Mitengo ya chithandizo ndi matenda a carotid arteriosulinosis

Kulandila (kufunsira) kwa dokotala wamkulu wa opaleshoni ya mtima

Kufunsidwa kwa opaleshoni ya mtima - kuyesedwa ndi katswiri wodziwa bwino za odwala omwe ali ndi matenda owopsa a m'mitsempha. Mukafuna kufunsa dokotala wa opaleshoni yam'mimba, zingakhale zofunika kuchita mayeso ena mwanjira ya ultrasound ya mitsempha kapena mitsempha.

Kulandila (kufunsira) kwa wamisala

Kuyesedwa koyambirira ndi katswiri wa mitsempha, kusankha chithandizo kapena kuyesedwa.

Kulandila (kufunsira) kwa dokotala wa opaleshoni ya mtima, chachikulu

Kufunsidwa kwa opaleshoni ya mtima kumachitika kuti mupeze matenda am'mitsempha ndi mitsempha ndikusankha njira yochizira matenda a mtima.

Kulandila (kufunsana) kwa dokotala wa opaleshoni ya mtima, mobwerezabwereza

Zimachitika kuti ziwunikire wodwalayo atalandira chithandizo (chosasamala kapena cha opaleshoni). Ndi kufunsidwa mobwerezabwereza, njira zowonjezera zowunikira kapena njira zamankhwala zingapangidwire.

Ma Ultrasound diagnostics

Transcranial Ultrasound Research

Kafukufuku wamagazi amayenda kudzera m'mitsempha yamagazi pogwiritsa ntchito chosakira cha ultrasound ndi sensor yapadera pogwiritsa ntchito pulogalamu yapadera.

Ultrasound ya mitsempha yayikulu ya mutu

Kufufuza kwa Ultrasound kwa mitsempha ya carotid ndi vertebral arps (ultrasound MAG) kumachitika kuti mupeze zovuta zowopsa chifukwa cha matenda a ischemic. Masiku ano zatsimikiziridwa kale kuti kuchepa kwa mitsempha ya mkati mwa carotid mitsempha kumakulitsa chiwopsezo cha sitiroko chifukwa cha carotid artery thrombosis kapena embolism (kusamutsa chidutswa) mu ziwiya zamadzimadzi. Izi ndi zowona m'mitsempha yama vertebral.

Zowunikira radiation

Zojambula zam'mitsempha yayikulu yamutu

Angiography yamitsempha yayikulu ya mutu imaphatikizira kafukufuku wosiyana wa mitsempha ya carotid ndi vertebral pogwiritsa ntchito x-ray angiographic unit. Imagwiritsidwa ntchito ngati njira yodziwira matendawa kuti apatsidwe matenda amitsempha yama mutu komanso pakuchita opaleshoni yam'mimba kuti athetse kufinya kwa mitsempha ya carotid kapena vertebral.

Multispiral composed tomography yam'mitsempha yayikulu yam'mutu ndi miyendo yam'mwamba

Njira yosawerengera yosasokoneza chotupa cha khosi ndi mutu. Mumakupatsani chithunzi cha mbali zitatu zam'mitsempha ndi mitsempha yaubongo yokhala ndi tsatanetsatane wambiri. Zimathandizira kuzindikira kupendekera, kutsekeka kwamitsempha yamagazi ndi aneurysms.

Zojambula zam'kati zam'mapapo - kuwunika kwa chifuwa cha ray ndi chifuwa chowonetseratu. Chimakulolani kuti muunike momwe kupumulira kumakhalira, mtima, kufotokozera. Ndi njira yofufuzira yochotsa mavuto akulu ndi mapapo ndi mtima pokonzekera opaleshoni yayikulu. Ngati matenda aliwonse amakayikiridwa, zowonjezera za x-ray zimayikidwa.

Mtengo wa opaleshoni ya mtima

Carotid endarterectomy (kuchotsera kwa zolengedwa mu mitsempha ya carotid)

Opaleshoni yochotsa zolengeza ku carotid artery. Mu chipatala chathu, amachitidwa pansi pa opaleshoni yakumaso, yomwe imawonjezera chitetezo chake.

Carotid endarterectomy ndi shunt yakanthawi

Opaleshoni yochotsa zododometsa pamitsempha ya carotid pofuna kupewa matenda a sitiroko. Mng'oma wosakhalitsa umagwiritsidwa ntchito ngati pachitika ngozi yamisempha pakagwidwa ziwongo. Ndi chubu yapulasitiki yapadera yokhala ndi mabaluni kumapeto kwake, omwe amawaika mu carotid artery wamba komanso wamkati. Chifukwa cha chipangizochi, zolembera zimatha kuchotsedwa popanda kusiya magazi kudzera mu mtsempha wama carotid.

Mtengo wa kulowererapo kwa mtima

Angioplasty ndi kununkhira kwa mkati mwa carotid mtsempha wamagazi

Imachitika ndi kuchepetsa kwa mkati mwa carotid mtsempha woposa 70% popewa ischemic stroke. Nthawi zambiri, wochititsa wapadera ndi wochitira catheter amadutsidwa kudzera mu kukodola kwamkati kumaloko komwe kumakhudzidwa ndi chotupa cha carotid. Fyuluta yapadera imadutsitsidwa ndi woyezera pamwamba pa malo opendekera, omwe amalepheretsa zidutswa za atherosselotic plaque kuti zisalowe m'mitsempha yaubongo nthawi ya angioplasty. Pambuyo kukhazikitsa zosefera, malo omwe amachepetsa nyanjayo amadzaza ndi baluni yapadera, kenako khoma la mitsempha limalimbikitsidwa ndi mauna apadera achitsulo - stent. Kutalika kwa kulowererapo ndi maminiti 30 mpaka 40.

Kuluma kwa gawo lamkati mwa mtsempha wamagazi wamkati

Kukhazikika kwa stent panthawi yochepetsetsa ya chotupa cha carotid mu gawo la intracerebral.

Ntchito pamitsempha yama carotid: Zizindikiro, mitundu, mayendedwe, zotsatira

Mitsempha yama carotid ndiyo imayambitsa magazi kupita ku minyewa yaubongo, chifukwa chake ma pathologies omwe ali m'mitsempha iyi ndiwopseza moyo.

Opaleshoni mwadzidzidzi akuwonetsedwa mu milandu yotsatirayi:

Kusintha ndi kinking kapena kupotoza (kuzungulira kwa mtsempha wama carotid),
Kuphwanya umphumphu wa chotengera (choboola kapena chodulidwa),
Carotid artery aneurysm (kutulutsa khoma ndi chiopsezo chotumphuka),
Kuchepetsa mphamvu ya chotengera, kutsogoza ku ubongo:
Kutulutsa kwa mtsempha wama carotid ndi embolus kapena thrombus,

Ntchito zoyeserera zimachitika pozindikira atherosulinosis, pamene cholesterol malo amachepetsa lumen ya chotengera, kupewa magazi enieni.

Matenda opindika pang'onopang'ono a mitsempha ya carotid ndi matenda osasinthika ndipo osaphunziridwa bwino. Cholesterol madipoziti (mapepala) opangidwa mchombo samasungunuka, ndipo samasowa chifukwa cha chithandizo chokhwima, ngakhale chopita patsogolo kwambiri.

Kusintha kwakanthawi kwamankhwala pambuyo pa mankhwala osokoneza bongo kumachitika makamaka ndi kufalikira kwa makoma amitsempha yamagazi mothandizidwa ndi mankhwala, komanso kubwezeretsa pang'ono kwina kwa magazi.

Pambuyo poletsa kugwiritsa ntchito mankhwala othandizira (kapena mankhwala opangidwa malinga ndi maphikidwe achikhalidwe), mosalephera pamakhala kuukira kwa hypoxia (kufa ndi njala ya oxygen), ndipo chiopsezo cha kuperewera kwa ischemic chimakulanso.

Opaleshoni yamitsempha yamagazi ya Carotid ndi njira yotsogola kwambiri komanso yothandiza kwambiri yochizira matenda a mtima.

Muzochitika zambiri zamankhwala, cholesterol plaque mu carotid artery imadziwika pambuyo pa sitiroko, kapena pakuwunikira kwa ultrasound yokhudzana ndi mitsempha yam'mimba (mutu, chizungulire, kuchepa kwa mawonekedwe owoneka, kukomoka, kusokonezeka kwa kayendedwe kazigawo, etc.).

Kugwiritsa ntchito kwa opaleshoni panthaka kuti mubwezeretse magwiridwe antchito a chotengera kumathandizira kuti masitepe a 60% asamavute (malinga ndi WHO).

Njira yochitira opareshoni ya atherosulinosis imasankhidwa ndi dokotala wofufuza zamitsempha pambuyo pofufuza mobwerezabwereza ndi MSCT, ndikupereka malingaliro atsatanetsatane a momwe mitsempha ya carotid ndi ziwiya zina zilili, ndikuloleza kuwunikira komwe kungakhale kowopsa kwa chithandizo champhamvu.

Ntchito zothandizanso pa ma carotid mitsempha

Opaleshoni yamakono yamitsempha, njira zingapo zogwirira ntchito zimapangidwanso m'mitsempha ya carotid zimagwiritsidwa ntchito, koma njira yolowera ndi chimodzimodzi pa milandu yonse:

Khungu limapangidwa pansi pake m'mphepete mwa nsagwada ya m'munsi kumbuyo kwa auricle,
Kuwala komweku kumapangidwira pakupanga kwa minofu ya sternomastoid kumalire a m'munsi ndi pakati lachitatu la khosi,
Mafuta ndi minyewa yozungulira (m.platysma) imasungidwa mpaka malo osangalatsa a carotid artery (malo obisika),
Msempha wamaso umadutsana ndi ma clamp
Mitsempha yama carotid yobisika imabisidwa,
Mitsempha ya hyoid imabisidwa,
Mitsempha yama carotid imabisidwa.

Pochita ndi chotupa chamkati cha carotid, kulumikizana mosamala kwambiri ndi makoma amitsempha kumafunika, chifukwa kusuntha kosasamala kungapangitse kuti ziwonongeke, ndipo, chifukwa chake, ku distal embolism. Maphunzirowa akutengera mtundu wa zotengera (kuchuluka kwa kuchuluka kwa ma piari, kuwongolera, ndi kutalika kwa makoma kumaganiziridwa).

Carotid Endarterectomy

Carotid endarterectomy ndi gulu lotseguka la carotid artery lomwe cholinga chake ndi kuchotsa cholesterol plaque. Njira yomwe imagwiritsidwa ntchito kwambiri pomanganso pulasitiki ndi chotengera cha pulasitiki.

Pambuyo poyambitsa anticoagulant mwachindunji (nthawi zambiri, heparin imagwiritsidwa ntchito) ndikugundana ndi tsambalo lamitsempha yama carotid, amadzinyamula khoma lakutsogolo. Ma elastic shunts amalowetsedwa mu lumen kuti ateteze ubongo hypoxia.

Chifukwa chake, malo opangira opaleshoni amawakhetsa, pomwe magazi abwinobwino amapita kuubongo.

carotid endarterectomy (kuchotsa zolengeza ku carotid mtsempha wamagazi)

Gawo lotsatira ndi kulekanitsa kakhalidwe ka sclerotic ku makoma a chotengera. Pambuyo posankha mozungulira mapangidwe a cholesterol, gawo lomalizira la zolembazo lidawolokedwa, ndiye kuti kutulutsidwa kwapamwamba kumachitika. M'mitsempha yakunja ndi yamkati ya carotid, zolembazo zimasungika kumtunda wokhazikika, womwe umaphatikizika kukhoma la chotengera ndi ulusi wapadera.

