Ukwephula neuropathy kwegazi: thrombosis kanye embolism

Ukungasebenzi kahle the ephakathi kanye neuropathy kwegazi eba ngenxa yezizathu ezahlukene. Nokho, isithombe basemtholampilo isimo ejwayelekile liyabonakala kuzo zonke izimo. Ngo umkhuba kuhlinzwa, lokhu kuyinkinga evamile, okuhlanganisa izimo eziningi sokugembula, ngandlela-thile kuphazamise egazini.

Izimbangela kuphazamiseka kwegazi

Ukuphazamisa ukunyakaza evamile wegazi ngokusebenzisa izitsha kungenzeka ezimweni ezehlukene:

1. Mafutha anciphisa isikhala esingaphakathi bomkhumbi kuyinto esingaweleki. Lokhu kungenzeka uma occlusion (isib thrombus noma uqwembe atherosclerotic) noma olugcwele (stenosis).
2. udonga izinguquko sokugembula (hypertrophy of umfutho wegazi ophakeme emithanjeni).
3. Ecindezela isitsha kusukela ngaphandle (isib isimila).
4. Ukulimala odongeni semithambo.
5. Izinguquko egazini rheology.
6. Ukunciphisa ngevolumu afundwa igazi (ngoba ukopha, ukuntuleka kwamanzi emzimbeni).
7. Ukwehlisa komfutho wegazi (ukushaqeka, ukuhluleka kwenhliziyo).
8. I zokugula wenhliziyo (ukukhubazeka, ukuhluleka kwenhliziyo), lapho ivolumu ukuncipha igazi ukhiphe ngesikhathi systole.

Konke lokhu izimo kungathinta ukugeleza kwegazi njengoba isifo esikhulu kanye neuropathy semithambo. Uma izinkinga ngenhliziyo, ukuphazamiseka hemodynamic, izinguquko ekuphakameni kwezwi igazi, sokugembula ekunqandeni izindlela kwegazi kahle kuwo wonke amazinga - kusukela ngobukhulu nezitsha kulencane igazi. Endaweni nenkinga efanayo (stenosis, thrombosis, semithambo odongeni hypertrophy) ziyabonakala ngqo endaweni lapho sekuvele.

Izimbangela iziyaluyalu kwegazi neuropathy, isimiso, iyafana nendawo. Nokho, ekhuluma zokugula wegazi ukugeleza ngesikhathi azungeze, ukubandakanya wendawo kwegazi iziyaluyalu ngokuyinhloko.

Ukwephula neuropathy kwegazi ukuhlinzwa - Ngokuyinhloko isimo ezihlobene ukumisa igazi ligeleze thrombosis zendawo, embolism, clamping isitsha isifo sokuqina kwemithambo yegazi. Konke lokhu uthi (ngaphandle, mhlawumbe, ka-atherosclerosis) kukhona esiphuthumayo, ocela usizo ngokushesha.

Ukwephula neuropathy kwegazi: izimpawu

Kuyini kubonakala ukumisa endawo ukugeleza kwegazi? Izicubu, bazithola ngaphandle koxhumano igazi owanele, angaqala ukuzwa ischemia, ngoba manje musa lithole umoya-mpilo adingekayo ukusebenza evamile. Kukhula nokungabi namandla, ukufa iseli kwenzeka ngokushesha kakhudlwana. In the ukungabikho adingekayo usizo ekuthuthukiseni esibhibhayo (m. E. necrosis kwezicubu bancishwa liningi igazi).

Ukwephula kwegazi neuropathy yezingalo nemilenze ephansi - isibonelo esihlaba umxhwele kakhulu. ukugeleza kwegazi iziyaluyalu kuleli cala bangase ukuthuthukisa ngokuzuma noma kancane kancane.

claudication ngakanye

I ezivame kakhulu kulesi simo kukhona isifo sokuqina kwemithambo yegazi eliphansi esitho lemithambo aortoarteriit nonspecific, thromboangiitis obliterans. Ukugeleza kwegazi ezitsheni sinqamukile ngenxa omncane mafutha anciphisa isikhala esingaphakathi ngokusebenzisa okuqhubekayo atherosclerotic qwembe neziqu noma ukuqina izindonga ngenxa yokusabela-non-ethize ukuvuvukala.

