MOB NTSHAV QAB ZIB ANGIOPATHY NTAWM QIS QIS: KEV KHO MOB THIAB TSOS MOB

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Ntshav qab zib angiopathy yog hu ua vascular lesions ntawm qhov loj (macroangiopathy) thiab me me (microangiopathy) caliber tshwm sim hauv cov neeg mob ntshav qab zib mellitus. Ntau dua li cov paj hlwb, qhov muag pom kev ntsuas, cov kab mob tso zis, lub plawv, cov hlab ntsha ntawm cov qis dua yog koom nrog hauv kev.

Mob ntshav qab zib angiopathy ntawm qis qis dua (ICD-10 code - I79.2 *) yog ib qho kev pom tshwm sim ntau tshaj plaws ntawm cov txheej txheem pathological. Nws tshwm sim hauv 70-80% ntawm cov neeg mob thiab ua rau mob rau sab hauv, mob caj dab thiab raug txiav ntawm ob txhais ceg. Tshooj lus tham txog cov tsos mob thiab kev kho mob ntshav qab zib angiopathy ntawm qis qis.

Cov yam ntxwv ntawm tus kab mob

Kev tsim tawm ntawm lub qhov txhab hauv cov ntshav los tiv thaiv cov ntshav qab zib mellitus yog nrog:

kev sib xyaw ntawm cov leeg ntsa;
lipid thiab roj cholesterol ntawm lub endothelium;
thrombosis;
txo qis vascular lumen;
qhov tsim ntawm puffiness thiab nce exudation;
ua txhaum ntawm trophic hlwb thiab cov nqaij ua kom txog thaum lawv tuag.

Txij li thaum cov hlab ntsha muaj qhov tsawg tshaj plaws tshem tawm ntawm txhua cov hlab ntsha ntawm hom arterial, lawv raug kev txom nyem hauv thawj qhov chaw. Qhov no txhais tau hais tias cov txheej txheem lesion pib nrog cov ntiv taw, ko taw, tom qab ntawd mus rau sab ceg qis thiab mus txog ntawm lub duav.

Soj ntsuam duab

Cov tsos mob ntawm tus mob ntshav qab zib angiopathy ntawm qis qis yog nyob ntawm chav kawm ntawm txoj kev pathological:

Rau Ntu I - tsis muaj qhov pom kev hloov pauv, tus neeg mob tsis muaj kev tsis txaus siab, cov khoom siv thiab kuaj ntsuas pom pom kev txhim kho cov txheej txheem atherosclerotic hauv cov hlab;
Theem II - qhov tshwm sim ntawm kev sib cav sib ceg - tus yam ntxwv tshwj xeeb, uas yog tus cwj pwm los ntawm qhov xav kom nres thaum taug kev vim kev mob hnyav ntawm txhais ceg, ploj mus thaum so;
Ntu III - qhov tsos mob mob tshwm sim thaum tsis muaj kev thauj khoom ntawm ob txhais ceg, yuav tsum hloov tas li ntawm txoj haujlwm hauv txaj;
Theem IV - kev tsim cov mob uas tsis mob thiab qhov tuag ntawm daim tawv nqaij vim yog qhov mob loj ntawm cov nqaij mos thiab mob hlwb.

Atherosclerosis yog ib qho kev pom ntawm cov mob ntshav qab zib ceg angiopathy.

Nrog cov tsos mob ua cim cov yam ntxwv ntawm kev puas tsuaj rau cov hlab ntsha ntawm ceg hauv ntshav qab zib mellitus:

kev hnov mob khaus, tingling, "goose bumps";
kev tsim ntawm kab laug sab veins;
pallor ntawm daim tawv nqaij;
tawv nqaij qhuav, tev, plaub hau ploj;
fragility ntawm ntiv taw;
kev loj hlob ntawm puffiness.

