Atherosclerosis ya m'munsi malekezero - mtengo wa matenda ndi chithandizo

Pochita mankhwalawa atherosulinosis a ziwiya zamagawo am'munsi, onse othandizira pochiritsira mothandizidwa ndi mankhwala ndi opaleshoni angagwiritsidwe ntchito.

Ndiko kusapezeka kwa zotsatira zabwino kuchokera kumagwiritsidwe ntchito a mankhwala omwe ali chisonyezo chogwiritsa ntchito opaleshoni yothandizira.

Kuchitapo kanthu kwa opaleshoni kumachitika kumapeto kwa nthawi, pamene mankhwala osokoneza bongo samabweretsa zotsatira zabwino. Pakapita nthawi matendawa atakula, minofu yofewa imamwalira ndipo zimayamba kukhala zigawenga.

Dokotala wochita opaleshoni, pakuthandizira opaleshoni, amachita zotupa za malo a minofu omwe akuchitika. Madera omwe adachitidwa opaleshoni adaphimbidwa ndi chikwama cha chikopa.

Opaleshoni ya atherosulinosis ya malekezero otsika kumapeto kwa kusuntha kungathandize kusintha bwino mkhalidwe waumoyo ndi moyo wa wodwalayo.

Pali njira zingapo zopangira opaleshoni. Njira zodziwika bwino ndi izi:

1. Opaleshoni ya Bypass - opareshoni imapangidwa kuti apange njira yowonjezerapo yoyenda magazi mozungulira malo owonongeka.
2. Ntchito balloon angioplasty munthawi ya ndulu wapadera amene amachepetsa ochepa chotengera.
3. Arterial stenting - kuyikika mu artery yapadera stent yomwe imasunga chopendekera cham chombo nthawi zonse pamlingo womwe mukufuna.
4. Endarterectomy - kuchotsa kwa gawo lowonongeka la chotengera ndi zolembera za atherosrance?
5. Autodermoplasty ndi mtundu wa njira zopangira opaleshoni zomwe zimagwiritsidwa ntchito pochiza zilonda zam'mimba, zomwe zimakhala zovuta kuthana ndi mankhwala. Kuchita opareshoni kumathandiza kupewa kukulira kwa gangrenous njira mu minofu ya m'munsi malekezero.
6. Prosthetics - njira yosinthira chotengera chachilendo kapena chopanga ndi gawo la bedi lamitsempha lomwe limavutika chifukwa cha kupitilira kwa kufalikira kwa atherosulinosis. Njira yochitira opaleshoni imakupatsani mwayi wobwezeretsa magazi kumalo owonongeka.
7. Kudzicheka - njira yochotsa mbali ya mwendo, ndikutsatira ma prosthetics.

Kusankhidwa kwa njira yoperekera opaleshoni kumadalira kuchuluka kwa kuwonongeka kwa ziwalo za miyendo ndi machitidwe a thupi la wodwalayo. Kusankha kwa njira yochizira kumachitidwa ndi dotolo wamankhwala ochita operekera mankhwalawo.

Pambuyo pakuchita opaleshoni, wodwala adzafunika kuchita njira yayitali ndikukonzanso mankhwala osokoneza bongo kuti ayambenso moyo wabwino.

Pochiza atherosclerosis ya ziwiya zamagetsi am'munsi, dokotala, posankha njira yochizira, amawunika madongosolo a njirayo komanso mwayi wambiri kuti opaleshoniyo imathandizira wodwalayo popanda kugwiritsa ntchito njira zina zolowererapo.

Zina za mitundu yosiyanasiyana ya mankhwala othandizira opaleshoni

Balloon angioplasty ndi njira yothandizira odwala opaleshoni yomwe imaphatikizapo kuyambitsa bedi lamitsempha pamalowo pakuchepetsa kwa catheter wapadera wokhala ndi baluni yapadera pamapeto.

Pambuyo pokhazikitsa catheter, balloon imayamba kututira mokakamizidwa, zomwe zimapangitsa kukulitsa makoma a chotengera ndikubwezeretsanso njira yonyamula magazi.

Ngati kubwezeretsanso kwa kayendedwe ka magazi sikutheka, chimango chapadera chimayambitsidwa m'gawo la kuwonongeka kwa chotengera.Ntchito ya chimangochi ndikusunga m'mimba mwake cham'madzi pamalo owonongeka pamlingo wovomerezeka. Choyimira kukhazikitsa munthawi ya njirayi chimapangidwa ndi aloyi yapadera.

Ngati zotsatira zomwe mukufuna sizinachitike, dokotala yemwe akupezekapo adzaganiza zogwiritsa ntchito njira yotseguka ya shunt.

Nthawi zambiri, kugwiritsa ntchito balloon angioplasty kumakupatsani mwayi wobwezeretsa magazi ndikupewa kugwiritsa ntchito njira zowonjezera komanso zoopsa.

Kugwiritsa ntchito kwa kulowererapo kwa mtima kumapangitsa kuti pakhale kupezeka matenda monga a Lerish's syndrome kusintha kwambiri moyo wa wodwala. Pambuyo pa kulowererapo, mkhalidwe wamagazi amayenda mumitsempha yam'munsi yam'munsi imakhala bwino.

Pulasitiki yopanda minyewa komanso yofinya yomwe imagwiritsidwa ntchito pamankhwala osakhazikika amadzimadzi imachotsa zinthu zomwe zimachitika pamaso pa mtima chifukwa cha kuperewera kwa mtima komwe kumachitika pambuyo povundikira chivundikiro cha mtsempha ndi magazi.

Ambiri mwa zipatala zotsogola padziko lapansi zomwe zimagwira ntchito pakuchita opaleshoni yamatumbo amakonda njira ya balloon angioplasty.

Nthawi zambiri, njirayi imagwiritsidwa ntchito pobwezeretsa patency yamitsempha yama popliteal.

Njira ya balloon angioplasty ayesedwa posachedwa.

Kwa balloon angioplasty, masilindala okhala ndi zokutira pansi pamanja amagwiritsidwa ntchito.

Mankhwala omwe amalowetsa khoma la balloon amalowetsedwa kukhoma lamitsempha ndikutchinga kuti matenda awonjezeke.

Malangizo a akatswiri

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 kuthandizira opaleshoni yam'mimba, zingakhale zofunika kuchita mayeso ena mwanjira ya ultrasound ya mitsempha kapena mitsempha.

Kulandila (kufunsira) kwa wamtima ndi ECG

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

Kuonana ndi dokotala wamankhwala ochita opaleshoni 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 msempha ndi visceral mitsempha

Ultrasound yam'mimba msempha ndipo nthambi zake zimachitika kuti azindikire aortic aneurysm, kutsekeka kwam'mimba, aimpso ndi matumbo. Mwa anthu opitilira 55, ziyenera kuchitidwa chaka chilichonse kuti azitha kuthana ndi aneurysm ndi zovuta zake, monga njira yowonera.

Ultrasound yamitsempha yamiyendo yam'munsi

Ultrasound angioscanning yam'mimba msempha ndi m'munsi miyendo. Ndi njira yothandiza kwambiri yodziwitsa matenda oyamba am'mimbamo. Mu chipatala chathu, chochititsidwa ndi akatswiri odziwa zambiri, pazida zapamwamba kwambiri.

Ultrasound ya mitsempha yayikulu ya mutu

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

Njira yodziwitsa za mtima wamtima, zolakwika zake, ntchito yake komanso kukakamiza kwake m'mitsempha.

Zowunikira radiation

Makamaka aorta ndi nthambi zake

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.

Lower nthambi zam'manja

Arteriography (angiography) ya malekezero am'munsi ndiyo njira yayikulu yodziwira zotupa za zotumphukira za miyendo. Imachitika kudzera pakabowoleza mu radial mtsempha wamagetsi kapena mkono. Pambuyo podzikongoletsa, catheter yapadera imayikidwa mu mtsempha, womwe umapangidwira kumalo osangalatsa. Pambuyo poika catheter, jakisoni wodzipangira wokha amalumikizidwa, kudzera momwe sing'anga yosiyanitsira imayendetsedwa mofulumira kwambiri, kenako makina a x-ray amatsegulidwa ndipo zithunzi zingapo zimatengedwa. Njira yosiyanitsira pakati imawoneka bwino ndipo imakupatsani mwayi wowunika momwe ziwiya zimapangidwira komanso kapangidwe ka khoma lamkati. Angiography imapereka chidziwitso chambiri chofunikira chomwe madokotala a opaleshoni a mtima amapanga.

Kafukufuku wazotsatira za ntchito zotseguka m'mitsempha ya miyendo nthawi yomweyo magazi atayamba. Amakulolani kuti muwerenge bwino za kukonzanso kwamitsempha komanso kuchitapo kanthu mukazindikira mavuto ndi bedi kapena shunt.

Multispiral composed tomography yam'mphepete ndi minyewa yam'munsi yamitsempha

Kusiyanitsa kotengera kwa msempha ndi mitsempha yamiyendo. Ndi njira yophunzitsira komanso yotetezeka kwambiri yodziwitsa matenda am'mimba ndi miyendo.

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.

Kusankha zotumphukira angiography

Kusankhidwa koyambitsa matenda a catheter ndi angiography am'munsi miyendo.

Mtengo wa opaleshoni ya mtima

Opaleshoni ya aortic-femoral bypass - ndikupanga kutulutsa magazi kozungulira m'mitsempha yotsekemera kapena yamitsempha yamagazi. Imachitidwa kudzera mkulowera kumanzere kwa navel ndi pa ntchafu. Shunt - chida chochita kupanga chimamangirizidwa ku gawo la msempha kenako kumtsempha wamagololo achikazi. Izi zimapanga njira yochita kupanga kuti magazi adutse ndikutuluka kwa magazi ndikuyenda mumiyendo ndikubwezeretsedwa.

Aorto-bifemoral prosthetics okhala ndi visceral nthambi m'malo

Aorto-bifemoral prosthetics okhala ndi mawonekedwe a nthambi yama visceral amatanthauza kuti pakhale kupangika kwa magazi kuti magazi azitsekedwa. Imachitidwa kudzera mkulowera kumanzere kwa navel ndi m'chiuno chonse. Shunt - chida chochita kupanga chimamangirizidwa ku dera louma la aorta kenako chamtsempha wamagololo achikazi. Izi zimapanga njira yochita kupanga kuti magazi adutse ndikutuluka kwa magazi ndikuyenda mumiyendo ndikubwezeretsedwa. Ndi chiwonetsero chachikulu cha msempha, kungakhale kofunikira kubwezeretsa magazi kudzera m'mitsempha omwe akupereka matumbo kapena impso. Mitsempha iyi imapangidwira mu ma cell oyambira, potero kubwezeretsa magazi.

Opaleshoni ya aorto-bifemoral bypass - ndikupanga kutalika kwa magazi ndi magazi m'mitsempha yotsekeka kapena yaac. Imachitidwa kudzera mkulowera kumanzere kwa navel ndi m'chiuno chonse. Shunt - chotengera cholumikizira chimalumikizidwa ku gawo lotha kusintha kwa msempha kenako ndi mitsempha yachikazi pamiyendo yonse iwiri. Izi zimapanga njira yochitira kuti magazi azitha kudutsa ndipo magaziwo atuluke m'miyendo. Mtengo wokwanira wa opareshoniyo popanda mtengo wa opaleshoni akuwonetsedwa.

Wolambalala wachikazi

Imeneyi ndi njira yachikazi. Imadutsa m'njira imodzi yachikazi (yopereka mitsempha) kupita kumtsempha wina miyendo inayo. Amachitidwa pamwamba pa pubis mosadukiza. Chofunikira kwambiri pakutsiriza bwino kwa opaleshoni iyi ndi kuyang'anira bwino kwa mtsinje wa woperekayo. Kuchita koteroko sikothandiza kwenikweni kuposa kukokana mwachindunji, koma amakulolani kupulumutsa mwendo mwa odwala omwe afooka ndi matenda oyanjana.

Mu femal distal popliteal bypass grafting

Kupanga makina oti magazi azigwira chifukwa cha chotupa cha akazi. Imapangidwa pogwiritsa ntchito mtsempha wa wodwalayo, womwe umakonzedwa pogwiritsa ntchito ukadaulo wapadera kuti pakhale kutuluka kwa magazi kuchokera pamwamba mpaka pansi. Tekinolojeyi imathandizira kulolera ndikuwongolera zotsatira zake.

Wamkazi Popliteal Proximal Bypass

Kupanga kolowera kuyeza kwa magazi kudutsa chotchinga chachikazi. Amapangidwa ndimtundu wa 2 pamtunda wapamwamba komanso wotsika. Chombo chapadera chojambulidwa chimasokonekera kumalo omwe amatha kupitirako, komwe kumakhala gawo lachitatu la ntchafu, komwe limasokonekera kumtsempha wa popliteal. Pamenepo, patency yayikulu pamtsempha imabwezeretseka.

Kuzindikiritsa kwamitsempha

Kuwunika kuti athe kuchita opaleshoni ya mtima kapena kuyesa kwa opaleshoni ya mtima.

Mpanda ndi kupanga chida cholumikizira (kunja kwa gawo la nthambi yolumikizidwa) + mtengo wa opareshoni

Kukonzekera kwa microsurgical shunting pamitsempha ya m'munsi kapena phazi. Muli ndi kutolera kwamitsempha yamafinya pamiyendo yosagwirizana kapena manja kuti apange mawonekedwe oyenda ndi olowa mu mtima.

Microsuction revascularization ya phazi

Opaleshoni yodutsa mitsempha ya phazi pansi pa maikulosikopu.

Microsuction fibular shunt

Kugwedezeka kwa kugundika kwamitsempha yamagetsi yosatheka pansi pa maikulosikopu.

Ma microsuction tibial akutseka mkati mwendo wotsika

Fibro-tibial bypass pogwiritsa ntchito mitsempha yanu ngati shunt. Tanthauzo la ntchitoyi ndikuwoloka mitsempha yotsekemera kuyambira ntchafu kupita kumunsi. Mng'oma umakulungidwa kumitsempha yam'munsi yam'manja pogwiritsa ntchito microsuction pansi pa maikulosikopu.

Kuphimba kawiri konse kwa microsuction mkati mwendo wakumbuyo

Kugwedezeka pansi pa microscope ya mitsempha iwiri ya mwendo wotsika. Amagwiritsidwa ntchito moipa m'mitsempha, pomwe pali magawo ochepa a arterial arterial.

Opaleshoni ya Microsurgical Tibioperoneal Bypass

Opaleshoni yam'mimba kuchokera ku chithokomiro chachikazi kupita ku thunthu la tibioperoneal chakumtunda kwachitatu kwa mwendo.

Open kapena theka-lotsekeka endarterectomy ndi puloteni yamitsempha yosakwana 10 cm

Opaleshoni yochotsa fayilo ya atherosselotic kuchokera kumtsempha kuti abwezeretse patency ya chotengera. Amachitidwa ngati opareshoni yodziimira payekha kapena kuchitidwa opaleshoni kuti abwezeretse magazi.

Opaleshoniyo imagwiritsidwa ntchito kuti izitsekeka kumitsempha kwa njeac ngati sikungatheke kuthandizira kulowererapo kwa mtima (angioplasty and stenting). Kupezeka kofanana ndi mwayi wofikira pamimba. Kuyambitsa pamimba ndi m'chiuno.

Opaleshoni kuti apange kudutsa kwamwazi m'magazi a matenda aorta ndi iliac m'magazi omwe ali ndi ischemia yovuta kwambiri. Amagwiritsidwa ntchito kwambiri odwala okalamba, pokonzekera mahule aakazi aorto. Mabala awiri akuyenera. Mmodzi pansi pa kolala kupatula mtsempha wamagazi, wina pa ntchafu.

Opaleshoni yobwezeretsa patency yakuya wamkazi Amagwiritsidwa ntchito kwa odwala omwe ali ndi ischemia yovuta, nthawi zambiri limodzi ndi opaleshoni ya bypass.

Advanced profundoplasty yogwiritsa ntchito microsuction njira

Opaleshoni kuti abwezeretse patency yakuya chachikazi ndi minyewa yake yayikulu kwambiri ya zotupa.Maikulosikopu imagwiritsidwa ntchito kukonzanso kuchuluka kwa nthambi zazing'ono.

Kapangidwe ka shunt yophatikizira (kuchokera kumagawo angapo amitsempha yamagalasi ogwiritsa ntchito veno-venous anastomoses kapena mawonekedwe a PTFE prosthesis okhala ndi mtsempha) + mtengo wa opaleshoni

Opaleshoni yopanga suleti yopanda autovenous, pakalibe mtsempha woyenera kuti shunting. Magawo osiyanasiyana a mitsempha amatengedwa ndikualumikizidwa mu gawo limodzi la kutalika kofunikira.

