Atherosclerosis yog ib yam kab mob uas muaj ntau yam. Ntawm ntau yam txheej txheem pathological, stenosing daim ntawv tsim nyog tau txais kev saib xyuas tshwj xeeb. Nws feem ntau tshwm sim hauv cov txiv neej hnub nyoog tshaj 50 xyoo. Nrog lub hnub nyoog, atherosclerotic hloov pauv hauv cov hlab ntsha tshwm sim hauv lub cev ntawm ntau tus neeg. Lawv tsis tsuas yog tus cwj pwm los ntawm cov tsos mob tsis zoo, tab sis kuj ua rau muaj kev hem thawj loj rau lub neej. Hauv tsab xov xwm no, peb yuav txiav txim siab txog lub ntsiab lus hauv cheeb tsam thiab cov tsos mob ntawm stenosing atherosclerosis, nrog rau cov txheej txheem ntawm kev kho tus kab mob los ntawm kws kho mob.
Kev piav qhia ntawm tus kab mob thiab kev txhim kho
Stenosing atherosclerosis yog cov txheej txheem pathological uas kis mus rau cov hlab ntsha loj ntawm lub cev. Lub mechanism ntawm nws tshwm sim yog heev yooj yim. Nyob rau hauv kev cuam tshuam ntawm qee yam hauv cov phab ntsa ntawm cov hlab ntsha pibCov rog dawb (cholesterol) yog tso tawm thiab ua cov plaques. Tus kab mob mus los ntawm ntau theem ntawm txoj kev loj hlob, theem kawg yog qhov nqaim ntawm cov hlab ntsha mus rau qhov tsawg kawg nkaus (stenosis). Raws li qhov tshwm sim, cov ntaub so ntswg thiab cov kabmob nyob ntawm qhov chaw ntawm cov ntshav tsis txaus muaj kev tsis muaj oxygen thiab cov as-ham.
Qhov teeb meem ntawm kev loj hlob ntawm cov cholesterol plaques thiab cov ntaub so ntswg sib txuas ntawm lawv cuam tshuam rau ntau yam hlab ntsha loj. Noj mus rau hauv tus account qhov chaw ntawm txoj kev loj hlob ntawm cov txheej txheem pathological, muaj ntau ntau yam ntawm tus kab mob. Qhov yooj yim tshaj plaws yog cov hlab ntsha peripheral ntawm qis extremities, lub paj hlwb thiab coronary aorta ntawm lub plawv. Qhov tsis muaj kev kho mob raws sij hawm feem ntau ua rau muaj qhov tshwm sim tsis zoo: myocardial infarction, gangrene ntawm ob txhais ceg, mob stroke, thromboembolism nrog kev puas tsuaj rau cov kab mob hauv nruab nrog cev.
Qhov laj thawj tseem ceeb
Kev loj hlob ntawm atherosclerotic lesions ntawm cov hlab ntsha loj yog vim qhov kev ua ntawm peb yam:
- Ua txhaum cov roj metabolism. Thaum lub cev lub cev rau kev sib txuas thiab kev thauj mus los ntawm cov roj (cholesterol) tsis ua haujlwm, cov khoom siv ntau dhau yuav pib tso rau ntawm phab ntsa ntawm cov hlab ntsha. Cov kab mob somatic, kev noj zaub mov tsis zoo, kev rog rog tuaj yeem ua lub luag haujlwm ua haujlwm.
- Hereditary predisposition. Yog tias cov neeg txheeb ze raug kuaj pom tias muaj stenosing atherosclerosis, qhov tshwm sim ntawm tus kab mob no nce ntau zaus.
- Txo qis hauv elasticity ntawm cov phab ntsa vascular. Cov roj cholesterol plaques tsis tuaj yeem tsimsmooth thiab noj qab nyob zoo nto. Cov kab mob hauv qab no ua rau muaj kev puas tsuaj rau phab ntsa vascular: ntshav qab zib mellitus, kev ua neej nyob tsis muaj zog, haus luam yeeb.
Yog tias muaj ib lossis ntau yam uas tau teev tseg saum toj no, nws yuav tsum tau ua tib zoo saib xyuas nws tus kheej kev noj qab haus huv, mus kuaj xyuas kev tiv thaiv ntau zaus.
Kev tshwm sim ntawm cerebral artery stenosis
Cov hlab ntsha brachiocephalic yog cov hlab ntsha loj uas tuaj ntawm lub aortic koov mus rau lub hlwb. Lawv ntau lub weaves tsim lub voj voog ntawm Willis. Nws muab cov ntshav txaus rau lub hlwb.
