Angiopathies yog ib pawg ntawm pathologies cuam tshuam nrog kev puas tsuaj rau cov hlab ntsha thiab ua rau cov ntshav khiav tsis zoo. Kev loj hlob ntawm tus kab mob tshwm sim maj mam: cov hlab ntsha thiab cov hlab ntsha poob lawv lub suab, qhov khoob hauv lawv nqaim. Yog li ntawd, lub cev muaj kev noj haus tsis txaus. Angiopathy ntawm qis qis yog kuaj pom hauv cov neeg mob ntshav qab zib mellitus. Tsis muaj kev kho mob txaus tuaj yeem ua rau txiav txiav thiab tuag. Txhawm rau zam qhov teeb meem zoo li no, nws yuav tsum paub tias cov tsos mob dab tsi nrog rau cov kab mob thiab thaum twg mus ntsib kws kho mob.
Angiopathy - tus tsos mob lossis kab mob?
Yuav luag txhua cov hlab ntsha hauv tib neeg lub cev tuaj yeem raug hloov pauv pathological. Ntawm qhov kev txaus siab yog qhov swb ntawm microcirculatory qauv, uas yog sawv cev los ntawm ntau plexuses. Hais txog angiopathy, feem ntau lawv txhais tau hais tias cov kab mob ntawm sab qis. Nrog rau qhov kev kuaj mob notxawm tias cov neeg noj qab haus huv kiag li yuav tsum tau ntsib. Vim li cas qhov no tshwm sim? Qhov tshwm sim no tuaj yeem piav qhia los ntawm qhov tsis muaj kev nkag siab ntawm cov kws tshaj lij sib txawv thiab cov neeg mob txaus siab heev. Thaum kawg, hnov ib qho kev kuaj mob tsis paub, ceeb tam sim.
Nws yuav tsum to taub kom meej tias qhov kev sib txawv tau piav qhia tsis tuaj yeem yog tus kab mob ywj pheej. Angiopathy yog ib qho tshwm sim lossis teeb meem ntawm qee yam kev ua haujlwm tsis zoo hauv lub cev. Hauv nws cov ntsiab lus yog qhov txo qis hauv elasticity thiab txo qis hauv lumen ntawm cov hlab ntsha. Yog li ntawd, cov tsos mob ntawm cov kab mob circulatory nyob rau hauv cov ntaub so ntswg tshwm. Xws li daim duab kho mob yog tus yam ntxwv ntawm qhov mob ntawm cov leeg nqaij ntawm phab ntsa vascular lossis kev hloov pauv hauv nws qhov innervation. Hauv qhov no, ib qho spasm tshwm sim nrog rau ib txhij qeeb hauv cov ntshav khiav.
Qhov laj thawj tseem ceeb ntawm angiopathy
Cov kws kho mob txheeb xyuas ntau yam uas ua rau muaj qhov tshwm sim ntawm cov txheej txheem pathological. Ntshav qab zib yog thawj ntawm lawv. Angiopathy ntawm qis extremities nyob rau hauv 70% ntawm cov mob tshwm sim tawm tsam keeb kwm ntawm cov ntshav qab zib ntau dhau. Qhov chaw thib ob belongs rau ntshav siab. Nrog cov tsos mob hnyav ntawm tus kab mob, cov hlab ntsha thiab cov hlab ntsha tsis tuaj yeem tiv nrog cov haujlwm uas tau muab rau lawv. Maj mam, cov phab ntsa ntawm cov hlab ntsha tau npog nrog roj, cov ntshav yuav thicker. Ua ke, cov xwm txheej no ua rau muaj kev loj hlob ntawm angiopathy.
Ntawm lwm cov laj thawj ntawm cov txheej txheem pathological tuaj yeem sau tseg:
- smoking;
- ua haujlwm nrog cov khoom siv tshuaj lom;
- hypotension;
- xeeb tubCov kab mob hauv cov hlab ntshav;
- kev hloov pauv.
Kev kho mob ntawm angiopathy nyob ntawm lub sijhawm ntawm kev kuaj mob. Yog li ntawd nws yog ib qho tseem ceeb kom muaj peev xwm paub cov tsos mob ntawm tus kab mob thaum ntxov.
