Chithandizo cha atherosulinosis obliterans a m'munsi malekezero

Sukulu yophunzitsa bajeti

maphunziro apamwamba

"Tver State Medical Academy"

Ministry of Health and Social Development

Dipatimenti Yamatenda Othandizira

Kukula kwa njira zamankhwala zamalangizo

kwa ophunzira a udokotala wa ana

NKHANI: Atherosulinosis obliterans

Wolemba MD N.A. Sergeev

Wowunikiranso: Mkulu wa Dipatimenti Yopanga Opaleshoni Yonse, Pulofesa E.M. Mokhov

Maupangiri ovomerezedwa ndi CCMS

CHOLINGA: kuphunzira magawidwe ndi chithunzi cha kufalikira kwa matenda a atherosulinosis, kudziwa njira zodziwira matenda, kupeza luso pakuwunika njira zamagetsi pofufuza ziwalo zam'mitsempha, komanso kupanga njira yothandizira odwala omwe akuwonongeka.

Atherosulinosis Mitsempha yam'munsi. Matenda ochepa ochepa. Gangrene Ntchito zoyeserera. Zojambula. Doppler ultrasound ndi kupanga mawonekedwe. Opaleshoni yamkati. Opaleshoni ya pulasitiki. Kudula.

MUTU WOPHUNZIRA TOPIC

Etiology. Gulu. Chithunzi cha chipatala. Zizindikiro Kusiyanitsa mitundu. Chithandizo. Mavuto Ziwonetsero

KUGWIRA NTCHITO ZOPHUNZITSA

Matenda ofala kwambiri omwe amachititsa kuti pang'onopang'ono kupendekera ndikuwonekera kwathunthu kwa lumen kwa msempha ndi mitsempha yayikulu ndi atherosulinosis obliterans, thromboangiitis obliterans, ndi nonspecific aortoarteritis. Ngakhale matenda amtunduwu ndi osiyana, onse amadziwika ndi matenda a ischemia syndrome a miyendo kapena ziwalo zamkati.

Kukula kwa matendawa kumasiyana kuchokera ku 2.2% mwa anthu wamba mpaka 17% pagulu lazaka 55-70.

Zoyambira zazikulu za pathology.

Atherosulinosis obliterans ndi matenda osachiritsika, omwe amachokera pakusintha kwachilengedwe khoma la mtima ndikupanga ma atheromas mu gawo laling'ono ndi kusintha kwawo kwotsatira.

Zowopsa za atherosclerosis ndi ochepa matenda oopsa, matenda ashuga, kusuta, lipid kagayidwe kachakudya, kuchuluka kwambiri kwa micrinogen, kuchuluka kwa plasma homocysteine, hypodynamia, ndi kusowa zakudya m'thupi.

Mokhazikika, kagwiritsidwe ka zovuta za pathogenetic titha kufotokozedwa m'magawo otsatirawa. Dyslipidemia ndi kukula kwa microthrombosis, mawonekedwe a mafuta ndi mawanga a gelatin. Kenako khungu limayamba (kuchuluka kwa minyewa yolumikizana). Atheroma imapangidwa kuchokera ku Madimbidwe amafuta, kuphatikiza cholesterol, albin, globulins ndi fibrin (zolembera za atherosulinotic nthawi zambiri zimachitika m'mitsempha yayikulu komanso yapakatikati, nthawi zambiri m'malo a bifurcations). Ndipo, pomaliza, zotupa za atheroma kapena kukha magazi zimachitika m'mimba, mawonekedwe am'magazi am'deralo, omwe amachititsa kuti mitsempha iwonongeke. Matenda amtundu wa thrombotic amachititsa kuti thupi lizisokoneza.

Atherosulinosis ndi matenda achilengedwe omwe amakhudza mitsempha yam'magawo osiyanasiyana a mtima. Pazakuchita zamankhwala, njira yamtunduwu, yomwe imapezeka m'mitsempha yama coronary (yowonetsedwa ndi zizindikiro za matenda amitsempha yamagazi), mitsempha ya carotid (gawo lalikulu la ischemic cerebral stroke), msempha wam'mimba komanso mitsempha yam'munsi yam'mimba (imayambitsa kupsinjika kwa miyendo ndi miyendo ya m'munsi). Dokotala waluso lililonse ayenera kudziwa kuti matenda onsewa ndi maulumikizidwe amtambo umodzi, njira imodzi yodziwika bwino yomwe imakhala ndi mawonekedwe osiyanasiyana omwe amachitika limodzi kapena kuponderezedwa ndi chimodzi mwazomwezo. Mu chaputala ichi, atherosulinosis obliterans imawerengedwa kuti ndi chifukwa chodwala miyendo yakumapeto kwa ziwalo.

gawo la aortic-iliac - Lerish's syndrome,

Kuwonongeka kwa multifocal - mitsempha ya miyendo, ubongo, ziwalo zamkati.

Magawo a miyendo yakanthawi kochepa kwambiri (malinga ndi Fontaine-Pokrovsky):

yoyamba ndi mtunda wopendekera mosakhazikika, wopitilira 1000 m,

Lachiwiri ndi mtunda wa malire a mawu:

- A - kuchokera pa 200 mpaka 1000 m,

- B - kuchokera 25 mpaka 200 m,

chachitatu - wodwalayo amatha kutenga njira zingapo, kupweteka pakupuma,

wachinayi - trophic matenda (zilonda, necrosis, gangrene).

Magawo achitatu ndi achinayi nthawi zambiri amaphatikizidwa pansi pa dzina wamba "ischemia yovuta".

Matenda oletsa kubereka a m'mimba ndi msempha wam'munsi wammimba amasonyezedwa ndi matenda ochepa owopsa. Mu magawo oyambilira, madandaulo owonjezera kumverera kwa kutentha kochepa, kumverera kwa dzanzi, paresthesia ndi kutopa kwa dzanja lakhudzidwa ndikudziwika. Pathognomonic yokhudzana ndi matendawa ndi chizindikiro cha kulumikizana kwapang'onopang'ono. Zimakhala ndikuwoneka pakuyenda kwambiri zowawa zomwe zimamveka mu gulu linalake la minofu yam'munsi ndipo zimakakamiza wodwalayo kuti ayime. Ichi ndi chifukwa magazi osakwanira ochepa magazi kukwaniritsa zosowa za minofu pakuchita masewera olimbitsa thupi. Pambuyo pakupuma kwakanthawi, ululuwo umatha, ndipo wodwalayo amathanso kupita kutali. Mtunda woyendayenda lisanayambike kupweteka m'chiwendo.

Dziwani kuti pafupifupi theka la odwala omwe ali ndi kusintha kwa hemodynamic okwanira kuti apangitse kulankhulira kwapang'onopang'ono samadandaula motsutsana ndi chizindikiro ichi. Pali zifukwa zingapo zochitira izi. Choyamba, odwala okalamba amawona zovuta zowonjezereka pakuyenda monga momwe zimakhalira zaka zawo, zomwe zimafunikira adotolo kuti atenge madandaulo mwachangu. Kachiwiri, izi zimachitika chifukwa cha kukhazikika mtima kwa odwala. Chachitatu, izi zimalongosoledwa ndi kufalikira kwakanthawi kothandizira kubwezerera kwa magazi kwa wachibale popanda kumayambitsa zizindikiro za ischemic.

Momwe magazi amayenda posakwanira kukhutiritsa zofunika za minyewa ya miyendo pakakhala kusuntha, kupweteka kumawonekera pakupuma. Imakonda kumveka zala ndi phazi. Nthawi zambiri ululu umawoneka usiku. Pamalo opingasa, gawo lama hydrostatic limatayika chifukwa cha kuchuluka kwa gawo la magazi pakati pa mtima ndi malire a chotengera. Kutsika komwe kumayenderana ndi kuthamanga kwa magazi kumayambitsa kuthamanga kwa magazi kumayambitsa kuchepa kwa magazi kudzera m'chigawo cha stenotic cha chotengera chija mpaka pambuyo pake. Zimatsogolera kukuwuka kwa wodwalayo. Kupweteka pakupuma ndi chizindikiro choopsa, chotupa cha chiwopsezo cha miyendo.

Zovuta zam'mimba za mbali yam'mimba zimawonetsedwa ndi kukula kwa zilonda. Zilonda zam'mimba zimawonedwa ngati ischemic ngati zimachitika motsutsana ndi maziko am'magazi a minyewa ya m'mimba ndipo samatha kuchiritsidwa kwa masabata 6. Amapezeka kawirikawiri pamtunda wopondera phazi kapena pakati pa zala, zala zimatha kudutsanso necrosis kwathunthu. Izi zimachitika chifukwa chovulala pakhungu, ngakhale laling'ono. Pa dzanja la ischemic, kuwonongeka kocheperako sikungathandize pachithandizo chakomweko ndipo nthawi zambiri kumapita patsogolo. Gawo lomaliza la kuchepa kwa arterial likuwonetsedwa ndi khungu necrosis ndi gangrene. Kujowina matenda opatsirana kwachiwiri kumatha kudzetsa kukula kwa chonyansa chamagulu ndikukhala gwero la sepsis.

Kuchulukana kwa machitidwe aorta ndi iliac artery (Lerish syndrome) amadziwika ndi mawonekedwe awa:

"Kukwezeka" kwapakati pang'onopang'ono (kupweteka ndikamayenda kumachitika m'misempha ya ng'ombe, komanso matako ndi kumbuyo kwa ntchafu),

Zizindikiro za kuchepa kwa minyewa yapansi pa pelvic pansi (mpweya wosakwana),

kuyerekezera kwamitundu kapena kusakhalapo kwamatumbo a akazi.

