Subclavian akwara. subclavian akwara syndrome

Subclavian akwara na-arịa na-ebu ọbara ha n'elu aka na ụkwụ nke ahụ mmadụ. Isiokwu a ga-atụle n'ụzọ zuru ezu na ihe niile isi banye n'eluigwe, nke isiokwu. Ị ga-amụta ihe ndị subclavian akwara syndrome na ihe ndị dị ya ọgwụgwọ e.

Gịnị bụ subclavian akwara?

The ọbara usoro bụ a mgbagwoju nke ndị dị iche iche intricacies nke veins, akwara, capillaries. Big okorobịa arịa na-anabatakwa ọbara si aortic njiko - subclavian akwara - ezo aka nile nke oké gburugburu nke ọbara mmadụ mgbasa. Ọ na-enye ọbara occipital ebe nke ụbụrụ, cerebellum, cervical òkè nke ọgidigi azụ, mọzụlụ, na akụkụ nke n'olu akụkụ, n'ubu-ọkiké na elu N'ịdị, nakwa dị ka akụkụ ụfọdụ nke ǹgụ na afo.

The ọdịdị ala nke subclavian akwara

Gịnị ka okwu ahụ "ọdịdị ala"? Nke a bụ nkịtị ọnụnọ ma ọ bụ ọnọdụ nke ihe ọ bụla na mmekọrita ụfọdụ ihe. Ka anyị tụlee ihe bụ ọdịdị ala nke subclavian akwara, ndị ọzọ okwu, ebe na na mmekọrita ihe ọ bụ. Ọ na-esite n'otu aka si brachiocephalic ogwe, na ndị ọzọ - si aortic njiko, bypasses onu ire na site oghere n'elu nke obi. The n'olu subclavian akwara bụ anya ebe nso ubu akwara plexus ma echekwara n'elu ala. Nke a na ọnọdụ nke arịa nwere ike ji mee ihe maka ịkwụsị ọbara ọgbụgba ma ọ bụ na o kwere omume ntinye nke ọgwụ. Next subclavian akwara eberede na onu, ọ na-aga n'okpuru clavicle na n'ime akpa abu, ebe ọ na-aghọ axillary ugbua. Mgbe ahụ, mgbe agafe akpa abu, ọ na-aga na ya n'ubu. The aha nke saịtị a - brachial akwara. Na n'ikpere aka ebe ọ diverges na okirikiri na ulna akwara.

Subclavian akwara catheterization. mgbapu

Dị ka anyị kwuru n'elu, na olu subclavian Vienna (na akwara kwa) ụgha n'elu. Nke a bụ ebe eji weghara na mgbapu catheter ntinye. Gịnị bụ bụkwanụ nke a akpan akpan oke nke arịa? E nwere ọtụtụ ibiere a nhọrọ na-:

1. Anatomical nnweta.
2. The kwụsie ike nke ọnọdụ na dayameta nke lumen.
3. Zuru ezu ma ọ bụ ịrịba size (dayameta).
4. ọbara ike ọsọ karịa ndị na-agba nke ọbara na veins nke nsọtụ.

Dabere na data depụtara n'elu, enyefe a akwara catheter ga na o siri ike na-emetụ na akwara mgbidi. Ọgwụ na-banyere ebe ya, ga-ngwa ngwa iru nri atrium na ventricle, ha na-eme ka na-arụsi ọrụ mmetụta hemodynamics. Ẹkenam n'ime subclavian akwara ọgwụ ngwa ngwa weere na ọbara, mgbe ọ bụghị iwe ime nke akwara. N'oge ụfọdụ, e nwere contraindications ịmapusị na catheter ntinye.

