Valve yomthambo i-aorta: isakhiwo, operation indlela. Stenosis futhi esingamahlalakhona of valve yomthambo i-aorta

Yomthambo i-aorta valvular isifo senhliziyo ngokuvamile libhekene umlingisi uthenge abonakalisa emtholampilo kuphela yokuguga. Ukuba khona kwabo kungabangela thuthuva ezinzima hemodynamic. Kobukhulu isifo ukuthi izinguquko ezithinta valve kukhona engelapheki.

isakhiwo inhliziyo: valve

Inhliziyo umzimba eziyize esakhiwa emakamelweni ezine. I neengcezu kwesokunxele nakwesokudla ahlukaniswa ngodonga lapho kungekho zokwakheka Nokho, phakathi ATRIUM futhi ventricle ohlangothini ngalunye has a imbobo ifakwe valve. Letakhi enze kube nokwenzeka ukuba alawule kwegazi, ukuvimbela regurgitation, okusho ekubunjweni reverse.

Ngakwesokunxele khona valve mitral siqukethe valve ezimbili, futhi ngakwesokudla - the tricuspid, it has amapheshana amathathu. Amaphayiphu zinikezwa umsipha izindikimba, iqinisekisa ukuvulwa isiqondiso eyodwa kuphela. Lokhu kuvimbela backflow wegazi ku thusi ATRIUM. Ngesikhathi ukwedlulela i-ventricle engakwesobunxele ku le-aorta, valve yomthambo i-aorta khona. Umsebenzi wayo - ukunikeza ukukhuthazwa eyodwa emaceleni wegazi ku le-aorta. Ohlangothini lwesokunene futhi valve we Umthambo yamaphaphu. Bobabili izinhlangano abizwa ngokuthi "semilunar" ngayinye amapheshana amathathu. Noma yimuphi angahlangani, isib, calcification of valve yomthambo i-aorta, kuholela ukuphazamiseka ukuhamba kwegazi. ukukhubazeka Kutholiwe ngokuvamile ehambisana nesifo. Ngakho-ke, abantu okuthiwa engcupheni kufanele bahlolwe njalo: ikakhulu echocardiogram.

Lo mshini valve yomthambo i-aorta

A indima ebalulekile ukuzungeza udlala valve yomthambo i-aorta. I enezinto uphawu noma mfushane - lokhu ingenye pathologies main. Kuba imbangela ukuntengantenga hemodynamic. Inhloso yalolu ingxenye yomzimba - ukuqinisekisa ukukhuthazwa igazi kusukela ATRIUM ngakwesokunxele ku-ventricle, ekuvimbeleni regurgitation. I valve zivulwa ngesikhathi systole atrial, lapho isikhathi igazi oqondiswe valve yomthambo i-aorta ku-ventricle. Ngaphezu kwalokho, enezinto zivaliwe ukuvimbela asakazwe reverse.

Inhliziyo yayo yayinezinkinga ezicini: ngezigaba

Ngesikhathi okuvela bungabonakala azalwa naso inhliziyo yayo yayinezinkinga ezicini (umphini yomthambo i-aorta nezinye izinhlangano) futhi atholwe. Izinguquko zingathinti nje ama-valve, kodwa izindonga inhliziyo. ukukhubazeka azalwa naso zivame kuhlangene, okwenza kube nzima ukuba nokwelapha.

Yomthambo i-aorta ne-valve stenosis

Pathology kuhilela ukuvaleka ukwedlulela i-ventricle engakwesobunxele ku le-aorta - kuthinta amapheshana umphini nezicubu zabo zonke nxazonke. Lesi sifo, ngokuvumelana izinkomba kwezibalo, evame kakhulu kwabesilisa. Ukubekwa uphawu kwabangu-izindonga le-aorta ne-valve yomthambo i-aorta ngokuvamile ezihlobene ne izilonda rheumatism futhi esiwohlozayo. Futhi, njengoba ejenti etiologic angasebenza endocarditis, i-rheumatoid arthritis. Lezi zifo kuholele Fusion we slats, ngaleyo ndlela kuncishiswe ukuhamba yabo futhi valve ubafihlela ngokugcwele ngesikhathi systole ka-ventricle engakwesobunxele. Lapho esegugile, isizathu ukwehluleka ngokuvamile atherosclerosis futhi calcification we yomthambo i-aorta ne-valve amapheshana.

Ngenxa ukuvaleka we orifice yomthambo i-aorta kukhona izinguquko eziphawulekayo hemodynamics. Basuke abona othile ewunikela ngesikhathi degree of stenosis uwukubonakaliswa - ukunciphisa ipheshana ngaphezu kuka-50%. Lokhu kuholela yokuthi le umyela we yomthambo i-aorta ne-valve ingcindezi izinguquko - ingcindezi yomthambo i-aorta uhlala evamile, kodwa kwandisa e-ventricle engakwesobunxele. ukuchayeka Ukwandiswa odongeni i-ventricle engakwesobunxele kuholela ukuthuthukiswa hypertrophy compensatory, okungukuthi, ukuba ukuqina yayo. Ngemva kwalokho siyabhubha umsebenzi diastolic nokuthi kubangela ukwenyuka ukugandeleleka ATRIUM ngakwesokunxele. Nokho, Hypertrophy kuholela-mpilo funa, anda esivimba amanzi mass akhawunti angaphambilini liningi igazi ngisho ukwehla pathologies concomitant. Lokhu kuholela ukuthuthukiswa ephethwe yisifo senhliziyo.

