Kev ua hauj lwm ntawm myocardium yog muab los ntawm cov pa oxygen, uas tuaj nrog ntshav los ntawm cov hlab ntsha coronary. Yog tias lawv raug puas tsuaj, kev xa roj ntsha tuaj yeem txhawm rau qog nqaij hlav thiab qog pob txha. Yog tsis muaj ntshav txaus, cov leeg nqaij tsis muaj zog los yog atrophies.
Ischemic plawv - ua rau
Cov kab mob hauv kev xav tau tshwm sim los ntawm qhov atherosclerosis ntawm coronary leeg ntawm nyias qib. Cov lumen ntawm cov hlab ntsha tuaj yeem raug qis vim qog nqaij npub los sis thaiv tag nrho. Tiv thaiv cov keeb kwm ntawm qhov atherosclerotic qhov hnyav, lwm yam ua rau tus kab mob plawv (kab mob hauv lub plawv) ntxiv:
- spasm ntawm cov leeg hlab ntsha tawg;
- tromboembolism;
- cardiospasm;
- obstruction ntawm coronary hlab ntsha.
Ischemic plawv kabmob - kev faib tawm
Tus kab mob no tau mob thiab mob ntev. Nyob ntawm seb nws qhov xwm txheej thiab qhov mob hnyav li cas, nws muaj xws li hom mob ntsws hauv plawv:
- angina pectoris;
- myocardial infarction thiab postinfarction cardiosclerosis;
- Sudden tuag ntsws;
- tsis hnov mob los sis hais tsis tau lus.
Ischemic plawv - angina
Qhov kev piav qhia ntawm pathology tau muab faib ua ob peb subgroups raws li cov xwm txheej ua rau kev mob siab heev. Kab mob siab ntsws ntev yog hais txog lub ntsws ruaj khov (nro). Lawv nyias txawv nyias rau hauv 4 chav kawm xws li qhov loj (I-IV). Cov tsos mob ntawm no angina tshwm sim rau qhov kev xav ntawm lub siab lub ntsws lossis lub cev kev nyuab siab.
Ischemic kab mob hauv lub plawv ntawm ib hom tsis muaj zog zoo li:
- progressing;
- thawj zaug tshwm sim;
- kev kho mob thaum ntxov;
- postinfarction.
Lwm hom mob angina pectoris:
- vasospastic;
- tshwm sim;
- variant (stenocardia ntawm Prinzmetal).
Feem ntau, mob siab heev yog cov nyom ntawm arrhythmia. Nws yog ib qho mob sib npaug zos thiab mob ntsws ntau. Arrhythmia muab cov kev ntsuam xyuas tshwm sim ntawm sab laug plawv nres tsis ua hauj lwm:
- txog kev ua tsis taus pa;
- hawb pob;
- o ntawm lub ntsws.
Ischemic plawv kabmob - myocardial infarction
Hom kab mob no yuav loj thiab me me focal, nyob ntawm seb qhov kawg ntawm cov pob txha ntawm cov leeg nqaij. Kab mob qog nqaij hlav hauv lub plawv los yog lub plawv nres yuav tsum tau pw hauv tsev kho mob tam sim ntawd, lwm yam teeb meem loj, xws li kev tuag, txhim kho. Ib qho ntawm feem ntau yuav tshwm sim ntawm qhov kev mob no yog cardiosclerosis (caws pliav ntawm myocardium). Nws yog kuaj li ntawm 2 lub hlis tom qab mob plab.
IHD - mob tuag sai sai
Unforeseen mob, uas yuav tsum muaj kev cuam tshuam hluav taws xob instability ntawm myocardium. Yog tias tus kab mob plawv hauv lub plawv tau ua rau tuag lossis tuag thaum 6 teev tom qab qhov kev tawm tsam, paub txog kev tuag sai sai. Hauv lwm cov teeb meem, qhov ua rau muaj teeb meem tuaj yeem pab lwm cov kab mob ntawm myocardium - infarction, cardiosclerosis los yog nyuaj angina pectoris.