Gawo lachitatu la opareshoni - kutsuka chotengera ndi saline yokhudza thupi, komanso komwe zidutswa zake zimachotsedwa - izi zimapangitsa kuti pakhale fupa losuntha mu chotupa cha carotid.

Gawo lomaliza ndikotseka kwotseguka kwa opaleshoni. Kuti apange chigamba pogwiritsa ntchito zida zakale ndi zamakono (PTFE, xenopericardium kapena transologous transplant). Kusankha kwa mtundu wa chigamba kumachitika ndi adokotala, kutengera mtundu wamakoma azombo. Chojambulachi chimakutidwa ndi ulusi wa prolene, kenako mankhwalawo amachotsedwa, ndipo chigamba chimasindikizidwa kuti chikhale cholimba.

Ma Clamp amachotsedwa, chigamba chimayikidwa pakamwa pa mtsempha wamkati wama carotid kuti magazi atulukemo. Pambuyo polowetsa m'magulu ang'onoang'ono amkati mwa chotupa chakunja, chimbacho chimachotsedwa. Patsamba lobwezeretsalo, ngalande zopangidwa ndi silicone ya elastic zimayikidwa m'dera lam'mphepete mwa chilondacho, pambuyo pake zimatulutsa zigawo zingapo.

Kutembenuka kwa carotid endarterectomy

Mtundu wa opaleshoni yamtunduwu umasonyezedwa chifukwa cha stenosis yamkati mwa carotid mkamwa, ngati zolembazo sizitha kupitirira 2 cm, komanso zogwira mtima mkati mwa minyewa yamkati.

Pambuyo podzipatula pamalo osakanikirana a mtima, kuyeserera kumachitika pokhudzana ndi mawonekedwe a carotid artery (kuwunika kumachitika malinga ndi momwe magazi akuwonekera ndi kuthamanga kwa magazi mkati mwa mtsempha wamagazi).

Ngati kulolerana kwanyumbayo kwa chida kwayamba kugundika, ndiye kuti mupitilize gawo lalikulu la opareshoni:

Mitsempha yamkati yamkati imadulidwa kuchokera ku glomus, kenako nkufalikira m'kamwa,
Mitsempha yolumikizidwa ili ndi zopindika zowonda,
Intima exfoliates ndi chipolopolo chapakati (pogwiritsa ntchito scalpel ndi scapula),
Chigoba chakunja cha sitimayo chimagwidwa ndi ma twitter ndikupindika mbali ina (monga kutulutsa kumachotsedwa),
Chikwangwanicho chimatulutsa kutalika konse kwa chotupa - kupita kumalo abwinoko a boti.

Mitsempha yovundikiridwa imawunikidwa kuti iwone ngati pali maubwenzi apamtima, ndiye kuti mchere waumunthu umaponyedwera. Ngati nthambi zolimba kwambiri sizimawoneka mu lumen mutatha kusamba ndi mpweya wopanikizika, ndiye kuti mutha kupitirira gawo lomaliza la opareshoni.

Ngati zidutswa za mafupa am'mimba zikuwoneka mu lumen zapezeka, kumangidwanso sikungachitike. Pankhaniyi, ma prosthetics a mitsempha ya carotid amachitidwa.

Pambuyo pochotsa mapangidwe a cholesterol ndikugundika kwa magazi kumitsempha wamkati, dokotalayo amapita ku endarterectomy kuchokera ku chotupa cha carotid. Gawo lomaliza ndikuwunika makoma a chotengera ndi ulusi wa 5-0, kapena 6-0.

Kutuluka kwa magazi kumabwezeretsedwa mosamalitsa monga mwa dongosolo lotsatirali:

Kuchuluka kumachotsedwa pamimba wamkati wa carotid (kwa masekondi angapo),
Mitsempha yamkati imakankhidwanso kachiwiri mu anastomosis,
Chokonza chimachotsedwa pamtsempha wa carotid wakunja,
Kuchulukitsa kumachotsedwa pamthambo wamba,
Chopondera chachiwiri chimachotsedwa pamzere wamkati wa carotid

Kununkha

Stenting - ntchito yobwezeretsanso lumen ya chotengera pogwiritsa ntchito tubular dilator (stent). Njira ya opaleshoni imeneyi siyikukhudza kuchotsa ziwiya zokha zokha. Kapangidwe kamene kamayang'anitsitsa lumen kamakanikizidwa mwamphamvu motsutsana ndi khoma la chotengera ndi chubu cha stent, pambuyo pake magazi amayambiranso.

Kuchita opareshoni kumachitika pansi pa mankhwala oletsa ululu, motsogozedwa ndi makina a x-ray. Kudzera pamatumbo pa ntchafu (kapena mkono) catheter imawongoleredwa kumalo a stenosis ya chotupa cha carotid. Dengu la fayilo ya mesh yomwe imakola zidutswa za cholesterol mwachisawawa imayikidwa pamwamba pa malo omwe ikugwiridwapo ntchito (izi ndi zofunika kuteteza ma emboli kapena ma magazi kuti asalowe mu ubongo).

Kuonjezera luso la ntchitoyo, zitsulo za balloon zimagwiritsidwa ntchito, zikuwonjezeka pamalowo pakuchepetsa mtsempha. Buluni yodzaza ndi mafuta imakanikizira chidacho molimba khoma. Pambuyo pobwezeretsa lumen yokhazikika, baluni imaphatikizidwa ndikuchotsedwa kudzera mu catheter pamodzi ndi fyuluta ya msampha.

Carotid prosthetics

Arterial prosthetics imawonetsedwa pakuwonongeka kwakukulu kwa makoma amkati mwa carotid mtsempha wophatikizana ndi calcification yayikulu. Ikani stenting ndi lotseguka carotid endarterectomy, pankhaniyi, ndizosatheka. Chombocho chimadulidwa pamalo a pakamwa, minofu yomwe ikukhudzidwa imapangidwanso, ndikuisintha ndi endoprosthesis yomwe imafanana ndi mainchepa a mtsempha wamkati.

Ndi aneurysm ya carotid artery, ntchito yotsatirayi imagwiritsidwa ntchito: chotengera chimapinidwa ndipo malo omwe akhudzidwa atsegulidwa, pambuyo pake kumalumikizidwa ndi shunt yolumikizidwa. Pambuyo pakupanga kwa anastomosis, shunt imachotsedwa, mpweya umachotsedwa ku lumen ya chiwiya ndi kumezanitsa, ndipo ma clamp amachotsedwa.

Ntchito ndi kutsutsa kwa carotid mitsempha

Kuchepa kwa cargenid mitsempha ya carotid (cruuosity) ndi chimodzi mwazomwe zimayambitsa kukula kwa ischemic stroke ndi ngozi ya cerebrovascular. Malinga ndi ziwerengero, wodwala aliyense wachitatu yemwe wamwalira ndi stroko anali ndi carotid kapena mitsempha yamitsempha.

mitundu yosiyanasiyana yamatsenga amtsempha

Njira ya opaleshoni imasankhidwa kutengera mtundu wa mtima wam'magazi:

Kugulitsa pakona pachimake (kukankha),
Kuboola (kuthira),
Kutalika kwa mitsempha.

Chidutswa chophatikizika cham'madzi chimakonzedwanso, ndipo kenako chimakonzedwanso.

Mavuto pambuyo opaleshoni yamitsempha yamagazi

Kutsatira carotid endarterectomy, zovuta zotsatirazi ndizotheka:

Myocardial infaration kapena stroke,
Kubwezeretsanso matendawa
Kupuma kovuta
Kuthamanga kwa magazi
Kuwonongeka kwamitsempha
Matenda owopsa.

Mavuto atatha kuluma siachilendo koma ngakhale atachitidwa opaleshoni, zotsatira zoyipa zimatheka, momwe kupangika kwa magazi kumakhala koyipa kwambiri.

Nthawi zina zosasangalatsa zomwe madokotala opanga maopaleshoni amafunika kuthana ndi izi ndi: kutulutsa magazi mkati, kuvulala m'malo obisalamo catheter, kuwonongeka kwa khoma la mitsempha, kusamva bwino, kusunthidwa mwamphamvu mkati mwa chombo.

M'masiku oyamba, kumeza movutikira, kupsya mtima, kupindika pammero, komanso kugunda kwamtima mwachangu kumawonedwa. Pang'onopang'ono, zizindikiro zosasangalatsa zimazimiririka.

Contraindication for carotid artery surge

Zopanda malire kwathunthu zimaphatikizapo:

Kusalolera pakuchita opaleshoni,
Malo osunthika,
Kapangidwe kapangidwe ka chombo,
Kulephera kwaimpso,
Matupi a ziwengo kwa titanium ndi cobalt (zinthu zonunkhira),
Kugwetsa makhoma a mtsempha wamagetsi wokhala ndi nthawi yomweyo,
Vuto lamagetsi onse.

Opaleshoni sikuchitika ndi ambiri akuvutika kwa wodwalayo, kukhalapo kwa matenda osachiritsika a magazi.

Kukonzanso

Pambuyo pa opaleshoni, wodwalayo amaikidwa m'chipinda chothandizira kwambiri. Kwa masiku atatu, kupumula kwa kama kumasonyezedwa. Pakatha masiku anayi, mutha kudzuka, kuyenda maulendo ochepa moyang'aniridwa ndi dokotala.

Kwa milungu iwiri, kuchita masewera olimbitsa thupi, squats, kugwada, ndi kusuntha kwadzidzidzi kumaletsedwa. Mutu ndi khosi zili pamalo osasunthika koma osapanikizika. Ndi chisamaliro chachikulu, mutu wotembenuka umapangidwa.

Ndikofunikira kutsatira mosamalitsa malangizo a dokotala okhudzana ndi zakudya ndi moyo (zakumwa zoledzeretsa, kusuta palinso).

Ntchito zamagalimoto a Carotid zimachitika pogwiritsa ntchito njira zopangira opaleshoni yoyendetsedwa bwino, motsogozedwa ndi zida zamankhwala zolondola kwambiri, zomwe zimachepetsa kwambiri ngozi.

M'malo ambiri azachipatala, chithandizo chamankhwala champhamvu kwambiri ndi njira yothandiza kwambiri poyerekeza ndi mankhwala othandizira.

Pambuyo pochotsa, odwala amawunikira kuchipatala komwe kuchitako opaleshoni, miyezi isanu ndi umodzi iliyonse.

Cholesterol zolembera za m'khosi, mankhwala a atherosulinosis mu carotid mtsempha wamagazi, momwe mungachotsere zosungitsa ziwiya za khomo lachiberekero

Zolemba za cholesterol m'mitsempha ya khosi (carotid artery) ndizowopsa, makamaka chifukwa zimalepheretsa magazi kulowa mu ubongo.

Zidindo za cholesterol (atherosulinotic) m'matumbo amberekedwe a khomo lachiberekero zimapangidwa chifukwa cha kuperewera kwa zakudya m'thupi (kudya mafuta osaneneka komanso zakudya zopatsa mphamvu za cholesterol) komanso kumangokhala moyo (limodzi - metabolic syndrome).

Nthawi zambiri mafupa a atherosselotic m'matumbo a khosi amakhala ndi miyendo (mitsempha ya varicose) komanso pamtima.

Zidole za cholesterol m'chiberekero zimadziwika bwino ndi kupimidwa kwa kafukufuku wa kukula kwa makulidwe a media intima media (TI) ya carotid artery (zambiri zakudziwitsa za cholesterol yapamwamba).

