Vascular malformation: zvinokonzera, zviratidzo, kuongorora chirwere uye kurapwa

Kana muitiro embryo pakukura kwakakanganiswa paumbwe kweropa ino, kuti vascular malformation aumbwa. Ichi chinhu zvisiri kubatana zviri mutsinga uye arteries, izvo kunooneka pacharo vari kuyaruka. Zvose kunotanga nomusoro, kutemwa nemusoro uye pfari. In Muzviitiko zvakaipisisa, vana vane pfari.

tsananguro

vascular mamiriro kwakasiyana yose kweropa hurongwa. Vamwe vari mukobvu, vamwe vari tsandanyama parusvingo, vamwe mavharuvhu, asi vari zvose zvakabatana mumwe neimwe kutevedzana. Kana kuti zvimwe chikonzero hwakagadzwa hunhu kutevedzana yaputswa, ivo conglomerates vari kuumbwa convoluted midziyo, inonzi malformations.

Kazhinji, izvi vachiberekwa kukanganisika zvisingazivikanwi chikonzero. It kunoitika muna nemapfumbamwe ane zviuru zvina mazana vachangoberekwa pagore. Anogona kukonzera malformation kuba urwere, dzvinya musana uye uropi, kuumba aneurysm uye kukonzera sitiroko uye ropa meninges. Kakawanda matambudziko kuitika vakura zera, pashure pemakore makumi mana.

kupatsanura

Kune dzakawanda zvinogona kutora vascular malformation. Nokuti systematization kwavo kushandisa wokurera muna 1996 American kupatsanura ISSVA. Its musiyano unokosha nevamwe classifications - kuparadzana ose anomalies vari namamota uye malformations.

1. Vascular anomera:
   - infantile hemangioma (rinowanika pauduku);
   - vachiberekwa hemangioma;
   - bunchy hemangioma;
   - veretenopodobnaya hemangioendothelioma;
   - kaposhiformnaya hemangioendothelioma;
   - akawana bundu.
2. malformations:
   - rirambe richibvira (telangiectasias, angoikeratomy);
   - venous (nguva dziri kure, glomangioma, Mafuchchi urwere);
   - node;
   - arterial;
   - arteriovenous;
   - zvabatanidzwa.

Malformation pamusoro mutsinga

Venous Malformation ndiye zvemamiriro kukura tsinga, ichiteverwa dzavo pathological chiwedzerwa. It ndicho pakati marudzi ose malformations. chirwere ichi ndicho vachiberekwa, asi anogona kuoneka pauduku uye vakura. Kushandura nzvimbo midziyo inogona kuva chinhu: a huta systemic, nhengo dzomukati, ganda, mapfupa kana tsandanyama.

Venous malformations vangava panyika kana mumuviri nhema mukobvu nevamwe kana tatamuka akawanda nhengo dzomuviri. Uyewo, pedyo vari rakamiswa kuti ganda pamusoro, zvikuru vazadza ruvara inopfumisa.

Nokuda kujairika chimiro uye ruvara kunogona kuvhiringidzwa nezvinhu hemangiomas. For differential chirwere zvikuru zvishomanana vachimanikidzwa kuti mugove dzakachinjwa. Malformations vari nyoro uye nyore kuchinja ruvara. Kana panowanikwa midziyo ropa kanganisika zvakadzama muna externally zvokurwara muviri haigoni kuratidzwa.

Pamwechete kukura vomwana dzikawedzera malformation, asi achifuridzirwa rukungiso zvinhu, zvakadai vavhiyiwa, kunotevera, utachiona, hormone zvinodhaka, mukubereka vana kana kubereka, ruzivo nokukurumidza rwakakura kukura midziyo ropa.

Chiari malformation

Ichi vascular malformation, iyo inozivikanwa nokuva yakaderera-nhema cerebellar tonsils. Hosha chinorondedzerwa mukunopera namapfumbamwe yeAustria chiremba remakore Hans Chiari, uyo nokukudzwa uye zita chinonakidza. Akazotaura vamwe vakawanda mhando anomaly ichi. Nokuda yakaderera nzvimbo ndimbo kuchidzivisa mvura water drainage kubva uropi kusvika musana, izvozvo anosika rakawedzera intracranial kumanikidzwa uye chinokurwadzai kukura hydrocephalus.

Chiari malformation mhando rinotsanangura misha cerebellar tonsils pasi uye kungoita navo kuburikidza foramen magnum. Urongwa uhwu chinokonzera kuwedzera pamusoro musana canal, izvo akaora hworatidza pacharo pakuyaruka. Rakajairika zviratidzo ndivo nemusoro, tinnitus kutsiga kana achifamba, diplopia, havachanyatsogoni nekunyatsotsanangura, pakuparadza matambudziko, uye dzimwe nguva kurutsa. For kuyaruka dzinoratidzwa yadzikira marwadzo netembiricha aikanganiswa chokumusoro hafu muviri uye maoko nemakumbo.

