Eisenmenger chirwere: Inokonzera, Zviratidzo, nechirwere, Treatment

In cardiology vakawanda uye vachiberekwa malformations Kunyanya panguva varipo kare makumi ezviuru ezvinhu "chezita". Vamwe vavo zvinorondedzerwa kwenguva refu uye zvinobudirira kurapwa panguva ante- uye neonatal nguva, asi vakawanda vachiri kutsvaga nevatsvakurudzi. Mumwe wavo ari Eisenmenger chirwere. The chirwere akaziviswa mukuvamba ramakumi remakore kubudikidza inozvikudza yeAustria wevana uye ikozvino inobereka zita rake.

tsananguro

Eisenmenger syndrome (Eisenmenger) - iri kutyora Natal kukura mumwoyo tsandanyama, zvinosanganisira kuvapo akaremara iri septum pakati ventricles, yeropa otzerkalennoe nechinzvimbo uye kuwedzera kukura zvakanaka ventricle. Sezvineiwo, kuremara ichi chinogona zvinobudirira vakavhiyiwa, uye vana zvakare akure saizvozvo sezvo vezera ravo.

nhamba

Panguva iyoyo, vanenge mashanu muzana zvose zviitiko cardiac anomalies muvana zvinotora Eisenmenger syndrome. chirwere mwoyo vachiberekwa inogona kupatsanurwa nevamwe mwoyo chirwere vachangoberekwa nevana vaduku. Vamwe vanachiremba havana kubatanidzwa untreated chero hemodynamic kuvhiringidzika urwere ichi.

Syndrome kana kunzwisisa

Govera takaparadzana kunzwisisa uye Eisenmenger syndrome. Syndrome - a rokuti zvaiitika kutyorwa wokufambisa ropa yokunzvenga kukura pakati in nomwoyo ventricles. A zvakaoma zvinosanganisira chaizvo nepfungwa dziri mudumbu kana achangozvarwa.

etiology

Muitiro sei chirwere ichi chakaumbwa, kusvikira pakuguma hazvizivikanwi, vasayendisiti uye vanachiremba vachiri kuedza kuwana tsananguro. Zvisinei, vakakwanisa kwazvo kuongorora zvinhu nokuda iyo Eisenmenger dzakaoma anooneka. Zvikonzero inogona rakakamurwa mhando mbiri: nechomukati, kana kuvabereki, uye zvimwewo kana dzezvakatipoteredza migumisiro.

1. Taura pamusoro zvakananga nhaka kupararira chirwere ichi haangavi, asi kana munhu vomuzana kana yechipiri-mutsetse hama varipo vachivavhiringidza pamusoro inotungamirwa zvinokosha nhengo, pane nguva dzose mukana kuti mwana ivo muka.
2. Kusvibisa panguva antenatal nguva. Ngozi chikamu zvinosanganisira vakadzi vane pamuviri vaigara mumaguta makuru, kushanda basa ngozi kana nevanhu kwemakemikari mumuviri utachiona.
3. Mishonga. Vamwe zvinodhaka zvine ngozi kutora munguva vana. Saka, asati pamuviri kana muvhiki dzokutanga pashure obstetrician anofanira akarangana vose vakapiwa mari. Kunyange kana chiri Mahwendefa nomusoro.
4. Kushandiswa mavhitamini uye muviri zvokuwedzera ose dubious yepamusoro. Kazhinji izvi zvinhu hazvikuvadzi, asi kashoma kacho vanogona kukuvadza kumutambo womuchato harisati matongosika marangwanda mwana kana rake nhengo dzomukati.
5. Kuvapo mumwe vabereki-to-refu chirwere.

Chokwadi, zvikonzero izvi haaratidzi zvakananga pamusoro Eisenmenger syndrome. Zviratidzo, ayo chirwere uye kurapwa zvinokurukurwa pazasi.

pathogenesis

Kana munhu ane akadaro anatomical zvinhu varipo, iva nechokwadi kuchava kuvhiringidzika kweropa. Nokuda kuvapo kuchikosha ventricular septal rakaremara, uyewo nokuda zvakaipa chinzvimbo yeropa vari vakavhengana venous uye kutsemuka ropa mumwoyo mhango. Kureva akaumba shunt uye shunt kubva kuruboshwe kuenda kurudyi. Nokufamba kwenguva, kwokudzvinyirira iri pulmonary hunde kuwedzera, dzimwe nguva zvingava kunyange pfuura vari yeropa. Izviwo, inoenda dzepanguva spasm zviduku midziyo ropa pulmonary riparadzirwe. Kukudziridza pulmonary neBP. Kana Rinotora nguva, zvino pane compensatory thickening kwemasvingo capillaries uye ropa stasis rinowanikwa mumapapu.

