Tricuspid valvụ. Tricuspid valvụ insufficiency 1, 2, 3 degrees: mgbaàmà na ọgwụgwọ

Isi muscle nke ahụ mmadụ bụ obi. O siri ike mere ndokwa usoro, mmiri nke nke bụ valves. Nri ọkara bụ tricuspid valvụ. Ọ na-ezi ndị atrium na ventricle. Mgbe ọ mkpọka, ọbara eruba na a nke muscle na-akwusila. N'ihi bụ a-eyi ndụ egwu ọnọdụ nke onye ahụ. Na ọgwụ omume, ọ na-mara dị ka "ọdịda nke tricuspid valvụ." Na taa isiokwu anyị ga-atụle isi na-akpata, ihe mgbaàmà na ọgwụgwọ nke ọrịa a.

anatomical akwụkwọ

A obi madu a muscular ngwa. Ya oghere ekewa 2 atria na ventricle 2. Nkwurịta okwu n'etiti ndị a owuwu ime site na valves. Ha na-ahụ maka ndị oruru ọbara na one direction.

N'akụkụ aka nri nke ime-ulo nile nke obi -ejikọrọ site tricuspid valvụ. Ọ mejupụtara nke na-esonụ anatomical owuwu:

• atọ mpempe akwụkwọ (septal, n'ihu ma n'azụ);
• akaị N'ezie;
• papillary uru;
• annulus fibrosus.

N'oge mkpi nke atrium tricuspid valvụ emepe. Nke nta nke nta, ọbara jupụta ventricle. Mgbe nke ahụ gasịrị myocardium amalite alternately abịakọrọ mgbe n'okpuru ike mgbali valvụ mpempe akwụkwọ slam. Ndị dị otú ahụ a na-agba ọsọ usoro egbochi reverse gbatara (regurgitation) ọbara. N'okpuru nduzi nke ụfọdụ ihe mgbe ụfọdụ na-arụ ọrụ ada ada. Na nke a anyị na-ekwu na-enwe tricuspid valvụ insufficiency. Otú ọ dị, na-arụ ọrụ n'ụzọ zuru ezu, ọ na-enweghị ike.

N'oge a daa ọrịa ọbara nri ventricle azụ n'ime atrium. A nta na-abawanye na olu nke mmiri mmiri bụ fọrọ enweghị mmetụta na ịrụ ọrụ nke isi akwara nke ahu. Na oké obi odida ata deformation ulo, mgbali egosi ịdị iche iche n'ụzọ dị ịrịba ama na ha. Ọ nwere ike na-amụba ka 8 ugboro tụnyere eke ụkpụrụ.

Brief nkọwa nke ọrịa

Tricuspid insufficiency - nke a bụ a ọrịa obi na ọrịa na-amalite n'ihi nkwarụ mmechi nke valvụ leaflets, agbara mgbatị ọbara nri ventricle n'ime atrium. Against ndabere nke mgbe nile na-regurgitation diastolic olu na nsogbu na Ọdịdị nke obi ụba. Nke a gụnyere hypertrophy na dilatation nke mgbidi ya. Dị ka a n'ihi nke emeghasịkwa nke compensatory usoro na ndidi ịzụlite mkpọchi ke idem.

Tricuspid insufficiency na-esokarị ndị ọzọ congenital obi ntụpọ. Dị ka ihe atụ, a patent foramen ovale ma ọ bụ atrial septal nkwarụ.

Main-akpata na iche-iche nke daa ọrịa

Insufficiency nke tricuspid valvụ bụ mgbe dị iche iche maka. Maka ezi nchoputa, ị ga-akpa chọpụta udi nke-enweghị nchịkwa na usoro. N'ihi nke a, na ọgwụ na ahụ ike omume, dị iche iche na ibiere: omume oge, orunótu nke mebiri emebi òkè nke valvụ, ogo regurgitation.

Dabere na oge mmepe, ọrịa na ajụjụ bụ nke abụọ iche iche. Dị ka a na-achị, na N'ọnọdụ nile ọ na-adịghị enwetara, na emee mgbe aza. Congenital malformation chọpụtara adịkarịghị amalite nọ n'afọ. On ọdịdị ya na-emetụta ihe nke na-adịghị mma na ihe na organism nke ime. Nke a nwere ike radieshon, na-efe efe ọrịa, ma ọ bụ X-ray irradiation.

