Atherosulinotic mtima: chithandizo, zimayambitsa, kupewa

Atherosulinosis imakhudza zotengera za munthu aliyense wachitatu pa Dziko Lapansi. Umu ndi momwe amapangira zikopa za "mafuta" pakhoma la mitsempha kapena mitsempha, yomwe imatha kukula kwakukulu - mpaka 7-12 cm. Ndi kukula kwawo kofunikira, chinyontho cha chotengera chimatha kupitilira, zomwe zimapangitsa kuti pakhale chosakwanira m'thupi kapena kuzimiririka ndimwazi mkati mwake. Kukula kwa mapangidwe amtunduwu mumitsempha yama mtima kumathandizira kuti pakhale matenda a ischemic (chidule monga IHD) ndi atherosranceotic cardiosranceosis.

Ngati woyamba, kusintha kwa chiwalo nthawi zambiri kumasinthika (kusiyanasiyana ndiko kukhazikitsidwa kwa vuto lamtima), ndiye ndi mtima, kuwonongeka kwa minofu yamtima kumatenga moyo. Mu myocardium, kuchuluka kwa minofu yolumikizidwa kumachitika, chifukwa chake ntchito yake imachepa ndipo, chifukwa chake, thupi lonse limatha kuvutika.

Zimayambitsa Cardiosulinosis

Zomwe zimayambitsa matenda a atherosulinotic cardiossteosis sizikudziwika. Madokotala amakhulupirira kuti chofunikira kwambiri ndi kuchuluka kwa lipids m'magazi (makamaka LDL, cholesterol) ndi kuwonongeka kwa mtima (ndi madontho oponderezedwa, kutupa, etc.). Nthawi zambiri, mikhalidwe imeneyi imawonedwa mwa anthu omwe ali ndi zinthu zotsatirazi:

• Ma genetic - ngati m'mbuyomu banja ambiri adadwala atherosclerosis, pali kuthekera kwakukulu kwa mbadwa zake,
• Zaka - zitatha zaka 50, "mafupa" am'madzi pazombozi amapanga liwiro kwambiri kuposa zaka zazing'ono. Izi zimachitika chifukwa chakuchepa kwa kayendedwe ka metabolic, kuchepa kwa ntchito ya chiwindi ndikusintha kwa khoma la mtima. Chifukwa cha izi, ma lipids amayendayenda m'magazi motalikirapo ndipo amakhala mosavuta m'mitsempha yowonongeka,
• Zogonana - malinga ndi ziwerengero, abambo amatenga matenda a atherosulinosis kwambiri kuposa azimayi omwe amatetezedwa ndi mahomoni ogonana (asanadutse),
• Zizolowezi zoipa - kusuta fodya komanso mowa,
• Kunenepa kwambiri - kumatsimikiziridwa ndi index yapadera (kulemera kwa thupi mu kg / kutalika 2). Ngati mtengo wake ndi wochepera 25, ndiye kuti kulemerako kumakhala koyenera,
• Matenda opatsirana - matenda ashuga (makamaka mtundu wachiwiri), chithokomiro (chithokomiro), kuchepa kwa chiwindi, matenda oopsa (kuthamanga kwa magazi pamwamba pa 140/90).

Kukhalapo kwa chinthu chimodzi kumathandizira kwambiri chiopsezo cha matenda a mtima. Njirayi imapangidwa pang'onopang'ono, motero nkovuta kudziwa kukhalapo kwake munthawi yake, popanda chidwi cha wodwalayo. Kuti muchite izi, muyenera kudziwa komwe matendawa amayamba komanso momwe amakulira.

Kodi atherosulinotic cardiosulinosis imayamba bwanji?

Choyamba, munthu ayenera kusintha kapangidwe kazinthu zamagazi. Mlingo wa lipids "zovulaza" ukuwonjezeka (LDL), ndipo "wopindulitsa" umachepa (HDL). Chifukwa cha izi, mafupa amafuta amawoneka m'makoma amitsempha yama coronary. Ndikosatheka kuzizindikira pa moyo, chifukwa sizipangitsa kuti zizindikilo zanu zizioneka.

Pambuyo pake, lipids, limodzi ndi ma cell am'magazi (mapulateleti) akupitilizabe kukhazikika m'chigawo cha mzere, ndikupanga chidikiro chokwanira. Pamene ikukula, choyamba imatseka mbali yake ya mtsempha. Pakadali pano, munthuyu ali ndi nkhawa ndi zoyamba za matenda a coronary. Ngati zolembazo zikadalipobe kwanthawi yayitali (kwa zaka zingapo) ndipo wodwalayo satenga mankhwala ochepetsa mphamvu ya lipid, atherosranceotic cardiosclerosis. Monga lamulo, limasokoneza chilengedwe - zofunika kwambiri zimapezeka m'malo osiyanasiyana a minofu yamtima.

Popanda chithandizo, matendawa amakula pang'onopang'ono - kuchuluka kwa minofu yolumikizana kumawonjezereka, m'malo mwa myocardium yokhazikika. Maselo otsala am'mimba amakula, kuyesa kukhalabe ndi mtima wabwinobwino. Zotsatira zake, izi zimatsogolera ku kusakwanira kwake komanso mawonekedwe a zizindikiro zazikulu.

Zizindikiro za atherosulinotic mtima

Odwala amapereka madandaulo awiri akuluakulu - pazowonekera za matenda ammimba komanso zizindikiro za kulephera kwa mtima. Choyamba ndi kupweteka, komwe kumatha kuzindikiridwa ndi zizindikiro zamakhalidwe. Onse akufotokozedwa mufunso lapadera, poyankha mafunso omwe, wodwalayo amatha kukayikira payokha IHD.

