Kwemithambo Subclavian. subclavian umfula syndrome

imithambo Subclavian zitya ukuba athwale igazi ukuba imilenze aphezulu emzimbeni womntu. Eli nqaku liza kuqwalaselwa ngokweenkcukacha zonke nezimaphambili ezingundoqo kwesi sifundo. Uza kufunda ntoni kwemithambo syndrome subclavian yaye ziziphi iinkalo zonyango kwakhe apho.

Yintoni kwemithambo subclavian?

Inkqubo yegazi yinto entsokothileyo nezo ezahlukeneyo imithambo yegazi, emithanjeni. guys isitya Big elifumana igazi ukusuka arch aortic - Umthambo subclavian - ibhekisa iimpahla kwisangqa enkulu nokuhamba kwegazi labantu. Unikeza iindawo Occipital igazi ebuchotsheni, kwiCerebellum, inxenye wesibeleko ze umnqonqo, izihlunu, amaqumrhu kwenxalenye entanyeni, umbhinqo egxalabeni kunye nemilenze, kwakunye ezinye iinxenye Isifuba kunye nesisu.

I-mphandle kwemithambo subclavian

Ntoni igama elithi 'ukuma'? Le ubukho yokoqobo okanye indawo nantoni ngokunxulumene kwezinye izinto. Makhe siqwalasele ukuba yintoni na isimo se kwemithambo subclavian, ngamanye amazwi, apho kwaye ngokunxulumene yintoni. Oku asuka kwelinye icala esiqwini brachiocephalic, yaye kwelinye - ukusuka arch aortic, bypasses enkcochoyini uphume emngxunyeni phezu kwesifuba. Kwemithambo Intamo subclavian na indawo ebonakalayo kufutshane kwegxalaba luvo plexus kwaye zigcinwe-sangqa kumphandle. Le indawo isitya ingasetyenziswa bokumisa ukopha okanye ukungena kwamayeza kunokwenzeka. Okulandelayo kwimithambo subclavian osimelela phezu ngohlangothi, udlula phantsi clavicle ukuya kwekhwapha, apho iba axillary kakade. Koko, emva acandacanda kwekhwapha, uyaphuma egxalabeni lakhe. Igama le site - umthambo brachial. Kule ndawo engqinibeni ukuba zohlukana phezu radius kunye ulna umthambo.

vein catheterization Subclavian. zokuhlatywa

Njengoko kukhankanyiwe ngasentla, kwi subclavian entanyeni eVienna (kunye Umthambo kakhulu) ubuxoki phezu komhlaba. Le ndawo kusetyenziselwa ukurekhoda kunye yokungena okuhlatywa catheter. Yintoni ingqiqo yale ukhetho oluthile isitya? Kukho iindlela ezininzi kule ukhetho zi:

1. ukufumaneka yokwakheka.
2. Uzinzo indawo apha le mithambo.
3. Ezoneleyo okanye kakhulu ubungakanani (ubukhulu).
4. flow kwegazi Velocity lidlula isantya igazi flow ngemithambo kweqondo.

Ngokusekelwe kwiinkcukacha ezichazwe ngasentla, kunikelwa ibe catheter umthambo ngenkankulu iyakusichaphazela udonga kwemithambo. Amayeza ukuba ungene ngalo; liya kukhawuleza ukufikelela intendelezo ekunene kwaye ventricle, benza igalelo nempembelelo esebenzayo kwi hemodynamics. Kwangena amachiza ndlela subclavian ezixutywe ngokukhawuleza kakhulu ngegazi, ngoxa bangabacaphukisi ngaphakathi umthambo. Kwezinye iimeko, kukho Izimo ukuba zokuhlatywa yaye catheter yokufaka umfanekiso.

