Atherosulinosis ea likepe tsa lipalo tse tlase ke lefu le sa foleng le khetholloang ka ho thehoa ha li-cholesterol plaque bokaholimo bo kahare ba membrane ea methapo e fanang ka maoto le matsoho a tlase
E hola haholoholo ha e se e le motho e moholo (lilemo tse 60-75), 'me e lebisa ho senyeha ha lisele tse bonolo tsa trophic.
Lisosa tsa atherosclerosis ea likarolo tse tlase
Nakong ea methapo ea methapo ka lebaka la hypercholesterolemia ea nako e telele le lintlha tse ling, ho thehoa li-amana tsa matsoele le lithane tse amanang le tsona.
Ho latela boholo le sebopeho sa polasetiki ea cholesterol, tlolo ea molao oa sekepe le ho fokotseha ha lisele tse bonolo tsa trophic ka lebaka la ischemia e hlaha.
Ha nako e ntse e tsamaea, lipalo li ea hlohlona, tekanyo ea ho fokola ha methapo ea methapo e eketseha.
Ntle le ho fokotsa bophara ba mokokotlo o amehang, lipontšo tse latelang tsa lefu lena lia khetholloa: stenosis, kapa ho fokotseha ho sa lekanang hoa lumen; occlusion (blockage e felletseng ea methapo ea mali), kapa atherosulinosis e felisang.
Lisosa tse ka sehloohong tsa atherosclerosis ea libaka tse tlase:
- Mafu a khahlano le pelo le methapo ea pelo (lefu la pelo, khatello ea mali).
- Tšekamelo ea ho lemalla hyperlipidemia le atherosclerosis (dyslipidemia), hyperfibrinemia, monocytosis, homocysteinemia.
- Mekgwa e mebe - ho nwa haholo le ho tsuba.
- Tlolo ea phepo - ho ja mafura le liprotheine tse ngata, lijo tse nang le cholesterol e ngata, ho se tsotelle lijo tsa semela.
- Maloetse a Endocrine, a kang mofuta oa lefu la tsoekere la 2 lefu la tsoekere, hypothyroidism (tlhahiso e sa lekanang ea lihomone tsa qoqotho), lefu la metabolic, botenya, lefu la Itsenko-Cushing. Ho nona haholo le ho nona ka boima ba 'mele ho etsa hore meroalo e eketsehe le matsoho a tlase.
- Ho eketsa boikoetliso ba 'mele ho boetse ho baka keketseho ea khatello methapong ea methapo.
- Ho ikoetlisa ka ho sa lekaneng - ho baka tšenyo ea hemodynamics le tischem ischemia.
- Psychitant pathology - li-varicose veins, lefu la tsoekere macroangiopathy kapa microangiopathy.
- Pathology ea litho tsa pelvic, e leng thrombosis le thromboembolism ea methapo ea kutlo.
- Ho senyeha ha Hormonal le tlhahiso e sa lekanang ea estrogen ka lebaka la ho khaotsa ho ilela khoeli le eona e lebisa ho eketseheng ha cholesterol le likaroloana tsa eona.
- Likotsi le serame tse feteletseng - li lebisa ho liphetoho tsa anatomical ka sebopeho sa lisele tse bonolo le tsa masapo.
- Maemo a sithabetsang le hypothermia.
Sesosa sa nts'etsopele ea lefu lena e ka ba liphetoho tse amanang le lilemo (ho batho ba tsofetseng, ho ruruha ha methapo ea methapo le ho fokotseha, mme esita le li-amana tsa cholesterol tse nyane li ka sitisa phallo ea mali haholo),
Bong bo boetse bo bapala karolo ea kholo ea lefu lena.
Hangata, atherosclerosis e hlaha ho banna, hobane ho basali lihormone tsa thobalano li na le tšireletso marakong a methapo ea mali.
Localization ea libaka tse anngoeng ke koluoa
Localization ea sebaka se amehileng ka boholo bo ama tekanyo ea ho eketseha ha mafu le ho teba ha litlamorao.
Nts'etsopele ea lefu lena e ka hlaha libakeng tse fapaneng tsa liphula tse tlase.
Ho latela sebaka, mefuta e 'maloa ea methapo ea methapo ea methapo e khetholloa.
Mefuta ena ea atherosclerosis ea likarolo tse tlase e khetholloa:
- atherosulinosis ea karolo ea aorto-iliac;
- ho felisoa ha sebaka sa popi sa botšehali;
- pathology e hlophisitsoeng sebakeng sa popliteal-tibial.
