Unyango olusasazekayo, okanye olungenasiphene, unyango?
Yintoni Enamandla Angina?
" I-angina ethembekileyo " ligama lingagqirha igama ukuchaza impawu ze- coronary artery disease (CAD) eziveliswa yiplantshi esesigxina, esingaphuli. Ngenxa yokuba i-plaque ayitshintshi (okanye iyatshintsha ngokuthe ngcembe), iimpawu ezivelisa (ngokuqhelekileyo, ukungathandeki kwesifuba) zivame ukuba zenzeke ngendlela enokuzaliseka, ngendlela eqikelelweyo.
Le pateni ibizwa ngokuba yi-angina eqinile.
- Funda malunga neempawu ze-angina.
- Funda malunga ne-angina engaqinisekanga- "enye" uhlobo lwe-angina.
Iinjongo zokuPhatha u-Angina ozinzileyo
Xa ugqirha ecebisa unyango lomntu onomsebenzi ozinzileyo, kukho iinjongo ezintathu ezihlukeneyo bobabini zifuna ukugcina engqondweni:
- Ukuphelisa okanye ukunciphisa kakhulu iimpawu ze-angina.
- Ukunciphisa ukuqhubela phambili kwesifo se-atherosclerotic esenza iiplate.
- Ukuthintela ukuqaliswa kweengxaki ezinzulu zesifo senhliziyo, kuquka ne -acon coronary syndrome (ACS) , ukungaphumeleli kwentliziyo kunye nokufa.
Naliphi na uhlobo lwenyango olugqityiweyo-unyango olungenasiphelo okanye unyango lwezokwelapha - unyango lufanele lwenze amathuba okuphumeza zonke ezi zintathu ziinjongo.
Ukunyanga ngokuchasene neNyango engaHlangayo
Indlela engavumelekanga kwi-angina ezinzileyo kukukhupha izibhengezo ezibalulekileyo kwiimitha ze-coronary artery, okanye i- angioplasty kunye ne- stenting .
Nangona kubonakala ngathi kucace ukuba ukucima ukukhutshwa kufuneka kukhuphe iziphumo ezilungileyo, amashumi eminyaka ezifundo zonyango ziye zabonisa ukuba kwiimeko ezininzi ezi zinto akunjalo. Ngokuqhelekileyo, unyango lonyango luphumela kwiziphumo zonyango ezilungileyo okanye ezingcono kuneziphumo eziphunyezwe ngokuhlinzwa okanye ukugulisa.
Uninzi lweengcali zincoma ngokuqala nge-non-invasive, indlela yezokwelapha kubantu abaninzi abane-angina eqinile. Le ndlela "indlela yokwelapha yokuqala" ichaza indlela entsha yokucinga ngeCAD .
Nangona kunjalo, kukho imeko ezimbini apho unyango olungenayo kufuneka luqwalaselwe ngamandla. Unyango olungenayo lungcono:
- Abantu abane-angina abanako ukulawulwa ngokwaneleyo ngeyeza lonyango.
- Abantu abanamabhobhoriyali e-coronary, apho iziphumo zonyango lonyango zodwa zibonakaliswe zibi kunokuba zonyango olungenayo.
Eli nqanaba lokugqibela libandakanya abantu abaneempawu ezinqamlekileyo kwi-artery coronary, okanye abanezifo ezintathu, okanye abanezifo kwicala lasekhohlo elingaphantsi kwe-artery ehlanganiswe nezifo ubuncinane omnye umzobo we-coronary.
Kuba uninzi lwabantu abane-angina oluzinzile, nangona kunjalo, unyango lwonyango lukhethiweyo.
Unyango lwezonyango kwi-Stable Angina
Ukuze unyango lube luncedo ekunciphiseni iimpawu, ukukhusela i-ACS, nokuphucula ukuphila kubantu abane-angina esomeleleyo, kufuneka kwenziwe amanyathelo amanyathelo okwelapha. Ezi zibandakanya zombini unyango lweziyobisi kunye nokuphila kakuhle.