Kuchotsa kwa suppurative aortic kwamitsempha yamagazi

Kwambiri kulowetsa kukonzanso kwa mtima kuphatikiza, zofunika, kuwonjezera pa kuchotsa puritive cholinga, kubwezeretsa magazi.

Kuchita opaleshoni ya thoraco-abdominal aorta (thoracophrenolumbotomy)

Kufikira kwa thoracic ndi adrenal pamimba aorta. Amagwiritsidwa ntchito pakugwira ntchito m'madipatimenti awa, kapena kwa opaleshoni ya aorto-bifemoral bypass pakalephera kufikira a subrenal aorta. Zimalipiridwa payokha kulipira mtengo wa opareshoni.

Mtengo wa opanganso pulasitiki wokonzanso

Kudulidwa kwa m'chiuno kumachitika ndi gangrene, kufalikira pamtunda wapakati pa mwendo, ngati nkosatheka kubwezeretsa magazi mu mwendo. Nthawi zina opaleshoni iyi imachitika mwachangu kwa pachimake m'munsi mwendo ischemia ndi kufa kwa minofu yonse kapena matenda a anaerobic omwe ali ndi sepsis.

Opaleshoni kuti muchotse mwendo wapansi ndi gangrene.

Kuduladula chala kumatha kuchitika ndi necrosis (necrosis) pokhapokha kubwezeretsa magazi. Itha kutha ndi kutseka kwa chitsa, ngati magazi atha kubwezeretsedwanso ndipo alibe matenda, kapena chitsa chimakhala chotseguka ndipo pang'onopang'ono chimadzichiritsa.

Gritti fupa-pulasitiki

Opaleshoni kuti muchotse mwendo wotsika ndi bondo mukusunga patella ndikuthandizira chitsa. Amagwiritsidwa ntchito pang'onopang'ono mwendo ndi phazi, ali ndi magazi othamanga ntchafu. Ubwino pa kudula kwachilendo kwa m'chiuno ndi chitsa chothandizira, chomwe sichimakhala chophatikizika ndi zilonda zowumiriza ndipo chimalola kugwiritsa ntchito mitundu yamakono ya mahule pamilandu yonyamula.

Pirogov osteoplastic kudulidwa kwam'munsi mwendo

Kudula mwendo wam'munsi ndikusungidwa kwa calcaneus ndikupanga chitsa. Adafotokozanso zaka za m'ma 1900. Ubwino ndi kuthekera kosuntha popanda prosthesis. Ndi ma prosthetics abwino zimakhala ndi zotsatira zabwino.

Kubwezeretsanso, mapangidwe a chitsa

Kuchita kwa mapangidwe ndi kutsekeka kwa chitsa cha mwendo pambuyo poti mwadzidzidzi mwadzidzidzi "guillotine" njira.

Kuchotsa gawo lakufa la phazi ndi kapena popanda chitsa. Ntchito gangore pambuyo kubwezeretsa magazi. Zimatanthauzira zazing'ono.

Mtengo wa kulowererapo kwa mtima

Angioplasty yamitsempha yama phazi ndi chopondera chamtunda pogwiritsa ntchito njira yobwezera

Amagwiritsidwa ntchito pamavuto popita m'mitsempha yotsekeka ngati njira ina. Ma Microcatheters, zida zing'onozing'ono ndi njira yapadera yolowerera imagwiritsidwa ntchito.

Angioplasty ya mtsempha m'miyendo (balloon imodzi imagwiritsidwa ntchito)

Angioplasty ndi kulowererapo kwa mtima kumene kumachitika mwa kupyoza m'mitsempha. Pambuyo pakuboola, chida chapadera chimayikidwa mu artery - intradusser, yomwe ndi catheter yochepa. Kudzera mu ntchito imeneyi, ntchito ina imachitika. Kondakitala wapadera amadutsa kudzera mu chotchinga kapena chaching'ono chomwe chimapangidwa baluni mwapadera. Mwa kuchepa balloon uyu, kutseguka kwa kuunikira kwa mitsempha ndi kubwezeretsanso kwa kayendedwe ka magazi m'derali kumakwaniritsidwa.

Kulumikizidwa kolimba mu iliac kapena kungotulutsira akazi kwakukulu

Kukhazikitsa zapadera zamitsempha kuti mulepheretse chotengera aneurysm.

Kubwezeretsanso kwa tibial artery occlusion pogwiritsa ntchito catheter yapadera kuthandizira

Kugwiritsa ntchito maluso ovuta, njira zosakhazikika pakuyenda kwachilendo kwa mitsempha ya mwendo kapena ntchafu.

Mitsempha imodzi

Pogwiritsa ntchito ma mesh apadera a stent pa ntchito kuti alimbikitse mtsempha kuchokera mkati, mtengo wa stent pawokha umaphatikizidwa ndi mtengo wamathandizowo.

Kuluma kwa popliteal kapena wamba femar artery ndi Supera stent

Zonunkhira zamwadzidzidzi sizoyenera kununkha m'dera la malo akulu. Chifukwa cha maimidwe pafupipafupi, zitsulo zachilendo zimatha kusweka ndi kupindika. M'mbuyomu, madera awa amawonedwa ngati osatheka kununkha, koma zonse zidasintha pomwe zatsopano za Super St kuchokera ku Abbot zidayamba kugwira ntchito. Chipatala chathu chinali chimodzi mwa zoyambirira kukhazikitsa masentensi awa ku Russia, ndipo akatswiri athu anali oyamba kulandira satifiketi yolingana. Supera imatha kupirira maulendo masauzande ambiri popanda kutaya ntchito ndi kapangidwe kake. Kugwiritsa ntchito stents izi kumathandizira kukulitsa mwayi wa chithandizo chamkati cham'mimba komanso mafupa achikazi.

Mtengo wa opaleshoni ndi chisamaliro chachikulu

Opaleshoni pa ntchito

Mtengo wa ola limodzi la kasamalidwe ka mankhwala

20% ya mtengo wogulitsa

Epidural opaleshoni yogwira ntchito

Epidural anesthesia imaphatikizira kulowetsedwa kwa catheter woonda mumsana, momwemo komwe kumayambitsa mankhwala okomoka. Zotsatira zake, kupweteka kwa ululu kumazimitsidwa pansipa ya jekeseni. The catheter amatha kukhalabe m'malo ovuta kwa nthawi yayitali ndikugwiritsidwa ntchito ngati othandizira ululu wammbuyo. Mtengo wa mankhwala ochita kupanga pa ola limodzi umawonetsedwa.

Mtengo wa ola limodzi la opaleshoni.

Mtengo wa mankhwalawa

Chithandizo cha matendawa popanda kubwezeretsa magazi

Mtengo woyerekeza kuchiza matenda osokoneza bongo popanda kubwezeretsa magazi

Chithandizo cha matendawa ndikubwezeretsa magazi

Akuyerekeza mtengo wochizira ischemia yovuta ndi zala zam'manja.

Endovascular chithandizo cha matenda a m'munsi miyendo

Akuyerekeza mtengo wa ntchito zingapo zochizira zotupa za mitsempha yam'munsi yamitsempha yamagazi pogwiritsa ntchito opaleshoni yamkati.

Atherosulinosis ya mitsempha ya m'munsi malekezero - zimayambitsa, matenda ndi chithandizo

1. Kodi arteriosulinosis ya mitsempha ndi chiani?
2. Zomwe zimayambitsa matendawa
3. Mawonetseredwe akulu am matendawa
4. Kutanthauzira kwa matenda a mtima
5. Zizindikiro
6. Chithandizo
7. Mfundo za Chithandizo cha Conservative
8. Mankhwala ochepetsa mphamvu
9. Mankhwala othandizira
10. Kugwiritsa ntchito njira zachikhalidwe

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

Atherosulinosis yamitsempha yama m'munsi yotsika mtengo ndi njira yoopsa ya mtima yomwe imayamba makamaka mu ukalamba. Pa gawo loyambirira, matendawa samawonetsa zizindikiro, muzochitika zapamwamba, kudula miyendo kungafunike kuti muchepetse zovuta zazikulu.

Kuunika kwakanthawi koyamba pa atherosulinosis yamitsempha kumathandizira dokotala kuti apereke njira yodalirika yothandizira odwala.

Kodi arteriosulinosis ya mitsempha ndi chiani?

Mitsempha yosasinthika ya gawo lililonse la thupi imakhala ndi chounikira chotere chomwe chimapangitsa kuyenda kosasunthika magazi ndi minofu zakudya, motero.

Kuchepetsa kwa mitsempha ya minyewa yayikulu ndi miyendo ndi chifukwa chodzikundikira mafuta m'makoma amkati. Zikhazikiko zimakhazikitsidwa koyamba pamalo ophatikizika, gawo ili lachitukuko cha matenda a pathology nthawi zambiri limatanthauzidwa kuti "banga banga".

Zosintha zomwe zikuchitika pakadali pano zitha kuyimitsidwa, koma zolembedwazo nthawi zambiri zimapezeka mwamwayi mukamayang'ana mitsempha yamagazi.

Pang'onopang'ono, zolembera za atherosulinotic zimakula, ndipo izi zimatsogolera kuti m'mimba mwake mumachepa pang'ono, motero, magazi amthupi akusokonezeka. Kuperewera kwa okosijeni ndi michere kumapangitsa kuchepa kwa zotumphukira za ziwiya zomwe zakhudzidwa, kuchepa kwawo kwa matenthedwe komanso kusintha kwa minofu yapafupi.

Pang'onopang'ono, calcium imadziunjikira mkati mwa zolembera zamafuta, imayamba kulimba. Atherocalcinosis imasokoneza kwambiri magazi, chifukwa cha hypoxia, minofu necrosis imachitika. Pali chiopsezo chodzilekanitsidwa ndi zigawo zomaliza za chikwangwani cha thrombus, chomwe chitha kutseka mtsempha waukulu ndikuyambitsa kusintha kosasinthika.

Stenosing atherosulinosis yamitsempha yama m'munsi kwambiri imakhala yofala pakati pa okalamba omwe ali ndi zaka zopitilira 60, koma matendawa sapezeka kawirikawiri kwa achinyamata ochepera zaka 40. Amuna amadwala pafupifupi nthawi 8 kuposa azimayi, ndipo kusuta kwa nthawi yayitali kumathandizira kuti kuchepa kwamitsempha yamagazi ndi ziwonetsero zamitsempha.

Zomwe zimayambitsa matendawa

Stenosing atherosulinosis ya mitsempha yayikulu yam'munsi yam'munsi imachitika mchikakamizo cha zinthu zosiyanasiyana zomwe zimadzetsa matendawa.

Kuchepa kwa mapangidwe a matenda kumachulukirachulukira mwa anthu:

1. Ndi cholowa chamtsogolo. Pamodzi ndi majini, mawonekedwe a lipid metabolism m'thupi, kuchuluka kwa mahomoni, kapangidwe ka khoma lamkati, komanso kuchuluka kwa chitetezo chokwanira, chomwe chimakhudza kuchuluka kwa chitukuko cha atherosulinosis.
2. Ndi zizolowezi zoyipa. Nicotine ya ndudu imapatsidwa mphamvu ya atherogenic, koma kuwonjezera apo, kusuta kumayambitsa kuphipha kwamitsempha yamagazi, ndipo ndizomwe zimapangitsa magazi kuyipa ndikupangitsa cholesterol yoyipa kulowa m'mitsempha. Mowa ndi mankhwala osokoneza bongo sizimavulaza thupi, zimasinthanso mwachangu kayendedwe ka khoma lamitsempha. Kumbali inayi, kugwiritsa ntchito moledzera kwamtengo wapamwamba kwambiri kumalingaliridwa kuti ndikolepheretsa kuyika kwa zolembera mkati mwa zotengera.
3. Ndi matenda onga. Atherosulinosis ya m'munsi malekezero ake imakhala yovuta ku shuga mellitus, odwala omwe amadziwika ndi cholesterol plaques amapezeka mwachangu kwambiri. Gulu lamavuto limaphatikizapo iwo omwe ali ndi mbiri yayitali ya matenda oopsa komanso chithokomiro cha chithokomiro.
4. Zambiri.
5. Ndi masewera olimbitsa thupi osakwanira. Hypodynamia imapangitsa kuti magazi a m'magazi akhale otsika, ndiye kuti, malo oyenera amapangidwira kufotokozera kwa cholesterol.
6. Ndi kuchepa kwakutali kwa m'maganizo kapena kupsinjika nthawi zambiri.
7. Ndi zotupa njira mu mitsempha yayikulu.

Chiwopsezo cha atherosclerosis chimawonjezeka ndi zaka, ndipo zinthu zomwe zimapangitsa kukhala mthupi la munthu, ndizowonjezereka zowonongeka kwa mtima.

Amadziwika kuti atherosulinosis yamitsempha yama miyendo imayamba kukhazikika pambuyo pochulukirachulukira, kuvulala koopsa, opaleshoni yam'mimba.

Mawonetseredwe akulu am matendawa

Ndi chisamaliro chathanzi lanu, ngakhale zizindikiro zoyambirira za atherosulinosis ya miyendo zimatha kukayikiridwa paokha.

Ndikulimbikitsidwa kuti mupimidwe pang'ono ngati zosintha izi zalembedwa:

• Kuyenda ndi zokwawa miyendo. Nthawi zambiri, odwala amawona kufanana kwa zizindikirozi ndi zomwe zimawonekera pambuyo povulaza dzanja nthawi yayitali. Koma kumva kosavutikira mumiyendo ndi atherosulinosis kumachitika popanda zifukwa zomveka.
• Kutentha kuzizira kwa dzanja. Chizindikiro ichi chimawonedwa mu nyengo zotentha za chaka.
• Kukongola kwa khungu.
• Kuchepetsa mafuta amthupi ndi minofu pamiyendo, m'chiuno, kumapazi. Kusintha kwa minofu kumalumikizidwa ndi kusowa kwa michere ndi mpweya.
• Kusenda khungu, ming'alu m'miyendo, kusintha kwa misomali. Poyerekeza ndi maziko a atherosulinosis, matenda a fungal nthawi zambiri amakula.
• Kutayika kwa tsitsi pamiyendo popanda kubwezeretsa tsitsi pambuyo pake. Kusintha kumeneku kumagwirizananso ndi njira zowonongeka pakhungu.
• Ululu Poyamba, kumva zopweteka kumachitika pakulimbitsa thupi, poyambira koyamba "kusinthana mawu" kumawonekera. Muzochitika zapamwamba, ululu umatha kupuma.
• Maonekedwe akunja kwakubadwa kwa khungu la mapazi ndi miyendo. Mdima wakuda umawonetsa thrombosis, ndipo ndi harbinger wa necrosis.
• Zilonda zamiyendo zamphongo, zopanda machiritso, nthawi zambiri amapezeka m'dera lamapazi.
• Gangrene Tissue necrosis imachitika kumapeto kwa atherosulinosis, kufalikira mwachangu kumapangidwa mwa anthu omwe ali ndi matenda ashuga komanso ena mwa ma concomitant pathologies.

Kutanthauzira kwa matenda a mtima

Matendawa amasankhidwa malinga ndi kusintha kwa mitsempha ndi zizindikiro za matendawa.

Pali magawo anayi a matenda:

• Gawo loyamba ndi lachilendo. Pakadali pano, lipoidosis imachitika - kusintha kwathunthu kwamafuta a mafuta, omwe akuwoneka ndi mawonekedwe a malo amafuta m'mitsempha. Kuvulala m'miyendo kumachitika pokhapokha ngati mutayenda mtunda wautali kapena mutangolimbitsa thupi mwamphamvu ndi miyendo yake. Pambuyo pakupuma, ululu amachoka.
• Pa gawo lachiwiri la matenda, zipsinjo kumapeto kumawonekera kale atagunda mtunda wa 250-1000 mita pamapazi.
• Mu gawo lachitatu, ischemia imafika pamtengo wofunikira. Kupweteka m'miyendo kumachitika atagunda mamita 50-100.
• Gawo lachinayi ndi gawo lomwe limawonekera zilonda zam'mimba ndi necrosis zomwe zingatheke pambuyo pake. Munthu amamva kupweteka kwambiri komanso kusasangalala m'miyendo yake ngakhale usiku nthawi yopuma.

