Coronary tsinga ndavhiyiwa - chii? Coronary yokunzvenga midziyo mwoyo

Nechirwere chemwoyo idenda chaiye remakore rechi21. Chinenge munhu wose wechipiri ari kutambura kubva chirwere ichi. Vamwe vanogona kubata chirwere pamwe mishonga, asi chii vamwe kuvhiya inokosha. Chimwe chedzidziso kushandiswa, kuderedza ropa riyerere nemidziyo mwoyo, munhu coronary yokunzvenga.

Chii?

Izvi izwi akatanga kuonekwa munzvimbo dzakawanda dzokurapa zvinyorwa kwenguva yakati. Pari kushanda iri rinenge chete rwayo. Maererano nenhamba, vakapoteredza nyika inenge miriyoni imwe nzira dzakadaro pagore.

Sezvambotaurwa, ruzhinji varwere coronary tsinga chirwere coronary tsinga ndavhiyiwa kunokosha. Chii - uzivewo zvinosuwisa kwete zhinji.

Coronary tsinga ndavhiyiwa hunosanganisira nokuiswa detours pamwoyo midziyo.

The oparesheni rakanyatsojeka zvakawanda uye zvakakomba.

Maererano nenhamba, kuvhiyiwa uku rinoitwa muzana 12 chete vose vaya vanoshayiwa. Mune dzimwe pane contraindications wayo waivako, vamwe havasi kurapwa.

Kamwe pokuvhiyiwa akaonekwa, masayendisiti akawanda inozvikudza vakaratidza kufarira kukuru pauri, Zvisinei, makore maviri pashure ayo rezvisikwa, kuvhiyiwa rairambidzwa. Re-akatanga muna makore mashomanana, kana kuvhiyiwa akatanga kuonekwa munyika nevezvenhau. Kubvira ipapo, kushandiswa kwayo rava anenge mazuva ose, uye vanachiremba vakawanda hadzibudisi zvichibvira mushonga coronary tsinga chirwere, asi kuti kuitisa oparesheni ichi.

The pathogenesis pamusoro coronary tsinga chirwere

Coronary tsinga chirwere hwapedyo kana coronary arteries vari kutanga kunzwa yakachena kukanganisika. Izvi kunoitika nokuda kuderedza pamusoro lumen. Zvikonzero zvichiita kuti aienda, vazhinji - kubvira pakupona uye zvemamiriro aienda kubva pakuzvarwa uye anopera vasanyanye ari lumen nokuda kuwandisa atherosclerotic plaques.

Kazhinji, IBS zviratidzo regai anozviratidza kusvikira zvino, kusvikira lumen haisi kujekesa nevanhu vanopfuura 70 muzana. The kiriniki anogona kuonekwa chete kana kuti zvaikosha kurovedza muviri.

The chikuru zviri kukura nechirwere chemwoyo ndiyo bhokisi marwadzo aine kupfupika mweya uye kunzwa kutya. With chinokosha aienda pamusoro coronary midziyo kunowedzera ngozi kurwiswa mwoyo.

Kana kuchinja kurapa iri basa (kugamuchirwa vasodilator zvinodhaka) vakatakura coronary tsinga yokunzvenga kusonanidzwa.

weboka oparesheni

The oparesheni rinoitwa akazaruka-mwoyo kuvhiyiwa, t. E. Zvakakodzera kuvhura chipfuva. The incision Kazhinji akaita achitevedza costal cartilages kuruboshwe.

Murwere nenguva kupindira zvakabatana kuti mwoyo-zvemapapu muchina.

The oparesheni rinoitwa pasi zvavo yokutindivadza.

Kusika shunt rinoshandiswa kazhinji midziyo zvachero (subcutaneous Vienna makumbo kana zvemukati mammary tsinga). Kunoguma shunt, kamwe kubviswa rinoshandisirwa kumusoro uye nechepasi aienda pamusoro coronary arteries uye sutured kupinda mudziyo. Izvi hwezvekukurukurirana aibuda ropa kuburikidza njodzi tsinga uye anobvumira kuti kubvisa myocardial ischemia.

Mune zvimwe zviitiko unodzokera ndinobvisa ari TOUR tsinga sezvo ropa riyerere kubudikidza arteries nani zvikuru pemipata.

Pari, vade kuita mabasa pasina kushandisa Moyo yokunzvenga, sezvo ropa vanopfuura kuburikidza chikwata ichi chinowedzera dzvuku kukuvara eropa uye hemolysis.

Zvairatidza kuti Step

Coronary yokunzvenga midziyo mwoyo unoratidzwa zvinotevera nyaya:

• Kwakaderedza ropa patency pamusoro kuruboshwe coronary tsinga kubudikidza dzinenge 50 muzana. mudziyo ichi chikuru infarction ari kudya kunovaka. Vazhinji ropa ari mubvunzo kwaari, nokuti izvo chinhu chinogumbura pachiyero mudziyo hwakazara zvikuru ischemia uye myocardial infarction.
• The vasanyanye lumen ari coronary midziyo 70 muzana.
• Kuvapo stenosis of Anterior interventricular tsinga (kunyanya achitandadza bifurcation).

kuverengwa ava zvinokosha kuti coronary ndavhiyiwa.

