Coarctation o ka aorta - He aha ka keia? Coarctation o ka aorta i loko o na keiki

Coarctation o ka aorta - he naau maʻi, i ua pu ma ka hou o ka lumen o ka nui moku i loko o ke kanaka kino. I mea, ia mea,ʻaʻole he maʻi o ka naʻau, e like me ka pathology ua IIeEeAIEUIeXAIIUE ma waho o nā palena o ka myocardium. Loa pinepine diagnosed coarctation o ka aorta i loko o na kamalii uuku, eia nae i kekahi manawa i ka maʻi ua 'akomi i mua i loko o kanaka makua nā mea maʻi. Loa pinepine, i ka maʻi ua eliminated eʻoki kino.

O ka holo ana, uaʻike, mea,ʻaʻole loa i ike i nā mea maʻi, a mea ia e panic. Pela no oe e aʻo hou aku e pili ana i ka mea i kēia maʻi, a mea complications e halawai me ke kanaka maʻi.

Coarctation o ka aorta: He aha ka keia?

Mua, e i ka hana me ka ano o ka makahiki. Coarctation o ka aorta - he congenital kina, i ua pu ma ka hou o ka aorta. Ma kēia 'ole o ka naʻau i loko o nā mea maʻi nei he maʻamau. Aka hoi, i ka aorta o ka nui loa moku ana o ke kanaka, a me ka 'aʻe' ana o ke koko i loko o kēia wahi negatively e loli ai i ka hana o ka i wale i ka naau a me ka ipu koko, akā, i ka mea a pau meaola.

E like me ka rula, i ke kapu ua hanaʻia i loko o ka wahi, kahi a ka aortic e pio mai hele i loko o ka lalo loa. Oia kekahi kumu o explainable, no ka mea, eia ka mea, he meaʻuʻuku maʻamau physiological hou. Ma ke ala, i ka maʻi i ho'ākāka 'ia ma ka manawa mua loa i ka 1791 ma D. Morgagni (Italian pathologist). E like me ke ana helu ikepili i ke alapine (frequency) o ka pathology mea i ka 15% o congenital malformations. Kekahi hana hoihoi oiaio mea i ka maʻi i loko o ia lŘlŘ keiki 3-5 manawa hou aku paha ma mua o nā mea maʻi wahine.

I ka papa kuhikuhiE ano o ka pathology

Ke kaumaha ma muli o nāʻano, coarctation o ka aorta hiki ia i mau hoailona ia mea:

• "Makua" coarctation ua wehewehe aku ma ka hou ana o ka lumen o ka aorta ma lalo o ka wahi, kahi i haalele mai ka hema subclavian artery; oiai e haule ana ka panina o ka ductus arteriosus;
• infantileʻano o ka pathology ua pu ma hypoplasia o ka aorta ma ka ia wahi o ke kumu o ka subclavian artery, akā, i ka pele, nō naʻe, noho hamama.

Anatomical hiʻona o ka pathology

Congenital coarctation o ka aorta i e pili me nā comorbidities. Ke kaumaha ma muli o kēia kina hiki ke maheleia i ekolu pūʻulu.

Pathology hiki e insulated - ma keia hihia ole o kekahi'ē aʻe mā i loko o ka ulu ana o ka mea'ōnaehana mānowai koko nenoaiu. Pinepine, coarctation o ka aorta i loko o nā keiki i ke pili me nā pathologies - keia i ia i aneurysm, aortic stenosis, septal hewa ma waena o nā ventricles a me atria, transposition o na moku nui.

Ke kolu o ka pūʻulu - coarctation, ma i ke koko kahe ua malama loaʻa. Ma na hihia a pau, i ka pathology hiki e:

• postduktalnoy (hou ua aia ma lalo o ka wahi, kahi haalele iaoaioa ductus arteriosus;
• yukstaduktalnoy (coarctation mea pono e wehe i ke kahe 'ilikai);
• preduktalnaya (arterial leki uea wehe lalo o ka constriction).

