Yog tias tus neeg mob nyob hauv qhov tshwj xeeb tshaj yog mob hnyav thiab qib siab ntawm atherosclerosis ntawm qis qis dua yog kuaj, qee qhov tsis muaj lwm txoj kev tawm nyob rau hauv kev kho mob zoo li txiav tawm ntawm qhov qis qis.
Obliterating atherosclerosis ntawm qis dua yog qhov muaj mob ntsig txog vascular ntawm nruab nrab thiab loj caliber, kev loj hlob tshwm sim los ntawm kev sib txuam ntawm lub cev ua haujlwm ntev thiab ua rau muaj kev puas tsuaj rau phab ntsa arterial, thaum tsis muaj kev kho kom zoo ua rau muaj teeb meem thiab xiam oob khab.
Cov laj thawj rau kev txhim kho atherosclerosis NK
Muaj ntau qhov laj thawj ntawm kev loj hlob ntawm atherosclerotic hloov hauv cov hlab ntsha ntawm nqua.
Cov laj thawj uas ua rau kev txhim kho atherosclerosis tuaj yeem faib ua ob pawg.
Cov pab pawg ntawm cov ua rau yog qhov ua rau muaj kev nce qib hauv tag nrho cov roj (cholesterol) thiab nws cov feem ntshav ntawm ntshav ntshav thiab yam uas nws ua rau kev puas tsuaj rau lub cev ntawm cov hlab ntsha.
Thawj pawg muaj xws li:
- Cov hauv paus hauv feem ntau ua rau cov roj (cholesterol) tsis ua raws li kev noj haus kom yog - noj ntau ntawm cov tsiaj rog thiab cov zaub mov muaj roj ntau ntau, thiab cov zaub mov kib hauv cov roj ntau, haus luam yeeb, qab ntsev thiab cov khoom noj ceev. Ntawm qhov tseem ceeb yog qhov txo qis hauv kev noj haus ntawm cov khoom siv fiber ntau - zaub ntsuab, txiv hmab txiv ntoo, zaub mov thiab legumes, tsis ua raws li cov cai haus, kev siv ntau ntawm cov dej qab zib, kas fes, tshuaj yej.
- Kev tswj hwm ntawm tsev neeg kuj tseem ceeb - ob qho tib si rau cov kab mob ntawm cov hlab plawv, kev rog rog, mob metabolic syndrome, lwm yam endocrine pathologies, thiab rau tsev neeg dyslipidemia, homocysteinemia, thiab lwm yam kab mob ntawm cov zaub mov tsis zoo.
Cov laj thawj ntawm pawg thib ob xam nrog:
- tus cwj pwm tsis zoo - haus cawv ntau dhau thiab haus luam yeeb cuam tshuam rau sab hauv txheej ntawm lub nkoj phab ntsa, rhuav tshem nws cov qauv thiab tsim cov kev mob rau kev txuas ntawm cov roj atheromatous thiab cov ntshav txhaws;
- tsis muaj kev qoj ib ce - nrog rau kev qoj ib ce qis thiab kev ua neej nyob rau sedentary, muaj ib qho kev xav ua kom cov ntshav hauv cov hlab ntsha ntawm qhov qis qis, nce siab hauv lawv thiab kuj ua rau mob endothelium;
- kev siv dag zog ntau dhau ntawm lub cev, ua haujlwm nyuaj - ua rau microtrauma ntawm cov leeg ntawm cov ceg thiab, raws li, lawv cov hlab ntsha, tsim cov xwm txheej rau kev txhim kho cov plahaum cov plahaum;
- kev raug mob thiab txo qhov mob siab tshaj plaws ntawm qhov kawg - ua rau mob ntshav khov hauv thaj chaw puas ntawm ob txhais ceg, ischemia;
- qhov pib ntawm atherosclerosis cuam tshuam los ntawm cov kab mob concomitant pathologies - cov kab mob thrombotic lossis thromboembolic, kev siv qee yam tshuaj - ua ke ntawm qhov ncauj tiv thaiv kab mob, glucocorticosteroids.
