Inatsekeratu mtsempha wamagazi kulambalala opaleshoni - ndichiyani? Inatsekeratu ziwiya kulambalala za mtima

Inatsekeratu matenda a mtima ndi mliri chenicheni cha m'ma 21. Pafupifupi munthu wachiwiri akudwala matenda. Ena kuchiza matenda ndi mankhwala, koma zimene ena opaleshoni kwambiri. Imodzi mwa ntchito zazikulu, kuchepetsa magazi mu zotengera za mtima, ndi inatsekeratu kulambalala.

Ndi chiyani icho?

Mawu amenewa anayamba kuoneka mu malo ambiri mankhwala kwa nthawi yaitali. Panopa ntchito ndi pafupifupi yekhayo wa mtundu wake. Malinga ndi kafukufuku, kuzungulira dziko pafupifupi theka la miliyoni njira zimenezi pachaka.

Monga tanenera, ambiri odwala opaleshoni inatsekeratu mtsempha wamagazi matenda mtsempha wamagazi kulambalala n'kofunika. Ndi chiyani icho - zindikira, mwatsoka, osati ambiri.

Inatsekeratu mtsempha wamagazi kulambalala opaleshoni ikukhudza imposition wa zopatuka pa zotengera mtima.

amachita ndithu yaikulu ndi woopsa.

Malinga ndi kafukufuku, ntchito imeneyi ikuchitika 12 peresenti zokha mu kusowa onse. Mu ena pali contraindications kuti ntchito zake, pamene ena nthawi zonse pitani kuchipatala.

Kamodzi opaleshoni waoneka, ambiri asayansi odziŵika ndi chidwi chachikulu kwa iwo, Koma patatha zaka ziwiri chilengedwe chake, opaleshoni anawaletsa. Re-anayambitsa mu zaka zambiri, pamene opaleshoni anayamba kuoneka mu TV dziko. Kuyambira pamenepo, ntchito kwake pafupifupi tsiku lililonse, ndipo madokotala ambiri sanena zotheka mankhwala inatsekeratu mtsempha wamagazi matenda, koma kuchita opaleshoni.

The pathogenesis cha matenda mtsempha wamagazi

Inatsekeratu mtsempha wamagazi matenda kuyambika mitsempha inatsekeratu ayamba kuona vuto la oxygen. Izi zimachitika chifukwa kuchepetsa wa lumen wa. The zifukwa zikubweretsa kuchepetsa ambiri - kuyambira kubadwa wopunduka ndi nthenda kuchepetsa chibadwire, kutsiriza ndi kuchepa lumen chifukwa cha kuchuluka kwa mipukutuyi atherosclerotic.

Mwachibadwa, IBS zizindikiro musati zimapezeka mpaka ndiye, mpaka lumen si mwapang'ono ndi maperesenti oposa 70. chipatala akhoza kuoneka okha nkhani ya ntchito yaikulu thupi.

Zinthu zofunika kwambiri pa chitukuko cha matenda a mitima ndi chifuwa ululu limodzi ndi kufupika kwa mpweya ndi kuchita mantha. Ndi kuchepetsa yofunika kwambiri ziwiya inatsekeratu kumaonjezera ngozi ya matenda a mtima.

Pamene mankhwala ndiwofatsa ndi operewera (phwando vasodilator mankhwala) analengeza inatsekeratu mtsempha wamagazi kulambalala kumezetsanitsa.

Inde ya opaleshoni

opaleshoni imagwiridwa otsegula mtima opaleshoni, T. E. M'pofunika kutsegula pachifuwa. ang'ambe thupilo Nthawi zambiri pamodzi cartilages costal kumanzere.

Wodwala nthawi za phukusi chikugwirizana ndi makina mtima m'mapapo.

opaleshoni imagwiridwa pogonekedwa ndi mankhwala ambiri.

Kuti alenge shunt ntchito zambiri ziwiya zachiphamaso (subcutaneous Vienna miyendo kapena mtsempha wamagazi mkati mammary). The shunt chifukwa, kamodzi kuchotsedwa, umagwiritsidwa pamwamba ndi pansi pa kuchepetsa wa mitsempha inatsekeratu ndi sutured mu chotengeracho. Izi facilitates otaya magazi kudzera mtsempha wamagazi wathuyo ndi limakupatsani kuchotsa m'mnyewa wamtima ischemia.

Nthawi zina amachita ndikasendeza womwe ndi mtsinje zozungulira ngati magazi kudzera mitsempha ndi bwino mipita.

Panopa, amakonda kuchita ntchito popanda kulambalala mouzirira, ngati magazi kudutsa wagawo zimenezi kumathandiza kuti kuwononga maselo ofiira magazi ndi hemolysis.

Zikuonetsa kuti Khwelero

Inatsekeratu ziwiya kulambalala mtima kumaonekeranso milandu zotsatirazi:

• Yafupika magazi patency wa mtsempha wamagazi kumanzere inatsekeratu peresenti osachepera 50. chotengera ichi ndi infarction zikuluzikulu zakudya. Ambiri a magazi ndi funso kwa iye, chifukwa cha zimene chipika mlingo wa chidebe ndi zinadzala ndi ischemia kwambiri ndi m'mnyewa wamtima infarction.
• The kuchepa lumen wa ziwiya inatsekeratu kwa 70 peresenti.
• Pamaso pa stenosis wa mtsempha wamagazi zapambuyo interventricular (makamaka pa nsonga ya bifurcation).

kuwerenga ndi zofunikira inatsekeratu opaleshoni kulambalala.

