I-valve ye-tricuspid. Ukungakwazi ukusebenza kwe-valve ye-tricuspid 1, 2, i-3 degrees: iimpawu kunye nokonyango

Umsipha ephambili umzimba womntu intliziyo. Oku yindlela nzima amalungiselelo, amacandelo ezo kwemithambo. Icala lasekunene le ivalve tricuspid. Uyavumelana intendelezo ventricle. Xa kuntlitheka, ukuhamba kwegazi kule nxalenye esihlunwini iphazamisekile. Isiphumo yimeko yomntu ezisongela ubomi. Xa yezonyango, akwabizwa ngokuba "ukungaphumeleli ivalve tricuspid." Kwinqaku lwanamhlanje siza kuxubusha unobangela ephambili, iimpawu kunye unyango ngenxa yesi sifo.

reference yokwakheka

Intliziyo yomntu ilungu dystrophy. kwisisu kwayo yahlulwe imithambo-2 kunye ventricle 2. Unxibelelwano phakathi kwezi zakhiwo kwenzeka kwemithambo. Abanoxanduva umthombo wegazi kwicala elinye.

Icala lasekunene egumbini intliziyo oxhulumene nge ivalve tricuspid. Luquka ezi izakhiwo yokwakheka zilandelayo:

• amaphetshana ezintathu (septal, ngaphambili nangesemva);
• course imicu;
• imisipha papillary;
• annulus fibrosus.

Ngexesha yindibanisela ivelufa intendelezo tricuspid ivula. Ngokuthe ngcembe, igazi igcwalisa ventricle. Emva koko myocardium luqala khosi zixinaniswe ngoxa phantsi strong koxinzelelo vana amaphetshana slam. Loo ndlela isebenza kunqanda reverse Isikolo (regurgitation) negazi. Phantsi yempembelelo yeemeko ezithile ukusebenza wambi lutshitshe. Kule meko sithi abafumana tricuspid valve insufficiency. Noko ke, ukuze isebenze ngokupheleleyo, yena akakwazi.

Kule igazi ngezifo evela ventricle babuyela intendelezo. Ukunyuka kancinane umthamo engamanzi cishe nafuthe ukusebenza izihlunu ezinkulu umzimba. Xa ukusilela ezinzima baye gumbi deformation, izalathisi xi ziyahluka kakhulu kuzo. It angandiswa ka-8 xa kuthelekiswa nezinto ezixabisekileyo zendalo.

Inkcazelo emfutshane ye sifo

insufficiency Tricuspid - oku sisifo sentliziyo ukuvela ngenxa yokuvalwa sinesiphene le amaphetshana vana, ekubunjweni reverse igazi ukusuka ventricle ekunene ukuya intendelezo. Ngokuchasene imvelaphi njalo regurgitation umthamo ukuzala kunye noxinzelelo kulwakhiwo yentliziyo landa. Oku kuthetha hypertrophy kunye dilatation beendonga zayo. Ngenxa yokuba ukuphazamiseka iindlela zembuyekezo kwi isigulana ukuphuhlisa ingxinano emzimbeni.

insufficiency Tricuspid Idla ngamanye iziphene ngentliziyo naso. Umzekelo, a foramen lomenzi ovale okanye atrial septal sisiphene.

izinto eziphambili kunye neentlobo kwegazi

Insufficiency ka vana tricuspid isoloko eyahlukileyo. Ukuxilongwa, kufuneka kuqala bajonge i imilo kwenkqubo yezifo. Ukulungiselela le njongo, xa yezonyango, kwasetyenziswa iikhrayitheriya ezizintlobo ngeentlobo: ixesha ukwenzeka, kwasendaweni kwenxalenye umonakalo ka vana, ubukhali regurgitation.

Ngokuxhomekeke kwixesha zophuhliso, esi sifo uchaphazelekayo yeentlobo ezimbini. Njengomgaqo, kuzo zonke iimeko akukho ababeyiqwebile, yaye kwenzeka emva kokuba inkqubo arhabaxa. malformation azalwa sifo ayifane senzeka esibelekweni. On bembonakalo yayo ichaphazela amanyathelo yeemeko elibi eziphilayo le abakhulelweyo. Oku imitha, izifo ezosulelayo, okanye X-ray zokukhanya.