Zizindikiro

Dokotala waluso amatha kukayikira kuwonongeka kwa mitsempha yam'munsi yomwe ili kale poyang'ana wodwalayo. Kuyang'aniridwa kumalipiridwa pakhungu la khungu, minofu atrophy, pulsation ya mitsempha.

Kuti mupeze matenda olondola, sankhani:

• Angiography. Iyi ndi njira yolondola kwambiri yothandizira kusintha kwamitsempha yamagazi. Choyamba, wogwirizirayo amalowetsedwa mu mtsempha wachikazi kenako X-ray ya miyendoyo. Angiography imakupatsani mwayi kuti mupeze malo onse a vasoconstriction komanso kupezeka kwa njira yolumikizana. Popeza njirayi imagwira ntchito, sikuti imagwidwa ndimatenda a impso komanso osalolera poyambira sing'anga (ayodini).
• Ultrasound Dopplerography - njirayi imakupatsani mwayi kuti mupeze malo ochepera mu 95% ya milandu.
• Zolemba pamakompyuta.
• Kuyesedwa kwa magazi kuti mupeze zomwe zili ndi cholesterol yoyipa komanso nthawi ya magazi.

Kuzindikira ndi kuchuluka kwa zotupa za atherosulinotic zimapangidwa pokhapokha pofufuza zonse zowunika. Chithandizo chimasankhidwa malinga ndi zomwe zidadziwika.

Ngati wodwala ali ndi mwayi ndipo matenda atakhazikitsidwa koyambirira kwa chitukuko, ndiye kuti kupewa zina ndikusintha zovuta zomwe zilipo, zingakhale zofunikira kupatula zomwe zingayambitse thupi.

Ndikofunikira:

• Choyamba, siyani kusuta
• Idyani m'njira yoti mafuta ochepa a nyama monga gwero la cholesterol oyipa amalowa mthupi,
• Kuchepetsa thupi ngati pali mapaundi owonjezera,
• Pewani kuwonjezeka kwa kuthamanga kwa magazi kuposa 140 mm Hg. st
• Limbitsa zolimbitsa thupi. Zida zamiyendo, kuyenda, kuyenda panjinga, kusambira ndizothandiza, mutha kuchita masewera olimbitsa thupi kunyumba,
• Kuchiza matenda osachiritsika. Ngati muli ndi matenda ashuga, muyenera kusunganso shuga m'magazi.

Chithandizo cha stenotic atherosulinosis yamitsempha yam'munsi yachiwiri komanso magawo a matenda am'magazi amagawika mosasintha, osasokoneza komanso opaleshoni.

Mfundo za Chithandizo cha Conservative

Njira zochizira zochizira zimaphatikizapo kumwa mankhwala ndi physiotherapy.Maphunziro a kuvomerezedwa omwe amasankhidwa mwapadera kutengera kusintha komwe kwawonekera mumankhwala amapangidwira miyezi 1.5-2, amafunika kubwerezedwa mpaka 4 pachaka.

Mwa mankhwala omwe amagwiritsidwa ntchito makamaka:

• Otsutsana, ndiye kuti, othandizira omwe amalepheretsa mapangidwe azigazi. Wosagwirizana wotchuka kwambiri ndi aspirin.
• Mankhwala omwe amasintha magazi. Awa ndi reopoliglyukin (kutumikiridwa mu chipatala) ndi pentoxifylline.
• Antispasmodics. Zotsatira za mankhwalawa ndikuchepetsa vasoconstriction, omwe amasintha magazi.
• Ma Anticoagulants amalembedwa mu gawo la kubwezera.

Cholinga cha ma statins chifukwa cha matenda a cholesterol m'magazi chikuwonetsedwa. Mu atherossteosis, kukonzekera kwa enzyme nthawi zambiri kumagwiritsidwa ntchito, chifukwa matendawa nthawi zambiri amakhala ndi kusintha kwa kapamba.

Mankhwala ena amayenera kumwa kamodzi, ena amagwiritsidwa ntchito nthawi zina, nthawi zina makhwala amayenera kumwa kwa moyo wonse. Zomwe zimachitika posankha chithandizo cha mankhwalawa zimatengera gawo la matenda ndi zovuta zina.

Mankhwala ochepetsa mphamvu

Njira zothandizira odwala omwe ali ndi atherosulinosis a m'munsi malekezero - kuchepera kwa baluni, angioplasty, kudukiza kwa mitsempha yomwe yakhudzidwa. Njira zowonongera pang'ono izi zimabwezeretsa kuyenda kwa magazi popanda kuchitidwa opaleshoni yayikulu.

Zimachitika pogwiritsa ntchito zida zapadera, nthawi yokonzanso imatenga nthawi yochepa ndipo wodwalayo amatha kuchira kunyumba.

Mankhwala othandizira

Njira zochepa zowukira sizingagwiritsidwe ntchito nthawi zonse. Ngati mbali zotsekeka za ziwiyazi ndizitali, ndiye kuti kuchitapo kanthu pakufunika kwa opaleshoni kuyenera kubwezeretsa magazi. Wodwalayo amaperekedwa ndi amodzi mwa mitundu ya opaleshoni:

• Prosthetics ya gawo losinthidwa la chotengera ndi zinthu zopangidwa.
• Opaleshoni ya Bypass ndikupanga njira yolumikizira yomwe imalola kufalikira kudzera njira yamagazi momwe ikufunikira.
• Thrombendarterectomy - kudula ma atherosselotic malo mu ziwiya.

Milandu yomwe matenda am'magazi adapezeka ndipo palibe zofunikira kubwezeretsa magazi, kudula chiwalo ndikofunikira. Opaleshoniyo amalembedwa kuti apulumutse moyo wa wodwalayo.

Kugwiritsa ntchito njira zachikhalidwe

Mankhwala ochokera ku mankhwala amchikhalidwe sichothandiza kwa atherosulinosis, ngati simugwiritsa ntchito mankhwala omwe adokotala adakupatsani. Koma mitundu ingapo ya zitsamba, malo osambira apadera, ma tinctures amathandizira kusintha kwamitsempha yamagazi ndi kapangidwe ka magazi, komanso imathandizira kukana kwa thupi kwathunthu.

Ndikulimbikitsidwa kugwiritsa ntchito:

• Zodzikongoletsera za mgoza wa mahatchi, zodzipweteka wamba. Zitsamba izi zimakulitsa magazi.
• Kusamba kwa nettle. Kugwiritsa ntchito kwake kumakongoletsa microcirculation ndipo kumathandizira kuchepetsa kusapeza bwino pa atherosulinosis.
• Mankhwala a Garlic. 10 cloves wa adyo ayenera peeled, wosweka ndi kutsanulira kapu ya mafuta osaphika masamba. Osakaniza amayenera kuthiridwa kwa tsiku, pambuyo pake amathanso kuthandizidwa. Mankhwalawa, supuni ya mafuta a adyo imasakanizidwa ndi supuni ya mandimu watsopano mwatsopano wofinyidwa, imwani mankhwalawa katatu patsiku.

Onetsetsani kuti mwatsata chakudya. Ndikulimbikitsidwa kudya masamba ndi zipatso zambiri, ndi mphesa yazipatso, vwende, viburnum, mtedza, tchizi, ndi nsomba zamafuta ndizothandiza. Tiyenera kukumbukira kuti kugwiritsa ntchito batala, nyama yamafuta, soseji, pastes, offal, muffin, mayonesi wamafuta atherosulinosis uyenera kuthetseratu.

Kugwirizana ndi chakudyacho sikungobwezeretsa zotengera zokha, komanso kungakhudze zomwe zimachitika m'thupi lonse. Ndikofunika kumwa mowonjezereka, ndikofunika kugwiritsa ntchito madzi oyera, ma compotes, tiyi wobiriwira kapena tiyi ndi mandimu, mankhwala ena azitsamba.

Ubwino wa ntchito baluni

Kugwiritsa ntchito opaleshoni yapulasitiki yokhala ndi balloon kuli mndandanda wonse wazabwino, zomwe zimaloleza kuti azitha kugwiritsidwa ntchito pochiza nthawi zambiri.

Chithandizo cha opaleshoni chimachitika popanda kuchita zowopsa pakhungu.

Kuti achite njirayi, kupuma pang'ono kumapangidwa pakhungu. Gawoli, pulogalamu yapadera imakhazikitsidwa pomwe kuyika kwa zida kumachitika, komanso zofunikira zimachitika.

Kuphatikiza apo, kugwiritsa ntchito balloon angioplasty kumapereka zotsatirazi:

• opaleshoni wamba safunikira, mankhwala owopsa kapena opweteka wamba amagwiritsidwa ntchito,
• kuleza kwa wodwala kwa nthawi yayitali sikufunika, wodwalayo amatha kudzuka ndikuyenda tsiku pambuyo pake
• zovuta zochepa poyerekeza ndi njira yotseguka,
• njirayi imatenga nthawi yocheperako, poyerekeza ndi njira zina,

Kuphatikiza apo, ndi revascularization, chiopsezo chokhala ndi vuto lachiwiri ndilochepa.

Kukhazikitsidwa kwa balloon mu lumen kwa chotengera kumalepheretsa kukula kwa kutupa ndikuyimitsa kukula kwa endothelium khoma lamitsempha.

Zotsatira Zapulasitiki

Kupititsa patsogolo kwabwinobwino kwa magazi kudzera mu chotengera chogwiriridwa pambuyo pa opaleshoni yapulasitiki pamitsempha yam'mimba imasungidwa kwa zaka zisanu odwala ambiri.

Zambiri zomwe zimapezeka pakuwunika kwa odwala zimathandizira adokotala kuti azilembera mozungulira zizindikiro zoyambirira za kusokonekera kwa thanzi ndipo ngati kuli koyenera, achite.

Kuti muwone momwe thanzi limakhalira, wodwalayo amalimbikitsidwa osachepera pachaka kuti ayesedwe thupi pogwiritsa ntchito ultrasound dopplerography ndipo kamodzi pachaka kukaunikira pogwiritsa ntchito tomography.

Wodwala akakhala akuyang'aniridwa ndikusamalidwa kwakanthawi ka thanzi lake kudzera pakuwonekera kwa mankhwala othandizira, kayendedwe ka wodwalayo kamasungidwa nthawi yonse ya moyo wake.

Zotsatira zomwe zimapezeka pogwiritsira ntchito balloon angioplasty kapena kuluma m'mitsempha yachikazi ndizofanana ndi zotsatira zomwe zimapezeka pakuthamangitsa gawo lazachikazi la popanikizana ndi mafupa am'mimba.

Malinga ndi ziwerengero zamankhwala, mu 80% ya odwala omwe amachitidwa opaleshoni ya pulasitiki, mphamvu ya kama yogona imakhalapo kwa zaka zosachepera zitatu. Ngati wodwalayo amakhala akuchita zolimbitsa thupi nthawi zambiri, ndiye kuti kufunika kothandizanso sikumuka.

Opaleshoni yapulasitiki imathetsa chiopsezo cha minofu necrotization ndi zovuta. Njirayi imalepheretsa kukula kwamavuto.

Kugwiritsa ntchito opaleshoni ya aortic femoral bypass

Chizindikiro chachikulu cha opaleshoni ya aortic-femoral bypass ndi ma occlusion mu kama wa m'mimba ndi kumayambira ndi kuwonjezeka kwa msempha kusakwanira.

Kuphatikiza apo, njirayi imagwiritsidwa ntchito kuti ipeze njira yodulitsira bedi la wodwala mu dziwe la eleal artery, malinga ndi momwe sizingatheke kuchitira opaleshoni ya pulasitiki yamkati.

Komanso, njirayi imawonetsedwa kuti igwiritsidwe ntchito kuzindikira aneurysms ya m'mimba aortic khoma.

Opaleshoni ya aorto-femoral bypass pakadali pano ndi njira yofala kwambiri komanso yodalirika yopewera kukula kwa mitundu yayikulu ya matenda a ischemic ndikudulidwa kwamiyendo mu matenda ashuga.

Malinga ndi ziwerengero zamankhwala zaposachedwa, kutayika kwa miyendo pakati pa odwala omwe ali ndi zotupa zam'magazi a miyendo ndi pafupifupi 20% ya mitundu yonse yovomerezeka ya pathological.

Pogwiritsa ntchito bwino msempha pamimba, chiwopsezo cha mavuto obwera chifukwa chakuduladula miyendo chimatsitsidwa ndikufunika mu 3% ya milandu.

Njira Yachitetezo

Tanthauzo la opaleshoni yolumikizira mafupa a ziwongo za m'munsi yam'munsi imatsitsidwa kuti ikhale gawo limodzi la msempha womwe uli pamwamba pa malo okhudzidwa ndi ma cholesterol amana.

Pakati pa njirayi, kuyamwa kumachitika pakatikati pamimba ndi kumtunda kwa chigawo chachikazi. Pambuyo pa izi, gawo la msempha limasankhidwa momwe madongosolo atherosulinotic samapezeka. M'derali, chombo chongogwirizira chimakola kwa aorta. Zinthu zomwe zimagwiritsidwa ntchito popanga sitimayi sizimatenga nthawi iliyonse ndipo sizimapangitsa kuti chitetezo cha mthupi chitetezeke. Kutha kwaulere kwa chiwiya chochita kupanga kumabwera kumadera omasuka a mitsempha yachikazi ndikuwakweza.

Shuting ikhoza kukhala yamtundu umodzi kapena umodzi.

Kutsetsereka kwa mitsempha yozungulira mwa njirayi ndi njira yovuta kwambiri. Izi ndichifukwa choti makoma a aorta nthawi zambiri amasintha mwamphamvu, zomwe zimatha kupangitsa kuti magazi aziwoneka akutuluka mkati mwa njirayi.

Kubwezeretsanso magazi ndi njira yokhayo yosungiramo miyendo mwa wodwala yemwe akuvutika kwambiri chifukwa cha kufafaniza kwa mitsempha.

Pambuyo pa ndondomekoyi, nthawi zina, kukula kwa kuphatikizika kwina ngati kupitiliza kwa prosthesis ndikotheka. Zomwe zingayambitse magazi kuwoneka.

Opaleshoni ya Bypass ndi angioplasty ndi njira zapamwamba zamankhwala opangira opaleshoni; mtengo wa chithandizo chotere ndi kuchuluka kwakukulu, komwe kumatha kuyambira pakuvuta kwa njirayi komanso malo othandizira opaleshoni.

Momwe mungagwiritsire matenda a atherosclerosis a miyendo auzeni katswiri muvidiyoyi.

• Imakhazikika pamisempha ya shuga kwa nthawi yayitali
• Imabwezeretsa kapangidwe ka insulin

Kuluma kwa ziwiya za m'munsi m'munsi - zikuwonetsa, kukonzekera ndi kupha

Kuthamanga kwa magazi m'miyendo kumasokonezedwa pazifukwa zosiyanasiyana, makamaka chifukwa cha kupangidwe kwa zolembera za atherosrance. Kuchedwetsa chithandizo kumakhala ndi zovuta kwambiri, mpaka kudula. Ngati mankhwalawa sagwira ntchito mokwanira, madokotala amalimbikitsa njira yotsatsira odwala - yolimbitsa ziwiya za m'munsi.

Ntchito yokhazikitsa stent imaphatikizapo kuyambitsa chipangizo chokulitsa chomwe chimasungitsa kuunikira kwachilengedwe kwa chombo.

Zizindikiro zakuchita opareshoni

Chimodzi mwazomwe zimafalikira m'munsi kwambiri ndi chotupa cha atherosulinotic.

Pamene atherosulinosis imawonekera, kudutsa kwamitsempha yamagazi kumachepetsedwa, ndiye kuti, stenosis imachitika (lumen yawo imatsika). Chifukwa cha zovuta zozungulira, munthu amakumana ndi mawonekedwe osasangalatsa.

Ngati wodwala sangachite chilichonse, matendawa amatsogolera minofu necrosis komanso poyizoni wa magazi.

Kuthamanga kwa magazi m'miyendo kumavulaza kwambiri matenda ashuga, omwe amawoneka ngati zilonda pakhungu lanu. Ngati zilonda zam'mimba zilibe chithandizo pakanthawi, wodwala amatha miyendo.

Kupweteka kulikonse m'miyendo kuyenera kukhala chifukwa cholembetsera mayeso. Ngakhale matendawa ali pachigawo choyambirira, azitha kuthana ndi mankhwalawa.

Zowonetsa kukomoka kwa mitsempha yam'munsi yotsika motere:

• kusintha kwa trophic (zilonda, mabala),
• manja osagwira bwino.