Kukhazikika kwa mitsempha yachikazi komanso ya popliteal ndizofala kwambiri. Ndi zotupa zokhazokha zapamwamba kwambiri zazimayi, chithunzi cha kuchipatala ndichosowa, popeza kusungika kwa magazi kudzera mu mtsempha wakuya wachikazi kudzera mu anastomoses ndi chotupa cha popliteal kumakwanira kuyenderera kwa magazi m'magawo akutali. Pamene chotupa ichi chikuphatikizidwa ndi kuphatikizika kwa mitsempha ya aorta kapena iliac, chithunzi chachipatalachi chimatchulidwa kwambiri - kuchokera ku ululu m'matumbo a ng'ombe mukamayenda mtunda waufupi ndikuwoneka wa necrotic foci.

Pokonzekera matenda osakhazikika a arterial, ndikofunikira kuzindikira kutuluka kwa stenosis kapena ma occlusion, kukhazikitsa zomwe zimayambitsa, kuwunika magawo a matendawa, kuopsa kwa matenda olimba komanso kuchuluka kwa kuwonongeka kwa maiwe ena olimbitsa.

Pokonzekera anamnesis, ndikofunikira kudziwa mtundu wa matendawa (kupangika kwakanthawi kokhazikika kapenanso kusintha kwakachotsere).

Mukamayang'ana miyendo yomwe yakhudzidwa, minofu hypotrophy, kuchepa kwa khungu, kuchepa kwa khungu pakhungu, kuchepa kwa tsitsi pamiyendo, hypertrophy ndi magawo a misomali ya msomali, hyperkeratosis imawululidwa. Pamene palpation ya miyendo imaganizira kuchepa kwa kutentha kwa khungu, kukhalapo kapena kusakhalapo kwa kutumphuka kwa mitsempha yachikazi komanso ya popliteal, komanso mitsempha ya phazi. Kuti mupeze stenosis, chidwi cha m'mimba msempha ndi chofala chazikazi chofunikira ndikofunikira. Kupezeka kwa kung'ung'udza kwa systolic kukuwonetsa chinyengo cha chotengera chofananira. Kuphatikiza pa kuyang'ana miyendo yonse, kumbuyo ndi kumbuyo (osati odwala omwe), wina ayenera kudziwa kukhalapo kwa vuto la magazi m'magazi ena amitsempha. Makamaka, mukamayesa odwala omwe athetsa matenda a atherosulinosis, kufunikira kwamitsempha yama carot ndikofunikira.

Njira zodziwitsa ena za zida.

Choyamba, wodwalayo ayenera kuchita kafukufuku wa ultrasound Doppler. Iyi ndi njira yosavuta kwambiri komanso yotsika mtengo yodziwira matenda, yomwe imalola kuti pakhale kuyang'ana kwazinthu zokhudzana ndi kufalikira kwa magazi ndi ziwonetsero zamagawo a systolic. Lingaliro lapadera la dziko la zotumphukira hemodynamics zam'munsi zam'mphepete zimaperekedwa ndi tanthauzo la cholondolera cha ankolo-brachial. Cholozeracho chimawerengeredwa ngati chiwopsezo cha kuthamanga kwambiri kwa ziwonetsero zamagetsi pamtunda umodzi wa mitsempha ya tibial kuzowonetsa izi pamtsempha wama brachial. Nthawi zambiri, mfundo zake zimaposa 1.0. Kutsika kwa mtengo wa chisonyezo kumakhala chizindikiritso cha zinthu zomwe zimakhala m'mitsempha. Kutsika kwa chizindikiro ichi pansipa 0.3 kumawonetsa kufooka kwa magazi m'chiwalo chathanzi.

Kutsimikiza kwa kolowera-ku brachial index, osati pakupuma kokha, komanso kuphatikiza mayeso oyenda, kumatilola kuti tiwone momwe magazi amayendera komanso kuloza kolimba kwa dzanja. Kuyenda pamtondo woyenda kumayambitsa magazi kulowa m'mitsempha yam'munsi. Ngati magazi amacheperachepera ndi proximal stenosis, kukakamiza kwa zigawo kumatsika. Kuyeza kumeneku kumakupatsani mwayi wofotokozera gawo la matendawa ndikusiyanitsa pakati pa odwala omwe ali ndi vutoli nthawi yayitali omwe ali pafupi ndi ischemia yovuta.

Chomwe chingalimbikitse kwambiri ndi kusanja kopanga. Makina amakono a ultrasound amatha kuwonetsa nthawi yomweyo kuwongolera kwa chotengera ndi kusanthula kwa omwe apezeka kuti akuwonetsetsa kutuluka kwa magazi mu lumen ya chotengera. Izi zimapangitsa kuwona m'maganizo ma steloses ndi stenoses, magawo a magazi osokonezeka omwe amayamba chifukwa cha kuwonongeka kwa khoma lamitsempha, komanso kudziwa malo omwe magazi amasokonezeka m'dera la hemodynamically stenoses. Kuphatikiza pa nthambi yomwe yakhudzidwa, odwala omwe atha kuthana ndi vuto la kuchepa kwa mitsempha, mitsempha ya carotid iyenera kuyesedwa.

Pakufufuza odwala omwe ali ndi ischemia yovuta, muyeso wokhazikika wa mpweya umagwiritsidwa ntchito kuti ayese kuyesa kwa minofu ndikulosera kuchiritsidwa kwa zilonda zam'mimba.

Gawo lomaliza la mayeso ndi angiography. Pogwiritsa ntchito njirayi, mutha kuwona m'maganizo mwathunthu wamitsempha kuchokera kummawa mpaka kumapazi. Ndikofunika kujambula zithunzi m'magulu awiri (mwachindunji ndi pambuyo pake).

Zizindikiro za atiosicosis ya atherosulinosis: kupindika kwa mitsempha yayikulu, "kupindika kwa mitsempha", mitsempha yodutsitsa mitsempha, kuwerengera kwamitsempha, ziwiya zazikulu zamkangano, zolunjika, komanso zopangidwa bwino. Nthawi zina, ma coronary arteriography amachitika pofuna kusankha njira zoyenera zochitira opaleshoni.

Ngati chiwonetsero cha preoperative sichinaperekepo chidziwitso chokwanira, kafukufuku wamasamba ochitika amachitika ngati pakufunika kuunikanso mwachindunji.

Monga njira zowonjezera zowunikira, zida zamagetsi ndi ma ergometry a njinga amagwiritsidwa ntchito.

Nthawi zambiri ndikofunikira kusiyanitsa pakati pawo zinthu zitatu zoyambitsa matenda osakwanira am'mphepete (atherosulinosis obliterans, thromboangiitis obliterans, nonspecific aortoarteritis).

Zizindikiro zamatenda zakuchotsa matenda a atherosulinosis:

Odwala omwe ali ndi zaka zoposa 40.

Kufalikira kwa zotupa - m'mimba msempha, mitsempha: carotid, coronary,

visceral, chachikazi komanso popliteal.

Mbiri yakusuta, matenda amtima.

Kulankhula mwachilungamo - inde.

Laboratory diagnostic - lipid kagayidwe kachakudya.

Njira yamatendawa ikupita patsogolo.

Zolinga za mankhwalawa ndikuchepetsa njira ya pathological, kuthetsa ululu, kubwezeretsa mphamvu yogwira ntchito, kupewa kutayika kwa miyendo ndi kulemala kwa wodwala.

Njira zamankhwala zochizira zimadalira gawo la kusakhazikika kwa arterial.

Ine ndi IIA magawo - chithandizo chokhazikika chomwe chikuwonetsedwa.

IIB, gawo lachitatu - chithandizo cha opaleshoni (opanga maopaleshoni okonzanso).

Gawo IV - chithandizo cha opaleshoni (kuchitanso opareshoni yowonjezeranso kuphatikiza ndi necrectomy kapena kudula pang'ono). Ngati ndizosatheka kusinthanso odwala omwe ali ndi ischemia yovuta kwambiri, kuduladula miyendo kumachitika.

Kuchiza kosasamala ndikofunikira kwa odwala onse, mosatengera gawo la matendawa, ayenera kukhala opitiliza ndi amoyo wonse. Chithandizo chimaphatikizira magawo akunja, ma inpatient ndi spa. Malangizo oyamba kwa odwala omwe amalumikizana pakapita nthawi yayitali ndi monga kusiya kusuta, kuwongolera thupi, kuchita masewera olimbitsa thupi osachepera ola limodzi patsiku (kuyenda mpaka kupweteka, kupuma, kenako kupitilizabe kuyenda). Kutsatira malangizowa nthawi zambiri kumabweretsa kuwonjezereka kapena kuwonjezeka kwakukulu mtunda woyenda. Mankhwala osokoneza bongo akuphatikizapo zinthu zotsatirazi.

Njira zomwe zimapangitsa kuti magazi azisinthasintha magazi, komanso ma antiplatelet othandizira (ma cell ochepa a kulemera kwa dextrans, aspirin, dipyridamole, zotumphukira zosiyanasiyana za pentoxifylline, ticlopedin, clopidogred).

Chithandizo cha dyslipoproteinemia ndi atherosulinosis - zakudya, lipid-kuchepetsa mankhwala (pravastin, lovastin, simvastin, clofibrate, nicotinic acid).

Amatanthawuza kuti njira yoyendetsera kagayidwe kazinthu kakang'ono ka miyendo yakhudzidwa (solcoseryl, actovegin, tanakan, mavitamini).

Kukonzekera kwa prostaglandin E1 (vazaprostan, alprostan).

Physiotherapeutic chithandizo chamankhwala (diathermy m'dera lumbar, ma diadynamic currents, maginito).

