Ivalve Aortic 1, 2, izidanga 3: nemiqondiso, iimpawu, uxilongo, unyango

Umzimba womntu wahlukile. Noko ke, maxa wambi kukho iimeko apho ilungu elithile sinesiphene yenza imisebenzi yayo. Kuyinto kukwaphula isakhiwo - ivalve aortic - umxholo weli nqaku.

lwesigama

Ekuqaleni, kufuneka siqonde imigaqo eziya kusetyenziswa kwinqaku langoku. Ngoko ke, yintoni na ukungaphumeleli kwe umba aortic? Le uphazamiseko umzimba, ebangela ukuba Iphaphazelisa ngokupheleleyo musani ukuvala ambathe. Oku kukhokelela ngxaki ezifana igazi ukusuka aorta aziphose emva ventricle intliziyo ekhohlo. Oku kwenzeka ngexesha diastole - ukugcwaliswa intliziyo ngegazi. Ngaphezu kokuba lugcwele? Ekubeni umzimba womntu ifumana ngaphantsi kwe ezifunekayo ukusebenza okuqhelekileyo umthamo wegazi. Ngenxa yoko, oku kwandisa umthwalo entliziyweni, ukuze kubuyekezelwe le ngxaki.

Xa sithetha nje ngokubanzi, eli yokuqala, kude umzimba usemtsha yaye izele lwamandla, aortic vana insufficiency badla ungambuyiseli naziphi na iingxaki. Kuphela, intliziyo ukuze nande kancinane ubukhulu ukuba ziyakwazi ukuzivumelanisa ngenxa yokunqongophala igazi. Symptomatology ekuqaleni engekho, kwaye sigulane asikwazi nkqu bangazi ubukho le ngxaki. Kamva uqala ukuba kwenzeka ukuphelelwa umoya, ukudinwa. Ukumelana nesi sifo, isigulane zinokuthunyelwa utyando ukuze aortic valve replacement.

Ingxaki kumanani

Izazinzulu niqaphele ukuba ukususela iingxaki ezifana insufficiency ka vana aortic, ichaphazela amaninzi abameli eyindoda. Ukuba sicinga ipesenti, inani lamathole kwesi sifo, xa kubhekiswa kubo bonke abafayo kunye iingxaki ezahlukeneyo ngentliziyo, iye malunga ne-14%. Ukuba bakugqala isifo, oko malunga ne-4% amatyala aortic vana insufficiency kwenzeka ngendlela yayo enyulu, yaye ngo-10.3% yamatyala - xa zidityaniswe kunye nezinye izifo ngentliziyo.

izizathu

Ngokubanzi, unobangela wale ngxaki, ngo 2/3 kwezi meko kuba kwezivalo rheumatism. Ngokuqhelekileyo, esi sifo ibangela endocarditis infective. Oosonzululwazi ezichongiweyo amaqela amabini yezizathu, leyo zahlulwe zibe acute kunye ezingapheliyo yenzeke.

Izinto ezibangela izifo ezingapheliyo

Kulo mzekelo, oogqirha baye bafumana eziliqela yezizathu ezibalulekileyo, esinokubangela iinkqubo ezigulo ezondeleyo:

• yesifo senhliziyo. Abantwana azalwe kuphela ngeengcango elinye okanye amabini, nto leyo ebangela ukuba ezininzi iingxaki neenzima yokumpompela igazi entliziyweni.
• Ukwaluphala. Oko kukuthi, ivelifa aortic wesinxibo, ibhadi ngokuhamba kwexesha.
• samathambo, nto leyo ebangela loloyiko le amaphetshana vana, nto leyo ethintela kubo closed ngokupheleleyo.
• iinkqubo ezisulelayo entliziyweni, xa lo sexesha lokukhula (i amathanga yonke iintsholongwane), "badla phezulu" i beziya vana, okanye nje yande phezu kwemithambo, izivimbela ukuba sivale ngokufanelekileyo.
• Ukunyuka aorta xa ibhalbhu yalo bulukwe ukuze kwemithambo abakwazi nje ivalwe phantsi ngokupheleleyo.
• Unyango iingxaki ezahlukahlukeneyo, nto leyo kunokubangela ukungaphumeleli ivalve aortic. Umzekelo, unyango radiation okanye ukusetyenziswa "Phentermine" - ichiza ukunciphisa umzimba, nto leyo Waziqhiwula yena ukusetyenziswa kwinkulungwane yama-20 emva kwexesha. Ngokutsho uphando ngabaphengululi, ukusetyenziswa kwalo kungabangela ezininzi iingxaki zentliziyo, kuquka aortic valve regurgitation.