Chiari malformation chechipiri mhando hwapedyo kana kwakawedzera saizi foramen. Panyaya iyi, iyo cerebellar tonsils urege kuwa, uye achawira mariri. Izvi zvinotungamirira compression pamusoro musana uye cerebellum azvaitwa. Panguva iyoyowo zvinokwanisika zviratidzo mvura chengetedzo muuropi, mwoyo kuremara, pakakuvara zvomudumbu turakiti embryo uye urogenital hurongwa.

musana

Malformation of musana - haiwanzowaniki chirwere inotungamirira mberi myelopathy. Arteriovenous malformations vanosarudza akaiswa pakati machira kana zvakaoma goko nhema pamusoro dorsal pemvura uropi iri thoracal kana lumbar nomuzongoza. The inonyanya zvokurwara anowanika nevanhu vakuru.

The chirwere afanane zviratidzo nemultiple sclerosis uye vanogona kupinda wetsinga kutsausa. A unopinza kudzikira kunoitika pashure atsamwira midziyo ropa uye nekudeura ropa munzvimbo subarachnoid muchadenga. Varwere vari kuchengetwa zvinetso inoshanda uye injini nharaunda, disruptions ari pelvic zvomukati. Kana anobatana cortical zviratidzo, maperembudzi tisafanana ALS zvakawanda (chinonzi amyotrophic lateral sclerosis).

Kana murwere anonyunyuta maitire maviri chetsinga akasiyana zvinetso, chiremba inofanira vanofungidzirwa vascular malformation uye kuitisa kutarisana vaongo- pamusoro nomuzongoza. Zviratidzo wakati kuchinjwa vascular lipoma uye vari nzvimbo yakawedzera pigmentation. Munhu akadaro anofanira akatumira rinobva resonance kuri kana makombiyuta myelography. Izvi zvichaita kubvumira kuti ritsigire zviratidzo.

zviratidzo

Vascular malformation anotarira akafanana nguva bhomba kana chivhorovhoro nenyundo cocked mumaoko mwana - hapana anoziva kana dambudziko kuchatanga. Pasinei nokuti chirwere ane vachiberekwa anomaly, rwunotanga kuoneka zvikuru gare gare. Kune mhando mbiri kuyerera vascular malformations:

- ropa (70% nyaya);
- torpid (mu vasara 30%).

Hapana nzira hazvigoni kunzi rikwezve munhu ane chirwere ichi. Kana Hemorrhagic kuyerera murwere ane BP, uye vascular chikwata muduku uye riri mu mumutsipa. Hafu yevanhu vane Hemorrhagic nevanga zvinoitika mhando malformation inotungamirira kuremara kana rufu. Ngozi ropa kunowedzera nezera, uye vakadzi nechimwezve chinhu ndiko nepamuviri uye pakusununguka.

Kana munhu akabudirira vakatamira sitiroko wokutanga, ipapo mukana 1: 3 mugore kuchaita kuzodzosera ropa. Zvino chetatu. Zvinosuruvarisa pashure Zvikamu matatu, vashoma vapone. Inenge hafu varwere kuoma zvitarisiko yokuumba intracranial hemorrhages, hematomas kana vakavhengana podobolochechnyh tamponade uye pfungwa ventricles.

The nzira yechipiri nokuyerera guru, iro riri mukati cerebral cortex vascular malformation. Zviratidzo zvacho chaizvo zvinowanzoitika:

- convulsive chemwoyo kana kuvapo epileptiform kurwiswa;
- kwazvo nomusoro;
- kuvapo dhefisiti zviratidzo zvakafanana bundu muuropi.

syncope

Vanenge vanhu vose vane vascular malformations iri muuropi, pakupedzisira kuzviratidza syncope (kureva, syncope). Izvi imhaka kwekanguva kuderera cerebral riparadzirwe. Panguva syncope murwere rakachenuruka, akafukidza ziya chando, maoko ake namakumbo akanga chando, kusimba kupomba uye kudzika kufema. The Kurwisa rwakatora mumasekonzi vanenge makumi maviri, uye pakupedzisira wayo murwere haazoyeukizve chinhu.

Gore negore pane zvinopfuura hafu yemiriyoni itsva dzokuita syncope, uye chete chiduku chikamu kwavo ane zvakajeka chikonzero-uye-kushanda ukama. Syncope zvinogona kukonzerwa nokutaurisa kweiyi ari carotid sinus, trigeminal neuralgia kana glossopharyngeal tsinga, mutemo autonomic insufficiency tsinga, mwoyo mutinhimira nenyonganiso uye, chokwadi, vascular malformations. Kupera arteries uye mutsinga zvinopa shunting ropa uye mhanyisa mvura yacho. Somugumisiro, uropi haasi kuwana zvakakwana zvokudya, izvo kunoratidzwa kusagadzikana chavanoziva.

yematambudziko

Kunyange asati malformation unooneka akaora muvanhu hwakavigwa pachava kusingarapiki pathological mananara. Izvi imhaka hypoxic mugove uropi, izvozvo dystrophy uye kufa. Zvichienderana nzvimbo njodzi nzvimbo iri kuchengetwa anozivikanwa zvatichiri zviratidzo (kutaura abnormalities, gait, yokuzvidira kufamba, njere uye t. N.) Unogona kuva zvipusha pfari.