The ekpe ma ziri ezi subclavian akwara

Nke a arịa - a paired ngwa, dị ka e kwuworo, sị: nri subclavian akwara na ekpe. The alaka mbụ bụ kacha brachiocephalic ogwe, gbasara n'aka ekpe, ọ na-aga nke aortic njiko. Ọzọkwa, nke ikpeazụ dị 4 cm ogologo karịa nke mbụ. Right subclavian akwara onunu ọbara ụfọdụ ebe nke aka-nri-ya, ọ na-enye isi na obi. The ekpe subclavian akwara transports mmiri mmiri ụgbọelu bekee mkpa maka ndụ support, na n'aka ekpe ogwe aka.

Main ngalaba nke subclavian akwara

The ekpe ma ziri ezi subclavian akwara kpere edoghi any kere atọ isi ngalaba, ma ọ bụ ngalaba:

1. N'ebe guzobe nke subclavian akwara tupu abanye interscalene ọdịiche.
2. Division, nke bụ mmachi interscalene ọdịiche.
3. Na ụzọ ọpụpụ si na ọdịiche na interscalene axillary olulu.

Alaka nke nkebi mbụ nke subclavian akwara

Nke a na akụkụ nke isiokwu a ga-agwa a dị nta banyere otú anya subclavian akwara na alaka ya, ya bụ, ihe akụkụ nke arịa alaka. Si ya mbụ kaadị (mbara n'etiti n'ọnụ ụzọ interscalene nkeji na mmalite nke akwara) wezuga ọtụtụ alaka, ndị a bụ ndị bụ isi:

1. Vertebral akwara, steamroom. Ọ na-aga site na transverse usoro nke isii cervical vertebra. Ọ gara n'ihu na-ebili na adaghị cranial oghere site na azụ nke isi, ya bụ, site na ya onu. Ọ na-ahụ na-ejikọ na otu akwara nke-ọzọ, si otú akpụ basilar akwara. Gịnị bụ ọrụ nke vertebral akwara? The arịa ọnọde ọbara na ọgidigi azụ, ike occipital n'ọnụ ọnụ ụbụrụ na akwara.
2. The esịtidem thoracic akwara amalite na ala nke subclavian akwara. Channel ọnọde ọbara thyroid, diaphragm, bronchi, wdg sternum.
3. Schitosheyny ogwe. Ọ na-esite nso n'ime onu scalene muscle, esịmde a ogologo banyere 1-2 cm. Schitosheyny ogwe ekewa alaka na-enye ọbara na muscle na agụba n'olu, na akpịrị.

The ramifications nke abụọ na nke atọ na ngalaba nke subclavian akwara

Nke abụọ nke subclavian akwara mmachi interscalene ọdịiche nwere naanị otu alaka ụlọ ọrụ, a na-akpọ na onu-cervical ogwe. Ọ na-amalite na azụ nke subclavian akwara na-ekewa n'ime ọtụtụ alaka:

1. The kasị elu intercostal akwara (akwara pụọ a posterior alaka eduga ọbara ka uru ahụ nke azụ).
2. Ọkpụkpụ azụ arịa.
3. Deep n'olu akwara.

The atọ nkewa nke subclavian akwara na-nwere otu alaka - a transverse cervical akwara. Ọ na-emetụta izute brachial na ekewa:

1. Na -edozi akwara, nke na-enye ọbara ndabere uru.
2. Dorsal akwara nke agụba. Ọ tụlee ka a sara mbara azụ mọzụlụ, nourishes ya na ịbụ nso obere uru.
3. Deep alaka nke subclavian akwara.

E na-kọwara na-ezu ezu dị otú ahụ echiche dị ka subclavian akwara na alaka ya, ndị ozi ndị ọzọ pụrụ ịmụta site na ahụ ike na akwụkwọ.

