Ciki aortic aneurysm: cututtuka, ganewar asali, magani

A lakã ne mafi girma a jijiya azygos. A nasa ne na tsari dabam dabam da kuma amfanin jiki duk gabobin da jikin mu ta jini. A lakã ne zuwa kashi 3 sassan da kuma 2 sassa - da na ciki da kuma thoracic. Mafi sau da yawa (95%) sami wani aneurysm na ciki lakã, wanda muke da shi a yau kuma za mu yi magana.

Aneurysm - sigar tsawo ko bulging na lakã. A cuta ne har yanzu tushen yawa tattaunawa, saboda likitoci ba zai iya zo da wani gagarimin ra'ayi, abin da mataki na fadada daga cikin jijiyoyin bugun gini bango za a iya bincikar lafiya a matsayin aneurysm. Tun da farko ganewar asali da aka tabbatar da karuwa a lakã 2 sau ko fadada da diamita fiye da 3 cm. Duk da haka, ba da gaskiya cewa lakã yana da wani diamita na 15 zuwa 32 cm, manufar "fiye da 3 cm" a fili quite m. Saboda haka, a shekarar 1991, godiya ga bincike na American masana kimiyya ya fara aneurysm dauke mahaukaci kara girma na lumen na lakã da 50% fiye da ta al'ada diamita. Amma wannan definition ne da ɗan sabani.

Wannan batu ne da muhimmanci musamman a zabi na dabara daga m baki, amma, alas, shi ne har yanzu a bude. A halin yanzu, daga aneurysm a kowace shekara ya kashe game da 15,000 Amirkawa a shekara. A mafi yawan lokuta, shi kawai ba shi da lokaci don gane asali.

Abin da likita ya kasance zalunta wani aneurysm?

Yana bi da wata cuta jijiyoyin bugun gini likita, a matsayin babban magani domin sarrafawa matsaloli. Idan aiki ba a nuna, da mãsu haƙuri ya kamata a gani da likita, mai likitan zuciyar ko internist (gwani a ciki magani) a hankali saka idanu hãlãyensu. Aneurysm quite insidious, shi zai iya ba zato ba tsammani fara girma, da kara hadarin mafi tsanani na ta rikitarwa - da rata.

Wane ne a hadarin?

An aneurysm aka bincikar lafiya a maza da mata (Malkisadik, duk da haka, shi ne da yawa kasa). Duk da haka, shi ya lura da cewa a cikin maza girmi shekaru 65, shi ya auku more akai-akai. Wannan shi ne sun fi mayar saboda da so na mutane da yawa zuwa shan taba, wanda shi ne musamman cutarwa a cikin tsufa.

Saboda haka, a hadarin sun hada da:

• mutanen da fama da hauhawar jini.
• smokers.
• abokai a cikin abin da iyali da aka yi fama da wani aneurysm na ciki lakã ko wasu cututtukan zuciya da kuma / ko cuta daga cikin na gefe zagayawa.
• masu kiba da kuma mutanen da suka kai a sedentary salon.

Gargadi! Tabbatar da gudanar da bincike, da yawa aneurysms aka gada daga kakanni.

Iri aneurysms na ciki lakã: rarrabuwa

Ciki aortic aneurysm ne zuwa kashi da dama iri dangane da siffar, sarrafawa da kuma pathological fasali:

1. Jakar kwai (yayi kama da 'yar jakar da cewa ta hanyar da cervix hade da lumen na lakã).
2. Fusiform. A siffar wani dogara sanda, wanda aka haɗa ta hanyar wani bude ga lumen na lakã. Mafi na kowa nau'i na aneurysm.

Bisa ga pathological halaye na wadannan iri aneurysms:

1. Gaskiya. Its kumbura jirgin ruwa bango, kamar yadda kafa wata jam'i na yadudduka na lakã.
2. Pseudoaneurysm. Yana bayyana bayan rauni saboda ci gaban pulsating hematoma.
3. Exfoliating. Ina nufin da ganuwar delaminate da intramural rami cika da hematoma, wanda ta hanyar bango na lalace jijiyoyin bugun gini nama yana da alaka da lumen na lakã.

Rarrabe tsakanin shi da kuma sarrafawa:

1. Aneurysm na infrarenal ciki lakã ne sama / kasa da na koda arteries reshe.
2. Suprarenal ne sama da sashe arteries
3. Total aneurysm aka yada tare da dukan tsawon da jirgin ruwa.

