Za'a iya yin kuskuren gano cutar hauhawar jini a wasu lokuta ba daidai ba, mara lafiya yana ɗaukar magani na dogon lokaci, amma ba ya kawo wani sakamako. Marasa lafiya suna rasa imani game da haɓaka rayuwarsu, kuma sannu a hankali suna haɓaka rikitarwa masu yawa masu haɗari.
Kimanin 15% na lokuta na saukar karfin jini suna da alaƙa da hauhawar jijiya ta jijiyoyin jini wanda ke lalacewa ta hanyar jijiyoyin gabobin ciki da ke cikin aikin matsa lamba.
An gano wannan yanayin a cikin 20% na masu ciwon sukari tare da cutar hauka, da ƙarancin amsa ga rashin lafiya. Sunan na biyu na cutar shine hauhawar jini. Likitocin sun ce ba cuta ba ce. Kimanin cututtukan 70 an san su da ke haifar da wannan alamar.
Sanadin da rarrabuwa na Pathology
Maganin hauhawar jijiyar jijiyoyin jini suna tasowa ne sakamakon amfani da wasu ƙwayoyi, alal misali, corticosteroids, maganin hana haihuwa. Akwai hanyoyin da yawa na ilimin halayyar cuta, sun dogara da babban dalilin karuwar matsin lamba.
An bambanta hauhawar jini (renoparenchymal, renovascular). Idan kodan bai sami isasshen jini ba, alal misali, tare da haɓakar atherosclerosis na artal koda, abubuwa ne da ke ba da gudummawa ga karuwar matsa lamba ana sakewa.
An gano cin zarafi tare da gabatarwar wakili na bambanci, lissafin tomography, duban dan tayi, gwaje-gwaje na dakin gwaje-gwaje. Za a iya haifar da hauhawar jini ta sakandare ta hanyar hematomas, vasoconstriction na haihuwa, cuta ko ƙangin neoplasms, da kuma tsarin kumburi.
Sauran dalilan na iya haɗawa:
- canje-canje atherosclerotic;
- jini clots da overlap da kuma kunkuntar na jijiyoyin bugun gini na koda na koda
- mai ciwon sukari mai ciwon sukari;
- hanyar rashin lafiya ta pyelonephritis;
- raunin da ya faru
- Mycobacterium da tarin fuka.
Tare da hauhawar jini na endocrine, muna magana ne game da karuwar alamun da ke nuna aldeosterone, catecholamines, glucocorticosteroids. A wannan yanayin, ana gano yanayin ilimin ta hanyar amfani da dabarun dakin gwaje-gwaje, angiography, CT, duban dan tayi. Ana lura da hauhawar jini na endocrine tare da cututtukan adrenogenital, acromegaly, cutar ta Hisenko-Cushing, hyperthyroidism, endothelin-neoplasms.
Wani nau'in hauhawar jini shine yake haifar da magunguna, yana tasowa lokacin da ba'a lura da matakan magunguna waɗanda basu da alaƙa da daidaita matakan matakan jini. Yana faruwa tare da tsawaita amfani da maganin hana haihuwa, magungunan anti-mai kumburi, cyclosporins, haɓakar ayyukan juyayi.
Cutar hauhawar jijiyoyin jini tana da nasaba da cututtukan kwayoyin halitta na tsarin juyayi na tsakiya:
- bugun jini;
- raunin da ya faru
- ciwan kwakwalwa;
- babban matsa lamba intracranial;
- acidosis na numfashi;
- encephalitis;
- bulbar poliomyelitis.
Ana gano waɗannan cututtukan a yayin CT, duban dan tayi na tasoshin jini na kwakwalwa, angiography of tasoshin jini ta amfani da matsakaici.
Tare da cutar haihuwar cuta ko cututtukan cututtukan zuciya na zuciya a cikin mai ciwon sukari, hauhawar hemodynamic mai yiwuwa ne. Abubuwan da ake buƙata don ci gaban matsala na iya zama kumburin aorta, lahanin ƙwayar zuciya, aortic aneurysm, erythremia, cikakkiyar toshe-tsafe-tsafe. Take hakkin zai nuna wani tsari mai kwakwalwa, Echo-KG, angiography.
A cikin haƙuri tare da ciwon sukari, mai guba da tashin hankali mai wahala yana yiwuwa. A magana ta farko muna magana ne game da guba na giya, abinci tare da matakan gubar, tyramine, thallium. Dalili na biyu yakamata a nemo shi cikin tashin hankalin-tunanin rai, rikicewar raunin raunuka, hadadden hanyoyin tiyata .. Mafi yawancin lokuta, likitoci sun binciki cutar koda, neurogenic, endocrine da hauhawar jini na hawan jini.
