Kutyora peripheral kweropa: thrombosis uye embolism

Zvirwere zviri nechepakati uye peripheral kweropa hwapedyo nezvikonzero zvakasiyana. Zvisinei, ari kurapwa mufananidzo kwokufara chairwo uye akazivikanwa zvose nyaya. In kuvhiya tsika, ichi idambudziko zvakafanana, zvinosanganisira mamiriro zhinji pathological, imwe nzira kana imwe sei muropa.

Zvinokonzera kweropa zvirwere

Kuvhiringidza chakaipa kufamba kweropa kuburikidza nhumbi angava mamiriro ezvinhu akasiyana:

1. The lumen ngarava iri safambika. Izvi zvinogoneka pakuparwa occlusion (semuenzaniso, thrombus kana atherosclerotic Dombo) kana kuderedza (stenosis).
2. Pathological rusvingo kuchinja (hypertrophy kuti chirwere cheBP).
3. Kudzvinya mugaba kubva kunze (semuenzaniso, bundu).
4. Kuvadza vascular madziro.
5. Aichinja ropa rheology.
6. Kuderedza Vhoriyamu achiparadzira ropa (nokuti ropa, kupera muviri).
7. BP (kuvhunduka, mwoyo kukundikana).
8. The zvokurwara komoyo (kuremara, mwoyo nokukundikana), umo shoma Vhoriyamu ropa vabudiswa panguva systole.

All ezvinhu izvi zvinogona kukanganisa ropa riyerere sezvo huru uye peripheral vascular chirwere. Kana matambudziko nemoyo hemodynamic nenyonganiso, kwenzwi ropa, pathological pakugwamba zvigadziriswe pakati kweropa vasingadzoreki zvese - kubva makuru nemaduku nemidziyo ropa. Local nyonganyonga chete (stenosis, thrombosis, vascular rusvingo hypertrophy) zvinoratidzwa zvakananga pamusoro munharaunda apo yakamuka.

Zvinokonzera kusagadzikana peripheral kuparadzirwa, pfungwa, sezvaiitwa pakati. Zvisinei, achitaura zvokurwara ropa riyerere panguva arikunze, kunyanya zvinosanganisira yomunharaunda ropa kutenderera zvirwere.

Kutyora peripheral kweropa iri kuvhiyiwa - kuchikonzerwa ezvinhu chokuita kumira ropa riyerere omunharaunda thrombosis, embolism, clamping mudziyo atherosclerosis. Vose inoti izvi (kunze, zvichida, mumwe atherosclerosis) okukurumidzira, inoda rubatsiro pakarepo.

Kutyora peripheral kweropa: zviratidzo

Chii vakaratidzawo omunharaunda kumira ropa riyerere? Zvinyama, vakazviwana asina zvakakwana ropa nemushonga, vanotanga kuona ischemia, nekuti zvino havasi kuwana inodiwa okisijeni kuti kwomuzvarirwo inoshanda. The kukuru kushaya simba, sero rufu kunoitika kurumidzei. Pasina anodiwa rubatsiro kusimukira neronda rinonyenga (m. E. Necrosis munyama kunyimwa ropa zvitengeswa).

Kutyora peripheral riparadzirwe rezasi Mbabvu - kupfuura mikuru muenzaniso. ropa kuyerera zvirwere munyika iyi inogona kuva pakarepo kana zvishoma nezvishoma.

inoratidza claudication

The kupfuura kakawanda zvinokonzera ichi vari atherosclerosis yakaderera muzvidimbu arteries, nonspecific aortoarteriit, thromboangiitis obliterans. Ropa kuyerera mumidziyo wakaputsika nokuda kuderedza pamusoro lumen kuburikidza mberi atherosclerotic Dombo growths kana thickening kwemasvingo somugumisiro asiri zvakananga anogumbura kuita.

