Ntau tus neeg mob uas muaj kab mob ntawm cov hlab plawv system xav paub yog vim li cas lub aorta ruptures thiab seb puas muaj peev xwm cawm tau ib tug neeg. Aneurysm implies ib qho tseem ceeb expansion ntawm lub lumen ntawm cov hlab ntsha thiab tsim ib tug protrusion ntawm phab ntsa. Atherosclerosis feem ntau provokes qhov pib ntawm tus kab mob, vim hais tias ntawm cov plaques tsim nyob rau hauv cov hlab ntsha.
Ib tus kab mob neoplasm tuaj yeem loj hlob sai heev hauv qab cov ntshav siab. Ib qho aneurysm tuaj yeem tawg tau txhua lub sijhawm, ua rau mob ntshav thiab tuag ntawm tus neeg mob.
Cov qauv ntawm cov hlab ntsha
Ua ntej txiav txim siab tias vim li cas qhov aneurysm tshwm sim, koj yuav tsum nkag siab meej tias lub aorta yog dab tsi thiab nws cov qauv yog dab tsi. Lub nkoj no los ntawm sab laug ventricle ntawm lub plawv thiab muab faib ua ob peb ntu, uas yog:
- nce;
- aortic arch;
- left subclavian;
- right humerocephalic cev.
Tom qab ntawd nws nkag mus rau hauv lub plab kab noj hniav los ntawm qhov qhib aortic hauv lub diaphragm kom nws qhov contraction tsis cuam tshuam cov ntshav khiav. Cov phab ntsa ntawm lub aorta yog ua los ntawm 3 txheej. Cov txheej sab hauv muaj cov hlwb tiaj tus uas haum snugly. Nws zoo tag nrhodu thiab ua kom cov ntshav txav hauv cov hlab ntsha.
Cov txheej txheem nruab nrab yog sawv cev los ntawm cov leeg nqaij leeg uas cog lus ua ke nrog lub plawv cov leeg, tsim kom muaj zog ntxiv kom txav ntshav los ntawm cov hlab ntsha. Cov txheej txheej sab nrauv yog cov ntaub so ntswg uas txhawb nqa cov duab ntawm lub nkoj thiab lav nws qhov chaw ib txwm muaj. Tom qab txiav txim siab seb lub aorta yog dab tsi, koj yuav tsum nkag siab tias vim li cas nws thiaj li tawg thiab qhov ua rau muaj qhov tshwm sim tuaj yeem yog.
Qhov laj thawj tseem ceeb
Ib yam mob uas ua rau muaj kev puas tsuaj yog ib qho kev loj hlob ntawm ib feem ntawm cov hlab ntsha. Ntawm cov laj thawj tseem ceeb ntawm aortic rupture yog:
- tus cwj pwm phem;
- laus;
- lub cev muaj zog;
- xeeb tub.
Maj mam loj hlob, qhov aneurysm exfoliates, tawg lub plhaub ntawm lub nkoj. Maj mam, cov ntshav pib sib sau, thiab yog tias cov ntaub so ntswg puas lawm, kev puas tsuaj tuaj yeem tshwm sim, uas ua rau tus neeg mob tuag. Thaum tsis muaj kev kho mob sai, nws tsis tuaj yeem cawm tib neeg.
Tsis tas li ntawd, muaj qhov ua rau muaj kev cuam tshuam rau aortic rupture. Qhov ua rau tuag yog tias tus neeg mob tsuas tsis muaj sijhawm los pab thawj zaug. Cov teeb meem tshwm sim muaj xws li lub sijhawm yug menyuam, nrog rau kev kub ntxhov siab.
YKev faib tawm ntawm pathology
Vim lub aorta muaj phab ntsa uas muaj zog heev uas tuaj yeem tiv taus cov ntshav siab, kev tsim kua muag tsis tshwm sim. Cov laj thawjaortic rupture tseem tsis tau to taub tag nrho, tab sis nws yog ib qho mob txaus ntshai heev. Cov kws tshaj lij txheeb xyuas ntau yam uas ua rau muaj tus mob no.
Nws tsim nyog sau cia tias qhov kev tawg ntawm qhov tawg ntawm aortic aneurysm tuaj yeem nyob hauv txhua qhov chaw. Vim yog kev ua txhaum ntawm kev ncaj ncees, qee qhov teeb meem yuav tshwm sim hauv kev ua haujlwm ntawm cov khoom nruab nrog cev uas nyob ib sab. Raws li qhov ceev ntawm cov txheej txheem pathological, ntau hom tuaj yeem paub qhov txawv, xws li:
- ntsim;
- subacute;
- mob.
