Useshonile le-aorta wenhliziyo - kuyini? Yomthambo i-aorta useshonile: Izimbangela, Izimpawu, Ukwelashwa

Phakathi yonke inhliziyo futhi semithambo izifo ezaziwayo odokotela ukuhlukanisa isigaba esimele ingozi enkulu ekuphileni komuntu. Kuhlanganisa isilethikusebenza, isifo sokuvuvukala kwemithambo yomthambo i-aorta. On the yokugcina, sixoxa ngokuningiliziwe esihlokweni.

useshonile yomthambo i-aorta wenhliziyo: kuyini nokuthi kuyingozi?

I-aorta - lokhu ingenye Umthambo ngobukhulu emzimbeni womuntu, okuyinto etholakala eduze inhliziyo. Ngokusebenzisa kwakhe, igazi ogeleza usuka imisipha eyinhloko kuyo yonke eminye imithambo. Senhliziyo useshonile yomthambo i-aorta kuyinto okungavamile, lapho ingxenye ukunwetshwa aorta ngenxa kwethonya izinto eziningi. Pathology kungaba azalwa naso noma bathenga ngokwemvelo.

Lesi sifo iqala neqiniso ukuthi ngaphansi ukucindezela ukugeleza kwegazi idabukile intima. Ngenxa yalokho, igazi uyakwazi ageleze ngqo ungqimba kwemisipha. Kuleli zinga isiguli ngokuvamile azizwa ukungakhululeki ubuhlungu esifubeni, esandleni sobunxele. isikhumba Pale, ingcindezi inyuka, kukhona izifiso nauseating. Ukuzigcwalisa igazi, udonga yomthambo i-aorta kancane kancane sisalokhu. Ngezinye ukudabuka lomuntu useshonile ungalahlekelwa ukwazi. Kwezinye izimo, kuba i ukufa osheshayo kusukela ezinzima ukopha futhi ukushaqeka.

I pathogenesis lesi sifo

Kangakanani useshonile inhliziyo le-aorta? Kuyini i-pathology, kungaqondakala uma wazi anatomy kwemisipha ezinkulu zomzimba womuntu. Ngo myocardium baye thinned izindonga ukuthi aphume ashone njalo ku ukudonsa igazi komunye ventricle kuze kube komunye. Uma umuntu inalesifo, elinganisela izindonga kancane kancane kubambezela. Lesi simo kwenza kube nzima njalo igazi ukudonsa.

Ngaphezu umonakalo ezindongeni le-aorta kwetinhlavu aneurysms nezinye izici asebenzayo hemodynamic kanye lokukhanda. Pathology ngokuvamile kwenzeka ezindaweni nokusebenza buhle ukuthi njalo ukuzwa umthwalo anda ngenxa egeleza velocity. Okungalapheki ukuhlukumezeka yomthambo i-aorta ne-umsebenzi ngokweqile enzyme proteolytic ukuyithukuthelisa nokwehliswa kwesithunzi Uhlaka nokunwebeka kanye ukubukeka nonspecific izinguquko esiwohlozayo nemvelo odongeni isitsha.

Kwakheka useshonile lukhula ngosayizi, njengoba ingcindezi odongeni wakhe kwandisa kuphela. Ngakolunye uhlangothi, ukugeleza kwegazi ku sac aneurysmal is ehlile futhi iba okuthiwa zeziyaluyalu. Ohlangothini distal,% 45 kuphela igazi liphuma okwamanje Imininingwane ku useshonile uqobo. Lokhu kungenxa yokuthi ku ingaphakathi layo egazini ageleza ngasezindongeni kokusakaza emaphakathi inakekelwa njalo omawala indlela futhi khona inqwaba ukugudluka thrombotic.

zokugula Izimbangela

Ososayensi ezivela emhlabeni wonke bayaqhubeka ngenkuthalo ukuhlola izifo ezifana useshonile inhliziyo le-aorta, lokho oyikho nalokho izici eziwumthelela ukuthuthukiswa yayo. Ngezansi kunezinye nje ezinye zazo:

1. Isifo sokuqina kwemithambo yegazi. zingcwecwe Sclerotic kwakheka Yiqiniso yalesi sifo, kungathinta odongeni yomthambo i-aorta ngibenze lugucugucuke.
2. ubunjalo ezithathelwanayo lesi sifo. useshonile senhliziyo le-aorta ngokuvamile kwenzeka ngokumelene isizinda ugcunsula nesifo sofuba.
3. izifo azalwa naso (se-Marfan syndrome, Ehlers-Danlos syndrome). Ngokuvamile umlando nesenzakalo kwezifo kuyaqashwa ngokuhlola umlando womndeni.
4. Ukulimala futhi umonakalo mechanical ngenxa izingozi zezimoto.
5. isilethikusebenza. Lena yimbangela ejwayelekile kakhulu lesi sifo. Ngo 35% wabantu abaye bahlupheka a isilethikusebenza, kwatholakala ukuthi unesifo senhliziyo useshonile. Kulokhu, kusolakala njengoba ukuqhubeka yayo eqondile.

By sengozini enkulu yokuba useshonile zihlanganisa ababhemayo, unesifo sikashukela, kwabantu abakhuluphele zokwenyuka komfutho cholesterol. Ngokwezibalo, isifo sokuvuvukala kwemithambo inhliziyo le-aorta izikhathi eziyisihlanu kaningi kutholakala kwabesilisa kuka azalela. Njengomthetho, iziguli yobudala - iminyaka engaphezu kuka-50.

isifo ngezigaba

Ngo ukuhlinzwa semithambo isebenzisa embodiments eziningana yomthambo i-aorta aneurysms ngeengaba ngokushesha kwasendaweni odongeni isakhiwo sabo, ifomu omsakazo.

Ngokuhambisana segmental typology ovelele: useshonile ka itheku we Valsalva unyuka / ingxenye ukwehla, lwaleli yomthambo i-aorta ne-aorta besisu.

Ukuhlolwa isakhiwo morphological isimo aneurysms ivumela kuwahlukanise ku yeqiniso neyamanga. Udonga yokugcina imelelwa ezicutshini, kwakheka ngenxa pulsatile hematoma kumiswa okuyinto.

Ubujamo useshonile kungaba saccular futhi fusiform.

Ziyini izimpawu ephelezelwa zokugula?

Ezimweni eziningi lesi sifo asymptomatic. Xilonga ke nomaphi, ngokuvamile phakathi ukuhlolwa okwejwayelekile noma ku ukuhlola nezinye izitho. Izikhalazo iziguli zivele uma isifo sokuvuvukala kwemithambo libhekene ukukhula ngokushesha kanye isivele bangaphambi ikhefu.

Useshonile le-aorta ekuntweleni inhliziyo futhi arc yayo ngokuvamile uhambisana isithombe esikhanyayo yomtholampilo, isizathu lena ikakhulukazi indawo yokwakheka. Pathology angase acindezele izimbambo nomgogodla thoracic. Iziguli esekhala ukukhwehlela kanye iphika ngenxa yokucinana ze- bronchi, palpitations inhliziyo, hoarseness.

Isikhathi eside ubuhlungu esivuthayo emhlane kuyinto sici pathologies le-aorta thoracic zenhliziyo. Kulokhu, iziguli ziwuphawu ukubukeka ezomile ukukhwehlela, edema, isiyezi kanye ubuthakathaka wonke umzimba.

Phakathi luhlolo zokuxilonga, udokotela kufanele anake ngokukhethekile izici zangaphandle lomuntu. Ukunwebeka wamasundu, ubude, kyphosis, deformity sternal - zonke lezi izimpawu zingase zibe Indlela Marfan syndrome. Sesixoxile ngakho kulesi sihloko.

Ngeshwa, ngokuvamile kakhulu kuvela izimpawu zokuqala zokugula kuyinto ukudabuka yomthambo i-aorta. Kubonisa ukopha kakhulu e ngokweqile, izitho zokugaya. Isiguli iye ukuhlanza ngegazi, ezinzima ubuhlungu besifuba ukuthi ibhebhetheka phansi yomgogodla. Ukuswelakala kokusebenza ngokuhlanganyela usizo ngesikhathi esifanele kungaphumela ekufeni nesineke.

Indlela ukuthola useshonile?

Ngokuvamile phakathi kokuhlolwa isimiso, odokotela okwatholakala "useshonile inhliziyo le-aorta." Kuyini, yiziphi izimbangela zezifo kanye nezindlela eyinhloko yokwelashwa, onguchwepheshe aqambe yokwamukela eyinhloko. Ukuze isifundo eningiliziwe inkinga kungase kudingeke ukucwaninga okwengeziwe, kuhlanganise CT, i-MRI, i-ultrasound. Ngokusho imiphumela uphethwe wokugcina, udokotela uthola isithombe esigcwele emitholampilo ye isifo.