Hnyav-dawb daim ntawv ntawm tus kab mob ntsws ischemic
Hom kab mob no tsis ua rau muaj cov tsos mob thiab kev tsis txaus siab tsis tuaj. Nws yog qhov yooj yim tshaj rau kev kuaj xyuas dua li cov kab txawv saum IHD, yog li ntawd lub ncauj lus qeeb qeeb qeeb thiab feem ntau ua rau muaj kev tsim txom phem. Nws yog ib qho tseem ceeb kom mus ntsib tus kws kho mob tsis tu ncua rau kev tiv thaiv. Tus kab mob qog nqaij hlav ceev ceev yog ib qho kab mob tsis txaus ntseeg, uas yog qhov tseeb tau pom txawm tias tseem muaj cov hluas. Yog tias tsis kho, nws tuaj yeem ua rau tuag cia li tuag.
Muaj tej yam tseem ceeb rau kev mob plawv hauv lub plawv
Muaj cov xwm txheej muaj feem xyuam rau cov tsos mob ntawm lub ncauj lus nug. Txoj kev loj hlob ntawm kev mob ntsws ischemic provoked yog cov nram qab no:
- noob caj noob ces;
- laus hnub nyoog;
- poj niam txivneej;
- arterial hypertension ;
- ntshav qab zib mellitus;
- dyslipidemia;
- rog;
- daim siab tsis ua haujlwm;
- propensity rau atherosclerosis.
Cov kab mob hauv lub plawv muaj ntau dua rau cov neeg uas muaj kev tsis zoo. Nws tshwm sim tawm tsam tom qab:
- haus luam yeeb;
- irrational nutrition;
- haus cawv;
- hypodynamia;
- tsis-ua raws ntawm kev ua hauj lwm thiab kev rov ua hauj lwm regime.
Ischemic plawv - Cov tsos mob
Ib qho raug soj ntsuam ntawm tus kab mob uas tau nthuav qhia yog ib yam mob qhov mob hauv cov laus hauv cheeb tsam retrosternal. Cov seem ntawm cov kab mob plawv hauv tus kab mob ntsig tsis muaj qhov tshwj xeeb, yog li ntawd lawv tsis tas li nrog cov kab mob uas tau piav. Nrog rau kev mob ntsws tsis muaj mob, kev tsis txaus siab tsis tu ncua, thiab tus tib neeg tus mob zoo li qub rau lub sijhawm ntev. Lwm cov tsos mob ntawm tus kabmob qog no:
- ua tsis taus pa luv luv, tshwj xeeb tshaj yog nrog kev siv lub cev;
- tsis muaj zog;
- kev xav tsis zoo ntawm kev ua haujlwm ntawm lub plawv, ua txhaum ntawm nws lub suab;
- kiv taub hau thiab xeev siab;
- o ntawm qis pob txha;
- tawm hws;
- tsaus muag los sis tsis nco qab.
Mob hauv kev kho kab mob ntsws ntsws
Tus kws kho mob tau hais los ntawm kev tsis xis nyob tsis yog hauv cheeb tsam hauv siab xwb. Feem ntau cov kab mob sib kis ischemic ua rau mob qhov mob hauv lwm qhov ntawm lub cev:
- tes, feem ntau sab laug;
- rov qab;
- sab hauv qab;
- xub pwg;
- scapula.
Tsis kaj siab yuav muaj qhov ua cim (tho, rub los yog nias). Thaum xub thawj, qhov mob tsis ntev, ntev li ob vib nas this, thiab tom qab ntawd nws tuaj. Qis qis, kab mob plawv hauv lub plawv nce zuj zus, thiab thaj chaw loj ntawm myocardium puas ntsoog. Qhov no ua rau mob plawv dhau los, thaum lub tsos mob tshwm sim tuaj.
Kev kuaj mob ntawm kab mob plawv
Ntawm kev txais tos, tus kws kho plawv ua tib zoo sau cov anamnesis. Nws yog ib qho tseem ceeb uas tsim kom muaj qhov xwm txheej thiab qhov ntev ntawm qhov mob hnyav, nws qhov kev sib raug zoo rau lub cev lub cev thiab muaj peev xwm ua kom haus cawv nrog nitroglycerin. Thaum lub caij kuaj ib ce, tus kws kho mob paub txog cov kab mob ntawm tus kabmob qog:
- lub xub ntiag ntawm edema;
- ntub hawb pob thaum ua pa;
- crepitation (crunchy suab) hauv cov ntsws;
- nce hauv daim siab loj (hepatomegaly).
