Kodi atherosulinosis ya mitsempha yayikulu yamutu ndi chiani?

Atherosulinosis ya mitsempha yayikulu ndi matenda osakhazikika ndipo amadziwonetsera pang'onopang'ono kwa lumen kapena kufalikira kwathunthu kwa mitsempha ya mutu, khosi ndi miyendo. Zimaphatikizidwa ndikupanga ma atherosulinotic plaques (lipid infiltrations) chifukwa cha kuphatikiza ndi kuchuluka kwa minofu yolumikizana. Izi zimapangitsa kuti magazi asagwere mu ubongo kapena miyendo.

Atherosulinosis, yomwe imakhudza mitsempha yayikulu yam'munsi, imawonedwa nthawi zambiri. Kwambiri, matenda amtunduwu amawonekera mwa amuna omwe adadutsa zaka 40 zaka. Koma mzimayi atalowa nthawi ya postmenopausal, mwayi wopezeka ndi atherosulinosis m'magulu onse awiri umofanana. Zomwezi zimagwiranso ntchito ku atherosulinosis ya mitsempha yayikulu ya mutu ndi khosi.

Zizindikiro za atherosulinosis ya mitsempha yayikulu

Kutengera ndi komwe mitsempha yayikulu idawonongeka ndi atherosulinosis, zizindikiro za matendawa zimasiyana.

Ngati tikulankhula za kuwonongeka kwa mitsempha ya ubongo, ndiye kuti munthu adzakumana ndi:

Zovuta zam'mutu komanso chizungulire champhamvu mosiyanasiyana,

Kuvutika kugona, kudzuka pakati pausiku, kugona tulo masana ndikugwira ntchito kwambiri,

Chulukani mukukumbukira kwakanthawi kochepa,

Sinthani pamakhalidwe, mawonekedwe a misozi, nkhawa zochulukirapo, kukayikira kwambiri komanso kulimbitsa mtima,

Vuto lamavuto ndi malankhulidwe, komanso zovuta zina zamitsempha.

Pamene atherosulinosis ikukhudza mitsempha yayikulu ya m'munsi komanso m'munsi, izi zimonekera motere:

Chifukwa cha kuwonongeka kwamitsempha yam'munsi, munthu nthawi zambiri amakhala ndi vuto la kutulutsa mawu pang'onopang'ono,

Kumva kutopa poyenda kumabwera kale kwambiri, kudutsa gawo lalitali panjirayo kumakhala ntchito yovuta,

Pali dystrophy yamatumbo a msomali, kuchepa kwa tsitsi pamiyendo, kuchepa kwa minofu ya ng'ombe yaing'ono.

Gangrene wa miyendo ndi pomwegee wakukula kwamatenda,

Kuchepetsa zamkati mumitsempha,

Ngati mitsempha yam'mwambamwamba ikukhudzidwa makamaka, ndiye kuti munthuyo akumva kuzizira m'manja, zilonda zimatha kupanga, ndipo mabala ang'onoang'ono amatuluka kwa nthawi yayitali.

Kodi atherosulinosis ya ziwiya zazikulu ndi chiyani?

Atherosulinosis ya ziwiya zikuluzikulu za mutu ndi njira yooneka bwino, yomwe imadziwika ndi kufalikira kwa maselo amafuta m'makoma amitsempha yamaubongo mu mawonekedwe a stenotic malo. Ndondomeko ya atherossteotic imalepheretsa pang'ono kapena kupangiratu mphete ya ubongo, yomwe imakhudza kutulutsa kwamitsempha yamagazi.

Popita nthawi, kusintha kwa zamitsempha m'mitsempha yaubongo kumapangitsa kuti magazi ayambe kuyenda m mitsempha. Zotsatira zake, bedi lamitsempha limasinthika kwambiri, mpaka kufalikira kwathunthu kwa kuwala kwake. Izi ndichifukwa cha zisonyezo zomwe zimadziwika ndi matendawa.

Zizindikiro ndi zovuta zotheka

Pa gawo loyamba Zizindikiro zakuchipatala zitha kukhala zofatsa kapena kusapezeka kwathunthu.

Ndi kupita patsogolo Atherosulinosis ya mitsempha yayikulu ya ziwalo, odwala amayamba kuzindikira zizindikiro zotsatirazi:

• kupweteka kosalekeza kumutu komwe kumachitika popanda chifukwa,
• chifukwa cha kukakamizidwa kwa kupanikizika, chizungulire chimawonekera, zomwe nthawi zambiri zimayambitsa kukayika kwakanthawi kochepa,
• mavuto akugona komanso kugona tulo,
• muzochitika zazikulu, zovuta zazikulu zamitsempha zimawonedwa: kusokonezeka kwa mawu, kusintha kwamatenda am'maganizo, kusakhazikika kwa machitidwe, chidziwitso-mnemonic matenda osokonezeka.

Atherosulinosis zigawo zakunja Mitsempha yayikulu yam'mutu imakhala chifukwa chakuchepa kwa kukumbukira kwakanthawi kochepa. Matenda osaneneka a kuthamanga kwa magazi mu ubongo kumabweretsa magawo angapo a discirculatory encephalopathy. Ngakhale mitundu ya nonthonotic ya atherosulinosis ya mitsempha ya chithokomiro chachikulu nthawi zambiri imayambitsa zovuta zazikulu. Chofala kwambiri mwa izi ndi ischemic stroke (matenda am'mimba). Chikwangwani chamafuta chomwe chimasokonekera chimalepheretsa kudziwa komwe kumachitika m'mitsempha, komwe kumapangitsa kutsekeka kwa magazi mu gawo ili la ubongo. Pambuyo maola ochepa, ischemia yosasinthika imayamba, yomwe imakhala choyambitsa mawonekedwe a minyewa yamanjenje.

Zomwe zimachitika komanso kukula

Chifukwa chachikulu chomwe chimayambitsa matenda atherosulinosis amawerengedwa cholesterol owonjezera m'magazi. Mothandizidwa ndi zinthu zoyipa, kugwiritsa ntchito cholesterol m'chiwindi kumayipa, ndipo kumamatira kulumikizana kwamkati kwamitsempha yamagazi, kuphatikiza mitsempha yayikulu ya ubongo. Pali zinthu zomwe zingayambitse vuto la hypercholesterolemia, ndipo chifukwa chake, atherosclerosis yayikulu: kumwa kwambiri, kusuta fodya kapena Hookah, kudya pafupipafupi zakudya zamafuta kwambiri, kulephera kuchita masewera olimbitsa thupi, kupsinjika nthawi yayitali, kugona mokwanira komanso kugona, kusowa katundu wokhazikika wamtima.

Carbohydrate kagayidwe Nthawi zambiri amakhumudwitsa kukula kwa lipid kagayidwe kachakudya matenda, amene posachedwa kumabweretsa atherosulinosis waukulu ziwiya.

Chiwopsezo chokhala wokhudzidwa ndi atherosclerosis yayikulu imadziwika ndi kugonana kolimba, omwe adutsa gawo lazaka 40. Chiwerewere chochepa kwambiri chimatha kutenga matenda ali ndi zaka makumi asanu. Kusiyana kumeneku kumachitika chifukwa cha mawonekedwe amomwe mayendedwe amakulu amthupi la akazi amakhala.

Zoyambitsa Atherosulinosis

Matendawa ali ndi zinthu zambiri zomwe zimayambitsa kutsogolera kwa atherosulinosis - kupezeka kwa cholesterol amana.

Izi ndi monga: kuwoneka kwa matenda osatha a mtima, matenda am'mimba komanso a mtima, kuledzera, kusuta, lipids yambiri, matenda a shuga, kunenepa kwambiri, kulephera kuchita masewera olimbitsa thupi, kuthana ndi nkhawa, zikhalidwe zosayenera kudya, kusagwira bwino ntchito kwa endocrine glands, vuto la zaka.

Njira za pathojeni

Atherosulinosis ya mitsempha yaubongo yaubongo imakhala yofala kuposa kuwonongeka kwa zinthu zamagazi kunja kwa cranium. Izi zimachitika chifukwa cha mawonekedwe a ziwiya zaubongo.

Makoma amitsempha yamagazi a m'mutu amakhala ochepa thupi kwambiri kuposa ma mitsempha ena, chifukwa chake, atherosulinosis imapita patsogolo mwachangu komanso imakhudza madera akuluakulu.

Madipoziti a cholesterol omwe amapangidwa m'madipatimenti osiyanasiyana amitsempha yayikulu amakhalanso ndi mawonekedwe awo. Mwachitsanzo, atherosulinosis ya zigawo zikuluzikulu za mitsempha yam'mutu imadziwika ndi fibrotic ndi stenotic neoplasms.

M'matumba akuluakulu, mapepala omwe ali ndi ziwonetsero zochepa za lipid ndi collagen ochulukirapo, ndipo ma carotid ali ndi gawo lofanana la collagen ndi mafuta.

Ngati umphumphu wa zigawo zokhala ndi lipids zambiri zowonongeka, chiopsezo chotumphuka kapena kudzipatula kwathunthu kuchokera khoma la chotengera ndikokwera. Izi zikuwopseza chitukuko cha: matenda a mtima, matenda a atherothrombotic, thromboembolism.

Zizindikiro za matenda

Pamene atherosulinosis ya mitsempha ya chithokomiro imachitika, munthu amakula ndi zofanana.Odwala sazindikira zizindikiro zoyambirira ndi zovuta zam'mitsempha, chifukwa chake, poyambira chitukuko cha matendawa, samvera chidwi ndi matenda, omwe amatsogolera kuwonjezeka kwa zizindikiro.

Mwa zina mwa matendawa ndi monga:

• kuwoneka kwa mutu wopweteka kwambiri, kumachitika kwa mavuto a kufooka komanso chizungulire. Pankhaniyi, mutu umakhala mwachizolowezi, mukukwanira, umatha kuwoneka nthawi iliyonse, mosasamala nthawi ya tsiku kapena usiku. Mphamvu ya chizungulire ndilinso yosiyana - kuchokera pakukweza pang'ono mpaka pakutha kwa chikumbumtima,

• tinnitus - zomverera mosasangalatsa zitha kuoneka kapena kuzimiririka, zimatha kulimba mutu ukakoloweka, nthawi yakumwa mutu komanso chizungulire,
• kufooka kosalekeza - Kuchokera kwa iye kumatuluka kutopa, kumakhala kumva kugona kosaletseka, komwe kumakhala tsiku lonse. Odwala amadwala matenda osowa tulo, nthawi zambiri amadzuka,
• ngati matenda am'matumbo amadzimadzi am'mitsempha yam'mimba, ndiye kuti anthu amatha kuvutika yochepa amnesia,

• kusokonezeka kwa malingaliro - odwala amakhala akulira kwambiri kapena amangokhala, amazunzidwa ndi nkhawa, mantha, kukayikira,
• zamisala zamitsempha, yowonetsedwa muzovuta zamakhalidwe, mavuto ndi mayendedwe.

Gawo Atherosulinosis

World Health Organisation yakonza dongosolo la matendawa, malinga ndi momwe magawo atatu a chitukuko amatha kusiyanitsira.

Gawo loyamba ndi atherosulinosis mage. mitsempha yamagazi yodziwika ndi zosokoneza zazing'ono. Imatchedwa gawo la lipid. Malo a Lipid, monga lamulo, samadziwonetsera mwanjira iliyonse, kotero odwala sakudziwa nkomwe zakuphwanya kumene.

Ngati mungayang'ane malo omwe ali pansi pa microscope, imatha kuwoneka ngati dontho kapena dontho lozungulira, lomwe limangokweza pang'ono pamwamba, ndipo nthawi zina limaphatikizanso.

Gawo lachiwiri limavala dzina la zolembera zam'manja. Pankhaniyi, kuyika kwa cholesterol sikumangowonekera pakhoma la mtsempha, koma kumatuluka kwambiri khoma lake kupita kolowera m'mitsempha. Matendawa amatha kufotokozedwa kale ngati matenda.

Kunja, mapepala ndi mawonekedwe a mtundu wowala - kuyambira oyera mpaka achikasu ndi sheen wa peyala. Amakhala ndi mawonekedwe ozungulira kapena ozungulira, osiyanasiyana kutalika ndi kutalika m'ngalawomo. Mkati, chikhazikitso chotere chimakhala ndi milomo yocheperako, koma kumtunda kumakokedwa ndi membrane wa fibrous kapena collagen.

Ngati chidule choterocho chimakwirira pafupifupi 60 peresenti ya lumen ya chombocho, ndiye kuti palibe zophwanya boma laumoyo ndipo munthuyo akumva wokhutira. Potseka lumen, zoposa 60 peresenti zimakhudza kale magazi, medulla imakhala ndi vuto la kusowa kwa zakudya komanso mpweya wabwino.

Mu gawo lachitatu kukula kwa matendawa mwa anthu, malembedwe ovuta amawonekera. Izi ndi madongosolo okhala ndi zotupa - hematomas, calcation, komanso omwe amaputa zilonda pamakoma amitsempha yamagazi. Momwe ma pathology akapita kuchokera ku gawo lachiwiri mpaka lachitatu, munthu amakhala ndi chiopsezo cha vuto la mtima, kukomoka, embolism (kusintha komwe magazi amayenda).

Zizindikiro

Atherosulinosis mage sizivuta kuzindikira zombo. Wodwala yemwe ali ndi mavuto azaumoyo ayenera kufunsa dokotala, kuti amuwone ngati ali ndi matenda a zamatsenga.

Kuzindikira matendawa koyambirira kumaphatikizapo kuyesa kwa wodwala ndi kusonkhanitsa deta yayikulu. Mtsogolomo, wodwalayo amayesedwa ndikuwunika ziwiya zaubongo. Kuphatikiza apo, adotolo angalimbikitse kulingalira kwamatsenga, komwe kumamveketsa bwino za matenda amitsempha yamagazi.

Mankhwala othandizira

Ngati kusintha kochepa kwa ma atherosulinotic m'matumbo akuluakulu atapezeka, odwala amafunika chithandizo cha nthawi yayitali, osati mankhwala okhawo omwe angayikidwe.Wodwala amafunikira:

• Sinthani moyo wanu, phatikizani zochitika zolimbitsa thupi munthawi zonse,
• lekani zizolowezi zoyipa,
• kuchulukitsa zakudya ndi zitsamba, zipatso, mkaka.

Mankhwala kwa odwala adzalembedwera kuchokera m'magulu osiyanasiyana:

• Cardiomagnyl kapena Plavix angatengedwe ngati mankhwala a antiplatelet,
• Sulodexide ndi yoyenera kupatulira magazi,

• Kupititsa patsogolo kufalikira kwa magazi mu ubongo, odwala amalimbikitsidwa nicotinic acid,
• kukhazikitsa kulumikizana kwamgwirizano, mutha kutenga Actovegin,
• pofuna kusintha kuchuluka kwa cholesterol, Krestor amalimbikitsidwa kwa odwala, ndikothekanso kutenga nicotinic acid.

Mndandanda wamankhwala awa ndi zitsanzo chabe ndipo nthawi zambiri umagwiritsidwa ntchito. Kutengera umunthu wa wodwalayo, momwe aliri, gawo la matendawa, mndandanda wazomwe mankhwala amatha kusintha.

Kuphatikiza apo, odwala amalimbikitsidwa kugwiritsa ntchito acetylsalicylic acid kwanthawi yayitali, komwe kumachepetsa chiopsezo cha kuwundana kwa magazi.

Opaleshoni

Mankhwala opangira opaleshoni amachitika ngati njira zochizira sizigwira ntchito, ndipo zotupa za mitsempha ya cell atinosselotic. Chithandizo cha opaleshoni ya mitsempha ya muubongo chimachitika pokhapokha ngati palibe zotengera zazikulu zitatu. Ndi chotupa chonse, opaleshoni ndiyothandiza.

Madokotala amatha kuchita mitundu iwiri ya ntchito - yoyamba imachitidwa kudzera mwa kukwapula pang'ono, ndipo chachiwiri kudzera pakukokoloka. Ndi maopareshoni amkati, ngakhale atherosulinosis yotsogola imatha kuchiritsidwa. Kuchita opaleshoni kumachitika ndikuikamo catheter kudzera mu chotupa cha akazi ndi kuyikika mu chotengera chamimba chachikulu.

Fungo lake - lotchedwa kamangidwe kake - ndi kasupe wopunthira, yemwe, pansi pa inertia yake, amakakamiza cholesterol plaque kukhoma la chotengera.

Kuchita opaleshoni yamakedzana kumatanthawuza kupukuta mitsempha ya muubongo kapena kulocha chida ndi gawo lina labwino la mtsempha. Pambuyo pa opaleshoni, odwala amalimbikitsidwa kuti atenge magazi ochepa, kutsatira zakudya, kudya zakudya zochepa zomwe zimakhala ndi mafuta ambiri.

Nthawi yakukonzanso kwa ntchito itatha, wodwalayo amaloledwa kuwonjezera zochita zolimbitsa thupi. Ndikulimbikitsidwa kuti azionedwa ndi madotolo aluso, kamodzi pachaka kuti apimidwe ziwiya zazikulu.

Kuzindikira kwa kuchira

Atherosclerosis ya mitsempha yayikulu ya mutu imakhala matenda a ubongo. Popeza matendawa ndi asymptomatic, odwala ambiri amaphunzira za izi pamlingo wachiwiri kapena wachitatu wa chitukuko, kuwonongeka kwakukulu kwa ubongo kumachitika.

Zambiri pa zakukula kwa matenda a ubongo theka la odwala atakula (mpaka zaka 55), matendawa ndi ovuta chifukwa cha matenda a ischemic chifukwa cha stenosis yayikulu imodzi ya mitsempha yayikulu. Theka la omwe akudwala matenda opha ziwalo amatha kufa kapena kukhalabe ndi olumala kwambiri.

Opitilira 80 peresenti ya odwala omwe ali ndi matenda a chithokomiro matenda am'matumbo amakhala ndi vuto losakhazikika kwa magazi, ndipo gawo limodzi mwa magawo atatu mwa odwala lotere limavutikanso ndi stroke. Ndipo mwa magawo asanu aliwonse a odwala omwe chotupa cha atherosulinotic chachikulu chotengera mu ubongo chimadutsa osazindikira, popanda kupereka zizindikiro za matendawa komanso popanda kuwopsa.