Mob ko taw

Ib qho mob hnyav tshaj plaws ntawm angiopathy ntawm cov hlab ntsha ntawm ob txhais ceg. Nws tuaj yeem txhim kho nrog hom tshuaj insulin thiab tsis muaj tshuaj insulin-tiv thaiv kab mob. Nws yog ua los ntawm cov txheej txheem purulent-necrotic, kev tsim cov qhov txhab, ua kev puas tsuaj rau cov pob txha thiab cov leeg. Txoj kab ke sab hauv, qhov cuab yeej nqaij, thiab cov nqaij sib sib zog nqus tau koom nrog hauv cov txheej txheem no.

Feem ntau tshwm sim tawm tsam keeb kwm yav dhau los txuas ntawm microflora kev sib kis, kev raug mob, pwm kis. Cov khau uas tsis xaiv tsis zoo thiab kev coj cwj pwm tsis zoo yog ib qho ua rau muaj kev vwm.

Cov tsos mob ntawm tus mob ko taw:

qhov txhab, mob rwj ntawm ob txhais ceg tawm tsam ntshav qab zib;
tuab ntawm cov ntsia hlau phaj;
fungal mob ntawm taw;
khaus
kev hnov mob mob
lameness lossis lwm yam nyuaj ntsib thaum taug kev;
ua kom txawv ntawm daim tawv nqaij;
o tuaj;
cov tsos ntawm loog;
hyperthermia.

Daj taw - ua kev puas tsuaj rau cov pob txha-leeg nyob rau tom qab ntawm "kab mob qab zib"

Kev kuaj mob

Nrog rau cov teeb meem zoo li no, koj tuaj yeem tiv tauj tus kws kho mob angiosurgeon lossis tus kws kho keeb endocrinologist. Tom qab tshuaj xyuas thiab sau cov lus tsis txaus siab, tus kws kho mob sau ib lub chaw kuaj, ntsuas thiab kho cov khoom ntsuas ntawm cov ntsuas hauv qab no:

Kev tshuaj ntsuam biochemical - qib ntawm cov piam thaj, creatinine, urea, lub xeev cov ntshav coagulation;
ECG, Ncha ntawm lub CG thaum so thiab nrog lub nra;
Kev kuaj mob xoo hluav taws xob;
arteriography ntawm qhov qis qis - kev ntsuam xyuas pom zoo siv qhov nruab nrab nruab nrab;
Dopplerography - kev kawm txog lub xeev ntawm cov hlab ntsha los ntawm ultrasound;
nyob rau hauv muaj purulent paug tawm los ntawm lub rwj - kuaj mob bacteriological nrog ib qho tshuaj tua kab mob;
kev txiav txim siab ntawm transcutaneous kev nyuaj siab - kev txheeb xyuas ntawm theem ntawm oxygen hauv cov nqaij mos ntawm cov nqaj;
khoos phis tawm capillaroscopy.

Tseem Ceeb! Cov txheej txheem kev kuaj mob yog nqa tawm tsis yog rau kev kuaj mob, tab sis kuj tseem nyob rau kev kho mob txhawm rau ntsuas lub xeev ntawm cov hlab ntsha hauv kev ruaj khov.

Cov yam ntxwv khomob

Lub hauv paus ntawm txoj kev kho yog tswj cov ntshav qab zib kom tsis pub dhau. Qhov tshuaj insulin-tiv thaiv hom mob ntshav qab zib mellitus yuav tsum tau txhaj tshuaj ntawm pancreatic hormone (insulin) raws li tus txheej txheem tsim los ntawm endocrinologist. Nws yog ib qho tsim nyog yuav tau soj ntsuam lub sijhawm ntawm kev txhaj tshuaj, kev noj tshuaj, kev tshuaj xyuas tus kheej uas siv glucometer.