Lwm yam ua rau muaj hnub nyoog (vascular elasticity txo rau cov neeg laus) thiab poj niam txiv neej (feem ntau tus kab mob loj hlob hauv txiv neej, vim tias cov poj niam txiv neej cov tshuaj hormones muaj kev tiv thaiv ntawm endothelium).
Hom mob txhab thiab tsos mob
Feem ntau feem ntau, cov kev mob vascular yog nrhiav tau - ib nrab lossis stenosis - lub cheeb ntawm txoj hlab ntshav tsis tau tag nrho. Nyob rau tib lub sijhawm, cov ntshav ntws tsis yooj yim, tsis ua rau muaj kev mob tshwm sim thiab cov tsos mob tseem ceeb, yog yooj yim yooj yim rau kev kho txoj kev kho.
Qhov thib ob hom - occlusion - lub lumen thaiv los ntawm ntau dua li ib nrab, cov ntshav ntws los tsis muaj peev xwm lossis tsis tuaj kiag li, ua rau muaj ntau cov tsos mob pheej tshwm sim thiab muaj teeb meem, xav tau kev kho mob phais, thiab tuaj yeem ua rau neeg xiam oob khab.
Cov tsos mob ntawm obliterating atherosclerosis ntawm qis qis yog ntau yam thiab nyob ntawm qhov ntsuas ntawm kev muaj mob.
Cov tsos mob tshwm sim feem ntau yog:
- Kev ua kom muaj zog thiab tsis xis nyob ntawm txhais ceg, txhawm rau mob, tom qab kev tawm dag zog lub cev, taug kev ntev.
- Ua txhaum ntawm thermal rhiab heev - ib qho kev xav paub qhov tseeb ntawm lub taw txias.
- Kev ua txhaum ntawm tactile thiab mob rhiab ntawm thaj chaw puas.
- Taug kev nyuaj, thaum muaj kab mob atherosclerotic plaque nyob rau ntawm qhov chaw ntawm aortic bifurcation ntawm tus cwj nrag hlab ntsha - ntu claudication.
- Qhov mob caj dab - los ntawm qhov pom ntawm qhov mob ntawm lub plab hlaub lossis femoral cov leeg tom qab kev tawm dag zog lossis taug kev ntev, khiav mus rau qhov mob tas mus li, txawm tias thaum so lossis thaum tsaus ntuj. Vim yog qhov xwm txheej ntawm qhov mob hauv atherosclerosis, feem ntau yog npub tas li, tsis khaus, tuaj yeem nce ntxiv thaum tawm dag zog lub cev.
- Kev ua txhaum ntawm trophism ntawm daim tawv nqaij thiab nws qhov tshwm sim, cov leeg - ua kom tawv nqaij thiab qhuav ntawm daim tawv nqaij, qhov hloov pauv ntawm nws cov xim (los ntawm daj ntseg thaum pib ntawm tus kab mob rau ntshav thiab dub nrog tsim ntawm gangrene thiab cov nqaij necrosis), cov plaub hau poob hauv thaj chaw cuam tshuam, tuab, ntsia hlau, mob caj dab, ncua kev kho mob ntawm qhov txhab ntawm daim tawv nqaij ntawm tus taw, qhov tsim ntawm qhov mob txhab thiav, necrosis ntawm daim tawv nqaij thiab cov nqaij mos.
Lub hom phiaj ntawm kev mob ntshav ntawm ob txhais ceg yog qhov tsis muaj mem tes hauv qhov kev tsis txaus ntseeg distal - popliteal, txoj hlab ntsha ntawm pob taws, thiab ncej puab. Cov tsos mob no yog tshwj xeeb tshaj yog rau kev pib kuaj mob thiab kev ntsuas tus kheej ntawm atherosclerosis.