Mene ne Sanadin aneurysms?

• Atherosclerosis, a cikin abin da jijiyoyin bugun gini bango na zama da kauri da kuma hasarar da elasticity, kuma aka kafa a ganuwar ta a cikin nau'i na kitse atherosclerotic plaques. A abun da ke ciki na plaques hada da cutarwa cholesterol da sauran fats. Duk da yake likitoci ba su da cikakken m yadda ta rinjayar da cin gaban atherosclerosis, aneurysm, amma shi ne a zaci cewa saboda wannan cuta ya bayyana Sistem sakulasan cuta a cikin jirgin ruwa da kuma tsaya a nan ba wadata da na gina jiki. A sakamakon haka, da jijiyoyin bugun gini tsoka ta lalace, bi da tsakiyan nonon. A sakamakon haka, da ganewar asali ne "na ciki aortic aneurysm".
• Ciwon wanda "Yana son" daukan hankali jini jijiya. An sau da yawa tare da retinopathy, nephropathy, aneurysms.
• Auren. A wasu nakasar syndromes (Ehlers -. Danlos ciwo, Marfan Erdheim pathologic cystic tsakiya necrosis, da dai sauransu) da jijiyoyi da bala'in ya shafa, ciki har da na ciki lakã. Shi ne sau da yawa yiwu a gano da dangantaka tsakanin aneurysm ciki lakã da kwayoyin cututtuka.
• Cututtuka. Wadannan sun hada da cututtuka da shafi ciki Layer na zuciya (endokart) - syphilis, ekdokardit, Salmonella, da dai sauransu ...
• Raunin da ciki. Alal misali, sa'ad da wani karfi tura zuwa kirji ko na ciki lakã iya shafi.
• Kumburi tafiyar matakai. Nonspecific aortoarteriit, misali, yana sa a weakening na aortic bango. Duk da haka, babu takamaiman bayani a kan wannan batun ba tukuna. Amma wadanda ba mai kumburi cututtuka na jijiyoyin bugun gini ganuwar akai-akai faruwa saboda atherosclerotic plaques.

A general, mafi sau da yawa a cikin hanyar aneurysms ne shan taba, ta jiki rashin aiki da shekaru. Yana da muhimmanci don gane asali da shi a cikin lokaci. Aneurysms na thoracic da kuma na ciki lakã da daban-daban cututtuka, wanda mu yanzu la'akari da.

Mene ne bayyanar cututtuka na ciki aortic aneurysm sashen?

Mafi sau da yawa, aneurysms taba sa kanta ji, da aka yi fama da damar a cikin binciken. Kamar yadda shi canjawa da gabobin, disrupting da ikon rayuwa, shi za a iya bincikar lafiya daidai, saboda shi yana da muhimmanci ga gudanar da wani na ciki duban dan tayi. Doctors lura cewa musamman "secretive" thoracic aneurysm. Yana ba za a iya nuna a duk ko sa ciwon kirji, tari, kuma shortness na numfashi. A cikin hali na kara gaggawa da aka samu aneurysm na ciki lakã.

Daga cikin 'yan cututtuka aneurysm ware wasu wanda ke faruwa tare, kõ dabam- dabam:

1. Nauyi a cikin ciki yankin, da m abin mamaki na cikar kuma bugun jini, wanda yayi kama da Littafi bugun zuciya.
2. Ciki zafi, m, m, aching, maras ban sha'awa hali. An sarrafa dama a cikin umbilicus ko hagu.

Kuma tsaye ba ãyõyi sa kanta ji na ciki aortic aneurysm. Its cututtuka su ne don haka daban-daban da cewa suna tuhumar da gaskiya matsalar da matukar wuya. Wannan shi ne saboda gaskiyar cewa a girma aneurysm iya rushe daban-daban gabobin da kuma tsarin. A sakamakon haka, ana iya gauraye da na koda colic, pancreatitis, ko sciatica.

Ishioradikulyarny ciwo Yanã zafi a cikin ƙananan baya (musamman, da kugu) da kuma tashin hankali ƙwarai a kafafu tare da wani motsi cuta.

Ciki ciwo bayyana ta amai, belching, zawo ko maƙarƙashiya, kazalika da rashin ci, wadda take kaiwa zuwa nauyi asara.

