Kev nthuav dav ntawm lub aorta yog ib qho txaus ntshai tshaj plaws ntawm kev kwv yees kab mob. Hauv lwm txoj kev, qhov tshwm sim no hu ua aneurysm. Kev nthuav dav ntawm lub aorta yog ib qho mob txaus ntshai heev rau tus neeg mob thaum nws loj tuaj, yog li ntawd, qhov no yuav tsum tau saib xyuas kev kho mob tas li. Raws li txoj cai, nrog xws li pathologies, ib qho kev nthuav dav ntawm lub nkoj yog tsim. Nws yuav tsum raug sau tseg tias tsis yog ib lub tuam tsev muaj kev tiv thaiv los ntawm kev nthuav dav ntawm aorta. Txawm li cas los xij, nws yog qhov nce siab tshaj plaws uas pheej hmoo tshaj plaws. Nws tsim nyog paub koj tus kheej kom paub meej ntxiv txog qhov aortic dilatation yog dab tsi, nws raug kuaj pom li cas, thiab cov kev kho mob twg yog siv los kho tus kab mob no.
Departments ntawm aorta
Lub aorta yog ib qho ntawm ob lub nkoj loj hauv tib neeg lub cev uas txuas rau sab laug ventricle thiab nws lub atrium. Nyob rau sab hauv ntawm lub nkoj no muaj peb lub sinuses ntawm valsalva. Lub aorta feem ntau nqa ntshav los ntawm lub plawv mus rautag nrho lwm yam kabmob hauv lub cev thiab tib neeg cov ntaub so ntswg. Lub aorta zoo nkaus li zoo ib yam li tsob ntoo, uas muaj lub cev thiab cov ceg me me. Lub aorta tau muab faib ua ob peb ntu tseem ceeb:
- Ascending, txav ntawm lub aortic valve mus rau lub cev brachiocephalic.
- Lub aortic arch yog ib ntu tsis ntev ntawm lub nkoj loj, uas yog suav tias yog ib feem tseem ceeb ntawm tag nrho cov hlab ntsha ntawm lub taub hau thiab lub xub pwg nyom. Cov hlab ntsha no, uas pub lub taub hau thiab lub xub pwg nyom, tsim ib hom arc txuas cov ntu nce thiab nqis ntawm lub nkoj loj.
- Txog los yog thoracic. Hauv seem no, cov hlab ntsha nyob rau hauv kev taw qhia los ntawm cov hlab ntsha subclavian ntawm sab laug mus rau lub diaphragm.
- Lub plab. Qhov chaw no yog nyob ntawm lub diaphragm mus rau qhov chaw uas lub ntsiab hlab ntsha bifurcates, lub luag hauj lwm uas yog ua si los ntawm lub aorta.
piav qhia dav dav ntawm pathology
Nyob rau hauv nws tus kheej, kev nthuav dav ntawm aorta ntawm lub plawv tau nthuav tawm nyob rau hauv daim ntawv ntawm kev nce hauv txoj kab uas hla ntawm lub nkoj los ntawm ib thiab ib nrab zaug, qee zaum ntau dua. Nrog xws li ib tug pathology, cov phab ntsa ntawm lub dilated hlab ntsha poob lawv qhov siab tshaj plaws elasticity, uas cuam tshuam tsis zoo rau cov ntshav ntws hauv tib neeg lub cev, nrog rau lub xeev ntawm cov ntshav siab. Txhua qhov kev nthuav dav ntawm aorta ntawm lub plawv feem ntau yog ntaus nqi rau cov pab pawg sib txawv, uas sib txawv ntawm ib leeg hauv cheeb tsam ntawm kev ua haujlwm, qhov tseem ceeb ntawm kev tsim ntawm pathology, nrog rau cov qauv ntawm cov phab ntsa ntawm lub aorta. Piv txwv li, raws li lub hauv paus ntawm kev nthuav dav, cov nram qab no hom ntawm aneurysms yuav tsum txawv:
- Aortic cag expansion.
- Aneurysm cuam tshuam rau lub nkoj nce los ntawm lub sinotubular ridge mus rau aortic arch.
