Kurapa kusingaiti, kana kusingaiti, kurapwa?
Chii Chine Utsi Angina?
" Stable angina " ndiro zita rokuti vanachiremba vanoshandisa kurondedzera zviratidzo zvekoniyuta arteri (CAD) iyo inogadzirwa nedanga rakasimbiswa, risina kuputika. Nemhaka yokuti ibwe iri harisi kuchinja (kana kuti riri kuchinja zvishoma nezvishoma), zviratidzo zvinowanzobereka (kazhinji, kusagadzikana kwechifu) zvinowanzoitika mune zvisingatarisirwi, nenzira inofungidzirwa.
Uyu muenzaniso unonzi rakasimba angina.
- Verenga pamusoro pezviratidzo zve angina.
- Verenga pamusoro pekunina isinganzwisisiki - iyo "imwe" yemhando ye angina.
Zvinangwa Zvokurapa Angina Yakasimba
Apo chiremba anorayira kurapwa kune munhu ane hukama hwakasimba, pane zvinangwa zvitatu zvakasiyana izvo ivo vose vanoda kuisa mupfungwa:
- Kugumisa kana kuderedza zviratidzo zve angina.
- Kuchengetedza kufambira mberi kwechirwere che atherosclerotic chiri kubudisa mapepa.
- Kuchengetedza kutanga kwezvinetso zvakakomba zvemwoyo, kusanganisira acon coronary syndrome (ACS) , kukanganisa mwoyo , nekufa.
Chero hupi hupi hwehutano hunosarudzwa pamusoro - chirwere chisina kumira kana chirwere cherapi - kurapwa kunofanira kuwedzera mikana yekuzadzisa zvose zvitatu zvezvinangwa izvi.
Kuvhiringidza vs. Kusapindira Kurapa
Nzira isingaiti yekusimudzira angina ndeyekudzivirira matambudziko makuru mumaketari emakoroni ane chirwere chekuvhiya , kana kuti angioplasty uye inopisa .
Kunyange zvazvo zvingaita sezviri pachena kufungidzira kuti kubvisa kuvhara kunofanira kupa zvakanakisisa zvingaguma, makumi emakore ekudzidza kwechipatara akaratidza kuti muzviitiko zvizhinji izvi hazvisi izvo zvinoitika. Kazhinji, kurapwa kunoga kunoguma mumagariro ekurapa ayo akanaka kana kuti nani kupfuura zviitiko zvinowanikwa nekuvhiyiwa kana kunhuwa.
Nyanzvi nyanzvi dzinokurudzira kutanga kutanga nevasingazivi, nzira yekurapa mune vanhu vakawanda vane sina angina. Ichi "kurapa kurapa kwekutanga" nzira inoratidza nzira itsva yekufunga pamusoro peCAD .
Zvisinei, kune mamiriro maviri maitiro umo kurapa kusingaiti kunofanira kufungwa zvikuru. Kurapa kusingaiti kungave kuri nani kune:
- Vanhu avo vane angina havakwanise kudzora zvakakwana kurapwa kwechiremba.
- Vanhu vane zvivharo zvakanyanya mumaketari emakoroni, mune izvo zvinoguma nemishonga inorapwa chete yakaratidzwa kuva yakaipisisa kudarika nekurapa kusingaiti.
Ichi chikwata chekupedzisira chinosanganisira vanhu vane blockades muruboshwe rukuru rwekoroniyamu, kana vane vane nhatu-mudziyo wezvirwere, kana vane zvirwere kuruboshwe rwechirwere anterior achidzika arteri pamwe nechirwere mune imwe imwe yeronary artery.
Nokuda kwevanhu vakawanda vane angina akachengeteka, zvisinei, kurapwa ndiko kusarudzwa kunosarudzwa.
Mushonga weAradio Angina
Kuti kurapwa kuchive kwakabudirira mukuderedza zviratidzo, kudzivirira ACS, nekuvandudza kupona kune vanhu vane angina akachengetedza, mabasa akawanda ekurapa anodiwa. Izvi zvinosanganisira zvose zvinodhaka remishonga uye mararamiro ekugadzirisa.
(Kujekesa, mararamiro ekugadzirisa mararamiro anodikanwa kunyange kana nzira isingaiti yekurapa inosarudzwa.)
Kurapwa kwekurapa kubvisa Angina
Mhando dzakasiyana siyana dzemishonga dzinowanzoshandiswa mazuva ano kudzikisa zviratidzo zvekuchengetedza angina. Vanhu vazhinji vane chirwere ichi vachawana mitsara yeviri kana kupfuura yemhando idzi dzemishonga:
Beta blockers: Beta vadziviriri vanoderedza kushanda kweAdrenaline pamusana wemwoyo, izvo zvinoderedza kutengesa kwemoyo uye simba remoyo mususu kuputika, nokudaro kuderedza kudiwa kwe okisijeni yemwoyo. Iyi mishonga inovandudzawo kupona mune vamwe varwere vane CAD. Dzinofanira kushandiswa kune ani zvake ane simba angina.
Verenga nezve beta blockers mukurapa angina .
Calcium blockers: Calcium blockers inoderedza kubuda kwe calcium mumoyo wemisungo, uyewo mumusana unotapira wemidzi yeropa. Izvi zvinoita kuti ropa riwedzere kuvhara, kunoderedza mwoyo, uye kuderedza simba rekurova mwoyo - zvose izvo zvinoderedza kudiwa kweokisijeni kwemoyo. Verenga nezve calcium blockers mukurapa angina .
Nitrates: Nitrates inokonzera kuwedzerwa kwemidyo yeropa, iyo inoderedza kushushikana pamusana wemwoyo, nokudaro kuderedza chido chemoyo chemhepo. Verenga nezve nitrates mukurapwa kwema angina .