Kullum ischemia na kafafu da aka bayyana, a take hakkin wurare dabam dabam (sanyi ƙafa), tsoka zafi a lokacin tafiya da kuma a sauran, lokaci-lokaci lameness.

Prostate cider shelanta kansa urinary cuta, zafi, ji na wani nauyi a cikin ƙananan baya, har ma da bayyanar ja jini Kwayoyin a cikin fitsari.

Katsewa na ciki aortic aneurysm fara da wani riba na jin zafi a ciki, janar wani rauni da juwa. Wani lokaci ciwo ya ba wa kugu, makwancin gwaiwa ko crotch. A wannan yanayin da haƙuri yana bukatar likita nan da nan da hankali, tun a jihar ne fraught tare da mutuwa. Sau da yawa aneurysm karya a tsakiyar kananan hanji, da ciki, ko da duodenum, akalla - a cikin wani lokacin farin ciki ciki. Lokacin da tsage ciki aortic aneurysm, da cututtuka iya a tare da tashin zuciya da kuma amai. A hagu ayyuka na ciki da aka palpated ilimi ne sannu a hankali kara da tare da wani karfi karuwa. Its suna iyaka ba palpated.

A katsewa na aneurysm cututtuka su ne sosai haske, amma su ne sauƙin rude tare da sauran m kiwon lafiya yanayi, don haka tabbata kira motar asibiti don wani m zafi a ciki ko kirji.

ganewar asali da cutar

A farko bincike mataki - likita jarrabawa, wanda a kan palpation ji mai karfi pulsation a ciki, shi ne na ciki aortic aneurysm. Diagnosing shi ya hada da bincike cewa ya ba da damar zuwa ganin abin da ke faruwa a cikin kogon ciki. Da farko, shi ne duban dan tayi, kuma lissafta tomography (CT) da kuma multislice lissafta tomography na lakã (MSCT).

Idan ana zargin ciki aortic aneurysm, duban dan tayi damar kusan cikakkar yaƙĩni tabbatar da kasancewar. Yana nuna ainihin wurin da aneurysm, jihar na jijiyoyin bugun gini bango, da wurin da rata, idan yana daukan wuri.

CT ko MSCT yi don gano calcification, aortic thrombosis vnutrimeshkovy, barazana ko karya data kasance rata.

Idan bincike gwaje-gwaje da aka jera a sama ba da damar m ganewar asali (ko da yake wannan ne quite rare), nada ta aortography. A Hanyar damar real-lokaci duba lakã da kuma rassansa da gabatar da musamman m cikin jirgin ruwa. Ya nuna cewa idan akwai tuhuma da rauni na visceral kuma koda arteries, da aka sani jihar na distal Sistem gado.

Matsalolin ciki aortic aneurysm

Wannan yanayin ne m ba kawai ga kiwon lafiya amma ga rayuwa. Da farko, da lakã iya haifar da wani embolism (blockage) na arteries, dauke da kwayar cutar rikitarwa, ci gaba zuciya rashin cin nasara.

Dissecting ciki aortic aneurysm - wani hatsari wahala cewa shi ne ta katsewa da jini shiga cikin jijiyoyin bugun gini yadudduka na jiki. Idan duk rabe Layer 3 da lakã karya gaba daya, akwai m jini hasãra.

Amma, ba shakka, mafi sharrin wahala na aneurysm - shi ne shi hutu. Mutane da yawa marasa lafiya da untreated aneurysms zai mutu a cikin shekaru 5. Kafin ka cire haɗin mutum ji zafi a ciki da kuma a cikin lumbar yankin. Idan wani aneurysm na ciki lakã tsage, da kuma cutar halin profuse zub da jini da take kaiwa zuwa buga da kuma mutuwa. Saboda haka lalle ne, haƙĩƙa kira motar asibiti idan akwai m zafi a ciki da kuma kirji, a matsayin bata lokaci ne mai hadarin gaske. Statistics nuna cewa kawai 3% da marasa lafiya mutu nan da nan bayan katsewa na lakã, yayin da wasu rayuwa daga 6 hours zuwa watanni 3. A mafi yawan lokuta, suka mutu a cikin kwanaki. Ta yaya za a iya yi wa wani aneurysm? La'akari da wadannan.

Jiyya na aneurysms ciki lakã

Mutane da yawa kuskure yi imani da cewa ganewar asali "aneurysm na ciki lakã," magani iya zama m. A gaskiya ma, akwai duk akayi daban-daban.

