Mtima malformation: zimayambitsa, zizindikiro, matenda ndi mankhwala

Ngati njira ya chitukuko embryonic ndi akusokoneza mapangidwe m'thupi, ndi malformation mtima aumbike. Ichi ndi polumikizira pachithunzichi ya mitsempha ndi mitsempha, amene kumaonekera mu unyamata. Izo zonse akuyamba ndi mutu, kupweteka kwa mutu ndi khunyu. Zikavuta, ana ndi khunyu.

tanthauzo

Kapangidwe mtima losiyana lonse m'thupi. Ena thicker, ena ndi akulu khoma, ena mavavu, koma iwo onse olumikizidwa kwa wina ndi mnzake mu ndondomeko inayake. Ngati pazifukwa zina chikhalidwe maziko a ndondomeko wasweka, ndi conglomerates anapanga ziwiya convoluted, wotchedwa malformations.

Childs, matenda kobadwa nako chochititsa osadziwika. Kumachitika mu akhanda naintini mwa zikwi zana chaka. Zingachititse malformation kuba syndrome, compress chingwe msana ndi ubongo minofu, kupanga aneurysm ndi kuyambitsa matenda opha ziwalo kukha mwazi meninges. Nthawi zambiri mavuto zimachitika ali okhwima, patapita zaka makumi anai.

Gawo

Pali njira zosiyanasiyana amene angatenge malformation mtima. Ntchito zawo systematization anatengera mu 1996 American gulu ISSVA. kusiyana amafotokoza ku classifications ena - kulekana kwa anomalies onse zotupa ndi malformations.

1. zotupa mtima:
   - infantile hemangioma (limapezeka ubwana);
   - kobadwa nako hemangioma;
   - bunchy hemangioma;
   - veretenopodobnaya hemangioendothelioma;
   - kaposhiformnaya hemangioendothelioma;
   - yotengedwa ndi chotupa cha.
2. malformations:
   - capillary (telangiectasias, angoikeratomy);
   - venous (ayi, glomangioma, syndrome Mafuchchi);
   - lymph;
   - wolumikizira;
   - arteriovenous;
   - pamodzi.

Malformation ya mitsempha

Venous Malformation ndi nthenda chitukuko cha mtsempha, kenako kutambasuka awo pathological. Ndi ambiri mwa mitundu yonse ya malformations. matenda ndi kobadwa nako, koma kungaonekere ana ndi mukadzakula. Kusintha malo ziwiya akhoza kukhala chilichonse: a mantha zokhudza zonse, ziwalo, khungu, mafupa kapena minofu.

malformations Venous akhale padziko kapena thupi bodza thicker kukhala olekanitsidwa kapena Tambasula mu magawo angapo thupi. Komanso, pafupi iwo unali pamwamba pakhungu, zambiri zimalimbikitsa mtundu phindu.

Chifukwa cha mawonekedwe odabwitsa komanso mtundu angakhale osokonezeka ndi hemangiomas. Pakuti matenda masiyanidwe pang'ono ndithu kuthamanga kwa gawo kusinthidwa. Malformations zofewa ndi zovuta kusintha mtundu. Mu nkhani ya yatsoka ziwiya nthenda magazi kwambiri mu thupi kunja kudwala angathe sasonyezedwa.

Pamodzi ndi kukula mwanayo ndi kuchuluka malformation, koma mchikakamizo cha zinthu choyambitsa, monga opaleshoni, zoopsa, matenda, mankhwala m'thupi, Kubereka kapena kusintha, anakumana mofulumira mopanda kukula kwa mitsempha.

Chiari malformation

Izi malformation mtima, amene amakhala ndi otsika-atagona tonsils cerebellar. Matendawa akufotokozedwa mu mochedwa chakhumi ndi chisanu ndi chinayi atumwi Austria dokotala Hans Chiari, amene ulemu ndi dzina lake chodabwitsa. Iye anafotokoza ena a mitundu yofala anomaly izi. Chifukwa otsika malo tonsil kungafoole outflow madzimadzi ku ubongo chingwe msana, izo amalenga chodziwa intracranial kuthamanga ndi amakwiya chitukuko cha hydrocephalus.

Chiari malformation mtundu limafotokoza kusamutsidwa cerebellar tonsils pansi ndi kuwathamangitsa mwa foramen magnum. makonzedwe amenewa amachititsa yowonjezera ngalande msana, amene kukomoka kumaonekera pa unamwali. Zizindikiro ambiri ali mutu, tinnitus, wosakhazikika poyenda, diplopia, mkhutu articulation, Pomeza mavuto komanso kusanza. Achinyamata yodziwika ndi ululu utachepa ndi kutentha tilinazo mu theka chapamwamba thupi ndi miyendo.

