Subclavia artery. Syndrome ye subclavia arteri

I-subclavia mitsetse ndiyo midziyo, inotakurisa ropa kumakumbo epamusoro emuviri womunhu. Ichi chinyorwa chichakurukura zvakadzama zvose zvinyorwa zvinyorwa panyaya iyi. Iwe unodzidza kuti chii chinonzi syndrome ye subclavia arteri uye chii chinoitwa pakurapa kwayo.

Chii chinonzi subclavian artery?

I-circulatory system inongova yakaoma yakaoma kubva mumakumbo akasiyana-siyana, arteri, uye capillaries. Imwe midziyo yakawanda, yakagamuchira ropa kubva kune aortic arch-subclavia ariti - inoreva midziyo yegenderedzwa guru rekupararira kwevanhu. Inopa ropa kumativi epipital europi, cerebellum, chikamu chemupendero wechepere, tsvina uye chikamu chemutsipa, bhanhire rebandauko uye chikamu chepamusoro, uyewo zvimwe zvikamu zvechifuva uye mimba yemimba.

Topography ye subclavia arteri

Izwi rokuti "nzvimbo" rinorevei? Uku ndiko kutsvaga chaiyo kana nzvimbo yeimwe chinhu pamusoro pezvimwe zvinhu. Ngationgororei nekunyatsorondedzera kuti kududzirwa kwechirongwa che subclavia kunorevei, mune mamwe mazwi, kupi uye kune imwe nzvimbo kune iyo iripo. Icho chinobva kune rumwe rutivi rwechirongo chechi brachiocephalic, uye kune rumwe - kubva pamagumo e-aorta, inopfuurira nechepamusoro pemapapu uye inopinda kuburikidza nekuvhura kwehuturo kubva kumusoro. Munzvimbo yemutsipa, arteri subclavia inoonekwa pedyo ne brachial plexus uye iri pamusoro. Iyi urongwa hweyo mudziyo inobvumira kuti ishandiswe kumira kubuda kunogona kubuda ropa kana kujowa kwemishonga. Uyezve, iyo subclavia ariti inotenderera mumubvu, inopfuura pasi pechipiri uye inopinda muchero, iyo inova axillary. Zvino, mushure mekunge apfuura muromo, anoenda kwaari mapepa. Zita renzvimbo iyi ndiyo arterial artery. Munharaunda yejoka yegorofu, inopinda mumararaire emarara uye ulnar.

Catheterization yevhisi ye subclavia. Puncture

Sezvatotaurwa pamusoro apa, mutsara we subclavia (uye arteri, zvakare) iri pamutsipa pamutsipa. Iyi ndiyo nzvimbo inoshandiswa kutora nguva, kuisa catheter. Ndeipi chikonzero chekusarudza chikamu ichi chemuti? Kune mitsva yakawanda yechisarudzo ichi:

1. Anatomical accessibility.
2. Kuramba kwechigaro uye chidimbu che lumeni.
3. Kukwana kwakakwana kana kukwirira (kureba).
4. Kuwedzerwa kweropa kunopfuuridza kuwedzerwa kweropa mumakumbo emakumbo.

Kubva pane data yakataurwa pamusoro apa, catheter yakaiswa mukati mechipfuva inenge yava kuda kubata masvingo ehateri. Mishonga inodhaka iyo inorohwa kuburikidza nayo ichakurumidza kusvika paanrium yakakodzera uye mhepo, inobatsira kuita zvinobudirira pane hemodynamics. Kupinda mumishonga yemasclavia yakasangana zvakakurumidza kusanganiswa neropa, asi isingatsamwisi mukati meyeri. Mune zvimwe zviitiko, pane zvinopesana zvekuvhara nekuiswa kwe catheter.