Qhov kev ntsuam xyuas zaum kawg ntawm "kev mob ntsws ntawm qog nqaij hlav" yog raws cov khoom siv thiab kev sim tshuaj ntsuam xyuas:
- tus txheej txheem los sis kev hloov hauv cov tshuab electrocardiographic;
- echocardiography ;
- ntshav ntsuam xyuas cov protein enzymes, qab zib, cov cholesterol thiab lwm cov yeeb yam;
- coronary angiography.
Ischemic plawv - kho
Txoj kev kho ntawm cov kab mob pathology no nyob ntawm nws qhov mob hnyav thiab zoo li cas. Tus kws kho plawv ib leeg zuj zus xaiv txoj kev yuav kho mob qog nqaij hlav hauv plawv, tab sis kuj muaj lus pom zoo rau txhua tus neeg mob:
- Txo qhov kev siv ntawm kev siv lub cev. Maj mam, lawv tuaj yeem tsim ntau ntxiv rau lub sijhawm rov kho dua.
- Nqa lub cev nyhav rov rau qub.
- Txwv kev noj cov ntsev thiab dej.
- Kho cov ntawv qhia zaub mov. Nws yog ntshaw kom tshem tawm cov khoom uas ua rau kev loj hlob ntawm atherosclerosis - tsiaj cov rog, cov khoom noj haus, khoom noj khoom kib, pickles, desserts.
- Tsis kam haus dej haus cawv thiab haus luam yeeb.
Txhawm rau kom tsis txhob muaj cov tsos mob ntawm IHD thiab rov qab ua haujlwm ntawm myocardium, ib tus kws kho mob tshwj xeeb yog ib qho kev kho mob tshuaj. Yog tias nws ua ke nrog kev ntsuas tsis tsim cov kev xav tshuaj, kev kho phais yog pom zoo:
- coronary artery bypass grafting (myocardial revascularization);
- balloon angioplasty;
- Stenting;
- bougie ntawm coronary vessels (balloon dilatation).
Kev kho mob ntawm coronary plawv kab mob - siv yeeb siv tshuaj
Conservative therapy yog tsim los cais rau txhua tus neeg mob plawv, tab sis nws muaj ib qho "ABC" scheme, uas muaj cov tshuaj 3 pawg ntawm cov tshuaj:
- antiplatelet cov neeg sawv cev - Thrombopol, Aspirin, Clopidogrel, Acecardol;
- beta-blockers - Niperten, Egilok, Dilatrend, Concor;
- statins thiab fibrates - Simvastatin, Lovastatin, Atorvastatin, Fenofibrate.
Thaum muaj cov kab mob ntsig txog cov kab mob ntsig, muaj cov tshuaj ntxiv. Ischemic kab mob - kev kho mob:
- anticoagulants - Heparin, Phenylin;
- nitrates - isosorbide mononitrate, Nitroglycerin ;
- Diuretics - Lasix, Furosemide;
- lipid-lowering drugs - polikozanol, Nolipid;
- tshuaj antiarrhythmic - Amiodarone, Cordarone;
- inhibitors ntawm angiotensin-converting enzyme - Captopril , Enalapril;
- metabolic cytoprotectors - Mexicor, Coronater.
Ischemic kab mob - kev kho mob nrog kev kho neeg pej xeem
Kev siv lwm hom tshuaj tsuas yog tso cai los ntawm kev tso cai los ntawm tus kws kho mob hauv qab kawg nkaus li kev kho mob. Nrog rau lawv cov kev pab, kev mob ntsws ischemic yog yooj yim - pej xeem tshuaj txo qhov siab zog, ua kom tshem tawm cov dej ntau dhau ntawm lub cev thiab txhim kho cov metabolism . Qee lub zog ntawm myocardium thiab tiv thaiv nws cov necrosis, lawv ua tsis tau.
Kev cog qoob loo los ntawm ischemic heart disease
Cov khoom xyaw:
- hawthorn paj - 100 g;
- tshuaj ntsuab Leonurus - 100 g;
- chamomile xim - 100 g;
- boiling dej - 120-150 ml.
