Eisenmenger syndrome: Amachititsa, Zizindikiro, Matendawa, Chithandizo

Mu cardiology ambiri ndi malformations kobadwa nako makamaka panyengo pali kale makumi zinthu "mwadzina". Ena a iwo anafotokoza kwa nthawi yaitali ndi bwino mankhwala pa nthawi ante- ndi neonatal, koma ambiri akufunafuna kafukufuku wa. Mmodzi wa iwo ndi matenda Eisenmenger. Matendawa anazindikiritsidwa mu m'ma makumi awiri ndi lopambana Austria dokotala ndipo tsopano limadziwika ndi dzina lake.

tanthauzo

Eisenmenger syndrome (Eisenmenger) - uyu kuphwanya Natal chitukuko cha minofu mtima, womwenso pamaso pa chilema septum pakati ventricles, ndi msempha otzerkalennoe malo ndi kukula kukula kwa ventricle bwino. Mwamwayi, chilema izi zikhoza opaleshoni, ndi ana zina kukula ndi kukhala mu njira yomweyo monga anzawo.

ziwerengero

Pa nthawi, pafupi faifi pa zana a milandu onse anomalies mtima ana amatenga matenda Eisenmenger. matenda obadwa nawo a mtima zikhoza kugawidwa ndi matenda ena mtima wa ana ndi ana aang'ono. Madokotala ena amaphatikizidwa Popanda kuchitapo kanthu chisokonezo aliyense hemodynamic mu syndrome izi.

Syndrome kapena zovuta

Kuonetsetsa osiyana komanso matenda Eisenmenger. Syndrome - mapangidwe uncorrected kuyan'anila za magazi yolambalalitsira chitukuko pakati pa cavities a ventricles mtima. zovuta A zikuphatikizapo matenda achindunji opezeka wosabadwa kapena akhanda.

etiology

The ndondomeko ya momwe matenda izi aumbike, mpaka kumapeto silikudziwika, asayansi ndiponso madokotala adakali kuyesera kupeza malongosoledwe. Komabe, iwo anakwanitsa bwino kufufuza zinthu chifukwa chimene Eisenmenger zovuta akuwonekera. Zifukwa akhoza kugawidwa m'magulu awiri: mkati, kapena majini, ndi akunja kapena chilengedwe zotsatira.

1. Kunena za mwachindunji cholowa kufala kwa matenda sangakhale, koma ngati atumwi kapena wachiwiri mzere achibale alipo chisokonezo mapangidwe a ziwalo zofunika kwambiri, pali mwayi kuti mwana Yak.
2. Chiphe m'nthawi antenatal. Chiopsezo gulu zikuphatikizapo amayi apakati okhala m'mizinda ikuluikulu, ntchito mu ntchito woopsawo kapena kulimbana ndi Mankhwala oipitsa mankhwala kapena thupi.
3. Kumwa mankhwala. Mankhwala ena owopsa kutenga pa kubala ana. Choncho, pamaso pa lingaliro kapena mu masabata choyamba pambuyo azamba ayenera anakambirana ndi ndalama onse analandira. Ngakhale ziri chabe mapiritsi mutu.
4. Ntchito mavitamini ndi zowonjezera zakudya khalidwe n'ngwokayikitsa. Kawirikawiri zinthu zimenezi ndi chabwinobwino, koma nthawi zina iwo kungawononge ku phwando sanabadwe anapanga mafupa a mwana kapena ziwalo wake mkati.
5. Kupezeka kwa umodzi wa matenda makolo ndi yaitali aakulu.

Kumene, zifukwa izi sizisonyeza makamaka pa matenda Eisenmenger. Zizindikiro, matenda ake ndi mankhwala zafotokozedwa pansipa.

pathogenesis

Pamene munthu ali ngati mbali anatomical alipo, onetsetsani kudzakhala chisokonezo magazi. Chifukwa kukhalapo kwa kwambiri yamitsempha yamagazi septal chilema, komanso chifukwa cha udindo cholakwika kwa msempha ndi wosanganiza venous ndi magazi kung'ambika mu M'mimbamo mtima. Ie anapanga shunt ndi shunt kuchokera kumanzere kupita kumanja. M'kupita kwa nthawi, kuthamanga mu m'mapapo mwanga ukuwonjezeka thunthu, nthawi zina akhoza ngakhale upambana anthu msempha. Izi, mu zingathandize kuti kuphipha reflex ziwiya ka magazi mu makope m'mapapo mwanga. Akutukuka oopsa m'mapapo mwanga. Ngati zimatha nthawi yaitali, ndiye pali thickening compensatory mpanda wa capillaries ndi magazi stasis amapezeka mu mapapo.

