Aortoarteriit nonspecific: Izimpawu kanye Ukwelashwa Izindlela

Okwamanje, kunezinhlobo lenqwaba izifo ezingathinta izitho ezihlukahlukene futhi zomzimba. Kodwa phakathi kwabo kukhona labo abakhetha ukukhetha ubulili ethile. Kulesi sihloko, thina simazi kangcono esinye salezi zifo - kuyinto aortoarteriit nonspecific, okuvame uhlushwa wobulili besifazane, kanye nentsha. Lesi sifo ngokuvamile kutholakala amazwe ase-Asia. Ake sibheke izimbangela zalo, izimpawu, futhi kanyekanye nixoxe ukuthi kungenzeka ukuba sibhekane nale egunjini lokuhlolwa kwezifo.

Ingqikithi yalo isifo

aortoarteriit Nonspecific iyisifo rheumatism lapho kukhona ebusweni ukulahlekelwa kwangaphakathi lemithambo namagatsha awo. Uma ukuvuvukala iqhubeka, semithambo odongeni ukuqina, bushelelezi imisipha ungqimba siqala ukubhodloza phansi futhi zithathelwe indawo ezicutshini, futhi igazi izitsha avele granulomas ehlanganisa cell omkhulu.

Ngenxa yalokho yegazi izinqubo ezinjalo ukuze sandise futhi iqhubu eba useshonile. Uma inqubo akuvimbi, khona-ke evala esiqedayo away of imicu enwebekayo yezicubu ka bushelelezi kwemisipha izicubu. Qala ebhekana kwezitho nezicubu ngenxa kahle ukugeleza kwegazi. Kuhlelo wezizwe ngezigaba izifo, isifo ngasinye has ikhodi yayo, hhayi ngaphandle aortoarteriit nonspecific. ICD M31.4 ukhishwa kuye ikhodi (yomthambo i-aorta lwaleli syndrome).

Izimbangela zesifo

Kuze kube manje, izimbangela ukuthi kumkhathaze ukuthuthukiswa kwalesi sifo, futhi ungazange sezisunguliwe. Abacwaningi abaningi abenza lolu daba, zinombono ukuthi akusiyo indima wokugcina kule eyadlalwa izifo, okuyizinto ezibangela immunodeficiency uthi. umbono okunjalo kwamiswa ngenxa yokuthi aortoarteriit non-ethize ngokuvamile uhlanganiswa izifo, okuncike izinkinga zesimiso sokuzivikela somzimba.

Okwamanje, kukhona iqembu lososayensi abathambekele ukuba zisekela umbono wentuthuko isifo sokuhlasela kwamasosha omzimba. Ubufakazi okungukuthi ukuthola iziguli plasma antiaortalnyh amasosha omzimba.

Singasho ukuthi lo mshini isifo sokuhlasela kwamasosha omzimba kungaqinisekiswa, kodwa ukuthi yimina yini eyinhloko, noma ekuphenduleni ukuvuvukala - uthi kuze kube manje kunzima.

Ukwahlukaniswa izifo

Aortoarteriit nonspecific kungaba ezahlukene kuye ngokuthi endaweni ethintekile:

1. Uhlobo lokuqala - kulokhu wamshaya lwaleli nabancane amagatsha yomthambo i-aorta kuphela ukunweba kuwo.
2. Ngo uhlobo lwesibili kukhona Umthambo ezithintekile thoracic futhi besisu.
3. Uhlobo lwesithathu - abathintekayo lwaleli yomthambo i-aorta ne thoracic futhi besisu.
4. Okwesine libhekene izilonda Umthambo yamaphaphu.

Ngoba noma yini kohlelo noma ukuthuthukisa aortoarteriit nonspecific (isifo Takayasu sika), ukukhubazeka okusongelayo ogulayo kaningi impela. Ikakhulukazi uma ukuxilongwa sekwephuzile.

symptomatology lesi sifo

Aortoarteriit izimpawu nonspecific ihlukile, incike efomini lesi sifo. Takayasu isifo kungenzeka isigaba chronic oyingozi.

