IHD le atherosclerotic cardiosulinosis ICD khoutu ea 10: ke eng?

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Cardiossteosis ke phetoho ea methapo ea methapo ea mesifa ea pelo le ho e nkela ka tishu e kenang, e etsahala kamora lefu la ho ruruha - myocarditis, endocarditis e tšoaetsanoang, kamora lefu la myocardial. Atherossteosis e boetse e lebisa ho hlaheng ha lefu la pelo, liphetoho tsa pathological li etsahala ka lebaka la tiske ischemia le phallo ea mali e sa sebetseng. Boemo bona bo hlaha hangata ho batho ba baholo kapa ba tsofetseng, le mafu a kopaneng a kang angina pectoris le khatello ea mali.

Atherosselotic cardiosclerosis e hlaha ka lebaka la ho kopanya lintho tse 'maloa, joalo ka mathata a ho ja - ho ata ha lijo tse nang le mafura le cholesterol le ho fokotseha hoa lijo tsa litholoana le meroho, ho fokotsa ts'ebetso ea' mele le mosebetsi oa ho ikoetlisa, ho tsuba le tšebeliso e mpe ea joala, khatello ea maikutlo, tloaelo ea lelapa ea mafu a pelo. sistimi.

Banna ba na le monyetla oa ho ba le lefu la atherosmithosis, joalo ka ha lihormone tsa botona tsa botšehali, tse joalo ka estrogen, li na le phello e sirelletsang maboteng a methapo ea mali le ho thibela ho thehoa ha litopo. Basali ba na le lefu la pelo le "hyperlipidemia", empa kamora lilemo tse 45 ho isa ho tse 50 kamora ho khaotsa ho ilela khoeli. Lintho tsena li lebisa ho spasm le ho fokolisa khanya ea likepe tsa coronary, ischemia le hypoxia ea myocyte, ho senyeha ha bona le atrophy.

Khahlano le semelo sa khaello ea oksijene, li-fibroblasts li qaptjoa, li etsa li-collagen le li-elastic fibers sebakeng sa lisele tse senyehileng tsa mesifa ea pelo. Butle-butle lisele tsa mesifa tse fetotsoeng li nkeloa sebaka ke lithane tse sebetsang, tse sa sebetseng mesebetsi ea contractile le ea conduction. Ha lefu lena le ntse le tsoela pele, mesifa ea mesifa e eketsehileng ea fokola le ho holofala, e lebisang ho ntlafatseng methapo ea methapo ea methapo ea methapo, bophelo bo ka 'nang ba sokela bophelo, bo kang ho senyeha ha methapo ea pelo, ho se sebetse hantle ha pelo le methapo.

Tlhophiso ea lefu la atherosclerosis le lefu la pelo ho latela ICD 10

Atherosclerotic cardiosulinosis ho ICD 10 hase mofuta o ikemetseng, empa ke e 'ngoe ea mefuta ea lefu la pelo.

Ho nolofalletsa ts'oaetso ka sebopeho sa machabeng, ke moetlo ho ela hloko maloetse ohle ho ea ka tatellano ea ICD 10.

E hlophisitsoe e le lethathamo la likarolo tsa alphanumeric, moo sehlopha ka seng sa lefu le abeloang khoutu ea eona e ikhethang.

Mathata a tsamaiso ea methapo ea pelo a bontšoa ke likhoutu tsa I00 ho ea ho I90.

Lefu la ischemic la pelo le sa foleng, ho ea ka ICD 10, le na le mefuta e latelang:

  1. I125.1 - Lefu la atherosselotic la methapo ea methapo ea kutlo.
  2. I125.2 - infarction ea myocardial e fetileng e fumanoeng ke matšoao a kliniki le lithuto tse eketsehileng - li-enzyme (ALT, AST, LDH), tlhahlobo ea troponin, ECG.
  3. I125.3 - Moetso oa pelo kapa aorta - ventricular kapa lebota.
  4. I125.4 - Aneurysm ea mokokotlo oa mokokotlo le mokokotlo oa lona, ​​e fumaneng fistula ea coronary arteriovenous fistula.
  5. I125.5 - Ischemic cardiomyopathy.
  6. I125.6 - Asymptomatic myocardial ischemia.
  7. I125.8 - Mefuta e meng ea lefu la pelo.
  8. I125.9 - Lefu la pelo le sa hlalosoang la ischemic.

Diffuse Cardiosclerosis e boetse e khetholleha ka lebaka la ho kenella ha naha le ts'ebetso ea ts'ebetso - lithaelese tse sebetsang li fumaneha hantle ka har'a myocardium, 'me leqeba kapa libaka tse tsepamisitsoeng - tse sclerotic li le mosesaane ebile li libakeng tse kholo.

Mofuta oa pele o hlaha kamora ts'ebetso ea ts'oaetso kapa ka lebaka la ischemia e sa foleng, ea bobeli - kamora ho kenngoa ha myocardial sebakeng sa necrosis ea lisele tsa mesifa ea pelo.

Ka bobeli mefuta ena ea tšenyo e ka etsahala ka nako e ts'oanang.

