Atherosclerosis ntawm intracranial hlab ntsha ntawm lub hlwb yog cov feem ntau ua rau mob hlab ntsha tawg. Nws yog qhov tsim nyog tias qhov kev pheej hmoo ntawm tus kab mob nyob ntawm cov tawv nqaij tawv nqaij, cov neeg European tsis tshua muaj kev cuam tshuam cov pathology dua li cov neeg sawv cev ntawm cov neeg Asian thiab Negroid.
Qhov ua rau muaj kev ua txhaum yog muaj cov kab mob atherosclerotic plaques ntawm lub qhov ncauj ntawm cov hlab ntsha me me, cov leeg ntshav ntawm lub plawv, thiab cov ntshav lub hlwb. Qhov ntau zaus ntawm kev rov huam dua qub yog tshwm sim los ntawm qhov tsis muaj peev xwm tswj tau cov ntshav ntws ib txwm.
Pathology ua rau muaj kev puas siab ntsws hauv lub hlwb, zoo ib yam li hloov atherosclerotic rau ntawm cov hlab ntsha cov hlab ntsha. Qhov kev hem thawj cuam tshuam nrog kev mob tshwm sim, kev nruam ntej thiab kev puas tsuaj ntawm atherosclerotic plaques.
Los ntawm qhov mob hnyav, tus kab mob no yog nyob rau qhov thib ob tom qab atherosclerosis ntawm txoj hlab ntshav ntawm lub plawv. Cov tsos mob ntawm tus kabmob yog:
- nco tsis taus;
- txo qis kev xav;
- qaug zog nce.
Cov neeg mob poob kev xav ruaj khov, ua kom lub siab nyob hauv siab, nce taub hau pib, tshwj xeeb tshaj yog thaum tsiv los ntawm kab rov tav mus rau txoj hauj lwm ntsug. Cov neeg mob muaj mob hlwb loj heev, tsis sib haum xeeb hauv ncauj tsev menyuam.
Cov hau kev rau kuaj kab mob pathology
Rau kev kuaj mob ntawm atherosclerosis ntawm intracranial ntawm cov hlab ntsha, kev kuaj mob ultrasound, cov duab hluav taws xob resonance, suav tomography, digital rho tawm angiography yog qhov yuav tsum tau ua. Tus txheej txheem kub ntawm kev kuaj mob yog qhov tseeb tom kawg tus qauv, tab sis tib lub sij hawm nws yog qhov tsis zoo, yuav tsum muaj kev qhia ntawm kev sib piv hauv nruab nrab. Nws kuj tseem ua rau muaj kev pheej hmoo ntawm cov leeg tsis zoo txuas ntawm lub hlwb.
Hais txog qhov tseeb ntawm cov hau kev uas tsis tas siv cov twj kho mob thiab khoom siv, cov ntaub ntawv tsis muaj nyob. Txij li qhov pom kev ntawm lub lumen nyob ntawm ntshav txaus, qhov mob ntawm cov txhab txhab tuaj yeem cuam tshuam.
Txhawm rau tshem tawm kev puas tsuaj rau cov hlab ntsha intracranial, transcranial dopplerography, MRI tau xyaum, tab sis lawv tsis ntseeg tau txaus los kuaj pom muaj stenosis thiab tsim nws qhov mob hnyav. Dopplerography muab ib lub tswv yim ntawm lub xeev ntawm cov hlab ntsha kom txog ntsha, pab txiav txim siab cerebrovascular reactivity.
Cov txheej txheem ib txwm siv los kuaj mob txhawm rau txhawm rau txhim kho qhov hnyav ntawm txoj hlab ntsha me.
Yog li ntawd, muaj qee qhov tsis zoo, feem ntau ua tsis tau ntawm kev txheeb xyuas:
- histological qauv ntawm cov quav hniav;
- degree ntawm quav hniav tsis khov;
- lwm yam ua rau stenosis.
Nyob rau lub sijhawm no, cov duab kos cov khoom siv ntsig txog lub ntsej muag, kuaj xyuas lub plawv khoob khoob khoob tau txais cov ntsiab lus tshwj xeeb. Cov txheej txheem pab rau kawm tus kab mob nyob rau hauv ntau dua. Qhov no yog qhov tshwj xeeb tshaj yog thaum ntxov ntawm tus kabmob, thaum vascular lumen cuam tshuam me ntsis.
MRI pab ua kom pom tseeb cov ntshav txhaws, pom nws cov kev ua haujlwm hauv tebchaws, tsim kom muaj qhov muaj pes tsawg leeg, muaj cov ntshav tawm, qhov degree ntawm kev ua si ntawm cov neoplasm. Kev tshawb fawb hauv Intravascular kuj qhia cov ntshav tawm hauv cov quav hniav, nws muaj pes tsawg leeg, raws li. Cov tswv yim muab ib txoj hauv kev los cuam tshuam cov kev pheej hmoo thiab kev cai ntawm kev kho mob atherosclerosis ntawm intracranial leeg.