Isigaba acute lesi sifo livezwa zimpawu ezilandelayo:

• ukukhathala Jikelele.
• Phakathi umsebenzi, ubuhlungu emisipheni nasemalungeni.
• Kubonakala ukuqubuka haemorrhagic.
• Thuthukisa erythema nodosum.
• Nokwandisa imingcele inhliziyo.
• Kubonakala nokububula systolic futhi ngezinye izikhathi diastolic.
• Ezimweni ezingavamile ka ubuhlungu besisu.
• Uma sifeza ukuhlolwa laboratory, babonisa anaemia ngokulinganisela, khona amaprotheni C-esisheshayo.

Kaningi, ukubonakaliswa izimpawu ezinjalo asitholakali kalula - "rheumatoid arthritis", "TB" noma "sepsis." Lokhu, ngeshwa, kwenzeka e-95% amacala.

Inqubekela phambili esigabeni ezingamahlalakhona lesi sifo

Uma izigaba lokuqala isifo ungathathi izinyathelo ngempumelelo ukwelapha ke, zokugula ngokushesha kuba amahlala khona. Symptomatology ihlukile kakade kusukela ukuthi esigabeni olunamandla ludlule:

• Cishe akukho ishayela kulolu hlangothi, futhi ngezinye izikhathi kokubili.
• Iziguli ngokuvamile zazisho esekhala ubuhlungu emikhawulweni, ukuthi nge okwandisa umthwalo iyakhula kuphela.
• Izandla buthakathaka, kwakunzima ngabantu ukuba ubambe izinto.
• Ngokuvamile iba isiyezi, okuyinto kungaholela nokulahlekelwa ukwazi.
• Uma uvakashela kudokotela wezifo zamehlo Kutholwe izinguquko fundus.
• Njengoba le nqubo ngokuvamile imithambo yenhliziyo, ke kungabonakala nasemkhakheni ukuhlaselwa ischemic.
• Lapho kunqotshwa le-aorta besisu uqale ahlupheke izinso.
• iziyaluyalu kwemizwa ziyabonakala njengoba ukunaka kahle futhi inkumbulo, linganciphisa umthamo wamandla ukusebenza.
• Uma emsipheni optic kuthintwa ngalesosikhathi jeza lo mbono, umbono double livela, kungase kube izimpumputhe kwelinye iso.
• Ukuzibandakanya Umthambo yamaphaphu okuholela ukuthuthukiswa iphika, ubuhlungu esifubeni.
• Vuma emalungeni ngezandla.
• Lapho nonspecific aortoarteriit esiphelweni inqubo iqala nge imithambo main, ngokuvamile kuholela umfutho wegazi ngenxa ukuvaleka imithambo yegazi.

Ngokuvamile, esigabeni acute lesi sifo kuba amahlala khona iminyaka 6-8. Iziguli kufanele uqaphele uma njalo bahlushwe ubuthakathaka, ikhanda elibuhlungu, ubuhlungu ngokuhamba imithambo ezinkulu, kusebentisana kahle futhi inkumbulo. Udinga ahlolwe ngokuphelele ukuze amise ukusazi ngokunembile isifo esikuphethe.

uphethwe

Uma kukhona izinsolo aortoarteriit non-ethize, ekuhlonzweni kubaluleke kakhulu. Lesi sifo obonwa odokotela, uma kukhona zimpawu ezilandelayo:

• Uma kukhona umehluko okukhulu blood pressure ezandleni ezahlukene.
• Pulse obuthaka kanzima noma cha avelayo.
• Kukhona claudication ngakanye.
• Lapho ukulalela umsindo nasemkhakheni aorta.
• Ukuhlolwa kwembula Umthambo ukuvaleka.
• Esingamahlalakhona of valve yomthambo i-aorta.
• ukwanda ziphikelele ingcindezi.
• ESR luyanda ngasizathu simbe.

