Cigaba maras kyau, ko maras amfani, magani?
Mene ne Angina?
" Stable angina " shine sunan likitocin amfani da su don bayyana alamun cututtukan cututtuka na jijiyoyin zuciya (CAD) waɗanda aka samo su ta hanyar barga, ba tare da ruptured plaque ba . Saboda nau'in plaque bai canza ba (ko yana canzawa kawai), alamun da ya samo (gaba daya, rashin kwakwalwar ajiya) yana faruwa a cikin wani abu mai sauƙi, wanda ake iya gani.
Wannan alamar ana kiran barga angina.
- Karanta game da bayyanar cututtuka na angina.
- Karanta game da angina maras kyau - da "sauran" irin angina.
Makasudin Gudanar da Angina
Idan likita ya ba da shawarar magani ga mutumin da yake da halayen angina, akwai nau'i uku da suka kamata suyi tunani:
- Don kawar ko rage yawan alamun cutar angina.
- Don rage jinkirin ciwon rashin lafiya wanda ke samar da alamu.
- Don hana ƙaddamar da matsalolin zuciya na zuciya mai tsanani, ciki har da ciwo na rashin jijiyoyin zuciya (ACS) , rashin zuciya zuciya , da mutuwa.
Kowace irin magani ne aka yanke shawarar - farfadowa ko ilimin likita - lura zai inganta chances na cimma dukkanin wadannan manufofi uku.
Cigaba vs. Ƙungiyoyin marasa lafiya
Hanyoyin haɗari ga bargaren angina shi ne don taimakawa wajen yin jigilar magungunan jijiyoyin zuciya tare da koyi aikin tiyata , ko kuma angioplasty da tsige .
Duk da yake yana iya zama a bayyane yake cewa yana taimakawa wajen warware matsalar ya kamata ya ba da sakamako mafi kyau, shekarun da suka gabata na nazarin asibitoci sun nuna cewa a mafi yawancin lokuta wannan ba abin da ya faru ba. Mafi yawancin lokuta, maganin likita kawai yana haifar da sakamako na asibiti da ke da kyau ko mafi kyau fiye da sakamakon da aka samu tare da tiyata ko ɓarna.
Yawancin masana sun bayar da shawarar fara tare da wadanda ba saɓaɓɓu ba, tsarin kiwon lafiya a mafi yawan mutane da bargaren angina. Wannan matsala na "likita na farko" yana nuna sabon hanyar yin tunanin CAD .
Duk da haka, akwai yanayi guda biyu wanda ya kamata a yi la'akari da yadda ya kamata a yi wa jiyya. Tsarin gaggawa na iya zama mafi alhẽri ga:
- Mutane wanda angina ba za su iya sarrafawa ta hanyar kiwon lafiya ba.
- Mutane da ke da nau'i na musamman a cikin suturar jijiyoyin jini, wanda aka nuna cewa sakamakon aikin likita ne kawai ya kasance mafi muni fiye da yadda ya kamata.
Wannan rukuni na ƙunshe da mutanen da ke da kwakwalwa a hagu na asibiti na hagu, ko kuma waɗanda ke da cutar ta uku, ko kuma wadanda ke da cutar a gefen hagu na hagu wanda ya haɗa tare da cutar a kalla ɗaya daga cikin maganin jini.
Ga mafi yawan mutanen da ke cikin angina, duk da haka, magani shine zaɓi mafiya fifiko.
Jiyya don Sanda Angina
Don maganin kiwon lafiya ya zama mai tasiri a rage cututtuka, hana ACS, da inganta rayuwar mutum tare da angina mai kwance, yawancin aikin da ake bukata ya kamata. Wadannan sun hada da magungunan maganin miyagun ƙwayoyi da kuma ingantawa na rayuwa.
(Don bayyanawa, salon gyaran salon rayuwa ya zama dole ko da za a zaba maƙasudin tsarin da ya dace.
Jiyya don kawar da Angina
Hanyoyi daban-daban hudu sune amfani da su a yau don taimakawa bayyanar cututtuka na angina. Yawancin mutane da wannan yanayin zasu karbi umarni na biyu ko fiye daga cikin wadannan kwayoyi:
Beta blockers: Beta blockers rage sakamako na adrenaline a kan zuciya tsoka, wanda ya rage zuciya da kuma ƙarfin zuciya ƙuntatawa muscle, saboda haka rage da oxygen bukatar da zuciya. Wadannan kwayoyi sun inganta zaman lafiya a wasu marasa lafiya tare da CAD. Ya kamata a yi amfani da su a duk wanda ke da angina.
Karanta game da beta blockers a lura da angina .
Masu launi na calcium: Masu kwakwalwa na calcium sun rage rinjaye na alli a cikin ƙwayar zuciya, har ma cikin tsoka mai tsoka da jini. Wannan yana haifar da rushewar jirgi na jini, yana rage ƙwayar zuciya, kuma rage karfin zuciya na kullun zuciya - duk wanda ya rage gaskiyar buƙatar zuciya. Karanta game da masu kwari a cikin maganin angina .
Nitrates: Nitrates yana haifar dashi na jini, wanda zai rage damuwa akan tsoka da zuciya, saboda haka rage karfin zuciya don oxygen. Karanta game da nitrates a maganin angina .