Kutyora peripheral ropa kuparadzirwa munzvimbo iyi akaratidza zvinotevera zvekuchipatara mufananidzo:

1. muripo rwakazara. It kunoratidzwa nechitarisiko kusimba makumbo, chinyamunhari chinorwadza uye kusagadzikana pamusoro mamiriro kurovedza muviri. Zvisinei, marwadzo kunoitika chete kana kufamba ari chinhambwe kwete asingasviki 0.5-1? Km.
2. Step subcompensation. Regai kufamba nokuda kwokurwadziwa makumbo pashure murwere anomanikidzwa 0.2-0.25? Km. Mbabvu Lower vanosangana vamwe kuchinja nokuda kushaya ropa rive: a rakachenuruka, akaoma, chinopfupfuduka ganda, pfava nzara, rive dete ari subcutaneous mafuta rukoko. Ripple pamusoro arteries simba.
3. Step decompensation. Kufamba pasina marwadzo zvinogoneka pamusoro chinhambwe kwete mamita anopfuura 100. Pane tsandanyama kuparadza, ganda anova dzakaonda-ganda iri kwayo pechiso mune muzvizhinji pamusoro makatsemuka uye maronda.
4. Stage kuchinja anoparadza. Pakadaro, ropa riyerere nemidziyo anomiswa zvinenge chose. Mbabvu Lower akafukidzwa maronda, kunyanya mu Muzviitiko zvakaipisisa, neronda rinonyenga hwapedyo minwe. Mavara akaderedza kugona kushanda.

Chokwadi, peripheral ropa riparadzirwe zvokurwara ichi anovandudza refu. neronda rinonyenga Danho asati inopfuura nguva yakawanda, panguva iyo unogona kutora matanho akakodzera kuti kudzivisa zvachose kumira ropa kuyerera.

Arterial thrombosis uye embolism

Muchiitiko chino, pane kwazvo kutyorwa peripheral kweropa, mumaawa mashomanana aigona kutungamirira kukura neronda rinonyenga ari muzvidimbu kana asina kundibatsira zvicharangarirwa.

The thrombus ari tsinga ingangoumbwa iri atherosclerotic Dombo, nzvimbo kuzvimba pamadziro ngarava kana kukuvadza. Akadana embolus, thrombi vakauya ropa rukova kubva mumwe chikamu vascular mubhedha. Somugumisiro, ngarava lumen kukurukurirana kwacho chose, ropa aibuda rinomira, nyama vanotanga kuona ischemia uye kufa (neronda rinonyenga hwapedyo) mu-refu nokuchengetedzwa izvi.

Clinic kuti chenjera peripheral kweropa zvirwere

Zvikuru nokukurumidza shanduko zviratidzo kuchengetwa embolism, nokuti iyi kumira ropa aibuda kunoitika nokukurumidza, vachisiya pasina mukana kuti compensatory kuchinja.

maawa okutanga maviri murwere zvakaitika kurwadziwa zvikuru maoko nemakumbo. The yokupedzisira inova rakacheneruka uye chando kuti ikabatwa. Pulsation ari distal arteries vasipo. Zvishoma nezvishoma, kurwadziwa zvinoderedza, uye pamwechete nayo, muted uye aikanganiswa kusvika zvizere yokutindivadza. Motor muzvidimbu basa achatambudzwa pakupedzisira anovandudza dzomuviri. Nokukurumidza, kusingarapiki kuchinja kuitika nyama uye rufu rwavo. Thrombosis of mufananidzo, pfungwa, zvakafanana, asi kukura kiriniki haisi kudaro kutsanya. Kukura thrombus kunoda imwe nguva, saka ropa riyerere haisi pakarepo kuputswa. Maererano kupatsanura Savelieva kusiyanisa ischemia giredhi 3:

1. Hwokuratidza utetsa zvirwere.
2. Join kufamba zvirwere.
3. Panguva iyi kunotanga tishu necrosis.

Kutyora peripheral kweropa: kurapa

Nzira kuvimba kwokuomerwa ischemia, uye kumhanya kugadzira kusingarapiki kuchinja munyama. Chenjera vanotaura pamusoro peripheral riparadzirwe kunoda kuvhiya kurapwa. In zvinoitirwawo zvishoma nezvishoma Kuipa ropa riyerere munzira nzendo muripo yakanaka mugumisiro inogona kubudirira, uye kuchinja kurapa.