Nrog hom 2 ntshav qab zib, cov tshuaj txo qis qab zib raug siv:

Metformin - pab txhawm rau txhim kho qhov rhiab ntawm lub cev lub cev rau insulin, nce nqus ntawm cov suab thaj los ntawm cov ntaub so ntswg. Cov Lus Cim - Glycon, Siofor.
Miglitol - inhibits lub peev xwm ntawm plab hnyuv plab zom cov carbohydrates rau monosaccharides. Qhov tshwm sim yog tsis muaj qab zib. Cov duab tshav puam yog Diastabol.
Glibenclamide (Maninyl) - txhawb kev ua kom muaj zog ntawm cov tshuaj insulin.
Amaryl - txhawb kev tsim cov tshuaj hormone-cov khoom ua si, uas pab txo cov suab thaj.
Diabeton - cov tshuaj uas pab txhim kho kev tsim cov tshuaj insulin, txhim kho rheological thaj chaw ntawm cov ntshav.

Tseem Ceeb! Hauv tib lub sijhawm, koj yuav tsum ua raws li cov zaub mov muaj carb qis, kho koj cov zaub mov kom zoo.

Txhais tau tias yuav txo qis roj

Cov tshuaj muaj peev xwm siv tau ob qho tib si ua ib feem ntawm kev kho thiab rau kev tiv thaiv ntawm kev txhim kho mob ntshav qab zib angiopathy ntawm qis qis. Cov tshuaj yuav tsum tau noj nrog kev kawm tshawb fawb ntawm biochemical ntshav tsis tau hauv kev ua haujlwm zoo.

Lub npe tshuaj	Yam khoom muaj sia	Cov Nta Muaj Dab Tsi
Atherostat	Simvastatin	Txo cov roj cholesterol thiab lipoproteins, yog cov tsis pom kev hauv lub raum, cov menyuam yaus, kev xeeb tub
Zokor	Simvastatin	Normalizes nqi ntawm triglycerides, qib ntawm cov roj (cholesterol) tag nrho. Siv nrog ceev faj nyob rau hauv pathology ntawm lub siab, ob lub raum, ib qho nce ntawm transaminases hauv cov ntshav cov ntshav, nrog cawv.
Cardiostatin	Lovastatin	Txo lub peev xwm ntawm daim siab los ua cov roj (cholesterol), yog li tswj nws qib hauv cov ntshav
Lovasterol	Lovastatin	Cardiostatin analog. Tsis siv thaum cev xeeb tub, thaum lactation, nrog mob raum tsis ua haujlwm
Liptonorm	Atorvastatin	Ntxiv cov kev tiv thaiv kev tiv thaiv ntawm phab ntsa vascular, inactivates txheej txheem ntawm kev tsim cov roj cholesterol

Cov tshuaj antihypertensive

Tawm tsam keeb kwm ntawm qhov txo qis hauv ntshav siab, vasodilation, antiarrhythmic nyhuv tshwm sim. Kev ntshav nce siab me ntsis. Siv txhais tau tias:

Nifedipine
Corinfar
Lub qaum qaum
Txoj kab nruab nrab
Binelol
Nebilet.

Corinfar - tus neeg sawv cev ntawm ib pawg tshuaj uas txo cov ntshav siab

Lub tshuab ntawm vasodilation ua raws li qhov tseeb tias muaj kev thaiv ntawm cov receptors nyob rau hauv cov phab ntsa ntawm cov hlab ntsha thiab lub siab. Qee yam tshuaj tuaj yeem kho lub plawv dhia.

Angioprotectors

Kev ua ntawm pab pawg ntawm cov tshuaj no yog tsim los txhim kho cov ntshav rau cov nqaij thiab lub hlwb ntawm lub cev, nrog rau kev nce ntxiv ntawm cov hlab ntshav.

Pentoxifylline (Trental) - cov tshuaj yuav pab tau kom cov hlab ntshav txhaws, txhim kho cov ntshav ncig, nce qhov kev txiav txim ntawm kev tiv thaiv ntawm cov endothelium.
Troxevasin - tiv thaiv lipid oxidation, muaj cov nyhuv antiexudative, thiab suppresses kev txhim kho ntawm cov txheej txheem inflammatory.
Niacin - los ntawm kev ntxiv ntshav hauv cov hlab ntshav, cov tshuaj kuj pab txo qis cov roj (cholesterol).
Bilobil - normalizes permeability ntawm cov leeg tshav, muaj kev koom tes hauv kev kho kom rov qab los ntawm cov khoom noj zom zaub mov.

