Abdominal kutsemuka aneurysm: zviratidzo, nechirwere, kurapwa

Yeropa ndiro rakakura kupfuura mamwe ose tsinga azygos. It ndohwaJehovha systemic kuparadzirwa uye zvinogara ose nhengo ropa muviri wedu. Yeropa rakakamurwa kuva 3 zvikamu uye 2 zvikamu - the abdominal uye thoracal. Kakawanda (95%) akawana aneurysm pamusoro abdominal yeropa, tine nhasi uye tozotaura.

Aneurysm - iri kuwedzera kana bulging yacho yeropa. The chirwere ichiri hwaro muchikurukura zhinji, nokuti vanachiremba havagoni kuuya mumwe pachisarudzo charakaita pfungwa, chii mwero rokuwedzera vascular rusvingo inogona chirwere ive aneurysm. Kwekutanga chirwere hwakasimbiswa pamwe nokuwedzera yeropa 2 nguva kana kuwedzera ayo dhayamita anopfuura 3 cm. Zvisinei, kupiwa chokwadi kuti yeropa ane dhayamita 15 kusvika 32 cm pfungwa "vanopfuura 3 masendimita" pachena zvikuru kujeka. Naizvozvo, muna 1991, nemhaka kutsvakurudza remasayendisiti American akatanga aneurysm vaiona zvemamiriro akawedzera lumen yacho yeropa ne50% kupfuura zvarakanga dhayamita. Asi tsanangudzo iyi zvishoma zvemasanga.

nyaya Izvi zvinokosha kunyanya pakusarudzwa zvidobi ose kuvhiya kupindira, asi, nhamo, achiri yakazaruka. Zvichakadai, kubva aneurysm nerimwe gore inouraya anenge 15,000 vokuAmerica pagore. Kazhinji, zvinongokonzerwa haana nguva rokuongorora.

Chii chiremba yave kubata chinhu aneurysm?

It anobata chirwere vascular chiremba, sezvo mukuru kurapwa kuti matambudziko operative. Kana oparesheni hakuratidzwi, murwere inofanira kuonekwa nachiremba, mumwe cardiologist kana internist (nyanzvi mune zvokurapa dzakawanda) kuti kunyatsotevera kuongorora avo ezvinhu. Aneurysm zvikuru achinyengera, unogona pakarepo kutanga kukura, kuwedzera pangozi dzakakomba zvikuru yematambudziko ayo - pakakoromoka.

Ndiani pangozi?

An aneurysm kunokwanisa kuonekwa mune varume nevakadzi (ekupedzisira, zvisinei, zviri zvishoma zvikuru). Zvisinei, izvozvo akacherechedza kuti mune varume vakuru makore 65, zvinoitika kakawanda. Izvi kunonyanya kukonzerwa nekuchiva vanhu vazhinji kusvuta, riri kunyanya chinokuvadza pakukwegura.

Saka, pangozi vanosanganisira:

• vanhu vachitambura kubva neBP;
• vanosvuta;
• masangano umo mhuri yave nechirwere ane aneurysm pamusoro abdominal yeropa kana zvimwe zvemwoyo chirwere uye / kana chirwere ari peripheral kutenderera;
• varidzi kufuta uye vanhu vanotungamirira ndakagara mararamiro.

Yambiro! Itariro tsvakurudzo, aneurysms vakawanda nhaka kubva kumadzitateguru.

Mhando aneurysms ari abdominal yeropa: kupatsanura

Abdominal kutsemuka aneurysm rakakamurwa marudzi vanoverengeka zvichienderana ayo chimiro, localization uye pathological zvinhu:

1. Sac (chakafanana homwe kuti kubudikidza cervix chokuita lumen yacho yeropa).
2. Fusiform. Chimiro chokurukisa, riri kubata kuburikidza pakazaruka kusvika lumen yacho yeropa. Vakawanda muchimiro aneurysm.

Maererano pathological zvechadenga zvinotevera marudzi aneurysms:

1. Ichokwadi. Its rakawedzerwa mudziyo rusvingo, sezvo aumba munhu muzvizhinji pakati akaturikidzana yacho yeropa.
2. Pseudoaneurysm. Kunenge mushure zvinokuvadza nokuda kukura pulsating hematoma.
3. Exfoliating. I.e. masvingo aro delaminate uye intramural mhango yakazara hematoma, iyo kuburikidza rusvingo hunenge vascular zvinyama chokuita lumen yacho yeropa.

Kusiyanisa pakati payo uye localization:

1. Aneurysm of infrarenal abdominal yeropa kumusoro / pazasi renal arteries bazi.
2. Suprarenal riri pamusoro branching arteries
3. aneurysm Total riri kupararira achitevedza yose kureba mudziyo.

