Koj puas noj tshuaj rau koj cov ntshav siab , tab sis nws tseem tsis txo qis? Tej zaum koj tus kws kho mob hais tias, "Txawm tias tom qab muab ntau hom tshuaj rau koj , koj cov ntshav siab yuav tsis txo qis." Qee zaum, txawm tias koj hloov koj txoj kev ua neej, tswj koj cov zaub mov noj , thiab tawm dag zog npaum li cas los xij, koj cov ntshav siab tseem tuaj yeem siab. Thaum lub sijhawm zoo li no, peb yuav tsum xav tias qhov ua rau muaj teeb meem nrog lub raum. Hnub no peb yuav tham txog qhov xwm txheej zoo li no.
Hais yooj yim xwb, renovascular hypertension yog dab tsi?
Txawm hais tias lub npe suab nyuaj me ntsis, zaj dab neeg yooj yim heev. Renovascular Hypertension yog ntshav siab uas tshwm sim los ntawm teeb meem nrog koj lub raum .
Xav txog nws li no. Lub raum yog ib qho ntawm cov kabmob tseem ceeb tshaj plaws hauv peb lub cev. Lawv txoj haujlwm tseem ceeb yog lim cov ntshav thiab tshem tawm cov khoom pov tseg ua zis . Yuav kom ua txoj haujlwm no kom raug, lub raum xav tau cov ntshav zoo. Cov hlab ntsha tseem ceeb ( arteries ) uas nqa cov ntshav mus rau lub raum hu ua 'renal arteries'.
Tam sim no xav txog tias vim li cas cov hlab ntsha no maj mam nqaim lossis nyias. Zoo li cov yeeb nkab dej raug nias rau hauv nruab nrab. Tom qab ntawd yuav ua li cas? Cov ntshav uas mus txog rau lub raum yuav txo qis.
Thaum cov ntshav ntws tsawg zuj zus li no, peb lub raum ntse xav tias, "Auj, kuv cov ntshav siab qis thoob plaws lub cev, yog vim li ntawd kuv thiaj tau txais ntshav tsawg dua." Yog li, vim lawv xav ua lawv txoj haujlwm kom raug, lawv ua cov kauj ruam los ua kom cov ntshav siab hauv lub cev nce ntxiv. Yuav ua li ntawd, lawv ua kom lub cev muaj zog hauv lub cev. Hauv kev kho mob, peb hu qhov no ua RAAS (Renin-Angiotensin-Aldosterone System) . Thaum lub cev muaj zog no ua haujlwm, cov hlab ntsha thoob plaws lub cev nqaim, thiab cov ntshav siab nce siab.
Hais yooj yim xwb, vim tsis muaj ntshav txaus mus rau lub raum, lub raum nws tus kheej ua rau lub siab nce siab hauv lub cev tag nrho. Qhov no hu ua renovascular hypertension.
Qhov no tsis zoo ib yam li cov ntshav siab ib txwm muaj. Qhov no poob rau hauv ib pawg hu ua ntshav siab theem ob. Uas yog, ntshav siab los ntawm lwm yam mob.
Cov tsos mob ntawm tus mob no yog dab tsi? Peb xav li cas txog nws?
Qhov teeb meem loj tshaj plaws ntawm no yog tias feem ntau tsis muaj cov tsos mob tshwj xeeb rau tus mob no. Qhov ntawd txhais tau tias koj yuav tsis pom dab tsi txawv. Txawm li cas los xij, thaum tus kws kho mob saib koj keeb kwm kev kho mob thiab cov tshuaj uas koj noj, nws yuav khaws qee cov cim qhia. Cov no yog cov yam uas ua rau tus kws kho mob xav tias qhov no.
