Aortic valvụ: Ọdịdị, ọrụ usoro. Stenosis na insufficiency nke aortic valvụ

Aortic valvular ọrịa obi na ọrịa na-emekarị ji zụrụ agwa na-egosipụta clinically naanị na agadi. Ọnụnọ ha nwere ike ime ka oké hemodynamic disturbances. Ogo nke ọrịa bụ na mgbanwe na-emetụta valves bụ irreversible.

Ọdịdị nke obi: valves

The obi a oghere ahụ nke bụ anọ-ulo. Ekpe na nri halves iche iche site partitions nke ọ na formations, Otú ọ dị, n'etiti atrium na ventricle n'akụkụ nke ọ bụla nwere a oghere onwem na a valvụ. Ndị a owuwu eme ka o kwe mezie ọbara, na-egbochi regurgitation, ie reverse nkedo.

Na hapụrụ ebe ahụ na mitral valvụ mejupụtara abụọ valves, na n'aka nri - ndị tricuspid, o nwere atọ mpempe akwụkwọ. Valves na-nyere akaị eri, nke ana achi achi oghere naanị otu direction. Nke a na-egbochi backflow ọbara n'ime atrium nkedo. Na ntughari nke ekpe ventricle n'ime aorta, aortic valvụ e. Ọrụ ya - inye a otu kwadoro nkwalite ọbara n'ime aorta. On n'akụkụ aka nri bụ nwekwara a valvụ nke akpa ume akwara. Ma entities na-akpọ "semilunar" ọ bụla n'ime ha nwere atọ mpempe akwụkwọ. Ọ bụla nhata, e.g., calcification nke aortic valvụ, na-eduga ná emeghasịkwa nke ọbara ije. Enwetara ntụpọ na-na-ejikọta ya na ihe ọ bụla ọrịa. Ya mere, ndị mmadụ na-akpọ ihe ize ndụ ihe ga-ekpuchi anya: tumadi echocardiogram.

The usoro nke aortic valvụ

A ịrịba ama ọrụ na mgbasa na-arụ na aortic valvụ. The flaps na-anọkwasị ma ọ bụ shortened - nke a bụ otu n'ime ndị isi pathologies. Ọ na-aghọ ihe na-akpata hemodynamic akwusighi. Ndị ọrụ nke akụkụ a nke ahu - iji hụ na nkwalite nke ọbara si ekpe atrium n'ime ventricle, na-egbochi regurgitation. The valves na-meghere n'oge atrial systole, na nke oge ọbara na-eduzi site aortic valvụ n'ime ventricle. Ọzọkwa, flaps na-emechi iji gbochie reverse nkedo.

Obi ntụpọ: nhazi ọkwa

Site na oge nke omume nwere ike mata congenital obi ntụpọ (aortic valvụ na ụlọ ọrụ ndị ọzọ) na enwetara. The mgbanwe imetụta ọ bụghị nanị valves, ma obi mgbidi. Congenital ntụpọ na-emekarị jikọtara, na-eme ka o sie ike ịchọpụta ma na-emeso.

Aortic valvụ stenosis

Pathology agụnye ibelata nke mgbanwe nke ekpe ventricle n'ime aorta - emetụta valvụ mpempe akwụkwọ na ha gbara ya gburugburu anụ ahụ. Nke a na ọrịa, dị ka mgbakọ na mwepụ na-egosi, ihe nkịtị na ụmụ nwoke. Akara nke mgbidi nke aorta na aortic valvụ na a metụtara na rheumatic na degenerative ọnya. Ọzọkwa, dị ka ndị etiologic gị n'ụlọnga nwere ike ime ihe endocarditis, ọrịa ogbu na nkwonkwo. Ọrịa ndị a ịkpata anọ na nke slats, si otú mbenata ha agagharị na valvụ ike n'ụzọ zuru ezu-emeghe n'oge systole nke ekpe ventricle. Na agadi, ihe mere ndị odida bụ mgbe atherosclerosis na calcification nke aortic valvụ mpempe akwụkwọ.

Dị ka a n'ihi nke ibelata nke aortic orifice e nwere ịrịba mgbanwe hemodynamics. Ha na-hụrụ mgbe ogo stenosis na-kwupụtara - mbenata tract site karịa 50%. Nke a na-eduga ná eziokwu ahụ bụ na grajentị nke aortic valvụ mgbali mgbanwe - aortic mgbali na-anọgide na nkịtị, kama ọ enwekwu na ekpe ventricle. Mụbara ikpughe na mgbidi nke ekpe ventricle-eduga ná mmepe nke compensatory hypertrophy, ya bụ, iji ya ndim. Ekemende nsogbu diastolic ọrụ ma na-akpata na-abawanye na mgbali na ekpe atrium. Hypertrophy eduga ụba oxygen ina, Otú ọ dị, ụba myocardial uka akaụntụ maka gara aga inweta ọbara na ọbụna a ọnụ ke concomitant pathologies. Nke a na-eduga ná mmepe nke obi ọdịda.