Chiari malformation mtundu wachiwiri akufotokozera ngati kuchuluka kukula foramen. Mu nkhani iyi, tonsils cerebellar musalekane, ndi sangagwelenso. Zimenezi zimabweretsa psinjika za chingwe msana ndi cerebellum motero. Pa nthawi yomweyo ndi zizindikiro zotheka wa posungira madzimadzi mu ubongo, kupunduka mtima, kuswa embryonic m'mimba thirakiti dongosolo urogenital.

msana

Malformation wa chingwe msana - ndi matenda kawirikawiri zimabweretsa mwapang'onopang'ono myelopathy. malformations Arteriovenous amakonda pabwino pakati pa mapepala kapena zovuta chipolopolo bodza pa dorsal padziko ubongo mu thoracic kapena lumbar msana. The kudwala kwambiri wamba wamba anthu wamkulu.

Matendawa akufanana zizindikiro za ofoola ziwalo, ndipo angaloŵe ndi katswiriyu wonyenga. A kuwonongeka lakuthwa zikadzatha anawononga Mitsempha ndi magazi mu danga subarachnoid. Odwala anati matenda tcheru ndi galimoto m'madera disruptions ziwalo m'chiuno. Ngati akulowa zizindikiro yokhudza kotekisi, nthendayo kufanana ALS (amyotrophic lateral sclerosis).

Ngati wodwala anadandaula khalidwe la matenda awiri osiyana ubongo, dokotala ayenera amaganiziridwa mtima malformation ndi kuchititsa anayendera zithunzi msana. Zizindikiro za m'mene anasintha mtima lipoma ndi madera a mtundu kuchuluka. Munthu woteroyo atumizidwe kwa kulingalira maginito kumveka kapena kompyuta myelography. Izi adzalola kuti titsimikize matenda.

zizindikiro

Mtima malformation amaoneka ngati nthawi bomba kapena mfuti ndi nyundo cocked m'manja mwa mwana - palibe aliyense akudziwa pamene tsoka udzayamba. Ngakhale kuti matenda ndi kobadwa nako anomaly, zimayamba kuonekera patapita nthawi yaitali. Pali mitundu iwiri ya malformations otaya mtima:

- magazi (70% milandu);
- torpid (otsalawo 30%).

Palibe njira akhoza kukhala wokongola kwa munthu matenda izi. Pankhani ya otaya hemorrhagic wodwalayo kuthamanga kwa magazi, ndi unit mtima ang'ono ndi ili pakhosi. Theka la anthu ndi hemorrhagic sitiroko zimachitika mtundu wa malformation kuti kumabweretsa kulumala kapena imfa. Kutenga magazi kumawonjezera ndi zaka, ndi akazi mfundo ina ndi pakati komanso pobereka.

Ngati munthu bwinobwino anasamukira anakhomedwa choyamba, ndiye ndi Mwina 1: 3 m'chaka adzakhala kachiwiri magazi. Ndiyeno lachitatu. Mwatsoka, pambuyo nkhani zitatu, ochepa alipobe. Pafupifupi theka la odwala ali ndi kobvuta akalumikidzidwa kupanga kukha magazi intracranial, hematomas kapena wosanganiza podobolochechnyh tamponade ndi ubongo ventricles.

Yachiwiri ndi otaya chachikulu, chimene chili m'kati mwenimweni mwa oziziritsa kotekisi mtima malformation. zizindikiro zake zikusonyeza ndithu:

- convulsive wokonzeka kapena kukhalapo kuukira epileptiform;
- mutu chaukali;
- pamaso zizindikiro kuchepekedwa ofanana ndi chotupa mu ubongo.

syncope

Pafupifupi anthu onse ndi malformations mtima ili mu ubongo, posapita nthawi kuoneka syncope (ie, syncope). Ichi ndi chifukwa sakuyendetsa afika kufalitsa ubongo. Pa syncope wodwala wotumbululuka, yokutidwa ndi thukuta ozizira, manja ndi mapazi ake anali ozizira, ofooka zimachitika ndi osaya kupuma. kumuukira unatha pafupi makumi awiri masekondi, ndipo pamapeto ake wodwala sakumbukira kalikonse.

Chaka chilichonse pali oposa theka miliyoni milandu watsopano syncope, ndi mbali yaing'ono chabe a iwo ali bwino chifukwa ndi zotsatira ubwenzi. Syncope bwino zimayamba ndi kukondoweza kwambiri za carotid nkusani, trigeminal neuralgia kapena mitsempha glossopharyngeal, lamulo autonomic insufficiency mantha dongosolo, mtima mungoli chisokonezo ndipo, ndithudi, mtima malformations. mitsempha nthenda ndi mitsempha kupereka shunting magazi ndi imathandizira madziwo. Chifukwa cha zimenezi, ubongo si kupeza zakudya zokwanira, omwe amasonyeza matenda a kutsitsimuka.

zosokonezeka

Ngakhale pamaso malformation umaonekera kukomoka anthu wabisika kukhala sizingasinthe zochitika pathological. Ichi ndi chifukwa hypoxic ubongo minofu gawo, izo dystrophy ndi kufa. Malinga ndi malo a zinkakhala m'dera zimawonedwa khalidwe zizindikiro focal (kuvutika kulankhula, gait, kayendedwe kwawo, luntha ndi T. N.) Kodi kukhala ndi khunyu khunyu.

