Tricuspid vharafu. Tricuspid vharafu insufficiency 1, 2, 3 madhigirii: Zviratidzo uye kurapwa

The chikuru tsandanyama womunhu wemuviri mwoyo. Zvakaoma akaronga mashandiro, zvinoumba inova mavharuvhu. The rworudyi hafu ndiyo tricuspid vharuvhu. Iye Anogovana atrium uye ventricle. Kana abondera, ropa riyerere muchikamu chino tsandanyama iri kuvhiringidzwa. Zvinoguma huri munhu zvinouraya. In okurapa, zviri kunzi "kukundikana tricuspid vharuvhu." Mazuva ano nyaya tichakurukura kukonzera, zviratidzo uye kurapwa kuti chirwere ichi.

anatomical bhuku

moyo womunhu uri tsandanyama nenyere. mhango Its rakakamurwa 2 atria uye ventricle 2. Kutaurirana pakati zvivako izvi kuitika nokuvaapostora mavharuvhu. Ivo basa aibuda ropa imwe divi.

Kurutivi rworudyi mukamuri mwoyo chokuita kuburikidza tricuspid vharuvhu. Inoitwa zvinotevera anatomical hurongwa:

• mapepa matatu (septal, kumberi uye neshure);
• mudzira kosi;
• papillary tsandanyama;
• annulus fibrosus.

Panguva marwadzo ari atrium tricuspid vharuvhu anovhura. Zvishoma nezvishoma, ropa anozadza ventricle. Zvadaro myocardium avamba rave compressed apo pasi simba kumanikidzwa vharafu mapepa slam. munhu achimhanya mashandiro kwakadaro kunotadzisa neizvi Scored (regurgitation) ropa. Nokupesvedzera zvimwe zvinhu nguva kushanda rotsva. Muchiitiko ichi tichiti kusangana tricuspid vharafu insufficiency. Zvisinei, kuti ishande zvakazara, haagoni.

At zvokurwara ichi ropa kubva kurudyi ventricle kunyika atrium. A zvishomanana kuwedzera bhuku emura iri kushanda hapana zvainoita kushanda mikuru tsandanyama dzomuviri. In zvikuru mwoyo nokukundikana kumbotambudzika deformation kamuri, kumanikidzwa zviratidzi siyana zvinoshamisa mavari. Rinogona ngazviwedzerwe 8 nguva kuenzaniswa dzinongoitika tsika.

tsanangudzo pfupi pamusoro chirwere

Tricuspid insufficiency - ichi chirwere mwoyo inoita kuti nemhaka chakaremara pakazovharwa vharuvhu mapepa, zvinopesana neizvi kukanda ropa kubva kurudyi ventricle kupinda atrium. Tikafunga kugara regurgitation diastolic vhoriyamu uye kumanikidzwa marongerwo mwoyo yakawedzera. Izvi zvinosanganisira hypertrophy uye dilatation masvingo aro. Somugumisiro nokuvhiringidzirwa compensatory zvigadziriswe murwere vanova kuzara mumuviri.

Tricuspid insufficiency kunowanzoguma dzimwe vachiberekwa mwoyo kuremara. Somuenzaniso, imwe bvumidzwa foramen ovale kana atrial septal kuremara.

Main zvinokonzera uye siyana zvokurwara

Insufficiency of tricuspid vharuvhu anogara chakasiyana. Nokuti kuongororwa zvakarurama, unofanira kutanga kuziva Maumbirwe pathological muitiro. Nokuti chinangwa ichi, ari okurapa, siyana zvinodiwa: kuwanikwa nguva, ari localization chomugove dzaparadzwa pakati vharuvhu, kwokuomerwa regurgitation.

Zvichienderana nguva kukura, chirwere mubvunzo nezvezvikwata zviviri. Kazhinji, mune zvose kacho haingowanwi, uye kunoitika pashure kushoma. Vachiberekwa malformation chirwere kazhinji anova mudumbu. On rwayo kunokanganisa kuitwa asina kunaka zvikonzero zviri pamusoro muviri ari pamuviri. Izvi zvinogona kuva nemwaranzi, zvirwere, kana X-ray irradiation.

