Pulmonary eVienna. ngemithambo Anomalous pulmonary

Pulmonary Vienna (umfanekiso eboniswe ngezantsi) - inqanawa ezisa igazi esimbaxa is ahlanganiswe ioksijini emiphungeni ukuya intendelezo ngasekhohlo.

Ukuqalisa evela emithanjeni pulmonary bahlanganisane kwezo zitya imithambo ngaphezulu ithunyelwa bronchi, ngoko ziqwempu amaqhezu, kunye nemiphunga iziqu ezinkulu kwesango kwakhiwa (ezimbini ingcambu ngamnye) ukuba ibhekiswe tye kwi kwinxalenye engentla intendelezo ekhohlo. Ukongeza, ngamnye imiphanda ukungena kwi indawo eyahlukileyo: ekhohlo - kwicala lasekhohlo intendelezo ekhohlo kwaye ekunene ukusuka ekunene. imithambo Ekunene pulmonary, emva atrial (ekhohlo) transversely phambana intendelezo ekunene (emqolo).

pulmonary engaphandle (ekunene) Vienna

Senziwe izahluko ndlela segmental ye esithinzini emiphungeni oluphakathi kunye eliphezulu.

• R.apicalis (apical yesebe) - fanekisela isiqu mfutshane lwemithambo, nto leyo ifumaneka kwi nomhlehlo elingaphezulu (mediastinal ubuso bawo) yaye igazi kwincam ingxenye. Phambi engena ekunene ndlela pulmonary ophezulu edibene rhoqo segmental (ngasemva) isebe.
• R. ngomva (isebe diff) ephethe ukuqokelelwa igazi umbuzo ongasemva. Eli sebe - kakhulu kuzo zonke imithambo big Vienna (segmental), apho zifumaneka nomhlehlo eliphezulu. Kule isikepe iindawo ezininzi ekwanti: vnutrisegmentarny poddolevoy icandelo kunye kwicandelo eqokelela igazi interlobar kobuso slits elibhalwe ngokumileyo.
• R.anterior (sebe ngaphambili) ephethe igazi eliphezulu yokuqokelela share (okanye cipande ingxenye). Kwezinye iimeko, kunokwenzeka ukuba oludibanisa amasebe ngaphambili nangesemva (ukuba awela buti eqhelekileyo).
• R.lobi medii (ophakathi lobe yesebe) wamkela igazi evela ziqwempu lung ekunene (avareji yawo). Kwezinye iimeko, oku kuthatha uhlobo omnye eVienna umphanda kwaye aqukuqela endlini ephezulu ekunene umthambo yemiphunga, kodwa isitya amiliswe ngamacandelo amabini: medial kunye osecaleni kwiidreyini ngokulandelelana ziqwempu medial and lateral.

pulmonary Lower (ekunene) Vienna

Le nqanawa kuthatha igazi nomhlehlo asezantsi (ziqwempu yayo 5) kwaye ekungeneni eziphambili ezimbini: umthambo carcinomas isebe eliphezulu eqhelekileyo.

Isebe eliphezulu

Kuxhomekeke phakathi carcinomas inxalenye aphezulu. Luqokelelane ukusuka yegazi ezongezelelweyo aphambili, kufuneka ube phambili kwaye phantsi, bedlula emva segmental bronchus apical. Eli sebe lo phezulu yonke engenanto kwi Kwangale asezantsi ekunene miphungeni.

Ngako yomoya eVienna iquka ekungeneni ezintathu eziphambili: osecaleni, medial eliphezulu, ibekwe uninzi intersegmental kodwa ingasebenza kunye vnutrisegmentarno.

Ngenxa ezongezelelweyo vein ephumayo igazi kuthwalwa abangakwaziyo eliphezulu (encopho yayo) kwingingqi poddolevuyu segmental ndlela diff lobe ephezulu (ngomva ingxenye yayo).