Daim ntawv mob ntev yog suav tias yog qhov nyab xeeb tshaj plaws, vim tias nws muaj peev xwm tiv thaiv kev tawg thiab los ntshav. Hauv daim ntawv mob hnyav, cov phab ntsa ntawm lub aorta tuaj yeem tawg tag nrho hauv lub sijhawm luv luv.
Nyob ntawm qhov chaw tawg ntawm aorta ntawm lub plawv tshwm sim, pathology muab faib ua proximal thiab distal. Daim ntawv proximal yog tus cwj pwm los ntawm qhov tseeb tias lub stratification tshwm sim nyob rau hauv lub ascending ib feem ntawm lub nkoj thiab muaj ib tug tom ntej kis ntawm nws hauv qab no. Daim ntawv distal txawv ntawm qhov pathology cuam tshuam rau sab qis xwb.
Symptomatics
Cov tsos mob ntawm aortic rupture tau hais tau zoo heev, thiab ntawm lawv cov hauv qab no tuaj yeem paub qhov txawv:
- tshwm sim mob hnyav;
- nrawm nrawm nrawm;
- qaug zog;
- kiv taub hau thiab tsis nco qab;
- ntuav thiab xeev siab.
Tag nrho cov kev tshwm sim no kuj yog tus yam ntxwv ntawm ntau lwm cov kab mob plawv, yog li, txhawm rau txiav txim siab nws raws li qhov uas twb muaj lawm.cov tsos mob nyuaj. Yog hais tias ib tug neeg yws txog qhov tsis zoo ntawm kev noj qab haus huv thiab tag nrho cov cim qhia ntawm kev tawg ntawm lub thoracic aorta tau pom, ces yuav tsum kuaj xyuas tam sim.
Rupture ntawm plab aorta
Yog tias muaj qhov aortic rupture tshwm sim, qhov ua rau tuag yog mob hnyav sab hauv, uas yog vim li cas nws tseem ceeb heev rau kev kuaj xyuas thiab kho tus neeg mob raws sijhawm. Cov tsos mob ntawm aneurysm yog txuam nrog qhov chaw ntawm nws qhov tshwm sim, nrog rau kev tsim ntawm rupture, ua rau mob hemorrhage nrog rau lub xeev ntawm kev poob siab.
Abdominal aortic rupture ntawm cheeb tsam plab yog tshwm sim los ntawm qhov mob hnyav hauv plab, tsis muaj zog tam sim ntawd thiab qhov muag tsis pom kev. Feem ntau, cov tsos mob tshwm sim sai heev uas tus neeg ntawd tsis muaj sij hawm los piav txog dab tsi thab nws, poob siab, thiab nws tuag tam sim ntawd.
Yog hais tias qhov sib txawv hauv cheeb tsam siab dua me ntsis, ces tej zaum yuav muaj mob hauv plawv, zoo li lub plawv nres. Thaum cov ntshav nkag mus rau hauv lub plab kab noj hniav, ib qho kev poob siab tshwm sim tam sim.
Rupture ntawm aorta ntawm lub siab
Tus mob no tau pom ntau zaus, tshwj xeeb tshaj yog muaj qhov ua rau muaj qhov tshwm sim. Thaum lub aorta ruptures, qhov ua rau tuag ntawm tus neeg mob yog hemorrhagic stroke thiab lub plawv tsis ua hauj lwm. Nyob rau tib lub sijhawm, cov ntshav tsis txav mus los ntawm cov leeg, tsis nkag mus rau hauv lub plawv, vim tias nws nres. Tag nrho lwm yam kabmob pib raug kev txom nyem los ntawm qhov tsis muaj ntshav txaus, txawm li cas los xij, vim qhov nrawm ntawm qhov pomcov paib cia li tsis tshwm.
Ntawm cov ua rau aortic rupture yog atherosclerotic tsim, kab mob fungal thiab ntshav siab. Cov neeg mob, ua ntej muaj kev tawg, yws ntawm qhov mob hnyav hauv cheeb tsam ntawm lub plawv, ua tsis taus pa, tsis muaj zog thiab palpitations.
Yog tias cov hlab ntsha sab sauv puas lawm, tus mob no tshwm sim nws tus kheej hauv daim ntawv ntawm o thiab o ntawm caj dab, ntsej muag thiab lub cev. Tsis tas li ntawd, muaj kev cuam tshuam hauv kev ua pa. Cov hlab ntsha hauv caj dab sai sai, thiab daim tawv nqaij tig xiav.
Kev pab ib zaug
Nws yog ib qho tseem ceeb tsis yog tsuas yog paub tias dab tsi ua rau aortic rupture, tab sis kuj yuav muab kev pab thawj zaug rau tus neeg mob kom nws txoj sia yuav dim. Nws yog nyob ntawm qhov ua tau zoo thiab lub sijhawm ntawm kev pab thawj zaug uas qhov kev kwv yees tom ntej rau tus neeg yuav nyob ntawm ntau. Nco ntsoov hu lub tsheb thauj neeg mob, thiab ua ntej nws tuaj txog, ua qee yam kev ntsuas. Hauv particular, koj yuav tsum muab tus neeg mob txoj hauj lwm kab rov tav, sim tsa nws lub taub hau. Tus neeg no yuav tsum tsis muaj zog txhua lub sijhawm.
