Semithambo ukuhlinzwa dlula yezingalo nemilenze engezansi: izinkomba, imiphumela

izifo Umhlinzi atholakala kwabesifazane nabesilisa. Izifo ezivame kakhulu ezithinta abantu yobudala emaphakathi futhi ubudala. Ngaphansi isifo ovamile ebonwe intsha. Kwezinye izimo, le zifo azalwa nako. Indawo ejwayelekile lesion kohlelo semithambo kukhona i-coronary, imithambo palsy, imithambo ye ingemuva kanye emikhawulweni aphansi. Nokho, lapho letindzala vasculitis inqubo kungenziwa basakaza wonke umzimba. Esinye sezizathu ezijwayeleke kakhulu ukwelashwa kuya dokotela varicose emithanjeni. Lokhu zokugula ngokuvamile kunjalo kwabesifazane. Izimpawu sici yilezi: tortuosity emithanjeni, isandiso yabo, a protrusion. Esinye isifo semithambo ubhekwa isifo sokuqina kwemithambo yegazi. It kuholela imithambo nezinkinga ngegazi patency ivimbekile. Ezimweni eziphambili, ukuhlinzwa dlula wemikhawulo aphansi Kwenziwa zombili pathologies. Lona umsebenzi kuhlinzwa, lapho ekwazile ukubuyisela ngokuphelele ukugeleza kwegazi.

Lokhu kwakwenziwa ngayiphi injongo wenziwa izitsha dlula imilenze?

Ngezinga elithile kudingekile nganoma yezifo ngemithambo yegazi kuyinto dlula wemikhawulo aphansi. Ukwelashwa e kusaqalwa ngendlela olandelanayo. Iziguli izilonda atherosclerotic, linqume izidakamizwa lipid-ukwehlisa (izidakamizwa "Atorvastatin" "Fenofibrate") Ukudla. Nge varicose emithanjeni Kunconywa ukuba agqoke izinto zangaphansi ekhethekile nokunwebeka, sclerotherapy. izitsha esitho Lower ukundlula ngokuxhunyelelwa wenziwa isimiso okunzima mafutha anciphisa isikhala esingaphakathi we Umthambo noma vein, enengcuphe enkulu thrombosis kanye nokuthuthukiswa esibhibhayo. Le nqubo kuba phakathi nenqubo yokuhlinzwa, kumelwe sifeze udokotela ohlinzayo nodokotela-semithambo. ukuhlinzwa Dula iyona esikhundleni umkhumbi isayithi nolwelwesi. Ngenxa yalokho, igazi eligciniwe kubuyiselwa, futhi ingozi thrombosis ancipha kakhulu. I shunt kungenzeka ezenziwe ngezinto zokwenziwa noma izicubu lesiguli siqu. Ngokuvamile imikhumbi eduze yezingalo nemilenze engezansi kusetshenziswe njengezaba nolwelwesi. Kukhethwa impahla incike ububanzi we Umthambo ethintekile noma vein, kanye izici egunjini lokuhlolwa kwezifo.

Izinkomba ukuhlinzwa dlula wemikhawulo aphansi

ukuhlinzwa Dula wemikhawulo aphansi wenziwa onguchwepheshe noma isibhedlela umnyango kuhlinzwa. Libhekisela inkimbinkimbi, ngakho kumele kwenziwe kuphela ngaphansi izinkomba esiqinile. Ukuze dlula izitsha akufanele asebenzise uma obturated ezingaphezu kuka-50% kwemithambo yegazi ubukhulu noma ngemithambo. Ngaphambi kokuba unqume on ukuhlinzwa, odokotela linqume ukwelashwa olandelanayo. Ukuhlinzwa wenziwa ukungabi khona umphumela yokwelapha. Kukhona izimpawu ezilandelayo ukuhlinzwa dlula wemikhawulo aphansi:

1. Isifo sokuqina kwemithambo yegazi kwemithambo yegazi.
2. Sikuveze zokugula kohlelo emithambo yegazi. Ngokuvamile nge emithanjeni varicose kanye thrombophlebitis izinsongo wenziwa stenting noma angioplasty. Nge Izimo ngoba ukwelapha ngalezi zindlela eyenziwa izitsha dlula.
3. Endarteritis. Lapho lesi sifo impendulo ukuvuvukala kuhlangene nokwaphakade okuqhubekayo izitsha ezincane. Kancane kancane, Umthambo kuyinto occluded ngokuphelele, okuholela esibhibhayo senyawo. Lesi sifo sivame uma ngaphezulu phakathi kwabesilisa.
4. Useshonile we ephansi emkhawulweni imithambo. Pathology engozini eyingozi eliphezulu ukopha, okuyinto okunzima kakhulu ukuyeka.