Ndezvipi zvinokonzera aneurysms?

• Atherosclerosis, umo rusvingo vascular inova gobvu uye anorasikirwa elasticity kwayo, uye chakaumbwa pamusoro pamasvingo aro muchimiro mafuta atherosclerotic plaques. The Kuronga plaques zvinosanganisira remafuta akawandisa kunokuvadza uye nemamwe mafuta. Nepo vanachiremba vasiri zvakazara kutsunga sei zvinokanganisawo kukura atherosclerosis, aneurysm, asi zvinofungirwa kuti nokuda chirwere ichi kuonekwa kweropa nepfungwa iri mumudziyo uye kudzivirira kugoverwa muviri. Somugumisiro, mashoko vascular zvinyama wakaremara, zvichiteverwa kwayo cleavage. Somugumisiro, chirwere chinonzi "abdominal kutsemuka aneurysm".
• Chirwere cheshuga uyo "anoda" mikuru ropa tsinga. It kunowanzoguma retinopathy, nephropathy, aneurysms.
• Dzinza rako. Mune dzimwe vachiberekwa syndromes (Ehlers -. Danlos urwere, Marfan Erdheim pathologic cystic medial necrosis, etc.) ari arteries vanokanganiswa, kusanganisira abdominal yeropa. Kazhinji zvinoita kuti kuronda ukama pakati aneurysm abdominal yeropa uye nemagene zvirwere.
• Zvirwere zvinotapuriranwa. Izvi zvinosanganisira zvirwere chokuita yomukati rukoko mwoyo (endokart) - njovhera, ekdokardit, salmonella, etc ...
• Kukuvara mudumbu. Somuenzaniso, kana kuvhunduka simba kuti chipfuva kana abdominal yeropa zvingakanganiswa.
• Anogumbura kwendangariro. Nonspecific aortoarteriit, Somuenzaniso, hunokonzera kwakaderera pakati kutsemuka rusvingo. Zvisinei, hapana mashoko akananga panyaya iyi asi. Asi zvisiri anogumbura zvirwere vascular masvingo kakawanda kuitika nokuda atherosclerotic plaques.

Kazhinji, kazhinji mhosva aneurysms fodya, nokusarovedza muviri uye zera. Zvinokosha kuziva nenguva. Aneurysms of thoracal uye abdominal yeropa vane zviratidzo zvakasiyana, yatiri funga ikozvino.

Ndezvipi zviratidzo abdominal kutsemuka aneurysm dhipatimendi?

Kakawanda, aneurysms haana anoita pacharo vainzwa, uye akaonekwa nemasanga ari ongororo. Sezvazvakanyorwa vachambokanganwa ari nhengo, kukanganisa kugona kwavo kuti vararame, rinogona chirwere nemazvo, nokuti zvinokosha kuitisa munhu abdominal Ultrasound. Vanachiremba cherechedza kuti kunyanya "kuvanza" thoracal aneurysm. Hazvigoni kuratidzwa panguva dzose kana kukonzera bhokisi marwadzo, chikosoro uye kupfupika mweya. Kana kuwedzera yokukurumidzira iri akamuka aneurysm pamusoro abdominal yeropa.

Of zviratidzo shoma aneurysm govera vamwe kuitika pamwe chete kana ariega:

1. Kutambudzika nomudumbu, zvinoitika manzwiro pakuzara uye kupomba, izvo afanane yakakura kurova kwehana.
2. Abdominal marwadzo, munyoro, asi, achirwadza, mikukutu hunhu. Zvinonzi vemunyika chaimo umbilicus kana kuruboshwe.

Uye zvisina kunanga zviratidzo zvinoita pacharo akanzwa abdominal kutsemuka aneurysm. Zviratidzo zvacho zvakasiyana kuti vakafungidzira dambudziko wechokwadi zvakaoma chaizvo. Izvi imhaka yokuti kuwedzera aneurysm zvinogona kuvhiringa siyana nhengo uye hurongwa. Somugumisiro, unogona kuvhiringidzwa renal colic, pfungwa nomuviri zvemwana asati, kana Sciatica.

Ishioradikulyarny chirwere kunokonzera kurwadziwa rezasi shure (zvikurukuru, muchiuno) uye kuvhiringidza aikanganiswa makumbo pamwe chete sangano nyonganyonga.

Abdominal chirwere kunoratidzwa kurutsa, belching, manyoka kana kupatira, uyewo nokushayiwa kudya, inotungamira uremu.

Chirwere ischemia of makumbo runoratidzwa zvaipesana wokufambisa (tsoka kuchitonhora), tsandanyama marwadzo panguva achifamba uye ndakazorora, nguva nenguva lameness.