Dabere na eziokwu, nke akụkụ mebiri emebi tricuspid valvụ insufficiency nwere ike ịbụ nke abụọ iche-iche. The organic nhọrọ esonyere a n'ahụ mgbanwe ke valves. Ha ji nwayọọ nwayọọ nkwarụ, kpuchie na oge ntoju. Mgbe ọtọ ụdị ọrịa valvụ emechi kpamkpam.

Development zụrụ organic tricuspid insufficiency mere site na-esonụ:

1. Rheumatic fever - mbufụt, inyịme ka esịtidem akụkụ nke usoro.
2. Carcinoid syndrome - imebi iche iche akụkụ ruru ka obere nsia etuto ahụ. Pathogenic ọcha nke etuto ahụ n'ime ọbara na amalite ọgụ ndị endocardium. Mgbe ha na-abanye akpa ume arịa.
3. Infective endocarditis - mbufụt nke lining nke obi.
4. Mitral commissurotomy. Nke a na ime ihe, nke na-eji na ọgwụgwọ nke stenosis.

Enwetara ọtọ (ikwu) tricuspid valvụ insufficiency amalite n'ihi mmebi nke papillary uru ma ọ bụ mmụba nke annulus fibrosus. Ke akpa idaha, ihe yiri nke ihe owuwu ahụ maka ịnọgide na-enwe moto ikike valves. Myocardial infarction papillary uru mebiri emebi. Nke a na-eduga ná emeghasịkwa nke arụmọrụ nke tricuspid valvụ.

Pathology nke fibrous mgbanaka nwere ike ime ka a dịgasị iche iche nke ọrịa. Ndị a ga na-agụnye myocarditis, etịbede chords etuto ahụ na etuto ahụ na gbochie ọbara-eru site na ventricle.

Nkebi nke mmepe nke insufficiency

Dabere na ogo nke regurgitation usoro, na N'ezie nke ọrịa na-emekarị na-akwanyere ùgwù ọtụtụ nkebi:

• 1. The ogo reverse ugbu a ọbara retains kacha nta ụkpụrụ na-adịghị esonyere hemodynamic aghara.
• Degree 2. Mgbe a na ogbo daa ọrịa so reverse ọbara stream tupu a anya nke na-adịghị gafere 2 cm.
• Degree 3. Blood eruba Ọganihu na atrium n'elu a anya nke 2 cm si n'elu valvụ.
• 4. The ogo n'oge regurgitation ọbara penetrates n'ime elu nkebi nke atrium, agafe ofụri ụlọ.

Banyere ihe mgbaàmà-eso ọ bụla ogbo nke ọrịa, ọ ga-atụle n'okpuru.

Mgbaàmà nke tricuspid valvụ insufficiency

Mgbe mbụ ogbo nke ọrịa obi na ọrịa bụ fọrọ nke nta na-adịghị na-egosipụta onwe. Mgbe ụfọdụ, mgbe ihe omumu ọrịa mara ọdịdị ike pulsation nke veins na olu. Ịchọpụta enweghị nchịkwa usoro-ekwe omume nanị site n'enyemaka nke ndị Doppler. Nkịtị ECG adịghị egosi ịrịba mgbanwe obi.

Tricuspid valvụ insufficiency so site na-abawanye nke 2 degrees laa azu ọbara olu. Right ventricular aghara na-eduga onye na-abawanye na ndị size nke obi. Dị ka a N'ihi ya, ndị na-adakarị picture na-gbakwunyere site ndị na-esonụ mgbaàmà:

• ike ọgwụgwụ, belata ahụ ha na ụbụrụ ọrụ;
• Ugboro urination na abalị;
• oké ọzịza nke ala na nsọtụ;
• iku ume ọkụ ọkụ;
• mmetụta nke ibu n'okpuru ọgiriga;
• dyspepsia.

Mgbe na-ege ntị obi na-ekpebisi ike pansystolic ụzụ na atrial fibrillation.

N'ihi ya, na-enwekwu ego nke daa ọrịa progression mgbaàmà gosipụtawo. Eleghara ha anya-adịghị atụ aro. Ọ dị mma na mbụ ogbo nke ọrịa na-achọ ruru eru ọgwụ ndụmọdụ. Tricuspid valvụ insufficiency nke 1-2 degrees ike ka a gwọọ ya na ọgwụ. Ntughari ka ọzọ ogbo nke ọrịa mgbe niile na-achọ ịwa ahụ. Ọbụna mgbe ọrụ ọ bụ omume na omume nke nsogbu.

Njirimara nke ọrịa na ụmụ

Ụmụ ọhụrụ oké regurgitation na ọnụnọ nke concomitant ọrịa obi na ọrịa ewekarị ngwa mmepe nke nri ventricular ọdịda. Ọtụtụ mgbe ọ na-agwụ na ọnwụ.

