Doppler yoopsa: zochitachita decoding

Today ku matenda a malformations yoopsa ndi nthenda yotaya yachibadwa matenda mimba akugwiritsa ntchito zipangizo zamakono kuti amalola kuyang'ana pa vuto kuchokera mkati. zida akupanga chimagwiritsidwa ntchito matenda ndi kusanthula matenda ndi zikhalidwe za thupi. Maphunziro amenewa ndi mwamphamvu mu yochizira matenda ndi pafupifupi singasiyanitsidwe mu ndondomeko chidwi ndi mankhwala. Kwa amayi oyembekezera, kuwonjezera pa maphunziro zonse adzaika yoopsa ultrasound ndi Doppler velocimetry. Sizachilendo kumapeto kwa malo chamankhwala.

Doppler

Kwa nthawi yonse gestation mwana mkazi yoikidwiratu kuphunzira ultrasound makina. Pamisinkhu yosiyanasiyana mimba, yoopsa Doppler akapatsidwa kufufuza ndi kuteteza matenda kakulidwe. Doppler - ultrasound ndi imodzi mwa mitundu, amene kawiri kawiri zimachitika pa miyezi yomaliza ya mimba, kawirikawiri mu trimester lachitatu.

Phunziro kwa magazi chapakati mitsempha mwana wosabadwayo, chiberekero, ndi latuluka kuonanso magazi mathamangidwe ndi boma ziwiya zazikulu ndi mitsempha umbilical, kupereka chilimbikitso komanso zakudya mwana wosabadwayo. Kuchita phunziro limeneli kumafuna nozzle wapadera. Childs, Doppler ultrasound imagwiridwa pamodzi ndi chachikulu kapena angathe kuperekedwa ngati osiyana, zina dokotala kuphunzira.

Kusankha ultrasound ndi Doppler

Doppler kudziwa kukula enieni, m'mimba mwake ndi malo mitsempha waukulu, zipatso osati kokha, komanso latuluka, umbilical chingwe, chiberekero ndi mkazi, magazi mathamangidwe mu zotengera, komanso zimathandiza kuti yake kudziwika pamaso pa monyanyira kapena ikutha ntchito ya latuluka, amene mwina nyengo yachisanu ikupita mavuto osiyanasiyana onse pa mimba ndi pa ntchito. Choncho, kufunika kafukufuku ena sayenera saganizira. Choncho yake Doppler yoopsa mawu olembedwa a magawo ake mpata kugwira ntchito yokonza njira, tisaletse chikhalidwe ndi kupewa ngozi zotheka.

Zikuonetsa kuti Doppler

Doppler apeza zina zomwe zingafunike kuti asankhe, ngati mayi woyembekezera anapeza matenda otsatirawa:

• Preeclampsia.
• Hypertensive matenda a mtima.
• matenda a impso.
• Shuga.

Komanso Doppler wosabadwa awerenge pa kuzindikira mwamsanga matenda kakulidwe, olumala, kakulidwe yomweyo, oligohydramnios, n'zotheka kusasitsa msanga wa latuluka, ndi umbilical kuvutika chingwe mu dongosolo kapena kuvutika kobadwa nako chromosomal, mitundu choopsa cha matenda a mtima ndi zina zotero. D.

Kuphunzira uterine mtsempha wamagazi Doppler njira

Doppler kuphunzira mtsempha wamagazi uterine kupenda boma la dongosolo mtima wa chiberekero, nsengwa, mezhresnichnogo danga. Mapangidwe mezhresnichnogo malo akupezeka ngakhale pa implantation wosabadwayo, pafupifupi sabata pambuyo pathupi. magazi aziyenda bwino mu chiberekero mkazi ikuchitika ndi nawo mitsempha awiri: yamchiberekero ndi uterine. Ngakhale pa mapangidwe a latuluka mu mpanda wa mitsempha, ena kusintha kumachitika, zomwe kenako kutsogolera kukula ndi kukula mu kufanana ndi kukula kwa latuluka lapansi. Monsemo mnjira, uteroplacental magazi aumbike kumaliza mapangidwe nsengwa ndi kuchuluka nthawi 10.