Inobva chokwadi, izvo chikamu wakaremara tricuspid vharafu insufficiency rinogona kaviri. The Organic Ipfungwa achiperekedzwa imwe vasiri kuchinja mavharuvhu. Zvishoma nezvishoma akaremara, akafukidza maruva. Kana dzichipfekeka chimiro chirwere vharuvhu anovhara zvachose.

Development yakatengwa Organic tricuspid insufficiency anokonzerwa zvinotevera:

1. Rheumatic fivha - kuzvimba, kuripa zvomukati wegadziriro.
2. Carcinoid chirwere - kukuvadza siyana nhengo yakafanira kune duku intestinal anomera. Pathogenic zvinhu anomera munzvimbo ropa uye kutanga kuzorwisa endocardium. Ipapo kupinda pulmonary midziyo.
3. Infective endocarditis - kuzvimba lining mwoyo.
4. Mitral commissurotomy. mashandiro ichi, rinoshandiswa pakurapa stenosis.

Vakatodzidza dzichipfekeka (hama) tricuspid vharafu insufficiency hwapedyo nokuda kuvadza papillary tsandanyama kana pakuwedzera annulus fibrosus. Muchiitiko chokutanga, mufananidzo pamusoro mamiriro mutoro kwokuramba injini nemano mavharuvhu. Myocardial infarction papillary tsandanyama wakaremara. Izvi zvinotungamirira nokuvhiringidzirwa ari functionality ari tricuspid vharuvhu.

Zvokurwara of fibrous rin'i kunogona kukonzera zvakasiyana siyana zvirwere. Izvi zvinofanira kusanganisira myocarditis, inotanga chords or the namamota uye mapundu kuti kudzivirira ropa kubva inoyerera kubva ventricle.

Zvokukura kukura insufficiency

Inobva kwokuomerwa regurgitation kwacho, nokufamba hosha dzakawanda kazhinji anokudzwa nzendo:

• 1. Mwero neizvi ropa ano anoramba shoma tsika haisi achiperekedzwa hemodynamic nyonganyonga.
• Dhigirii 2. Panguva iyi mudariro zvokurwara pamwe neizvi ropa rukova mberi kure usingabereki pfuura 2 cm.
• Dhigirii 3. Blood aibuda kufambira mberi kuti atrium pamusoro chinhambwe 2 cm kubva pechiso vharuvhu.
• 4. dhigirii panguva regurgitation ropa chinopinda muimba mapazi ari atrium, vakapfuura kusvikira yomukati.

About chii zviratidzo pamwe Danho rimwe nerimwe nehosha, izvozvo ichakurukurwa pazasi.

Zviratidzo tricuspid vharafu insufficiency

Panguva kutanga kwekupwanyiwa mwoyo chirwere anenge asingadi unooneka. Dzimwe nguva pashure muviri varwere cherechedza kuonekwa simba pulsation ose mutsinga dziri mumutsipa. Wanikidza pathological muitiro zvinogoneka chete tichibatsirwa Doppler. Normal ECG haaratidzi kuchinja mumwoyo.

Tricuspid vharafu insufficiency pamwe kuwedzera 2 madhigirii harungashandurwi ropa riyerere vhoriyamu. Right ventricular rebipolar kunotungamirira nokuwedzera kukura mumwoyo. Somugumisiro, mashoko chiremba mufananidzo vaisanganisa kubudikidza anotevera zviratidzo:

• kuneta, akaderedza mumuviri uye basa pfungwa;
• kuita weti kakawanda usiku;
• chakakomba mumatenhere ezasi wamativi;
• kupfupika mweya;
• Kunzwa uremu pasi mbabvu;
• dyspepsia.

Kana kuteerera mwoyo takatsunga pansystolic ruzha uye atrial fibrillation.

Somugumisiro, anowedzera uwandu zvokurwara kunoita zviratidzo hwakaratidza. Hanya nechitarisiko chavo hakuna inokurudzirwa. Zviri nani ari kutanga kwekupwanyiwa chirwere kurapwa zano vakakodzera. Tricuspid vharafu insufficiency pamusoro 1-2 madhigirii vanogona kurapwa pamwe nemishonga. Yezwi inotevera padariro chirwere nguva dzose kunoda kuvhiyiwa. Kunyange avhiyiwa zvinokwanisika panowanikwa yematambudziko.