Kupezeka kwa cholesterol plaque mu carotid artery kumawonetsa kudzikundikira kwawo m'mitsempha yamagazi ndi ziwalo zina ndi ziwalo zathupi, kuphatikiza m'mitsempha yama mtima (yomwe ingayambitse kukula kwa angina pectoris ndikuwonetsa kuwonongeka kwa mtima) komanso muubongo (stroke).

Zolemba za cholesterol m'khosi zimapangidwa pamlingo wochepa wotsika komanso makamaka otsika kwambiri a lipoproteins (LDL ndi VLDL) m'magazi. Pakhosi, mitsempha yamagazi ndiyopyapyala, yomwe imathandizira mapangidwe a ma atherosulinotic amana pano.

Zotsatira zomwe zimayambitsa zimatha kuuma pakapita nthawi (atherocalciosis, kudziwika kwa calcium kumachitika) ndikuphulika (ngati cholesterol chatsopano chikuphulika popanda calcium, ndiye kuti, pali chiopsezo cha magazi omwe amapanga magazi a magazi).

Zizindikiro zazikulu za cholesterol plaque mu carotid artery ndi:

kukumbukira kwamisala ndi ntchito zamaubongo,
mutu
kutopa ndi kutopa kwambiri,
chizungulire
kumva kuwawa m'mutu
kumva komanso kusawona bwino (kuphatikizapo ntchentche pamaso), kuyankhula,
mgwirizano wolakwika,
kuchuluka kukwiya.

Atherosulinosis imayamba pang'onopang'ono ndipo nthawi zambiri imakhala ya asymptomatic (palibe zizindikiro za kukwera kwa cholesterol m'magazi) mpaka chiwopsezo chovuta cha ma atherosranceotic amana Zizindikiro zomwe zimapangidwa ndikupanga kuchuluka kwa cholesterol mu carotid artery ndi ziwiya za khomo lachiberekero zimawonetsedwa mwa 60% ya milandu yomwe anawona.

Zomwe zimayambitsa mapangidwe a atherosulinotic amana mu mitsempha yamagazi khosi ndi:

matenda oopsa (kuthamanga kwa magazi) - kuthamanga kwa magazi kumakhazikika m'makoma amitsempha yamagazi ngati kumenyedwa kwamphongo, kukhathamira kukakamizidwa, kumakhala pachiwopsezo chowonongeka cha makhoma (ngakhale matenda oopsa sindiwo amayambitsa cholesterol yayikulu m'magazi)
zotupa mu mitsempha ndi mitsempha, zikubweretsa kuwonongeka kwa endothelium - kulowa kwa lipoprotein kumachitika mu "ming'alu",
kuwonongeka kwa ziwiya za khomo lachiberekero ndi ma virus a herpes, cytomegalovirus, ma tizilombo (mwachitsanzo, chlamydia),
kuwonongeka kwa makoma amitsempha yamagazi ndi ma antioxidants ndi (kapena) ma free radicals,
kunenepa kwambiri komanso cholesterol yambiri ya m'magazi (hypercholesterolemia) - chida chachikulu chomangirira ma depherits atherosulinotic ndi LDL,
kusokonezeka kwa mahormoni (kuphatikizika kwa mahomoni a adrenocorticotropic ndi gonadotropic, komwe kumabweretsa kuwonjezeka kwa kupanga - kaphatikizidwe - endo native, intrinsic, cholesterol).

Tiyenera kudziwa kuti pali zinthu zingapo zomwe zimawonjezera chiopsezo kuti chimodzi mwazambiri mwazifukwa izi zomwe zimapangitsa kuti mapangidwe a cholesterol akhazikitse mapangidwe ake. Izi zimaphatikizapo kusachita masewera olimbitsa thupi (kukhala pansi), kusuta fodya, kumwa mowa kwambiri, matenda ashuga, kunenepa kwambiri, kuthamanga kwa magazi, kupsinjika nthawi zonse ndi nkhawa.

Zosasinthika (zifukwa) za kupangika kwa ma atherosselotic amana mu carotid mtsempha wamagetsi zimaphatikizira cholowa cham'badwo, m'badwo.

Chithandizo cha mapilogalamu a Cholesterol pa Khosi

Njira zochizira cholesterol plaque mu ziwiya za khosi zimatsimikiziridwa ndi gawo la matendawa. Mu atherossteosis, ndichizolowezi kusiyanitsa magawo angapo: koyamba, pamene kokhazikika (kosasokoneza, i.e.

safuna kulowererapo kwa opaleshoni) njira zochotsetsera cholesterol - mawonekedwe amafuta pama khoma lamkati lamitsempha yamagazi, ndipo lipids imalowa m'matumbo a endothelial.

Thupi limayankha pambuyo pake pomapanga ma antibodies (macrophages), omwe "amamatira" kupangidwe kwa lipid, ndikupanga pang'onopang'ono chidutswa.

Gawo loyamba lingakhale chithandizo cha cholesterol plaque mu carotid artery kudzera mwapadera zakudya zamafuta am'mwazi, kusewera masewera, kumwa mankhwala kuti muchepetse cholesterol yamagazi (ma statins), kugwiritsa ntchito mankhwala azikhalidwe ndi zakudya zamagulu ena (zakudya zowonjezera) zochokera ku omega- 3 zidulo ndi mafuta opaka. Mafuta omwe amapezeka m'mitsempha yama carotid amathanso kusintha paokha pakapita nthawi, osafuna chithandizo chilichonse. Kuti muchite izi, siyani kwakanthawi kugwiritsa ntchito zotsekemera, zokhuthala komanso mafuta.

Momwe mungagwiritsire cholesterol plaque pa carotid artery yachiwiri? Gawo lachiwiri limatanthawuza kupangika kwa mafayilo a fibrin ("milatho" kuchokera ku ma minyewa okhudzana) pakati pa madongosolo atherosulinotic - sizingatheke konse kuchitira cholesterol ogwiritsidwa ntchito popanda kugwiritsa ntchito opaleshoni (mutha kuyimitsa vutoli ndikuwongolera pang'onopang'ono chidacho potenga mapiritsi a cholesterol). Komabe, cholesterol plaque mu carotid artery sangafunike chithandizo - amatha kukula mpaka malire, kenako kulowa gawo la zero.

Kuchotsa cholesterol malo mu carotid mtsempha wamagazi

Kuchotsa cholesterol plaque pa carotid artery mu gawo lachiwiri (fibrosis) komanso lachitatu (calcosis) kumachitika m'njira zingapo:

jakisoni wa magazi (ochepa) - koma njirayi imakhala yodziwika pakapangidwe kowonongeka kwamitsempha yamagazi ndipo, chifukwa, mapangidwe atsopano ma atherosulinotic deposits,
Kukula kwa mitsempha yamagazi, komabe, njirayi siyothandiza pamitsempha yama carotid ndipo imagwiritsidwa ntchito nthawi zambiri ndi mitsempha ya varicose yam'mphepete,
kuchuluka kwamitsempha yamagazi,
kuyeretsa magazi kuchokera ku cholesterol - komabe, njirayi sikuti imangowononga zolembera zomwe zilipo, koma imagwira ntchito ngati kupewa kupanga kwatsopano.

Mtengo wochotsa cholesterol plaque pa carotid artery ndi mankhwala umatsimikiziridwa kwathunthu ndi mtengo wa mankhwalawa omwe amagwiritsidwa ntchito. Mtengo wamankhwala othandizira opaleshoni (carotid endarterectomy, angioplasty, stenting) ndiwokwera kwambiri ngati singachitike pa inshuwaransi. Chithandizo cha opaleshoni chimatembenukira ku nthawi yomwe njira zosasinthika zilibe mphamvu.

Momwe mungachotsere cholesterol plaque ku carotid artery? Opaleshoni ili ndi zoopsa zina, ndipo kugwiritsa ntchito mankhwala osokoneza bongo kumakhala ndi zotsutsana komanso zoyipa.

Kugwiritsa ntchito mankhwala osokoneza bongo kungapangitse kuchepetsa kuchepa kwa cholesterol ndi chiwindi, kuwonjezera mphamvu ya metabolism m'maselo - mwanjira iyi amachotsa mafuta m'thupi amthupi ndi m'mitsempha ya carotid.

Njira ina ndi ma infusions, zitsamba zochokera ku cholesterol plaque, koma mphamvu yake imakhalabe yopanda umboni.

Momwe mungachotsere cholesterol plaque ku carotid artery

Lingaliro la momwe mungachotsere cholesterol plaque pamatumbo a khosi ndi carotid artery amapangidwa malinga ndi zotsatira za kuyesedwa ndi mtima, oculist, neurologist, nephrologist ndi opaleshoni ya mtima.

Kuyesedwa kwa kupsinjika, ECG, coronography, ultrasound ya msempha ndi mitsempha ya mtima, angiography. Kuyesa kutuluka kwa magazi mu carotid artery kumalola kupanga mobwerezabwereza komanso maulendo atatu.

MRI itha kufunikanso - kuti muzitha kuwona m'matumba ndi zikwangwani.

Kuchotsa cholesterol plaque mu ziwiya za khomo lachiberekero, kusintha kwa moyo, chithandizo chogwiritsira ntchito mankhwalawa chidzalembedwera.

Zakudya za cholesterol zolembera mu carotid mitsempha

Zakudya za cholesterol plaque mu ziwiya za khosi zimakhala prophylactic ndipo zimaphatikizapo kukana zakudya zamafuta (mafuta a nyama ndiye maziko a "zomangamanga" popanga cholesterol amkati), zakudya zomwe zimakhala ndi mafuta ambiri m'thupi (cholesterol). Komanso, chakudya chambiri chomera chikuyembekezeka muzakudya (osachepera 400 magalamu kapena, mwakutanthauza ulusi wabwino - sungunuka komanso osapatsa - mpaka 30 g).

Kugwiritsanso ntchito: mafuta opukutidwa ndi fulakesi, omega-3 ndi - mocheperako - ma omega-6 acids (omwe amapezeka mu nsomba zamadzi ozizira ndi mafuta a nsomba).

Vitamini C, adyo (mafuta ofunikira) sanawonetse phindu lililonse pokhudzana ndi ma atherosulinotic amana, komabe, amagwira ntchito motsutsana ndi njira zotupa, zomwe nthawi zambiri zimayambitsa kuwonongeka kwamitsempha yamagazi ndipo, mapangidwe ake.

Kulimbitsa katundu komwe kumakhala ndi mankhwala monga ma statins, fibrate, nicotinic acid ndi bile acid zotsatana - mankhwalawa sangathe kuwononga ma atherosranceotic amana, koma amatha kuchepetsa kapena kupondereza kukhazikitsa kwatsopano.

Opaleshoni yochotsa cholesterol zolembera pakhosi

Kuthandizira kwa opaleshoni (opareshoni) yochotsa cholesterol plaque m'mitsempha ya khosi kumadziwika kuti njira zamankhwala sizinabweretse (kapena sizingabweretse) zotsatira, kapena ngati matenda oyambitsidwa adabweretsa zovuta. Opaleshoni yochotsa cholesterol zolembedwa pakhosi sizikuyambitsa kuchira kwathunthu, chifukwa osati chomwe chimayambitsa matendawa kuchotsedwa, koma zotulukapo zake.

Opaleshoni yochotsa cholesterol plaque pamitsempha wama carotid imatchedwa opaleshoni ya carotid artery bypass. Cholinga cha ndondomekoyi, komanso kutsimikiza mtima komwe kungachitike pangozi ya thanzi ndi moyo wa wodwalayo, kumachitika ndi dokotala wa opaleshoni ya mtima, mtima ndi mtima. Zotsatira zake, opaleshoni yamitsempha yamagazi imabwezeretseka, i.e. kukonzanso kumachitika.