Qib ntawm Atherosclerosis NK
Tus kab mob yog faib raws cov theem uas cov kev sib tw ntxiv ntawm kev kho nyob ntawm - kev xaiv ntawm tus kws kho mob lossis kev txuag ua haujlwm, lossis kev siv cov txheej txheem phais mob.
Thawj qib raug txheeb xyuas thaum mob mob tsuas yog tshwm sim tom qab kev tawm dag zog lub cev, taug kev qhov deb ntawm ntau dua 1 km yog tsis mob. Nyob rau theem no, tus neeg mob xav tau kev saib xyuas kom zoo - kev hloov kho ntawm txoj kev ua neej, thiab rau kev ntsuas - kev kho tshuaj.
Qhov theem thib ob yog pom qhov txo qis hauv lub siab rau kev qoj ib ce, qhov tshwm sim ntawm qhov mob hauv cov leeg ntawm ob txhais ceg thaum taug kev ntawm qhov deb ntawm 250 meters txog 1 kilometer. Rau cov neeg mob zoo li no, txoj kev kho mob muaj nyob rau hauv txoj kev siv tshuaj tsis yog tshuaj yeeb thiab tshuaj.
Qeb thib peb yog qhov kev ncua deb ntawm kev taug kev mob tsis nrawm ntawm 50 txog 250 metres, lwm cov tsos mob tshwm sim - trophic, hnov qhov tsis hnov, mob kuj tseem muaj peev xwm ua thaum hmo ntuj thiab thaum so. Rau cov neeg mob zoo li no, nws yog ib qhov tsim nyog los ua ke ntawm txoj kev kho mob thiab siv tsawg tshaj plaws ntawm kev phais mob.
Qeb plaub muaj tag nrho cov yam ntxwv ntawm tus thib peb, tab sis yog ntxiv los ntawm qhov tshwm sim ntawm ischemic cov kev mob - trophic mob rau, mob caj pas. Raws li txoj cai, txoj kev kho mob phais yog siv rau cov neeg mob zoo li no, txij li theem no txoj kev pheej hmoo ntawm tus neeg mob nrog kev siv tsis raws cai thiab kev kho mob tsis txaus.
Kev kuaj mob ntawm atherosclerosis ntawm qis qis dua
Thawj kauj ruam hauv kev kuaj mob yog keeb kwm ntawm lub neej (yav dhau los thiab mob ntev, kev khiav haujlwm, kev raug mob, tsev neeg nyiam, kev ua neej, khoom noj khoom haus, tus cwj pwm tsis zoo).
Keeb kwm ntawm tus kabmob kuj tseem ceeb (pib, yam tshwm sim tuaj, thawj tus tsos mob, sijhawm ntawm tus kabmob, nws txoj kev txhim kho, kev kho yav dhau los, nws cov txiaj ntsig).
Cov hau kev nram qab no yog nyob ntawm yeem, xav tau los tshawb kom paub tseeb.
Cov no suav nrog kev kuaj sim:
- Ua kom tiav cov ntshav suav, tso zis tso zis dav dav.
- Cov piam thaj hauv ntshav (kuaj ntshav qab zib thiab tshem tawm cov ntshav qab zib ua kom muaj ntshav qab zib).
- Kev kuaj ntshav biochemical - txiav txim siab lipid spectrum (qib ntawm cov roj cholesterol tag nrho, cov lipoproteins ntau thiab qis tsis txaus, triglycerides), mob siab (AlAT, AcAT, alkaline phosphatase kuj tseem ceeb - statins yog contraindicated nrog rau kev nce hauv cov tsis xws luag) thiab kuaj raum (creatinine, urea).
Kev kuaj mob zaum kawg yog txiav txim siab tom qab ntxiv cov txiaj ntsig kev tshuaj xyuas tau ua uas tso cai rau koj los txiav txim siab theem ntawm kev puas tsuaj, qhov txoj kab uas hla ntawm lub patency ntawm lub nkoj thiab txawm pom lub ntshav ntws.