Carcinoma iyonke Vienna

It is a isiqu emfutshane lwemithambo, kwenziwa kudibana yegazi ezisezantsi neziphezulu carcinomas amasebe eziphambili leyo alale phezu ngakumbi imbonakalo efanayo.

Carcinoma top eVienna. Akhiwa ngokudibana yegazi segmental inkulu carcinomas imithambo ethumela igazi evela medial, cipande kunye namacandelo lateral.

ngezantsi carcinoma eVienna. Okuqhotyoshelwe kule ndlela jikelele carcinomas ukusuka kumphezulu wayo esezantsi umva. Eyona ekungeneni wesingxobo - carcinomas yesebe ngomva eqokelela igazi carcinomas ngomva ingxenye. Kwezinye iimeko, le carcinomas yaseVienna asezantsi bangaya phezulu Kusenjalo Uhlobo Lokuqala.

ADLV

Sisifo sentliziyo naso apho isahlakalo ibanjiwe neanatomichnoe imithambo pulmonary ukuya intendelezo (ekunene), okanye ziqukwe wakutshanje kuphando lwe-cava Vena.

Le ngezifo ihamba semiphunga rhoqo, ukudinwa, ukuphelelwa umoya, ukubambezeleka lophuhliso ngokwasemzimbeni, iintlungu intliziyo. Njengoko noxilongo asetyenziswa: ECG, MRI,-X-reyi, catheterization kwentliziyo, ultrasound, kwaye atriografiyu ventrikulo-, angiopulmonography.

siphene unyango Surgical ixhomekeke kuhlobo yayo.

Overview

ADLV - isiphako naso kwaye imalunga 1.5-3.0% of iziphene intliziyo. Uninzi waphawula kwizigulana eyindoda.

Amaninzi kule isiphene kudityaniswe okweqanda (open) window kunye neziphene ekudibaneni phakathi ventricles. Kancinane ngaphantsi (20%) - egazini buti eqhelekileyo, hypoplastic kwicala lasekhohlo wentliziyo, VSD, dextrocardia, tetralogy ka Fallot, kunye transposition iimpahla ezinkulu, jikelele intliziyo ventricle.

Ukongeza kwezi iziphene, soloko ilandelwa ADLV extracardiac ngezifo: hernias enkabeni, iziphene uluhlu amathambo kunye neenkqubo yonyango, diverticula isisu, intsimbi yehashe kidney, isifo sezintso polycystic kunye hydronephrosis.

Classification anomalous pulmonary semibhobho lwemithambo (ADLV)

Kwimeko ekudibaneni yegazi kwi kwegazi okanye intendelezo ekunene, le isiphene kuthiwa umsele epheleleyo anomalous, ukuba kubume ngasentla eliya omnye okanye mithambo ezimbalwa, kukho isiphene eso kuthiwa buso.

Ukungqinelana inqanaba ekudibaneni kubabela ezinye iindlela ezigqibeleleyo zibe lishumi elinane;

• lobeko lokuqala: nadserdechny (suprakardialny). Le mithambo pulmonary (ezifana buti okanye eyahlulweyo) ingena cava Vena eliphezulu okanye amasebe awo.
• Option ezimbini: intliziyo (intracardiac). ngemithambo pulmonary likhanyelwe kwi sinus coronary okanye intendelezo ekunene.
• ATHUNYIWEYO Okwesithathu: podserdechny (infrared okanye subcardial). ngemithambo pulmonary ngenisa portal okanye Vena cava elisezantsi (ngaphantsi kakhulu duct emithanjeni).
• Ukhetho wesine: kuxutywe. ngemithambo pulmonary ifakiwe izakhiwo ezahlukeneyo kumanqanaba ahlukeneyo.

iimpawu hemodynamics

Esibelekweni siphene esebenzayo ngokuqhelekileyo ezingabonwayo, ngenxa awohluke ejikeleza Palsy. Emva kokuzalwa kosana mpawu hemodynamic zichazwa kule isiphene kunye idityaniswe yayo kunye nezinye okungahambi bekhubazekile.