Njira ina yopangira opaleshoni kuti ichotse cholesterol plaque mu carotid artery ndiyo kununkha kwamitsempha yamagazi - izi sizowopsa zomwe zimapangitsa kuti stent imayikidwe m'mitsempha kuti iwonjezere chimbudzi cha ziwiya ndi zosefera zapadera. Membranes amasefa magazi kuchokera ku micothrombi, koma osasokoneza magazi mu ubongo.

Maphunziro olimbitsa thupi ndi zochitika zolimbitsa thupi ndi atherosulinosis yamitsempha yam'khosi

Maphunziro olimbitsa thupi komanso kuchita masewera olimbitsa thupi ngati atherosulinosis ya mitsempha ya carotid ndi mitsempha yamakhosi imakhala yotetezeka mwachilengedwe ndipo cholinga chake ndi kuchepetsa cholesterol cha LDL ndikuwonjezera HDL, kukulitsa kukula kwa makoma amitsempha yamagazi, kuchepetsa kuchepa kwa iwo. Pulogalamu yothandizira zolimbitsa thupi ya ziwiya za khosi imapangidwa malinga ndi mkhalidwe waumoyo wa wodwala, kukula kwake kwamatenda oyamba ndi omwe amayanjana nawo.

Kuchita masewera olimbitsa thupi kwa atherosulinosis yamitsempha yama khosi kumaphatikiza, ngati kuli kotheka, kuyenda tsiku ndi tsiku, kusambira (mpaka 2 - 3 pa sabata), kuthamanga (mutadutsa mayeso opsinjika ndi chilolezo cha mtima). Kuchita masewera olimbitsa thupi sikungathetse cholesterol plaque mu khomo lachiberekero, koma ndi njira yolepheretsa kupititsa patsogolo kwa matendawa.

Physiotherapy ya atherosulinosis ya carotid mitsempha yodwala ngati ili ndi matenda akuluakulu imaphatikizanso masewera olimbitsa thupi a magulu onse a minofu.

Monga ndi kusankha kwa masewera olimbitsa thupi pulogalamu yamatenda a ubongo, kayendedwe kamene kamasinthidwa kwambiri ndi mutu: kuphatikizapo kuthamanga kapena kuzungulira kwa mutu komanso thupi

Achire olimbitsa thupi ndi physiotherapy ya atherosulinosis ya ziwiya za khosi (carotid artery) imaphatikizapo zolimbitsa zolimbitsa thupi, masewera olimbitsa thupi.

Opaleshoni yochotsa cholesterol malo mu atherosulinosis (endarterectomy)

Endarterectomy ndi opaleshoni yokhazikika yomwe cholinga chake ndikubwezeretsanso magazi ake kudzera pachiwiya chomwe chimakhudzidwa ndi atherosclerosis. Endarterectomy ndi opareshoni yopangidwira mwachindunji kuchotsa atherosulinotic plaque ku mtsempha wamagetsi,

Arterial endothelium mwa anthu athanzi amakhala ndi malo osalala komanso osalala. Njira ya atherosclerotic imakhudzira makoma amitsempha yamagazi, zomwe zimayambitsa kuchepetsedwa kwa lumen ya mtsempha wamagazi ndi kusokonezeka kwa kayendedwe ka magazi.

Ndi kupitilira kwa atherosulinosis, cholesterol ndi zotumphukira zake, michere ya calcium komanso yolumikizana imayikidwa pa mtima endothelium. Izi zimapanga zolembera zamtundu wa atherosclerotic, zomwe zimapangitsa kuti makhoma a mtsempha olimba azikhala olimba komanso osakhazikika nthawi imodzi.

Kuphwanya kayendedwe ka magazi am'deralo kapena mwatsatanetsatane kumabweretsa magazi osakwanira ziwalo zamkati. Ischemia imayamba ndi zizindikiro zamatenda zamatenda.

Kuchotsa zikhothi m'mitsempha yamagazi kumachitika ndi njira zosiyanasiyana, mwa zomwe palinso zowononga zochepa. Kuchita kumawonetsa kuti endarterectomy ndi njira yothandiza, yotetezeka komanso yotsika mtengo yolumikizira opaleshoni. Kuchita opareshoni kumachitidwa ndi akatswiri odziwa ntchito za opaleshoni m'magulu azachipatala kapena a mtima.

Kukonzekera kogwira ntchito

Asanachitike endarterectomy, odwala pofuna kupewa thrombosis amapatsidwa njira yochepa ya anticoagulants kapena antiplatelet agents ndipo amafunsidwa kuti athetse ma NSAIDs.

Kuchita bwino kwambiri kwa odwala ndi kuwunika kwamankhwala kokwanira kumakhala ndi kuyeza kuthamanga kwa magazi, kudziwa mawonekedwe a lipid ndi zizindikiro zamagetsi opanga magazi, kuchititsa electrocardiography ndi echocardiography. Endocrinologist amawunika odwala omwe ali ndi matenda osokoneza bongo ndipo amawona kuchuluka kwa shuga m'magazi nthawi yomweyo asanachitidwe opaleshoni. Maola 12 asanafike kulowererapo, odwala saloledwa kudya ndi madzi.

Munthawi yogwira ntchito, akatswiri amafufuza odwala moyenera, zomwe zimaphatikizapo njira zingapo zodziwitsira komanso zomwe zimakupatsani mwayi kuti muwadziwe bwino malo omwe alembedwayo:

Ultrasound yamitsempha yamagazi,
MRI ya mutu,
CT angiography
Zojambula zamtundu wa digito.

Chizindikiro chachikulu cha endarterectomy ndi kuchepa kwa lumen ya mtsempha wamagazi (makamaka carotid ndi carotid) ndi ubongo), komwe kunayambitsa kuchepa kwa ischemic, discirculatory encephalopathy, matenda a pachimake a ischemia, kuwononga atherosulinosis yamitsempha yam'munsi, komanso kuwonongeka kwa ziwalo zamkati chifukwa cha hypoxia.

Endarterectomy imapikisidwa chifukwa cha anthu omwe ali ndi matenda oopsa, oncopathology, matenda a shuga, matenda a mtima, kuchepa kwa mtima, matenda a Alzheimer's.

Endarterectomy, monga kuchitapo kanthu opaleshoni iliyonse, imakhala ndi ngozi. Iye ogwidwa kwambiri pamene mankhwala othandizira sagwira ntchito. Mtsogolomo, popanda chithandizo chamankhwala posachedwa ndi chithandizo chamankhwala, endarterectomy ingayambitse mapangidwe atsopano m'matumbo, ischemia ya ubongo, kapena kusokonezeka kwapang'onopang'ono.

Direct endarterectomy

The tingachipeze powerenga ntchito kwa atherosulinosis mwachindunji endarterectomy. Angiosurgeon amakakamiza mtsempha wamafuta pamwamba pa chotupa ndikuchotsa khungu, kutumiza chotengera. Mng'oma umalowetsedwa momwe umalowera, kulumikiza mbali zapafupi za mtsempha. Kuwala kwamtsempha kumatsegulidwa, chipangizo chapadera chimayambitsidwa mu incision ndipo cholesterol plaque imachotsedwa.

Chigamba chimasungidwa mumtsempha kuti chikulitse, ndipo mankhwalawo amachotsedwa. Pambuyo pobwezeretsa kayendedwe ka magazi, chotengera chija chimakola, ndipo machubu amadzimadzawo amatsala pachilondacho kwa masiku angapo. Kuchotsa cholesterol plaque kumachitika pogwiritsa ntchito zida zopangira opaleshoni - makina ophatikiza ma boni ndi maikulosikopu ogwiritsa ntchito.

Kutalika kwa ntchito ndi maola angapo ndipo zimatengera kuopsa kwa matenda ndi momwe wodwalayo aliri.

Kutembenuka mtima

Njira inanso yodziwika bwino yotsatirana ndi kusokonekera. Muli kudula kosinthika kwa mtsempha womwe wakhudzidwa pansipa pomwe pali chinsalu. Tinthu tating'onoting'ono totulutsa minofu ndi ma adventitia amasungunuka kuchoka pachakhudzidwa ndikutuluka. Intima yosinthidwa imadulidwa, ndipo minyewa yosanjikiza ndi ochita masewera anzawo amabwerera m'malo mwawo. Chilondacho chimasokonekera, ndipo ngati pakufunika anastomosis imayikidwa.

Endarterectomy kwa atherosulinosis ya miyendo

Endarterectomy ndi opaleshoni yotsitsa chotupa cha ziwiya zam'munsi, kupewa kuthana ndi mwendo womwe wakhudzidwa.

Pali njira zingapo zochotsera kugonana kosintha:: lotseguka, lotsekeka komanso lotsekeka.

Njira yotseguka imakhala yotembenuza khoma la artery ndikulekanitsa ndi zolembera zamtundu wa atherosclerotic. Njira yotsekedwa yokhayo ndikugwiritsa ntchito zida zapadera: malupu a mtima kapena mphete.

Mitundu ya mankhwala oletsa kupweteka kwa endarterectomy

Opaleshoni yam'deralo imalepheretsa kufalitsa kwa mitsempha m'dera lomwe lakhudzidwa. Njira yothandizira opaleshoni iyi imalola dokotala kuti athe kulumikizana ndi wodwala pakuchita opareshoni ndikuwunika thanzi lake. Opaleshoni yam'deralo imasonyezedwa pakuchita opaleshoni kwa anthu okalamba omwe ali ndi matenda osakhazikika a mtima kapena bronchopulmonary system. Amaphatikizidwa kwa ana, anthu omwe ali ndi vuto la aphatic, kuvutikira kwakamtima.
Endotracheal anesthesia kwathunthu chimatchinga ululu kumva. Wodwalayo amagona pa opaleshoni. Mwa opaleshoni wamba, osakaniza a nitrous oxide ndi okosijeni amagwiritsidwa ntchito kapena intravenous fractional narcotic analgesics amaperekedwa.

Nthawi yogwira ntchito

Endarterectomy imagwira ntchito kuchipatala. Kuchipatala kwa wodwala kumakhalapo kuyambira tsiku limodzi mpaka sabata limodzi, koma osinthidwa ndi adotolo chifukwa cha zovuta.

Wodwala yemwe wachita endarterectomy amayang'aniridwa ndi akatswiri tsiku loyamba.

Ngati odwala ali ndi mawonekedwe osasunthika a hemodynamic, amawasamutsa kumalo osungirako odwala kwambiri.

Patatha tsiku limodzi atachitidwa opaleshoni, mankhwala othandizira amayamba. Odwala adalembedwa:

Ma Anticoagulants - "Wessel Duet F", "Fragmin", "Fenilin", "Warfarin". Amalepheretsa ntchito ya kuphatikiza kwa magazi ndimagazi ndipo amalepheretsa kupindika chifukwa cha kuchepa kwa khungu.
Ma Microcirculators - angioprotectors: "Vinpocetine", "Trental", "Cavinton". Amasinthasintha kayendedwe ka magazi m'mitsempha ya microvasculature, kukulitsa ma arterioles, capillaries ndi venological, ndikusintha kwatsiku la magazi.
Nootropics - "Actovegin", "Phenibut", "Piracetam", "Cerebrolysin". Mankhwalawa amalimbikitsa ntchito zamaganizidwe, kusintha kukumbukira, kuwonjezera luso la kuphunzira komanso kukana kwa ubongo pazinthu zingapo zoyipa, kupsinjika kwambiri ndi hypoxia.
Analgesics - "Analgin", "Amidopyrine", "Indomethacin", "Ibuprofen". Amathandizira kupweteka, kupondereza ntchito zowawa, popanda kukhudza kwambiri mitundu ina yamva.
Ma anti-sipekitiramu othandizira kuchokera pagulu la fluoroquinolones, macrolides, cephalosporins, penicillins.