Sanatorium-resort chithandizo (hydrogen sulfide, radon, narzan, coniferous, pearl-oxygen baths, matope ogwiritsira ntchito lumbar dera, masewera olimbitsa thupi.

Chithandizo cha opereshoni chimaphatikizira kulowererapo kwa mtima, kuchitanso opaleshoni yotseguka komanso kudula miyendo.

Pakadali pano, mitsempha ya stonosed (occluded) ndi balloon angioplasty imagwiritsidwa ntchito kwambiri. Njirayi imakhala ndi jakisoni wokhotakhota pofunda wa mabatani awiri a baluni wa Grünzig kulowa m'mitsempha yamagetsi yomwe ikukhudzidwa ndikuwonjezera balloon mkati mwa lumen ya mtsempha wamagetsi. Izi zimapangitsa kukulitsidwa kwa lumen mwa kuthyola chimwala, "kukanikiza" chinsalu cha atherosrance ndi ndikutambasulira khoma lamankhwala. Njirayi imayenda bwino mu stenoses komanso imakhala ndi ma ma occlusions mpaka 10 cm.Wowonjezera ma straling amapititsa patsogolo zotsatira za balloon angioplasty komanso amachepetsa chiopsezo chokhala ndi stenosis yobwerezabwereza ya zone.

Endarterectomy imagwiritsidwa ntchito pochotsa zotupa za wamkazi. Pambuyo pochotsa malo a atherosselotically osinthika amkati ndi kubwezeretsanso kwa magazi, zotsekemera za mtima zam'mimba zimachitika ndi chigamba chokhazikitsidwa ndi autoimous.

Uwu ndi mtundu wodziwika kwambiri wobwezeretsa mwachindunji magazi oyenda ndi kugwiritsa ntchito chinthu chochita kupanga pogwiritsa ntchito zida zosiyanasiyana (zozikika mwapadera, zopangidwa ndi zinthu zina). Zowonjezera pamwamba pa khola la inguinal, kulumikizidwa kophatikizidwa nthawi zambiri kumagwiritsidwa ntchito paichi.

Ngati kulowererapo kuchitidwa pa mitsempha yomwe ili pansi pa inguinal fold, mumakonda kupatsidwa njira yolumikizira mothandizidwa ndi autovena, yomwe imapereka chidziwitso cha nthawi yayitali.

Pali njira ziwiri zosinthira pakuchita opaleshoni yotsatira mwa zokha: kusintha mitsempha kapena mu vein. Njira yoyamba imaphatikizapo kugawa mtsempha m'litali mwake lonse, kutembenuka kwake, kutanthauza kuti, kutentha kwa 180 ° kotero kuti ma ma valo a venous asasokoneze kuthamanga kwa magazi, ndikuthira pamwambapa ndi pansi pa gawo la gawo la gawo la chotupa. Panjira yachiwiri, mtsempha wamphongo ukadali malo, ndi zigawo zowoneka bwino zokha ndi zomwe zimapangidwa kuti zigwiritsidwe ntchito za anastomoses. Ma Valaviyamu amawonongeka ndi chida chapadera (valvulotome) chomwe chimayikidwa kumapeto kwa zomata kapena kudzera m'nthambi zake. Kuwotchera kwa vein kuyenera kumangidwapo njinga kuti magazi asatayike. Ubwino wa njirayi ndikutha kugwiritsa ntchito mitsempha yaying'ono ndi geometry yabwinoko. Zipangizo zopangira zokonzanso kumadera akumunsi zimalimbikitsidwa kuti zizigwiritsidwa ntchito pokhapokha ngati palibe autovene wokwanira kapena chiyembekezo chamoyo chomwe wodwalayo amakhala nacho sichidutsa zaka ziwiri.

Uku ndikusintha kwa malo a chotengera chomwe chakhudzidwacho ndi chida choikirachi ndikuchiyika ndikuika pabedi la chotupa. Kuchita uku sikugwiritsidwa ntchito kawirikawiri chifukwa chakuwonongeka kwake.

Njira zosalunjika za revascularization.

Njirazi zimaphatikizira kuphatikizika kwa omentum yayikulu kumwendo wakumbuyo (imatha kukhala yaulere kapena pamitsempha yam'mimba) poyembekezera kukhazikitsidwa kwa kama wogona.

Opaleshoni yodziwika bwino kwambiri mu gawo IV la matenda ndikuduladula miyendo. Pankhaniyi, mulingo woyenera kwambiri wamadulidwa posankha gawo lokwanira magazi ndi malire a zovuta za ischemic.

Ntchito nthawi zambiri zimachitidwa pansi pa opaleshoni wamba. Madokotala ambiri opanga maopaleshoni amakonda kutsetsereka kwachilengedwe, chifukwa njirayi imalola ma analgesia ogwira mtima omwe ali ndi chiwopsezo chochepa cha mtima. Kutalika (kwa masiku angapo) kukhazikitsa mankhwala oletsa kubwezeretsa m'mimba kudzera mu catheter yomwe imayikidwa mu malo othandizira, mu postoperative nthawi kumapereka analgesia ndi distal vasodilation.

Pambuyo pa opaleshoni, odwala amalemala kwa miyezi 1-3. Maphunziro a chithandizo cha Conservative akuyenera kuchitika kawiri pachaka.

Mavuto osaneneka a purulent amapezeka mu 1-2% ya odwala omwe amachitidwa opaleshoni yam'mbuyo. Pafupipafupi ma postoperative thrombosis panthawi amakonzanso gawo la aorto-iliac sioposa 3%, ndipo chachikazi-popliteal - 8%.

Imfa pambuyo opaleshoni ya mtima yosaposa si 3%.

Odwala mu gawo loyamba la matenda ochepa osakwanira, ndi chithandizo chokhazikika, 75% ya milandu, matenda a ischemic sapita patsogolo. Pafupipafupi pamadulidwe mpaka zaka 8 ndizochepera 7%.

Zotsatira zogwiranso ntchito zimadalira gawo (mulingo) wa kulowererapo. Pambuyo pokonzanso ntchito pa gawo la aortic-iliac, patency yamankhwala opanga mpaka 10 imafika 80-90%. Zaka ziwiri pambuyo pa balloon angioplasty, 85% ya mitsempha ya iliac yomwe ikulowerera ndipo 50% ya zachikazi imakhalabe yotheka.

Choyambitsa matenda ambiri mwa odwala omwe ali ndi vuto lochepa kwambiri la kuchepa kwam'munsi ndikuwonjezereka kwa zotupa za atherosselotic zotupa zina zam'mimba ndi zovuta zotsatirazi. Chiwopsezo chotenga imfa kuchokera ku matenda amtima chimafikira pafupifupi 60% ya imfa zonse m'gululi. Imfa yakugwidwa ndi ischemic stroke ndi 10-15%. Zomwe zimayambitsa mtima, monga visceral infarction ndi kupasuka kwa aortic aneurysm, zimapha milandu 10%.

Kuyesa Mtundu Woyeserera KWA GAWO lirilonse la TOPIC

Wodwala wazaka 45 amakhala ndi ululu m'khosi kumanzere kwa miyendo 7. Posachedwa, amatha kudutsa 60-70 m popanda kuima .. Khungu la phazi lakumanzere ndi mwendo wotsika limakhala lotumbululuka, lozizira mpaka kukhudza. Kuyenda kwathunthu. Kutumphukira kwa mtsempha wamagetsi wachikazi pansi pa khola la inguinal ndikosiyana, kotalikirana - kosatsimikizika. Arteriography idachitidwa, ndipo zidapezeka kuti, kuyambira pakati pa ntchafu, bedi lakale silimasiyanitsa.

Mukuzindikira bwanji?

Kodi opaleshoni imawoneka kangati kwa wodwala?

Wodwalayo ali ndi chithunzi ndi matenda a angiographic a occlusion ya kumanzere kwachikazi.

Kuti muchepetse kufunsa kwa kuchuluka kwa opaleshoni, zowonjezera zimafunikira pamikhalidwe yogona ya distal mtima.

Wodwala wazaka 54 wazaka 5 wakhala akukumana ndi ululu kumapazi ake amanzere ndi mwendo wotsika akayenda. Posachedwa, amatha kudutsa 40-50 mamita osayima .. Mkhalidwe wamba wa wodwalayo ndiwokhutiritsa. Pulse - 72 pamphindi, nyimbo. HELL - 150/90 mm Hg Khungu la phazi lakumanzere ndi mwendo wotsika limakhala lotumbululuka, lozizira kukhudza, kuyenda kozungulira kwathunthu, kupindika kwa mitsempha sikumatsimikizika m'chiwalo chonse. Kutupa kwa mitsempha yoyenera ya chikazi ndi popliteal, komanso mitsempha yamapazi, kumakhala kofooka. Aortography adachitidwa, pomwe zidapezeka kuti wopikisana naye samalowa mgonero wamanzere wa iliac.

Mukuzindikira bwanji?

Kodi njira yochizira ndi iti?

Wodwala ali ndi atherosselotic occlusion ya kumanzere kwakeac mtsempha wamagazi.

Njira zabwino kwambiri zothandizira kupatsirana ndi njira yolumikizana ndi ma femicrip.

Wodwala wazaka 42 wazaka zisanu ndi chimodzi adazindikira kupweteka m'miyendo yonse yam'munsi pakuyenda. Posachedwa, kupweteka kwa minofu ya mwendo ndi ntchafu kunayamba kuonekera ndikuyenda kwa ma 150-200 m. Pamodzi ndi izi, wodwalayo adayamba kuchepa kwa vuto logonana.