Angina pectoris kapena Prinzmetal - apakati / otsika mwamphamvu,

Angina pectoris wosakhazikika - kuwoneka kwa ululu waukulu ndizotheka. Wodwalayo amatha "kuzimiririka" pakukomoka, popeza akuwopa kukulitsa chizindikirocho.

Ndi mtundu uliwonse wamatenda a mtima (kupatula vuto la mtima), ululu umachoka mutatenga Nitroglycerin. Ngati ipitilira kwa mphindi zoposa 10 - iyi ndi nthawi yolumikizana ndi ambulansi.

Ndi angina khola, ululu umatha msanga pambuyo pakupuma kwapafupipafupi (mu mphindi 5-7).

Kuphatikiza pazizomwe tafotokozazi, wodwala yemwe ali ndi vuto la atherosselotic mtima amatha kuona zizindikiro zakulephera kwa mtima:

• Kupuma pang'ono komwe kumachitika nthawi yayitali. Nthawi zambiri, odwala amazindikira akamakwera masitepe kapena akuyenda mtunda wautali (oposa 400). Ndi mtima wodala, kupuma kwa wodwala kumatha kukhala kovuta ngakhale pakupuma,
• Edema - m'magawo oyamba, miyendo yokha ndi yomwe imakhudzidwa (m'dera la mapazi ndi miyendo). Pambuyo pake, edema imatha kuchitika mthupi lonse, kuphatikiza ziwalo zamkati,
• Zosintha pakhungu ndi misomali - odwala omwe ali ndi mtima wamtima amazindikira kuzizira kwa manja ndi mapazi, khungu louma mosalekeza. Kutayika kwa tsitsi komanso kuwonongeka kwa misomali ndizotheka (zimakhala ndi mawonekedwe ozungulira, zimakhazikika),
• Kutsika kwa kupanikizika (pansipa 100/70 mm Hg) kumawonekera pokhapokha kumbuyo kwa kusintha kwakukulu mu myocardium. Nthawi zambiri limodzi ndi chizungulire komanso kukomoka kwakanthawi.

Komanso, atherosulinotic cardiossteosis imatha kutsatiridwa ndi kusokonezeka kwa mitsempha, mawonekedwe a "kugunda kwa mtima" ndi "zolakwika" mu mtima. Komabe, izi sizipezeka kawirikawiri.

Matenda a atherosranceotic mtima

Atherosulinosis ikhoza kuganiziridwa pophunzira magazi a wodwala. Kuti muchite izi, ndikokwanira kuwunikira zamomwe mumayang'ana mbali zotsatirazi, momwe muyenera kuyang'anirani zotsatirazi:

lipids ")

Kuti atsimikizire kupezeka kwa atherosclerotic cardiossteosis, madokotala amagwiritsa ntchito zida zothandizila kuzindikira. Njira zotsatirazi ndizofala ku Russia:

• ECG ndi kafukufuku wotsika mtengo komanso wowoneka bwino yemwe amakupatsani mwayi wokayikira zamtima chifukwa cha ischemia yamadera ena a mtima,
• Ultrasound yamtima (echocardiography) ndiyo njira yosavuta yodziwira minofu yolumikizira m'malo mwa myocardium, kuwunika kuchuluka kwa pathological foci ndi kukula kwake,
• Coronary angiography ndiyo njira yolondola kwambiri komanso yotsika mtengo kwambiri yodziwira matenda a atherosulinosis. Phunziroli limachitika m'm zipatala zazikulu zokha, chifukwa zimafuna zida zamtengo wapatali, zida ndi akatswiri odziwa bwino ntchito yawo. Algorithm yovomerezeka ya angiography ili motere:
  1. Kudzera mu mtsempha wachikazi, dokotalayo amaika catheter yapadera (chubu loonda) yomwe imatsogolera ku msempha wamitsempha yama cell.
  2. Wosiyanitsa ndi ena amabweretsedwa mu catheter,
  3. Tengani chithunzi cha dera lamtima wamtundu uliwonse mwa njira ya X-ray (nthawi zambiri izi zimapangidwira tomography).

Pambuyo pakutsimikizira kuti ali ndi vutoli, madokotala amamulembera chithandizo chokwanira. Imaletsa kukula kwa matendawa, kumachepetsa kuopsa kwa Zizindikiro ndipo kumachepetsa chiopsezo cha kugunda kwamtima, chomwe chiri chifukwa chofala mwa odwala.

Chithandizo cha atherosulinotic mtima

Choyamba, odwala amalimbikitsidwa kuti azitsatira zakudya zomwe zimachepetsa kuchuluka kwa lipids yamagazi. Zimatanthawuza kupatula kwa yokazinga, ufa, utsi ndi mbale zamchere. Gome la wodwalayo liyenera makamaka kukhala ndi msuzi wa msuzi wa nkhuku, chimanga, nyama yazakudya (nkhuku, nyama yamwana wamkati, nkhata) ndi zinthu zamasamba (masamba, zipatso).

Wodwala ayenera kusintha moyo wake kuti athandizire kusintha kwamankhwala. Zochita zolimbitsa thupi (kusambira, kuyenda pafupipafupi, kuthamanga mopepuka) ndizofunikira, zomwe zingathandize kuthana ndi kulemera kowonjezereka, ndikukulitsa kulolerana (kulolerana) kupsinjika.