Cov no suav nrog:
- angiography yog ib qho ntawm kev yooj yim thiab pheej yig tshaj plaws rau kev kuaj mob, raws li kev taw qhia ntawm kev xoo hluav taws xob xoo neeg sawv cev mus rau cov hlab ntsha thiab X-ray duab ntawm nqaj;
- multispiral xaj tomography thiab cov duab sib nqus resonance yog cov kev tshawb fawb cov ntaub ntawv uas pab ua kom pom qhov theem ntawm vascular kev cuam tshuam;
- duplex ultrasound scanning yog cov txheej txheem kub rau kev kuaj mob ntawm obliterating atherosclerosis, ua rau nws ua tau kom taug qab ntshav ntws los ntawm thaj chaw puas, ua kom pom tseeb cov hlab ntsha hauv pob ntseg.
Tsis tas li ntawd nyob rau hauv cov txheej txheem kev kuaj mob suav nrog ntsuas kev ntsuas ntshav ntawm caj npab thiab txhais ceg, suav nrog lub pob luj taws-sab hluav taws xob.
Kev kho tus qauv rau atherosclerosis ntawm qis qis
Kev kho yog nyob ntawm cov tsos mob ntawm tus kabmob, nws theem, thiab suav nrog kev hloov kho ntawm tus neeg mob txoj kev ua neej, kev noj tshuaj thiab kev phais mob.
Kev kho mob ntawm cov theem thaum xub thawj tuaj yeem ua tau txhawm rau txhawm rau, tus neeg mob tau txais kev pom zoo rau kev noj zaub mov, ua si lub cev ib nrab, thiab saib xyuas ko taw.
Kev noj zaub mov rau kev kho kab mob atherosclerosis yuav tsum muaj qhov sib npaug, nrog rau kev suav nrog kev noj zaub thiab txiv hmab txiv ntoo, zaub mov, zaub mov tsis muaj roj ntau yam ntawm cov nqaij thiab ntses, kev noj haus zoo txaus.
Raws li cov peev txheej ntawm protein, nqaij qaib nqaij, nqaij ntses uas tsis muaj rog, legumes, kua taum, nqaij qaib qe protein yog tsim nyog.
Cov khoom noj muaj rog yog cov tsis suav nrog - sausages, pastes, yolks, cov khoom noj ceev, cov zaub mov yooj yim.
Kev saib xyuas ko taw kom zoo kuj tseem ceeb - kom tsis txhob muaj lub siab ntev, hnav kom xis nyob, tsis txhob nyob ze, lossis cov khau zoo nkauj yog tias ua tau, txhawm rau nqa cov kev taug ko taw, kho cov qhov txhab me me ntawm daim tawv nqaij nrog kev siv tshuaj tiv thaiv kab mob.
Nws kuj raug nquahu kom siv cov dej da dej sib xws nrog kev ntsaws tshuaj ntsuab los yog ntsev, zaws.
Hauv Is Taws Nem koj tuaj yeem pom kev tshuaj xyuas zoo txog pej xeem cov tshuaj rau kev kho mob, cov no suav nrog roj pleev cov tawv nqaij nrog txiv ntseej lossis roj hiav txwv buckthorn roj, decoctions ntawm roob tshauv lossis dill. Tab sis nws yuav tsum nco ntsoov tias nws yog ib qho tsim nyog yuav tsum tau siv xws li cov zaub mov txawv hauv kev sib xyaw nrog lwm txoj kev kho mob thiab tsis muaj contraindications.
Kev kho tshuaj atherosclerosis:
- Cov kab mob hypolipidemic - Atorvastatin, Rosuvastatin, Simvastatin, fibrates, nicotinic acid.
- Antispasmodics - Tsis-shpa, Drotaverin, Papaverin.
- Cov tshuaj vasoactive - Vazoprostan, Trental, Curantil, Cilostazol.
