Isifo sikashukela i-angiopathy ibizwa ngokuthi izilonda ze-vascular of ezinkulu (macroangiopathy) nezincane (ezincane ze-microangiopathy) eziphuma kwiziguli ezinesifo sikashukela i-mellitus. Kaningi ubuchopho, ukuhlaziya okubonakalayo, uhlelo lomchamo, inhliziyo, imithambo yemikhawulo engezansi kuyabandakanyeka kule nqubo.
Izici zesifo
Ukuthuthukiswa kwesilonda ekuhlinzekweni kwegazi ngokulwa nesifo sikashukela kuhambisana:
- ukuhlangana kwezindonga ze-vascular;
- i-lipid ne-cholesterol deposits ku-endothelium;
- i-thrombosis;
- ukwehla kwe-vascular lumen;
- ukwakheka kwe-puffness kanye nokwanda kwe-exudation
- ukwephulwa kwamaseli we-trophic nezicubu kuze kube sekufeni kwabo.
Njengoba ama-capillaries enokuncane okuncane phakathi kwayo yonke imikhumbi yohlobo lwentaba, abahlupheka kuqala. Lokhu kusho ukuthi inqubo ye-lesion iqala ngezinzwane, izinyawo, bese iqhubekela emilenzeni engezansi bese ifinyelela okhalweni.
Izithombe zemitholampilo
Izimpawu ze-angiopathy zesifo sikashukela semikhawulo ephansi zincike enkambweni yenqubo ye-pathological:
- Isiteji I - azikho izinguquko ezibukwayo, isiguli asinazikhalazo, izivivinyo ezisetshenziswayo nezokuhlolwa kwelebhu zibonisa ukuthuthukiswa kwenqubo ye-atherosulinotic emikhunjini;
- Isigaba II - ukuvela kwalokhu okubizwa ngokuthi yi-intermittent claudication - uphawu oluthile oluvezwa yisidingo sokuma ngenkathi uhamba ngenxa yobuhlungu obukhulu emilenzeni, ukunyamalala ngesikhathi sokuphumula;
- Isigaba III - i-pain syndrome ivela lapho ungekho umthwalo khona emilenzeni, idinga ukushintshwa kwezikhundla njalo embhedeni;
- Isiteji IV - ukwakheka kwezilonda ezingenabuhlungu nesikhumba esifile esikhunjeni ngenxa yokuphazamiseka okukhulu kwezimpawu zezicubu namaseli.
I-Atherossteosis ingenye yezimpawu zesifo sikashukela somlenze we-diabetes.
Izimpawu ezihambisanayo uphawu lomonakalo emithanjeni yemilenze ku-mellitus yesifo sikashukela:
- umuzwa ovuthayo, ukudinwa, "izikhala ezinkulu";
- ukwakheka kwemithambo yesicabucabu;
- indlala yesikhumba;
- isikhumba esomile, i-peeling, ukulahleka kwezinwele;
- fragility of toenails;
- ukuthuthukiswa kwe-puffness.
Isifo sikashukela
Enye yezinkinga ezinkulu kakhulu ze-angiopathy yemikhumbi yemilenze. Ingakhula ngezinhlobo zesifo ezincike ku-insulin futhi ezingatheni nge-insulin. Kubonakaliswa izinqubo ze-purulent-necrotic, ukwakheka kwezilonda, ukulimala kwezinhlaka zamathambo nezama-tendon. Uhlelo lwe-innervation, imishini yokuhlinzeka ngemisipha, nezicubu ezijulile ziyabandakanyeka kule nqubo.
Izimpawu zonyawo lwesifo sikashukela:
- amanxeba, izilonda emilenzeni ngokumelene nesifo sikashukela;
- ukuqina kwamapuleti ezipikili;
- ukutheleleka fungal ezinyaweni;
- ukulunywa
- isifo sezinhlungu
- i-lameness noma obunye ubunzima ohlangane nabo ngenkathi uhamba;
- ukucwilisa isikhumba;
- ukudumba;
- ukubonakala kokuqina;
- i-hyperthermia
Unyawo lwesifo sikashukela - ukulimala okujulile kwezakhiwo ze-bone-tendon ngemuva "kwesifo esimnandi"
Ukuxilonga
Ngezinkinga ezinjalo, ungaxhumana ne-angiosurgeon noma i-endocrinologist. Ngemuva kokuhlola nokuqoqa izikhalazo, udokotela unquma ukuhlolwa kwelabhorethri, kwethalente ne-hardware kwalezi zinkomba ezilandelayo:
- ukuhlolwa kwe-biochemical - izinga le-glucose, i-creatinine, i-urea, isimo sokuqalwa kwegazi;
- ECG, i-Echo ye-CG ekuphumuleni nangomthwalo;
- Ukuhlolwa kwe-X-ray;
- i-arteriography yemikhawulo ephansi - ukuhlolwa kwe-patency kusetshenziswa i-Medi ephakathi;
- I-Dopplerography - isifundo sesimo semithambo yegazi nge-ultrasound;
- phambi kokukhipha kwe-purulent kusuka isilonda - ukuhlolwa kwe-bacteriological nge-antibioticogram;
- ukuzimisela kwengcindezi eshintshashintshayo - ukuhlolwa kwezinga le-oksijini kwezicubu zezitho;
- ikhompyuter capillaroscopy.
