Muscat chiwindi: thunthu, histology, patomorfologija

Muscat chiwindi - chifukwa cha matenda congestive venous plethora a ziwalo. chikhalidwe ichi zimaonekera osati dongosolo m'mimba, koma pa mtima, mapapo, impso ndi ubongo.

Gawo

Morphologically pali magawo atatu a kusintha kumene kunachitika chiwindi matenda m'kati:

1. Muscat chiwindi: pa maziko a maselo mafuta (chikasu) anawona vasodilatation (mdima wofiira).
2. Patsogolo fibrosis: nsalu kwambiri wandiweyani chifukwa cha minofu connective wa kumera. Magazi m'makala ndi parenchyma wa limba, komanso kuwonekera zotupa sclerosis.
3. Mtima matenda enaake: thupi pamwamba amakhala maonekedwe m'goli.

etiology

Kulakwila otaya magazi zotsatira dongosolo zipata mu mapangidwe zochitika monga muscat chiwindi. Zimayambitsa stagnation - kuphwanya ntchito yamitsempha yamagazi ndi kuchepetsa venous kubwerera. mawonetseredwe Izi kulephera congestive mtima, ndipo nthawi zambiri limodzi ndi matenda a mitima. Kuthamanga mu dongosolo venous, komanso kuchulukana ndi stagnation magazi mu zotengera magazi kungafoole zothandiza magazi ziwalo.

EPIDEMIOLOGY

Matendawa zosagwirizana ndi akazi kapena amuna kapena zaka. Koma powerengera ambiri a iwo amagwira amuna ndi senile okalamba. Nthawi zambiri yekha autopsy tingadziwire kuti wodwala ali ndi chiwindi Muscat. Necropsy akhoza kupereka mayankho a mafunso amene chidwi dokotala. Kuchita izi, mabungwe omwe si zowoneka yekha ayesedwa, komanso anatumiza Kupenda histological.

zinthu chiopsezo cha matenda chiwindi ndi asamapereke, zakudya osauka, zizolowezi zoipa, pamaso pa matenda a mtima mu mbiri, komanso zaka wachikulire munthu.

chipatala

Nthawi zambiri, mtima kulephera zizindikiro amachuluka mu chithunzi matenda a matenda, kotero wodwala akhoza kukhala kuti sakudziwa kuti iye ali ndi vuto la chiwindi. Muscat chiwindi, komanso matenda enaake ina, anaonetsa ululu ufulu nusu chapamwamba, matenda a chikasu ndiyo wa khungu ndi mucous zimagwira ntchito zosiyanasiyana, kutupa mu miyendo pa mapeto a tsiku, ascites (kudzikundikira madzimadzi mu zonse m'mimba). Koma zizindikiro zonse umboni. Ikani kwathunthu akhoza matenda pokhapokha autopsy, chifukwa palibe njira zamakono kulingalira sangathe kusonyeza ngati thupi akufanana ndi nutmeg. Chiwindi palpation ndi wandiweyani, m'mphepete ndi adzakhale ndi anatuluka ku Chipilala costal.

diagnostics

Pofuna kuti matenda "aakulu chabe venous kuchulukana", muyenera:

1. Kuti atsimikizire pamaso pa kulephera mtima (instrumentally kapena Kupenda thupi):

• X-ray a chifuwa (kusonyeza anasinthira venous kuchulukana mu mapapo, kapena kukhalapo kwa effusion pleural);
• Doppler Kupenda mtima, wosakoma vena cava (kudziwa zimene zimayambitsa matenda a mtima);
• CT kapena Kujambula;
• ECG.

2. kugwira mayesero choyezera, monga umagwirira magazi ndi mayesero chiwindi ntchito :

• magazi bilirubin adakula;
• amtengo kuchuluka transaminase (alt, Ast);
• kuenjezera phosphatase zamchere;
• ndichepe mu albumin ndi kutalikitsa nthawi clotting.

3. Amachita diagnostics malangizo, kukhazikitsa mfundo za morphologically alibe chiwindi. maphunziro njirazi ndi izi:

• laparocentesis (ufulu aspirating madzimadzi kuchokera zonse m'mimba) kudziwa zimayambitsa ascites;
• singano biopsy (kutsimikiza matenda "muscat chiwindi" zithunzi angathe kukhala ndi moyo wodwalayo).

matenda poyerekeza zikuphatikizapo matenda monga matenda enaake mowa, khansa, matenda a mtima, hemochromatosis, thrombosis wa otsika vena cava ndi matenda oopsa zipata. Musaiwale za matenda tizilombo chiwindi - kutupa A, B, C, D, E. Komanso, pali kuthekera kwa matenda parasitic.

zosokonezeka

Muscat chiwindi ndi kuchititsa matenda enaake ake mtima sanali kwambiri zotsatira za matenda a mtima. Nthawi imene pachimake chiwindi kulephera anali chifukwa cha imfa, n'zochepa ndipo sangatengedwe kukhala zimasonyeza. Magazi matenda - komanso n'zochepa kwambiri, ngakhale kale lonse. Akatswiri ena akuganiza kuti pali kugwirizana pakati pa chiwindi matenda enaake ndi zochitika za zotupa zilonda, koma chiphunzitso sikuti zatsimikiziridwa.

chithandizo

mankhwala ayenera kuthetsa matenda vutoli, mwachitsanzo kulephera mtima. A matenda enaake mu payokha ilibe mankhwala enieni. Komanso, mtima wa akulangizidwa kutsatira zakudya ndi kuletsa mchere ndi achinsinsi kusintha dongosolo la tsiku lanu kugona bwino, kukhala panja ndi masewera olimbitsa thupi mokwanira. Izi mwai yosavuta yomwe ingakuthandizeni kuchepetsa magazi mu zotengera kwambiri, kuphatikizapo m'mitsempha zipata.

mankhwala Symptomatic ndi okodzetsa (kuchepetsa wa madzimadzi m'mimba), ndipo beta-blockers ndi Ace zoletsa (kuti normalization kwa mtima).

Opaleshoni chithandizocho zambiri osati anachita. Iwo amagwirizana ndi pangozi yaikulu wodwala ndipo si zifukwa lokha. Nthawi zina adokotala akhoza kugamula kuti kuzilambalala mbali ya intrahepatic mtsempha zipata, koma zimenezi zingapangitse kulephera aakulu mtima wa mtundu woyenera yamitsempha yamagazi ndi edema m'mapapo mwanga chifukwa zikuchepa kuonjezera venous kubwerera.