Zvinoitwa chirwere muvana

Vana vacheche zvakaoma. regurgitation uye kuvapo concomitant mwoyo chirwere asingatani nokukurumidza kusimudzira rworudyi ventricular kukundikana. Kakawanda painoguma murufu.

The vawana chimiro hosha ikabuda mune matambudziko evamwe zvirwere. Kakawanda iri streptococcus utachiona, iyo inosvitsa rheumatic.

Pakati pezvimwe zvikonzero kukundikana vana vangazivikanwa:

• chenjera chimiro neBP;
• chirwere of myocardium;
• randakambosangana naro zvinokuvadza;
• nyanyisa neoplasms.

Panguva kutanga pavaipfuura tricuspid vharuvhu insufficiency muvana inokurukurwawo sezvo anatomical zvinhu. The dhigirii of pathological muitiro wokutanga kunoda hapana kurapwa. With zera, chirwere kazhinji inotsidza mumwoyo pamusoro wayo.

Kukundikana mitral uye tricuspid vharafu

Kakawanda, kutyorwa mudzimu vharuvhu kurudyi unobatanidzwa pamwe dysfunction pamusoro Zvivako rworuboshwe nehafu. Munharaunda iyi, chikuru mutoro ari inonzi mitral vharafu. Zviratidzo zviri chirwere vari muchidimbu. Tikafunga zvirwere izvi inokanganisa pamusoro basa rworudyi ventricle, izvo rakaoma nokuda kweboka pulmonary neBP. Varwere chirwere kuti "mitral insufficiency, uye tricuspid vharafu 1 dhigirii" inokurudzirwa kuvhiyiwa.

nzira nechirwere

Early kuonekwa chirwere chinoita zvakananga basa kubudirira kurapwa, uye kunokanganisa murwere upenyu anotarisirwa. Sezvo kukundikana tricuspid vharuvhu 1 dhigirii anobuda anenge asymptomatic zvokurwara padzakacherechedza chete pashure yezwi chinotevera Danho okukura.

Chirwere chinotanga kuongorora murwere, kudzidza nhoroondo yaro uye kuongorora chaiko. Mibvunzo yakasiyana-siyana kuti murwere, chiremba anosarudza mashoko navanachiremba mufananidzo, nguva yokutanga zviratidzo. It inoda kuziva chii chirwere yakanga pakurukurwa kukundikana. Kana kuongororwa kwokunze kazhinji anoratidza ganda cyanosis uye edema, uye auscultation - mwoyo mutinhimira vachivavhiringidza.

Sechikamu nechirwere hazvo basa akawanda rabhoritari nemiedzo. Pakati pavo, zvikuru mashoko inozivikanwa neropa kuongorora uye kudzidza immunological mamiriro murwere. Maererano migumisiro Murabhoritari miedzo inogona kutonga pamberi kuzvimba pamuviri, zvichiitika inofambirana zvirwere.

Kujekesa nechirwere chiremba anogona kushandisa Hardware ongororo nzira. Idzi dzinosanganisira:

1. ECG. Zvinonzi kuitwa kuziva atrium mavhoriyamu vawedzere.
2. Phonocardiogram. Kunoratidza systolic ruzha.
3. Zononoka CT. It chinopa mashoko mufananidzo huru tsandanyama dzomuviri.
4. Radiograph. Anopa pfungwa ukuru mwoyo, anoona kuzara.
5. Koronokardiografiya. Richishandiswa asati avhiyiwa uye kuongorora ropa riyerere.
6. Echocardiography. Anoratidza deformation pakati ichibhabhamisa, kuvapo idzodzo zvitsva izvi.

Doctor anowana pfungwa ezvinhu tricuspid vharuvhu pachishandiswa azere migumisiro ongororo. Kushaikwa mamiriro iyi zvakanaka kurapwa chete panguva kutanga kwekupwanyiwa kukura. More zvakawanda embodiments yokurapa mune chirwere ichi ichakurukurwa hereinafter.

kurapwa Guidelines

Insufficiency of tricuspid vharuvhu 1 dhigirii hakurevi kurapwa. Kana chirwere chinoita kuti inotevera padariro kukura, murwere basa kurapwa. Zvinogona kuva zvokurapa uye zvomusejari. Achishandisa chokupedzisira muna zvakakura kacho, apo kushandisa mapiritsi uye majekiseni haashandi.

