ʻO ka Obliterating atherosclerosis kahi hana pathological koʻikoʻi o ka ʻōnaehana cardiovascular, ka mea e hōʻike ana iā ia iho i ka hiʻu o ka lumen o nā moku o ka elastic a me ka ʻano ʻōiwi ma ka pua, i hoʻopiha ʻia me ka momona-protein infiltration, nā loko.
Ke alakaʻi nei kēia i ka hōʻino o ka trophism o ka wahi i hoʻomākoakoa ʻia e ka pā kani. Loaʻa ka poʻe maʻi i ka ʻeha nui loa me nā puka pōkole o nā atherosclerosis o nā lalo haʻahaʻa.
Ma kēia hihia, hoʻemi nui ʻia ka nalo ʻana i nā mākala me ka lactic acid a me nā metabolites i hoʻopili lohi ʻia, no laila hiki mai ka ʻeha ʻole. E noʻonoʻo i ka etiology a me nā pathogenesis o kēia maʻi.
ʻO nā kumu a me nā hana hoʻomohala
He nui nā kumu kumu no ka hoʻomohala ʻana o ka maʻi. ʻAʻole i aʻo ʻia kahi mīkini ʻikepili o ka atherosclerosis, akā ma ka lāʻau lapaʻau e pili ana i kēia mau loina, nā ʻano kumuhana no kēia maʻi. Ka mea i kēia inā inā loaʻa i ka mea maʻi kekahi o nā kiʻi e hōʻike ana, a laila hoʻonui ka manawa o nā loli o ka atherosclerotic.
Aia kēia mau mea:
- ʻOi momona. ʻOi aku ka poʻe o ka poʻe kaumaha ma mua o ka maʻi ma muli o kahi pilikia i kahi nui o nā ala kikiʻenehana. E like me ka hoʻopili ʻia ʻana nā momona i loko o ka kiko adipose, ʻo kēia mau triglycerides like kolala, kolamu, nā mea lipid hiki ke komo i loko o nā sela endothelial o ka pā vascular. No ka hui like like, hiki ke hōʻike ʻia i ka momona momona, nā meaʻai kiʻekiʻe e kāhea ana i ka ʻaina enzyme.
- Ka wa elemakule, wahine ʻAʻole liʻiliʻi ka wahine i ka atherosclerosis ma muli o ka hiki o ka estrogen, ka mea i pale i ke kaʻina o disorganization o nā membrane cell. Maʻi ʻelima pinepine nā kāne. Eia nō hoʻi, ʻo nā kānaka ma hope o 40 mau makahiki e maʻalahi i ka maʻi ma muli o ka hōʻemi kūlohelohe o kolagala i ka pā vascular a me ka nalowale o kā lākou elasticity.
- Laula. ʻO Nikotine a me nā mea ʻē aʻe o ka uahi o ka uahi olakino e hoʻonāukiuki i ka ʻōpū o nā kīʻaha koko, e hoʻonāwaliwali iā lākou i ka wā o ka manawa. He mea maʻalahi loa ia e komo i loko o ka pā o ke kolamu ma mua o kahi paʻa.
- Naʻi maʻi mellitus. Ma kēia hihia, ʻaʻole hele nā lipid oxidation a hiki i ka hopena, a pono nā mea ʻike ʻole ʻia e nūnū me ke koko i loko o ke koko, kahi e komo ai lākou i kā lākou membic tropic.
ʻO ke koko koko kiʻekiʻe, he ola puʻuwai, heredity ma ke ʻano o ka noho ʻana o nā hoahānau o nā maʻi cardiovascular - ʻaʻole kēia he papa piha o nā mea e alakaʻi ai i ka atherosclerosis.