Pali zotsutsana pamiyeso:

• m'mimba mwake chotengera chomwe chimakhudzidwa ndi chaching'ono kwambiri (zotengera zokhala ndi mainchesi osachepera 2,5 mm ndizoyenera kununkha),
• kusokoneza stenosis (pamene chotengera cham'madzi chimakhudzidwa),
• kupuma komanso kulephera kwa impso,
• vuto la magazi,
• chidwi chachikulu cha ayodini (chinthu chogwiritsidwa ntchito posiyanitsa).

Kuchita opaleshoni yake pa nthawi yake kupewa kupewa.

Njira yophera

Kuluma kwa m'munsi kumachitika m'magawo angapo:

1. Kugwiritsa ntchito mankhwala ogwiritsira ntchito komweko kumagwiritsidwa ntchito pamalo omwe amakumba ziwiya.
2. Nthawi zambiri, kuluma kwa mitsempha yachikazi kumachitidwa.
3. Pambuyo pakuboola chotengera, amaika catheter yapadera, yomwe imakhala ndi puto kumapeto. Dokotalayo amatsogolera catheter m'mbali mwa mtsempha wamagetsi kupita kumalo komwe kunali kupendekera kovuta. Chifukwa cha kuchuluka kwa balloon, lumen ya artery imabwezeretseka.

1. Catheter ina imagwiritsidwa ntchito, mothandizidwa ndi pomwe stent imakakamizidwa kudera lomwe lakhudzidwalo. Pambuyo pake, adzachira, atakhazikika pamakoma a chotengera. Tsinde lake limawoneka ngati chubu lamiyala ya mauna.
2. Dokotala amawona zomwe zikuchitika mothandizidwa ndi kuyerekezera kwa x-ray.
3. Pamapeto omaliza, zinthu zonse zomwe zalowetsedwa zimabwezeretsedwa kupatula fungo. Popewa kutulutsa magazi, dzenje limakhala lopindika kwa mphindi 10 mpaka 15.

Zofunika! Ngati gawo lopunduka ndi lalitali kwambiri, zitsulo zingapo zimayikidwa pa ntchito.

Kuluma kumatha kuchitidwa osati kokha pamtsempha wachikazi. Mwambiri, zotupa za atherosulinotic zimakhudza ziwiya za popliteal.

Kuluma kwa ziwiya zamiyendo, kutengera kuchuluka kwa matendawa, kumatenga ola limodzi mpaka atatu, pomwe wodwalayo samamva kupweteka kulikonse. Chifukwa cha opaleshoni yakumaloko, munthu amatha kudziwitsa madokotala za momwe akumvera.

Zidutswa zamitundu yosiyanasiyana zimagwiritsidwa ntchito kuwonjezera msana. Zogulitsa ndi:

• zitsulo zosavuta
• ndi zokutira zapadera zomwe zimatulutsa mankhwala pang'ono m'magazi.

Ubwino wa Njira

Ubwino wokakamira pakamwa ndi monga izi:

1. Zowononga zochepa. Poyerekeza ndi njira zina zopangira opaleshoni, momwe zimafunikira kuti zichepetse malo ena, pakukakamira, kungopumira kokha ndikufunika pambuyo pake ndikuyika catheter.
2. Kuchita opaleshoni kwanuko kumachotsa zoopsa zomwe zimachitika chifukwa cha opaleshoni yotupa, yomwe ndiyofunika kwambiri kwa anthu okalamba.
3. Nthawi yochepa yochira. Pambuyo pa opaleshoni, wodwalayo nthawi zambiri amachoka kuchipatala tsiku lotsatira.
4. Mwayi wochepa wamavuto.

Kukonzekera

Asanalankhule misempha yam'munsi, wodwala ayenera kukonzekera mwanjira inayake. Ngati zikuwonetsa kuti ali ndi opereshoni, amatumizidwa:

• kusanthula kwakanthawi kwamkodzo ndi magazi,
• coagulograms
• kuyesa kwamwazi wamagazi,

• electrocardiograms
• malalachi
• Ultropopi wa ziwiya za m'munsi,
• angiography ndi maphunziro ena.

Ndi zoletsedwa kudya chakudya ndi madzi osachepera maola 12 musanachite opareshoni. Kwa sabata limodzi, adotolo amasintha mankhwalawa, ndipo kwa masiku awiri kapena atatu, amalembera othandizira antiplatelet.

Mavuto atandichita opareshoni

Ndi chithandizo chilichonse cha opaleshoni, zovuta sizimachotsedwa. Kuluma kungayambitse:

• Kusintha kwa khoma la mtima kapena kung'ambika kwake,
• kutulutsa magazi
• mapangidwe a hematomas kapena zotupa pamalo opumira,
• kuwonongeka kwaimpso,
• restenosis (kubwereza kuchuluka kwa lumen),
• kukomoka.

Zotsatira zomwe zalembedwa ndizosowa kwenikweni.

Kubwezeretsa nthawi

Madokotala anachenjeza kuti kukhazikitsa stent sikuchiritsa matendawa. Opaleshoniyo amathandiza kuthetsa zotsatirapo zake. Munthawi ya ntchito, muyenera kusamalira thanzi lanu nthawi zonse.

1. Kukhazikika kwa mankhwala ndi antiplatelet kwenikweni. Nthawi zambiri, mankhwalawa amayenera kuledzera pafupifupi miyezi itatu atachitidwa opareshoni. Mlingo ndi nthawi ya maphunzirowa zimaperekedwa mosiyanasiyana.
2. Kugwirizana ndi zakudya zopatsa lipid.Wodwala ayenera kudya zakudya zomwe zimachepetsa cholesterol.

1. Kuyang'anira kuthamanga kwa magazi. Ngati manambala akukwera kwambiri, muyenera kusintha moyo wanu. Dokotala wanu angakupatseni mankhwala othandiza kuti muchepetse kupanikizika. Onetsetsani kuti muchepetsa mchere.
2. Kuchotsa kwakukulu kwa zinthu zomwe zimayambitsa chitukuko cha atherosulinosis. M'pofunika kuti muchepetse kunenepa kwanu, muchotsere chizolowezi chomwa chikonga, kusiya kumwa mowa kwambiri, kuchita masewera olimbitsa thupi moyenera.

Mtengo wa opaleshoni imayendetsedwa ndi zinthu zambiri. Kukwapula kumachitika pogwiritsa ntchito zida zodula. Zida zonse zofunikira zimachitika ndi akatswiri oyenerera. Kuphatikiza apo, mtengo umatengera zomwe zimagwiritsidwa ntchito. Fungo lomwe limalumikizidwa ndi mankhwala am'mimba ndiwodula kwambiri. Fungo wamba limadula ma ruble 50,000.

M'makliniki osiyanasiyana chithandizo choterocho chili ndi mtengo wake. Kuchuluka kwa zovuta za matendawa komanso kuchuluka kwa zombo zomwe zimafunikira opaleshoni zimaganiziridwa. Mwambiri, opaleshoni yogwiritsa ntchito stents imalipira odwala osachepera 80,000 rubles.

Simuyenera kupulumutsa thanzi lanu, makamaka chifukwa opareshoniyo amathandiza odwala ambiri kubwerera kumakhalidwe abwino. Zotsatira zakuyenda kwamagazi zitha kukhala zowopsa. Pali nthawi zina pomwe, chifukwa cha kuwonongeka kumadera akumunsi, wodwalayo amwalira. Kuchita pakukakamiza kumatsimikizira mtengo wake.

Chifukwa cha kununkha, odwala amatha kuchotsa vuto losasangalatsa m'miyendo. Komabe, popanda kuyang'anira malingaliro onse a dokotala panthawi yokonzanso, kubwereza kwa stenosis kwamatumbo ndikotheka. Ngati mungazindikire kusintha kwakadalipo paumoyo wanu ndikupita kwa akatswiri, ndizotheka kupewa zovuta.

Kuwopseza ziwiya zamiyendo: Zizindikiro, mayendedwe, zotsatira, kukonzanso, matenda am'mimba

Kutentha kwamitsempha yam'munsi kwambiri ndikulowerera kochita opaleshoni komwe kumakupatsani mwayi wobwezeretsa magazi m'miyendo. Zimapangidwa ndikupanga detour (shunt) yomwe siyikupatula dera lomwe lakhudzidwa ndi magazi.

Imachitika nthawi zambiri m'mitsempha yam'munsi, koma nthawi zina, kulowetsedwa m'mitsempha kumasonyezedwanso.

Kuchita opareshoni kumachitika kokha ndi akatswiri odziwa bwino ntchito yawo komanso odziwa bwino ntchito yawo m'mankhwala odziwika bwino odwala atapimidwa kwathunthu, ndipo kufunika kwa njirayi kumatsimikiziridwa.

Magulu ogwiritsa ntchito ali amitundu iwiri: yachilengedwe ndi makina:

• Zoyambira mwachilengedwe kapena zachilengedwe zimapangidwa kuchokera kwa chopangira magetsi - minofu ya thupi lanu. Awa ndimagulu olimba omwe amatha kupititsa magazi mkati mwake. Minofu yachilengedwe ya thupi imagwiritsidwa ntchito kwambiri. Opanga maopaleshoni amakonda zojambula zochokera ku mitsempha yamadzi yotulutsa, mkati mwa thoracic artery, radial artery of the hand. Ngati dera la lesion ndilalikulu, ndipo mkhalidwe wamakhoma ulili wosakhutira, maulalo opangidwa amagwiritsidwa ntchito.
• Makina opangira kapena opanga amapangidwa kuchokera kuma polima. Ma synthes a mtima opaka ntchito amagwiritsidwa ntchito pakukoka ziwiya zazikulu mokakamizidwa ndi mtsinje wamagazi wamphamvu.

Pali zonyamula ming'alu yosiyanasiyana yomwe imagwiritsidwa ntchito pamaso pa mitsempha yokhala ndi patency yolowera patali. Zotsatira zakufalikira zam'mbuyo zomwe zimagwira ntchito yolumikiza milatho ndi malo athanzi.

Kuwonongeka kwa ziwiya zamagawo akumunsi kumawonedwa pafupipafupi kuposa zina zotumphukira. Shunting imafotokozedwa kwa odwala pakalibe njira zochizira zochizira. Kapangidwe kake ndi kantchito ka ziwiya zamiyendo kamasinthasintha pamatumbo ndi aneurysm, arteritis, mitsempha ya varicose, atherosulinosis, gangrene.

zidutsa za m'munsi

Mitsempha yathanzi yathanzi yokhala ndi malo osalala imakhudzidwa, makoma awo amakhala olimba komanso osakhazikika, osakhazikika, okutidwa ndi cholesterol plaque, omatidwa ndimisempha yamagazi, omwe amachepetsa lumen ndikupangitsa magazi kulowa.

Ngati cholepheretsa magazi kuyenda bwino, kupweteka kwa nthawi yayitali m'mitsempha ya ng'ombe, kutsekeka kwa miyendo kumachepa. Odwala amatopa msanga poyenda, nthawi zambiri amayimirira ndikudikirira kuti ululu udutse.

Kupindika kwapang'onopang'ono kwa ziwiya ndi kuphatikizira kwathunthu kwa lumen kumayambitsa kuphwanya magazi ndikupereka minofu, kukulitsa kwa ischemia ndi necrosis. Pokhapokha ngati mankhwala akuyembekezeredwa, amayambiranso opaleshoni.

kusokoneza magazi ku minofu ndi kukula kwa gangrene

Kuwonongeka kwa mitsemayo, kumawonekera ndi kufooka kwa khoma lamkati, kuphwanya misempha, kufutukuka kwake, mapangidwe amitsempha yamagazi, kukula kwa zovuta zamtundu wanthawi zonse. Pachiwopsezo chovuta kwambiri, odwala amathanso kuwonetsedwa.

Opaleshoni yam'mimba yopanga minyewa imagwiritsidwa ntchito makamaka kwa odwala omwe amachitidwa opaleshoni yamkati. Mng'oma umamangiriridwa pachiwiya ndipo umatha mbali imodzi pamwamba pa malisiti, ndi wina pansipa.

Izi zimapangitsa kuti zizungulira malo amtsempha wamagazi omwe akhudzidwa ndi matendawa.

Chifukwa cha kulowererapo kwa opaleshoni, ndikotheka kubwezeretsa kwathunthu magazi, kuti muchepetse kukula kwa khungu ndi kuduladula miyendo.

Zizindikiro ndi contraindication

Kuwononga zam'munsi kwambiri ndi njira yovuta yomwe iyenera kuchitidwa monga momwe zikuwonekera. Opaleshoniyo imachitidwa ndi angiosurgeons mu milandu yotsatirayi:

1. Peripheral artery aneurysm,
2. Atherosulinotic zotupa zam'mitsempha,
3. Kuletsa endarteritis,
4. Kuyamba kwamiyendo,
5. Mitsempha ya Varicose,
6. Supombosis ndi thrombophlebitis,
7. Kulephera kugwiritsa ntchito njira zina.
8. Kuperewera kwa mankhwala.

Opaleshoni yam'mimbayo siichitika ngati:

• Mwayi wopambana wa angioplasty
• Kulephera kwa wodwala,
• Muli wosakhutira wodwala,
• Matenda a ziwalo zamkati mu gawo la kubwezeretsa.

Kuthandizira opaleshoni

Kuwotcha ziwiya zamiyendo ndi ntchito yovuta kwambiri yomwe imafunikira kuti dokotalayo akhale waluso kwambiri ndipo akhale ndi chidziwitso chantchito. Opaleshoni imachitidwa pansi pa opaleshoni wamba, chifukwa cha zovuta zamankhwala komanso chikhalidwe cha odwala. Epidural anesthesia imadziwika kuti ndi njira yamakono kwambiri ya analgesia, yomwe imachepetsa kwambiri ntchito.

Opaleshoni ya Bypass amachitika ngati patency yamtundu wamatumbo ndi venous imalephera, ngati mayendedwe awo amaposa 50% ya awiri. Pa nthawi ya opareshoni, workaround imapangidwa pogwiritsa ntchito kufalikira kuyambira pachiwopsezo mpaka kumapeto. Kuchita moyenera ntchito kumathandizira kuti kubwezeretsanso kwamitsempha mu magazi.

Magawo a opareshoni:

• Chitani zosanjikiza zakhungu ndi zotseguka pamwamba komanso pansipa malo omwe akhudzidwa.
• Chombo chimasiyanitsidwa, chimayesedwa ndikuyenerera kwake pakubwera kwamtunduwu kumatsimikizika.
• Chombo chimapangidwa pansi pa zotupa, mankhwalawa amakwiriridwa, kenako nkukhazikika pamwamba.
• Yang'anani umphumphu wa zomwe zidalowetsedwa.
• Pambuyo pofufuza momwe magazi amayendera ndikutupa kwa mtsempha wamagazi, minofu yakuya ndi khungu limatenthedwa.

Pali zosankha zingapo za opaleshoni yamphongo. Kusankha kwa aliyense kumatsimikiziridwa ndi kutengera kwadera lakhudzidwa. Opaleshoniyo akangom'chita, wodwalayo amapaka chigoba cha okosijeni ndipo mankhwala oletsa kuperewera amaperekedwa.

Masiku awiri oyamba atachitidwa opaleshoni, odwala amawonetsedwa kugona. Kenako odwala amaloledwa kuyenda mozungulira chipindacho ndi makonde. Cold compress yoperekedwa kwa mphindi 20 ingathandize kuthetsa ululu komanso kuchepetsa kutupa kwa tsiku lakuyamba.

Odwala onse amalangizidwa kuti azivala masokisi otetemera ndi masokosi kupewa matenda a thrombosis. Kusintha ntchito yamapapu, spirometer yolimbikitsa iyenera kugwiritsidwa ntchito. Tsiku lililonse, madokotala amawunika zomwe zimayambitsa matenda.

Pakupita masiku 10 atachitidwa opaleshoni, akatswiri amathandizira kuwunika wodwalayo, kuwunika zisonyezo zofunikira za thupi.

Opaleshoni yam'mimba yopanda phokoso samachotsa chidziwitso cha matenda, koma chimathandizira njira yake komanso momwe odwala alili. Kuchiza kwathunthu kwamatenda oyamba sikumangopanga opaleshoni yokha, komanso kusintha kwa moyo komwe kumalepheretsa chitukuko cha matenda.

Nthawi yogwira ntchito

Thupi la wodwalayo limabwezeretseka mofulumira atachitidwa opaleshoni. Patsiku la chisanu ndi chiwiri, madokotala a opaleshoni amachotsa zipsinjo, kuyeza mkhalidwe wodwala ndi kumuchotsa kuchipatala masiku 10-14.

