Rikicin yaduwar abu yana faruwa a yayin da bango na cikin jiki (babbar magungunan jiki) tasowa hawaye, wanda ya ba da damar jini ya shiga bango na jirgin ruwa, rarraba (ko ya rabu da) sassan bango. Rashin fashewar iska zai iya haifar da rauni mai yawa zuwa gabobi daban-daban da mutuwa mai saurin gaske, kuma ya kamata a riƙa la'akari da shi azaman gaggawa.
Dalilin
Rikicin yakamata yana faruwa a yayin da murfin baya na bango na jikin ya zama raunana, yana barin hawaye ya zama.
Wannan raunana yana hade da hawan jini . Haka kuma za'a iya ganinsa tare da cututtukan nama na haɗuwa irin su scleroderma da kuma ciwo na Marfan, ciwon Turner, ciwo na Ehlers-Danlos , raunin cututtuka (kamar yadda ya faru da Princess Diana), tare da kumburi da jini. Rawanin yakamata yana haifar da amfani da cocaine.
Bambanci mai yaduwa yafi yawan gani a cikin mutane tsakanin shekarun 50 zuwa 70 kuma yana faruwa sau da yawa cikin maza fiye da mata.
Abin da ke faruwa tare da Harkokin Cutar Aortic
Lokacin da yaduwar iska ta auku, jini yana tafiya a ƙarƙashin matsa lamba mai karfi a cikin bango na fadin, yana kawar da sassan launi. Hanyoyin jini mai yawa na iya shiga cikin bango mai kwalliya, kuma wannan jini ya ɓata zuwa tarwatsawa - kamar dai yadda jini ya faru. Ruwan yaduwa zai iya tafiya tare da tsawon lokaci, wanda ya rufe tasoshin jini wanda ya tashi daga kwari kuma yana haddasa lalata gabobin da aka bayar da waɗannan jini.
Rashin fashewar wani abu zai iya haifar da rudani mai tsafta , maye gurbi , ƙananan cututtuka , nakasar cututtukan zuciya, koda koda , da kuma zubar da jini gastrointestinal . Bugu da ƙari, raguwa na ruwa zai iya rushe dabbar ta gaba ɗaya, wanda zai haifar da zub da jini na ciki.
Saboda wadannan dalilan da suka sa mace da mace tare da raguwa ta hanyar kwalliya, ko da tare da saurin yaduwa da sauri, yana da yawa.
Cutar cututtuka
Yawancin lokaci, rikitarwa ta hanyar motsa jiki yana haifar da kwatsam mai mahimmanci, mai tsanani, "ciwo" zafi a cikin kirji ko baya, wanda sau da yawa yana haskakawa cikin ciki. Cikin baƙin ciki zai iya haɗawa tare da syncope (asarar sani), ta takaitacce mai tsanani, ko kuma ta hanyar bayyanar cututtuka na bugun jini . Kullum, bayyanar cututtuka da rarrabuwa mai kwakwalwa suna tsoratarwa da tsanani sosai cewa akwai ƙananan tambayoyin a cikin damuwa game da ko an gaggawa taimakon gaggawa.
Jiyya
Jiyya ya dogara ne da wane ɓangare na aorta da ke cikin, kuma a kan yanayin mai haƙuri.
A cikin dukkan lokuta, marasa lafiya da rikitarwa mai kwakwalwa suna kaiwa ɗakin kulawa mai kulawa sosai kuma an saka su a kan magunguna masu magunguna (yawanci tare da nitroprusside ) da nufin rage karfin jini . Rage karfin jini zai iya rage jinkirin ci gaba na bango na lalata.
Wadannan marasa lafiya suna ba da beta blockers (ko dai propranolol ko labetalol) don rage yawan zuciya, kuma don rage ƙarfin kowace bugun jini. Wannan mataki kuma yana nufin ƙayyade ƙaddamarwa.
Da zarar an tabbatar da alamun alamun haƙuri cikakke, ana yin nazari na hoto (mafi yawancin CT scan ko MRI ) don cikakke ma'anar ɓangare na alamar.
Dangane da wurinsa, an laƙaɗa rarraba ko dai tace A A ko Type B.