Cov ntaub ntawv dab tsi ua rau angiopathy ntawm qis qis qis?
ICD-10 (International Classification of Diseases) muab tus lej 179.2 rau cov kab mob no. Hauv nws cov chav kawm, nws yog ib txwm ua kom paub qhov txawv ntawm ob hom:
- Microangiopathy (kev puas tsuaj rau cov hlab ntsha me me). Feem ntau cuam tshuam nrog retinal dysfunction, lub raum ntshav khiav tsis zoo.
- Macroangiopathy (kev puas tsuaj rau cov hlab ntsha ntawm nruab nrab thiab loj caliber). Qhov kev ua txhaum cai no tsuas yog rau cov hlab ntsha ntawm cov extremities xwb.
Txhua daim ntawv ntawm cov txheej txheem pathological muaj ib daim duab kho mob tshwj xeeb.
Cov tsos mob Microangiopathy
Nyob rau theem pib, microangiopathy ntawm qis extremities xyaum tsis tshwm sim nws tus kheej. Txawm li cas los xij, thaum kuaj xyuas cov hlab ntsha, qee qhov kev hloov pauv tau kuaj pom hauv lawv, uas thaum kawg pib ua rau tsis xis nyob. Cov tawv nqaij ua daj ntseg thiab txias rau qhov kov. Cov mob me me tshwm sim ntawm ob txhais ceg, uas kis tau sai heev rau thaj chaw tshiab. Tus neeg mob tuaj yeem cuam tshuam los ntawm kev tsis xis nyob, mob tom qab kev tawm dag zog lub cev. Nyob ib ncig ntawm lub qhov txhab, daim tawv nqaij kis ib tug reddish tint, o. Kev nkag mus ntawm cov txheej txheem pathological rau hauv cov leeg nqaij lossis pob txha cov ntaub so ntswg yog nrog los ntawm cov tsos ntawm phlegmon. Necrotic thaj chaw maj mam dhau muskab mob kis mus rau tus ntiv tes. Yog tias tag nrho ko taw raug cuam tshuam, tib txoj kev los cawm ob txhais ceg yog txiav ib feem ntawm nws.
Cov tsos mob Macroangiopathy
Kev loj hlob ntawm pathology kuj tshwm sim maj mam. Thaum xub thawj, cov neeg mob yws ntawm qhov tawv nqaij ntawm ob txhais ceg thaum sawv ntxov. Tom qab ntawd qhov tsis xis nyob tsis ploj mus thoob plaws ib hnub thiab ua tiav los ntawm kev loog hauv cov ntiv tes. Cov ko taw txias tas li, qee zaum muaj kev sib tshuam lameness. Daim tawv nqaij ua daj ntseg. Nquag claudication ua ntau pronounced nyob rau hauv ib hnub. Rau tag nrho cov tsos mob yog ntxiv mob hnyav nyob rau hauv ob txhais ceg, cramps. Kev hnov mob tsis zoo (kub, tingling) tsis txhob tawm hauv tus neeg mob txawm tias thaum so. Tom qab ntawd, edema thiab mob tshwm sim nrog cov tsos mob ntawm necrosis. Txhua qhov chaw tshiab tau maj mam koom nrog cov txheej txheem pathological. Macroangiopathy ntawm qis qis feem ntau nrog ua npaws, tsis muaj zog.
txaus ntshai npaum li cas yog angiopathy hauv ntshav qab zib mellitus?
Kev hloov pauv hauv cov hlab ntsha ntawm cov extremities yog ib qho kev sib koom ua ke ntawm cov neeg mob ntshav qab zib mellitus. Atrophy thiab circulatory ntshawv siab nyob rau hauv ko taw yog qhov tshwm sim ntawm qhov poob ntawm capillary muaj peev xwm. Cov piam thaj ntau dhau hauv cov ntshav maj mam rhuav tshem cov phab ntsa ntawm cov hlab ntsha. Hauv qee qhov chaw lawv ua thinner, hauv lwm qhov lawv thicken. Yog li ntawd, lub lumen ntawm cov hlab ntsha nqaim, thiab cov ntaub so ntswg tuag tawm tsam keeb kwm ntawm oxygen tshaib plab. Raws li tus kab mob tshwm sim, tus ntiv tes atrophy ua ntej, tom qab ntawd tag nrho ko taw, sab ceg thiab ncej puab. Cov txheej txheem cuam tshuam yuav tsum tau txiav tam sim ntawd, raws li lawv tsimcov txheej txheem gangrenous. Hauv qhov no, feem ntau muaj kev khaws cia ntawm cov hlab ntsha hauv cov ceg.