Kev tshawb nrhiav cov txheej txheem tshwj xeeb tshaj yog tseem ceeb rau cov hlab ntsha tawg thiab tsis ua rau cov hlab ntsha puas tsuaj, yog tias tsis tuaj yeem kuaj cov plaques vim tsis muaj cov kev kuaj mob hlwb.
Cov chaw kho mob cov tsos mob
Rau kev txheeb xyuas, cov tsos mob hauv zos ntawm tus kab mob yog qhov tseem ceeb. Yog tias tus neeg muaj mob atherosclerosis ntawm cov hlab ntsha mus rau lub medulla oblongata, nws muaj lub ntsws ua pa Cheyne-Stokes. Nrog lub caij nyoog ua rau lub chaw ua pa, cyanosis, mob leeg plab hlaub ntawm cov leeg ntawm lub ntsej muag yog pom. Poob ntawm kev hais lus, dig muag, lag ntseg, tuag tes tuag taw ntawm cov ceg ntoo kuj tseem tau.
Lub sij hawm luv luv pib ntawm cov tsos mob tshwm sim los ntawm kev hnoos qeev ntawm cov hlab ntsha ntawm lub paj hlwb, nrog tus cwj pwm tsis tu ncua, lub lumen kaw, thiab cov tshuaj ntawm cov hlab ntsha mus rau qib tom ntej ntawm tus kab mob.
Nrog arterial occlusion, lub paj hlwb tuag. Nrog kev rub tawm ntawm phab ntsa ntawm cov hlab ntsha, hemorrhage hauv daim ntaub yog kuaj mob. Thrombosis provokes kev ua txhaum ntawm lub hlwb ua haujlwm, hemorrhage ceev. Kev puas tsuaj rau cov chaw zov me nyuam tseem ceeb ua rau neeg tuag. Cov neeg mob yuav tsum saib xyuas ntawm kws kho paj hlwb thiab hlwb hlwb.
Cov phom sij txaus ntshai ntawm atherosclerosis ntawm intracranial hlab ntsha yog:
- sij hawm ischemic nres;
- ntshav siab
- mob stroke.
Stenosis ntawm nruab nrab cerebral leeg ntshav muab lacunar infarction, ischemia nyob rau thaj tsam ntawm cov ntshav nyob ib sab. Stenosis ntawm sab qaum carotid leeg yog pom los ntawm foci haib, teeb meem grey tseem koom nrog hauv cov txheej txheem pathological. Hauv qhov no, txoj hlab ntaws tsis ua haujlwm dhau los ua neeg hais lus ntau dua li mob stenosis ntawm cerebral leeg.
Ntxiv nrog rau qhov tsis hnov mob thiab lub cev muaj zog hauv cov qhov txhab ntawm lub caudate nucleus, grey teeb meem lossis thalamus, tus mob ntshav qab zib yuav muaj qhov tsis pom kev zoo. Lawv txhim kho tsis muaj lub plawv nres yog qhov tshwm sim ntawm kev txo qis ntawm lub hlwb ceusion.Qhov kev kawm asymptomatic ntawm tus kab mob tsis raug cais tawm, nyob rau hauv rooj plaub no tus kab mob pathology ua rau nws tus kheej tsuas yog tom qab pib ntawm qee yam.
Atherosclerosis ntawm intracranial hlab ntsha muaj peev xwm:
- rau kev vam meej;
- kom ruaj khov;
- mus rau regress.
Thaum tsis muaj cov tsos mob, qhov tshwm sim ntawm tus kab mob no yog ntseeg tau tias muaj kev txaus siab heev. Nrog cov plaques ntawm nruab nrab cerebral leeg, txoj kev ua haujlwm zoo tau kwv yees. Neoplasms yog calcified, yog tus cwj pwm los ntawm kev muaj peev xwm ntau ntxiv ntawm embolism. Thaum lub sijhawm kawm, cov kws kho mob txheeb xyuas qhov sib txawv ntawm cov chav kawm ntawm stenosis thiab hauv cheeb tsam.
Tau tsim cov txheej txheem ntawm kev ua rau thawj zaug mob hlab ntsha tawg, tus kws kho mob tuaj yeem kwv yees cov mechanism ntawm kev rov ua dua ntawm tus kab mob.
Feem ntau, cov kab mob atherosclerotic mob tau tshawb pom hauv nruab nrab ntawm cov hlab ntsha leeg thiab cov leeg carotid.
Kev Kho thiab Tiv Thaiv
Kev kho mob ntawm atherosclerosis ntawm intracranial ntawm cov hlab ntsha muab rau kev tiv thaiv ntawm kev rov qab mob huam sai.