Rubuta A Dissections. Rubuta An rarraba fassarar aorta mai hawa (farkon ɓangaren da ke bada jini ga zuciya, kwakwalwa, da makamai). Rubuta An yi amfani da tsararraki tare da gyaran gyare-gyaren gyare-gyare, wanda yawanci ya kunshi cire ɓangaren ɓarna na lalata kuma ya maye gurbin shi tare da takalmin dacron. Idan ba tare da tiyata ba, waɗannan marasa lafiya suna da mummunan haɗari ga rikice-rikicen kwalliya, ƙaddarar ƙwayar cuta ko bugun jini, kuma yawanci sukan mutu daga irin wannan rikitarwa. Tiyata yana da wahala da rikitarwa, duk da haka, kuma hadarin mutuwa tare da tiyata yana da kusan 35%.
Anyi amfani da tiyata don Rubutun Aiki saboda lalacewar ya fi girma tare da aikin likita.
Rubutun B Dissections. A cikin B na B, an rarraba rarrabuwa a fadin aorta (ɓangaren sashin da ke gaban gaban spine kuma yana bada jini ga gabobin ciki da kafafu). A cikin waɗannan lokuta, mace-mace ba shine mafi kyau ba - kuma zai iya zama mafi girma - tare da tiyata fiye da kulawa. Saboda haka jiyya mafi yawanci yana kunshe da ci gaba da likita, wato, ci gaba da matsa lamba na jini da kuma beta blockers. Idan shaidar ta haifar da lalacewar kodan, ƙwayar hanji, ko ƙananan ƙarancin , duk da haka, tiyata zai zama dole.
Ajiyewa Daga Kayan Kwance Aortic
Bayan da aka magance mummunan yaduwar cutar ta jiki, dole ne mai karbar zuciya ya ci gaba da kasancewa a kan beta blockers ga sauran rayuwarsa, kuma kyakkyawar kulawar jini yana da dole. Maimaita maimaita MRI da aka yi kafin zuwan asibiti, karin lokuta fiye da shekara ta gaba, kuma kowannensu zuwa shekaru biyu bayan haka. Wannan kuskuren ya zama dole saboda, rashin alheri, game da kashi 25 cikin 100 na wadanda suka tsira daga rashawa na duniya zasu buƙatar sake yin aikin sakewa domin sake fashewar tashin hankali a cikin 'yan shekaru masu zuwa.
Saboda rikitarwa aortic ya zama akalla canzawar rayuwa idan ba na mutuwa ba, yana da mafi kyau don hana shi fiye da bi da shi. Zaka iya rage ƙananan ku na ciwon dissection ta hanyar kulawa da hankali ga cututtukan ƙwayar zuciya , musamman hauhawar jini, da kuma yin aiki da haɓaka don inganta bayanin martabar ku.
> Sources:
> Hiratzka LF, Bakris GL, Beckman JA, et al. 2010 ACCF / AHA / AATS / ACR / ASA / SCA / SCAI / SIR / STS / SVM Jagora Don Bincike da Gudanarwa ga Marasa lafiya Da Ciwon Cutar Daji na Thoracic: Rahoton Cibiyar Kasuwanci ta Ƙasar Amirka da Cibiyar Harkokin Kasuwancin Amirka ta Aminci Jagoran, Ƙungiyar Amirka don Tashin Ƙasa, Cibiyar Harkokin Labaran {asar Amirka, {ungiyar Harkokin Lafiya ta {asar Amirka, {ungiyar Harkokin Kwayoyin Tsarin Lafiyar Nahiyar Amirka, {ungiyar Harkokin Lafiya ta Duniya da Harkokin Tsarin Mulki, Cibiyar Harkokin Tsarin Harkokin Ci Gaba da Cibiyar Harkokin Tsarin Harkokin Cutar Kasuwanci, Cibiyar Nazarin Siyasa ta Thoracic, da Cibiyar Nazarin Yammaci. Yanayi 2010; 121: e266.
> LeMaire SA, Russell L. Epidemiology na Thoracic Aortic Dissection. Nat Rev Cardiol 2011; 8: 103.
> Melvinsdottir IH, Lund SH, Agnarsson BA, et al. Abinda ke faruwa da kuma rashin mutuwa daga ƙwararrun kwayar cutar ƙwararrun ƙwayoyi: sakamakon daga binciken dukan al'umma. Eur J Cardiothorac Surg 2016; 50: 1111.