O ka holo ana, symptoms pili kēia hilinaʻi nui kaʻoi loa ma keʻano a me nā 'ano o ka coarctation.

He aha nō nā kumu o ka Hope?

Pinepine e hoʻomōhala ana i coarctation o ka aorta i loko o ka fetus. No ke aha la i keia ahaʻia nei? Ua ua ike ia i fetal kūpono 'ana i loko o ke kino o ke keiki ua functioning arterial leki uea, a hoʻohuiʻia ka aorta a me ka hema pulmonary artery. Kēia 'ole ua wale nō e pono ai ka manawa. Ma hope iho o ka hanau ana, a me ka hoʻomaka o pulmonary ka hanu nā leki uea e haapau nei i.

Aia ka he pähola 'ia kekahi kumu' ole kekahi i kekahi uuku hapa o'aʻaʻa o ka pele e neʻe aku i loko o ka aorta ke keiki, no laila, ka wā e pani i ka leki uea i loko o ke kaʻina komo ai, a me ka aortic pa, e alakai ana i kona contraction.

Nā kumu no kēia kaʻina, auwe, i ike ole. Epekema wale ike mai ia i ka maʻi loa prone nā mea maʻi me ka chromosomal Turner ka maʻi pale (i ke alo o ka hoʻokahi wale nō ke keka chromosome). Ua aneane ua ia akulla 'na keiki hapaʻumi me kaʻike, o keia kina.

Coarctation o ka aorta (IBC) aʻole i ia e congenital. Ike pohihihi keia hihia kahi vasoconstriction iloko mua ma ka adulthood. Ma na hihia ke kumu coarctation i poino a me ka aortic atherosclerotic lesions, hoʻoʻino mai o ka ike ole etiology vascular pā (Takayasu ka maʻi pale).

'Aʻe' ana o hemodynamic coarctation

O ka holo ana, aortic constriction ia ma luna o ka holoʻokoʻa mea'ōnaehana mānowai koko'ōnaehana, a hiki ina ke kahu hewa iʻaʻole i loaʻa. Ke alo aku o ka coarctation i nā hualoaʻa ma ka kahua o nā 'okoʻa pele? Eiia io.

Hou ka lewa ma luna o ke koko, ua mahuahua, i hiki aku ai i? Anoe? O ka lumen o na moku koko. Ma muli o ka systolic overload hoʻomōhala i ka hema ventricular hypertrophy. Akā, ma lalo o ka wahi o ka coarctation o ke kulana o ke ku pono ana i - ka meheu o ke koko kahe, ke koko, ua kuu iho la. E like me ke kino i ke keiki i ka haʻalele no uku 'maomeka - ulu mau moku collateral mea i ke koko pele holo alaʻokoʻa.

I ka wa e hele ai i ka makua 'ano o ke kina, na nā mea maʻi malama hema ventricular hypertrophy, loa hypertension, a me ka hoomahuahua i ka ai hoʻolahaʻia ke koko buke. I ka infantile coarctation ka wā o ka ductus arteriosus e hamama ana, ka mea ma luna aʻe 'ana i ole ai maopopo i ho'ākāka'. Akā, he mea'ē aʻe pathologies. No ka laʻana, ka wā i ke 'ano o ka pathology postduktativnom koko mai ka aorta lalo kiʻekiʻe puʻe ua hāʻawi' ana i loko o ka pulmonary artery, i hiki aku ai i ka mahuahua ma ka puʻe i loko o nā ipu o ka pulmonary holo.

Ma kekahi hihia he mea he hahau nui o ka hemodynamics, a ma kekahi hihia e ole e AOON, no ka mea, o ka hopena hiki e keu o.

He aha i na symptoms o ka maʻi ua pu e?

Symptoms o aortic coarctation pili kēia hilinaʻi ma ka degere o ka hou ana o ka moku, e like me ka pono me ke alo a kaawale o concomitant mā. Mehana coarctation o nā mea a pau hiki ole ke hōʻike.