- occlusion ea sebaka sa leoto;
- Tšenyo ea masapo ea multilevel.
Hape, ho latela tekanyo ea ho fokola ha lumen ea sekepe, atherosclerosis ea methapo ea letsoho le ka tlase e arotsoe ka ho senyeha, ka ts'ebetso ea "lumel" e fetang 50% ea lumen, mme e sa senyehe, ka ho fokotsa ho honyenyane.
Matšoao a tšobotsi le methati ea methapo ea methapo
Bolwetse bo ka iponahatsa ka matšoao a fapaneng.
Matšoao a lefu lena a itšetlehile ka hore na o hatetse pele hakae, sebaka seo a leng ho sona le boholo ba tšenyo ea methapo.
Litletlebo tsa pele e kanna ea ba mokhathala maotong ha o tsamaea, bohloko bo sa feleng mesifa, ho phola ha maoto.
Kamora nako, matšoao a mang a hlaha:
- Tlas'a mocheso le kutloelo-bohloko ea letlalo la maoto le maoto, boteng ba tsona.
- Ho hloka taolo ea "trophic" kapa letlalo le boreleli, ho kuta ha eona, ho omella, ho lahleheloa ke moriri, ho akheha kapa ho thatafala ha lipekere. Ka ischemia ea bohlokoa le ea nako e telele, li-uloph tsa trophic le gangrene lia hola.
- Boitšoaro ba methapo ea methapo ea methapo ha bo kenngoe hantle, bo ka lebisang mats'oafong a leoto hangata hangata bosiu.
- Lefu la bohloko le hlaha - ho tloha bonolo ho isa ho e matla esita le ha u le phomolong. Ha e le molao, bohloko bo eketseha nakong ea ho tsamaea.
Letšoao la pathognomonic bakeng sa atherosclerosis obliterans ea lipheletsong tse tlase ke ho fana ka maikutlo nako le nako.
Ho ipapisitse le ho se sebetse hantle, mehato e 'maloa ea ho senyeha ha maoto le matsoho ea arohantsoe, mokhoa o ka sehloohong ke sebaka sa ho tsamaea ntle le bohloko.
Boemong ba pele, mokuli a ka tsamaea lik'hilomithara tse fetang e le 'ngoe khafetsa, bohloko bo hlaha ka matla a mangata a' mele.
Mohato oa bobeli oa "A" o tšoauoa ka ponahalo ea bohloko ha o tsamaea ka sebaka sa limithara tse 250 ho ea ho kilometer e le ngoe, "B" ea bobeli - ho tloha ho 50 ho isa ho 250 metres.
Mokhahlelo oa boraro - ischemia e bohlokoa - e tšoauoa ka phokotso ea sebaka sa ho tsamaea se se nang bohloko ha se tlase ho 50 m, ponahalo ea matšoao a eketsehileng, bohloko bo phehella esita le phomolong.
Mokhahlelo oa bone o kopanya matšoao a lefu la boraro le ho eketseha ha trophic ho hlaha, ho fihla ho gangrene ea liphihlelo.
Mekhoa ea mantlha ea ho hlahloba mafu
Ho tseba ka lefu lena ho ipapisitse le litletlebo tsa mokuli, tlhaiso-leseling ka nalane ea bongaka (ha matšoao a qala ho hlaha, tlhaho ea bona, nako e atisang ho etsahala, na mokuli o amahanya lefu le lintlha tse ling - ho sithabela maikutlo, hypothermia), nalane ea bophelo (maloetse a fetileng, tšekamelo ea malapa ea khatello ea mali, angina pectoris, boteng ba atherosclerosis ea sebaka se fapaneng).
Hape, bakeng sa tlhahlobo, tlhaiso-leseling ea tlhahlobo ea sepheo e bohlokoa, ke hore, boemo ba letlalo le masapo a lona, mesifa e bonolo le mesifa ea maoto, ho hlohlona ho lijana tsa distal tsa leoto le leoto. Ba boetse ba sebelisa liteko tsa tlhahlobo ea mali bakeng sa mojaro, ka mohlala, ho tloha sebakeng sa tšohanyetso, mokuli o hloka ho phahamisa maoto ka likhato tse 45 le ho e tšoara nako e teletsana. Pro atherosclerosis e bonts'a ho qaleha ka potlako ha mokhathala, pallor ea maoto.
