Valve Aortic: isakhiwo, indlela yokusebenza. Stenosis kunye insufficiency le umba aortic

Aortic isifo sentliziyo valvular ngokuqhelekileyo luphawulwa umlinganiswa zithengwe kwaye babonakaliswa ngokwezonyango kuphela ebudaleni. ubukho babo kunokubangela ukuphazamiseka kakhulu hemodynamic. Ubuzaza sifo kukuba utshintsho ezichaphazela valve na vuhlayiseki.

isakhiwo wentliziyo: kwemithambo

Intliziyo umzimba umngxuma equka amagumbi ezine. Le iihafu asekhohlo nasekunene ezahlulwe sisithuba izahlulelo apho kungekho ngokobuninzi, Noko ke, phakathi intendelezo ventricle kwicala ngalinye inomngxuma mayixhotyiswe vana. Ezi zithinteli kwenza kube lula ukuba ukujikeleza kwegazi, ukuthintela regurgitation, okt eyahlulayo umva.

Ngasekhohlo apho umba mitral iqulathe semigudu amabini, kwaye ngasekunene - le tricuspid, iye amaphetshana ezintathu. Valve zibonelelwa imisonto imicu, eqinisekisa ukuvulwa kwicala elinye kuphela. Oku kuthintela sokuphuma igazi ekubunjweni intendelezo. Xa Ukutshintsha ventricle ekhohlo ukuya aorta, ivalve aortic apho. umsebenzi wayo - ukunika promotion ngomnye umntu engakhange eve igazi kulo aorta. Kwicala lungelo isivingco kwemithambo miphungeni. Omabini la mashishini ngokuba "semilunar" ngayinye kufuneka amaphetshana ezintathu. Nawuphi na ukungaqheleki, umz, calcification ka vana aortic, kukhokelela uphazamiseko intshukumo kwegazi. iziphene ezithengiweyo zidla enxulumene nasiphi na isifo. Ngoko ke, abantu ekuthiwa ubungozi kufuneka umana usiya rhoqo: ikakhulu echocardiogram.

Indlela ye umba aortic

A indima ebalulekileyo ukusasazwa idlala ivalve aortic. Le enezinto uphawu okanye asisifutshane - le yenye yezona ezimbi eziphambili. Irubrikhi unobangela kozinzo hemodynamic. Umsebenzi weli yinxalenye yomzimba - ukuqinisekisa ukukhuthazwa igazi intendelezo ekhohlo ukuya ventricle, ukuvimbela regurgitation. Kwemithambo ziyavulwa xa systole atrial, apho igazi ixesha waqondisa ivalve aortic kungena ventricle. Ngaphezu koko, le beziya zivaliwe ukuthintela eyahlulayo umva.

iziphene Heart: yokuhlela

Ngexesha lubandakanywe ziyakwazi ukuchongeka iziphene intliziyo naso (valve aortic kunye namanye amaqumrhu) kwaye ziyafikelelwa. Olu tshintsho luchaphazela kuphela kwemithambo, kodwa iindonga intliziyo. bekhubazekile amathuba amaninzi zidityaniswa, iyenza nzima ukuxilonga nokunyanga.

Aortic valve stenosis

Pathology ibandakanya licuthe nokutshintshwa ventricle ekhohlo ukuya aorta - luchaphazela amaphetshana ivalve nezihlunu zawo ezingqongileyo. Esi sifo, ngokutsho nezalathisi-manani, kuxhaphaka kakhulu into eyindoda. Uphawu iindonga aorta yaye ivelufa aortic uqobo ezinxulumene izilonda samathambo kunye sisiba mandundu. Kwakhona, njengoko arhente etiologic abanokusebenza endocarditis, isifo samathambo. Ezi zifo nesiphumo ngxubevange the abasuke, ngokwenjenjalo kuncitshiswe ukuhamba yabo ayikwazi kuvulelwa ngokupheleleyo ngexesha systole le ventricle ekhohlo vana. Ebudaleni ikwandim, isizathu ukusilela idla yegazi kunye calcification le amaphetshana vana aortic.

Ngenxa licuthe le orifice aortic kukho utshintsho ebalulekileyo hemodynamics. Bona babona xa iqondo stenosis kubonakaliswa - ekunciphiseni iphecana ngomyinge ongaphezu kwe-50%. Oku kukhokelela ekubeni yinto yokuba ithambeka ingqalelo iinguqu uxinzelelo ivalve aortic - uxinzelelo aortic kuhlala eqhelekileyo, kodwa yandisa kwi ventricle ekhohlo. exposure Ukwanda phezu eludongeni ventricle ekhohlo kukhokelela kuphuhliso hypertrophy zembuyekezo, oko kukuthi, ukuba ukuqina yayo. Kamva ukuphazamiseka umsebenzi ukuzala yaye ebangela ukunyuka koxinzelelo intendelezo ekhohlo. Noko ke, Hypertrophy kukhokelela ekwandeni kwemfuno ioksijini, nokwanda akhawunti ubunzima engabalulekanga ukuba igazi lwangaphambili kwaye nkqu ukuhla ezimbi ezihamba. Oku kukhokelela kuphuhliso ukusilela kwentliziyo.