I oi loa hoopii, na symptoms mea, ua hiki i ka makahiki mua o ke ola. I hāʻawe pinepine e ae mai ka li nui o na ia maʻiʻaʻai a me ka maʻamau recurrence. Children paleʻili a me ka hanu pilikia - dyspnea akaka i ka palaoa, lealea a hiki i maha. Pinepine, keiki me kēiaʻike, kāohi hoʻomōhala oi ma mua o kā lākou mau na¯ lohi.

Manao i ke alo o ka Hope like hiki ana hoʻolohe i ka naʻau mea kani-, e like me ka manao paa o ka lāʻau ikiʻai wale i loko o nā ipu koko o ka luna, a malaloʻaoʻao. Nā arteries ma ulnar pā e ike hiki ripple anakahi uila, oiai loa nāwaliwali ma ka femoral lāʻau ikiʻai wale nei.

I ka preduktalnoy coarctation malama heterogeneous cyanosis - he keiki ka ili ma na wawae i cyanotic hue, oiai o kaʻili i ka luna o ke kino aua i ka maoli waihoʻoluʻu.

Ua pinepine ka hana i ka pathology ua ua diagnosed ma ka mua e poohina ai - i kula-makahiki keiki, adolescents, makua. Symptoms ma keia hihia ka lolouila māhuahua ke koko. E hoomanawanui i ohumu o ka luhi, headaches, pinepine pōniuniu,ʻeha ma ka naʻau, nosebleeds a me ka luhi. Pinepine i kekahi ke malama pono i ka disproportionate kūpono 'ana o nā nāʻiʻo o ke kino luna, a malalo ma ka ninaninau. Symptoms nā nawaliwali i loko o nā wāwae, pinepine cramps, pā lonoaʻili i ke anu wawae. Women ke mālama i ka menstrual kalapona kāna hana, a me kekahi manawa infertility.

Coarctation o ka aorta:ʻike,

Manao i ke alo o ka Hope kauka hiki ana hoʻolohe i ka naʻau kani. Hou 'ana i mālama' ē aʻe PalekanaEND_LINK ana, i kōkua ole wale, e hookupaa aku i ka alo o ka coarctation o ka fax, akā, i wehe aʻe nā mā, a hoʻoholo i ka nui o ka pio ana o ka mea'ōnaehana mānowai koko'ōnaehana:

• Kekahi o ka poe noonoo ole loa, a ho'āmana iaoia o ka electrocardiogram. Ka mea, i ka loa informativeʻano hana, mai ka lōpū hou o ka aorta o ka hoʻomanawanui electrocardiogram e nānā pono maʻamau. Nā keiki i loko o ka makahiki mua o ke ola e ike hiki ke pohupani hale o ka uila (axis) o ka naau i ke kaʻina hana. ʻO kā mua hiki ua huai ae i na hoailona o ka hema ventricular hypertrophy. I kanaka makua nā mea maʻi, i ka uila (axis) o ka naau ua 'oni iki i ka hema, a me kekahi manawa, he mea i kāpili blockade o ka haʻalele pua lala hihia.
• nā mea maʻi i pinepine hoakaka phonocardiography. Kēia kaʻina hana apono 'oe i ka palapala kani a me nā kuekueni mai ana o ka hana ana o na ipu naau a me ke koko. Ma ke alo o ka coarctation e hai waiwai o ka lua o ka leo o ka aorta, like hoʻi me ka helehelena o ka systolic'ōhumu ma ke kua, a ma ka lua o ka intercostal makahiki kokoke i ka sternum kaʻe (akau a me ka hema).
• Informative mea ultrasound o ka naau, i hiki kōkua e huai ae hou o ka aorta. Nō hoʻi, i ke akamai ke ike i ka mahuahua i loko o ka naʻau o ke kaumaha. Doppler echocardiography ua hoʻohana 'ia e kuhikuhi i ke ano o ka symptoms pathology, ma ka nui, ke koko, oko ao ma luna o kaʻai ma luna a ma lalo o ka constriction, i ke alo o ka māpuna systolic pele.
• Eia kekahi radiography maʻiʻaʻai a me ka naau. Nō kāu, i ka nui o ka naau e maʻamau, akā, oe, e hai i ka nui? Anoe o ka pii aorta. Pulmonary unuhi hiki ke hoʻokāʻoi 'ia e ka arterial kahi moe, eia nae keia ua malama ole mau.
• Aortography - he kaʻina hana i ua hoakaka no ka pōkole i loko o ka aorta o ka kūikawā Akä agena, ukali ma ka malama ana i kona hoi o ka makana ma luna o ka moku. Kēia like hiki pololei hoʻoholo i ka nui a me ka nui o ka hou o ka aorta.
• Cardiac catheterization - heʻano huikau ina hana. Aka, ma ka kūikawā catheter i hoʻolaunaʻia ma loko o ka lumen o ka moku hiki e pololei ana ke koko,.