Ekhohlo nasekunene umfula subclavian

Le inqanawa - ilungu bafundelane ngezibini, njengoko kutshiwo ngasentla: kwemithambo ekunene subclavian kwaye nasekhohlo. Isebe yokuqala brachiocephalic buti ngokupheleleyo, ngokubhekiselele ngasekhohlo, iya kuphuma Arch aortic. Ngaphaya koko, i-4 cm yokugqibela elide ngaphezu kuneyokuqala. Ekunene izinto Umthambo subclavian igazi kwiindawo ezithile ngesandla sokunene, unikeza intloko kunye nesifuba. Kwemithambo subclavian ngasekhohlo ohambisa izinto yenethiwekhi ulwelo ebalulekileyo inkxaso yobomi, kwingalo yasekhohlo.

amacandelo Main kwemithambo subclavian

Kwemithambo subclavian ekhohlo nasekunene kuphela lokungavinjwa yahlulwe kumacandelo aphambili amathathu, okanye icandelo:

1. Ukususela indawo lokusekwa kwemithambo subclavian phambi kokuba bangene umsantsa interscalene.
2. Division, nto leyo umsantsa interscalene elilinganiselweyo.
3. Ngelo ephumayo ukusuka umsantsa ukuya emhadini interscalene axillary.

Amasebe kwicandelo lokuqala kwemithambo subclavian

Le nxalenye nqaku liza uxelele kancinci malunga ukukhangela ngayo umthambo subclavian kunye namasebe ayo, oko kukuthi, yintoni iinxalenye amasebe isitya. Ukususela card lakhe lokuqala (ukuba isithuba phakathi emnyango lekhefu interscalene kunye ekuqaleni kwemithambo) zimke amasebe ezininzi, ezi ke ezona ziphambili:

1. Umthambo Vertebral, steamroom. Udlula inkqubo ezinqamlezayo le vertebra yesithandathu wesibeleko. Waphinda osuka yeyela kwisisu cranial ngokusebenzisa ngasemva intloko, oko kukuthi, ngenxa emngxunyeni wayo. Ngoko ke kanga kwemithambo elinye kwelinye icala, ngoko kusekwe kwemithambo basilar. Yintoni umsebenzi kwemithambo vertebral? Inqanawa usinika igazi umnqonqo, nzima abane-zobuchopho kunye nezihlunu.
2. Kwemithambo thoracic yangaphakathi iqala emazantsi kwemithambo subclavian. Channel usinika ndlala igazi, uvalo, bronchi, njl kwentamo.
3. esiqwini Schitosheyny. It asuka kufutshane engaphakathi kumngcipheko scalene kwezihlunu, ayafika ubude malunga 1-2 cm. Schitosheyny buti ihlukane kumasebe unikezele igazi esihlunwini kunye blade entanyeni, nomqala.

Le ramifications yeli candelo yesibini neyesithathu kwemithambo subclavian

Okwesibini ingxenye subclavian Umthambo interscalene limited msantsa uye isebe omnye kuphela, oko kuthiwa i buti buthelezi-wesibeleko. Iqala emva kwemithambo subclavian kwaye yahlulwe amasebe ezininzi:

1. Kwemithambo liphezulu intercostal (Umthambo kumka kule amasebe ngomva esa igazi izihlunu umva).
2. imikhumbi spinal.
3. entanyeni kwemithambo Deep.

Isahlulo sesithathu kwemithambo subclavian kwakhona enye isebe - a umthambo ezinqamlezayo wesibeleko. Bubalaselisa kumkhawulela brachial kwaye yahlulwe:

1. Umthambo phezulu, obubonelela igazi ukuba back izihlunu.
2. Amaphiko umfula ikhaba. Yehla ukuba ebanzi kwizihlunu umva, iwukhulise kunye nokuba kufutshane imisipha ezincinane.
3. isebe anzulu kwemithambo subclavian.