Ranexa (ranolazine): Ranexa chirongwa chitsva chema anti-angina mishonga inoratidzika kushanda nekuvhara izvo zvinonzi "late sodium channel" mumoyo masero ayo anotambura neIschemia. Kudzivirira iyi saruminiri inovandudza metabolism mu ischemic moyo masero, kuderedza kukuvadza kumutsipa wemwoyo, uye kuderedza zviratidzo zvema angina. Verenga zvakawanda pamusoro paRanexa mukurapa angina .
Mishonga iyi yose inoshandiswa sei? Chero ani zvake ane chinyorwa angina anofanira kuiswa pa beta blocker. Nitroglycerin (imwe ye nitrates) inofanira kupiwa kuti ishandiswe zvakanyanyisa kana zvichifanira kubata chero zvikamu zvei angina. Kana beta blockers chete asiri kubvisa angina, zvino kana iyo yakareba inoshanda ye nitrate therapy kana calcium channel blocker (kana maviri) inowanzowedzerwa. Ranexa, ichiri chirwere chitsva, chinowanzopiwa sechitatu kanachina chechina kana zvichidiwa - asi vamwe vane cardiologists vakaona kuti inobatsira kana yawedzerwa kare.
Kurapa Kwokudzivirira Kuwedzera kweCAD
Antiplatelet therapy: Kuti kuderedze njodzi yeAAC, ani naani ane angina anofanira kunge ari kurapwa kuderedza ropa kuvhara. Kune vanhu vazhinji izvi zvinoreva zuva nezuva aspirin therapy (75 kusvika 325 mg / zuva). Plavix (clopidogrel) inogona kushandiswa kune vanhu vanokonzera aspirin.
Ngozi Inoshandiswa Kuchinja: Kuderedza kufambira mberi kweAristrosclerosis kunokosha. Izvi zvinoreva kudzora dambudziko rekuwedzera kwehutano , kusasvuta, kuraira uremu, kurapwa nemutemo, kutarisa chirwere cheshuga, nekuita muviri.
Ita maitiro ekurapa: Mukuwedzera pakuderedza kufambira mberi kweAristrosclerosis, kurovedza muviri nguva dzose kunogona kuva iyo inobatsira kurapa angina akachengetedza. Nguva isingagumi, yakadzika-yakasimba yokuita zvekuita (kuburikidza, kufamba kana kuti mabhasikoro) "kunodzidzisa" mhepo yehutano uye maronda emakumbo kuti ave anoshanda zvakanyanya. Izvi zvinoreva kuti zvikwata zvepamusoro zvekuvhiya zvinogona kuwanikwa pasina kukonzera angina. Vanhu vane angina vakachengeteka vanofanira kukumbira chiremba wavo kuti vatumire ku chirongwa chemararamiro ekuvandudza mwoyo kuvabatsira kuti vawane purogiramu yekugara, yakachengeteka.
Zvimwe Zvokufunga Mukurapa Simba Yakasimba Angina
Kushungurudzika kwepfungwa: Mhando isina kunaka yekuzvidya mwoyo inogona kukuvadza kune chero munhu ane CAD, uye chirongwa chokuderedza kunetseka chingabatsira.
- Verenga pamusoro pekushungurudzika uye mwoyo.
- Verenga nezvekushungurudzika.
Kusvuta kusvuta: Kupera kusvuta kwakataurwa kare, asi izvi zvakakosha kunoda kudanwa zvakare. Kupfuurira kusvuta kunogona kuva, uye kazhinji, kunopisa mumunhu ane CAD. Kupera kusvuta ndiko kunofanirwa.
Kuvandudzwa kwekunze kwekuchengetedza (EECP): EECP inoratidzika mushonga weakinina akachengetedzeka unogona kuva wakakosha kune vamwe varwere, asi iyo inonyanya kukanganiswa nevarapi vemapurisa.
Kana kushungurudzika uye zvakakodzera kushandiswa, nzira iyi isingaiti yekurapa angina yakagadzikana yakawanda inobereka migumisiro iyo inenge yakaenzana yakaenzana, kana isiri nani, pane zvakagadziriswa neine invasive therapy. Zvisinei, chero ipi zvayo inoswedera pedyo newe, funga mupfungwa kuti CAD chirwere chisingagumi chinotanga kufambira mberi. Iwe unoda kushanda pamwe chete ne cardiologist yako kuti uongorore uye udzokezve mamiriro ako ezvinhu sekufamba kwenguva, uye iva nechokwadi chokuti kurapa kwako kuri kuramba kuchivandudzwa uye kwakagadziridzwa.
Sources:
Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF / AHA / ACP / AATS / PCNA / SCAI / STS nhungamiro yekuongororwa uye kutungamirirwa kwevarwere vane chirwere chemoyo chinosimba chinonzi ischemic: mushumo weAmerican College of Cardiology Foundation / American Heart Association basa rekuita mitemo, uye America College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, uye Society of Thoracic Surgeons. Circulation 2012; 126: e354.
Fihn SD, Blankenship JC, Alexander KP, et al. 2014 ACC / AHA / AATS / PCNA / SCAI / STS yakarongedza tsanangudzo yehutungamiri hwekuongororwa uye kutarirwa kwevarwere vane hutano hwakasimba hwechirwere chepfungwa: mushumo weAmerican College of Cardiology / American Heart Association Task Force pamusoro Pemitemo Yezvokuita, uye American Association for Chipatracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, uye Society of Thoracic Surgeons. J Am Coll Cardiol 2014; 64: 1929.