Njira Zodziwitsira

Diagnosis ya atherosulinosis ya mitsempha yayikulu yazizere zimatheka pokhapokha atayeza mayeso athunthu, omwe adokotala amupatsa pambuyo pokhazikitsa.Panthawi yolumikizana ndi wodwalayo, katswiri amasankha mosamala ma anamnesis a matendawa ndi moyo, zambiri momwe angathere madandaulo onse omwe wodwala adafunsa, amafunsa za kukhalapo kwa zinthu zomwe zikuwonetsa ku atherosulinosis yayikulu.

Kenako wodwala amayenera kukayezetsa magazi - mbiri ya lipid. Phunziroli limakupatsani mwayi wodziwa kuchuluka kwa cholesterol ndi tizigawo ting'onoting'ono tambiri m'magazi a seramu, komanso kuchuluka kwake. Izi zithandiza dokotala kuwunika mkhalidwe wamafuta a mafuta.

Muyezo wagolide pa matenda a atherosulinosis ambiri ndi dopplerographic mayeso mitsempha yayikulu ya khosi ndi mutu. Kugwiritsa ntchito ma ultrasound, akatswiri amawunika kuthamanga ndi kuthamanga kwa magazi mu kama wamitsempha yamavuto omwe anaphunziridwawo. Njirayi imakuthandizani kuti muzindikire kuchuluka kwa mafuta omwe ali mkati mwazolowera zamitsempha yamagazi, komanso kuchuluka kwake komanso kukula kwake.

Angiography imagwiritsidwanso ntchito pofufuza matenda atherosulinosis. Uku ndikuwunikira kwa X-ray ndikukhazikitsa gawo lopatula loyimira ayodini m'magazi. Kwa odwala omwe amadwala iodini, angiography imatsutsana. Mothandizidwa ndi phunziroli, ndizotheka kuzindikira madera akuluakulu amisili omwe amakhudzidwa ndi atherosulinosis.

Nthawi zina, madokotala amatiuza kuti muzikhala ndi vuto lotenga mphamvu yamagetsi. Ndi chithandizo chake, ndikuthekanso kuzindikira kutuluka kwachilengedwe ndi kuchuluka kwa zotupa za atherosulinotic zazikulu zotengera muubongo.

Kukula kwa atherosulinosis kwa dipatimenti ya intracranial ndi extracranial

Atherossteosis ndikuchepetsa lumen ya mtsempha chifukwa cha kukula kwa cholengeza mkati mwake, wopangidwa ndi cholesterol wotsika kwambiri, mamolekyulu a calcium, ndipo chikhodzacho chidakutidwa ndi minyewa ya michere yapakati.

Izi minyewa yam'magazi imabweretsa kuphwanya kuthamanga kwa magazi m'mitsempha yayikulu ndikusakwanira kwa ziwalo zamagazi ndi magazi, zomwe zimayambitsa kuperewera kwa mpweya wa ziwalo (hypoxia).

Atherosulinotic neoplasms imatha kukula m'madipatimenti amtundu wakutali wam'mutu, komanso m'mitsempha yama intracranial (ziwiya zamkati).

Kuchuluka kwa extracranial ndi sclerosis ya thoracic ndi mathirakiti a chiberekero, zomwe zimayambitsa kusowa kwa magazi m'magawo onse a ubongo. Mlingo wa intracranial ndi hypoxia wa gawo limodzi la ubongo komwe magazi ochokera pachiwiya chowonongeka samalowa m'magazi.

Chifukwa cha kufooka kwa magazi muubongo, ma magazi amadziunjikira m'malo oyambira, komanso m'malo osiyanasiyana amitsempha yamagazi.

Zotsatira za thrombosis yamitsempha yamagazi:

• Necrotic yokhudza maselo aubongo,
• Kukula kwa maselo aubongo ndi kukula kwa masisitilo,
• Dystrophy ndi kufa kwa ma neuron, omwe amachepetsa luntha la munthu, ndipo amamutsogolera ku dementia.

Trunk atherosulinosis yaubongo ndi njira yoopsa yomwe ingayambitse imfa.

Mitsempha yonse yopereka magazi ku mitsempha ya ziwongo imachokera ku aorta, chifukwa chake aortic atherosulinosis ingasokoneze kwambiri magazi kumitsempha, ndipo tsinde la brachiocephalic sililandira kuchuluka kwa magazi m'mitsempha ya ubongo.

Zoyambitsa matenda

The etiology ya chitukuko cha sclerosis ya mitsempha yayikulu ya ubongo ndi yotakata, ndipo imagwirizana ndi zaka komanso jenda ndi wodwala, cholowa chake cholowa.

Zomwe zimayambitsa kwambiri:

• Matenda oopsa ndi kuchuluka kwa nthawi yayitali komanso kokhazikika kwa magazi.
• Mafuta a cholesterol ochulukirapo komanso kusakhazikika kwapakati pa lipoprotein yapamwamba, kutsika kwa lipids, komanso kuchuluka kwa triglycerides m'magazi,
• Kudalira kwa mowa pachimake, kudwalitsa matenda oopsa komanso dongosolo la atherosulinosis,
• Mankhwala osokoneza bongo a Nikotine - zombo zimatha mphamvu komanso kutanuka mothandizidwa ndi nikotini, zomwe zimabweretsa zoopsa mpaka ku endothelium, pomwe pamapezeka zisonyezo.
• Kunenepa kwambiri
• Matenda a shuga a m'matenda,
• Matenda a mtima
• Moyo wopanda ntchito, womwe umapangitsa kukula kwa cholesterol m'misewu yayikulu, chifukwa zikalephera kuchita ntchito, kuthamanga kwa magazi kumachepa komanso mawonekedwe a magazi,
• Kupanda chikhalidwe mu zakudya. Kudya kwambiri zamafuta ndi mafuta okazinga, komanso kukonda chakudya mwachangu,
• Kubadwanso kwatsopano kwa nthambi ya msempha, komanso kuwunika kwa thunthu la brachiocephalic ndi kapangidwe ka mitsempha ya carotid.

Mitsempha yama brachiocephalic

Chitsa cha brachiocephalic ndi gawo limodzi la nthambi ya msempha, womwe ndi mtsempha waukulu wamitsempha yamagazi.

Nthambi za mtengo wa brachiocephalic zimapereka magazi kudzanja lamanja la humerus ya ziwiya zazikulu:

• Mtsempha waukulu wam'madzi mwa subclavia,
• Mitsempha yayikulu ya carotid,
• Chida chachikulu chakumanja chakumanja.

Ndikofunikira kwambiri kuti muzisamalira chitukuko cha mitsempha ya brachiocephalic, chifukwa ndi njira yayikulu yoperekera magazi kumaselo aubongo.

Ndi chitukuko cha atherosulinosis ya ngalande yayikulu, imatha kukhala ndi dementia muubongo ndikupangitsa kugwidwa.

Nthawi zambiri, kukha magazi mu ubongo kumatha ndi imfa ya munthu wodwala.

Mitundu iwiri ya zotupa za atherosulinotic ya mitsempha ya brachiocephalic imasiyanitsidwa.

Mtundu wa matenda amatengera kukula kwa zotupa za chotengera:

• Mtundu wa non-stenotic wa atherosulinosis BCA,
• Stentosing yotupa ya BCA.

Ndi kukula kwambiri kwa atherosulinosis ya non-stenotic sclerosis mu brachiocephalic mitsempha, malo a atherosulinotic atenga gawo lalikulu la lumen ndikuwatsogolera kutsekeka kwa mtsempha wamagazi.

Mtundu wonyansa wa BCA atherosulinosis ndi njira yayikulu yokhazikika yomwe njira yakukula mkati mwa lumen imapitirira mwachangu, zomwe zingayambitse kufupika kwa thunthu ndi kufa.

Atherosulinosis ya mitsempha ya brachiocephalic ya ubongo ku nkhani zake ↑

Systemic atherosulinosis yamkati mwa carotid mitsempha

Kutengera ndi mawonetseredwe azachipatala mu mitsempha ya carotid, atherosulinosis imagawidwa kukhala:

• Stenosing mtundu waukulu wa carotid sclerosis - kuwala kwa carotid artery kumachepetsedwa ndi oposa 50.0%. Mankhwala othandizira opaleshoni yokha
• Mtundu wopanda-stenotic wa carotid atherosulinosis - kuunikira kwa mtsempha wamagazi kumachepetsedwa ndi ochepera 50.0%. Mankhwala kwa nthawi yayitali,
• Multifocal mtundu wa waukulu carotid sclerosis. Izi matenda amathandizidwa kutengera mtundu wa magwiridwe a ubongo.

Mikwingwirima ya Ischemic kapena mitsempha ya m'mimba imapha mu 5.0% ya odwala omwe ali ndi atherosulinosis mu ziwiya zazikulu za carotid.

Kuopsa kwa mapangidwe a atherosselotic neoplasms m'mitsempha ya carotid ndikuti mamolekyu am'magazi amatsatira gawo lowonongeka la endothelial ndikupanga magazi omwe angalowe m'mitsempha yamitsempha m'mitsempha yayikulu ndikubweretsa sitiroko.

Zizindikiro zakugonjetsedwa

Sclerosis imayamba pang'onopang'ono, chifukwa cha kuchuluka kwakukulu kwa zotengera zazikulu, ndipo wodwalayo akumva zizindikiritso zoyambirira ndiye, chingwe cha atherosulinosis sichikuyenda m'matumbo a extracranial okha, komanso mbali zina zaubongo.

Zizindikiro za sclerosis yamutu yayikulu ndi:

• Zowawa m'mutu, zomwe zimakhala zowawa kwambiri ndipo zimadziwonetsa.
• Mutu wakuda umayamba mwadzidzidzi,
• Chizungulire champhamvu,
• Kufooka kwathunthu ndi kutopa kwa thupi,
• Miyendo yakumaso imatha, zala zimatha,
• Ntchentche yomwe imangouluka pachinthu chowoneka, ndikuchepa kwamawonedwe.
• Kugona kumasokonezeka, wodwala amadzuka kwambiri usiku osagona,
• Kusakhazikika ndi kusakhazikika kwa gait,
• Kuchepa kwamtima kukumbukira,
• Mkhalidwe wofotokozedwa wakuphwanya maluso waluntha,
• Dementia ikukula
• Chisoni ndi kukhumudwa
• Kukomoka
• Kuchepa kwa ntchito kapena kuwonongeka kwathunthu.

Magawo otukuka

Kuwonetsedwa kwa sclerosis yayikulu yamitsempha yamagazi pakuwunika kumakupatsani mwayi wokhazikitsa gawo la chitukuko cha matenda.

Gawo 1:

• Anawo amayankha pang'onopang'ono kuwala,
• Asymmetric kapena pathological limawonetsa wodwala.

Gawo 2:

• Kukumbukira koyipa kwambiri. Wodwalayo amakhala wopanda chiyembekezo ndipo amalephera kuwongolera zinthu,
• Kutsika kwakukulu pakugwira ntchito
• Maluso anzeru akuwonongeka
• Psyche imasweka
• Ma Microstrokes ndi zotsatira zawo mwanjira yakufa ziwalo.

Gawo No. 3:

• Ntchito yanzeru imalephera kwambiri,
• Zowonongeka zazikulu zamitsempha.

Chithandizo cha atherosulinosis yayikulu iyenera kuyamba ndi njira zosagwiritsa ntchito mankhwalawa:

• Chotsani izi - kusuta ndi mowa,
• Limbani Kunenepa kwambiri - muchepetse kunenepa pogwiritsa ntchito masewera olimbitsa thupi komanso zakudya zochepa zopatsa mphamvu,
• Pewani zochitika zamanjenje ndi nkhawa,
• Sinthani mphamvu - alowetsani nsomba muzakudya, komanso kuchuluka kwamasamba, masamba am'minda ndi zipatso. Idyani zakudya monga chimanga ndi mafuta a masamba tsiku lililonse. Pewani nyama yamafuta ndi mafuta amkaka omwe amapezeka muzakudya. Nyama iyenera kukhala - nkhuku ndi nkhuku yopanda khungu, nyama yamwana wamchere wopanda mafuta. Zopangira mkaka wowonda ziyenera kukhala zopanda mafuta. Chotsani maswiti ndi zopangidwa ndi ufa pazakudya,
• Onani zochitika za tsiku ndi tsiku - kupumula kwa usiku wonse kumachepetsa kuchepa kwa matenda a sclerosis,
• Mutha kuthana ndi kusachita masewera olimbitsa thupi mwa kuphunzitsa masewera. kapena njira zochizira.

Chithandizo cha kufooka kwa ziwiya zazikulu zaubongo zimachitika ndi dokotala wokhawokha. Mankhwala amaikidwa pamaziko a zotsatira zakuzindikira.

Kugwiritsa ntchito mankhwala podzichitira nokha ndiopsa, chifukwa mankhwalawa ali ndi zotsutsana zambiri komanso zoyipa mthupi.

Ngati mankhwala osokoneza bongo sanathandizire kuchepetsa mawonekedwe a atherosulinotic mawonetseredwe ndikuchepetsa plaque ndi osakwana 50.0% a lumen, ndiye kuti mankhwala amathandizidwa ndi opaleshoni.

M'mitsempha yayikulu ya ubongo, opaleshoni yotseguka imachitidwa ndipo njira yotsatsira yomwe imagwiritsidwa ntchito, yomwe imakhala yovuta kwambiri.

Njira zakugwiritsira ntchito ziwiya zazikulu za bongo:

• Carotid Endarterectomy - Opaleshoni yotseguka kuti muchotse zolembera za atherosselotic mu zigawo za ziwiya zazikulu,
• Balloon-mofuta angioplasty amachitika m'malo osatheka pomwe endarterectomy siyotheka.. Ophunzirawo amachitidwa m'madipatimenti ena a kunja ndi kumayiko ena.
• Njira zowononga zachilendo. Kudzera pakabowoleza thupi, stent imayikidwira mu mtsempha waukulu, womwe umakulitsa kuyerekeza kwake,
• Prosthetics ya mzere wowonongeka mdera la extracranial. Gawo lowonongeka la thunthu limalowetsedwa ndi chofukizira, kapena mbali ya mtsempha kuchokera m'thupi lake.

Kupewa

• Khazikitsani zakudya zoyenera,
• Kuchita masewera olimbitsa thupi mokwanira,
• Kukana nikotini ndi mowa,
• Kuzindikira koyeserera kwa thupi. Ma diagnostics a Laborator amatha kudziwa cholesterol yokwezeka kwambiri, ndipo zida zothandiza kuzidziwitsa zimazindikira kukula kwa sclerosis m'matumba akuluakulu oyambira.

Chithandizo ndi kupewa matendawa

Odwala omwe ali ndi atherosulinosis ya mitsempha yayikulu ya chithokomiro ayenera kumvetsetsa kuchira kwathunthu matenda zosatheka. Koma zamakono zamankhwala zili ndi mphamvu zotha kuyimitsa chitukuko, potero zimawonjezera nthawi yayitali komanso moyo wa odwala. Mpaka pano, pali mankhwala othandizira komanso opaleshoni yayikulu ya atherosulinosis.

Chithandizo cha mankhwala osokoneza bongo chimaphatikizapo kukhazikitsa lipid-kuchepetsa mankhwala (Lovastatin, Atorvastatin), mankhwala antithrombotic (Cardiomagnyl, Losperin), komanso mankhwala a mtima (Latren, Actovegin, Pentoxifylline). Kuphatikiza kwa mankhwalawa ndi mankhwala achikhalidwe (infusions, decoctions zamankhwala azomera) ndizotheka.

Poyerekeza ndi maziko a chithandizo chamankhwala, chofunikira kuchita kukonza moyo wodwala. Madokotala ati kuphatikiza matenda othandizira kuthana ndi vuto kumathandizira kuletsa matendawa. Mufunikanso katundu wa tsiku ndi tsiku wa Cardio (kuyenda, kusambira kapena kuyendetsa njinga), kubwezeretsa kugona ndi kugona. Ndikofunikira posachedwa kusiya zizolowezi zovulaza (mowa, kusuta fodya kapena hookah, kukhala pakompyuta nthawi yayitali). Akatswiri amapereka malingaliro omwewo kuti apewe kuwoneka kwa atherosulinosis yayikulu mwa odwala omwe ali ndi vuto la izo.

Popanda chithandizo choyenera chodwala, odwala amapemphedwa kuti athetse vutoli opaleshoni. Chomwe chimapangidwira opaleshoni ya atherosulinosis yamitsempha yayikulu ya chithokomiro ndikubwezeretsa umunthu wawo pakukhazikitsa chida chapadera - stent kapena pochotsa madipoziti amafuta kuchokera mkati mwa ziwiya.

Atherosulinosis ya ziwiya zazikulu kwambiri zodwala ndi matenda oopsa omwe pakapita nthawi imayambitsa kulumala kapena kufa msanga kwa odwala. Kuti mupewe izi, muyenera kutsatira njira zodzitetezera, muzifufuza pafupipafupi mafuta a metabolism.

Zizindikiro zoyambirira zikaonekera, pitani kuchipatala msanga. Izi zikuthandizani kuti mupeze nthawi yolimbana ndi matendawa!

Chithandizo cha atherosulinosis chachikulu mitsempha

Chithandizo cha atherosclerosis chachikulu mitsempha n`chosatheka popanda njira. Sizotheka kusintha mkhalidwe waumoyo kokha potsatira zakudya zoyenera, kapena, m'malo mwake, pokhapokha mutamwa mapiritsi okhazikitsidwa ndi adokotala.