Ekugcineni, ukuze usize ekutholweni izifundo ezilandelayo:

1. ukuhlaziywa kwamakhemikhali kwegazi kukhombisa ku kwezinso igazi ukuthi kukhona isici ukubhebhetheka kwalesi sifo.
2. Ultrasound ukuhlola izitsha ukuhlola isimo sabo futhi ngesilinganiso ukugeleza kwegazi.
3. Angiography nge Ngokuphambene umjovo kuthola lwemithambo constriction.
4. X-reyi yesifuba nokuthola indawo izilonda le-aorta ne-pulmonary Umthambo.
5. Echocardiography ukuhlola ukusebenza inhliziyo.
6. Ngu electroencephalography kungathola yokuphazamiseka imithambo yegazi cerebral palsy.

Ngakho, ngenxa yanoma yisiphi isifo, kuhlanganise e ezifana aortoarteriit nonspecific, umlando wezempilo iqala inhlolovo egcwele, okuyinto ihlose ukulungisa uphethwe.

ukuxilongwa umehluko

Kubalulekile kakhulu uphethwe ukuhlukanisa aortoarteriit anomalies azalwa naso we isimiso semithambo yegazi futhi thromboembolism. Kule yakamuva libhekene inkambo okukhulu ukwakheka okungenzeka ihlule legazi ngalo ingaphakathi of imisipha yenhliziyo.

Isici esibalulekile wukuthi non-ethize kuthinta aortoarteriit iqembu nemikhumbi, nakuba i-anomalies azalwa naso ahlupheke imithambo ezithile.

Uma bathembele nomfutho wegazi ophezulu uphethwe renovascular, kubalulekile ukukhumbula ukuthi ingakha izitsha isifo sokuqina kwemithambo yegazi kanye kwezinso. Uma aortoarteriit nonspecific eba ikakhulukazi abesifazane abasebasha, isifo sokuqina kwemithambo yegazi kuthinta amadoda amadala.

Kuphela ukuhlolisisa ephelele futhi onguchwepheshe oqeqeshiwe ngawo kuyosiza ekwenzeni lezi Ihlahlubo ukuqala ukwelashwa okuphumelelayo.

syndromes Clinical ngaphakathi zokugula

Njengoba sazi ukuthi kule zokugula kungathinta izingxenye ezahlukene izitsha ukuphakela igazi ukuze izibilini, kungenzeka ukwaba syndromes emitholampilo eziningana:

1. ukuntula syndrome ka-peripheral ukugeleza kwegazi. Ngesikhathi esifanayo kukhona ubuhlungu izingalo umuzwa ndikindiki iminwe. Uma ehlaselwa imithambo vertebral, ubuhlungu emuva lapho.
2. Senhliziyo syndrome - lihlotshaniswa ukuthuthukiswa kwegazi izibambiso. Can ukuxilonga izimpawu of myocarditis, ischemia.
3. Uma abathintekayo lwaleli yomthambo i-aorta, le ekuthuthukiseni cerebrovascular syndrome. Owabonakaliswa ikhanda, umbono encishisiwe, ukuphazamiseka kwegazi cerebral palsy.
4. Besisu syndrome livezwa ubuhlungu esiswini, okuyinto paroxysmal ngokwemvelo. Lokhu kubonakaliswa kuyoboniswa nguMbusi akuyona into engavamile e izilonda le-aorta besisu.
5. Kwegazi syndrome - ibonakala njengoba phetho izilonda kwemithambo yegazi kwezinso.

Ukwelapha

Uma uphethwe ukwelashwa "aortoarteriit nonspecific" kuhloswe ukuba:

1. nomthelela obalulekile focus ukuvuvukala, mhlawumbe ngokunciphisa ke esiphansi.
2. Fight nge yezinkinga ischemic.
3. Susa izenzo nomfutho wegazi ophezulu.

Kuthiwani uma umuntu has a aortoarteriit non-ethize? Sifo kwenziwe ukuhlolwa, ngokwesibalo samagama, umsebenzi Uchwepheshe - ukwakha lwemithi yokwelapha. Ukwelashwa kungase kube kanje:

• Imithi.
• Surgery.

