Mitsempha yam'mimba > Matenda a shuga ndi impso

Mitsempha yam'mimba yam'mimba ndi matenda omwe amayamba chifukwa chopendekera kapena kutsekeka kwa mitsempha ya impso. Zambiri kuchokera ku kafukufuku wamatenda akuwonetsa kuti matenda am'mimba amapezeka mu 6.8% ya anthu azaka 65 ndi kupitirira. Choopsa cha matenda a m'mitsempha ndikuti mu 73% ya milandu yokhala ndi chilengedwe chake kwa zaka zisanu ndi ziwiri, odwala amafa.

Zomwe zimayambitsa matenda a renal Artery Stenosis
Zizindikiro za Renal Artery Stenosis
Kupeza matenda a impso
Chithandizo cha aimpso a stenosis
Kuzindikira kwa aimpso stenosis

Odwala omwe ali ndi aimpso a stenosis, magazi amayenda ku impso movutikira kwambiri komanso mocheperako kuposa momwe amafunikira, zomwe zimayambitsa kuwonongeka mu kusefera komanso kuwonjezeka. Mavuto oyenda ndi magazi amayambitsanso impso. Ngati matendawa sanalandiridwe kwa nthawi yayitali, impso imafooka ndipo singathe kugwira ntchito zake. Matendawa amawononga thanzi la wodwalayo: Kusintha kwa mahomoni kumasokonekera, mapuloteni amatayika, kuchuluka kwa magazi kumasinthasintha, ndipo mkhalidwe wa zotengera ukuwonongeka.

Zomwe zimayambitsa matenda a renal Artery Stenosis

Mwa zina mwa matenda omwe amayambitsa stenosis a mitsempha ya impso, atherosulinosis ndi fibromuscular dysplasia.

Atherossteotic, ndiye kuti, limodzi ndi mapangidwe a mitsempha zigawo Tizilombo tating'onoting'ono tomwe timatulutsa kukhoma, kafungo ka minyewa ya m'mimba nthawi zambiri timagwirizana ndi matenda a shuga, matenda a mtima, kapena matenda oopsa.

Pankhaniyi, mapepala nthawi zambiri amakhala okhazikika mu dera la aortic, lomwe limakhala ndi zotsatirapo zoyipa kwambiri kwa wodwala.

Fibromuscular dysplasia monga chifukwa cha stenosis, nthawi zambiri imakhala ndi chikhalidwe cha cholowa ndipo imakonda kwambiri azimayi azaka 30-45. Matendawa ndi kukula kwa minyewa kapena minyewa ya minofu yophimba makoma amitsempha.

Nthawi zina, aimpso mtsempha wamagazi stenosis imatha kuyambitsa aneurysms, arteriovenous shunts, nonspecific aortoarteritis, thrombosis kapena embolism wa aimpso mitsempha, kukakamizidwa kwa aimpso ziwonetsero ndi achilendo thupi kapena chotupa, nephroptosis.

Zizindikiro zomwe zimayambitsa kukanika kwa aimpso stenosis makamaka:

kuthamanga kwa magazi
kulephera kwa aimpso
kuchepa kwa impso imodzi kapena zonse ziwiri.

Malinga ndi ziwerengero, omwe akuganiza kuti a impso artery stenosis, kuthamanga kwa magazi (ana oopsa) mwa anthu ochepera zaka 50 kumawonetsa, monga lamulo, dysplasia ya fibromuscular, ndi odwala omwe ali ndi zaka zopitilira 50, atherosulinosis ya mitsempha ya impso.

Ngati stenosis ya mitsempha ya impso imayambitsa kulephera kwa aimpso, ndiye kuti izi zitha kuwonetsedwa ndi kupweteka kosakhazikika m'dera lumbar, ndipo mu gawo lotsogola, kulowetsedwa kwa impso.

Ndi kuphatikiza kwa aimpso a stenosis ndi atherosulinosis m'matumbo ena kapena, mwachitsanzo, nonspecific aortoarteritis, ischemia (kusowa kwa magazi) kwam'mimba, matumbo akumtunda komanso apansi amatha.

Kuzindikira ndi kuchiza aimpso a stenosis

Kuzindikira a impso artery stenosis mu dipatimenti ya phlebology yachipatala cha MedicCity, kuyezetsa magazi kwa biochemical, kuyesa kwa impso, kuphatikiza ma ultrasound dopplerography ndikusanthula kwa mitsempha ya impso, zida za X-ray (monga, makamaka urology ndi renal angiography).

Ndi matenda a a impso a stenosis, mankhwala nthawi zambiri amathandizira mu chilengedwe ndipo chithandizo cha opaleshoni chimasonyezedwa.

Mtundu wofala kwambiri wa kulowerera kwa aimpso stenosis chifukwa cha fibromuscular dysplasiaballoon endovascular kuchepa kwamphamvu kwa mafupa a impso.

At atherosulinotic a retery artery stenosis pa mankhwalawa angagwiritsidwe ntchito:

mng'oma (mapa, masentic, maphiri)
aimpso mtsempha wamagazi.

Nthawi zina, kusanthula kwa gawo lamkati la minyewa ya m'magazi ndi kugwirizananso kwa msempha, kugwiritsa ntchito kwa anastomosis, kapena kupindika kwa minyewa ya m'magazi kochitidwa ndi mtima.

Mitsempha yam'mimba yam'mimba chifukwa cha nephroptosis, nthawi zambiri imafuna kukhazikitsidwa kwa nephropexy.

Ngati ndizosatheka kuchita ntchito yobwezeretsa (kubwezeretsa), madokotala - opaleshoni ya mtima amatembenukira ku nephrectomy.

Tikukulimbikitsani kuti mumasanthula mtima ndi mitsempha ya magazi nthawi zonse kuti mupewe matenda akulu ndi zovuta zawo. MedicCity imapereka njira zowerengera, zowunikira komanso kuchitira matenda a mtima pogwiritsa ntchito njira zapamwamba kwambiri. Kulandila kumachitika ndi akatswiri odziwa bwino zikhalidwe zapamwamba.

Ogwira ntchito pakati panu adzakupatsani chidziwitso chofunikira pa mafunso anu onse.

Mutha kugwiritsanso ntchito mafomu omwe ali pansipa kufunsa funso kwa katswiri wathu, kuonana ndi a chipatalacho kapena kupempha kuti mudzabwerenso. Funsani funso kapena sonyezani vuto lomwe mungafune kulumikizana nafe, ndipo posachedwa tidzakulumikizani kuti mudziwe zambiri.

Atherosulinosis

Nthawi zambiri, stenosis wa aimpso minyewa amakhumudwitsa atherosulinosis. Mawuwa amatanthauza njira yophatikizira zolembera kuchokera ku cholesterol, mafuta ndi calcium m'mitsempha yama impso, yomwe imayambitsa kuchepa. Chiwopsezo chotenga matendawa chimawonjezeka ndi zaka. Pangozi ndi odwala omwe ali ndi zotupa za m'mabala, ochepa matenda oopsa, komanso zotupa zam'msempha. Izi matenda amadziwika ndi kugonjetsedwa kwa gulu limodzi la zotengera chifukwa cha stenosis, sclerosis, kuwonongeka kwa mitsempha, zovuta za atherothrombotic. Nthawi zambiri, stenosis imakhala m'magawo a mitsempha ya impso pafupi ndi msempha, m'magawo apakati, pamalo omwe amapezeka mitsempha yamitsempha yamagazi, m'magawo a distal reasis.

