Peripheral tsinga chirwere - makumbo

Peripheral artery chirwere (PAD) mamiriro emitsipa yeropa inopa makumbo netsoka. Zvinoitika nekuda kwekutetepa kwetsinga mumakumbo. Izvi zvinokonzera kuderera kweropa, izvo zvinogona kukuvadza tsinga uye zvimwe zvinyama.

PAD inokonzerwa neatherosclerosis. Dambudziko iri rinoitika kana chakakora (plaque) chakavakira pamadziro etsinga dzako uye chichiita kuti chiderere. Masvingo etsinga zvakare anoomarara uye haakwanise kuwedzera (kutambanuka) kubvumira kuyerera kweropa kukuru pazvinenge zvichidikanwa.

Nekuda kweizvozvo, mhasuru dzemakumbo ako hadziwane ropa rakakwana neoksijeni pavanenge vachishanda zvakanyanya (senge panguva yekurovedza muviri kana kufamba). Kana PAD ikava yakaoma, panogona kunge pasina yakakwana ropa neoksijeni, kunyangwe kana mhasuru dzichizorora.

PAD chirwere chakajairika. Inowanzo bata varume vanopfuura makore makumi mashanu, asi vakadzi vanogona kuva nayo futi. Vanhu vari panjodzi yakakwira kana vaine nhoroondo ye:

• Cholesterol isina kujairika
• Chirwere cheshuga
• Chirwere chemwoyo (coronary arteri chirwere)
• Kuwedzera kweropa (hypertension)
• Chirwere cheitsvo chinosanganisira hemodialysis
• Kusvuta
• Stroke (chirwere checebrovascular)

Zviratidzo zvikuru zvePAD kurwadziwa, kusuruvara, kuneta, kupisa, kana kusagadzikana mumhasuru dzetsoka dzako, mhuru, kana zvidya. Zviratidzo izvi zvinowanzoonekwa panguva yekufamba kana kurovedza muviri, uye woenda mushure memamwe maminetsi ekuzorora.

• Pakutanga, izvi zviratidzo zvinogona kuoneka chete kana iwe uchifamba uchikwira, uchifamba nekukurumidza, kana kufamba nzendo refu.
• Zvishoma nezvishoma, izvi zviratidzo zvinoitika nekukurumidza uye zvishoma kurovedza muviri.
• Makumbo ako kana tsoka dzinogona kunzwa kupera kana iwe uchinge uchizorora. Makumbo anogona zvakare kunzwa kutonhorera pakubata, uye ganda rinogona kuratidzika kuva rakachenuruka.

Kana PAD ikava yakaoma, unogona kunge uine:

• Kushaya simba
• Marwadzo uye kurwadza husiku
• Kurwadziwa kana kugunun'una mutsoka kana zvigunwe, izvo zvinogona kunge zvakanyanya zvekuti kunyange huremu hwembatya kana machira emubhedha zvinorwadza
• Marwadzo akaipisisa iwe paunosimudza makumbo ako, uye anovandudza kana iwe uchinge wakanamatira makumbo ako padivi pemubhedha
• Ganda rinotaridzika serima uye rebhuruu
• Maronda asingarape

Munguva yebvunzo, mupi wehutano anogona kuwana:

• Inzwi rekushushikana kana iyo stethoscope inobatwa pamusoro petsinga (arterial bruits)
• Yakadzikira BP kumanheru akakuvadzwa
• Mapundu asina kusimba kana asipo munhengo

Kana PAD yakanyanyisa, zviwanikwa zvinogona kusanganisira:

• Mhuru dzemhuru dzinodzikira (dzinosvava kana atrophy)
• Kusuruvara pamusoro pemakumbo, tsoka uye zvigunwe
• Maronda anorwadza, asingabude ropa patsoka kana zvigunwe (kazhinji kacho nhema) ayo anononoka kupora
• Rudzi rweganda kana ruvara rwebhuruu muzvigunwe kana tsoka (cyanosis)
• Kupenya, rakasimba ganda
• Zvigunwe zvakakora

Kuongororwa kweropa kunogona kuratidza yakakwira cholesterol kana chirwere cheshuga.