Kuruboshwe uye kurudyi subclavia ariti

Uyu mudziyo inhengo yakarongeka, sezvatotaurwa pamusoro apa: kodzero yakanaka ye subclavian uye kuruboshwe. Yokutanga ndiyo yekupedzisira bazi redu rinonzi brachiocephalic, kusvika kune rumwe rworuboshwe, rinosiya chikamu che aorta. Mukuwedzera, iyo yekupedzisira inenge 4 cm yakareba kupfuura yekutanga. Izvo zvakanaka subclavia ariti inopa ropa kune zvimwe zvikamu zvekono rorudyi, inozvipa iyo nemusoro uye nyota. Sirasi yekupedzisira ye subclavia inotakura mvura inotakura zvinhu zvinokosha pakutsigira hupenyu kuruoko rworuboshwe.

Iyo huru madhipatimendi e subclavia artery

Kuruboshwe uye kurudyi subclavia ariti yakakamurwa zvakananga mumamiriro matatu matatu, kana nzvimbo:

1. Kubva panzvimbo yekuumbwa kwe subclavia arteri kusvika pavanopinda mukati nzvimbo.
2. Kurambidza, iyo yakavharidzirwa kusvika kune imwe nzvimbo.
3. Pamugumo kubva pane imwe nzvimbo kusvika kune armpit.

Matavi ekutanga subclavian ariti

Iyi chikamu chechinyorwa chichataura zvishomanana nezvekuti subclavian arteri namatavi awo anotarira sei, ndiko kuti, pane zvikamu izvi chirongo chinonzi branched. Kubva pane chikamu chayo chekutanga (nzvimbo iri pakati pekupinda kwepakati yepakati uye kutanga kwetari) matavi akawanda anobuda, apa ndiwo makuru:

1. Vertebral artery, paired. Inopfuura nepakati pekutenderera kwechitanhatu chepervical vertebra. Uyezve, inokwira kumusoro uye inowira mumucheto weghehenya kuburikidza nape, kureva, kuburikidza nekuvhura kwayo. Zvadaro zvinosangana kune arteri imwechete kune rumwe rutivi, nokudaro nokuumba basilar artery. Chii chinoshandiswa nehutachiona? Uyu mudziyo unopa ropa kumutsipa wespinha, masimba occipital lobes europi nemasumbu.
2. Iko mukati mekutenderera mutsara inotanga pamucheto wepasi pe subclavian artery. Nharaunda inopa ropa kune chirwere chetachiona, diaphragm, bronchi, sternum, nezvimwewo.
3. Shield shaft. Inotangira pedyo nechomukati chemucheto we staircase, inosvika kureba inenge 1-2 masikati.Chiganda chakasanganiswa chinopatsanurwa kuva matavi anopa ropa kumisungo ye scapula nemutsipa, uyewo maruva.

Kushambadzira kwechipiri nechechitatu subclavia arteri

Chikamu chechipiri chesclavia artery, rakasungwa ne-interstitial space, ine rimwe chete rebazi, rinonzi rib-cervical trunk. Inotanga kumashure kwechikamu che subclavia uye inoparadzanisa mumatavi akaverengeka:

1. Iyo yakanyanyisa inonzi intercostal arteri (kubva pane iyi ariti, matavi emashure anotungamirira kumishure kumashure).
2. Zvipembenene zvemidziyo.
3. Deep neck neck cervical artery.

Dare rechitatu re subclavia arteri inewo branching imwechete - iyi ndiyo mutsetse unoyerera wemutsipa. Iyo inowedzera kunyadziswa kwepafudzi uye yakakamurwa kuva:

1. Chimiro chepamusoro chinopa ropa kumutsipa wemupfupa.
2. Dorsal artery ye scapula. Anoburukira kumusana wakareruka mushure, anodyora uye zviduku zvishoma pedyo nayo.
3. Pasi pebazi re subclavia arteri .

Pano, pfungwa dzakadai sedare re subclavia uye matavi awo anorondedzerwa mune zvakakwana, ruzivo rwezvekuwedzera runogona kuwanikwa kubva mune zvekurapa.