Kwimeko iyonke yokuhambisa amanzi anomalous ukuphazamiseka hemodynamic wavakalisa hypoxemia, ukucima kombane hyperkinetic intliziyo ekunene kunye noxinzelelo lwegazi nezengekho miphungeni.

Kwimeko hemodynamics yokuhambisa amanzi buso efanayo naleyo abane ASD. Indima ekhokelayo fanele ukuba ukutyeshelwa shunt ezingaqhelekanga arteriovenous, nto leyo ekhokelela ukuba ukwanda umthamo wegazi kwisangqa encinane.

Iimpawu anomalous yamanzi pulmonary lwemithambo

Kids kule isiphene badla ubunzima izifo ezihlasela zosulele nezolo yokuphefumla wentsholongwane egazini kunye nenyumoniya, bathi khohlo, libya ukutyeba, tachycardia, ukuphelelwa umoya, iintlungu intliziyo, cyanosis ukukhanya nokudinwa.

Kwimeko lwegazi yemiphunga kubonakala yobudala amancinci kubonakala ukusilela intliziyo, wavakalisa cyanosis kunye elisemqolo intliziyo.

ekuxilongweni

Umfanekiso auscultation e ADLV efanayo ASD, oko kukuthi ezakheke ingazinzi ingxolo iSystolic auscultated kwi projections of imithambo yegazi (imithambo pulmonary) kunye kukwahlukana ithoni 2.

• Imiqondiso ECG of tye na intliziyo omninzi, ecaleni eos yaye kuvalwe ekunene (incomplete result), bundle kwibhloko yesebe.
• Xa iimpawu phonography lwe ASD.
• Xa ray bafumane ukukhanya ipateni equmbile pulmonary (arc wayo), ukwandisa ilungelo imida kwentliziyo, "Turkish saber" uphawu.
• Echocardiography.
• Eqonda ukuqanda inhliziyo.
• Venography.
• Atriografiya (ekunene).
• Angiography.
• Ventriculography.

uxilongo mahluko kule isiphene kufuneka lwenziwe:

• Lymphangiectasia.
• atresia Aortic / valve mitral.
• imikhumbi transposition.
• stenosis Mitral.
• Stenosis le ekunene / ekhohlo mithambo miphungeni.
• Trehpredserdnym intliziyo.
• ASD qwaba.

unyango

Iintlobo zotyando sesixokelelwano ngokuyinxenye emiselwe mnye, ezigqibeleleyo, ubungakanani kunye nendawo ASD.

umyalezo Atrial ukususa usebenzisa iplastiki okanye suturing ASD. Iintsana ukuya kutsho kwiminyaka elishumi ezintathu belimele ezibalulekileyo, enze uqhaqho lokudambisa (atrioseptotomiyu closed), olujoliswe ekwandiseni unxibelelwano interatrial.

Iyonke ulungiso siphene olukhulu (iifom total) ibandakanya zazo ezininzi.

• Tubal izithuba yezifo imithambo yegazi.
• Ukuqhela yegazi miphungeni.
• Ukuvalwa ASD.
• Anastomosis phakathi intendelezo ngasekhohlo ngemithambo nezengekho miphungeni.

Le ngenxa imisebenzi enjalo kungaba: ukwanda pulmonary lwegazi syndrome yaye ukusilela sinus node.

uqikelelo

I-ALS lekhosi zendalo kule isiphene esibi, ukususela-80% yezigulane kufa kwisithuba kunyaka wabo wokuqala bezelwe.

Izigulane ne phambi kutsalwe kwenxenye ungaphila ukuya kwiminyaka engamashumi amathathu. Ukufa izigulane ezinjalo kakhulu unxulunyaniswa izifo pulmonary, okanye ukusilela ezinzima.

Iziphumo of ulungiso unesiphako ngokufuthi iyanelisa, kodwa lethality lweentsana ngexesha okanye emva kotyando iphezulu.