ikliniki

Kumanqanaba okuqala ivalve aortic egulayo akuthethi ukuzibonakalisa. utshintsho Clinical kwenzeka xa uvula le isithintelo ukuya 2/3 oluqhelekileyo. Xa amandla kakhulu izigulane baqala ukuphazamisa intlungu, yaba emva breastbone. Iintlungu syndrome kwiimeko ezinqabileyo, esinxulunyaniswa kulahleka ezingqondweni ngenxa vasodilatation systemic. Formation nomfutho yemiphunga ekhokelela ukuphelelwa umoya, ekuqaleni elalijongene kuphela umthwalo, kodwa ke kukho e ukuphumla. Ikhosi isifo elide kuba ngunobangela ukusilela kwentliziyo ezigulo ezondeleyo. Pathology kufuna unyango ngotyando, njengoko kukho umngcipheko imandundu, kunye nokufa intliziyo ngesiquphe.

ekuxilongweni

Ngosuku loviwo, izigulane kufuneka pallor uphawu ezinxulumene nokuphungulwa imveliso intliziyo. Iphiramidi ebonisa kwimithambo sazi kwi bi ubonwe - yinto enqabileyo kalujaca. Auscultation waphawula kuncipha abanzi-2 okanye ukuqhekeka. ECG ayikho ulwazi ngokwaneleyo - iimpawu hypertrophy azimisele kuphela stenosis kakhulu. I-echocardiography kakhulu bhetele ukuze kuhlolwe vana aortic. Le enezinto uphawu kwaye eqinileyo, iingqameko lokuvula - zezona Indlela diagnostic, enceda ukubona le sifundo. The degree of stenosis kunye noxinzelelo ithambeka eyiyo ukujonga ukuqanda catheterization.

unyango

Ukuze enomoya-to-ukumodareyitha stenosis ifuna kuphela ulungiso yokuphila - yokuphepha umthambo ngokugqithisileyo, unyango comorbidities. Ngenxa izifinyezo qho ityumbe blocker, yaye ukusilela intliziyo womchamo olusebenzayo, glycosides inhliziyo. uphawu yabonisa iindonga aorta nesivalo aortic zifuna unyango ngotyando. Ngokuqhelekileyo isikhundla sokwenziwa okanye ibhaloni dilatation.

Aortic valve insufficiency

Igama inikwa ngezifo sachaza amaphiko nesmykaniem. Le nto ikhokelela ukubuya igazi waphoswa ventricle ekhohlo ukuba kwenzeka ngexesha diastole. Izithembiso Eastern idla kwingxaki ye endocarditis infective kunye rheumatism. Ngaphantsi Ngokufuthi oko kukhokelela negcushuwa, kwemithambo aortic, lo aorta, lwegazi, yiMarfan engqondweni, systemic lupus zomzimba.

ivalve Aortic kudlala indima ebalulekileyo kwegazi. ukuvalwa engaphelelanga amaphiko ayo ebangela regurgitation, oko kukuthi, ukubuya igazi ukuya ventricle ukulahlwa ekhohlo. Isiphumo kukuba umthamo wegazi ngokugqithisileyo kwisisu wayo, nto leyo ekhokelela ukuba ukuzithwalisa imithwalo kunye stretchability. umsebenzi iSystolic ukuphazamiseka kunye noxinzelelo lwegazi kukhokelela kuphuhliso hypertrophy. kunyuka Retrograde uxinzelelo kwi kwisangqa amancinci - ezimile lwegazi miphungeni.

ikliniki

Njengoko stenosis, ngezifo uzenza waziva kuphela okukwiqondo kakhulu ukuphanza. Xa kwenzeka kuso ukuphelelwa, inxulunyaniswa lwegazi miphungeni. Iintlungu kuphazanyiswa kuphela ngo-20% yamatyala. Ngelo xesha wavakalisa auscultation kunye neempawu kwezimilo:

1. Pulsation kwemithambo carotid.
2. Uphawu Duroziez okanye ekwenzekeni bambombozela iSystolic kwi kwemithambo femoral. Oku kwenzeka xa pinched ngakumbi ukuphulaphula sikhundla.
3. Uphawu angioedema - ukutshintsha umbala we imilebe kunye nezikhonkwane ngokungqinelana pulsation le arterioles.
4. Traube iithowuni kabini, elikhulu, "kunaso" ezivelayo phezu kwemithambo femoral.
5. Uphawu de Musset, wabonakalisa enikina intloko yakhe.
6. ingxolo ukuzala emva 2 iithowuni ezenzeka auscultation wentliziyo, ngokunjalo buthathaka 1 yitela.

ekuxilongweni

iindlela enengcombolo ziquka echocardiography kunye catheterization ukuqanda. Amvumela ukuba ukuvavanya ivalve aortic, kwakunye nokujonga umthamo wegazi regurgitated. Ngokusekelwe kwezi zifundo kumiselwa yengxinano vice kwaye umba yemfuneko utyando.

unyango

Ukungabikho kwe umthamo omkhulu regurgitation, kwangumqondiso olunzulu kufuna unyango ngotyando. isivuno Optimal - izivingco enziweyo aortic, ezivumela ukuba ukubuyisela umsebenzi intliziyo. Ukuba kuyimfuneko, abelwa amayeza nomqondiso.

Stenosis nesivalo aortic - womonakalo intliziyo ixhaphakileyo, ezivame sisiphumo isifo wengingqi okanye zenkqubo. Le ngezifo sanda kunokuba kancinane, nto leyo evumela ixesha basibone ngayo. iindlela zale mihla unyango ukunceda ukubuyisela umsebenzi ivalve nokuphucula imeko yesigulane.