Pambali pali chowawa, symptomatic zizindikiro. Iwo amayamba ndi kumamwa kawirikawiri angina (ululu, kumverera kwa constriction mu chifuwa), ndipo kawirikawiri cropped mankhwala. Komabe, vuto limakhala lalikulu kwambiri choncho kumene mankhwala wotaya nchito zake, ndiponso kuukira akukhala pafupipafupi. Kuti mu nkhani iyi ayenera kale ankanena za shunting.

contraindications

Chifukwa kufala lonse la umisiri zambiri, aphunzire za inatsekeratu mtsempha wamagazi kulambalala opaleshoni - chimene icho chiri, chimene umboni wake - sikovuta. Chirichonse ndi zovuta ndi contraindications.

Mosiyana ndi zizindikiro opaleshoni, contraindications onse wachibale, chifukwa chakuti funso lililonse wodwalayo za ntchito ayenera kuonedwa otuluka deta yake yeniyeni.

Iye akhapidziwa kuti m'badwo wodwala, zaka makamaka pa 70, ndi chinthu prohibitive kuchita zikunena. Pakali pano, odwala ambiri achikulire kulekerera kulowelela mu mtima (ndi chifukwa pakalibe matenda concomitant aakulu zokhudza hemodynamics). Kwa anthu amene ali matenda, madokotala ambiri okonda ndi kumuika mtima ndi mtima (pokhapokha limati pali decompensated).

Poyamba, inatsekeratu kulambalala opaleshoni ziwiya mtima kunachitidwa zoopsa aimpso kapena yogwira oncological ndondomeko. Tsopano mungapeze mudziwe zikunena wokongola bwinobwino amachitika odwalawo ndi zotsatira zabwino ndi prolongation wa moyo kwa zaka zoposa 10.

konzanso odwala

Popeza opaleshoni kwambiri zedi ndi woopsa, kutsindika ndithu ndi kasamalidwe koyenera ka odwala likufa inatsekeratu mtsempha wamagazi kulambalala kumezetsanitsa. Pambuyo opaleshoni sachedwa kukhala mavuto monga imfa ya m'mapapo mpweya (chifukwa motalika wodwala pa othandizira a) ndi mavuto opatsirana.

Prophylaxis matenda kupuma anachita ntchito zibaluni kufufuma kapena zidole wapadera. Kupewa chitukuko cha mavuto matenda ndi zovuta zambiri - osati nthawi zonse mosamala yake kusintha kwa nsalu kupewa matenda.

Onetsetsani kuti aziona magawo a magazi wodwalayo, monga chifukwa massiveness ya opaleshoni zambiri zingaoneke kwambiri magazi otayika. Pankhaniyi, wodwala ayenera kungokhala magazi zoperewerazo zolakwa zake.

odwala onse kuti ntchito imeneyi zinachitikadi - inatsekeratu kulambalala opaleshoni - ndi nthawi yaitali pochitika konzanso ndi kupewa nkhawa. Izi zachitika pofuna kupewa kusiyana zitsulo zakudya zamtundu oletsa sternum lapansi.

Maganizo odwala okhudza ntchito

Ambiri odwala ndi phukusi m'zotengera mtima. Ngati inu kufufuza malo osiyanasiyana ndipo maonekedwe zoyenera vutoli, kuoneka kuti anthu ambiri amene akhala akukonza inatsekeratu kulambalala opaleshoni, ndi ndemanga mwachilungamo positive. Kwambiri bwino khalidwe la moyo, ndipo odwala ambiri akhoza kubwerera ku ntchito bwinobwino (pokhapokha nthawi konzanso). Amachepetsa chiwerengero cha kuukira angina, amene kwambiri kumakhudzanso zochita za moyo watsiku ndi tsiku.

Anthu ambiri amadzifunsa - mochuluka bwanji ndi ntchito imeneyi?

Izi zidalira pa zimene ukupeza wodwalayo pa nthawi ya mtima mwa zizindikiro kwa opaleshoni. Mukakhala inatsekeratu mtsempha wamagazi kulambalala opaleshoni, mtengo mudzangokhala zinthu monga buku la phukusi, ndi Choyenereza ya opaleshoni opaleshoni, koma pafupifupi ntchito zonsezi akutsatiridwa kwaulere. Ndalama awo kukhazikitsa zigwire ndi boma bajeti (m'zipatala payekha mtengo wa opaleshoni ranges ku madola 7 10 sauzande, amene ali mtengo kwambiri).

Kodi ndizofunikira kuchita opaleshoni?

odwala ambiri amene yaitali angina, inatsekeratu mtsempha wamagazi kulambalala opaleshoni kukuonetsedwa. Kodi izo - anthu ochepa mukudziwa, chifukwa cha zimene kwenikweni ayenera kukhala kumasulira kwa Tsatanetsatane pa dokotala. Ena amachita mantha ndiponso kukana ntchito, chifukwa ndondomeko imavuta kwambiri ndi zovuta, ndi chiopsezo cha matenda oyamba zedi mkulu. Ena mwadala kuyesera, podziwa kuti popanda alowererepo onse usiye kunja zikuipiraipirabe.

Ndiyenera kuchita opaleshoni - kusankha ndi mwangwiro payekha. Komabe, ngati ntchito kumaonekeranso, ndi bwino kuchita, popeza yabwino zotsatira (lethality pa ntchito ndi zosakwana peresenti 2) kwambiri bwino chikhalidwe ndi khalidwe la moyo.