Mankhwala osokoneza bongo amachepetsa kutenga ndalama zotsatirazi:

Ma antiplatelet othandizira, kuphatikizapo cardiomagnyl, plavix, thrombo-bulu ndi ena,

Njira zotanthauza kuchepetsa magazi. Izi zikuphatikizapo phloenzyme, sulodexide ndi ena,

Mankhwala osokoneza bongo kuti athandize kufalikira kwaziphuphu - nicotinic acid, alprostan,

Mankhwala omwe amalimbikitsa kufalikira kwa mgwirizano. Awa ndi actovegin ndi solcoseryl,

Njira zomwe zingachepetse cholesterol yamagazi, mwa iwo: torvakard, krestor ndi ena,

Mankhwala opangidwa kuti athetsere zizindikiro za ululu (analgesics), amachepetsa kutupa (NSAIDs), amachotseretu matenda ofanana (etiological agents).

Kuphatikiza apo, odwala akuwonetsedwa kukonzekera kwa acetylsalicylic acid, komwe kumachepetsa chiopsezo cha magazi. Ikhoza kukhala Cardiomagnyl kapena bulu wa thrombotic. Maphunzirowa akudya mavitaminiwa amakhala kuti amateteza minofu ndi ziwalo zomwe zimasowa magazi.

Odwala omwe apezeka ndi atherosulinosis a mitsempha yayikulu adzafunika kuwunikiranso moyo wawo. Izi zimaphatikizapo kusiya zizolowezi zoipa: kumwa mowa ndi kusuta. Pamaso pa kunenepa kwambiri, kuchepetsa kwake kofunikira ndikofunikira. Kukonzanso chakudyacho ndi vuto linanso kuti mupewe mavuto omwe amadza chifukwa cha zilonda zapakhosi. Chosafunikanso kwambiri ndicho kukonzanso kwa magazi ndi kuthamanga kwa magazi.

Ngati chithokomiro cha atherosulinotic chachepetsa lumen ya oposa mtsempha wama 50%, ndiye kuti wodwalayo atumizidwa kuti akaonane ndi dokotala wa opaleshoni yam'manja yemwe wasankha pakufunika kuchitapo kanthu.

Maphunziro: Moscow State University of Medicine ndi Dentistry (1996). Mu 2003, adalandira dipuloma kuchokera ku Training and Science Science Center for Management ya Purezidenti wa Russian Federation.

Zithandizo zothandiza ndi masks pakuwonongeka kwa tsitsi (maphikidwe apanyumba)

Momwe mungachepetse cholesterol mosavuta popanda mankhwala kunyumba?

Atherosulinosis ndi nthenda yamagazi yamtsempha wamagazi momwe cholesterol ndi mafuta ena amkati mwa zolembedwa ndi zolembera zimayikidwa kukhoma lamkati lamitsempha, ndipo makoma enieni amakhala onyansa ndikutha mphamvu. Zombozi zimayamba kuuma pang'onopang'ono chifukwa cha mafuta ndi mandimu pamakoma, ndikutha mphamvu.

Mankhwala azitsamba ngati njira yochizira, malinga ndi madokotala, amatha kukhala othandiza mu atherosulinosis. Zitsamba zamafuta nthawi zambiri zimagwiritsidwa ntchito ngati othandizira kuwonjezera zotsatira za mankhwala opangira mankhwala, komanso njira yayikulu yochizira matendawa. Malingaliro a odwala ambiri amawaona ngati olakwika.

Atherosulinosis yokhala m'munsi yotsika ndi gulu la njira zomwe zimakhudza mitsempha yayikulu yam'munsi, ndipo ndikuphwanya kwapang'onopang'ono kwa magazi kumisempha chifukwa chakufinya (stenosis) kapena kufinya (kufalitsa) kwamitsempha. Mawu oti "kuwononga" ndi.

Atherosulinosis ya msempha wamtima ndi matenda osachiritsika omwe amakhudza zotanuka zamtundu wa mitsempha. Amadziwika ndi mapangidwe amodzi kapena zingapo za lipid amana, otchedwa atheromatous malo, mkati mwa mkati mwa mtima. Kufikira pamlingo.

Atherosclerosis ya ziwiya zaubongo imayenda pang'onopang'ono mwadongosolo zotengera zomwe zili m'chigawo chofanana. Mankhwala, mutha kupeza matanthauzidwe ena a matendawa, mwachitsanzo, zotupa za atherosulinosis kapena zotupa za atherosselotic zotupa zam'mimba, koma tanthauzo silikhala losasinthika.

Lingaliro loti chakudyacho ndi chosasangalatsa komanso chopweteka, popeza chimakakamiza munthu kusiya zakudya zambiri “zokoma” chifukwa cha "amoyo wathanzi," zakhazikika m'maganizo a ambiri. Komabe, mndandanda wazinthu zovomerezeka kuti zigwiritsidwe ntchito ku atherosulinosis ndiwotakata. Lamulo lalikulu la zakudya m'thupi.

Matendawa amagwirizanitsidwa ndi kuphwanya kwa lipid metabolism. Kulephera koteroko kumakwiyitsa kudziunjikira kwa cholesterol yotchedwa "yoyipa" m'magazi. Zotsatira zake, "cholesterol plaques" amapangidwa. Iwo, atagona pamakoma amitsempha yamagazi, amakhala ndi ngozi yayikulu.Pamalo opangira zolembera, chotengera chimakhala chosalimba, chake.

Ambiri, ngati si onse, kamodzi kamodzi m'moyo wawo adawona mawonetsero owoneka bwino a kusintha kwachilengedwe mu ubongo: kupweteka kwa mutu wopanda kanthu, kulira ndi tinnitus, mavuto a kukumbukira, ma photopsies (malingaliro abodza a kuwala m'maso), ndi zina. Zizindikiro zikuwonetsa ischemia, kapena, mopepuka, kuphwanya magazi.

Makhalidwe a matenda

Atherosulinosis ya mitsempha yayikulu ya mutu imayamba ndi kudzikundikira kwa maselo amafuta m'makoma amitsempha yamagazi. Poyamba, timagulu tating'onoting'ono timakhala tating'onoting'ono ndipo sabweretsa vuto lalikulu mthupi. Komabe, ngati njira za panthawi yake sizinatengedwe, mapepala amawonjezera kukula ndi kuchuluka kwake, pang'onopang'ono kutsekeka kwa lumen ya mtima.

Atherosulinosis ya mitsempha yayikulu ndiyowopsa paumoyo wa anthu, chifukwa chifukwa cha chitukuko cha matenda, mpweya wopita ku chofunikira kwambiri cha munthu, ubongo, umakhala ndi malire. Mu gawo lovuta kwambiri la atherosulinosis, makoma am'mimba amawonongeka, aneurysms amapangidwa. Zotsatira za atherosulinosis zimatha kukhala thromboembolism - matenda oopsa, omwe nthawi zambiri amatsogolera kuimfa.

Atherosulinosis ya mitsempha yayikulu ya ubongo imagawika m'magulu awiri - yam'deralo ndikupatsirana. Local atherosulinosis imayamba mu gawo limodzi la ubongo, kutsogolo kapena parietal. Diffuse atherosulinosis imadziwika ndi kuwonongeka kwathunthu kwa ubongo, momwe maselo aubongo amasinthidwa ndi minofu yolumikizana. Ndi kufalitsa kwa atherosclerosis, tomogram yodziwika imawonetsa kukhalapo kwa njira za necrotic komanso aneurysms angapo.

Malinga ndi kukula kwa chitukuko, magawo otsatirawa a chotupa cha mitsempha ya m'magazi ndi amodzi:

1. Non-stenotic atherosulinosis. Matendawa akuimira gawo loyambirira la atherosulinotic matenda a mitsempha yayikulu ya ubongo. Pakadali pano, zolembera za cholesterol zimadzaza mitsempha mosaposa theka. Non-stenotic atherosulinosis imayankha bwino chithandizo, popeza kusintha m'matumbo kumakhalabe kochepa. Chithandizo cha Conservative chikusonyezedwa.
2. Stenosing atherosulinosis. Pathology yamtunduwu imanena za magawo a matenda a ubongo wamitsempha yamagazi. Matendawa ndi oopsa m'moyo, popeza kuti ziwiya zotchinga zopitilira theka, zomwe zimapangitsa magazi kulowa mu ubongo. Magawo onse a muubongo ndi akunja kwa mitsempha yayikulu yamutu imakhudzidwa. Chithandizo chovuta chimagwiritsidwa ntchito, kuphatikizapo mankhwala othandizira, opaleshoni. Ndi stenotic atherosulinosis, wodwalayo amatha kukhala ndi zovuta komanso kufa.

Osatengera momwe malowedwe amitsempha akuluakulu amakhudzidwa ndi cholesterol plaque, zomwe zimayambitsa atherosulinosis:

1. Kukhalapo kwa zizolowezi zoyipa. Makamaka owopsa m'lingaliro ili ndi kusuta.
2. Kunenepa kwambiri
3. Kuchepetsa shuga m'magazi.
4. Zakudya zopanda thanzi.
5. Kupsinjika kwamaganizidwe pafupipafupi.

1. Popita nthawi, kuthamanga kwa magazi. Tikulankhula makamaka pamikhalidwe pamene dziko lotere silinasiye mwanjira iliyonse.
2. Mafuta akulu kwambiri.
3. Matenda a endocrine chiyambi.
4. Zosintha zokhudzana ndi zaka.

Atherosulinosis ya magawo a mitsempha ya extracranial imadziwika ndi mawonekedwe owonetsa. Zizindikiro za matendawa zimakhudzidwa ndikudziwika kwa matenda.

Zizindikiro za atherosulinosis ya mitsempha yayikulu ndi monga:

1. Tinnitus.
2. Kugwedezeka kwadzidzidzi.
3. Mutu wamakhalidwe ophatikizika. Mphamvu ya ululu wamankhwala imatsimikiziridwa ndi gawo la atherosulinosis, kuchuluka kwa ma occlusion, komwe kuli cholesterol plaque.
4. Kuwonongeka kwakumbuyo mwachangu. Kukumbukira kwakanthawi kochepa kumakhudzidwa kwambiri. Wodwala mofulumira amaiwala zomwe zangolankhulidwa komanso zochitika zaposachedwa. Munthu amaiwala mawu osavuta.Kukumbukira kwanthawi yayitali kumamipira kumapeto kwa atherosulinosis yamitsempha yayikulu.
5. Kuperewera koyanjana.
6. Kulankhula kopanda tanthauzo, mawu osokoneza.
7. Kuphwanya usiku kugona. Wodwala samatha kugona kwanthawi yayitali, nthawi zambiri amadzuka pakati pausiku. Masana, munthu amatopa komanso kugona.
8. Maonekedwe a malo amdima patsogolo pa maso. Wodwalayo amatha kuwawona onse ali patsogolo pamaso otseguka komanso otsekeka.
9. Kutunda kwa manja.
10. Kuphwanya zochita. Odwala amakhala ndi nkhawa, misozi, chizolowezi chosintha mwadzidzidzi, nkhawa zosakhazikika, kukayikira, komanso kutsimikiza mtima. Mkhalidwe wamaganiza wodwala sakhazikika: Munthu amakwiya kapena kukwiya pazifukwa zopanda pake.

Atherosclerosis yamitsempha yamaubongo imafalikira kwambiri, kuphatikiza mpaka miyendo. Poterepa, zizindikirazo zimathandizidwa ndi izi:

1. Kuchepetsa kumadera akumunsi.
2. Kutopa panthawi yolimbitsa thupi. Makamaka munthu amatopa poyenda mtunda wautali.
3. Manja ozizira. Zilonda zazing'ono zimatha kuwoneka.
4. Pakapita nthawi matendawa, zotupa za pakhungu zimatha kukhala zodwala.
5. Ndi kuwonongeka kwa ziwiya zamiyendo, lameness imachitika.
6. Misomali yopindika.
7. Miyendo imagwera tsitsi.

Ngati kukayikira koyamba kwa atherosulinosis kukuwonekera, muyenera kufunsa dokotala. Dokotala amathandizira kuzindikira ngati kuli koyenera, kupereka mankhwala.

Mankhwala

Zochizira atherosulinosis, magulu osiyanasiyana a mankhwala amagwiritsidwa ntchito:

1. Ma antiplatelet. Mankhwala a gululi amagwiritsidwa ntchito kuti apewe kudziphatika kwa magazi. Izi zimachepetsa mwayi wa thrombosis. Ma antiplatelet othandizira sangathe kugwiritsidwa ntchito pochiza matenda a atherosulinosis ngati wodwala akudwala chiwindi kapena matenda a impso, zilonda zam'mimba kapena akuvutidwa ndi hemorrhagic stroke. Ndiosafunika kugwiritsa ntchito antiplatelet othandizira pa nthawi ya pakati. Mankhwala a gulu akuphatikizapo Thrombo-bulu, Cardiomagnyl, Plavix, ndi ena.
2. Mankhwala ochepetsa magazi. Lolani magazi kuti adutse kudzera m'mitsempha mosavuta. Gulu la mankhwala amtunduwu limaphatikizapo Sulodexide, Flogenzim ndi ena.

1. Nicotinic acid Amasintha magazi m'mitsempha yamagazi.
2. Mankhwala ochepetsa magazi m'thupi. Lolani chithandizo chokwanira cha non-stenotic atherosulinosis. Mankhwala odziwika kwambiri a gululi ndi Krestor, Torvakard.
3. Mankhwala opititsa patsogolo kayendedwe ka mgwirizano. Mankhwala amtunduwu amaphatikizapo Solcoseryl, Actovegin ndi ena angapo.
4. Mankhwala osokoneza bongo kuti athetse zizindikiro za atherosulinosis. Pakati pawo, choyambirira, anti-yotupa mankhwala ndi analgesics.

Njira ya mankhwala nthawi zambiri imatenga masabata 8 mpaka 12. Mlingo ndi nthawi yayitali ya mankhwala amakhazikitsidwa ndi dokotala - padera pa wodwala aliyense.

Mankhwala othandizira

Opaleshoni ya atherosulinosis imalembedwa chifukwa cha matenda a stenotic. Pali mitundu itatu ya opaleshoni:

1. Opaleshoni yam'mimba. Opaleshoniyo imakhala yopanga njira yowonjezera yoyenda ndi magazi pafupi ndi chotengera chowonongeka. Zotsatira zake, dokotalayo amakwaniritsa kusintha kwa magazi.
2. Kununkha. Kuchita opareshoni kumakhala kukhazikitsa chikhazikitso, chifukwa chomwe magaziwo amayenda bwino m'mitsempha.
3. Balloon angioplasty. Pa nthawi ya opareshoni, baluni yapadera imayikidwa mchombo. Kenako, kuthamangitsidwa mu baluni kumakulitsidwa, kukulitsa chotengera chiwonongekacho.

Zochita zolimbitsa thupi

Zochita zochizira zimagwiritsidwa ntchito posanensa ya stherotic atherosulinosis. Ndikofunikira kuchita makalasi ndi katswiri. Zochita padera zimachitidwa ndi wodwalayo payokha:

1. Kuyenda mozungulira chipindacho muyeso. Panthawi yochita masewera olimbitsa thupi, ndikofunikira kuwunika kuchuluka kwa kuthamanga kwa magazi.
2. Malo otsetsereka m'khosi. Nyamuka mowongoka.Kutulutsa kofinya, ndikonzeretsani mutu wanu, ndikukhazikika pachifuwa cham'mimba momwe mungathere. Sungani mutu wanu pamasekondi awiri ndi atatu, kenako mubwerere pomwe munayambira. Bwerezaninso masewera olimbitsa thupi, koma nthawi ino sinthirani mtsogolo.
3. Manja mmwamba. Tengani choimirira, manja ali pachifuwa chake. Kwezani manja anu mmwamba, ndikuwongola msana momwe mungathere. Kwezani manja anu, kubwerera kumalo oyambira. Bwerezani masewera olimbitsa thupi maulendo 10 mpaka 12.

1. Zilonda zam'mbali. Nyamuka mowongoka. Tsamira mbali zonse.
2. Kubala miyendo pampando. Khalani pampando wapamwamba wakumbuyo. Tengani mwendo wanu kumbali ndikuwugwirira kwa masekondi angapo m'malo awa. Bwererani ku malo oyambira ndikubwereza zolimbitsa thupi ndi mwendo wina.

Chithandizo cha anthu

Mankhwala achikhalidwe sagwiritsidwa ntchito ngati chithandizo chokha, koma monga mankhwala. Ntchito yayikulu ya mankhwala ochokera ku zida zamankhwala wowerengeka azitsamba ndikuchepetsa kukula kwa zizindikiro za mitsempha yayikulu ya mitsempha.

Njira zotsimikiziridwa ndizophatikizira zotsatirazi:

1. Mu 300 magalamu a madzi otentha yikani supuni ya masamba a birch. Kuphatikizikako kumawiritsa kwa theka la ola. Kenako, chida chimapatsidwa maola awiri kuti azidziwitsa. Gwiritsani ntchito tincture katatu patsiku kwa magalamu 100.
2. 200 magalamu a madzi otentha amawonjezera supuni ya maluwa owuma a hawthorn. Kenako wiritsani madziwo kwa mphindi 30. Sula msuzi ndipo ulole. Tengani mawonekedwe ake katatu pa tsiku.
3. Kuti mukonzekere mankhwala, muyenera madzi a anyezi ndi supuni ya uchi. Zomwe zimapangidwira zimaphatikizidwa, madzi ochepa amomwe amaphatikizidwa amadzimadzi amawonjezeredwa. Gwiritsani ntchito mankhwalawa katatu patsiku supuni.

Mankhwala othandizira

Chithandizo cha atherosclerosis ya mitsempha yayikulu imalumikizidwa ndi chakudya chokhwima. Cholinga chachikulu chazakudya zochiritsira ndikuletsa kudya kwambiri mafuta ochepa ("oyipa") cholesterol.

Pazakudya zoyenera, malamulo awa akuyenera kuonedwa:

1. Phatikizaninso zakudya zomwe zimakhala ndi ayodini ambiri muzakudya zanu. Chitsanzo cha zotere zimasokonekera.
2. Patulani kwathunthu kugwiritsa ntchito mafuta azinyama. Kuperewera kwa mapuloteni tikulimbikitsidwa kuti m'malo mwake ndi miyendo. Nyama imaloledwa - nkhuku ndi nkhuku. Nyama zamafuta zimayenera kusiyidwa kwathunthu kuchokera ku menyu.

