Matenda opatsirana pogonana ndi mtundu wa chiwopsezo chachikulu chomwe chimayambitsa kusintha kosasintha kwa magazi nthawi zonse mpaka impso. Ngakhale kuti matenda opatsirana mofulumira amayamba kuwonekera nthawi yomweyo kwa odwala omwe amadziwika kuti ali ndi vuto la impso, amapezeka kawirikawiri pambuyo pozindikira ndi kuyesedwa. Chifukwa cha impso ntchito, renovascular hypertension kawirikawiri imaipiraipira ngati sichikuchiritsidwa.
Zimayambitsa
Mitsempha yapakatikati yomwe imatchedwa mitsempha yamphongo imabweretsa impso ndi magazi omwe nthawi zonse amayenera kusankhidwa ndikubwezeretsanso kuthupi. Chifukwa chakuti ntchito zowonongeka za impso zimayendetsedwa ndi mphamvu ya magazi, impso zimakhala bwino pozindikira kusintha kwa magazi. Ngati impso zowona kuti kuthamanga kwa magazi kumachepa kwambiri kuti pakhale mphamvu yowonongeka kwa magazi, amayankha mwa kutulutsa mahomoni omwe amachititsa kuti magazi ayambe kuthamanga.
Ngati kutuluka kwa magazi kupyolera mu mitsempha ya nthendayi kumachepetsa chifukwa china chilichonse, impso zinganyengedwe mu kuganiza kuti kuthamanga kwa magazi ndi kotsika kwambiri. Mwachitsanzo, matenda omwe amatchedwa "renal artery stenosis" angachititse kuti mitsempha yambiri ichepetse, zomwe zimachepetsa kuchuluka kwa magazi omwe amathamangira impso. Impso zimazindikira kuti izi zimachepa ndikumasula mahomoni kuti ayambe kuthamanga kwa magazi ndikubwezeretsanso magazi.
Mavuto amayamba pamene, monga momwe zimagwirira ntchito m'mimba, kuchepa kwa magazi sikumayambitsa kuthamanga kwa magazi. Pazochitikazi, impso zimathera kuthamanga kwa magazi kwapamwamba kwambiri kuti akankhire magazi ambiri kudzera m'mitsempha yaing'onoting'ono ya mphuno.
Kudziwa
Kwa odwala omwe amadziwika kuti ali ndi mitsempha ya magazi kapena mavuto a impso, mwadzidzidzi kumayambitsa kuthamanga kwambiri kwa magazi ndi chizindikiro cholimba chakuti vuto lokonzanso matendawa lingakhale lolakwa.
Komabe, kawirikawiri matendawa amafunika kufufuza mosamala ndi mayesero angapo. Zizindikiro zina zomwe zimapereka mphamvu zowonjezera matenda ndi:
- Kuthamanga kwa magazi kwambiri mwa anthu osakwana 30
- Kuyamba mwadzidzidzi kuthamanga kwa magazi kwambiri kwa anthu oposa 55
- Kupanikizika kwa magazi komwe sikungayankhe pakamwa mankhwala osokoneza bongo
- Kupanikizika kwa magazi komwe kumasiya kuthana ndi mankhwala opindulitsa kale
Mayeso a magazi amachitika kawirikawiri m'maganizo amodzi a matenda opatsirana mofulumira, koma njira yokhayo yotsimikizirira kuti ndi yothetsera vuto ndikutenga mitsempha yowonjezera. Izi kawirikawiri zimayendetsedwa ndi njira yosalowera monga MRI kapena CT scan, koma nthawi zina zowonjezera zowonjezera zimayenera. Pazochitikazi, kathete kakang'ono kamasulidwa kupyola mu chigwacho, ndipo dye yaying'ono imatulutsidwa ku catheter. Zithunzi zimatengedwa zomwe zimasonyeza momwe dye imatsatira; izi ziwulukitsa malo ochepetsetsa mu mitsempha.
Chithandizo
Kuchiza matenda opatsirana pogonana sikuli kofanana ndi kuchiza kuthamanga kwa magazi. Chifukwa chimodzi mwa zozizwitsa za matendawa ndi kulephera kulapa mankhwala ochizira, njira zamakono zochizira sizothandiza. Kachigawo kake ka magazi kamene kamakhala ndi matenda opatsirana pogonana kwenikweni ndi chizindikiro cha matenda oyambitsa matenda - chida chotsalira cha mphuno - chomwe chiyenera kumachiritsidwa.