Zinthu zofananira ndizokhutiritsa. Khungu la malekezero onse apansi limakhala lotumbululuka, lozizira kukhudza, kuyenda kokwanira. Kupanga kwamtunda sikumawonekera kutalika konsekonse. Aortography idachitika pa wodwalayo, pomwe zidawululidwa kuti wosiyanayo salowa m'mitsempha wamba wamba wa iliac, mitsempha yamkati ya Eliac siyisiyanasiyana.

Kodi njira yochizira ndi iti?

Wodwala ali ndi chithunzi cha matenda ndi chithunzi cha Lerish's Lerish's. Kuchepa kwa kugonana chifukwa cha kuchuluka kwa mitsempha ya mkati ya iliac.

Njira zabwino kwambiri zothandizira kupatsirana ndi kuphatikiza mitundu ya akazi.

KUGWIRA NTCHITO KWA ZINYAMA ZONSE ZA MUTU

1. NJIRA YABWINO KWAMBIRI YOPANGIRA ZOLEMEKEZEKA NDI:

a) kusinthika

b) kudalitsika kwamkati (xenotransplantation)

c) Kugulitsa kudzipatula

d) kuyamwa ndi anastomosis kutha

e) kulowetsedwa kwa dera lomwe lakhudzidwa ndi msempha ndi synthesis

2. Atherosclerotic aneurysms nthawi zambiri kuposa ayi

a) mitsempha yotupa

b) chotupa cha radial

c) Mitsempha yachikazi

d) Mtsempha wamagazi

d) gawo lachigawo cham'mimba

3. FODula ya ARTERIO-Venous imapangidwa nthawi zambiri.

Zambiri zokhudzana ndi matendawa

Atherosulinosis obliterans amatanthauza matenda osakhazikika komanso osakhazikika omwe amatsutsana ndi kuwonongeka kwamitsempha yam'munsi, ntchafu, phazi, zovuta zamagazi, stenosis ndi occlusion yamitsempha yama m'munsi.

Kukula kwa OASNK kumachitika m'magawo angapo. Pa dolipid akuyamba kudzikundikira kwa mapuloteni ophatikizika ndi ma lipids mu minofu, kusintha kwa masanjidwe am'mimba ndi mapangidwe ofunda a magazi. Nthawi yomweyo, kupanga ma collagen ndi ma cell kumakulirakulira. Tiziwopsezo tambiri tomwe timayambira mbali yachiwiri, kenako maselo ofunda amawoneka. Pa gawo lotsatira, mafupa amitundu ina amapanga mitundu. Ndondomeko ya atheromatous imatha ndikupanga cholembera chovuta kwambiri cha atherosulinotic. Pakadali pano, kutaya magazi kumachitika mkati mwa chinsalu, ndipo nkhope yake imakutidwa ndi zilonda, ming'alu ndi misozi. Gawo lomaliza la chitukuko cha matendawa limadziwika ndi mawonekedwe a calcium calcium ndi zolembera zolimba. Zotsatira zake, makoma amitsempha am'mbali amakhala osakhazikika komanso osatetezeka.

Zizindikiro ndi zomwe zingachitike pangozi

Nthawi zambiri, atherosulinosis yokhala ndi mpweya siziwoneka kwa nthawi yayitali. Zizindikiro zoyambirira za matendawa ndi dzanzi komanso kumva kuzizira m'mapazi, kutsekeka, kumva pang'ono pang'onopang'ono komanso kuzindikira kwambiri kuzizira. Thrombosis kapena embolism monga chizindikiro choyamba sichosowa.

Kukula kwa kutha kwa atherosulinosis kumatha kuzindikiridwa ndi zizindikiro monga:

• Kulankhula momveka bwino
• Miyendo yonse ngakhale yopuma
• Kutentha pang'ono kwa dzanja lakhudzidwa,
• Kusintha khungu,
• Kugunda kofowoka kapena kusowa kwake mu milomo ya popliteal ndi pa ntchafu,
• Kuchepetsa minofu ndi minyewa ya adipose pa nthambi yomwe yakhudzidwa,
• Alopecia wa nthambi yomwe yakhudzidwa
• Maonekedwe a zilonda zam'mimba,
• Gangrene

Zomwe zimayambitsa kuthana ndi atherosulinosis ndi:

• M'badwo, jenda, komanso chibadwa
• Kulephera kuchita masewera olimbitsa thupi,
• Kuperewera kwa zakudya m'thupi
• Zamakhalidwe oyipa
• Mkhalidwe wamavuto osasangalatsa, kupsinjika pafupipafupi, kukhumudwa,
• Kuphwanya mafuta kagayidwe (kuchuluka kwa mafuta m'thupi, kutsika HDL),
• Hypertension, matenda am'mapapo, matenda a impso, matenda a mtima,
• Kulemera kwambiri
• Matenda a shuga, hyperglycemia, hypothyroidism ndi chifuwa chachikulu,
• Njira zotupa zosafunikira.

Gulu lamavuto limaphatikizapo anthu omwe amamwa mowa ndi fodya kwa nthawi yayitali komanso ambiri. Nikotine sichimakhudza kuchuluka kwa cholesterol, koma kumabweretsa mtima wa stenosis. Mowa waukulu komanso pafupipafupi wa mowa umapangitsa kuti ziwiya zisamakhale zotetezeka komanso zosavuta kugwidwa ndi mafuta.

Chizindikiro choyamba komanso chachikulu cha OASNA ndikulankhula kwapadera. Vutoli, limodzi ndi kupweteka kwambiri kwa minofu poyenda, kukakamiza kusiya kupuma.

Kugawika kwa magawo anayi a kutha kwa atherosulinosis kumagawidwa malinga ndi izi:

• Zowawa zimachitika mukamayenda mtunda woposa kilomita yayitali komanso mwamphamvu kwambiri,
• Popanda kupweteka, mutha kuyenda mpaka 1 km,
• Ululu umachitika pakadutsa 250 m,
• Zowawa zimadziwonetsera ngakhale pakupuma komanso kugona.

Pa gawo lotsiriza, kuwoneka kwa zovuta zamatumbo, kupezeka kwa necrosis, gangrene ya zala kapena phewa lonse.

Atherosulinosis ya malekezero a mmunsi ali ndi mitundu itatu, yomwe imakhala ndi magawo osiyanasiyana azovuta, dera la morphology ndi zizindikiro. The pachimake mawonekedwe limodzi ndi mwachangu chitukuko, kufulumira kwa mitsempha ndi kuphwanya minofu trophism. Gangrene amakula mkati mwa zaka zoyambirira pambuyo poti adziwe. Fomu ya subacute imadziwika ndi njira yokhazikika ndi nyengo zowonjezera. Matenda a OASNA amakhala ndi zovuta zina, zomwe zimayamba chifukwa cha chithandizo chosayenera.

Atherosulinosis ya ziwiya zamiyendo: mwadzidzidzi, mankhwala, udokotala

Kwa zaka zambiri osavutika ndi CHOLESTEROL?

Mutu wa Bungwe: “Mudzadabwa momwe zimakhalira zosavuta kuchepetsa mafuta m'thupi mwakumwa tsiku lililonse.

Atherosulinosis ya ziwiya zamagetsi am'munsi ndi amodzi mwa matenda oopsa kwambiri amitsempha miyendo. Amadziwika ndi chifukwa chakuti, chifukwa cha kufalikira kwa mitsempha ya magazi ndi malo amitsempha kapena magazi, kuwunika kwakanthawi kapena kokwanira kwa magazi m'magawo otsika kumachitika.

Ndi atherosclerosis, kupendekera (stenosis) kapena kutsekeka kwathunthu (chidziwitso) cha ma lumen am'magazi omwe amapereka magazi kumapeto kumachitika, zomwe zimalepheretsa kuyenda kwamagazi kumisempha. Ndi arterial stenosis yoposa 70%, zikuwonetsa kuthamanga ndi mawonekedwe amtundu wamagazi amasintha kwambiri, magazi osakwanira m'maselo ndi minyewa yokhala ndi mpweya komanso michere imachitika, ndipo amasiya kugwira ntchito mwachizolowezi.

Kuwonongeka kwa mitsempha kumabweretsa kupweteka m'miyendo. Pankhani yakudwala kwamatenda, komanso ngati mulibe chithandizo chokwanira kapena cholakwika, zilonda zam'mimba za m'mimba kapena ngakhale necrosis ya malekezero (gangrene) imatha kuonekera. Mwamwayi, izi zimachitika kawirikawiri.

Arteriosclerosis obliterans ya mitsempha yam'munsi yamatenda ndi matenda ofala kwambiri amitsempha yama miyendo. Chiwerengero chachikulu cha milandu imapezeka mu gulu lazaka zopitilira 60 - 5-7%, wazaka 50-60 wazaka - 2-3%, wazaka 40-50 - 1%. Koma atherosulinosis imatha kupezekanso mwa anthu achichepere - mu 0.3% amadwala odwala azaka 30 mpaka 40. Ndizofunikira kudziwa kuti amuna amadwala atherosclerosis 8 nthawi zambiri kuposa akazi.

Zoona zake: Amuna osuta opitirira zaka 50 ali pachiwopsezo chachikulu chotenga matenda a atherosranceosis obliterans.

Zoyambitsa zazikulu za atherosulinosis

Choyambitsa chachikulu cha atherosulinosis ndi kusuta. Nikotine yomwe ili mu fodya imayambitsa mitsempha kuti isamenye, motero imalepheretsa magazi kuyenda m'mitsempha ndikuwonjezera mwayi wamagazi mkati mwake.

