Ukophulwa kwegazi peripheral: thrombosis kunye Embolism

Ukuphazamiseka ye kwegazi esembindini neuropathy luphuhlisa ngenxa yezizathu ezahlukeneyo. Noko ke, umfanekiso kwezonyango imeko zoqobo liyabonakala kuzo zonke iimeko. Xa kusenziwa utyando, le yingxaki eqhelekileyo, equka iimeko ezininzi lwezidumbu, ngendlela enye okanye ngenye zichaphazela egazini.

Izinto ezibangela izifo kwegazi

Iphazamise movement igazi iimpahla inokuba kwiimeko ezahlukeneyo:

1. Le mithambo benqanawa leyo ivaleke. Oku kunokwenzeka xa occlusion (umz, thrombus okanye icwecwe atherosclerotic) okanye valiweyo (stenosis).
2. utshintsho udonga yezifo (hypertrophy of umfutho wegazi).
3. Abenze kwisikhongozeli evela ngaphandle (umz, ithumba).
4. Ukonakala kodonga nemithambo.
5. Utshintsho rheology egazini.
6. Ukunciphisa umthamo elijikeleza igazi (ukuba ukopha, emzimbeni).
7. Ukwehlisa uxinzelelo lwegazi (athuke kakhulu, ukusilela kwentliziyo).
8. Le ngezifo wentliziyo (iziphene, ukusilela kwentliziyo), apho umthamo yehlise igazi betekisi ngexesha systole.

Zonke ezi meko zingachaphazela ukuhamba kwegazi njengoko sifo ezingundoqo neuropathy nemithambo. Kwimeko yeengxaki ngentliziyo, ukuphazamiseka hemodynamic, utshintsho umthamo wegazi, indlela amahlwili zophendlo lwezifo nokuhamba kwegazi kuphazamisekile kuwo onke amanqanaba - ukusuka inkulu ezityeni zincinane yegazi. efanayo disorder Local (stenosis, thrombosis, imithambo udonga hypertrophy) ziboniswa ngqo kwi ndawo apho kwavele.

Izinto ezibangela ukuphazamiseka ejikeleza peripheral, umgaqo, ngokufanayo embindini. Noko ke, ethetha ngezifo yokumpompoza igazi kwimida, ngokuyintloko zibandakanya iingxaki nokuhamba kwegazi yasekuhlaleni.

Ukophulwa igazi kwegazi yoluvo kutyando - isikakhulu imeko enxulumene ekuyekeni kwemali yegazi thrombosis zasekuhlaleni, Embolism, nokubotshwa isitya yegazi. Zonke ezi states (ngaphandle, mhlawumbi, ngenxa yamafutha) izinto ezingxamisekileyo, efuna uncedo ngoko nangoko.

Ukophulwa kwegazi yoluvo: zesifo

Yintoni wabonisa kumiwe asekuhlaleni lokuhamba kwegazi? Tissue, bazifumanisa ngaphandle eyanele igazi, uqala ukubona ischemia, kuba ngoku abayifumani ioksijini efunekayo eqhelekileyo yokusebenza. Okuya uba mkhulu umsantsa ukungabikho kwamandla, ukufa iseli kwenzeka ngokukhawuleza kakhulu. Xa kungekho eyimfuneko uncedo ekuphuhliseni njengesilonda (m. Kwinyama E. Necrosis evinjwa igazi).

Ephula ejikeleza engabalulekanga nemilenze - umzekelo kakhulu umxhelo. ukuphazamiseka flow igazi kule kunokwenzeka phambili okanye ngokuthe ngcembe.

claudication uveza

Ezingunobangela lixhaphakile eli meko imithambo yalityatya yamafutha asezantsi, aortoarteriit nonspecific, thromboangiitis obliterans. Ukuhamba kwegazi kwimikhumbi yaphukile ngenxa ukuvala le mithambo ngokusebenzisa neziqu uqweqwe oluqhubekayo atherosclerotic okanye ukuqina iindonga ngenxa non-ngqo indlela arhabaxa.