The enwetara ụdị ọrịa amalite na nsogbu nke ọrịa ndị ọzọ. Ọtụtụ mgbe, ọ bụ a streptococcus ọrịa, nke na-eduga rheumatic.

Tinyere ihe ndị ọzọ ihe n'ihi na ọdịda ụmụaka nwere ike mata:

• nnukwu ụdị ọbara mgbali;
• ọrịa nke myocardium;
• traumatic mmerụ;
• ịza aza neoplasms.

Mgbe mbụ ogbo nke tricuspid valvụ insufficiency na ụmụaka a na-ewere dị ka anatomical atụmatụ. The akpa ntaifiọk nke enweghị nchịkwa usoro na-achọ ọ ọgwụgwọ. Na afọ, ọrịa na-emekarị ekwurịta na ya.

Ọdịda nke mitral na tricuspid valvụ

Ọtụtụ mgbe, a mebiri nke ọrụ valvụ n'akụkụ aka nri na-achọkwa na dysfunction nke owuwu nke ekpe ọkara. Na mpaghara a, isi ibu bụ na a na-akpọ mitral valvụ. Mgbaàmà nke aghara na-chịkọtara. Nchikota ndị a na-anaghị ekwe nwere a ezighị ezi mmetụta na-arụ ọrụ nke nri ventricle, nke na-mgbagwoju anya site ọdịdị akpa ume ọbara mgbali. Ọrịa na a nchoputa nke "mitral insufficiency, na tricuspid valvụ 1 ogo" na-atụ aro ịwa ahụ.

ụzọ nke nchoputa

Early nchọpụta nke ọrịa na-arụ a kpọmkwem ọrụ ịga nke ọma nke ọgwụgwọ, nakwa dị ka mmetụta na ndu ndimmadu nke onye ọrịa. Ebe ọ bụ na ọdịda nke tricuspid valvụ nke 1 ogo wee fọrọ nke nta asymptomatic daa ọrịa achọpụtara nanị mgbe ntughari ka ọzọ ogbo nke development.

Diagnosis-amalite na a nnyocha e mere na onye ọrịa, na-amụ ihe nke akụkọ ihe mere eme na-ahụ ule. Ịjụ ajụjụ dị iche iche na-enwe ndidi, dọkịta na-ekpebi na-adakarị picture, oge mbụ mgbaàmà. Ọ dịkwa mkpa ka ị mara ihe ọrịa kpọkwasịwo ọdịda. Mgbe mpụga ule na-emekarị na-ekpughe akpụkpọ cyanosis na edema, na auscultation - obi n'afọ iri na ụma disturbances.

Dị ka akụkụ nke nchoputa bụchaghị kenyere ọtụtụ laabu ule. N'etiti ha, ndị kasị ihe ọmụma ji ọbara analysis na-amụ immunological ọnọdụ nke onye ọrịa. Dị ka ihe laabu ule nwere ike ikpe ikpe na ọnụnọ nke mbufụt ke idem, na-ewere ọnọdụ ke ukem ọrịa.

Iji dokwuo anya nchoputa dọkịta nwere ike iji a ngwaike nnyocha e mere na ụzọ. Ndị a gụnyere:

1. ECG. Ọ na-ekenịmde ịmata atrium mpịakọta mụbaa.
2. Phonocardiogram. Egosi systolic mkpọtụ.
3. Gburugburu CT. Ọ na-enye ihe ọmụma image nke isi akwara nke ahu.
4. Radiograph. Enye otu echiche nke ndị size nke obi, ọ na-achọpụta rụọ mkpọchi.
5. Koronokardiografiya. Ọ na-eji tupu ịwa ahụ na inwale ọbara.
6. Echocardiography. Ọ na-egosi deformation nke flaps, ọnụnọ nke ọhụrụ ndị a formations.

Doctor ọkọkpọhi ihe echiche nke ọnọdụ nke tricuspid valvụ na ndabere nke zuru pụta nke nnyocha e mere. Enweghị a Ọdịdị na-ọma-emeso naanị na mbụ ogbo nke development. More zuru ezu embodiments nke ọgwụ na ọrịa a ga-atụle dịrị gaba n'ime ebe.