Zowonjezera zomwe zimapangitsa atherosulinosis yamitsempha yama m'munsi ndipo zimayambitsa kumayambiriro koyambira komanso matenda oopsa:

• cholesterol yayikulu yokhala ndi zakudya zamafuta a nyama nthawi zambiri,
• kuthamanga kwa magazi
• onenepa kwambiri
• chibadwire
• matenda ashuga
• kusowa mokwanira zolimbitsa thupi,
• zopsinjika pafupipafupi.

Zizindikiro za atherosulinosis ya ziwiya zamiyendo

Chizindikiro chachikulu chomwe muyenera kuyang'anira ndi kupweteka kwa mwendo. Nthawi zambiri, ululu umachitika poyenda mu minofu ya ng'ombe ndi minofu yamatumbo. Mukamayenda m'matumbo am'munsi, kufunikira kwa magazi ochepa kumawonjezeka, komwe kumapereka mpweya ku minofu. Mitsempha yopingasa panthawi yolimbitsa thupi singakwaniritse zokwanira kufunikira kwa magazi am'magazi, chifukwa chake kufa ndi njala kumayamba mwa iwo, ndikudziwoneka ngati ululu waukulu. Kumayambiriro kwa matendawa, ululu umadutsa mwachangu machitidwe olimbitsa thupi atatha, koma kenako amabwereranso mukamasuntha. Pali ena otchedwa intermittent claudication syndrome, omwe ndi amodzi mwa zizindikiro zazikulu zamatenda a atherosulinosis obliterans a mitsempha yam'munsi. Ululu m'matumbo a chiuno umatchedwa ululu wamtundu wanthawi yayitali, ndipo kupweteka m'matumbo amiyendo kumatchedwa kupweteka kwa mtundu wocheperako pang'onopang'ono.

Mukakalamba, zopweteka zotere zimasokonezeka mosavuta ndi kupweteka komwe kumalumikizana ndi arthrosis ndi matenda ena olowa. Arthrosis sodziwika ndi minofu, ndiyo, ululu wamkati, womwe umakhala ndi mphamvu yayikulu kwambiri poyambira kusunthira, kenako kenako umafooka wodwala "akamayenda."

Kuphatikiza pa kupweteka m'misempha ya miyendo mukuyenda, atherosclerosis obliterans yamitsempha yam'munsi yam'munsi imatha kuyambitsa zizindikiro zotsatirazi mwa odwala (amodzi mwa iwo kapena angapo):

1. Kuzizira ndi dzanzi kumapazi, kukulitsidwa ndikukwera masitepe, kuyenda kapena katundu wina.
2. Kusiyana kotentha pakati pamagawo am'munsi (mwendo womwe umakhudzidwa ndi atherosulinosis yamatumbo nthawi zambiri kumakhala kozizira pang'ono kuposa wathanzi).
3. Ululu wammbuyo popanda kulimbitsa thupi.
4. Zilonda zopanda machiritso kapena zilonda zimawoneka kumapazi kapena kutsika kwachitatu kwa mwendo.
5. Malo amdima amapezeka kumapazi ndi kumapazi.
6. Chizindikiro china cha atherosclerosis chikhoza kukhala kuchepa kwa zamkati m'mitsempha yam'munsi - kumbuyo kwa chidendene chamkati, mu popliteal fossa, pa ntchafu.

Magawo a matenda

Malinga ndi gulu lomwe lili ndi vuto la kuchepa kwa ziwalo zamiyendo, zizindikiro zomwe zili pamwambazi zitha kugawidwa m'magawo anayi a matenda.

• Gawo I - kupweteka m'miyendo, komwe kumawoneka pambuyo pazochita zambiri zolimbitsa thupi, monga kuyenda mtunda wautali.
• IIa siteji - kupweteka poyenda mtunda wautali (250-1000 m).
• IIb siteji - mtunda woyenda wopanda ululu amachepetsa mpaka 50-250 m.
• Gawo III (ischemia yovuta) - kupweteka kwamiyendo kumawoneka poyenda mtunda wosakwana 50. Pakadali pano, ululu m'mitsempha yam'munsi imatha kuyamba ngakhale wodwalayo atapuma, izi zimawonetsedwa makamaka usiku. Kuti muchepetse ululu, odwala nthawi zambiri amatsitsa miyendo yawo kuchokera pabedi.
• IV siteji - pakadali pano pamapezeka zilonda zam'mimba. Monga lamulo, madera akhungu lakuda (necrosis) amawonekera pazala kapena malo othala. Mtsogolo, izi zitha kuyambitsa gangore.

Pofuna kuti matenda asamawonongeke kwambiri, ndibwino kuti muzindikire munthawi yake ndikupereka chithandizo kuchipatala.

Chithandizo cha atherosulinosis yamitsempha yama m'munsi

Matendawa amafunika mtundu wa wodwala aliyense payekha. Chithandizo cha atherosclerosis ya ziwiya zam'munsi malembedwe zimatengera gawo la matenda, nthawi yake, mulingo wowonongeka m'mitsempha yamagazi. Kuphatikiza apo, kudziwika ndi kuphatikizika kwa chithunzi chachipatala kumathandizanso kupezeka kwa matenda oyanjana ndi wodwala.

Ngati kuwonongeka kwa atherosulinosis kwapezeka koyambirira, kungakhale kokwanira kuti muchepetse zinthu zomwe zikuwoneka kuti zitha kusintha. Potere, thandizirani:

1. Kukakamiza kusuta fodya komanso zizolowezi zina zoyipa.
2. Kutsatira zakudya zochepa m'mafuta a nyama ndi kutsitsa mafuta m'thupi.
3. Ngati onenepa kwambiri kapena onenepa kwambiri - kunenepa.
4. Kusungabe kuthamanga kwa magazi pamlingo wosaposa 140/90 mm RT. Art.
5. Zochita zolimbitsa thupi pafupipafupi (kuyenda, dziwe losambira, kuchita njinga yochitira masewera olimbitsa thupi, ndi zina zambiri).
6. Kwa odwala matenda a shuga - magazi amawongolera.

Pankhani ya atherosulinosis ya mtima, zotsatirazi ndizoletsedwa: batala, margarine, mafuta anyama, margarine, nyama yamafuta, soseji, pastes, offal, mkaka wokhala ndi mafuta ambiri, mbatata yokazinga, ayisikilimu, mayonesi, makeke.

Chofunikira: Kukhala moyo wongokhala kumapangitsa kuti ziwiya zisamayende bwino ndipo zimathandizira kukula kwa matendawa.

Nthawi zina, njira zotsatirazi zimagwiritsidwa ntchito pochiza matenda a atherosulinosis a ziwiya zotsika:

• Zodzikongoletsa
• Endovascular (pang'ono zowononga),
• Yogwira.

Chithandizo cha Conservative

Itha kugwiritsidwanso ntchito poyambira matendawa, komanso panjira yomwe wodwalayo salola kugwiritsa ntchito njira zina (zovuta za concomitant pathology). Chithandizo cha Conservative chimaphatikizapo kugwiritsa ntchito mankhwala, physiotherapy komanso pneumopressotherapy, dosed kuyenda ndikuchita masewera olimbitsa thupi.

Owerenga athu adagwiritsa ntchito bwino Aterol kutsitsa cholesterol. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Tsoka ilo, palibe mankhwala omwe angabwezeretsenso magazi moyenera m'mitsempha yotsekeka komanso kuchiritsa atherosclerosis. Kugwiritsira ntchito mankhwala osokoneza bongo kumangothandizira komanso kukhudza ziwiya zing'onozing'ono zomwe magazi amayenda gawo lozungulira la mtsempha. Chithandizo cha mankhwala ndicholinga chakukula ndi "ntchito izi" ndikuthandizira kuti magazi asamayende bwino.

Kuti muchepetse kuphipha m'mitsempha yaying'ono yam'madzi, onjezerani magazi ndikuteteza makoma a mitsempha kuti iwonongeke kwambiri, mumagwiritsidwa ntchito mankhwala apadera, omwe ena amafunika kuledzera ndi maphunziro, ndipo ena amayenera kumwa mosalekeza.

Kuphatikiza pa mankhwala, odwala amamuika pneumopressotherapy - kutikita minofu yofewa mwendo mothandizidwa ndi zida zapadera. Mwa kusinthasintha kutsika komanso kuthamanga kwa cuff yomwe imavala dzanja, zotupa zam'mitsempha zimakulitsa, magazi amayenda pakhungu, minofu ndi minyewa yodutsa m'mimba imakulitsidwa.

Mankhwala a Endovascular

Njira zofala kwambiri zochizira matenda am'miyendo ndi njira zamkati - zonunkha zamitsempha, balloon dilatation, angioplasty. Amakulolani kuti mubwezeretse magazi mozungulira ngati chotupa popanda kuchitapo opareshoni.

Njira zotere zimachitika mu x-ray, pazida zapadera. Mapeto ake, kuvala kovutirapo kumayikidwa mwendo wa wodwala, ndipo ayenera kupumula kwa kama kwa maola 12-18.

Mankhwala othandizira

Ngati mbali zolumikizirana zam'mitsempha m'miyendo ndizitali kwambiri kuti njira zamkati zisabwezeretse magazi m'miyendo, imodzi mwanjira zotsatirazi:

1. Prosthetics of the artery site with a artificial chombo (alloprosthesis),
2. Opaleshoni ya Bypass - kubwezeretsa kayendedwe ka magazi mwa kuwongolera kuthamanga kwa magazi kudzera mu chotengera chopanga (shunt). Monga shunt, gawo lamtsempha wa wodwalayo lingagwiritsidwe ntchito,
3. Thrombendarterectomy - kuchotsedwa kwa zolembedwa za atherosselotic kuchokera kumtsempha wamagazi.