Nguva yose kurapa murwere unofanira kuomerera mitemo zvinotevera:

1. Chose kusvuta.
2. Dzivisa hypothermia uye zvinokangaidza.
3. A Kudya kuderedza mutoro pamwoyo.
4. Kuderedza uye huwandu muviri.

Kuomerera nhungamiro idzi anowedzera kubudirira mishonga, uyewo mhando muzvidzivirire yematambudziko.

mishonga

Mwero tricuspid vharafu insufficiency hakunganzi chiratidzo kuti kuvhiya kupindira. Muchiitiko chino, kurapwa rinoitwa tichibatsirwa zvinodhaka. Standard kurapa zano kunosanganisira kushandisa zvinotevera mishonga:

1. Diuretics ( "Britomar", "Hydrochlorothiazide"). Kubvisa kurega kunotanga mu dzomumuviri mhanyisa excretion rikurumidze.
2. Potassium zvinodhaka ( "Panangin", "Asparkam"). Anobatsira muviri kwete kuunganidza zvakawandisa mvura.
3. Venous dilators ( "Korvaton", "Nitrosorbide"). Kuderedza mutoro nezuva mwoyo kuburikidza neropa dhipoziti.
4. Anticoagulants ( "Varfareks '' Warfarin").
5. Cardiac glycosides ( "Digoxin", "Korglikon"). Rubatsiro pakurwisa arrhythmia.
6. Beta-blockers ( "Diltiazem" "Carvedilol"). Kuderedza kuitika rworuboshwe ventricular marwadzo.

The chipimo chemushonga zvaiitwa uye chipimo chemushonga kugadzirira takatsunga nomumwe tichifunga kwokuomerwa chirwere.

kushanda kupindira

Tricuspid vharafu insufficiency 3 madhigirii anonzi kuva chiratidzo chikuru kuti kuvhiya kupindira. Operation zvakare pachii varwere kwazvo deformations ichibhabhamisa kana kuratidzwa kukundikana kushanda kwavo.

Kana vakachengeteka vharuvhu midziyo yaishandiswa annuloplasty. Panguva oparesheni chiremba superimposes U-zvakaumbwa majoini ukama nzvimbo.

Kana Kupindira rakanga basa, pane pachena STRUCTURAL kuchinja, murwere akaisa chakagadzirwa huchidonha. Pashure muchibereko pamusoro prosthesis kwaida anticoagulation. Panguva muchibereko chaivo prosthesis iye anopfeka pfupi-rokuti hunhu. Kana chakagadzirwa dzokurapwa alloys, Mabatirwo tricuspid vharafu Zvinotora nguva shoma.

Possible yematambudziko uye fungidziro hwokuponesa

Kushaya nenguva kunokwanisa kukonzera kuchinja chirwere. Pathological kwacho iyi kunosanganisira kwete chete tricuspid vharuvhu. Kukundikana zvishoma nezvishoma inoendesa ndechokuti muviri anotanga kutsvaka compensatory zvigadziriswe zvitsva. Naizvozvo anoedza kutsungirira aivapo kutyorwa. Zvichienderana ndasiya zvirwere agamuchire kunyongana zvinotevera:

• nemabayo;
• chakawedzerwa chiropa, cirrhosis;
• pulmonary embolism;
• ascites.

Maererano nenhamba dziri yematambudziko kuitika muna 90% nyaya.

Achitaura for kupora, zvinoenderana zvachose pamusoro mwero chirwere kukura. Insufficiency of tricuspid vharuvhu 2 madhigirii anopindura zvakanaka yokurapwa, uye ngozi yematambudziko ari kushanda razero. Kana dhigirii ari pathological muitiro wechitatu chinosanganisira anenge makore mashanu kupona 60-70%. Izvi nhamba anowanzoramba varwere vanenge vaitova kuvhiyiwa. Kana decompensated chimiro kukundikana, achiperekedzwa chisingaperi zvemapapu chirwere, asi fungidziro iri zvisingafadzi..