umtholampilo

Esikhathini kusaqalwa ethintekile valve yomthambo i-aorta ungakwazi akusho ukuzibonakalisa. izinguquko Clinical zenzeka lapho uvula umkhawulo kuya 2/3 of evamile. Kokuvivinya ezinzima iziguli uqale abaphazamisa ubuhlungu, owenziwe waba owasendaweni ngemuva breastbone. Ubuhlungu syndrome ezimweni ezingajwayelekile, kungenzeka ukuthi umataniswe nge nokulahlekelwa ukwazi ngenxa vasodilatation letindzala. Ukwakhiwa nomfutho wegazi ophezulu yamaphaphu okuholela iphika, okuyinto ekuqaleni sikhathalela kuphela umthwalo, kodwa ke kukhona uyaphumula. Eside isifo Yiqiniso iba imbangela ezingamahlalakhona yokumelwa yinhliziyo. Pathology zidinga ukwelashwa kuhlinzwa, njengoba kukhona ingozi yokuwohloka, futhi kungazelelwe ukufa inhliziyo.

ukuhlola

On luhlolo, iziguli pallor isici ezihambisana enciphile okukhipha inhliziyo. Osabalalayo Umthambo ishayela at ngokulambisa selitholakala - it is a ezingavamile futhi ibuthakathaka. Auscultation waphawula buthakathaka 2 amathoni noma eqhekeza. ECG akuyona ngokwanele ulwazi - izimpawu hypertrophy zinqunywa kuphela stenosis ezinzima. I echocardiography ukwambulwa kakhulu ukuze kuhlolwe valve yomthambo i-aorta. I enezinto zivaliwe futhi uqweqwe, ayisesemikhulu ukuvulwa - kukhona nenqubo main zokuxilonga, esiza ukuthola lolu cwaningo. I degree of stenosis nokucindezelwa umyela ngempumelelo ukunquma catheterization izimbotshana.

ukwelashwa

Ukuze omnene-to-ngokulinganisela stenosis idinge kuphela ukulungiswa yokuphila - ukugwema umsebenzi ngokweqile, ekwelapheni comorbidities. Nge anda imvamisa izifinyezo uqoke blocker, futhi ukwehluleka inhliziyo isisu ngempumelelo, glycosides inhliziyo. uphawu Sikuveze ezindongeni aorta ne-valve yomthambo i-aorta zidinga ukwelashwa kuhlinzwa. Ngokuvamile labetibambile sokwenziwa noma ibhaluni dilatation.

Yomthambo i-aorta ne-valve esingamahlalakhona

Igama elinikeziwe zokugula libhekene amaphiko nesmykaniem. Lesi simo esiyingqayizivele sibangelwa kuholela ukubuya igazi ziphonswe ventricle engakwesobunxele ukuthi kwenzeka ngesikhathi diastole. Izithembiso Eastern ngokuvamile inkinga ka endocarditis infective futhi rheumatism. Ngaphansi ngokuvamile kuholela ugcunsula, isifo sokuvuvukala kwemithambo yomthambo i-aorta, le-aorta, umfutho wegazi ophakeme, Marfan Syndrome, omzimba izicubu erythematosus.

valve yomthambo i-aorta udlala indima ebalulekile kwegazi. Ukuvalwa Akuphelele amaphiko ayo kubangela regurgitation, okungukuthi, ukubuya igazi kwesokunxele ventricle ekusakazeni. Umphumela ngokweqile igazi ivolumu ingaphakathi layo, okuholela overload futhi stretchability. Disturbed systolic umsebenzi nomfutho wegazi ophakeme kuholela ukuthuthukiswa hypertrophy. inyuka retrograde ingcindezi kumbuthano encane - ezimise nomfutho wegazi ophezulu yamaphaphu.

umtholampilo

Njengoba stenosis, zokugula izenze wazizwa kuphela degree okunzima ukwehluleka. Lapho ukuzikhandla kufushane kwenzeka, ihlobene nomfutho wegazi ophezulu yamaphaphu. Ubuhlungu nomsindo kuphela e-20% amacala. Ngesikhathi esifanayo uzwakalise auscultation futhi izimpawu zokugula:

1. Okusizwa ukushaya kwemithambo yegazi carotid.
2. Uphawu Duroziez noma nesenzakalo systolic nokububula ngesikhathi Umthambo femoral. Kwenzeka lapho yena babancwebe eduze isikhundla ukulalela.
3. Uphawu angioedema - ukushintsha umbala izindebe nezinzipho ngokuhambisana okusizwa ukushaya we arteriole.
4. Traube amathoni double, elikhulu, "inganono" ezingavela phezu Umthambo femoral.
5. Uphawu de Musset, ebonakaliswa shaking ikhanda.
6. umsindo diastolic emva 2 amathoni ezenzeka auscultation wenhliziyo, kanye buthaka 1 phezulu.

ukuhlola

izindlela zokwazisa zihlanganisa echocardiography futhi catheterization izimbotshana. Bavumela ukuba uhlaziye valve yomthambo i-aorta, kanye ukulandelela ivolumu wegazi okuphalazwe. Ngesisekelo yalezizifundo kunqunywa kobukhulu okuphambene futhi ziqondiswe udaba isidingo ukuhlinzwa.

ukwelashwa

yokuntuleka okunzima umthamo omkhulu regurgitation, lingaze olunzulu zidinga ukwelashwa kuhlinzwa. isivuno kahle - valve yokufakelwa yomthambo i-aorta, okukuvumela ukuba ubuyisele inhliziyo umsebenzi. Uma kudingeka, kunikezelwe imithi lingaze.

Stenosis kanye valve yomthambo i-aorta - izici inhliziyo ezivamile, ngokuvamile umphumela isifo sendawo noma letindzala. I zokugula iqhubeka kunalokho kancane, okuvumela isikhathi ukuxilonga ke. izindlela zesimanje ukwelashwa ukusiza ekuvuseleleni izindawo umphini umsebenzi futhi sithuthukise isimo lesiguli.