Cia peb saib seb cov cim qhia ntawd yog dab tsi.
| Lub cim qhia txog kev ua txhaum cai | Ib qho lus piav qhia yooj yim |
|---|---|
| Kev pib ntawm kev nyuaj siab thaum muaj hnub nyoog txawv txawv | Feem ntau cov ntshav siab tshwm sim sai sai ua ntej hnub nyoog 30 xyoo lossis tom qab hnub nyoog 50 xyoo. |
| Kev nce siab sai sai uas tau tswj tau zoo | Qhov kev nyuaj siab, uas tau tswj tau zoo nrog tshuaj ntev heev, tam sim ntawd nce mus txog qib uas tsis tuaj yeem tswj tau. |
| Tsis teb rau cov tshuaj | Tus kws kho mob tau sau ntau hom tshuaj kho ntshav siab (peb lossis ntau dua), tab sis ntshav siab tsis tau txo qis. Peb hu qhov no tias 'resistant hypertension'. |
| Kev Kub Ntxhov Siab | Nce ntshav siab ntau zaus mus rau qib txaus ntshai (piv txwv li, ntau dua 180/120 mmHg). |
| Flash Pulmonary Edema | Muaj ntau zaus uas cov kua dej hauv lub ntsws puv sai sai uas tsis paub meej. |
| Cov rog tso rau hauv lwm cov hlab ntsha | Muaj keeb kwm ntawm cov rog tso rau hauv cov hlab ntsha ntawm lub plawv, caj dab, lossis ceg. |
| Kev ua haujlwm tsis zoo ntawm lub raum | Kev ua haujlwm ntawm lub raum maj mam poob qis yam tsis muaj lwm yam ua rau pom tseeb. |
| Ib lub suab tshwj xeeb uas tus kws kho mob hnov (Bruit) | Thaum tus kws kho mob muab lub stethoscope tso rau ntawm koj lub plab, koj hnov lub suab "swooshing" thaum cov ntshav txav mus los ntawm cov hlab ntsha uas raug thaiv. |
Vim li cas qhov no thiaj tshwm sim? Cov laj thawj tseem ceeb yog dab tsi?
Qhov ua rau cov hlab ntsha uas mus rau lub raum txhaws yog ib yam mob hu ua renal artery stenosis . Qhov no txhais tau tias cov hlab ntsha hauv lub raum nqaim zuj zus. Muaj ob qho laj thawj tseem ceeb rau qhov no.
1. Kab mob Atherosclerosis: Qhov no yog qhov ua rau feem ntau. Hais yooj yim xwb, nws yog qhov maj mam nqaim ntawm cov hlab ntsha vim muaj cov rog thiab cov roj cholesterol (hu ua 'plaque') ntawm phab ntsa ntawm cov hlab ntsha. Qhov no feem ntau tshwm sim nrog hnub nyoog, ntshav qab zib, cov roj cholesterol ntau, thiab kev haus luam yeeb.
2. Mob Fibromuscular Dysplasia (FMD): Qhov no yog ib qho mob tsis tshua muaj. Nws tshwm sim thaum cov hlwb (cov leeg thiab cov hlwb fibrous) hauv phab ntsa ntawm cov hlab ntsha loj hlob tsis zoo, ua rau cov hlab ntsha nqaim rau qee qhov chaw. Mob no feem ntau tshwm sim rau cov poj niam hluas.
Ntxiv rau ob qho laj thawj tseem ceeb no, tej zaum yuav muaj ntau lwm yam laj thawj tsis tshua muaj.
| Cov laj thawj tsis tshua muaj | Ib qho lus piav qhia yooj yim |
|---|---|
| Kab mob vasculitis | Cov hlab ntsha ua nyias vim yog o. |
| Aneurysm ntawm cov hlab ntsha hauv lub raum | Kev qaug zog ntawm phab ntsa ntawm cov hlab ntsha hauv lub raum, ua rau nws o zoo li lub pob. |
| Kev nyuaj siab los ntawm lub qog | Ib qho qog uas tsim nyob ze ntawm lub raum lossis cov hlab ntsha, ua rau muaj kev nyuaj rau sab nraud ntawm cov hlab ntsha. |
| Kev mob qog nqaij hlav (Fibrosis) los ntawm kev kho mob hluav taws xob | Tom qab tau txais kev kho mob hluav taws xob rau ib yam mob xws li mob qog noj ntshav, cov hlab ntsha hauv thaj chaw ntawd yuav tuab zuj zus, ua rau muaj qhov txhab, thiab raug thaiv. |
Yog tias tsis quav ntsej qhov no, yuav muaj teeb meem dab tsi tshwm sim?