Izinto ezibangela ukungondleki ahlekise

Amagqirha phambili aortic vana insufficiency kwakhona cell ukuba izifo ezifana endocarditis (usulelo umonakalo omzimba), asike aortic (apho igazi aqukuqela izikhewu kwakhiwa). Ngamanye amaxesha izigulane emva kokwenziswa utyando endaweni vana aortic nawo ekuphuhliseni waso. ezibangela Acute le ngxaki ubalisa ngakumbi nongcungcutheko ityesi (umzekelo, ngexesha isithuthi yokungqubana xa umntu swipes elisesifubeni kwidashboard). Oku kukhokelela yomonakalo ivalve aortic.

iingxaki symptomatology

Ziintoni iimpawu aortic vana regurgitation, nto leyo ukufumanisa ubukho ingxaki? Njengoko sele kukhankanyiwe ngentla apha, ekuqaleni iimpawu isenokungabi. Oko kukuthi, isigulana ukuze azive ukuba iingxaki ezithile. Noko ke, kule minyaka, le meko uyatshintsha. Heart ukuba asebenze ngaphezulu ngenkuthalo ukuvala yokungabikho kwegazi. Ngenxa yoko, le ventricle lasekhohlo kwandisa kancinane, kwaye intliziyo ngokwayo iya isiba buthathaka. Apha kwakhona wenza ngokwayo waziva valve aortic. Iimpawu, nto kulo mzekelo angavela:

• ukukhathala njalo, ubuthathaka umzimba uphela.
• Ogulayo uphelelwa ngumphefumlo. Inyusa ebudeni eyahlukahlukeneyo.
• arrhythmias Kwakhona waphawula okt engaqhelekanga intliziyo isingqisho.
• Isiguli ezikhala yomntanakhe ngokukhawuleza.
• Imithwalo zinokwenzeka iintlungu esifubeni (angina).
• Ayifane, izigulane nabo ubunzima ilahleko lokuqonda.

Ukuba isigulana sokusilela etsolo, wozibonakalisa zonke iimpawu ngesiquphe, amandla abo ngakumbi, ukuba kuvela eliqaqambileyo. Kulo mzekelo, izigulane badla kufuna olungxamisekileyo zoncedo lokuqala, ukuze basindise ubomi.

Malunga iqondo elingonelanga

Kwakhona unalo ngxaki ezifana ivalve aortic, inqanaba lophuhliso. Ahluke kwi ubude jet, nto leyo lesitofu umva waya ventricle ngokusebenzisa beziya kabi avaliweyo. Ngokuxhomekeka kulo, ukuba ezintathu: okokuqala, eyesibini, neyesithathu.

isidanga sokuqala

Yintoni eyodwa malunga nalo umba aortic regurgitation 1 degree na? Kulo mzekelo, i-jet ayidluli 5 mm ngobude ukusuka amaphetshana aortic. Ngoko ke, le ngxaki kusengenziwa ngokuba minor. Ngapha koko, igazi iyaqokelelwa malunga emizini ezininzi ngaphandle ibangela naziphi na iingxaki. Aortic umphini 1 degree akuthethi ukuba ukunyuka okukhulu ventricle ngasekhohlo, kule meko kunokuba ngokupheleleyo zobukhulu eziqhelekileyo.

besigaba sesibili

ivalve Aortic degrees 2 ezizodwa ukuba ubude jet kule meko yandiswa kwi-10 mm. Oko kukuthi, igazi "splatters" umgama omalunga-10 mm ukusuka amaphetshana vana. Kulo mzekelo, i-jet unako ukufikelela beziya ze ivelufa mitral, leyo mandundu kakhulu imeko. ivalve Aortic regurgitation grade 2 kwandisa pulsation kwi imithambo carotid nentliziyo, kuyanda ventricle ngasekhohlo. Aba bonke lula ukubonakala phezu echocardiogram.

degree wesithathu

Aortic valve grade 3 ungachazwa ukuba igazi umva ungabutofela yi kumgama engaphezulu kwe-10 mm. Kulo mzekelo, i-jet sinqumla ivelufa mitral, kwaye ukufikelela phezulu ventricle ekhohlo. Kulo mzekelo, iintliziyo umda yandiswa kakhulu ngaphezulu kwe-2 cm, lo ECG kunokuba "zingajongwa" ngasekhohlo ventricular hypertrophy.

Insufficiency kubantwana

Ngokwahlukeneyo ufuna ukuqwalasela aortic valve insufficiency ebantwaneni. Ngaba kukho naziphi na umahluko phakathi omdala nomntwana? Ngoko ke, uya kuba iimpawu ezahlukileyo. Kulo mzekelo, abantwana amaninzi wabona pallor, pulsation kwemithambo kwi yesiqephu basenokuba luphawu Musset (umntwana uya kunyikima intloko yakhe ecaleni, kuxhomekeke izinga kwentliziyo). Njengoko ngokuba unyango kunye ekufumaniseni iingxaki, yaye abantwana kunye nabantu abadala, le nkqubo iya kuba njalo.

ekuxilongweni

Uxilongo lokuqala "umba aortic" Unokuyifaka kugqirha emva kokuphulaphula (auscultation) uncharacteristic ingxolo entliziyweni (bambombozela ukuzala yinto engaqhelekanga). Noko ke, loo nto ibe uqikelelo kuphela. Okulandelayo, ugqirha uyakukubuza iimpawu asenokubonisa ubukho bale ngxaki, ukuqokelela anamnesis ngokupheleleyo. Okulandelayo, ugqirha uza kuthumela isigulane ukuba izifundo ezongezelelweyo eziya kuqinisekisa okanye ukuphikisa lokufunyaniswa pre-zavela.

• Ngokucofa. Kule meko umntu amisele jitter kwi kwisiseko kwentliziyo esebenzisa zokuhlola. Oku kwenzeka ngenxa yokuba kukhululwe umthamo omkhulu kakhulu igazi. Kwakhona, "akukho nto" zezihlokomiso, xa imida intliziyo "yiya 'ukuya ekhohlo.
• ECG. Le nkqubo yenza kube lula ukufumanisa ukwanda ubungakanani ventricle lasekhohlo kwentliziyo.
• Echocardiography. Le nkqubo ikwindlela yokuchola okuntlandlo-mbini utyhila ventricular hypertrophy ngasekhohlo. Xa lowo-mbini - iyakwazi ukwahlula umba atrial mitral ngenxa zingene jet.
• Doppler unika ithuba ukugqiba isidanga se insufficiency ka vana aortic - kubonisa ubude esihlambo igazi umva lesitofu.
• X-ray. Ukuba ivelufa aortic kubonakaliswa, le nkqubo yenza kube lula ukuba 'babone' ukwanda ubungakanani intliziyo, calcification le amaphetshana.
• Ukwandisa efumanise uxinzelelo intracardiac nga maliqhutywe catheterization kwentliziyo ukuqanda nkqubo. Kulo mzekelo, oogqirha aba izidanga ezine aortic vana insufficiency ngokungqinelana umthamo emva igazi zifakwa. I isidanga sokuqala limalunga ne-15%, ngelixa yesibini - ukususela-15 ukuya kwi-30%, nangowesithathu - ukususela-30 ukuya kuma-50%, lo gama i lesine - ngaphezu kwe-50%.

Ukuba isigulane ngaphambili une "umba aortic" iingxaki kusenokwenzeka ukuba wenziwe ngoncedo zonke ezi ndlela. Ngoko ke, ugqirha isigqibo ngokwakhe oko isigulana ngeli nqanaba oko kuyimfuneko. Kufuneka kuqatshelwe ukuba ukongeza kwiindlela ngentla loxilongo, maxa wambi kusetyenziswa kwaye angiography coronary, leyo linokukwenziwa kuba kuyabonisa efanayo naleyo echazwe stenosis aortic.

unyango ngamachiza

Ukuba umntu efunyaniswe ene unyango "umba aortic" iya kuxhomekeka isifo yesigulane. Ngenxa yoko, ukungxamiseka ukusebenzisa iziyobisi ezithile okanye unyango ngamazinga ngokona kuqatha yokubonakalaliswa iimpawu. Ukuba uhlobo zesifo - a, unyango esinganyangekiyo mhlawumbi nezinyangayo.

