Eisenmenger syndrome: Ubangela, Izimpawu, Ihlahlubo, Ukwelashwa

Ngo nezenhliziyo jikelele, kwa-kombungu esizalweni ngokukhethekile ngaleso sikhathi kukhona kakade amashumi izimo "okuzisholo". Ezinye zazo zichazwe isikhathi eside futhi iphathwa ngempumelelo ngesikhathi inkathi ante- kanye nezinsana, kodwa eziningi zaziwa asathungatha umcwaningi. Omunye wabo Eisenmenger isifo. Lesi sifo kwahlonzwa e ekuqaleni kwekhulu lamashumi amabili ovelele wezingane Austrian futhi manje ebizwa ngegama lakhe.

definition

Eisenmenger syndrome (Eisenmenger) - lokhu ukuhlukumeza ukuthuthukiswa natal imisipha yenhliziyo, ehlanganisa khona ukuphazamiseka septum phakathi ventricles, le-aorta isikhundla otzerkalennoe nokukhuphula usayizi i-ventricle yangakwesokudla. Ngenhlanhla, le nkinga ungakwazi sebebe nempumelelo ekuhlinzeni kufanele, nezingane eminye akhule ngendlela efanayo njengoba ontanga yabo.

izibalo

Okwamanje, cishe ezinhlanu amaphesenti wonke amacala anomalies inhliziyo e abantwana kudinga Eisenmenger syndrome. Yesifo senhliziyo azalwa naso ingahlukaniswa nezinye isifo senhliziyo ezinsaneni nabantwana. Abanye odokotela baye bathi kuhlanganiswe ingelashwa iyiphi thuthuva hemodynamic e yilesi sifo.

Syndrome noma eziyinkimbinkimbi

Ukwabela eziyinkimbinkimbi ehlukile futhi Eisenmenger syndrome. Syndrome - igama elibi ukwephulwa uncorrected kwegazi legazi ukundlula ukuthuthukiswa phakathi izimbotshana we ventricles inhliziyo. A eziyinkimbinkimbi kuhlanganisa iziyaluyalu oqondile otholakala umbungu noma esanda kuzalwa.

omsakazo

Inqubo kwakhiwa kanjani lokhu sifo, kuze kube sekupheleni ayaziwa, ososayensi nodokotela basazama ukuthola incazelo. Nokho, bakwazi kahle ukuba sihlole izici ngenxa okuyinto Eisenmenger eziyinkimbinkimbi livela. Izizathu zingahlukaniswa izigaba ezimbili: nemiphumela yangaphakathi, noma izakhi zofuzo, nangaphandle noma kwemvelo.

1. Khuluma ukudluliswa ngqo lezinceku lesi sifo akukwazi, kodwa uma izihlobo lokuqala noma lesibili umugqa kukhona thuthuva samanje kumiswa izitho ezibalulekile, kukhona njalo ithuba ukuthi ingane lapho kuphakama isidingo.
2. Ushevu ngesikhathi zabakhulelwe. Isigaba ingozi kuhlanganisa abesifazane abakhulelwe abahlala emadolobheni amakhulu, abasebenza umsebenzi enobungozi noma ekubhekaneni ezingcolisa amakhemikhali noma ngokomzimba.
3. Ukuthatha imithi. Ezinye izidakamizwa eziyingozi ukuthatha ngesikhathi abantwana. Ngakho-ke, ngaphambi nje ebamba isisu noma emavikini ekucala emva obelethisayo kufanele zithintwe nazo zonke izimali ezitholwe. Ngisho noma nje a amaphilisi ikhanda.
4. Ukusetshenziswa amavithamini kanye lwezakhamzimba quality ezingabazisayo. Ngokuvamile lezi izinto akunangozi, kodwa ezimweni ezingajwayelekile bangakwazi umonakalo reception ongakabi kwakheka skeleton kwengane noma kwezitho zakhe zangaphakathi.
5. Ukuba khona omunye wabazali-to-eside isifo esingelapheki.

Yiqiniso, lezi izizathu ayibonisi ngokuqondile ku Eisenmenger syndrome. Izimpawu, uphethwe yayo kanye nokwelashwa zichaziwe ngezansi.

pathogenesis

Uma umuntu izici ezifana yokwakheka abakhona, qiniseka kuyoba yokuphazamiseka kwegazi. Ngenxa yokuba khona abalulekile ventricular septal isici kulo, kanye ngenxa isikhundla okungalungile le-aorta kukhona emithambo yegazi okuxubile negazi yomthambo i-aorta kule ingaphakathi inhliziyo. Okungukuthi kwakhiwa shunt futhi shunt kusuka kwesokunxele kuya kwesokudla. Ngokuhamba kwesikhathi, ukugandeleleka yamaphaphu isiqu inyuka, ngezinye izikhathi kungase idlule ngisho labo le-aorta. Lokhu, kuholela spasm reflex emincane igazi yokujikeleza kwegazi eliya emaphashini. Ukuthuthukisa nomfutho wegazi ophezulu yamaphaphu. Uma kuthatha isikhathi eside, lapho-ke kuyinto ukuqina compensatory kwezindonga capillary negazi stasis kwenzeka emaphashini.