1. Idyani zakudya zambiri zokhala ndi diuretic. Izi zikuphatikizapo mavwende, mavwende, maapulo.
2. Phatikizaninso masamba, zipatso, zipatso, ndi mtedza muzakudya zanu.
3. Lekani kwathunthu lokoma, tiyi wamphamvu, khofi, chokoleti, kusungidwa.

Zakudya zathanzi zimachedwetsa kukula kwa atherosulinosis ya mitsempha yayikulu ndikuchepetsa kuyambika kwa zizindikiro.

Mavuto ndi kudwala kwa matendawa

Zowopsa zomwe zimakhala zovuta za atherosulinosis, zomwe ndi:

1. Kulephera kuchita ntchito iliyonse yamalingaliro chifukwa cha stenosis yomwe ikupita patsogolo.
2. Stroko Chifukwa cha kufalikira kwathunthu, chotupa cha chotengera ndi kukha mwazi mu ubongo kumachitika. Kuchuluka kwa magazi kumatha kubweretsanso zotsatirazi. Matenda oopsa amathanso kupindika ziwiya, chifukwa chake kuwonekera kwawo kumachepetsedwa kwambiri.
3. Kuwongolera kwa minofu ya muubongo. Zotsatira zake.
4. Zowonjezera mu mitsempha ya ubongo. Zovuta zowopsa, chifukwa cha zomwe makoma am'mimba amang'ambika.

Kukula kwa atherosulinosis kumatsimikiziridwa ndi gawo la matenda, kuchuluka kwa kuchepetsedwa kwa lumen m'matengera, kutanthauzira kwa njirayi, kuchuluka kwa cholesterol plaques.

Kupambana kwa mankhwalawa atherosclerosis a mitsempha yayikulu imatsimikiziridwa ndi nthawi yodziwira matenda. Matendawa akangopezeka ndi matendawa, ndi pomwe amapambana.

Ultrasound ya ziwiya za khosi (duplex angioscanning of the main mtsempha wam'mutu)

Mtengo wa kuwunika koyeserera kwa ziwiya zazikulu za khosi ndi 200 hryvnia.Mtengo umaphatikizaponso kusanthula kwa ziwiya za beseni la carotid ndi ma setera amitsempha yamagazi, njira zotulutsira matumbo ndi njira zoyeserera. Ripoti latsatanetsatane pa phunziroli, kusindikiza zithunzi ndi kujambula pazamagetsi zamagetsi.

Kukweza: powunika ziwiya zam'mutu ndi khosi (kupanga kabina) - echocardiography (ultrasound ya mtima) - kwaulere! Kupulumutsa 250 hryvnia!

Zolinga za ultrasound zamawiya am'khosi

Ultrasound ya ziwiya za khosi imagwiritsidwa ntchito pofufuza kusintha m'mitsempha yamagazi . Amachokera ku khola la msempha ndipo amakhala ndi magazi kupita ku ubongo, minyewa ya khosi ndi mutu, komanso ku chithokomiro cha chithokomiro. Ma ultrasound a ziwiya za khosi amakupatsani mwayi kuti muwone kusintha kwa mitsempha monga brachiocephalic thunthu kumanja, mitsempha ya carotid mbali zonse, mitsempha ya vertebral mbali zonse, mitsempha yakunja ndi yamkati ya carotid mbali zonse ziwiri. Ndi ultrasound yamatumbo a khosi, m'mimba mwake mwa mitsempha, malo amipanda ya ziwiya, amasintha mu lumen chifukwa cha kuchuluka kwa magazi, matenda a khoma la chotengera, mapangidwe a atherosclerotic kapena kupindika kwa zotengera kuchokera kunja zimayesedwa. Ndikotheka kuzindikira kusiyana kwa mapangidwe amitsempha yamagazi - mwachitsanzo, kukoka kwa pathological, kusowa kwa chotengera, kupendekera kapena kukula kwake. Funso lalikulu lomwe limafunsidwa pakupanga ziwiya za khosi ndikuwunika kwa ziwiya kuti zipereke chakudya ku ubongo. Njira iliyonse yomwe imachitika mkati mwa chotengera komanso kuchokera kunja imatha kubweretsa kufowoka kwa chotupa - stenosis kapena kutsekeka kwathunthu kwa lumen ya chotengera - occlusion. Ntchito ya ultrasound ya chotengera ndikuwunika kuchuluka kwa stenosis, komanso kupenda, kuwunika kukula kwa kayendedwe ka kayendedwe kazinthu kozungulira. Njira yozungulira yozungulira imayamba ndi kuonekera kwa njira yoperekera magazi ku malo omwe amaperekedwa ndi magazi ndi mtsempha wamagazi. Chitsanzo chochititsa chidwi kwambiri ndi atherosulinosis ya mtsempha wamagazini, pomwe kuthiridwa kwa magazi kunkono kudutsa mu minyewa ya m'mitsempha ndikuyenda kwa mkono kungayambitse kuwonongeka m'magazi kupita ku ubongo. Kuti mupeze vutoli, ndikofunikira kuti musadziwe kokha kuchuluka kwa ziwiya za khosi, komanso chitsogozo cha kayendedwe ka magazi mwa iwo. Ndi ultrasound yamatumbo a khosi, mawonekedwe a kayendedwe ka magazi amawunikira - kuthamanga kwa magazi kudzera m'matumbo, chikhalidwe cha kutuluka kwa magazi (laminar kapena chipwirikiti), velocity imatsika m'magawo osiyanasiyana a chotengera, kutanuka kwa khoma la chotengera, mawonekedwe a mawonekedwe onsewa mbali zonse ziwiri.

Kafukufuku wotere wamatumbo a khosi amatchedwa duplex angioscanning, popeza phunziroli limagwiritsidwa ntchito nthawi imodzi mumitundu iwiri komanso mumachitidwe a Doppler (mtundu ndi / kapena wowonera).

Kuyesa kwa kuchepetsa kwa mitsempha ndi ma ultrasound a ziwiya za khosi

Mu 2003, American Society of Radiologists inalimbikitsa kugwiritsa ntchito njira zotsatirazi pofuna kudziwa mtundu wa carotid artery stenosis.

• Norm - zotumphukira kwambiri za systolic veterity mkati mwa carotid mtsempha sizidutsa 125 cm / s, pomwe malemba kapena kukula kwa mkati mwa chotengera sikuwoneka
• Stenosis kuchokera ku 50-69% - zotumphukira kwambiri za masentimita 500-230 cm / s
• Stenosis yoposa 70% - nsonga zotumphukira kwambiri pamtunda wa 230 cm / s
• Stenosis yoposa 90% - ndi kukonzanso kopukutira, kuchepa kwakukulu kwa lumen ya chotengera komanso kuchepa kwa kuthamanga kwa magazi kulembedwa
• Ndi kuchepera kwathunthu (kufalikira) kwa chotengera - kutuluka kwa magazi sikunalembetsedwe.
• Chofunikiradi ndikutsimikiza kwa chiŵerengero cha nsonga za systolic velocity mkati ndi wamba carotid mitsempha. Ndi stenosis ya mkati mwa carotid mtsempha wamagazi, kuchuluka kwake kumachulukanso katatu. Chofunika kwambiri ndi kuwerengera kwa kuchuluka kumeneku kwa odwala omwe ali ndi vuto la mtima komanso kuchepa kwa kachigawo kakang'ono ka minofu yamtima (kumanzere kwamtima). Pazifukwa zomwezi, ndikofunikira kuyeza kuthamanga kwa magazi m'manja onse awiri wodwala musanayesedwe.

Njira zodziwika bwino za ultrasound ya ziwiya za khosi

Pazida zamakono zokhala ndi mawonekedwe apamwamba a ultrasound a ziwiya zakhosi, mkhalidwe wazowonetsa media umayesedwa. Ili ndiye gawo lamkati mwa ziwiya zamtundu wa arterial, zomwe zimayamba kusintha ndi atherosclerosis. Kusintha makulidwe ndi makina a intima-media ndi chizindikiro chofunikira kwambiri chakuzindikira kwa ziwiya za pakhosi. Amakhulupirira kuti kukula kwambiri kwa makulidwe a intima-media m'mitsempha wamba wa carotid kumaposa 0.87 mm, ndipo mu carotid artery yayikulu kuposa 0.9 mm ndi chinthu chomwe chimalumikizidwa ndi chiopsezo chachikulu cha matenda amtima (infarction ya myocardial ndi stroke). Kunena mophiphiritsa, kuwunika kwa makulidwe apamaso a carotid mitsempha ndi zenera momwe mungayang'anire kupezeka kwa zotupa za atherosranceotic zamatumbo onse. Mtengo wa makulidwe ochulukitsa a zovutazi amasiyanasiyana kutengera jenda, zaka komanso mtundu.

Zomwe zimatha kupezeka ndi ultrasound ya ziwiya za khosi

Matenda ofala kwambiri omwe amapezeka ndi ma ultrasound a ziwiya za khosi - kukhalapo kwa zolembedwa za atherosselotic mu lumen yamitsempha yamagazi. Popeza zizindikiro za kusokonezeka kwa magazi, zodziwikiratu kwa wodwalayo, zimangokhazikitsidwa pokhoma kutsitsa lumen ya chiwiya ndiopitilira 60%, kupangika kwa mapepala ndi milingo yamagazi kumatha kukhala kwachidziwikire kwa nthawi yayitali. Makatani okhala ndi ma ultrasound a ziwiya za khosi amatha kukhala osiyanasiyana mawonekedwe ndi nyimbo. Ntchito ya wofufuzayo ndikufotokozera mwatsatanetsatane kapangidwe ka zolembazo ndi momwe zimapangidwira.

Nthawi zambiri mafupa a atherosselotic amasungunuka, mafupa am'magazi amapangika pa iwo, omwe amatha kulepheretsa chithokomiro chamitsempha kapena kutuluka, zomwe zimapangitsa kutsekeka kwa zina, zing'onozing'ono. Izi nthawi zambiri zimatha mu kukula kwa sitiroko (kufa kwa gawo lina la minyewa yaubongo) chifukwa cha ngozi ya pachimake ya ubongo. Stroke ndi matenda omwe amapha anthu ambiri (pafupifupi 40%), ndipo opitilira theka opulumuka omwe ali ndi stroke amakhala olumala. Posachedwa, mikwingwirima imayamba mwa anthu adakali aang'ono (mpaka zaka 60).

Zomwe zimathandizira kukulitsa sitiroko: kusuta, matenda ashuga, kuthamanga kwa magazi, kunenepa kwambiri, amuna ndi akazi, kupezeka kwa matenda ofanana ndi abale.

Zinthu ngati izi zikupezeka mwa munthu, amayenera kuwerengera zotengera za khosi mapema. Komanso, kafukufuku wamatumbo a khosi amayenera kuchitika ngati muli ndi nkhawa ya chizungulire, kupweteka pamutu, kulumikizana mwamphamvu, kukumbukira komanso kuyankhula.

Mwa zina zosowa zomwe zimapezeka kuti ndi ma ultrasound a ziwiya za khosi, ndikuwunika kwa khoma la carotid artery - kufalikira kwa malo ake ndi thrombosis yotsatira.

Chidziwitso chofunikira chomwe chimapezedwa ndi ultrasound ya ziwiya za khosi ndikuphunzira kuchuluka kwa magazi omwe amayenda mumitsempha yonse ya khosi kulowa mu ubongo nthawi yonse. Kutuluka kwa magazi mokwanira kupita ku ubongo ndiye chinthu chachikulu chomwe chimaganiziridwa mukamayang'ana momwe magazi amayendera. Nthawi zambiri, mwa munthu wathanzi, pafupifupi 15% ya magazi omwe mtima umapompa m'mphindi imodzi umalowa m'mitsempha ya ubongo. Mothandizidwa ndi ultrasound ya ziwiya za khosi, ndizotheka kuwerengetsa molondola kuchuluka kwa magazi omwe amalowa mu ubongo. Pachifukwa ichi, kuchuluka kwa magazi a volumetric kumawonjezeredwa m'mitsempha inayi yonse yomwe imapereka ubongo, ndiko kuti, m'mitsempha yamkati ya carotid komanso m'mitsempha yama vertebral mbali zonse ziwiri. Kafukufuku wopangidwa moyenera amayandikira molondola pazotsatira zomwe zimapezeka pa positron emission tomography.

Kukonzekera ndi machitidwe a phunziroli

Kukonzekera kwa ultrasound kwa ziwiya za khosi sikufunika. Ndikofunikira, ngati nkotheka, kukana kumwa mankhwala omwe amakhudza kuthamanga kwa magazi.

Pa kafukufukuyu, wodwalayo samakumana ndi zovuta kapena zowawa zilizonse.Kafukufuku wamatumbo a khosi amachitika mu ndege zingapo, zoyambirira ndi zakuda, kenako amasintha ndikusintha kopanga ndikusintha dopplerometry. Nthawi yomweyo, mawonekedwe a chotengera ndi ma geometry ake amayesedwa koyamba, mawonekedwe amizere ndi madera pamaso pa stenosis amayeza. Colour Doppler chimagwiritsidwa ntchito makamaka podziwitsa anthu zolembera zakuda ndi zoyera. M'malo ochepa othamanga, mwachitsanzo, ndi kungafikisidwa kwathunthu kwa chombo, chinthu chogwiritsa ntchito mphamvu chimagwiritsidwa ntchito. Pogwiritsa ntchito Doppler ya pulsed, mizere yamagazi ndi volumetric imatengedwa.

Nthawi zambiri, ma ultrasound a ziwiya zakhosi amachitidwa ngati kafukufuku asanaperekedwe kwa ziwiya zaubongo. Izi ndichifukwa choti, mukamafufuza zomwe zimayambitsa ngozi ya ubongo, ndizomveka poyamba kuti zitsimikizire kuti magazi okwanira amayenda m'mitsempha yayikulu.

Atherosulinotic zotupa za mitsempha yayikulu ya mutu

ZITSANZO ZOTHANDIZA KWAULERE

Mwa matenda opaka minyewa, kugwidwa kwa matenda a m'magazi kumakhala malo amodzi otsogolera pafupipafupi komanso mwakuvuta kwa maphunzirowa, komanso mu kulumala kwa anthu komanso kufa.

Ku Russia, anthu 35 pa anthu 10 miliyoni amavutika ndi ngozi ya mtima pachaka chilichonse, i.e. mpaka 700,000 pachaka, ndipo malo otsogola pakati pawo ndi stroke ischemic. Pakadali pano, anthu opitilira 1 miliyoni mdziko muno ali olumala kwambiri chifukwa cha sitiroko. Ku Moscow kokha, pazaka zisanu zapitazi, zovuta za ischemic zamagazi zikuchulukitsidwa ndi 40%. Imfa pambuyo pa matenda amisempha imakhaladi yokwera 30%. 10% peresenti yokha. odwala omwe apulumuka pachimake cha matendawa amabwezeretsedwa kuntchito, enawo amayamba kulumala ndi kuperewera kwamitsempha. Tsopano, molingana ndi kuwonongeka kwachuma, matenda a ubongo adayamba kukhazikika, ndikupitilira infaration yongoyerekeza. Mtengo wa chithandizo ndi chitetezo chamtundu kwa odwala omwe adadwala matenda opha ziwalo ndi akulu, ku USA, mwachitsanzo, amapezeka $ 7.5 biliyoni pachaka.

Zowoneka za chitukuko cha matenda ammimba ischemic sitingaoneke ngati chisonyezo cha kulowererapo kwa opaleshoni. Makamaka, sitiroko yomwe idayamba chifukwa cha embolism ya zinthu zakale za endocarditis kapena kupatsirana kwa atherosulinosis masiku ano alibe chiyembekezo chochitikira opaleshoni. Njira zothandizira revascularization pa pial-capillary bed ya arterial bed sizinapitirire mopitirira muyeso wa ma laboratories oyesera, ndipo cholemetsa chachikulu cha chithandizo cha gulu ili la odwala chagona kuchipatala chamitsempha.

Mankhwala othandizira opha ziwalo, chifukwa cha kuwonongeka kwa ziwiya zamkati mwa intracranial, nthawi zambiri zimatha kupangidwa kudzera mwa zina zowonjezera - kugwiritsa ntchito anastomoses yowonjezera-mu intracranial mu nyengo ya zipatala za neurosurgical ndi mtima.

Chithandizo cha matenda amitsempha chifukwa cha matenda a ziwiya zazikulu za m'mimba ndi zina mwazinthu zofunika kwambiri pakuchita opaleshoni ya mtima ndi mitsempha.

Chodziwika bwino ndi vuto la opaleshoni ya zotupa za ma atherosselotic zotupa zazikuluzikulu za "masitiroko" asanafike, pomwe odwala amangomenyedwa ndi ischemic yochepa kapena ali ndi vuto la magazi kuubongo.

Gawo lomwe likuthandizapo kuthana ndi mavuto azidziwitso ndi chithandizo cha matenda amitsempha yodziwika ndi chidziwitso chokwanira chazovuta zakuzindikira zovuta ndi zida za opaleshoni. Nthawi yomweyo, zida zamankhwala zothandizira kuphatikiza zigwirizano za pathogenetic sizinasinthe kwambiri. Izi zapangitsa kuwonjezeka kwakukulu kwa gawo la njira zakuchiritsira zochizira matenda amitsempha yamagazi ndi mitsempha yayikulu ya mutu, zotulukapo kapena zovuta zomwe ndi matenda ammimba. Njira zochizira opaleshoni yokhala ndi mtundu wa revascularizing zimakhala ndi zofunika kwambiri, ndipo nthawi zina zotsogola pantchito yovuta ya matenda amitsempha yamagazi ndi zotsalira zawo, kukwaniritsa bwino ntchito yobwezeretsa vuto la matenda osokoneza bongo komanso kukonza magwero a magazi.