(Ukucaca, ukulungiswa kwendlela yokuphila kuyimfuneko nangona ukhetho olukhethiweyo kunyango lukhethwa.)
Unyango lwezoNyango ukuLawula u-Angina
Iintlobo ezine ezahlukeneyo zeziyobisi zisetyenziswa namhlanje ukukhupha iimpawu ze-angina esomeleleyo. Uninzi lwabantu abaneli meko ziya kufumana imimiselo emibini okanye ngaphezulu kwezi ntloba zamachiza:
Beta blockers: Beta blockers banciphise umphumo we-adrenaline kwintliziyo yesisindo, okunciphisa izinga lentliziyo kunye nomoya we-muscle contraction, ngaloo ndlela ukunciphisa imfuno ye-oksijini yentliziyo. La machiza aphucula nokuphila kwezinye izigulane ezine-CAD. Zifanele zisetyenziswe kunoma ubani omelelekileyo angina.
Funda malunga ne-beta blockers kunyango lwe-angina .
I-block block ye-calcium: I- calcium blockers iyanciphisa ukunyuka kwe-calcium kwi-heart muscle, nayo ibe yimisipha yegazi. Oku kubangela ukuhlamba kwegazi, ukunciphisa izinga lentliziyo, nokunciphisa amandla okubetha kwentliziyo - konke okunciphisa intswelo ye-oksijini yentliziyo. Funda malunga ne-calcium blockers kwonyango lwe-angina .
I-nitrate: I- nitrate ibangela ukunyuka kwemithambo yegazi, okunciphisa uxinzelelo kwi-heart muscle, ngaloo ndlela ukunciphisa isidingo senhliziyo somoya. Funda malunga ne-nitrate kwonyango lwe-angina .
URanexa (ranolazine): URanexa luhlobo olutsha lwe-anti-angina yeziyobisi ebonakalayo isebenza ngokuthintela into ebizwa ngokuthi "umzila we-sodium ngasekupheleni" ezintliziyweni zentsholongwane ezihluphekayo kwi-ischemia. Ukuthintela lo mzila we-sodium kuphucula i-metabolism kwiinhliziyo ze-ischemic, ukunciphisa umonakalo kwimisipha yentliziyo, kunye nokunciphisa impawu ze-angina. Funda kabanzi ngoRanexa kunyango lwe-angina .
Ziyazisebenzisa njani ezi zi yobisi? Nabani na ozinzile angina kufuneka afakwe kwi-beta blocker. I-nitrolycerin (enye ye-nitrate) kufuneka inikwe ukuba isetyenziswe ngokuthe xa ifunekayo ukuphatha nayiphi na i-episodes ye-angina. Ukuba ngaba i-beta blockers yedwa ayinakuphelisa i-angina, ngokokuba i-long-acting form of therapy okanye i-calcium channel blocker (okanye zombini) idibene ngokubanzi. U-Ranexa, isisisiza esitsha, sisoloko sinikwe njengesicatshulwa sesithathu okanye sesine xa kuyimfuneko-kodwa ezinye izazi ze-cardiologists zifumene ukuba zincedo xa zenziwe ngaphambili.
Unyango lokuthintela ukuhlaziya kwe-CAD
I-antiplatelet yonyango: Ukunciphisa umngcipheko we-ACS, nabani na abane-angina kufuneka babe kunyango ukunciphisa i-blood clotting. Kuba abaninzi abantu oku kuthetha ukunyanga kwama-aspirin (75 ukuya ku-325 mg / ngosuku). I-Plavix (clopidogrel) ingasetyenziselwa kubantu abaphikisayo kwi-aspirin.
Isisombululo soMngcipheko: Ukunciphisa ukuqhubela phambili kwe-atherosclerosis kubalulekile. Oku kuthetha ukulawulwa komfutho wegazi , ukubhema, ukulawula ubunzima, unyango kunye ne- statin , ukulawula isifo sikashukela kunye nokusetyenziswa.