Uterine mtsempha wamagazi Doppler walola kuti asa- kugwira ntchito kwa mwauzimu mtsempha wamagazi mapangidwe amene kumathera pamwamba ya trimester 3. Ngati mavuto mkatimkati mwa mimba zimachokeradi mu mitsempha onse kusintha thupi, kotero iwo alibe kukuza ndi kukula pa kukula kwa latuluka lapansi. Potero mitsempha kukhala sangathe kuonetsetsa mokwanira aziyenda ndi nthenda yotaya magazi kwa latuluka, amene zingachititse kuti imfa kapena akusowa zakudya, oxygen. Zimenezi, kungachititse kuti detachment wa latuluka, padera ndi padera.

Doppler: mawu olembedwa

Pa phunziro Doppler pa ultrasound chipangizo chophimba akuonetsa chifaniziro mawonekedwe a magazi mathamangidwe mu mitsempha pa lililonse mkombero mtima, amene amasiyana ndi systolic ndi diastolic. Kuti timvetse m'tsogolo, zimene uli pangozi, kodi mawu olembedwa:

• Systole - kuthamanga chifukwa cha kuchepetsa minofu mtima.
• Diastole - ndi kuthamanga kwaiye pa zosangalatsa za minofu mtima.

Choncho, mtima umodzi kumenya kuwerenga kuwonekera systolic ndi diastolic magazi mu mitsempha ya. Pakuti aliyense wa ziwiya mayeso ndi malamulo chake ndi makhalidwe magazi lililonse otaya mathamangidwe zokhotakhota.

Kupenda mfundo ndi zizindikiro magazi ntchito akalozera zotsatirazi:

• Systolic-diastolic chiŵerengero.
• Kugunda index.
• kukana index.

Systolic-diastolic chiŵerengero, adzionere index ndi kukana index kusonyeza boma la mitsempha yaikulu ndi msempha ndi magazi mwa iwo, chimene chiri cholinga cha maphunziro ano, monga Doppler lapansi. Mchikhalidwe ndi zolakwika kwa iwo kusonyeza osiyanasiyana kuyan'anila za chitukuko yoopsa, chimatanthauza kudwala kugwirizana ndi zotsatira za magazi kubala mwana. Choncho, adokotala akhoza kuwunika kugwira ntchito nsengwa ndi viability zake, Zinapereka mpweya wa mwana wosabadwayo kudzera chingwe umbilical, komanso zopindika zotheka mu chitukuko yoopsa kugwirizana ndi matenda magazi ndi matenda a minofu mtima.

Doppler: malamulo

Kuonanso bwino zotsatira za Doppler maphunziro ntchito tebulo wapadera wa makhalidwe abwino. Iwo mwachindunji malamulo onse zovomerezeka yoopsa Doppler kwa zizindikiro zitatu:

• Systolic-diastolic chiŵerengero.
• kukana index.
• Kugunda index.

Maphunziro amenewa ayenera kuchitika amayi apakati, koma ndi lofunika kwambiri kwa aliyense amene ali pangozi ndipo ali ndi mavuto ndi magazi, kapena kupunduka cholowa.

Doppler yoopsa ndi mtima kuphunzira ultrasound amasankhidwa kwa nthawi ya masabata 23 a mimba. Nthawi imeneyi, ndondomeko ndi zogwirizana kwambiri ziyenera gulu chiopsezo cha matenda oyamba ndi malformations placental, kungachititse kuchotsa mimbayo. Koma kafukufuku idzachitika kuyambira masabata 13 mpaka mapeto a mimba. Mlungu uliwonse ali Doppler ake akalozera mwini. maphunziro onsewa akutsatiridwa kufufuza mitsempha zazikulu zitatu: umbilical mtsempha wamagazi, uterine, yoopsa msempha.

Chizindikiro systolic-diastolic chiŵerengero, kuyambira masabata 20 a mimba, ayenera kukhala 2.4 kapena zochepa.

kukana index kuchita masamu kuti mtsempha wamagazi umbilical, uterine, ndi MCA. The m'chigulugulu ndi:

• mayi - zosakwana kapena wolingana 0,58;
• chifukwa mtsempha wamagazi umbilical - ndi zosakwana kapena wolingana 0,62;
• index ayenera kukhala osachepera kapena wolingana 0,77 pakati oziziritsa mtsempha wamagazi wa mwana wosabadwa.

