Subclavian mtsempha wamagazi. subclavian mtsempha wamagazi matenda

mitsempha Subclavian ndi zipangizo kunyamula magazi kuti nthambi kumtunda kwa thupi. Nkhaniyi tikambirana mwatsatanetsatane mfundo zonse zoyambirira za nkhaniyi. Mudzaphunzira zimene subclavian mtsempha wamagazi matenda ndi zimene mbali ya mankhwala kumeneko.

Kodi mtsempha wamagazi subclavian?

Mitsempha ya magazi ndi zovuta za intricacies zosiyanasiyana za mitsempha, mitsempha, capillaries. Big anyamata chotengera wolandira magazi kuchokera kung'ambika Chipilala - mtsempha wamagazi subclavian - amatanthauza zotengera za bwalo lalikulu la anthu magazi. Iwo amapereka magazi m'madera occipital ya ubongo, cerebellum, gawo khomo lachiberekero wa chingwe msana, minofu ndi ziwalo za khosi gawo, mapewa lamba ndi nthambi chapamwamba, komanso mbali zina za thorax ndi pamimba.

The zimachititsa chilumbachi a mtsempha wamagazi ndi subclavian

Kodi mawu akuti "zimachititsa chilumbachi"? Izi ndi kukhalapo weniweni kapena malo chilichonse poyerekezera ndi zinthu zina. Tiyeni tione zimene zimachititsa chilumbachi ndi la mtsempha wamagazi ndi subclavian, mwa kulankhula kwina, kumene ndi poyerekezera ndi chimene icho chiri. Izo zimachokera pa dzanja limodzi kwa thunthu brachiocephalic, ndi pa zina - kuchokera Chipilala kung'ambika, bypasses pachimake ndi kunja kudutsa mu dzenje pamwamba pa chifuwa. Womwe ndi mtsinje khosi subclavian kumaoneka m'dera pafupi plexus phewa mitsempha ndi kusungidwa pamwamba. Tsambali chombocho angagwiritsidwe ntchito atseka magazi kapena kulowa n'zotheka mankhwala. Kenako mtsempha wamagazi subclavian akutsamira pa m'mphepete, chitadutsa pansi clavicle ndi mu armpit, kumene akukhala axillary kale. Kenako kudutsa armpit, iye amapita paphewa pake. Dzina wa tsambali - mtsempha wamagazi brachial. M'dera chigongono izo diverges pa utali wozungulira ndi ulna mtsempha wamagazi.

Subclavian mtsempha catheterization. puncture

Monga ife tatchulazi, mu khosi subclavian Vienna (ndi mtsempha wamagazi kwambiri) bodza padziko. Malowa ntchito kugwila ndi kulowa puncture catheter. ndi chowaloleza wosankha imeneyi chotengera chiyani? Pali i angapo kusankha zinthu izi:

1. Anatomical kupezeka.
2. Kukhazikitsidwa kwa malo ndi awiri a lumen wa.
3. Wokwanira kapena chidwi kukula (m'mimba mwake).
4. magazi mathamangidwe kuposa liwiro magazi mu misempha ya malekezero.

Potengera deta zafotokozedwa pamwambapa, anaperekedwa mu mtsempha catheter sililimbikitsa kukhudza mtsempha wamagazi khoma. Mankhwala amene analowa mu izo, mwamsanga kuwafika atrium chabwino ndi ventricle zimathandiza kuti chimachita yogwira pa hemodynamics. Anadzetsa mankhwala subclavian mtsempha mofulumira kwambiri wothira magazi, osati mtima mkati mwa mtsempha wamagazi ndi. Nthawi zina, pali contraindications kuti puncture ndi catheter mayikidwe.