Malamulo omwe akuyenera kutsatidwa munyengo yakugwirira ntchito:

1. Tsatirani zakudya ndipo musamadye zakudya zomwe zimakhala ndi cholesterol ndikuthandizira kunenepa.
2. Imwani mankhwala omwe amateteza thrombosis komanso kuchepa kwa mafuta m'thupi (cholesterol).
3. Gwirani ntchito ndi olimbitsa thupi.
4. Yendani mtunda wowonjezereka tsiku lililonse.
5. Khazikikani pamalo okweza miyendo mukagona.
6. Chitani zaukhondo pochita mabala a postoperative.
7. Chitani zolimbitsa thupi zosavuta zomwe zimapangitsa magazi kulowa m'miyendo.
8. Sinthani kulemera kwa thupi.
9. Imwani kuyezetsa magazi nthawi ndi nthawi kuti mupeze kupatsidwa magazi ndi ma cholesterol.
10. Lekani kusuta fodya komanso mowa.
11. Chithandizo matenda oyanjana.
12. Tsatirani zonena za angiosurgeons.
13. Mavuto akachitika pamalo opangira opaleshoni, pitani kuchipatala mwachangu.

Odwala, kuchuluka kwake ndi kudula kwamiyendo kumadalira kuchuluka kwa ma shunts ndi kuchuluka kwa zotupa. Pambuyo pa opaleshoni yolumikizira mafupa a pachifuwa, kutupa kumachitika nthawi zambiri. Odwala samamva kutentha kosasangalatsa pamasamba ochotsa mitsempha. Kumva kumakhala kwambiri pachimake komanso usiku.

Pambuyo pakuchita opaleshoni ya mtima, kubwezeretsa ziwalo zam'mimba kumachitika pakatha miyezi iwiri, ndipo wodwalayo amakhala bwino nthawi yomweyo: kupweteka kwa mwendo kumachepa kapena kutha, ndipo ntchito yake yamagalimoto pang'onopang'ono imayambiranso. Kuti muchepetse njirayi ndikubwezeretsa minofu yolimba, wodwalayo ayenera kuyesetsa ndi kukulitsa.

Kutalika kwa moyo wathunthu pambuyo pochita opaleshoni ya mtima kumasiyana ndipo kumadalira zaka za wodwalayo, jenda, kupezeka kwa zizolowezi ndi matenda okhudzana, kutsatira malangizo a dokotala.

Nthawi zambiri, odwala omwe akuchitidwa opaleshoni amavutika ndi mtundu waukulu wa atherosulinosis yamitsempha yamagazi. Nthawi zambiri, imfa imachitika kuchokera ku myocardial ischemia kapena minyewa ya ubongo (vuto la mtima, stroke).

Ngati kugunda kwamiyendo ya miyendo sikupambana, wodwalayo akuwopsezedwa kuti adzadulidwa miyendo ndi kufa kumbuyo kwakuti sangachite.

Kuluma kwa ziwiya za m'munsi m'munsi - zikuwonetsa, kukonzekera ndi kupha

Kuthamanga kwa magazi m'miyendo kumasokonezedwa pazifukwa zosiyanasiyana, makamaka chifukwa cha kupangidwe kwa zolembera za atherosrance. Kuchedwetsa chithandizo kumakhala ndi zovuta kwambiri, mpaka kudula. Ngati mankhwalawa sagwira ntchito mokwanira, madokotala amalimbikitsa njira yotsatsira odwala - yolimbitsa ziwiya za m'munsi.

Ntchito yokhazikitsa stent imaphatikizapo kuyambitsa chipangizo chokulitsa chomwe chimasungitsa kuunikira kwachilengedwe kwa chombo.

Kupewa

Zipezi zimatha kugwira ntchito pafupipafupi kwa zaka 5 ngati atakayezetsa kawirikawiri kuchipatala ndikuchitapo kanthu pofuna kupewa thrombosis.

Akatswiri amalimbikitsa odwala:

• Limbana ndi zizolowezi zoipa
• Sinthani kulemera kwa thupi
• Yang'anirani zakudya zanu, kupatula zakudya zamafuta kwambiri,
• Sungani zolimbitsa thupi pamlingo woyenera,
• Imwani mankhwala omwe amateteza kukula kwa thrombosis "Aspirin Cardio", "Thrombo Ass", "Cardiomagnyl",
• Tengani ndalama ku atherosulinosis - "Lovastatin", "Atorvastatin", "Atromidine", "Clofibrin",
• Pitani kwa dokotala wa opaleshoni ya mtima pafupipafupi.

Opaleshoni yodutsa apa imagwiritsidwa ntchito pafupipafupi kuposa venous, chifukwa cha kuchuluka kwambiri kwa matenda am'mimba. Opaleshoni imeneyi nthawi zambiri imakhala njira yokhayo yothanirana ndi chiwonetsero chazovuta za ochepa. Kuchita opaleshoni kumathandiza kwambiri kukhala ndi moyo wa odwala komanso kumalepheretsa kukula kwa malo oponderezedwa.

Kodi miyendo ya miyendo imagwedezeka chifukwa chiyani?

Muyeso wokakamizika matenda a mitsempha ndi mitsempha ndi mitsempha ya m'munsi. Kuchiza koyambirira kumachitika. Odwala omwe ali ndi zotupa za atherosulinotic amapatsidwa mankhwala ochepetsa lipid (Atorvastatin, mankhwala a Fenofibrat), komanso zakudya. Ndi mitsempha ya varicose, yovala zovala zapadera zotanuka, sclerotherapy imalimbikitsa. Kutupa kwa ziwiya zam'munsi kumachitika ndi kufalikira kwa chotupa cha mtsempha wamagazi kapena mtsempha, chiopsezo cha thrombosis komanso kukula kwa gangrene. Njira iyi ndi opareshoni, iyenera kuchitidwa ndi angiosurgeon. Opaleshoni yam'mimba ndi kulowetsedwa kwa gawo lina la chotengera chofunikira. Zotsatira zake, magazi amawabwezeretsa, ndipo chiopsezo cha thrombosis chimachepetsedwa kwambiri. Mng'oma umatha kupangidwa ndi zida zojambula kapena zingwe zodwala. Nthawi zambiri ziwiya zapafupi zam'manja zimagwiritsidwa ntchito ngati chodzala. Kusankhidwa kwa zakutengera kumatengera m'mimba mwake mwa mtsempha wowonongeka kapena mtsempha, komanso machitidwe a pathology.

Zonse zodutsa zombo za m'munsi

Zida zaumunthu zokhala ndi thanzi mkati zimakhala ndi malo osalala komanso osalala.

Maonekedwe a atherosulinosis amadziwika ndi mapangidwe omwe amachepetsa lumen ya ziwiya, zomwe zimayambitsa kusokonezeka kwa magazi, ndipo kuchepa kwa lumen kumatsekereza kuperekera kwa magazi ku minofu, ndikupangitsa necrosis.

Ngati nkhondo yolimbana ndi kufalikira kwa mtima ndi mankhwala osagwira ntchito, yeserani opaleshoni.

Kodi opareshoni ndi chiyani?

Opaleshoni ya mtima yam'mimba amatchedwa opaleshoni kuti abwezeretse magazi munthawi ina m'thupi. Kwa malekezero apansi, izi zimachitika ndi ma cell a prostheses - shunts, kapena kupanga maalumikizidwe (anastomoses) okhala ndi zombo zapafupi. Mtundu wa opangidwawu umayendetsedwa ndi cholinga chomwe chiyenera kukwaniritsidwa chifukwa cha kulowererapo.

Mwachitsanzo, pakuchotsa kwa akazi, kuikidwa kwa ma cell a khungu kumasankhidwa, popeza m'derali chotengera chimakhala ndi zotupa za atherosrance. Kuchepa kwakadutsa nthawi kumapangitsa kuti pakhale chiwalo chimodzi kapena mbali zonse ziwiri.

Tekinolo yamakono ya endoscopic imalola opareshoni kuti ichitike poyambitsa shunt kudzera mu mtsempha wamagazi pogwiritsa ntchito mankhwala oletsa ululu, omwe sikuwavulaza anthu okalamba komanso ofooka kuposa onse.

Zizindikiro za

Opaleshoni miyendo ndi manja anachita mu milandu yotsatirayi:

1. Chidziwitso cha zotumphukira zamitsempha.
2. Contraindication ku stenting kapena angioplasty.
3. Kuletsa atherosulinosis.
4. Endarteritis.
5. Ndikupweteka kosalekeza mumiyendo, kuwopseza kwa gangore ndi kulephera kwa mankhwala.

Pazovuta zam'munsi, wodwala sayenera kunama. Munthu wosadukiza amaduladula chifukwa cha matenda akulu omwe adayambitsa gangore.

Kubwezeretsa Pambuyo pa Ntchito

Opaleshoni kumatenga maola 1-3. Pambuyo pake, nthawi zina ndikofunikira kuvala chovala cha oxygen, ndipo mkati mwa masiku 1-2 mankhwala oletsa kupweteka amayambitsidwa pogwiritsa ntchito dontho. Ndi opaleshoni yothandizira, singano siyitulutsidwa masiku 3-5. kuchepetsa ululu. Pambuyo pochotsa, ma pinkiller amaperekedwa nthawi yomweyo. Monga njira zothandizira kukonzanso kuchipatala, zotsatirazi zimagwiritsidwa ntchito:

1. Pakadutsa masiku 1-2 kuti muchepetse kutupa komanso kupweteka, kuzizira kumazizira kwa mphindi 15 mpaka 20.
2. Kuvala masokosi apadera ndi nsapato kuti muchepetse magazi.
3. Kugwiritsa ntchito spirometer yolimbikitsa yomwe imapangitsa ntchito yamapapu.
4. Kawunikidwe pafupipafupi kuti muwone ngati pali matenda.

Pambuyo pochoka kuchipatala kuchira bwino, njira zotsatirazi zimatengedwa:

1. Gwirani ntchito ndi olimbitsa thupi.
2. Kuyenda nokha ndikuwonjezeranso mtunda wa tsiku ndi tsiku, zomwe zimapangitsa miyendo yanu kukhala yolimba.
3. Pogona komanso mutakhala, miyendo imayenera kunyamulidwa.
4. Pulumutsani mabala a postoperative popanda kugwiritsa ntchito ufa kapena ufa.
5. Osamadya zakudya zamafuta kapena utsi.
6. Tsatirani malangizo a dokotala ndikubwerera ku moyo watsiku ndi tsiku.

Ntchito kwa atherosulinosis ziwiya am'munsi malekezero pamwamba pa inguinal ligament

Kuchitapo kanthu mu gawo la aortic-iliac kumakhala kopambana kwambiri komanso kwakanthawi, ndipo kuphatikiza ndi zotengera zofananira zamtundu kumabweretsa kusintha kwakukulu m'moyo.

Opaleshoni ya atherosulinosis ya ziwiya zamagawo am'munsi pa gawo lazimayi-popliteal amadziwika ndi kufooka kwapafupipafupi kwambiri komanso kusakhala bwino kwa nthawi yayitali zombozo.

Chifukwa chake, kulowererapo kwa mtima kumayenera kugwiritsidwa ntchito kokha mwa odwala omwe ali ndi zotupa zakumaso komanso chidziwitso chabwino.

Zowonetsera zamankhwala infrarenal aortic stenosis nthawi zambiri imayamba mwa akazi, makamaka ndi hyperlipidemia. Zilonda zosavuta zimathetsedwa bwino ndi kuchepetsedwa kwa baluni. Kupambana koyambirira kwa kulowereraku kupitirira 90%, ndipo patency yam'mimba pakapita nthawi yayitali (zaka 4) imapitilira mu 70-90% ya milandu.

Palibe mayeso omwe adachitika mwachisawawa omwe akuwonetsa kukhathamiritsa kwakukulu, mwina sangakhale chifukwa cha kuchuluka kwa matendawa. Ngati stent imalepheretsa embolism, ndiye kuti ikhoza kuyikidwa m'dera lalikulu kapena eccentric stenosis.

Kuchita bwino kwaukatswiri m'derali ndi 90-100%, ndipo kuchuluka kwa chotengera pambuyo pa zaka 4 kuli pafupifupi wofanana ndi 90%.

Zonunkhira zosavuta zamitsempha yama Iliac zimachotsedwa mosavuta ndi kuchepa kwa baluni. Kukula koyamba kumafika pa 88-99% ndi kuchuluka kwapakati pa 3,6%. Patency yayitali yonyamula chombo ndi 67-95% patatha chaka chimodzi, 60-80% patatha zaka zitatu ndi 55-80% patatha zaka zisanu. Zotsatira zabwino zitha kuyembekezedwa ngati gawo lalifupi lakhudzidwa.

Ngakhale kusowa kwa chidziwitso chodalirika pakuthandizira stenosis yamitsempha ya iliac, njirayi ikupitilizabe kutsatira malinga ndi chikhalidwe.

Muzochitika zamankhwala, akukhulupirira kuti stenting mu gawo la aortic-iliac ikuwonetsedwa ngati angioplasty alephera - kubwereranso kwa stenosis, kutsekeka kwa magazi kapena kutsika kwatsalira m'dera lomwe lakhudzidwa (ngakhale palibe kuvomereza pazomwe kusintha kungaganizidwe kukhala kwakukulu hemeninamical pakuyeza kukomoka kwa iliac. mitsempha). Ziphuphu zimagwiritsidwanso ntchito ngati pali chiwopsezo chachikulu chakulephera koyambirira (mwachitsanzo, eccentric stenosis, aakulu iliac artery occlusion) kapena distal chombo embolism. Zawoneka kuti stentosis yokhazikitsidwa yolimba kwa iliac stenosis imadziwika ndi kupambana kwaukadaulo kwamatenda 95-100% pamilandu yokhala ndi zovuta 6.6% komanso patency yayitali ya 78-95% patatha chaka chimodzi, 53-95% patatha zaka zitatu ndi 72% pambuyo Zaka 5Zotsatira izi ndizabwinoko pang'ono kuposa ndi angioplasty nokha, koma sizinapezeke m'mayesero osankhidwa mwapadera.

Kuwunika meta kwa zotsatira za angioplasty ndi kuluma pakuthana ndi matenda a atorto-femoral gawo (nthawi zambiri awa ndi maphunziro owonera) kumawonetsa kuti kukomoka kumasiyana poyerekeza ndi angioplasty:

• - pafupipafupi paukadaulo waluso,
• - pafupipafupi pamavuto,
• - Kuchepetsa chiopsezo cha kulephera kwakanthawi kwa 39%.

Pakadali pano, kuyesa kosasinthika kwa opaleshoni yamatumbo am'munsi kochepa pakali pano sikokwanira. Chiwonetsero chodziwika bwino cha Richter chosasankhidwa sichimasindikizidwa mokwanira m'magazini owonetsedwa ndi anzawo, pali chidule chake chokha.

Chifukwa chake, odwala omwe ali ndi stenosis ya mitsempha ya iliac adasinthidwa mwachisawawa mgululi la angioplasty ndi stenting. Mu gulu lokhumudwitsa, pafupipafupi kupezeka koyenda koyambirira ndikuwoneka bwino kwa sitimayo kwa zaka 5 kunapezeka (64,6% motsutsana ndi 93.6%). Mofananamo, m'gulu lokakamira, kuchuluka kwa zipatala kumawonjezeka pambuyo pa zaka 5 kuchokera pa 69.7 mpaka 92.7%.

Komabe, kusowa kwa kufalitsa kovomerezeka kumapangitsa kukayikira pakudziwika kwa izi.

Gulu la Dutch Iliac Stent Trial Gulu lafalitsa mwachisawawa mayeso oyambira okhwimitsa komanso osankhidwa odwala a ileal arteriosranceosis obliterans.

Phunziroli, odwala 279 omwe ali ndi HRP (intermittent claudication) ndi kuwonongeka kwa mitsempha (kuphatikiza ma occlusions 12 okha) adasinthidwa mwanjira yoyamba kukakamira kapena kununkha pambuyo pa angioplasty ngati magawo wamba otsala amaposa 10 mmHg.

Ofufuzawo sanapeze kusiyana pakati pa njira ziwirizi, pakanthawi kochepa komanso kwakanthawi, kupatula kuti kusankha mawu okongoletsa anali otsika mtengo kuposa kutsutsana koyambira.

Iwo adaganiza kuti odwala omwe ali ndi HRP ndi zotupa zam'mitsempha, kusankha stenting kuli ndi mwayi pamfundo yayikulu. Komabe, kuyesaku kudakhazikitsidwa poganiza kuti zotsalira zomwe zimatsalira pambuyo pa angioplasty ndizowonjezera pazotsatira zoyipa.