Nephrological matenda

Nephrological pathologies nthawi zambiri imayambitsa matenda a stenosis. Matendawa amaphatikizapo aneurysms, hypoplasia, occlusion ndi kunja kukakamiza kwa aimpso, vasculitis, thrombosis, nephroptosis, arteriovenous shunts.

Madokotala amazindikiranso zinthu zingapo zomwe zimayambitsa matendawa. Izi zikudziwikiratu:

kusuta
kuperewera kwa zakudya m'thupi (kuchuluka kwa zakudya zokhala ndi shuga, mafuta ndi mafuta m'thupi kwambiri),
kunenepa
chibadwa
matenda a impso
kuchuluka kwa shuga m'magazi ndi cholesterol,
ukalamba.

Zizindikiro za Renal Artery Stenosis

Kuunika kwathunthu ndi nephrologist ndi kwa odwala omwe akhudzidwa ndi izi:

Kulephera kwamkati - kumawonekera chifukwa cha kuwonongeka kwa impso, komwe kumachitika pang'onopang'ono m'magazi awo chifukwa cha kuchepa kwa mitsempha m'mimba mwake.
Kuthamanga kwa magazi, komwe sikungathe kuchepetsedwa ndi kupezeka kwa mankhwala a antihypertensive.
Maonekedwe a phokoso omwe amatha kuwoneka mukamayang'ana pamimba ndi stethoscope.
Kuchulukitsa kwa kuthamanga kwa magazi (kwambiri kapena pang'ono) mwa odwala omwe ali ndi mbiri ya stroko kapena myocardial infarction.
Kuchulukitsitsa kwa odwala osakwanitsa zaka 30 ndi okulirapo kuposa 50.
Aimpso kuwonongeka pambuyo kumwa antihypertensive mankhwala monga angiotensin receptor blocker kapena angiotensin kutembenuza enzyme inhibitor.

Chifukwa chake, titha kunena kuti a impso artery stenosis imapezeka mwa odwala omwe ali ndi matenda oopsa komanso opuwala aimpso. Zizindikiro zodziwika bwino za matenda a impso stenosis ndi monga: chizungulire, kusokonezeka kwa tulo, kufupika, kupweteka kwam'mimba, kufooka kwa minyewa, kuchepa kwam'mbuyo kumbuyo, kusakhazikika m'maganizo, ntchentche patsogolo pa maso, kutupa m'matumbo, kusanza ndi mseru, kuchepa kapena kukodza pokodza.

Kupeza matenda a impso

Kafukufuku wa Laborator. Kuchulukitsa kwa magazi urea nayitrogeni ndi seramu creatine ndizizindikiro zoyambirira za matenda omwe adotolo amalipira. Pozindikira, kuyesa kwamikodzo kumayesedwanso, komwe kumawonetsa, ngati pali matenda, kusayenda bwino kwamikodzo ndi proteinuria.
Duplex ultrasound ya mitsempha ya impso ndiyo njira yotsika mtengo kwambiri komanso yolondola yodziwira matendawa, yomwe imakuthandizani kuti muone kuyipa kwa stenosis mwakuwunika kuthamanga kwa magazi m'mitsempha. Kukhalapo kwa matenda kukuwonetseredwa ndi kuthamanga kwa magazi, kuthamangitsidwa ndi kupindika kwa mitsempha. Komabe, ziyenera kukumbukiridwa kuti mwa odwala omwe ali ndi kunenepa kwambiri kapena kuwonekera, zotsatira za ultrasound zimatha kukhala zosadalirika.
Scintigraphy ya impso: imagwiritsidwa ntchito kuyerekezera kuphatikizika kwa impso kumanzere ndi kumanja. Njira imeneyi imagwiritsidwanso ntchito kuyeza kuchuluka kwa kusefera kwa impso.
Magnetic resonance angiography. Njira imeneyi imakuthandizani kuti mupeze chithunzi cha mitsempha yaimpso ndi msempha. Ubwino wa MRI pakuzindikira matenda a stenosis ndi kusagwira kwakeko komanso kuthekera kopeza chithunzi cha mbali zitatu za dera lomwe lakhudzidwa ndi mtsempha. Komabe, njirayi ilinso ndi zovuta: mtengo wokwera kwambiri, kuchuluka kwa zovuta za stenosis, ndi kusatheka mwa njira zina kusiyanitsa stenosis ndi occlusion.
Kusankha aimpso arteriography: kumakuthandizani kudziwa kukula ndi malo a chotupa a mtsempha wamagazi. Wonongetsani ndi kuyambitsa mankhwala a radiopaque.

Chithandizo cha aimpso a stenosis

Poyamba, chithandizo cha aimpso a stenosis amatanthauza kuchotsedwa kwa zomwe zimakhudzidwa. Koma masiku ano pali njira zabwino zochizira matendawa komanso njira zothetsera matendawa.

Chithandizo cha mankhwala osokoneza bongo chimatengera gawo lake:

Gawo loyamba (kuchuluka kwa matenda oopsa). Pakadali pano zamatenda, wodwalayo amakhala ndi thanzi labwino komanso ntchito yofanana ndi impso, kupanikizika kumakhala kwabwinobwino kapena kupitirira malire ake. Kuthana ndi stenosis, dokotala atha kukulemberani mankhwala a antihypertensive kapena okodzetsa.
Gawo lachiwiri (kubwezera). Chithunzi chachipatala cha matenda pakadali pano chimatchulidwa motere: Kupitilira kwa matenda oopsa kumawonekera, kuwonongeka kwa impso, komanso kuchepa kwawo. Wodwala amafunikira chithandizo chokwanira chowayang'aniridwa ndi dokotala.
Gawo lachitatu (kubwezeretsa). Wodwala amakhala ndi matenda oopsa oopsa, omwe sangathetsedwe mothandizidwa ndi mankhwala a antihypertensive, impso zimaleka kugwira ntchito ndikuchepa kwambiri kukula kwake. Popeza thanzi la wodwala limayamba kufooka, chithandizo chake chimachitika kuchipatala.

M'magawo onse a matendawa, madokotala nthawi zambiri amapereka mankhwala kuchokera m'magulu a angiotensin-II receptor blockers ndi ACE inhibitors. Kuchepetsa mafuta m'thupi m'magazi ndikukhazikika pamatenda am'magazi, mankhwala ochokera ku gulu la statins ndi omwe amapatsidwa.

Kuti muthandizidwe ndi matenda a stenosis, kusuta kusiya komanso kuchepa thupi kunenepa kwambiri. Kuphatikiza apo, muyenera kutsatira zakudya zamafuta ochepa, zomwe zingathandize kuchepetsa shuga m'magazi motero kupewa matenda a impso. Kudya koteroko kumathandizanso kuchepetsa magazi m'thupi, komwe kumachepetsa kukula kwa onse atherosulinosis ndi stenosis.

