Kung'ambika vavu: kapangidwe, ntchito limagwirira. Stenosis ndi insufficiency wa valavu kung'ambika

Kung'ambika valvular matenda a mtima nthawi yodziwika ndi khalidwe anagula ndi kuwonetseredwa kukomoka yekha mu ukalamba. pamaso pawo zingachititse aakulu hemodynamic chisokonezo. The kukula kwa matenda ndi kusintha zokhudza mavavu ndi kulisiya.

Kapangidwe ka mtima: mavavu

The mtima ndi thupi dzenje chomwe zipinda zinayi. The lamanzere ndi lamanja amachepetsa ankasiyana partitions imene palibe dongosolo Komabe, pakati pa atrium ndi ventricle mbali ali dzenje okonzeka ndi valavu. nyumba izi n'zotheka kuti zonse magazi, kuteteza regurgitation, mwachitsanzo kuponyera iwowo.

Pa anachoka kumeneko valavu mitral tichipeza kuli nthambi ziwiri, ndipo kumanja - ndi tricuspid, lili timapepala ta atatu. Mavavu Amawapatsa ulusi tendon, amene amaonetsetsa kutsegula mbali imodzi yokha. Zimenezi zimathandiza backflow magazi mu atrium kuponyera. Pa kusintha kwa ventricle kumanzere mu msempha, kung'ambika vavu kumeneko. Ntchito yake - kupereka Kukwezeleza mmodzi ndiye amaganiza magazi mu msempha. Kumanja komanso ndi valavu wa mtsempha wamagazi ndi m'mapapo mwanga. mabungwe onse amatchedwa "semilunar" aliyense timapepala ta atatu. chosayenerera aliyense, mwachitsanzo, calcification wa valavu kung'ambika, kumabweretsa kusokoneza kayendedwe magazi. zopindika anapeza zambiri amagwirizana ndi matenda aliwonse. Choncho, anthu ndi zinthu otchedwa chiopsezo ayenera ndisanabadwe zonse: makamaka echocardiogram.

Limagwirira wa valavu kung'ambika

A mbali yofunika kwambiri kupezeka pa masewero valavu kung'ambika. kutseka kuti uchiwo usatuluke The munasindikizidwa kapena adzafupikitsidwa - ichi ndi chimodzi mwa pathologies waukulu. Zimakhala chifukwa cha Kusakhazikika hemodynamic. Ntchito gawo ili la thupi - kuonetsetsa Kukwezeleza magazi kuchokera atrium kumanzere mu ventricle ndi, kuteteza regurgitation. mavavu ali kutsegulidwa pa systole matenda, pa mwazi nthawi anauza valavu kung'ambika mu ventricle lapansi. Komanso, kutseka kuti uchiwo usatuluke amakhala otseka kuteteza kuponyera iwowo.

Mtima zopindika: Gawo

Ndi nthawi yatsoka ndi tingaone olumala mtima (kung'ambika valavu ndi mabungwe ena) ndi zinazake. kusintha bwanji mavavu osati malinga mtima. olumala nthawi zambiri zimagwira zikhale zovuta oterewa ndi kuchitira.

Kung'ambika vavu stenosis

Kudwala kumaphatikizapo kuchepetsa wa kusintha kwa ventricle kumanzere mu msempha - amakhudza timapepala ta valavu ndipo zimakhala ozungulira. matenda, malinga ndi zizindikiro zowerengera, ambiri mwa amuna. Kusindikiza kwa mpanda wa msempha ndi valavu kung'ambika ndi ambiri kugwirizana ndi zotupa enaake ophwanya ndi osachiritsika. Komanso, monga etiologic wothandizila akhoza kuchita endocarditis, nyamakazi. matenda amenewa kungachititse maphatikizidwe wa slats, potero kuchepetsa sayenda awo ndi vavu sangakhale kwathunthu pa nthawi systole wa ventricle kumanzere. Mu ukalamba, chifukwa cholephera zambiri atherosclerosis ndi calcification wa timapepala ta kung'ambika valavu.

Chifukwa cha kuchepetsa wa orifice kung'ambika pali kusintha kwakukulu mu hemodynamics. Iwo anaona pamene mlingo wa stenosis amalifotokoza - kuchepetsa kapepala ndi oposa 50%. Zimenezi zimabweretsa chakuti masinthidwe amtundu wa kusintha kung'ambika vavu kuthamanga - kung'ambika kuthamanga amakhalabe wabwinobwino, koma kumawonjezera mu ventricle kumanzere. Kuchuluka kukhudzana pa mpanda wa ventricle kumanzere kumabweretsa chitukuko cha hypertrophy compensatory, kutanthauza kuti thickening ake. Kenako anasokonezeka ntchito diastolic ndi zimene zimachititsa ponso mu kuthamanga mu atrium kumanzere. Hypertrophy kumabweretsa kufunika kuchuluka mpweya Komabe, kuchuluka m'mnyewa wamtima misa nkhani kwa kotunga yapita magazi ndipo ngakhale kuchepa pathologies concomitant. Zimenezi zimabweretsa chitukuko cha matenda a mtima.