Bakeng sa mekhoa e meng ea tlhatlhobo, ho sebelisoa mekhoa e akaretsang ea bongaka - palo ea mali ka kakaretso, tlhahlobo ea moroto ka kakaretso, tsoekere ea mali (ho qolla diabetic angiopathy), biochemistry ea mali ka boikemisetso ba cholesterol e felletseng (hangata ho fihla ho 5,5 mmol ka litha e le ngoe), lipoprotein tse fokolang (li-atherogenic), lipoproteins letsoalo le phahameng (karoloana ea anti-atherogenic), lithuto tsa lihormone - lihormone tsa qoqotho ea qoqotho.
Ho sebelisoa mekhoa ea seletsa - ho ntlafatsa methapo ea methapo, tekanyo ea khatello ka sepheo sa index ea ankle-brachial, angiography, magnetic resonance angiography, angiography e kopantsoeng ea multispiral compute angiography, peripheral arteriography, duplex scanning (US) ea methapo ea methapo.
Phekolo e itšetlehile ka ho teba ha boemo, ho tsebahala ha lesapo, boholo ba eona, boemo ba lefu lena, 'me le na le liphetoho tsa mokhoa oa bophelo, litlamorao tsa lithethefatsi le kalafo ea ho buuoa.
Khalemelo ea mokhoa oa bophelo le atherosclerosis ea likarolo tse tlase
Mohato oa pele oa ho phekoloa ha atherosulinosis o qala hang kamora ho fumanoa 'me o kenyelletsa ho lokisoa ha tsela ea bophelo.
Sena se kenyelletsa phepo e nepahetseng kapa phepo e nepahetseng ea bongaka, ho lahla mekhoa e mebe, molao oa ho ikoetlisa.
Lijo tse fanang ka phepo e nepahetseng kapa phepo e nepahetseng ke mohato oa pele oa ho phekola mafu ohle a amanang le lefu la pelo, kaha palo ea cholesterol e mpe maling le khatello ea mali e itšetlehile ka lijo tsa motho.
Lingaka li khothaletsa ho latela lijo tse khahlanong le atherogenic ntle le mafura a liphoofolo le liprotheine, lijo tse nang le cholesterol e ngata - merobo, lipere, mahe a likhoho. Mehloli ea fiber e loketse ho kenella lijong - meroho e tala (saladi, k'habeche, zucchini, broccoli), litholoana, lijo-thollo le linaoa (e le mohloli oa liprotheine tse rarahaneng le liprotheine tsa meroho), linate (e le mehloli ea mafura a phetseng hantle).
E le mohloli oa liprotheine, likhoho (khoho, letata, likoekoe), tlhapi (mefuta e fokolang ea mafura) le linaoa lia amoheleha. Ho bohlokoa ho boloka mmuso oa ho nooa - li-millione tse 30 ho isa ho tse 50 tsa ode e sa khabisitsoeng ka khilograma ka boima ba 'mele, metsi a khabisitsoeng ka khabone a lokela ho felisoa ka botlalo. U boetse u hloka ho lahla lijo tse potlakileng, lijo tse bonolo, tse tsubang, lijo tse halikiloeng, lijana tse halikiloeng le tse halikiloeng.
Ntho ea bohlokoa haholo ke ho lahla mekhoa e mebe - tšebeliso e mpe ea joala, ho tsuba.
Ho ikoetlisa 'meleng mathoasong a lefu lena ho ka ama boemo ba lefu lena hantle. O ka qala ka ho tsamaea letsatsi le leng le le leng la metsotso e 30-60, ho matha, ho ikoetlisa ka baesekele ea stationary, ho sesa. Ho eletsoa hore butle-butle o eketse mojaro ka nako, o nahana ka matšoao a lefu lena, tekanyo ea thibelo ea motsamao.
Tlhokomelo ea maoto le eona e bohlokoa ho bakuli - ho itlhatsoa letsatsi le leng le le leng, pedicure e nepahetseng, kalafo ea maqeba le likotsi tse ling ka li-antiseptic agents.
Tšebeliso ea meriana
Mohato o latelang oa kalafo ke khalemelo ea bongaka ea matšoao a hlahang ho mokuli. Hang ha u qala kalafo, mathata a atherosclerosis a mangata u ka a thibelang 'me a nyenyefatsa tsenyo ea maoto le matsoho.