Ngokusekelwe Eneneni, leyo inxalenye yonakele tricuspid valve insufficiency unokuba iifom ezimbini. Le ukhetho eziphilayo lukhatshwe utshintsho komzimba kwi kwemithambo. Kancane gqitha, Bathiwe wambu yintlahla. Xa uhlobo yomsebenzi ivelufa sifo luvalwe ngokupheleleyo.

Development uthenge organic tricuspid insufficiency okubangelwa yezi zizathu zilandelayo:

1. samathambo - nangokurhala, uqhebeke amalungu angaphakathi nkqubo.
2. Carcinoid syndrome - umonakalo amalungu ahlukeneyo ngenxa nangezilonda amancinci emathunjini. izinto izifo yamathumba egazini kwaye uqala ukuba ahlasele endocardium. Emva koko faka neempahla miphungeni.
3. Infective endocarditis - ukudumba ingaphakathi intliziyo.
4. commissurotomy Mitral. Lo msebenzi, nto leyo isetyenziswa kunyango stenosis.

Ezifuniweyo functional (isihlobo) tricuspid valve insufficiency kuphuhlisa ngenxa yomonakalo izihlunu papillary okanye ukwandiswa fibrosus annulus. Kwimeko yokuqala, ukumelwa kobume noxanduva lokugcina ubuchule motor lwezivalo. Engabalulekanga izihlunu iqhosha papillary yonakaliswe. Oku kukhokelela ukuphazamiseka ukusebenza ivalve tricuspid.

Pathology le ring ezinezikhondo kunokubangela ezahlukahlukeneyo iingxaki. Ezi kufuneka iquke myocarditis, iphula taxi nangezilonda, nangezilonda ethintela igazi aqukuqelayo evela ventricle.

Amanqanaba ekukhuleni insufficiency

Ngokusekelwe ubungqongqo inkqubo regurgitation, Ekuhambeni esi sifo izigaba ngokuqhelekileyo avelele ezininzi:

• 1. Ubungakanani igazi umva ngoku igcine amaxabiso lincinane ezingahambi disorder hemodynamic.
• Degree 2. Kweli ngezifo sigaba kunye reverse egazini kwangaphambili umgama ukuba ayidluli 2 cm.
• Degree 3. Blood flow phambili ukuya intendelezo phezu kumgama-2 cm ukusuka kumphezulu vana.
• 4. isidanga ngexesha igazi regurgitation lingena singene kummandla ongentla intendelezo, badlula kuyo egumbini.

Malunga oko iimpawu kunye kwisigaba ngasinye sifo, kuya kuxoxwa ngezantsi.

Iimpawu tricuspid valve insufficiency

Ngelo lokuqala nesifo sentliziyo phantse akuthethi ukuzibonakalisa. Ngamanye amaxesha emva kokuba umzimba izigulane qaphela ukubonakala pulsation enamandla ngemithambo entanyeni. Ukubona inkqubo yezifo kunokwenzeka kuphela ngoncedo Doppler. ECG Normal alubonisi utshintsho olubalulekileyo entliziyweni.

Tricuspid insufficiency vana kukhatshwa kukwanda degrees 2 umva umthamo flow wegazi. disorder Ilungelo ventricular kukhokelela ekwandeni ubungakanani kwentliziyo. Ngenxa yoko, umfanekiso lwezonyango yi zincediswa mpawu zilandelayo:

• ukudinwa, kunciphise emzimbeni kunye nomsebenzi engqondweni;
• Ukuchama rhoqo ebusuku;
• Ukudumba kakhulu kweqondo asezantsi;
• ukuphelelwa umoya;
• imvakalelo ubunzima phantsi iimbambo;
• ukuqunjelwa.

Xa ukumamela intliziyo azimisele ingxolo pansystolic kunye fibrillation atrial.

Ngenxa yoko, kwandisa isixa iimpawu progression ngezifo ukubonwa. Ziba ukubonakala kwazo ayikhuthazwa. Kungcono kwi lokuqala sifo bafune iingcebiso zonyango abafanelekayo. Tricuspid valve insufficiency degrees 1-2 zisenako zinokunyangeka amayeza. Inguqu ukuya kwisigaba esilandelayo sifo isoloko ifuna uqhaqho. Kwanasemva kokuba umsebenzi ke ukwenzeka yeengxaki kunokwenzeka.

