Aneurysm pakati yeropa kwomwoyo - chii? Kutsemuka Aneurysm: Zvinokonzera, Zviratidzo, Treatment

Pakati zvose mwoyo uye vascular zvirwere zvinozivikanwa vanachiremba kusiyanisa muboka kuti unomirira mukuru ngozi kuupenyu hwomunhu. Unosanganisira myocardial infarction, kutsemuka aneurysm. On vapedzisira, tinokurukura zvizere zvikuru munyaya.

Kutsemuka aneurysm kwomwoyo; chii uye sei ngozi?

Yeropa - iyi ndiyo imwe makurusa tsinga mumuviri womunhu, riri pedyo mwoyo. Kubudikidza naye, ropa runoyerera kubva huru tsandanyama ose dzimwe arteries. Cardiac kutsemuka aneurysm chiri kanganisika, nokuda uko kuwedzera chikamu yeropa kufurirwa zvinhu zvakawanda. Zvokurwara vangava vachiberekwa kana vawana zvakasikwa.

The chirwere inotanga chokuti pasi kwokudzvinyirira kwomunhu ropa kuyerera yakabvaruka intima. Saka, ropa anokwanisa kuyerera zvakananga kupinda tsandanyama rukoko. In mamiriro ichi murwere kazhinji anonzwa zvinorwadza kusanzwa ari mubhokisi, noruoko rworuboshwe. ganda rakachenuruka, kumanikidza kunowandawo, pane nauseating zvido. Soaking ropa, rusvingo kutsemuka iri zvishoma nezvishoma rwakatambanudzwa. Panguva atsamwira of aneurysm munhu anogona kurasikirwa kuziva. Mune zvimwe zviitiko, kunouya imwe rufu pakarepo kubva ropa rakawanda uye kuvhunduka.

The pathogenesis chirwere

cardiac aneurysm pakati yeropa sei? Chii nokuda zvokurwara kunogona kunzwisiswa, kana imi munoziva anatomi mikuru tsandanyama dzemuviri. Muna myocardium kunge thinned masvingo kuti protrude dzose muropa kupomba kubva ventricle kune vamwe. Kana munhu ane chirwere ichi, Kusaita masvingo zvishoma nezvishoma DZEMUNHU DZINODZORA. Izvi zvinoita zvakaoma kuramba ropa kupomba.

Kuwedzera kukuvadza pamadziro yeropa pakugadzirwa aneurysms ndeyakewo kushingaira hemodynamic uye nomuviri zvinhu. Zvokurwara rinowanzoberekera munzvimbo operatively kusvinwa kuti vari kuramba kunzwa yakawedzerwa mutoro nokuda mukuru chokubuda velocity. Chirwere kutsemuka kunotevera uye kunyanya basa proteolytic makemikari kutsamwisa kudzikisirana pamusoro kwakavharwa nenyama pepuranga uye chitarisiko nonspecific kuchinja chinopedza hunhu ari mudziyo pamadziro.

Akaumba munhu aneurysm iri kukura kukura, sezvo kumanikidza pamadziro wake chete inowedzera. Ukuwo, ropa riyerere kupinda aneurysmal zai iri seiyi uye inova anonzi inonetsa. Munguva distal nhungamiro, 45 chete% ropa chinowa zvachose chipo iri aneurysm pacharo. Izvi imhaka wayo mhango ropa runoyerera pamwe masvingo nechepakati yorwizi anodzokororwa kugara mhirizhonga mashandiro uye kuvapo yakawanda thrombotic zvavo.

zvokurwara Zvinokonzera

Masayendisiti pasi pose kuramba vachishingaira kuongorora zvirwere zvakadai cardiac aneurysm yacho yeropa, chii uye chii zvinoita dzinobatsira ayo budiriro. Akanyorwa pazasi inongova mimwe vavo:

1. Atherosclerosis. Sclerotic plaques akaumba mukufamba chirwere ichi, kunogona kukanganisa kutsemuka rusvingo ndoita kusanduka zvakakwana.
2. Zvirwere zvakaita chirwere. Cardiac aneurysm pakati yeropa rinowanzoberekera pamusoro yaitwa njovhera kana tibhii.
3. Vachiberekwa zvirwere (Marfan urwere, Ehlers-Danlos urwere). Kazhinji nhoroondo panowanikwa chirwere ari kuongororwa nokuongorora nhoroondo yemhuri.
4. Kukuvara uye zvokuimba kukuvadzwa somugumisiro tsaona dzemotokari.
5. Myocardial infarction. Ndicho chikonzero chinonyanya zvinowanzovapo chirwere. Muna 35% vanhu vakatambura munhu myocardial infarction, akaonekwa mwoyo aneurysm. Muchiitiko chino, zviri vachinzwisisa sezvo yaro zvakananga kuenderera.

Pakazosvika mikana yokuva ane aneurysm zvinosanganisira vanosvuta, vane chirwere cheBP, vanhu kufuta vane BP remafuta akawandisa. Maererano nenhamba, cardiac aneurysm yacho yeropa kusvikira kashanu kakawanda chirwere pane varume kupfuura vakadzi. Kazhinji, varwere zera - makore anopfuura 50.

chirwere kupatsanura

In vascular Kuvhiya anoshandisa embodiments akawanda kutsemuka aneurysms classifications kwakavakirwa dzavo localization rusvingo mamiriro, chimiro uye etiology.

Maererano segmental typology anokudzwa: aneurysm pamusoro sinus pamusoro Valsalva, vachikwira / achiburuka kacho kutsemuka chematenga uye abdominal yeropa.

Maonero ari morphological maumbirwo aneurysms ehurumende kunoita kugovera muvira chechokwadi nechenhema. Rusvingo yokupedzisira chinomiririrwa connective rinenge riri kuumbwa nokuda pulsatile hematoma inotungamirwa.

Maumbirwe aneurysm kunogona saccular uye fusiform.

Ndezvipi zviratidzo pamwe zvokurwara?

Kazhinji chirwere chacho asymptomatic. Rokuongorora nayo pavaidira, kazhinji munguva yokungoitawo inspections kana kuongorora dzimwe nhengo. Zvichemo varwere kuonekwa kana aneurysm kunoratidzwa nokukurumidza uye kwava pamusoro avaida ari kumbozorora.

Aneurysm of vachikwira yeropa mwoyo wayo chinhu chakakombama inowanzopiwa achiperekedzwa rakajeka kunotoda mufananidzo, chikonzero ichi ndicho chatinonyanya anatomical nzvimbo. Zvokurwara anogona vomanikidza mbabvu uye thoracal nomuzongoza. Varwere chokunyunyuta pamusoro chikosoro uye kupfupika mweya nokuda compression ari principales, mwoyo palpitations, hoarseness.

Refu unopfuta marwadzo kumashure huri unhu pathologies ari thoracal yeropa mwoyo. Muchiitiko chino, varwere kazhinji chiratidzo chakaita akaoma chikosoro, edema, dzungu uye utera yose muviri.

Panguva chirwere kuongororwa, chiremba anofanira kupa ngwariro chaiyo kwokunze zviri wacho. Elongation remichindwe, varefu, kyphosis, sternal wakarebesa - zvose zviratidzo izvi zvingava anoratidza Marfan syndrome. Tatotaura nezvazvo munyaya ino.

Zvinosuruvarisa chaizvo kazhinji chiratidzo zvokurwara rokutanga kutsemuka atsamwira. Kunoratidza kunonyengedza ropa iri zvomudumbu zvomukati. Murwere yave kurutsa neropa, zvikuru muchipfuva marwadzo kuti anopararira pasi nomuzongoza. Kushaya rubatsiro nenguva kunogona kuguma murwere rufu.

How kuziva chinhu aneurysm?

Kakawanda munguva purogiramu unoongororwa, vanachiremba akaonekwa se "cardiac aneurysm yacho yeropa." Chii, chii vari zvinokonzera chirwere uye chikuru nzira yokurapa, chiremba wacho anofanira kuudza zvikuru kugamuchira. Kuti uwane kudzidza dambudziko angada zvinoverengeka zvimwe zvidzidzo, kusanganisira CT, MRI, Ultrasound. Maererano migumisiro wokupedzisira nechirwere, chiremba anogamuchira zvizere kunotoda mufananidzo chirwere.