On luhlolo kubalulekile acabangele yokuthi useshonile izimpawu zabo iyafana nezinye izifo. Yingakho indima ekhethekile uphethwe baphiwa abantu izifundo umehluko.

zokugula bangabonwa futhi mhlawumbe kuvinjwe ukuhlolwa. Ochwepheshe batusa ukuthatha amadoda njalo ngemva kweminyaka engu-60, abangakwazi give up imikhuba emibi noma banomlando yalesi sifo.

Useshonile le-aorta wenhliziyo: Ukwelashwa

Futhi izimpawu zesifo kanye nokwelashwa ezihlobene ngokuqondile. Ngemva udokotela azoqinisekisa ukuthi uphethwe wokugcina, ungakwazi uqhubekele ukwelashwa.

Ngo asymptomatic yokwelapha zokugula kukhawulwe kokuqondisa wombuso by udokotela ohlinza imithambo yegazi kanye njalo ukulawula-X-ray. Ukuze kuncishiswe ingozi yezinkinga kwezinye iziguli iqondiswa anticoagulants.

Ukuhlinzwa kuvezwa useshonile usayizi esikhulu (4 cm), kanye ekukhuleni kwayo okuqhubekayo. Lokhu kwelashwa Kunconywa cishe zonke iziguli okwadingeka asebenzelane ne zokugula ngokuthi "isifo sokuvuvukala kwemithambo inhliziyo le-aorta."

Ukusebenza ngokuyifunda excising a onesifo isitsha ingxenye, suturing, noma kwaso indawo isici sokwenziwa semithambo.

Ngeshwa, onalesi sifo kwalesi sifo kulezi zimo ezingezinhle kakhulu. Kusukela ekuqaleni kuka-ukuthuthukiswa isifo sokuvuvukala kwemithambo futhi ziyafa 75% eziguli ingakapheli iminyaka emihlanu. Ingxenye yayo abulawa ukudabuka okungazelelwe le-aorta, kanti bonke abanye - by pathologies concomitant (stroke, ischemia).

yezinkinga useshonile

1. Amaphutha umphini yomthambo i-aorta ne-yokumelwa yinhliziyo.
2. Useshonile ukudabuka. Ngakho kukhona ukopha kanzulu ngalo ingaphakathi pleural, zokuphefumula, inhliziyo noma esikhwameni emphinjeni. Endabeni ka ukopha ngqo ngaphakathi komgodi pericardial asathuthuka tamponade inhliziyo.
3. Acute useshonile ekunqandeni.

Yezinkinga oshiwo ngenhla, uma kungekhona ukunakekela okuhle kwezokwelapha ngesikhathi esifanele kungaba yingozi iziguli ekuxilongelweni "useshonile inhliziyo le-aorta." Ukwelashwa lokhu udokotela isifo ukhetha, esekelwe isimo jikelele isiguli kanye degree of kobukhulu egunjini lokuhlolwa kwezifo.

izinyathelo

Uma kuziwa nokuvimbela khona wabangwa nezibi, zonke izincomo enempilo nokwenqaba ukulahla imikhuba emibi kufanele kubhekwe kuqala. Njengoba sekushiwo, isikhathi eside kungavuka ifomu ezifihliwe useshonile inhliziyo le-aorta. Izimpawu kulokhu aliveli, isiguli singazazi khona kwale egunjini lokuhlolwa kwezifo. Yingakho uma umuntu isengozini (ukubhema, umfutho wegazi ophakeme, a Umlando womkhaya wokusebenzisa kabi izimo asike izidumbu zabantu yomthambo i-aorta), kufanele ibhekane njalo nokuhlola ephelele yokuhlola. Ngenxa yalezi zinjongo, ngokuvamile zisebenzisa ultrasound, aortography usebenzisa i-MRI Ngokuphambene ejenti. Ukuthola Isikhathi esijwayelekile isifo ukuphila.

isiphetho

Lesi sihloko sinikeza ulwazi "Kuvele useshonile le-aorta wenhliziyo. Izimbangela, Izimpawu kanye Ukwelashwa" Ungesabi lesi sifo, njengoba uphethwe ngesikhathi esifanele kanye nokwelashwa abanekhono kuzo lapho kusaqalwa vumela cishe phakade ukhohlwe ngenkinga.