- Cov tshuaj tiv thaiv kab mob thiab anticoagulants - Aspirin, Cardiomagnyl, Magnikor, Fraksiparin, Heparin, Enoksiparin, Clopidogrel.
Ntxiv rau, kev kho vitamin thiab lub cev siv dag zog yog siv hauv cov txheej txheem kho.
Kev kho kab mob atherosclerosis
Txhawm rau rov qab los ntshav ntshav hauv thawj thiab theem thib ob, kev ua haujlwm qoj ib ce tsawg kawg yog siv - stenting, bypass phais, zais pa angioplasty, thrombendarteriectomy, angioplasty nrog ntxiv alloprosthetics lossis autoprosthetics.
Rau kev kho mob ntawm qib peb thiab plaub theem ntawm atherosclerosis, kev kho nyuaj yog siv, uas suav nrog cov lus qhia dav dav ntawm txoj kev ntawm lub neej thiab kev noj haus, kev kho tshuaj thiab phais mob.
Rau cov neeg mob uas muaj ischemia tseem ceeb, nws tsis tuaj yeem ua qhov kev phais me me, vim tias cov ntshav ntws tau yog qhov cuam tshuam, thiab kev hloov tsis tau ischemic thiab necrotic hloov tshwm sim.
Qee zaum tsuas yog txoj kev tawm hauv cov xwm txheej zoo li no, nyob rau hauv qhov muaj ntau ntawm cov kua nqaij necrotic, kev puas tsuaj tsis tsuas yog muag muag tab sis kuj ua rau cov nqaij mos pob txha, yog qhov txiav ntawm qhov chaw muaj kev cuam tshuam.
Qhov no yog ib txoj haujlwm qub tshaj plaws hauv kev phais mob, nws lub ntsiab lus yog tshem tawm ib feem ntawm qhov povtseg raws tus pob txha, txiav tawm ntawm qhov qis qis nrog atherosclerosis tsuas yog siv nyob rau hauv qhov xwm txheej uas tsis tuaj yeem txuag lub cev nqaij.
Nyob ntawm theem ntawm vascular occlusion thiab kev hloov pauv ntawm thaj chaw nyob ib sab, siab thiab qis txiav tawm yog txawv.
Kev txiav tawm siab yog hu ua thaum lub hleb txiav tawm saum toj ntawm lub hauv caug, qis - nrog rov kis ntawm cov ntiv tes, ko taw, sab ceg qis.
Kev txiav tawm kuj muab faib ua thawj thiab theem nrab.
Kev taw qhia rau kev siv - ua tiav vascular occlusion, nrog rau mob hnyav, tsis muaj txiaj ntsig los ntawm kev kho txoj kev kho kom zoo, hloov necrotic ntawm daim tawv nqaij thiab cov leeg.
Kev phais mob radical tiv thaiv qhov tshwm sim ntawm cov teeb meem - sepsis, kev kis tus kab mob thib ob ntawm lwm yam kabmob.
Nws yuav tsum nco ntsoov tias tom qab txiav tes txiav taw, kev kho mob ntawm qib no tsis xaus, txij li atherosclerosis feem ntau ua tiav multifocal, thiab tsis ntev cov xwm txheej nrog cov ntshav tsis txaus yuav rov muaj dua.
Tom qab radical kev phais mob, kev ntsuas rov qab yog qhov tsim nyog - kev hla dhau kev phais lossis stenting, prosthetics ntawm qhov muab tshem tawm sib koom ua ke.
Kev tiv thaiv ntawm kev ua kom lub cev atherosclerosis muaj kev tswj xyuas lub cev, tswj kev noj zaub mov kom zoo, txiav kev haus luam yeeb thiab dej cawv, kuaj xyuas cov roj (cholesterol) thiab lwm cov lipid feem, ntshav siab, kev kho mob kom sai.
Yuav kho tus mob atherosclerosis li cas tau piav qhia hauv cov yeeb yaj kiab hauv tsab xov xwm no.