On ongororo zvinokosha kufunga kuti ane aneurysm zviratidzo zvavo zvakafanana nezvimwe zvirwere. Ndokusaka basa rinokosha nechirwere yapiwa differential zvidzidzo.

zvokurwara kuonekwa uye zvichida kuongorora. Nyanzvi dzinorumbidza nguva dzose kutora varume pashure pemakore 60, ndiani anogona kurega miitiro yakaipa kana vane nhoroondo chirwere ichi.

Aneurysm pakati yeropa mumoyo: kurapwa

Uye zviratidzo chirwere uye kurapwa zvakananga ukama. Mushure chiremba achasimbisa wokupedzisira nechirwere, unogona mberi kurapwa.

In asymptomatic zvokurwara ARV chete kutarisira nezviripo munhu vascular chiremba uye kugara X-ray kuzvidzora. Yekuzvidzivirira yematambudziko mune vamwe varwere raitongwa anticoagulants.

Kuvhiya unoratidzwa aneurysm guru kukura (4 cm), uyewo wayo mberi kukura. kurapwa ichi inokurudzirwa kwerinenge varwere vose vaifanira kubata zvokurwara rinonzi "cardiac aneurysm yacho yeropa."

Operation zvinoreva nokuda excising munhu hosha mudziyo mugove, suturing, kana yokutsiva yaro kuremara vascular prosthesis.

Zvinosuruvarisa kuti fungidziro chirwere ichi mu kupfuura zvisingafadzi. kacho. Kubva kutanga aneurysm uye kufa vanenge 75% wevarwere mukati mumakore mashanu. Hafu yavo vari vakaurayiwa kamwe atsamwira yacho yeropa, uye vakasara - ne concomitant pathologies (sitiroko, ischemia).

matambudziko anoitika aneurysm

1. Zvikanganiso kutsemuka vharafu uye mwoyo nokukundikana.
2. Aneurysm atsamwira. Saka pane zvakawanda ropa munzvimbo pleural mhango, kufema, mwoyo kana yegurokuro bhegi. Kana ropa zvakananga kupinda pericardial mhango kuti dzichiri cardiac tamponade.
3. Chenjera aneurysm pakugwamba.

The-vataurwa pamusoro matambudziko, kana kwete kupa nenguva hanya yezvokurapa inogona kuuraya varwere vane chirwere kuti "cardiac aneurysm yacho yeropa." Mabatirwo chiremba uyu chirwere anosarudza, kwakavakirwa zvinonyatsorehwa ezvinhu omurwere uye mwero kwokuomerwa ari zvokurwara.

matanho

Kana totaura kudzivisa chirwere yakadaro chakakomba, zvose kunenge pamusoro utano hwakanaka uye kuramba tsika dzakaipa inofanira kutanga kukurukurwa. Sezvambotaurwa, kwenguva refu kunogona kuitika munguva rudzi cardiac aneurysm yacho yeropa yakavanzika. Zviratidzo izvi nyaya hariwaniki, murwere haazivi pamberi zvokurwara ichi. Ndokusaka kana munhu pangozi (kusvuta, BP, nhoroondo mhuri kutsemuka kwetsinga nyaya), vanofanira kugara kumbotambudzika yakakwana chirwere kuongorora. Zvinangwa izvi, kazhinji kushandisa Ultrasound, aortography kushandisa MRI musiyano mumiririri. Panguva Chaiyo kuonekwa zvirwere anogona kuponesa upenyu.

mhedziso

Nyaya ino rinopa mashoko "An aneurysm pakati yeropa mwoyo. Zvinokonzera, Zviratidzo neMarapirwo" Musatya nehosha, sezvo nenguva chirwere uye nomazvo kurapwa pakutanga mumatanho achitirega kushanda zvachose kukanganwa nezvedambudziko racho.