Iimpawu zesi sifo kubantwana

iintsana ezisanda kuzalwa kunye regurgitation kakhulu kwaye kukho isifo sentliziyo ezihamba othambekele luphuhliso olukhawulezayo ukusilela ventricular ekunene. Amaxesha amaninzi oko kuphelela ekufeni.

Ifom efumaneke kwesi sifo senzeka iingxaki zezinye izifo. Kaninzi iba usulelo iStreptococcus, nto leyo ekhokelela rheumatism.

Phakathi kwezinye izizathu zokusilela ebantwaneni kungathiwa:

• uhlobo nokoyika wegazi;
• isifo le myocardium;
• ukulimala ebuhlungu;
• neoplasms amabi.

Ngelo lokuqala ivelufa insufficiency tricuspid ebantwaneni ithathwa njengokuba iimpawu yokwakheka. I isidanga sokuqala senkqubo i zophendlo lwezifo kufuna akukho unyango. Nge ubudala, esi sifo sidla usombulula ngokwayo.

Ekungaphumelelini mitral nesivalo tricuspid

Amaxesha amaninzi, ukugxojwa ukusebenza ivalve kwicala lasekunene kudityaniswe kwekhono izakhiwo kwesiqingatha ekhohlo. Kulo mmandla, umthwalo iphambili kwindawo ebizwa ngokuba yi- valve mitral. Iimpawu sigulo zishwankathelwe. Ukudityaniswa kwezi ukuphazamiseka kunefuthe elibi umsebenzi ventricle ekunene, nto leyo nzima imbonakalo wegazi miphungeni. Izigulane unesifo "insufficiency mitral, kwaye tricuspid vana 1 degree" ekucetyiswa uqhaqho.

iindlela isifo

ukubhaqwa esi sifo lidlala indima ngqo kwi impumelelo unyango, kwaye kananjalo kuchaphazela yesigulana sokuphila. Ukususela sentsilelo vana tricuspid of 1 okuphuma phantse ngezifo nazimpawu ibhaqwe kuphela emva kokuba lenguqu ukuya kwinqanaba elilandelayo lophuhliso.

Uxilongo luqala uphando kwisigulana, ukufunda imbali yayo nokuxilongwa kwemizimba yabo. Ukubuza imibuzo ezahlukeneyo kwisigulana, ugqirha imisela mfanekiso lwezonyango, ixesha iimpawu kuqala. Kwakhona kufuneka ukwazi ukuba yintoni na isifo kwakhokelwa ukusilela. Xa noviwo lwangaphandle ngokuqhelekileyo ibonisa ulusu cyanosis kunye nokudumba, kunye auscultation - nokuphazamiseka intliziyo isingqisho.

Njengenxalenye uxilongo abayabelwe ngokuyimfuneko nemvavanyo zaselaborathri eziliqela. Phakathi kwabo, ezifundisayo kakhulu esibonakala yegazi kunye nofundo lokuba iwonga ngumzimba yesigulana. Ngokutsho iziphumo zeemvavanyo yemigaqo kugweba ubukho ukudumba emzimbeni, ivela izigulo ngaxeshanye.

Ukucacisa uxilongo ugqirha angasebenzisa i iindlela uphando zekhompyutha. Ezi ziquka:

1. ECG. Luqhutywa ukuchonga intendelezo imiqulu kwanda.
2. Phonocardiogram. Ubonakalisa umsindo iSystolic.
3. Ukonakala CT. Inika umfanekiso efundisayo izihlunu eziphambili umzimba.
4. Radiograph. Kunika uluvo lokuba ubungakanani wentliziyo, sibona ingxinano.
5. Koronokardiografiya. Ayisafani phambi kutyando nokuvavanya ukuhamba kwegazi.
6. Echocardiography. Ibonisa deformation kwezi beziya, phambi kwe- ezintsha.

Doctor ifumana ulwazi imeko vana tricuspid ngokususela iziphumo ezipheleleyo zolu phando. Ukungabikho kwale nesakhiwo iphathwa kakuhle kuphela xa lokuqala lophuhliso. embodiments ezichanisekileyo unyango kule sifo kuya kuxoxwa ngazo apha.

Izikhokelo zonyango

Insufficiency ka vana tricuspid of 1 ayifuni unyango. Ukuba isifo ihambisa ukuya kwinqanaba elilandelayo yophuhliso, isigulana wabelwa unyango. Kunokuba ibe zombini konyango,. Esebenzisa licebo lokugqibela kwiimeko ezininzi kakhulu, apho ukusetyenziswa amacwecwe kunye iinaliti ayisebenzi.