Zvirwere zvinogona kuitika zve subclavia arteri

Chirwere chikuru chinokanganisa subclavia ariti uye matavi awo ndiyo nyonganyonga yemwenje yemidziyo, mune mamwe mazwi, stenosis. Chikonzero chikuru chechirwere ichi ndechokuti atherosclerosis ye subclavia arteri (kuiswa kwe lipids pamadziro emisvi yeropa) kana kuti thrombosis. Ichi chirwere chinowanzowanikwa, asi kune mamiriro ehutano. Zvimwe zvinokonzerwa neAristrosclerosis ye subclavia ariti ndeiyi:

1. Arterial hypertension.
2. Kusvuta.
3. Kuwedzera kuwedzera, kuneta.
4. Diabetes mellitus uye dzimwe zvirwere.

Chikonzero chinonyanya kukanganisa che stenosis ye subclavia arteri chirwere chemagetsi mumutumbi wemunhu, neoplasms nekuputira maitiro. Simba stenosis rinotungamirira ku kuderera kwekuyerera kweropa kusvika kune nhengo dzinokosha dzevanhu, pane kukanganisa kwe okisijeni uye michina mumatumbu. Mukuwedzera, stenosis inogona kukonzera chirwere cheschemic, kunyanya chirwere.

Syndrome ye subclavia arteri

Kusakwana kwekuyerera kweropa kunogona kukonzerwa kwete chete nekudzivirira kubuda kweropa nekuda kwechiremera-stenotic zvipembenene, asiwo ne vertebral-subclavia "kuba". Iyi subclavian artery syndrome, kana style-syndrome, inokura kana paine stenosis kana kusvibiswa mumutambo wekutanga wemudziyo. Zvichinyatsojeka, ropa riri mumugwagwa we subclavia haubvi kubva kune aorta, asi kubva mumutsetse wetteral, iyo inogona kutungamirira kuucherechedza ischemia. Kuwanda kwezviratidzo zvechirwere ichi kunokonzera kushungurudzika kwemuviri pachimusoro.

Zviratidzo zvechirwere ichi:

1. Chizutu.
2. Prescensory mamiriro.
3. Kusagadzikana kwemaonero.
4. Utachiona husina simba kune rumwe rutivi rwechiremera.
5. Kuchengetedzwa kana kukwana kusakwana kwemapurisa kune rumwe rutivi rwechirwere.

Zvimwe ruzivo pamusoro pe stenosis ye subclavia arteri

Iyo yakaiswa pamadziro emidziyo inotungamirira kumanikidziro ezvokupedzisira ane lipid, iyo, ndiyo inowanikwa yakagadzirwa necholesterol. Izvi zvinogona kuderedza chimiro chemudziyo kusvika ku80%, dzimwe nguva kunyange kuchivhara zvachose. Mukuwedzera kune izvo zvataurwa pamusoro apa zvinokonzera stenosis ye subclavia arteri, kune mamwe, akadai se:

1. Irradiation.
2. Arteritis.
3. Compression syndromes.
4. Zvipembenene zvakasiyana-siyana, zvakadai se fibro-muscular dysplasia, nezvimwewo.

Kazhinji mune vanhu vanotambura ne stenosis ye subclavia artery, iyo midziyo yakasara inoshandiswa. Izvi zvinogona kuva mumigero yemvura, kureva, moyo, uye carotid - arteri yekumucheto. Chaizvoizvo, nehutachiona hwakadaro sechinyunyuko chechiedza chemidziyo, sariti yekasiki yecclavia inoshandiswa. Maererano nehuwandu, izvi zvinoitika kazhinji kakawanda kakawanda kupfuura nekodzero.

Zviratidzo zve stenosis:

1. Kushaya simba mumasumbu.
2. Kunzwa kuneta.
3. Pain in the upper legs.
4. Necrosis yeminwe.
5. Kudzingirira mumusana.

Mukuwedzera, zviratidzo zvehutano zvinogona kuonekwa, kureva kuti, "kuba" kunowanikwa: ropa rinotungamirirwa kubva mumidziyo yakazara kuenda kunharaunda inobatwa. Zviratidzo zvezvirwere zvepfungwa:

1. Kuona kuora mwoyo.
2. Kurasikirwa kwekuziva.
3. Kupesana kwekutaura.
4. Kurasikirwa kwehutano.
5. Chizutu.
6. Kurasikirwa kwekunzwisisika muchiso.