Koj yuav tsum sim ua kom tus neeg mob siab, thiaj li tsis ua rau tus mob hnyav ntxiv lossis ua rau muaj kev poob siab. Tsis tas li ntawd, nws yog txwv tsis pub muab zaub mov lossis dej haus, nrog rau kev siv cov tshuaj laxatives. Yog tias muaj nitroglycerin nyob hauv tsev, koj yuav tsum tau muab ib ntsiav tshuaj tso rau hauv qab tus neeg mob tus nplaig kom txo qhov mob me ntsis.
Tom qab ntawd, koj yuav tsum tau tos lub tsheb thauj neeg mob, vim tias qhov mob aortic rupture tsuas yog kho los ntawm kev tuavphais kev cuam tshuam. Tsis tas li ntawd, cov tshuaj ntxiv tau raug sau tseg los kho cov kab mob hauv qab, uas tuaj yeem ua rau lub nkoj tawg.
Diagnostics
Kev kuaj mob aneurysm yuav tsum tau kuaj xyuas kom ntxaws. Txawm li cas los xij, yog tias muaj kev puas tsuaj ntawm aortic xav tias yog ib tug hluas lossis cov neeg laus, tus kws kho mob tau sau ntawv kho mob, uas tom qab ntawd hloov kho raws li kev tshawb pom.
Ultrasound thiab magnetic resonance imaging yog qhov yuav tsum tau ua, tsuas yog qhov no yuav pab ua kom qhov tseeb thiab tsis suav nrog lwm yam kab mob. Nws tuaj yeem paub qhov tseeb ntawm tus kab mob tsuas yog nrog kev kawm kho vajtse.
Txoj kev kho mob
Kev ntsuas kev rov zoo yog txhawm rau txhim kho tus neeg mob tus mob, tshem tawm qhov mob poob siab, tsis txhob los ntshav, thiab tiv thaiv lub raum tsis ua haujlwm. Txoj kev kho mob hnyav suav nrog:
- kev tswj hwm cov ntshav qabzib-ntsev cov tshuaj;
- diuretics;
- calcium gluconate;
- siv lub clamp rau ntawm cov hlab ntsha;
- daim ntawv thov tshwj xeeb compress ntawm aorta;
- tso lub zais pa catheter rau hauv cov hlab ntsha.
Tom qab tso tseg cov ntshav, cov hlab ntsha raug tshem tawm thiab hloov cov hlab ntsha.
Kev ua haujlwm
Kev phais mob rau aortic rupture yuav tsum tsuas yog ua los ntawm tus kws kho mob uas muaj kev paub dhau los, raws li qhov hnyavmuaj teeb meem thiab muaj kev pheej hmoo ntawm kev tuag. Lub sternum tau qhib, thiab tom qab ntawd qhov chaw puas ntawm lub nkoj raug tshem tawm tag nrho thiab sutured los ntawm kev siv cov khoom siv tshwj xeeb rau kev sib tshuam. Yog tias tsim nyog, cov khoom siv ntawm lub plawv yuav tsum tau ua.
Rupture ntawm lub plab aorta yog kho los ntawm kev phais plab mus txog rau pubis. Rau kev pom zoo, duodenum raug tshem tawm ntawm lub plab kab noj hniav ib ntus. Tom qab ob peb feeb, tus kws kho mob ua ob peb incisions thiab tshem tawm lub aorta, uas yog ces clamped. Ib qho zoo sib xws ntawm lub aorta tshwm sim nyob ze ntawm cov hlab ntsha uas muab cov ntshav rau lub raum. Yog li ntawd, lub raum tsis ua haujlwm tuaj yeem tsim. Tias yog vim li cas qhov kev ua haujlwm tau ua tiav sai li sai tau.
Tom qab cov pob qij txha nyob hauv qhov chaw, cov clamps raug tshem tawm ntawm lub aorta. Cov kws phais mob tom qab ntawd ua qhov kev kuaj xyuas kom paub tseeb tias cov hlab ntsha ua haujlwm zoo. Tsuas yog tom qab ntawd cov kua dej raug tshem tawm thiab siv cov sutures. Kev kho mob feem ntau ua rau muaj txiaj ntsig zoo, tab sis qhov tseem ceeb yog tias nws yuav tsum tau ua raws sijhawm thiab ua tiav.