Njira zochizira zimasiyana malinga ndi zomwe zimapangitsa kuti mitsempha yamphongo ikhale yopapatiza, koma zolinga ziri chimodzimodzi pazochitika zonse - kukulitsa mitsempha yokha ndi kubwezeretsa mwazi wokhazikika m'magazi. Njira yeniyeni yomwe izi zikukwaniritsidwira zimadalira chimodzimodzi chomwe chikuchititsa kuti mitsempha ikhale yopanda pang'onopang'ono. Kwa anthu achikulire, kuchepetsedwa ndiko kaŵirikaŵiri chifukwa cha mafuta omwe amatha kufanana ndi omwe angayambitse mtima. Gawo loyamba lachiritso kawirikawiri amayesera mankhwala omwe amasungunula ma depositi awa. Ngati izi sizinapambane, zosankha zambiri zosafunikira zingafunike, kuphatikizapo kukulitsa chombocho mpaka kukula kwake ndi mtundu wa opaleshoni yotchedwa stenting.
Nthaŵi zina, kuponderezedwa kumachitika chifukwa cha zinthu zomwe zimakhala zovuta kuzilamulira. Matenda ena amatha kupangitsa kuti makoma a mitsempha asamaye, zomwe zingachititse kuti chombocho chichepetse. Izi sizingakhoze kuchiritsidwa ndi mankhwala, kotero mitundu yowopsya-kapena yowonjezereka kwambiri ya opaleshoni - imafunika nthawi zambiri. Njira zenizeni zothandizira pakadali pano zimadalira pazifukwa zambiri zomwe zimatha kusiyana ndi odwala mpaka odwala, choncho ndondomeko zamankhwala zowonongeka ndizokhalitsa bwino.
Kuchiza matenda opatsirana pogonana n'kovuta kwambiri kuposa kuchiza mitundu ina, yowonjezera "yowonjezera" ya kuthamanga kwambiri kwa magazi, ndipo ngakhale kuti kupambana kwabwino kuli kwakukulu, imakhala ndi zoopsa zambiri komanso zovuta zambiri. Kugwira ntchito ndi dokotala kukhazikitsa ndondomeko yoyenera ya chithandizo ndi njira yofunikira yothetsera matenda aakulu.
> Zotsatira:
> Derkx, FH, Schalekamp, MA. Nthenda ya Aral Stenosis ndi Hypertension. Lancet 1994; 344: 237.
> Hirsch, AT, Haskal, ZJ, Hertzer, NR, et al. ACC / AHA 2005 Gwiritsani Ntchito Malangizo Othandizira Odwala Odwala Pachipatala Arterial Disease (Low Extremity, Renal, Mesenteric, ndi Mimba Aortic): Lipoti Yoyanjana Kuchokera ku American Society for Vascular Surgery / Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions , Society for Vascula Medicine ndi Biology, Society of Interventional Radiology, ndi ACC / AHA Task Force pa Zophunzitsira Zophunzitsira (Komiti Yolemba Kulimbikitsa Malangizo Othandiza Odwala Ndi Odwala Pachimake Arterial): akuvomerezedwa ndi American Association of Cardiovascular and Pulmonary Rehabilitation ; National Heart, Lung, ndi Blood Institute; Society for Nursing Vascular; TransAtlantic Inter-Society Consensus; ndi Mavenda Odwala Matenda Aakulu. Kuyendayenda kwa 2006; 113: e463.
> Mann, SJ, Pickering, TG. Chidziwitso cha Matenda Ochepetsa Matenda. State of Art: 1992. Ann Intern Med 1992; 117: 845.
> Safiya, RD, Textor, SC. Mitsempha yotchedwa Stalosis. N Engl J Med 2001; 344: 431.
> Vasbinder, GB, Nelemans, PJ, Kessels, AG, et al. Mayesero Odziwitsa Odwala Matenda Odzimitsa Mitsempha Amuna Odwala Akuyembekezeredwa Kukhala ndi Matenda Oopsa: a Meta-Analysis Ann Intern Med 2001; 135: 401.