Zovuta zimachotsedwa tsiku lachisanu ndi chiwiri. Pambuyo pakuchotsa, odwala amapatsidwa antiplatelet agents - Acetylsalicylic Acid, Clopidogrel, antihypertensive mankhwala - Kapoten, Analapril kwa nthawi yayitali. Ndi atherosulinosis yomwe ikupita patsogolo, ma statin adayikidwa - Lovastatin, Fluvastatin.

Patatha mwezi umodzi atachitidwa opaleshoni, odwala amayenera kukaonana ndi dokotala kuti awone kuthamanga kwa magazi ndi khungu pakhungu lowonekera.

Ngati chizungulire, malaise, kupweteka ndi kupweteka kwa m'mimba, dysphonia, kuwonongeka kwa mawonekedwe, kuledzera, kutupa komanso kutupa kwa magazi, kutuluka magazi kuchokera bala, kufupika ndi kuperewera kwa vuto la dyspeptic, muyenera kufunsa dokotala.

Kuti muchepetse chiwopsezo chatsopano cha mapangidwe apakhungu, zakudya zopatsa thanzi ziyenera kukhala zofanana kunyumba, ndipo ovuta kwambiri, ayenera kutsatira zakudya zolimba.

Zakudyazi ziyenera kuphatikizapo zakudya zomwe zimakhala ndimafuta a masamba, mapuloteni, chakudya chamagulu, michere ndi mavitamini.

Madokotala amalimbikitsa kusewera masewera, kusintha kulemera kwa thupi, kusiya kusuta fodya komanso kukayezetsa apo ndi apo, kuphatikiza kudziwa mawonekedwe a lipid ndi zizindikiritso za kayendedwe ka magazi.

Atherosulinotic plaque mu carotid artery: ntchito ndi mtengo wa njirayi

Carotid atherosulinosis ndi matenda oopsa, osakhazikika nthawi yomwe malo omwe ma atherosocolotic amakaikidwa mu makhoma a mitsempha ya carotid.

Chifukwa chachikulu cha matenda awa ndi kuchuluka kwa cholesterol, makamaka yogwirizana ndi otsika osalimba a lipoprotein.

Chifukwa chiyani arteriosulinosis ya mitsempha ya carotid imabuka ndipo ndi owopsa?

Atherosulinosis ndi nthenda ya polyetiological. Pali zifukwa zambiri zomwe zimayambitsa matenda m'thupi la munthu. Mwa zina zonse zomwe zimayambitsa matendawa, pali zingapo zomwe zimafala kwambiri.

Zomwe zimayambitsa matendawa ndi izi:

Zaka zopitilira 40.
Amuna amadwala chifukwa cha kupezeka kwa cholesterol plaque kanayi kuposa amayi.
Kusuta kumatsogolera ku kuwonongeka kwakanema chifukwa cha kusintha kwa kapangidwe ka makoma awo.
Kunenepa kwambiri.
Matenda a shuga, makamaka amtundu wachiwiri.
Matenda a mahomoni, kuphatikizapo kuperewera kwa mahomoni a chithokomiro komanso kusamba kwa kusintha kwa msambo mwa akazi.
Mowa.
Udindo wofunikira umachitika ndi chibadwidwe.
Mavuto apakati a kagayidwe ka lipid m'thupi.
Kusowa kwa lipoproteins wapamwamba ("wabwino" cholesterol).
Khalidwe labwino.
Metabolic syndrome ndi mkhalidwe wapadera womwe umaphatikizapo kuwonetsedwa kwa matenda oopsa (kuthamanga kwa magazi), kunenepa kwambiri makamaka pamimba, triglycerides owonjezera, komanso kulekerera shuga.
Kupsinjika pafupipafupi, kusakhazikika mtima.

Kuwonongeka kwa mitsempha ya carotid kumakhala kowopsa chifukwa cha kusokonezeka kwa magazi muubongo, chifukwa amakhala ndi magazi okhala ndi mpweya m'maselo ake ndi minyewa yake.

Poyamba, zizindikiro zazing'ono zimatha kuwoneka, monga kuchepa kwa kukumbukira, kusinthasintha kwa mtima, kupweteka mutu, kuchepa kwa luntha, komanso kusakhazikika maganizo.

Mtsogolomo, zomwe zimadziwika kuti ndizosachedwa kusokonekera (TIAs) zimatha kuchitika - izi ndizovuta kwakanthawi (zopatsirana) zomwe zimachitika osakwana tsiku limodzi. Amadziwika ndi matenda osiyanasiyana amtundu wamiyendo, kuwonongeka kwa mawonekedwe, ngakhale ziwalo zimatheka.

Ngati zizindikiro za kanthawi kochepa kovutikira sizisowa m'maola 24, ndiye kuti mukupezanso matenda ena - stroko.

A sitiroko ndi necrosis yamitsempha yamaubongo. Itha kuchitika chifukwa cha hypoxia (kusowa kwa oxygen) yaubongo kapena chifukwa cha kukha mtima kwakukulu m'menemo.

Tissue hypoxia imatha kuchitika chifukwa cha matenda oopsa (ziwiya ndizochepa kwambiri, ndipo magazi amayenda bwino) kapena atherosulinosis (zolembera za atherosulinotic zimatha kutuluka mu lumen ya chotengera ndikuchepetsa kuchepa kwa magazi koyenera). Pankhaniyi, sitiroko imatchedwa ischemic (ischemia - kusowa kwa magazi opatsa mpweya).

Ngati hemorrhage ipezeka mu minofu ya muubongo, ndiye chomwe chimapangitsa kwambiri ndi mtima wa vasurm - kupendekera ndi kukulitsa khoma la chotengera, chifukwa chomwe chimataya kuyerekezera kwake ndikutha kupasuka mosavuta nthawi iliyonse chifukwa cha kuchuluka kapena kupsinjika. Aneurysm, ikhoza kukhazikika pamaso pa atherosulinosis. Cerebral hemorrhage ikuwonetsa kuti hemorrhagic stroke (hemorrhage - magazi).

Monga momwe mumadziwonera nokha, atherosulinosis ya mitsempha ya carotid imatha kukhala zotsatirapo zomvetsa chisoni. Ndipo koposa zonse, palibe amene anganeneretu momwe sitirayo idzadziwonekera. Ngati simupereka chithandizo chamankhwala munthawi yake, ndiye kuti munthu atha kukhala wopunduka kwathunthu kapena kufa kumene.

Chifukwa chake, ngati atapezeka ndi chotupa cha ma carotid mitsempha, imodzi mwanjira zomwe amathandizira pochita opaleshoni ndi kuchitidwa opareshoni.

Kodi opaleshoni ndiyofunikira?

Kuchitapo kanthu kwa opaleshoni kumachitika pokhapokha ngati matendawo apezeka kale.

Kuphatikiza apo, opareshoni imachitika ndi mphamvu yochepa ya mankhwalawa omwe amagwiritsidwa ntchito, omwe sangathe kukhazikika ku boma.

Opaleshoni pofuna kuthana ndi carotid arteriosulinosis ali ndi zisonyezo zingapo, zokhazikika.

Zizindikiro ndi stenosis (kuchepa) kwa lumen ya carotid mtsempha woposa 70%, kuphatikiza milandu yomwe kulibe chiwonetsero chazachipatala, stenosis ya carotid artery yoposa theka ngati pali zizindikiro za matenda a ischemia, kuthamanga kwa magazi (TIA) kapena mikwingwirima.

Komanso, opaleshoni imalembedwa ngati pali kufupika kwa lumen kochepera hafu, ngati kale panali milandu ya TIA ndi stroko, kuphwanya kwadzidzidzi kwa ntchito zaubongo kapena kupitilira kwa ubongo ischemia, kuwonongeka kumanzere kumanzere kwa carotid, kuwonongeka kwa munthawi yomweyo kwa mitsempha ya carotid, vertebral ndi subclavian.

Palinso zosokoneza zambiri pakuchita opareshoni, chifukwa nthawi zambiri anthu achikulire amakumana ndi mavuto omwewo.

Kwa iwo, zochitika ngati izi ndizopweteka kwambiri, motero pamakhala zotsutsana pamakhalidwe awo:

matenda opatsirana a mtima, bronchopulmonary dongosolo ndi impso panthawi yakukokoka - ndiye vuto loyamba, chifukwa thupi motsogozedwa ndi opaleshoni ya m'mimba silingathe kupirira,
kupsinjika kwakukulu kwa chikumbumtima, mpaka kukomoka,
siteji yowopsa ya stroko,
hemorrhage mu ubongo minofu ndi concomitant foci wa ischemia.

Chinanso chomwe chikuyambitsa cholakwika ndicho kufa kwathunthu kwa maselo aubongo omwe amatuluka kwambiri m'mitsempha yama carotid.

Zosiyanasiyana maopareshoni yama carotid

Madokotala asanadziwe momwe angachitire opaleshoni, odwala amafunika kukayezetsa magazi: kuyesa magazi ndi mkodzo, kuyezetsa magazi osiyanasiyana, kupatula mtima (kupatula matenda amtima), fluorography (mayeso ofunikira chifuwa chachikulu), ndi coagulogram (kutsimikiza kwa magazi kuundana).

Njira zowonjezera pakufufuzira pankhaniyi, zomwe tikulingalira, zikuphatikiza ma carotid artery angiography (angiography ndikusanthula kwa mitsempha yamagazi pogwiritsa ntchito njira yosiyanitsa), mitsempha yamagazi obwereza, compact tomography (CT), kapena maginito a resonance imaging (MRI).

Pali mitundu itatu yayikulu ya njira yochitira opaleshoni yamitsempha yama carotid: carotid endarterectomy, mtima stenting, mtima prosthetics.

Kusankhidwa kwa njira yochitira opaleshoni mwachindunji kumadalira kuchuluka kwa kuvulala kwamitsempha, pa zaka komanso zikhalidwe la wodwalayo, komanso kuchipatala komwe mchitidwewo udzachitidwira.