Miedzo yePAD inosanganisira:

• Angiography yemakumbo
• Ropa kumanikidzwa kuyerwa mumaoko nemakumbo ekuenzanisa (ankle / brachial index, kana ABI)
• Doppler ultrasound bvunzo yemhedzisiro
• Magnetic resonance angiography kana CT angiography

Zvinhu zvaunogona kuita kudzora PAD zvinosanganisira:

• Balance kurovedza muviri nekuzorora. Famba kana kuita chimwe chiitiko kusvika pakurwadziwa uye wochinjanisa nenguva dzekuzorora. Nokufamba kwenguva, kutenderera kwako kunogona kuvandudzika senge nyowani, mitsipa yeropa fomu. Nguva dzose taura nemupi usati watanga chirongwa chekurovedza muviri.
• Rega kusvuta. Kusvuta kunoderedza tsinga, kunoderedza kugona kweropa kutakura okisijeni, uye kunowedzera mukana wekuumba clots (thrombi uye emboli).
• Chengetedza tsoka dzako, kunyanya kana iwe uine chirwere cheshuga. Pfeka shangu dzinokwana zvakanaka. Teerera kune chero akachekwa, mabara, kana kukuvara, uye ona wako mupi ipapo ipapo. Nyama dzinopora zvishoma nezvishoma uye dzinogona kutapukirwa kana paine kudzikira kwekutenderera.
• Ita shuwa kuti yako BP yakachengetedzwa zvakanaka.
• Kana iwe uri kufutisa, dzikisa huremu hwako.
• Kana cholesterol yako yakakwira, idya yakaderera-cholesterol uye yakaderera-mafuta kudya.
• Chengetedza huwandu hweshuga yeropa kana uine chirwere cheshuga, uye chengeta icho chiri pasi pekutonga.

Mishonga inogona kudikanwa kudzora kusagadzikana, kusanganisira:

• Aspirin kana mushonga unonzi clopidogrel (Plavix), unoita kuti ropa rako risaumbike mutsinga dzako. Usarege kutora mishonga iyi usati watanga kutaura nemupi wako.
• Cilostazol, mushonga unoshanda kuwedzera (kuwedzera) tsinga yakakanganiswa kana maarteri ezviyero zvine mwero-kusvika-zvakakomba izvo zvisina kukwikwidza kuvhiyiwa.
• Mushonga wekubatsira kudzikisa cholesterol yako.
• Marwadzo anoderedza.

Kana iwe uri kutora mishonga yehosha yepamusoro yeropa kana chirwere cheshuga, tora iyo sekupa kwaunopihwa nemupi wako.

Kuvhiya kunogona kuitwa kana mamiriro ari akakomba uye ari kukanganisa kugona kwako kushanda kana kuita zviitiko zvakakosha, uri kurwadziwa kana kuzorora, kana uine maronda kana maronda pagumbo rako risingarape. Sarudzo ndedze:

• Maitiro ekuvhura yakamanikana kana yakavharika tsinga dzeropa dzinopa ropa kumakumbo ako
• Kuvhiya kudzosera ropa parutivi petsinga yakavharika

Vamwe vanhu vane PAD vangangoda kuti gumbo ribviswe (kudimburwa).

Kazhinji kesi dzePAD yemakumbo dzinogona kudzorwa pasina kuvhiyiwa. Kunyangwe kuvhiyiwa kuchipa zororo rakanaka rechiratidzo muzviitiko zvakakomba, angioplasty uye nzira dzinonhuwa dziri kushandiswa panzvimbo yekuvhiya kakawanda uye kazhinji.