Ekwe Omume ọrịa subclavian akwara

The isi ọrịa na-emetụta subclavian akwara na alaka ya - a ibelata nke lumen nke ọbara arịa, ndị ọzọ okwu, stenosis. Isi kpatara nke a na ọrịa bụ atherosclerosis subclavian akwara (lipid deposition na arịa mgbidi) ma ọ bụ thrombosis. Ọrịa a esiwak zụrụ, ma e nwere otu na congenital. Ihe ize ndụ ihe maka atherosclerosis nke subclavian akwara bụ:

1. Ọbara mgbali.
2. Ise siga.
3. Buru ibu, ibu oké ibu.
4. Diabetes na ụfọdụ ọrịa ndị ọzọ.

The ebutekarị stenosis nke subclavian akwara - a metabolic aghara na ụmụ mmadụ, etuto ahụ na mkpali Filiks. Ike owụt stenosis eduga a Mbelata ọbara ka dị oké mkpa akụkụ, e nwere ụkọ nke oxygen na nri na anụ ahụ. Ke adianade do, stenosis nwere ike ime ka ọrịa obi, akpan akpan ọrịa strok.

subclavian akwara syndrome

Erughị eru ọbara nwere ike mere ka ọ bụghị nanị na a na ihe mgbochi ka ọbara ruru ka occlusive-stenotic ọnya, kamakwa vertebral-subclavian "ezu". Nke a syndrome subclavian akwara, ma ọ bụ na-ezu ohi syndrome amalite na ikpe nke occlusion ma ọ bụ stenosis lesion na mbụ nke arịa. Nanị tinye, ọbara na subclavian ọwa anaghị igba si aorta na nke vertebral akwara, bụ nke pụrụ iduga ụbụrụ ischemia. The kasị elu ediyarade nke ọrịa mere site nkịtị ibu na elu na nsọtụ.

Mgbaàmà nke ọrịa:

1. Dizziness.
2. Awọ.
3. Bịara ikiri ọhụụ.
4. Akwara adịghị ike na otụk n'akụkụ.
5. Ibenata mmasi ma ọ bụ zuru ezu na enweghị a usu na otụk n'akụkụ.

Maka ozi ọzọ na subclavian akwara stenosis

Ego na mgbidi ọbara arịa, na-eduga na ibelata nke gara aga, nwere a lipid ndabere, ya bụ, n'ezie bụ nkwekọrịta nke cholesterol. Ndị a ego nwere ike belata lumen nke arịa ruo 80%, mgbe ụfọdụ ọbụna na kpamkpam clog ya. Tụkwasị na nke a na ihe na-eme ka ndị subclavian akwara stenosis, e nwere ndị ọzọ dị ka:

1. Irradiation.
2. Arteritis.
3. Mkpakọ ọrịamkpokọta.
4. Dị iche iche na ọnya, dị ka fibromuscular dysplasia et al.

Ọtụtụ mgbe, ndị mmadụ na-ata ahụhụ site na stenosis nke subclavian akwara, na ndị ọzọ na arịa na-emetụta. Ọ pụrụ ịbụ akwara ọwa, na nke ahụ bụ obi na carotid - akwara nke ala na nsọtụ. Ke ofụri ofụri dị otú ahụ na daa ọrịa, dị ka vasoconstriction lumen infestation ekpe subclavian akwara. Dị ka ọnụ ọgụgụ, ọ bụ ọtụtụ ugboro karịa nri.

Mgbaàmà mgbaàmà nke stenosis:

1. Adịghị ike na uru.
2. Mmetụta ike gwụrụ.
3. Pain ke n'elu aka na ụkwụ.
4. Necrosis nke mkpịsị aka.
5. Agba ọbara ke ntu ebe.