Kafukufuku wambiri wazotsatira zamankhwala omwe amapha anthu ambiri ku Europe (European Trial of Carotid Surgery - ECST), ku North America ndikuchita nawo malo angapo ku Europe (North American Simptomatic Carotid Endarterectomy Trial - NASCET). Kuphatikiza apo, kafukufuku wachitatu (Asymptomatic Carotid Atherosulinosis Study - ACAS) adachitidwa mwa anthu omwe ali ndi carotid arteriosranceosis popanda zofananira za ubongo mu malo aku North America. Maphunzirowa, omwe ali ndi milandu pafupifupi 1,500, adatha kupanga zofunikira pakuwonetsa opaleshoni yayikulu yam'mutu. Kutengera mayesero osasankhidwa, njira ziwiri zochiritsira zimayerekezedwa: carotid endarterectomy kuphatikiza kupewetsa mankhwala osokoneza bongo ndi stroke kokha. Mwayi wosakayikitsa wa carotid endarterectomy unatsimikiziridwa, makamaka ndi kuwonjezeka kwa kuchuluka kwa stenosis kwa odwala omwe ali ndi chiwonetsero chazakuwonetsa dyscirculation mu dziwe la mtsempha wamagazi wamkati, zinthu zina zonse kukhala zofanana. Mu asymptomatic njira ya matendawa, opaleshoni ya opaleshoni imapereka pang'ono, koma kukuwonjezeka kwakukulu kwa pafupipafupi kwa anthu omwe amachepetsa m'mimba mwake mwa chotupa cha mkati mwa carotid ndi oposa 60 peresenti.

Chithandizo ndi kuwunika kwa odwala omwe ali ndi cerebrovascular pathology chifukwa cha zotupa za mutu waukulu wamutu ziyenera kuchitika moyang'aniridwa ndi akatswiri a mitsempha - ma neurosurgeons ndi opaleshoni ya mtima.

The diagnostic algorithm imaphatikizapo kuwunika kwakuthupi ndi kwamitsempha, ma ultrasound Dopplerografia ofunikira owonjezera- komanso intracranial, kusunthanso, kupangidwira kwa ubongo kapena maginito a kulingalira kwa ubongo, matenda osokoneza bongo, kuphunzira kwa chapakati pa hemodynamics, kupuma ntchito, impso, zamankhwala am'magazi komanso zamankhwala kafukufuku.

Kuchuluka kwa kafukufuku wazidziwitso pang'onopang'ono kwa odwala omwe akuwadwala kwakanthawi komanso kuthamanga kwa mitsempha yam'mimba pamaso pa dopplerographic hemodynamically stenosis ya mitsempha yayikulu ya mutu (MAG) popereka dziwe.

Panthawi yamatenda okhathamira kapena othandizira pang'onopang'ono, njira yolumikizira iyenera kuchepetsedwa, ndipo odwala oterewa amatumizidwa kuchokera ku chipatala kupita ku dipatimenti yapadera mwadzidzidzi.

Odwala omwe ali ndi matendawa akuwonetsa kuti ali ndi vuto losakwanira malinga ndi zotsatira za mayeso amayenera kuperekedwa ku gulu la othandizira kapena opaleshoni.

Opaleshoni yamankhwala imagwiritsidwa ntchito kwa odwala omwe ali ndi mitundu yosiyanasiyana ya zotupa za carotid ndi vertebral-basilar. Zowona kwathunthu ndi wachibale ndi contraindication opaleshoni njira chithandizo amatsimikiza.

Zowunikira kwathunthu kwa carotid endarterectomy (CEAE):

- carotid stenosis ndi chipatala chosakhalitsa ischemic akuwukira kapena kuwonetsa kuwonongeka kwa discirculatory encephalopathy (odwala omwe ali ndi vuto lochulukirapo, oposa 70%.

- kupezeka kwa malo opezeka pakamwa pakatikati pa carotid artery ya ICA, ngakhale ndi asymptomatic stenosis.

Gululi liyeneranso kuganizira zomwe zingayambitse matenda a stroko, monga msinkhu, matenda oopsa, milomo yokhala ndi magazi, kusuta, shuga.

Zowunikira za CEEA:

- asymptomatic stenosis (mpaka 70%) ya mitsempha ya carotid,

- asymptomatic stenosis ya carotid mitsempha yokhala ndi dopplerographic zizindikiro za stenosis yoposa 90 peresenti,

stenosis ya carotid mitsempha kuchokera 30 mpaka 69 peresenti. ndimawonekedwe amanjenje,

carotid stenosis yomwe ikukula msanga (odwala asymptomatic stenosis miyezi isanu ndi umodzi yapitayo),

grotid stenosis yokhala ndi chizindikiro chamtsempha wamatsenga komanso mgwirizano wa carotid artery thrombosis,

grotid stenosis wokhala ndi chizindikiro chimodzi - fuga ipsilateral amovrosis,

kukula kwa carotid stenosis yovuta ndi sitiroko ndi mawonekedwe a hemiparesis kapena aphasia (osapitirira mwezi umodzi atadwala),

carotid stenosis yokwanira kumenya dziwe la mtsempha wamagetsi,

grost carotid stenosis yokhala ndi zizindikiro za ipsilateral komanso zam'mtima zomwe zimayambitsa matenda a sitiroko (zimatsimikiziridwa ndi echocardiography kapena atria fibrillation),

grotid stenosis, yomwe ikuchitika mosadukiza isanayambike kukomoka kwa mitsempha yodutsa.

Zotsatira za carotid endarterectomy:

- carotid stenosis osakwana 30 peresenti. ndi ipsilateral neurological deficit,

- carotid artery thrombosis yokhala ndi zizindikiro zam'mimba zam'mimba,

- Zizindikiro zopanda hemispatic, monga mutu, kutopa, syncope, etc. ndi chitsimikiziro chachikulu cha carotid stenosis,

- kuvulaza kwakanthawi ischemic mu beseni la vertebro-basilar,

- carotid stenosis yayikulu ndi kuwonongeka kwa mbali yakumaso kwa ubongo,

- grotid stenosis yayikulu ndi ipsilateral kwambiri stroke ndi hemiplegia ndi / kapena chikomokere,

Rot carotid stenosis yokhala ndi chizindikiro cha ipsilateral komanso matenda ophatikizika a khansa (metastases ya khansa, kuwonongeka kwa organic kwa chapakati mantha dongosolo, etc.).

Pali mitundu ingapo ya carotid endarterectomies - yotseguka, yopindika, mitundu yosiyanasiyana ya ma cell am'mitsempha yama cell omwe amagwiritsa ntchito mitsempha ndi mahule (homo ndi heterotransplants). Kusankhidwa kwa njira yogwirira ntchito kumatengera kuwonongeka kwa dziwe la carotid, kutalika kwake. Zabwino kwambiri ndizotsimikizika ndi maulendo obisika - ndi omaliza, nthawi yogwirirayo ntchito imachepetsedwa, ndipo magawo a chombo chomangidwanso amasinthidwa pang'ono.

Kuti muteteze ubongo mokwanira pa carotid endarterectomy, kusankha odwala mosamala, njira yothandizira opaleshoni yothamanga, opaleshoni yayikulu, kupatsirana kwadongosolo, komanso kuwunika kwa Dopplerographic pakadali nthawi yayitali komanso yogwira ntchito. Nthawi zina, ndikofunikira kugwiritsa ntchito shuntumuminal shunt, zomwe zikugwiritsidwa ntchito zomwe ndi izi:

1) kuphatikiza kwamkati mwa mtsempha wamagazi wamkati,

2) stenosis yayikulu kapena chidziwitso cha chotupa cha vertebral kapena chotupa chachikulu chokhala ndi bwalo lochepera lamisempha (kusowa kwa gawo la PSoA kapena A1).

3) kulolera kochepa kwa ubongo kupita ku ischemia, ngakhale motsutsana ndi maziko a njira zapamwamba za intracranial microanastomosis.

Zisonyezero za kumangidwanso kwamitsempha yamagazi:

Zizindikiro za hemodynamics yosakhazikika padziwe la vertebral-basilar:

- stenosis ya mtsempha wamafunde kwambiri wopitilira 75 peresenti.,

- stenosing ndondomeko ndi digiri yomweyo ya stenosis ya onse vertebral mitsempha,

- gawo lachigawo chachigawo chamtsempha wamagazi pamaso pa hypoplasia ina.

2. Chipatala cha tsinde kudulidwa kwa chiyambi cha thrombembolic pozindikira gwero la embolism kuchokera ku mtsempha wamagazi.

3. Stenosis ya dziwe la carotid, malinga ndi kukonzanso kupezeka kwa matenda mu vertebral-basilar pool, yolembedwa m'ndime yoyamba.

4.Kukhudza kwambiri ma vertebral flow flowvasvas compression (khosi lachiberekero, Kimmerle anomaly, uncovertral ndi zifukwa zina za spondylogenic).

Kupangidwanso kwa opaleshoni ya pathology ya gawo loyambirira la mtsempha wamagazi kumakhala ndi gawo limodzi lokhala ndi mkodzo kudzera mu supraclavicular kulowa, ndipo ngati sizingatheke kutero (ndi kuwonongeka kwa ma vertebral ndi / kapena subclavian mitsempha), ndikofunikira kugwiritsa ntchito njira zosunthira mtsempha wamagazi - vertebral carpid anampassid. .

Zisonyezero zamankhwala opaleshoni ya zotupa zam'madzi am'mimba:

1. Kukhalapo kwa zochitika za "kuba" mwachinsinsi, zomwe zimakhala ndi ischemia mu dziwe la vertebral-basilar ndi / kapena nthambi yam'mwamba.Zizindikiro zophatikizika zamitsempha yama carotid ndi ma vertebral-basilar minofu nthawi yomweyo.

Njira yodziwika kwambiri yopangidwira zizindikirozi ndi kuletsa kwamphamvu kwa magazi chifukwa chofunikira kwambiri cha stenosis kapena embolism ya chotengera cham'mimba chifukwa cha zilonda zam'mphepete mwa atheromatous.

2. Heterogenible atherosulinotic plaques mu gawo loyambirira la gawo la subclavia pomwe kulibe mawonetseredwe a intracranial arterial pathology, owonetsedwa ndi vertebral-basilar discirculation.

3. Wodziwika bwino (75 peresenti kapena kuposerapo) stenosis ya gawo loyamba la gawo la m'mimba.

4. zotupa za asymptomatic za gawo loyambirira la msana wamagawo ochepa a m'mimba (> 75% ya m'mimba mwake) mwa odwala omwe akuwonetsedwa kuti ali ndi anastomosis ya mammary-cormary-subclavian ".

5. Subclavian artery revascularization imawonetsedwanso kwa odwala omwe adakhala ndi mammary-coronary anastomosis, ndipo kupita patsogolo kwa matenda amitsempha yamagazi kumalumikizana ndi chodabwitsa cha "kuba" kwa coronary-mammary-subclavian.

6. Kuchulukitsa kwa asymptomatic occlusion ya mtsempha wamagonthaka kuti apange magazi oyenda kwambiri mwa odwala omwe akuwonetsedwa mwa dongosolo la hemodialysis kapena opaleshoni ya subclavian (axial) - yopangira opaleshoni yodutsa.

Kusankha pakati pa sternal ndi supraclavicular kufikira kutengera magawo a thunthu. Ndi asthenic physique komanso odwala wodyetsa pang'ono, ndikofunikira kukhazikitsa anastomosis ya carotid-subclavian. Kwa anthu omwe ali ndi thupi la Normosthenic kapena hypersthenic physique yolimbana ndi chakudya chomwe chikukula, ndikofunikira kugwiritsa ntchito carotid-subclavian prosthetics.

Zisonyezero zogwiritsa ntchito anastomosis yowonjezera-intracranial:

- ICA thrombosis ndi kukomoka kwa akasungidwe ka mgwirizano,

- hemodynamically yofunika stenosis ya zigawo za intracranial m'misasa yapakati, mitsempha yakumbuyo kapena yam'mbuyo.

- ngati gawo loyamba la carotid endarterectomy kumbali ya ipsilateral posakhalitsa pakubwera magazi oyenda motsatira mabwalo a vilizium,

- zotupa zamkati mwa carotid mtsempha wamagazi pang'ono ndi kulekerera kwa ubongo kupita ku ischemia, pamene chithandizo chambiri cha opaleshoni chikuwonetsedwa,

- ndi bicarotid stenosis yokhala ndi vuto limodzi la carotid: woyamba, gawo loyamba ndikubwezeretsa kokwanira kwa carotid artery, contralateral tandem lesion, kenako kugwiritsa ntchito kwa EIKMA.

X-ray endovascular angioplasty iyenera kuchitidwa pokhapokha ndi zida zokwanira zaukadaulo. Endovascular angioplasty yam'deralo stenosis imakonda.

Kuunika mosamalitsa kwa zisonyezo ndi kuponderezedwa kwa chithandizo cha opaleshoni, kufotokozera za magawo a opareshoni, kukhalapo kwa gulu la akatswiri odziwa ntchito kwambiri, kuyang'anira zovuta za matenda a chithokomiro, mapindu olimbikitsanso zokwanira ndizinthu zazikulu zomwe zimachepetsa chiopsezo cha zovuta za postoperative ndikubwezeretsanso moyenera matenda opatsirana.

Pomaliza, ziyenera kudziwitsidwa kuti chithandizo cha matenda oopsa kwambiri komanso oopsa a cerebrovascular path, mwachidziwikire, ziyenera kuchitika ndi njira zomwe ambiri amavomereza. Palibe kukayika konse kufunika kwa chithandizo chachikhalidwe pochiza odwala.

Zochitika zimawonetsa kuti pali gulu lomwe limafotokozedwa mosamalitsa kwa odwala omwe ali ndi matenda amitsempha yama mutu oyambira, omwe mosakayikira ali pachiwopsezo chokhala ndi vuto la ubongo kapena kale lomwe ali ndi vuto la matenda a chithokomiro matenda, chithandizo choyenera chomwe chingapezeke mwa kuchitidwa opaleshoni.Kafukufuku wothandizirana padziko lonse lapansi watsimikizira mwayi wosakayikira wa chithandizo cha opaleshoni ya zotupa za m'mitsempha yayikulu ya mutu kuletsa kukula kwa stroko kapena kufalikira kwake.

Njira yolondola yachipatala ku gululi la odwala ikhoza kukhala yotsimikiza popewa kukula kwa matendawa, kukhalabe ndi moyo wabwino, komanso moyo weniweniwo, ngati funso lazidziwitso ndi mawonekedwe a chithandizo cha opaleshoni atha kuthetsedwa panthawi yake. Kusankha kwazowonetsa,

Georgy MITROSHIN, Mutu wa Center

opaleshoni yamtima

A.A. Vishnevsky, Dokotala Wolemekezeka wa Russian Federation.

Valery LAZAREV, Wofufuza Wotsogolera

zamankhwala dipatimenti ya Research Institute of Neurosurgery

iwo. NN Burdenko RAMS, dokotala wa sayansi yamankhwala.

Gennady ANTONOV, Mutu wa Dipatimenti

Angioneurosurgery TsVKG adatchulidwa A.A. Vishnevsky,

Amatsenga a atherosulinosis ndi njira ya m'magazi momwe cholesterol malo amisomali amaikidwira pazitsekezero zazikulu zam'mutu, magazi ndi kuperekera kwa oksijeni ku ubongo kumasokonezeka. Matendawa amakhudza amuna atatha zaka 45, azimayi - zaka 55.

Moyo, kuperewera kwa zakudya m'thupi kumakhudza thanzi lanu. Kudya kwamafuta ochulukirapo, kuchuluka kwa mapangidwe a lipid m'thupi ndizochititsa zazikulu zomwe zimatsogolera ku stenosis ya ubongo, mitsempha ya m'mimba, mitsempha yamagazi ya ubongo, miyendo ndi khosi. Arteriosulinosis ndi asymptomatic kwa nthawi yayitali. Mphamvu yamkati ikatha, zizindikiro za MAG zimawonekera:

1. Kukhazikika kwadzidzidzi, kupweteka kwa mutu. Kukula kwa kupweteka kwa matendawa kumadalira kutalika kwa njira, mulingo, kuchuluka kwa mapangidwe, kutanthauzira kwa zolembazo.
2. Odwala amadwala tinnitus, chizungulire.
3. Kukumbukira kumayamba kuchepa. Chizindikiro chodziwika bwino cha matendawa ndi kuphwanya kukumbukira kwakanthawi kochepa: mawu amaiwalika pakukambirana, zochitika zaposachedwa. Kukumbukira kwanthawi yayitali sikumayamba kuvutika.
4. Kusintha kwakhalidwe kumasintha: kumakhala kukhumudwa, kugwetsa, nkhawa zopanda nkhawa. Odwala amayamba kukayikira, kufunsa, kukwiya, kukwiya msanga.
5. Kusokonezeka kwa tulo usiku. Odwala sangathe kugona kwanthawi yayitali, kudzuka pakati pausiku. Usiku wonse akumva kutopa kosalekeza, kugona.
6. Pali kusintha kwa gait, manyazi.
7. Kuyankhula kumakhala kosamveka, kopanda tanthauzo. Odwala amaiwala mayina amawu.
8. Odwala amadandaula za mawanga amdima omwe amapezeka pamaso pa maso otseguka, otsekeka.
9. Kugwirana chanza kumawoneka.

Pomaliza magawo, atherosulinosis ya mitsempha yayikulu ya ubongo imayambitsa matenda osokoneza bongo. Munthu samayang'ana umunthu wake, malo okhala. Gawo lowongolera limafunikira chisamaliro chakunja kwa wodwala. Sathanso kuchita zoyambira.

Arteriosulinosis imagawidwa kukhala stenotic komanso sanali stenotic.

Non-stenotic atherosulinosis ndi gawo loyambirira la zotupa za atherosulinotic m'mitsempha yayikulu ya mutu. Kuzindikira koteroko sikupezeka konse chifukwa zosintha pakuyandikira kwa botilo silili laling'ono, chotengera chilibebe. Chikwangwani cha cholesterol chimatseka lumen ndi zosakwana 50%. Matendawa ndi abwino, zotsatira zabwino zimawonedwa kuchokera ku mankhwala ochepetsa mphamvu.

