Atherosclerosis na jiragen ruwa na ƙananan ƙarshen cuta cuta ce mai ƙwanƙwasawa wacce ke tattare da haɓakar ƙwayoyin cholesterol a saman ciki na membrane na arteries wanda ke samar da ƙananan gabobin.
Yana ci gaba mafi girma a cikin balagaggu (shekaru 60-75), kuma yana haifar da lalata lalata kyallen takarda mai laushi.
Sanadin atherosclerosis na ƙananan sassan
A cikin jijiyoyin jijiyoyin jijiyoyin jijiyoyi masu tasowa saboda tsawan tsohuwar ƙwayar cuta da sauran dalilai, an samar da adibas na ƙwararrun atheromatous da nama mai haɗuwa.
Ya danganta da girman da tsarin kwafin cholesterol, cin zarafin jirgin ruwa da raguwar ƙwayar fata mai laushi saboda ischemia.
A kwana a tashi, filayen kwanuka suna karawa, yanayin ragewar hanji yana ƙaruwa.
Baya ga rage diamita na jijiya wanda ya shafa, ana rarrabe bayyanannun cututtukan cutar: stenosis, ko cikakkiyar ƙarancin lumen; tsinkaye (cikakkiyar toshe hanyoyin jijiyoyin jini), ko kuma shafe atherosclerosis.
Babban abubuwanda ke haifar da atherosclerosis na ƙananan sassan:
- Cututtukan rikice-rikice na tsarin zuciya da jijiyoyin jini (cututtukan zuciya da jijiyoyin jini, hauhawar jini).
- Halin gado na hyperlipidemia da atherosclerosis (familial dyslipidemia), hyperfibrinemia, monocytosis, homocysteinemia.
- Halaye mara kyau - yawan shan giya da shan sigari.
- Take hakkin abinci - cin abinci mai yawa na dabbobi da sunadarai, abinci mai inganci a cikin cholesterol, sakaci da kayan shuka.
- Cututtukan Endocrin, kamar su guda biyu na ciwon sukari mellitus, hypothyroidism (isasshen samar da hormones thyroid), cututtukan metabolism, kiba, Cutar Hisenko-Cushing. Kiba da kiba mai yawa suna haifar da karuwa a ƙananan ƙafafun.
- Activityara yawan motsa jiki yana haifar da karuwar matsin lamba a cikin jijiyoyin wuya.
- Adearancin aiki na jiki - yana haifar da take hakkin hemodynamics da ischemia nama.
- Kwayar cuta mai rikice-rikice - varicose veins, ciwon sukari macroangiopathy ko microangiopathy.
- Pathology na pelvic gabobin, watau thrombosis da thromboembolism na jijiyoyin ƙashin ƙugu.
- Rushewar Hormonal da isasshen samar da estrogen saboda menopause kuma suna haifar da hauhawar cholesterol da gabobinta.
- Raunin raunin da tsananin sanyi na ƙarshen - yana haifar da canje-canje na jiki a cikin tsarin laushi da kasusuwa ƙasusuwa.
- Halin damuwa da hauhawar jini.
Sanadin ci gaba da cutar na iya zama canje-canje da suka shafi shekaru (a cikin tsofaffi, da yawaitar jijiya yana raguwa, har ma da adadi kaɗan na cholesterol na iya rage tasirin jini),
Jinsi ya kuma taka rawa wajen ci gaban cutar.
Mafi sau da yawa, atherosclerosis yana tasowa a cikin maza, tunda a cikin kwayoyin jima'i na mata suna da tasirin kariya a jikin bangon jijiyoyin jini,
Fassarar wuraren da abin ya shafa
Fassarar yankin da cutar ta shafa har zuwa wani babban yanki yana shafar yawan ci gaban cutar da kuma tsananin sakamakon.
Ci gaban cutar na iya faruwa a wurare da dama na ƙananan ƙarshen.
Dangane da wurin, an bambanta nau'ikan cututtukan tarihin.