Kuchita bwino kwa atherosulinotic cardiossteosis sikutheka popanda kutsatira malangizowo, koma chithandizo choyenera ndimathandizanso. Monga lamulo, mulinso magulu otsatirawa a mankhwalawa:

• Oonda magazi - Aspirin Cardio, Cardiomagnyl. Amatengedwa kuti aletse kukula kwa zodutsa komanso kufalikira kwa mitsempha yamagazi. Kugwiritsa ntchito mankhwalawa pafupipafupi kumalepheretsa kulowetsedwa kwa myocardial mu 76%,
• Lipid kutsika - Atorvastatin, Rosuvastatin, Simvastatin,
• Kuchotsa kuukiridwa kwa IHD - Nitroglycerin mu kutsitsi / mapiritsi pansi pa lilime. Imagwira ntchito kwakanthawi kochepa. Ndi kukomoka pafupipafupi, mafomu okhalitsa maola 8-12 amalimbikitsidwa: Isosorbide dinitrate kapena mononitrate,
• Kuchotsa edema - Diuretics Veroshpiron, Spironolactone. Ndi edema yayikulu komanso yotchulidwa, kuikidwa kwa Furosemide ndikotheka,
• Kupititsa Kukonzeratu - Enalapril, Lisinopril, Captopril. Mankhwalawa amachepetsa kuopsa kwa kulephera kwa mtima komanso kuchepetsa magazi.

Izi zimatha kuphatikizidwanso ndi mankhwala ena, kutengera mkhalidwe wa wodwalayo. Ngati mankhwala akulephera kuchepetsa ziwonetsero za atherosulinotic cardiosranceosis, tikulimbikitsidwa kuti mupite ku opaleshoni. Amakhala pakukweza magazi kupita ku myocardium ndikukulitsa mitsempha ya coronary (renduminal balloon angioplasty) kapena kudutsa kuthamanga kwa magazi (coronary artery bypass grafting).

Kupewa kwa atherosulinotic mtima

Mwayi wopanga njirayi ndiwokwera kwambiri, chifukwa chake, prophylaxis iyenera kuyamba ali mwana. Amakhala ndi kusintha kosavuta pamakhalidwe, cholinga chochepetsera milingo ya lipid komanso kupewa kuwonongeka kwa mtima. Malangizo a madotolo ndi awa:

• Chitani masewera olimbitsa thupi katatu pa sabata. Kuthamanga, masewera / kusewera ndi kusambira ndi abwino;
• Siyani kusuta, kugwiritsa ntchito mankhwala osokoneza bongo ndi kumwa Mlingo waukulu (ndikulimbikitsidwa kuti musamwe mowa wopitilira 100 g patsiku),
• Nthawi ndi nthawi muyeze kuthamanga ndi shuga,
• Pafupipafupi (miyezi isanu ndi umodzi) mutenge maultivitamini
• Muchepetse mafuta ochulukirapo, ufa, zakudya. Zakudya siziyenera kuwonjezeredwa.

Kupewa atherosclerotic cardiosulinosis ndikosavuta kuposa kuchiza. Zochitika pamwambazi zimathandizira kukhalabe ndi moyo wabwino kwa munthu ngakhale atakalamba.

Kodi atherosulinotic mtima ndi chiyani?

Kudziwika kotereku kwa "atherosulinotic cardiosclerosis" kulibe kwa nthawi yayitali komanso kuchokera kwa katswiri wazodziwa inu musamve. Liwuli limagwiritsidwa ntchito kutchulira zotsatira za matenda a mtima kuti afotokozere bwino momwe masinthidwe am'magazi amawonongeka.

Matendawa amawonetsedwa ndi kuwonjezeka kwakukulu kwa mtima, makamaka, mapokoso ake amanzere, komanso kusokonezeka kwa mitsempha. Zizindikiro za matendawa ndizofanana ndikuwonetsa kulephera kwa mtima.

Asanayambe atherosulinotic mtima, wodwalayo amatha kudwala angina pectoris kwa nthawi yayitali.

Matendawa amatengera mphamvu ya masisitimu athanzi myocardium, chifukwa cha coronary arteriosranceosis. Izi zimachitika chifukwa cha kusayenda bwino kwa magazi ndi magazi osakwanira ku myocardium - chiwonetsero cha ischemic. Zotsatira zake, mtsogolomo, zolinga zambiri zimapangidwa mu minofu ya mtima, momwe njira ya necrotic idayamba.

Matenda a atherosulinotic nthawi zambiri amakhala "pafupi" ndi kuthamanga kwa magazi, komanso kuwonongeka kwa msempha. Nthawi zambiri, wodwalayo amakhala ndi fibrillation ya atria ndi matenda amisempha.

Kodi matenda amapangidwa bwanji?

Pakadulidwa kochepa thupi, tonse timayesa kuti ichitike posachedwa, koma khungu silikhala ndi ulusi wamalonda m'malo ano - minyewa yaying'ono ipangika. Zofananazo zimachitika ndi mtima.