Pakadali pano, palibe chifukwa chokwanira chakufotokozera izi, kuwonjezera apo, palibe mayesero omwe amafotokozedwa mosasiyanitsa angioplasty amodzi ndi stenting for atherosulinosis ya ziwalo zam'munsi zam'manja (kusankha kapena njira zina) kuwonetsera bwino kukweza kwa stenting.

Angioplasty yokhala ndi leal artery stenosis ndi njira yabwino komanso yotetezeka. Zopindika zimayenera kugwiritsidwa ntchito pazotsatira zam'modzi zaopyopy kapena kusokonekera komwe kumalepheretsa kuthamanga kwa magazi, ngakhale kuti kafukufuku wofunikirabe akufunika.

Iliac artery occlusion imathanso kutha ndi balloon angioplasty. Pangano la transatlantic pakati pagulu linawunikiranso mayesero azachipatala a angioplasty for occonation ya arac.

Malinga ndi zotsatira za kuwunikirako, akuti kuwonjezereka kwa kuthekera kopambana paukadaulo kumeneku ndi 83%, kuchuluka kwapakati pa zovuta ndi 6%, kusintha kwa mtima kwa 1% kumasungidwa mu milandu 99, ndipo pambuyo pa zaka zitatu mu 60% (ngakhale kuphatikiza kuchuluka kwa zolephera zoyambira zaukadaulo , ndiye kuti chizindikirochi chomaliza chikufika mpaka 85 ndi 77%, motsatana). Maphunziro enanso a Leu et al. Simaphatikizidwa pakuwunikanso kwa Pangano la Transatlantic Cross-Community. Imanenanso za kuchuluka kwachulukidwe ka distal embolism (24% ya milandu) pochiza matenda ena amitsempha yama cell ochepa ndi angioplasty okha.Kuganiza kuti kuikidwa stent kumalimbitsa chotupa chachikulu ndipo potero kumachepetsa chiopsezo cha embolism ndi chimodzi mwa zifukwa zazikulu zoyambitsa kukakamira. Pakadali pano, umboni wotsimikizira njirayi (komanso kuti kukokoloka kwamanja kumakhala kotheka) ndizochepa. Malinga ndi Transatlantic Inter-Community Agwirizano, kuchuluka kwa kupambana kwaukadaulo polimbikitsa kukopa kwamitsempha yayikulu ndi 82%, kuchuluka kwa zovuta ndi 5.6%, ndipo ulemu pambuyo pa zaka 1 ndi 3 ndi 75 ndi 64%, motsatana, kukulira mpaka 90 ndi 82% pa kuchotsedwa kwa kulephera kwaukadaulo waukadaulo. Zotsatira zomwe zapezedwa ndizosiyana pang'ono ndi angioplasty, ndipo tikuyembekeza zotsatira za mayesero osankhidwa mwachisawawa ku Sheffield.

Bypass opaleshoni ya atherosulinosis yamatumbo am'munsi am'munsi mwa inguinal ligament

Ntchito ngati opaleshoni ya aortic-femoral-femoral bypass zimakhala ndi zotsatira zoyambirira zabwino. Nthawi yomweyo, patency ya mtima wazaka 5 imafika 85-90% yokhala ndi kufa kwa 1-4%. Pakadali pano, pali chiopsezo chotenga matenda a shunt ndi kusabala. Opaleshoni yapakati pa akazi kapena iliac-femoral bypass ndi njira yabwino yochizira zilonda zam'mimba.

Komanso, odwala ndi HR, mtima patency pambuyo 1 chaka akupitilira 90% ya milandu. Ubwino umaphatikizidwanso ndi kufa pang'ono komanso chiwopsezo chochepa cha kusabala kwa neurogenic. Ankalumikiza mwa Iliac-umwini wam'mawonekedwe amtunduwu kumakhala kotupa kwamitsempha yayitali poyerekeza ndi kukhathamira pakati pa akazi.

Komabe, chotupa chachikulu chobwerera kumbuyo komanso chotupa chotupa, chomwe sichinawerengeredwe pamafunika kuchitidwa opaleshoni yaakazi yopanda njira. Musanachite opaleshoni yodutsa kudzera mwa chachikazi, chotchinga chotupa cha operekayo pogwiritsa ntchito angioplasty kapena stenting chizichotsedwa.

Komabe, pankhani yonyamula zotupa za gawo limodzi la gawo la aortic-iliac, ndibwino kuchitira opaleshoni ya aortic-femoral-femoral bypass, popeza kuthandizira kwakutali kwa sitimayo ndikokwera.

Patency ya axillo-femoral shunts ikadali yoyipa, chifukwa chake, kugwiritsidwa ntchito kwawo sikuli koyenera kwa odwala omwe ali ndi HR. Monga percutaneous angioplasty ndi stenting kufalikira, kugwiritsa ntchito endarterectomy kwa zilonda zam'deralo zopanda chifukwa.

Odwala omwe ali ndi zotupa m'magawo angapo, ndikofunikira kulingalira za momwe matenda amathandizira pakukhazikika kwa mtima m'malo mopanga kumanganso mitsempha pamwambapa komanso pansipa ya inguinal ligament.

Mwamwambo, laparotomy yapakatikati imagwiritsidwa ntchito kufikira aorta, ngakhale gawo lamtundu wa oblique limalola kuwonekera bwino kwa chotengera ndikuyambitsa kupweteka kwaposachedwa kwa postoperative. Pofikira mobwerezabwereza, mawonekedwe osinthika kapena osakhazikika amagwiritsidwa ntchito, koma kuwunikira ndikubwera.

Pali umboni wocheperako wa zopindulitsa kapena kugwirira ntchito pogwiritsa ntchito laparoscopy. Anastomosis ya proximal iyenera kuyikidwa kwambiri momwe angathere, chifukwa zigawo zam'mimbayo sizitha kutengera njira ya atherosulinotic. Anastomosis imatha kuyikidwa kumapeto kapena kumapeto.

Pa opaleshoni ya atherosulinosis yamatumbo am'munsi am'munsi, anastomosis yotsirizira imasonyezedwa ndi conuritant aneurysm kapena gawo lathunthu la chotupa cha minyewa.

Madokotala ena ochita opaleshoni amati kusinthaku kumapereka mwayi wokhala ndi nthawi yayitali komanso chiopsezo chochepa chokhala ndi aorto-duodenal fistula, ngakhale kuti palibe mayeso mwangozi. Komabe, anastomosis kumathera mbali kumakhala kosavuta kuyika, pangozi yochepa ya kusabala. Kuphatikiza apo, njirayi imakuthandizani kuti musunge mitsempha yotsika ya mesenteric ndi mkati mwa iliac.

Kuchita bwino kwa kulowererapo kwa mtima kwa HR chifukwa cha kuwonongeka kwa gawo la akazi sichidziwika bwino chifukwa cha zotsatira zoyambirira za mapulogalamu olimbitsa thupi olamulidwa. Zotsatira zam'mbuyomu komanso mochedwa za angioplasty zimakhala zoyipa kuposa zomwe zili gawo la aorto-iliac.

Pakalipano, zotsatira ndi nthawi ya opaleshoni ya atherosulinosis yamatumbo am'munsi, onse mu gawo la aorto-iliac komanso gawo la femor-popliteal, zimatengera kuchuluka, kuchuluka ndi mtundu wa zotupa.

Kukula kokwanira kwa angioplasty ndi 90%, kuchuluka kwapakati ndi 4,3%, ndipo ulemu pambuyo pa 1, 3, 5 zaka zasungidwa mu 61, 51 ndi 48% ya milandu, mowonjezereka, mpaka 71, 61 ndi 58% kusiyapo kuyambira zolephera.

Monga momwe zilili gawo la aortic-iliac, stenting idayesedwa kuti ipangitse zotsatira zake. Komabe, ngakhale kuti kupambana kwa njirayi ndikokwera (98%), zovuta ndizofala kwambiri (7.3%), ndipo mawonekedwe a mtima ali ofanana - 67% pambuyo pa chaka chimodzi ndi 58% patatha zaka zitatu.

Kafukufuku waposachedwa kwambiri, kuphatikiza maphunziro owonera, akuwonetsa kuti stenting ili ndi mwayi kwa odwala omwe ali ndi matenda oopsa komanso zotupa zovuta, ngakhale olemba amavomereza kuti izi zitha kukhala chifukwa cholakwitsa kufalitsa.

Mwambiri, ngakhale mayeso osasankhidwa samawonetsa phindu la miyambo yachikhalidwe ndipo (mosiyana ndi mitsempha ya m'magazi) samathandizira kugwiritsidwa ntchito kwa ma stenti opereka mankhwala. Chifukwa chake, kununkha nthawi zambiri sikugwira ntchito iliyonse pochiza matenda a atherosclerosis a gawo la femal-popliteal, kupatula angioplasty ovuta chifukwa cha stratization kapena thrombosis.

Poganizira izi, komanso zovuta za opaleshoni yamatumbo am'munsi, mgwirizano wamtundu wa Transatlantic ukuwonetsa kuti kusankha pakati poti mankhwala a endovascular kapena opaleshoni ya atherosclerosis ya gawo la femoral-popliteal mu PH akuyenera kutengera ndi morphology ya matendawa. Pankhaniyi, zotupa za mtundu wovuta kwambiri A ndizothandiza kuchiritsa ndi angioplasty, ndi zotupa zovuta za mtundu D zomwe zimapangitsa opereshoni. Palibenso malo onunkhira mu chizolowezi chothandizira matenda a atherosulinosis a gawo la femal-popliteal.

Palibe umboni wotsimikizira kugwiritsidwa ntchito kwa njira zina zamkati, monga ma lasers, zida za atherectomy, ndi zokongoletsa, popeza palibe umboni wotsimikizira kuti ali ndi apamwamba kuposa angioplasty / stenting mu atherosclerosis obliterans a aorto-iliac kapena femor popliteal. Komabe, pali umboni wochepa woti brachytherapy imasintha zotsatira za angioplasty / stenting, ngakhale umboni wambiri ukufunika wokhudzana ndi gawo la njirayi pamachitidwe azachipatala amasiku onse.

Lumbar sympathectomy

Palibe umboni uliwonse wokuthandizira kugwira bwino ntchito kwa lumbar sympathectomy pakuwonongeka kwa atherosulinosis. Kulowerera sikumawonjezera kutuluka kwa magazi pakupuma kapena panthawi yochita masewera olimbitsa thupi.

Lumbar sympathectomy imathandizira pakuchiza kwa CIC (miyendo yofunika kwambiri ya ischemia) yomwe singathe kumangidwanso chifukwa imasokoneza kuchepa kwa khungu ndipo imapereka mtundu wina wa analgesia.

Ntchito ya opaleshoni

Muli ndi funso kapena ndi losamveka? Funsani wolemba nkhani - apa.

Udindo wa opaleshoni yamatenda am'mitsempha yam'munsi imatsimikizika ndipo, choyamba, izi zimakhudza kuwonongeka kwa mitsempha yamagazi pansipa ya inguinal ligament.

Chisangalalo choyambacho chinazimiririka ndikuzindikira kuti kusakhazikika kwa chindoko ndi kufa kwa opaleshoni ya odwala omwe ali ndi matenda amtima wapamwamba komanso kuphatikiza kawirikawiri kosakwanira kwa shunts sikungakhale kwabwinoko kwambiri kuposa ndi matendawa popanda kulowererapo. Dokotala aliyense wamankhwala amachititsa wodwala kuti amupatse chithandizo chomwe adamaliza pambuyo poti watupa kapena matenda a shunt.

Nkhaniyi idakonzedwa ndikuwongoleredwa ndi: dokotala wa opaleshoni I. B. Pigovich

Arterial thrombosis ya m'munsi malekezero

Vein Thrombosis: General

Thrombosis ndi atherosclerosis ya ziwiya zam'munsi kwambiri ndi matenda akulu. Thrombosis ndi atherosulinosis zimachitika chifukwa cha kufalikira kwa magazi. Nthawi zambiri, matendawa amachititsa kuti mitsempha iwonongeke komanso kuti masinthidwe amtundu wina asinthe.

Thrombosis imatha kutchedwa kuti complication of atherosulinosis. Ndi matenda awa, kufalikira kwathunthu kwa chotengera (mtsempha) kumachitika.

Chifukwa chiyani pali vuto?

Kukonda kwa minyewa yakumapeto kumatha kuchitika ndi ma pathologies monga:

Kukokoloka kwa khoma la mtima (khoma la mitsempha).

Matenda oyambitsa magazi.

Zilonda za khoma lamasamba (khoma lamitsempha).

Mkuyu. 1. Magawo a stenting of endovascular stenting vuto la atherosulinosis of the artery femoral artery (PBA): a) occlusion (occlusion) ya PBA, b) kuyambiranso kwa kutulutsa kwa msempha ndi kalozera, c) kuphatikizika kwa intravascular stent (dilator) m'mitsempha yomwe yasokonekera (mitsempha), d) - patency ya mtsempha wamagazi limabwezeretseka kwathunthu.

Mkuyu. 2. Kukakamira kwa mafupa am'mitsempha ya mitsempha (mitsempha) ya mafupa am'mimba: a) kupindika kwa mitsempha yodutsa (muvi), kuwonetsa kwathunthu kwa mitsempha ya mitsempha (mitsempha) (mivi iwiri), b) pambuyo pa kulowererapo - mawonekedwe a mitsempha (mitsempha) ya mafupa amachira. mivi).

Pachimake thrombosis nthawi zambiri amakula motsutsana maziko a atherosulinosis ya mitsempha. Nthawi yomweyo, kuletsa kupititsa patsogolo kwa matendawa sikophweka.

Zofunika! Matenda a mtima (vein) ndiofala komanso operewera. Malinga ndi ziwerengero, gawo limodzi mwa magawo khumi la anthu limakhala ndi izi. Makamaka omwe ali pachiwopsezo chachikulu ndi amuna opitirira zaka 60-65. Thrombosis imapezekanso mwa odwala achichepere. Komanso ,imfa yodwala matendawa ku Russia ifika pa 61%.

Kodi matenda atha kupewedwa?

Inde! Ngati musamala thanzi lanu.

Pofuna kupewa thrombosis, malingaliro angapo ayenera kutsatiridwa:

Pewani kuchepa madzi m'thupi. Chofunikira kwambiri pakukula kwa thrombosis ndendende kusowa kwamadzi. Imwani osati pokhapokha ngati mukufunadi! Imwani madzi okwanira malita awiri patsiku.

Pitani pazamasewera, olimbitsa thupi. Kumbukirani kuti kuchita masewera olimbitsa thupi mosangalatsa kumalimbitsa mtima. Izi zimakuthandizani kuti mulimbikitse kuthamanga kwa magazi. Chifukwa cha izi, thrombosis imatha kupewedwa.

Samalani chakudya. Chiwopsezo cha thrombosis chimawonjezeka ndi kudya kwambiri mafuta okhala ndi cholesterol. Pewani zakudya zokazinga, zamafuta. Popewa thrombosis, gwiritsani ntchito zipatso ndi masamba ambiri, siyani mowa, musute.

Zofunika! Ndiosavuta kupewa thrombosis, koma imatha kuthandizidwa zaka! Ichi ndichifukwa chake ndikofunikira kuwunikira mosamala mkhalidwe waumoyo pamaso poti mukhale ndi chiyembekezo cha thrombosis yamitsempha yosiyanasiyana. Kotero mutha kupewa kupezeka kwa matenda monga thrombosis ya mitsempha ina. Ngakhale patakhala matenda a mtsempha, akatswiri azitha kuthana nawo bwinobwino.

Chithandizo cha thrombosis ndi atherosulinosis

M'zaka zaposachedwa, mankhwalawa atherosulinosis, thrombosis ya mitsempha (mitsempha), njira za endovascular (intravascular) amagwiritsidwa ntchito kwambiri - stenting (endoprosthetics) ndi balloon angioplasty.

Akatswiri azamaphunziro a angiology ndi opaleshoni ya mtima ya magulu otchuka kwambiri aku America, Europe ndi Russia (ROACX, ACC / AHA, TASC, CIRSE) amalimbikitsa kuti aziganiza ngati njira yothandizira matenda am'mimba (ma blockages) a kama wam'magazi am'mbuyo ndi mbali stenosis, mosasamala kanthu komwe kudayera.