Thaum muaj kev cuam tshuam hauv daim ntawv ntawm atherosclerotic plaque tsim nyob rau hauv ib qho ntawm cov ntu ntawm lub voj voog ntawm Willis, lawv hais txog kev txhim kho stenosis. Tus kab mob no cuam tshuam rau tag nrho cov ntshav ntawm lub hlwb. Kev kho tsis raws sijhawm tuaj yeem ua rau hypoxia lossis mob stroke. Cov cim qhia ntawm cov txheej txheem pathological nyob ntawm seb muaj pes tsawg tus atherosclerotic plaques hauv cov hlab ntsha.
Thaum pib, tus kab mob no asymptomatic. Yog tias lub lumen ntawm cov hlab ntsha raug thaiv los ntawm cov quav hniav los ntawm 50% lossis ntau dua, tus neeg mob yuav nco ntsoov cov tsos mob tsis zoo. Ntawm lawv yog:
- kiv taub hau tawm tsam keeb kwm ntawm kev txo cov ntshav siab;
- kev xav lability nrog kev ua siab loj ntawm kev nyuaj siab;
- kev xav tsis thoob;
- teeb meem hnov-pob ntseg (tinnitus, hnov tsis hnov lus, yoov ua ntej ob lub qhov muag);
- chronic fatigue syndrome;
- npaum ntiv tes;
- thermoregulation tsis meej.
Cov tsos mob uas tau teev tseg thaum xub thawj ua tau tsis cuam tshuam rau lub neej zoo. Ntau tus neeg mob tsuas tsis quav ntsej lawv. Progressive stenosing atherosclerosis ntawm cov hlab ntsha brachiocephalic yuam koj mus nrhiav kev pab kho mob.
Kev tshwm sim ntawm stenosis ntawm cov hlab ntsha ntawm lub plawv
Oxygen thiab cov as-ham raug xa mus rau lub plawv los ntawm cov hlab ntsha coronary. Kev swb ntawm cov hlab ntsha no los ntawm atherosclerosis ua rau muaj kev hem thawj loj rau cov leeg nqaij ntawm lub cev, cuam tshuam rau nws txoj kev sib dhos thiab ua tiav ntawm kev cog lus. Nrog rau tus kab mob no, cov neeg mob feem ntau yws ntawm qhov mob hauv qhov chaw retrosternal. Lawv thawj zaug tshwm sim tom qab kev tawm dag zog lossis kev ntxhov siab. Nyob rau tib lub sijhawm, kev tsis xis nyob tsis tso ib tug neeg txawm tias thaum so. Lub sijhawm ntawm qhov mob tshwm sim yog li 30 feeb.
Myocardial infarction yog suav tias yog ib qho mob tshwm sim ntawm cov txheej txheem pathological. Tus kab mob no nrog rau qhov mob hnyav hauv cheeb tsam ntawm lub plawv, uas tsis tuaj yeem nres nrog ib ntsiav tshuaj nitroglycerin. Ntshav siab poob qis, ua rau kiv taub hau hnyav, tsis muaj zog. Atherosclerosis stenosing, cuam tshuam rau cov hlab ntsha coronary, tuaj yeem ua rau muaj teeb meem loj. Cov no muaj xws li mob plawv aneurysm, cardiogenic shock, thiab rupture ntawm cov leeg nws tus kheej. Tshwj xeeb tshaj yog, cov kws kho mob kuaj mob sudden death syndrome.
Kev tshwm sim ntawm stenosis ntawm cov hlab ntsha ntawm qis extremities
Los ntawm cov hlab ntsha femoral, cov ntshav ntws mus rau qhov chaw siab tshaj plaws ntawm lub cev, nyob ntawm ko taw. Stenosing atherosclerosisqis extremities ranks thib peb nyob rau hauv cov nqe lus ntawm zaus ntawm qhov tshwm sim. Cov tsos mob ntawm tus kab mob no muaj ntau haiv neeg. Yog li, nws raug nquahu kom xav txog kev txhim kho cov txheej txheem pathological hauv theem:
- Thaum pib, tus neeg mob raug cuam tshuam los ntawm kev xav tias chilliness, kub hnyiab lossis tingling ntawm ko taw. Cov tawv nqaij ntawm ob txhais ceg yuav pom tseeb paler.