Carotid enadarterectomy ndichomwe chimagwira ntchito kwambiri pamwambapa. Muli ndi kuchotsedwa kwathunthu kwa cholesterol plaque kuchokera khoma la chotengera, zomwe zimapangitsa kuti zibwezeretsedwe kwathunthu. Nthawi zambiri imachitika pogwiritsa ntchito mankhwala opha ululu, koma nthawi zina kwanuko kumatha. Imachitika ndi atherosulinosis ndi carotid artery thrombosis, momwe mumanenedwa matenda akuwonekera kwa ngozi yamitsempha, kapena asymptomatic atherosulinosis, koma ndi mtima wamphamvu wa stenosis. Pa opaleshoniyo, khungu limapangidwa kumbuyo kwa auricle 2 cm pansi pamphepete mwa nsagwada yam'munsi; imapitilizidwa limodzi ndi minofu ya sternocleidomastoid masentimita khumi. Kenako khungu ndi subcutaneous mafuta minofu timatulutsa. Zitatha izi, kuchuluka kwakweko (chotupa) cha chotupa chamagulu amadzipatula ndipo mkati timapezeka. Chingwe cha atherosulinotic chimachotsedwa kwathunthu ku lumen yake pamodzi ndi zinthu zosinthika za khoma la mtima. Kenako malowa amatsukidwa ndi njira yothandizira ya sodium kolorayidi. Khoma lamitsempha limakulungidwa pogwiritsa ntchito chigamba chapadera. Itha kupangidwa kuchokera ku zinthu zopangidwa kapena kuchokera ku minofu ya wodwalayo. Pamapeto pa opareshoni, chilondacho chimasokonekera m'magulu, ndikusiya drainage (chubu) m'chigawo chotsikira kuti utulutse madzi.
Ndikuluma - pakadali pano, opaleshoni iyi imakondedwa kwambiri, chifukwa mwachilengedwe imakhala yovuta, ndipo, motero, sizimamukhumudwitsa anthu. Kwa stenting, kuyang'anira pafupipafupi kwa x-ray ndikofunikira, momwe sing'anga yosiyanitsidwa imatumizidwa mchombo ndikugawa kuyang'aniridwa. Kuchita opareshoni kumachitika pansi pa mankhwala oletsa ululu. Choyamba, kupyoza (kupyoza) kwa chotupa cha carotid kumachitika. Kenako, motsogozedwa ndi X-ray, balloon yapadera imayambitsidwa mkati mwake, yomwe imakulitsa kuwunikira kwa chotengera pamalo ofunikira. Pambuyo pa izi, stent imayikika - kasupe wachitsulo, yemwe amasunga nthawi zonse chithunzicho. Pamapeto pa opareshoni, baluniyo imachotsedwa. Mukakhala ndi kununkha, zovuta monga kuwonongeka kwa zolengeza, carotid artery thrombosis imatha kuonedwa.
Prosthetics mwina ndi njira yovuta kwambiri kuchitira opaleshoni nthawi yayitali. Amagwiritsidwa ntchito pakuwonjezera zotupa za atherosselotic, kuyika kwamchere kwa khoma la chotengera, komanso pamaso pa kukwiya kapena kuchuluka kwa mtsempha.Pa ma prosthetics, chotupa chamkati cha carotid chimadulidwa, malo omwe akhudzidwa amachotsedwa kwathunthu, zotengera zimatsukidwa m'malo omwe adasungidwa, ndipo gawo lotsala la chotupa chamkati mwa carotid limaphatikizidwa ndi chotupa wamba cha carotid. Pomanga ndi maapozi opangidwa ndi zinthu zopangidwa moyenerana ndi ma diameter a ziwiya. Gawo lomaliza ndikukhazikitsa ngalande zotulutsira madzi.

Nthawi yokonzanso pambuyo pochita opaleshoni ya zolembera zam'mimba mu carotid artery samapitilira sabata. Mavuto amakula nthawi zambiri. Zotsatira za opaleshoniyo nthawi zambiri zimakhala zabwino. Ndemanga za ntchito ili pamwambapa ndizabwino.

Carotid arteriosulinosis akufotokozedwa mu kanema munkhaniyi.

Njira yamaphunziro

Maonekedwe a zolembera amakhudzidwa ndikuphwanya mafuta kagayidwe. Zimatsimikizika kuti chimodzi mwazinthu zomwe zimapanga mafuta metabolism ndi njira yopangira ndi kugwiritsira ntchito lipoproteins ndi triglycerides. Amapangidwa usiku ndi maselo a chiwindi kuchokera ku mafuta a nyama omwe amalandiridwa kuchokera ku chakudya, kulowa m'magazi, ndikufika pama cellular, komwe amatenga nawo gawo pantchito yopanga minofu, kapangidwe ka mahomoni ndi mavitamini. Zotsalira zimabwezedwa ku chiwindi kuti ziwonongeke. Monga momwe dzinalo limanenera, lipoproteins ndi mankhwala a mamolekyulu amafuta ndi mapuloteni. Gawo lamafuta ndi cholesterol lodziwika kwa onse.

Asayansi apeza tizigawo ting'onoting'ono ta lipoprotein timene timathandizira pakukula kwa atherosulinosis:

kukwera kwambiri
kachulukidwe kakang'ono
kachulukidwe kakang'ono kwambiri.

Ngati lipoprotein yochuluka imadziunjikira (mwina mafuta ambiri amachokera ku chakudya, kapena chiwindi sichitha kukonza), kuvulaza kwawo khoma la mtima kumayamba. Kuphatikiza apo, lipoproteins yapamwamba imakhala ndi zotsatira zabwino, ndipo yotsika - imakhala chida chomanga cholesterol plaque. Mayina "cholesterol abwino" ndi "cholesterol yoyipa" ndi ozika mizu.

Kodi cholembera wa cholesterol ndi chiyani?

Kuti chikwangwani chiwonekere, pamafunika zinthu ziwiri:

vutoli mu mafuta kagayidwe,
kuwonongeka kwa khoma lamkati la chotengera.

Nthawi zambiri, mulingo woyenera umasungidwa pakati pa cholesterol chabwino “ndi chabwino”, choloproteins chachikulu. Ndi atherosulinosis, kuchuluka kwa mapuloteni okhala ndi mafuta ochepa komanso ochepa kwambiri.

Pa intima (nkhono yamkati) yamatumbo akulu ndi apakatikati, zotupa zazing'ono zimawonekera. Makamaka nthawi zambiri m'malo a nthambi zapanthambi. Umboni wasayansi umawagwirizanitsa ndi kachilombo ka virus. Ndi fuluwenza, matenda opumira kwambiri a pakhungu, herpes pamilomo ndi mapiko a mphuno, ma virus samapezeka kokha pamatumbo amkati, komanso m'matumbo. Izi zikuwonetsedwa ndi kufananizidwa kwa ziwopsezo zakufa kuchokera ku sitiroko ndi kugunda kwa mtima pakuwuka kwa matenda oyambitsidwa ndi ma virus ndi fuluwenza. Matenda a chlamydial, cytomegalovirus, ali ndi zofanana.

Kupitilira apo, mapangidwe a zolembedwa amapitilira magulu atatu:

Gawo la banga la mafuta - pamalo owonongeka, khoma lamanjenje limasulidwa ndikutupa, limatetezedwa kuti lisatuluke ndi ma enzymes. Akasungika, cholesterol "choyipa" chimasungidwa pachiyanjano chowonongeka. Kutalika kwa njirayi ndikosiyana, pakhoza kukhala malo kuchokera paubwana, popeza pansi pa maikulosikopu imapezeka mwa ana.
M'malo wamafuta, ulusi wophatikiza umawoneka ndikukula, umakhala wonenepa, koma wotayirira komanso wofewa. Pakadali pano, cholesterol plaque ikhoza kusungunuka ndikuchotseredwa. Komabe, pamakhala ngozi yoti ingang'ambe chidutswa, kupangika kwa mkokomo ndi kutsekeka kwa mtsempha. Khoma lomwe limakhala pamalo ovulalawo limapangidwa makina, limapweteka, zomwe zimapangitsa kuti ziwombere komanso zimawonjezera chiopsezo cha kuwundana kwa magazi.
Mchere wa calcium umayikidwa (atherocalcinosis), zolembera zimayamba kukula. Kusintha sikungatheke. Mikhalidwe yapangidwa kuti ichepetse kuthamanga kwa magazi ndi kuchuluka kwa magazi. Amapanga zigawo zamagazi (zigawo zamagazi), zomwe zimayambitsa kuwonekera kwamankhwala. Ndi kukula msanga, kudwala mwadzidzidzi kapena matenda osakhalitsa kumachitika ndi kutsekeka pang'onopang'ono kwa magazi kulowa gawo lomwe lakhudzidwa.

Njira ya atherosulinotic imakhudza ziwiya zamagetsi za kukula ndi kukula kwakukulu. Zombo zoyipa ndi zam'mimba, komanso ma capillaries ang'onoang'ono sizowonongeka. Malo omwe amakonda kutukuka kwa malo okumbika ndi zotengera za zotanuka (mitsempha yayikulu, kuphatikiza thoracic ndi m'mimba msempha, chotupa cha akazi) ndi mtundu wa minofu-elastic (carotid artery, shipping ya mtima, ubongo, impso).

Kupezeka kwa cholesterol plaques m'mitsempha ya mtima kumabweretsa kuphwanya kwamphamvu kwa magazi kupita ku myocardium (minofu minofu) ndipo kumayambitsa kuperewera kwa coronary mu mawonekedwe a angina kugunda kapena kugunda kwamtima kwambiri. Kuchuluka kwa kuwonongeka kwa mtima kumadalira dera lomwe lawonongeka, kuchuluka, komanso mphamvu ya thupi yopanga magazi ena (ziwalo zamkati).

Zolemba za cholesterol m'matumbo a khosi zimachepetsa thanzi la ziwalo zonse zomwe zimapezeka m'mutu. Choyamba, ubongo, maso. Izi zikuwonetsedwa ndi kuchepa kwa magwiridwe antchito awo: kukumbukira, kuwona, njira yoganizira, mwayi wophunzirira. Zovuta zam'mutu zomwe zimakhala ndi mseru komanso kusanza, kuchuluka kwa magazi komanso kuthamanga kwa matenda oopsa zimagwirizananso ndi atherosulinosis ya ziwiya zaubongo ndi impso, cholesterol plaque mu carotid artery. Ndi kupatuka kwadzidzidzi kwa magazi kapena gawo la zolengeza, kuphwanya kwamphamvu kwa magazi kumachitika - sitiroko yokhala ndi ziwalo zathunthu zamkati. Chithunzi cha chipatala chimatengera komwe kuli thrombus.

Pakatha zaka makumi asanu ndi limodzi, odwala amatha kuwona chizindikiro cha plaque mu thoracic aorta. Kwambiri, izi zimawonetsedwa ndi kupweteka kosalekeza kumbuyo kwa sternum, mpaka kumbuyo. Mosiyana ndi angina pectoris, samadalira zolimbitsa thupi kapena kupsinjika. Vuto lalikulu ndi kupasuka kwa msempha.

Mitsempha yachikazi ndi ziwiya zam'mapazi zapansi zimakhudzidwa, kuzizira kwamiyendo, lamile, komwe kumakupatsani kusiya kupweteka, kuphwanya phazi ndi kupweteka kwambiri komanso kuwonongeka kwa minofu, kumachitika.

Zosintha m'mitsempha yama impso zimatha kuchotsa chiwalo chogwira ntchito, zomwe zimabweretsa kulephera kwa impso, kudzikundikira kwa zinthu za nayitrogeni komanso poizoni yemwe sanatsidwe mkodzo. Kuperewera kwa zakudya m'thupi kwa adrenal kumapangitsa kuti magazi asamangokhala osagwirizana.

Kutsekeka kwa m'mimba msempha kumapangitsa kupweteka kwam'mimba, necrosis yamatumbo, kapamba.

Kukula kwa atherosulinosis koyambirira kwa ziwiya zazing'onoting'ono zimapezeka ndi kuchepa kwa potency ndi kukokoloka kwa erectile mwa amuna.

Dipo lama cholesterol ndi lotheka pakhungu la mafupa, khosi, chifuwa. Zambiri mwa azimayi. Komabe, sizolumikizana konse ndi zombo. Dzinalo loyenera la cholesterol plaques kumaso ndi xanthelasma. Amawoneka ngati chifukwa cha kusokonekera kwamafuta kagayidwe. Ena mpaka amawawona ngati mtundu wa chisonyezo cha kukula kwa njira ya atherosulinotic m'thupi.

Ma Xanthelasms amakhala ndi mawonekedwe ozungulira, osalala kapena oterera, kuyambira ochepa kwambiri mpaka nandolo. Awa ndi mayendedwe abwino. Amakula nthawi yonse ya moyo, osapweteka, ofewa kukhudza. Malo omwe ma cholesterol amapezeka m'maso ndi vuto lochita zodzikongoletsera, sizikhudza masomphenya. Malingaliro a madokotala pazakudya ndi chimodzimodzi ndi chitukuko cha atherosulinosis. Xanthelasma imatha kumera, kuwonekanso malo ena. Pofunsidwa ndi wodwalayo, kuchotsedwa kwa cholesterol plaque kumapeto kumachitika pogwiritsa ntchito kuzizira (cryotherapy), thermocoagulation, mtengo wa laser, komanso opaleshoni.

