Nomfutho wegazi ophezulu Renovascular: kuyini? Ukwelashwa, izimbangela, izimpawu, zokuvimbela

Lapho ububanzi we ukuvaleka umfula kwezinso itsatfwa okonakele kwezinso ukugeleza kwegazi. Sokugembula mkhuba isici ukubhebhetheka kwalesi sifo njengoba nomfutho wegazi ophezulu renovascular. Lena ngenye yama-izinhlobo umfutho wegazi ophakeme, okuyinto eyenzeka kuphela 3-5% leziguli-high blood pressure. Izimpawu zincike ezizathwini ezaholela ukuthuthukiswa yayo. Ake sicabangele pathogenesis, isethulo yomtholampilo, izindlela zokuxilonga kanye nokwelashwa yalesi sifo.

nomfutho wegazi ophezulu Renovascular - kuyini?

Okwamanje, zokugula kohlelo senhliziyo ziya ziba mandla kutholakala ukuthi uphethwe yini, hhayi kuphela abantu asebekhulile, kodwa futhi lesi sizukulwane esisha. Lokhu kungenxa ithonya elibi izici ezihlukahlukene: yofuzo, walutheka, khona izifo. Lesi sifo sibanga ukuthuthukiswa nezinye pathologies efanayo. Omunye isifo ezinjalo kuba renovascular nomfutho wegazi ophezulu.

Syndrome kwenzeka ngokumelene isizinda ukuvaleka imithambo yegazi e nezinso ukuwohloka kwegazi. Uma iyekwa ingelashwa sifo kungaholela izicubu ischemia, ukwehluleka kwezinso. Ukwephulwa kutholakala kuphela inani elincane ezigulini unezinkinga blood pressure. nomfutho wegazi ophezulu Renovascular kungathinta esisodwa noma zombili izinso ngesikhathi esisodwa.

pathogenesis

Ngokusho ucwaningo olwenziwa ochwepheshe, constriction we Umthambo kwezinso kubangela zamagama lelitfutfukile renin - ingxenye elawula umfutho wegazi futhi obangela ukwehla ivolumu yegazi neuropathy. Kuyadingeka ngenxa ukuzinza kokuphakelwa kwegazi nezinso. Nokho, igebe ayisesemikhulu imithambo ayivumeli ukusungula ukugeleza kwegazi.

Kanyekanye le nqubo, kukhona umsebenzi kakhudlwana aldosterone futhi angiotensin egazini. Isithako sokuqala hormone ethakwa by the nezindlala adrenal. Ikhishwe ngenxa angiotensin (olegopeptidny i-hormone) futhi sithinta izinso enempilo kuphela, nokuncipha umchamo komkhiqizo ngenxa yokuphutha sodium nokugcinwa. Lokhu kuvimbela izinso ukwenza ngokugcwele umsebenzi wawo wokuhlanza igazi kubangela ukuthuthukiswa lesi sifo njengoba nomfutho wegazi ophezulu renovascular.

I pathogenesis lesi sifo kusenza siqonde indlela abasafufusa syndrome, futhi yini okufanele siyenze ukuze ubuyisele izinso ukuze isebenze kahle. Lapho ukuzinza ephelele ukugeleza kwegazi izitsha ethintekile kanye isimo lesiguli kuthuthukisa ezikhoselweni isifo.

Izimbangela zesifo

Okwamanje, abanye odokotela ushayele izizathu eziyinhloko ezingaba ukukhonza njengomdala umfutho ekuthuthukiseni isimo sokugembula. Renovascular (renovascular) nomfutho wegazi ophezulu ngokuvamile kwenzeka ngokumelene isizinda lezi zifo ezilandelayo:

• Isifo sokuqina kwemithambo yegazi - imbangela eyinhloko kwezinso umfutho wegazi ophakeme emithanjeni. Cholesterol zingcwecwe unciphise inesikhala isitsha by cishe uhhafu endaweni engena izinso. Ukugula avame kuthinta amadoda abaneminyaka engu 40-55. Abesifazane zokugula ngokuvamile kwenzeka ngemva kweminyaka engu-60.
• dysplasia Fibromuscular kwemithambo yegazi kwezinso - ukuvuvukala lapho isakhiwo kuyahlukahluka semithambo kwemisipha izicubu. Hyperplasia ngokuvamile kwenzeka kubantu abasha, kanye nezingane. Ngaphezu Hyperplasia kwemisipha amaseli, kukhona kumiswa microaneurysms. Etiology fibromuscular dysplasia alwaziwa.
• isifo Takayasu sika - a syndrome ezihambisana yisihlungu ku-aorta kanye kumiswa ihlule legazi. Lesi sifo ubizwa nangokuthi isifo pulseless. Ngu ukuvaleka imithambo yegazi imiphumela ukuqina nolwelwesi semithambo ngemuva lokubhubhisa nokuvuvukala izicubu semithambo. Ukugula kuyinto omsakazo sokuhlasela kwamasosha omzimba.
• kokucindezelwa Mechanical yegazi - kwenzeka ngokumelene ingemuva izimila, izinhlumba futhi aneurysms semithambo. Uma ukwephula wegazi ukugeleza eba renovascular nomfutho wegazi ophezulu. Kuyini futhi kanjani ukubhekana nalesi sifo, kuzoxoxwa ngezansi.

emitholampilo isithombe

Symptomatology lesi sifo inezimpawu kuphazamiseka kwezinso nomfutho wegazi ophezulu kanye. Ubucayi yesifo emitholampilo incike ukuma ukugeleza nomfutho wegazi ophezulu renovascular kanye izici ezaholela ukuthuthukiswa yayo. Nge ukuthuthukiswa ngokushesha izimpawu nobuntu ziphakamisa uhlobo ebulalayo. Uma zokugula eba kancane - lesi sifo kungavamile ukuba ingozi.

Ezimweni eziningi kutholakala ukuthi uphethwe yini ezinzima nomfutho wegazi ophezulu renovascular. Izimpawu zesifo zihlanganisa:

• njalo high blood pressure akuyona encishisiwe ngisho nesicelo izidakamizwa;
• anda diastolic blood pressure ne-systolic evamile;
• hypertrophy esivimba amanzi;
• okwandisa ingcindezi isizinda ubuhlungu obuhlabayo esifundeni lumbar;
• umsindo lapho ukulalela imithambo kwezinso.

Lapho eneminyaka engu ezisencane kuzuba abukhali wegazi kumele sokukhathazeka. Lokhu kuyiqiniso ikakhulukazi ezimweni lapho omkhaya akazange ahlupheke isifo nomfutho wegazi ophezulu kanye ayikwazanga wadluliselwa ifa.

Izimpawu ingozi nesibulalayo nomfutho wegazi ophezulu renovascular

Nge kancane phakathi ukuthuthukiswa inqubo sokugembula kuye kwabangela ukwanda kancane ingcindezi "engenhla" futhi nokwanda okuphawulekayo ingcindezi "ephansi". Ngokwesibonelo, 130/110 noma 140/110 mmHg. Art. Kulokhu, isiguli ekhononda we ukuwohloka jikelele, ukubukeka iphika, ubuthakathaka.

Ukubukeka izimpawu ezifana angaboni kahle, nobuhlungu obukhulu entanyeni, isicanucanu nokuhlanza, senyusa izinga lomfutho womoya "ephansi" ku-120 mm HG. Art. Lithi ekuthuthukiseni abulalayo nomfutho wegazi ophezulu renovascular. Kwenzekani kumuntu onalesi sifo kulesi simo unika onguchwepheshe? Kakhulu abampofu, ngoba iziguli akuvamile esifike ngesikhathi nokufuna usizo lochwepheshe bezokwelapha.

Ukuze uphethwe efanele futhi kuvimbele ukuthuthukiswa isifo ezinzima kumele bahlolwe izimpawu zokuqala nomfutho wegazi ophezulu.

izindlela ukuxilongwa

Esikhathini eyinhloko yokwelashwa Uchwepheshe uzothumela isiguli cwaningo laboratory. ukusazi ngokunembile isifo esikuphethe kuphela omunye izimpawu futhi izikhalazo isiguli kulokhu cishe kungenakwenzeka. Kufanele iphumelele ekuhlolweni ukunquma amazinga cholesterol, creatinine, renin, aldosterone, kanye potassium egazini. Ukuhlaziya igazi serum ACE ukunquma stenosis ekhipha igazi enhliziyweni. izifundo Laboratory ukusiza ukuhlukanisa yilesi sifo ukuvuvukala nezinso.

izindlela Instrumental lokuhlolwa ayadingeka ukuthuthukiswa esolwa ezifweni ezimbi ezifana nomfutho wegazi ophezulu renovascular. Sifo ngokuvamile iqala ultrasound, lapho kungenzeka ukunquma usayizi izinso, khona izimila kanye izinhlumba, ukukhula isitho.