Ambiri mwa akatswiri othandiza ochokera kumaiko ambiri padziko lapansi amalimbikitsa milandu ngati mwadzidzidzi nthendayo yadzala ndi kuduladuka kwa mwendo, choyambirira ndikofunikira kuchitapo kanthu mosaganizira wina aliyense, ngakhale mitundu yapamwamba kwambiri ya atherosclerosis, poganiza kuti ma patency a mitsempha amakhalabe miyezi 12 mpaka 24 pambuyo pa opaleshoni. Cholinga cha izi ndikuti njira yothetsa mwachangu zizindikiro zamankhwala ikupitirirabe.Kuphatikiza apo, opaleshoni yovomerezeka ya thrombosis yamitsempha yosiyanasiyana imalola, ngati kuli kotheka, kutsatira mobwerezabwereza kosunthika kapena kulowerera kwamtsempha.

Njira yayitali yachipatala ikuwonetsa kuti, ngakhale kuli kwothandiza kwambiri kwa njira zakuchipatala zochizira matendawa, munthawi zina, zovuta za x-ray zomwe zingachitike sizingatheke pazifukwa zingapo.

Chifukwa chake, malinga ndi kupita patsogolo kwa Charing Cross Congress, komwe kunachitika ku London mu Meyi 2013, zinaonekeratu kuti kukomoka kwa mitsempha yodutsa mitsempha yomwe ili mchigawo chambiri komanso pa ntchafu, ngati wodwalayo atasunthira, zitha kubweretsa zovuta zina mu 10-30% ya milandu , yomwe imayendetsedwa ndi kuphwanya kwa zitsulo stent (kukulitsa), kapena kubwezeretsa. Poganizira izi zomwe sizingatheke, oposa 80% mwa omwe atchulidwa kale pamsonkhanowu adatsutsa kukhazikitsidwa kwa masitayilo amitsempha.

Kodi chithandizo chingathe ku chipatala cha Moscow?

Akatswiri odziwa ntchito ali okonzeka kuthandiza wodwala aliyense yemwe ali ndi thrombosis!

Choyamba, mitsempha imasanthulidwa bwino.

Kuti muchite izi:

Kupenda kwakunja kwa mitsempha ndi thupi lonse. Zimakupatsani mwayi wolemba khungu, kuchepa kwa tsitsi, misomali yophimba, khungu losungunuka, zilonda zam'mimba, kufinya kwa minofu ya mkono.

Palpation. Katswiriyu amasamalira kutentha kwa khungu. Ndi thrombosis, kutentha asymmetry kumatchulidwa. Kuphatikiza apo, adotolo amatha kukonza kusowa kwa ripple.

Njira yofunikira kwambiri yofufuzira mitsempha ya m'magazi ndi kuwunika mobwerezabwereza. Dokotala amatha kuwunika momwe makoma a mitsempha amapezekera, kupezeka kwa zotupa, zinthu zomwe zimapangitsa kunja kukakamira.

Mitsempha ya CT ndi MRI imathanso kuchitidwa.

Mukaonana ndi dokotala liti? Ndi zizindikiro ziti zamitsempha yamitsempha yomwe ndiyenera kuyang'ana?

Ndikofunikira kumvetsetsa kuti thrombosis ndi matenda owopsa. Ndi kuwonongeka kwa bedi lamitsempha, zovuta zazikulu zimabuka. Mutha kuwaletsa polumikizana ndi dokotala panthawi. Thrombosis imafunikira chithandizo cham'tsogolo.

Kodi ndi zizindikiro ziti zofunika kuti muzindikire?

Zizindikiro zotsatirazi ndizodziwika za thrombosis yamitsempha yambiri:

Ululu m'miyendo mukamayenda, zolimbitsa thupi. Nthawi zambiri, odwala amayamba kuyenda. Kuchulukitsa (kutsika) kumakhala malo opweteka, nthawi zonse kumayambitsa kusasangalatsa.

Kumva dzanzi. Chizindikiro cha matenda am'mimba chimachitika magazi atayenda m'mitsempha atasiya.

Zilonda zosachiritsa, chimanga pamiyendo. Nthawi zambiri maonekedwe ake amapezeka pamiyendo, m'munsi mwendo.

Kuchepa kapena kutsika kwa khungu la miyendo.

Kutalika kwa miyendo italii, yokuundana chifukwa cha magazi m'mitsempha.

Kuwopsa kwa minofu ya miyendo. Chizindikiro ichi chimagwirizananso ndi kupezeka kwa magazi m'mitsempha.

Alopecia m'munsi mwendo.

Nthawi zambiri wodwalayo samadzimva kuti ali ndi chiwalo (chotsika)!

Nthawi zina, zizindikiro zina zimawonekera. Amalumikizidwa ndi miyendo yonse (m'munsi) ndi thupi lonse. Zonsezi zimafunikira chisamaliro chapadera.

Zodabwitsa ndizakuti, odwala amatha kuyambitsa mawonetseredwe onse a zovuta ndi ziwiya zamatopa, malaise. M'malo mwake, chotchinga cha venous sichichedwetsa kulandira chithandizo!

Zochizira pogwiritsa ntchito njira zamakono

Mankhwalawa atherosclerosis ya mafupa am'mimba ndi miyendo, thrombosis yamitsempha yosiyanasiyana, akatswiri ku Endovascular Surgery Center amagwiritsa ntchito zida zapamwamba kwambiri zamkati. Amakulolani kuti muchotse chachikulu chomwe chimayambitsa matendawa - zolembera za atherosselotic ndi masisitere a thrombotic.

Magulu a TurboHawk (USA) ndi AngioJet (USA) a atherectomy ndi Ocelot (USA) pobwezeretsa patency ya ma occlusions owonjezera amitsempha yamagazi (mitsempha) amagwiritsidwa ntchito mwakhama pakati pathu.Zida zonse zidalandiridwa pamisonkhano yapadziko lonse pa opaleshoni yamkati mu 2010 - 2013.

Mkuyu. 3. Endovascular thrombectomy from the iliac artery and AngioJet system: a) thrombosis ya njeac artery mivi (mivi), b) atatha kulowererapo - vein patency imabwezeretseka kwathunthu (mivi), ndi stentlation siofunikira.

Mkuyu. 4. Mfundo yakuchotsa phula pamatumbo (m'mitsempha): a) chithunzi chokulirapo cha mpeni wa kaboni mkati mwa catheter, b) catheter imadutsa m'malo a vein lesion, c) catheter amachotsa zolemba za atherosranceotic, d) odula ma atheromatous misa kulowa mu catheter cone .

Mkuyu. 5. Endovascular athectomy of the artery femoral artery, b) the catheter-aterectomy amachotsa zigawo, c) vein patency imabwezeretseka kwathunthu pambuyo pa kulowererapo - STENT IMPLANTATION SIKUFUNIKIRA, d-e) odula ma atheromatous masheine mkati mwa catheter atachotsedwa.

Kuphatikiza apo, Pulofesa S. A. Kapranov ndi ogwira nawo ntchito amagwiritsa ntchito okhawo omwe amapanga ma balloon catheters. Izi zimakuthandizani kuti mulimbikitse achire mu thrombosis yamitsempha yosiyanasiyana ndi 32-56%. Ndikofunikanso kuti mahule a endovascular akhale ndi chitsimikizo cha zaka 5.

Poganizira malingaliro a akatswiri abwino kwambiri pantchito yodwalitsa ya zotupa zam'mimba, kupindika kwamitsempha yosiyanasiyana, Pulofesa S. A. Kapranov ndi gulu lake amagwiritsa ntchito zida zapamwamba kwambiri pochita opaleshoni kuti abwezeretse ntchito ya mtima.

Kugwiritsa ntchito kwawo kumatsimikizira kuti matupi a wodwalayo amasungidwa, pomwe kukhazikika kwa mafupa amkati samafunikira, ndipo zotsatira zabwino zamankhwala sizingatheke pamilandu 93%.

Akatswiri a malo opangira opaleshoni ya mtima safuna kukwaniritsa zotsatira za "zodzikongoletsera" atatha kulowererapo, koma kuti abwezeretse kuchuluka kwa ziwiya za wodwalayo momwe angathere.

Kodi kukonza patency kumachitika bwanji?

Opaleshoni ya thrombosis yamitsempha yosiyanasiyana imachitika pansi pa opaleshoni yam'nyumba. Kudzera pakabowoleza khoma, woyambitsa amayilowetsa mu mtsempha. Chida ichi ndi chubu chomwe zida zonse zimayikidwa. Kenako, catheter woonda kwambiri ndiye woyeserera.

Ndi chithandizo chake, chotengera chowonongeka chimapezeka. Ziwonetsero zonse zimachitika motsogozedwa ndi zida zapadera za radiology. Chifukwa cha izi, dokotala wa opaleshoni yam'mimba amatha kuwunika momwe mitsempha imayambira (mitsempha), kutsatira zochita zawo pazenera.

Utoto wapadera wokhala ndi baluni umaperekedwa kudzera mu catheter kupita kumalo ochepera. Ballo watambasulidwa. Chifukwa cha izi, stent imawongoka ndipo imatha kukhalabe mkati mwamitsempha yam'munsi.

Kodi opaleshoni imabwezeretsa liti mitsempha?

Pamaso pa zizindikiro za atherosulinosis, thrombosis m'mitsempha yam'munsi.

Zomwe zimadziwika paziwonetsero zakusokonekera kwa mitsempha.

Kodi pali ma contraindication opaleshoni yamiyendo yam'munsi, pelvis?

Inde! Koma alipo ochepa a iwo:

Mitsempha yowonjezereka.

Aimpso mwamphamvu, kupuma.

Matenda a dongosolo la magazi.

Matupi a ayodini wa ayodini, omwe amagwiritsidwa ntchito pochita opaleshoni kuti abwezeretsenso kuchuluka kwa mitsempha ndi thrombosis ndi atherosulinosis.

Ubwino wa njira yogwiritsidwira ntchito

Kuthetsa kwa thrombosis m'mitsempha yosiyanasiyana pogwiritsa ntchito njira zomwe zaperekedwa kumakhala ndi zabwino zingapo.

Chitetezo Panthawi yolowererapo kuti abwezeretsere bedi lamitsempha, odwala samakumana ndi zoopsa zambiri.

Palibenso chifukwa chothandizira opaleshoni. Izi zimakuthandizani kuti muchepetse zoyipa pamthupi lonse la wodwalayo.

Chiwerengero chochepa chotsutsana.Opaleshoni yobwezeretsa patency ya chotengera (mtsempha) imachitidwa kwa odwala ambiri.

Palibe ululu panthawi yolowerera. Odwala samakumana ndi mavuto atachitidwa opaleshoni. Izi ndichifukwa choti ma painkiller amakono amagwiritsidwa ntchito.

Kuchira msanga pambuyo pakuchita opaleshoni pamitsempha yamagazi. Pakatha masiku ochepa, wodwalayo amatha kubwerera kumoyo wawo.

Kuchita bwino kwambiri. Opaleshoni kuti abwezeretse patency ya bedi lamitsempha imapereka zotsatira zofunika nthawi zambiri.

Mtengo wabwino kwambiri. Zimatengera kuwonongeka kwa mitsempha, gawo la thrombosis, ndi zizindikiro zina zofunika. Komanso, mtengo wothetsa matenda ammimba umakhudzidwa ndi zinthu zingapo zowonjezera.

Zolemba zamankhwala pakati pa Pulofesa Kapranov

Kuchita bwino kwambiri. Kutembenukira kwa ife, mumalandira thandizo ndipo mutha kuthana ndi thrombosis.

Kupanda kupweteka. Simuyenera kuchita mantha! Opaleshoni yobwezeretsanso patency sikubweretsa vuto.

Zipinda zabwino ndi antchito omvetsera. Mumasankha pakati poti mupeze chithandizo. Izi zikutanthauza kuti inunso mutha kudziwa momwe mungakhalire mchipatala, mayeso, ndi zina zotero.

Kodi chimatsimikizira mtengo wa kuchiza matenda a thrombosis ndi chiyani?

Kuchokera pamaphunziro a kufunsa kopatsa, kulimbikitsidwa ndikuwoneka bwino kwa kuchipatala.

Zofunika! Izi sizikugwirizana mwachindunji ndi zochizira. Chifukwa cha izi, ngakhale mutawononga ndalama zochepa, mumalandira thandizo laukadaulo.

Mukufuna kusaina ndi Pulofesa Kapranov?

Imbani manambala ake:

Pamodzi ndi inu, dokotala wodziwa bwino za opaleshoni yam'mimba asankha nthawi yabwino yolowererapo ndi chipatala choyenerera. Sergey Anatolyevich adzauza onse za njira yogwiritsidwira ntchito, phindu lake lalikulu. Mutha kufunsanso mafunso okhudzana ndi zoopsa, zotsatira zoyipa za kulowererapo.

Mutha kuyitananso magulu azachipatala omwe Pulofesa Kapranov amavomereza ndikupangana ndi oyang'anira.

Zisonyezo zodutsa zombo za m'munsi

Kuchita opaleshoni yodutsa zonyamula zokhala m'munsi kwambiri kumachitika mu dipatimenti yapadera kapena ya opaleshoni kuchipatala. Zimatanthawuza njira zovuta, chifukwa chake, ziyenera kuchitidwa malinga ndi mawonekedwe okhwima. Ndikofunika kugwiritsa ntchito zodutsa ngati zodutsa 50% za m'mimba mwake. Asanaganize chochita opaleshoni, madokotala amamulembera mankhwala othandiza. Kuchitapo kanthu kwa opaleshoni kumachitika pokhapokha pakuchitika zovuta zamankhwala. Izi zikuwonetsa izi:

1. Arteriosulinosis obliterans mitsempha.
2. Matenda ofunsira a venous system. Nthawi zambiri ndi varicose mitsempha ndi kuwopseza kwa thrombophlebitis, stenting kapena angioplasty amachitidwa. Ndi contraindication mwa njira zamankhwala zotere, opaleshoni yam'madzi yam'mimba imachitidwa.
3. Endarteritis. Ndi matenda amtunduwu, kutupa komwe kumachitika ndikuphatikizidwa ndikuwonekera pang'onopang'ono kwa ziwiya zazing'ono. Pang'onopang'ono, mitsempha imatsekeka kwathunthu, ndikupangitsa kuti pakhale phazi lamapazi. Matendawa amafala kwambiri pakati pa amuna.
4. Chidziwitso cha mitsempha yam'munsi. Pathology ndiyowopsa ndikuteteza magazi kwambiri, zomwe ndizovuta kwambiri kuyimitsa.

Nthawi zina, zonyamula zokhala m'munsi zimadutsana ndi zala zakumiyendo kapena kumapazi. Momwe matendawa amathandizira pakuchita opaleshoni iyi siabwino nthawi zonse ndipo zimatengera gawo la necrosis komanso machitidwe a thupi. Nthawi zina, opareshoniyo imabweretsa kuchiritsidwa kwa matenda osokoneza bongo kapena kuchepa kwa omwe akukhudzidwa.

Kodi ndi nthawi ziti pamene kusokonezedwa kumatsutsana?

Ngakhale opaleshoni yam'mimba inadutsa, ndikofunikira kukumbukira kuti opareshoni yotereyi ndiyowopsa. Chifukwa chake, zimachitika pokhapokha ngati njira zina zochiritsira sizikuthandizira. Pali zingapo zotsutsana za opaleshoni yamphongo. Zina mwa izo ndi:

1. Matenda oopsa oletsa kuyatsidwa ndi mankhwala a antihypertensive. Pankhaniyi, opaleshoni yam'mimba imatha kuyambitsa kugwedezeka kwa mtima, kuchepa kwamitsempha, kapena stroko.
2. Mtima kuwonongeka, limodzi ndi edematous syndrome ndi kulimbitsa dyspnea.
3. Angina pectoris.
4. Pachimake mtima kulephera ndi myocardial infarction.
5. Chidziwitso cha msempha, ziwiya zamitsempha.
6. Paroxysmal mtima mungoli zosokoneza.

Kutupa kwa ziwiya za m'munsi kwambiri sikungachitike chifukwa cha matenda opatsirana, kuwonongeka pakhungu, kuwonongeka kwa matenda a shuga. Muzochitika izi, opareshoni imachitika pambuyo pokhazikika kwa wodwalayo.