- theem thib ob yog tus cwj pwm los ntawm qhov pom ntawm qhov sib cuam tshuam claudication. Ib ceg ceg, thaum taug kev lossis ua si kis las, pib nkees ua ntej lwm tus. Kev hnov lus tsis txaus siab maj mam nthuav dav hauv thaj tsam ntawm cov leeg nqaij nyuj, ua rau cyanosis tshwm sim.
- Nyob rau theem tom ntej, qhov kev siv ntawm kev sib cuam tshuam claudication nce ntxiv. Nws nyuaj rau tus neeg mob taug txoj kev ib txwm tsis nres. Feem ntau cov neeg mob yws ntawm qhov mob ntawm cov ntiv taw uas tsis ploj mus thaum so. Cov tawv nqaij ntawm ko taw tau txais cov xim marbled, yuav tawg thiab nyias.
- Nyob rau theem plaub, kev lameness tau hais tias ib tug neeg raug yuam kom nres txhua 50 kauj ruam. Tej zaum qhov tsos ntawm trophic ulcers, o. Kev mob hnyav ntawm ob txhais ceg cuam tshuam nrog ib hmo so.
Peb tsis tuaj yeem tos qhov tsis tuaj yeem rov qab los ntawm tus kab mob hauv daim ntawv gangrene. Yog tias koj muaj cov tsos mob ntawm cov hlab ntsha hauv ob txhais ceg (tsis muaj zog, tsis sib xws claudication), koj yuav tsum mus ntsib kws kho mob tam sim ntawd. Yog tias tus kws kho mob pom zoo tias stenosing atherosclerosis ntawm cov hlab ntsha ntawm qis qis, kev kho mob yuav raug muab tshuaj tam sim.
Txoj kev kuaj mob
Txhawm rau txhawm rau txheeb xyuas tus kabmob raws sijhawm thiab pib kho nws, cov kws kho mob pom zoo kom txhua tus neeg muaj hnub nyoog 40 xyoo raug kuaj xyuas kev tiv thaiv ib xyoos ib zaug. Nws txaus los kuaj ntshav rau cov ntsuas hauv qab no:
- roj cholesterol, lipoproteins, triglycerides;
- fibrinogen;
- glucose;
- club.
Cov kev txwv no tuaj yeem qhia ncaj qha rau kev ua txhaum ntawm cov protein-lipid metabolism, uas ua rau muaj kev loj hlob ntawm pathology.
Stenosing atherosclerosis ntawm cov hlab ntsha ntawm lub hlwb, lub plawv lossis qis qis yog qhov yooj yim los kuaj xyuas. Txhawm rau ua qhov no, tus neeg mob tau muab tshuaj ntsuam xyuas, uas suav nrog cov txheej txheem hauv qab no:
- hlab / hlab ntsha angiography nrog qhov sib txawv;
- rheovasography;
- doppler kawm;
- triplex scanning.
Raws li cov txiaj ntsig ntawm kev kuaj mob, tus kws kho mob tuaj yeem lees paub qhov kev kuaj mob ua ntej. Tom qab ntawd, tus neeg mob tau txais kev kho mob.
Txoj Cai Kho Mob
Kev kho mob stenosing atherosclerosis feem ntau nyob ntawm seb theem twg ntawm kev txhim kho tus kab mob tus neeg mob mus rau kws kho mob. Thaum pib, ntxiv rau kev kho tshuaj, koj yuav tsum sim hloov koj txoj kev ua neej. Nws yog ib qho tseem ceeb uas yuav tsum tso tus cwj pwm phem, sim so kom txaus. Txwv tsis pub, kev noj tshuaj tsuas yog ua rau qeeb ntawm tus kab mob, tab sis yuav tsis tso tseg kiag li.
Yog tsis ua tsis tau, tus kws kho mob tau sau ntawv rau tus neeg mob noj zaub mov (xov 10), nplua nujzaub zaub. Nws feem ntau pom zoo rau cov neeg mob ntshav siab lossis lub plawv tsis ua haujlwm. Yog tias koj ua raws li kev noj zaub mov zoo li no, koj tuaj yeem tsis tsuas yog txo cov roj cholesterol, tab sis kuj tshem tawm nws ntau dhau ntawm lub cev. Nyob rau hauv rooj plaub no, koj tsis tuaj yeem mus noj zaub mov kom poob phaus. Khoom noj khoom haus yuav tsum sib npaug thiab ua kom tiav. Txwv tsis pub, txoj kev kho yuav tsis coj qhov kev xav tau.