Vanachiremba vaiita "chena" uye "yebhuruu" Eisenmenger syndrome. Muchiitiko chokutanga, kuti shunt iri kwayo chaiwo shanduro, kureva, kubva kuruboshwe kuenda kurudyi, uye yechipiri - pamusoro zvinopesana.

zviratidzo

In vacheche uye vana vaduku anyatsocherechedza zviratidzo chakaoma. Physical nevakangwara kukura kwevana havatamburi. Kana zera sokuti pakatarisana shunting, ipapo munhu kupfupika mweya, zvitema nasolabial netriangle uye migumo, kurukutika, palpitations kana arrhythmia palpable kurwadza angina mhando. Typical ndiwo mamiriro ezvinhu kuti varwere kutora kuderedza zviratidzo - squatting. Saka zvinova nyore kuti kufema.

Of vanhuwo zvirwere zvinogona kazhinji kunzwa zvichemo zviri musoro, nosebleeds, uye vangakosora ropa. Unogona kushandura inzwi nokuda compression pamusoro etsinga harinzwi ari arteries dilated. Kazhinji munhu anogona kuchengeta pathologies akafanana protrusion pechipfuva mhando ano uye kuchinja chinouraya phalanges ari zvigunwe sezvo drumsticks, achinongedza Moyo kukundikana, unonzi Eisenmenger kuti syndrome. Zvinokonzera, zviratidzo, chirwere zivai ose cardiologist.

The kunzwisisa kunogona kuoma nokuda bronchitis, mabayo, endocarditis kwemabhakitiriya etiology, ropa kubva mapapu, uye kunyange mwoyo yavo kurwisa. Pasina kurapwa, upenyu hunotarisirwa pavarwere kwevanhu haisi anopfuura matatu.

Diagnostics

Zvinosuruvarisa, apo Zvavo kuongororwa anoratidza chirwere hazvibviri. Kuti asimbise presumptive nechirwere, zvinoda anokosha nzira tsvakurudzo:

1. Maekisirei pechipfuva, iyo tigokuzivisai kuona kuchinja mwoyo contours nemidziyo zvikuru.
2. Angiography zvakaipa kufanana kuri unyanzvi kuti vascular pakukura rinoshandiswa kakawanda, asi muchiitiko chino hazvina zvakananga, uye unogona chete kuziva kuchinja ruzivo chaizvo nyanzvi.
3. ECG pachena kuti nyaya, kana inoitwa pasi Holter kuongorora. Ipapo mashoko chiremba haangazorori shanu maminitsi Inspection, uye nokuda pamasikati, uye achakwanisa kuziva kuchinja chimbadzo.
4. Echocardiography - Ultrasound mwoyo iri. An nzira yakanakisisa nokuti Detective kuremara ari in nomwoyo uye ropa zvirwere.
5. Cardiac catheterization, muchiitiko ichi - kupfuura zvinogamuchirika uye yakavimbika nzira kutsvakurudza. Zvinobatsira kuziva zvikanganiso zvose, kuona zvinoitwa mwoyo chete uye kuva kurapwa.

Ndizvo wakaoma rokuongorora Eisenmenger syndrome. Zviratidzo (chirwere kurapwa multistage uye nguva yakawanda) ayo nonspecific zvokurwara iri yakazonyorwa sechinhu chakajairika chirwere uye anopukunyuka pfungwa zvavo vanoita.

mabatiro

Pasinei husingaperi nebope pakati vanovhiya uye vanachiremba, mune nyaya chirwere ichi, vakabvuma kuti vagari kuita kuda kubatwa sezvo kuchinja kurapwa pachayo haapi zvinozoita, uye nokukurumidza haigoni kupa yakagadzikana kanganwiro. Saka, kuva zviyero rakagadzirirwa kubvisa Eisenmenger urwere:

1. Ropa (ane monyorora ano, ichi anonzi "phlebotomy"). Simple uye dambudziko isina nzira. It rinoshandiswa varwere zvokurwara nekusimba vaviri pagore. Usati uye pashure nzira hazvo pakutsvaga ari viscosity ropa uye Chizenga pamwero.
2. Kushandisa inhaled okisijeni. Kushandiswa adjunct kurapa kukurira cyanosis uye hypoxia yechipiri. Mukuwedzera, vane psychosomatic zvainoita varwere.
3. Anticoagulants. Havafaniri kuva zvakakwana azvipire uchapupu sezvinobvira kubuda chakabikwa pani mumoto, uye pachinzvimbo ropa thinners kundomutora nesvorachivaemost zvizere.
4. Other mishonga:
   - diuretics chokubvisa pulmonary edema;
   - zvingaitwa kunatsiridza hemodynamics.
5. Kuvhiya Technique:
   - pacemaker kudzikamisa arrhythmia;
   - kwakakwana kubviswa munhu ventricular septal kuremara kuvhara uye vanokara shunt.

Tsoziva kurapa Eisenmenger chirwere anofanira kugadziriswa nachiremba wako kana kunyange unyanzvi akawanda. Saka sei kupa runovimbisa kubudirira haagoni kuva munhu nzira.