Ukususwa kweempahla zecala eliphantsi: izibonakaliso, nemiphumo

Izifo zeempahla zifumaneka kubini abasetyhini kunye namadoda. Ngokuqhelekileyo i-pathologies ithintela abantu abaphakathi nabadala. Izifo ezingaphantsi kwesifo se-vascular ziyabonwa kubantu abaselula. Kwezinye iimeko, ezinjalo iintsholongwane zizalwa. Uhlobo lwendawo oluqhelekileyo lwezilonda zesistim ye-vascular i-coronary, i-artery arteries, i-rectal ne-lower extremity veins. Nangona kunjalo, nge- vasculitis ye-systemic, inkqubo inokusasazeka kuwo wonke umzimba. Esinye sezizathu eziqhelekileyo zokuqhagamshelana nodokotela ogqirha yi-varicose veins. Olu hlobo lentsholongwane luqhelekileyo kubasetyhini. Iimpawu zeempawu ziyiyo: i-tortuosity yeemvini, ukwanda kwawo, ukukhutshwa. Esinye isifo seempahla yi-atherosclerosis. Ikhokelela ekukhuselweni kwemibhobho kunye nokuhamba kwegazi okungakhubazeki. Kwiimeko eziphambili, zombini i-pathologies zenziwa ngokutshintshwa kweempahla eziphantsi. Yinto yokuhlinzwa, ngenxa yokuphuma kwegazi ngokupheleleyo.

Iyintoni injongo yokutshintsha iimpahla zemilenze?

Isilinganiselo esithintekayo kwizifo zeemvini kunye nemithambo ye-articular is the shunting of vessels of the legs. Unyango kumaziko okuqala luqhutywa ngokuzimeleyo. Izigulane ezibhekene ne-atherosclerotic lesion zichazwe izidakamizwa ezinciphisa i-lipid (amayeza "Atorvastatin", "Fenofibrate"), ukutya. Kwiimvumba ze-varicose, kucetyiswa ukuba ugqoke iiplastiki ezizodwa ze-elastic, sclerotherapy. Ukususwa kweempahla zecala elingaphantsi kwenziwa nge-obstruction engummiselo we-artery okanye i-lumin lumen, umngcipheko omkhulu we-thrombosis kunye nophuhliso lwe-gangrene. Le nqubo yongenelelo lophulo-mthetho, kufuneka lwenziwa ngunyango osebenza nge-angio-surgeon. Ukuqhawula ukutshintshwa kwendawo yokukhupha isitya ngokufakelwa. Ngenxa yoko, ukunikezelwa kwegazi kubuyiselwe, kwaye umngcipheko wokubunjwa kwe-thrombus uyancitshiswa kakhulu. I-shunt ingenziwa kwizinto zokwenza izinto okanye izicubu zomzimba. Ngokuqhelekileyo iinqanawa ezikufutshane zeziphelo eziphantsi zisetyenziselwa ukufakelwa. Ukukhethwa kwezinto eziphathekayo kuxhomekeke kububanzi beetriyiti okanye i-vein ewonakalisiweyo, kwakunye nezixhobo zokugula.

Izibonakaliso zokushenxiswa kweempahla zecala eliphantsi

Ugqirha lokukhusela iinqwelo zecala elingezantsi lenziwa kwisebe elikhethekileyo okanye eligqirha esibhedlele. Ibhekisela kwiinkqubo ezilukhuni, ngoko kufuneka iqhutywe kuphela kwiinkcazo eziqinileyo. I-Vascular bypass ifanele iqhutyelwe ukuba ngaphezulu kwe-50% yobubanzi bomthamo okanye umvini uvalwe. Ngaphambi kokuthatha isigqibo malunga nokuhlinzwa, oogqirha banika unyango olulondolozayo. Ingenelelo yokuphanda iyenziwa ngokungabikho komphumo wonyango. Kukho ezi zilandelayo zibonakaliso zokungena kwiinqanawa eziphezulu:

1. Ukuphelisa i-arteriosclerosis yemida.
2. Ukuvakaliswa kwezilwanyana kwi-systemous venous system. Ngokuphindaphindiweyo kunye nemilenze ye-varicose kunye nosongelo lwe-thrombophlebitis, ukugquma okanye i-angioplasty yenziwa. Ngokuchasene neendlela ezinjalo zonyango, ukukhutshwa kweempahla kuyenziwa.
3. Endarteritis. Ngaloo ntsholongwane, ukuphendula okuvuthayo kudibaniswa nokutshatyalaliswa okuqhubekayo kweenqanawa ezincinci. Kancinci iirriyiti zivaliwe ngokupheleleyo, zikhokelela ekugqibeleni kweenyawo. Esi sifo siqhelekileyo phakathi kwabantu besilisa.
4. Aneurysm yeemibhobho ezisezantsi. I-Pathology iyingozi yengozi enkulu yokuphuma kwamanzi, okunzima kakhulu ukuyeka.