Kwezinye izimo, bahlinza dlula wemikhawulo aphansi kanye esibhibhayo we izinzwane noma izinyawo. Onalesi sifo lokhu ukuhlinzwa akuyona njalo evumayo, futhi kuncike endaweni necrosis nezici ngamanye umzimba. Kwezinye izimo, ukuhlinzwa okuholela ekululameni ka esibhibhayo noma ukuncishiswa ubukhulu lesion.

Kwezinye izimo, ukuhlinzwa dlula is contraindicated?

Naphezu kwamandla okufanela semithambo ukuhlinzwa dlula, kuyafaneleka ukukhumbula ukuthi ukusebenza ezifana kuyingozi kakhulu. Ngakho-ke, wenziwa kuphela ezimweni lapho yingaba yini engakusiza ungazange kwasiza. Ngokufeza ukuhlinzwa dlula enezinto eziningi Izimo. Phakathi kwabo:

1. Abanomfutho wegazi ophakeme nesifo senhliziyo kungalawulwa nezidakamizwa antihypertensive. Kulokhu, ukusebenza emikhunjini kungabangela ukushaqeka cardiogenic, isilethikusebenza noma ukushaywa unhlangothi.
2. ukuhluleka kwenhliziyo Decompensated, syndrome edematous ephelezelwa iphika njalo.
3. angina engazinzile.
4. Congestive senhliziyo futhi isilethikusebenza.
5. useshonile yomthambo i-aorta, izitsha palsy.
6. Paroxysmal arrhythmias inhliziyo.

ukuhlinzwa Dula wemikhawulo aphansi asikwazi ukwenziwa abasebenza ngezifo ezithathelwanayo, izilonda zesikhumba, decompensation sikashukela. Kulezi zimo, msebenzi kwenziwe emva kuqiniswa isiguli.

Amasu ngokuxhunyelelwa

Umthambo ukuhlinzwa dlula wenziwa kaningi. Lokhu kungenxa yokuthi lezi zifo kwandile ngaphezulu. Ngaphezu kwalokho, ezinye izindlela zokwelapha Kunconywa e izilonda emithanjeni. Phakathi kwabo - ibhaluni angioplasty futhi stenting. Njengoba shunts ukubuyisela ukugeleza kwegazi usebenzisa saphenous vein ethangeni. Lapho endaweni enkulu yokulimala noma esibi semithambo esetshenziswa zokwenziwa izimila. Kukhona izindlela eziningana wokusebenza. Phakathi kwabo:

1. Bifemoralnoe ukuhlinzwa aorto-dlula. Ukuhlinzwa wenziwa ezingeni imbilapho. Ingqikithi yalo msebenzi ukwakha anastomosis dlula phakathi aorta besisu nokuvaleka kwemithambo femoral.
2. Femoropopliteal ukuhlinzwa dlula. Azakhele anastomosis phakathi kwemithambo ezimbili ezinkulu esitho engezansi. Shunt kuvela ngesikhathi inyonga ihlinzekwa kumila kwedolo esifundeni ngokuhlanganyela (ngenhla noma ngezansi ngokuhlanganyela).
3. ukuhlinzwa Cross-dlula. Anastomosis ligcinwe phakathi kwemithambo ezimbili femoral (kusuka umlenze wesokunene emlenzeni kwesokunxele, noma okuphambene nalokho).
4. dlula Femorotibialnoe. xhumelela Umhlinzi lebhokisi Umthambo femoral futhi tibial.

Ilungiselela nesiguli semithambo ukuhlinzwa dlula

Amalungiselelo shunting kuhlanganisa uchungechunge izindlela zokuxilonga, futhi ukusetshenziswa kwezidakamizwa. Ngaphambi ukusebenza, kufanele zidlule ukuhlolwa laboratory: Kla, OAM, igazi amakhemikhali nokusebenzelana kwawo, coagulation. Futhi wenziwa Doppler imithambo yegazi wemikhawulo aphansi, ECG, EhoKS. Ukuvimbela thrombus kumiswa phakathi nokuhlinzwa, isonto ngaphambi igazi thinners wakhe ebekiwe. Lezi zihlanganisa izidakamizwa "aspirin Cardio", "Magnikor". Futhi ebekiwe antibiotic izidakamizwa eqeda ukuvuvukala. NGOBUSUKU obungaphambi siguli, kumelwe uyeka ukuphuza amanzi nokudla.