Mitundu ya magwiridwe

Pali njira zambiri zochitira opaleshoni yamitsempha yama carotid. Onsewa ali m'magulu awiri:

tsegulani - lingalirani kudula minofu pamwamba pa zotengera. Izi zimaphatikizapo opaleshoni yam'mbuyo, ma prosthetics, carotid endarterectomy, resection,
endovascular - amagwiritsidwa ntchito pogwiritsa ntchito zida zapadera zomwe zimayikidwa mu mtsempha waukulu (nthawi zambiri zachikazi) komanso zotsogola mpaka tsamba la mtima. Izi zimaphatikizapo endovascular angioplasty, stinging, embolization wa aneurysm.

Kusankhidwa kwa mtundu wa opareshoni kumadalira mawonekedwe amomwe amapezeka, wodwalayo, thanzi lanu, kuwonongeka kwa mtima, kapena vuto la mtima.

Zizindikiro zazikulu za opareshoni - kuphwanya kayendedwe kazisamba, chiwopsezo cha kugwidwa ndi minyewa:

Kuchepetsa lumen ya chotengera (stenosis),
kutseka kwa mtsempha wama carotid,
aneurysm
pathological kuzunza kwamitsempha yamagazi.

Njira Yogwirira Ntchito

Pali njira zingapo zochititsira spacecraft:

Tsegulani. Wopanga opaleshoni amaika chida cham'madzi, amatenga gawo lalitali pamwamba pamalopo, amachotsa chikwangwani cha hemope kapena atherosselotic kudzera pamenepo ndi malo osinthika a mtsempha. Matendawa amayatsidwa, nthawi zambiri amawonjezera ndi “chigamba” chomwe amadula m'mitsempha ndi odwala. Kuchenjera kumeneku kumathandizira kukulitsa kuunikira kwa chotengera.
Half anatsekedwa. Dokotalayo amapanga zigawo zing'onozing'ono zazitali ndipo kudzera mwa iwo ndi spatula kapena chiuno amachotsa zolembera za cholesterol. Njirayi ndiyofunika kwambiri pakafunikira opaleshoni pama gawo ambiri a chotengera.
Eversion carotid endarterectomy (njira yopotera). Kupyola pang'ono, khoma la mtsempha wamafunde limakhala ngati sock, kuwulula malo okhudzidwawo. Wopanga opaleshoniyo amatsuka zolembazo, kenako ndikusesa chotengera.

Physiology (kubwezeretsa kayendedwe ka magazi popanda kusintha matupi a mitsempha),
kusungidwa kwa zombo zazing'ono zomwe malo owonongeka amathandizana nazo,
kusowa kwa matupi akunja.

kutalika
kupapatiza kwapadera: chokhacho chofunikira kuchititsa ndikupezeka kwa zolembedwa za atherosulinotic.

Kubwezeretsanso pambuyo

Pambuyo pakuchita opaleshoni pamitsempha yama carotid, wodwalayo amakhala masiku angapo kuchipatala. Nthawi zambiri nthawi imeneyi imatha masiku 2-3. Odwala omwe ali ndi kuthamanga kwa magazi pambuyo pakuchita opaleshoni amaikidwa m'chipinda chothandizira kwambiri. Zovuta zimachotsedwa patsiku la 7-10. Ndi njira yabwino ya nthawi ya postoperative, mutha kubwerera kuntchito pambuyo pa masabata 1-2.

Pa kuchira, tikulimbikitsidwa:

Imwani mankhwala onse opangidwa ndi dokotala mwanjira yoyenera. Izi zimathandizira machiritso, kupewa kuti pakhale zovuta.
Sungani chofufumira. Zochizira paukhondo gwiritsani ntchito hydrogen peroxide, chlorhexidine. Kavalidwe kanu kamayenera kusinthidwa ndikamakhala konyansa.
Osatupa msoko. Poyamba, odwala amamva kuti samamva bwino, amakhala kuti ali ndi vuto lodzala. Ma painkiller amathandizira kuthana ndi zizindikiro.
Pezani nthawi yosuta. Zigawo za fodya zimapangitsa kuti pakhale mapangidwe magazi, kukula kwa sitiroko kapena kugunda kwa mtima.
Chepetsani zolimbitsa thupi. Masiku oyamba, yesani kukana ngakhale homuweki. Kenako pang'onopang'ono kuwonjezera katundu: yambani kuyenda, kugwira ntchito kuzungulira nyumba. Masewera, makamaka mitundu yolumikizana, ndibwino kuchedwetsa.
Idyani pafupipafupi. Panthawi yochira, thupi limakhudzidwa makamaka ndikusowa kwa mphamvu, michere, zinthu zovulaza. Yesani kuchepetsa kuchuluka kwanu kwa zakudya zamafuta, mchere, shuga, ufa, zakudya zazakudya. Idyani nthawi zambiri, koma pang'ono. Patani zokonda kubzala, zakudya zamafuta ochepa, nsomba.
Osayendetsa. Kuti mudziteteze, komanso chitetezo cha ena, dikirani kanthawi poyambira kuyendetsa galimoto. Kuwonongeka mwadzidzidzi kungayambitse kuwonongeka kwa makina. Anthu ambiri amayamba kuyendetsa galimoto patadutsa milungu iwiri kapena itatha atachitidwa opaleshoni. Kupumula kwakutali kumalimbikitsidwa kwa odwala matenda a stroke, microstroke - osachepera mwezi.

Kuwopsa ndi zovuta zotheka

Carotid endarterectomy ndimayendedwe omwe nthawi zambiri amapita popanda zovuta. Choopsa kwambiri mwa iwo ndi ischemic stroke. Chiwopsezo cha stroke ndi 2% yokha, ndipo imfa - 1%.

Mavuto ofatsa ndiofala, koma owopsa. Izi zikuphatikiza:

kupweteka, dzanzi m'deralo,
magazi ochokera pachilonda
matenda a msoko
kuwonongeka kwa mitsempha
Kuchepetsa kubwereza kwakanthawi kapena mkati mwa mtsempha (restenosis).

Angioplasty

Mtundu wodziwika kwambiri wa maopaleshoni yamkati. Ntchito pa carotid mitsempha ndi njirayi amalimbikitsidwa kwa odwala omwe ali ndi contraindication njira zina. Angioplasty imachitidwanso ngati chithandizo chadzidzidzi chikufunika, chifukwa uku ndiko ntchito yotetezeka kwambiri. Muli magawo angapo:

Dokotalayo amaika catheter yopyapyala pachiwiya chachikulu m'manja kapena m'mafayilo. Moyang'aniridwa ndi X-ray, adokotala amapititsa chubuyo kupita pamalowo. Kenako, chubu chopyapyala komanso chopukutira kumapeto chimayikidwa mu catheter. Dokotalayo amasunthira kumalo a stenosis, kenaka amadzichulukitsa kangapo, amaphulika pa ballo. Zomwe zimayambitsa ndizowonjezera ndizowonjezereka kwa kuwala kwa mitsempha.
Pofuna kupewa kufupikitsidwanso, kukonzanso kwa cholembedwacho, chubu china chokhala ndi fungo, cholumikizira, chimayikidwa kudzera mu catheter, chomwe, pambuyo pakuwongola, chimapangitsa kuti khoma la chotchilo "lotseguka".

kusazungulira,
zitha kuchitika popanda kukonzekera mwamphamvu,
kuchira msanga.

zida zofunikira
kuthekera kwakukulu kobwereranso poyerekeza ndi carotid endarterectomy.

Opaleshoni yam'mimba

Ntchito yotseguka pamitsempha yama carotid, yokhudzana ndi kusoka kwa chotengera china pamwambapa, pansi pa malo ochepera. Ma prostheses ndi opanga kapena achilengedwe: amadula ndikusintha mtsempha / mtsempha wamagazi. Chizindikiro chachikulu ndicho stenosis yayitali. Nthawi zina, kuti apange "workaround", dokotalayo amatha kulumikizana ndi subclavian mtsempha wamagazi ndi carotid. Njira imeneyi imatchedwa carotid-subclavian bypass.

zopweteka kwambiri kuposa carotid endarterectomy,
kuthekera kwa chithandizo chofunikira pakapitiriza kwa stenosis.

chiopsezo cha thrombosis wa shunt.

Mankhwala othandizira opaleshoni ya aneurysm

Carotid artery aneurysm imayendetsedwa ndi njira zotseguka komanso zamkati. Omaliza a iwo amasankhidwa, makamaka ndi kufikira kovuta m'dera lomwe lakhudzidwalo. Zotheka kuchiza:

kuwona kwa gawo la aneurysm ndi ntchito yotseguka yophatikizira kuchotsa kwa protrusion ndikutsata kumapeto kwa zombo kapena mahule awo.
kudula - ikani dzenje laling'ono mu chigaza cha chidutswa chapadera chachitsulo, chomwe chimakakamiza khoma la chotengera chowonongeka,
kukumbukiza ndi njira yotetezeka kwambiri, yotsogola kwambiri. Kudzera mkati mwa chotupa cha akazi kulowa mu aneurysm m'mphepete mwa catheter, mpweya umasunthidwa, womwe umawongoka, umakhala mkati mwa protrusion mkati. Pakapita kanthawi, chilema chidzafalikira ndi minofu yolumikizira, kusiya kukhala ngozi. Kwa aneurysms yayikulu, stent yowonjezera imayikidwa kuti ichepetse gawo la kulowamo kwa aneurysm.

Kugwira ntchito ndi kutsika kwa mitsempha ya carotid

Pathological tortuosity kapena kinking amatchedwa kutalika kwa mitsempha ndi mapangidwe a mitundu yosiyanasiyana ya ma kink, malupu. Kusintha koteroko kapangidwe ka chotengera nthawi zambiri kumayendetsedwa ndi kuphwanya kwa magazi, mawonekedwe a cholesterol cholembera pamakoma amitsempha yamagazi. Ndi chisokonezo chachikulu cha hemodynamic, njira yokhayo yochiritsira ndikutsatira (malo) a patological site. Pambuyo pakuchotsa, malekezero otsalawo a chiwiyachi amalungidwa limodzi.

Kodi mungaimitse bwanji atherosclerosis?

Simungachotse zolembera za cholesterol ndi mankhwala.Chifukwa cha izi, njira zingapo za opaleshoni zimagwiritsidwa ntchito.

Choyamba, odwala ayenera kupimidwa mozama kuti athe kupeza mayeso osiyanasiyana, kuphatikizapo tanthauzo la milomo yowonjezera, kuwunika kwa electrocardiographic, kuyesa kwa mtima, impso. Mphamvu zaubongo zimawerengeredwa pogwiritsa ntchito computer tomography, electroencephalography. Mwa kuyambitsa zinthu zosiyanasiyananso panthawi ya angiography, kulingalira kwa maginito, malo ndi kukula kwa magazi omwe ali mumtsikawo amatsimikizika.

Nthawi ya opaleshoni, dokotala wa opaleshoniyo, pamodzi ndi thrombus, amachotsa gawo limodzi la zolembazo. Momwe mungachotsere cholesterol malo mwachangu zimatengera kulimba kwa thupi lomwe lakhudzidwalo komanso munthu mwiniyo.