Lithethefatsi tsa pele kalafo le thibelo ea atherosulinosis ea leha e le efe ea lehae ke li-statins - Atorvastatin, Lovastatin, Rosuvastatin. Li ama metabolism ea k'holeseterole le ho tlangoa ha eona ke sebete, ho fokotsa bongata ba eona maling. Hape, fokotsa palo ea lipoprotein maling e lumella fiber, nicotinic acid, probucol.
Sebelisa li-antiplatelet agents - Aspirin, Cardiomagnyl, Magnikor, Thrombo-Ass, lithethefatsi tsena li ama compaction ea maselese ea atheromatous le pokello ea liplatele libakeng tse senyehileng tsa endothelium. Ha ho na le li-contraindication (peptic ulcer ea mala kapa lefu la duodenal, lefu la mali, ho se mamellehe ka mokhoa o mong le o mong), tšebeliso ea nako e telele ea Aspirin ke li-milligram tse 75 ho isa ka letsatsi bakeng sa thibelo ea mathata a thrombotic.
Ha ho na le mathata a thrombotic ho anamnesis le maloetse a amanang le tsamaiso ea mali a nang le tšekamelo ea khatello ea maikutlo, ho bohlokoa ho sebelisa li-anticoagulants - Warfarin, Heparin, Fraxiparin.
Mokhoa oa kalafo o kenyelletsa lithethefatsi tsa vasodilator - antispasmodics No-spa, Drotaverin, Papaverine, lithethefatsi tse tlatsetsang Vazoprostan, Trental, Agapurin.
Ho fokotsa matšoao le ho fokotsa bohloko, Pentoxifylline, Cilostazole li sebelisoa; ho ntlafatsa trophism ho lisele tse amehang tse bobebe - Zincteral.
Phekolo ea lehae e bontšoa molemong oa nts'etsopele ea mathata a tšoaetsanoang le liso tsa trophic; Ho sebelisoa litlolo tsa Oflokain, Levomekol, Delaskin.
Ho feta moo, ho sebelisoa li-tata tsa vithamine, kalafo ea physiotherapy - electrophoresis e nang le novocaine kapa lidocaine, darsonvalization.
Ho tlameha ho phekola lefu la atherosclerosis feela, empa le mafu a kopaneng (khatello ea maikutlo, angina pectoris, lefu la tsoekere) le mathata.
Mekhoa ea ho buoa
Khetho le tšebeliso ea mokhoa oa phekolo ea ho buoa li etsoa ke ngaka, ho nahanela lintlha tse ngata.
Phekolo ea ho buuoa e ea hlokahala maemong a ho kula haholo, ho hana phekolo ea lithethefatsi kapa ho se e mamelle.
Bophahamo ba phallo ea bongaka bo itšetlehile ka sehlooho sa lesion, tekanyo ea tlhahiso ea sekepe, boteng ba liso tsa trophic tsa letlalo le lisele tse bonolo, le mathata a atherosclerosis.
Hona le mefuta ea ts'ebetso e joalo:
- Opereishene ea Bypass ke ho kenella ka mokhoa o sa lebiseng letho, mohopolo oa eona ke ho theha tsela e 'ngoe ea phallo ea mali ka ho feta sebakeng se amehileng le ho khutlisetsa li-trophism tsa tiske ka tsela ena.
- Ho tsitsisa ke ho kenngoa ha tube e entsoeng ka thepa ea maiketsetso kahara thipa ea sekepe, e thibelang lumen hore e se ke ea fokotseha.
- Balloon angioplasty - katoloso ea lumen ea methapo ka libalune.
- Endarteriectomy - ho tlosoa hoa methapo e amehang hammoho le maselese a atheromatous, le li-prosthetics tse ling.
- Autodermoplasty - mokhoa oa kalafo bakeng sa liso tsa trophic, e kenyeletsa ho khutlisetsa letlalo le amehang ka letlalo la mokuli ka boeena, le nkiloeng libakeng tse ling.
- Ka nts'etsopele ea mathata a, a kang gangreneng, ho pongoa libaka tsa necrotic le maoto a maiketsetso ho sebelisoa.
Thibelo ea atherosclerosis e lokela ho ba e akaretsang le e tsoelang pele, ho kenyelletsa le ho hlahloba khatello ea mali, ho lekola boemo ba mali ba mali, ho buisana le ngaka ea pelo le ngaka ea masapo ha ho hlokahala.
Mokhoa oa ho phekola atherosclerosis ea maoto o hlalositsoe videong ena.
