Eisenmenger syndrome: Ibangela, Iimpawu, diagnosis, Treatment

Xa zentliziyo ngokubanzi kunye malformations iziphene ingakumbi ngalo mzuzu sele kukho amashumi iimeko "ukulinganisa". Ezinye zazo zichazwe ixesha elide kwaye baphathwe ngempumelelo kwithuba ante- kwaye lweentsana, kodwa inkoliso nangoku ekhangela ukuba uphando. Omnye kubo izifo Eisenmenger. Esi sifo iye yachongwa ekuqaleni kwenkulungwane yamashumi amabini nge udokotela baziincamisa Austrian kwaye ngoku ebizwa ngegama lakhe.

definition

Eisenmenger syndrome (Eisenmenger) - le ukuhlukunyezwa yophuhliso natal kwemisipha intliziyo, equka ubukho unesiphene ekudibaneni phakathi ventricles, lo aorta position otzerkalennoe nokwandisa ubukhulu ventricle ekunene. Ngethamsanqa, kungenziwa eziqhutshwa ngempumelelo kule isiphene, nabantwana ngakumbi bakhule nokuphuhlisa ngendlela efanayo njengoko oontanga babo.

izibalo

Okwangoku, malunga amahlanu ekhulwini kuzo zonke iimeko ezingekho mgceni kwentliziyo xa abantwana kudinga Eisenmenger syndrome. isifo sentliziyo azalwa nabanako ukwahlulelana kunye nezinye izifo intliziyo ezisanda kuzalwa kunye nabantwana abancinane. Abanye oogqirha ziyadibana lunganyangwa naziphi na ukuphazamiseka hemodynamic kwesi sifo.

Syndrome nanzima

Bekela bucala entsonkothileyo eyahlukileyo kunye Eisenmenger syndrome. Syndrome - unyulo ephule unqandayo ejikeleza igazi yokucima uphuhliso phakathi nemingxuma ye ventricles intliziyo. Elukhuni iquka ukuphazamiseka ezifumaneka olungekazalwa okanye usana.

umyalezo weimeyile

Inkqubo yesi sifo indlela ekwenzeka ngayo, kude kube sekupheleni akaziwa, oosonzululwazi kunye noogqirha basazama ukufumana ingcaciso. Noko ke, abazange bakwazi kakuhle ukuze sihlole izinto ngenxa apho Eisenmenger isakhiwo ibonakala. Izizathu zinokwahlulwa zibe ziindidi ezimbini: neziphumo yangaphakathi, okanye yemfuza, nangaphandle okanye kokusingqongileyo.

1. Thetha malunga transmission ngqo ilifa kwesi sifo kuba, kodwa ukuba izalamane lokuqala okanye lodidi lwesibini ukuphazamiseka ezikhoyo ukuyilwa amalungu kubalulekile, kusoloko kukho ithuba lokuba umntwana zivela.
2. Ukonakalisa ngexesha kokubeleka. Le udidi lomngcipheko kuquka abasetyhini abakhulelweyo abahlala kwizixeko ezikhulu, besebenza eziyingozi okanye nokujongana ezingcolisa imichiza okanye ngokwasemzimbeni.
3. Ukuthatha amayeza. Amanye amachiza ayingozi ukuthatha ngexesha nabantwana. Ngoko ke, ngaphambi kokuba akheke okanye kwiiveki zokuqala emva kokuba obstetrician ukuba kuthethwane nazo zonke iimali ezifunyenweyo. Kwanokuba nje amacwecwe ebuhlungu.
4. Ukusetyenziswa iivithamini kunye nezongezelelo zesondlo quality ezingaqondakaliyo. Ngokuqhelekileyo ezi izinto azinabungozi, kodwa kwiimeko ezinqabileyo zinokubangela umonakalo ulwamkelo iye angekayazi eyona amathambo womntwana okanye amalungu akhe zangaphakathi.
5. Ubukho omnye wabazali-to-ixesha elide isifo esinganyangekiyo.

Kakade ke, ezi zizathu azibonisi ngokukhethekileyo kwi Eisenmenger syndrome. Iimpawu, isifo zalo zonyango kuxoxwa ngezantsi.

Pathogenesis

Xa umntu iimpawu ezinjalo yokwakheka abakhoyo, qiniseka apho kuya kubakho yokuphazamiseka nokuhamba kwegazi. Ngenxa yobukho ebalulekileyo ventricular septal onesiphene, kwakunye ngenxa yemeko elingafanelekanga aorta zezi lwemithambo ephikisanayo kunye negazi aortic em- entliziyweni. Okt kwakhiwa shunt kunye shunt ukusuka ekhohlo ukuya ekunene. Ekuhambeni kwexesha, uxinzelelo kwi ukunyuka buti pulmonary, maxa wambi kusenokuba ngaphezu abo aorta. Oku kukhokelela ekubeni spasm reflex kwemithambo ezincinane kwegazi miphungeni. Ukuphuhlisa lwegazi miphungeni. Ukuba ihlala ixesha elide, ngoko ke kukho ukuqina zembuyekezo kweendonga emithanjeni kunye stasis igazi kwenzeka emiphungeni.