Odokotela namanesi eyabelwe "amhlophe" futhi "blue" Eisenmenger syndrome. Esimweni sokuqala, lo shunt ungaphakathi version yayo zakudala, okungukuthi, kusukela kwesobunxele kuya kwesokudla, futhi okwesibili - kunalokho.

izimpawu

Kwezinhliziyo zezinsana nezezingane ezincane izimpawu ezikhethekile isaziso kunzima. ukuthuthukiswa nokuhlakanipha izingane ababuzwa. Uma iminyaka yobudala livela shunting okuphambene, khona-ke umuntu iphika, blue unxantathu Nasolabial futhi emikhawulweni, ukukhathala, palpitations noma arrhythmia ubuhlungu palpable ka angina hlobo. Nasi isimo ukuthi iziguli ukuze banciphise izimpawu - nokuzikhulula. Ngakho-ke kuba lula ukuphefumula.

Kulaba izifo ezivamile ngokuvamile ungezwa ngezikhalo ikhanda, umongozima, futhi ukhwehlela igazi. Ungashintsha izwi ngenxa yokucinana we eziyimpumelelo ezinzwa kwemithambo yegazi osuke usuvulekile. Kwakuvame ukuthi oyedwa bangase bazibone pathologies like protrusion yohlobo esifubeni idolo futhi ushintshe phalanges ukuphela kwe-iminwe drumsticks, ekhomba ukwehluleka cardiopulmonary, othiwa Eisenmenger Syndrome. Izimbangela, izimpawu, uphethwe kakwaziwe zonke wenhliziyo.

I eziyinkimbinkimbi bangase nzima ukucinana kwemigudu yokuphefumula, inyumoniya, endocarditis webhaktheriya omsakazo, ngopha emaphashini, ngisho yinhliziyo. Ngaphandle kokwelashwa, isilinganiso sobude bokuphila kwabantu iziguli womuntu awuwona eminyakeni engaphezu kuka amathathu.

ukuhlola

Ngeshwa, lapho luhlolo Ordinary embule isifo akunakwenzeka. Ukuze uqinisekise uphethwe presumptive, zidinga izindlela ezikhethekile ucwaningo:

1. X-ray yesifuba, ezovela ushintsho okubonakalayo wabuka inhliziyo nezitsha ezinkulu.
2. imikhuba emibi Angiography like imaging inqubo yentuthuko semithambo lisetshenziswa, kodwa kulokhu akuyona ethize, futhi kungaba kuphela ukuthola izinguquko Uchwepheshe abanolwazi kakhulu.
3. ECG yembula icala, uma kucatshangwa ngaphansi Holter ukuqapha. Khona-ke ulwazi kudokotela ngeke imizuzu emihlanu Ukuhlolwa, futhi usuku lonke, futhi uzokwazi ukubona izinguquko senzalo.
4. Echocardiography - ultrasound inhliziyo eyikho. Indlela enhle kakhulu nxa uzingela yokulimala izimbotshana ezisekujuleni kwenhliziyo futhi zegazi ezibangelwa.
5. catheterization senhliziyo, kuleli cala - indlela eyamukelekayo kakhulu futhi enokwethenjelwa zocwaningo. Kuyasiza ukubona konke ukushiyeka, ukucacisa izici inhliziyo eyodwa nokuthuthukisa ukwelashwa.

Leyo enzima kangaka ukuxilonga Eisenmenger syndrome. Izimpawu (isifo ukwelashwa multistage isikhathi) zokugula yayo nonspecific okucashile njengoba isifo ovamile kanye ngokulambisa ukunakwa zifunda jikelele.

ukwelashwa

Naphezu ngxabano okuphakade phakathi odokotela abahlinzayo nababulala odokotela, esimweni yalesi sifo, bavuma ukuthi imizamo ngokuhlanganyela kudingeka aphathwe njengodoti ukwelashwa ngoludala ngokwako akukuniki umphumela oyifunayo, futhi uyale ayikwazi ukunikeza ukuthethelelwa esitebeleni. Ngakho-ke, iqoqo izinyathelo lwakhiwe ukuqeda Eisenmenger syndrome:

1. Bleed (nge twist zanamuhla, lokhu kubizwa ngokuthi "phlebotomy"). Simple futhi elingenazinkinga izindlela. Isetshenziselwa in iziguli zokugula efakazelwe izikhathi ezimbalwa ngonyaka. Ngaphambi nangemva inqubo ngempela kunqunywa viscosity kwegazi futhi athwala umoya-mpilo ezingeni.
2. Sebenzisa i-oksijini imuncwe. Isetshenziswa njengesici yokwelapha adjunct ukubhekana cyanosis futhi hypoxia yesibili. Ngaphezu kwalokho, baba nethonya zengqondo ku iziguli.
3. Anticoagulants. Abanaso ezingeni ezanele ubufakazi ngangokunokwenzeka ukuphuma pan ukuthosa emlilweni, futhi esikhundleni igazi thinners ukuthola nesvorachivaemost wakhe ogcwele.
4. Neminye imithi:
   - isisu zokususa edema yamaphaphu;
   - iinsombululo ngcono hemodynamics.
5. Technique Steel:
   - pacemaker isinxephezeliso arrhythmia;
   - ukususwa ephelele a ventricular septal isici Ukuvalwa kanye shunt ongaphilile.

Uqinisile indlela yokuphatha Eisenmenger syndrome kufanele zithunyelwe nodokotela wakho noma ngisho ongoti amaningana. Ngakho ukubapha isiqinisekiso sempumelelo akukwazi noma iyiphi indlela eyodwa.