Lipontšo tsa lefu lena

Matšoao a lefu lena a hlaha feela ka phello e kholo ea lumen ea likepe le ischemia ea myocardial, ho ipapisitsoe le ho ata le ho tsebisoa ha tšebetso ea methapo ea methapo.

Lipontšo tsa pele tsa lefu lena ke bohloko bo bokhutšoanyane ka morao ho sternum kapa maikutlo a ho se khotsofale sebakeng sena kamora khatello ea maikutlo kapa maikutlo, hypothermia. Ho opeloa hoa bohloko hoa tlhaho, ho opa kapa ho choachoasela, ho tsamaea le bofokoli bo akaretsang, ho tsekela le ho fufuleloa ho batang ho ka bonoa.

Ka nako e 'ngoe mokuli o utloisa bohloko libakeng tse ling - lehetleng le letsohong kapa letsohong, lehetleng. Nako ea bohloko ho lefu la pelo ea coronary e tsoa ho metsotso e 2 ho isa ho e meraro, e ea phomola kapa e emisa kamora ho phomola, ho nka Nitroglycerin.

Ha lefu lena le ntse le eketseha, ho eketsoa matšoao a ho hloleha ha pelo - ho hema hanyane, ho ruruha ha leoto, ho ruruha ha letlalo, ho khohlela ho se sebetseng hantle ha leqhubu la pelo, ho holisa sebete le mokokotlo, tachycardia kapa bradycardia.

Ho hema hanyane ho hlaha khafetsa kamora ho imeloa kelellong le maikutlong, maemong a phahameng, ho fokotsa ho phomola, ho lutse. Ka nts'etsopele ea ho hloleha ho hlobaetsang hoo ka ho le letšehali ha pelo, ho hema hanyane ka hanyane, le ho khohlela ho omileng hoa utloahala.

Edema ke letšoao la ho bola ha pelo ea ho se sebetse hantle, ho etsahala ha methapo ea methapo ea maoto e tletse ka mali mme ts'ebetso ea pompo ea pelo e fokotseha. Qalong ea lefu lena, edema ea maoto le maoto feela e bonoa, ka tsoelo-pele ea bona ea phahama, 'me e ka tsebahala ka sefahleho le sefuba, pericardial, mpa ea mpa.

Matšoao a ischemia le hypoxia ea mokokotlo a boetse a bonoa - hlooho, ho tsekela, tinnitus, ho akheha. Ka phetoho e kholo ea myocyte ea tsamaiso ea pelo e nang le lithane tse sebetsanang, litšitiso tsa tšitiso - li-blockages, arrhythmias, li ka hlaha.

Haholo-holo, li-arrhythmias li ka bonahatsoa ke litšitiso tse bang teng mosebetsing oa pelo, litšebelisong tsa pele ho nako kapa tsa mabota, e leng maikutlo a ho hlonepha. Khahlano le semelo sa lefu la pelo, maemo a kang tachycardia kapa bradycardia, blockade, fibrillation ea atria, li-extrasystoles tsa atrial kapa ventricular localization, li-ventricular fibrillation li ka etsahala.

Cardiosulinosis ea tšimolohong ea atherosulinotic ke lefu le tsoelang pele butle le ka etsahalang ka ho fetelletse le ho tlosoa.

Mekhoa ea ho fumanoa ha lefu la pelo

Tlhahlobo ea lefu lena e na le datha e nang le bokhoni - nako ea ho qaleha ha lefu lena, matšoao a pele, tlhaho ea bona, nako, tlhahlobo le kalafo. Hape, bakeng sa ho etsa tlhahlobo ea mafu, ho bohlokoa ho fumana nalane ea bophelo ba mokuli - maloetse a fetileng, ts'ebetso le likotsi, tšekamelo ea lelapa ho mafu, ho ba teng ha mekhoa e mebe, mokhoa oa bophelo, lintlha tsa litsebi.

Matšoao a tleleniki ke a mantlha ho tlhahlobisong ea methapo ea pelo, ho bohlokoa ho hlakisa matšoao a teng, maemo a ho hlaha ha ona, matla a matla ho pholletsa le lefu lena. Tlatsetsa tlhaiso-leseling ka mekhoa ea lipatlisiso ea laboratori le e sebetsang.

Sebelisa mekhoa e meng:

  • Tlhahlobo e akaretsang ea mali le moroto - ka bokuli bo bobebe, liteko tsena li ke ke tsa fetoloa. Ho hypoxia e matla e sa foleng, ho fokotseha ha hemoglobin le erythrocyte le keketseho ea SOE li bonoa tlhahlobong ea mali.
  • Teko ea mali bakeng sa tsoekere, teko ea mamello ea tsoekere - ho kheloha ho teng feela ka tsoekere e kopaneng ea lefu la tsoekere le mamello e fokolang ea tsoekere.
  • Teko ea mali a biochemical - tseba hore na profid ea lipid ke eng, e nang le atherosulinosis, cholesterol e felletseng e tla phahamisoa, lipoprotein tse tlaase le tse tlase haholo li fokotsoe.