Technique we dlula wemikhawulo aphansi

ukuhlinzwa Dula wemikhawulo aphansi - operation eziyinkimbinkimbi, okuyiwona ezingeni lelisetulu nobuchwepheshe bale udokotela ohlinzayo liyadingeka. Izikhundla wenziwa ngaphansi izinzwa jikelele. I imbobo isikhumba kanye nezicubu sangenzansi labetibambile ezindaweni ezimbili - nangaphezulu Umthambo ethintekile. Okubekwe isitsha ukuvimbela ukopha izibopho. Ngemva kokuhlaziywa imbobo lesion ukwenziwa isitsha bese ilungiswe shunt ngesandla esisodwa. Okulandelayo, jova semithambo iqinile phakathi ezicubwini. Ngakho, i-shunt kancane kancane fed indawo notch yesibili (ngaphezu lesion) futhi fixed kanye ekupheleni kwaso. Ngemva kwalokho, udokotela ohlinzayo wangitshela ihlola isimo ukugeleza kwegazi. Phakathi Umthambo uqala ugaye abe umsebenzi kuphumelele. Kwezinye izimo, kwenziwe izindlela wezinsimbi of luhlolo. Isigaba sokugcina zokuhlinzwa iwukuba suture izicubu ezijulile futhi isikhumba.

kuyinto kwaba ngemva kwezikhathi zokulotshwa op kanjani?

Kubalulekile observation inpatient esiguli, ngubani efike wahlinzwa khona. Ikakhulukazi uma lokhu zokukhwabanisa - ukuhlinzwa dlula wemikhawulo aphansi. isikhathi postoperative lapho yokwelashwa okuphumelelayo imayelana 2 amaviki. 7-10 izinsuku udokotela ohlinzayo kususa ezivuzayo. Nakuba isiguli esibhedlela, udinga ukwenza izindlela zokuxilonga ukuhlola ukuphumelela ukwelashwa. Ngaphezu kwalokho, udokotela kufanele siqinisekise ukuthi kube nezinkinga post-op. Kakade emva kokuhlinzwa ngezinsuku zokuqala kutuswa uvuke ezinyaweni zawo. Esikhathini isikhundla ehlezi nokuqamba amanga nemilenze aphansi ukuze kuzolungiswa esimweni esiphakeme.

Izincomo esikhathini yokutakula

Ngemva kokuhlinzwa dlula wemikhawulo aphansi kuyadingeka ukuqapha isimo ukugeleza kwegazi. Ngenxa yale njongo, isiguli kumelwe ibhekane wokuhlola ngezikhathi (kanye Doppler ultrasound). Futhi kunconyiwe:

1. Yeka ukubhema.
2. Yamukela izidakamizwa antiplatelet ukuvimbela thrombosis.
3. Gcina umbhalo walokho esisindo. Njengoba kwanda BMI linqume Ukudla lipid-ukwehlisa nemithi.
4. Yenza ukuhamba nsuku zonke.
5. Gqoka amasokisi ekhethekile (amasokisi) nezicathulo.

ukuhlinzwa Dula wemikhawulo aphansi: kobufakazi nesineke

Izibuyekezo ekubulaleni iziguli ezigulela Ngahlinzwa, ikakhulukazi omuhle. Iziguli kubika ukwehla ubuhlungu, ukuba ndikindiki kusukela emilenzeni. Noma kunjalo, kwezinye izimo, abantu akhononde ukubuya izimpawu emva kwesikhashana. Lokhu kungenxa kokunqotshwa imithambo elingumakhelwane emithanjeni. Kubalulekile nokukhumbula ukuthi dlula akuyona ekwelapheni isifo sokuqina kwemithambo yegazi, futhi imbangela izilonda semithambo musa zinyamalale ngemva kokuhlinzwa. Ngakho-ke, ukuze ugweme ukuthuthukiswa thrombosis nezilonda ezingapholi, kubalulekile ukuthobela izinyathelo.

ukuhlinzwa Dula wemikhawulo aphansi: yezinkinga ukuhlinzwa

Izinkinga ukuhlinzwa zihlanganisa ukwakhiwa ihlule legazi le shunt, ukuthuthukiswa congestive inhliziyo ukwehluleka, embolism yamaphaphu. Isikhathi yokutakula kungenzeka iqhubeka amanxeba amalunga opha wakhe. Naphezu kweqiniso lokuthi ukusebenza kubhekwa ukuba yinkimbinkimbi futhi yesikhathi eside (kufika ku 3 amahora), ukuxakeka awavamile. Imvamisa ukuthuthukiswa imayelana 2%.