Imirhoba yimizila yegazi apho izondlo ezinegazi kunye ne-oxygen ezityebi zijikeleza kwizitho ezinjengeentliziyo, intliziyo kunye nengqondo. I-oksijeni kunye nezondlo zibalulekile ekusindeni kwayo yonke into enomzimba.
Iingqungquthela eziphambili ezenza igazi kwingqondo yimizobo ye-carotid ne-vertebral. Naliphi na ingxaki ngokuhamba kwegazi kule mingcipheko ingabangela ukubetha.
Uhlobo olungaqhelekanga lwesiphako semithambo, olubizwa ngokuba yimisipha yomzimba, lunokubangela ukubetha.
Yisiphi isisombululo seArterial?
Ukuphazamiseka kwamagciwane kubhekiselele kwinto engavamile, kwaye ngokukhawuleza, ukubunjwa kweengqumbo ngaphakathi kwodonga lwangaphakathi lomthi. Njengoko iinyembezi ziba zikhulu, zenza isikhwama esincinci apho oogqirha babiza ngokuthi "lumen yangamanga." Igazi eliqokelela ngaphakathi kweli lumen lamanga lingakhokelela ekubetheni kwindlela elandelayo:
- Amachibi egazini ngaphakathi kwodonga lomthi wada waqala ukuphazamisa ukuhamba kwegazi. Ipulazi ekhulayo yegazi eludongeni lomthambo ubizwa ngokuba yi "pseudoaneurysm." I-pseudoaneurysms ingakhokelela kwiimpawu zokubetha ngokunyanzela kwizakhiwo zobuchopho ezikufuphi. Ziyakwazi ukugqithisa kwaye zibangele ukuphuma kwegazi enkulu kwingqondo (izibetho ezinzima). Xa oku kwenzekayo, i-pseudoaneurysm ibhekiselwa "njenge-dissecting aneurysm" okanye "idibanisa i-pseudoaneurysm."
- Igazi ngaphakathi kwe-lumen yamanga inokuthi iguqulwe kwaye yandise ngokukhawuleza kwingingqi apho igazi lihamba ngokuqhelekileyo. Oku kunokunciphisa okanye ukuphazamisa ngokupheleleyo ukuhamba kwegazi kwingxenye yengqondo.
- Amancinci amancinci kwi-blood clot ekhulayo angakwazi ukupheka, agijime ngaphesheya, aze afakwe ngaphakathi kwintsimbi encinci engqondweni. Esi siganeko saziwa ngokuba "umthambo-to-artery thromboembolism."
Ukuchithwa kwe-Arterial inexanduva elingaphantsi kwama-2 ekhulwini kuwo onke amanxeba. Nangona kunjalo, i-akhawunti yokudibanisa i-akhawunti yokufikelela kwikota enye yazo yonke imivimbo ebantwini abancinci nabangaphakathi.
Unyaka ngamnye eUnited States, phakathi kwabantu abayi-12 000 no-15,000 bachaphazelekayo ngokuchithwa ngokukhawuleza kweerarotic okanye i-vertebral arteries.
Iimpawu
Izimpawu eziqhelekileyo ziquka:
- Ubuhlungu kumnye okanye kumacala omabili entanyeni, ubuso, okanye intloko
- Iintlungu zeso, okanye omnye umfundi omncinane ongaqhelekanga
- Ikhosidi ye-droopy okanye umbono obini
- Ukungakwazi ukuvala iliso elinye
- Utshintsho olukhawulezileyo lokukwazi ukunambitha ukutya
- Ukubetha ezindlebeni, isiyezi okanye i-vertigo
- Ukukhubazeka kwanoma yiphi imisipha yentamo kwaye ubhekane kwicala elinye
Iimpawu zesifo okanye ukuhlaselwa kwe-ischemic esingaphantsi kwexesha kunokuvela iintsuku ezimbalwa kwiiveki ezimbalwa emva kokuqala kweminye impawu echazwe ngasentla.
Izizathu
Imithambo ye-carotid kunye ne-vertebral ingonakaliswe ngengozi yentamo okanye kwintamo. Ezi zilandelayo ziimeko ezithile ezidibaniswe ne-dissection ye-artibrate ne-vertebral arteries:
- Ukwandiswa kwekhasi ngexesha lokuhlamba iinwele kwibala lembali
- Ukuphathwa kwe-Chiropractic entanyeni
- Ukulimala kweWiflash
- Ukuphazamiseka okungenangqondo entanyeni
- Ukwandisa intanyeni ngexesha le-yoga
- Ukudweba isilingi
- Ukuqhwala, ukuhlanza nokucoca
- Ukwandiswa kweNeck ngelixa ufumana umlomo ngomlomo ngexesha lokuvuselela i-cardiopulmonary (CPR)
Ukutshatyalaliswa ngokungaqhelekanga kwemibhobho ye-carotid kunye ne-vertebral yiyona nto ibangela ingozi yesiqhelo.