Lonke ixesha lonyango, isigulane kufuneka zilandele ngqo le migaqo ilandelayo:

1. Ngokupheleleyo ukuyeka ukutshaya.
2. Kuphephe emzimbeni kunye neemeko uxinezeleko.
3. Ukudla ukunciphisa umthwalo entliziyweni.
4. Ukunciphisa amandla kunye nemali umthambo.

Unamathelo kule migaqo kwandisa ukusebenza nothomalaliso, kwakunye uhlobo yokuthintela iingxaki.

amayeza

Moderate tricuspid ivelufa insufficiency akujongwa inkomba yokungenelela yotyando. Kulo mzekelo, unyango lwenziwa ngoncedo iziyobisi. scheme therapy Standard lubandakanya ukusetyenziswa amayeza zilandelayo:

1. Womchamo ( "Britomar", "Hydrochlorothiazide"). Aphelise ngxi kwiincindi zomzimba ukukhawulezisa inkqubo zinomgutyulo.
2. amachiza potassium ( "Panangin", "Asparkam"). Inceda umzimba ukuba yande fluid kwemfuneko.
3. dilators lwemithambo ( "Korvaton", "Nitrosorbide"). Ukunciphisa umthwalo entliziyweni ngalo igazi idipozithi.
4. Anticoagulants ( "Varfareks '' Warfarin").
5. glycosides wentliziyo ( "digoxin", "Korglikon"). Nceda ekulweni arrhythmia.
6. Beta-blocker ( "Diltiazem" "Carvedilol"). Ukunciphisa izehlo ventricular nokuncipha ngasekhohlo.

Umthamo rejimeni kwaye idosi amalungiselelo azimisele elowo ngenxa yengxinano sifo.

ukungenelela operative

Tricuspid valve insufficiency 3 degrees uthathwa ukuba ebonisa ephambili yokungenelela yotyando. Umsebenzi Kukwacetyiswa kwakhona ukuba izigulane kunye deformations kakhulu enezinto okanye wavakalisa ukusilela umsebenzi wabo.

Xa izixhobo vana yokhuseleko kusetyenziswa annuloplasty. Ngexesha ukusebenza ugqirha superimposes amalungu ezimilise U kummandla yonakele.

Ukuba ngenelelo waba kuphumelele, kukho utshintsho ezicacileyo kwisakhiwo, isigulane wabeka ankconkcozayo ngumntu. Emva kokuba umzila ka afakelweyo efunekayo anticoagulation. Ngexesha umzila ka afakelweyo eziphilayo yena unxiba uhlobo elifutshane. Ukuba yenziwe ze zonyango, unyango umphini tricuspid kuthatha ixesha elincinane kakhulu.

iingxaki kunokwenzeka abantu abane ukwenzela ukufumana kwakhona kwemali

Yokunqongophala konyango kwangexesha kungakhokelela ekubeni ukuqhubela phambili kwesifo. inkqubo yezifo kulo mzekelo ibandakanya kungekuphela nje ivalve tricuspid. ngcembe Ukusilela kukhokelela ekubeni umzimba uqalisa ukukhangela iindlela ezintsha zembuyekezo. Ngoko uzama ukumelana ukunyhashwa ezikhoyo. Kuxhomekeka izifo abangakhathalelwanga balamkele ukuphazamiseka zilandelayo:

• pneumonia;
• isibindi ezandisiweyo, ukuqina;
• Embolism pulmonary;
• ascites.

Ngokutsho manani iingxaki kuluhlu kwenzeka ngo-90% yamatyala.

Ngokuphathelele sase- ekuphulukenwe, oko kuxhomekeke iqondo yophuhliso sifo. Insufficiency ka vana tricuspid degrees 2 iphendula kakuhle unyango, kunye nengozi iingxaki cishe zero. Xa iqondo wesithathu inkqubo zophendlo lwezifo ibandakanya malunga seminyaka emihlanu-ukusinda ka-60-70%. La manani okufana kwizigulane abasele befumene uqhaqho. Xa decompensated uhlobo ukungaphumeleli, kunye nesifo semiphunga esinganyangekiyo, i-ALS elingamncediyo.