Lamanzere ndi lamanja mtsempha wamagazi subclavian

Izi chotengera - ndi wophatikizidwa limba, monga zanenedwa pamwambapa: lamanja subclavian mtsempha wamagazi ndi kumanzere. Nthambi yoyamba ndi mtheradi brachiocephalic thunthu, ndi nkhani lamanzere, icho chimapita kuchokera Chipilala kung'ambika. Komanso, otsiriza pafupifupi 4 cm yaitali kuposa poyamba. Kumanja subclavian katundu mtsempha wamagazi magazi m'madera ena ku dzanja lamanja, izo amapereka mutu ndi chifuwa. Anachoka mtsempha wamagazi subclavian Amakweza madzi chonyamulira zinthu zofunika thandizo moyo, mu dzanja lamanzere.

Ndime Main a mtsempha wamagazi ndi subclavian

Lamanzere ndi lamanja mtsempha wamagazi subclavian mwangwiro amangosankha yagawidwa m'magawo zazikulu zitatu, kapena gawo:

1. Ku malo a mapangidwe mtsempha wamagazi ndi subclavian asanalowe kusiyana interscalene.
2. Division, ndiwo malire interscalene kusiyana.
3. Pa kuchoka ku kusiyana kwa interscalene axillary dzenje.

Nthambi za chigawo choyamba cha mtsempha wamagazi ndi subclavian

Mbali imeneyi ya nkhani adzatiuza pang'ono za mmene angapezere subclavian mtsempha wamagazi ndi nthambi zake, kuti zimene mbali ya nthambi chotengera. Kuyambira khadi yake yoyamba (danga pakati pa khomo la interscalene imeneyi ndi chiyambi cha mitsempha ya) achoke nthambi zingapo izi ndi akuluakulu:

1. Vertebral mtsempha wamagazi, steamroom. Umadutsa ndondomeko yopingasa wa chisanu linkawonongeka khomo lachiberekero. Iye zina kukacha ndipo igwera mu M'mimbamo cranial kudzera kumbuyo kwa mutu, kuti, kudzera mwa dzenje ake. Izo ndiye zikugwirizana ndi mtsempha wamagazi womwewo wa kutsidya lina, potero kupanga mtsempha wamagazi basilar. ndi ntchito ya mtsempha wamagazi ndi vertebral chiyani? chotengeracho amapereka magazi kwa chingwe msana, molimba occipital Lobe a ubongo ndi minofu.
2. The mkati mtsempha wamagazi thoracic akuyamba pansi pa mtsempha wamagazi ndi subclavian. amapereka Channel magazi a chithokomiro, zakulera, bronchi, etc. sternum.
3. Schitosheyny thunthu. Iwo anachokera pafupi lamkati m'mphepete scalene minofu, kufika kutalika pafupifupi 1-2 cm. Schitosheyny thunthu ukugawa mu nthambi kuti kupereka magazi minofu ndi tsamba khosi komanso pakhosi.

The ramifications a chigawo wachiwiri ndi wachitatu mtsempha wamagazi ndi subclavian

Chachiwiri gawo subclavian mtsempha wamagazi zochepa interscalene kusiyana ali nthambi mmodzi, akutchedwa m'mphepete-khomo lachiberekero thunthu. Umayamba kumbuyo kwa mtsempha wamagazi ndi subclavian ndi lagawidwa nthambi zingapo:

1. Mwapamwamba intercostal mtsempha wamagazi (mtsempha wamagazi achoke nthambi izi zapambuyo kutsogolera magazi minofu ya kumbuyo).
2. Msana ziwiya.
3. Nato khosi mtsempha wamagazi.

Kudulidwa chachitatu cha mtsempha wamagazi ndi subclavian alinso ofesi ina - ndi yopingasa mtsempha wamagazi khomo lachiberekero. Chimaonekera kukakomana ndi brachial ndi lagawidwa:

1. Zachiphamaso mtsempha wamagazi, amene amapereka magazi kumbuyo minofu.
2. Dorsal mtsempha wamagazi wa tsamba. Iwo ukutsika ndi yotakata minofu kumbuyo, chakudya ndi kukhala pafupi ndi minofu yaing'ono.
3. Nato nthambi ya mtsempha wamagazi ndi subclavian.