Stenosing ndi yofala, imayimira gawo la matendawo. Kuwonekera kwamitsempha yayikulu ya mutu kumatsekedwa ndi 50% kapena kupitirira.Mankhwala othandizira kwambiri, opaleshoni ndiyofunikira. Stenosing atherosulinosis ya mitsempha yayikulu ya mutu nthawi zambiri imayambitsa zovuta, imfa. Kugonjetsedwa kwa ubongo ndi magawano a extracranial amatsenga amadziwika.

Zinthu Zachitukuko

Zolemba za cholesterol zimakhudza maiwe osiyanasiyana am'magazi. Magazi a chotengera chachikulu atatsekedwa, magazi ake amayenda ziwalo zonse zamkati.

Kutengera ndi komweko, zotupa za mitsempha yayikulu imasiyanitsidwa ndi intracranial komanso extracranial (extracranial):

1. Matenda a ubongo. Matendawa amawonekera pakuwonekera kwa lipid maofesi yamkati yamitsempha yamagazi. Wodwalayo amamva kupweteka mutu pafupipafupi, chizungulire, kuiwalaiwala, kugona pang'ono, alibe chidwi, komanso amakhala ndi nkhawa. Pathology imagawidwa kukhala wamba komanso kuyambitsa. Yoyamba imachitika mu psychology ya gawo limodzi kapena zingapo za ubongo, kutsogolo ndi parietal dera. Diffuse atherosulinotic lesion - chowopseza moyo chomwe mosalekeza chimatsogolera kulumala. Ndi matenda awa, maselo aubongo amalowa m'malo mwa minyewa yolumikizana. A Sc scan imawululira necrotic foci, aneurysms ya mtima.
2. Atherosulinosis ya zigawo zikuluzikulu za mitsempha yayikulu imadziwika ndi zizindikiro zofananira, zomwe zimayamba mwachangu kuposa mitundu ina ya matendawa.
3. Intracranial - imadziwonekera mu nthawi yakusokonezeka kwakanthawi kokhudza magazi kupita ku ubongo. Mankhwala, matenda a pathological amatchedwa kuchepa kwa nthawi. Zizindikiro zake zimakhala zofanana ndi stroke, koma zimatha patsiku limodzi. Zikatero, kufunsa kwa dokotala kumafunika.
4. Atherosulinosis ya mitsempha ya carotid imawoneka ndi kuwonongeka kofananako kwa ziwiya zazikulu zamutu. Chipatalachi ndi chofanana ndi mitundu ina. Pamene ziwiya zingapo zazikulu zikuphatikizidwa mu pathological process, chiopsezo cha ischemic stroke ndi kufa chikuchulukitsidwa.
5. Atherosulinotic zotupa za mitsempha ya brachiocephalic imayendera limodzi ndi kuphwanya kwamitsempha yamagazi m'maselo a ubongo, khosi.
6. Cholesterol imayikidwa pazida za mtima. Coronary imabweretsa matenda a mtima, kugunda kwa mtima, mtima, mitundu yosiyanasiyana ya angina pectoris, mtima arrhythmias (arrhythmias, blockades). Kufalikira kwathunthu kumawopseza kulephera kwa mtima. Poyerekeza ndi maziko a coronary sclerosis, ochepa matenda oopsa amachitika, omwe nthawi zambiri amayambitsa stroko.
7. Mimbulu yam'mimba imakhala ndi vuto lochokera pama cell a cholesterol. Matendawa amawonetsedwa ndi kupweteka m'dera la epigastric, kumverera kwodzaza, kupindika, nseru. Ndikosavuta kusiyanitsa ndi matenda ena ammimba, amafunika kuwazindikira
8. Kutulutsa kwa lipid maofesi amapezeka m'matumbo a impso. Zizindikiro za matendawa zimakhala kuthamanga kwa magazi, chizungulire, kusintha kwamayesero amkodzo.
9. Atherosulinosis imakhudza madera otsika. Odwala amamva kupweteka, kutopa poyenda, kutupa, mapazi ozizira. Kugunda kofowoka kumatsimikiziridwa pa dzanja lakhudzidwa. Atherosclerosis ya ziwiya zamiyendo ndimakonda chifukwa cha thrombosis, embolism.

Njira zowunika za atherosulinosis zimaphatikizapo:

• Kutolere mbiri yachipatala. Dziwani zomwe zimayambitsa, matenda oyanjana, zizolowezi zoyipa, nthawi,
• kuchuluka kwa kuthamanga kwa magazi, kugaya, kuchuluka kwa kupuma,
• mayeso azachipatala ambiri (magazi, mkodzo, mayeso a shuga),
• kuyesa kwa magazi kwamankhwala am'magazi (mapidrum wope, aimpso, hepatic tata) kumawonetsa kuchuluka kwa cholesterol, magawo ake, amathandizira kudziwa matenda oyanjana,
• ultrasound imawunika mkhalidwe wa carotid ndi mafupa am'mitsempha. Dokotala amazindikira kukula kwa zombo, kukula kwake,
• kulingalira kwa maginito ndi makina owerengera ndi ena mwa njira zolondola kwambiri.Amathandizanso kudziwa kapangidwe ka ziwiya zam'mutu za mutu, khosi, miyendo. Pazithunzi zomwe mwapeza, zithunzi m'mafanizo onse zimawoneka, zomwe zimaloleza kuzindikira kwachilengedwe ndi kuchuluka kwa matenda.
• angiography imakupatsani mwayi wofufuza momwe magazi amapezekera m'mitsempha yamagazi.

Pambuyo pazoyeserera zofunikira, dokotala amafufuza njira zamankhwala zothandizira. Ngati mankhwala okhwima amapereka mankhwala a matendawa (ma statins, anticoagulants). Ngati vutolo likufuna kuchitapo kanthu opaleshoni, iye amalangiza wodwalayo za opareshoni yomwe ikubwera.

Mavuto omwe angakhalepo komanso chidziwitso cha moyo

Mavuto oyendayenda ndi owopsa ku thanzi. Ubongo sukulandila kuchuluka kwa oxygen ndi magazi, kufa ndi njala ya oxygen, ndipo kumachitika madera a ischemic. Mavuto a matendawa ali ndi mawonekedwe awa:

1. Stenosis imawopseza kuthekera kochita ntchito zamaganizidwe.
2. Stroko Kutulutsa kwathunthu kumayambitsa zotupa. Zofananazo zimachitika ndi kuthamanga kwa magazi. Poyerekeza ndi vuto la matenda oopsa, ziwiya zam'madzi (stelose), ma lumen ochepa amachepa kwambiri.
3. Kuchepa kwa minyewa yaubongo kumabweretsa kusokonezeka kwa malingaliro, dementia.
4. Nthawi zambiri pamakhala mitsempha ya mitsempha ya m'magazi, yomwe imapangitsa kuti khoma lamitsempha yama magazi.

Kukula kwa matendawa kumatengera gawo la atherosulinosis, kuchuluka kwa kuchepetsa, kutulutsa, komanso kuchuluka kwa zotupa. M'magawo oyamba, ndi chithandizo cha nthawi yake, kupititsa patsogolo matendawa kungathe kupewedwa. Ndikofunikira kutsatira malingaliro a dokotala, kusintha moyo, kutsatira chithandizo cha zakudya. Pambuyo pake, kupezeka kwa chiwonetsero chazovuta zonse kumabweretsa kudwala kwa wodwala.

Ndi atherosclerosis, mitsempha yayikulu imaphatikizidwa poyambira kale. Atherosclerosis ya ziwiya zazikulu za mutu imawopseza ndi stroko.

Atherosulinosis mage (yofupikira ya "mitsempha yayikulu ya mutu") ndi matenda omwe amachititsa kuti magazi aziyenda bwino ku ubongo. Izi zimachitika chifukwa cha kupezeka kwa cholesterol plaques pamakoma amitsempha yayikulu.

Mapangidwe a cholesterol amachepetsa minyewa yotupa, chifukwa pomwe ubongo sualandila mpweya wokwanira kudzera m'magazi. Matenda a atherosulin ambiri amakhudza amuna achikulire kuposa zaka 45 ndipo azimayi atatha zaka 55.

Zinthu za atherosulinosis zamatumbo akulu

Kukula kwa atherosulinosis kumalumikizidwa ndi kuyika kwa maselo amafuta m'makoma amitsempha yamagazi. Poyamba, masango ndi ochepa ndipo samayambitsa kuvulaza kwambiri. Ngati zinthu sizingatenge nthawi, malo osungiramo malo amakula kwambiri ndikuletsa lumen ya zombozo. Zotsatira zake, kufalikira kwa magazi kumakulirakulira.

Atherosulinosis ya mitsempha yayikulu ya mutu imakhala pachiwopsezo chachikulu kwa anthu. Matendawa akamakula, magazi amatuluka m'matumbo a khosi ndi mutu, omwe amachititsa kuti magazi azikhala ndi ubongo wambiri.

Matenda owopsa a matendawa amatha kutsagana ndi kuwonongedwa kwa khoma la chotengera ndikupanga aneurysm. Kutalika kwa mphamvu kumatha kukulitsa vutolo. Kutumphukira kwa aneurysm kotereku kumakhala ndi zotsatirapo zoyipa zaumoyo mpaka kufa.

Kutengera ndi kuwopsa kwa matendawa, mitundu iwiri yayikulu ndiyopadera:

1. Non-stenotic atherosulinosis. Mawuwa amatanthauza mkhalidwe momwe cholembera sichikuposa 50% yakuunikira kwa chotengera. Fomuyi imawonedwa ngati yochepetsetsa kwa moyo wa munthu komanso thanzi.
2. Stenosing atherosulinosis. Ndi matendawa, matendawa amatsekedwa ndi zolembedwa zoposa theka. Izi zimakhudza kwambiri magazi omwe amapezeka mkati.

Matendawa akangopezeka ndi matendawa, amakhala ndi mwayi wopambana.Ndizosatheka kuthetsa matendawa kwathunthu, chifukwa chake munthu aliyense ayenera kuchitapo kanthu kupatula zinthu zomwe zimayambitsa matenda a atherosulinosis.

Kodi ndi zinthu ziti zomwe zimayambitsa matendawa?

Kuti mankhwalawa atherosulinosis a MAG akhale opambana, ndikofunikira kuzindikira ndikuchotsa chomwe chimayambitsa mawonekedwe ake. Zina mwa izo ndi:

1. Kuthamanga kwa magazi.
2. Kuchuluka kwa cholesterol m'magazi.
3. Matenda a endocrine dongosolo.
4. Kumwa mowa kwambiri ndi kusuta.
5. Mavuto a shuga.
6. Kulephera kuchita zolimbitsa thupi.
7. Kutsatira kuperewera kwa zakudya m'thupi.
8. Zosintha zokhudzana ndi zaka m'thupi.
9. Khalani nthawi yayitali pamavuto.
10. Kunenepa kwambiri.

Nthawi zambiri, matendawa amakhudza amuna achikulire. Ndikofunikira kwambiri kuti awunikire momwe thanzi lawo lilili, kutsatira mfundo zolondola za kadyedwe koyenera komanso moyo wawo.

Munthu aliyense nthawi ndi nthawi amayenera kuwongolera kuchuluka kwa kuthamanga kwa magazi ndi cholesterol m'magazi. Kuyesedwa kwakanthawi kachipatala kungathandize pa izi.

Zizindikiro za atherosulinosis

Atherosulinosis ya mitsempha ya extracranial imawonetsedwa ndi zizindikiro zowoneka bwino. Zimatengera kwambiri malo omwe zidakhazikikazo. Ngati chotupa chikugwera pamatumbo a ubongo, ndiye kuti pali zotsatirazi:

1. Maonekedwe a tinnitus.
2. Mutu waukulu ndi chizungulire.
3. Mavuto amakumbukiro.
4. Kusazindikira mayendedwe, mawu opuwala. Zovuta zina zamitsempha zimatha.
5. Vuto kugona. Munthu amagona kwanthawi yayitali, nthawi zambiri akamadzuka pakati pausiku, masana akuvutika ndi tulo.
6. Sinthani mu psyche. Pali kuwonjezereka kwa nkhawa, nkhawa ya munthu, amakhala misozi ndi kukayikira.

Zilonda za atherosulinotic zitha kupezeka m'mitsempha ya miyendo. Pankhaniyi, zizindikirazi zidzakhala zosiyana. Zizindikiro zotsatirazi za matendawa zimawonekera:

1. Kutsika pang'ono m'munsi.
2. Kutopa msanga panthawi yolimbitsa thupi. Izi zimatchulidwa makamaka poyenda mtunda wautali.
3. Manja amayamba kuzizira. Zilonda zazing'ono zimatha kuwoneka.
4. Woopsa milandu, gangrene amakula.
5. Ngati ziwiya zam'munsi zimakhudzidwa, ndiye kuti munthuyo ayamba kulumala.
6. Mitengo ya misomali ikucheperachepera.
7. M'malo am'munsi, kuchepa kwa tsitsi kumawonedwa.

Zizindikiro za atherosulinosis MAG ikhoza kukhala ndi kusiyanasiyana. Pakumayambiriro koyamba, ndizotheka kudziwa vutoli pokhapokha mukamayesedwa.

Ngati mukupeza zizindikiro zoyambirira za matendawa, muyenera kufunsa dokotala nthawi yomweyo. Pokhapokha ngati mukudwala matendawa panthawi yomwe mungathe kusiya matendawa.

Kuzindikira koyenera

Ndikotheka kudziwa kuwonongeka kwa mitsempha yayikulu ya mutu pokhapokha pakuyang'ana kwathunthu kuchipatala. Akatswiri amafunika kudziwa momwe vutoli limapangidwira, magawo a zolembedwazo, komanso kupezeka kwa kuchuluka kwa minofu yolumikizana.

Njira zotsatirazi zodziwira matenda zimagwira ntchito:

1. Kuyesa kwazonse ndi zamankhwala am'mwazi.
2. Kuyesa kwa Ultrasound Kuunika kwamitsempha yamagazi, komwe kumayambitsa magazi kupita ku ubongo. Mitsempha ya carotid ndi vertebral imayesedwa. Katswiriyu amawona momwe alili, m'mimba mwake, kusintha chilolezo.
3. Magnetic resonance imaging. Uku ndikuwunika komwe kumakupatsani mwayi wowerengera momwe maselo a ubongo, khosi, ndi miyendo zimagwirira ntchito. Zida zamakono zimatsimikizira kuti mupeze zithunzi muzosiyanasiyana. Njira imeneyi imawonedwa kuti ndi yophunzitsa kwambiri.
4. Angiography. Mumakulolani kuti muwerenge ma pathologies onse a mtima wam'magazi. Njira yosiyanitsa yapadera imalowetsedwa m'magazi a wodwala. Pambuyo pa izi, kuyesedwa kwa X-ray kumachitika.

Njira yotsatirira mayeso imasankhidwa ndi dokotala payekhapayekha kwa wodwala aliyense. Izi zimaganizira mawonekedwe a thupi, komanso zida zomwe chipatala chili nacho.

Kodi mankhwalawa amachitika bwanji?

Non-stenotic atherosulinosis koyambirira kumatha kuchiritsidwa. Ndi njira yophatikizidwa ndikutsatira molondola malangizo onse a katswiri, ndikotheka kuyimitsa chitukuko cha matendawa.

Masiku ano, njira zotsatirazi ndizothandiza kwambiri:

1. Mankhwala. Zimaphatikizapo kumwa mankhwala apadera.
2. Kuthandizira opaleshoni. Njirayi imabweretsa chiopsezo ku moyo ndi thanzi la wodwalayo. Ikani mankhwala pokhapokha ngati njira zina zamankhwala sizothandiza. Kuchita opaleshoni yopanda stenotic atherosulinosis sikuthandiza.
3. Kusintha kwa moyo. Kuti muchepetse kukula kwa matendawa, ndikofunikira kusiya zizolowezi zoyipa, makamaka kusuta. Muyenera kuchepetsa kugwiritsa ntchito mafuta, okazinga, osuta zakudya. Muyenera kusunthira kwambiri, kuchita masewera, kulembetsa padziwe. Pankhaniyi, katunduyo ayenera kukhala ochepa. Ndikofunika kufunsa katswiri.
4. Zakudya zopatsa thanzi. Akatswiri amalimbikitsa kutsatira malamulo apadera azopatsa thanzi. Izi zikuthandizira kuchepetsa cholesterol.
5. Chitani masewera olimbitsa thupi. Pali masewera olimbitsa thupi apadera omwe amathandizira kubwezeretsa magazi moyenera kumagawo onse a ubongo ndi miyendo.
6. Kuwunikira zaumoyo. Ndikofunikira kuyeza kuthamanga kwa magazi, kuwunika kuchuluka kwa cholesterol m'magazi. Matenda onse ophatikizika amayenera kuthandizidwa munthawi yake.

Kuchita bwino mankhwala kumatheka pokhapokha ngati zinthu zonse zoipa zitachotsedwa. Wodwala ayenera kupewa zovuta zomwe zingachitike, kudya bwino ndikuyenda kwambiri. Nthawi yomweyo, kutsatira kwambiri malangizo onse a dokotala ndikofunikira.

Mankhwala omwe amagwiritsidwa ntchito pochiritsa

Masiku ano, magulu angapo a mankhwala akhazikitsidwa omwe amapereka chothandiza pothandizira matenda a atherosulinosis a ziwiya zazikulu za ubongo:

1. Ma antiplatelet. Mankhwala osokoneza bongo amtunduwu amatchinga kumamatira m'mapazi am'magazi, omwe amachepetsa chiopsezo cha thrombosis. Mankhwalawa amaletsedwa kugwiritsidwa ntchito ngati impso ndi chiwindi kulephera, kutenga pakati, zilonda zam'mimba komanso hemorrhagic stroke. Mankhwala odziwika kwambiri a gululi ndi Thrombo-bulu, Cardiomagnyl, Plavix ndi ena otero.
2. Mitsempha yotsitsa magazi. Amathandizira magazi kuyenda bwino kudutsa malo ochepa. Izi zimaphatikizapo sulodexide. Flogenzim ndi ena.
3. Mankhwala ozunguza bongo a nicotinic acid. Amapangidwa kuti azithandiza magazi.
4. Mankhwala omwe amachepetsa kuchuluka kwa cholesterol m'magazi. Ndi thandizo lawo, ma stherotic atherosulinosis amatha kuthandizidwa moyenera. Ena mwa iwo ndi Krestor, Torvakard ndi ena.
5. Njira zowonjezera kufalikira kwa mgwirizano. Gululi limaphatikizapo Solcoseryl, Actovegin ndi ena.
6. Kukonzekera kuchotsedwa kwa zizindikiro. Amatha kukhala odana ndi yotupa komanso ma analgesics.

