Malformation semithambo: oonobangela, iimpawu, isifo kwaye unyango

Ukuba kwinkqubo yophuhliso osandul iphazamisekile ukuyilwa kwegazi, lo malformation nemithambo usenziwa. Lo uxhulumaniso olungachanekanga imithambo yegazi, esizibonakalisa elivisayo. Yonke lento iqala ngo yintloko, uqaqanjelwa nokuxutha izinto. Kwiimeko kakhulu, abantwana uhlaselwe.

definition

isakhiwo semithambo kwahlukile lonke kwegazi. Ezinye ziyatyeba, ezinye udonga dystrophy, abanye baye izivingco, kodwa bonke oxhulumene omnye komnye ngolandelelwano ethile. Ukuba iyaqhubeka ukusebenza, ezinye uhlobo ezisekiweyo ulandelelwano yophukile, le conglomerates akhiwa iimpahla kwalula, ebizwa malformations.

Ngokuqhelekileyo, esi sifo naso imbangela ayaziwa. Senzeka elinethoba ngaphandle ezilikhulu lamawaka kuzalwa kunyaka ngamnye. Kungabangela malformation bebe syndrome, compress umnqonqo kunye izihlunu ingqondo, ukwenza kwemithambo zibangele kobetho legazi meninges. Amaninzi iingxaki kwenzeka kwiminyaka oqolileyo, emva kweminyaka engamashumi amane.

ngezigaba

Kukho iintlobo ezininzi ezinokuthatha indawo malformation nemithambo. Kuba ukusebenzisa kwabo systematization wavunywa ngo 1996 ulwahlulohlulo ISSVA American. umahluko zalo ezisisiseko kwezinye ukuhlelwa - ukwahlulwa zonke mgaqweni e nangezilonda, malformations.

1. ngamathumba yegazi:
   - hemangioma bobusana (livela ebuntwaneni);
   - hemangioma naso;
   - bunchy hemangioma;
   - veretenopodobnaya hemangioendothelioma;
   - kaposhiformnaya hemangioendothelioma;
   - ezifunyenwe yi nethumba.
2. malformations:
   - capillary (telangiectasias, angoikeratomy);
   - lwemithambo (manqapha, glomangioma, Mafuchchi syndrome);
   - nkovu;
   - lwemithambo;
   - arteriovenous;
   - zihlangene.

Malformation of emithanjeni

Lwemithambo Malformation uphuhliso okungaqhelekanga ngayo umthambo, kulandele ulwandiso lwabo zophendlo lwezifo. Yeyona eqhelekileyo kakhulu phakathi kwazo zonke iindidi malformations. Esi sifo enaso, kodwa ubonakala ebuntwaneni kwaye sele umdala. Tshintsha indawo iimpahla kuba nantoni na: a luvo systemic, enyama yangaphakathi, isikhumba, amathambo okanye izihlunu.

malformations lwemithambo ukuze ibe phezu kobuso okanye ubuxoki emzimbeni ziyatyeba ukuba wedwa okanye twa ku amalungu omzimba eziliqela. Ukongeza, kokukhona abekwe kumphezulu eluswini, kokukhona ayegcwele inzuzo umbala.

Ngenxa imilo engaqhelekanga kunye nombala kunokuba bedidekile hemangiomas. Moshilongo umahluko uxinzelelo kakhulu kancinane isahlulo ilungiswe. Malformations ukuba athambe kwaye kulula ukutshintsha umbala. Kwimeko ingenzeka kwemithambo yegazi engaqhelekanga nzulu emzimbeni womntu ngaphandle ngezifo ayikwazi bangaboniswa.

Kunye komntwana ukukhula kunye malformation anda, kodwa phantsi kweempembelelo zizathu senyanga, ezifana utyando, kwentlungu, usuleleko, iziyobisi hormone, ukuba nomntwana okanye exesheni, nokukhula ngokukhawuleza zikhula kwemithambo yegazi.