He aha ka mea e kū ai i ke kino? I ka wā mua, ʻaʻole liʻiliʻi nā hoʻololi, hiki ke ʻae ʻia e ka maʻi biochemical wale nō. Lawe ʻia ka kolamu ma ke kino i nā ala halihali i kahi kiʻekiʻe o ka haʻahaʻa a haʻahaʻa. ʻO ka mea mua, ʻo ia ka mea i kapa ʻia ʻo kolamu "hoʻohana" maikaʻi, i ka hana i lawe ʻia no ka synthesis o nā hormones a me ka hoʻoponopono ʻana o ka membra permeability, me ka hoʻokaʻawale ʻana. ʻO ke ʻano lua he mea hoʻoilina kolesterol no ka mālama. ʻO ka maʻamau, ʻehā ʻehā e liʻiliʻi ma mua o ka mea mua, akā i kekahi manawa ke haki nei ka uku. A laila hoʻomaka ka infiltration momona. Hoʻomaopopo ʻia kēia hana dolipid.
Aia he nui nā pae o ka holomua o ka maʻi
- ʻO kahi papa - Lipoidosis. I kēia hoʻomakaʻana, hiki ke loaʻa nā lehelehe lipid a me nā welelau, ʻo ia hoʻi kahi hōʻailona mua o ka atherosclerosis.
- Atheromatosis - hoʻonui i ka pākeke, hoʻopili i ka lumen ʻoi aku, keu me ka capillaries a me fibrin. ʻIke ʻia nā hōʻailona mua o ka maʻi.
- ʻO ke ʻano hope he fibrosis a i ʻole ka helu ʻana. Hiki ke loliʻokoʻa ka pākeke i ka ʻili hoʻohui, e hoʻomoʻi ʻia me ka paʻakai a ʻo ka paakiki, ʻo ia ka mea i hoʻopiha i nā koho lapaʻau i kahi maʻi pale.
He aha nā ʻano o atherosclerosis ma laila?
Hiki i ke atherosclerosis ke hoʻopilikia i nā moku nui a i ʻole ma ke kino holoʻokoʻa.
Nā puka pōʻino e pili ana - ka coronary (pani ʻana o nā moku e hānai ana i ka naʻau), cerebral (ka komo ʻana o ka pahu brachiocephalic a me ka pāheona kūhelu carotid maʻamau), nā hiʻona haʻahaʻa (hōʻino i ka palaki femoral ma kona lōʻihi holoʻokoʻa).
Kuhi ʻia ana nā leka o ka atherosclerosis o nā haʻahaʻa haʻahaʻa e like me nā kumu he nui - nā hōʻailona, nā maʻi hana a me nā hōʻailona morphological.
ʻO nā mea nui e pono e noʻonoʻo:
Hāpai ʻia
- 1 - ʻaʻole makemake ke kanaka i ka ʻeha i ka wā e hele ana ʻo ia ma kahi mamao ma kahi o 1 kilomita. Loaʻa paha ka ulu ʻana o ka eha me ka hōʻeha kino kino. ʻO nā hōʻailona hou aʻe, tingling i nā manamana lima, sensation o ke anuanu o ka maʻa loa, kahi pallor o ka ʻili ma ka wāwae, hiki i ka numbness.
- 2a - ua loaʻa ke kaumaha ma kahi mamao o 1 km. Hōʻailona ka mea āpau i kahi pā lehelehe ma muli o ke kahe ʻana o ke koko i loko o nā veins, hyperkeratosis (ʻili maloʻo), nā kui palapu. I kēia manawa, ʻaʻohe hana hou e hoʻoholo ai i ka pulsation o nā moku lahilahi i nā wāwae.
- 2b - ʻaʻole hiki i ka mea maʻi ke hele ma ka 250 m ma ka wāwae me ka ʻole ke kaohi ma muli o ka ʻeha e hiki mai ana ma hope o kahi hoʻomaha iki.
- 3 - ʻeha pinepine ka ʻeha a hiki i ka mea maʻi ke hala ma ke ala 50 mika ʻaʻole e pani. Pili loa kēia papa kuana pili i ka ulen o ka moku. Holo ka lauoho ma luna o ka wāwae, no ka mea, ʻaʻohe pono ka meaʻaiʻai. Kuhi nā ʻōleʻa ma ka ʻili, lilo ia i mea palupalu a lawe i kahi kala momi.