Nzira yekurapa stenosis ye subclavia ariti?

Kurapa kwe stenosis kunogona kuva mishonga, kupora uye kupindira. Iyo nzira huru yekurapa ndeye X-ray endovascular stenting ye subclavia arteri uye hopey subclavian shunting. Iyo nzira yekupedzisira inokurudzirwa kuvanhu vane hypersthenic muviri, umo zvakaoma kusiyanisa chikamu chekutanga chetari. Iyi nzira yekurapa inokurudzirwawo kuti stenosis muchechi yechipiri ye subclavia arteri.

Kutsiva kwe subclavia arteri

Kushungurudzika ndiko kurapwa kwechirwere che subclavia kuburikidza nekukanganiswa kuduku paganda, 2-3 mm murefu, yakaitwa nenzira yekuvhara. Iyi nzira yekurapa inobatsira zvishoma pamusoro pokupindira kwekuvhiya, sezvo inokonzera kukuvadzwa zvishoma uye kusagadzikana. Mukuwedzera, iyi ndiyo nzira inoshandiswa yekuchengetedza uye yekuchengetedza nhengo yekuchengetedza, iyo iyo subclavia ariti inoramba iri muhupenyu hwayo, iyo inonyanya kukosha kune murwere.

Nzira yekudengenyeka inenge isinganzwisisi uye iri pasi peaneshesia. Kuvhiya uku kunobvumira kuwedzera chiedza chemidziyo pamwe nekushandiswa kwekathetta chaiyo nemashizha nenzira yezvirindi. Iyo yekupedzisira ndiyo cylindrical endoprosthesis yakagadzirwa nea laser kubva kune imwe tsvina yesimbi. Iyi faira inosungirirwa ku-balloon catheter chaiyo uye inomanikidzwa mu subclavia arteri. Apo iyo stent inosvika pane imwe nzvimbo yemhepo inogadziriswa, dzimwe nzira dzekutonga dzinoitwa, dzine chokuita nenzvimbo yayo yakakodzera. Mushure meizvi, chigadzirwa chacho chakazarurwa pasi pekumanikidzwa kukuru. Kana iyo stent isiri yakakwana yakazaruka, angioplasty yeimba yakaisvonaka inogadzirwa ne catheter chaiyo ine chinyorwa pamagumo ekubudirira kwakakwana kwechigumisiro. Kusvika iye zvino, zvinoita kuti uite basa iri pasina, unogona kuzviita nokuwana chikamu chehurumende. Murwere ane chirwere chakafanana anofanira kuonana nachiremba anotarisira.

Zvimwe zvinokonzera kutyisa

Iyo nzira yekusimudzira sclavia arteri inotora maawa maviri. Kuvhiya kunoitwa mudhipatimendi rekucheka mwoyo. Mushure mokumanikidzwa, kana zvichidikanwa, mishonga inorwadza inotorwa, sezvo kunzwa kunorwadza kunogona kuonekwa munzvimbo iyo subclavia arteri uye matukisi ave akaiswa. Matambudziko mushure mekuita nenzira iyi ishoma zvikuru, sezvinoita murwere asati agadzirira nekugadzirisa zvakakwana. Asi zvakadaro mamwe mamiriro ezvinhu asingafadzi angasimuka, ndeokuti:

1. Allergy kumishonga.
2. Mhinduro yeanesthetics.
3. Minor achibuda ropa pamucheto wekudzivirira.
4. Kupisa.
5. Headache.
6. Kurwara.
7. Air embolism.
8. Kuparadza kumadziro eArteri kana aorta.
9. Subclavian artery thrombosis.
10. Kutama kwechigamba.
11. Matambudziko eurourological, nezvimwewo.

Kupindira kwechirwere chesclase ye subclavia arteri ne balloon angioplasty uye kuvepa kunotyisa kwemazuva ano, zvishoma uye zvisingaiti. Vane nguva shoma shomanana yekugadzirisa nguva uye yekurapa.