Aneurysm wa msempha za mtima - ndichiyani? Kung'ambika Aneurysm: Zoyambitsa, Zizindikiro, Chithandizo

Ena mwa matenda onse odziwika mtima ndi mtima madokotala kusiyanitsa gulu kuti akuyimira chiopsezo chachikulu ku moyo wa munthu. Pamafunikanso m'mnyewa wamtima infarction, kung'ambika aneurysm. Pa otsiriza, tikambirana mwatsatanetsatane nkhani.

Kung'ambika aneurysm za mtima: ndichiyani ndi mmene n'koopsa?

The msempha - ichi ndi chimodzi mwa mtsempha wamagazi waukulu mu thupi laumunthu, limene lili pafupi mtima. Kudzera mwa iye, magazi uyenda kuchokela minofu waukulu mu mitsempha ena onse. Mtima kung'ambika aneurysm ndi nthenda, limene patsogolo gawo la msempha chifukwa chikoka cha zinthu zambiri. Kudwala ikhoza kukhala kobadwa nako kapena kugula m'chilengedwe.

Matendawa limayamba ndi chakuti pansi kuthamanga kwa magazi wang'ambidwa intima. Choncho, magazi amatha kuyenda molunjika mu minofu wosanjikiza. Mmenemonso wodwala zambiri amamva chowawa kusapeza mu chifuwa, ku dzanja lamanzere. khungu wotumbululuka, ukuwonjezeka kuthamanga, pali zilakolako nauseating. Akuwukha magazi, khoma kung'ambika pang'ono ndi pang'ono anatambasula. Pa chophukacho wa aneurysm munthu akhoza kutaya kutsitsimuka. Nthawi zina, apo pakubwera imfa yomweyo kuchokera sankatha magazi ndi mantha.

The pathogenesis matendawa

Kodi mtima aneurysm kwa msempha? Ndi chiyani icho kwa kudwala, akhoza kuzindikiridwa ngati inu mukudziwa thunthu minofu yaikulu ya thupi. Mu myocardium akhala thinned makoma kuti protrude zonse mu ikukoka magazi ventricle wina ndi mzake. Ngati munthu ali ndi matenda, Kulekezera makoma pang'onopang'ono kubweza. Zimenezi zimapangitsa kukhala kovuta zonse ikukoka magazi.

Komanso kumawononga mu mpanda wa msempha mu mapangidwe aneurysms alinso yogwira hemodynamic ndi makina zinthu. Kudwala nthawi zambiri amapezeka mu malo operatively sefani kuti mowirikiza kumva katundu chinawonjezeka chifukwa mathamangidwe mkulu otaya. Matenda kung'ambika zoopsa ndi ntchito yambiri pa michere proteolytic imautsa kunyoza chimango zotanuka ndi maonekedwe a nonspecific kusintha osachiritsika chilengedwe khoma chotengera.

Kupangidwa ndi aneurysm ikukula mu kukula, monga kuthamanga pa khoma lake kumawonjezera yekha. Komano, otaya magazi mu aneurysmal sac mochedwa pansi ndipo otchedwa chipwirikiti. Motsogozedwa wapotalikira,% 45 magazi ukugwa kuchokera pano okwana mu aneurysm yokha. Ichi ndi chifukwa M'mimbamo ake magazi umayenda pamodzi makoma a mtsinje chapakati anakhalabe zonse kugwedezekagwedezeka limagwirira ndi kukhalapo kwa wambiri misa thrombotic.

kudwala Zoyambitsa

Asayansi padziko lonse kupitiriza mwachangu kufufuza matenda monga mtima aneurysm kwa msempha, chimene icho chiri ndi mfundo ziti zimathandiza kuti chitukuko. Ili pansipa ndi ena mwa iwo:

1. Atherosclerosis. mipukutuyi Sclerotic aumbike mwa njira ya matenda, zimakhudza khoma kung'ambika ndi kuwapanga iwo kusintha zokwanira.
2. Opatsirana chikhalidwe cha matenda. Mtima aneurysm kwa msempha zambiri amapezeka ndi maziko a chindoko kapena chifuwa chachikulu.
3. matenda kobadwa nako (Marfan syndrome, Ehlers-Danlos syndrome). Nthawi zambiri mbiri ya zosayembekezereka wa matenda ndi kuyang'aniridwa ndi kusanthula mbiri banja.
4. Ngozi ndiponso kuwonongeka makina chifukwa cha ngozi ya galimoto.
5. M'mnyewa wamtima infarction. Ichi ndi chifukwa ambiri a matenda. Mu 35% ya anthu amene zowawa infarction m'mnyewa wamtima, matenda mtima aneurysm. Mu nkhani iyi, amaona ngati kupitiriza ake mwachindunji.

Ndi chiopsezo kukhala ndi aneurysm kuchuluka monga osuta, hypertensive, anthu onenepa kwambiri ndi mafuta magazi. Malinga ndi kafukufuku, mtima aneurysm wa msempha mpaka kasanu zambiri matenda amuna kuposa akazi. Monga ulamuliro, odwala zaka - zaka zoposa 50.

Gawo matenda

Opaleshoni mtima amagwiritsa embodiments angapo kung'ambika aneurysms classifications zochokera yomweyo kapangidwe kutanthauzira linga lawo, mawonekedwe ndi etiology.

Malinga ndi segmental kufanizitsa wolemekezeka: aneurysm la nkusani wa Valsalva, akwera / ukutsika mbali Chipilala kung'ambika ndi msempha m'mimba.

Kufufuza kapangidwe morphological a boma aneurysms amalola kuti andigawireko iwo mu woona ndi wabodza. Mpanda wa iwowa ukufanizidwa ndi minofu connective, amene anapanga chifukwa pulsatile hematoma mapangidwe.

Mawonekedwe a aneurysm kungakhale saccular ndi fusiform.

ndi zizindikiro limodzi ndi kudwala chiyani?

Nthawi zambiri matenda ndi asymptomatic. Oterewa mwachisawawa, kangapo chiphasochi chizolowezi kapena kuzionetsetsa ziwalo zina. Madandaulo odwala amaoneka ngati aneurysm amakhala ndi kukula mofulumira ndi kale madzulo a kuswa.

Aneurysm wa akwera msempha wa mtima ndi Arc zake zambiri limodzi ndi chithunzi chowala ovutika chifukwa cha izi ndicho makamaka anatomical malo. Kudwala akhoza kukakamiza nthiti ndi thoracic msana. Odwala amadandaula chifuwa ndi kufupika kwa mpweya chifukwa cha psinjika wa bronchi, mtima palpitations, hoarseness.

Yaitali woyaka ndiululu kumsana ndi khalidwe la pathologies wa msempha thoracic za mtima. Pankhaniyi, odwala zambiri yang'anirani maonekedwe a chifuwa youma, edema, chizungulire ndi kufooka thupi lonse.

Pamene anali kumupima matenda dokotala ayenera kupereka chisamaliro chapadera ku mbali kunja munthu. Elongation ya kanjedza, wamtali, kyphosis, sternal chilema - zonse mwa zizindikiro zimenezi zingakhale zimasonyeza syndrome Marfan. Takambirana kale za izo m'nkhaniyi.

Mwatsoka, nthawi zambiri chizindikiro choyamba cha kudwala ndi kung'ambika chophukacho. Kumaonetsa magazi profuse mu ziwalo m'mimba. Wodwala wakhala akusanza magazi, kupweteka m'chifuwa chimene chimayanga pansi msana. Chosowa thandizo yake akhoza kupha mtima.

Kodi kudziwa ndi aneurysm?

Nthawi zambiri pa akandiyeze chizolowezi, madokotala anandipeza ndi "mtima aneurysm kwa msempha." Ndichiyani, kodi zimayambitsa matenda ndi njira yaikulu ya chithandizo, katswiri asauze phwando chachikulu. Pakuti kuphunzira zambiri za vuto ayenera angapo maphunziro, kuphatikizapo CT, Kujambula, ultrasound. Malinga ndi zotsatira za matenda komaliza, dokotala walandira matenda chithunzi zonse za matenda.