Kwezinye iimeko, ukutshintshwa kweempahla zecala elingezantsi kunye neengqungquthela zezinzwane okanye iinyawo zenziwa. Ukunyanzeliswa kwale ngongenelelo yokungcungcutheka akuhlali kulungile kwaye kuxhomekeke kwingingqi ye-necrosis kunye neempawu zomntu ngamnye. Kwezinye iimeko, usebenzo lukhokelela ekuphulukisweni kwesibhedlele okanye ukunciphisa ngobukhulu becala elijoliswe kulo.

Ziziphi iimeko ezigqityiweyo zonyango?

Nangona ukusebenza kweenqanawa zokuhamba, kulungile ukuba sikhumbule ukuba lo msebenzi unzima kakhulu. Ngoko ke, kuyenziwa kuphela kwiimeko xa ezinye iindlela zonyango zingancedi. Kukho inani leenkcenkceshelwano zokuvala. Phakathi kwazo:

1. Isifo esiyingozi, asilawulwa yiziyobisi ezinobungozi. Kule meko, utyando lwe-vascular lungakhokelela ekutshitshweni kwemizimba, i-myocardial infarction okanye i-stroke.
2. Ukungaphumeleli kwentliziyo, ukuhamba kunye ne-edematous syndrome kunye nokuphefumula okuqhubekayo.
3. Angina engaqinisekanga.
4. Ukungaphumeleli kwintliziyo ye-congestive kunye ne-myocardial infarction.
5. Aneurysm ye-aorta, iinqanawa zengqondo.
6. Ukuphazamiseka kwentliziyo yeParoxysmal.

Ukususwa kweempahla zecala elingaphantsi akukwazi ukuqhutywa nezifo ezithathelwanayo, izilonda zesikhumba, ukuhlaziywa kwesifo sikashukela. Kule meko, usebenzo lwenziwe emva kokuzinza kwesimo somguli.

Izindlela zokuvala

Ngokuqhelekileyo, imirhoxo iyadlula. Oku kubangelwa kukuba iifatholo ezifanayo ziqhelekileyo. Ukongezelela, ngokunqotshwa kweemvini, ezinye iindlela zonyango ziyacetyiswa. Phakathi kwabo - ibhaluni angioplasty kunye ne-stenting. Njengokuyeka ukubuyisela ukujikeleza kwegazi, sebenzisa umgca ongaphantsi kwethanga. Ngommandla omkhulu womonakalo okanye imeko enganelisekiyo yeempahla, izixhobo zokufakelwa zenziwe. Kukho iindlela ezininzi zokuqhuba ukusebenza. Phakathi kwazo:

1. I-Aorto-bifemoral shunting. Ingenelelo yokuphanda iqhutyelwa kwinqanaba le-inguinal. Ingundoqo yesenzo kukudala i-anastomosis phakathi kwesisu esiswini se-aorta kunye nemithambo yamakhosikazi.
2. I-Hips ne-popliteal bypass. I-anastomosis yenziwa phakathi kweemibhobho ezimbini ezinkulu zomlenze ongezantsi. I-shunt ivela kwisiseko sethanga kwaye iziswa kummandla wexolo elihlangene (ngaphantsi okanye ngaphezulu kwegama).
3. ICrossover inpass. I-anastomosis idlula phakathi kwemibhobho yesibini yamakhosikazi (ukusuka emlenzeni wokunene ukuya kumlenze osezantsi, okanye ngokulandelana).
4. I-Femotothyroid shunting. Uluhlu lwama-vascular ludibanisa umzobo wesifazane kunye ne-tibial.

Ukulungiselela isigulane sokusebenza kwe-vascular overpass operation

Ukulungelelanisa ukubandakanya kubandakanya iinkqubo ezininzi zokuxilonga, kunye nokusetyenziswa kwamachiza. Ngaphambi kokusebenza kubalulekile ukuba ufumane uviwo lwebhoratri: i-OAK, i-OAM, uvavanyo lwegazi, i-coagulogram. Ukutshatyalaliswa kwemifanekiso yeempahla zecala eliphantsi, i-ECG, i-Echocardi iphinda yenziwe. Ukuze ugweme i-thrombosis ngexesha lotyando, iveki ngaphambi kokumisela imishanguzo yokunyuka kwegazi. Ezi ziquka amayeza "Aspirin cardio", "Magnikor". Amachiza e-Antibiotics kunye nezidakamizwa ezichasayo nazo ziyalelwe. Ngokuhlwa, ekupheleni komsebenzi, kubalulekile ukuyeka ukuthatha amanzi kunye nokutya.