- 4 - ka hōʻike o nā hōʻailona o waho i ke ʻano o nā ʻōpala trophic a me ka foci o nā nekrosis. He kūlana paʻakikī kēia e kīnā nei i ka pōʻino. Hōʻike ʻia ka ʻōpū o ka gangrenous e nā ʻeha pōkole i hiki ʻole ke hōʻoluʻolu ʻia e nā mea hōʻeha. Hōʻulaʻula nā wāwae, a keheʻe nei ka wāwae.
Wahi a ka hoʻonohonoho ʻana o ka manaʻo.
- Hoʻopilikia ke kaʻina hana i ka arela iliac a me ka aorta ʻōpū.
- Me ka hoʻomohala hou, ua komo ʻia nā kīkole wahine a me nā lālā popliteal mua.
- ʻO ka pili pūnaewele popliteal a me nā moku o ka mahele tibial e pili ana.
- ʻO ka pohō paʻakikī o nā pauku aʻe i luna.
- ʻO ka maʻi Multifocal - he nui nā foci a puni ke kino, kahi ʻano laulā.
Atherosclerosis o nā haʻahaʻa haʻahaʻa ke helu ʻia e like me ka helu o ka holomua o ka maʻi (ʻākala a me ke koʻokoʻo), ka nui o ka mālama ʻana i ke kaila o ke koko (hoʻopuni, subcompensated, decompensated).
Pehea e ʻike ai i ka maʻi i ka manawa?
Hoʻomaka kekahi mea hoʻomaka me kahi loiloi haʻawina, ʻo ia hoʻi, me ka hoʻopiʻi hoʻomanawanui.
ʻO nā hiʻohiʻona maʻamau anamnestic o ka atherosclerosis o nā haʻahaʻa haʻahaʻa e pili ana i ka hōʻeha, ke kuni hōʻeha ke hele nei ma ka wāwae haʻahaʻa (me ka hōʻeha i ka aorta ʻōpū, hope a me nā ʻeha o ka ʻeha, a me ka impotence i ka 50% o nā hihia), ka uluʻana o kaʻeha, hōʻeha o nā limahana, ka hōʻemi ʻana o ka hōʻeha o ka ʻili o nā wāwae, hoʻololi ko lākou mau kala, hala ka pulse.
Ma hope o ka loiloi, hiki iā ʻoe ke hoʻomau i ka ʻike ʻoihana ʻoihana.
- ʻO ka koho ʻana o ka mākeu-lipach index e loiloi i ke kahe koko i nā ʻaoʻao haʻahaʻa. Hoʻohālikelike ia ʻo ka māhele o ke kaomi o ka nui o ke kaomi tibial ma i ka artery brachial. Hoʻohālikelike i kahi.
- ʻO ka loiloi duplex ultrasound. Ke hoʻohana nei i kēia ʻano, ke kau nei ke ʻano o ka lāʻau i makemake ʻia, ka pae o ke kuapo, a me ka wikiwiki o ka holo kahawai wai me kona mau ʻāpana rheological - density, hiki i ka regurgitation ke hoʻoholo ʻia. ʻO kēia kahi ala hoʻoholo i ka hopena o ka maʻi.
- ʻO Angiography - i hui pū me ka CT, hiki iā ia ke hoʻokaʻawale ke ʻike i ke ala o nā kīʻaha koko ma ke kū pono a ʻike i ka wahi i hoʻopau ʻia. Hoʻokomo ʻia nā hemahema ka invasiveness, no ka mea pono ke nānā pono ʻia e hoʻolauna i ka hoʻohālikelike intravenous.
E nānā i ke kūlana o nā palupalu palupalu, hoʻohana ʻia ka MRI a ʻike ʻia ka luhi o ka oxygen, inā pono, e hoʻoholo i nā wahi kahi i ola ʻia a pono paha e wehe aku.