Njira zopangira opaleshoni zimatha kuphatikizidwa kapena kuthandizidwa ndi mitundu ina ya opareshoni. Ngati opaleshoniyo ikuchitika pa gawo la IV la matendawa, pomwe mbali zakufa zayamba kale kuchitika, kuchotsedwa kwa madera ndikutsekeka kwa zilonda zam'mimba zokhala ndi kukulira kwa khungu kumachitika.

Ngati kufooketsa atherosulinosis kwapita patsogolo kwambiri, pamene wodwala wapanga matenda am'munsi ndipo ndikosatheka kubwezeretsa magazi, kudula mwendo kumachitika. Nthawi zina iyi imakhala njira yokhayo yopulumutsira moyo wa wodwala.

Kodi kupewa matenda?

Kupewa matenda a atherosulinosis ndi koyamba:

• Kusuta kufafaniza.
• Zakudya zoyenera, zakudya zopanda mafuta a cholesterol.
• Zochita zolimbitsa thupi.

Awa ndi maunyolo atatu omwe amachepetsa chiopsezo cha atherosulinosis a ziwiya zapansi. Sizofunikira kuti mutopetse zolimbitsa thupi, mutha kumangoyenda tsiku ndi tsiku ndikuchita masewera olimbitsa thupi miyendo. Kuphatikiza apo, acupressure yapadera ndi maphikidwe achikhalidwe chamankhwala amathandizira monga prophylactic.

Werengani zambiri za kupewa kwathunthu kwa atherosulinosis apa.

Zokhudza maphunzirowa ndi chithandizo cha atherosulinosis mwa okalamba

Atherosulinosis imayamba kukula pang'onopang'ono zaka 30, ndipo nthawi zina limapezeka mwa achichepere. Matendawa amagwirizanitsidwa ndi kufalikira kwa ziphuphu za atherosselotic pamakoma amitsempha yamagazi. Pang'onopang'ono zimakula ndikuphimba kuyerekeza kwa chotengera. Madzi amatuluka. Nthawi zambiri, atherosclerosis mu okalamba amapezeka atha zaka 60. Amakhudza mitsempha yayikulu, msempha, ziwiya zam'mimba.

Zowopsa

Choyambitsa chachikulu cha atherosulinosis ndi zomwe zili kwambiri za cholesterol "yoyipa" m'magazi. Pali zifukwa zinanso zomwe zimayambitsa matendawa:

• zaka
• matenda oopsa
• matenda ashuga
• kusowa zolimbitsa thupi,
• chibadwa
• chakudya chopanda malire
• kunenepa.

Zizolowezi zoyipa (kusuta fodya komanso kumwa mowa kwambiri) zitha kuchititsa kuti mapangidwe a atherosulinotic. Zomwe zimathandizira matenda a coronary, stroko, myocardial infarction. Mwazi umayenda m'malire, ubongo, mitsempha ya mtima.

Cerebral arteriosulinosis

Zizindikiro zoyambirira za matenda amiseche zimachitika muukalamba. Wawonongeka
magazi kupita ku intracranial komanso pafupi ndi ziwiya zam'kati zomwe zimadyetsa ubongo. Pali kusintha kwamkati mwa dongosolo lamanjenje. Kungachitike stroko, zodabwitsika m'maganizo zimawonekera.

Kuthamanga kwa magazi kuubongo kumadutsa mu carotid ndi mitsempha ya vertebral. Kugonjetsedwa kwa atherosulinosis kwa ziwiya zotere kumachepetsa magazi. Zizindikiro ndi mawonekedwe ake akuwonekera zimadalira kuwonongeka kwa ziwopsezo zamkati mwa ziwiya zapakati panthaka.

Pa gawo loyamba lachitukuko, amatha kuoneka
Zizindikiro zotsatirazi:

• kusokonezeka ndende,
• kukumbukira kukukula
• Mwina kuphwanya malankhulidwe kwakanthawi, masomphenya,
• kutopa, kuchepa kwa mphamvu yogwira ntchito.

Zizindikirozi zimachitika pang'onopang'ono, zimatha kuchiritsidwa, zimadutsa kwakanthawi.

Kwambiri atherosclerosis ya mitsempha ya ubongo nthawi zambiri kumabweretsa stroko. Ili ndi zizindikiro zowoneka bwino:

• kuchepa kwa chidwi, ziwengo, matenda opuwala,
• nkhawa, psychopathic
• zosokoneza tulo
• pafupipafupi kusintha kosinthika
• zigawo zachinyengo za zowonongeka, kuvutitsidwa, ndi zina.

Nthawi zambiri odwala awa amakayikira matenda owopsa omwe sanawonekere pakuwunika.

Gawo lachitatu la matenda a cerebrovascular amatchedwa dementia (anapeza dementia). Ili ndi dzina losavuta - senile senility. Gawo ili limadziwika ndi kuwonongeka kwa ntchito zamaganizidwe chifukwa cha kuwonongeka kwa ubongo.

Ndi mitsempha yokhala ndi mtima wam'mimba, kukumbukira kwakanthawi komanso kwakanthawi, malingaliro osakhazikika amasokonezeka, pali zovuta kulumikizana ndi anthu ozungulira, kusintha kwa umunthu.

Coronary atherosulinosis

Zizindikiro za atherosulinosis ya mitsempha yamtima nthawi yoyambirira matendawa sikuwonetsedwa. Ndi chitukuko chowonjezereka, ali ofanana ndi zizindikiro za matenda a ischemic:

Owerenga athu adagwiritsa ntchito bwino Aterol kutsitsa cholesterol. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

• ululu wakuthwa kumbuyo kwa sternum, womwe umaperekedwa kuchokera kumbali yakumanzere, kumbuyo,
• kupuma movutikira kumawoneka ngakhale ndikuyenda modekha,
• chizungulire, mseru ungakulitse vutolo.

Kusayenda bwino kwamagazi ndi kuchepa kwa magazi m'mitsempha ya mtima kumabweretsa kuti wodwalayo ali ndi angina pectoris, fibrillation ya atria, kulakwitsa kwa minofu ya mtima. Izi zimatha kubweretsa myocardial infarction.

Atherosulinosis ya ziwiya zamagawo akumunsi

Kuwonongeka kwa ziwiya zam'munsi zokhala ndi zolembera za atherosulinotic nthawi zambiri kumapezeka mwa odwala okalamba. Zomwe zikuchitika pamatendawa ndi izi:

• kupweteka m'miyendo mukuyenda,
• "Kulowerera mkati" kumapangitsa minofu ya ng'ombe kumayenda.
• zopweteka zowonjezera zikuyenda, zikukwera pamtunda wokhazikika.
• khungu layamba kuzizira, khungu limayamba kuzimiririka, khungu limayamba kutuwa poyamba,
• matendawa akapita patsogolo, khungu limakhala ndi kuwala kwamtambo,
• necrosis imawoneka, kutupa kwa mapazi.

Kuopsa kwa atherosulinosis, komwe kumakhudza ziwiya zam'munsi, ndikuti khungu limayamba chifukwa cha minofu ya necrosis, yomwe imayambitsa kuduladula.

Zizindikiro

Kuti mudziwe atherosclerosis, ma labotale ndi zida zofunikira za ma mitsempha amachitika.

1. Kuwunika kwa biochemical kumawonetsa kuchuluka kwa cholesterol, triglycerides, LDL ndi HDL m'magazi.
2. Dopplerografia, kuwunika kwa ultrasound kumawunika kuwonongeka kwa mitsempha ndi zolembera za atherosulinotic. Carotid, vertebral, subclavian mitsempha, aorta amayesedwa.
3. X-ray (angiography).
4. Magnetic resonance imaging.
5. Kuyesa kwa Ultrasound

Pambuyo pakupenda kwathunthu ziwiya zazikulu, chithandizo chovuta chimayikidwa.

Chithandizo cha Conservative chimaphatikizapo zinthu ngati izi.

1. Zakudya zotsutsana ndi cholesterol zomwe zimachepetsa kuchuluka kwa zakudya zomwe zimakhala ndi cholesterol yapamwamba kuposa zabwinobwino, vitamini D. Mndandanda wazakudya uyenera kuphatikiza: mafuta ophikira masamba, tchizi yamafuta ochepa, nsomba, bowa, broccoli, phala.
2. Zochita zolimbitsa thupi, kuyenda.
3. Njira zomwe zimachepetsa kukwiya, kupsinjika. Njira yina yothandizira ndikupumulira imakhazikitsidwa.
4. Matenda a kukakamiza.
5. Malangizo osintha moyo wanu. Chofunikira ndikutchotsa kusuta, mowa.

Chithandizo cha mtima atherosulinosis ndi mankhwala umalimbana kuchepetsa kuchuluka kwa cholesterol "yoyipa", ndikuwonjezera kuchuluka kwapachulukidwe lipoproteins:

• Kuchepetsa lipoproteins ochepa, lecithin akulimbikitsidwa kuphatikiza mafuta omega-3 acid,
• mavitamini a gulu C, PP ndi B,
• mankhwala a group la statin, awa akuphatikizapo Lovastatin, Simvastatin,
• mankhwala a gulu la fibrate - Fenofibrate, Ciprofibrate,
• nicotinic acid.

Ngati boma lakhumudwa linapezeka, amathandizidwa ndi antidepressants. Nkhawa nkhawa amathandizidwa ndi tranquilizer.

Ngati pakuchita kafukufuku wothandizirana kuchepera kwa chotengera choposa 70% kapena kutuluka kwathunthu, ndiye kuti mankhwalawo amathandizidwa. Kuluma kwa malo omwe akhudzidwa ndi chombocho.