I-Technique yeenqwelo zokukhupha ezisezantsi

Ukususwa kweempahla zecala elingezantsi kukusebenza okunzima, apho ubugcisa obunzulu bufuneka khona. Ukunyanzelisa kwenziwa phantsi kwe-anesthesia jikelele. Ukukhangela kwesikhumba kunye nezicubu ezincinci zenziwa kwiindawo ezi-2 - ngasentla nangaphantsi kwendawo echaphazelekayo yomda. Isitya siyacinywa ukuze kuthintela ukuphuma kwegazi. Emva kokuvavanywa kwendawo echaphazelekayo, kwenziwa ukukhankanywa kwinqanawa kwaye i-shunt icwangciswe kwelinye icala. Emva koko i-flap-flap ishicilelwe phakathi kweemisipha kunye neetoni. Ngaloo ndlela, i-shunt iyaniswa ngokukhawuleza kwindawo yeso sihlandlo sesibini (ngaphezu kwesilonda) kwaye isilungise isiphelo sayo. Emva koko, ugqirha uhlola ukuhamba kwegazi. Xa usebenziso oluyimpumelelo lomzila luqala ukukhupha. Kwezinye iimeko, iindlela zokusebenza zeemviwo zenziwa. Inqanaba lokugqibela lokungenelela ngophakanyiso kukuba i-suturing of tisses and skin.

Ixesha elisebenza emva kwexesha?

Kubaluleke kakhulu ukulandelelana kwesigulane ngesigulane esithotyelwe ngophengululo. Ngokukodwa ukuba ukuxhatshazwa kukhwela izitya zephantsi. Ixesha lokusebenza emva kokunyanga impumelelo malunga neveki ezimbini. Ngomhla wesi-7-10 ugqirha uyasusa izibonda. Nangona isigulane sisesibhedlele, kubalulekile ukwenza iinkqubo zokuxilonga ukuvavanya ukuphumelela kwonyango. Ukongezelela, ugqirha kufuneka aqinisekiswe ngokungabikho kweengxaki zokuhamba emva kokusebenza. Sekuqaleni kweentsuku zokuqala emva kokusebenza kuyacetyiswa ukuba uvuke ezinyaweni zakho. Kwiindawo zokuhlala kunye nokulala, iigxina ezisezantsi kufuneka zizinze kwindawo ephakanyisiweyo.

Iingcebiso ngexesha lokubuyisela

Emva kokuvala izitya zeenyawo ezingaphantsi, kufuneka ubeke iliso ukuhamba kwegazi. Kule nto, isigulane kufuneka sifunde ukuhlolwa kwexesha (i-ultrasound kunye ne-dopplerography). Kucetyiswa kwakhona:

1. Yeka ukutshaya.
2. Thatha iziyobisi zeproplatelet ukukhusela i-thrombosis.
3. Gcina umgca wesisindo somzimba. Ngokunyuka kwe-BMI kunyuse ukutya okunciphisa i-lipid kunye namayeza.
4. Yenza imihla ngemihla ngeenyawo.
5. Gqoka izitokisi ezikhethekileyo (amasokisi) kunye nezicathulo.

Ukusuka kweemikhumbi ezisezantsi: impendulo yesigulane

Impendulo evela kwizigulane ezathi zenziwa ukuhlinzwa zazikhokelela. Izigulane zibika ukuhla kweentlungu zesifo, ukuphazamiseka kwimilenze. Nangona kunjalo, kwiimeko ezininzi, abantu bayakhalaza ngokuqala kweempawu emva kwexesha. Oku kubangelwa ukutshatyalaliswa kwemithambo emilwane kunye neemvini. Kufanelekile ukukhumbuza ukuba ukuvuna akuyona yonyango ye-atherosclerosis, kwaye imbangela yesilonda se-vascular does not disappear after the operation. Ngoko ke, ukwenzela ukuba ugweme i-thrombosis kunye nophuhliso lwe-gangrene, kubalulekile ukulandela amanyathelo okukhusela.

Ukususwa kweemikhumbi ezisezantsi: iingxaki zokuhlinzwa

Iingxaki zokuhlinzwa zibandakanya ukwakheka kwe-thrombus kwi-shunt, ukuphuhliswa kwentliziyo engaphumeleli, ukugqithiswa kwe-pulmonary artery. Kwixesha lokubuyiselwa, kunokwenzeka ukuba kuhlaziywe kwilonda kwindawo yokuthunga kunye nokuphuma kumanzi. Nangona into yokuba usebenzo lubonakala lukhuni kwaye lude (ukuya kwiiyure ezingama-3), iingxaki ezinqabile. Ubume bezophuhliso lwabo malunga ne-2%.