Ukwephula neuropathy kwegazi kuleli cala ubukisa isithombe esilandelayo emitholampilo:

1. isinxephezelo esiteji. It libhekene ukubukeka ubuthaka imilenze, amajaqamba kanye nokuhlukumezeka ku ngemuva umzimba. Nokho, ubuhlungu kwenzeka kuphela uma uhamba at ibanga km hhayi ngaphansi kuka 0.5-1.
2. Isinyathelo subcompensation. Misa uhamba ngenxa yobuhlungu emilenzeni ngemuva kokuba isiguli sekutholakele ukuthi uphoqelekile ukuba 0.2-0.25 km. nemilenze Lower nezinguquko ezithile ngenxa yokungabi bikho kokuphakelwa kwegazi: a okhanyayo, esomile, isikhumba olungaqinile, izinzipho ziyaqothuka, ehlambulula we ongama amafutha ungqimba. Ripple ku imithambo iba buthakathaka.
3. Isinyathelo decompensation. Ukuhamba ngaphandle ubuhlungu kungenzeka webanga elingamamitha angu-100 ukuphakama. Kukhona imisipha esincunzayo, isikhumba kuba mncane elinsundu ku ubuso bayo e sebuningini imifantu futhi izilonda.
4. Nakwele izinguquko elimazayo. Kulesi simo, ukugeleza kwegazi izitsha wayeka cishe ngokuphelele. nemilenze Lower embozwe izilonda, ikakhulukazi ezimweni ezimbi kakhulu, esibhibhayo eba iminwe. Ngokucijile encishisiwe ikhono emsebenzini.

Yiqiniso, i-neuropathy kwegazi kuleli zokugula eba eside. Ngaphambi esibhibhayo esiteji sihamba isikhathi esiningi, futhi phakathi naleso ungathatha izinyathelo ezidingekayo ukuze avimbele ukumisa okuphelele ukugeleza kwegazi.

thrombosis Arterial kanye embolism

Kulokhu, kukhona okunzima neuropathy kwegazi, futhi ngemva kwamahora ambalwa kungaholela ukuthuthukiswa esibhibhayo esitho, uma kungekhona usizo ngesikhathi esifanele zizonikezwa.

I thrombus ku Umthambo kungenzeka kwakheka kwi i-plaque atherosclerotic, izindawo ukuvuvukala udonga isitsha noma ukulimala. Ngokuthi embolus, thrombi alethwe ekusakazeni igazi lomunye ingxenye embhedeni semithambo. Ngenxa yalokho, mafutha anciphisa isikhala esingaphakathi isikepe sivinjelwe ngokuphelele, ukugeleza kwegazi eyeka, izicubu angaqala ukuzwa ischemia futhi afe (esibhibhayo eba) e ukulondolozwa eside kulesi simo.

Umtholampilo we-acute neuropathy iziyaluyalu kwegazi

Kakhulu ushintsho ngokushesha izimpawu ebonwe embolism, ngoba kulokhu ukumisa ukugeleza kwegazi kwenzeka ngokuzumayo engashiyanga kungenzeka izinguquko compensatory.

Eyokuqala amahora amabili okuhlangenwe nakho nesineke sebuhlungwini obunzima ezingalweni nasemilenzeni. Lesi sakamuva iba ugodo amakhaza uma uyithinta. Okusizwa ukushaya e imithambo distal engekho. Kancane kancane, ubuhlungu incipha, futhi nalo, uthulisiwe lobukhali kuze kube izinzwa egcwele. Motor kwemilenze noma iba nanenkinga ekugcineni esakha ukukhubazeka. Maduze, izinguquko ezingenakuhlehliswa zenzeka ezicutshini futhi ukufa kwabo. Thrombosis yesithombe, isimiso, okufanayo, kodwa ukuthuthukiswa emtholampilo akuyona yonke indawo ngokushesha. Kukhula thrombus kudinga isikhathi esithile, ngakho igazi ukugeleza is hhayi ngokushesha ngobugebengu. Ngokuhambisana ngezigaba Savelieva ukuhlukanisa ischemia grade 3:

1. Libhekene ukuzwela iziyaluyalu.
2. Joyina ukunyakaza iziyaluyalu.
3. Kulesi sigaba siqala izicubu necrosis.

Ukwephula neuropathy kwegazi: ukuphathwa

Amaqhinga zincike kobukhulu ischemia, nesivinini nokuthuthukiswa izinguquko ezingenakuhlehliswa emisipheni. ukungakhuli okukhulu kwegazi neuropathy zidinga ukwelashwa kuhlinzwa. Esimeni ziwohloke kancane kancane igazi flow izigaba isinxephezelo yalokho okuhle ongase ukufeze, futhi ukwelashwa olandelanayo.