Mankhwala othandizira

Panthawi yovuta, stenosis singachiritsidwe pogwiritsa ntchito njira zosafunikira, motero ndikofunikira kuti muthe kugwiritsa ntchito opaleshoni. Nthawi zambiri, opaleshoni imalembedwa pazisonyezo zotsatirazi: kusakhazikika kwa angina pectoris kapena pulmonary edema pamaso pa hemodynamically stenosis, matenda aimpso kulephera, ochepa stenosis pamaso pa impso imodzi yogwira ntchito, matenda osawerengeka, kupweteka kwa mtima pakati.

Opaleshoni ya Bypass - kupanga njira yina yotaya magazi (kudutsa gawo lomwe latsala ndi mtsempha) pogwiritsa ntchito zikopa.
Angioplasty ndikukulitsa chotengera chochepa mphamvu pakulowetsa bullo.
Kuluma ndiko kufutukula kwa mtsempha wama impso pogwiritsa ntchito mauna kapena masentimita, omwe amayikidwa mkati mwa chotengera, potero kukulitsa ndi kusintha magazi.
Kuyambiranso kwa malo am'mtsempha - kuchotsa kwa dera lomwe lakhudzidwa ndi mtsempha.
Prosthetics ndi ntchito yomanganso yomwe nthawi zambiri imachitika pambuyo pakutsalira kwa aimpso. Amauzidwa kuti abwezeretse magazi moyenera ndi ma cell a impso.
Nephondolaomy ndi njira yochizira matenda, yomwe imaphatikizapo kuchotsa kwathunthu kwa zomwe zakhudzidwa.

Kuzindikira kwa aimpso stenosis

Kuchiza matenda mosapatsirana kumatha kubweretsa mavuto monga stroko, aimpso ndi mtima, mtima wamitsempha. Pankhani ya chithandizo chanthawi yake, pomwe matendawa sanadutsebe mu gawo lovuta, kudalirika kwa wodwalayo ndikabwino. Zimatenga miyezi isanu ndi umodzi kuti muchiritse bwino matenda a stenosis.

Pofuna kupewa a impso stenosis:

kumayesedwa kamodzi pachaka kuti muwonetsetse kuti ntchito ya impso ndi kuthamanga kwa magazi ndizabwino,
idyani moyenera - konda nyama, zipatso, chepetsa mchere, zakudya zam'chitini, maswiti, ma tchipisi, tchipisi, batala, mafuta anyama ndi mkaka,
masewera olimbitsa thupi pafupipafupi
kukhala ndi thanzi labwino
kusiya mowa ndi kusuta,
Pewani kupsinjika mtima
masewera olimbitsa.

Zambiri

Renal artery stenosis ndi imodzi mwazovuta kwambiri mu urology wamakono. Pathology imayamba chifukwa chosinthika komanso kukhala ndi masinthidwe amitsempha yamagetsi, zomwe zimapangitsa kuchepa kwa magazi aimpso komanso kukula kwa matenda oopsa a nephrogenic. Mosiyana ndi matenda a parenchymal omwe amayamba chifukwa cha matenda oyamba a impso (glomerulonephritis, pyelonephritis, nephrolithiasis, hydronephrosis, polycystosis, zotupa, cysts, chifuwa chachikulu cha impso, etc.

Matenda oopsa obwera chifukwa cha mafupa am'mimba komanso am'mimba am'mitsempha yamagazi amalembedwa mu 10-15% ya odwala ofunikira komanso 30% omwe ali ndi matenda oopsa a nephrogenic. Matendawa atha kukhala limodzi ndi mavuto owopsa m'moyo: mtima kulephera, kugunda, kupunduka kwa mtima, kuchepa kwaimpso.

Zomwe zimayambitsa matenda a impso artery stenosis ndi atherosulinosis (65-70%) ndi fibromuscular dysplasia (25-30%). Atherosulinotic stenosis imapezeka mwa amuna a zaka zopitilira 50 zaka 2 kawiri kuposa akazi. Nthawi yomweyo, malo opezeka atheromatous amatha kupezeka m'magawo a mitsempha ya impso pafupi ndi aorta (mu 74%), mkati mwa zigawo zam'magazi (mu 16%), m'dera la masinthidwe amitsempha yamagazi (mu 5%) kapena munthambi za malo amitsempha yama impso (mu 5%) . Zilonda zam'mimba za mitsempha yaimpso makamaka zimayamba kutsutsana ndi maziko a matenda oopsa a shuga, matenda oopsa am'mimba, ischemic matenda a mtima.

Matenda a chifuwa chifukwa cha kubadwa kwa gawo lina la mafupa am'mimba (fibrous kapena minofu kukula kwa nembanemba yamitsempha) imatha kupezeka kawiri mwa akazi akulu kuposa zaka 30 mpaka 40. Nthawi zambiri, chotupa chakumaso chimakhazikika pakatikati pa mtsempha wama impso.Malinga ndi mawonekedwe a morphological ndi arteriographic makhalidwe, okwanira, amisala ndi peromedial fibromuscular dysplasia amadziwika. Mitsempha yamkati ya m'mimba yomwe imagwira minyewa ya m'mimba imakhala ndi kutulutsa kwapawiri.

Pafupifupi 5% ya nthendayi, nthendayi imayambitsidwa ndi zifukwa zina, kuphatikizapo ochepa anurysms, arteriovenous shunts, vasculitis, matenda a Takayasu, thrombosis kapena embolism of the renal artery, compression of the impso cell kuchokera kunja ndi thupi lakunja kapena chotupa, nephroptosis, coarctation kwa msempha, etc. imayendetsa makina ovuta a renin-angiotensin-aldosterone system, yomwe imayendetsedwa ndi matenda aimpso okhazikika.

Real artery stenosis imadziwika ndi ma syndromes awiri: ochepa ochepa oopsa komanso ischemic nephropathy. Kukula kofulumira kwa matenda oopsa osapitirira zaka 50, monga lamulo, kumatipangitsa kuti tilingalire za dysplasia ya fibromuscular, ndi odwala omwe ali ndi zaka zopitilira 50 - za atherosranceotic stenosis. Matenda oopsa a arterial ndi matenda amtunduwu amatsutsana ndi antihypertensive mankhwala ndipo amadziwika ndi kuthamanga kwa magazi a diastolic, mpaka 140-170 mm RT. Art. Zovuta zamankhwala oopsa zomwe zimapangitsa vasorenal kuchepa kwa magazi ndizosowa.

Kukula kwa matenda oopsa nthawi zambiri kumayendera limodzi ndi zizindikiro zam'matumbo - kupweteka mutu, kutentha kwambiri, kulemera m'mutu, kupweteka m'maso, tinnitus, "kuthina" kutsogolo kwa maso, kusokonezeka kukumbukira, kugona tulo, kusokonekera. Kuchuluka kwa mtima wamanzere kumathandizira kuti pakhale kulephera kwa mtima, komwe kumawonetsedwa ndi ululu wamkati, kupweteka mumtima, kumverera kokhazikika kumbuyo kwa sternum, kufupika kwa mpweya. Mukudwala kwambiri stenosis, mapangidwe a m'mapapo amino amatha kupezekanso.