Drug unyango ukuba isigulana ukuze kufuneka:

1. Womchamo. Eyona Injongo yezi machiza kulo mzekelo - imveliso fluid kwemfuneko ivela emzimbeni, bemthoba uxinzelelo lwegazi.
2. Antibiotics. Linokwenziwa njengoko prophylaxis kwezifo ezosulelayo kwiinkqubo utyando okanye wamazinyo.
3. Kwaye bonyulwa blocker calcium channel (ubukhulu becala iziyobisi "Nifedipine") kunye nenjongo ephambili - ukunciphisa ukuvuza igazi. Kufuneka kuqatshelwe ukuba kwezinye iimeko kusetyenziswe la machiza sibe enye ebalaseleyo uqhaqho.
4. Kwakhona kufuneka yabelwe kunye nezinye iziyobisi ezifana inhibitors ACE okanye blocker receptor angiotensin.

Kufuneka kuqatshelwe ukuba izigulane kunye nale ngxaki, enoba ndikho ngendlela yezigulo ezondeleyo, kumele babhaliswe kunye nogqirha. Bona ngamaxesha athile kufuneka ukutyelela ugqirha. saside kule ityala alisonjululwanga zihlala ziboniswa.

ukungenelela kuhlinzwa

Ukuba isifo sinobuzaza, kukho imfuneko ngoncedo engxamisekileyo yotyando. Phuthuma umntu ufumana kugqirha, kungona ithuba ukuze bahlale bephila. Nangona izinga lokusweleka iphantsi kulo mzekelo, ibhekisela oogqirha ukulibaziseka isigulane zinokubiza ubomi.

Kwakhona, ahlinzwe kubonisiwe kwizigulane zityalwa kwakudala kwafunyaniswa ukuba "ivalve aortic". Ukuba isigulane liqulunqe iimpawu, kwanokuba ekuqaleni inobulali, washiya ventricle contractility ulahlekelwa - ukuba zonke ukwalatha for kuhlinzwa aortic valve replacement.

Njengoko reference kufanele kuqatshelwe ukuba namhlanje, ahlinzwe ngokuqhelekileyo iziphelo HIV kwaye izisa isiphumo isigulane ezinqwenelekayo. umsebenzi wakhe wokuqala onjalo wenziwa emva ngo-1960 nguGqirha Harkenom ukuba amaso aorta iplastiki Prosthetic and yentsimbi. Ngomhla kummandla yiSoviet Union, lo msebenzi lwenziwa kuqala ngo-1964, waphumelela. Ukususela ngelo xesha, ugqirha kuphuhliswa ubuchule neendlela ezininzi ukwenza oku utyando umgangatho ophezulu kunye ngempumelelo.

ukusinda

Ukuba ogulayo eliphakathi okanye nowobulali ukusilela intliziyo, unyaka-10 izinga ukusinda eliphezulu kakhulu kwaye kuthetha ukuba phantse ama-90% azo zonke izigulane. Ukuba izikhalazo kuqalisa ukuhluma, kukho iimpawu, imeko unokuba mbi ngokukhawuleza. Kulo mzekelo, ukuba anithanga ukubhenela utyando, ukufa kwenzeka kwiminyaka emalunga 2-5, kuxhomekeke kuphuhliso izifo ezithile.

Ukuba isifo nazimpawu ngokupheleleyo, i-ALS kuFeliks. Kwimeko enjalo, ungenelelo yentsebenziswano kufuneka% 4 kuphela amatyala. Kwangaxeshanye, izikhalazo kwenzeka izigulane kule minyaka mihlanu yokuqala - 20% yezigulane, iminyaka esixhenxe - malunga ne-25% yezigulane. Ukuba ukusilela etsolo, kakhulu, mhlawumbi ezibulalayo xa ventricular fibrillation. Ukuba ixesha ukwenza utyando, oku uya kuziphepha.

ukuvimbela

amanyathelo othintelo ukuba ukufumana sisifo, akukho. Kulo mzekelo, ukutya okanye indlela ethile yokuphila akayi kuba nako ukunceda. Kodwa nantsi ke kwizigulane basengozini bangazikhusela. Ngoko ke, rhoqo ukuba abafundi bapase iimviwo kwi ugqirha, yenza inkqubo yokuqeshwa. Cwangcisa i survey kuba ezahlukeneyo, kodwa aninako ndwendwela ugqirha wakho ngaphantsi kaninzi ngaphezu kwexesha 1 kunyaka ngamnye.