- Expansion of the aortic arch.
yam ntxwv ntawm kev ua txhaum
Thaum lub sijhawm zoo li no, cov kws tshaj lij tau sau tseg tias muaj kev nthuav dav ntawm lub nkoj hauv daim ntawv ntawm spindle lossis hnab. Aneurysmal expansion ntawm lub aorta tuaj yeem tsim tau kiag li ntawm txhua qhov ntawm lub nkoj no. Txij li thaum cov ntshav nkag mus rau ntau yam hauv nruab nrog cev hauv lub cev ncaj qha los ntawm aorta, thiab qhov no tau txhawb nqa los ntawm kev nce siab, cov kab mob yog suav tias yog qhov txaus ntshai heev rau tib neeg kev noj qab haus huv. Ib qho kev ua txhaum tsis tuaj yeem yog qhov nthuav dav ntawm lub lumen ntawm lub nkoj loj.
Txheeb cais qhia tias kwv yees li 38% ntawm cov neeg mob tau tshaj tawm yog vim kev nthuav dav ntawm lub plab aorta, txog 24% - mus rau ascending aorta, txog 18% - mus rau aortic arch.
Qhov laj thawj tseem ceeb rau kev txhim kho
Kev kuaj mob ntawm cov kab mob no yuav tsum tau ua los ntawm kws kho plawv nkaus xwb. Tom qab ntawd, tus kws kho mob tshwj xeeb yuav tsum tau muab tshuaj kho rau aortic o. Raws li cov laj thawj tseem ceeb rau kev tsim cov kab mob no, nws yog ib qho kev cai rau ib leeg tawm ob peb:
- Ntau yam kis kab mob thiab cov txheej txheem inflammatory.
- Kev tsim cov roj cholesterol plaques ntawm lub nkoj loj, uas feem ntau hu ua atherosclerosis hauv tshuaj.
- Qee yam ntawm cov hlab ntsha raug mob thaum lub sijhawm phais kev cuam tshuam ntawm cov hlab plawv.
- Congenital connective tissue dysplasia.
- Kev yug me nyuamvalves hauv me nyuam.
- Presence of hypertension.
- Congenital aneurysms hauv cov menyuam yug tshiab.
- Ntau yam kab mob genetic pathologies ntsig txog hom Marfan syndrome thiab lwm tus.
Nws tseem tsim nyog sau cia tias thaum cev xeeb tub hauv poj niam lub cev, cov txheej txheem ntawm kev tso tawm ntau ntxiv hauv cov ntshav mus rau hauv cov hlab ntsha pib tsim, uas kuj yog qhov ua rau kev loj hlob ntawm cov kab mob no. Tsis tas li ntawd, kev nthuav dav ntawm ascending aorta lossis lwm chav haujlwm yuav tshwm sim vim kev quav yeeb quav tshuaj lossis nicotine.
Ntau yam ntawm pathology
Raws li twb tau sau tseg lawm, txhua hom kab mob aneurysms txawv ntawm ib leeg nrog rau thaj chaw hauv cheeb tsam. Nws tsim nyog paub koj tus kheej kom ntxaws ntxiv nrog rau cov hom uas feem ntau kuaj pom hauv cov neeg mob.
Expansion of the plab aorta
Qhov no pathology yog ib qho ntawm feem ntau. Feem ntau ntawm cov ntaub ntawv tshaj tawm, hom kev nthuav dav no suav hais tias yog qhov tshwm sim ntawm qhov tshwm sim ntawm blunt kev raug mob rau thaj tsam plab, nrog rau qhov tshwm sim ntawm kev haus luam yeeb. Feem ntau cov txiv neej uas muaj hnub nyoog tshaj 75 xyoo raug kev txom nyem los ntawm cov kab mob no. Qhov txaus ntshai ntawm qhov aneurysm yog tias nws yuav luag ib txwm ruptures instantly, thiab qhov no tshwm sim yuav luag tsis mob. Tab sis yog tias qhov sib txawv tau pom meej hauv thaj tsam plab, tom qab ntawd tus neeg mob pib hnov qhov mob, ua rau thaj tsam lumbar thiab plab. Yog hais tias qhov rupture tshwm sim imperceptibly, ces muaj ib tug siab heev tshwm sim uas tus neeg mob yuav tuag vim nyob rau hauv hemorrhage.
Thaum nthuav dav ntawm lub plab plabIb tug neeg yuav hnov mob hauv lub raum, ureters, pancreas, thiab hauv cov hnyuv. Yog hais tias qhov chaw loj dhau mus rau lub ureter, qhov no yuav provoke hydronephrosis. Yog hais tias lub duodenum raug squeezing, ces tus neeg mob yuav stagnation ntawm cov zaub mov noj nyob rau hauv cov hnyuv.
Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias lub ntsiab lus tseem ceeb ntawm cov kab mob no suav tias yog qhov ua kom lub cev tsis tu ncua nyob rau hauv lub dab teg.
Arc expansion
Lub aortic arch yog thaj tsam ntawm lub nkoj loj uas feem ntau yuav tsim muaj qhov mob. Raws li txoj cai, hauv cheeb tsam no, cov ntshav ntws nrawm nrawm hloov nws cov kev taw qhia. Nws nyob ntawm no tias lub siab, tshaj tawm thiab turbulence ntawm cov ntshav khiav hloov. Raws li qhov tshwm sim ntawm tag nrho cov no, kev nthuav dav ntawm lumen ntawm lub aorta tuaj yeem txhim kho. Yeej, ib qho aneurysm ntawm lub koov manifests nws tus kheej nyob rau hauv daim ntawv ntawm ua tsis taus pa thiab hnoos qhuav, npub o nyob rau hauv lub xub pwg hniav, hoarseness, thiab tas li pulsation nyob rau hauv lub dab teg.
Txoj kev nthuav dav hauv cheeb tsam
Raws li txoj cai, nyob rau hauv cov ntaub ntawv no, lub pathology muaj ib tug fusiform los yog lub hnab-zoo li daim ntawv. Ob lub plab thiab cov hlab ntsha thoracic raug kev txom nyem los ntawm qhov nthuav dav no. Qhov laj thawj tseem ceeb rau kev nthuav dav ntawm cov hlab ntsha qis qis yog suav tias yog cov roj cholesterol plaque. Hom kab mob no tau kuaj pom thaum lub sijhawm x-rays ntawm lub cev, nrog rau cov hlab ntsha nyob hauv thaj tsam hauv siab. Raws li txoj cai, xws li pathology tsis muaj cov tsos mob. Tsuas yog qee zaus tus neeg mob tuaj yeem hnov mob tas li.mob hauv plab sab sauv.
Txoj kev kuaj mob
Feem ntau, aortic dilatation tsis muaj cov tsos mob lossis cov tsos mob tseem ceeb. Feem ntau, cov kab mob no tau kuaj pom los ntawm lub sijhawm thaum kuaj pom cov kab mob thib ob lossis thaum tiv thaiv cov txheej txheem. Yog tias tus kws kho mob tshwj xeeb muaj qhov tsis txaus ntseeg ntawm kev nthuav dav ntawm cov hlab ntsha tseem ceeb hauv tib neeg lub cev, ces nws yuav tsum tau sau cov kev ntsuas hauv qab no rau tus neeg mob:
- X-ray. Nws yuav tsum raug sau tseg tias X-ray yog thov txheeb ze rau lub tuam tsev uas muaj qhov tsis txaus ntseeg ntawm lub nkoj dilation.
- Echocardiography. Txoj kev kuaj mob no feem ntau yog siv thaum nthuav dav ascending aorta.
- MRI lossis CT ntawm lub nkoj loj ntawm lub plab lossis cov thoracic.
- Kev ua haujlwm angiography los ntsuas kev ua haujlwm ntawm cov hlab ntsha loj.
Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias feem ntau aneurysms yog disguised li lwm yam txheej txheem pathological, uas tuaj yeem ua rau tus kws kho mob mus yuam kev. Vim li no, nws yog ib qho tsim nyog yuav tsum tau ua kom muaj qhov sib txawv ntawm qhov tsim ntawm cov qog thiab lwm yam pathologies uas tshwm sim hauv lub ntsws lossis lwm yam kabmob uas nyob hauv lub plab kab noj hniav.
daim duab kho mob dav dav
Yog tias peb xav txog cov cim qhia ntawm kev nthuav dav ntawm lub nkoj loj, ces qhov pib ntawm kab mob no tsis muaj tsos mob thiab cov tsos mob. Yog hais tias mob tshwm sim, ces nws yog tsuas yog nyob rau hauv lub cheeb tsam ntawm lub aneurysm thiab manifests nws tus kheej nyob rau hauv daim ntawv.ripple.
Ua ntej tshaj plaws, cov tsos mob ntawm ntau hom vasodilation yog raws li hauv qab no:
- Nrog rau qhov nthuav dav ntawm lub plab aorta, hnyav tshwm sim hauv thaj tsam plab, cem quav, ntuav, tsis ua haujlwm ntawm lub plab, belching. Thaum palpation, tus kws kho mob tshwj xeeb yuav hnov mob me ntsis, uas yog pulsating.