Matenda oopsa a Vasorenal amakhala m'magawo. Mu gawo la chindapusa, standardotension kapena kuchuluka kwa ochepa matenda oopsa, okonzedwa ndi mankhwala, amawonedwa, impso imakhalabe yolimba. Gawo la kubwezeredwa kwapachibale limadziwika ndi matenda oopsa a magazi, kuchepa kwapakati pa ntchito yaimpso ndi kuchepa pang'ono kukula kwake.

Mu gawo lowongolera, matenda oopsa kwambiri amakhala okhathamira, okana mankhwala a antihypertensive, ntchito za impso zimachepetsedwa, kukula kwa impso kumachepetsedwa mpaka 4 cm. Matenda oopsa a arterial amatha kukhala ovulaza (kuyambitsa mwachangu komanso kupitirira patsogolo kwathunthu), ndikulepheretsa kwakukulu kwa ntchito yaimpso komanso kuchepa kukula kwake impso za 5 kapena kuposa cm.

Nephropathy imawonetsedwa ndi zizindikiro za ischemia ya impso - kumverera kolemetsa kapena kupweteka kwapansi kumbuyo, ndi kulowetsedwa kwa impso - hematuria. Nthawi zambiri hyperaldosteronism yachiwiri imayamba, yodziwika ndi kufooka kwa minofu, polyuria, polydipsia, nocturia, paresthesias, ndi tetany.

Kuphatikizika kwa aimpso stenosis ndi kuwonongeka kwa ma dothi ena amitsempha yamagazi (ndi atherosulinosis, nonspecific aortoarteritis) kungakhale limodzi ndi zisonyezo za ischemia zam'munsi kapena zapamwamba, ziwalo zam'mimba. Kupita patsogolo kwa zamatenda kumabweretsa zovuta zowopsa zam'mimba komanso aimpso - retinal angiopathy, ngozi yovuta kwambiri yamatenda, infarction ya myocardial, ndi kulephera kwa aimpso.

Zotsogola ndi kupewa

Mankhwala othandizira aimpso a stenosis amalola kusintha kwa magazi mu 70-80% ya odwala omwe ali ndi dysplasia ya minofu ya 50-60% ndi atherosclerosis. Nthawi ya postoperative matenda a kuthamanga kwa magazi imatha kutenga miyezi isanu ndi umodzi. Pofuna kuthana ndi zotsalira zamagazi, mankhwala oletsa antihypertgency ndi omwe amapatsidwa. Odwala amalimbikitsidwa kuyang'aniridwa ndi nephrologist ndi mtima. Kupewa kumatengera kuzindikira kwakanthawi ndi chithandizo cha matenda omwe amatsogolera pakukula kwa stenosis.

Zambiri ndi code ya ICD-10

Arterial stenosis imatanthawuza kupendekera kwamitsempha imodzi kapena zingapo zamitsempha yamagazi kamodzi, kapena nthambi zake, zomwe zimayendera limodzi ndi kuchepa kwa impso ya impso. Oddlyly, koma matenda awa amatengedwa kuti ndi amodzi ovuta kwambiri osati mu nephrology ndi urology, komanso mu mtima.

Mwa munthu wathanzi, magazi amasefedwa ndi impso, chifukwa mkodzo woyamba umapangidwa, kachulukidwe kamene kamakhala kofanana ndi kachulukidwe ka magazi, ndipo pakukhavula, kuchuluka kwa magazi omwe amalowa mchiberekero kumacheperachepera, ndipo kumasefedwa kwambiri, ndiye chifukwa chake munthuyo akuwonjezera magazi.

Stenoses imasankhidwa malinga ndi malo:

wamanzere
kumanja
mayiko awiri.

Matendawa alandila nambala yake molingana ndi MKD - I15.0 -renovascular hypertension.

Zomwe zimachitika

Choyambitsa chachikulu cha matenda (mu milandu 7 mwa 10) ndi mawonekedwe a atheromatous malo a zipupa za mitsempha. Zina zomwe zimayambitsa matendawa ndi:

fibromuscular dysplasia (yobadwa mwatsopano kapena yotenga),
kuvulala kwa impso
kusintha kokhudza ziwalo
onenepa kwambiri
matenda ashuga.

Mitsempha yamagazi ikatha kumasuka, imakumana ndi vuto la oxygen, zomwe zimapangitsa kuti zinthu zisinthe ndipo amasiya kusefa.

Stenosis chifukwa cha kupezeka kwa zolembedwa za atherosulinotic ndizowopsa zomwe zimakhudza amuna kuposa akazi. Koma dysplasia ya fibromuscular imakhala chifukwa chachikulu cha matendawa makamaka mwa akazi okulirapo zaka 40.

Pali matenda ena angapo omwe amachititsa kuti izi zichitike (pafupifupi 5% ya 100%):

mhalidwe wam'mbuyo,
vasculitis
Matenda a Takayasu
aimpso mtsempha wamagazi,
chotengera cha kunja chotengera
nephropotosis.

Mosasamala zomwe zidayambitsa matendawa, zimayambitsa kusokonezeka kwa kayendedwe ka magazi ndikuwonongeka kwa ziwalo zamkati.

Zizindikiro

Kwa stenosis ya mitsempha ya impso, zizindikiro ziwiri zazikulu ndizodziwika - matenda oopsa ndipo ischemic nephropathy.

Yoyamba imaphatikizidwa ndi kupweteka mutu, kusasangalala m'maso, tinnitus, mawonekedwe a "nyenyezi" kutsogolo kwa maso, kufooketsa kukumbukira, kusokoneza tulo, kusokonekera.

Chifukwa chophwanya magwiridwe antchito a mtima, kumakhala kuwonjezeka kwa kugunda kwa mtima, kumva kukakamira kumbuyo kwa chifuwa kumachitika, kupuma movutikira kumawonekera. Komanso, odwala amatha kupweteka kumbuyo, hematuria, kukomoka kumatha kuoneka.

Zizindikiro m'magawo osiyanasiyana

Matenda mukukula kwake amapita pamiyeso ingapo, iliyonse yomwe imakhala ndi zizindikiro zake.

Gawo loyambirira limadziwika ndi kusungidwa kwa impso, wodwalayo amawonetsa kuchuluka kapena kuthamanga kwa magazi, komwe kungasinthidwe ndi mankhwala.
Gawo la subcomproll limawonetsedwa ndi vuto laimpso, ochepa matenda oopsa amakhala okhazikika. Ziwalo zamkodzo zomwezo zimatha kuchepa pang'ono kukula.
Kubwezera - kutchulidwa kuti aimpso kulephera kumawonekera, matenda oopsa oopsa amakhala okhwima, ovuta kuchiritsa, chiwalo chokhazikika chimatha kuchepa kukula mpaka 4 cm.
Gawo lothandizira - matenda oopsa amakhala ovulala, kuthamanga kwa magazi kumafika magawo 250-280 ndipo sikungathandize kuti mankhwalawa athandizike. Chiwalo sichimagwira ntchito zake, kukula kwake kumatha kutsika kuposa 5 cm.