Mankhwala osokoneza bongo atenga miyezi iwiri kapena itatu. Mlingo ndi nthawi yayitali ya mankhwala amatsimikiziridwa ndi katswiri kwa wodwala aliyense.

Odwala omwe akuwonetsedwa akuwonetsedwa asitikali ya acetylsalicylic acid. Mankhwalawa athandizira kuchepetsa chiopsezo cha thrombosis.

Mankhwala othandizira

Woopsa milandu, matenda atherosulinosis amathandizidwa ndi opaleshoni. Njira imeneyi imagwiritsidwa ntchito ngati matenda a stenotic. Pali njira zitatu zazikulu zogwirira ntchito:

1. Opaleshoni yam'mimba. Pogwira opaleshoni iyi, dokotalayo amapanga njira yowonjezera yoyenda ndi magazi pafupi ndi malo owonongeka.Chifukwa chake, ndikotheka kubwezeretsa kayendedwe kabwino ka magazi.
2. Kununkha. Kuchita uku kumakhudza kukhazikitsidwa kwapadera, komwe kumatha kubwezeretsa magazi.
3. Balloon angioplasty. Mchitidwewu umaphatikizanso kuyambitsa kupopera kwapadera mumtsuko. Kupanikizika kumayikiridwa, komwe kumakulitsa chotengera chomwe chikukhudzidwa.

Njira inayake imasankhidwa ndi katswiri potengera momwe wodwalayo alili, komanso momwe magawo a masisitimu am'mimba amathandizira.

Njira zochizira anthu

Mutha kuthandizira pulogalamu yayikulu yamankhwala mothandizidwa ndi mankhwala achikhalidwe. Sangakhale njira yokhayo yothandizira.

Chimodzi mwa maphikidwe othandiza kwambiri pothana ndi atherosulinosis ndi awa:

1. Thirani supuni ya tiyi ya birch mu kapu yamadzi otentha. Wiritsani zikuchokera kwa mphindi 25. Pambuyo pake, siyani chinthucho kwa maola angapo kuti mukalimbikire. Tengani zakonzedweratu katatu patsiku kuchuluka kwa 100 ml.
2. Thirani supuni ya maluwa owuma a hawthorn ndi kapu yamadzi. Mapangidwe oterowo ayenera kuwiritsa kwa mphindi 25. Pambuyo pake, imatha kusefedwa. Yembekezerani msuzi kuti uzizire. Amamwa theka lagalasi katatu patsiku.
3. Finyani madziwo mu anyezi umodzi. Phatikizani ndi uchi wachilengedwe. Supuni imodzi ya madzi imafunikira uchi umodzi. Onjezani madzi ena kuti amwe madzi. Ndikofunikira kumwa supuni imodzi yodzikongoletsa katatu patsiku.

Njira zophweka zoterezi zithandiza kupititsa patsogolo njira zachilengedwe. Nthawi zina zimayambitsa kukwiya chifukwa chake musanazigwiritse ntchito, muyenera kufunsa dokotala.

Zakudya zamagulu

Pa chithandizo, odwala atherosulinosis amawonetsedwa kuti azitsatira zakudya zapadera. Iyi ndi njira yokhayo yochepetsera kuyenda kwa cholesterol m'mwazi. Malangizo otsatirawa akuyenera kutsatiridwa:

1. Zakudya zopatsa thanzi za ayodini, monga zam'madzi zam'madzi, zimalimbikitsidwa.
2. Kukana kwathunthu kwamafuta a nyama kukuwonetsedwa. Kuperewera kwamapuloteni kumatha kupangidwira nthangala.
3. Idyani zakudya zambiri zokhala ndi diuretic. Izi zikuphatikizapo mavwende, maapulo, mavwende ndi ena.
4. Zakudyazi ziyenera kuphatikizapo masamba, zipatso, mtedza, zipatso.
5. Amaloledwa kudya nkhuku ndi nkhuku. Zakudya zamafuta ndi mafuta ndizoletsedwa.
6. Muyenera kukana maswiti, khofi, tiyi wamphamvu, chokoleti, ndi zakudya zamzitini.

Kutsatira mfundo zachakudya zoyenera kumathandizira kuimitsa chitukuko cha matendawa komanso kulimbikitsa mphamvu ya mankhwala. Pamawonetsero oyamba a atherosclerosis, muyenera kufunafuna thandizo kwa katswiri. Vuto likangopezeka posachedwa, ndiye mwayi wokhala wathanzi.

Malinga ndi ziwerengero zaposachedwa kwambiri, anthu ochulukirachulukirachulukirapo amapezeka ndi matendawa. Ngati kale matendawa amatengedwa ngati okhudzana ndi zaka, tsopano akuyamba kukhala achichepere. Mitundu yake yoopsa kwambiri ndi stenotic atherosulinosis ya MAG (mitsempha yayikulu yamutu). Vutoli limakhudzana ndi kufalikira kwa cholesterol plaque m'mitsempha a ubongo, khosi komanso mitsempha yayikulu yam'munsi. Matendawa ndi osachiritsika ndipo nkosatheka kuchichotsa kwathunthu. Koma mutha kuchitapo kanthu kuti muchepetse kukula msanga. Kuti muchite izi, muyenera kukumbukira mawonekedwe apadera a matendawa ndi njira zazikulu zochiritsira.

Mwachidule za stenotic atherosulinosis

Atherossteosis ndi matenda osachiritsika omwe amadziwika ndi kuwonongeka kwa mitsempha ndi mapangidwe a cholesterol zolembera mwa iwo. Pakadali pano, madokotala amakhulupirira kuti chomwe chimayambitsa matenda a metabolic, makamaka mapuloteni ndi lipids.Cholesterol yowonjezera, yomwe imakhalabe m'thupi chifukwa chogwiritsa ntchito lipoprotein, imakhazikika pamitsempha, ndikupanga zolembera.

Zidutswa izi zimachepetsa mphamvu yakuwala ndipo samadzipangitsa kumverera koyambirira kwa matendawa. Koma ngati mulingo wa cholesterol m'mwazi suchepa, ndiye kuti iwo amakula, amakula khoma la chotengera ndikupangitsa mawonekedwe a minyewa yolumikizidwa (njirayi imatchedwa sclerosis). Zotsatira zake, khoma lamkati la mtsempha limakhala lonyentchera, chotchinga chake chimakula munjira ya magazi, ndipo minyewa yomwe chida chimatsogolera simalandira mpweya wofunikira.

Kumayambiriro kwa chitukuko cha atherosulinosis, zolembera ndizochepa kwambiri kotero kuti sizimakhudza kuthamanga kwa magazi, ndipo matendawo awoneka ngati "non-stenotic atherosulinosis". Pamene lumen imachepetsedwa kwambiri, "stenosis" imawonekera ndipo choyambirira "sichiri" chimazimiririka. Kuchepetsa mphamvu ya mtsempha ndi 50% kumawonetsedwa mochititsa chidwi ngati matenda amtunduwu.

Ndikofunika kudziwa chinthu chosangalatsa: kudziwika kwa "non-stenotic atherosulinosis" mu gulu la matenda padziko lonse lapansi (ICD-10) kulibe. Izi ndichifukwa choti madokotala sagwirizana mokwanira ndi njira zoperekera matenda ake komanso matenda ake.

Zomwe zimayambitsa Stenosing Atherosulinosis

Zomwe zimayambitsa matendawa ndimatenda ambiri. Ichi ndichifukwa chake matenda afala kwambiri padziko lonse lapansi. Ngati titaya zifukwa zosowa komanso zoponderezedwa, mndandanda waukulu umawoneka motere:

• Kusuta. Malinga ndi European Cardiological Community, chizolowezi cha nikotini ndicho chifukwa chachikulu chopangitsa matenda a atherosulinosis.
• Matenda a shuga.
• Kunenepa kwambiri Izi zimaphatikizaponso kukhala pansi.
• Cholesterol chokwera, lipids owonjezera.
• Matenda oopsa Ngati kupanikizika ndikokwera kuposa 140/90, ndiye kuti pali chifukwa choganiza.
• Kupsinjika Izi zimapangitsa kuti thupi lonse lisawonongeke, makamaka pamachitidwe a mtima ndi mantha.
• Zakudya zopanda pake. Choopsa kwambiri ndizochulukirapo zamafuta ndi mafuta m'thupi.
• Khalidweli.

Osachepera chimodzi mwazinthu izi zimapezeka pafupifupi munthu aliyense. Pachifukwa ichi, stenotic atherosulinosis imayamba chifukwa cha kufa kwa odwala omwe ali ndi matenda a mtima ndipo ndi milandu 8 mwa anthu 1000.

Mitsempha yama coronary

Kuwonetsedwa kwa stenosing atherosulinosis yam'mitsempha yama coronary kumalumikizidwa ndi matenda a mtima (matenda a mtima) komanso kulephera kwa mtima, chifukwa myocardium simalandira oxygen yoyenera. Zotsatira zake, minofu yamtima wapakati, zipinda zam'magazi, ndi ma valavu ndizoyipa. Odwala amadandaula za:

• Chizungulire
• Tachycardia.
• Kuukira kwa angina pectoris. Poyamba, kupweteka kumbuyo kwa sternum kumawonekera pokhapokha polimbitsa thupi, pambuyo pake, kumenyedwa kwa theka la ola kumatha kupumula.
• Myocardial infaration.

Kugunda kwa mtima ndi zotsatira zomaliza komanso zowopsa za coronary atherosulinosis. Mtsempha watsekedwa kwathunthu, myocardium imadutsa necrosis. Kukula kwa zovuta kumatsimikizika motere: aneurysm, mantha, kupasuka ndi kufa mwadzidzidzi. Ngati myocardial infarction idachitika, ndiye kuti mitsempha ya mtima imakhudzidwa kwambiri ndi matendawa.

Atherosulinosis ya mitsempha ya impso imadzipereka ngati chizindikiro chokhacho - kuchuluka kosalekeza, kosayima magazi. Pankhani yotseka impso imodzi, matendawa amapitilira mosakhazikika, ndikungoletsa matenda, zilonda zoyipa za matendawa ndizotheka.

Stenosing atherosulinosis yamitsempha yama m'munsi yam'munsi imayambitsa kuvulala: kuwonda, kupweteka kwapafupipafupi, kudula. Matendawa amayambika ndi mawonetsedwe ang'onoang'ono, monga kumva kulasalasa kumadera ena, kumva kuzizira, kugona. Ngati simukuyesetsa kusintha thanzi lanu, zizindikiro zazing'onoting'ono zimayamba kuonda, kufooka kwa minofu, kutchulidwa kozizira miyendo, kupweteka kwambiri. Mu gawo lomaliza, kupsinjika, zotupa za necrosis ndi zilonda zam'mimba zimawonekera.

Nthawi zambiri, zolembedwa za atherosulinotic zimachitika m'mitsempha yayikulu ya thupi. Kuchokera pamenepo, zidutswa za magazi zomwe zimasungunuka zimatha kulowa gawo lililonse la thupi, kutseka ndima ndikuyambitsa matenda a mtima. Kuphatikiza apo, kumera kwa mapepala kumabweretsa kukula kwa makoma a msempha, msempha wamsempha ndikuwundana, komwe kumabweretsa kufa kwakanthawi.

Nthawi zambiri matumbo amadwala kusintha kwa atherosulinotic mu msempha. Odwala amadandaula za kupwetekedwa mwadzidzidzi m'mimba, kupweteka kwachilendo m'matumbo. Zikatero, kuthandizidwa kuchipatala mwachangu ndikofunikira, chifukwa kupindika kwa minofu mkati mwa peritoneum ndikotheka.

Mitsempha yama carotid

Kuwonongeka kwa atherosulinosis kwamitsempha yama carotid kumapangitsa kuti anthu asamaganize bwino komanso nkhope. Choyamba, pamakhala mutu komanso kutopa, kenako kukumbukira kukumbukira. Woopsa, kufotokozera bwino kumakhala ndi vuto, masomphenya, minyewa yamaso imasiya kupindika.

Zovuta zowonekera kwambiri pakugwira ntchito kwa ubongo (ubongo ndi chingwe cha msana) ndi madipatimenti ena okhudzana nawo. Stenosing ya ubongo ya atherosulinosis imawononga mbali zosiyanasiyana za chithokomiro cham'mimba, zomwe zimasintha malingaliro, umunthu ndi machitidwe a munthu. Ndi kwachulukidwe ka njira za necrotic m'malo omwe amayankhula, kuwona ndi kumva, wodwalayo amalandila zowonongeka izi ndikugwira mpaka kulephera kwathunthu.

Ndi atherosulinosis ya magawo a extracranial a mitsempha ya brachiocephalic, kupweteka kwambiri khosi ndi mseru kumawonekera, makamaka mutatembenuza mutu.

Ngati stenosing atherosulinosis ya BCA imakhudza msana, wodwalayo amamva kupweteka kumbuyo ndi sternum, kuyabwa ndikusonyeza miyendo, nseru. Kupanikizika kumachepetsedwa, masomphenya, kumva ndi kuyankhula kumatsitsidwa.

Zotsatira za atherosulinosis

Pakakhala chithandizo chokwanira, gawo lomaliza la stenosis la mtsempha uliwonse wam'mimba ndikuwunikira gawo lomwe limatsogolera. Izi zikutanthauza kuti mpweya umatha kulowa m'gululi, ndipo umafa mwachangu ndikupanga minofu ya necrotic (yakufa).

Kwa mtima, izi zikutanthauza kulowetsedwa kwa myocardial, bongo, kugunda kwa impso, kuphwanya impso, ndi zina zambiri. Matenda a mtima ndi owopsa osati chifukwa chiwalo chasiya kugwira ntchito, komanso chifukwa minofu yakufa ija ikayamba kuwola, ndikutulutsa poizoni m'thupi. Nthawi zambiri kuwonetseredwa kwa matenda amizimu kumabweretsa imfa.

Popewa mathero omvetsa chisoni, muyenera kuzindikira kuwopsa kwakanthawi ndikuwonana ndi dokotala kuti adziwe ngati ali ndi chithandizo.

Njira zochizira

Mankhwala, mitundu yonse ya mankhwalawa imagawidwa m'mitundu (mapiritsi) ndi opaleshoni (opaleshoni). M'malo mwathu, chithandizo chachikhalidwe chimagawidwanso kukhala mankhwala komanso thanzi. Chifukwa chake, ndi stenotic atherosulinosis, mankhwalawa amagawidwa mu mawonekedwe komanso achire. Pofuna kuti tisasokonezedwe ndi utsogoleriwu, timayambira pansi.

Chithandizo cha Zizindikiro ndicholinga chofuna kuthetseratu zizindikiro zomwe zimayambitsa matenda a atherosulinosis. Izi zitha kukhala ma aspirin kuti achepetse magazi, opaka magazi kuti athetse ululu, mndandanda wambiri wamankhwala kuti ubweretse dongosolo mu ubongo.

Mankhwala amaletsa matendawa pawokha. Mapiritsi ena amatha kutsitsa magazi m'thupi, ena amachepetsa kuthamanga kwa magazi kuti achepetse kuthamanga kwa magazi.

Pamodzi ndi mankhwala othandizira komanso operekera chizindikiro, wodwalayo amapatsidwa mankhwala othandizira olimbitsa thupi. Popeza matendawa nthawi zambiri amakhumudwitsidwa ndi moyo wosayenera, wodwalayo ayenera kusiya kusuta, kuyenda kwambiri, kuchita masewera olimbitsa thupi, kukhala wopanda mantha, kugona bwino komanso kudya bwino. Mndandanda womwewo umaphatikizidwa pochiza matenda a atherosulinosis.

Pazonse, mapiritsi ndi moyo wathanzi ayenera kusiya kukula kwa atherosulinosis ndikukonza pang'onopang'ono mitsempha yowonongeka. Koma nthawi zina matendawa amapitilira kuti chithandizo cha chikhalidwe sichikwanira. Pankhaniyi, katswiriyo akhoza kukuthandizani kuti mupeze opaleshoni - opaleshoni yodutsa, angioplasty, stenting kapena opaleshoni kuti muchotse.Ikadutsa, chombo choyikiratu chimakhazikitsidwa kuti chimadutsa mu mtsempha womwe wakhudzidwa, angioplasty imakulitsa kuunikira kwam'bwatolo, ndikumauma posachedwa, ndikulepheretsa chithunzicho pogwiritsa ntchito chikwapu, ndipo chikachotsedwa, chotengera chowonongeka chimachotsedwa kwathunthu.

Mwambiri, thandizo la madokotala othandizira opaleshoni limafunikira mokulira. Ngati wodwala atembenukira kwa dokotala panthawi komanso osadzivulaza ndi mankhwala ake enieni, nthawi zambiri amatha kuthandizidwa ndi njira zachikhalidwe.

Chifukwa chake, stenotic atherosulinosis ndimatenda osachiritsika omwe amayamba nthawi yayitali ndipo amadzimva pakatha zaka 40. Imadziwoneka yokha ngati mapangidwe am'mitsempha ndipo imayendetsa magazi mpaka itatsekedwa kwathunthu. Kusaphunzitsidwa, kumabweretsa zovuta m'mthupi, kulumala ndi kufa. Ngati mukukayikira matenda, musadzinamize kuti musataye nthawi - muyenera kuwona dokotala posachedwa ndikuyamba mayeso.

Ndani amayendetsa chiopsezo chotenga matenda a atherosrance?