Kunze kwavari pane yaivhuvhuta, symptomatic zviratidzo. Vari anokonzerwa kakawanda tichibatwa angina (marwadzo, kunzwa constriction ari mubhokisi), uye ari kazhinji yakasvikawo mishonga. Zvisinei, chinetso anova ihombe panyaya apo mishonga anorasikirwa kushanda kwayo, uye kurwisa vari kuva kakawanda. Izvozvo iyi inofanira kare akamutsa nyaya shunting.

Contraindications

Nokuda kwazvo kupararira mashoko michina, dzidza pamusoro coronary tsinga ndavhiyiwa - chii, chii uchapupu hwake - hakusi nyore. Zvose zviri zvikuru kuoma pamwe contraindications.

Kusiyana zvairatidza kuti kuvhiyiwa, contraindications zvose vari hama, sezvo mubvunzo mumwe murwere pamusoro oparesheni zvinofanira kufungwa unobva yaro chaiyo mashoko.

Zvaidavirwa kuti murwere zera, makore kunyanya pamusoro 70, ndiye prohibitive chokufunga kuitisa kupindira. Parizvino, varwere vakawanda vakwegura kushivirira chipingaidzo mukati mumoyo (ndiko nokuda kusavapo concomitant chisingaperi zvirwere kukanganisa hemodynamics). Nokuti vaya vane zvirwere zvakadai, vanachiremba vane anyanye mwoyo nokuisazve uye vascular (kutoti pane decompensated inoti).

Kare, coronary ndavhiyiwa mwoyo midziyo chaiitirwa mune renal kukundikana kana kushingaira oncological muitiro. Zvino unogona kuwana ruzivo pamusoro runako vakabudirira ichiitwa kupindira wakanaka mugumisiro uye prolongation upenyu kwemakore anopfuura 10 mune varwere izvi.

kunaya varwere

Sezvo oparesheni rakanyatsojeka zvakawanda uye zvakakomba, yakawanda kusimbisa zvakakodzera kurapa varwere kuwana coronary tsinga yokunzvenga kusonanidzwa. Pashure vavhiyiwa kazhinji kuva nemamwe matambudziko akadai kurasikirwa zvemapapu kufefetedza (nokuda refu mutsigiro murwere ari ventilator) uye zvirwere matambudziko.

Prophylaxis kuti kufema zvirwere anoitwa kushandisa chibharuma mitengo kana matoyi chaiwo. Kudzivirira kukura zvinotapuriranwa yematambudziko zvakawanda zvakaoma - kwete nguva dzose kungwarira uye nenguva kuchinja mabhandeji kubatsira hutachiwana.

Iva nechokwadi kuti kuongorora parameters ropa murwere, sezvo nokuda massiveness hwokushanda kazhinji kuitwa chinokosha kurasikirwa neropa. Panyaya iyi, murwere anongoti vanoda kuwedzerwa ropa kudzikamisa zvikanganiso ayo.

varwere zvose kuti oparesheni iyi kunze - coronary ndavhiyiwa - vane nguva refu kupfuura rokuchinjwa uye kudzivisa kuneta mupfungwa. Izvi zvinoitwa kuitira kudzivisa zvinodyiwa kusabvumirana simbi zvavakatemerwa pamusoro sternum.

Opinions varwere chokuita oparesheni

An kuwedzera varwere vari kupindira mumwoyo midziyo. Kana Paunoongorora nzvimbo dzakasiyana-siyana uye forum vakazvipira dambudziko iri, unoonekwa kuti vanhu vakawanda ndavhiyiwa coronary ndavhiyiwa, mumwe kumbonyanya Wongororo. Sezvineiwo nani kunaka upenyu, uye varwere vakawanda vanogona kudzokera dzose basa (chete pashure rokuchinjwa nguva). It kunoderedza uwandu angina kurwiswa, izvo yekudyidzana kunokanganisa mabasa vapenyu nezuva.

Vakawanda vanonetseka - zvakadini iri kuvhiyiwa uku?

Zvose zvinoenderana chii murwere ezvinhu utano panguva vakatsunga zvairatidza kuti kuvhiyiwa. Kana ukaratidza coronary tsinga ndavhiyiwa, mutengo panofanira kuti zvinhu zvakadai bhuku kupindira, asi zvinodiwa yacho uchishandisa chiremba, asi zvinenge zvinhu zvose zvakadaro zvinoitwa mahara. Mari Implementation yavo dzinounzwa neHurumende bhajeti (toga muzvipatara mari pakuvhiya anoda kubva 7 kusvika 10 zviuru zvamadhora, izvo zvinodhura chaizvo).

Zvakakodzera kuita oparesheni ichi?

Varwere vakawanda nechirwere kwenguva refu angina, coronary tsinga ndavhiyiwa kunoratidzwa. Chii - vanhu vashoma vanoziva, nokuda chii hazvo zvinofanira kuva uchida tsananguro imwe chiremba. Vamwe vanotya uye marara kushandiswa, sezvo nzira iri kwakatooma zvikuru uye zvakaoma, uye ngozi yematambudziko zvakakwirira zvikuru. Vamwe nemaune pangozi, achiziva kuti pasina kupindira zvose azvidzore panze zviipe.

Ndinofanira kuita oparesheni - kusarudza chinokuvadzwa nomumwe. Zvisinei, kana mukushanda kunoratidzwa zviri nani kuita, sezvo yakanaka mugumisiro (lethality panguva oparesheni idukusa 2 muzana) Sezvineiwo anovandudza mamiriro uye kunaka kwoupenyu.