Izici zokwelapha
Isisekelo sokwelapha ukugcina amazinga kashukela egazini ngaphakathi kwemikhawulo eyamukelekayo. Uhlobo oluncike kuyi-insulin yesifo sikashukela ludinga imijovo ye-pancreatic hormone (insulin) ngokuhambisana nohlelo olusungulwe yi-endocrinologist. Kuyadingeka ukugcina isikhathi somjovo, umthamo, ukuzihlola usebenzisa i-glucometer.
Ngohlobo 2 lwesifo sikashukela, kusetshenziswa izidakamizwa ezinciphisa ushukela:
- I-Metformin - isiza ukuthuthukisa ukuzwela kwamaseli womzimba ukungena ku-insulin, ukukhulisa ukumuncwa koshukela yizicubu. Ama-Analogs - Glycon, Siofor.
- I-Miglitol - ivimbela amandla e-enzyme yamathumbu ukuphula ama-carbohydrate kuma-monosaccharides. Umphumela uba ukushoda koshukela. I-analogue yi-Diastabol.
- I-Glibenclamide (Maninyl) - ikhuthaza ukwenziwa kwe-insulin synthesis.
- I-Amaryl - ivuselela ukukhiqizwa kwezinto ezisebenza ngama-hormone, ezisiza ukunciphisa inani loshukela.
- I-Diabeteson - isidakamizwa esithuthukisa ukukhiqizwa kwe-insulin, sithuthukisa izakhiwo zegazi ezihlangene.
Kusho ukwehlisa i-cholesterol
Izidakamizwa zingasetshenziswa zombili njengengxenye yokwelapha kanye nokuvikela ukuthuthukiswa kwe-angiopathy yesifo sikashukela emikhawulweni ephansi. Imithi kumele ithathwe nezifundo zaselebhu zamakhemikhali egazi we-biochemical in Dynamics.
| Igama lezidakamizwa | Into esebenzayo | Izici zesenzo |
| I-Atherostat | Simvastatin | Kwehlisa i-cholesterol ne-lipoprotein, kufakwa emzimbeni wehluleki wezinso, izingane, zikhulelwe |
| I-Zokor | Simvastatin | Ibuyisela inani le-triglycerides, inani le-cholesterol ephelele. Sebenzisa ngokuqapha ku-pathology yesibindi, izinso, inani elinyukayo lama-transaminases e-serum yegazi, ngotshwala. |
| I-Cardiostatin | ILovastatin | Yehlisa amandla wesibindi ukwakha i-cholesterol, ngaleyo ndlela ilawula izinga layo esegazini |
| ILovasterol | ILovastatin | I-Cardiostatin analog. Ayisetshenziswanga ngesikhathi sokukhulelwa, ngesikhathi sokuzala, ngokuhluleka okukhulu kwe-renal |
| I-Liptonorm | Atorvastatin | Kwandisa izindlela zokuvikela odongeni lwe-vascular, inactivates inqubo yokwakhiwa kwe-cholesterol |
Izidakamizwa ze-antihypertensive
Ngokuphikisana nesizinda sokwehla kwengcindezi yegazi, i-vasodilation, umphumela we-antiarrhythmic kwenzeka. Ukujikeleza kwegazi kuthuthuka kancane. Sebenzisa izindlela:
- INifedipine
- UCorffar
- Cordipin
- I-Equator
- I-Binelol
- Nebile.
UCorffar - ummeleli weqembu lemithi elehlisa umfutho wegazi
Umshini we-vasodilation usekelwe ekutheni kukhona ukuqhuma kwama-receptors akhiwe ezindongeni zemithambo yegazi nemithanjeni yenhliziyo. Eminye yemithi ingabuyisela ukushaya kwenhliziyo.