Rau cov laj thawj no, kev soj ntsuam cov ntshav siab, kev ntsuas pom tseeb ntawm cov rog zoo li roj yog qhia. Kev kho qhov hnyav ntawm cov seem phom sij ntxiv yog nqa tawm: poob phaus, nce lub cev, ua lub luag haujlwm tsis zoo, tswj kev ua haujlwm ntawm glycemia. Ib qho ntxiv, kev kho mob antithrombotic yuav tsum.
Kev kho mob monotherapy nrog cov tshuaj tiv thaiv antiplatelet yog qhov zoo dua, rau kev tiv thaiv kev mob stroke rov tshwm sim thaum ntxov, ob chav antiplatelet kho yog qhia. Kev noj tshuaj suav ua ke nrog kev sib zog kho ntawm cov txiaj ntsig ua ntej.
Tau ntev, kev sim tau ua rau kev phais mob ntawm atherosclerotic stenosis ntawm intracranial cov hlab ntsha, qhov tshwm sim ntawm tus kab mob. Cov txheej txheem tshawb ntxov tshaj plaws yog daim ntawv thov ntxiv ntawm intracranial anastomosis. Txawm li cas los xij, thaum lub sijhawm tam sim no hom tsis tau dav siv.
Ntau zaus, ntau cov qauv kev kho mob niaj hnub no tau coj los siv:
- cov kev cuam tshuam endovascular siv lub zais pa angioplasty nrog stenting;
- zais pa angioplasty.
Kev phais mob ib txwm muab cov txiaj ntsig zoo, qhov yooj yim yooj yim rau nruab. Ntxiv mus, hauv qee kis, kev xaiv yog muab rau kev kho mob.
Hauv tshuaj asymptomatic atherosclerosis, kev tiv thaiv thawj ntawm cerebral ischemia yuav tsum tau nqa tawm, suav nrog kev cuam tshuam txog kev pheej hmoo. Txij li thaum muaj qhov ntxim nyiam ntawm kev muaj mob ntawm atherosclerotic lesions, nws yog qhov yuav tsum tau soj ntsuam qhov mob ntawm cov hlab ntsha tsawg kawg ib zaug txhua ob xyoos.
Stenosis ntawm intracranial cov hlab ntsha tau nyaij tawm tsam keeb kwm ntawm dysregulation ntawm cerebral ntshav txaus, qhov tsim ntawm thaj chaw ntawm qis perfusion. Cov neeg mob zoo li no yuav tsum tau sau tshuaj noj uas muaj teebmeem:
- neurotrophic;
- antihypoxic;
- metabolic.
Actovegin muaj cov yam ntxwv no, nws muaj daim qhia txog kev nyab xeeb.
Cov kev tshawb fawb tau qhia txog qhov ua tau zoo ntawm Actovegin thaum kho cov neeg laus laus uas muaj kev dementia tsis tshua mob pes tsawg, suav nrog vascular etiology. Kev kho yog nrog nrog kev txhim kho tseem ceeb hauv tus cwj pwm ntawm tus cwj pwm, cov txiaj ntsig ntawm kev tshawb nrhiav neuropsychological.
Actovegin muaj qhov cuam tshuam zoo rau kev saib xyuas, lub cim xeeb, txhim kho cov kev mob hlwb ntawm cov ntshav qab zib, thiab tiv thaiv kev txhim kho ntawm cov kev mob tshwm sim ntawm atherosclerosis. Nws ua tau kom txo tau qhov mob hnyav ntawm asthenic, kev nyuaj siab ntxhov siab, txhim kho pw tsaug zog, muaj txiaj ntsig zoo.
Endoterioprotective zoo, muaj txiaj ntsig zoo ntawm microcirculation kuj tau rov ua pov thawj. Cov suav nrog cov tshuaj rau hauv kev kho mob rau cov neeg mob nrog mob atherosclerosis, nrog rau kev tiv thaiv, pab tshem tawm cov kev mob hauv lub hlwb thiab txhim kho tus neeg mob lub mob.
Raws li koj tuaj yeem pom, atherosclerosis ntawm intracranial ntawm cov hlab ntsha yog qhov tseem ceeb hauv kev txhim kho ntawm cov mob ntshav khov sai, muaj txoj hauv kev tshwj xeeb rau kev kuaj mob thiab kho mob. Ua tsaug rau kev vam meej hauv kev kawm txog tus kabmob thiab nws txoj kev tshawb fawb, ib tus tuaj yeem suav ntawm qhov zoo ntawm qhov txheej txheem pathological.
Cov kev kho mob atherosclerosis yog sib tham hauv daim yeeb yaj kiab hauv tsab xov xwm no.