Oonoklinikhi ekwabelwana "white" yaye "blue" Eisenmenger syndrome. Kwimeko yokuqala, shunt na uguqulelo yayo Classic, oko kukuthi, ukusuka ekhohlo ukuya ekunene, yaye elesibini - phezu koko.

iimpawu

Kwiintsana kunye nabantwana abancinane iimpawu ingqalelo ekhethekileyo kunzima. uphuhliso lwabantwana emzimbeni nasengqondweni abazani. Ukuba yobudala kubonakala zokushenxisela esahlukileyo, ngoko ke umntu ukuphelelwa umoya, blue unxantathu nasolabial kunye iziphelo, ukudinwa, iyangongoza okanye arrhythmia intlungu uvalo lohlobo angina. Gumbini na imeko ukuba izigulane ukuze kuncitshiswe iimpawu - ndichopha. Ngoko kuba lula ukuba aphefumle.

Kwezi zifo eziqhelekileyo amaninzi ukuva izikhalazo yintloko, nokopha, kwaye sifo kukukhohlela igazi. Unga tshintsha ilizwi ngenxa ucinezelo ke kwalapho kwemithambo inimba. Ngokufuthi umntu bagcine ezimbi ezifana Buze lohlobo esifubeni elisemqolo kwaye utshintshe phalanges yesiphelo neminwe njengoko drumsticks, ekhomba ukusilela cardiopulmonary, ekuthiwa Eisenmenger engqondweni. Oonobangela, iimpawu, diagnosis ukuba yonke cardiologist eyaziwa.

I-sakhiwo ukuba nzima nephika, inyumoniya, endocarditis ziibhakteriya umyalezo, ukopha evela imiphunga, yaye attack intliziyo yabo. Ngaphandle konyango, iminyaka yobomi izigulane womntu kwiminyaka engaphezu kwama mathathu.

ekuxilongweni

Ngelishwa, xa uviwo Ordinary zibonisa sifo akwenzeki. Ukuze uqinisekise uxilongo presumptive, zifuna iindlela ezizodwa zophando:

1. -X-reyi yesifuba, nto leyo iya kubonisa utshintsho olubonakalayo lwe iikhonto sentliziyo kunye neempahla ezinkulu.
2. emibi angiography ezifana umfanekiso ubuchule lophuhliso semithambo isetyenziswa rhoqo, kodwa kule meko ke akukho athile, kwaye babone kuphela utshintsho zeengcali onamava kakhulu.
3. ECG uyaziveza mzekelo, xa kuthiwa phantsi Holter iliso. Ngoko ke ulwazi ugqirha akayi kuba ezintlanu imizuzu Ukuhlola, nokuba imini ngokupheleleyo, yaye uya kukwazi ukubona utshintsho wenzala.
4. Echocardiography - ultrasound intliziyo. Indlela elisemagqabini uzingela ziintsilelo nemingxuma zentliziyo kunye negazi ukuphazamiseka.
5. catheterization kwentliziyo, kulo mzekelo - indlela kakhulu nokwamkeleka oluthembekileyo nophando. Kuyanceda ukuchonga zonke iziphene, ukufumanisa iimpawu yintliziyo abangatshatanga ukuphuhlisa unyango.

Yiloo nto kunzima kangaka ukuxilonga Eisenmenger syndrome. Iimpawu (multistage unyango lwezifo kunye nexesha elide) ngezifo yayo nonspecific okuqunywa njenge sifo okuqhelekileyo iyasinda ingqalelo neengcali jikelele.

unyango

Nangona longquzulwano ongunaphakade phakathi oogqirha kunye amagqirha, kwimeko esi sifo, bavuma ukuba iinzame ezibambeneyo kufuneka uthathwe unyango endala ngokwayo engaphenduli yifuna, yaye ngokukhawuleza akanako ukunika uxolelo izinzile. Ngoko ke, iseti amanyathelo yenzelwe ukuphelisa Eisenmenger syndrome:

1. Wopha (kunye twist mihla, oku kubizwa ngokuba "phlebotomy"). elula nenkathazo-free. Lusetyenziswa izigulane ngezifo obuvunyiweyo isibini amaxesha ngonyaka. Ngaphambi kunye nasemva inkqubo ngokuyimfuneko emiselwe le viscosity igazi futhi umthamo inqanaba.
2. Ukusetyenziswa oxygen ukurhogele. Kusetyenziswa unyango njengesongezelelo ukujongana cyanosis kunye hypoxia eziziisekondari. Ukongeza, kuba nefuthe zengqondo phezu izigulane.
3. Anticoagulants. Abanalo inqanaba ezaneleyo ubungqina kangangoko kunokwenzeka ukuze ube nokuphuma kweso ipani ngembiza emlilweni, kwaye endaweni ithinasi igazi ukufumana nesvorachivaemost yakhe ngokupheleleyo.
4. Eminye imithi:
   - womchamo ngenxa yokubulala nokudumba pulmonary;
   - izisombululo ukuphucula hemodynamics.
5. Technique Steel:
   - ntliziyo ukuze ukuvala arrhythmia;
   - nokususwa ngokupheleleyo ukuvalwa ventricular septal isiphako kunye shunt engaqhelekanga.

Kanye indlela yokuphatha Eisenmenger syndrome kufuneka iqwalaselwe nogqirha wakho okanye iingcali ezininzi. Ngoko ukunika indlela isiqinisekiso sempumelelo hayi inokuba yiyo nayiphi indlela enye.