Ukuphenya izitsha kwezinso esetshenziswa angiography. Indlela evumela ukusungula degree of imikhawulo yabo ngokwethula i-ejenti ukuze kuvele umehluko. Indlela zokuxilonga anezinye Izimo okumele kuqala ukufunda.

Ukuze ukuhlola isimo imithambo yegazi izinso kwenza Doppler. Lena ngenye indlela ultrasound luhlolo. Nokho, ngokungafani ultrasound ezivamile, Doppler kuyasiza ukuthola ulwazi oluyigugu kakhudlwana. It ezinqunyiwe at omsakazo engaziwa nomfutho wegazi ophezulu ngoba ukuhlolwa kwegazi kanye izimila osayizi therein esolwa ukwehluleka kwezinso.

urography radionuclide

nomfutho wegazi ophezulu Renovascular ngokuvamile watholakala urography radionuclide. Indlela kuhlanganisa nokukhipha esincane izidakamizwa enemisebe. Umsebenzi zomuthi ithumba gamma ikhamera, phambi lapho isiguli itholakala.

Isikhathi inhlolovo incike kobukhulu isimo lesiguli. Inqubo ngokuvamile eyenziwa ihora elingu-1. I kwaphumela inhlolovo izithombe kunikeza umbono umsebenzi kokubili izinso nokugeleza kwegazi kuzo.

izidakamizwa Radioactive, ngokungafani ejenti Ngokuphambene kukhona ingasaphathwa engabangela ukuthuthukiswa yini imiphumela emibi.

nomfutho wegazi ophezulu Renovascular: ukwelashwa

Ukwelashwa lokhu uhlobo nomfutho wegazi ophezulu presents ubunzima obukhulu. Ukugula ngokuvamile kubonakala injalo okubulalayo nokuhlala nemithi. Nge ukuthuthukiswa ngokushesha izimpawu kungenzeka ukushayisana kwesibindi, ubuchopho kanye namaphaphu. Ngokuvamile kulezi zimo ukungenela kuhlinzwa.

izindlela Radical ukwelashwa uvumele (ezimweni eziningi) ukuvimbela nemiphumela enqala. kokungenela Steel kuphela eyenziwa ngenkathi sigcina izinso imisebenzi yabo. Enye indlela iwukuba ukuvuleka angioplasty. Phakathi ukusebenza e mafutha anciphisa isikhala esingaphakathi we stenosed Umthambo ipayipi ne abicah ibhaluni at ithiphu yayo. Lapho ukufinyelela emphinjeni kwesigaba ibhaluni is Ayihaba, nokuthi, esikhundleni salokho, adalule mikroprotez ngokufanele ekupheleni le ipayipi. Le nqubo kunezinzuzo eziningana - invasiveness ongaphakeme kanye ukungabikho izinzwa ukuhlinzwa.

It nanela ukuthi indlela echazwe ngenhla asifanele ekuxilongweni stenosis semithambo, sise umlomo Umthambo kwezinso noma ukusikwa walo. Kulokhu, sikhonjiswa Ukuhlinzwa okukhulu.

Uma lesi sifo isungule ngokumelene isizinda kuwuphawu lwesimila, simila noma hematoma, kubalulekile ukuqhuba ukuhlinzwa futhi asuse isimila. Lokhu kuzobuyisela ukugeleza kwegazi nogwali umsebenzi.

Zokugula ingozi uphatha ngempela ngempumelelo ephansi blood pressure, ukuthi uyoqeda ubuhlungu e izinso esebenzisa yokwelapha olandelanayo. Umfutho ophakeme wegazi, e Umq. H. Renovascular, iphathwa ngaphansi kokuqondisa esiqinile of onguchwepheshe. udokotela kuphela Ungakhetha indlela yokwelapha kuhlanganiswe okuhloswe ngazo ukuthuthukisa ngezimo zesiguli.