Npaj, siv :
- Cov khoom noj qhuav qhuav mus zom thiab sib tov.
- Ib tug teaspoon ntawm sau yuav tsum tau poured nrog boiling dej thiab them.
- Txhaws tshuaj rau 20 feeb.
- Lim lub kua.
- Haus tag nrho cov tshuaj noj thaum sawv ntxov ntawm lub plab tas.
- Mus kho kom ntxiv kom txog thaum muaj kev txhim kho kom zoo dua.
Tincture rau lub plawv
Cov khoom xyaw:
- tshiab qej - 50 g;
- vodka - 120-140 ml.
Npaj, siv :
- Grate qej, tsis txhob nyem kua txiv.
- Ncuav gruel nrog vodka, do.
- Insist txhais tau tias yog 72 teev.
- Peb zaug ib hnub, noj 8 tshuaj ntawm cov tshuaj, ntxiv rau lawv kom qab zib, dej huv.
- Cov kev kho mob yog 7 hnub.
Kho decoction
Cov khoom xyaw:- qhuav txiv hmab txiv ntoo ntawm hawthorn - 20 g;
- dej yog 200-220 ml.
Npaj, siv :
- Boil dej, muab berries nyob rau hauv nws.
- Boil lub txiv hmab txiv ntoo rau 2 feeb, tua tawm qhov hluav taws kub.
- Txhob muab tshuaj khi rau hauv lub hau lossis hauv lub thawv rau 2 teev.
- Txiav qhov kev daws teeb meem.
- Ib nrab ib teev ua ntej txhua pluas noj, haus 2 dia. spoons ntawm cov tshuaj.
Kev mob ntsws mob ntsws zoo li cas?
Cov kev ntsuam xyuas pathology yog mob ntev thiab tas mus li, ua rau tsis muaj kev puas tsuaj rau lub hlwb thiab cov kev pheej hmoo. Yog tias qog nqaij hlav hauv lub plawv, qhov teeb meem tuaj yeem ua raws li nram no:
- cardiosclerosis ;
- tsis muaj txeej ntawm cov metabolism hauv lub cev;
- kev mob ntawm automatism, kev sib tsoo thiab excitability ntawm myocardium;
- ua txhaum ntawm systolic thiab diastolic npuag zog;
- deterioration ntawm contractility ntawm sab laug ventricle ("stunned myocardium").
Cov kab mob ntsiag to ntawm Ischemic nyuaj rau feem ntau ua rau tus yees khov kho hauv kev siv ntawm kev mob ntsws. Ua ke nrog cov kev hloov ntawm morphofunctional thiab kev atherosclerosis ntawm cov hlab ntsha, qhov no ua rau lub plawv tsis ua haujlwm. Tus kab mob no feem ntau yog qhov ua rau kev tuag ntxov, tshwj xeeb tshaj yog cov txiv neej ntawm cov neeg laus.
Prophylaxis ntawm kab mob plawv
Txhawm rau tiv thaiv kev txhim kho ntawm qhov kev ntsuam xyuas pathology, nws yog ib qho tsim nyog yuav tau ntsuas kom muaj kev sib hloov nyob rau hauv lub xeev li qub thiab tiv thaiv atherosclerosis.
Prophylaxis ntawm tus kab mob plawv hauv lub plawv:
- Ua raws li cov cai ntawm kev noj qab haus huv noj qab haus huv, preferring noj cov zaub mov qis rau cov tsiaj rog thiab cov roj cholesterol.
- Txaus siab siv cawv thiab haus luam yeeb.
- Nruam thiab mob siab rau lub cev ua ub no.
- Soj ntsuam lub regime ntawm lub hnub, tag nrho pw.
- Tuav pom kev hnyav.
- Zam kev puas siab puas ntsws thiab kev xav siab tshaj.
- Saib xyuas ntshav siab.
- Tawm sib tham nrog tus kws kho mob tshwj xeeb rau kev kuaj mob tiv thaiv.
- Tshaj tag nrho electrocardiography txhua xyoo.
- Mus ntsib kws kho mob tshwj xeeb, cov chaw so.