Wale nō ma hope o ka piha kiʻi o ke kauka ke haawi i kēla a koho i ka mea kūpono ki ina hana like, e hoʻopau i kēia Hope.

Aole anei au e pono aiʻoki kino?

He aha inā ua loaʻa i ka hoʻomanawanui coarctation o ka aorta? Ke hana, o ka papa, o ka mea wale nō ka hoʻokō 'ano o ke kāpaeʻana i ka hewa. Akā, i ka olelo hooholo, e paa i kaʻoki kino i ke i wale e lapaau poe i kama'āina i ka mōʻaukala a me ka lapaʻau hōʻike.

Ma kekahi hihia (ina he mea kekahi hōʻemi iki hou wale nō, a uaʻaneʻane ole ia ma hemodynamics), i ka hana i ole e koi 'ia. Ke hoomanawanui ua wale kēlā wā i kēia wā i hala examinations.

Inā i ke koena unuhi i loko o systolic arterial puʻe o ka luna, a malalo lala, ua oi aku ma mua o 50 mm o Hg. Art., Kauka pinepine paipai e hoʻomaka i kaʻoki lāʻau lapaʻau ina hana. Inā aortic coarctation i na kamalii uuku, ua diagnosed, i ka hana (pilikia) ua lawe mai i loko o ka hihia ma ka opiopio e hoomanawanui i noho loa hypertension a me cardiac decompensation. Ma na wahi i ka maʻi, kŘpa a maikaʻi, a me ka kiʻekiʻe pilikia no ke ola o ke keiki mea i ike, i ke kaʻina hana i keʻula a hōʻea elima a eono paha makahiki o ka makahiki.

ʻoki lāʻau lapaʻau lapaʻau o ka naau maʻi

I ka lā, loaʻa nō kekahi mau ano e hoʻopau i kēia Hope. Kohoʻoki lāʻau lapaʻau 'ana i kūpono hilinaʻi nui ma luna o ke ano o ke ahonui, ke ano o ka maʻi a me ka coarctation nui.

• Ma kekahi mau hihia, kauka hana resection (excision) o ka hou hapa o ka aorta, a laila, hui hou ana i ka welau o ka ipu, ana i ka anastomosis. Kēia ke kaʻina hana no ka hiki wale ina ka coarctation mai he uuku loa.
• I ka hanana i ke kapu hapa ka lōʻihi, a me ka poʻe anastomosis mea,ʻaʻole e hiki, hoʻohana 'prosthesis. Iloko o ke kaʻina hana o ka surgeon e lawe aku oe i ka hapa e pili mai o ka aorta, i kau ai i nā wēlauʻelua o ka ipu i hui me ka kūikawā prosthesis i ka kemikala mea.
• Aortoplastika - kekahiʻano o ka hana, akā, ma kēia hihia o ka lōʻihi o ka aorta, e hoʻihoʻi 'aʻole hoʻohana' ia ka kemikala prosthesis, e like me ka hapa o ka hema subclavian artery o ka hoʻomanawanui.
• I kekahi manawa kauka olelo e pana aku au i ka aortic holo alaʻokoʻa. Ma ia ano hihia, he kemikala prosthesis, kona lua penei; akeke nui ma luna a ma lalo o ka hou hapa o ka moku - pela e pili ana i ka holo alaʻokoʻa ala no ke koko pele.
• Aia i kekahi kaʻina hana i kapa hoʻonui angioplasty. Ua ua lawe mai i loko o ia mau hihia a pau, ina ma hope o mua i hana 'ʻoki kino reappeared vasoconstriction. Iloko o ke kaʻina hana, ke kauka inserts ma na ipuʻike ākea ma ka aortic lumen kūikawā hoʻonui, kona mau palena nalo ka wā inflated. Ma kekahi mau hihia, he hou 'ia paha i na mea paakiki stents e malama i ka nui o ka aortic lumen.

