Pulmonary Vienna. Anomalous pulmonary mutsinga

Pulmonary Vienna (mufananidzo pasi apa) - mudziyo rinounza arterial ropa kunowedzerwa pamwe okisijeni mumapapu kuruboshwe atrium.

Kutanga kubva pulmonary capillaries batanidza mumidziyo izvi zvimwe mutsinga vanotumwa kuti principales, ipapo zvikamu zvikamu zviduku, uye zvemapapu gedhi hombe hunde dzacho vakaumba (maviri neimwe mudzi) kuti tinotungamirirwa yakatambarara chokumusoro chikamu atrium kuruboshwe. Uyezve, mumwe nomumwe emiti pinda mugomba yoga buri: kuruboshwe - kurutivi rworuboshwe atrium rworuboshwe uye kodzero kubva kurudyi. Right pulmonary mutsinga, vachitevera atrial (kuruboshwe) transversely piringisha zvakarurama atrium (musana wake).

Rokunze pulmonary (kurudyi) Vienna

Kuvakwa segmental tsinga zvikamu yapakati uye yokumusoro zvemapapu lobes.

• R.apicalis (bazi apical) - aimiririra pfupi venous hunde, riri pamusoro yokumusoro akafukidza (mediastinal kwayo pamusoro) uye anotakura ropa kubva chidimbu muromo. Vasati vachipinda zvakanaka mukuru pulmonary tsinga kazhinji pamwe segmental (shure) bazi.
• R. posterior (rwemberi bazi) anotakura ropa muunganidzwa neshure chidimbu. bazi iri - kupfuura vose guru Vienna mutsinga (segmental), izvo riri yokumusoro akafukidza. Mumudziyo izvi oga akati wandei zvikamu: vnutrisegmentarny poddolevoy chidimbu uye chidimbu kuti anounganidza ropa kubva interlobar panyika nzvimbo oblique slits.
• R.anterior (bazi pamberi) anotakura ropa kubva yokumusoro yakaungana mugove (kana Anterior chidimbu). Mune zvimwe zviitiko, zvinoita kuti nokubatanidza kumberi uye neshure matavi (kana ivo vanowira zvakafanana hunde).
• R.lobi medii (pakati akafukidza bazi) anogamuchira ropa kubva kurudyi zvemapapu zvikamu (ayo avhareji mugove). Mune zvimwe zviitiko, izvi zvinotora chimiro chimwe Vienna mudende uye runoyerera muimba zvakanaka pulmonary tsinga, asi kazhinji mudziyo achiumbwa zvikamu vaviri medial uye lateral kuti wopedza azvaitwa medial uye lateral zvikamu.

Lower pulmonary (kurudyi) Vienna

mudziyo uyu anotora ropa apasi akafukidza (zvikamu zvaro 5) uye ane chikuru maviri inflow: basal tsinga uye zvakafanana yokumusoro bazi.

Yokumusoro Bazi

It nhema pakati basal uye okumusoro zvikamu. Achiumbwa kubva mamwe uye chikuru mutsinga, zvinofanira kuva mberi uye pasi, vakapfuura seri apical segmental bronchus. bazi iri ndiro pamusoro zvose chinhu munzvimbo dzapasi zvakanaka pulmonary tsinga.

Maererano bronchitis Vienna unotora chikuru inflow matatu: lateral, rokumusoro medial, riri vazhinji intersegmental asi anogona kumhanya uye vnutrisegmentarno.

Nokuda okuwedzera ropa water drainage tsinga kutakurwa rokumusoro chidimbu (pamusoro wayo) munzvimbo poddolevuyu segmental tsinga veshure yokumusoro akafukidza (ayo posterior chidimbu).

Basal muunganidzwa Vienna

Zviri pfupi venous hunde, yakaumbwa panguva panosangana rezasi uye yokumusoro basal mutsinga huru mapazi izvo nhema zvakadzama pamberi zvakafanana pamusoro.

Basal pamusoro Vienna. Inoumbwa kwemapazi makurusa basal segmental mutsinga uye mutsinga kuti takura ropa kubva medial, Anterior uye lateral zvikamu.

Basal pasi Vienna. Vasiyana zvinonakisa basal tsinga kubva ayo pasi musana penyika. The chikuru inflow the mudziyo - basal posterior bazi kuti anounganidza ropa kubva basal posterior chidimbu. Mune zvimwe zviitiko, rezasi basal Vienna anogona kutaura pamusoro basal tsinga.

ADLV

Ihosha chomwoyo chokuberekwa nacho panguva iyo chiitiko iri dzakaonekwa neanatomichnoe pulmonary mutsinga kuti atrium (kurudyi), kana dziri azvino pamusoro vena cava.

zvokurwara Izvi pamwe kakawanda nemabayo, kurukutika, kupfupika mweya, kunonoka kwomuviri, cardiac marwadzo. Sezvo Diagnostics anoshandiswa: ECG, MRI, maekisirei, cardiac catheterization, Ultrasound, uye ventrikulo- atriografiyu, angiopulmonography.

Kuvhiya kurapwa urema inotsamira ayo mhando.

tsananguro

ADLV - vachiberekwa kuremara uye anenge 1.5-3.0% moyo kuremara. Vakawanda kuchengetwa varwere makono.

Kakawanda kuremara ichi unobatanidzwa ane denderedzwa (rakashama) hwindo uye zvikanganiso septum pakati ventricles. Zvishoma zvishoma (20%) - kubva vanhuwo hunde ropa, hypoplastic rworuboshwe divi mwoyo, VSD, dextrocardia, tetralogy pamusoro Fallot, uye transposition midziyo kukuru, mukuru mwoyo ventricle.