Operations egazini acute ukugeleza iziyaluyalu

ukwelashwa okulondoloza kuyinto ayizwakali kuleli cala, t. K. Ingabe abakwazi ukubhubhisa ngokuphelele ihlule futhi ukususa ukuvimbela ukuba ukugeleza kwegazi. Ukhetho lwakhe kungenzeka kuphela uma comorbidity ezinzima ukusabela eyanele compensatory. Ngemva sinjalo esiguli, ukuhlinzwa kubuyiswa ihlule legazi kusuka mafutha anciphisa isikhala esingaphakathi isitsha. Encishisiwe ukugeleza kwegazi ngendlela elandelayo. Mafutha anciphisa isikhala esingaphakathi we Umthambo ethintekile ngaphezu ukuvaleka Fogarty ipayipi, ngayo nefunda ngayo ukukhiqiza ukususwa thrombus. Ukuze ukwethulwa kwe ipayipi ukufinyelela kuhlinzwa wenziwa ezingeni we bifurcation ka umfula femoral (e izilonda nemilenze ephansi), noma brachial Umthambo (i engenhla emkhawulweni izilonda). Ngemva kokwenza arteriotomy Fogarty ipayipi loko inikezwa ukuvaleka isitsha ngumuntu thrombus, Kwenziwa ngokusebenzisa isithiyo, bese ulele futhi kulesi sifundazwe ayabuya. Ayihaba ibhaluni eliseningizimu ye iqopha ipayipi futhi entrains le thrombus.

Esimeni a thrombosis emkhakheni izinguquko organic odongeni isitsha kuyinto amathuba eliphezulu kokushelela. Ngakho-ke, ngemva nokubuyiselwa ukugeleza kwegazi kudingekile ukwenza ukuhlinzwa lohleliwe reconstructive.

Uma isimo sele zifakiwe futhi ithuthukiswe esibhibhayo esitho ukunqunywa wenziwa.

Ukwelashwa nya izifo kwemithambo

ukwelashwa okulondoloza kwenziwe kusaqala isifo, kanye contraindications ukwelashwa kuhlinzwa. izimiso eziyisisekelo yokwelapha:

1. Ukuqedwa izici ibangela spasm kwemithambo yegazi enjengokubhema, utshwala, hypothermia.
2. Ukuqokwa antispasmodics.
3. Analgesics ngenxa yobuhlungu.
4. Nciphisa igazi viscosity ngokusebenzisa ukuqokwa kwe-ejenti antiplatelet futhi anticoagulants.
5. Ukudla okuhloswe ngazo ukunciphisa ezingeni cholesterol egazini.
6. Statin ngenxa ukuzinza we umzimba lipid.
7. Ukwelashwa comorbidities zibulale izitsha: umfutho wegazi ophakeme, isifo sikashukela, isifo sokuqina kwemithambo yegazi.

Nokho, ukwelashwa okuphumelelayo kakhulu uhlala operation reconstructive - the dlula (dlula anastomosis ukudalwa), stent (stent ku mafutha anciphisa isikhala esingaphakathi bomkhumbi).

Kufinyeta

I-peripheral kwegazi kungenzeka ngenxa yezizathu ezahlukene. Kubalulekile ukukhumbula ukuthi i-acute igazi disorder eside ekhona noma kubangelwa kungaholela izinguquko ezingenakuhlehliswa ku kwezicubu kuholele esibhibhayo.

Ngokuba nokuvimbela izifo zenhliziyo kuyadingeka ukuze balondoloze yokuphila enempilo, ukudla okufanele, ukugwema imikhuba eyingozi, kanye ukwelashwa esifike ngesikhathi izifo, iqhaza ekuthuthukiseni angiopathy.