Wadannan nau'ikan atherosclerosis na ƙananan sassan ana rarrabe su:
- atherosclerosis na sassan aorto-iliac;
- shan kashi na rukunin yanar gizo na femasin-popliteal;
- ilimin halin da ake ciki a cikin yanki na popliteal-tibial kashi.
- cirewar yankin kafa;
- lalata lalataccen jijiyoyin jiki.
Hakanan, ya danganta da matakin takaitaccen tsinkayen jirgin, atherosclerosis na jijiyoyin guntun kafa ya kasu kashi biyu, tare da cirewar kashi sama da 50% na lumen, kuma ba a goge ba, tare da rage kadan.
Alamar halayyar halayya da matakai
Cutar na iya bayyana kanta da alamu daban-daban.
Bayyanar cutar ta dogara da matakin ci gaban, shafin da girman lalacewar jijiyoyin jiki.
Gunaguni na farko na iya zama gajiya na ƙafa yayin tafiya, zafi na lokaci-lokaci a cikin tsokoki, sanyaya ƙafa.
A tsawon lokaci, sauran alamun ci gaba:
- Take hakkin zazzabi da azanci ji na fata na kafafu da ƙafa, ƙamƙansu.
- Rashin rikicewar ƙwayar cuta - pallor ko ƙyalli na fata, bakin sa, bushewa, asarar gashi, fitarwar ko ƙusoshin ƙusoshin. Tare da ischemia mai mahimmanci da tsawan lokaci, rauni na trophic ulcers da gangrene suna haɓaka.
- Gudanarwa tare da ƙwayar jijiya, wanda zai haifar da lalata ƙafa, mafi yawan lokuta da dare.
- Raunin ciwo yana bayyana - daga m zuwa mai tsanani har a hutawa. A matsayinka na mai mulki, zafi yana ƙaruwa yayin tafiya.
Wata alama ta pathognomonic don cutar atherosclerosis ta rushewar ƙananan ƙarshen shine bayyananne.
Dogaro da lalata, an rarrabe matakai da yawa na lalacewar hannu, babban shaci shine nesa na tafiya mara jin zafi.
A matakin farko, mai haƙuri na iya tafiya sama da kilomita ɗaya a ci gaba, jin zafi yana faruwa tare da gagarumar ƙoƙarin jiki.
Mataki na biyu "A" ana bayyanar da bayyanar zafin lokacin tafiya a nesa daga nisan mita 250 zuwa kilomita ɗaya, na biyu “B” - daga mita 50 zuwa 250.
Mataki na uku - ischemia mai mahimmanci - ana nuna shi ta hanyar raguwa a cikin nisa na tafiya mara jin zafi ƙasa da 50 m, bayyanar ƙarin alamun, zafin ya ci gaba har ma da hutawa.
Mataki na huɗu yana haɗuwa da alamun cutar ta uku kuma ƙarin rikicewar trophic sun bayyana, har zuwa ƙarshen ta'addancin.
Hanyoyin bincike na asali
Binciken cutar ta samo asali ne daga koke-koke na mai haƙuri, bayanai kan tarihin likita (lokacin da alamomin suka fara bayyana, yanayin su, tsawon lokaci, yawan faruwar lamarin, shin mai haƙuri yana danganta cutar tare da wasu abubuwan - trauma, hypothermia), tarihin rayuwar (cututtukan da suka gabata, halayyar iyali zuwa hauhawar jini, angina pectoris, kasancewar atherosclerosis na wani wuri daban).
Hakanan, don ganewar asali, bayani game da binciken ƙima yana da mahimmanci, shine, yanayin fata da abubuwan ƙaƙa, kyallen takarda da tsokoki na ƙafafu, bugun jini a kan tasoshin ƙafafun ƙafa da ƙafa. Hakanan suna amfani da gwaje-gwaje na bincike tare da kaya, alal misali wannan: daga matsayi mai sauƙi, mai haƙuri yana buƙatar ɗaga ƙafafunsa da digiri 45 kuma riƙe shi na ɗan lokaci. Pro atherosclerosis yana nuna saurin fara gajiya, pallor na wata gabar jiki.