Kuzionetsetsa n'kofunika kuganizira chakuti aneurysm zizindikiro ndi yofanana ndi matenda ena. N'chifukwa chake ndi udindo wapadera matenda imene maphunziro masiyanidwe.

kudwala kudziwika ndi mwina mosamala. Akatswiri amalangiza nthaŵi zonse amuna pambuyo pa zaka 60, amene sangathe kusiya zizolowezi zoipa kapena mbiri za matenda.

Aneurysm wa msempha za mtima: chithandizo

Ndipo zizindikiro za matenda ndi mankhwala mwachindunji zokhudzana. Pamene dotolo adzatsimikizira matenda komaliza, mukhoza chitani chithandizo.

Mu kudwala mankhwala asymptomatic okha kuti kuyang'aniridwa ndi boma ndi dokotala mtima ndi zonse X-ray kulamulira. Kuchepetsa chiopsezo cha matenda oyamba odwala ena kutumikiridwa anticoagulants.

Opaleshoni imaonekera mu aneurysm lalikulu kukula (4 cm), komanso kukula pang'onopang'ono. Mankhwalawa akulimbikitsidwa pafupifupi odwala onse amene anali kulimbana ndi kudwala amatchedwa "mtima aneurysm kwa msempha."

Opaleshoni njira excising ndi matenda chotengera gawo suturing, kapena m'malo ake ndi chilema mtima prosthesis.

Mwatsoka, madokotala ananena zawo za matenda milandu kwambiri akumane. Chiyambireni cha chitukuko cha aneurysm ndi kufa pafupifupi 75% odwala pasanapite zaka zisanu. Theka anafa ndi chophukacho mwadzidzidzi msempha, ndi zina - ndi pathologies concomitant (sitiroko, ischemia).

mavuto a aneurysm

1. Zolakwika kung'ambika valavu ndi matenda a mtima.
2. Aneurysm chophukacho. Choncho pali magazi yaikulu mu pleural M'mimbamo, kupuma, mtima kapena thumba kum'mero. Mu nkhani ya magazi mwachindunji kuti patsekeke pericardial kukhala mtima tamponade.
3. Pachimake aneurysm clotting.

Tatchulawa mavuto, ngati si kupereka chithandizo yake akhoza chakupha odwala ndi matenda a "mtima aneurysm kwa msempha." Chithandizo sing'anga matenda amasankha lagona pa mkhalidwe wonse wa wodwalayo ndi digiri ya kukula kwa kudwala lapansi.

zodzitetezera

Pankhani kupewa ngati matenda aakulu, malangizo onse pa moyo wathanzi ndi kukana makhalidwe oipa ayenera kuwaganizira poyamba. Monga tanenera kale, kwa nthawi yaitali angayambe mawonekedwe wobisika wa mtima aneurysm kwa msempha. Zizindikiro Pankhaniyi sizimawoneka, wodwala sakudziwa cha kukhalapo kudwala izi. Ndicho chifukwa chake ngati munthu ali pangozi (kusuta, kuthamanga kwa magazi, mbiriyakale banja la milandu kung'ambika kung'ambika), nthawi zonse tiyenera kukumana wathunthu matenda kuwunika. Pakuti zolinga zimenezi, ambiri ntchito ultrasound, aortography ntchito Kujambula Mosiyana wothandizira. Panthawi yake kudziwika matenda akhoza kupulumutsa moyo.

Pomaliza

Nkhaniyi ili ndi mfundo zokhudza "An aneurysm wa msempha za mtima. Zoyambitsa, Zizindikiro ndi Chithandizo" Usaope cha matenda, monga matenda yake ndi mankhwala woyenera mu magawo oyambirira choti pafupifupi muyaya kuyiwala za vutolo.