Njira Zowonongera

Nthawi zambiri, opaleshoni ya mitsempha ya m'mimba imachitidwa. Izi ndichifukwa choti ma pathologies oterewa ndiofala. Kuphatikiza apo, ndi kuwonongeka kwa venous, njira zina zamankhwala zimalimbikitsidwa. Zina mwazo ndi balloon angioplasty ndi stenting. Monga shunt yobwezeretsa magazi ochepa, gwiritsani ntchito chotupa cha ntchafu. Ndi dera lalikulu la lesion kapena mkhalidwe wosakhutira wa zotengera, zofunikira kupanga. Pali njira zingapo zogwirira ntchito. Zina mwa izo ndi:

1. Opaleshoni ya aorto-bifemoral bypass. Kuchitapo kanthu kwa opaleshoni kumachitika pamlingo wa inguinal dera. Chinsinsi cha ntchitoyo ndikupanga anastomosis yodutsa pakati pamimba ya msempha ndi mafupa amphongo.
2. Opaleshoni yachikazi ya popliteal bypass. Anastomosis imapangidwa pakati pamitsempha iwiri yayikulu yam'munsi. Shunt imachokera kumunsi kwa ntchafu ndipo imabweretsedwa m'dera la bondo lolumikizana (pansi kapena pamwamba pa cholumikizira).
3. Wolokerani Anastomosis imadutsa pakati pa mitsempha iwiri yachikazi (kuchokera kumanzere kumanzere kumanzere dzanja, kapena mosemphanitsa).
4. Kutupa kwachikazi. Kukongoletsa kwam'mimba kumalumikiza mitsempha yachikazi komanso ya tibial.

Njira yakumapeto kwa zombo zam'munsi

Kuyika ziwiya zamagawo akum'munsi ndi ntchito yovuta, yomwe imafunikira katswiri wa opaleshoniyo. Kudzimbidwa kumachitika pansi pa opaleshoni wamba. Kusintha kwa khungu ndi minyewa yomwe imapangidwa mkati mwake imachitika m'malo awiri - pamwambapa komanso pansipa m'dera lomwe lakhudzidwa ndi mtsempha. Ma Clampu amayikidwa pachiwiya kuti magazi asatayike. Pambuyo pakuyesa dera lomwe lakhudzidwalo, kuyikika kumapangidwa pamatenthengako ndipo shuntyo imakhazikika mbali imodzi. Kenako, chotupa cham'mimba chimakhazikitsidwa pakati pa minofu ndi minyewa. Chifukwa chake, shunt imabweretsedwa pang'onopang'ono kumalo kwachiwiri (pamwamba pa chotupa) ndikutha kwake. Pambuyo pake, dokotalayo amawunika momwe magazi akutuluka. Mukamayendetsa bwino ntchito, mtsempha wamafunde umayamba kugundika. Nthawi zina, njira zoyeserera zofunikira zimachitidwa. Gawo lomaliza la opaleshoni ndikusisita minofu yakuya komanso khungu.

Kodi nthawi ya postoperative ili bwanji?

Kuyang'anira wodwala amene wachitidwa opaleshoni ndikofunikira kwambiri. Makamaka ngati kudalitsa uku kudutsa ziwiya zam'munsi. Nthawi yothandizira ndi chithandizo chathanzi ili pafupifupi milungu iwiri. Patsiku la 7-10, dokotalayo amachotsa zipsera. Wodwalayo akadali m'chipatala, ndikofunikira kuchita njira zodziwunikira kuti adziwe kuyenera kwa chithandizo. Kuphatikiza apo, adotolo ayenera kuonetsetsa kuti palibe zovuta za postoperative. Kale m'masiku oyamba atachitidwa opaleshoni, tikulimbikitsidwa kuyimirira. Pakukhala ndi kugona, miyendo yam'munsi imayenera kukhazikika.

Malangizo Kubwezeretsa

Pambuyo pakutseka ziwiya zamagawo am'munsi, ndikofunikira kuyang'anira momwe magazi akuyendera. Kuti izi zitheke, wodwalayo amayenera kuwunikira nthawi ndi nthawi (ultrasound ndi Doppler ultrasound). Yalimbikitsa:

1. Siyani kusuta.
2. Tengani mankhwala a antiplatelet kuti muchepetse thrombosis.
3. Yang'anirani thupi. Ndi kuchuluka kwa BMI, zakudya zopatsa lipid ndi kuchepetsa mankhwala zimayikidwa.
4. Yendani tsiku ndi tsiku.
5. Valani masokisi apadera (masokosi) ndi nsapato.

Opaleshoni odutsa ofunitsitsa am'munsi malekezero: ndemanga za wodwala

Ndemanga za odwala omwe adachitidwa opaleshoni ndiyabwino kwambiri. Odwala adawona kuchepa kwa ululu, dzanzi m'miyendo. Komabe, nthawi zambiri, anthu amadandaula za kubwerezanso kwa zizindikiro patapita nthawi. Izi zikuchitika chifukwa cha kuwonongeka kwa mitsempha yoyandikira ndi mitsempha. Ndikofunika kukumbukira kuti opaleshoni yopitilira si njira yothandizira atherosulinosis, ndipo chomwe chimapangitsa kuti minyewa iwonongeke sichitha pambuyo pakuchita opareshoni. Chifukwa chake, popewa thrombosis komanso kukula kwa gangrene, ndikofunikira kuwona njira zopewera.

Minyewa ya m'munsi yam'mphepete: zovuta za opaleshoni

Mavuto a opareshoniwa ndi monga kupangika kwa magazi mkati mwa mankhwalawa, kukula kwa mtima pachimake, kupunduka kwa m'mapapo. Munthawi yakuchira, kuwonjezeranso chilonda m'malo otupa ndikutsuka magazi ndizotheka. Ngakhale kuti opareshoni imawonedwa ngati yovuta komanso yayitali (mpaka maola atatu), zovuta ndizochepa. Pafupipafupi kukula kwawo kuli pafupifupi 2%.

Mitundu ya maopaleshoni

Pakadali pano, mitundu ingapo ya kuchitapo kanthu kwa opaleshoni yamitundu yosiyanasiyana yamavuto amagwiritsidwa ntchito pochotsa zolembera za atherosrance.

Pozindikira atherosclerosis, opaleshoni yamtundu wina kapena ina imayikidwa ndi dokotala wothandizidwa ndi zotsatira za mayeso, poganizira zomwe wodwalayo ali ndi zaka: kuchuluka, kutseka kwa kama wodwala, kulemera, kupezeka kwa matenda ena.

Ntchito zotsatirazi zimatengedwa kuti ndizothandiza kwambiri ku atherosulinosis ya m'munsi yotsika:

• Balloon angioplasty.
• Bypass mitsempha ya m'munsi malekezero.
• Njira ya laser.
• Endarterectomy.

Ganizirani njira iliyonse ya opaleshoni mwatsatanetsatane.

Balloon angioplasty

Opaleshoni yamtunduwu ya atherosulinosis yam'munsi yam'munsi imakuthandizani kuti muthamangitse magazi, kuthetsa kufooka kwa bedi lamitsempha, lomwe limapulumutsa wodwalayo pachiwopsezo cha minofu necrosis komanso kufunika kokadula.

Opaleshoniyo amachitidwa motere: kukankhira kakang'ono kumapangidwa pamalowo pachitetezo cha ngalawa yomwe yakhudzidwa. Kenako, catheter yaying'ono yokhala ndi baluni kumapeto kwake imayikidwa mu kama wamitsempha, wokutidwa ndi ma cholesterol amana.

Pambuyo pake, mpweya umayamba kulowa mu cylinder, womwe umapangitsa kuti ifutukuke, ndikuwulula kuwala kochepa mphamvu kwa chombo. Ngati vutoli silikuwoneka bwino kwa adotolo, chipangizo chachitsulo chimayikidwa kumalo osungidwa kuti abwezeretse m'lifupi momwe muliri.

Imodzi mwazipatso za balloon angioplasty ndi opaleshoni zovuta, pamene baluni yophimba ndi mankhwala amapangidwa. Njirayi imathandizira osati kubwezeretsa patency yamtsempha, komanso kupewa kutukusira kwa chotupa, limodzi ndi kuchuluka kwa minyewa ya endothelial.

Zotsatira za kulowerera mu mawonekedwe a patency yobwezeretsedwayo yamogona osachepera zaka zisanu. Pambuyo pa opaleshoni, wodwalayo ayenera kuyang'aniridwa ndi njira ya ultrasound kawiri pachaka ndi kuvomerezedwa tomography kamodzi pachaka. Izi zimakuthandizani kuti muzindikira nthawi yoipa yamitsempha yamagazi ndikuthandizira kusintha kwakanthawi.

Ubwino wa opaleshoni yapulasitiki yotsuka:

1. Kuwonongeka kocheperako: catheter amalowa kudzera mu micronadder ya zimakhala kulowa mu chombo chowonongeka.
2. General mankhwala opaleshoni safunikira kulowererapo, mankhwala opaleshoni yakwanira.
3. Kubwezeretsa mwachangu - odwala amaloledwa kusuntha pasanathe tsiku limodzi.
4. Kuwopseza kwa zovuta ndi matenda a zimakhala ndi opaleshoni yotereyi sikukhudzidwa konse.

Zingagwire ntchito bwanji pachipatala chabwino? Pafupifupi, mtengo wa pulasitiki wa balloon wopanda stent udzakhala pafupifupi ma ruble 80,000.

Opaleshoni yam'mimbayo

Zikuwonetsedwa ndi izi:

• Atherosulinosis obliterans - opaleshoni imathandiza kuthetsa kufalikira kwa lumen.
• Kuletsa endarteritis.
• Zowonjezera za zotumphukira zokhudzana ndi ziwiya zamagetsi.
• Contraindication kuti pute pulasitiki ndi stenting.

Opaleshoni yakumaloko kapena wamba imaperekedwa kwa wodwala; Kusankha uku kumakhala koyenera chifukwa chakuti mapangidwe atherosulinotic sanapangidwe mu venous of miyendo, zotengera zomwezo ndizazikulu, chifukwa chake zimawoneka zoyenera kugwiritsa ntchito ngati shunts. Nthawi zina zinthu zopangira zinthu zimagwiritsidwa ntchito pa chifukwa ichi.

Dokotalayo amayambitsa chibwibwi pamalo pomwe pali bowo, lomwe limapangidwa m'malo awiri ndipo limayikiridwa mwakachetechete. Opaleshoni yotereyi ili m'gulu la zovuta, zomwe zimangochitika ndi akatswiri odziwa ntchito komanso akatswiri oyenerera.

Pambuyo pa kulowererapo, wodwalayo amatumizidwa kuti ayang'anitsidwe ndi ultrasound ndikuwunika angiographic kuti atsimikizire kupambana kwa opaleshoni ya atherosulinosis.

Nthawi yokonzanso imatha kuyambira masiku 2-3 mpaka sabata, ndiye kuti wodwalayo ayenera kutsatira zingapo:

1. Mankhwala okhazikika ndi ma statins ndi anticoagulants.
2. Kunenepa.
3. Kuletsa zakudya.
4. Kukana zizolowezi zoipa.

Mtengo wa opaleshoniyo ndiwokwera kwambiri, m'makliniki azachipatala opitilira opaleshoni yamitsempha yam'munsi yotsika mtengo amatha kutengera ma ruble 130 mpaka 170,000.

Laser chithandizo

Chimodzi mwazinthu zowononga kwambiri komanso zopanda ululu pochita opaleshoni yam'munsi yotsika. Amathandizira kuthetsa kufinya kwamitsempha, kubwezeretsa mkhalidwe wamakoma amitsempha yamagazi.

Chimalimbikitsidwa pochotsa zolembera za atherosselotic zomwe zimatsekeka mwamphamvu lumen.

Njira ya laser imaphatikizapo kuloza kochepa mu minofu, yochitidwa ndi njira yotsiriza. Kodi izi zikutanthauza chiyani: mtsempha womwe wakhudzidwa umakodwa, chipangizo chapadera, chogwiritsa ntchito laser, chimalowa mkati mwake kudzera mu bowo lomwe lidapangidwa. Kudzera pamakina, matalala a laser amalowa mchombo, ndikuwononga ma cholesterol amana.

Kuchitapo kanthu kumachitika muofesi ya radiologist yomwe ikuwongoleredwa ndi Hardware kuti musayike chida cholondola.

Mukamaliza njirayi, catheter imachotsedwa limodzi ndi zotsalira za mayendedwe a cholesterol.

Malinga ndi ndemanga za madokotala ochita opaleshoni ndi odwala, pali zabwino zambiri zamankhwala a laser atherosulinosis:

• Palibe chifukwa chochitira opaleshoni yathunthu.
• Kuperewera kwa nyengo yokonzanso - wodwala amaloledwa kusuntha nthawi yomweyo.
• Kuthekera kwa kulowererapo ndi contraindication ambiri.
• Kuthana ndi kutsekeka kwa chotengera cham'mbuyo, kubwezeretsanso magazi kumiyendo kwakanthawi kochepa.
• Mtengo wotsika kwambiri - malinga ndi deta ya boma, njira imodzi imagwiritsa ntchito ma ruble 15,000, mukakhazikitsa stent, muyenera kulipira enanso 4-5,000.

Endarterectomy

Ndi kulowereraku kosautsa kochotsa mwachindunji ma cholesterol plaque ndi kubwezeretsanso kwa magazi ake.

Opaleshoni isanachitike, odwala amapatsidwa njira yochepetsera magazi molumikizana ndi kuthetsedwa kwa mankhwala othandizira kutupa.

Maola 12 asana opaleshoni, odwala ayenera kusiya kudya ndi zakumwa.

Mtundu wa kulowererapo kwa atherosulinosis uli m'gulu la zovuta kwambiri, umapangidwira njira yapamwamba kwambiri yamatenda.

Ngati wodwalayo samatsatira malingaliro a madotolo pambuyo pa nthawi ya ntchito, mwayi wobwerezanso wa matendawa, kuwonekera kwa ma cholesterol atsopano, kuwonongeka kwa ischemic kumitsempha ndikokwera.

Njira zothandizira

1. Chombo chosinthika chomwe chimakhudzidwa ndi zolembapo chimapinikizidwa. Kenako, pakhungu limapangika pakhungu kuti lizitulutsa timitsempha tating'onoting'ono.
2. Mng'oma waikidwa pachiwonetsero cholumikizira kuti chikalumikizane ndi zigawo zina zapamadzi.
3. Kenako nyamayo imapangidwa, kachipangizo kochotsa chidikacho kamayikidwa mchilondacho.
4. Khoma la mitsempha limathandizidwa ndi chigamba chapadera kuti chibwezeretse mulifupi mwake.
5. The shunt ikuchotsedwa.
6. Magazi atatha kubwezeretsanso, mtsempha wamagazi umasungunuka, ndipo chubu lokwanira (imodzi kapena zingapo) limayikidwa pamalo operekera chithandizo.
7. Opaleshoniyo amachitidwa pogwiritsa ntchito zida zapadera zochitira opaleshoni: chowongolera ma binocul ndi maikulosikopu.
8. Kutalika kwa opareshoniyo mpaka maola angapo, kutengera kuchuluka kwa matendawo ndi momwe thanzi la wodwalayo lilili.

Ndi endarterectomy yamitsempha ya miyendo, mitundu iwiri ya opaleshoni imagwiritsidwa ntchito:

• Kwathunthu - kutsutsana kwathunthu ndi kupweteka kwa kupweteka. Zimaphatikizapo kugona kwa wodwala pakuchita opareshoni yonse.
• Zapafupi - zimatchinga ululu pamachitidwe opaleshoni. Amawonetsedwa kwa openshoni, odwala omwe ali ndi matenda a mtima ndi mitsempha yamatumbo, matenda oopsa a m'mapapo.

Kukonzanso

Pambuyo pa opaleshoni yamtunduwu ya atherosulinosis, kukonzanso kumatenga nthawi yayitali kuyambira masiku 1-2 mpaka sabata, pambuyo pake wodwala amachotsedwa kuchipatala. Maoperative a postoperative amachotsedwa tsiku lachisanu ndi chiwiri.

Imodzi mwa mitundu ya kulowererapo - carotid endarterectomy - imagwiridwa kuti ichotse ma cholesterol amana ku carotid artery. Opaleshoni isanachitike, odwala amapukutidwa mbali ya scalp, opaleshoni yambirimbiri imayendetsedwa, chotengera chokha chimayikidwa padera, chikwangwani chimachotsedwa, khoma la mtsempha limatsukidwa, ndipo bala limasukidwa.

Pambuyo 1 tsiku atachitidwa opaleshoni, odwala mankhwala mankhwala:

1. Mankhwala ochepetsa magazi: Warfarin, Fragmin.
2. Angioprotectors: Detralex, Aescusan.
3. Ma antibacterial othandizira a gulu la penicillin.
4. Ma painkiller omwe ali ndi anti-yotupa: Ibuprofen, Indomethacin.