Ib yam li lwm yam mob ntshav siab, qhov mob no tuaj yeem ua rau muaj teeb meem loj yog tias tsis tswj tau ntev.
- Kev puas tsuaj rau lub plawv: Kev ntshav siab ntev tuaj yeem ua rau lub plawv ua haujlwm hnyav dua, ua rau muaj cov mob xws li cov leeg nqaij plawv tuab, mob plawv nres, thiab lub plawv tsis ua haujlwm.
- Kev puas tsuaj ntxiv rau lub raum: Lub raum, uas twb muaj cov ntshav ntws tsawg lawm, tuaj yeem raug puas tsuaj ntxiv los ntawm kev siab siab, ua rau lub raum tsis ua haujlwm.
- Kev puas tsuaj rau lub qhov muag: Kev puas tsuaj rau cov hlab ntsha hauv lub qhov muag tuaj yeem ua rau pom kev tsis meej (kab mob ntawm lub qhov muag).
- Mob stroke: Kev puas tsuaj rau cov hlab ntsha uas mus rau lub hlwb ua rau muaj kev pheej hmoo ntawm mob stroke ntau ntxiv.
Tus kws kho mob nrhiav tau qhov no li cas tiag?
Yog koj tus kws kho mob xav tias muaj tus mob no, nws yuav ua haujlwm zoo li tus kws tshawb nrhiav, muab cov lus qhia ua ke kom txog thaum xaus. Cov txheej txheem no muaj ntau kauj ruam tseem ceeb.
1. Kev kuaj lub cev: Tus kws kho mob yuav kuaj koj, tshwj xeeb yog muab lub stethoscope tso rau ntawm koj lub plab kom paub seb puas muaj suab 'bruit' uas peb tau hais ua ntej.
2. Nug txog koj keeb kwm kev mob nkeeg: Koj yuav raug nug ntau lo lus nug, xws li koj muaj hnub nyoog li cas los ntshav siab, puas muaj leej twg hauv koj tsev neeg muaj mob ntshav siab, koj noj tshuaj dab tsi, thiab koj puas muaj lwm yam mob.
3. Kev kuaj tshwj xeeb: Yuav tsum tau ua ntau yam kev kuaj kom paub tseeb tias muaj qhov kev xav tsis thoob.
- Kev kuaj ntshav: Xyuas seb lub raum ua haujlwm li cas (creatinine, eGFR) thiab cov tshuaj hormones ntawm RAAS system.
- Kev kuaj zis: Xyuas seb puas muaj cov protein nyob hauv cov zis.
- Lub raum Ultrasound Doppler: Qhov no yog qhov kev kuaj tseem ceeb tshaj plaws. Nws ntsuas qhov ceev ntawm cov ntshav ntws hauv cov hlab ntsha uas nqa cov ntshav mus rau lub raum thiab tuaj yeem ntes tau qhov txhaws.
- Lwm cov kev soj ntsuam: Qee zaum, yuav pom zoo kom ua cov kev soj ntsuam nyuaj dua xws li CT angiogram lossis MR angiogram.
Zoo, tam sim no cia peb tham txog kev kho mob.
Thaum kuaj pom tus mob no lawm, tsis muaj dab tsi yuav tsum ntshai. Muaj cov kev kho mob zoo rau qhov no. Lub hom phiaj tseem ceeb ntawm kev kho mob yog tswj cov ntshav siab thiab tiv thaiv lub raum thiab lwm yam kabmob.
