Kwemithambo le aorta bentliziyo - yintoni na? Aortic kwemithambo: Oonobangela, Iimpawu, Treatment

Phakathi zonke izifo ngentliziyo kunye semithambo eyaziwa oogqirha ezahlula udidi emela ubungozi kakhulu ebomini bomntu. Oku kuquka iposi engabalulekanga, kwemithambo aortic. Ngomhla wokugqibela, kuchazwa iinkcukacha ezingakumbi kweli nqaku.

kwemithambo Aortic intliziyo: yintoni nokuba njani yingozi?

Le aorta - le yenye kwemithambo inkulu emzimbeni womntu, nto leyo ifumaneka kufuphi intliziyo. Ngokusebenzisa kwakhe, igazi aqukuqela ephuma izihlunu eziphambili kuzo zonke ezinye imithambo. kwemithambo wentliziyo aortic yi ekhubazekile, apho ukwanda isabelo aorta ngenxa yempembelelo yezinto ezininzi. Pathology inokuba nokuba naso okanye lufundiwe kwindalo.

Isifo iqala nesibakala sokuba phantsi yengcinezelo ukuhamba kwegazi neqwengiweyo intima. Ngoko, igazi uyakwazi iqukuqela igalele ngqo kwi esibekwa kwezihlunu. Kule meko isigulane lusiva nobunzima esibuhlungu esifubeni, esandleni sasekhohlo. isikhumba libunile, ukunyuka koxinzelelo, kukho iminqweno nauseating. Efunxa igazi, udonga aortic ebegqwese nangengalo. Xa uqhekeko yomntu kwemithambo unokuphulukana abazi lutho. Kwezinye iimeko, kukho siveza ukufa yethutyana ngenxa yokulahlekelwa kwegazi kunye nokothuka.

Le Pathogenesis kwesifo

Njani na kwemithambo kwentliziyo le aorta? Yintoni na ngenxa ngezifo, ziyalandeleka ukuba uyayazi kwendlela ezakhiwe ngayo izihlunu ezinkulu emzimbeni womntu. Xa myocardium ziye thinned ngeendonga ezivelileyo rhoqo egazini zokumpompa ukusuka ventricle enye ukuya kwenye. Ukuba umntu lo sifo, elinganisela iindonga ngcembe ehla. Le meko yenza kube nzima zokumpompa igazi rhoqo.

Ukongeza umonakalo iindonga aorta kukwenziwa aneurysms nazo izinto ezisebenzayo hemodynamic nobomatshini. Pathology kaninzi kwenzeka kwiindawo nokusebenza bumuncu ukuba namava rhoqo umthwalo landile ngenxa ukuhamba Velocity eliphezulu. umothuko Chronic aortic kunye nomsebenzi ngokugqithiseleyo enqanda proteolytic bawaphikise ukuthotywa isakhelo elastic ukubonakala nonspecific utshintsho sisiba mandundu uhlobo eludongeni inqanawa.

Bakha kwemithambo olukhulayo ngobukhulu, njengoko uxinzelelo eludongeni lwayo kwandisa kuphela. Kwelinye icala, ukuhamba kwegazi kulo sac aneurysmal ukuba zithe phantsi kwaye lube ebizwa ngokuba yi-lesiphithiphithi. Kwicala distal,% 45 kuphela igazi iwela ukusuka langoku iyonke kwemithambo ngokwayo. Oku kungenxa kwisisu layo igazi aqukuqela ngasezindongeni esihlambo esetyenziswayo yokugcina mechanism sophazamiseko rhoqo kwaye ubukho izixa ezikhulu izihlwele thrombotic.

Kubanga zokugula

Izazinzulu ezivela ehlabathini lonke kuqhubeka ukuphonononga ngokubonakalayo izifo ezifana kwemithambo kwentliziyo ka aorta, yintoni na kwaye yintoni iimeko igalelo kuphuhliso lwayo. Zidweliswe apha ngezantsi nje ezinye zazo:

