Lub ntsws yog muab los ntawm ob lub vascular sib cais, suav nrog cov hlab ntsws thiab cov hlab ntsha bronchial. Cov hlab ntsha pulmonary nqa cov ntshav deoxygenated ntawm qhov tsis tshua muaj siab. Kev sib txuas ntawm cov hlab ntsws thiab cov hlab ntsha bronchial kuj yog nyob rau hauv qhov tseeb tias lawv, hla lub capillaries, tsim vascular anastomoses. Lawv muab 99% ntawm cov ntshav ntws mus rau lub ntsws thiab koom nrog kev sib pauv roj ntawm lub alveolar capillary membrane.
Kev ua haujlwm ntawm cov hlab ntsha bronchial
Cov hlab ntsha no muab cov qauv kev txhawb nqa ntawm lub ntsws, suav nrog cov hlab ntsha pulmonary, tab sis feem ntau tsis koom nrog kev sib pauv roj. Cov ceg ntawm cov hlab ntsha bronchial nqa cov ntshav oxygenated mus rau lub ntsws ntawm lub siab rau lub sijhawm ntawm lub siab hauv cov hlab ntsha pulmonary. Lawv txuas nrog lub ntsws los ntawm ob peb microvascular anastomoses ntawm qib ntawm alveoli thiab ua pa bronchioles.
Nyob rau hauv ntau qhov xwm txheej uas cuam tshuam nrog kev cuam tshuam ntawm cov hlab ntsha pulmonary (xws li vasculitis thiab mob ntsws pulmonary thromboembolic kab mob), cov hlab ntsha thiab lawv cov anastomotic. Kev sib txuas tuaj yeem nthuav dav, tso cai rau qhov feem pua ntawm cov zis tawm los ntawm cov hlab ntsha bronchial.
Qhov chaw
Cov hlab ntsha bronchial feem ntau yog los ntawm qhov sib thooj ntawm cov hlab ntsha hauv lub thoracic. Lawv hu ua orthotopic thaum lawv nyob nruab nrab ntawm lub phaj siab kawg ntawm T5 vertebral lub cev thiab qis kawg phaj ntawm T6 vertebral lub cev. Angiography tseem ceeb rau cov hlab ntsha orthotopic 1 cm saum toj no lossis qis dua qib ntawm sab laug lub ntsiab bronchus thaum transecting the descending thoracic aorta.
Cov hlab ntsha uas nyob rau lwm qhov hauv lub aorta lossis los ntawm lwm cov hlab ntsha hu ua ectopic.
Ntawm CT angiography tshuaj xyuas hemoptysis, 64% ntawm cov neeg mob muaj cov hlab ntsha orthotopic thiab cov seem 36% muaj tsawg kawg yog ib qho hlab ntsha ectopic, feem ntau tshwm sim los ntawm qhov chaw tsis zoo ntawm lub aortic arch.
Lwm cov lus ceeb toom tom qab bronchial ultrasound qhia tias muaj cov hlab ntsha ectopic hauv 8.3-56% ntawm txhua tus neeg mob, nyob ntawm seb txoj kev kuaj mob (piv txwv li, autopsy lossis angiography).
Muaj peev xwm ectopic keeb kwm suav nrog:
- inferior aortic arch;
- distal descending thoracic aorta;
- subclavian artery;
- thyroid cell;
- internal mammary artery;
- hlab ntsha.
Cov hlab ntsha bronchial, uas yog los ntawm cov hlab ntsha coronary, tuaj yeem ua rau myocardial infarction lossisangina vim tub sab tub nyiag.
Kev kho mob ntsig txog
Bronchial hlab ntsha tuaj yeem hloov pauv hauv ntau yam pathologies. Piv txwv li, lawv nthuav thiab ua tortuous nyob rau hauv cov ntaub ntawv ntawm kub siab nyob rau hauv pulmonary thromboembolism. Rau qee yam kab mob (bronchiectasis, mob cancer, tuberculosis, thiab lwm yam) uas ua rau hemoptysis, arterial embolization tuaj yeem siv los nres los ntshav.
Kev tawm tsam ntawm cov hlab ntsha bronchial rau atherosclerosis
Nws tseem tsis paub yog tias kab mob arteriosclerotic cuam tshuam rau cov hlab ntsha no.
Tab sis Asmeskas cov kws tshawb fawb tau ua qhov kev tshawb fawb los ntsuas qhov tshwm sim ntawm cov kab mob arteriosclerosis, cuam tshuam nrog qee qhov chaw kho mob thiab chaw kuaj mob ntawm cov kab mob arteriosclerotic lossis ib qho kab mob coronary artery, thiab lees paub qhov tseem ceeb ntawm kev kho mob.
Cov hlab ntsha 10-15 hli ntev tau coj los ntawm 40 tus neeg mob uas muaj hnub nyoog nruab nrab ntawm 62-63 xyoo. Lawv cov keeb kwm kev kho mob thiab cov ncauj lus kom ntxaws txog kev kho mob thiab chaw kuaj mob muaj feem cuam tshuam rau arteriosclerosis tau sau tseg.