Ama-Angioprotectors
Isenzo saleli qembu lemithi sihlose ukuthuthukisa ukunikezwa kwegazi kwezicubu namaseli omzimba, kanye nokwandisa ukumelana kwemithambo yegazi.
- I-Pentoxifylline (Trental) - umuthi uyasiza ekunciphiseni imithambo yegazi, uthuthukise ukujikeleza kwegazi, ukhuphule isenzo sezindlela zokuvikela ze-endothelium.
- I-Troxevasin - ivimbela i-lipid oxidation, inomphumela we-antiexudative, futhi icindezela ukuthuthukiswa kwezinqubo zokuvuvukala.
- INiacin - ngokufaka imithambo yegazi, umuthi futhi usiza ukunciphisa i-cholesterol ephelele.
- I-Bilobil - yenza kube lula ukuqina kwezindonga ze-vascular, ibambe iqhaza ekubuyiselweni kwezinqubo ze-metabolic.
Ama-antiplatelet agents
Amasokisi ezokwelashwa kwabanesifo sikashukelaIzidakamizwa zivimba izinqubo ze-biochemical zokwakheka kwe-thrombus, zivimbela ukuvalwa kwe-lumen ye-vascular. Abamele abalandelayo bakhombise ukusebenza ngempumelelo:
- Aspirin
- I-ReoPro,
- ETirofiban,
- I-Curantil
- I-dipyridamole
- I-Plavix.
Ama-enzymes namavithamini
Le mishanguzo ibuyisa izinqubo ze-metabolic, ibamba iqhaza ekujuleni kokubonakala kwezindonga zemithambo, ibe nomphumela we-antioxidant, ikhuphule izinga lokusebenzisa ushukela amaseli nezicubu, inikela kule nqubo yokwehla kwegazi layo. Faka uSolcoseryl, ATP, amavithamini e-B-chungechunge, i-Ascorbic acid, i-Pyridoxine.
Ukwelashwa kokuhlinzwa
Ukubuyisela ubunikazi be-artery noma ingxenye ethile yayo, kuyenziwa imisebenzi yokuvuselela amandla.
Ukuhlinzwa kweBypass - ukugcwala kwesilondolozi esifakwa emthanjeni ngesimo se-workaround ukubuyisa ukujikeleza kwegazi lapho kungenakwenzeka ukwandisa umkhanyisi womkhumbi. Kunemigwaqo ye-aortic-femoral, femoral-popliteal kanye ne-iliac-femoral, ngokuya ngokuthi ukuthunga kuthungathwe kuliphi isiza.
I-Profundoplasty - umsebenzi wokufaka esikhundleni sengxenye evaliwe ye-atherosulinosis yomthambo ngesibambiso sokwenziwa kwezinto zokwenziwa. Kuhlanganiswe ne-endarterectomy.
I-Lumbar sympathectomy - ukususwa kwe-lumbar ganglia okubangela i-vasospasm. Ngokubona kwazo, imithambo iyanda, ithuthukisa ukuphuma kwegazi endaweni ethintekile yemithambo yegazi. Ngokuvamile kuhlanganiswa ne-profundoplasty noma ukuhlinzwa kwe-bypass.
Ukuvuselela i-osteotrepanation - ukwenziwa kwamafutha kufakwa ezicutshini zamathambo ukuze kusebenze ukugeleza kwegazi okuhambisanayo.
I-Balloon angioplasty - ukwethulwa kwamadivayisi akhethekile (amasilinda) ku-lumen ye-artery ethintekile ukukhuphula ngokwanda.
Ipulasitiki ye-vascular balloon ngokubekwa okuqinile - ukungenelela okusebenzayo kwemithambo
I-Stenting yenziwa ngendlela efanayo ne-balloon angioplasty, kuphela stent esele kulumben womkhumbi. Isisetshenziswa esinjalo asivumeli i-artery ukuthi ibe mincane futhi icuphe izinqwaba zabantu.
Ezigabeni ezithuthukile zalesi sifo, ukunqunywa kungadingeka ukusindisa impilo yesiguli. Udokotela unquma ukuphakama kokungenelela ngezinga lokuba khona kwezicubu "eziphilayo". Ukuqalwa ngesikhathi kwezokwelapha kuzonciphisa ubungozi bezinkinga futhi kubuyisele izinga eliphezulu lempilo esigulini.