Pali anafotokoza mfundo zokwanira monga mtsempha wamagazi subclavian ndi nthambi zake, mfundo zina tingaiphunzire mabuku zachipatala.

matenda zotheka mtsempha wamagazi subclavian

The matenda waukulu amakhudza mtsempha wamagazi subclavian ndi nthambi zake - ndi kuchepetsa wa lumen Mitsempha, mwa kulankhula kwina, stenosis. Chifukwa chachikulu cha matenda ndi atherosclerosis subclavian mtsempha wamagazi (zamadzimadzi mafunsidwe pa makoma chotengera) kapena thrombosis. matenda nthawi zambiri anagula, koma pali milandu ndi kobadwa nako. Zifukwa kwa atherosclerosis a mtsempha wamagazi ndi subclavian ndi:

1. Oopsa.
2. Kusuta.
3. Onenepa, kunenepa.
4. Shuga ndi matenda ena.

Chifukwa ambiri stenosis a mtsempha wamagazi ndi subclavian - matenda kagayidwe kachakudya anthu, zotupa ndi njira yotupa. Mwamphamvu anasonyeza stenosis akutitsogolera kuti kuchepetsa magazi kuti ziwalo zofunika kwambiri, pali kuchepa kwa mpweya ndi zakudya zimakhala ndi. Komanso, stenosis zingachititse matenda a mitima, mu sitiroko makamaka.

subclavian mtsempha wamagazi matenda

Kuchepa magazi bwino zimayamba osati chopinga magazi chifukwa zotupa occlusive-stenotic, komanso vertebral-subclavian "kuba". Izi mtsempha wamagazi matenda subclavian, kapena kuba syndrome akufotokozera pa nkhani ya occlusion kapena stenosis chotupa mu chipinda choyamba cha chotengeracho. Kunena mwachidule, magazi mu njira subclavian si zichokere msempha ndi wa mtsempha wamagazi vertebral, tingayambe ubongo ischemia. Chionetsero chapamwamba matenda chifukwa cha katundu thupi kumalekezero chapamwamba.

Zizindikiro za matendawa:

1. Chizungulire.
2. Headedness.
3. Amaona masomphenya.
4. Minofu kuchepa mphamvu pa mbali akhudzidwa.
5. Kuchepetsa kapena anasiya ndi zimachitika pa mbali akhudzidwa.

Kuti mudziwe zambiri pa subclavian mtsempha wamagazi stenosis

Madipoziti pa Mitsempha, zikubweretsa kuchepetsa zakale, ndi zamadzimadzi maziko, kuti zoona ndi zotumphukira wa mafuta m'thupi. madipoziti awa akhoza kuchepetsa lumen chombocho 80%, nthawi zina kwathunthu kuononga izo. Kuphatikiza pazifukwa izi kuchititsa subclavian mtsempha wamagazi stenosis, pali ena monga:

1. Walitsa.
2. Arteritis.
3. Psinjika syndromes.
4. zotupa zosiyanasiyana, monga fibromuscular dysplasia neri Al.

Nthawi zambiri, anthu odwala stenosis a mtsempha wamagazi ndi subclavian, ndi ziwiya zina akhudzidwa. Izo zikhoza kukhala njira inatsekeratu, kuti mtima ndi carotid - mtsempha wamagazi wa malekezero a m'munsi. Ambiri ndi kudwala, monganso vasoconstriction lumen infestation kumanzere mtsempha wamagazi subclavian. Malinga ndi kafukufuku, ndi kangapo zambiri kuposa kumanja.

Zizindikiro zizindikiro za stenosis:

1. Kufooka mwa minofu.
2. Kumverera wotopa.
3. Ululu miyendo chapamwamba.
4. Necrosis ya zala.
5. Magazi m'dera misomali.