Daga cikin ƙarin hanyoyin bincike, ana amfani da hanyoyin asibiti gaba ɗaya - ƙidaya jini gaba ɗaya, urinalysis na gaba ɗaya, glucose jini (don ware ciwon sukari), nazarin halittu na jini tare da ƙuduri na jimlar cholesterol (yawanci har zuwa 5.5 mmol a kowace lita), ƙarancin lipoproteins (atherogenic), lipoproteins babban yawa (ƙwararren anti-atherogenic), nazarin hormonal - matakan hormones thyroid, hormones na jima'i.
Ana amfani da hanyoyi na yau da kullun - ana amfani da tushen arteries, auna matsin lamba tare da ƙudurin ƙoshin gwiwar gwiwa, angiography, majio resonance Magnetic, angiography multispiral, angioiografin yanki, zane-zane na duplex (US) na arteries.
Jiyya yana dogara da tsananin yanayin, yanayin raunin, ƙaruwar, matakin cutar, ya ƙunshi gyare-gyare na rayuwa, tasirin magani da magani na tiyata.
Gyara yanayin rayuwa tare da atherosclerosis na ƙananan ƙarshen
Mataki na farko a cikin lura da cutar atherosclerosis yana farawa nan da nan bayan ganewar asali kuma ya ƙunshi gyaran hanyar rayuwa.
Wannan ya hada da abinci ko abinci na likita, kin yarda da munanan halaye, tsari na aiki.
Abincin abinci ko warkewa shine farkon matakin kulawa da kusan dukkanin cututtukan zuciya, tunda yawan mummunan cholesterol a cikin jini da hawan jini ya dogara da abincin mutum.
Likitocin sun ba da shawarar bin abincin da ake yin rigakafin ƙwayoyin cutar atherogenic in ban da kitsen dabbobi da furotin, abinci mai wadatar cholesterol - man alade, abubuwan gona, ƙwai na kaza, sausages. Tushen ƙwayar fiber ya kamata ya fi dacewa a cikin abincin - kayan lambu kore (salads, kabeji, zucchini, broccoli), 'ya'yan itãcen marmari, hatsi da kayan lemo (a matsayin tushen hadaddun carbohydrates da furotin kayan lambu), kwayoyi (a matsayin tushen ƙoshin mai mai lafiya).
A matsayin tushen furotin, kaji (kaza, kaji, dabbar kwalliya), kifi (nau'in mai mai), da kayan kiwo an yarda dasu. Yana da mahimmanci a lura da tsarin shan giya - 30 zuwa 50 milliliters na tsabtataccen non-carbonated ode a kilo kilogram na nauyin jikin, ruwan carbonated mai dadi ya kamata a cire shi gaba ɗaya. Hakanan kuna buƙatar barin kayan abinci da sauri, abinci mai dacewa, kyafaffen, abinci mai zurfi, gwangwani da kayan dafa abinci.
Babban mahimmanci shine ƙin halaye marasa kyau - shan barasa, shan taba.
Ayyukan jiki a farkon cutar na iya tasiri sosai kan cutar. Kuna iya farawa tare da tafiya na yau da kullun na minti 30-60, tsere, motsa jiki akan keɓaɓɓun keke, yin iyo. Yana da kyau a hankali kara nauyin a kan lokaci, la'akari da alamun cutar, matakin ƙuntatawa motsi.
Kulawa na ƙafa yana da mahimmanci ga marasa lafiya - tsabtace kullun, ingantaccen shinge, lura da raunuka da sauran raunin da ya faru tare da wakilai na maganin cututtukan fata.
Amfani da magani
Mataki na gaba a magani shine gyaran likita na alamun da ke tashi a cikin haƙuri. Da zaran kun fara jiyya, ƙarin rikice-rikice na atherosclerosis zaku iya hanawa kuma ƙarami lalacewar ƙashin ƙafa.