Ukusebenzisa unyango: Ukongeza ekunciphiseni ukuqhubela phambili kwe-atherosclerosis, ukuzivocavoca rhoqo kuya kuba yinkqubo efanelekileyo ye-angina. Umzimba osisigxina, ongaphantsi kwe-aerobic umzimba (umzekelo, ukuhamba okanye ukuhamba ngebhayisikili) "uqeqesha" inkqubo ye-cardiovascular and muscle muscle ukuze iphumelele ngakumbi. Oku kuthetha ukuba amazinga aphezulu omzimba angafezekiswa ngaphandle kokubangela ukuba angina. Abantu abane-angina bomeleleyo kufuneka bacele ugqirha wabo ukuba bahanjiswe kwinkqubo yokuvuselela inhliziyo ukuze bancede bafikelele kwinkqubo yokuzilolonga rhoqo.
Ezinye iingqwalasela ekuphatheni iStina esisigxina
Uxinzelelo olungapheliyo: Uhlobo olungapheliyo lwengcinezelo lunokulimaza nakubani na abane-CAD, kwaye inkqubo yokunciphisa uxinzelelo ingaba luncedo.
- Funda malunga noxinzelelo kunye nentliziyo.
- Funda malunga nokulawulwa kwengcinezelo.
Ukuyeka ukubhema: Ukuyeka ukutshaya kubhekisiwe ngaphambili, kodwa oku kubaluleke kakhulu kufuneka kukhishwe kwakhona. Ukuqhuma ukutshaya kunokuba njalo, kwaye kaninzi, kuyintlekele kumntu one-CAD. Ukuyeka ukubhema kuyimfuneko.
Ukuphuculwa kwezilwanyana zangaphandle (EECP): I- EECP yonyango ekhethekileyo ye-angina ezinzileyo ezinokusebenza kakuhle kwezinye izigulane, kodwa ziphi na izidumbu ze-cardiologist ezizihoxayo.
Xa sisetyenziswe ngokugqithisileyo kwaye sisetyenziswe kakuhle, le ndlela engeyiyo yokunyanga i-angina igxininise ngokubanzi ivelisa iziphumo ezincinane ezilinganayo, ukuba kungengcono, kuneziphumo ezithotywe ngonyango olungenayo. Nangona kunjalo, nayiphi na indlela ongayigqiba ngayo, gcinani engqondweni ukuba i-CAD isifo esingapheliyo esenza inkqubela phambili. Uya kufuneka usebenze ngokusondeleyo kunye ne-cardiologist yakho ukubeka iliso nokuphinda uphinde uhlole imeko yakho njengoko ixesha lihamba, kwaye uqinisekise ukuba unyango lwakho luqhubeka luhlaziywa kwaye lulungiswe.
Imithombo:
Fihn SD, Gardin JM, Abrams J, et al. Isikhokelo se-ACCF / AHA / ACP / AATS / PCNA / SCAI / STS yokuxilongwa kunye nokulawulwa kwezigulane ezinezifo zesifo senhliziyo esisisigxina: ingxelo ye-American College of Cardiology Foundation / i-American Heart Association iqela elikukhokelo, kunye ne-American Ikholeji yamaGqirha, i-American Association ye-Thoracic Surgery, i-Preventive Cardiovascular Association Association, uMbutho we-Cardiovascular Angiography kunye neNongenelelo, kunye noMbutho weeNgcali zeTriracic. Ukuhamba ngo-2012; 126: e354.
Fihn SD, Blankenship JC, uAlexander KP, et al. U-ACC / AHA / AATS / PCNA / SCAI / STS ukuhlaziywa okugxilweyo kwesikhokelo sokuxilongwa nokulawulwa kwezigulane ezinezifo zesifo senhliziyo esisisigxina: ingxelo ye-American College of Cardiology / i-American Heart Association Task Force kwiZikhokelo zokuSebenza, kunye Umbutho waseMerika woTyhutyrikhi, i-Preventive Cardiovascular Association, uMbutho weeNdiovvascular Angeography kunye neNguqulelo, kunye noMbutho weeTrhage zoTyholo. J Am Coll Cardiol 2014; 64: 1929.