Thutong ena, liteko tsa hepatic le tsa renal li boetse li ikemiselitsoe, tse ka bonts'ang tšenyo ea litho tsena nakong ea ischemia ea nako e telele.

Mekhoa e meng ea ts'ebetso

X-ray ea litho tsa sefuba - e etsa hore ho khonehe ho khetholla cardiomegaly, aortic deformation, aneurysm ea pelo le methapo ea mali, tšubuhlellano matšoafong, edema ea bona. Angiography ke mokhoa o hlaselang, o entsoeng ka ho hlahisoa ha moemeli oa methapo ea kutlo, o u lumellang ho fumana boemo le ho hlaphoheloa ha methapo ea mali, phallo ea mali libakeng tsa motho ka mong. kholo ea khokahano. Dopplerografia ea methapo ea mali kapa skena ea triplex, e etsoang ka maqhubu a phofo, eu lumella ho tseba mofuta oa phallo ea mali le boemo ba tšitiso.

Ho tlameha ho etsoa ts'ebetso ea motlakase oa motlakase - e lekola boteng ba li-arrhythmias, hypertrophy ea letsoho le letšehali kapa le letšehali, systolic overload ea pelo, ho qala ha infarction ea myocardial. Liphetoho tsa Ischemic li bonoa ho electrocardiogram ka ho fokotseha ha matla (boholo) ba meno ohle, khatello ea maikutlo (ho fokotseha) ha karolo ea ST ka tlase ho contour, leqhubu le lebe la T.

ECG e tlatselletsoa ke boithuto ba echocardiographic, kapa ultrasound ea pelo - e khethollang boholo le sebopeho, contractility ea myocardial, boteng ba libaka tse sa sisinyeheng, lipalo, ts'ebetso ea sistimi ea li-valve, phetoho ea metaboliki kapa metabolism.

Mokhoa o motle haholo oa ho hlahloba lits'ebetso tsa methapo ea methapo ea methapo ke scintigraphy - setšoantšo se hlakileng sa ho bokella lintho tse fapaneng kapa tse thathamisitsoeng ke isotopes ke myocardium. Ka tloaelo, kabo ea ntho ena e tsoana, ha ho na libaka tse eketsang kapa tsa fokola. Lithane tse hokahaneng li na le bokhoni bo fokotsehileng ba ho khetholla phapang, 'me likarolo tsa sclerosis ha li bonoe setšoantšong.

Bakeng sa ho fumanwa ha lesapo la methapo ea methapo ea sebakeng leha e le sefe, ho hlahlojoa ha mahlaseli a matla a khoheli, li-tomography tse ngata tse hlophisitsoeng ka bongata li lula e le mokhoa oa khetho. Monyetla oa bona o bohlokoa haholo molemong oa bongaka, bokhoni ba ho bonts'a tharollo ea lehae.

Maemong a mang, bakeng sa tlhahlobo e nepahetseng haholoanyane, liteko tsa li-hormone lia etsoa, ​​ka mohlala, ho fumana hypothyroidism kapa lefu la Itsenko-Cushing.

Phekolo ea lefu la pelo le pelo le pelo

Phekolo le thibelo ea lefu la pelo ea coronary e qala ka liphetoho tsa mokhoa oa bophelo - ho latela mokhoa oa ho ja lijo tse nang le khalori e tlase, ho tlohela mekhoa e mebe, thuto ea 'mele kapa boikoetliso.

Lijo tsa atherosclerosis li thehiloe ho lijo tsa lebese le tsa meroho, ka ho hana ka ho felletseng lijo tse potlakileng, tse mafura le tse halikiloeng, lijo tse phehiloeng, nama e mafura le tlhapi, confectionery, chokolete.

Lijo li jeoa haholo - mehloli ea fiber (meroho le litholoana, lijo-thollo le linaoa), mafura a sa phetseng hantle (oli ea meroho, tlhapi, linate), mekhoa ea ho pheha - ho pheha, ho baka, ho hlapisa.

Lithethefatsi tse sebelisitsoeng bakeng sa k'holeseterole e phahameng le lefu la pelo ke nitrate tsa ho kokobetsa litlhaselo tsa angina (Nitroglycerin, Nitro-nako e telele), li-antiplatelet agents bakeng sa thibelo ea thrombosis (Aspirin, Thrombo Ass), anticoagulants moo ho nang le hypercoagulation (Heparin, Enoxyparin, Hypindia, le inhibitors). , Ramipril), diuretics (Furosemide, Veroshpiron) - ho imolla ho ruruha.

Statins (Atorvastatin, Lovastatin) kapa fibrate, acid ea nicotinic le eona e sebelisetsoa ho thibela hypercholesterolemia le tsoelo-pele ea lefu lena.

Bakeng sa arrhythmias, lithethefatsi tsa antiarimic (Verapamil, Amiodarone), li-beta-blockers (Metoprolol, Atenolol) li fanoa, 'me ho sebelisoa pelo ho phekola ho hloleha ha pelo ho sa feleng.

Cardiossteosis e hlalositsoe ka videong ena.

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