Kulephera kwa impso, kumakhala gawo lomaliza la matendawa, wodwalayo amakhala ndi zizindikiro za kuledzera - mseru komanso kusanza, kupweteka mutu, kutupa. Odwala oterewa amakonda kupena chibayo, kutupa kwam'mimba.

Ndani angalumikizane ndi momwe mungazindikirire

Ngati pali zisonyezo zomwe zikuwonetsa impso ndi impso, choyamba ndikofunikira kukaonana ndi othandizira, ngati atenga anamnesis, adokotala akuwonetsetsa kuti zizindikiro za matendawa zikukamba za matenda a impso, ndiye kuti wodwalayo azilangizidwa kuti akafunso kwa urologist kapena nephrologist.

Kuti mupewe matenda a pathologist, ndikofunikira kuchita maphunziro ena apadera, kuphatikiza njira izi:

Ultrasound a impso ndi pamimba
Dopplerometry
CT angiography
arteriography
urology
PET
scintigraphy,

Kuphatikiza pa maphunziro apadera kwambiri, wodwalayo amakumananso ndi mayeso ena, cholinga chake chachikulu ndicho kudziwa zomwe zimayambitsa matenda a stenosis:

kuyezetsa magazi ndi zamankhwala osiyanasiyana,
urinalysis
electrocardiography
mafuta.

Njira zonse zodziwikiratu zimasankhidwa ndi dokotala aliyense payekhapayekha, kutengera zisonyezo zake.

Mankhwala othandizira

Posachedwa, njira yokhayo yomwe imagwiritsidwa ntchito pochiza matenda a impso stenosis imawonedwa ngati opaleshoni - ndiye kuti impso yowonongeka idachotsedwa.

Asanayambe chithandizo, wodwalayo amalangizidwa kusiya kugwiritsa ntchito mchere, mowa ndi kusuta, kuwonjezera apo, ngati wodwalayo ndi wonenepa kwambiri, ndiye kuti choyamba ayenera kuchepetsa thupi.

Njira zachipatala

Ndi matenda awa, mankhwala a mankhwala ndiwothandiza kwambiri, sangathe kuthetsa chomwe chimayambitsa matenda oopsa ndipo ischemia impso.

Choyamba, ndikofunikira kusintha kukakamiza, chifukwa izi ndizofanana ndi za antihypertensive ndi diuretics ndi blockers zimagwiritsidwa ntchito. Mukamagwiritsa ntchito mankhwalawa, ndikofunikira kuwongolera ntchito ya ziwalo zamkodzo kuti chithandizo chisawakhumudwitse.

Chifukwa chake Captopril ikhoza kugwiritsidwa ntchito, nthawi zambiri mankhwalawa ndi 6.25-12,5 mg katatu patsiku, ngati kuthinikizidwa sikunabwerere kwawokha mkati mwa sabata, mlingo umachulukitsidwa mpaka 25 mg 4 pa tsiku.

Mankhwalawa sangathe kugwiritsidwa ntchito mwa odwala omwe ali ndi matenda osokoneza bongo komanso kulephera kwamtima. Zikatero, zotsatirazi zingagwire ntchito:

Cardioselective beta-blockers (Egiloc pa mlingo wa 100 mg patsiku, m'malo ovuta kwambiri, kuchuluka kwa 200 mg ndikololedwa).
Ochepetsa calcium blockers (nifedipine mpaka 20 mg patsiku),
Loop diuretics (Furosemide - mlingo uliwonse umasankhidwa payekhapayekha),
Imidazoline receptor agonists (Moxonidine 0,2-0.6 mg patsiku, kutengera malangizo a dokotala).

Panthawi ya kusankha kwa mankhwalawa, ndikofunikira kuyang'anira kuchuluka kwa creatinine ndi potaziyamu m'magazi a wodwala.

Kwa odwala omwe ali ndi atherosclerotic stenosis, ma statin amafunikira kuti muchepetse cholesterol, mwachitsanzo:

Atoris: kudya kwambiri kumayamba ndi 10 mg patsiku, mlingo waukulu ndi 80 mg,
Rosucard: Mlingo wochokera pa 5 mpaka 40m patsiku, osagwiritsidwa ntchito pakulephera kwa impso,
Liptonorm: mlingo malinga ndi momwe wodwalayo alili 10 mpaka 40 mg patsiku.

Kusankha kwa mankhwala ndi Mlingo uliwonse umasankhidwa payekhapayekha, poganizira kusefera, mwina impso.

Odwala omwe ali ndi matenda a shuga amatha kupatsidwa insulin.

Kuthandizira opaleshoni

Ngati lumen ya chotengera imachepetsedwa ndi oposa 65%, ndiye kuti chithandizo chamankhwala sichingakhale ndi zotsatira zabwino, njira yokhayo yobwezeretsanso magazi ku impso ndikuchita opaleshoni. Kuphatikiza apo, zomwe zikuwonetsa opaleshoni ndi:

mawonedwe ofunika kwambiri amitundu,
pakuchitika kuti matenda akupezeka mu impso imodzi yomwe imagwira ntchito,
stenosis yomwe imatsogolera ku matenda oopsa osagwirizana.

Ngati wodwala wapezeka ndi strenosis stenosis, balloon angioplasty ndiyo njira yothandizira kwambiri - ndiye kuti, kuyambitsa buluku lapadera kudzera mu mtsempha wamagololo m'chigawo cholumikizira mtsempha, komwe kumapanga pang'onopang'ono, komwe kumapangitsa kukula kwa mtsempha.

Njira yofinya imatha kugwiritsidwanso ntchito - pogwiritsa ntchito balloon catheter, stent (microtubule) imabwera ndikubweretsa malo ofunikira chombo, ndiye kuti baluniyo imakulira ndipo stent imakanikizidwa kukhoma la chotengera, ndikukhalabe lumen mtsogolomo.

Nthawi zina wodwala amakumana ndi mafupa am'mitsempha, pomwe malo okhudzidwanso amapangidwanso, opaleshoni iyi imachitika pambuyo poti dera lomwe lakhudzidwalo la chotengera - chikhazikitso chapadera chimagwiritsidwa ntchito kubwezeretsa magazi mu chiwalo ngati ntchito yachitika kale.

Ngati ziwiya zambiri zakhudzidwa, ndipo chiwalo chasiya kugwira ntchito, ndiye kuti chimachotsedwa.

Zambiri pa Renal Artery Stenosis

Mtsempha wam'mimba umakhala wochepetsedwa ndi lumen ya chotengera, chifukwa cha zovuta zosiyanasiyana zam'mitsempha. Matendawa amatchedwa nephropathic pathologies. Mitsempha yama cell ndi mitsempha yayikulu yomwe imapereka magazi ku ziwalo zathupi. Ndi stenosis, amachepera m'mimba mwake. Zotsatira zake, magazi omwe amaperekedwa kwa impso amasokonezeka. Izi zimabweretsa zovuta zazikulu monga yachiwiri yokhudzana ndi matenda oopsa, kulephera kwa impso. Pali njira ziwiri zoyambitsira stenosis. Zina mwa izo ndi:

Njira ya Atherosulinotic. Amawonedwa mwa ambiri mwa odwala omwe ali ndi matenda awa. Njira yofananira yopangira stenosis ndi kufalikira pang'onopang'ono kwa lumen kwa chotengera ndi zolembera za cholesterol. Nthawi zambiri kwambiri occlusion yamatumbo imadziwika mu ukalamba.
Fibromuscular dysplasia. Izi zofunikira pakukula kwa matenda a pathology sizachilendo. Itha kuchitika pakati pa azimayi azaka zapakati, komanso pakati pa atsikana ang'ono. Dysplasia minofu ndi vuto lobadwa nalo.