Hoʻomaʻamaʻa a me ka pale ʻana o ka maʻi
Ma hope o ka hana ʻana i kahi maʻi lapaʻau, hele ka kauka i ke koho o ka lāʻau lapaʻau.
I ka hihia o ka atherosclerosis, ʻelua wale nō o lākou - ka ʻūhane a me ka maʻi maʻi (conservative).
Pono ʻoe e hoʻomaopopo he hiki wale ke koho mua wale nō inā ʻaʻole i holo i nā ʻano o kēia maʻi, hiki ke ʻae ʻia e nā mākena pharmacological.
Ke loaʻa nei kēia mau lāʻau:
- ʻO ka hoʻohana ʻana i nā ʻaina antiplatelet (Dextran, Reopoliglyukin, Pentoxifylline (Trental), Aspirin, Ticlopidine) i mea e pale ʻole ai i nā ʻolua koko ʻole i ka pili pū ʻana i nā ʻāpana paʻa o ke kahe wai - e hoʻomāhuahua hou aʻe kēia i ka ischemia.
- ʻO ka maʻi Hypolipidemic (ka makeʻana o Lovastatin, Simvastatin, Atorvastatin, Ciprofibrate, ka waikiko nicotinic).
- Hoʻohana ʻia ʻo Antispasmodics (Drotaverin, No-Shpa, Papaverin) no ka hoʻomaikaʻi ʻana i ke kahe koko i loko o ka wahi i hoʻopili ʻia ai. Hoʻololi kēia i ka ʻeha a hoʻolōʻihi i ka manawa pregangrenous o ka maʻi, e pale ana i ke ʻano o nā uluna.
- Me ka hoʻoweliweli ʻana o ka thromboembolism, thrombolytics a me nā fibrinolytics (Streptokinase, Heparin, Urokinase) e mālama ʻia i ka hana intravenously.
- Hoʻolaha ʻia ka pīpeku.
Hoʻopili ʻia nā lāʻau hoʻohui i ka hoʻohana ʻana o nā kaʻina hana physiotherapeutic (electrophoresis, magnetotherapy), ka pilina oxygen oxygen kikoo a me ke ʻano ozone therapy.
ʻO nā hana loiloi e mālama ai i ka atiteros aterosclerosis o nā haʻahaʻa haʻahaʻa e komo i ka hana o ka endovascular - he hana hou kēia o ke ʻano hana, i ka wā ma lalo o ka mākaʻi o ka palena o ka mea hana x-ray, hele mai ke kauka i ka wahi i hoʻopaʻa ʻia a pili:
- Hoʻomukala mīkini hoʻi i nā hoʻokū kaʻa lōʻihi lōʻihi.
- Hoʻopili i kahi koko koko a iʻa paha i ka pa.
- Kūkākūkā i ka moku pili.
- ʻO ka hoʻokomo ʻana i kahi pōkō micro-pale e hoʻopau i ka stenosis.
ʻO kēia mau kaʻina hana a loaʻa i nā loiloi maikaʻi loa mai nā mea maʻi a me nā loea, e kūʻē i nā hana hōʻeha weliweli.
ʻO ka wehe ʻana i nā hana ma luna o nā moku o ka lalo o ka lalo o ka haʻawina piha ka hoʻopau ʻana o ka moku i hoʻopuni ʻia, indirectculascularization a ʻokiʻoki paha.
I mea e pale ai i kēia maʻi, ua kūpono e pili i ka ʻai koʻikoʻi, hoʻonui i ka kaila koko e ka hoʻonui ʻana i ka hana pilikino maikaʻi, e hele pinepine no ka ʻohi a hoʻopili i ka ʻūhā, ʻai i ka meaʻai liʻiliʻi, ma laila kahi hui pū o nā momona + kālama.
Pehea e ho'ōla ai i ka atherosclerosis o nā wāwae e haʻi i ka loea i ke wikiō ma kēia ʻatikala.
