Aortic dissection inowanikwa apo rusvingo rweaorta (ruzivo rukuru rwemuviri) runocheka kubvambura, kunobvumira ropa kuti ripinde mumudziyo wemadziro, kuparadzanisa (kana kuparadzanisa) zvikamu zvemasvingo. Aortic dissection inogona kukuvadza zvakanyanya nhengo dzakasiyana-siyana nekufa nokukurumidza, uye inofanira kugara ichionekwa sechirwere chekukurumidzira.
Zvinokonzera
Aortic dissection inowanikwa apo kunze kwekunze kwetambo re aortic kunowedzera simba, zvichibvumira kubvaruka kuumba.
Uku kuderedza kunowanzobatanidzwa zvikuru nehana yeupupuriro . Inogona kuonekwawo nehutano hwehutachiona hwakadai se scleroderma uye naMarfan syndrome , Turner syndrome, Ehlers-Danlos syndrome , kukuvadzwa kunorwadza (kwakadai kwakaitika neChristine Diana), uye nekuputika kwemidziyo yeropa. Aortic dissection inokonzerwawo nekushandiswa kwecocaine.
Aortic dissection ndiyo inowanzoonekwa kuvanhu vari pakati pemakore makumi mashanu nemakumi manomwe nemakore uye inowanzoitika kune varume kupfuura vakadzi.
Chii Chinoitika NeAortic Dissection
Apo kuparadzaniswa kweaortic kunoitika, ropa richifamba pasi pekumanikidzika kwakasimba mukati mawo mumasvingo e-aorta, kuparadzanisa zvidimbu zvemasvingo. Ropa rakawanda kwazvo rinogona kupinda munharaunda ye aortic, uye ropa iri rinorasikirwa kusvika pakupararira - sekunge ropa rakakura rakaitika. Ropa rekuparadzanisa rinogona kufamba pamwe nekureba kweaorta, kuvhara midzi yeropa inokonzerwa neaorta uye ichikonzera kukanganisa kune nhengo dzinopiwa nemidziyo iyoyo yeropa.
Aortic dissection inogona kutungamirira ku- aortic kudzoka , pericardial effusion , myocardial infarction , zvirwere zveuropi , zvirwere zvepfungwa, kusagadzikana kwepvo , uye kubuda kwepamuviri . Uyezve, kuparadzaniswa kwe aortic kunogona kuputsa aorta zvakakwana, zvichiita kuti kubuda mukati kunobva mukati.
Nokuda kwezvikonzero zvose izvi kufa neAortic dissection, kunyange nekukurumidza uye kushungurudza, kwakanyanya.
Zviratidzo
Kazhinji kacho, aortic dissection inokonzera kukurumidza kuitika kune yakanyanya kupinza, kwakanyanya, "kuputika" marwadzo mubhokisi kana kumashure, iyo inowanzowedzera kumimba. Iyo kurwadziwa kunogona kuendeswa ne syncope (kurasikirwa kwekuziva), nekupererwa kwekufema kwakanyanya, kana nezviratidzo zvekurohwa . Kazhinji, zviratidzo neAortic dissection zvinotyisa uye zvakanyanya zvokuti hapana mubvunzo muduku mupfungwa yeanofunga nezvekuti rubatsiro rwekurapa runodiwa runodiwa.
Kurapa
Kurapa kunoenderana nokuti chikamu chei aorta chinobatanidzwa, uye pamamiriro ezvinhu omurwere.
Muzviitiko zvose, varwere vane aortic dissection vanounzwa kuimba huru yekuchengetedza uye vanobva vangoiswa pamishonga inopinza (kazhinji ne nitroprusside ) inotarisirwa kuchenesa zvikuru ropa ravo . Kuderedza ropa rinogona kuderedza kuputika kwepasvingo kweaorta.
Ava varwere vanopiwawo zvirwere zvepa beta blockers (zvichida propranolol kana kuti labetalol) kuderedza mwoyo wekutengesa, uye kuderedza simba rega rega. Uyu danho rinotarirwawo nekugadzirisa kukanganisa kwakawedzerwa.
