Angiography: chii ichocho, tsanangudzo yenzira uye zvikamu zve

Varwere vanotambura nemwoyo uye zvirwere zvevascular vanogara vachidzidza zvidzidzo zvekliniki. Primary diagnostic inokubvumira kuparadzanisa hutachiona uye kugadzirisa chirwere chakakodzera, uye miongorori mumagetsi anobatsira kujekesa mamiriro emutumbi munguva yerapi uye inodzivirira chikonzero chekuvandudzwa kwematambudziko. Nzira inowanzoshandiswa yekuongorora zvirwere zvemwoyo yematambudziko ndeye angiography. Chii chinonzi diagnostic chakakosha chinoratidzwa nekunyengedza uye kuti chinoitwa sei, chinotaridzwa munyaya yacho.

General Information

Kuzadzika kwechirevo chekuonekwa kwemaiiography kwakatora makore anopfuura makumi matatu kubva apo nyanzvi yezvemapikisa Bekhterev akataura mazwi ake: "Kana mhinduro dzichipo dzisingambosviki miviri ye X-ray, saka mvura yakadaro inogona kuzadzwa nemidziyo uye inotorwa." Kuti kugadzirisa kuve kwakapararira uye kushanda mukushandiswa, zvakatora mamwe makumi mana.

Varwere vanorayirwa nzira yacho vanofarira: "Angiography - chii ichocho?" Iyi ndiyo nzira yekutsvaga mamiriro uye mararamiro emidziyo, iyo inoshandiswa achishandisa zvinhu zvinonzi radiopaque. Iyo nzira inokubvumira kuti uongorore zvinotevera zviratidzo:

• Ropa runotsika velocity;
• Nzvimbo yemidziyo;
• Kuvapo kwekusununguka anomalies;
• Kunyoresa;
• Kugadzirwa kwepakati pedzi ropa;
• Mamiriro emidziyo inopedza chironda chacho.

Ndeipi iyo inotorwa inoitwa?

Zviongorori nzvimbo (yakaderera kana yakawandisa profile) uye zvipatara zvakagadzirirwa zvivako zvakakosha zvemaiiography.

Zvose zviri mumamiriro ezvinhu eAsopisis zvinosangana pano. Makamuri ane mishini yakakodzera:

• Angiograph - chigadzirwa chinonzi X-ray chikwata chekuongorora mamiriro emiringa yeropa (arteri, veins, capillaries, nemidziyo ye lymphatic);
• High-speed fluorography chamber;
• Chigadzirwa, basa rekuita X-ray multishooting uye rekodhi rekodhi.

Mune zvikwata zvakanyatsoongorora zvirwere, CT angiography inoitwa. Iyi nzira inokubvumira kuwana mufananidzo wakajeka wemamiriro emidziyo (muzvinyorwa), uye naizvozvo inoda kushandiswa kwemafambisi akafambira mberi.

Mazano ekutsvakurudza

Muropa iri mudziyo, iyo inofanirwa kuongorora nekudzidza, inotanga imwe X-ray kusiyana nezvinhu, iyo iodine yakagadzirwa. Izvi zvinogadzirwa ne catheterization kana kupera. Kana mudziyo uine chikamu chiduku pasi peganda, iyo inogadziriswa ine sirin (kuvhara).

Catheterization inoshandiswa pakadzika midzi kana mitsetse. Muchidimbu chekuedza mudziyo, anesthesia yemunharaunda inoitwa. Mushure mekucheka ganda nemafuta akaiswa pasi, muto unoedzwa unowanikwa, mutauriri unoiswa mukati maro (imwe tsvina yepurasitiki inenge 10 cm murefu). Kupfurikidza nemutangisi wacho shandisai zvigadziriswe uye catheter kuti zviitike kwete kuparadza masvingo emidziyo yeropa. Mumwe muparidzi anopinzwa anojowa kuburikidza ne catheter.

Mushure mokunge sarudzo inopinda mumudziyo, inopararira kuburikidza nehurongwa. Chokutanga, mishonga uye mitsetse yakazadza, zvino arterioles, vhutu uye capillaries. Panguva ino, nerubatsiro rwechina X-ray, tora shomanana shoma kana kutora vhidhiyo pfupi.

Iyo yakaitwa angiography yemagetsi kana mitsetse (mhinduro dzekudzidza) yakagadzirirwa pane imwe yeruzhinji, iyo inobvumira kuratidzira kudengesa deta kune dzimwe nyanzvi.

Ipi iyo inoshandiswa?