ọgwụ

Ná mmalite nkebi nke emetụtara aortic valvụ nwere ike anaghị egosipụta onwe. Clinical mgbanwe ime mgbe emeghe mmachi ka 2/3 nke nkịtị. Na oké exertion ọrịa amalite ichegbu na mgbu, metụtara nanị akụkụ ụfọdụ na-akpata breastbone. Pain syndrome na obere okwu, nwere ike na-metụtara ndị ọnwụ nke nsụhọ n'ihi systemic vasodilatation. Formation nke akpa ume ọbara mgbali na-eduga na iku ume ọkụ ọkụ, nke ibido naanị na ibu, ma mgbe ahụ, e nwere mgbe ike. Protracted ọrịa N'ezie na-aghọ a na-akpata adịghị ala ala obi ọdịda. Pathology achọ ịwa ahụ ọgwụgwọ, dị ka e nwere ihe ize ndụ nke na-arịa ọrịa, na mberede gbasara obi ọnwụ.

nchọpụta nsogbu

On nnyocha, ọrịa e ji mara pallor jikọtara belatara gbasara obi mmepụta. Radial akwara usu na sonso detectable - ọ bụ a obere na-adịghị ike. Auscultation hụrụ idem emem nke 2-aj u ma ọ bụ gbawara. ECG bụghị zuru ezu ihe ọmụma - ịrịba ama nke hypertrophy kpebisiri ike na naanị na oké stenosis. The kasị mkpughe echocardiography iji amata aortic valvụ. The flaps na-anọkwasị na thickened, narrowed oghere - bụ isi na-achọpụta ọrịa ibiere, nke na-enyere aka ịchọpụta ọmụmụ a. Ogo stenosis na nsogbu grajentị irè iji chọpụta catheterization cavities.

ọgwụgwọ

N'ihi na dị nwayọọ na-agafeghị oke stenosis achọ naanị mgbazi nke si ebi ndụ - ezere oké omumu, ọgwụgwọ nke comorbidities. Na ụba ugboro edebiri ikpo blockers, na obi odida irè diuretics, gbasara obi glycosides. Egosi akara mgbidi nke aorta na aortic valvụ achọ ịwa ahụ ọgwụgwọ. Enwekarị prosthesis ma ọ bụ balloon dilatation.

Aortic valvụ insufficiency

Aha e nyere daa ọrịa ji nesmykaniem nku. Nke a na onu na-eduga ná nloghachi nke ọbara ẹsịn ekpe ventricle na emee n'oge diastole. Eastern Nkwa bụ na-emekarị a sikwuoro nke infective endocarditis na rheumatic. Obere mgbe ọ na-eduga syphilis, aortic aneurysm, aorta, ọbara mgbali elu, Marfan si syndrome, systemic lupus erythematosus.

Aortic valvụ ekere òkè dị mkpa na mgbasa. Ezughị ezu mmechi nke nku ya na-akpata regurgitation, ie, nloghachi nke ọbara ka ekpe ventricle nkedo. N'ihi bụ oké ọbara olu nke ya uji eze, nke na-eduga bufee na stretchability. Esogbu systolic ọrụ na ọbara mgbali elu na-eduga ná mmepe nke hypertrophy. Retrograde abawanye nsogbu na obere gburugburu - ekara akpa ume ọbara mgbali.

ọgwụ

Ka stenosis, daa ọrịa na-eme ka ya onwe ya chere naanị na oké ogo ọdịda. Mgbe exertion mkpụmkpụ emee, a na-ejikọta ya na akpa ume ọbara mgbali. Pain nsogbu naanị na 20% nke ikpe. N'otu oge ahụ kwuru auscultation na mgbaàmà nke daa ọrịa:

1. Pulsation nke carotid akwara.
2. Mgbaàmà Duroziez ma ọ bụ omume systolic nātamu ntamu na femoral akwara. Ọ na-adị mgbe ọ na-pinched nso ka na-ege ntị ọnọdụ.
3. Mgbaàmà angioedema - agbanwe agba nke egbugbere ọnụ ma mbọ na dị na pulsation nke arterioles.
4. Traube abụọ aj u, dara ụda, "egbe ala" na-ebilite n'elu femoral akwara.
5. Mgbaàmà de Musset, gosipụtara n'ikwe isi ya.
6. Diastolic mkpọtụ mgbe 2 aj u na-ewere ọnọdụ na auscultation nke obi, nakwa dị ka-ebelata 1 pitch.

nchọpụta nsogbu

Ndị ụzọ gụnyere echocardiography na catheterization cavities. Ha na-ekwe ka ị na-amata aortic valvụ, nakwa dị ka soro olu nke regurgitated ọbara. Na ndabere nke a ọmụmụ kpebisiri ogo osote na kwara nke nke mkpa n'ịwa ahụ.

ọgwụgwọ

Oké ụkọ nke a nnukwu olu nke regurgitation, kpụ ọkụ n'ọnụ symptomatic achọ ịwa ahụ ọgwụgwọ. Ezigbo mkpụrụ - wuru aortic valves, nke ka ị na-iji weghachi n'obi ọrụ. Ọ bụrụ na ọ dị mkpa, e kenyere symptomatic ọgwụ.

Stenosis na aortic valvụ - kasị nkịtị obi ntụpọ, nke na-enwekarị ihe ga-esi a obodo ma ọ bụ ọrịa. The daa ọrịa na-aga n'ihu kama nwayọọ nwayọọ, nke na-enye ohere oge ịchọpụta ya. Modern ụzọ nke ọgwụgwọ aka weghachi valvụ ọrụ ma melite ọrịa na-arịa.