Chiari malformation

Le malformation semithambo, nto leyo zibandakanya tonsils cerebellar ezisezantsi zogqunyelelwe. Isifo uchazwa ngasekupheleni elinethoba ugqirha Austria kwinkulungwane Hans Chiari, athanda ukuyibeka embekweni yaye yathiywa isenzeko. Yena iyichongile eminye yeyona ixhaphakileyo yale anomaly iintlobo. Ngenxa kwindawo idlala eliphantsi akusithelisi lokuphuma fluid yobuchopho umnqonqo, oko kudala uxinzelelo intracranial okwandileyo kwaye kuphakamisa nophuhliso hydrocephalus.

Chiari uhlobo malformation ichaza ukubana tonsils cerebellar phantsi ukuzityhala ngokusebenzisa magnum foramen. Eli lungiselelo ibangela ukwandiswa emjelweni spinal, esizibonakalisa ngokwezonyango xa ufikisa. Iimpawu kakhulu zixhaphakileyo intloko ebuhlungu, ukuduma, ongazinzanga xa ehamba, diplopia, zokucacisa kakuhle, yokuginya iingxaki, kwaye maxa wambi ukugabha. Intsha esibonakala iintlungu lehla kunye nobushushu novakalelo kwisiqingatha ongentla umzimba omzimba.

Chiari malformation Uhlobo lwesibini iphuhlise ukuba ukwanda foramen ubukhulu. Kulo mzekelo, i tonsils cerebellar musa kuwa, yaye kuwela kuwo. Oku kukhokelela ucinezelo le umnqonqo kunye kwiCerebellum ngokulandelelana. Ngelo xesha iimpawu lokugcina fluid ebuchotsheni, iziphene intliziyo, ukophulwa phecana osandul wokudla kunye nenkqubo enzala kunokwenzeka.

umnqonqo

Malformation le umnqonqo - sisifo inqabile ekhokelela myelopathy okuqhubekayo. malformations Arteriovenous ukhetha phakathi amaphepha okanye iqokobhe bubuxoki nzima phezu amaphiko phezu nobuchopho emqolo thoracic okanye empontshwa. Eyona ngezifo iqhelekileyo eqhelekileyo kubantu abadala.

Isifo ifuze iimpawu sclerosis kwaye ufake luvo ezilahlekisayo. A ukonakala ezibukhali kwenzeka emva komsipha kwemithambo yegazi kunye nokopha kwi isithuba subarachnoid. Izigulana babona iingxaki kwiindawo ezibuthathaka kunye neyezihlunu, ukuphazamiseka amalungu zangasese. Ukuba ejoyina iimpawu cortical, esi sifo liya lisiba ngathi ALS (lateral sclerosis).

Ukuba isigulane ikhalazela uphawu ukuphazamiseka ezimbini luvo ezahlukeneyo, ugqirha kufuneka kuyakrokreleka malformation nemithambo kwaye lenze uhlolo olubonakalayo yomqolo. Imiqondiso yokuba etshintshiweyo semithambo lipoma kwaye iindawo awandisiweyo nombala. Loo mntu kufuneka ithunyelwe mishini livakale Imagnethi okanye myelography ngekhompyutha. Oku kuya kuvumela ukuqinisekisa uxilongo.

iimpawu

malformation semithambo ikhangeleka ngathi lixesha iibhombu okanye ngompu kunye ihamile cocked ezandleni yomntwana - akukho bani owaziyo kuya kuqala xa intlekele. Ngaphandle kwento yokuba sifo a anomaly enaso, iqalisa ukuzibonakalisa kakhulu kamva. Kukho iindidi ezimbini malformations flow semithambo:

- ukopha (70% amatyala);
- torpid (in i-30%).

Akukho nasinye zeenketho engamelanga ithathwe njenge ibenomtsalane ukuba umntu lo unesifo. Kwimeko kwemali ukopha ogulayo uxinzelelo oluphezulu lwegazi, kwaye iyunithi nemithambo sincinci kwaye ibekwe entanyeni. Isiqingatha abantu ukopha ngesibetho kwenzeka uhlobo malformation ekhokelela ukukhubazeka okanye ukufa. Umngcipheko ukopha kwandisa kunye ubudala, nabafazi inkalo engaphezulu ekhulelwe naxa ezala.