Ke adianade do, ike na-egosi ihe mgbaàmà nke neurologic agwa, ya bụ, na e nwere a "ezu": ọbara na-ibugharị nkịtị arịa nọ n'ógbè ihe. Mgbaàmà nke akwara ozi ọrịa:

1. Mkpọchị ọhụụ.
2. Loss nke nsụhọ.
3. okwu aghara.
4. Loss nke itule.
5. Dizziness.
6. ọnwụ nke ụjọ na ihu.

Olee otú na-emeso stenosis nke subclavian akwara?

stenosis ọgwụgwọ nwere ike nke ọgwụ na ahụ ike, ịwa ahụ na interventional. Isi ụzọ nke ọgwụgwọ - ya endovascular stenting nke subclavian akwara na carotid-subclavian uzo. Nke ikpeazụ usoro a na-atụ aro ka ndị mmadụ na hypersthenic physique na nke ọ bụ ike ime ka a mata ụzọ akwara ngalaba. Ọzọkwa, usoro a ọgwụgwọ na-atụ aro na a stenosis na akụkụ nke abụọ nke subclavian akwara.

Subclavian akwara stenting

Stenting - a ọgwụgwọ nke subclavian akwara site a obere mbepụ ke ikpa, 2-3 mm ogologo, mere ya site na mgbapu onu. Nke a na usoro ọgwụgwọ nwere ọtụtụ uru n'elu usiakidem, dị ka na-eme obere mmerụ ahụ na ahụ erughị ala. Ke adianade do, ọ bụ ihe kasị nwayọọ na ngwa-echebekwa ọgwụgwọ usoro nke subclavian akwara ẹnịm ke akpasarade ụdị, nke dị ezigbo mkpa n'ihi ọrịa.

stenting usoro fọrọ nke nta enweghi mgbu na-ewe ebe n'okpuru obodo Nkụnwụ. Nke a na ime ihe nwere ike dịkwuo vaskụla lumen iji pụrụ iche catheters na stents n'ụdị cylinders. Ikpeazụ - a cylindrical endoprosthesis laser bee si siri ike metal tube. Ngwaọrụ a n'elu a pụrụ iche balloon catheter na a abịakọrọ steeti a na-akpụ akpụ na subclavian akwara. Mgbe stent esịmde arịa constriction mpaghara, rụrụ ụfọdụ akara usoro metụtara nri nke ya na ọnọdụ. Mgbe nke ahụ gasịrị, ngwaọrụ mara n'okpuru elu nsogbu. Ọ bụrụ na ndị stent na-adịghị zuru ezu meghere, mgbe ahụ, ndị pụrụ iche òkè stented angioplasty catheter na a balloon ke n'ọnụ iji nweta ezigbo ihe. Iji ụbọchị, ọ bụ omume na-arụ ọrụ maka free, i nwere ike na-eme ya site na-na-na gọọmenti etiti oke. Ọrịa na yiri ọrịa ga ịkpọ dọkịta.

Ekwe Omume ize ndụ nke stenting

stenting usoro dịruru dị subclavian akwara banyere 2 awa. Nke a na ime ihe a rụrụ na ngalaba gbasara obi catheterization. Mgbe stenting natara ahụ mgbu, n'ihi na ebe ahụ subclavian akwara, na anụ ahụ na-incised, nwere ike ịpụta na-egbu mgbu, ma ọ bụrụ na ọ dị mkpa. Nsogbu si usoro bụ obere, n'ihi na onye ọrịa tupu ọ na-ọma zụrụ azụ na-nyochaa. Ma, ka ụfọdụ na-adịghị esi na ya pụta pụrụ ibilite bụ:

1. Allergy na-ọgwụ.
2. The mmeghachi omume na anestetiiki.
3. Minor ọbara ọgbụgba na saịtị nke mbepụ.
4. Okpomọkụ.
5. Isi ọwụwa.
6. Ofufe Ọrịa.
7. Air embolism.
8. Mmebi nke akwara ma ọ bụ ndị aorta mgbidi.
9. Thrombosis nke subclavian akwara.
10. Mbugharị nke stent.
11. Akwara ozi nsogbu et al.

Interventional ọgwụgwọ nke stenosis nke subclavian akwara site balloon angioplasty na stenting - a oge a minimally invasive na irè ọgwụgwọ ụzọ. Ha nwere a dị nnọọ obere oge mgbe na postoperative ụlọ ọgwụ.