Mob ntshav qab zib angiopathy ntawm qis qis yog qhov teeb meem loj tshaj plaws los ntawm cov neeg mob uas tsis muaj insulin hauv cov ntshav. Nws txoj kev tiv thaiv raug pom zoo tam sim tom qab kuaj pom tseeb.
Cov txheej txheem kuaj mob niaj hnub
Thaum xav tias muaj angiopathy ntawm qis qis qis, thawj kauj ruam ntawm kev kuaj mob yog coj tus neeg mob keeb kwm thiab tshuaj xyuas cov chaw cuam tshuam. Tom qab ntawd, lawv mus rau kev tshawb fawb hauv chav sim siv cov cuab yeej siv siab:
- MRI. Tso cai rau koj los ntsuas cov qauv ntawm cov ntaub so ntswg.
- Ultrasound. Kev tshawb fawb Doppler pab txiav txim siab txog lub xeev ntawm cov phab ntsa ntawm cov hlab ntsha, thiab duplex scanning - qhov ceev ntawm cov ntshav khiav.
- Angiography. Kev kuaj X-ray siv tus neeg sawv cev sib txawv tso cai rau koj pom qhov patency ntawm cov hlab ntsha.
- CT. Siv los kawm txog thaj chaw pathological ntawm caj dab.
Kev siv cov kev kuaj mob saum toj no yog qhov tsim nyog kom tau txais cov duab dav dav ntawm cov txheej txheem pathological, txhawm rau ntsuas qhov ntsuas ntawm cov hlab ntsha puas. Kev kuaj mob ntawm tus neeg mob kuj tso cai rau koj los txiav txim seb daim ntawv angiopathy ntawm qis qis yog dab tsi.
Kev kho mob: kho mob thiab phais
Txoj kev kho mob ntawm angiopathy nyob ntawm qhov ua rau ua rau nws tshwm sim. Nyob rau theem pib, qee zaum txawm tias kev hloov pauv khoom noj khoom haus yooj yimthiab txoj kev ua neej ua rau qeeb qeeb hauv cov txheej txheem pathological. Puas muaj lwm txoj kev kho mob dab tsi?
- Tshuaj kho mob. Cov neeg mob tau kuaj pom tias "angiopathy ntawm qis qis" yog cov tshuaj kho mob los txhim kho vascular tone thiab normalize siab. Nws kuj tseem pom zoo kom noj cov tshuaj uas txhawb nqa cov txheej txheem ntshav (Actovegin, Aescusan, Heparin). Txhua cov tshuaj raug xaiv ib tus zuj zus, suav nrog tag nrho cov duab kho mob ntawm tus kab mob.
- Lymph modulation. Ua cov txheej txheem tshwj xeeb txhim kho cov ntshav thiab qog ntshav hauv lub cev, tshem tawm sai ntawm cov khoom lag luam metabolic. Tom qab ob peb zaug kev kho mob, qhov o ntawm daim tawv nqaij nyob rau hauv cov cheeb tsam cuam tshuam pom tau tias txo qis.
- Kev ua haujlwm. Kev cuam tshuam kev phais implies cov ntaub so ntswg plastics thiab reconstruction ntawm altered hlab ntsha. Hauv cov xwm txheej hnyav tshwj xeeb, thaum cov txheej txheem necrotic tau kis mus rau tag nrho ko taw, kev txiav tawm yog qhia.
Kev nkag mus rau tus kws kho mob raws sijhawm tso cai rau koj tso tseg cov txheej txheem pathological thiab zam kev cuam tshuam kev phais. Cov ntaub ntawv tu siab qhia tau tias hauv 10% ntawm cov neeg mob, ntshav lom ua rau tuag.