ọgwụgwọ Iwu

Insufficiency nke tricuspid valvụ nke 1 ogo adịghị achọ ọgwụgwọ. Ọ bụrụ na ọrịa na-akpali ọzọ ogbo nke mmepe, onye ọrịa na-kenyere ọgwụgwọ. Ọ nwere ike na-abụ ma na nkà ọgwụ na-awa ahụ. Site ikpeazụ resotu ke kasị njọ ikpe, ebe ojiji nke mbadamba na injections anaghị arụ ọrụ.

The dum oge nke ọgwụgwọ, onye ọrịa ga-rube isi na ụkpụrụ ndị a:

1. Kpamkpam ịkwụsị ise siga.
2. Zere hypothermia na-akpata nrụgide.
3. A na-eri iji belata ibu na obi.
4. Belata osisi ike na ego nke mmega.

Ikwenyesi ike ụkpụrụ nduzi ndị a enwekwu irè nke ọgwụgwọ, nakwa dị ka a ụdị mgbochi nke nsogbu.

ọgwụ

Agafeghị oke tricuspid valvụ insufficiency na-adịghị na-ewere ihe na-egosi ịwa ahụ aka. Na nke a, ọgwụgwọ a rụrụ na-enyemaka nke ọgwụ ọjọọ. Standard ọgwụ atụmatụ agụnye iji ihe ndị na-esonụ ọgwụ:

1. Diuretics ( "Britomar", "Hydrochlorothiazide"). Kwụsị ọnọdụ na-achọghị na mmiri ahụ mee ngwangwa excretion usoro.
2. Potassium ọgwụ ọjọọ ( "Panangin", "Asparkam"). Enyere ahụ bụghị imubanye ngafe ọmụmụ.
3. Venous dilators ( "Korvaton", "Nitrosorbide"). Belata ibu na obi site na ọbara nke nkwụnye ego.
4. Anticoagulants ( "Varfareks '' Warfarin").
5. Gbasara obi glycosides ( "Digoxin", "Korglikon"). Nyere na-alụso arrhythmia.
6. Beta-blockers ( "Diltiazem" "Carvedilol"). Belata omume nke ekpe ventricular mkpi.

The onunu ogwu Usoro na onunu ogwu preparations kpebisiri ike n'otu n'otu anya nke ogo nke ọrịa.

ịkpa aka

Tricuspid valvụ insufficiency 3 degrees-atụle ga-isi na-egosi maka ịwa ahụ aka. Ọrụ na-atụ aro maka ọrịa na oké deformations flaps ma ọ bụ gosi ọdịda ha ọrụ.

Mgbe nchekwa valvụ ngwa mee annuloplasty. N'oge ọrụ dọkịta superimposes U ekara nkwonkwo na mebiri emebi ebe.

Ọ bụrụ na aka bụ adighi ike, e nwere doro anya bughi mgbanwe ahụ, onye ọrịa na-etinye aka wuru dripping. Mgbe nkunye nke prosthesis chọrọ anticoagulation. N'oge nkunye nke ndu prosthesis ọ wears a mkpụmkpụ-okwu okike. Ọ bụrụ na ọ ka nke ọgwụ alloys, ọgwụgwọ nke tricuspid valvụ na-ewe a obere oge.

Ekwe Omume nsogbu na prognosis mgbake

Enweghị adọ ọgwụgwọ pụrụ iduga ná ndị ọrịa. Enweghị nchịkwa usoro na nke a na-agụnye ọ bụghị nanị na tricuspid valvụ. Odida nwayọọ nwayọọ na-eduga ná eziokwu na ahụ na-amalite ịchọ ọhụrụ compensatory usoro. Ya mere, ọ na-agba mbọ iji nagide ẹdude imebi. Dabere na-eleghara anya ọrịa nwere ike na-enweta ndị na-esonụ na-anaghị ekwe:

• oyi baa;
• ikpọ imeju, imeju;
• akpa ume embolism;
• ascites.

Dị ka ọnụ ọgụgụ ndị e depụtara nsogbu ime na 90% nke ikpe.

Banyere amụma mgbake, ọ na-adabere kpam na ogo nke ọrịa development. Insufficiency nke tricuspid valvụ of 2 degrees emegharị nke ọma ọgwụgwọ, na ihe ize ndụ nke nsogbu bụ fọrọ efu. Mgbe nke atọ ogo-enweghị nchịkwa na usoro mejupụtara banyere afọ ise lanarị 60-70%. A na ọnụ ọgụgụ na-ahụkarị maka ọrịa ndị ugbua nwere n'ịwa ahụ. Mgbe decompensated ụdị ọdịda, Bilie-adịghị ala ala akpa ume ọrịa, prognosis na-adịghị mma.