Kuwedzera urema izvi, kazhinji pamwe ADLV extracardiac zvokurwara: achiine rukuvhute hernias, kuremara mu pfupa inotungamirwa uye kwemakemikari anobudiswa enyika, intestinal diverticula, chidhongi itsvo, polycystic cheitsvo uye hydronephrosis.

Kupatsanura anomalous pulmonary venous abudise (ADLV)

Kana ari confluence zviri mutsinga dziri systemic riparadzirwe kana kupinda zvakanaka atrium, kuremara ichi inonzi yakazara anomalous abudise, kana ari pamusoro mamiriro runoyerera kupinda rimwe kana mutsinga shoma, zvakakanganisika akadaro anonzi kukwana.

Maererano nenhanho confluence govera vamwe mhosva kuita:

• First musiyano wezvinyorwa: nadserdechny (suprakardialny). The pulmonary mutsinga (akadai vanhuwo hunde kana vakaparadzana) dzinoyerera muimba vena cava kana awo.
• Option maviri: mwoyo (intracardiac). Pulmonary mutsinga vakapedzwa kupinda coronary sinus kana zvakarurama atrium.
• Third musimboti: podserdechny (michini kana subcardial). Pulmonary mutsinga kupinda portal kana vena cava ezasi (ndoda ari nhengo dzinobudisa mutsinga dzinofamba nemukaka).
• Kusarudza chechina: yakavhenganiswa. Pulmonary mutsinga dziri zvivako siyana uye pamwero yakasiyana-siyana.

Features hemodynamics

In utero vanoshingaira urema inowanzopiwa kuona, nokuda peculiarities fetus kutenderera. Pashure kuberekwa kwemwana hemodynamic kuratidzwa anotsanangurwa kuti kuremara ichi uye mubatanidzwa ayo vamwe vachiberekwa anomalies.

Kana zvachose anomalous abudise kuti hemodynamic zvirwere vakaratidza hypoxemia, hyperkinetic zadzisa rwerudyi mwoyo uye pulmonary neBP.

Kana haasaruri abudise hemodynamics yakafanana pamwe ASD. The aitungamirira basa ndohwaJehovha kutyorwa kanganisika arteriovenous shunt, iyo inosvitsa kuwedzera vhoriyamu ropa duku denderedzwa.

Zviratidzo anomalous pulmonary venous abudise

Kids vane urema ichi vanowanzotambura idzokororo chakasimba kufema kutapukirwa noutachiona uye nemabayo, vanoti chikosoro, pasi kufuta, tachycardia, kupfupika mweya, marwadzo mwoyo, chiedza cyanosis uye kuneta.

Kana pulmonary neBP hunooneka zera diki kuonekwa mwoyo kukundikana, akaratidza cyanosis uye mwoyo ano.

Diagnostics

Mufananidzo auscultation pana ADLV akafanana ASD, kuti ndizvo zvayakaita kusagadzikana auscultated systolic ruzha iri pamaberere pakati mutsinga arteries (pulmonary mutsinga) uye kukamurwa 2nd matauriro.

• The ECG zviratidzo zvakarurama mwoyo zadzisa, nokutsauka EOS zvakanaka blockade (kukwana), zvakanaka tutira bazi nechigumbuso.
• Kana phonography nezviratidzo ASD.
• In radiography vawane muenzaniso chiedza bulging pulmonary tsinga (ayo chinhu chakakombama), kuwedzera kodzero cardiac miganhu, "Turkish Saber" chiratidzo.
• Echocardiography.
• Achiona cardiac in.
• Venography.
• Atriografiya (kurudyi).
• Angiography.
• Ventriculography.

Differential chirwere kuremadza ichi zvinofanira kuitwa:

• Lymphangiectasia.
• Kutsemuka Surgery / mitral vharafu.
• midziyo transposition.
• Mitral stenosis.
• Stenosis rwerudyi / akasiya pulmonary mutsinga.
• Trehpredserdnym mwoyo.
• Kure ASD.

mabatiro

Types Kuvhiya zvishomanana abudise vakatsunga nomumwe kuremara, ukuru uye nzvimbo ASD.

Atrial shoko kubvisa kushandisa mapurasitiki kana suturing ASD. Vacheche kusvika makore matatu vari dzinonetsa dzakaoma ezvinhu, ubudise palliative Kuvhiya (namahwindo atrioseptotomiyu), nechinangwa kuwedzera interatrial kutaurirana.

Total yakakura urema kururamiswa (zvachose siyana) zvinosanganisira manipulations akawanda.

• Ligation pathological mbiru vascular mutsinga.
• Voga pakati pulmonary mutsinga.
• Kuvhara kuti ASD.
• Anastomosis pakati atrium rworuboshwewo uye pulmonary mutsinga.

Mhedzisiro kwacho kungava: Zvakaunganidzwa pulmonary neBP chirwere uye sinus raiva pedyo nebundu kukundikana.

Zvaifungidzirwa

The fungidziro zvakasikwa nzira kuremara ichi vanoshorwa, kubvira 80% wevarwere vanofa mukati gore upenyu rokutanga.

Varwere kuvapo haasaruri abudise anogona kurarama makore matatu. Kufa varwere dzakadaro kakawanda chokuita pulmonary zvirwere, kana zvakakomba mwoyo kukundikana.

Kunobva kuvhiya of mhosva kazhinji dzinogutsa, asi mune neonatal lethality panguva kana pashure pakuvhiya zvakakwirira.