Ukuba umntu wafudukela ngempumelelo kukubethwa yokuqala, koko amathuba 1: 3 kunyaka kuphinda-ukopha. Kwaye ngoko wesithathu. Ngelishwa, emva iziqephu ezintathu, bambalwa asinde. Malunga nesiqingatha izigulane ziye zingabi iimilo ukwenza hemorrhages intracranial, hematomas okanye oxutyiweyo podobolochechnyh tamponade nobuchopho ventricles.

Le ndlela sesibini flow enkulu, edulusele nzulu neuron malformation nemithambo. iimpawu zayo kakhulu kuvamile:

- ukulungela convulsive okanye ubukho yokuhlaselwa epileptiform;
- enentloko engapheliyo;
- ubukho neempawu intsilelo efana ithumba ebuchotsheni.

syncope

Phantse bonke abantu malformations nemithambo ibekwe ebuchotsheni, kungekudala ukuvela syncope (oko kukuthi, syncope). Oku kubangelwa kukuhla bokwexeshana kwegazi lobuchopho. Ngexesha syncope isigulane libunile, Bathiwe wambu umbilo yengqele, izandla zakhe neenyawo ububanda, ukubetha kwentliziyo buthathaka nokuphefumla nzulu. Ukuhlaselwa yathatha imizuzwana malunga mabini, yaye ekupheleni kwayo isigulane akakhumbuli nto.

Rhoqo ngonyaka kukho ngaphezu kwesiqingatha sesigidi iimeko ezintsha syncope, yaye kuphela inxalenye encinane kubo ubudlelwane unobangela kunye nesiphumo ecacileyo. Syncope ezinokubangelwa zovuselelo ngokugqithisileyo kulo sinus carotid, neuralgia trigeminal okanye luvo glossopharyngeal, ulawulo nervous system insufficiency yawo, nokuphazamiseka intliziyo isingqisho, kakade, malformations nemithambo. imithambo ezingahambi ngemithambo zinika zokushenxisela igazi nokukhawulezisa flow yayo. Ngenxa yoko, ingqondo akaneliseki ukutya ngokwaneleyo, nto leyo ebonakalisa ukuphazamiseka lokuqonda.

ukungaphili

Kwanangaphambi kokuba malformation ukuzibonakalisa ngokwezonyango ebantwini efihliweyo iza kuphuhlisa izenzakalo ongenakulungiseka zophendlo lwezifo. Oku kungenxa yokuba hypoxic inxenye inyama ingqondo, oko muscular baza bafa. Kuxhomekeka indawo kummandla ochaphazelekayo waphawula ukuba iimpawu mpawu focal (abanala makhwiniba intetho, umlenze ahambe, iintshukumo ngokuzithandela, ubukrelekrele kunye t. N.) Ngaba kuba sokuwa.

iingxaki ezimandundu iqala sele umdala. imithambo yegazi ezingahambi kufuneka iindonga ezingcakacileyo kwaye usesichengeni kwizaphuko, ngoko izigulane malformations imivumbo eqhelekileyo kakhulu kobuchopho. conglomerates ezinkulu emithanjeni ngemithambo compress esikule ngeenxa zonke kubo, ebangela hydrocephalus. Eyona eyingozi legazi ngenxa komsipha nobeempahla eziliqela. Isenokuba okanye nemiphumela ebulalayo, neziphela ngo neziphumo kancinane okanye hayi. Konke kuxhomekeke kwinani igazi mngcelele. Sophele ezikuyo kakhulu ezithembisayo kangako Outlook kwaye ziphinde zenzeke ngokuhamba kwexesha.

ekuxilongweni

Uviwo lokuqala lwezempilo akufunekanga aveze nantoni na engaqhelekanga kubantu malformations nemithambo. Ngokuqhelekileyo oku kufuna uzimisele neemviwo ngokucokisekileyo kakhulu ukuchonga ukwaphulwa. Ukuba isigulane ikhalazela of yintloko ebuhlungu rhoqo, iingcangcazela, ukuphazamiseka ngamaxesha sezingqondweni angaboni kahle okanye ukuhamba, yinto ithuba ukuthumela ukuba baqhube neuroimaging. Ngamafutshane, ikhompyutha okanye livakale magnetic ufaniso ebuchotsheni.

