Aneurysm nke aorta nke obi - ihe ọ bụ? Aortic Aneurysm: akpatara, Mgbaàmà, Ọgwụgwọ

Nile n'etiti ndi nile mara obi na vaskụla ọrịa dọkịta iche na udi na-anọchite anya ndị kasị ukwuu n'ihe ize ndụ ka ndụ mmadụ. Ọ na-agụnye myocardial infarction, aortic aneurysm. On ikpeazụ, anyị na-atụle n'ụzọ sara mbara karị isiokwu.

Aortic aneurysm nke obi: ihe ọ bụ na otú ọ dị ize ndụ?

The aorta - nke a bụ otu n'ime ndị kasị ibu akwara na ahụ mmadụ, bụ nke dị nso na obi. Site na ya, na ọbara-aga site na isi uru ndị ọzọ niile na akwara. Gbasara obi aortic aneurysm bụ ọrịa ntutu ịdapụsị, na nke na mgbasa òkè nke aorta n'ihi na mmetụta nke ọtụtụ ihe. Pathology nwere ike ma congenital ma ọ bụ enwetara ke uwa.

The ọrịa amalite na eziokwu na n'okpuru nrụgide nke ọbara eruba na-adọwa intima. N'ihi ya, ọbara bụ ike igba kpọmkwem n'ime muscle oyi akwa. Na steeti a na-enwe ndidi na-emekarị na-eche na-egbu mgbu erughị ala na obi, na n'aka-ekpe. Icha mmirimmiri anụ ahụ, na nsogbu na-abawanye, e nwere nauseating ọchịchọ. Nrịrọ ọbara, na aortic mgbidi nke nta nke nta na-agbatị. Na-agbawa nke aneurysm onye nwere ike ida nsụhọ. Mgbe ụfọdụ, na-abịa ntabi ọnwụ si na oké ọbara ọnwụ na-akpata.

The pathogenesis nke ọrịa

Olee otú gbasara obi aneurysm nke aorta? Gịnị ka ọ bụ maka daa ọrịa, a pụrụ ịghọta ma ọ bụrụ na ị maara na Mmebe nke isi akwara nke ahụ mmadụ. Na myocardium nwere thinned mgbidi na protrude mgbe niile n'ime ọbara pumping si otu ventricle nke ọzọ. Ọ bụrụ na mmadụ nwere ọrịa a, Ịhapụ mgbidi nwayọọ nwayọọ slows ala. Ọnọdụ a na-eme ka o sie ike mgbe niile ọbara pumping.

Ke adianade na-emebi na mgbidi nke aorta ke kpụworo aneurysms nwekwara ifịk hemodynamic na n'ibu ihe. Pathology-abụkarị na operatively imebi ebe na-mgbe niile na-enweta ihe mụbara ibu ruru akwa eruba ike ọsọ. Adịghị ala ala aortic trauma na ịṅụbiga ọrụ nke proteolytic enzymes akpasu ndị Ihere na-agbanwe etiti ma ọdịdị nonspecific mgbanwe degenerative agwa na-arịa mgbidi.

Kpụrụ ihe aneurysm-eto eto na size, dị ka nsogbu na ya mgbidi naanị enwekwu. N'aka nke ọzọ, ọbara eruba n'ime aneurysmal nwa na-kwụsịlata na-aghọ a na-akpọ n'ọgba aghara. Na distal direction, naanị 45% nke ọbara dara site na ngụkọta ugbu ke aneurysm onwe ya. Nke a bụ n'ihi na ya oghere ọbara aga tinyere mgbidi Central iyi na-nọgidere na-enwe mgbe nile ịgbā usoro na ọnụnọ nke nnukwu quantities nke thrombotic pụta.

daa ọrịa akpatara

Ọkà mmụta sayensị si gburugburu ụwa anọgide na-ifịk ifịk inyocha ọrịa ndị dị ka gbasara obi aneurysm nke aorta, ihe ọ bụ na ihe so na-eme ya mmepe. Depụtara n'okpuru bụ ụfọdụ n'ime ha:

1. Atherosclerosis. Sclerotic mbadamba nkume ndị e guzobere na N'ezie nke ọrịa a, pụrụ imetụta aortic mgbidi na-eme ka ha na-agbanwe ezuru.
2. Infectious ọdịdị nke ọrịa. Gbasara obi aneurysm nke aorta abụkarị megide a ndabere nke syphilis ma ọ bụ ụkwara nta.
3. Congenital ọrịa (Marfan syndrome, Ehlers-Danlos syndrome). Ọtụtụ mgbe akụkọ ihe mere eme nke omume nke ọrịa a na-ekwu site n'inyocha akụkọ ezinụlọ ya.
4. Injury na n'ibu mmebi dị ka a n'ihi nke mberede ụgbọala.
5. Myocardial infarction. Nke a bụ ihe kasị nkịtị na-akpata ọrịa ahụ. Na 35% nke ndị tara ahụhụ a myocardial infarction, chọpụtara obi aneurysm. Na nke a, na ọ na-aghọta ka ya kpọmkwem n'ihu.