Antiplatelet tus neeg sawv cev

Cov thom khwm kho mob rau cov neeg mob ntshav qab zib

Cov tshuaj thaiv cov txheej txheem biochemical ntawm kev tsim thrombus, tiv thaiv clogging ntawm vascular lumen. Cov sawv cev hauv qab no qhia tau qhov ua tau zoo:

Tshuaj aspirin
ReoPro,
Tirofiban,
Curantil
Dipyridamole
Plavix.

Enzymes thiab vitamins

Cov tshuaj ua rau rov qab los ntawm cov txheej txheem hauv lub cev, koom nrog qhov ib txwm ua rau cov permeability ntawm cov vascular phab ntsa, muaj lub zog antioxidant, nce qib ntawm kev siv cov piam thaj los ntawm cov hlwb thiab cov nqaij mos, pab txhawb rau cov txheej txheem no ntawm nws txo qis hauv cov ntshav. Thov Solcoseryl, ATP, B-series vitamins, Ascorbic acid, Pyridoxine.

Kev phais mob

Txhawm rau kom rov qab patency ntawm cov leeg los yog qee ntu ntawm nws, kev ua haujlwm ntawm kev rov ua haujlwm tau ua tiav.

Tseem Ceeb! Txoj kev xaiv ntawm kev phais mob nyob ntawm cov angiosurgeon nkaus xwb. Tag nrho cov kev ua haujlwm tau ua los ntawm kev siv tshuaj loog pob (qee zaum hauv zos) ua kom loog. Endotracheal tshuaj loog yog tham nrog tus kheej.

Kev phais Bypass - suturing ntawm vuam cog rau hauv daim ntawv ntawm ib qho kev sib tw ua haujlwm kom kho cov ntshav ncig thaum nws tsis tuaj yeem nthuav cov lumen ntawm lub nkoj. Muaj aortic-femoral, femoral-popliteal thiab iliac-femoral bypasses, nyob ntawm seb qhov chaw twg lub shunt yog sewn mus rau.

Profundoplasty - kev ua haujlwm los hloov qhov atherosclerosis-kaw ib feem ntawm cov leeg ntshav nrog thaj ntawm cov khoom siv hluavtaws. Ua ke nrog endarterectomy.

Lumbar sympathectomy - tshem tawm ntawm lub lumbar ganglia uas ua rau vasospasm. Nrog lawv cov kev zam ntxiv, cov hlab ntsha nthuav dav, txhim kho cov ntshav txaus hauv thaj chaw muaj kev cuam tshuam ntawm cov hlab ntsha. Feem ntau ua ke nrog profundoplasty lossis bypass phais.

Revascularizing osteotrepanation - perforations yog ua nyob rau hauv cov pob txha ntaub so kom ua kom cov ntshav ntws los ntshav.

Zais pa angioplasty - kev qhia ntawm cov cuab yeej tshwj xeeb (lub tog raj kheej) rau hauv lumen ntawm cov leeg cuam tshuam nce nws los ntawm kev ua kom poob.

Vascular zais pa yas nrog stent muab tso rau - zoo vascular kev cuam tshuam

Stenting tau ua zoo ib yam li zais pa angioplasty, tsuas yog ib qho stent nyob hauv lub lumen ntawm lub nkoj. Xws li cov cuab yeej tsis tso cai rau cov leeg kom nqaim thiab cov ntxiab thrombotic pawg.

Hauv theem siab ntawm tus kab mob, kev txiav tes txiav taw yuav tsim nyog los cawm tus neeg mob lub neej. Tus kws kho mob txiav txim siab qhov siab ntawm kev cuam tshuam los ntawm theem ntawm qhov muaj "nyob" cov ntaub so ntswg. Kev pib kho mob kom raws sij hawm yuav txo qhov kev pheej hmoo ntawm cov teeb meem thiab xa rov qab qib kev noj qab haus huv rau tus neeg mob.

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