Isakhiwo enenkcukacha kwaye nolwazi oluchanileyo nemithambo ibonisa umahluko angiography. Kuba oku njengesigulane kwemithambo carotid lwazo lesitofu ulwelo radiopaque kwaye wenze uthotho kuqhume. Le ndlela iye eziliqela iingxaki kunye neziphumo ebezingalindelekanga, ngoko, usebenza kuphela xa nobunzima ekwenzeni isifo.

Ukujonga isantya, ulwalathiso izinga kwegazi liya utshintsho kwisigaba, esebenzisa Doppler ultrasound. Le ndlela ivumela sikwazi ukubona ukumpompoza kwegazi phakathi kwemithambo ngemithambo, ukuba ukujonga uhlobo nempahla, ukuseka ubukho aneurysms kunye nezinye iingxaki.

unyango

Nokuba malformations olujikeleza iSADC ukulungiswa? iindlela Treatment ixhomekeka kuhlobo ukungaqheleki, indawo yayo, ubungakanani kunye ingqalelo imbali imivimbo.

Kukho iindlela ezintathu eziphambili zonyango:

- surgery evulekileyo;
- embolization kancinane invasive;
- unyango radiosurgical non-invasive test.

Ngokuba elowo kubo kukho izikhokelo, Izimo, kunye noluhlu kubunzima kunokwenzeka.

Eyona nto ibuhlungu kukuba uqhaqho evulekileyo. Ukuze ufumane emlilweni, ukwenza evula cranium, klipiruyut izitya niwele nawo. Loo ngobuwena kunokwenzeka malformation kwimeko ibekwe phezu komhlaba ingqondo kwaye ineenkalo ezincinane. Iinzame ukufikelela izilonda ezinzulu zaloo kunokubangela umonakalo iingongoma ezibalulekileyo kunye esibulalayo.

Yintoni enokwenziwa ukuba isigulane malformation kakhulu? Unyango embolization endovascular. Le nkqubo noko nokuthantamisa, ngexesha apho inqanawa enkulu otyisa nabaphathi aziqhelekanga, catheter obhityileyo ifakiwe phantsi kolawulo X-reyi kwaye ugqirha ufumana ukuya malformation. Ke yegazi mithambo iziyobisi elawulwa hypoallergenic ejikeleze ezikhoyo isithuba kunye neebhloko kwegazi kulo mmandla. Ngelishwa, le ndlela ayiboneleli njengeziqinisekiso ukuba isikepe ngokupheleleyo obliterans. Ngoko ke, amaxesha amaninzi oko isetyenziswa njengonyango ziyahambisana.

Eyona ndlela kakhulu zaphambili anxulumene nemithambo Malformations kuzakuthathwa operation usebenzisa imela cyber (radiosurgery). Kakuhle eli ndlela kukuba ukuvala ukusingatha reyi radioactive eziko okungaqhelekanga kwiikona ezahlukeneyo. Oku kukuvumela ukuba ngokukhawuleza kutshabalalisa utshintsho nemithambo, ngaphandle kokonakalisa ephilile. Inkqubo yokuqaqadeka kwemithambo yegazi kwi avareji kuthatha iinyanga ezimbalwa. Unalungelo lini na ke ukungabi yeengxaki kule luvo. Kodwa kukho umda ukuba ukusetyenziswa kwale ndlela:

1. bepali iyonke iimpahla mayingagqithi iisentimitha ezintathu.
2. Xa imbali kufuneka ibe istrowuku okanye enye ukopha. Ekubeni udonga obhityileyo kwaye abakwazi ukumelana komsipha kwi lekhefu phakathi ngokwenziwa ngenkqubo kunye ukuqaqadeka yokugqibela malformation.