Yeprostate cider inozivisa pacharo Urinary zvinetso, marwadzo, kunzwa waziya panzvimbo dzapasi shure, uye kunyange chitarisiko matsvuku masero ari weti.

Atsamwira pamusoro abdominal kutsemuka aneurysm chinotanga pfuma kurwadziwa mudumbu, vakawanda simba uye dzungu. Dzimwe nguva marwadzo anopa muchiuno, panosangana makumbo kana crotch. Panyaya iyi murwere inoda kurapwa nokukurumidza, sezvo mamiriro hwakazara rufu. Kazhinji aneurysm hwatsvuka iri pakati ura duku, mudumbu kana duodenum, dzinenge - mugomba gobvu dumbu. Kana chakabvamburanyiwa abdominal kutsemuka aneurysm, zviratidzo angaperekedzwa svoto uye kurutsa. In rworuboshwe the pane ari mudumbu ari palpated dzidzo iri zvishoma nezvishoma kuwedzera uye ane simba pakaitika. miganhu yayo havana palpated.

Panguva atsamwira of aneurysm zviratidzo yakajeka kwazvo, asi vari nyore kuvhiringidzika nedzimwe ezvinhu ngozi utano, saka kuva nechokwadi kudana amburenzi kuti chero kurwadziwa mudumbu kana pachipfuva.

chirwere chirwere

Yokutanga chirwere Danho - kuongororwa navanachiremba, izvo pamusoro palpation anonzwa ane simba pulsation mudumbu, ndicho abdominal kutsemuka aneurysm. Diagnosing zvinosanganisira kutsvakurudza kuti kubvumira kuti kufungidzira zviri kuitika zviri abdominal mhango. Kutanga, zviri Ultrasound, uye computed tomography (CT) uye multislice computed tomography yacho yeropa (MSCT).

Kana vanofungidzirwa abdominal kutsemuka aneurysm, Ultrasound anobvumira anenge neMhedziso chokwadi kuzosimbisa ayo kuvapo. Zvinoratidza chaiyo nzvimbo yacho aneurysm, mamiriro ari vascular rusvingo, nzvimbo pakakoromoka, kana zvaitika.

CT kana MSCT akaita kuziva calcification, kutsemuka thrombosis vnutrimeshkovy, vanotyisidzira kana kuvhuna kumbova pakakoromoka.

Kana chirwere nemiedzo dziri pamusoro usarega kuongororwa zvakarurama (kunyange izvi zvisinganyanyi kuitika), akagadzwa aortography. Nzira unobvumidza-chaizvoizvo nguva vanoona yeropa uye awo nokusuma chinokosha mvura kupinda mudziyo. Anoratidza kuti kana pane fungidziro pakati lesion pakati visceral uye renal arteries, anozivikanwa mamiriro ari distal kweropa mubhedha.

Matambudziko abdominal kutsemuka aneurysm

Ichi ndiyo ngozi kwete chete nokuda utano asi upenyu. Chokutanga, yeropa zvinogona kuita embolism (blockage) pakati arteries, zvirwere matambudziko, kutanga mwoyo kukundikana.

Nokupatsanura abdominal kutsemuka aneurysm - pakava ngozi iri kwayo atsamwira uye ropa anopinda vascular akaturikidzana muviri. Kana zvose stratified rukoko 3 uye yeropa hwatsvuka zvachose, pane zvikuru kurasikirwa neropa.

Asi, chokwadi, chakaipisisa kuomesa kwakaita aneurysm - iri zororo. Varwere vakawanda untreated aneurysms achafa mukati 5 years. Usati patsanura munhu anonzwa kurwadziwa mudumbu uye lumbar nharaunda. Kana aneurysm pamusoro abdominal yeropa zvakabvaruka, chirwere kunoratidzwa kunonyengedza ropa inotungamirira kuvhundutsa uye rufu. Naizvozvo zvirokwazvo kudaidza amburenzi pakuparwa kurwadziwa mudumbu uye chipfuva, sezvo nokukurumidza kune ngozi. Nhamba dzinoratidza kuti 3 chete% wevarwere kufa pakarepo pashure atsamwira yacho yeropa, vamwe vanogara kubva maawa 6 kusvika 3 months. Kazhinji, Vanofa mukati mazuva. Sei kubata chinhu aneurysm? Funga zvinotevera.

Mabatirwo aneurysms abdominal yeropa

Vanhu vazhinji zvakakanganisika vanotenda kuti nechirwere "aneurysm pamusoro abdominal yeropa," kunokwanisa chete kuva zvomusejari. Kutaura zvazviri, pane zvose nomumwe.