Ukophulwa kwegazi yoluvo kulo mzekelo ebonisa umfanekiso clinical zilandelayo:

1. sigaba imbuyekezo. Lubonakala kukuvela ubuthathaka imilenze, amahlaba kuhlolwe kwisiqalo umzimba. Nakuba kunjalo, iintlungu kwenzeka kuphela xa uhamba kumgama ongekho ngaphantsi kwe 0.5-1 km.
2. Step subcompensation. Siyeke ukuhamba ngenxa uqaqanjelwa imilenze emva kokuba isigulane kuyanyanzeleka ukuba km 0.2-0.25. nemilenze lenziwe iinguqulelo ngenxa yokungabikho igazi: a lipholi, eyomileyo, isikhumba ejiyileyo, izikhonkwane nkum olindelwe yezityebileyo umaleko ongama. Ripples phezu imithambo kuba buthathaka.
3. Step decompensation. Ukuhamba ngaphandle buhlungu kunokwenzeka phezu kumgama ongekho ngaphezulu kwe-100 m. Kukho izihlunu esiqhenqethayo, isikhumba uba zibhityile-olukhanyayo kumphezulu wayo ezininzi neentanda kunye nezilonda.
4. Sikhathi utshintsho yentshabalalo. Kulo meko, ukuhamba kwegazi nasezimpahleni iyakuvingca phantse ngokupheleleyo. nemilenze zigqunywe izilonda, ingakumbi kwiimeko kakhulu, babe iphuhlisa iminwe. Kabukhali yokuhla ukusebenza.

Kakade ke, igazi kuye kwasasazwa peripheral kule ngezifo senzeka elide. Phambi sigaba njengesilonda ipasisa ixesha elininzi, ngexesha apho ukuthatha amanyathelo ayimfuneko ukuthintela ukuyekwa ngokupheleleyo yokumpompoza kwegazi.

thrombosis lwemithambo kunye Embolism

Kulo mzekelo, kukho okunzima nokuhamba kwegazi peripheral, ngeeyure ezimbalwa kunokukhokelela kuphuhliso njengesilonda alo mlenze, ukuba akunjalo uncedo ngexesha ziya kunikwa.

Le thrombus kwi umthambo ukuze zazi i nebhodi atherosclerotic, iinkalo ukudumba eludongeni benqanawa okanye umonakalo. embolus ekuthiwa, thrombi bazisa egazini evela kwenye inxalenye ebhedini nemithambo. Ngenxa yoko, le mithambo inqanawa iyabhlokwa ngokupheleleyo, ukuhamba kwegazi zokumisa, tissue uqala ukubona ischemia ufe (njengesilonda senzeka) ekusindisweni ixesha elide yale meko.

Clinic ukuphazamiseka zosulele peripheral kwegazi

Le utshintsho olukhawulezayo kakhulu iimpawu iqatshelwe Embolism, kuba kulo mzekelo ukuyekwa yokumpompoza kwegazi lwenzeka ngesiquphe, kungasali kungenzeka utshintsho zembuyekezo.

Eyokuqala iiyure ezimbini isiguli intlungu kakhulu kwi imilenze. Le yokugqibela kuba luthuthu nengqele ukuya ngaphandle kwebala. Pulsation kwi imithambo distal angekhoyo. Ngokuthe ngcembe, iintlungu liyancipha, kunye nayo, wu- kunye novakalelo ukuya Ukubulawa ngokupheleleyo. umsebenzi Motor kwemilenze nokuva ubunzima ekugcineni esakha ukukhubazeka. ngokukhawuleza kakhulu, utshintsho ayibuyiseki umva kwenzeka ancedisana ekufeni kwabo. Thrombosis lo mfanekiso, umgaqo, ngokufanayo, kodwa ke uphuhliso ekliniki ayikho ngokukhawuleza. Ukukhula thrombus kufuna ixesha elithile, ngoko ukuhamba kwegazi akukho ngoko nangoko yaphulwe. Ngokuhambelana zokuhlela Savelieva ukwahlula ischemia grade 3:

1. Luphawulwa iingxaki uvakalelo.
2. Dibanisa iingxaki intshukumo.
3. Kweli nqanaba luqala ijwabu necrosis.

Ukophulwa kwegazi yoluvo: unyango

Amaqhinga zixhomekeke ubungqongqo ischemia, kunye nesantya nophuhliso utshintsho ayibuyiseki umva emzimbeni. lomonakalo Acute ye zethala peripheral kufuna unyango ngotyando. Kwimeko ngezimvo kancinane yegazi-flow amanqanaba imbuyekezo nemiphumo emihle kungafezekiswa, kunye nonyango elondoloza.