Cov neeg mob kuaj tau "stenosing atherosclerosis ntawm qis qis" kev kho mob yuav tsum tau ntxiv nrog kev ua kis las. Kev nyiam yuav tsum tau muab rau Nordic taug kev lossis ua luam dej. Ntawm thawj cov cim qhia ntawm kev qaug zog ntawm ob txhais ceg, koj yuav tsum tau so tam sim ntawd, tsis muaj lub cev hnyav dhau.
siv tshuaj kho
Kev kho mob atherosclerosis yog qhov ua tsis tau xav txog yam tsis siv tshuaj. Feem ntau, cov neeg mob uas muaj qhov kev kuaj mob no tau muab cov tshuaj hauv qab no:
- Kev tsis sib haum xeeb. Tiv thaiv kev tsim cov ntshav txhaws hauv cov hlab ntsha.
- Anspasmodics. Txhim kho cov ntshav ncig thoob plaws lub cev.
- Tshuaj kom normalize cov ntshav rheological. Ua ntej, ib tug drip ntawm cov tshuaj yog muab, ces nws yog hloov nrog ib tug ntsiav tshuaj daim ntawv.
- Anticoagulants.
Txhua yam tshuaj raug xaiv rau txhua tus neeg mob ib leeg. Nco ntsoov tus kws kho mob yuav tsum coj mus rau hauv tus account theem ntawm tus kab mob thiab nws daim ntawv.
Surgery
Stenosing atherosclerosis nyob rau theem siab yuav tsum tau phais. Kev phaisKev cuam tshuam tso cai rau koj los kho cov hlab ntsha li qub, tshem tawm cov cholesterol plaques. Rau lub hom phiaj no, shunting, stenting lossis angioplasty yog ua. Cov txheej txheem teev tseg tau ua tiav ob qho tib si endoscopically thiab qhib siv tshuaj loog.
Txoj kev mob tshwm sim
Qhov tshwm sim ntawm tus kab mob no tuaj yeem ua rau mob hnyav heev thiab ua rau muaj kev phom sij rau lub neej. Piv txwv li, stenosing atherosclerosis ntawm cov hlab ntsha ntawm lub hlwb feem ntau provokes txoj kev loj hlob ntawm ib tug mob stroke. Tau kawg, qhov teeb meem no tsis tshwm sim rau txhua tus. Nws tag nrho yog nyob ntawm tus yam ntxwv ntawm lub cev, lub predisposition rau qhov pib ntawm tus kab mob. Cov kev tshawb fawb pom tau tias kwv yees li 70% ntawm cov pej xeem tshaj 60 tsis txaus siab ntawm ntau yam tshwm sim ntawm atherosclerosis. Qhov no pathology yog lub ntsiab ua rau lub hlwb tsis ua hauj lwm syndrome.
Stenosing atherosclerosis ntawm cov hlab ntsha ntawm qis extremities kuj tsis ib txwm muaj kev pom zoo. Yog tias cov hlab ntsha raug thaiv tag nrho, qhov yuav tshwm sim ntawm ischemic gangrene nce. Tshwj xeeb tshaj yog feem ntau, pathology tshwm sim hauv cov neeg mob ntshav qab zib, vim tias tus kab mob no ua rau cov txheej txheem ntawm stenosis.
ntsuas kev tiv thaiv
Pib tiv thaiv stenosing atherosclerosis yog qhov tsim nyog txij thaum yau. Txhua tus neeg uas ua raws li txoj kev ua neej tsis zoo yuav muaj kev pheej hmoo kis tus kabmob.
Kev Tiv Thaiv suav nrog:
- hom kev huv;
- kev tawm dag zog;
- ua raws li txoj cai ua haujlwm thiabso.
Tsis txhob hnov qab txog kev noj zaub mov kom raug. Cov zaub mov yuav tsum muaj cov nqaij ntshiv thiab nqaij nruab deg, nrog rau cov zaub mov cog.
Txoj kev ua neej noj qab nyob zoo txhais tau tias tso tus cwj pwm phem. Txawm li cas los xij, nws yog qhov zoo dua tsis txhob haus luam yeeb thiab haus cawv txhua.
Cov lus qhia saum toj no yuav tsum ua raws li ob lub sijhawm thiab ua ntej kho. Cov lus qhia zoo li no tuaj yeem pab koj kom tsis txhob muaj teeb meem ntawm tus kab mob. Thaum thawj cov tsos mob tshwm sim, qhia tias stenosing atherosclerosis, koj yuav tsum sab laj nrog kws kho mob thiab xyuas cov hlab ntsha. Yog tias tsim nyog, tus kws kho mob yuav sau cov kev kho mob uas tsim nyog.