Kev kho mob nrog pej xeem tshuaj
Cov kws kho mob ib txwm muab lawv cov zaub mov rau kev kho mob xws li angiopathy ntawm qis qis. Cov tsos mob thiab kev tshwm sim ntawm cov txheej txheem pathological nyob rau theem pib feem ntau tsis ua rau tsis xis nyob. Yog tias lawv raug lees paub raws sijhawm, nws muaj peev xwm ceeb toomntxiv kev loj hlob ntawm vascular mob. Nws yuav tsum raug sau tseg tias kev kho mob pej xeem yuav tsum tau ua ke nrog cov txheej txheem ib txwm muaj.
Cov kws kho mob qhia kom siv cov nroj tsuag hauv kev kho mob uas pab ua kom cov metabolism hauv lub cev. Cov no yog ginseng, Manchurian aralia, safflower leuzea thiab lwm yam. Cov nroj tsuag no tuaj yeem siv los ua decoctions thiab tinctures. Txhawm rau txhim kho cov metabolism hauv carbohydrate, cov kws kho mob pom zoo kom ntxiv cov tshuaj dandelion nplooj thiab elecampane rau tshuaj yej. Kas fes yog qhov zoo dua los hloov nrog chicory. Nws yuav tsum tau qhuav, roasted thiab hauv av. Cov nplooj ntawm cov nroj tsuag tuaj yeem siv rau hauv kev hnav khaub ncaws hnav.
Kev kho mob angiopathy hauv ntshav qab zib mellitus
Yav dhau los, peb twb tau qhia dab tsi cov tsos mob nrog angiopathy ntawm qis qis. Hauv cov ntshav qab zib mellitus, kev kho mob xyaum tsis txawv ntawm qhov ua rau lwm yam ua rau cov txheej txheem pathological. Lub hauv paus ntawm kev kho tshuaj yog cov tshuaj uas txhim kho cov ntshav txhaws. Glucose theem yog tswj los ntawm kev tswj hwm ntawm insulin. Ib qho kev kho mob ntxiv yog muab los ntawm physiotherapy. Piv txwv li, kev kho av nkos thiab plasmapheresis tuaj yeem ntxuav cov ntshav.
Hauv cov xwm txheej siab, lawv tau txais kev cuam tshuam kev phais. Hauv thawj theem ntawm kev txhim kho pathology, lumbar sympathectomy yog siv. Reconstructive phais kuj muaj qhov zoo, ua tsaug uas nws muaj peev xwm normalize microcirculation. Kev tsis saib xyuas angiopathy ntawm cov hlab ntsha ntawm qis qis, nrog rau gangrene, yuav tsum tau txiav tawm. Tom qab ib chav kawm ntawm kev kho mob, tus neeg mob tau uazoo prosthesis.
ntsuas kev tiv thaiv
Hauv ntshav qab zib lossis ntshav siab, kev tiv thaiv angiopathy yuav tsum tau pib tam sim tom qab kuaj pom tseeb. Txhawm rau ua qhov no, nws raug nquahu kom kuaj xyuas ib ntus thiab kuaj xyuas kev kho mob. Nws yog ib qho tseem ceeb los saib xyuas cov ntshav qab zib tas li, saib xyuas cov ntshav siab thiab qhov xwm txheej ntawm cov hlab ntsha. Mob ntshav qab zib angiopathy ntawm cov hlab ntsha ntawm qis qis yuav tsum tau kho tam sim ntawd thaum thawj cov tsos mob tshwm sim. Kev kho mob yuav tsum tau muab los ntawm kws kho mob.
Ntxiv rau, kev tiv thaiv kev hloov pauv hauv cov hlab ntsha suav nrog cov haujlwm hauv qab no:
- txiav luam yeeb thiab lwm yam kev quav yeeb quav tshuaj;
- ua kis las ua tau;
- ntxiv dag zog rau kev tiv thaiv thiab hauv nruab nrab paj hlwb;
- khoom noj muaj txiaj ntsig;
- tawm tsam rog dhau.
Qhov tseem ceeb tshaj plaws yog tus cwj pwm zoo. Nws yog tus uas, raws li txoj cai, muaj kev txiav txim siab rau txoj kev rov qab los.