Operations mu chenjera ropa riyerere zvirwere

Kuchinja mabatiro iri basa iyi, t. K. Ko kukwanisa kuparadza clot zvachose uye kubvisa mhingaidzo kuti ropa riyerere. Kugadzwa ake zvinogoneka chete kana chakakomba comorbidity pamwe zvakakwana compensatory siyana. Pashure Kudzikamiswa murwere, kuvhiyiwa kuti wokuwanazve ropa clot kubva mudziyo lumen. Akaderedza ropa kuyerera sezvinotevera. The lumen pakati njodzi tsinga pamusoro blockage Fogarty anobudisa mushonga zvishoma nezvishoma, hwaishandiswa zvinosvibisa thrombus rokubvisa. Nokuti kutanga pamusoro anobudisa mushonga zvishoma nezvishoma kuvhiya kuwana rinoitwa panguva ufanane bifurcation ose ari femoral tsinga (mu maronda repasi Mbabvu), kana brachial tsinga (nokuti rokumusoro kumugumo maronda). Apedza arteriotomy Fogarty anobudisa mushonga zvishoma nezvishoma iri yemhando kuti blockage ari mudziyo pedyo thrombus, rinoitwa kuburikidza chipingamupinyi, uye ipapo inflated uye mamiriro iyi akapora. Inflated chibharuma pa muromo anobudisa mushonga zvishoma nezvishoma rinoburitsa uye entrains ari thrombus.

Panguva chiitiko mumwe thrombosis mumunda Organic rokuchinja ngarava rusvingo zvakakwirira mukana wokuti wava kusvutazve. Naizvozvo, pashure nokudzorerwa ropa kuyerera zvakafanira kuti aite akaronga reconstructive kuvhiyiwa.

Kana mamiriro ezvinhu rave raparurwa uye vakava neronda rinonyenga muzvidimbu kudimurwa rinoitwa.

Zvipatara kuti vatsvaire zvirwere arteries

Kuchinja mabatiro anopiwa mangwanani chirwere, uyewo contraindications kuti kuvhiya kurapwa. Basic misimboti yokurapa:

1. Kubviswa zvinokonzera kukonzera spasm pakati arteries sokusvuta, doro, hypothermia.
2. Kugadzwa antispasmodics.
3. Analgesics kurwadziwa.
4. Usanyanya ropa viscosity kuburikidza kugadzwa antiplatelet nevamiririri uye anticoagulants.
5. Diet zvainanga kuderedza padanho remafuta akawandisa muropa.
6. Statins nokuti normalization yacho lipid muviri.
7. Treatment comorbidities kukanganisa midziyo: BP, chirwere cheshuga, atherosclerosis.

Zvisinei, chinonyanya inobudirira kurapwa anoramba reconstructive oparesheni - the yokunzvenga (yokunzvenga anastomosis kusikwa), stent (stent kupinda lumen ari mudziyo).

To muchidimbu

The peripheral kweropa kungava nokuda kwezvimwe zvikonzero. Zvakakosha kuyeuka kuti kare yaivapo kana akaita rikwanise ropa nyonganyonga kungaita kuti kusingarapiki zvachinja zvinyama uye kuguma neronda rinonyenga.

Nokuti kudzivirira zvemwoyo zvirwere zvakafanira kuti kuchengetedza utano hwakanaka, kudya kwakakodzera, tichidzivisa miitiro inokuvadza, uyewo nenguva kurapwa zvirwere, zvikaita kuti pave angiopathy.