Kana imwe nguva zvirwere zvakakosha zvakanyatsogadziriswa zvakakwana, chidzidzo chekufungidzira (chinowanzowanzoitwa CT scan kana MRI ) chinoshandiswa kunyatsotsanangura chikamu chipi cheaorta chinobatanidzwa.
Zvichienderana nenzvimbo yaro, kuputika kwakanyorwa seChirungu A kana kuti B.
Tora A Dissections. Ita A dissections inowanikwa mukukwira aorta (pakutanga kweaorta inopa ropa kumwoyo, uropi, uye maoko). Ita A dissections inowanzobatwa nekugadzirwa kwekugadzira, iyo kazhinji inosanganisira kubvisa chikamu chakakanganiswa cheaorta uye kuchinjeka ne dacron graft. Pasina kuvhiyiwa, ava varwere vari pangozi yakakura yeaortic regurgitation, myocardial infarction kana chirwere, uye kazhinji vanofa kubva pamatambudziko akadaro. Kuvhima kwakaoma uye kwakaoma, zvisinei, uye njodzi yokufa nekuvhiyiwa inopfuura 35%.
Kuvhiya kunorudzirwa kupesana kweChirungu A nokuti kufa kune zvakanyanya kunyanya kurapa kurapwa chete.
Tora B Dissections. Muchidimbu B, kuputika kunosvika pakuburuka kweaorta (chikamu che aorta chiri pamberi pepamusoro uye chinopa ropa kune nhengo dzomumakumbo nemakumbo). Mune zviitiko izvi, kufa hakuna kuenzanisa zvakanaka-uye kunogona kunge kwakakwirira - nekuvhiyiwa kupfuura nekurapa. Saka kurapwa kazhinji kunowanzosanganisira kurapwa kwechiremba, kureva, kupfuurira kwehutano hwekutengesa kweropa uye beta blockers. Kana humwe uchapupu huripo hwekukuvadza kune itsvo, mukati yemukati, kana kumucheto kwakadzika , zvisinei, kuvhiwa kunogona kudiwa.
Kudzoka Kubva kuAortic Dissection
Mushure mokunge chirwere chinonzi aortic dissection chave chichirapwa, murwere anoraramisa anofanira kuramba ari pa beta blockers kwehupenyu hwake hwose, uye rakanyanya kunaka kwekutonga kweropa inofanirwa. Dzorerai MRI maitiro anoitwa vasati vasvika kuchipatara kubuda, dzimwe nguva dzakawanda pamusoro pegore rinotevera, uye imwe neimwe kusvika makore maviri mushure meizvi. Izvi zvinotevera zvakakosha nokuti, zvinosuruvarisa, vanenge 25 muzana yevanopukunyuka aortic dissection inoda kubvunzwazve kwekudzoka kwechiitiko chinowanzoitika mumakore mashomanana anotevera.
Nokuti kuputika kwe-aortic ingangove hupenyu huchichinja kana husingarevi, zviri nani kuti uzvidzivirire pane kuzvichengeta. Iwe unogona kuderedza matanho ako ekuva ne-aortic dissection nekubhadhara zvakanyanya nezvepfungwa dzako dzenjodzi zvinokonzera , kunyanya kuwedzera kwehutano, uye kushanda zvine utsinye kuti uvandudze purogiramu yako yengozi.
> Sources:
> Hiratzka LF, Bakris GL, Beckman JA, et al. 2010 ACCF / AHA / AATS / ACR / ASA / SCA / SCAI / SIR / STS / SVM Zvinyorwa Zvokuziva uye Kurapa Kwevarwere NeTrracic Aortic Disease: Mharidzo yeAmerican College of Cardiology Foundation / American Heart Association Task Force on Practice Mirayiridzo, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, uye Society for Vascular Medicine. Circulation 2010; 121: e266.
> LeMaire SA, Russell L. Epidemiology yeTraracic Aortic Dissection. Nat Rev Cardiol 2011; 8: 103.
> Melvinsdottir IH, Lund SH, Agnarsson BA, et al. Kuitika Uye Kufa KweActute Thoracic Aortic Dissection: Zvibereko Kubva Kuchidzidzo CheNyika Yose. Eur J Cardiothorac Surg 2016; 50: 1111.