Cov tshuaj (tshuaj)
Feem ntau, tus mob no siv tshuaj kho tau zoo. Ntxiv rau cov tshuaj uas siv rau cov ntshav siab, tus kws kho mob yuav sau ntawv kom siv cov tshuaj uas haum rau tus mob no.
- Cov Tshuaj Angiotensin-Converting Enzyme (ACE) Inhibitors: Piv txwv li, cov tshuaj xws li Enalapril thiab Lisinopril.
- Angiotensin Receptor Blockers (ARBs): Piv txwv li, cov tshuaj xws li Losartan thiab Telmisartan.
Ob yam tshuaj no tswj kev ua haujlwm ntawm RAAS hormone system uas peb tau tham txog ua ntej thiab tiv thaiv cov ntshav siab kom tsis txhob nce.
Tseem Ceeb: Thaum pib noj cov tshuaj no, tej zaum yuav muaj qhov cuam tshuam me ntsis rau kev ua haujlwm ntawm lub raum. Yog li ntawd, koj tus kws kho mob yuav kuaj xyuas koj txoj haujlwm ntawm lub raum dua tom qab li ib lossis ob lub lis piam tom qab pib noj cov tshuaj no. Tsis txhob txhawj, nws yog ib qho txheej txheem ib txwm muaj.
Ntxiv rau, lwm yam tshuaj xws li cov tshuaj cholesterol-lowering statins, calcium channel blockers, thiab diuretics yuav raug sau tseg nyob ntawm koj tus mob.
Cov txheej txheem yuav tsum tau ua yog tias tsim nyog
Qee zaum nws nyuaj rau tswj koj cov ntshav siab nrog tshuaj xwb. Los yog tias cov hlab ntsha raug thaiv hnyav heev, koj tus kws kho mob yuav qhia ib txoj kev kho mob tshwj xeeb.
- Kev Kho Mob Angioplasty thiab Stenting rau Cov Ntshav Qab Zib: Qhov no zoo ib yam li kev kho mob angioplasty rau cov hlab ntsha hauv lub plawv. Ib lub raj nyias nyias raug ntxig los ntawm cov hlab ntsha hauv ceg lossis caj npab thiab mus rau cov hlab ntsha hauv lub raum uas raug thaiv. Tom qab ntawd lub raj raug cua nrog lub npas me me kom nthuav dav thaj chaw uas raug thaiv. Txhawm rau tiv thaiv nws kom tsis txhob raug thaiv dua, ib lub raj me me zoo li daim ntaub mesh (stent) raug muab tso rau hauv thaj chaw.
- Kev Kho Mob Raum: Qhov no yog ib txoj kev kho mob tshiab. Nws siv cua sov lossis lub zog ultrasound los txo cov haujlwm ntawm cov hlab ntsha nyob ib puag ncig cov hlab ntsha raum. Cov hlab ntsha no yog cov uas xa cov cim mus rau lub hlwb kom nce siab. Yog li los ntawm kev txo lawv cov haujlwm, cov ntshav siab tuaj yeem raug txo.
Kev phais mob
Tsis tshua muaj kev phais mob. Kev phais mob tsuas yog siv tau yog tias cov qauv ntawm cov hlab ntsha nyuaj dhau rau cov txheej txheem xws li angioplasty, lossis yog tias cov txheej txheem ntawd ua tsis tau.
- Kev phais kho cov hlab ntsha hauv lub raum: Qhov no kuj hu ua kev phais hla lub raum.Ntawm no, tus kws phais siv ib daim hlab ntsha uas coj los ntawm lwm qhov ntawm koj lub cev lossis ib lub raj cuav los tsim ib txoj kev tshiab (bypass) los nqa cov ntshav mus rau lub raum, hla qhov uas raug thaiv.
Tom qab kho mob tas lawm, muaj dab tsi tshwm sim?