Kukho ichazwe ngokwenkcukacha ezaneleyo iingqiqo ezifana kwemithambo subclavian kunye amasebe awo, ulwazi olongezelelweyo nga elinesihloko esithi kwiincwadi zonyango.

izifo ezinokuba umfula subclavian

Eyona sifo ochaphazela kwemithambo subclavian kunye namasebe ayo - a licuthe le mithambo kwemithambo yegazi, ngamanye amazwi, stenosis. Esona sizathu sokuba esi sifo yamafutha kwemithambo subclavian (lipid nokufumba kwi emithanjeni) okanye thrombosis. Esi sifo amaninzi kuthengwa, kodwa ke kukho iimeko kunye bekhubazekile. Imiba yomngcipheko ngenxa yegazi kwemithambo subclavian zezi:

1. Kwegazi.
2. Ukutshaya.
3. Utyebile, ukutyeba.
4. Seswekile kunye nezinye izifo.

Unobangela uqhelekileyo stenosis kwemithambo subclavian - kuphazamiseka pathways ebantwini, nangezilonda kunye neenkqubo arhabaxa. Ngamandla wavakalisa kukhokelela stenosis ekuncitshisweni kwegazi amalungu omzimba abalulekileyo, kukho ukunqongophala ioksijini kunye mzimba emzimbeni. Ukongeza, le stenosis kungadala isifo sentliziyo, xa stroke ethile.

subclavian umfula syndrome

flow kwegazi ezingonelanga ingabangelwa nje kuphela umqobo igazi ngenxa ezitshangubeni occlusive-stenotic, kodwa vertebral-subclavian "ukuba". Le Umthambo syndrome subclavian, okanye bebe syndrome kwimeko occlusion okanye stenosis sisilonda esidumbileyoesingaphakathi kwindawo yokuqala isitya. Ngamafutshane, igazi kwisiteshi subclavian engaphenduli flow ukusuka aorta kunye kwemithambo vertebral, nto leyo inokukhokelela ischemia ebuchotsheni. Okubonakalisa eliphezulu esi sifo ebangelwe umthwalo ebonakalayo ngecala eliphezulu.

Iimpawu zesi sifo:

1. Nesiyezi.
2. Waluphele.
3. ukungaboni.
4. Muscle ubuthathaka kwicala abachaphazelekayo.
5. Unciphiso okanye ukungabikho ngokupheleleyo ukubetha kwentliziyo kwicala abachaphazelekayo.

Ukuze ufumane inkcazelo engakumbi malunga kwemithambo stenosis subclavian

Iidipozithi iindonga imithambo yegazi, ekhokelela licuthe elidlulileyo, kufuneka isiseko lipid, oko kukuthi, eneneni kukho yezabelo cholesterol. Ezi iidipozithi ungaxinanisa le mithambo benqanawa ukuya kwi-80%, ngamanye amaxesha wenza ucingo kude ngokupheleleyo oko. Ukongeza kule miba ibangela kwemithambo stenosis subclavian, kukho abanye ezifana:

1. Zokukhanya.
2. Arteritis.
3. syndromes ucinezelo.
4. izilonda ezahlukeneyo, ezifana fibromuscular dysplasia et al.

Amaxesha amaninzi, abantu abaphethwe stenosis kwemithambo subclavian, kunye nezinye iimpahla achaphazeleka. Isenokuba ngamajelo coronary, oko kukuthi intliziyo carotid - Umthambo kweqondo asezantsi. Ngokubanzi ne ngezifo ezifana, njengoko vasoconstriction sayo ohlaselo ngasekhohlo umthambo subclavian. Ngokutsho manani, kuba izihlandlo eziliqela kaninzi ngaphezu ekunene.

Iimpawu zesifo stenosis:

1. Ubuthathaka imisipha.
2. Ukuziva udiniwe.
3. Intlungu phezu kwesebe eliphezulu.
4. Necrosis neminwe.
5. Ukopha kule ndawo isikhonkwane.

Ukongeza, unako ukubonisa iimpawu unesimilo neurologic, oko kukuthi, kukho "ebe": igazi kwakhona empahleni abaqhelekileyo kwi kummandla ochaphazelekayo. Iimpawu zezifo luvo:

1. ukufiphala kwamehlo.
2. Ukulahleka lokuqonda.
3. nentetho engekho mgaqweni.
4. Ukuphelelwa eseleyo.
5. Nesiyezi.
6. ukulahleka koluvo ebusweni.