Clinicians adagawa "woyera" ndi "buluu" syndrome Eisenmenger. Mbali yoyamba, ndi shunt ndi nkhani yake yakale, ndiko kuti, kuchokera kumanzere kupita kumanja, ndipo lachiwiri - M'malo mwake.

zizindikiro

Makanda ndi ana aang'ono zizindikiro zapadera zindikirani zovuta. Thupi ndi ozindikira chitukuko cha ana savutika. Ngati zaka limapezeka zosiyana shunting, ndiye munthu kufupika kwa mpweya, buluu nasolabial makona ndi malekezero, kutopa, palpitations kapena arrhythmia palpable ululu wa mtundu angina. Chitsanzo zili odwala kuti apewe zizindikiro - kutchire kukakumba ndikafuna kudzithandiza. Choncho mosavuta kupuma.

Wa matenda wamba zambiri kumva kulira kwa mutu, nosebleeds, ndi kutsokomola magazi. Mukhoza kusintha mawu chifukwa psinjika za molekezera mitsempha ya mitsempha ya dilated. Nthawi zambiri munthu angaone pathologies ngati protrusion a mtundu chifuwa cha hump ndi kusintha phalanges osachiritsika a zala monga drumsticks, akuloza kulephera mouzirira, wotchedwa syndrome Eisenmenger a. Zoyambitsa, zizindikiro, matenda izo kudziwika kwa aliyense cardiologist.

zovuta akhoza kumva ndi matenda, chibayo, endocarditis bakiteriya etiology, magazi kuchokera mapapo, ndipo ngakhale mitima yawo kuukira. Popanda mankhwala, moyo amayembekezeka odwala anthu si zaka zoposa makumi atatu.

diagnostics

Mwatsoka, pamene kuona Wamba awulule matenda sizingatheke. Pofuna kutsimikizira matenda presumptive, amafuna njira yapadera ya kafukufuku:

1. X-ray a chifuwa, umene kusonyeza kusintha zithunzi contours mtima ndi ziwiya lalikulu.
2. makhalidwe Angiography ngati kulingalira njira ya chitukuko mtima amagwiritsidwa ntchito, koma mu nkhani iyi si yeniyeni, ndipo akhoza kuona kusintha yaitali katswiri.
3. ECG kuwulula kwa iwo, ngati umachitika mu Holter kuwunika. Ndiye mfundo dokotala sadzakhala mphindi zisanu kasamalidwe, ndi kwa tsiku lathunthu, ndipo adzatha kuzindikira kusintha chiwongola dzanja.
4. Echocardiography - ultrasound cha mu mtima. Njira zotichititsa kupeza zopindika mu cavities a mtima ndi magazi matenda a.
5. Mtima catheterization, mu nkhani iyi - njira zambiri zovomerezeka ndi odalirika kafukufuku. Izi zimathandiza kudziwa zilema zonse, kudziwa makhalidwe a mtima umodzi ndi kukhala chithandizo.

Ameneyo ndi zovuta matenda syndrome Eisenmenger. Zizindikiro (matenda chithandizo multistage ndi nthawi yambiri) kudwala ake nonspecific zinthu zobisika monga matenda wamba ndi kuthaŵa chidwi madokotala ambiri.

chithandizo

Ngakhale atasemphana wosatha pakati pa madokotala ndi madokotala, pa nkhani ya matenda, iwo anavomera kuti khama olowa amafunabe mankhwala monga mankhwala ndiwofatsa palokha sapereka zotsatira kuilakalaka, ndipo mwamsanga sangathe kupereka chikhululukiro khola. Choncho, ya miyeso lalembedwa kuthetsa vuto Eisenmenger:

1. Magazi (zitasinthidwa ano kumatchedwa "phlebotomy"). Zambiri ndi vuto lililonse njira. Izo ntchito odwala ndi kudwala kutsimikiziridwa angapo nthawi chaka. Pambuyo pa ndondomeko kwenikweni anatsimikiza mtima ndi kukhuthala magazi ndi hemoglobin.
2. Ntchito Mpweya oxygen. Ntchito ngati mankhwala adjunct kuthana ndi cyanosis ndi hypoxia sekondale. Komanso, iwo ndi zotsatira choganiza pa odwala.
3. Anticoagulants. Iwo alibe mlingo okwanira umboni kuti adzapezekepo kutuluka mu Frying poto pamoto, ndipo m'malo thinners magazi kuti nesvorachivaemost wake wonse.
4. Mankhwala ena:
   - okodzetsa kochotsa edema m'mapapo mwanga;
   - njira kusintha hemodynamics.
5. Opaleshoni Kadyedwe Kake:
   - pacemaker zoperewerazo arrhythmia;
   - wathunthu kuchotsa ndi yamitsempha yamagazi septal chilema kutsekedwa ndi shunt nthenda.

Ndendende mmene tiyenera kuchitira syndrome Eisenmenger azilankhula ndi dokotala kapena ngakhale akatswiri angapo. Ndiye kodi kupereka adzapambana sangakhale iliyonse njira imodzi.