Pakuti theka lachiwiri la mimba, Chiwerengerochi pafupifupi sichinasinthe. Ndi mapeto a nthawi ya zizindikiro gestation wa systolic-diastolic chiŵerengero sayenera upambana mayunitsi awiri.

kusonyeza mfundo

Doppler 3 trimester maphunziro yoopsa magazi ndi limathandiza kuti matenda oyambirira, cholinga kupewa placental insufficiency, chithandizo cha preeclampsia ndi kusintha khalidwe la magazi m'zotengera uterine. Kudziwa kuchepa makhalidwe zikutanthauza diastolic, systolic-diastolic chiŵerengero ndi bwino kwambiri, ndi zimenezo, ndi index zina, anawerengetsera pa maziko ake, akuchuluka.

Pamene Doppler lachiwiri ndi lachitatu teremu mimba mwapadera linaperekedwa kwa akatswiri mtsempha wamagazi umbilical. The pamapindikira atamva za mtsempha wamagazi chapakati cha magazi umbilical chingwe amatenga zofunika pambuyo pa sabata chakhumi cha mimba. Mu mbali iyi ya otaya diastolic mwazi sizingathe kuonedwa kwa milungu 14. Mu yoopsa chromosomal chosayenerera amene ali ndi khalidwe pa masabata 10-13 gestation zambiri olembedwa n'zosiyana diastolic otaya.

Mu wopepuka mimba mlingo systolic-diastolic chiŵerengero si upambana mayunitsi atatu pa pamapindikira kusonyeza m'magazi. Pakuti kudwala yoopsa yodziwika ndi utachepa kutha diastolic mathamangidwe mpaka mofulumira wathunthu.

Ndi mwezi wachisanu mimba ndi patsogolo zizindikiro zofunika kwambiri yodziwira ndi kafukufuku zipatso za magazi. Imafufuza makamaka msempha ndi mtsempha wamagazi pakati ubongo. Khalidwe utuluke izi magazi ndi mkulu pamakomo systolic kuthamanga kusintha mu msempha, nthawi zambiri limodzi ndi kuchepa mu ntchito diastolic. Ang'onoang'ono iwo ali, ndi apamwamba chiopsezo pathologies. Mkhalidwe kwambiri akumane ndi ziro mtengo diastolic chigawo.

Pakuti pakati oziziritsa mtsempha wamagazi kusintha matenda mu magazi akhozanso kukopeka M'malo mwake, akuchuluka mu chigawo diastolic, amene nawonso, kumasonyeza hyperperfusion oziziritsa ndipo ikusonyeza chitukuko cha hypoxia yoopsa.

Mu kuphunzira magazi ambiri venous ritsa nsonga systolic zatenga kwambiri m'dera chidwi a pamapindikira ndipo chamadzi popanda kusintha mwadzidzidzi nthawi akusunsa kuwonekera diastolic zikuluzikulu za nthawi yochepa. Choncho, pamapindikira lonse zayamba yunifolomu popanda odzipereka nsonga lakuthwa. Ngati amaimira nsonga mkulu wa systolic chigawo, kapena kutha kwa kuthamanga diastolic, kungasonyeze chromosomal yoopsa kudwala, komanso pakutchulidwa wa hypoxia yoopsa.

Yolondola njira ultrasound Doppler ndi pafupifupi 70%. The yabwino kwambiri ndi kuphunzira utero-placental ndi yoopsa-placental magazi, omwe ali pafupi kwathunthu akhoza oterewa matenda osiyanasiyana.

Kufufuza zotsatira kuphunzira

Malinga akalozera zosiyanasiyana matenda a magazi zizindikiro ogaŵikana madigiri osiyana:

• 1 digiri - chisokonezo ichi mu otaya uteroplacental magazi pa zonse zipatso placental magazi kapena placental kuphwanya zipatso ndi uteroplacental unmodified.
• 2 digiri - ndi kusintha kamodzi ndi chisokonezo mitundu onse a mwazi utuluke, zizindikiro zimene samafuna mfundo iliyonse yovuta, koma iwo ali nawo malo kukhala.
• Kalasi 3 - ndi kupezeka kwa kuyan'anila yovuta mwa mawu a zipatso placental magazi, kaya kusintha kapena kuswa zazing'ono utero-placental magazi.

