Author/Editor		Poredoš, Pavel; Fras, Zlatko
Title		Možnosti zdravljenja prekrvitvenih motenj v območju mikrocirkulacije
Translated title		Possibilities of treatment of circulatory disorders in microcirculation
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 35, št. Suppl 2
Publication year		1996
Volume		str. 201-10
Language		slo
Abstract		The paper presents the possibilities of treatment of changes in microcirculation. In blood flow obstruction when changes in microcirculation occur, removal of the obstruction is the therapy of choice: either by a surgical revascularisation procedure, dilatation of constricted vessels or dissolving of the clot which caused the blood vessel obstruction. If revascularisation is successful, improvement of hemodynamic conditions occurs also in microcirculation. Blood flow in microcirculation can also be influenced by changing of the composition of blood. Regarding factors which have an influence on blood viscosity, its fluidity can be improved by hemodilution, defibrinogenisation and influencing the rheological properties of blood cells. Such procedures are rational in advanced arterial circulatory disorders when a revascularisation procedure is not possible and especially when signs of hyperviscose syndrome are present. The possibilities of drug influence on hemorheology are limited. Such effects have to date been proven for pentoxyphilline and prostaglandins, while their long-term clinical efficacy has not yet been finally determined. Some therapeutic possibilities in sepsis, pathological changes in coronary microcirculation and diabetic microangiopathy are presented too.
Summary		V prispevku so predstavljene možnosti zdravljenja sprememb v mikrocirkulaciji. Pri obstrukciji v krvnem obtoku, ko pride do posledičnih sprememb v mikrocirkulaciji, je zdravljenje izbora odstrnitev te ovire; bodi s kirurškim revaskularizacijskim posegom, dilatacijo žilne zožitve ali raztopitvijo krvnega strdka, ki je povzročil žilno zaporo. Če je revaskularizacija uspešna, pride do izboljšanja hemodinamskih pogojev tudi v mikrocirkulaciji. Na tok krvi v mikrocirkulaciji lahko vplivamo tudi s spreminjanjem sestave krvi. Z ozirom na dejavnike, ki vplivajo na viskoznost krvi, lahko njeno tekočnost izboljšamo s hemodilucijo, defibrinogenizacijo in z vplivanjem na reološke lastnosti krvnih celic. Taki posegi so smiselni pri napredovalih motnjah arterijske prekrvavitve, ko revaskularizacijski poseg ni možen, še zlasti ko so prisotni znaki hiperviskoznega sindroma. Možnosti vplivanja na hemoreologijo z zdravili so omejene. Tak učinek je bil doslej dokazan za pentoksifilin in prostaglandine, njihova dolgoročna klinična učinkovitost pa še ni dokončno opredeljena. Pikazane so tudi nekatere možnosti zdravljenja ob sepsi, bolezenskih spremembah v koronarni mikrocirkulaciji in pri diabetični mikroangiopatiji.
Descriptors		PERIPHERAL VASCULAR DISEASES ARTERIAL OCCLUSIVE DISEASES HEMORHEOLOGY MICROCIRCULATION SEPSIS ANGINA PECTORIS DIABETIC ANGIOPATHIES