Indlela yokuphatha stenosis kwemithambo subclavian?

unyango stenosis be zonyango, zoqhaqho kunye interventional. Iindlela eziphambili kunyango - nto stenting endovascular le subclavian umfula kunye carotid-subclavian bypass. Le ndlela yokugqibela Kucetyiswa ukuba abantu nokuma hypersthenic apho kunzima ukubalaselisa kwisebe kwemithambo yokuqala. Kwakhona, le ndlela unyango ekhuthazwayo a stenosis kwi kwinxalenye yesibini kwemithambo subclavian.

Subclavian umfula stenting

Stenting - unyango lwe subclavian Umthambo ngokusebenzisa liqatywe encinane kakhulu eluswini, 2-3 mm ubude, wayenza kumngxuma okuhlatywa. Le ndlela unyango zinezibonelelo eziliqela phezu kotyando, njengoko wenza ukwenzakala ngaphantsi kuhlolwe. Ukongeza, kuba indlela unyango kakhulu emyoli organ-kugcinwe apho kwemithambo subclavian igcinwe kwimo yalo yantlandlolo, leyo ibaluleke kakhulu umguli.

Inkqubo stenting phantse yalula kwaye kwenzeka phantsi Ukubulawa yasekuhlaleni. Lo msebenzi kungandisa sayo olujikeleza usebenzisa catheters ezizodwa kunye stents ngohlobo cylinder. Last - a endoprosthesis laser zezindlu wonqanyulwa, ukusuka okuqinileyo ityhubhu metal. Esi sixhobo ukhwele ibhaloni catheter ezizodwa zikarhulumente zixinaniswe ihambela kwi kwemithambo subclavian. Xa stent lufika ummandla isitya constriction, kwenziwa ezinye iinkqubo zolawulo ezinxulumene ilungelo kwindawo yayo. Emva koko, lo isixhobo echazwa phantsi koxinzelelo oluphezulu. Ukuba stent ayenziwanga ngokwaneleyo kuvulwa, ngoko ke isabelo ezizodwa angioplasty stented catheter kunye ibhaluni kwi kwincam ukuba bazuze iziphumo ezigqwesileyo. Ukuza kuthi ga ngoku, ukuba unako ukwenza i operation for free, ungakwenza oko ngokuthi afumane quota federal. Ezinesifo efanayo kufuneka udibane nogqirha.

iingozi ezinokwenzeka of stenting

stenting inkqubo ihlala Umthambo malunga subclavian malunga neeyure ezi-2. Lo msebenzi wenziwa kwisebe catheterization intliziyo. Emva stenting ntlungu ezifunyenweyo, ngenxa yokuba indawo apho kwemithambo subclavian, kwaye izicwili ke zona, ukuze babonakale buhlungu, xa kukho imfuneko. Iingxaki evela inkqubo zinqabile, ngenxa yokuba isigulane phambi kokuba baqeqeshwe kakuhle yaye kubekwe esweni. Kodwa ezinye nesohlwayo ukuze kuvela:

1. Aleji ukuthatha amayeza.
2. Indlela abasabela ngayo iintlungu.
3. ukopha Minor kwisiza liqatywe.
4. Iqondo lobushushu.
5. Intloko ebuhlungu.
6. Gciwane.
7. Embolism Air.
8. Ukonakala kwemithambo okanye udonga aorta.
9. Thrombosis kwemithambo subclavian.
10. Yokufuduka kulo stent.
11. iingxaki luvo et al.

unyango Interventional of stenosis kwemithambo subclavian ngebhaloni angioplasty kunye stenting - a iindlela zale mihla unyango kancinane ezonakalisayo kunye ngempumelelo. Zinelungelo ixesha elifutshane kakhulu kunye nokulaliswa esibhedlele postoperative.