Aneurysm yog qhov loj ntawm lub nkoj uas ntau dua ob npaug ntawm nws txoj kab uas hla. Ntau tshaj 60% ntawm tag nrho cov aneurysms nyob rau hauv lub plab aorta. Cov kab mob no tshwm sim ntau zaus hauv cov neeg mob rheumatism, aortoarteritis, syphilis, atherosclerosis, thiab tuberculosis. Ib qho ua rau muaj qhov aneurysm yog mob plab, phais aortic.
Mechanism ntawm qhov tshwm sim
Qhov tshwm sim ntawm kev nthuav dav yog cuam tshuam nrog kev hloov pauv hauv cov txheej txheem elastic ntawm lub aorta. Nrog rau qhov nce hauv qhov tsis kam ntawm cov hlab ntsha distal, siab hauv plab aorta nce. Nyob rau hauv qhov tsis muaj peev xwm ntawm lub nkoj los tiv thaiv kev nce siab, nws qhov nthuav dav tshwm sim hauv ib qho chaw. Ib qho aneurysm yog ib feem ntawm lub aorta nrog cov ntshav ntws tawm, uas feem ntau cov ntshav txhaws.
Clinic
Nrog rau txoj kab uas hla me me (tsawg dua 20% ntawm cov neeg mob), qhov kev kawm asymptomatic tuaj yeem ua tau. Hauv lwm qhov xwm txheej, tag nrho cov tsos mob ntawm tus mob aneurysm tau muab faib ua qhov raug thiab tsis ncaj. Hom: pulsating tsim nyob rau hauv lub plab, mob, suab nrov thaum lub plawv contraction tshaj lub aneurysm. Mob tej zaum yuav zoo li lub siab los yog lub raum colic, nyob rau sab laug ntawm txoj hlab ntaws, tuaj yeem tawm mus rau sab nraub qaum lossis sab nraub qaum.
Indirect kos npe
- Mob plab plab: xeev siab, ntuav, tsis qab los noj mov, poob phaus.
- Urological syndrome: hematuria, dysuric mob.
- Ischioradicular syndrome: mob nraub qaum qis, lub cev muaj zog thiab kev hnov mob hauv ob txhais ceg.
- Tus mob ceg tawv ischemia: sib quas ntus claudication, trophic hloov.
Aneurysm yog ib yam kab mob loj zuj zus. Ntau tshaj li ib nrab ntawm cov neeg mob tuag hauv 2 xyoos ntawm kev kuaj mob los ntawm cov teeb meem.
Diagnosis
kuaj ultrasound tso cai rau koj los tsim qhov chaw thiab qhov loj ntawm kev kawm. Ntawm lub monitor, aneurysm yog ib qho kev nthuav dav ntawm lub nkoj nrog cov duab meej meej, parietal overlays thiab qeeb cov ntshav ntws. Angiography nthuav tawm ib qho aorta loj. Nyob rau hauv daim ntawv ntsuam xyuas X-ray duab ntawm lub plab kab noj hniav, dilated contours ntawm lub aorta nrog deposition ntawm calcifications yog pom, feem ntau nrog los ntawm impressions ntawm lub vertebrae - usura. CT qhia tau hais tias ib puag ncig tsim nrog pom tseeb contours, nyias phab ntsa, parietal thrombi thiab calcifications.
Kev kho mob
Aneurysm yog ib yam kab mob uas feem ntau ntawm cov kev phais mob tau ua, uas cuam tshuam nrog kev pheej hmoo siab ntawm cov teeb meem. Kev ua haujlwm yog contraindicated nyob rau hauv cov neeg mob uas tau raug mob myocardial infarction, muaj keeb kwm ntawm circulatory tsis ua hauj lwm, stroke.
Surgery
Muaj ntau yam kev xaiv rau kev kho mob phais:
- tshem tawm ntawm qhov aneurysm nrog rau lub hnab ntim aneurysmal, hloov aortic lossis bypass;
- kev tshem tawm tsis muaj pob khaus nrog rau hauv lub hnab yas.
Prosthetics feem ntau nrog aortofemoral prosthetics. Kev tuag tom qab kev cuam tshuam tsis pub tshaj 10%. Nrog rau kev pheej hmoo siab ntawm kev phais, aortic stenting tau ua: dhau qhov kev nthuav dav ntawm tus kheej los ntawm cov hlab ntsha femoral.
Complicated aneurysm
Qhov tshwm sim ntawm qhov aneurysm ncaj qha nyob ntawm nws qhov loj: qhov loj dua, qhov ntau dua nws yog qhov tawg lossis tawg.