Idan aneurysm kai 4.5 cm a diamita, da aiki ba da aka nuna, saboda ta iya gudanar da wani mafi girma hadarin ga rayuwa fiye da da ya karu a size jirgin ruwa. Yawanci, irin wannan Trend An lura a mazan maza suka sha wahala daga co-morbidities, kuma a Bugu da kari ba a daina shan taba (kuma da irin wannan ganewar asali tasha shan taba kawai bukatar!). Domin su, a jira game, saboda hadarin aortic katsewa a irin wannan diamita ne kawai game da 3% a kowace shekara. A wannan yanayin, kowane watanni shida da haƙuri da aka tilasta su yi duban dan tayi don gano girman da lakã. Idan jijiyoyin bugun gini bango a hankali yana faɗaɗa, shi ne na farko nuni ga tiyata, saboda yiwuwar BREAKING an karu da 50%.

Tsofaffi, wanda ya saukar da wani aneurysm na ciki lakã, da magani ne desirably za'ayi da wajen wani endovascular, minimally cin zali hanya. A lokacin aiki, da haƙuri da aka gudanar a cikin jijiya da wani catheter ta hanyar da suka hada da stent. Kama a lakã, shi ya buɗe da kuma maida hankali da jijiya, sakamakon maye gurbin ya shafa yankin na jikin ta. Amfanin aiki sun hada da wani hur portability da kuma kananan dawo lokaci - kawai 'yan kwanaki. Amma wannan hanya na da nuances, don haka gudanar da shi ne ba duka. Babban drawback na wannan aiki - to 10% na lokuta can ne distal hijirarsa na kafa tsayawar.

Idan kamu da "na ciki aortic aneurysm", da aiki shi ne sau da yawa bude. A lokacin da ta shafa yankin na lakã aka cire da kuma maye gurbinsu da wani prosthesis sanya na Dacron (roba masana'anta dangane polyester). Domin samar da damar yin amfani da lakã, ta amfani tsakãtsaki ce laparotomy. Duration na tiyata yawanci ne game da 2-3 hours. Bayan tiyata zauna a bayyane tabo.

A haƙuri dawo dasu game da makonni biyu. Farfado da aikin a wasu lokuta mai yiwuwa ne kawai bayan 4-10 makonni. A haƙuri ne tsananin haramta jiki aiki, ya nuna zaman lafiya, kuma yanã tafiya.

Contraindications bude tiyata

Haramta tiyata a karkashin wadannan yanayi:

• Recent tsokar zuciya infarction (ba kasa da wata daya).
• Cardiac da na huhu insufficiency.
• Koda insufficiency.
• Iliac da femoral jijiyoyi.

Fi bayan tiyata

Hakika, gaban rikitarwa bayan tiyata shafi haƙuri da shekaru da kuma hade cututtuka. Har ila yau, haƙuri da yanayin iya worsen idan ta jiki da aka riga ya raunana (HIV, Oncology, da ciwon sukari), akwai kiba da kuma cututtukan zuciya. Bugu da ƙari, pre-habarta aiki bada haƙuri mafi kusantar su tsira, kuma mai da fiye da gaggawa shiga tsakani a katsewa na wani aortic aneurysm.

Matsalolin na iya faruwa kamar yadda a dauki janar maganin sa barci, wanda ba ya gudanar da dukan, ci gaban kamuwa da cuta, da lalacewar kayan ciki da zub da jini. The sosai kananan yawan lokuta ne m aiki.

Idan tiyata da aka shirya, likitoci bayar da shawarar a mako kafin ta dauke daina shan miyagun kwayoyi, jini thinners, da kuma anti-kumburi kwayoyi (asfirin da sauransu.). Tabbata a sanar da likita game da abin da irin magani kana shan a wannan lokacin, kafin aiki.

Kasadar komowa ne musamman kananan, amma idan wani mutum ba zato ba tsammani ya fara ta da zafi a baya ko ciki, tashin zuciya da amai, numbness a ƙafafunsa, ko da wani janar ji unwell, kamata kanemi shawara nan da nan.

rigakafin aneurysm

Ciki aortic aneurysm auku ku ne m iya idan ka ki (da kuma, fi dacewa, ba saya da al'ada), shan taba, da za su sarrafa matsa lamba kuma ka nauyi. Yana da muhimmanci a shiryar da wani aiki da lafiya salon. Zauna lafiya!