Imisebenzi egazini oyingozi ukuphazamiseka flow

unyango Conservative na alusebenzi kulo mzekelo, t. K. Ngaba nako ngokupheleleyo ihlwili kwaye ukususa ekuphazamiseni kwiimfuno zokungena nokuphuma kwegazi. ukuqeshwa kwakhe kunokwenzeka kuphela xa comorbidity kakhulu kunye ngayo ngokwaneleyo zembuyekezo. Emva nokuzinziswa isigulane, utyando ukuze uvumbulula ihlwili legazi evela sayo isitya. Ukucutheka kwamanzi igazi ngolu hlobo lulandelayo. Le mithambo kwemithambo ochaphazelekayo ngaphezu ukuvaleka Fogarty catheter, ngokusebenzisa nezithi zikhuphe sokususwa thrombus. Kuba ukuqaliswa kwe-catheter ukufikelela zoqhaqho olwenziwa kwinqanaba bifurcation ye kwemithambo femoral (xa izitshanguba of the nemilenze), okanye brachial Umthambo (ngokuba ukwenzakala ezisekupheleni phezulu). Emva kokwenza arteriotomy Fogarty catheter selekhulile ukuya ukuvaleka inqanawa eyenziwe thrombus, ikhutshwa phandle nge umqobo, uze emva koko anomoya kwaye kule meko incamatheliswe. Eqolo ibhaloni kwi ngencam ithumba catheter kwaye entrains le thrombus.

Kwimeko apho kukho thrombosis kwicandelo utshintsho somgquba udonga isikepe okuba eliphezulu likakade. Ngoko ke, emva ukubuyiselwa yokumpompoza kwegazi kuyimfuneko ukuba enze uqhaqho ocwangcisiweyo Nokulungiswa.

Ukuba imeko sele sisungulwe kwaye ziphuhliswe njengesilonda nomlenze umlenze olwenziweyo.

Therapy ngenxa lokutshabalalisa izifo ezincinane

unyango Conservative inikwa kwangoko sifo, kwakunye Izimo kunyango yotyando. imigaqo esisiseko unyango:

1. Ukuphelisa iimeko ezibangela ukuba spasm kwemithambo njengoko ukutshaya, utywala, emzimbeni.
2. antispasmodics Ukubekwa.
3. Analgesics ukuba ubuhlungu.
4. Nciphisa viscosity igazi ngenxa ukuqeshwa arhente antiplatelet kunye anticoagulants.
5. Ukutya ejolise ekunciphiseni izinga cholesterol egazini.
6. Statins ukuba kuqheleke nethe lipid.
7. comorbidities Treatment zibulale iimpahla: lwegazi, isifo seswekile, yegazi.

Noko ke, unyango isebenzayo ihlala ukusebenza Nokulungiswa - indlela esa (esa indalo anastomosis), stent (stent kulo mithambo benqanawa).

Ngamafuphi

Le kwegazi peripheral inokuba ngenxa yezizathu ezahlukeneyo. Kubalulekile ukukhumbula ukuba elide-ezikhoyo okanye yabangela etsolo igazi disorder kusenokukhokelela kwiinguqu vuhlayiseki kwi esikule kwaye ibangele ukubola.

Yokuthintela ukuphazamiseka sentliziyo kuyimfuneko ukugcina yokuphila esempilweni, ukutya okufanelekileyo, uphambuke imikhwa emibi, ngokunjalo unyango ngexesha elililo lwezifo, igalelo kuphuhliso angiopathy.