1. Yamafutha. umonakalo Sclerotic eqalisiweyo ekuhambeni sifo, zingachaphazela udonga aortic uze uzenze bhetyebhetye ngokupheleleyo.
2. uhlobo ezosulelayo esi sifo. kwemithambo wentliziyo le aorta kaninzi kwenzeka nxamnye imvelaphi yazo negcushuwa okanye sisifo sephepha.
3. Izifo iziphene (yiMarfan syndrome, Ehlers-Danlos syndrome). Ngokufuthi imbali isahlakalo sifo esweni sihlola imbali yosapho.
4. Ukwenzakala kunye umonakalo ngenxa yingozi yemoto.
5. iposi engabalulekanga. Oku ngoyena nobangela uqhelekileyo esi sifo. Ngowe-35% yabantu abathe ubunzima iposi engabalulekanga, kwafunyaniswa ukuba kwemithambo intliziyo. Kulo mzekelo, oku kubonwa phambili yayo ngqo.

Xa ingozi enkulu yokuba i kwemithambo ziquka abatshayayo,, abantu unesifo abatyebe kunye yegazi ephezulu. Ngokutsho manani, kwemithambo kwentliziyo ka aorta ukuya izihlandlo ezihlanu rhoqo ngakumbi olufunyanwa amadoda kunokuba amabhinqa. Njengomgaqo, izigulane ubudala - kwiminyaka engaphezu kwama-50.

ngezigaba izifo

Kutyando semithambo isebenzisa embodiments eziliqela aortic aneurysms ukuhlela ngokusekelwe zabo isakhiwo kwasendaweni eludongeni, ifomu kunye umyalezo.

Ngokungqinelana segmental typology owahlukileyo: kwemithambo of sinus ka Valsalva, zinyuka / inxalenye zisihla, Arch aortic kunye aorta esiswini.

Uvavanyo lobume morphological karhulumente aneurysms ivumela ukuba bazohlule babe lokwenyaniso nolobuxoki kubo. Udonga le yokugqibela bubonakaliswe kwizicwili, oluthi luqokelelane ngenxa pulsatile hematoma ukwakhiwa.

Imilo kwemithambo kunokuba saccular kunye fusiform.

Ziintoni iimpawu kunye zokugula?

Kwiimeko ezininzi isifo nazimpawu. Besiya kwi ngequbuliso, ngokufuthi ngexesha bahlole njalo okanye uviwo zeminye imibutho. Nezikhalazo zezigulane kubonakala ukuba kwemithambo iphawulwa kukukhula ngokukhawuleza kwaye sele olwandulela ikhefu.

Kwemithambo le zinyuka aorta intliziyo arc yayo lidla ikhatshwe ngumfanekiso eliqaqambileyo lwezonyango, isizathu soku indawo ethile yokwakheka. Pathology ukuze sibeke uxinzelelo phezu iimbambo kunye umqolo thoracic. Izigulane ezikhala ukhohlokhohlo kwakunye nokubamba-bamba umphefumlo ngenxa ucinezelo le bronchi, iyangongoza intliziyo, hoarseness.

ubuhlungu elivuthayo elide kwi kokusemva uphawu izinto ezimbi le aorta thoracic kwentliziyo. Kulo mzekelo, izigulane ngokuqhelekileyo uphawu ukubonakala ukhohlokhohlo owomileyo, nokudumba, isiyezi kunye ubuthathaka wonke umzimba.

Ngethuba loviwo zokuxilonga, ugqirha kufuneka anikele ingqalelo ekhethekileyo iimpawu lwangaphandle umntu. Zobude wamasundu, mde, kyphosis, ukukhubazeka sternal - zonke ezi mpawu kusenokuba kubonisa yiMarfan syndrome. Sele sathetha ngayo kweli nqaku.

Ngelishwa, amaxesha amaninzi umqondiso lokuqala ngezifo na komsipha aortic. Kubonisa ukopha lweenkcukacha kwi izitho zokugaya. Isigulane iye ukugabha ngegazi, iintlungu esifubeni, ukuba kuthe kwaqhenqetha phantsi kwalapho. Ukungabikho uncedo ngexesha kunokuphumela ekufeni nomonde.

Indlela ukubona i kwemithambo?

Amaninzi ngexesha kuxilongelwa lwesiqhelo, oogqirha une "kwemithambo kwentliziyo ka aorta." Yintoni na, yintoni na unobangela wezifo kunye neendlela ezingundoqo konyango, yingcali kufuneka uxelele ulwamkelo lokuqala. Ukuze Ufundo ngakumbi ingxaki kusenokufuneka inani izifundo ezongezelelweyo, kubandakanywa CT, MRI, ultrasound. Ngokutsho iziphumo uxilongo lokugqibela, ugqirha ifumana umfanekiso lwezonyango ngokupheleleyo kwesi sifo.

Ngosuku loviwo kubalulekile ukuba uthathe ingqalelo into yokuba kukho kwemithambo kweempawu zabo kuyafana nezinye izigulo. Kungenxa yoko le nto indima ekhethekileyo uxilongo enikwa kwizifundo umehluko.

Ubhaqo ngezifo kwaye mhlawumbi yi zokuhlola. Iingcali sincoma rhoqo uthabathe amadoda emva kweminyaka engama-60, ongakwaziyo ukunikezela imikhwa emibi okanye abe imbali kwesi sifo.

Kwemithambo le aorta entliziyweni: unyango

Kwaye ke iimpawu zesi sifo yaye nonyango ezinxulumene ngqo. Emva kokuba ugqirha uza kuqinisekisa uxilongo lokugqibela, unako phambili kunyango.

Xa therapy ngezifo nazimpawu imiselwe kweliso karhulumente ngogqirha nemithambo kunye nolawulo rhoqo X-ray. Ukunciphisa ubungozi iingxaki kwezinye izigulane alawulwa anticoagulants.

Surgery kuvezwa kwemithambo ubungakanani enkulu (4 cm), kwakunye nokukhula kwayo phambili. Olu nyango nekucetyiswa ukuba phantse zonke izigulane kwakufuneka ukujongana ngezifo ebizwa ngokuba 'kwemithambo kwentliziyo ka aorta. "

Umsebenzi kuthetha ngokuthi excising inxalenye enesifo ngesitya, suturing, okanye indawo yayo siphene afakelweyo nemithambo.

Ngelishwa, le ALS kwesi sifo kwiimeko ezingaginyisi mathe. Ukususela ekuqalekeni uphuhliso kwemithambo ufe malunga ne-75% ezigulane kwisithuba seminyaka emihlanu. Isiqingatha kubo abulawa komsipha ngequbuliso loo aorta, kwaye abanye - ngu ezimbi ezihamba (stroke, ischemia).

iingxaki kwemithambo

1. Ukushiyeka vana aortic kunye nokungaphumeleli intliziyo.
2. Kwemithambo komsipha. Ngenxa yoko kukho ukopha nzulu kwisisu pleural, ezokuphefumla, intliziyo okanye ibhegi umphimbo. Kwimeko yokuba ukopha ngqo kwisisu pericardial yokuphuhlisa tamponade intliziyo.
3. kwemithambo ekunqandeni olunamandla.

Iingxaki zikhankanywe apha ngasentla, ukuba ukunika unyango ngexesha inokubulala ukuba izigulane unesifo "kwemithambo kwentliziyo ka aorta." Unyango lo gqirha sifo ukhetha, ngokusekelwe kwi imeko yeli yomguli kunye neqondo ebukhulwini ngezifo.

amanyathelo othintelo

Xa kufikwa ekuthinteleni ukugula kakhulu ezinjalo, zonke iingcebiso yokuphila esempilweni kunye ekukhatyweni nemikhwa emibi kufuneka ziqwalaselwe kuqala. Njengoko sele kukhankanyiwe, kuba ixesha elide kwenzeka ngohlobo ezifihlakeleyo kwemithambo kwentliziyo ka aorta. kubonakala iimpawu kulo mzekelo, isigulana abazi phambi kwale ngezifo. Kungenxa yoko le nto xa umntu usemngciphekweni (ukutshaya, uxinzelelo oluphezulu lwegazi, imbali yosapho amatyala asike aortic), kufuneka bangenele uvavanyo olupheleleyo diagnostic rhoqo. Ukuze ezi njongo, sebenzisa ultrasound ngokubanzi, aortography usebenzisa arhente nshita MRI. Ubhaqo ngexesha isifo unakho ukusindisa ubomi.

isiphelo

Eli nqaku inika ulwazi "An kwemithambo le aorta entliziyweni:. Oonobangela, Iimpawu and Treatment" Musa ukumoyika sifo, njengokuba isifo ngexesha kunye nonyango nobuchule usaqala avumela phantse ukulibala ngonaphakade ngale ngxaki.