Ranexa (ranolazine): Ranexa sabon sababbin maganin maganin anti-angina wanda ya bayyana yana aiki ta hanyar hanawa abin da ake kira "marigayi sodium channel" a cikin ƙwayar zuciya wanda ke fama da ischemia. Yin watsi da wannan tashar sodium yana inganta metabolism a cikin jiki mai yaduwar ƙwayoyin cuta, rage lalacewa ga tsoka da tsoka, da kuma rage cututtukan angina. Kara karantawa game da Ranexa a cikin maganin angina .
Yaya ake amfani da wadannan kwayoyi? Duk wanda yake da angina ya kamata a sanya shi a kan beta blocker. Nitroglycerin (daya daga cikin nitrates) ya kamata a ba da ita don amfani da shi a yayin da ya dace ya bi duk wani ɓangaren angina. Idan beta blockers kadai ba kawar da angina, to, ko dai wani aiki mai tsawo na magani na nitrate ko kuma mai kwakwalwa mai kwakwalwa (ko duka biyu) an kara da cewa. Ranexa, har yanzu ƙwayar miyagun ƙwayoyi ne, yawanci ana ba da shi azaman na uku ko na hudu idan ya cancanta - amma wasu masu kwakwalwa sun gano shi don amfani idan aka kara da su a baya.
Jiyya don hana ƙaddamar da CAD
Magungunan Antiplatelet: Don rage haɗarin ACS, duk wanda yake tare da angina ya kasance a kan magani don rage yaduwar jini. Ga mafi yawan mutane wannan na nufin aspirin farfadowa (75 zuwa 325 MG / rana). Plavix (clopidogrel) za a iya amfani dashi a cikin mutanen da ke fama da aspirin.
Rashin Faɗar Rashin Faɗakarwa: Rage ci gaba na atherosclerosis mai tsanani ne. Wannan yana nufin sarrafa hauhawar jini , ba shan taba ba, sarrafa iko, jiyya tare da statin , ciwon sukari da kuma motsa jiki.
Harkokin aikin motsa jiki: Bugu da ƙari, don rage ci gaba na atherosclerosis, motsa jiki na yau da kullum zai iya zama magani mai mahimmanci ga angina. Gwanin lokaci, aikin motsa jiki na mairo-rage (alal misali, tafiya ko motsa jiki) "sukar" tsarin zuciya da jijiyoyin ƙwayoyin cuta don zama mafi inganci. Wannan yana nufin cewa za a iya cimma matakan da suka fi girma ba tare da jawo hankalin angina ba. Mutanen da ke da halayen angina su nemi likitan su don su mayar da hankali kan shirin gyaran zuciya na zuciya don taimakawa su shiga shirin na yau da kullum.
Sauran Ƙididdiga a Yin Biyan Angina
Matsalar lokaci: Yanayin damuwa ba zai iya cutar da kowa ba tare da CAD, kuma shirin ragewa na ragewa zai iya taimakawa.
- Karanta game da damuwa da zuciya.
- Karanta game da kulawa da damuwa.
Cessation shan taba: An ambaci mutuwar shan taba a baya, amma wannan yana da mahimmanci yana buƙatar sake kira. Ci gaba da taba shan taba yana iya kasancewa, kuma sau da yawa, ya faru ne a cikin mutumin da ke tare da CAD. Cessation cessation ne dole ne.
Ƙinƙasasshen ƙwarewar waje na waje (EECP): EECP wani magani ne na musamman don angina wanda zai iya zama mai tasiri a wasu marasa lafiya, amma abin da mafi yawan magungunan cardiologists suka yi watsi da su.
A lokacin da ya dace da kuma amfani da shi, wannan hanyar da ba ta dace ba wajen kula da angina barci yakan haifar da sakamako wanda ya fi daidai, idan ba mafi alhẽri ba, fiye da sakamakon da aka samu tare da tursasawa. Duk da haka, duk inda kuka zartar da ku, ku tuna cewa CAD wata cuta ce mai ci gaba da ci gaba. Kuna buƙatar yin aiki tare da likitan zuciyar ku don dubawa da sake sake yanayin ku yayin da lokaci ya wuce, kuma ku tabbatar cewa an cigaba da sabuntawa kuma an daidaita shi.
Sources:
Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF / AHA / ACP / AATS / PCNA / SCAI / STS jagorancin ganowa da kuma kula da marasa lafiya da cututtukan zuciya mai kwakwalwa: rahotanni na Kwalejin Kasuwancin Kasuwancin Amirka da Ƙungiyar Ƙungiyar Harkokin Kasuwancin Amurka ta Amurka game da ka'idojin aiki, da kuma Amurka Kolejin likitoci, Ƙungiyar Amirka don Tashin Tashin Taya, Cibiyar Nazarin Ƙwararren Ƙwararriya ta Lafiyar Jama'a, Ƙungiyar Harkokin Cigaban Lafiyar Hoto da Tsarin Harkokin Cutar, da Ƙungiyar Tsirarrun Thoracic. Yanayin 2012; 126: e354.
Fihn SD, Blankenship JC, Alexander KP, et al. 2014 ACC / AHA / AATS / PCNA / SCAI / STS a mayar da hankali kan jagorancin maganin ganewa da kuma kula da marasa lafiya da cututtukan zuciya: Ƙungiyar {asar Amirka don Harkokin Turawa, Cibiyar Nazarin Nursoshin Tafiyar Lafiya, Cibiyar Nazarin Harkokin Ciwon Lafiyar Hoto da Tsarin Harkokin Cutar, da Cibiyar Nazarin Yanke Thoracic. J Am Coll Cardiol 2014; 64: 1929.