Zilonda pamtima zitha kuonekera pazifukwa izi:

1. Pambuyo pa kutupa (myocarditis). Muubwana, chomwe chimayambitsa izi ndi matenda akale, monga chikuku, rubella, malungo ofiira. Akuluakulu - syphilis, chifuwa chachikulu. Ndi chithandizo, kutupa kumachepa ndipo sikufalikira. Koma nthawi zina chilonda chimatsalira pambuyo pake, i.e. minofu yam'mimba imasinthidwa ndikuvulaza ndipo salinso ndi mgwirizano. Matendawa amatchedwa myocarditis cardiossteosis.
2. Pofunika minofu yotsalira pakatha opareshoni yomwe imagwira pamtima.
3. Kuikidwa motsatira kotsitsa pachimake ndi mtundu wa matenda a mtima. Chifukwa cha necrosis imakonda kupasuka, motero ndikofunikira kuti ipangitse khungu lowonda mothandizidwa ndi mankhwala.
4. Atherosulinosis ya ziwiya imayambitsa kuchepa, chifukwa cha mapangidwe amkati mwa cholesterol. Kusakwanira kwa okosijeni minofu ya minofu kumayambitsa kukonzanso pang'ono pang'onopang'ono kwa minofu yathanzi. Kuwonetsera kwamtunduwu kwamatenda a ischemic matenda kumatha kupezeka pafupifupi anthu onse okalamba.

Cholinga chachikulu cha kukhazikitsidwa kwa matenda ndi kupanga mapangidwe a cholesterol mkati mwa zombo. Popita nthawi, zimachulukana kukula komanso zimasokoneza kayendedwe kabwino kama magazi, michere ndi okosijeni.

Pamene lumen imakhala yochepa kwambiri, mavuto amtima amayamba. Imakhala yokhazikika mu hypoxia, chifukwa chake matenda amtima amayamba, kenako atherosranceotic mtima.

Kukhala mu mkhalidwe uwu kwa nthawi yayitali, maselo amisempha am'mimba amasinthidwa ndi cholumikizira, ndipo mtima umaleka kukhazikika bwino.

Zowopsa zomwe zimayambitsa chitukuko cha matendawa:

• Makamaka
• Okwatirana Amuna amatenga matendawa mosavuta kuposa azimayi,
• Chowonera zaka. Matendawa amakula nthawi zambiri atakwanitsa zaka 50. Akuluakulu akamakula, amapanga mapangidwe a cholesterol, motero, matenda amitsempha yamagazi.
• Kupezeka kwa zizolowezi zoipa,
• Zovuta kuchita
• Kuperewera kwa zakudya m'thupi
• Kunenepa kwambiri
• Kukhalapo kwa matenda olumikizana, monga lamulo, ndi matenda a shuga, kulephera kwa impso, matenda oopsa.

Pali mitundu iwiri ya atherosulinotic mtima:

• Sinthani zochepera,
• Sinthani chachikulu chachikulu.

Potere, matendawa agawidwa m'mitundu itatu:

• Ischemic - imachitika monga chifukwa cha kusala kudya kwanthawi yayitali chifukwa chosowa magazi,
• Postinfarction - imapezeka patsamba la minofu yomwe yakhudzidwa ndi necrosis,
• Osakanikirana - kwa mtundu uwu zizindikiro ziwiri zam'mbuyo ndizodziwika.

Zizindikiro

Matenda a atherosulinotic ndi matenda omwe amakhala ndi nthawi yayitali, koma popanda chithandizo choyenera, akupita patsogolo. M'mayambiriro oyamba, wodwalayo sangamve chilichonse, chifukwa chake, zolakwika mu ntchito ya mtima zitha kuzindikirika pa ECG yokha.

Ndi ukalamba, chiopsezo cha mtima wamatenda cham'mimba kwambiri, chifukwa chake, popanda chinyengo cham'mbuyomu, munthu angaganize kuti pali zipsera zing'onozing'ono pamtima.

• Choyamba, wodwalayo amawona mawonekedwe a kufupika, komwe kumawonekera pakulimbitsa thupi. Ndi chitukuko cha matendawa, zimayamba kuvutitsa munthu ngakhale pakuyenda pang'onopang'ono. Munthu amayamba kumva kutopa kwambiri, kufooka ndipo samatha kuchita chilichonse mwachangu.
• Pali zowawa m'dera la mtima, zomwe zimakulirakulira usiku. Matenda a angina samadziwikiratu. Ululu umawongolera kumbali yakumanzere, phewa, kapena mkono.
• Mutu, kugundana kwammphuno ndi tinnitus zikuwonetsa kuti ubongo umakumana ndi vuto la oxygen.
• Mitundu ya mtima wasokonezeka. Kutheka kwa tachycardia ndi fibrillation ya atria.

Njira Zodziwitsira

Kuzindikiritsa kwa atherosmithotic cardiossteosis kumapangidwa pamaziko a mbiri yakale yomwe yasungidwa (m'mbuyomu wamatsenga m'mbuyomu, kukhalapo kwa matenda a mtima, arrhasmia), zizindikiro zowonetsedwa ndi deta yomwe imapezeka kudzera maphunziro a labotale.

1. ECG imachitika pa wodwala, pomwe zizindikiro za kuchepa kwa mtima, kukhalapo kwa minofu, mtima arrhythmias, kumanzere kwamitsempha yamagazi kumatha kutsimikizika.
2. Kuyesedwa kwa biochemical magazi kumachitika komwe kumavumbula hypercholesterolemia.
3. Dongosolo la Echocardiography limawonetsa kuphwanya kwa myocardial contractility.
4. Njinga ergometry imawonetsa kukula kwa kusowa kwa myocardial.

Kuti mupeze vuto lolondola la atherosulinotic mtima, maphunziro otsatirawa akhoza kuchitika: kuwunika tsiku ndi tsiku kwa ECG, mtima MRI, ventriculography, ultrasound yam'mimba yotsekemera, ultrasound yam'mimba, chifuwa radiografia, rhythmocardiography.

Palibe chithandizo chotere cha atherosulinotic mtima, chifukwa ndikosatheka kukonza minofu yowonongeka. Mankhwala onse ndi othandizira kuchepetsa zizindikiro komanso kufalikira.

Mankhwala ena amaperekedwa kwa wodwala kwa moyo wonse. Onetsetsani kuti mwapereka mankhwala omwe angalimbikitse ndikukula makoma a mitsempha yamagazi. Ngati pali umboni, opareshoni imatha kuchitika nthawi yomwe zilembo zazikulu pamakoma amitsempha zimachotsedwa. Maziko a mankhwalawa ndi zakudya zoyenera komanso zolimbitsa thupi zolimbitsa thupi.

Kupewa matenda

Pofuna kupewa matenda, matendawa ndi ofunika kwambiri kuyang'anira thanzi lanu nthawi, makamaka ngati pakhala pali zochitika zina zokhudzana ndi matenda a atherosranceotic cardiossteosis.

Njira zoyambirira kupewa ndizoyenera kupatsa thanzi komanso kupewa kunenepa kwambiri. Ndikofunikira kwambiri kuchita masewera olimbitsa thupi tsiku ndi tsiku, kuti musakhale moyo wongokhala, kupita pafupipafupi kwa dokotala ndikuwunikira cholesterol yamagazi.

Kupewa kwachiwiri ndi kuchiza matenda omwe angayambitse matenda a mtima. Pankhani yopeza matendawa poyambira chitukuko ndikuti malingaliro onse a dotolo amatsatiridwa, matenda a mtima sangathe kupitilira ndipo angalole munthu kutsata moyo wathunthu.

Kodi atherosulinotic cardiossteosis

Lingaliro lachipatala la "mtima ndi mtima" limatanthauzira matenda owopsa a minofu ya mtima omwe amayambitsidwa ndi njira yopukusa kapena kufalikira kwa minofu yolumikizira minofu ya myocardial. Pali mitundu yamatendawa pamalo omwe amapanga zovuta - aortocardiosranceosis ndi coronary cardiosclerosis. Matendawa amadziwika ndi kufalikira pang'onopang'ono ndi njira yayitali.

Atherosulinosis yam'mitsempha yama coronary, kapena stenotic coronary sclerosis, imayambitsa kusintha kwakukulu kwa metabolic mu myocardium ndi ischemia. Popita nthawi, minyewa minyewa imachepa ndikufa, matenda a mtima akuwonjezeka chifukwa chakuchepa kwa kukakamiza kwa zosokoneza ndi kusokonekera kwa miyendo. Matenda a mtima nthawi zambiri amakhudza amuna achikulire kapena azaka zapakati.

Zambiri

Matenda a mtima (myocardiossteosis) - njira ya kukhazikika kapena kuyikiratu minyewa yam'mimba ya myocardium yokhala ndi minofu yolumikizira. Kutengera etiology, ndichizolowezi kusiyanitsa pakati pa myocarditis (chifukwa cha myocarditis, rheumatism), atherosulinotic, postinfarction ndi pulayimale (yokhala ndi collagenoses, fibroelastoses) mtima. Atherosulinotic mtima mu mtima imawonedwa ngati chiwonetsero cha matenda a mtima chifukwa cha kupitirira kwa atherosulinosis ya ziwiya zamkati. Matenda a atherosulinotic a mtima amapezeka makamaka pakati pa amuna azaka zapakati komanso achikulire.

Chofunika cha matenda

Kodi atherosulinotic mtima ndi chiyani? Iyi ndi njira yothandizira momwe minofu yamkati yam'mnyewa imalowedwa m'malo ndi minyewa yolumikizana minofu. Cardiosulinosis imatha kusiyana mu etiology ya pathological process, ikhoza kukhala myocardial, atherosulinotic, pulayimale komanso pambuyo pake.

Mu cardiology, matenda amtunduwu amawonedwa ngati atherosulinosis yamatumbo a coronary komanso monga chiwonetsero cha matenda amitsempha yamagazi, matenda a atherosranceotic mtima nthawi zambiri amawonedwa ngati amuna achikulire ndi amuna okalamba.

Zimayambitsa Atherosclerotic Cardiosulinosis

Matendawa omwe amawaganizira amachokera pa zotupa zamatumbo a coronary. Chomwe chimatsogolera pakukula kwa atherosulinosis ndikuphwanya cholesterol metabolism, limodzi ndi kuchuluka kwa lipids mkati mwa mtsempha wamagazi. Kuchuluka kwa mapangidwe a coronary atherosulinosis kumakhudzidwa kwambiri ndi matenda oopsa a magazi, chizolowezi cha vasoconstriction, komanso kudya kwambiri mafuta ambiri a cholesterol.

Atherosulinosis yamitsempha yama coronary imatsogolera ku kuchepa kwa mphamvu ya mitsempha ya m'magazi, kutsekeka kwa magazi ku myocardium, ndikutsatiridwa ndi kusintha kwa minofu ya minofu yokhala ndi minyewa yovuta (atherosranceotic cardiossteosis).

Khodi ya ICD-10

Malinga ndi gulu la khumi la International Classization of Diseases (ICD 10), lomwe limathandiza kuzindikira matendawa m'mbiri ya matendawa ndikusankha mankhwalawo, palibe nambala yeniyeni yokhudzana ndi matenda a mtima. Madotolo amagwiritsa ntchito I 25.1 yotanthauza matenda a mtima. Nthawi zina, dzina la 125.5 limagwiritsidwa ntchito - ischemic cardiomyopathy kapena I20-I25 - matenda a mtima.

Kwa nthawi yayitali, atherosselotic cardiossteosis mwina sapezeka. Zizindikiro mu mawonekedwe a kusapeza nthawi zambiri zolakwika kuti malaise osavuta. Ngati zizindikiro za mtima zimayamba kuvuta pafupipafupi, muyenera kufunsa dokotala. Zizindikiro zotsatirazi zimakhala chifukwa chothandizira:

• kufooka, kuchepa kwa ntchito,
• kupuma movutikira kumapezeka,
• kupweteka kwa epigastrium,
• kutsokomola popanda zizindikiro za chimfine, limodzi ndi pulmonary edema,
• arrhythmia, tachycardia,
• kupweteka kwapakatikati kumbuyo, kufikira kumanja kumanzere, nkono kapena phewa,
• nkhawa zochulukirapo.

Chizindikiro chosowa cha atherosclerotic cardiossteosis ndikukulitsa pang'ono kwa chiwindi. Chithunzi cha matenda matendawa ndizovuta kudziwa, motsogozedwa ndi zomwe wodwalayo akumva, ali ofanana ndi zizindikiro za matenda ena. Kusiyanako kukukhala poti m'kupita kwa nthawi, kulimba kwa zomwe zimachitika, zimayamba kuwonekera pafupipafupi, kuvala wamba. Odwala omwe ali ndi kulowetsedwa kwa atherosulinotic zolembera, mwayi woti abwererenso ndiwokwera.

Zotsatira ndi zovuta

Atherosulinotic cardiossteosis imadziwika ndi matenda osasintha, omwe amapita patsogolo pang'onopang'ono. Kusintha kwakanthawi kumatha kukhala nthawi yayitali, koma kuwukira pafupipafupi kwa kusokonekera kwa magazi kumachitika pang'onopang'ono kumayambitsa kuwonongeka kwa odwala.

Matenda a atherosranceotic mtima amatsimikiza ndi zinthu zambiri, makamaka:

• myocardial lesion area,
• mtundu wa kaperekedwe ndi arrhythmia,
• gawo la mtima kulephera pa nthawi kudziwa matenda,
• kukhalapo kwa matenda amodzi,
• zaka odwala.

Pakakhala zinthu zomwe zikukulitsa, chithandizo chamankhwala chokwanira komanso kukhazikitsa malangizo othandizira odwala, matendawa ndiabwino.

Amayambitsa ndi pathogenesis

Zomwe zimayambitsa chitukuko cha matendawa zitha kukhala motere:

• onenepa kwambiri
• cholesterol yayikulu
• zizolowezi zoipa
• kumangokhala
• matenda a shuga ndi mavuto ena a endocrine,
• matenda a mtima.

Zinthu za atherosulinotic mu mtima zimatsogolera ku necrosis pamitsempha ya mtima, ma receptors amafa chifukwa cha matenda amtunduwu, omwe amatsogolera kuchepa kwa chidwi cha mtima ndi mpweya.

Matendawa amadziwika ndi nthawi yayitali komanso yogwira ntchito mwachangu, chifukwa chake, mpweya wamanzere umachulukitsa kwambiri, womwe umayenda ndi kulephera kwa mtima ndi zonse zomwe zikupezeka (kusokonezeka kwa phokoso la mtima, angina pectoris, etc.).

Zizindikiro zamakhalidwe

Zizindikiro za atherosulinotic mtima ndi zosiyana mwamphamvu, zimatengera kutanthauzira kwake kwa njirayi komanso kuchuluka kwake. Pa magawo oyamba a matendawo, wodwalayo amakhala ndi nkhawa yokhudza kupuma movutikira, ndipo zimachitika ndi kulimbitsa thupi komwe m'mbuyomu sikunayambitse zizindikiro zilizonse. Ndi chitukuko cha matendawa, dyspnea imayamba kuwoneka pakupuma. Kuphatikiza apo, atherosclerotic cardiosulinosis imawonetsedwa motere:

• mndandanda umayamba,
• pamakhala kupweteka m'dera la mtima, ndipo kulimba kwake kumatha kukhala kosiyanasiyana - kuyambira pang'ono kusinthika mpaka kuwukiridwa kowopsa, kupweteka kumaperekedwa mbali yakumanzere ya thupi,
• kuthamanga kwa magazi kumakhala kosalala,
• chizungulire ndi makutu otakasuka ndizotheka,
• kutupa kumawonekera.

Ngati post-infarction cardiossteosis ili ndi zizindikiro zonsezi modabwitsa komanso mosalekeza, ndiye kuti atherosulinotic imadziwika ndi njira ya wavy, popeza njira za m'melocardium zimachitika pang'onopang'ono.

Kuzindikira matendawa

Kuzindikira kumakhazikitsidwa ndi kafukufuku wazopanga, monga momwe tafotokozera pamwambapa zitha kuwonedwa m'matenda ena omwe sagwirizana ndi mtima, mwachitsanzo, mphumu. Mtundu wolimbikira kwambiri wa diagnostics wa Hardware ndi ECG. Ndikofunika kwambiri kupulumutsa zotsatira zonse za ECG kuti adotolo athe kudziwa momwe matendawo akutsutsira komanso nthawi yake. Zovuta pa ECG zitha kupangidwanso ndi katswiri.

Ngati pali zizindikiro za kusokonezeka kwa mtima, chiwonetsero chimodzi chawonekera pamtima, ngati chikhodzodzo chikulephera, adokotala amawona, ndipo mano amatha kuwonekeranso mu mtima, omwe wodwala sanakhalepo nawo kale.

Ultrasound yamtima imaperekanso chidziwitso chakuyenda bwino kwa magazi. Pozindikira matenda am'mimba, njira zina zofufuzira zimagwiritsidwanso ntchito - echocardiography ndi ergometry ya njinga. Maphunzirowa amapereka chidziwitso cholondola chokhudza momwe mtima ulili pakupumula komanso nthawi yomwe mukuchita khama.

Kodi kuopsa kwa matendawa ndi chiani ndipo mwina zovuta zake ndi ziti

Matenda a atherosulinotic ndi matenda am'tsogolo, ndipo popeza umalumikizidwa ndi mtima, ngozi imadzilankhulira yokha. Matenda a mtima ndi oopsa chifukwa cha kusintha kwake kosasinthika. Zotsatira za magazi osayenda bwino myocardium, kufa ndi mpweya wa okosijeni, ndipo mtima sugwira ntchito moyenera. Zotsatira zake, makoma amtima amalemera, ndipo amakula kukula. Chifukwa cha kusokonezeka kwambiri kwa minofu, chotengera chingawonongeke (kapena kung'ambika kwathunthu), kulowetsedwa kwa myocardial kumachitika.

Mavuto a atherosulinotic mtima ndi matenda osiyanasiyana amtima omwe amatha kupha.

Mitundu ndi magawo a mtima

Pali magawo angapo a chitukuko cha matenda a m'matumbo, chilichonse chimakhala ndi zofunikira zake, ndipo chithandizo pamagulu osiyanasiyana amakhalanso ndi kusiyana:

• Gawo 1 - tachycardia ndi kupuma movutikira, zimachitika pokhapokha pochita masewera olimbitsa thupi,
• Gawo lachiwiri ndi kulephera kwamitsempha kwamanzere - Zizindikiro zimachitika ndi masewera olimbitsa thupi,
• Gawo lachiwiri ngati vuto la kupezeka kwamanja lamitsempha - pali zotupa pamiyendo, palpitations, mwachangu, acrocyanosis wamphepete,
• Gawo 2B - kusayenda kumawonedwa m'magawo onse oyenda magazi, chiwindi chimakulitsidwa, kutupa sikuchepa,
• Gawo 3 - zizindikirazi ndizokhazikika, ntchito ya machitidwe ndi ziwalo zonse zimasokonekera.

Matenda a mtima akhoza kukhala amodzi mwa awa:

• atherosulinotic - akufotokozera chifukwa kutsika kwa atherosulinotic malo mu coronary zombo,
• chidziwitso pambuyo
• kusokoneza mtima - minofu ya mtima yophimbidwa kwathunthu ndi njira ya pathological,
• postmyocardial - njira zotupa mu myocardium.

Kuchiza matenda

Chinthu choyamba chomwe chimalimbikitsidwa kwa wodwala ndi chakudya chamagulu. Ndikofunikira kusiya kudya mafuta, yokazinga, ufa, mchere ndi mchere wosuta. Ndikofunika kuletsa chimanga, nyama yazakudya monga nkhuku, nkhuku, nyama yamchere, idyani zipatso zambiri komanso masamba.

Zomwe zikuwonetsedwanso ndikusintha kwa moyo - masewera olimbitsa thupi (kusambira, kuthamanga osayenda, kuyenda), pang'onopang'ono katunduyo akuyenera kuwonjezeka. Njira zonsezi ndi chithandizo chothandizira pa mankhwala osokoneza bongo, popanda kusintha kwa odwala omwe ali ndi atherosulinosis.

Mankhwala omwe ayenera kugwiritsidwa ntchito pochiza matenda a mtima atherosulinotic, dokotala akuyenera kuvomereza, ndizosatheka kumwa nokha mankhwala, kuti mupewe zovuta.

Mankhwala omwe amathandizira kuti muchepetse magazi m'magazi - Cardiomagnyl kapena Aspirin. Kulandilidwa kwawo ndikofunikira kuti mapangidwe a zolembedwazo amachepetsedwa ndipo kutsekeka kwa chotengera sikumachitika. Kudya nthawi yayitali komanso kugwiritsa ntchito ndalamazi ndizothandiza kupewa kulowetsedwa kwa magazi.

Mankhwala omwe amatsitsa lipids yamagazi: Simvastatin, Atorvastatin, Rosuvastatin. Nitroglycerin akuwonetsedwa chifukwa chodwala matenda a mtima, koma zotsatira zake zimakhala zakanthawi, ngati kukomoka kumachitika pafupipafupi, ndikofunikira kugwiritsa ntchito mankhwala omwe ali ndi mphamvu yayitali.

Ndi edema yayikulu, diuretics Spironolactone, Veroshpiron ndi mankhwala, ngati ndalamazi sizothandiza, ndiye kuti Furosemide ndi mankhwala. Kuphatikiza apo, mankhwalawa amayikidwa kuti achepetse kuthamanga kwa magazi komanso kuthana ndi chizindikiro cha kulephera kwa mtima: Enalapril, Captopril, Lisinopril.

Ngati ndi kotheka, mankhwala ena amawonjezeredwa ku regimen yothandizira. Ndi kusagwira ntchito kwa mankhwala, mankhwala opangira opaleshoni amafunsidwa, omwe cholinga chake ndikuwongolera magazi kupita ku myocardium.

Zotsogola ndi njira zopewera

Matendawa amatha kuperekedwa pokhapokha ngati wodwala atazindikira kwathunthu, kuwunika kwake komanso kuchuluka kwa matenda oyambitsidwa. Malinga ndi ziwerengero, ngati atherosulinotic cardiosulinosis sinapereke zovuta komanso zowopsa m'moyo, ndipo ngati chithandizo chinayambika panthawi yake ndikuchita bwino, titha kulankhula za kupulumuka 100%.