Pomaliza

Ndi zaka, makoma amitsempha yamagazi amatayika. Kwa zaka zambiri, kukula kwa ma atherosselotic mapepala kumapangitsa kuti magazi ayambe kuyenda. Zotsatira zake zitha kukhala kupangidwa kwa magazi, komwe kumatchinga chotengera. Chifukwa cha kufalikira, chiwopsezo ku moyo wa munthu chikuwonekera. Okalamba nthawi zambiri amakhala pachiwopsezo cha stroke, myocardial infarction.

Zimayambitsa ndi zizindikiro za atherosulinosis

Pofuna kupewa zovuta za matendawa, muyenera kudziwa chomwe chimayambitsa matenda.

Choyambirira, munthu amatha kupatula chomwe chimayambitsa matendawa kumayambira.

Mwa zina mwazinthu zomwe zimakhala zofunikira kwambiri pakuchitika kwa matenda.

Zina mwa zifukwa zazikulu ndi izi:

• Mowa. Mowa uliwonse umakhudza mtima ndi mitsempha yamagazi, chifukwa chake kugwiritsidwa ntchito nthawi zonse kumachepetsa kukula kwa makhoma a mitsempha, komanso kumakhudza minofu yamtima.
• Kusuta sikungakhudze kukula kwa matenda monga atherosulinosis, komanso kuonjezera ngozi zomwe zingayambitse matenda owopsa. Chifukwa chake, kusiya chizolowezi choyipa ichi, munthu amachepetsa mwayi wamatenda amtima ndi mitsempha yamagazi ndi 80%.
• Kudya zakudya zowononga zambiri zomwe zimakhala ndi mafuta ambiri azinyama.
• Mitundu ya chibadwa. Ngati wachibale wa munthu akudwala atherosulinosis, kapena magazi m'thupi, ayenera kumayezetsa kuchipatala pafupipafupi ndi kupewetsa ziwopsezo zina pamoyo.
• Kukhalapo kwa kunenepa kwambiri kumayendera limodzi ndi zovuta zina zomwe zimayambitsa matenda a atherosulinosis, kapena zovuta zofanana.
• Kukhalapo kwa mbiri ya matenda oopsa, kapena matenda oopsa pakuwonetsedwa kulikonse.

Chimodzi mwa zinthu ziyenera kuyambitsa kusintha ndi kuwunika pafupipafupi kuchipatala cha mtima.

Nthawi zambiri, kuti atherosulinosis ichitike, muyenera zifukwa zingapo. Kuti thandizo liperekedwe munthawi yake, muyenera kudziwa zomwe sizitha kunyalanyazidwa.

Ngakhale nthendayi imadutsa mosazindikira, mu magawo omaliza mutha kuwona zambiri izi:

1. kupweteka mutu pafupipafupi
2. kukomoka mtima,
3. lamumo
4. kulemera kwamiyendo
5. chizungulire
6. nseru
7. kusanza
8. kupuma movutikira
9. kutuluka thukuta kwambiri
10. kuponderezedwa kowonjezereka
11. matenda a mtima
12. kupweteka pachifuwa

Zizindikirozi ndizofala pamitundu yambiri ya atherosulinosis. Mwachitsanzo, kuwononga ma atherosulinosis a malekezero am'munsi amadziwika ndi zovuta pakuyenda, kuzungulira. Nthawi zambiri nthambi imodzi imatupa, khungu limasintha mtundu. Zimakhala zovuta kuti munthu ayende mtunda wautali, ndipo pakapita nthawi, mtunda umangoyenda. Izi zimakhudzana mwachindunji ndi kuchuluka kwa cholesterol plaques komanso kupezeka kwa matenda a ischemic.

Atherosulinosis obliterans imatha kukhala mwa anthu azaka zosiyanasiyana.

Malangizo azachipatala a atherosulinosis

Malangizo azachipatala amaphatikizapo chithandizo chosagwiritsa ntchito mankhwala osokoneza bongo.

Popereka chithandizo cha matenda, munthu ayenera kutsatira malangizo a dokotala.

Njira zochizira zosagwiritsa ntchito mankhwalawa zimaphatikizapo: kutsatira zakudya zapadera za cholesterol yambiri, kuwonjezera zolimbitsa thupi, kusintha thupi, komanso kusiya zizolowezi zoyipa.

Mukamaliza kudya, wodwalayo ayenera kutsatira mfundo izi:

• osiyanasiyana zakudya
• menyu uyenera kuthandiza kuchepetsa kulemera kwa wodwalayo,
• kuchuluka kwa zipatso ndi masamba,
• kukana confectionery, mutha kudya mkate wopanda tirigu,
• kuchuluka kwa nsomba zogulitsa pamenyu,
• kuwonjezera ku menyu tsiku ndi tsiku Omega-3,
• kuchuluka kwa mafuta sikuyenera kupitirira 30% ya chakudya chonse,

Nthawi zina, muyenera kufunsa katswiri pa nkhani ya zakudya. Makamaka pafupipafupi, matenda a lipid metabolism amawonedwa mwa anthu omwe ali ndi thupi lochulukirapo. Chifukwa chake, makulidwe a kulemera amakhalanso ndi mankhwala ambiri, omwe amathandizira ku metabolic ya lipids ndi kusintha kwa mitundu yawo.

Kuchepetsa thupi kumafunikanso kupewa zovuta zomwe zingakhudze mtima wamtima.

Izi zitha kuchitika potsatira zakudya zapadera, zomwe zimapangidwa poganizira zomwe zimachitika mthupi la munthu komanso matendawa.

Kuti mukwaniritse izi, muyenera kuchotsa osachepera 10% ya kulemera koyambirira. Komanso, odwala onse omwe akudwala matenda omwe mtima wawo umadwala, amafunika kuwonjezera zolimbitsa thupi. Mwachilengedwe, izi ziyenera kuganizira zaka ndi momwe wodwalayo alili.

Ndikofunika kuwonjezera katundu pang'onopang'ono. Anthu omwe alibe matenda a mtima amatha kupatsidwa masewera oyenera kwambiri. Ulamuliro wa katundu uyenera kuvomerezedwa ndi katswiri.

Komanso, kusuta fodya kumaphatikizidwanso mu zovuta zamankhwala.

Katswiriyo ayenera kutsimikizira wodwalayo kuti asiye kusuta pogwiritsa ntchito algorithm:

1. Kufunsa za kusuta.
2. Kuyesa gawo la chizolowezi komanso kufunitsitsa kwa wodwala kusiya.
3. Kukangana kusiya chikhalidwe.
4. Thandizo lapadera pa izi, kuphatikizapo njira zamankhwala othandizira.
5. Kuwunikiranso odwala pankhaniyi.

Njira ina yovomerezeka ndi kukana zakumwa zoledzeretsa.

Mankhwala Osokoneza Mankhwala

Malangizo aku Russia othandizira atherosulinosis akuphatikizira kuvomerezedwa kwa mankhwala apadera. Amathandizira kuti magawo onse azikhala mthupi la munthu komanso kayendedwe ka mafuta kagayidwe.

Mlingo ndi njira yoyendetsera imayikidwa ndi adokotala okha. Kwenikweni, chithandizo choterechi chimafotokozedwa ngati vuto la mankhwala osagwiritsidwa ntchito ndi anthu omwe ali pachiwopsezo chachikulu cha zovuta.

Mankhwala ayenera kumwedwa pokhapokha ndi njira zina zomwe zingachiritse matendawa.

Madokotala amalimbikitsa kugwiritsa ntchito atherosulinosis:

• GMK-CoA enzyme inhibitors (ma statins),
• othandizira a bile acids (ma resins),
• nicotinic acid
• michere ya michere
• cholesterol mayamwidwe inhibitor.

Statin amathandizira kuchepetsa cholesterol m'magazi a anthu. Kuphatikiza pa lipid-kutsitsa, amathandizira kugwira ntchito kwa endothelium. Mlingo ndi njira yogwiritsira ntchito ziyenera kuyikidwa kokha ndi katswiri woyenera, kutengera mtundu wa thanzi la munthu. Zotsatira zoyipa za gulu la mankhwalawa zimaphatikizapo kudzimbidwa, kusefukira, ndipo nthawi zina nseru. Kwenikweni, mankhwala amavomerezedwa ndi thupi. Izi zikachitika, muyenera kusintha mlingo.

Mlingo wa bile acid umaperekedwa kwa odwala omwe ali ndi zaka zopitilira 30. Popewa zovuta zam'mimba, anali mankhwalawa omwe adatsimikiza kugwira ntchito kwawo. Kukhazikitsidwa kwa ndalama zina kuyenera kuchitika kokha ndi dokotala. Zotsatira zoyipa zimaphatikizapo dyspepsia, kudzimbidwa. Nthawi zambiri, odwala amakana kumwa chifukwa cha kukoma kosasangalatsa. Nthawi zambiri amatumiza mankhwala okhala ndi vuto lofanana kuti musamutse mankhwalawo kuti mupewe mavuto.

Kugwiritsa ntchito kwa ma fibrate kumatsutsidwa chifukwa cha kukhudza bwino kwa chiwindi, chomwe ndi chinthu chachikulu pakupanga cholesterol. Chifukwa cha njira zina, kuphatikiza kwawo kumawonjezera kuchuluka kwa lipoproteins yapamwamba. Amalandira makamaka mitundu yosiyanasiyana ya hyperlipidemia.

Nthawi zambiri, mankhwalawa amaloledwa bwino ndi odwala, koma nthawi zina pamakhala kudzimbidwa, kusefukira kwam'mutu, kupweteka mutu komanso nseru.