Komanso, tingasonyeze zizindikiro za khalidwe neurologic, ndiko kuti, pali "kuba": magazi kunam'sintha kwa ziwiya yachibadwa mu zinkakhala m'dera. Zizindikiro za matenda a ubongo:

1. Mkhutu masomphenya.
2. Imfa ya chikumbumtima.
3. kulankhula matenda.
4. Loss zinthu monyanyira.
5. Chizungulire.
6. imfa ya kumverera mu nkhope.

Kodi kuchitira stenosis a mtsempha wamagazi ndi subclavian?

stenosis chithandizo akhoza zachipatala, opaleshoni ndipo interventional. Njira yaikulu ya mankhwala - izo endovascular stenting wa subclavian mtsempha wamagazi ndi carotid-subclavian kulambalala. The njira yamasika akulimbikitsidwa anthu ndi kukula kwa thupi hypersthenic imene n'zovuta kuunikila woyamba dipatimenti mtsempha wamagazi. Komanso, njira ya mankhwala tikulimbikitsidwa pa stenosis mu gawo lachiwiri la mtsempha wamagazi ndi subclavian.

Subclavian mtsempha wamagazi stenting

Stenting - mankhwala a mtsempha wamagazi subclavian kupyolera ang'ambe thupilo ting'onoting'ono pakhungu, 2-3 mm yaitali, tinadutsa una puncture. Njira imeneyi mankhwala angapo ubwino pa opaleshoni, monga amachita zochepa kuvulaza komanso nkhawa. Komanso, ndiye wofatsa ndi chiwalo-asayambe mankhwala njira imene mtsempha wamagazi subclavian lili mtundu wapachiyambi, chimene chiri chofunika kwambiri wodwalayo.

stenting ndondomeko pafupifupi sabweretsa chisoni ndi kumachitika pansi mankhwala oletsa ululu pamalopo. Opaleshoni imeneyi angathe kuonjezera mtima lumen ntchito catheters wapadera ndi stents mu mawonekedwe a zonenepa. Last - ndi cylindrical endoprosthesis laser kudula kwa chubu olimba zitsulo. chipangizo ichi yakwera wapadera zibaluni catheter boma wothinikizidwa ikuyenda mu mtsempha wamagazi ndi subclavian. Pamene stent umalandira zone chotengera constriction, ikuchitika ndondomeko kulamulira ena zokhudza ufulu wa malo ake. Kenako, chipangizo anamasulira pansi kuthamanga. Ngati stent si mokwanira zinatsegulidwa, ndiye kenako gawo lapadera stented angioplasty catheter ndi zibaluni pa nsonga kuti iyende mulingo woyenera. Pakali pano, n'zotheka opaleshoni kwaulere, inu mukhoza kuchita izo mwa kutenga kuumba feduro. Odwala matenda ofanana ayenera kufunsa dokotala.

kuopsa mwina stenting

stenting ndondomeko kumatenga mtsempha wamagazi pafupifupi subclavian za 2 hours. Opaleshoni imeneyi ikuchitika mu dipatimenti ya catheterization mtima. Pambuyo stenting othetsa ululu analandira, chifukwa malo mtsempha wamagazi subclavian, ndi minofu anali incised zimakhala zopweteka ngati n'koyenera. Matenda ndondomeko n'zochepa, chifukwa mtima pamaso mosamala ophunzitsidwa ndi kuyang'aniridwa. Koma ena zotsatira zoipa angakhalepo ndi:

1. Ziwengo kumwa mankhwala.
2. The anachita popha ululu wa.
3. magazi Minor pa malo ang'ambe thupilo.
4. Kutentha.
5. Mutu.
6. Infection.
7. Air embolism.
8. Kuwonongeka kwa mtsempha wamagazi kapena pakhoma msempha.
9. Thrombosis a mtsempha wamagazi ndi subclavian.
10. Kusamuka kwa stent lapansi.
11. zosokonezeka ubongo neri Al.

Interventional chithandizo cha stenosis a mtsempha wamagazi ndi subclavian ndi zibaluni angioplasty ndi stenting - masiku asang'ambe komanso zothandiza mankhwala njira. Ali aafupi kwambiri nthawi ndi postoperative m'chipatala.