Atherosulinosis imawonedwa ndi ambiri kukhala matenda osafunikira okalamba. Komabe, poyang'ana anthu okalamba, si aliyense amene ali ndi zizindikilo zoonekeratu. Zadziwika kuti "zomwe zimakonda" zotsutsana ndizotsatira:

• anthu omwe ali ndi cholowa cholemedwa (achibale amakhala ndi matenda oopsa, myocardial ischemia, mikwingwirima yapitayi),
• wofooka mwakuthupi
• ndi magalimoto ochepa,
• amakonda kudya kwambiri komanso kunenepa kwambiri,
• kupulumuka kupsinjika mtima ndikukhala ndi ntchito yamavuto ambiri amanjenje.

Kodi chimachitika ndi chiyani m'mitsempha yamagazi?

Palibe cholakwika kusankha chimodzi mwazifukwa ndi kudziletsa, mwachitsanzo, kungopatsa thanzi. Kuoneka ngati phula lochepetsa chotchinga kumayambika ndi nthawi yayitali, kuyambira ubwana. Non-stenotic atherosclerosis iyenera kudutsa magawo ena.

Munthawi ya dolipid, zombo zimayenda pafupipafupi. Chofunikira kwambiri ndizomwe zimaperekedwa poyankha pamavuto, kuphatikizapo kusintha kwa pituitary-adrenal. Pofuna kupitirira kwa atherosulinosis, kuchuluka kwa chotengera, kusintha kapangidwe ka khoma ndikofunikira. Udindowu umachitika ndi othandizira matenda opatsirana, kuwonongeka kwa malo okhala.

Lipoidosis imachitika pamene mafuta inclusions amalowa momasuka khoma la mitsempha kuchokera ku lumen ya chotengera pamodzi ndi madzi a m'magazi.

Kuchuluka kwa ma lipids omwe amaperekedwa ndi chakudya ndizochulukirapo kakhumi poyerekeza ndi zomwe zimapangidwa mkati mwa thupi. Zinthu zamafuta zomwe cholesterol imang'ambika "nyengo" zakhazikitsidwa: triglycerides, α-lipoproteins ndi β-lipoproteins. Awa ndi mapuloteni okhala ndi mafuta omwe amapezeka mosiyanasiyana malinga ndi mapuloteni komanso mafuta (mu α-lipoproteins, lip.3r3 39% ndi mapuloteni 60%, mu β-lipoproteins, lipids 78,7% ndi mapuloteni 43%. Chifukwa cha "zochulukitsa" zamafuta, ma op-lipoproteins sakhazikika ndipo amasweka mosavuta, akumasungunuka lipids.

The enzyme lipase imakhudzidwa ndi triglycerides. Imaphwanya mankhwala kuti ipange β-lipoproteins. Chifukwa chake, popanga cholesterol madongosolo amitsempha yamagazi, kufunikira kwa kuchepetsedwa kwa ntchito ya lipase kumamangirizidwa.

Ndi zizindikiro ziti zomwe zitha kuphatikizidwa ndi nthawi yoyamba ya atherosulinosis?

Kusintha kwa atherosulinotic koyambirira m'mitsempha yamagazi sikumayendera limodzi ndi zovuta zamatenda, chifukwa chake, nthawi zambiri sapezeka. Nthawi yoyambirira kapena mawonekedwe osaneneka a maphunzirowa amatha kuganiziridwa pamaziko a vuto la mitsempha ndi ma metabolic:

• chizolowezi chazambiri
• kuchuluka kwa mafuta m'thupi komanso kusintha kwa lipoproteins,
• chizindikiritso cha mtima wamisala pakayesedwa.

Nthawi zambiri, non-stenotic atherosulinosis imakhudza mitsempha ya brachiocephalic, msempha, ndi zombo zam'munsi.

Pali magawo awiri a matenda:

1. preclinical
2. ndi zizindikiro zamankhwala.

Amadziwika kuti zizindikiro zamankhwala zimawonekera mukamachepetsa theka la botilo kapena zambiri. Kenako wodwalayo amadzazindikira kusintha kwake.

Kutulutsa kwamitsempha m'mitsempha ya ubongo kumayambitsa zizindikiro zoyambirira:

• kutopa,
• kusamalira chidwi
• chizungulire
• kusakhazikika
• kusokonezeka kwa kukumbukira
• kusowa tulo

Zizindikiro zoyambirira ziyenera kuyang'aniridwa ndi adokotala ndi mafunso otsogolera. Makamaka wodwala akuwonetsa kukalamba asanachitike:

• khungu louma lokwanira
• kuwonda ndi kuwonongeka kwa tsitsi,
• misomali yosweka
• gait pang'ono
• kusintha kwa chikhalidwe ndi luntha.

Mu gawo loyambirira la atherosulinosis yam'mitsempha yama brachiocephalic (amaphatikiza zovuta zam'manja zam'magazi, carotid ndi vertebral) mukafufuza wodwala, mutha kudziwa:

• kupweteka mutu ndi chizungulire ndi magazi abwinobwino,
• tinnitus, kukulitsidwa ndimutu,
• mawonekedwe ofooka wamba,
• dzanzi lam'munsi,
• Kuchepetsa maonedwe, nthawi ndi nthawi kumadetsa, "ntchentche" ndi "chipale chofewa" m'maso.

Ndi kuwonongeka kwa preortinical kwa msempha, atherosulinosis imatheka m'madipatimenti ake onse, onse mu thoracic komanso m'mimba. Wodwalayo ali:

• kusasangalala mumtima.
• nthawi zina kupweteka kwam'mimba kosakhudzana ndi kudya,
• mwadzidzidzi kuvumbulutsidwa mwadzidzidzi kukwera kwa systolic (chapamwamba),
• kuyamwa kwamawu ndi chifuwa popanda zizindikiro zozizira.

Kumayambiriro kwa atherosulinosis kwamitsempha yam'munsi yotsika ndikuwonetsa:

• kudumphadumpha mukuyenda chifukwa cha ululu m'misempha ya ng'ombe,
• kutha kwa zowawa pakapumula,
• mwendo kukokana usiku
• mapazi owoneka bwino ngakhale malo otentha.

Zizindikiro zakuzindikira

Zinthu zosavuta kuzindikira zomwe madokotala onse amadziwa zimaphatikizapo:

• kuchuluka systolic kuthamanga ndi abwinobwino otsika otsika, kutchulidwa phokoso panthawi ya aorta ndi atherosulinosis kwa msempha,
• Kutentha kwa phazi lakhudzidwa ndi kukhudza, kulephera kudziwa kupindika kumbuyo kwa phazi, kutsimikiza kwa chidendene cha brashial (kuyeza kuthamanga kwa mwendo poika cuff pamwamba pa bondo komanso momwe amagwirira mkono), mulingo wofunikira ukhale 1, ndi kuchepa kwa mgwirizano mpaka 0.8 titha kunena za sclerosis ya ziwiya zamiyendo.

• rheoencephalography - imakuthandizani kukhazikitsa kuchepa kwa michere yaubongo kudzera m'mitsempha yotsogola,
• rheovasography - njira yofananira yomwe imagwiritsidwa ntchito poyang'ana zotengera za madera ena,
• angiography - kusiyanitsa kwapakatikati kumakonza mawonekedwe ndi mawonekedwe a mitsempha yama radiograph,
• X-ray ya mtima m'magawo awiri - ikuwonetsa mkhalidwe wa chipilala cha aortic,
• Ultrasound yamitsempha yama carotid - imawona ikuchepa kwambiri.
• Kufufuza kwamitsempha yamagazi - njira yophunzirira kukula kwa chotengera, kuthamanga kwa magazi, ma contours ndi wallens wall.
• kusanthula isotope ndi kafukufuku wamtengo wapatali wochitidwa m'malo apadera.

Kodi zovuta ndi ziti?

Kusintha kwa njira yopanda stenotic yochepetsera ndikupanga magawo amtsogolo a ischemic, thrombonecrotic ndi fibrous magawo angatengedwe ngati njira yovuta.

1. Mchigawo cha ischemia, wodwalayo ali ndi vuto la mtima komanso matenda amtundu wa angina pectoris, matenda osokoneza bongo a ischemic, magazi amatuluka m'mitsempha yamafupa, mafupa am'mimba ndi mesenteric.
2. Supombonecrotic zovuta - yodziwika ndi zizindikiro za kuwonongeka kwa magazi kutsika: myocardial infarction, stroke, thrombosis ndi embolism ya ziwiya zina.
3. Mu gawo la fibrotic kapena sclerotic, gawo la parenchyma limasinthidwa ndi minofu yaying'ono, ntchito yawo imachepetsedwa kwambiri, Zizindikiro zimatsimikizira kusakwanira kwa mtima, ubongo, impso ndi chiwindi. Zosintha izi sizingasinthe.

Zomwe zimayambitsa matendawa

Choyambirira komanso chofunikira kwambiri cha atherosulinosis ndi kusintha kwokhudzana ndi zaka m'matumbo, zomwe zimayambitsidwa ndi zifukwa zosiyanasiyana. Matendawa m'magawo oyambawo sangathe kudziwonetsa mwanjira iliyonse, chifukwa anthu ambiri sakayikira kuti ali ndi vuto ndi zotengera.

Mtundu wonunkha wa atherosulinosis umapezeka kwambiri mwaimuna, pomwe theka laanthu laumunthu silimavutika ndi matendawa.

Zakutsogolo

Kuphatikiza pazomwe zimachitika zaka zambiri, maonekedwe a atherosulinosis a mitundu ya stenosing amakhudzidwanso ndi:

Zina mwazinthu izi, zizolowezi zoyipa zimawonedwa kuti ndizofunikira kwambiri. Amachititsa kuti pakhale kusintha kwa ma atherosselotic m'matumbo. Vuto lachiwiri lomwe limayambitsa vuto la kuperewera kwa zakudya m'thupi ndi kuperewera kwa zakudya m'thupi, komwe kumakhala ndi cholesterol yambiri yoyipa m'thupi. Cholesterol chovulaza sichimasungunuka kwathunthu m'madzi a m'magazi, chimasiya mpweya, womwe umakhala pamakoma amitsempha yamagazi, ndikupanga zolembedwa za atherosrance.

Zombo zam'munsi zakutali ndizovuta kwambiri kuzisintha kwa atherosulinotic. Inde, makina ena am'mimba amakhudzidwanso ndi stenotic atherosulinosis, koma zotengera zam'munsi kwambiri zimakonda kusintha. Izi zikufotokozedwa ndikuti ziwiya zamiyendo zimakhala pansi pazombo zina zonse, ziribe kanthu momwe zimamvekera zachilendo.

Choyipa choopsa kwambiri m ziwiya zam'madzi ndi kumwa mowa ndi chikonga. Nikotini mu ndudu ingayambitse kupindika m'mitsempha yamagazi. Mowa umadzetsa mavuto mu ubongo wamunthu ndipo umapangitsa kuchuluka kwa cholesterol.

Kuphatikiza apo, moyo wamunthu komanso momwe amagwirira ntchito zimakhudzanso. Ngati munthu ali ndi moyo wokonda kugwira ntchito ndikugwira ntchito muofesi yabwino, ndiye kuti patatha zaka 10 moyo woterewu, amathandizidwa ndi atherosclerosis pafupifupi milandu zana limodzi. Kuti zombozo zizikhala bwino, munthu ayenera kuyenda osachepera 10 km tsiku lililonse, ndipo ndi njira iyi ya moyo sizingatheke.

Komanso, zinthu zakumudzi zimatha kuthana ndi matenda atherosclerotic a m'munsi malekezero:

Zosiyanasiyana za stenosing atherosulinosis. Brachiocephalic atherosulinosis ya mtundu wa kununkha

Pali mitundu ingapo ya atherosulinosis. Mitundu yowopsa kwambiri imatha kutchedwa atherosulinosis ya mitsempha ya carotid (kapena, mwasayansi, brachiocephalic). Mitsempha iyi ndiyofunikira chifukwa imatengera magazi okhala ndi mpweya wambiri mwachindunji ku bongo.

Atherossteosis, mitsempha ya carotid imatha kukhudzidwa ngati ma cell ena a thupi akukhudzidwa.

Zizindikiro za stenosing atherosulinosis ya mitsempha ya brachiocephalic:

Zizindikirozi zimatha kukhala zizindikiritso zamatenda amthupi, komanso ziwiya zina. Kuti mudziwe zenizeni mtundu wa matenda omwe mumadwala, onani dokotala.

Choyambitsa chachikulu cha matenda a atherosclerotic carotid artery matenda ndi mawonekedwe a plaque. Nthawi zambiri malo opezeka atherosselotic amapezeka chifukwa chokhala ndi moyo wosayenera (kudya mafuta ambiri anyama).

Zizindikiro zakukula kwa matendawa

Zizindikiro za matendawa zimatha kukhala zosiyana. Zonse zimatengera zomwe ngalawa zidakhudzidwa. Mwachitsanzo, atherosulinosis yokhala m'munsi yotsika imatha kudziwoneka ngati yowuma usiku pakamagona. Komabe, izi zitha kukhala chifukwa cha mtundu wina wa atherosclerosis.

Chifukwa chake, gawo loyamba, atherosclerosis yamtundu wamtunduwu ikhoza kuwonekera motere:

Mu gawo lachiwiri la matendawa, kupweteka m'miyendo ndi kutopa mwachangu kwa chimodzi mwendo zimatha kuwonjezeredwa pazizindikiro zam'mbuyomu. Komanso, toenails imayamba kuthyoka ndikusweka, zotsekemera zimawoneka m'matumbo. Zizindikiro za matenda a coronary aziwoneka. Kuphatikiza apo, ma pulsation pazotengera pamiyendo amachepa.

Mu gawo lachitatu, kuuma kumakulirakulira.Masitepe makumi asanu aliwonse mpaka makumi asanu ndi awiri akuyenera kuima. Zowawa zazing'ono zimawonekera ngakhale panthawi yopuma. Mwana wa ng'ombe amawonda pang'ono. Tsitsi limayamba kugwa, khungu limakhala loonda komanso lopanda tsankho, ming'alu idzawoneka zala.

Gawo lachinayi la matendawa ndiwakulu kwambiri, njira zake zimakhala zosasinthika. Khungu limakhala lofiira ndi tint yamkuwa. Mapazi ayamba kutupa, zilonda zam'mimba zimatuluka. Usiku, ululu wofatsa umayamba, womwe umakulira pakapita nthawi. Nthawi zambiri kutentha kwa thupi kumakwezedwa. Chowoneka bwino kwambiri cha matendawa ndi mawonekedwe a gangren, pomwe sipangakhale mwayi wowachira.

Stenosing atherosulinosis ya mbali zazikulu za ubongo

Stenosing atherosulinosis ya mitsempha yayikulu ya mutu imatha kulepheretsa ubongo. Zilonda za atherossteotic zomwe zili mu carotid ndi mitsempha ina yomwe imanyamula magazi kupita ku ubongo ndiyowopsa kwambiri, chifukwa imakula msanga m'malo awa kuposa m'malo ena.

Zizindikiro za Kutha kwa Ubongo

Pankhaniyi, magulu atatu azizindikiro amatha kusiyanitsidwa. Zizindikiro zake:

• Kukumbukira koyipa
• Kuchepetsa mphamvu ya ubongo ndi mphamvu,

Mawonekedwe a chikhalidwe cha ocular akuphatikizapo:

• Kuphonya pang'ono, "kulanda" khungu,

Mawonekedwe a hempis:

• Mavuto Olankhula
• Asymmetry ya nkhope
• Zowawa ndi zosokoneza pakuyenda m'miyendo.

BCA stenosing atherosulinosis imadziwika ndi mawonekedwe awa:

Momwe mungapezere matenda?

Kuti muzindikire matenda amitsempha yamagazi. Izi zitha kuchitika pamakina amakono a ultrasound, omwe ali ndi sensor vascular.

Phunziro lokha lomwe limagwiritsa ntchito duplex ultrasound ndi lomwe lingadziwe kuwonongeka kwa mitsempha ya carotid mwa anthu. Phunziroli silithandiza kudziwa matendawo, komanso kudziwa msanga wake. Makina a ultrasound amatha kudziwa kuchuluka kwa ziwiya zomwe zimachepetsedwa, komwe kuli zolembera (kupendekera), kuthamanga kwa magazi, komanso komwe akupita.

Kuchiza kumayendetsedwa ndi katswiri wazachipatala ndipo zimatengera mwachindunji gawo la matendawo ndi komwe akukhala. Chithandizo nthawi zambiri chimagwiritsidwa ntchito. Mwachitsanzo, ngati wodwala ali ndi kuthamanga kwa magazi, ndiye kuti amapatsidwa mankhwala omwe amamuchepetsa.

• Kutsatira
• Zakudya zoyenera, momwe mafuta a nyama samakhalako konse,
• Kuyenda pafupipafupi kwa maola angapo.

Kuphatikiza apo, mankhwala omwe amachepetsa cholesterol amadziwika. Izi zisanachitike, mayeso ofunikira amatumizidwa. Muzochitika zovuta kwambiri, mankhwala okhala ndi statin ndi omwe amachepetsa kuphatikiza mafuta m'thupi la chiwindi. Zakudya zoyenera Komanso zimathetseratu mchere ndi shuga.

Monga chithandizo chowonjezera, mutha kugwiritsa ntchito mankhwala achikhalidwe komanso achire. Musanagwiritse ntchito, onetsetsani kuonana ndi dokotala.

Nthawi yochizira imatengera mawonekedwe amunthu, koma nthawi zambiri imakhala miyezi isanu ndi umodzi. Popewa kukula kwa matendawa, tsatirani malingaliro awa:

1. Sunthani zina. Yendani ma kilomita 10 pafupipafupi
2. Ngati mukugwira ntchito muofesi, ndiye kuti theka la ola lililonse muzichita zolimbitsa thupi pang'ono,
3. Idyani moyenera komanso moyenera, idyani mchere wochepa ndi mafuta a nyama,
4. Siyani zizolowezi zoyipa. Madokotala amalimbikitsa kuchita izi pang'onopang'ono, osati mowongoka, kuti musatopetse nkhawa, Kugwetsa ma atherosclerosis am'mitsempha yam'munsi ya Cerebral atherosulinosis