Matenda Dego a. mtima stenting

matenda Dego a - matenda kawirikawiri imayamba ndi zizindikiro khungu ndipo nthawi zambiri amapha ndi maonekedwe a "pamimba pachimake". Imayamba ndi maonekedwe pa khungu la kobwereza kuwala pinki. pang'ono kutupa totupa papular, pakati limene mbali patapita kanthawi chimaonekadi retracted. Pa nthawi imeneyi kukhala woyera. Iwo zili makamaka pa thunthu ndi khosi khungu. Pa nthawi imeneyi, nsalu kusinthidwa adzakanidwe ndi mu malo awo, zilonda ndi felemu ankatenthetsa. Patapita milungu ingapo wodwalayo kupweteka kwambiri mu lamanja epigastric dera, malungo, kusanza magazi. Matenda ululu zimachitika mukatha kudya. Pafupifupi iliyonse kuukira pali profuse m'mimba. ululu lekeza limodzi adynamia, imfa ya mphamvu ndiponso kutopa wodwala. Odwala osauka proteinemiya, hypotension, bilirubinemia. Magazi chithunzi matenda amakhala bwinobwino. Pambuyo kuoneka zizindikiro chotero imfa kumachitika mwa masiku angapo. Pa autopsy chowululidwa thrombosis ya mitsempha ndi matumbo necrosis a intestine popanda perforation.

matenda Dego a - cutaneous m'mimba matenda, limene madokotala pafupifupi nthawi zonse kupereka madokotala ananena zawo osauka. Totupa pa matenda nthawi zambiri amakhala zinthu zosiyanasiyana zimene kosiyana chitukuko. Papules pafupi mwezi ndi chilonda ndi aumbike pa zaka 0.5.

Pa kafukufuku histological mu dermis wodwalayo zasonyezedwa kusintha kwakukulu mu dongosolo mtima. Nthawi zambiri pali magazi kuundana, arterioles, za indofeliyamu, blockage ziwiya yaikuluikulu. The kolajeni minofu padziko ziwiya akhudzidwa ndi makoma awo anati foci wa necrosis fibrinoid. Mu capillaries yaing'ono amapezeka tromboendoteliit. Mu malo ya kolajeni mbali atrophic kwambiri ting'onoting'ono basi ndipo ali ndi mamba ndi khungu ndi thinned. Pa circumference formations papular simuli zotengera dilated magazi kuti paliponse adzalowerera lymphohistiocytic. matenda Dego a analanda ndi ziwiya zikuluzikulu ili m'kati mwenimweni mwa dermis ndi subcutaneous minofu. Zimenezi ndi kusalola angapo ndipo alibe ntchito zida matumbo magazi, khungu ndi ziwalo zina ndi ofanana kwambiri panarteriit knotty.

Ngakhale matenda Dego ndi chitukuko pachimake ali ndi madokotala ananena zawo osauka, pali milandu ndi mbiri yaitali kuti angathe kuchizidwa. The mankhwala a matenda ikuchitika ndi mankhwala, magazi, corticosteroid, heparin, mavitamini ndi mankhwala. Mu "pachimake pamimba" chithandizo pafupifupi sapereka zotsatira zabwino.

matenda alionse mtima, makamaka anthu okalamba, mwina mavuto aakulu kwambiri. kusintha Atherosclerotic nthawi zina zimakhudza dziko lonse la mtima. Mu zotupa za inatsekeratu ndi carotid mitsempha, miyendo, wolumikizira restenosis opaleshoni monga stenting mtima. Makamaka chimasonyeza ngati ndondomeko ndi pa chiopsezo infarction m'mnyewa wamtima, matenda magazi mu ubongo, siudzalandilidwa ngathi lamulo la nthambi ntchito, kusintha trophic.

Stenting contraindicated mu mitsempha yaing'ono awiri (zosakwana 2.5 mm), akakufunsani stenosis (kwa malo lalikulu vasoconstriction), aimpso ndi kupuma insufficiency, pathologies mu dongosolo magazi coagulation, ziwengo kuti formulations ayodini munali (ntchito X-ray Mosiyana chiphunzitso).

Pamaso opaleshoni, ikuchitika izi chamoyo kafukufuku wa mtima, ultrasound kuphunzira intravascular, Doppler ultrasound, angiography, yopangidwa tomography, Kujambula, akugwirira, echocardiography, electrocardiography. Pamaso opaleshoni ikuchitika mankhwala antiplatelet mankhwala kuti kuchepetsa chiopsezo cha matenda oyamba thrombotic.

Ntchito stenting mtima imagwiridwa pansi mankhwala oletsa ululu pamalopo, anachita mu lalikulu mtsempha wamagazi malo pa mwendo kapena mkono. Pakuti ntchito zozungulira, femoral kapena mtsempha wamagazi mammary angagwiritsidwe ntchito. The dokotalayo ndi amene amachita puncture zotumphukira mtsempha wamagazi khoma ndipo amalowa izo m'chimake (chubu mwa zomwe zida zina anaikapo).

Woonda catheter kupulumutsa stent kudzera ziwiya balonchikom zotumphukira kuti mtsempha wamagazi ndi chifunirocho. The kutsitsi akhoza ndi X-ray Mosiyana wothandizira. Iwo lidakali ndi stent, amene apangidwe, kapangidwe mauna zitsulo ndi anaweramuka. Ntchito lonse zimaonekera pa zenera. Kukondetsa wa stent izo ikuchitika ndi kuganiza mpanda mtsempha wamagazi. Pa nthawi yomweyo zotheka kukhazikitsa stents angapo. Ndiye zida amafikira kwa lumen wa chotengeracho. ntchito kumatenga ola. Wodwala pafupifupi Kodi Simumva kuwawa ndi kusapeza kuoneka yekha pa nthawi ya anakokomeza balonchika. Pambuyo pa opaleshoni, wodwalayo m'chipatala mu masiku pang'ono. Pamenepo nthawi yoikidwiratu antiagregatnaya, antibacterial, odana ndi yotupa mankhwala.

zosokonezeka kutheka pambuyo opaleshoni: kuwonongeka kwa mpanda mtsempha wamagazi, hematoma mapangidwe pa puncture malo, magazi, clogging mitsempha, kukanika aimpso, thupi lawo siligwirizana, clotting dera la stent lapansi.