Pambuyo pofunsidwa mwaukadaulo ndi pomwe angadziwe matenda a impso. ICD ndi gulu la ma pathologies omwe amagwiritsidwa ntchito padziko lonse lapansi. Mulinso matenda ambiri, omwe ali ndi nambala yakeyake. Real stenosis imatsekedwa m'njira ziwiri, kutengera zomwe zachitika. Njira imodzi ndi nambala I15.0, yomwe imatanthawuza "kukonzanso kwamphamvu kwa magazi." Khodi ina ya ICD ndi Q27.1. Imayimira "kubadwa kwatsopano kwa matenda a impso." Zonsezi ziwiri zimafunikira chithandizo ndi dokotala wa urologist kapena opaleshoni ya mtima.

Ral Artery Stenosis: Zomwe zimayambitsa Pathology

Kuchepetsa kwa lumen ya zotumphukira m'mitsempha kumatanthauza matenda a mtima. Pali zifukwa zingapo za stenosis. Chodziwika kwambiri mwa izi ndi atherosulinosis. Monga mukudziwa, nthawi zambiri zimawonedwa mwa anthu onenepa kwambiri, omwe amakhala moyo wongokhala kapena wodwala matenda ashuga. Atherosulinosis imatha kukula pakapita nthawi. Komabe, sizipezeka kawirikawiri mpaka zizindikiro za mitsempha yolumikizana. Zomwe zimayambitsa stenosis ndizophatikiza:

Fibromuscular dysplasia. Mawuwa amatanthauza chibadwa chobadwa nacho chomwe chimapangitsa kuti minyewa isamapange khoma la chotengera. Pathology imawonedwa mwa akazi azaka zilizonse.
Chidziwitso cha mitsempha ya impso.
Zingwe zama chotumphukira.
Congenital komanso anapeza vasculitis.
Kuphatikizika kwa mtsempha wama impso ndi neoplasms ochokera ku ziwalo za oyandikana nawo.

Zomwe zalembedwera zimapezeka kawirikawiri. Chifukwa chake, amapezeka pokhapokha atasankhidwa mu atherosulinosis.

Limagwirira chitukuko cha matenda oopsa

Chizindikiro chachikulu cha stenosis ya mitsempha ya impso ndi kuwonjezeka kwa kuthamanga kwa magazi. Chifukwa chake, ndi matenda amtunduwu, kuunika kwa impso ndikofunikira. Kodi matenda a mitsempha ya impso amagwirizana bwanji? Njira ziwiri zimathandizira pakuwonjezera kuthamanga kwa magazi:

Kachitidwe ka renin-angiotensin. Mothandizidwa ndi zinthu zachilengedwe izi, kupendekera kwa arterioles kumakula. Zotsatira zake, kukana kwa zotumphukira kumawonjezeka. Chifukwa chake, kuthamanga kwa magazi m'mitsempha kumakwera.
Zochita za aldosterone.Hormone iyi imapangidwa mu adrenal cortex. Nthawi zambiri, limakhalapo mthupi. Komabe, ndi artery stenosis, kapangidwe kake kamachuluka. Chifukwa cha kuchuluka kwa aldosterone, madzi amadzimadzi ndi sodium amadziunjikira m'thupi. Izi, zimapangitsanso kuchuluka kwa magazi.

Chifukwa cha matenda oopsa oopsa, kusintha kumachitika m'mbali mwa mtima. Kumanzere kwamitsempha pang'onopang'ono hypertrophies ndikutambasuka. Ichi ndiye chifukwa china choopsa.

Kusiyanitsa mitundu

Popeza kuti hypertensive syndrome ikuwongolera, aimpso mtsempha wamagazi umasiyanitsidwa ndi mtima pathologies, aortic atherosclerosis. Zizindikiro zimatha kufanananso ndi matenda a Itzingo-Cushing ndi pheochromocytoma.

Ngati zizindikiro za ischemic nephropathy zilipo, ndiye kuti stenosis imasiyanitsidwa ndi zotupa za impso. Izi zimaphatikizapo pyelo- ndi glomerulonephritis. Komanso, zofananira zimawonedwa ndi kuphatikizika kwa matenda ashuga.

Conservative mankhwala aimpso mtsempha wamagazi

Chithandizo cha aimpso mtsempha wamagazi stenosis amayamba ndi njira zosakhazikika. Ndi matenda oopsa oopsa omwe amayamba chifukwa cha kuchepetsa ziwongo, kuphatikiza kwa mankhwala angapo ndikofunikira. Angiotensin otembenuza enzyme zoletsa amasankhidwa. Koma mankhwalawa ali osavomerezeka chifukwa cha zotupa zamatenda zam'mimba. Kuphatikizikako kumakhala ndi magulu otsatirawa a mankhwala:

Beta blockers. Izi zikuphatikiza mankhwala "Metoprolol", "Coronal", "Bisoprolol".
Zojambula zotuluka m'miyendo. Mankhwala osankhidwa ndi mankhwala a Furosemide.
Calcium calcium blockers. Pakati pawo pali mankhwala "Verapamil", "Diltiazem".

Kuphatikiza apo, wodwalayo ayenera kumwa mankhwalawa omwe amafunika pochizira matenda oyambitsidwa ndi matenda a matenda a m'mimba (atherosulinosis, matenda a shuga).

Kuzindikira pambuyo opaleshoni mankhwala a stenosis

Mosasamala kanthu kuti chotupa chake chinali chotani (stenosis ya kumanzere impongo kapena kumanja), matendawo pambuyo pa opaleshoni zimatengera malingaliro a dokotala komanso mkhalidwe wa wodwalayo. Nthawi zambiri, chithandizo cha opaleshoni chimatha kukhala ndi zotsatirapo zabwino. Pambuyo miyezi ingapo, matenda a kuthamanga kwa magazi amapezeka mu 60-70% ya odwala.

Kupewa

Njira zodzitetezera zimaphatikizira kuyang'anira kuthamanga kwa magazi pamaso pa zodandaula za chizungulire komanso tinnitus, kusiya kusuta fodya komanso kumwa mowa. Kupewa kupitilira kwa atherosulinosis, ndikofunikira kutsatira zakudya zapadera za hypocholesterol, kukhala ndi moyo wokangalika. Odwala ena ayenera kumwa mankhwala apadera - ma statins.

Chithandizo cha anthu

Monga mankhwala osokoneza bongo, maphikidwe a wowerengeka sangathe kuchiritsidwa kwa stenosis, komabe, ndizotheka kusintha mkhalidwe wamitsempha yamagazi ndikuchepetsa zizindikiro zamankhwala. Pazifukwa zotere, infusions machiritso, decoctions angagwiritsidwe ntchito.