Magunguna na farko a cikin jiyya da rigakafin atherosclerosis na kowane wuri sune statins - Atorvastatin, Lovastatin, Rosuvastatin. Suna shafar metabolism na cholesterol da kuma hanta da hanta, suna rage adadinta a cikin jini. Hakanan, rage adadin lipoproteins a cikin jini yana ba da fibrates, nicotinic acid, probucol.
Yi amfani da wakilan antiplatelet - Aspirin, Cardiomagnyl, Magnikor, Thrombo-Ass, waɗannan kwayoyi suna shafar mahaɗan atheromatous da tarin platelet a cikin wuraren da aka lalace na endothelium. Idan babu contraindications (peptic ulcer of ciki ko duodenal miki, cutar jini, rashin haƙuri a cikin mutum), shawarar da aka sha na yawan asfirin shine 75ig milligrams 75-10 a kowace rana don rigakafin rikitarwa na thrombotic.
A gaban rikitarwa na thrombotic a cikin anamnesis da cututtukan da ke hade da tsarin jini tare da raunin hypercoagulation, yana da kyau a yi amfani da maganin anticoagulants - Warfarin, Heparin, Fraxiparin.
Adadin aikin kulawa ya hada da magungunan vasodilator - antispasmodics No-spa, Drotaverin, Papaverine, magungunan vasoactive Vazoprostan, Trental, Agapurin.
Don rage bayyanar cututtuka da rage ciwo, ana amfani da Pentoxifylline, Cilostazole; don inganta haɓakar trophism a cikin kyallen takarda mai laushi - Zincteral.
Ana nuna magani na gida don haɓakar rikice-rikice na cututtukan fata da cututtukan trophic; Oflokain, Levomekol, maganin shafawa na Delaskin ana amfani da su.
Bugu da ƙari, ana amfani da hadaddun bitamin, magani na ilimin lissafi - electrophoresis tare da novocaine ko lidocaine, darsonvalization.
Wajibi ne a bi da ba kawai atherosclerosis ba, har ma da cututtukan haɗin gwiwa (hauhawar jini, angina pectoris, ciwon sukari mellitus) da rikitarwa.
Hanyoyin tiyata
Zaɓin da amfani da hanyar tiyata ta likita ne, ana yin la’akari da manyan dalilai.
Jiyya na tiyata ya zama dole idan akwai cuta mai wahala, juriya ga magani ko rashin yarda da shi.
Interventionarar da aikin tiyata ya dogara da batun cutar rauni, matakin ƙarar jirgin ruwa, kasancewar cututtukan trophic na fata da laushin taushi, da rikitarwa na atherosclerosis.
Akwai nau'ikan nau'ikan ayyukan:
- Kewaya tiyata wani karamin rauni ne na wucin gadi, asalinsa shine ƙirƙirar wata hanya ta zubar da jini ta hanyar keɓance yankin da abin ya shafa da dawo da ƙwayar nama ta wannan hanyar.
- Stenting shine shigowar bututu da aka yi da kayan roba a cikin ramin jirgin ruwa, wanda ke hana lumen tazara.
- Balloon angioplasty - yaduwar ƙwayar ƙwayar jijiya tare da balloon.
- Endarteriectomy - cirewar jijiyar da ya shafa tare da yawan atheromatous, tare da ƙarin aikin sujuju.
- Autodermoplasty - hanyar magani don cututtukan trophic, ya ƙunshi maye gurbin fatar da abin ya shafa da fatar mai haƙuri da kansa, wanda aka karɓa daga wasu shafuka.
- Tare da haɓaka rikitarwa, irin su gangrene, ana amfani da yanki na wuraren necrotic da ƙafar roba.
Yin rigakafin atherosclerosis ya kamata ya zama cikakke kuma yana ci gaba, gami da saka idanu akan hawan jini, saka idanu kan bayanan libul na jini, tuntuɓar likitan zuciya da likitan jijiyoyin bugun gini idan ya cancanta.
Yadda za a kula da atherosclerosis na kafafu an bayyana su a cikin bidiyo a wannan labarin.