Site n'ihe ize ndụ nke na-emepe emepe ihe aneurysm agụnye na-ese siga, hypertensive, ibu ibu ndị na-elu ọbara cholesterol. Dị ka ọnụ ọgụgụ, gbasara obi aneurysm nke aorta ka ise ugboro ọzọ mgbe a chọpụtara na nwoke karịa na nwanyị. Dị ka a na-achị, ndị ọrịa afọ - ihe karịrị afọ 50.

ọrịa nhazi ọkwa

Na vaskụla ịwa ahụ na-eji ọtụtụ embodiments aortic aneurysms classifications dabere na ha ozugbo orunótu mgbidi Ọdịdị, ụdị na etiology.

Na dị na segmental typology na-akwanyere ùgwù: aneurysm nke imi nke Valsalva, arịgo / agbadata akụkụ, ndị aortic njiko na abdominal aorta.

Evaluation nke morphological Ọdịdị nke aneurysms obodo na-enye ohere ka ha kee ha n'ime ezi na ụgha. The mgbidi nke ikpeazụ na-anọchi anya connective anụ ahụ, nke na-kpụrụ n'ihi pulsatile hematoma guzobere.

The udi nke aneurysm nwere ike ịbụ saccular na fusiform.

Gịnị bụ ihe mgbaàmà esonyere daa ọrịa?

N'ọnọdụ ka ukwuu ọrịa bụ asymptomatic. Ịchọpụta na ọ na random, mgbe, n'oge na-eme nyocha ma ọ bụ na nnyocha nke ndị ọzọ na akụkụ. Mkpesa nke ọrịa na-egosi na ọ bụrụ na aneurysm e ji eto ngwa ngwa na bụ ugbua na Iv nke ezumike.

Aneurysm nke arịgo aorta obi na ya aak na-emekarị so a na-egbuke egbuke-adakarị picture, ihe mere nke a bụ akpan akpan anatomical ọnọdụ. Pathology pụrụ itinye nsogbu na ọgịrịga na thoracic spain. Ọrịa mkpesa nke ụkwara na iku ume ọkụ ọkụ n'ihi na mkpakọ nke bronchi, obi palpitations, hoarseness.

Ruo ogologo oge ọkụ mgbu na azụ bụ ihe e ji mara nke pathologies nke thoracic aorta nke obi. Na nke a, ọrịa na-emekarị ememme ahụ anya nke akọrọ ụkwara, edema, dizziness na adịghị ike ofụri idem.

N'oge na-achọpụta ọrịa ule, dọkịta ga-enye pụrụ iche anya ka mpụga atụmatụ nke onye. Elongation nkwu, ogologo, kyphosis, sternal nrụrụ - niile nke ndị a ihe ịrịba ama nwere ike indicative nke Marfan syndrome. Anyị na-ama na-ekwu banyere ya n'isiokwu a.

Dị mwute ikwu na, mgbe mgbe, ihe àmà mbụ nke daa ọrịa bụ aortic agbawa. Ọ na-egosipụta profuse ọbara ọgbụgba na digestive akụkụ. Onye ọrịa e vomiting na ọbara, oké obi mgbu na-agbasa ala ọkpụkpụ azụ. The enweghị adọ aka pụrụ ịkpata ọrịa ọnwụ.

Olee otú iji chọpụta ihe aneurysm?

Ọtụtụ mgbe, n'oge a na-eme lee gị ahụ, ndị dọkịta chọpụtara na dị ka "gbasara obi aneurysm nke aorta." Gịnị ka ọ bụ, ihe ndị na-akpata ọrịa na isi ụzọ nke ọgwụgwọ ahụ, ọkachamara kwesịrị ịgwa ndị isi n'ikuku. N'ihi na a ọzọ zuru ezu ọmụmụ nke nsogbu nwere ike mkpa a ọnụ ọgụgụ nke ndị ọzọ ọmụmụ, gụnyere CT, MRI, ultrasound. Dị ka ihe ikpeazụ nchoputa, dọkịta na-enweta zuru adakarị picture nke ọrịa.