I-dissection ngokukhawuleza ibhekiselele kwisiphazamiso sokusasaza esingenaso isizathu esifikiweyo. Ukuphazamiseka kwemithambo ye-carotid kunye ne-vertebral iyakwenzeka ngokukhawuleza ngokubambisana nezi zilandelayo zifo:
- I-Marfan's syndrome
- Isifo sezintso zePolycystic
- Osteogenesis imperfecta
- I-fibromuscular dysplasia
Ukuxilongwa
Uvavanyo oluqhelekileyo olusetyenziswa ukuxilonga i-dissection ye-carotid okanye umthambo we-vertebral yi-angiogram. Kule vavanyo, idayi eyahlukileyo ifakwe ngaphakathi kwimiba yeerteries eyenza igazi kwingqondo. I-x-ray isetyenziselwa ukujonga ukuma kweempawu ze-carotid kunye ne-vertebral njengokuba idayi ihamba kuwo (jonga umfanekiso).
I-dissection ifunyaniswa xa i-angiogram ibonisa umzobo obonakala ukwahlukana kwiindawo ezimbini ezihlukeneyo, enye yazo ichazwa ngokuba 'yi-lumen yenkohliso' (ichazwe apha ngezantsi.) Xa i-dissection inzima kangangokuba ikhusela ngokupheleleyo igazi elichaphazelekayo umzobo, idayi igxotha kwaye iphela kwinqanaba apho i-artery ivalwe ngokupheleleyo. Xa i-dissection ibangela i-pseudoaneurysm, i-angiogram ibonisa ukuqoqwa kwedayi ngaphakathi kwodonga lwe-artery echithwe.
Ezinye iimvavanyo ezisetyenziselwa ukuxilongwa kwe-carotid kunye ne-dissection ye-vertebral ziquka i-acontic resonance angiography (MRA), kunye ne-duplex ultrasound.
Unyango
I-carotid kunye ne-vertebral artery dissection inokuphathwa nge-heparin, iyeza elithintela ukwandiswa kwe-clot yegazi kwindawo yokuchithwa. I-Heparin yonyango. Xa lixesha lokuphuma esibhedlele, iCoumaden (i-warfarin) igazi elincinci elingathathwa ngomlomo.
Ngokuqhelekileyo, umntu ophumayo kwi-dissection ye-arterial dissection kulindeleke ukuba athathe i-bloodline ye-prescription yeenyanga ezi-3 ukuya kwezi-6. Nangona kunjalo, ukuba iimvavanyo zokulandelela azibonakali uphuculo olulandelayo emva kweenyanga ezi-6, amayeza anqunywe ixesha elide. Ukuba akukho nto iphuculweyo, utyando okanye i-balloon engioplasty kunye ne-stenting enye inokukhetha.
Ukubuyisela
Uninzi lwabantu abanobuhlungu obunxulumene nokuchasana kwamagalelo abuye abuyele kakuhle. Enyanisweni, abangaphantsi kwama-5% abo banesigxina sokuguqulwa kwamagciwane bayafa ngenxa yesiganeko. Ngaphezu kwe-90% yamatyala apho i-artery carotid igxininiswe ngokukodwa, kwaye ngaphezu kwama-66% amacala apho ivalwe ngokupheleleyo yi-dissection, isombululo kwisithuba seenyanga ezimbalwa emva kokuba iimpawu zifumaneke. Kwezinye iimeko, intloko eqhubekayo ingase ihlale iiveki ezimbalwa okanye iinyanga ezimbalwa.
Ama-Aneurysms anxulumene ne-dissection ayengaze aphule, kodwa anokukhokelela ekubunjweni kwegazi kunye ne- stroke ye-thromboembolic kwiimeko ezingaqhelekanga.
ILizwi
Ukuchithwa kwe-Arterial kuyinto imeko enzima. Kodwa ngolawulo lwezonyango, abaninzi abantu abanokuphikisana kwamagciwane baphila kwaye baqhuba ukwenza kakuhle. Ukuba wena okanye othandekayo uye waba ne-stroke ebangelwa ukuchasana kwamagciwane, nawe uya kufuna ixesha elithile lokubuya kwi-stroke. Ukulungiswa kwesisu kudla ngokufuna ukuthatha inxaxheba, kwaye unokuba ukhathala, kodwa uza kubona ukuphucula nokuphucula njengoko ixesha liqhubeka.
> Imithombo:
> Ukuchithwa kwe-septum ye-interventricular: i-Echocardiographic, i-X X, i-Y, i-Luan S, i-Zhao Y, i-Sun L, i-Zhang H, i-Nixon JV, i-Medicine (i-Baltimore). Ngo-2017 Mar; 96 (10): e6191