Ngendlela efanele usaqala yentuthuko zokugula ubonisa isicelo amaqembu elandelayo ukuthaka imithi:

1. Angiotensin yokwamukela blocker (kuncishiswe ingozi yokuhlaselwa isifo senhliziyo kanye nesifo sohlangothi);
2. ACE inhibitor babe (cytoprotective futhi vasodilator umphumela);
3. Calcium channel blocker (izinga le-calcium kuthiwa uhlaliseke).

nomfutho wegazi ophezulu Renovascular futhi ziphathwe isisu namaphilisi ukunciphisa umfutho wegazi. Izidakamizwa Isikali incike kobukhulu isimo lesiguli. Ngekusetjentiswa eside ukuthaka imithi kudingeka uhlole njalo ngemva kwezinyanga eziyisithupha potassium ezingeni egazini. Buphawuleka kakhulu nomphumela oqabulayo ihumusha kuphela yokwelapha eziyinkimbinkimbi ukuze esiphezulu umthamo lwemithi.

izindlela kwesiko

Ukwelashwa nomfutho wegazi ophezulu renovascular, futhi kungase kwenziwe ngokusebenzisa amathekhiniki ethandwa. Nokho, kungcono ukusebenzisa ngokuhlanganyela imithi yendabuko. zokupheka Traditional kuyasiza kulesetayelekile blood pressure, izitsha ezihlanzekile cholesterol zingcwecwe futhi sithuthukise ukugeleza kwegazi. Imiphumela emihle etholakale ngokusebenzisa okhalweni. Lesi sitshalo has a isisu enamandla. Lapho kunesidingo yokuphisa ingcindezi izinso 1 tbsp. l. izithelo enkomishini yamanzi abilayo, ukugcizelela okugeza amanzi imizuzu 15 kuthathwe njengendlela itiye kabili ngosuku.

Lower high blood pressure kuzosiza nekufakwa amaqabunga billberry. amahlamvu Oku (2. tbsp L.) Ingabe ochotshoziwe futhi wanezela 250 ml amanzi abilayo. Ingxube kwaphumela kwaba sigcizelele ukuthi sibe okugeza amanzi okungenani isigamu sehora, kuhlungwa, selehlile futhi ezithathwe ingxenye yesithathu umlomo wombhobho izikhathi 3 ngosuku.

Uma nomfutho wegazi ophezulu renovascular kwatholakala ukuthi isheshe itholakale yentuthuko, ungakwazi nokulungisa ukumnika zingxenye ezilandelayo:

• peppermint - 2 tbsp. l.
• inflorescence hawthorn - 3 tbsp. l.
• birch ishiya - 3 tbsp. l.
• izinso itiye amaqabunga - 4 wezipuni. l.
• Motherwort - 4 tbsp. l.

iqoqo izingxenye zokwelapha kumele kahle ngephutha esitsheni ehlukile. Nsuku zonke kufanele uzilungiselele umhluzi fresh 3 g lokuqoqa 300 ml amanzi abilayo. Decoction kufanele bagcizelele ihora. Ngemva zingaphazamisi azithathe isiphuzo 100 ml ezintathu izikhathi ngosuku.

inzuzo Kakhulu emikhunjini ukuletha juice beetroot. Kunconywa ukusebenzisa nsuku zonke 100-120 ml, ngaphambili unezela uju noma ijusi buhlanjululwe ngamanzi ahlanzekile. Izingxenye eziqukethwe juice, ikhuthaza ukuwohloka cholesterol zingcwecwe kanye amahlule encane yegazi.

ukudla

Abantu ababeka sebethole nomfutho wegazi ophezulu renovascular, Ukudla imibukiso njalo. Kuyadingeka ukuba kukhawulwe ukusetshenziswa soy, usawoti, okunamafutha kanye nokudla ngabhema. Yokuzuza umzimba ukuletha izimila zasolwandle, imifino, izithelo, amaprotheni isilwane (amaqanda, ubisi). Kunconywe engayitholi nsuku zonke okunamafutha izinhlanzi.

Carbohydrate - ngesisekelo yokudla isifo so-renal. Kube kufanele ababale linani wamaprotheni idliwe ngosuku. Ezimweni umile ekwelapheni iziguli ebekiwe itafula wezokudla № 7. Lapho yokungezwani komzimba ukuze amaqanda angaba nombono imikhiqizo yobisi.