Cabangela lobu bufakazi futhi izici indlela ngayinye.

ngemithi

Imithi aortoarteriit lapho ucabangela kobukhulu isimo lesiguli kanye ukugeleza izici ukuvuvukala. Izidakamizwa elandelayo enqunyiwe avame:

• "Prednisolone" e isamba 1-2 mg kilogram of isisindo isiguli ngasinye. Ukwamukelwa Kwenziwa for 1-2 izinyanga.
• Uma ukuvuvukala has a uhlamvu ababuthakathaka, uboniswa ethola aminohinolinovogo izidakamizwa, isibonelo, "do Lago" ukuze 0.25 g
• yokwelapha Basic kusekelwe yokwamukela "methotrexate". Umthamo kuyinto 7-10 mg ngayinye square imitha surface body endaweni. Reception - kanye ngesonto.
• ejenti Asizayo kukhona anticoagulants, inhliziyo namaphilisi kunciphise umfutho wegazi.

ukwelashwa has a uhlamvu njalo, uma kungekho ngcono noma kukhona ukuphazamiseka wawubona kwamalungu omzimba, ubuchopho, kutuswa ukuba iphendukele kokungenela kuhlinzwa.

ukwelashwa kuhlinzwa

Uma ukwelashwa ngoludala musa asize, futhi isimo iyovele ibhebhetheke, kufanele iphendukele ukunakekelwa kuhlinzwa. Ukuhlinzwa kusiza ukubuyisela igazi ligeleze kwezitho nezicubu. Kodwa-ke kumele kukhunjulwe ukuthi i ukuvuvukala kufanele kumiswe ngaphambi ukuhlinzwa. Kukhona izindlela eziningana ukuze lolu hlobo yokwelapha:

• Endarterectomy. It wenziwa khona angawodwa segmental occlusion kwemithambo yegazi, okuyinto ukusebenzisa ngokuqondile aorta.
• Agnioplastika kwenziwe uma kukhona izinguquko ezitsheni ngabanye nezinso.
• Dula ngokuxhunyelelwa Kwenziwa besebenzisa zokwenziwa sokwenziwa semithambo. sokungenela liphumelele izilonda semithambo amaningi.

Ngemva kwesikhathi ukuhlinzwa nokuvuselelwa kubalulekile, ukuhambisana udokotela izincomo.

Iseluleko iziguli

Sithole ukuthi aortoarteriit izimpawu nonspecific nokwelashwa kucatshangelwe, kodwa isiguli Kubaluleke ngokufanayo bagcine iziqondiso ezilandelayo:

1. Isiguli ngasinye kufanele uqaphele ukuthi ukwelapha lesi sifo kudinga isikhathi kanye nokubhekela aphoyintimenti zonke kadokotela.
2. Kuyadingeka ukuba zithobele icebo kanye umthamo imithi oye belulekwa kudokotela.
3. Njengoba ukuphuza esiningi izidakamizwa, kukhona ingozi nemiphumela ehlukahlukene enqabayo ngesikhathi yokwelapha. Ukunciphisa kubo, kubalulekile ukuba ibhekane izivivinyo njalo futhi pass ukuhlolwa.
4. Lapho Ukuwohloka isidingo ukwazisa onguchwepheshe.

Uma abanamathela lezi zincomo, therapy lesi sifo ngeke aphumelele kakhulu.

Onalesi sifo ngoba iziguli

Ngeshwa, ukuqeda aortoarteritis non-ethize akunakwenzeka, kodwa uma bonke izincomo udokotela nokwelashwa ngempumelelo ingafinyelela ukuthethelelwa. Lokhu kuzovumela iziguli ukuthi bahlanganyele imisebenzi evamile futhi ubuhlungu.

Ukuphumelela ukwelashwa incike kobukhulu ukuvuvukala khona izinkinga, futhi kuthintwa ukunemba nejubane ukuxilongwa. Ngakho ngenxa yokwelapha wawumuhle, kubalulekile ukuthola lesi sifo zisaqala.

Amagadango akhethekileko zokuvimbela kungukuthi enikeziwe.

Noma yimuphi isifo kudinga kalula, indlela kuphela ukufeza ngcono noma ukunqoba lesi sifo. Nakekela impilo yakho futhi bahlolwe njalo - ukuze ukwazi ukubona kahle kwezinso ngendlela efanele usaqala futhi ukukhetha ukwelashwa okuphumelelayo.