O ia ka leo mea he kina? Iaea ua kapaia "coarctation o ka aorta." Ma hope oʻoki kino, i ke ahonui, o ka papa, mea e hoopili i kekahi mau lula. Ma kekahi, e pono eʻai'ākau, pale aku excessive physical exertion, a physical inactivity, e akahele kanaka hoʻoponopono i ka moku'āina o ke ola kino a me ka undergo regular ponopono-ae la i ka hele cardiologist.

He aha complications e hiki?

Coarctation o ka aorta - he mea pepehi maʻi, a ma kekahi hihia e ole e AOON. I ka noho lakou malaila papa kina hiki alakai i loa pilikia complications:

• Aie i ka hou ana o ka moku , nā mea maʻi e hoʻomōhala loa hypertension.
• Pinepine, i kēia naau kina - pu aku la keia ma ke kahua o ka aneurysm a me kona mahope rupture - aortic coarctation.
• Complications i nā hahauʻana a me ka subarachnoid effusion o ke koko.
• Ma ke kāʻei kua o kēia maʻi i loko o nā mea maʻi pinepine ulu naau e hemahema, a ua pu ma ka ai-kapaia cardiac asthma a me pulmonary edema.
• Hou o ka aortic lumen e loli ai ka holoʻokoʻa vascular nenoaiu. No ka mea, o ka giperenzii kaumaha e 'ai pono i ka poe liilii,ʻaʻa puʻuwai arteries.
• Kēlā wā i kēia wā hoʻomanawanui iki mai hoʻomōhala mea koʻohune endocarditis. Oia complication ana ia lŘlŘ i loko o ka hanana e coarctation o ka aorta ua pili i abnormalities o ka aortic kiwikā. Eia naʻe, i loko o ka hapanui hoopii, i kēia mau mea koʻohune naau maʻi e hoʻopale ai i antibiotics.

E like me 'oe ke ike, coarctation o ka aorta i loko o nā keiki a me nā mākua ke e ona. Ia mea ke kumu ia mea no laila, nui 'eleuʻike, a me ka nui kūpono Inc.

Ke prognosis no nā mea maʻi me ka coarctation

Loa pinepine diagnosed coarctation o ka aorta i loko o na kamalii uuku. He aha ka ke Outlook no opiopio nā mea maʻi, a mea e mākua manaʻo ai? I mea, ia a pau hilinaʻi nui ma luna o ka degere o ka hou o na moku koko. Ma kekahi mau hihia, i ka maʻi koi kokeʻoki lāʻau lapaʻau 'uao. Inā ka mea, 'o ka lōpūʻano o ka Hope, a ina pau ka kauka mau koi nā mea maʻi ola wale 30-35 makahiki, a me ke kumu o ka make, e like me ka rula, ia mea he hahauʻana a aneurysm rupture.

Mehana hou kekahi manawa ponoʻoki kino - ke kauka wale ia kekahi ma ke kamepiula undergo e ho'āʻo ai e huai ae complications. Ma na hihia a pau, i ke alo o ka naau maʻi kākaʻikahi e loli ai i ka lōʻihi like 'ole o ka hoʻomanawanui ka ola.