chipatala

Mu magawo oyambirira a akhudzidwa vavu kung'ambika akhoza alibe kuonekera. kusintha matenda zimachitika pamene kutsegula chiletso ku 2/3 la yachibadwa. Mu yaikulu aakulu odwala kuyamba kusokoneza ululu, isanafalikire kumbuyo breastbone lapansi. syndrome ululu Nthawi zina, akhoza kugwirizana ndi imfa ya kutsitsimuka chifukwa zokhudza zonse vasodilatation. Mapangidwe matenda oopsa m'mapapo mwanga zikubweretsa kufupika kwa mpweya, amene poyamba okha ndi katundu, komano pali zina. Protracted matenda N'zoona chimakhala chifukwa cha kulephera aakulu mtima. Kudwala amafuna chithandizo opaleshoni, monga pali chiopsezo cha kuwonongeka, ndi imfa ya nthumbi mtima.

diagnostics

Kuzionetsetsa, odwala ndi khalidwe pallor kugwirizana ndi wotsikirapo linanena bungwe mtima. Zozungulira mtsempha wamagazi zimachitika pa sadzachitanso zimadziŵika - ndi osowa ndi ofooka. Auscultation anati chifooke malankhulidwe 2 kapena akuwaza. ECG si mokwanira nkhani - zizindikiro za hypertrophy atsimikiziridwa okha stenosis kwambiri. The echocardiography kwambiri kuwulula kuti awunike vavu kung'ambika. The kutseka kuti uchiwo usatuluke munasindikizidwa ndi unakhuthala mwapang'ono kutsegula - ndi yaikulu matenda muyezo umene ungatithandize kudziwa phunziroli. Mlingo wa stenosis ndi kuthamanga masinthidwe amtundu bwino kudziwa catheterization cavities.

chithandizo

Pakuti wofatsa ndi zolimbitsa stenosis amafuna yekha kuwukonza moyo - kupewa kuchita masewera olimbitsa thupi kwambiri, mankhwala a comorbidities. Ndi kuchuluka pafupipafupi achidule tisonyezeni blockers, ndi mtima kulephera okodzetsa ogwira, mtima glycosides. Kulankhula chisindikizo mpanda wa msempha ndi valavu kung'ambika amafuna chithandizo opaleshoni. Zambiri imachitikira prosthesis kapena zibaluni dilatation.

Kung'ambika vavu insufficiency

The dzina kudwala yodziwika mapiko nesmykaniem. zodabwitsazi amatsogolera ndi kubweranso kwa magazi m'ng'anjo ventricle kumanzere kuti zidzachitika diastole. Malonjezo kum'mawa ndi zambiri vuto la endocarditis infective ndi enaake ophwanya. Pasanathe nthawi zambiri kumayambitsa chindoko, kung'ambika aneurysm, ndi msempha, matenda oopsa, syndrome Marfan ndi zokhudza zonse lupus erythematosus.

Kung'ambika vavu kungathandize kwambiri kupezeka pa. Chosakwanira kutsekedwa mapiko ake amachititsa regurgitation, ie, kubwerera kwa magazi lamanzere ventricle kuponyera. Chifukwa ndi magazi kwambiri voliyumu ya M'mimbamo ake, imbaenda zimamuchulukira ndi stretchability. Kutanganidwa systolic ntchito ndi kuthamanga kwa magazi kumabweretsa chitukuko cha hypertrophy. Retrograde ukuwonjezeka kuthamanga mu bwalo kakang'ono - zooneka oopsa m'mapapo mwanga.

chipatala

Monga stenosis, kudwala zimapangitsa lokha anamva okha digiri aakulu kulephera. Pamene yaikulu kufupika zachitika, amagwirizana ndi matenda oopsa m'mapapo mwanga. Ululu kusokonezedwa okha 20% ya milandu. Pa nthawi yomweyo anafotokoza auscultation ndi zizindikiro za kudwala:

1. Pulsation ya mitsempha carotid.
2. Zizindikiro Duroziez kapena yatsoka systolic kudandaula pa mtsempha wamagazi ndi femoral. Kumachitika pamene iye wotsinidwa pafupi pamalo omvetserawo.
3. Zizindikiro angioedema - kusintha mtundu wa milomo ndi misomali malinga ndi pulsation wa arterioles lapansi.
4. Traube malankhulidwe awiri, mokweza, "Cannon" amene angapeze pa mtsempha wamagazi ndi femoral.
5. Zizindikiro de A Musset, akuwonetseredwa kugwedeza mutu wake.
6. Diastolic phokoso pambuyo 2 malankhulidwe zikuchitika padziko auscultation mtima, komanso zofooketsa 1 phula.

diagnostics

njira zomveka monga echocardiography ndi catheterization cavities. Iwo adzalola inu kuti aone vavu kung'ambika, komanso younikira voliyumu ya magazi regurgitated. Pamaziko a maphunziro awa anatsimikiza zovuta wachiwiri ndipo analankhula nkhani ya kufunika opaleshoni.

chithandizo

Aakulu kusowa kwa buku lalikulu regurgitation, tamaliza symptomatic amafuna chithandizo opaleshoni. Mulingo woyenera zokolola - yokumba kung'ambika mavavu, moti inu kubwezeretsa mtima ntchito. Ngati ndi kotheka, anatumizidwa mankhwala symptomatic.

Stenosis ndi valavu kung'ambika - ndi zilema ambiri mtima, amene amakhala zotsatira za matenda wamba kapena zokhudza zonse. The kudwala m'kati m'malo pang'onopang'ono, amene amalola nthawi oterewa. njira yamakono ya mankhwala kuthandiza kubwezeretsa vavu ntchito ndi kusintha alili.