Pogwiritsa ntchito nthawi yayitali, ma fibrate amatha kuthana ndi bile.

Ubwino wopezeka ndi nthawi yake matendawa ndikugwiritsa ntchito Omega 3

Kuchepa kwa lipid kagayidwe ndi imodzi mwazinthu zazikulu pakupanga matenda a mtima ndi mtima.

Kuzindikira kwakanthawi ndimayendedwe a lipid metabolism kuti mupewe komanso kuthandizira atherosclerosis iyenera kukhala yofunika kwambiri, chifukwa munjira imeneyi ndizotheka kupewa zovuta za matenda, zomwe nthawi zambiri zimatha kupha.

Makamaka nthawi zambiri amadwala matenda a ubongo. Palibe vuto limodzi lachipatala lomwe linapha ndi kupezeka kwa nthawi kwa katswiri. Kupewa kumathandizanso kwambiri m'matumbo athanzi.

Chimodzi mwazomwe zimathandizira ndikugwiritsa ntchito mafuta ochulukirapo a polyunsaturated. Omega-3 amagwiritsidwa ntchito kuti matenda a metabolism abweretse thupi.

M'gawo la Russian Federation, Omacor wa mankhwala, omwe ali ndi izi, amalembetsedwa.

Kafukufuku akuwonetsa kuti kugwiritsa ntchito mankhwala ngati amenewa nthawi zambiri kumachepetsa kuchuluka kwa triglycerides m'mwazi ndi 50%. Malinga ndi protocol, zinthu zina zomwe zili ndi zomwezo sizikulimbikitsidwa kuti zitengedwe chifukwa cha kuthekera kwa gawo lenileni la kuchuluka, kafukufuku wokwanira wogwirizana ndi mankhwala ena othandizira. Ndizinthu izi zomwe zimatsitsa cholesterol ndikuthandizira kupewa kuwonekera kwa matenda a mtima. Kukhazikitsidwa kwa Omega-3 kumachitika nthawi zonse pogwiritsa ntchito mankhwala ena osagwiritsa ntchito mankhwala osokoneza bongo, kuphatikiza njira zamankhwala azikhalidwe.

Atherossteosis akufotokozedwa mu kanema munkhaniyi.

Chithandizo cha OASNA

Ngati chizindikiro choyamba cha matendawa chikuwonekera, muyenera kufunsa dokotala. Kupereka chithandizo chamankhwala mosalephera kapena kulephera kutsatira malingaliro a dokotala kungayambitse kukula kwa khungu, ischemia, kuduladula miyendo ndi imfa.

Potsimikizira matendawa, kuwononga ma atherosclerosis a ziwiya zam'munsi, mankhwalawo amasankhidwa potengera chithunzi cha matendawa, njira yachitatuyo, zaka ndi zomwe wodwala ali nazo. Nthawi zambiri zimakhala ndi mankhwala othandizira, kusintha kwa moyo, masewera olimbitsa thupi.

Njira zopangira opaleshoni zimakhazikitsidwa pokhapokha pachitika ngozi.

Mankhwala

Chithandizo cha mankhwala a atherosulinosis obliterans a m'munsi malembedwe sicholinga chake popewa kukula kwa matenda, komanso kuchepetsa mavuto a matenda ophatikizika ndi zina:

• Kunenepa kwambiri
• Zovuta zambiri
• Zakudya zomanga thupi ndi kuchepa kwa lipid
• Kuzindikira kwamagazi.

Mankhwala omwe amaperekedwa kwa OASNK amagawika m'magulu angapo malinga ndi zomwe achitazo:

• Kuchepetsa magazi ndi kupewa kukula kwa mikwingwirima ndi magazi kuwundana, ma antiplatelet amagwiritsidwa ntchito,
• Kutsitsa cholesterol, LDL ndi VLDL ndi ma statins,
• Ma anticoagulants adapangidwa kuti aletse magazi ndi kuwundana kwa magazi,
• Kukonzekera kwa Vitamini motengera nicotinic acid ndikofunikira kubwezeretsa minofu trophism.

Kuphatikiza apo, mankhwalawa atha kutumikiridwa kuti achepetse mitsempha ya magazi, kuchepetsa magazi, kupewa mavuto obwera chifukwa cha matenda oopsa. Kuti kukhazikika kwa kagayidwe kachakudya njira ndi kusintha mkhalidwe wa minofu, chitetezo cha m'thupi ndi kulimbitsa thupi, zakudya zowonjezera, antioxidants ndi maphunziro a multivitamini. Madongosolo onse amakonzedwa ndi adokotala. Kudziyendetsa nokha pakumwa mankhwala ndikusinthira njira yamankhwala sikuvomerezeka.

Kuzungulira kozungulira

Mawu achipatala awa amatanthauzira ngati magazi akuyenda mu zotumphukira za miyendo limodzi ndi nthambi zina. Kukula kwa kufalikira kotsalira kumadalira:

• Mapangidwe amitsempha yamagazi akulu ndi akale,
• Dawo, mtundu ndi ngodya ya mapangidwe ndi chotupa chachikulu,
• Vuto la mtima
• Kukula kwa kagayidwe kachakudya njira.

Mitsempha yayikulu yamagazi ndi kugonjetsedwa imatenga gawo la chotchinga chotchinga ndipo amatchedwa mabatani a anatomical (preexisting). Kubwezeretsa magazi moyenera, njira zothandizira kuyendetsa magazi kapena kuchepetsa kunenepa kwa oxygen zimagwiritsidwa ntchito. Kuzindikira mawonekedwe a anatomical kapangidwe ka mabatani kungathandize kudziwa malo enieni a ligature: ndikofunikira kusankha malo omwe ali pansi pa nthambi kuchokera kumtsinje waukulu.

Opaleshoni yam'mimba

Njira yake idakhazikitsidwa ndikumatha kulumikizana kudera lomwe lakhudzidwa. Monga prosthesis, mumagwiritsa ntchito gawo limodzi la minofu yayikulu yamphamvu yokhala ndi miyendo yathanzi kapena kupanga. Kuchita opaleshoni kumatheka pokhapokha mtima ukasiya ndipo wodwalayo amalumikizidwa ndi makina am'mapapu.

Prosthetics

Kuchita kwa ma prosthetics kumagwiritsidwa ntchito ngati mufunika kuchotsa malo omwe chigawocho ndimapazi ndipo chimatchinga magazi. Mano opangira zida amagwiritsidwa ntchito ngati ma prosthetics, ndipo gawo lomwe likukhudzidwa limachotsedwa. Zovala zamakono zimasinthiratu zotengera zachilengedwe ndipo zimapatsa odwala moyo wokwanira komanso wautali.

Njira zopumira

Opaleshoni yam'mimba imasiyanitsidwa ndikuti maopareshoni amachitidwa kudzera ma incaring ang'onoang'ono (mpaka 4 mm). Nthawi ya opareshoni imayendetsedwa ndi njira za x-ray, ndipo kupatula kwake ndikuti madokotala othandizira amatha kuchita chithandizo popanda opaleshoni yodziwika bwino. Ntchito izi zimaperekedwa kwa odwala omwe OASNK imayendera limodzi ndi zovuta zovuta.

Kukonzanso

Mu nthawi ya postoperative komanso pofotokoza mankhwala othandizira, ndikofunikira kuti mukhale ndi moyo wathanzi:

• Siyani kusuta ndi mowa,
• Yambitsani zolimbitsa thupi zoyenera,
• Kuchepetsa thupi
• Idyani wathanzi,
• Sinthani mulingo wamchere wamadzi.

Gawo lofunika kwambiri pakuchira ndikutsatira zomwe adotolo adachita ndikukhala momasuka pamalingaliro. Nthawi zina, kuyankhulana ndi katswiri wama psychologist kumayendetsedwa kuti athandize wodwalayo ndikulimbikitsa kusintha kwa zochitika.

Physiotherapy

Kuthandiza OASNA ndi mankhwala okha sikokwanira. Gawo lofunika la chithandizo ndi physiotherapy. Njira zopaka massage cholinga chake ndi kukonza kayendedwe ka madzi amthupi ndi masanjidwe am'mimba. Masewera olimbitsa thupi a atherosulinosis a ziwiya zokhala m'munsi amasiyana amasankhidwa ndi adokotala omwe amawaganizira kutalika ndi kulemera kwa wodwalayo, gawo lazomwe zimayambitsa matenda a m'badwo ndi zaka. Kuchita zolimbitsa thupi zochizira atherosclerosis ya m'munsi malekezero kumathandizanso kukulitsa zotanuka minofu minofu, kusintha mgwirizano ndi kupirira.

Mwa njira zowonjezera, electrophoresis, magnetotherapy kapena darsonvalization ndi omwe amapatsidwa. Njirazi zimakonza makonzedwe a mankhwala, ochita ngati ma pulsed mafunde ndi maginito. Zotsatira za maphunzirowa ndi kusintha kwa kayendedwe ka magazi, anti-yotupa ndi antibacterial, kukhazikika kwa mawonekedwe amitsempha yamagazi.

Kuthana ndi atherosulinosis ya malekezero am'munsi si chiganizo. Ndi chithandizo choyenera ndikutsatira malingaliro a madokotala, matendawa amatha kugonjetsedwa. Komabe, wodwalayo ayenera kutsatira zakudya zapadera, azichita masewera olimbitsa thupi ndikuwongolera momwe akumvera. Kuti mupewe zotsatira zoyipa komanso zoopsa, ndi zovomerezeka kudzizindikira ndikugwiritsa ntchito mankhwala achikhalidwe popanda chilolezo cha dokotala.