Zvinetso zvinogona kusanganisira:

• Ropa rinovhara kana emboli inovhara tsinga diki
• Coronary tsinga chirwere
• Kushaya simba
• Vhura maronda (ischemic ulcers pamakumbo epasi)
• Tissue rufu (maronda)
• Gumbo kana tsoka yakakanganisika ingangoda kudimburwa

Fonera mupiki wako kana iwe uine:

• Gumbo kana tsoka inova inotonhorera pakubata, kucheneruka, bhuruu, kana kuti chiveve
• Kurwadziwa pachifuva kana kupfupika kwemweya nekurwadziwa kwegumbo
• Kurwadziwa kwegumbo kusingaendi, kunyangwe iwe usiri kufamba kana kufamba (kunonzi kurwadziwa kwekuzorora)
• Makumbo akatsvuka, anopisa kana kuzvimba
• Maronda matsva / maronda
• Zviratidzo zvehutachiona (fivha, kutsvuka, kazhinji kurwara kunzwa)
• Zviratidzo zve arteriosclerosis yemagumo

Iko hakuna bvunzo yekuongorora inokurudzirwa kuti uone PAD mune varwere vasina zviratidzo.

Dzimwe dzenjodzi dzechirwere chetsinga dzaunogona kuchinja ndidzi:

• Kwete kusvuta. Kana iwe uchisvuta, rega.
• Kudzora cholesterol yako kuburikidza nekudya, kurovedza muviri, uye mishonga.
• Kudzora kukwira kweropa kuburikidza nekudya, kurovedza muviri, uye mishonga, kana zvichidikanwa.
• Kudzora chirwere cheshuga kuburikidza nekudya, kurovedza muviri, uye mishonga, kana zvichidikanwa.
• Kurovedza muviri kanenge maminitsi makumi matatu pazuva.
• Kuchengeta kune huremu hune hutano nekudya chikafu chine hutano, kudya zvishoma, uye kujoina chirongwa chekudzora uremu, kana iwe uchida kudzikira uremu.
• Kudzidza nzira dzine hutano dzekutarisana nekushushikana kuburikidza neakakosha makirasi kana zvirongwa, kana zvinhu sekufungisisa kana iyo yoga.
• Kudzikisira kuti unonwa doro rakawanda sei kunwa 1 pazuva pazuva revakadzi uye 2 pazuva kuvarume.

Peripheral vascular chirwere; PVD; PAD; Arteriosclerosis obliterans; Kuvharika kwetsinga dzemakumbo; Claudication; Kupindirana kwepakati; Chirwere chinonzi Vaso-chinogoneka chemakumbo; Arterial kusakwana kwemakumbo; Kudzokorora kurwadziwa kwegumbo nekupwanya; Mhuru kurwadziwa nekurovedza muviri

• Angioplasty uye stent kuiswa - peripheral arteri - kubuda
• Antiplatelet zvinodhaka - P2Y12 inhibitors
• Cholesterol uye mararamiro
• Mafuta echikafu akatsanangura
• Kurumidza kudya matipi
• Rutsoka kudimburwa - kubuda
• Maitiro ekuverenga zvinyorwa zvekudya
• Kudimburwa gumbo - kubuda
• Gumbo kana tsoka kudimburwa - kupfeka shanduko
• Kudya kweMediterranean
• Peripheral tsinga inopfuura - gumbo - kubuda

• Atherosclerosis yemagumo
• Arterial yekupfuura gumbo - akateedzana

Bonaca MP, Creager MA. Peripheral tsinga chirwere. Mune: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Chirwere Chemwoyo cheBraunwald: A Chinyorwa cheCardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019: chitsuwa 64.

Ridker PM, Libby P, Kurapa JE. Zviratidzo zvengozi uye chekutanga kudzivirira chirwere chemwoyo. Mune: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Chirwere Chemwoyo cheBraunwald: A Chinyorwa cheCardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019: chitsuwa 45.

Simons JP, Robinson WP, Schanzer A. Kumucheto kwekupedzisira arterial chirwere: kurapwa kwekurapa uye kuita sarudzo. Mune: Sidawy AN, Perler BA, eds. Rutherford Kuvhiya kweVascular uye Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019: chits. 105.

US Preventive Services Task Force, Curry SJ, Krist AH, Owens DK, et al. Kuongororwa kweanoperera arteri chirwere uye yemoyo chirwere chirwere kuongororwa pamwe neankle-brachial index: US Preventive Services Task Force Kurudziro Chirevo. JAMA. 2018; 320 (2): 177-183. PMID: 29998344 pubmed.ncbi.nlm.nih.gov/29998344/.

Chena CJ. Atherosclerotic peripheral arterial chirwere. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chits. 71.