Makungwa a phulusa. Kuti muchite izi, 200 gr. kutsanulira madzi a cortex 600 ml ndi kuwiritsa pamoto wochepa kwa maola atatu, chakumwa chizikhala 3 tbsp. supuni musanadye.
Garlic. Pogaya magalamu 80 a adyo mu blender, kuwonjezera magalamu 200 a vodika, ndikuumirira masiku 10 mumdima. Tengani madontho 10 kawiri tsiku lililonse musanadye.
Hawthorn ndi duwa lakutchire. Tengani 10 tbsp. l hawthorn ndi 5 tbsp. supuni zakutchire duwa, pogaya ndi kutsanulira malita awiri a madzi otentha. Pindani poto ndi thaulo ndikuyika malo otentha kwa tsiku limodzi. Kupsyinjika, gwiritsani ntchito 1 tbsp. musanadye.

Zachidziwikire, ndizosatheka kuthana ndi stenosis ndi maphikidwe awa, koma mutha kusintha moyo wabwino, zokhazo zomwe mungagwiritse ntchito pochita izi ndi kufunsa dokotala.

Mavuto ndi zotsatirapo zake

Kupezeka kwa matendawa ndiwowopsa kwambiri chifukwa cha zovuta zazikulu. Chifukwa chake zingayambitse:

aakulu ischemia
kulephera kwa aimpso
pulmonary edema,
retinal angiopathy,
vuto la mtima
sitiroko.

Mulimonsemo, wodwalayo akachedwa kupita kwa katswiri ndipo samalabadira zomwe akuwonetsa, ndiye kuti akuwopsa kwambiri.

Chifukwa pali stenosis ya kumanja, kumanzere impso mtsempha wamagulu

Odwala ambiri (pafupifupi 70%) ali ndi atherosulinosis monga chinthu chachikulu cha etiology. Zimakhudza amuna pambuyo 50 mobwerezabwereza kuposa akazi. Kafukufuku wodziwika bwino wa zolembedwa za atherosclerotic ndi nthambi yochokera ku msempha. Mkhalidwe wakumbuyo wa stenosis ndi: matenda oopsa komanso ischemic, matenda a shuga.

Kukula kwa kobadwa nako kwa zigawo zamitsempha kumawonekera, ngati lamulo, mwa akazi pambuyo pa zaka 35. Malo ochepera pamilandu iyi amakhala m'malo apakati. Kuchulukaku kungakhudze umunthu wamkati kapena wapakati wa imodzi, koma nthawi zambiri, mafupa onse a impso.

Zina mwazomwe zimayambitsa ndizambiri:

aortic aneurysm kapena coarctation,
kulumikizana kwachulukidwe (kukula kopitilira muyeso),
Takayasu matenda
zokhudza zonse vasculitis
kufalikira kwa mtsempha wamagetsi wokhala ndi thrombus, embolus,
kukakamiza pa chotupa chotupa,
kusowa kwa impso.

Aortic aneurysm - chimodzi mwazomwe zimayambitsa aimpso a stenosis

Kuperewera kwa magazi kumapangitsa kuti dongosolo la renin-angiotensin-aldosterone liyambe kugwira ntchito. Izi zimatsogolera ku kulimbikira kwamwambo matenda oopsa.

Timalimbikitsa kuwerenga nkhani yokhudza matenda a impso. Kuchokera pamenepo muphunzira za kuopsa kwa nthendayo ndi matenda ake, njira zakuchira ndi zovuta zina.

Ndipo izi ndizambiri pa yachiwiri matenda oopsa.

Zizindikiro zakuyamba kwamatenda

Pozindikira kuthamanga kwa magazi, ndizofunikira nthawi zonse kupatula komwe amachokera, kuphatikizapo chiyambi. Gawo lalikulu la matenda oopsa otere nthawi zambiri amakhala opsinjika kwambiri (otsika). Itha kukulira mpaka 140 - 160 mm RT. Art. pa 90 %. Matenda oopsa a mphuno nthawi zambiri samabweretsa mavuto ndipo amadziwika chifukwa chosagwirizana ndi mankhwala a antihypertensive.

Ndi kukakamizidwa kowonjezereka, odwala azindikire izi:

kupweteka kumbuyo kwa mutu, nsidze, kulemera m'mutu,
kutentha kwamoto
tinnitus
chisokonezo cha kugona, kukwiya, kutopa,
Kuwala kwa madontho kapena malo owonekera pamaso,
kuchuluka kwa mtima
kupuma movutikira
Cardialgia, kupsinjika kumbuyo kwa sternum,
m`mapapo mwanga edema komanso mobwerezabwereza maphunziro woopsa matenda.

Ndi kuwonjezeka kosavuta kwa kupanikizika, magawo otsatirawo a matenda amadziwika:

Kubwezera ndikuwonjezereka pang'ono, kutsitsidwa ndi mankhwala, impso zikugwira ntchito mwachizolowezi.
Chithandizo chothandizira - kuphatikiza kukakamiza, kutsitsa mphamvu ya kusefa kwa impso, kuchepetsa kukula kwake.
Kubwezera - matenda oopsa, sangathe kuchotsedwa ndi mankhwala, kulephera kwaimpso, impso zotupa.

Kwa nephropathy, mawonekedwe awowonekera ndi kupweteka, kulemera kwa dera lumbar, kutupa pamiyendo ndi pansi pa maso, kufooka kwa minofu, kukodzanso kwamkodzo ndi ludzu, kuchuluka kwamkodzo wamadzulo kumatha masana, kunjenjemera komanso kugwedeza mwamphamvu miyendo.

Onerani kanema wazizindikiro ndi mankhwala ochizira

Kodi owopsa aimpso a stenosis

Kuchuluka kwa magazi kumabweretsa zovuta izi:

retinal angiopathy ndi kuchepa kwa masomphenya,
pachimake kapena matenda okomoka aukazitape (stroko kapena ischemic),
kulowetsa minofu yamtima,
kulephera kwazungulira
utachepetsa magazi, uremia.

Kuzindikira wodwalayo

Mukamawunika, khungu limakhudzika komanso kufupika kwa miyendo ndi nkhope zitha kuzindikirika. Ndi kuzindikira, malire a myocardium amakulitsidwa chifukwa cha kumanzere kwamanzere. Kumvetsera kwa mtima kumavumbula mawu amtundu wa 2 pamwamba pa msempha ndi kung'ung'udza komwe kumachitika pamimba yakumtunda.

Kuti mumvetse bwino za matendawa, kuwunika koteroko kumayikidwa:

magazi zamankhwala amuzolengedwa - mayesero a impso,
urinalysis - maselo ofiira am'magazi, mapuloteni,
Ultrasound ya impso - kuchepa kwa kukula kwa minofu ya impso,
urology - kukula kozama komanso kusiyanasiyana kwa impso,
wa radioisotope renogram amawulula kusintha kukula ndi mawonekedwe a impso yomwe yakhudzidwa, momwe imagwirira ntchito komanso kayendedwe ka magazi,
arteriography imamveketsa malo ndi kutalika kwa stenosis, komwe adachokera komanso kufunika kwake.

