Thoracic aortic aneurysm

Aneurysm ndikukula modabwitsa kapena kubaluni kwa gawo lina la mtsempha chifukwa chofooka pakhoma la mtsempha wamagazi.

Matenda a thoracic aortic aneurysm amapezeka mgawo lalikulu kwambiri la thupi (aorta) lomwe limadutsa pachifuwa.

Chifukwa chofala kwambiri cha thoracic aortic aneurysm ndikulimba kwa mitsempha. Matendawa amapezeka kwambiri kwa anthu omwe ali ndi cholesterol, kuthamanga kwa magazi kwakanthawi, kapena omwe amasuta.

Zina mwaziwopsezo zamatenda amtundu wa thoracic ndi monga:

• Zosintha zomwe zimadza chifukwa cha msinkhu
• Matenda olumikizirana monga Marfan kapena Ehlers-Danlos syndrome
• Kutupa kwa msempha
• Kuvulaza kugwa kapena ngozi zapagalimoto
• Chindoko

Ma Aneurysms amakula pang'onopang'ono kwazaka zambiri. Anthu ambiri alibe zizindikiritso mpaka pomwe mpweya umayamba kutuluka kapena kukulira.

Zizindikiro nthawi zambiri zimayamba mwadzidzidzi pamene:

• Matendawa amamera mofulumira.
• Misozi ya aneurysm imatseguka (yotchedwa chotupa).
• Magazi amatuluka pakhoma la aorta (aortic dissection).

Ngati aneurysm ikanikiza pamalo oyandikira, zizindikilo izi zitha kuchitika:

• Kuopsa
• Kumeza mavuto
• Kupuma kwapamwamba (stridor)
• Kutupa m'khosi

Zizindikiro zina zitha kuphatikiza:

• Chifuwa kapena kupweteka kwa msana
• Khungu lachikopa
• Nseru ndi kusanza
• Kuthamanga kwa mtima mwachangu
• Dziwani za chiwonongeko chomwe chikuyandikira

Kuyezetsa thupi nthawi zambiri kumakhala koyenera pokhapokha kuphulika kapena kutayikira kwachitika.

Matenda ambiri a thoracic aortic aneurysms amapezeka pazoyesa kujambula zomwe zachitika pazifukwa zina. Mayesowa akuphatikizapo x-ray pachifuwa, echocardiogram, kapena chifuwa cha CT scan kapena MRI.Kufufuza kwa chifuwa cha CT kumawonetsa kukula kwa msempha ndi malo enieni a aneurysm.

Aortogram (zithunzi zapadera za x-ray zopangidwa utoto utalowetsedwa mu aorta) zimatha kuzindikira matenda am'mimba ndi nthambi zilizonse za aorta zomwe zingachitike.

Pali chiopsezo kuti aneurysm ikhoza kutsegula (kuphulika) ngati simukuchitidwa opaleshoni kuti mukonze.

Mankhwalawa amatengera malo omwe ali ndi aneurysm. Morta wapangidwa ndi magawo atatu:

• Gawo loyambirira limayenda kupita kumutu. Amatchedwa aorta yokwera.
• Gawo lapakati ndilopindika. Amatchedwa chipilala cha aortic.
• Gawo lomaliza limasunthira pansi, kumapazi. Amatchedwa kutsika kwa msempha.

Kwa anthu omwe ali ndi ma hemurysms a aorta omwe akukwera kapena aortic arch:

• Kuchita opaleshoni m'malo mwa aorta ndikulimbikitsidwa ngati aneurysm ili yayikulu kuposa masentimita 5 mpaka 6.
• Kudulidwa kumapangidwa pakati pa chifuwa.
• The aorta imalowetsedwa m'malo ndi pulasitiki kapena nsalu yolumikiza.
• Uku ndi opaleshoni yayikulu yomwe imafuna makina am'mapapu amtima.

Kwa anthu omwe ali ndi zovuta zokhudzana ndi kutsika kwa thoracic aorta:

• Kuchita opaleshoni yayikulu kumachitika m'malo mwa aorta ndikulumikiza nsalu ngati aneurysm ili yayikulu kuposa masentimita 6.
• Kuchita opaleshoniyi kumachitika kudzera pocheka mbali yakumanzere ya chifuwa, yomwe imatha kufikira pamimba.
• Endovascular stenting ndi njira yocheperako. Stent ndi kachitsulo kakang'ono kapena kama pulasitiki kamene kamagwiritsira ntchito kutsegula mtsempha. Zitsulo zimatha kuyikidwa m'thupi osadula pachifuwa. Komabe, si anthu onse omwe ali ndi zotsalira zamtundu wa thoracic omwe akufuna kuyimitsidwa.

Kuwona kwakanthawi kwa anthu omwe ali ndi thoracic aortic aneurysm kumadalira mavuto ena azachipatala, monga matenda amtima, kuthamanga kwa magazi, ndi matenda ashuga. Mavutowa atha kukhala kuti adayambitsa kapena athandizapo.

Zovuta zazikulu pambuyo pa opaleshoni ya aortic zitha kuphatikiza:

• Magazi
• Matenda olowerera
• Matenda amtima
• Kugunda kwamtima kosasintha
• Kuwonongeka kwa impso
• Kufa ziwalo
• Sitiroko

Imfa itangotha ​​kumene opaleshoniyo imachitika mwa anthu 5% mpaka 10%.

Zovuta pambuyo povulazidwa ndi aneurysm zimaphatikizaponso kuwonongeka kwa mitsempha yamagazi yopereka mwendo, yomwe ingafune kuchitanso opaleshoni ina.

Uzani wothandizira zaumoyo wanu ngati muli:

• Mbiri ya banja yamavuto olumikizana ndi minofu (monga Marfan kapena Ehlers-Danlos syndrome)
• Kusapeza bwino pachifuwa kapena kumbuyo

Kupewa matenda a atherosclerosis:

• Sungani kuthamanga kwa magazi anu ndi milingo yamagazi yamagazi.
• Osasuta.
• Idyani chakudya chopatsa thanzi.
• Chitani masewera olimbitsa thupi nthawi zonse.

Aortic aneurysm - thoracic; Syphilitic aneurysm; Aneurysm - thoracic kung'ambika

• Kukonzekera kwa m'mimba kwa aortic aneurysm - kutseguka - kutulutsa
• Kukonza kwa aortic aneurysm - endovascular - kutulutsa

• Aortic aneurysm
• Kuphulika kwa aortic - x-ray pachifuwa

Acher CW, Wynn M. Thoracic ndi thoracoabdominal aneurysms: chithandizo chamankhwala chotseguka. Mu: Sidawy AN, Perler BA, olemba. Rutherford Opaleshoni ya Mitsempha ndi Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019: mutu 77.

Braverman AC, Schermerhorn M. Matenda a aorta. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: mutu 63.

Lederle FA. Matenda a msempha. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 69.

Singh MJ, Makaroun MS. Matenda a thoracic ndi thoracoabdominal: chithandizo cham'mitsempha. Mu: Sidawy AN, Perler BA, olemba. Rutherford Opaleshoni ya Mitsempha ndi Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019: chap 78.