Lokacin da yanayin cututtukan cuta ya zama ɗaya daga cikin alamun cutar, ba alama ce ta farko ba, ba za a faɗi ta cikin bayyanar cutar ba.
Misali, hakan na faruwa ne da wata cuta ko kuma cutar ta Itenko-Cushing, ta rarraba mai guba.
Alamun Zalunci
A cikin mafi yawan lokuta na bayyanar cututtuka na Symptomatic arterial hauhawar jini yi kansu ji da karuwa a saukar karfin jini. Sauran alamun za su kasance bayyanar ringing da tinnitus, kumburin kai, amai, tashin zuciya da amai, amai da gudawa a gaban idanun, gajiya kullun.
Halin da ke tattare da cuta yana haɗuwa tare da yawan wucewa, jin zafi a cikin yanki na occipital, a cikin zuciya, lokaci-lokaci yakan tashi cikin zafin jiki na gaba ɗaya, rashin tausayi, da yawan damuwa.
Yayin gwajin gani, likita zai tantance alamun cutar hauhawar jini ventricular hagu, ƙarfafawar sautin na biyu akan aorta, canje-canje daban-daban a cikin jijiyoyin jijiyoyin jini.
Cutar da ke haifar da hauhawar jini a cikin nesa ba ta da kullun rakiyar abubuwa masu alamomi. A irin waɗannan yanayi, yana da matukar wahala a tuhumi yanayin yanayin hauhawar jini.
Sau da yawa ana danganta shi da abubuwan:
- m ci gaba, saurin ci gaban hauhawar jini;
- matasa ko bayan shekara 50;
- rashin ingantaccen magani don hawan jini.
Yawancin lokaci tsarin a cikin kodan yakan ci gaba ba tare da alamun bayyananniya ba, yana tare da sauyi da kuma canzawar fitsari ne kawai. Proteinuria yana samun ƙimar bincike yayin yin la'akari da yawan furotin na yau da kullun da aka rasa tare da fitsari. Proteinuria akan 1 g kowace rana ana ɗauka azaman wata alama ce ta haɓakar hauhawar jijiya tare da lalacewa ta asali.
A cikin tsofaffi masu cutar sukari da yawa, hauhawar jini ba ta da matsala, daga lokaci zuwa lokaci rashin hauhawa da raguwa a hawan jini. Halin hauhawar jijiyoyinsu ana yin shi ne ta hanyar hauhawar matsin lamba na systolic tare da adadin kuzarin al'ada. Wannan yanayin ana kiransa atherosclerotic ko hauhawar jini da suke da shekaru.
Bayyanar cututtukan jijiyoyin mahaifa atherosclerosis na sa sannuwar ƙwaƙwalwar ƙwayar atherosclerotic mai yiwuwa.
Tare da shi, bugun jini a cikin jijiyoyin ƙananan hancin ya ragu, kafafu suna yin sanyi kullun da taɓawa.
Hanyoyin bincike daban-daban
Likita na iya tantance abubuwan da ke haifar da hauhawar ƙwayar cuta bayan tattara tarihin mai haƙuri, zai zama dole a kafa lamurran raunin da suka faru, cututtukan da suka gabata, da kuma ƙaddara don ƙara hawan jini.
Wajibi ne don auna matsin lamba sau da yawa, a cikin masu ciwon sukari na gida suna buƙatar adana tsinkayen bayanai na musamman inda suke ɗaukar bayanai akan alamomin hawan jini.
Eterayyade abubuwan da ke haifar da raguwar matsin lamba ya ƙunshi ƙaddamar da gwaje-gwaje na ɗakin gwaji: janar da gwajin jini na biochemical, nazarin matakan hormone, urinalysis, echo-kg, wani electrocardiogram, duban dan tayi na kodan, tasoshin renal, angiography, lissafin tomography.
Bayan kafa yanayin kiwon lafiya, samun sakamakon gwaje-gwaje na dakin gwaje-gwaje, ana iya tsara ƙarin matakan maganin cutar ga mai haƙuri:
- electroencephalography;
- introvenous urography;
- nazarin halittar koda;
- rheoencephalography.
Wasu marasa lafiya zasu buƙaci sabuntawa na isotopic, bincike game da ingantaccen matakin sodium da potassium a cikin fitsari, al'adar fitsari akan Gulda, zaɓin adrenal gland phlebography.
Don tabbatar da kasancewar duwatsun koda, rashin haɓakawa na tasoshin koda wanda zai iya haifar da micro- da macrohematuria. Tare da hematuria, don ware neoplasms, ban da maganin urography na ban mamaki, sikirin kodan, lissafin tomography, bambancin cavography, aortography.