Kuongororwa kwemamiriro uye kushandiswa kwemidziyo kunoshandiswa munzvimbo dzakadai semishonga se:

• Kuvhiyiwa kwevascular - vasati vambovhiyiwa, chiremba anotsanangura nzvimbo uye sarudzo dzenharaunda dzinoshandiswa;
• Oncology - nzvimbo yenzvimbo yekutanga uye metastases inoongororwa panguva yekuvakwa kwekombiyuta yavo;
• Pulmonology - inobvumira kuongororodza ruzivo rwemapapu emapapu, uyewo kugona kunzvimbo yekubuda ropa;
• Phlebology - nyanzvi dzinosarudza kuvepo kwezvinongororwa, kuonekwa kweanorysms, kuumbwa kwetrombi, zvipembenene zvevasculaclerosis, zvisizvo zvean innate;
• Neurology - angiography yemidziyo yeuropi inoratidza kuvapo kweanaurysms, hemorrhages, kuderedza, chiremera chekuita.

Kana zvakakosha kuongorora midziyo yese yeimwe nzvimbo, zvino iyo nzira inonzi "general angiography". Munyaya yekuongorora mamiriro emidziyo imwechete, kudzidza kwakadaro kunonzi kusarudza.

Angiography yemakamuri emarara

Nokuda kwekuongororwa, dhaka reRaopaopase inotungamirirwa ne catheterization yeimwe yemishonga iyi, yakadai seyi:

• Right femal;
• Shoulder;
• Ulnar;
• Subclavia.

Iyo catheter inofambisa mberi neropa rejinga system kuenda kunzvimbo iyo bazi rekuedzwa kwemudziyo iripo. Mhinduro inoshandiswa mukunyorera kwayo. Nenguva pfupi ita mapepa emifananidzo padivi nepamusoro pemusoro. Kana zvakakosha kudzidza zvimwe zvivako zviri kure, chikamu chechipiri chezvinhu zvinotanga. Zvakare, mutsara wemifananidzo muzvirongwa zvinodiwa zvinotevera. Zvinhu zvakapinda zvinoshandiswa, uye kuongororwa kunofungidzirwa kwakazara.

Angiography yeuropi inoda kushandiswa kweanesthesia yemunharaunda kuti iite anesthetize nzvimbo iyo catheterization inoitwa. Kunyange zvazvo catheter iri kuchinjwa mumuviri, murwere haanzwi kunetseka. Nekuiswa kwechigadziriswa, ruvara rwesimbi mumuromo, hypermia weganda rechitsipa, kunzwa kwekuparara kunogona kuonekwa. Izvo zvinoshamisa zvinonyangarika mushure memaminetsi mashomanana.

Zviratidzo zvekuongororwa kwemidziyo yeperebral

Zvimwe zvirwere zvepfungwa zvinoda kuongororwa (nokuda kwezvinyorwa zvemashoko, MRI angiography inoitwa):

• Ane anorysm - kuwedzerwa kwemudziyo, iyo inogona kukonzera kuora ropa;
• Angioma - vascular tumor;
• Stroke ischemic nature - chiremba anoongorora kudiwa kwe thrombolysis;
• Stroke hemorrhagic character - iyo inokonzera kupisa kwemvura yakatemwa;
• Kusagadzikana kwemidziyo yeropa - chiremba anoongorora huwandu hwehutano uye hunobva kubuda ropa;
• CCT - inokubvumira kuti uone migumisiro yekukuvara;
• Hematoma - nyanzvi inofungidzira kugona uye ukuru;
• Tumhanho - sarudza ukuru, nzvimbo, mamiriro ekudyisa midziyo.

Angiography yemidziyo yemwoyo

Coronary angiography - chii ichocho? Iyi ndiyo nzira yekuongorora mishonga yeropa yemwoyo. Icho chikadzi kana radial arter is catheterized uye catheter inotorwa kune aorta. Radiocontrast solution injected inopinda mumakironi emakona akanaka uye akasiyiwa . Mutsara wemifananidzo unoitwa pakarepo.

Murwere anokwanisa kunyunyutira kuonekwa kwezviratidzo zvakadaro kana chirwere chacho chiri kutarisirwa, chakadai:

• Fever muchiso;
• Arrhythmia;
• Dhizinesi;
• Nausea, kurutsa;
• Cough.

Zviratidzo zvekufambisa zvipembenene, chirwere chemwoyo, cardiosclerosis, congenital heart anomalies.

