, ebekelwa ukuqinisa izivikelo zomzimba kanye nokwandisa inani lamaseli omzimba ukulwa nezinto ezingalimaza umkhumbi.
Ngokungasebenzi kahle kwazo zonke izindlela zokwelapha i-atherosclerosis, kusele ukuhlinzwa kuphela esikhungweni senhliziyo. Kungaba kumkhumbi ovulekile noma i-endoscopic. Njengamanje, indlela yokugcina iyathandwa ngenxa yokushiswa komzimba okuphansi nokufa okuncane ngemuva kokuhlinzwa.
Kunezinhlobo ezimbili zokuhlinzwa kwe-endoscopic - ukwelashwa nge-balloon kanye ne-stenting. Esimweni sokuqala, kufakwa ibhaluni elikhethekile emthanjeni, elivele lapho lincane kakhulu, linwebele umgodi. Esimweni sesibili, kusetshenziswa i-stent - ishubhu elincane elinesakhiwo se-mesh. Ngenxa yokwakheka kwe-hypoallergenic, ingashiywa ngaphakathi komkhumbi ukuze kulondolozwe imvume eyanele. Kunoma yikuphi, zonke izindlela zokwelashwa kufanele zixoxwe nodokotela oholayo ukuze kugwenywe ukwanda kwezinkinga.
Kuyini ingozi ye-atherossteosis ezotshela uchwepheshe kule vidiyo ekulesi sihloko.