Don gano cututtukan cututtukan ƙwayar ƙwayar mahaifa, wanda kuma aka bayyana ta hanyar ilimin ilimin ƙwaƙwalwar ƙwayar cuta, ana bada shawarar maganin ƙwayar koda. Nazarin yana taimakawa ƙarshe tabbatar da kasancewar lalacewar ƙwayoyin amyloid. Idan likita ya ba da shawarar hauhawar jini na vasorenal, an wajabta angiography. Ana amfani da duka hanyoyin bincike don tsayayyun alamomi.
An yi wa annan ankara don yara masu fama da cutar sankara tare da masu fama da cutar sankara ciwan ƙoshin lafiya da ƙarancin ingancin aikin magani.
Hanyoyin jiyya
Kulawa da cutar hawan jini da alama yana haifar da kawar da abubuwan da ke haifar da karuwar hawan jini. Ana gudanar da aikin likita da tiyata, hangen nesa na tasiri kai tsaye ya dogara da tsananin cutar rashin lafiyar.
An tsara masu ciwon sukari a matsayin hanya na magungunan rigakafin ƙwayar cuta, an zaɓi su daban-daban, dangane da alamun matsa lamba, kasancewar contraindications wa abubuwa masu aiki, sanadin hauhawar jijiyoyin jini.
Tare da tabbatar da hauhawar jini na koda, an nuna shi don ɗaukar diuretics, masu hana ACE. Lokacin da tasirin hypotensive ba ya faruwa, naɗaɗɗen vasodilali, P-blockers ya kamata a ɗauka. Don matsalolin koda, ana yin hemodialysis.
Ya kamata a lura cewa tsarin kulawa guda ɗaya don hauhawar ƙwayar cuta ba ta wanzu. Wasu magunguna daga cikin jerin magungunan da aka bada shawarar don asalin cutar cutar suna contraindicated a lokuta na cuta daga:
- kwakwalwa;
- koda
- magudanar jini.
Misali, an hana masu hana ruwa gudu a cikin jijiyoyin jini wanda ke haifar da hauhawar jini. Beta-blockers ba za a iya tsara shi don mummunan nau'ikan arrhythmia ba, lokacin da asibitin ke haɗuwa da mummunar rikicewar ƙwayar zuciya, coarctation na aorta.
Hada magani tare da yin amfani da magunguna na ƙungiyoyi daban-daban ana nuna su don barkewar tashin hankali, hauhawar jini na kowane jijiyoyin jini, hauhawar jini.
Don cimma daidaituwa game da sautin jijiyoyin jini na kwakwalwa, haɓaka ƙa'idodin ayyukan jijiyoyi, likitoci suna ba da ƙananan allurai na maganin kafeyin, Cordiamine. Ana ɗaukar ma'ana da safe, lokacin da hauhawar jini ke da matakin ƙarancin yanayi.
An zaɓi hanyar kulawa don kowane mai haƙuri, zaɓin an yi shi ne ta hanyar haɗin gwiwa na ƙwararren likitan ƙwaƙwalwa, likitan zuciya, likitan tiyata da endocrinologist. Yana da mahimmanci a hankali la'akari da zaɓin sashi na magunguna, wannan gaskiya ne ga tsofaffi marasa lafiya.
Sharparancin raguwa a cikin alamomin matsin lamba zai haifar da cin zarafin maƙarƙashiya, jijiyoyin jini da kuma zagayawa koda.
Rashin tsinkaye, matakan matakan rigakafin rikice-rikice
Zai yuwu ku dogara ga cikakkiyar kawarda hauhawar jijiyoyin jijiyoyin jini wanda aka bayar da cewa dalilinsa ya lalace a lokaci. Prolongara yawan jini a cikin haɓakar jini yana haifar da ci gaba da ci gaban arteriosclerosis, kuma tsarin aikin koda yana shiga cikin pathogenesis. A wannan yanayin, akwai yiwuwar saba tsarin yanayin yana da shakka.
Idan ba a iya samun murmurewa ba, ci gaban ya dogara da tsananin yanayin cutar, tsayayya da magungunan antihypertensive, halayen cututtukan da ke tattare da cutar, da kuma lafiyar masu ciwon suga.
Matakan rigakafin cutar hauhawar cututtukan cuta suna saukowa da rigakafin cututtukan da ke tattare da shi. Wani muhimmin mahimmanci shine kulawa na lokaci na mummunan pyelonephritis, glomerulonephritis, atherosclerosis. Idan babu ingantaccen magani, waɗannan cututtukan suna zama tarihi.
Ana ba da bayani game da hauhawar ƙwayar cuta a cikin bidiyon a cikin wannan labarin.