Kudzidza midziyo yemigumo

Angiography yemigumo inosanganisira nzira yekuongorora mamiriro ezvinhu emasangano uye mitsipa emaoko nemaoko. Kuongororwa kwemaoko ekumusoro kunoitwa nekuisa i-X-ray kusiyanisa zvinhu mumusara we brachial. Nokuda kwemakumbo maviri pasi-mudumbu re-aorta kana mumasita emadzimai, zvichienderana nehupi hwehutano hwekuongorora hunodiwa. Kudzidza midziyo yetsoka uye kuvhara, kuputika kwemashure ekupedzisira tibharia kunoitwa. Apo mhinduro yacho inoshandiswa, murwere anokwanisa kunzwa achikurumidza kupisa mumakumbo.

Zviratidzo zvekutsvakurudza:

• Atherosclerosis yemiganhu yakadzika;
• Kubvisa endarteritis;
• Thrombosis, thrombophlebitis;
• Thromboembolism;
• Kukuvara kunofambidzana nekupararira kwemidziyo yeropa;
• Exfoliating aneurysm;
• Kuongorora kwehutano hwekurapa.

Kugadzirira kurapwa

Zvakakosha kujekesa kusawirirana kweumwe munhu hypersensitivity kune iodine uye zvigadzirwa zvayo. Kana murwere ane pamuviri, X-rays haashandisi. Munyaya iyi, MR angiography inonakidza.

Kwevhiki mbiri usabatanidha doro, kwevhiki - anticoagulants ("Heparin", "Warfarin", "Aspirin"). Mazuva mashomanana kusati kwaonekwa, huwandu hwezvidzidzo zvinoitwa, zvakadai se:

• Kuchipiki yekuongorora ropa neropa, coagulogram, biochemistry;
• ECG uye ultrasound yemwoyo;
• Fluorography yemapapu;
• Kutsunga kweboka reropa uye Rh factor;
• Miedzo yekutapukirwa (HIV, hepatitis, syphilis).

Mumazuva eEngiography, muedzo unogadzirwa nokuda kwechirwere chema radiopaque. Pinda 0,1 mita yegadzirisa mukati moutini. Mukana we urticaria, allergenic rhinitis, conjunctivitis, arrhythmia, mushonga haufaniri kushandiswa.

Mune manheru kusati kwaitwa, nzira yekuchenesa, hutano hunoitwa. Nyanzvi inoratidzira zvekuzvidzivirira zvinokubvumira kuti usunungure uye ugare murwere. Mangwanani, nyaya yacho haifaniri kudya kana kunwa, isati yaitwa, chirwere chinofanira kubviswa.

Nuances yekugadzirira

Pane huwandu hwehutano hwemamiriro ezvinhu hunoda nguva yakareba uye yakanyatsogadzirirwa mukugadzirira nzira yakadai sa angiography. Chii chinofanira kuitwa nevarwere kuita kuti chirwere chacho chiende pasina zvinetso?

Pakudzvinyirirwa kwepamusoro kunofanira kusimbiswa. Kuti uite izvi, shandisa "Nifedipine", "Dibazol", "Raunatin" kana chero mimwe mishonga inopesana nemishonga inogara ichirapa murwere.

Mukuvapo kwekuputsika kwemwoyo rhythm, pinda "Panangin" kana potassium chloride. Nokugadzwa, chiremba anoshandisa mwoyo glycosides. NeHD kana kuti chirwere chemwoyo chinoshandisa "Nitroglycerin", "Erinit", "Sustak".

Chirwere chepocho chinoda kuwaniswa kwemuviri nemvura. Iyo inonzi radiopaque inoshandiswa ichaita zvishomanana kuita seinovhiringidza uye ichinyorwa nokukurumidza kubva mumuviri nemuyo.

Kana pane zviitiko zvisingagumi zvehutachiona (sinusitis, bronchitis), nyanzvi inoratidzira antibacterial drugs kana sulfonamides masvondo maviri vasati vaedzwa.

Contraindications kune angiography

Kuongorora nzira haisi kuitwa kana kune ngozi kune mamiriro uye hutano hwomurwere. Izvi zvinoitika mumamiriro ezvinhu akadai se:

• Zvirwere zvinoputika kwazvo;
• Mafungiro asina kunaka;
• Kuora kweiyo;
• Kukundikana kwemoyo mumutambo wekudzikinura;
• Kurwisana neIodine uye zvigadzirwa zvayo;
• Zvirwere zvakaperekedzwa nekuputsa ropa kuvhara;
• Kubata.

Angiography ndiyo nzira inoshanda uye inoshandiswa nenzira yakawanda yekudzidza mishonga yevascular, iyo inobatsira zvakawanda pamusoro peimwe nzira yekuongorora.