Thaum lub sijhawm ua haujlwm, cov ntshav khiav mus rau lub tshuab lub plawv-lub ntsws, uas yuav ua haujlwm ntawm lub plawv ib ntus. Tom qab kev ua haujlwm, tus neeg mob xav tau lub sijhawm ntev ntawm kev kho mob raws li kev saib xyuas nruj ntawm tus kws kho mob.
Yog qhov mob rwj tseem tsis tau tawg, tab sis muaj kev hem thawj, cov kws kho mob thovtxheej txheem stenting. Nws qhia txog kev txhim kho ntawm phab ntsa ntawm cov hlab ntsha los ntawm kev qhia txog endoprosthesis. Qhov no yog kev ua haujlwm nyab xeeb thiab ua haujlwm tsawg kawg nkaus.
Huab cua
Yog hais tias lub aorta tau tawg tag, ces qhov kev tshwm sim hauv qhov no yog qhov tsis zoo, feem ntau cov neeg mob tuag. Qhov no yog vim muaj ntau yam, tshwj xeeb, xws li:
- lub tsheb thauj neeg mob tuaj txog lig;
- ntshav ntau dhau;
- misdiagnosed;
- mob hnyav rau tshuaj loog;
- laus laus.
Nyob rau theem ntxov ntawm qhov teeb meem, tus neeg mob yuav muaj ntau dua yog tias koj tig mus rau tus kws kho mob kom pab raws sijhawm. Kev phais tau lees tias qhov rov zoo tag nrho, tab sis cov kev pheej hmoo cuam tshuam nrog kev ua haujlwm nws tus kheej tseem nyob.
ntsuas kev tiv thaiv
Txij li thaum aortic rupture nyob rau hauv ntau lub sij hawm xaus nyob rau hauv lub tuag ntawm tus neeg mob, nws yog tsim nyog los siv kev tiv thaiv los pab tiv thaiv qhov tshwm sim ntawm tus mob no. Kev kho kom raug los ntawm kev siv qee yam tshuaj pab txo qis cov txheej txheem ntawm stratification ntawm vascular cov ntaub so ntswg. Tsis tas li ntawd, cov neeg mob yuav tau txais cov tshuaj txo cov roj cholesterol.
Nrog rau qhov nce ntxiv ntawm cov ntaub so ntswg puas tsuaj, cov kws kho plawv pom zoo kom muaj kev phais. Kev phais yog yuav tsum tau rau cov neeg uas muaj Marfan syndrome.
Qhov zoo tshaj plaws, nws yog qhov zoo tshaj kom tsis txhob muaj qhov txhab. Txij li qhov kev pheej hmoo ntawm ruptureCov ntaub so ntswg nce nrog kev loj hlob ntawm atherosclerosis, tom qab ntawd txhawm rau tiv thaiv nws, koj yuav tsum noj cov tshuaj uas txo qis triglycerin thiab cov roj cholesterol. Nco ntsoov ua lub neej nquag txhawm rau tiv thaiv kev rog, thiab ua rau muaj qhov tshwm sim ntawm hypodynamia. Cov kws kho plawv pom zoo kom kho raws sijhawm ntawm kev kub siab thiab ntshav qab zib. Tsis tas li ntawd, yuav tsum tau noj zaub mov tshwj xeeb.
Khoom noj khoom haus
Kev noj haus ntawm tus neeg uas muaj kev pheej hmoo rau aortic rupture yog qhov tseem ceeb. Cov npe ntawm cov zaub mov noj qab haus huv suav nrog avocados, vim tias lawv muaj cov roj ntsha fatty acids, nrog rau cov vitamins uas txo qis kev pheej hmoo ntawm kev tsim teeb meem vascular. Cov zaub no pab tshem tawm cov roj (cholesterol) phem. Nws tuaj yeem noj nyoos lossis ntxiv rau zaub nyoos.
Grapefruit yog suav tias yog ib yam khoom muaj txiaj ntsig, vim nws muaj ntau cov vitamins thiab fiber ntau. Nws tshem tawm txoj kev pheej hmoo ntawm ischemia, atherosclerosis, thiab tseem txhim kho kev ua haujlwm ntawm cov hlab plawv.
Pomegranate yog qhov zoo rau kev haus vim nws muaj cov tshuaj antioxidants uas pab txo cov roj cholesterol, txo qhov kev pheej hmoo ntawm aneurysms, thiab kuj normalize ntshav ncig. Qej pab tawm tsam cov teeb meem vascular, vim nws muaj ntau yam tseem ceeb.
Ua ke nrog cov tshuaj, koj yuav tsum siv cov tshuaj ib txwm siv, tab sis ua ntej koj yuav tsum sab laj nrog koj tus kws kho mob. Tag nrho cov haujlwm no pab ua kom lub neej ntev thiab txo qhov kev pheej hmoo ntawm cov teeb meem.