Zikuonetsa kuti Doppler Kusankhidwa

Yoopsa Doppler angathe kuperekedwa kamodzi kapena kawiri m'kati mimbayo monga ndondomeko chizolowezi. Nthawi zina Kwalamulidwa zambiri. Izi zimachitika ngati pali mavuto kapena pathologies wa mwana wosabadwayo, kapena chofunika chikhalidwe cha chiberekero ndi latuluka. Pali mndandanda wa zizindikiro zimene chabe muyenera kuonetsetsa ndi Doppler otaya maphunziro:

• Ngati m'badwo mayi ndi zaka kuposa 35 kapena zosakwana 20 (oyambirira kapena mimba mochedwa).
• Polyhydramnios ndi oligohydramnios.
• Pa kale kuphunzira opangidwa ultrasound makina anaulula chingwe kukodwa.
• chitukuko yoopsa lags kumbuyo malamulo anakhazikitsa.
• Mayi anati matenda aakulu okhalitsa.
• Pamene mimba yapita idatha padera kapena ana anabadwa ndi zilema kwambiri kapena atafa kale.
• Ngati pali kukhala kukayikitsa malformations.
• Pamene mimba angapo.
• Ngati mayi ali ndi zoipa RH chinthu, zomwe zingadzetse kusalandira mwana wosabadwayo ndi makope osauka.
• Pa osagwira CTG magawo.
• Ngati anali ndi malo pakati m'mimba zoopsa.

Ngati pali kuopseza ndi kusokoneza mwadzidzidzi mimba, onetsetsani maphunziro kusankhidwa Doppler kudziwa zimayambitsa mantha amenewo. Pankhaniyi, mkazi wogona mu tsiku kuchipatala, komwe yoyamba akuwerengedwa mosamala pa Doppler ultrasound ndipo amalandira timadzi mankhwala kuti kukhala ndi mimba mawu akuti, umene n'zotheka kuchita yobereka otetezedwa ndi chiopsezo kochepa.

Kukonzekera Survey

Pokonzekera maphunziro Doppler ku pakati zofunika kwa maola angapo pamaso pa ulendo wa ofesi US kutenga chakudya kenako okha madzi. Pakuti anayamba kuphunzira ayenera kugona pabedi pafupi ndi makina pamsana pake, kuwulula nthawi yomweyo m'mimba ku chifuwa kuti groin lapansi. Padziko pamimba wa pakati ntchito limodzi kapena angapo m'malovu a gel osakaniza wapadera conductive kumathandiza malowedwe a akupanga mbendera ndi superimposed kachipangizo wapadera, zimene zimachititsa bwino padziko pamimba.

Yoopsa Doppler angathe kuchitidwa monga wakuda ndi woyera zovala, ndi pa mtundu pano imene ultrasound katswiri adzaona zokhotakhota ndi nsonga osonyeza mphamvu ndi mlingo wa zopatuka kapena magazi mu mitsempha. Zotsatirazi, dokotalayo adzabweretsa deta tinasonkhanitsa pa kumupima, ndipo usazilembe kuti mawu olembedwa, kenako adzakupatsani mapeto a Doppler ultrasound m'manja mwa mayi oyembekezerayo.

Doppler yoopsa zizindikiro ndi kumasulira kwawo adzakhala thandizo wabwino kwa azamba-gynecologist pa kayendetsedwe ka amayi apakati kukonzekera otetezeka yobereka ndi ulamuliro zosokonezeka. Kuunikira ziwalo za mwana wosabadwayo mwa Doppler maphunziro ndi chosavuta kwambiri ndipo wakhala zaka zambiri zimatsimikizira Mwachangu ake ndi zoona. A ambiri maphunziro imachitika zaposachedwapa, thandizani anayendera chitetezo ndi luso ultrasound, kuchotsa kuthekera kuvulaza thanzi la mayi woyembekezera ndi mwana wosabadwayo.