Mankhwala

Mankhwala a antihypertensive amagwiritsidwa ntchito - blockers a beta receptors, renin, calcium calcium njira, aldosterone, popeza ndi othandiza kwambiri ku chiyambi chaimpso cha matenda oopsa.

Koma ndi stenosis, gawo lawo ndilochepa, popeza mawonekedwe amtunduwu amalimbana ndi mankhwala ambiri kuti muchepetse kuthamanga kwa magazi. Nthawi zambiri amagwiritsidwa ntchito pomwe sizingatheke kuchita opareshoni kapena kukonzekera kwina.

Ponena za zoletsa za ACE, udindo wa madokotala ndiwofatsa, osavomerezeka kwa odwala omwe ali ndi stenosis yoopsa kapena yapakati, chifukwa chake, sagwiritsidwa ntchito monotherapy.

Komanso, ndikutsimikizika kwa atherosulinotic komwe kumayambira matenda, ndikofunikira kupangira zakudya ndi mankhwala kuti muchepetse cholesterol yamagazi. Ngati ntchito ya impso sikokwanira, hemodialysis imatha kutumikiridwa.

Opaleshoni

Ngati a impso artery stenosis imatsimikiziridwa pa angiogram, ndiye chizindikiro cha opaleshoni. Mitundu yotsatirayi ikuchitika:

Kukula kwa balloon mwa njira yakumapeto,
opereshoni kapena opaleshoni yam'mbuyo,
Kukhazikikanso kwina kwa malo ochepa:
Kuchotsa kwamkati wamkati limodzi ndi malo atherosulinotic,
kuyamwa kwa impso ukutsika,
Kuchotsa pakakhala kosatheka kubwezeretsa patency ya mtsempha wamagazi.

Zoyenera kuchita ngati aimpso matenda oopsa a stenosis komanso matenda oopsa

Matenda ngati amenewa sangathe kuchiritsidwa popanda kugwiritsa ntchito njira za opaleshoni aimpso. Kudzibwezeretsa wekha kwamphamvu ya mtsempha wamagazi sikunakonzedwenso.

Chifukwa chake, chiyembekezo chokha chamankhwala ndichakuchita opareshoni. Ngati sichikuchitika panthawi yoyenera (mpaka impso italephera kugwira ntchito), ndiye m'malo mwa njira yothandizira, yomwe ingachitike popanda kuchipatala, kuchotsedwa kwa impso kukufunika. Izi ndizowopsa makamaka ndi khansa yapakati.

Kuzindikira kwa wodwala

Kutengera ndi chifukwa cha stenosis, opaleshoni yotsitsimutsanso imabwezeretsa magazi moyenera kuchokera ku 70% (ndi makulidwe a zotupa za mitsempha) mpaka 50% (kusintha kwa atherosulinotic). Pambuyo pakuchita opaleshoni yam'mimba, kukonzanso kumatenga miyezi 1 mpaka 3, ndipo ndikulowerera kwam'mimba, kumatha kutenga miyezi isanu ndi umodzi.

Woopsa stenosis, makamaka nthawi yomweyo kumanja ndi kumanzere kwamitsempha popanda opaleshoni, odwala awonongeka, pamakhala chiopsezo chachikulu cha kufa chifukwa cholephera impso, mtima, kuvulala kwamitsempha yam'mimba.

Timalimbikitsa kuwerenga nkhaniyi pa stenosis ya chotupa cha carotid. Kuchokera pamenepo muphunzira za matenda a matenda am'mimba ndi zoopsa, mitundu ya matenda, kuzindikira ndi chithandizo.

Ndipo pali zambiri za atherosulinosis ya m'mimba msempha.

Minyewa ya m'mimba imayamba ndi kukula kwa khoma kapena khansa ya atherosselotic. Zowonetsera zazikulu ndizovuta kwambiri mawonekedwe oopsa, osagwirizana ndi mankhwala, nephropathy. Mankhwala, mankhwala ndi wowerengeka azitsamba pamlingo wothira magazi kwambiri angagwiritsidwe ntchito. Muzochitika zina zonse, opaleshoni yokhayo yomwe ingathandize - opaleshoni ya pulasitiki, kukakamira kapena kununkha, kuchotsa madera owuma.

Kufunika kwa mankhwalawa aimpso chifukwa cha zizindikiro zomwe zimawononga kwambiri moyo. Mapiritsi ndi mankhwala, komanso mankhwala ena othandizira angathandize pothandizira matenda oopsa a stenosis a mitsempha ya impso, polephera kwa aimpso.

ACE zoletsa amaikidwa mankhwala zochizira matenda oopsa. Kapangidwe kawo kazomwe zimathandizira kuti zombo ziwonjezeke, ndipo gulu limakupatsani mwayi woti musankhe m'badwo womaliza kapena woyamba, mukuzindikira zomwe mukuwonetsa. Pali zovuta zina, monga kutsokomola. Nthawi zina amamwa ndi ma diuretics.

Amawerengedwa kuti ndi amodzi a Valsartan amakono kuchokera pamavuto. Wothandizirana ndi antihypertensive akhoza kukhala m'mapiritsi ndi makapisozi. Mankhwalawa amathandizira ngakhale odwala omwe ali ndi chifuwa pambuyo pa mankhwala omwe amapezeka nthawi zonse.

Kudziwa cholesterol zolembera mu carotid mtsempha wamagazi kumayambitsa ubongo. Chithandizo nthawi zambiri chimaphatikizapo opareshoni. Kuchotsedwa ndi njira zina kumatha kukhala kosathandiza. Kodi kuyeretsa bwanji ndikudya?

Matendawa ndi aimpso omwe amawononga moyo. Zomwe zimawonekera ndi zolakwika za valavu, kumenya m'mimba, kukhazikika kwa stent ndi ena. Zizindikiro ndi ofanana ndi pachimake aimpso colic.

Matenda a mitsempha ya mitsempha ya impso amakula chifukwa cha ukalamba, zizolowezi zoipa, kunenepa kwambiri. Poyamba, Zizindikiro zimabisidwa, ngati zikuwoneka, ndiye matendawa amakula kwambiri. Pankhaniyi, mankhwala kapena opaleshoni ndiyofunikira.

Pambuyo pa zaka 65, non-stenotic atherosclerosis yam'mimba msempha ndi iliac mitsempha imapezeka mwa 1 mwa anthu 20. Ndi chithandizo chiti chovomerezeka pamenepa?

Chifukwa cha atherosulinosis ndi matenda ena, carotid artery stenosis imatha kuchitika. Zitha kukhala zofunikira komanso zofunikira kwambiri, kukhala ndi madigiri osiyanasiyana. Zizindikiro zimathandizira kusankha chithandizo chamankhwala, kupatula ngati pakufunika ntchito. Kodi mathedwe amoyo ndi otani?

Kugundika kwamitsempha kwam'mimba kumachitika ndi mawonekedwe osasunthika oopsa, momwe mankhwalawa alibe njira zoyenera. Chiwonetsero chaimpso chamawonekedwe ali ndi zotsutsana.