On ule ọ dị mkpa ka gaa na akaụntụ eziokwu ahụ bụ na ihe aneurysm nke ha mgbaàmà yiri ọrịa ndị ọzọ. Ọ bụ ya mere a ọrụ pụrụ iche na nchoputa nyere esi ọmụmụ.

daa ọrịa nchọpụta na ikekwe site echetakwa. Ọkachamara nwere ike ikwu mgbe nile na-ndikom mgbe afọ 60, bụ ndị nwere ike mbà àgwà ọjọọ ma ọ bụ nwere a akụkọ ihe mere eme nke a na ọrịa.

Aneurysm nke aorta nke obi: ọgwụgwọ

Na mgbaàmà nke ọrịa na ọgwụgwọ kpọmkwem metụtara. Mgbe dọkịta ga-egosi ikpeazụ nchoputa, i nwere ike n'ihu ọgwụgwọ.

Na asymptomatic daa ọrịa ọgwụ na-ejedebeghị na-elekọta nke ala site na a vaskụla dọkịta na-awa na a mgbe nile na-X-ray akara. Iji belata ihe ize ndụ nke nsogbu na ụfọdụ ọrịa ndinọ anticoagulants.

Surgery na-owụt ke aneurysm nnukwu size (4 cm), nakwa dị ka na-aga n'ihu ibu. Nke a na ọgwụgwọ a na-atụ aro maka fọrọ nke nta niile ndị ọrịa bụ ndị nwere obibi na daa ọrịa na-akpọ "gbasara obi aneurysm nke aorta."

Operation pụtara site excising a ọrịa arịa òkè, suturing, ma ọ bụ ya nnọchi site nkwarụ vaskụla prosthesis.

N'ụzọ dị mwute, prognosis nke ọrịa a na ihe ndị kasị ọjọọ ikpe. Ebe ọ bụ na mmalite nke mmepe nke aneurysm ma na-anwụ banyere 75% nke ọrịa n'ime afọ ise. Nkera-ha na-gburu site na mberede-agbawa nke aorta, na ndị fọdụrụ - by concomitant pathologies (ọrịa strok, ischemia).

nsogbu nke aneurysm

1. Ntupo aortic valvụ na obi ọdịda.
2. Aneurysm agbawa. N'ihi ya, ọ ọtụtụ ọbara ọgbụgba n'ime pleural uji eze, akụkụ okuku ume na, obi ma ọ bụ na nkọlọ akpa. Bụrụ na nke na-agba ọbara kpọmkwem n'ime pericardial oghere nke na-emepe emepe gbasara obi tamponade.
3. Nnukwu aneurysm clotting.

The n'elu-e kwuru nsogbu, ma ọ bụrụ na ọ bụghị inye adọ ọgwụ nwere ike igbu ndị ọrịa na a nchoputa nke "gbasara obi aneurysm nke aorta." Ọgwụgwọ nke ọrịa a dibịa ahọrọ, dabeere na mkpokọta ọnọdụ onye ọrịa na ogo ogo nke daa ọrịa.

mgbochi

Mgbe ọ na-abịa mgbochi nke ndị dị otú ahụ a ọrịa, niile na-atụ aro na ike ndụ na ịjụ àgwà ọjọọ ga-atụle ụzọ. Dị ka ekwuola, ruo ogologo oge nwere ike ime na a zoro ezo ụdị gbasara obi aneurysm nke aorta. Mgbaàmà nke a adịghị egosi, onye ọrịa bụ na-amaghị nke ọnụnọ nke a daa ọrịa. Ọ bụ ya mere ma ọ bụrụ na mmadụ bụ onye na n'ihe ize ndụ (ise siga, ọbara mgbali elu, a akụkọ ezinụlọ nke aortic dissection ikpe), na ha kwesịrị ịna-ata a zuru ezu na-achọpụta ọrịa nwale. N'ihi na ndị a na nzube, n'ozuzu iji ultrasound, aortography iji MRI iche n'ụlọnga. Bịara n'Ezi Oge nchọpụta nke ọrịa nwere ike ịzọpụta ndụ.

ọgwụgwụ

Isiokwu a na-enye ihe ọmụma na "An aneurysm nke aorta nke obi: akpatara, Mgbaàmà na Ọgwụgwọ." Atụla egwu nke ọrịa, dị ka na-adọ nchoputa na eru ọgwụgwọ ná mmalite nkebi kwere fọrọ ruo mgbe ebighị ebi na-echefu banyere nsogbu.