- Nrog rau qhov nthuav dav ntawm ntu nce mus, qhov mob tshwm hauv thaj chaw sternum. Nyob rau hauv cov ntaub ntawv no, tus neeg mob kuj yuav muaj o nyob rau hauv lub Upper torso, nrog rau ntawm lub ntsej muag. Ua tsis taus pa, kiv taub hau thiab tachycardia.
- Thaum lub aortic arch nthuav dav, tus neeg mob yuav hnoos qhuav, bradycardia, salivation. Yog hais tias lub aorta yog compressed nyob rau hauv cheeb tsam ntawm lub bronchi thiab lub ntsws, ces mob ntsws yuav tshwm sim.
Txoj Kev Kho Mob
Txoj kev ntawm kev kho mob ntawm kev nthuav dav ntawm lub nkoj loj yuav tsum ua raws li daim ntawv tshwj xeeb ntawm aneurysm, nws qhov loj thiab qhov chaw. Yog tias muaj qhov me me ntawm lub lumen ntawm lub nkoj, tom qab ntawd tus neeg mob tuaj yeem pom tsuas yog nyob rau hauv dynamic. Hauv qhov no, tus kws kho mob tshwj xeeb tuaj yeem sau cov tshuaj hauv qab no:
- Cov tshuaj tiv thaiv ntshav siab kom txo qis ntshav siab.
- Venotonics uas tuaj yeem ua kom cov phab ntsa ntawm cov hlab ntsha.
- Tshuaj uas txo cov roj cholesterol.
- Ntau cov vitamin complexes kom normalize cov txheej txheem metabolic hauv myocardium.
- Anticoagulants tiv thaiv cov ntshav txhaws.
Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias txhua yam tshuaj yuav tsum raug sau tseg nkaus xwbkho mob plawv. Kev saib xyuas tshwj xeeb yuav tsum tau them rau qhov tseeb tias tsis muaj cov tshuaj pej xeem hauv kev kho mob ntawm cov kab mob no tsis raug.
Yog tias lub lumen ntawm cov hlab ntsha tseem ceeb hauv cheeb tsam plab yog ntau dua 4 cm, thiab hauv cheeb tsam thoracic nws loj dua 6 cm, ces tus neeg mob yuav xav tau kev phais. Tsis tas li ntawd, kev phais raug muab tshuaj rau hauv cov neeg mob lub lumen tau nce qhov loj ntawm 0.5 cm hauv rau lub hlis.
Lub hauv paus ntsiab lus ntawm kev cuam tshuam kev phais yog raws li kev tshem tawm ntawm ib feem ntawm lub nkoj, lossis ntawm nws qhov txo qis. Qee zaum, ib qho tshwj xeeb prosthetic stent muab tso rau. Kev ua haujlwm tuaj yeem tsim tau ob qho tib si nrog txoj kev qhib thiab nrog ib qho endoscopic.
Tiv thaiv kab mob
Yuav kom tsis txhob raug tus kab mob tsis zoo li no, koj yuav tsum saib xyuas koj txoj kev noj qab haus huv. Tshwj xeeb, txij thaum hluas nws raug pom zoo kom ntxiv dag zog rau koj cov hlab ntsha, uas koj yuav tsum tso tseg kev siv cawv thiab luam yeeb. Tom qab hnub nyoog 45 xyoos, tib neeg yuav tsum tau saib xyuas lawv cov ntshav siab. Yog tias pom muaj teeb meem, ces koj yuav tsum nrhiav kev pab los ntawm tus kws phais plawv.
Nyob rau hauv xaus, nws yog tsim nyog sau cia hais tias thaum xub thawj siab ib muag, ib tug tsis muaj mob pathology ua tau ib tug incredibly txaus ntshai rau tib neeg lub neej. Qhov tseeb yog tias qhov nthuav dav ntawm lub nkoj loj tuaj yeem ua rau muaj kev puas tsuaj ntawm lub aorta txhua lub sijhawm, uas tuaj yeem ua rau tuag sai. Yog li ntawd, nws yog ib qho tsim nyog yuav tau kho kom zoo thiab tsim nyog.qhov no pathology. Nws yuav tsum nco ntsoov tias kev ncua ntawm tus neeg mob tuaj yeem ua rau nws tuag.