Tom qab USGD ntawm cov hlab ntsha bronchial, lawv txoj kab nruab nrab yog 0.97 hli. Histology qhia tawm medial calcific sclerosis nyob rau hauv tsuas yog 1 tus neeg mob (2.5%) yam tsis muaj concurrent tsim atherosclerotic lesions los yog luminal nqaim. Tsis tas li ntawd, txoj kab uas hla ntawm cov hlab ntsha tau cuam tshuam tsis tau tsuas yog nrog cov theem siab tshaj plaws ntawm tus kab mob (p=0.031), tab sis kuj tseem nrog cov ceg ntoo bronchial occlusion (p=0.042). Cov kws tshawb fawb tau sau tseg me ntsis kev sib raug zoo ntawmatherosclerosis thiab metabolic syndrome (p=0.075).
Kev txhais ntawm cov hlab ntsha pulmonary thiab nws txoj haujlwm
Cov hlab ntsws pulmonary pib ntawm theem ntawm txoj cai ventricle ntawm lub plawv thiab tom qab ntawd faib ua ob mus rau txhua lub ntsws, qhov chaw nws faib ua ntau ceg. Lub luag haujlwm ntawm cov hlab ntsha pulmonary yog thauj cov ntshav, depleting nws oxygen, los ntawm lub plawv mus rau lub ntsws. Pulmonary embolism tuaj yeem tshwm sim hauv cov hlab ntsha pulmonary thaum nws raug cuam tshuam los ntawm cov hlab ntsha uas txiav tawm kev ncig. Cov neeg dhia dej qee zaum dhau los ua cov neeg raug tsim txom ntawm pulmonary embolism tom qab tsim cov pa roj npuas hauv cov hlab ntsha pulmonary.
Txoj kev ceg
Cov ceg ntawm cov hlab ntsws muaj qhov ntev ntawm 4.5 cm txog 5 cm. Nws txoj kab uas hla yog 3.5 cm thiab nws tuab yog li 1 hli.
Kab rov tav ntawm lub hauv siab kov cov ceg pulmonary raws nws qhov ntev.
Cov hlab ntsha pulmonary yog ib puag ncig los ntawm serosa uas yog yam ntxwv ntawm lub aorta.
kab mob pulmonary artery
Pulmonary embolism yog ib qho thaiv ntawm cov hlab ntsha los ntawm cov hlab ntsha los yog cov pa roj uas tsis yaj hauv cov ntshav. Cov hlab ntsha feem ntau raug kev txom nyem los ntawm qhov tshwm sim ntawm tus kab mob thromboembolic. Cov txheej txheem rau kev kuaj mob pulmonary embolism:
- perfusion scintigraphy kom pom qhov sib txawv ntawm lub ntsws ua pa thiab cov hlab ntsha tsis zoo. Qhov kev ntsuam xyuas no tuaj yeem kuaj pom qhov sib txawv ntawm qhov cua thiab perfusion, thiaj li kuaj tau tus neeg mob kom raug;
- angioscope(arteriography/CT) yog siv los kuaj mob ntsws uas twb muaj lawm.
Qee lub plawv tsis xws luag tuaj yeem cuam tshuam rau cov hlab ntsha:
- tsis muaj lossis atresia ntawm cov hlab ntsha pulmonary;
- nqaim lossis stenosis ntawm pulmonary artery;
- qhov chaw tsis raug.
Yog tias lub ntsws ntshav siab siab dhau lawm, ces kuaj pom cov hlab ntsha pulmonary arterial hypertension lossis PAH, uas yog ib yam kab mob sib txawv ntawm cov hlab ntshav siab. Nws tuaj yeem yog qhov qub (uas yog, tsis muaj laj thawj) lossis theem nrab.
Superior and inferior vena cava
Tib neeg lub cev muaj ob hom vena cava: superior vena cava thiab inferior vena cava. Ob leeg ua haujlwm nqa ntshav los ntawm lub cev mus rau lub plawv. Yog li, qhov inferior vena cava tau txais cov ntshav los ntawm ntau yam kab mob nyob rau hauv lub plab kab noj hniav, digestive ib ntsuj av thiab qis extremities los ntawm lub portal vein.
Lub superior vena cava sau cov ntshav los ntawm lub taub hau, caj dab, hauv siab, thiab sab qaum los ntawm cov hlab ntsha azygos. Cov veins no muaj ib qho taw tes nyob rau hauv txoj cai atrium ntawm lub plawv.
Zoo kawg
Cov hlab ntsha bronchial yuav tsum tsis txhob nkag siab nrog cov hlab ntsha pulmonary. Lawv yog ib feem ntawm cov hlab ntsws thiab muab kev ua haujlwm ntawm lub ntsws vascularization los ntawm kev nqa cov ntshav dawb oxygenated los ntawm txoj cai ventricle kom oxygenated. Ntawm qhov tod tes, cov hlab ntsha bronchial ua lub luag haujlwm tseem ceeb: lawv coj mus rau lub ntswscov ntshav muaj oxygenated thiab cov khoom noj muaj txiaj ntsig.