mavuto aakulu ayamba kale mu mukadzakula. ziwiya nthenda magazi ndi zipupa woonda ndipo sitichedwa fractures, kotero odwala ndi malformations ambiri zikwapu ischemic. conglomerates Large mitsempha ndi mitsempha compress minofu owazungulira, kuchititsa hydrocephalus. The owopsa ndi kukha magazi chifukwa chotupa ziwiya angapo. Mwina kapena angakhalenso ndi zotsatirapo woopsa, ndi kutha ndi mavuto pang'ono kapena ayi. Izi zidalira pa chiwerengero cha magazi akukhamukira. Hemorrhagic sitiroko ndi zochepa zingamuthandize malingaliro ndi mwina anawathetsa akuyambiranso pa nthawi.

diagnostics

Koyamba ubongo Kupenda mwina saulula kuvutika aliyense mwa anthu ndi malformations mtima. Kawirikawiri Pamafunika aiming ndi bwinobwino kwambiri kudziwa kuyan'anila. Ngati wodwala anadandaula za pafupipafupi mutu kwambiri, kenaka utentha mamba, chisokonezo nthawi ya chikumbumtima ndi mkhutu masomphenya kapena kuyenda, ndi mwayi kutumiza kuchititsa neuroimaging. Mwachidule, kompyuta kapena maginito kumveka kulingalira ubongo.

Kwambiri zambiri ndi zolondola mtima dongosolo zikusonyeza kusiyana angiography. Kwa wodwala uyu mu carotid mtsempha wamagazi wamba jekeseni madzi radiopaque ndi kupanga angapo akatemera. Njira angapo matendawo ndi mavuto, Choncho, ntchito kokha ngati vuto kupanga matenda.

Kuti muwone liwiro, malangizo ndi mlingo wa otaya magazi kwa kusintha gawo, ntchito Doppler ultrasound. Njira imeneyi zimathandiza kuona kumaliseche magazi pakati mitsempha ndi mitsempha, kudziwa mtundu wa ziwiya, kukhazikitsa pamaso pa aneurysms ndi mavuto ena.

chithandizo

Kaya mtima malformations amenable kukonza? njira Chithandizo zimadalira mtundu wa chosayenerera, malo ake, kukula ndi cholinga cha mbiri ya zikwapu.

Pali njira zitatu za mankhwala:

- opaleshoni lotseguka;
- asang'ambe embolization;
- si olanda radiosurgical chithandizo.

Pakuti aliyense wa iwo pali zizindikiro, contraindications, komanso mndandanda wa mavuto zotheka.

The zoopsa kwambiri ndi lotseguka opaleshoni. Pofuna kupeza moto, kupanga kutsegula cranium, klipiruyut ziwiya ndi kudutsa iwo. Chotero chimake ndi zotheka ngati malformation inali pamwamba pa ubongo ndipo ali miyeso yaing'ono. Kuyesa kuwafika zotupa kwambiri pansi angachotsedwe kuwonongeka kwa mfundo zofunika ndi zotsatira amapha.

Kodi tingatani ngati wodwala kwambiri malformation? Chithandizo ndi endovascular embolization. Iyi ndi ndondomeko mwachilungamo wofatsa, imene chotengera yaikulu imene amadyetsa yense nthenda, ndi catheter woonda ndi anaikapo lolamulidwa X-ray ndi dokotala amapatsidwa malformation lapansi. Ndiye mtima lumen hypoallergenic kutumikiridwa mankhwala chimadzaza alipo malo ndi midadada magazi kudera. Mwatsoka, njira imeneyi sasamalira chitsimikizo chonse kuti chotengera ndi kwathunthu obliterans. Choncho, nthawi zambiri ndi ntchito ngati mankhwala wowonjezera.

The njira zotsogola kwa mtima Malformations ankaganiza opareshoni ntchito Cyber mpeni (radiosurgery). Akamanena za njira ndi anachepetsa kusamalira cheza nyukiliya nthenda moto kuchokera kumathandiza kupeza ngodya zosiyanasiyana. Zimenezi zimathandiza kuti mwamsanga kuwononga kusintha mtima, popanda kuwononga minofu wathanzi. The ndondomeko ya oipa Mitsempha pa avareji amatenga miyezi ingapo. Ubwino ndi anasiya mavuto mu wamanjenje dongosolo. Koma pali zofooka za kugwiritsa ntchito njira iyi:

1. awiri wonse wa ziwiya sayenera upambana masentimita atatu.
2. Mu mbiri sayenera sitiroko kapena magazi ena. Popeza khoma woonda ndi sangaime chotupa mu imeneyi pakati pa kuphedwa kwa ndondomeko ndi oipa chomaliza cha malformation lapansi.