Kana aneurysm rinosvika 4,5 masendimita ari dhayamita, kuvhiyiwa hakuratidzwi, nekuti iye anogona kutakura zvikuru ngozi upenyu kupfuura yakawedzera kukura mudziyo. Kazhinji, kwakadaro Muitiro Zvakacherechedzwa mune varume vakuru vanotambura co-morbidities, uye Kuwedzera haagumiri kusvuta (uye yakadaro chirwere kusvuta chete vanoda!). Kwavari, amirire mutambo, nokuti mukana kutsemuka atsamwira panguva dhayamita kwakadaro chete anenge 3% pagore. Muchiitiko chino, mwedzi mitanhatu ose murwere anomanikidzwa kuita Ultrasound kuziva kukura yeropa. Kana rusvingo vascular zvishoma nezvishoma anowedzera, ndicho chikuru chiratidzo kunorapwa, nokuti ndingangokuvara kutsemuka ichiwedzerwa ne50%.

Vakwegura, uyo akaratidza muenzaniso aneurysm pamusoro abdominal yeropa, mishonga iri desirably kuitwa pachishandiswa ngirozi endovascular, zvishoma invasive nzira. Munguva oparesheni, murwere chinotarisirwa kupinda tsinga anobudisa mushonga zvishoma nezvishoma kuburikidza iyo yaisanganisira stent. Ukabatwa yeropa, izvozvo anovhura uye zvinovhara tsinga, nokudaro kutsiva zvakakanganisa nzvimbo dzomuviri wake. Kubatsira kushanda anosanganisira lightweight portability nechiduku kupora nguva - Mazuva mashoma. Asi nzira iyi ine nuances ayo, saka takasungwa hakusi zvose. The chikuru drawback kushanda ichi - kuti 10% nyaya kune distal yokutama hwakagadzwa kumira.

Kana nechirwere "abdominal kutsemuka aneurysm", pokuvhiyiwa kazhinji rakashama. Panguva yake njodzi nzvimbo yeropa rakabvisirwa uye chikatsiviwa prosthesis yakagadzirwa Dacron (jira chakaita zvokugadzirwa kwakavakirwa polyester). Kuti vawane mukana yeropa, uchishandisa evaMedhia laparotomy. Duration wokuvhiya Kazhinji maawa anenge 2-3. Pashure pokuvhiyiwa anoramba rinooneka vanga.

Murwere akapora anenge masvondo maviri. Resumption basa dzimwe nguva zvinogoneka chete pashure pemavhiki 4-10. The murwere zvachose wairambidza kurovedza muviri, anoratidza rugare uye anofamba.

Contraindications kuvhura kuvhiyiwa

Wairambidza Kuvhiya pasi zvinotevera ezvinhu:

• Recent myocardial infarction (kwete mwedzi asingasviki mumwe).
• Cardiac uye pulmonary insufficiency.
• Renal insufficiency.
• Iliac uye femoral arteries.

Rehabilitation pashure pokuvhiyiwa

Chokwadi, kuvapo yematambudziko pashure pokuvhiyiwa sei murwere zera uye chokuita nezvirwere. Uyewo, murwere nemamiriro anogona achiipa kana muviri wayo atopiwa simba (HIV, oncology, chirwere cheshuga), pane kufutisa uye mwoyo chirwere. Uyezve, pre-akaronga oparesheni anopa murwere vangangoramba kurarama uye achapora pane nechimbichimbi kupindira panguva atsamwira ane kutsemuka aneurysm.

Matambudziko anogona kuitika sezvo kwomusikirwo vakawanda yokutindivadza chisingazivi kutakura zvose, kukura chirwere, kukuvara zvomukati uye ropa. The chaizvo vashomanana vanenge zvinouraya oparesheni.

Kana vavhiyiwa iri aronga, vanachiremba vanoti vhiki pamberi kwayo kutakura kurega kushandisa zvinodhaka, ropa thinners, uye Anti-anogumbura zvinodhaka (asipurini nevamwe.). Iva nechokwadi kunoudza chiremba wako pamusoro pemhando mishonga yauri kutora panguva, pamberi oparesheni.

Ngozi dzokororo ishoma zvikuru, asi kana munhu pakarepo anotanga kunokanganisa marwadzo ari shure kana dumbu, kuda kurutsa, kurutsa, kupera simba pamakumbo kana neimwewo kunzwa kurwara, vanofanira kutsvaka zano zvokurapa pakarepo.

Prevention aneurysm

Abdominal kutsemuka aneurysm kunoitika iwe kashoma kana mukaramba (uye, Zvakanakisa, asingadi kuwana tsika), kusvuta, uye kudzora kumanikidza uye yenyu uremu. Zvinokoshawo kuti atungamirire basa uye utano mararamiro. Stay utano!