Pa magawo oyamba a matendawa (mafuta banga), mankhwala monga ma enzymes amagwiritsidwa ntchito kusungunula cholesterol plaques, koma amayenera kuperekedwa mwachindunji ndi tsamba la zotupa. Chithandizo chotere ndi chovuta kwambiri ndipo chimatheka m'magawo apadera a mtima. Chifukwa chake, ndizowona kwambiri kuti musaganize momwe mungachotsere cholesterol, koma momwe mungapewere mawonekedwe awo oyamba, okhudzana ndi mwayi wopewa matenda a atherosulinosis.

Pali mitundu iwiri yoyambitsa matenda a atherosulinosis:

zifukwa zomwe sitingathe kutengera (zaka, chibadwa, chibadwa),
kugwa m'malire amomwe munthu angathe kuchita ngati akufuna.

Ndi njira yachiwiri yomwe iyenera kukondweretsa anthu patatha zaka makumi anayi.

Madera asanu adadziwika momwe udindo wa munthu ndiofunika:

kudya mafuta ochulukirapo a nyama zomwe zidachokera - zimayambitsa kudya mafuta ochulukitsa "oyipa", omwe chiwindi chimalephera kupirira,
Kusowa kwa mayendedwe - kumachepetsa kudya mafuta m'thupi mwa thupi, kuchepa kwamafuta a metabolism kumabweretsa matenda,
kusuta ndi uchidakwa - chimodzi mwazochita za chikonga ndi mowa zimayamba kuwonongeka koopsa kwa chiwindi ndipo thupi siligwirizana ndi kukonza mafuta,
kunenepa kwambiri - kumayambitsa kuphwanya mitundu yonse ya kagayidwe, kuphatikizapo mafuta,
kuchuluka kukhudzika kwa nkhawa - thupi limakhala likuchitidwa ndi adrenaline ya mahomoni, izi zimasokoneza makina osinthika, zimayambitsa kudzikundikira kwa lipoproteins yotsika.

Chakudya chosemphana ndi mafuta a metabolism sayenera kupatula mafuta a nyama (mafuta a nyama, mafuta anyama, batala, kirimu), mbale zotsekemera ndi ufa. Tsiku lililonse muyenera kutenga osachepera 0,4 kg a zipatso ndi ndiwo zamasamba. Zimatsimikiziridwa kuti pokhapokha pakudya kwa mwezi umodzi, cholesterol "yoyipa" itha kutsitsidwa ndi khumi.

Zochita zolimbitsa thupi zimayenera kupakidwa, mpaka mphindi 40 tsiku lililonse. Kuyenda, kusambira, kuyendetsa njinga ndikulimbikitsidwa. Palibe chifukwa chomwe muyenera kuchita masewera olimbitsa thupi atakwanitsa zaka 50.

Kukana kupsinjika mtima kumatha kupangidwa mothandizidwa ndi masewera olimbitsa thupi, kumwa mankhwala ochepetsa zitsamba othandizira.

Mwa mankhwala omwe amathandiza kuchepetsa cholesterol, ma statins amagwiritsidwa ntchito kwambiri. Dokotala angakuthandizeni kusankha mankhwala oyenera.

Kodi zingwe zochokera mu carotid artery zimachotsedwa bwanji?

Momwe mungachotsere cholesterol plaque kumadalira kuchuluka kwa momwe lumen imapangidwira:

ndi zigawo zochepa, akalolera magazi kufalikira kwathunthu kudzera m'matumbo, mankhwala amagwiritsidwa ntchito, komanso kukonza moyo,
Ngati lumen yomwe ili m'ngalawamo idachepetsedwa kwambiri, ndipo wodwalayo akadwala mosakhalitsa, kapena mwadzidzidzi wadwala, ndiye kuti njira yokhayo ndiyo kuchotsa zochotsekerazo mu chotengera.

Kuwongolera njira yamoyo ndikusiya kusuta, mowa, komanso kadyedwe. Munthu ayenera kulabadira zolimbitsa thupi. Zinthu zonsezi zimathandizira kuti muchepetse kupita patsogolo kwa mitsempha ya mitsempha ya carotid. Chofunikanso chimodzimodzi ndikuwunika zaumoyo. Chidwi chachikulu chimaperekedwa ku kuthamanga kwa magazi, shuga m'magazi a shuga. Munthu ayenera kuyang'anitsitsa kuchuluka kwa cholesterol.

Mankhwala osokoneza bongo ali ndi ntchito: antispasmodics, antiplatelet agents, anticoagulants. Chithandizo cha mankhwala osokoneza bongo chikuchitika moyang'aniridwa ndi dokotala.

Ntchito zomwe zimachitika khosi pochotsa cholesterol plaques ku carotid artery:

carotid endarterectomy,
kusinthika kwamaphunziro,
stenting (thunthu la njirayo - stent imayikidwa pamalo ophulika, omwe amalepheretsa lumen ya chotengera kuti isafupike).

Zizindikiro ndi contraindication opaleshoni

Atherosulinosis ya mitsempha ya carotid ndiye chisonyezo chachikulu cha endarterectomy. Kuchita koteroko kumatha kusintha moyo wamunthu, komanso kupewa matenda oopsa - matenda opha ziwalo, omwe angayambitse imfa. Kuchotsa zochotsera m'mitsempha yamagazi kumaoneka ngati njira yabwino kwambiri yochizira matendawa. Kupatula apo, zimatsimikiziridwa kuti zithandizira kupulumutsa wodwalayo pazotsatira zomwe zingachitike, mosiyana ndi mankhwala.

Zizindikiro zazikulu za opaleshoni:

Stenosis ya chotupa cha carotid ndi yoposa 50%, ndipo ngati m'miyezi isanu ndi umodzi yapitayo munthu wagwidwa ndi ischemic yochepa, ndiye kuti ichi chidzakhala chisonyezo cha 100% chothandizira kuchitidwa opaleshoni.
Carotid stenosis yaposa 70%, ndipo pakufunikanso kulumikizana kwa mitsempha ya m'mitsempha.
Matenda opita patsogolo.
Carotid stenosis imaposa 80%.

Pali odwala omwe ma cholesterol malo omwe amapangidwa pamakoma amitsempha yamagazi samadzipangitsa kumva. Odwala oterewa amatchedwa asymptomatic. Kwa iwo, opaleshoni yochotsa zolembera amasonyezedwa ngati carotid artery stenosis imaposa 65%, ndipo kusakhazikika kwa zolembazo kumawonedwanso. Vuto linanso ndi chiopsezo chochepa kwambiri cha opaleshoni.

Pali zinthu zingapo zomwe zimachitidwa opaleshoni mosamala kapena nthawi zambiri zimaphatikizidwa: m'miyezi isanu ndi umodzi yapitayo, anthu adakhala ndi vuto la mtima, kuchepa kwa mtima, kutupa, sitiroko kwambiri, angina osakhazikika, matenda oopsa, matenda a Alzheimer's.

Kafukufuku

Choyamba, wodwalayo amawonetsedwa ndi mtundu wa ultrasound wobwereza, pomwe adotolo amatha kuwona cholesterol plaque mu mtsempha wama carotid. Njira yodziwira matendawa imathandizira kupeza chithunzi chokwanira cha chotengera chomwe chakhudzidwa, komanso kudziwa kuchuluka kwa stenosis komanso kuchepa kwa zolembazo. Ngati data ya diagnostics a ultrasound idathandizira kudziwa zofunikira zonse, ndiye kuti kuwunika koteroko ndikokwanira kuti kumufotokozere wodwalayo kuti achite opereshoni.

Ngati munthu saona zizindikiro zazikulu, koma akudwala matenda opha ziwalo, kapena akuwoneka kuti ali ndi stroke, ndiye kuti muyenera kugwiritsa ntchito njira zodziwitsira matenda:

Kupimidwa kowonjezera kumafuna odwala omwe:

anali ndi endarterectomy kale
anachitidwa opaleshoni m'khosi,
khalani ndi khosi lalifupi
anasamutsa radiation mankhwala pakhosi.

Pamaso njira yochotsera zolembera ku carotid artery, wodwalayo amapima magazi ndi mkodzo pafupipafupi, amapatsidwa electrocardiogram ndi arteriography.

Zonsezi zimayambira ndi mankhwala ochititsa manyazi. Monga lamulo, mankhwala ochita opaleshoni wamba amagwiritsidwa ntchito, koma nthawi zina amapita kwa opaleshoni yam'deralo (imaganiziridwa kuti ndi imodzi mwanjira zapamwamba). Opaleshoni yam'deralo imagwiritsidwa ntchito kawirikawiri, chifukwa imatha kuyambitsa nkhawa kwa wodwalayo panthawi ya njirayi chifukwa chosamva bwino m'khosi ndi mantha. Koma ngati mu anamnesis pali zotsutsana ndi opaleshoni yayikulu, ndiye njira yokhayo ndikutembenukira kwina.

Ubwino wa mankhwala opaleshoni:

kutsika kwa kukula kwa minyewa yaubongo,
kuchuluka kwamitsempha yamagazi m'mitsempha,
kuchepetsa nkhawa kwa wodwala ndi dokotala.

Kupewa

Njira yopangira cholesterol plaques imatenga nthawi yayitali kwambiri, osakudziwitsani. Nthawi zina atherosulinosis imapezeka kale kumapeto, pamene chithandizo chamankhwala ndi njira zina sichithandizanso, ndikuchotsa opaleshoni kumafunika. Koma popewa matendawa, muyenera kudziwa za njira zazikulu zopeweretsera matendawa.

Mafuta akulu a cholesterol ndi chifukwa chachikulu chomwe chimapangidwira mapangidwe a cholesterol. Kuti muchepetse mulingo uwu, komanso osaloleza, muyenera kutsatira malamulo atatu oyambira:

kutsatira zakudya
kumwa mankhwala
kuwongolera kulemera.

Cholesterol amalowa m'thupi ndi chakudya. Chifukwa chake, muyenera kuchepetsa kuchuluka kwa nyama ndi nsomba, komanso kukonda mitundu yamafuta ochepa. Zinthu zamkaka ziyenera kusankhidwa ndi mafuta ochepa. Maziko a zakudya - masamba atsopano, zipatso, zomwe zimathandizira kuti mafuta azichotsa m'thupi.

Ngati chakudya chokhwima sichikupatsani zotsatira zomwe mukufuna, ndiye kuti m'malo oterowo amapezeka ndi mankhwala omwe amachepetsa cholesterol yamagazi, potero kuletsa mapangidwe m'matumba. Nthawi zambiri mankhwala mankhwala gulu la statins. Kuwongolera kwawo kumafunikira kuwongolera mawonekedwe a lipid. Zimasokonezanso kugwira ntchito kwa ziwalo zamkati, makamaka chiwindi. Chododometsa china ndikuti kusiya kwa mankhwalawa kumawopseza kukhudzanso kwina kwa cholesterol.

Pofuna kupewa mapangidwe a cholesterol, munthu ayenera kuwunika kulemera kwake. Sipayenera kupitirira zoyenera. Kuti muchite izi, mutha kuwerengera pawokha mndandanda wama index wa thupi - kulemera / kutalika2. Zotsatira zake siziyenera kupitirira 30.

Zolemba za cholesterol sizipanga mafuta nthawi zonse. Chofunikira ndichikhalidwe cha makoma amitsempha yamagazi omwe amafunika kulimbikitsidwa.

Njira zazikulu zolimbikitsira mitsempha yamagazi: kusiya zizolowezi zoyipa (kusuta, kumwa mowa), samalani zolimbitsa thupi, yang'anani kuthamanga kwa magazi (ngati kuli kotheka, chithandizirani matenda oopsa), lamulirani mkhalidwe wanu wamalingaliro.