Zvakakomba yematambudziko kutanga kare vakura. midziyo zvemamiriro ropa vane matete masvingo uye vari tichikurumidza mitswe, saka varwere malformations anonyanya ischemic zvokurova. conglomerates Large arteries uye mutsinga dzvinya zvinyama vakavapoteredza, zvichikonzera hydrocephalus. Chinonyanya ngozi ndiyo ropa nokuda atsamwira rwengarava anoverengeka. Zvingaita kana vave ngozi nemigumisiro, uye kupera zvishoma kana hapana chinokanganisika. Zvose zvinoenderana nokuwanda vakamhanyira ropa. Hemorrhagic ronda iri ndoda vaizotibata akanaka uye anogona recur pamusoro nguva.

Diagnostics

Initial chetsinga kuongororwa varege kuzivisa chero abnormalities mune vanhu vane vascular malformations. Kazhinji kunoda aiming uye kwazvo kwazvo kuongororwa kuziva kutyorwa. Kana murwere anonyunyuta kuti kakawanda kwazvo nomusoro, chakamira pakunodengenyeka zvine, nguva nenguva nenyonganiso kuti pfungwa uye vasanyatsoona kana muchifamba, ndiko mukana kumutuma kuitisa neuroimaging. Zvichitaurwa zviri nyore, kombiyuta kana rinobva resonance kuri wouropi.

Kupfuura hwakadzama uye yakarurama vascular marongerwo zvinoratidza musiyano angiography. Nokuti murwere ichi vari vanhuwo carotid tsinga yakanga jekiseni radiopaque mvura uye kuita dzakatevedzana kwepfuti. Nzira iyi ine nhamba yematambudziko uye marwadzo, naizvozvo, rinoshanda chete kana wakaomerwa mukuita chirwere.

Kuona nokukurumidza, kutungamirira uye mwero ropa riyerere kuti Pasika shanduko, uchishandisa Doppler Ultrasound. Nzira iyi inobvumira kuti kuona ropa zvinoyerera pakati arteries uye mutsinga, kuona mhando dzose, kuti asimbise kuvapo aneurysms nezvimwe matambudziko.

mabatiro

Kana vascular malformations amenable kuti kururamiswa? Treatment nzira kuvimba mhando abnormality, ayo nzvimbo, ukuru uye pfungwa nhoroondo kurohwa.

Pane chikuru nzira zvitatu kurapwa:

- rakavhurika Kuvhiya;
- zvishoma invasive embolization;
- non-invasive radiosurgical kurapwa.

Nokuti mumwe nomumwe wavo zvichiratidza, contraindications, uye pakarongwa zvichibvira yematambudziko.

Chinonyanya zvinorwadza rakazaruka kuvhiyiwa. Kuti vasvike kune moto, kuti kuzarura cranium, klipiruyut midziyo uye kuyambuka navo. Akadaro musimboti zvinogoneka kuna malformation riri pamusoro pemvura uropi uye ane miganhu diki. Kuedza kusvika maronda vainazvo angaguma kukuvara chinokosha pfungwa uye chinouraya mugumisiro.

Chii chingaitwa kana murwere zvikuru malformation? Treatment iri endovascular embolization. Uyu zvakanaka zvinyoronyoro muitiro, umo mudziyo chikuru kuti anodyisa ari zvemamiriro conglomerate, nhete anobudisa mushonga zvishoma nezvishoma akaiswa pasi X-ray kuzvidzora uye chiremba zvikanzwika malformation. Zvadaro vascular lumen hypoallergenic raitongwa chinodhaka kwakazara iripo nzvimbo namatombo ropa riyerere munharaunda iyi. Zvinosuruvarisa, chidobi ichi haripi Mhedziso vimbiso kuti ngarava iri zvakazara obliterans. Naizvozvo, kazhinji rinoshandiswa senzira nopindirana kurapwa.

The zvemberi nzira Vascular Malformations ndokuchinja kushanda uchishandisa banga cyber (radiosurgery). Musimboti nzira iri kuderedza kubata radioactive mwaranzi zvemamiriro pachoto akasiyana pamakona. Izvi zvinobvumira kuti nokukurumidza kuparadza vascular kuchinja, pasina kukanganisa tishu utano. Pfungwa nokuomesa ropa midziyo paavhareji anotora mishoma. The anobatsirwei kusavapo wakakwana yematambudziko ari tsinga. Asi pane zvausingakwanisi pakushandisa nzira iyi:

1. zvinonyatsorehwa dhayamita midziyo havafaniri kupfuudza masendimita matatu.
2. nhoroondo hakufaniri sitiroko kana zvimwe ropa. Sezvo dzakaonda rusvingo uye haagoni kumira atsamwira ari penguva pakati aurayiwe nzira uye yokupedzisira nokuomesa yacho malformation.