Ndiyenera kunena kuti pafupifupi zovuta zonse zomwe zimakhudza kuchuluka kwa kupulumuka zimakhudzana ndi zomwe wodwalayo pambuyo pake amatembenukira kwa dokotala kuti akathandizidwe, komanso kulephera kutsatira malingaliro onse omwe katswiri adayambitsa.

Mankhwalawa a mtima ndi mtima matenda, kuphatikizapo atherosulinosis, ndiwotalikirapo komanso osavuta, chifukwa chake, ngati munthu ali ndi vuto latsopanoli, ndiye kuti kuyenera kupewa kupewera munthawi yake. Kudziwa zomwe zimayambitsa matendawa, ndikosavuta kumvetsetsa zomwe kuletsa matenda a mtima:

1. Zakudya zoyenera. Zakudya ziyenera kukhala zopindulitsa thupi zokha, ziyenera kuphikidwa ndi mafuta ochepa, ndiye kuti, njira zophika zofatsa ziyenera kugwiritsidwa ntchito. Zakudya zamafuta ndi zakusuta ziyenera kuchepetsedwa kwambiri;
2. Matenda a kulemera. Ukalamba usanachitike komanso mavuto ambiri mthupi amachitika chifukwa cha kunenepa kwambiri. Sizofunikira kutsatira zakudya zokhwima komanso zowononga thanzi, ndizokwanira kudya moyenerera komanso moyenera, ndipo kulemera kwake kumakhalanso kosavulaza komanso kuvutikira thupi.
3. Onetsetsani kuti mwasiya zizolowezi zoipa. Iyi ndi mfundo yofunika kwambiri pa matenda a mtima ndi mtima. Kusuta fodya komanso kumwa mowa mwauchidakwa zimakhudza mkhalidwe wa mthupi ndi ziwalo zonse za anthu, zosokoneza bongo zimawononga mitsempha yamagazi komanso njira zoyipa za metabolic.
4. Kukhala wakhama ndi kofunika kwambiri kuti munthu akhale wathanzi komanso kulimbitsa thupi lathunthu. Komabe, sizoyenera kukhala wachangu kwambiri pamasewera, zolimbitsa thupi ziyenera kukhala zotheka ndikupatsa munthu chisangalalo. Ngati palibe chikhumbo chothamanga ndikusambira, ndiye kuti mutha kusankha mayendedwe kapena ntchito zina.

Kupewa kwamatenda am'mtima komanso mtima wamakhalidwe ndi moyo wathanzi. Tsoka ilo, m'zaka zaposachedwa, anthu ochepa omwe amasamala zaumoyo wawo ndikumvera malangizo a madokotala, ayenera kukumbukira kuti atherosranceotic cardiosranceosis ndi matenda omwe amapezeka zaka zambiri, sangathe kuchiritsidwa msanga, koma amatha kupewedwa.

Pathogenesis ya atherosulinotic mtima

Stenosing atherosclerosis yamitsempha yama coronary imayendera limodzi ndi ischemia ndi kusokonezeka kwa metabolic mu myocardium, ndipo, chifukwa chake, pang'onopang'ono komanso pang'onopang'ono timatumbo tating'onoting'ono, atrophy ndi kufa kwa minofu minofu, pomwe malo a necrosis ndi microscopic mabala. Imfa ya zolandilira imathandizira kuchepetsa kukhudzika kwa michere ya myocardial ku oxygen, zomwe zimatsogolera kupitanso patsogolo kwa matenda a mtima.

Matenda a atherosulinotic mtima amapatsirana komanso amakhala nthawi yayitali. Ndi kukula kwa atherosulinotic mtima, kukakamiza matenda oopsa, kenako kuchekeka kwa chamanzere kwamkati, zizindikiro za mtima zalephera.

Popeza njira zopangira pathogenetic, ischemic, postinfarction, ndi mitundu yosiyanasiyana ya atherosulinotic mtima ndi mtima zimasiyanitsidwa. Ischemic matenda amtima amayamba chifukwa chotenga nthawi yayitali, kumayenda pang'onopang'ono, ndikuwononga minofu ya mtima. Post-infarction (post-necrotic) zamtima zimakhazikitsidwa pamalo omwe kale anali necrosis. Matenda osakanikirana (osakhalitsa) a atherosranceotic mtima amaphatikizira zonse ziwiri pamwambapa ndipo amadziwika ndi kupendekera kwapang'onopang'ono kwa minofu ya fibrous, yomwe necrotic foci nthawi ndi nthawi imapangika mobwerezabwereza infarction.

Kuzindikira ndi kupewa atherosulinotic mtima

Kukula kwa atherosulinotic mtima ndi kutengera kwa chotupa, kukhalapo ndi mtundu wa phokoso ndi kusokonezeka kwa magonedwe, komanso gawo la kulephera kwa magazi.

Kupewera kwakukulu kwa atherosulinotic mtima ndi kuletsa kusintha kwa mitsempha m'magazi (zakudya zoyenera, masewera olimbitsa thupi, ndi zina zambiri). Njira zina zodzitetezera zimaphatikizira chithandizo chokwanira cha atherosulinosis, kupweteka, arrhythmias ndi kulephera kwa mtima. Odwala omwe ali ndi atherosulinotic mtima amafunika kuwunika pafupipafupi ndi mtima, kufufuza mtima ndi mtima.