Tsis txhob xav tias txhua yam tas lawm thaum koj pib kho mob. Nws yog ib qho tseem ceeb uas koj yuav tsum mus ntsib kws kho mob raws li koj tus kws kho mob tau hais.
Hauv cov chaw kho mob no, Dr.
- Lawv ntsuas koj cov ntshav siab thiab saib seb kev kho mob ua tiav li cas.
- Kev kuaj ntshav raug ua los saib xyuas kev ua haujlwm ntawm lub raum.
- Yog tias tsim nyog, koj cov tshuaj noj yuav raug hloov lossis yuav ntxiv cov tshuaj tshiab.
Cov kev teem caij no tseem ceeb heev rau koj thiab. Qhov no yog lub sijhawm zoo los nug tus kws kho mob txog tej lus nug lossis kev txhawj xeeb uas koj muaj.
Tus mob no puas kho tau tag nrho?
Kev mob ntshav siab uas rov tshwm sim dua tshiab yog ib yam mob uas kho tau . Qhov ntawd txhais tau tias yog siv tshuaj kho mob zoo thiab, yog tias tsim nyog, kev kho mob kom zoo, koj cov ntshav siab yuav raug txo kom qis mus rau qib zoo. Tab sis nws yog qhov tseeb dua los hais tias nws tuaj yeem "tswj tau zoo" es tsis yog "kho tau tag nrho."
Nco ntsoov tias, koj txoj kev pab txhawb nqa tseem ceeb heev rau txoj kev taug no. Txawm tias tus kws kho mob kho mob zoo npaum li cas los xij, yog tias koj tsis ua qhov yog ntawm koj ib feem, cov txiaj ntsig yuav tsis zoo.
- Noj koj cov tshuaj raws sijhawm: Noj koj cov tshuaj raws nraim li koj tus kws kho mob tau hais, tsis txhob hla ib hnub twg.
- Saib xyuas koj cov zaub mov noj: Txo cov khoom noj uas muaj ntsev, roj, thiab qab zib ntau. Yog tias koj tus kws kho mob pom zoo kom noj zaub mov tshwj xeeb xws li DASH diet , ua raws li ntawd.
- Kev Ua Si: Nug koj tus kws kho mob seb kev ua si twg yog qhov zoo rau koj lub cev thiab koj yuav tsum ua ntev npaum li cas, thiab ua raws li qhov ntawd.
Thaum koj paub tias qhov no yog qhov ua rau koj muaj ntshav siab uas tsis tuaj yeem tswj tau, koj yuav xav tias zoo siab heev. Vim tias tam sim no koj paub qhov ua rau, koj tuaj yeem tau txais kev kho mob zoo rau nws. Yog li, yog tias koj muaj lus nug txog qhov no, tsis txhob ntshai tham nrog koj tus kws kho mob.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Ntshav siab uas tsis tuaj yeem tswj tau txawm tias siv ntau yam tshuaj los xij, tej zaum yuav yog vim muaj teeb meem raum.
- Qhov laj thawj tseem ceeb rau qhov no yog qhov nqaim ntawm cov hlab ntsha uas nqa ntshav mus rau lub raum.
- Tus mob no ua rau muaj kev pheej hmoo ntawm kev puas tsuaj rau lub plawv, lub hlwb, thiab lub raum.
- Tus mob no tuaj yeem kuaj pom tseeb los ntawm kev kuaj scanning.
- Tsis tas yuav ntshai vim muaj kev kho mob zoo xws li tshuaj thiab angioplasty.
- Nws yog ib qho tseem ceeb heev uas yuav tsum ua raws li koj tus kws kho mob cov lus qhia kom meej thiab mus ntsib cov chaw kho mob raws sijhawm.
Kev mob ntshav siab Renovascular, ntshav siab, siab, raum, renal artery stenosis, ntshav siab, ntshav siab Sinhala, kab mob raum Sinhala, kab mob raum, ua rau muaj siab
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus