Umthambo Subclavian. subclavian Umthambo syndrome

imithambo Subclavian ziyizitsha ukuthi athwala igazi ukuba nasemilenzeni engenhla yomzimba womuntu. Lesi sihloko kuzoxoxwa ngokuningiliziwe yonke imiqondo eyisisekelo isihloko. Uzofunda lokho subclavian Umthambo syndrome ne Yiziphi izici ayokwelashwa khona.

Uyini Umthambo subclavian?

Ihlelo lokukhambisa iingazi kuyinto eyinkimbinkimbi nobunyonici ezihlukahlukene imithambo yegazi, ama-capillary. Big guys isitsha uthola igazi lwaleli yomthambo i-aorta - Umthambo subclavian - libhekisela izitsha oyibanga kwabantu kwegazi. It usinikeza igazi occipital izindawo zobuchopho, cerebellum, ingxenye wesibeletho we umgogodla, imisipha, kanye nezinhlaka entanyeni ingxenye, ibhande ehlombe futhi esitho elingenhla, kanye izingxenye ezithile thorax kanye esiswini.

Ukuma kwendawo yendlela we Umthambo subclavian

Lisho ukuthini igama elithi "sendawo"? Lona khona ngokoqobo noma indawo lutho maqondana ezinye izinto. Ake sicabangele lokho kuyinto nesimo sendawo we Umthambo subclavian, ngamanye amazwi, lapho futhi maqondana kuyini. It kuvela kulolu hlangothi esiqwini brachiocephalic, futhi ngakolunye - kusukela lwaleli yomthambo i-aorta, Bypasses sokudlondlobala futhi waphuma ngembobo phezu kwesifuba. I Umthambo entanyeni subclavian kuyinto endaweni ebonakalayo eduze ezinzwa ehlombe plexus futhi agcinwe phezulu. Le ndawo bomkhumbi ingasetshenziswa bokumisa ukopha noma entry kungenzeka kwemithi. Okulandelayo Umthambo subclavian Asondele phezu konqenqema, sidlule ngaphansi clavicle futhi zibe ikhwapha, lapho iba axillary kakade. Khona-ke, ngemva edabula ikhwapha, usafunda ehlombe. Igama le sayithi - Umthambo brachial. Endaweni indololwane it siyahluka ku engaba futhi ulna Umthambo.

Subclavian vein catheterization. wokubhoboza

Njengoba sishilo ngenhla, entanyeni subclavian Vienna (futhi Umthambo kakhulu) amanga phezu. Le ndawo isetshenziswa ukuba abambe futhi wokubhoboza ipayipi entry. Kuyini inkolelo lokhu ukukhetha ethile bomkhumbi? Kukhona isimo sokunquma eziningana ezibangela lokhu ukukhetha yilezi:

1. ukutholakala yokwakheka.
2. Ukuzinza isikhundla futhi ububanzi we Isikhala sayo esingaphakathi.
3. usayizi ngezinga elanele noma obungeke abalulekile (ububanzi).
4. ukugeleza kwegazi Isivinini idlula ngesivinini ukugeleza kwegazi e ngemithambo wemikhawulo.

Ngokusekelwe idatha echazwe ngenhla, ikhashelwa ipayipi emthanjeni ngeke uthinte udonga Umthambo. Imithi ukuthi ungene ngalo, uzoshesha ufike ATRIUM kwesokudla futhi ventricle, bathuthukisa nethonya esebenzayo ku hemodynamics. Busuka subclavian izidakamizwa vein ngokushesha okukhulu kuxutshaniswe negazi, kuyilapho ningabacasuli ingaphakathi Umthambo. Kwezinye izimo kukhona contraindications lubhoboze kanye ipayipi Ukufakwa.

I kwesokudla noma kwesokunxele Umthambo subclavian

Lokhu isitsha - isitho abhanqiwe, njengoba kushiwo ngenhla ukuthi: ilungelo Umthambo subclavian futhi ngakwesobunxele. Leli igatsha lokuqala is ultimate brachiocephalic isiqu, ngokuphathelene kwesokunxele, iphuma lwaleli yomthambo i-aorta. Ngaphezu kwalokho, isikhathi eside zokugcina cishe 4 cm kulokuqala. Kwesokudla subclavian Umthambo igazi ezindaweni ezithile ngakwesokunene, usinikeza yomuzi ekhanda nasesifubeni. I kwesokunxele Umthambo subclavian uyisa ketshezi yenethiwekhi izinto ezibalulekile ukwesekwa ukuphila, engalweni ngakwesokunxele.

izigaba eziyinhloko Umthambo subclavian

I kwesokudla noma kwesokunxele Umthambo subclavian luyingxenye ezinqumela kuhlukaniswe kathathu main, noma kwesigaba:

1. Kusukela endaweni ukwakheka Umthambo subclavian ngaphambi kokungena igebe interscalene.
2. Division, elinganiselwe interscalene igebe.
3. Ngesikhathi ophumayo kusukela igebe egodini interscalene axillary.

Amagatsha esigabeni lokuqala Umthambo subclavian

Le ngxenye sihloko sizokusiza ngikuthi fahla fahla kanjani ukubheka Umthambo subclavian namagatsha alo, okungukuthi, lokho izingxenye amagatsha isitsha. Kusukela ikhadi lakhe lokuqala (isikhala phakathi kwesango isikhawu interscalene futhi kuqale imithambo) asuke amagatsha amaningana, lena iyilabo main:

1. Umthambo vertebral, steamroom. Udabula inqubo transverse lesithupha vertebra wesibeletho. Waphinda evuka futhi iwela ingaphakathi cranial ngokusebenzisa ngemuva ekhanda, okuwukuthi, kusetshenziswa umgodi yayo. It ke uxhuma umfula efanayo ngakolunye uhlangothi, kanjalo zakha Umthambo basilar. Yini umsebenzi we Umthambo vertebral? Lo mkhumbi onika igazi ukuze emgogodleni, kanzima Lobe occipital zobuchopho futhi imisipha.
2. I yangaphakathi Umthambo thoracic iqala ezansi ukuba umthambo subclavian. Isiteshi onika igazi yegilo, diaphragm, bronchi, njll sternum.
3. isiqu Schitosheyny. It kuvela eduze kwangaphakathi onqenqemeni scalene imisipha, sifinyelela ubude mayelana 1-2 cm. Schitosheyny isiqu ihlukane amagatsha letiphakela igazi ukuze imisipha futhi blade entanyeni, nomphimbo.

Ramifications esigabeni okwesibili nokwesithathu umfula subclavian

Okwesibili ingxenye subclavian Umthambo interscalene elinganiselwe igebe has legatsha eyodwa kuphela, ubizwa ngokuthi onqenqemeni-wesibeletho isiqu. Licala ngemuva Umthambo subclavian futhi ihlukaniswe yaba amagatsha amaningana:

1. The esiphezulu Umthambo intercostal (Umthambo amuke kuleli amagatsha posterior ehola igazi ukuze imisipha emuva).
2. izitsha Spinal.
3. Deep entanyeni Umthambo.

Lesi sigaba wesithathu Umthambo subclavian libuye libe igatsha - a Umthambo transverse wesibeletho. Kubonakala kubantu bawo ukuhlangabezana brachial futhi ihlukaniswe yaba:

1. Umthambo okukha phezulu, enezela igazi ukuze ulondoloze imisipha.
2. Amaphiko Umthambo we blade. It lehla okuvulekile imisipha emuva, iwukhulise nokuba eduze imisipha encane.
3. legatsha Deep we Umthambo subclavian.

Kukhona zichazwe eyanele ngokuningiliziwe imiqondo ezifana Umthambo subclavian namagatsha alo, ulwazi olwengeziwe kungenziwa elinesihloko izincwadi zezokwelapha ezisekelwe ekwazisweni.

izifo Okungenzeka Umthambo subclavian

Lesi sifo main esithinta Umthambo subclavian amagatsha awo - ukuvaleka mafutha anciphisa isikhala esingaphakathi imithambo yegazi, ngamanye amazwi, stenosis. Imbangela enkulu yalesi sifo atherosclerosis Umthambo subclavian (lipid sebethule ku isitsha izindonga) noma thrombosis. Lesi sifo ngokuvamile iningi uthenge, kodwa kukhona izimo kanye azalwa nako. Izinto eziyingozi ezingabangela i-atherosclerosis we Umthambo subclavian yilezi:

1. Umfutho ophakeme wegazi.
2. Ukubhema.
3. Ukhuluphele, ukukhuluphala.
4. Isifo sikashukela namanye izifo.

Imbangela ezivame kakhulu stenosis we Umthambo subclavian - ukuphazamiseka umzimba kubantu, izimila nezinqubo ukuvuvukala. Kakhulu uzwakalise stenosis kuholela ukwehla kwe-ukugeleza kwegazi ezithweni ezibalulekile, bayantuleka oksijini izakhi ezicutshini. Ngaphezu kwalokho, stenosis kungabangela isifo senhliziyo, e-stroke ethile.

subclavian Umthambo syndrome

Imphumelelo ukugeleza kwegazi kungadalwa hhayi kuphela yisithiyo ukugeleza kwegazi ngenxa izilonda occlusive-stenotic, kodwa futhi vertebral-subclavian "ebe khona." Lokhu Umthambo syndrome subclavian, noma ukweba syndrome esimweni occlusion noma stenosis lesion egumbini lokuqala bomkhumbi. Uma sikubeka kalula, igazi esiteshini subclavian akusho ukuthi kuqhamuke njalo aorta nangalowo Umthambo vertebral, okungaholela ubuchopho ischemia. Ukubonakaliswa esiphezulu Isifo esibangelwa umthwalo ngokomzimba emkhawulweni engenhla.

Izimpawu zesifo:

1. Isiyezi.
2. Nasebumpungeni.
3. angaboni kahle.
4. Ubuthakathaka bemisipha ohlangothini ethintekile.
5. Ukuncishiswa noma ukungabi oluphelele ishayela ohlangothini ethintekile.

Ukuze uthole ukwaziswa okwengeziwe mayelana nokwakheka kwe subclavian Umthambo stenosis

Imali phezu Imithambo yegazi, okuholela ukuvaleka esidlule, abe lipid isisekelo, okungukuthi, eqinisweni kukhona okunye cholesterol. Lezi ezifakwa inganciphisa mafutha anciphisa isikhala esingaphakathi bomkhumbi ku-80%, ngezinye izikhathi wenza ucingo ngisho ngokuphelele ke. Ngaphezu kwalezi zici abangela subclavian Umthambo stenosis Kunabanye ezifana:

1. Ngemisebe.
2. Arteritis.
3. Kokucindezela syndromes.
4. izilonda abahlukahlukene, njengoZeyusi fibromuscular dysplasia et al.

Isikhathi esining impela, abantu abaphethwe stenosis we Umthambo subclavian, kanye nezinye izitsha kuthinteka. Kungaba iziteshi yenhliziyo, okungukuthi inhliziyo futhi carotid - Umthambo wemikhawulo aphansi. Ngokuvamile nge zokugula ezinjalo, njengoba vasoconstriction inesikhala KWAMAGUNDANE kwesokunxele Umthambo subclavian. Ngokwezibalo, kuba izikhathi eziningana kaningi ngaphezu ilungelo.

Izimpawu Izimpawu ze-stenosis:

1. Ubuthakathaka bemisipha.
2. Ukuzizwa ukhathele.
3. Nobuhlungu ezingalweni nasemilenzeni engenhla.
4. Necrosis neminwe.
5. Ukopha endaweni nail.

Ngaphezu kwalokho, ungakwazi ekhombisa izimpawu zokungenwa uhlamvu neurologic, okungukuthi, kukhona "ukweba": igazi uqondiswe emikhunjini evamile endaweni ethintekile. Izimpawu izifo zezinzwa:

1. umbono Ukuphazamiseka.
2. Nokulahlekelwa ukwazi.
3. inkulumo sifo.
4. Ukulahlekelwa ibhalansi.
5. Isiyezi.
6. ukulahlekelwa ukuzwa ebusweni.

Indlela esiphatha ngayo stenosis we Umthambo subclavian?

ukwelashwa stenosis bungabi yezokwelapha, kuhlinzwa interventional. Izindlela eziyinhloko yokwelashwa - ke stenting endovascular we subclavian Umthambo futhi carotid-subclavian dlula. Indlela yokugcina Kunconywa abantu Imizimba hypersthenic lapho kunzima ukugqamisa umnyango Umthambo kuqala. Futhi, le ndlela yokwelapha Kunconywa ngesikhathi stenosis e ingxenye Umthambo subclavian yesibili.

Subclavian Umthambo stenting

Stenting - a ekwelapheni subclavian Umthambo ngokusebenzisa imbobo encane esikhumbeni, 2-3 mm eside, wakwenza ngembobo wokubhoboza. Le ndlela yokwelashwa kunezinzuzo eziningana phezu ukuhlinzwa, njengoba enza ukulimala okuncane kanye nokuhlukumezeka. Ngaphezu kwalokho, kuba mnene kakhulu nogwali-ekulondolozeni ukwelashwa indlela lapho Umthambo subclavian liyalondolozwa ifomu yayo yasekuqaleni, okuyinto ebaluleke kakhulu ukuze isiguli.

Inqubo stenting cishe kobuhlungu futhi kuthatha indawo ngaphansi izinzwa wendawo. Lo msebenzi ungenziwa ukwandisa mafutha anciphisa isikhala esingaphakathi semithambo usebenzisa catheters akhethekile stents ngesimo amasilinda. Kugcine - a cylindrical endoprosthesis laser ukusika okuqinile tube lensimbi. Le divayisi igibele ibhaluni ipayipi ekhethekile esimweni onomfutho ihamba ku Umthambo subclavian. Lapho stent ifinyelela zone isitsha constriction, eyenziwa ezinye nezinqubo zokulawula eziphathelene ilungelo indawo yayo. Ngemva kwalokho, idivayisi kudalulwe ngaphansi kwengcindezi okusezingeni eliphezulu. Uma stent akuyona ngokwanele wavula yayo, kuyothi leyongxenye ekhethekile angioplasty stented ipayipi nge ibhaluni eliseningizimu ukuze zithole imiphumela elilungile. Kuze kube manje, kungenzeka ukumhlinza mahhala, ungakwenza ngokuthola quota sikahulumeni. Iziguli isifo esifanayo kufanele uthintane nodokotela.

izingozi olungenzeka stenting

stenting inqubo ihlala Umthambo cishe subclavian amahora mayelana 2. Lo msebenzi wenziwa uMnyango catheterization inhliziyo. Ngemva stenting amaphilisi ezinhlungu wathola, ngoba indawo lapho umfula subclavian, kanye nezicubu ukuthi ezaziqoshwe, kungase kubonakale ubuhlungu, uma kunesidingo. Izinkinga kwinqubo ezingajwayelekile, ngoba nesineke ngaphambi kokuba abaqeqeshiwe ngokucophelela futsi abhekwe ngalokufanele. Kodwa namanje kungase kuphakame nemiphumela ebuhlungu yilezi:

1. Allergy ukuthatha imithi.
2. I yokusabela kuya imithi ebulala izinzwa.
3. ukopha Minor endaweni imbobo.
4. Lokushisa.
5. Ubuhlungu bekhanda.
6. Ukutheleleka.
7. Air embolism.
8. Ukulimala Umthambo noma udonga aorta.
9. Thrombosis we Umthambo subclavian.
10. Ukumikiswa we stent.
11. yezinkinga kwemizwa et al.

ukuphathwa interventional ka stenosis we Umthambo subclavian ngu ibhaluni angioplasty futhi stenting - izindlela ukwelashwa yesimanje kancane koda futhi ngempumelelo. Banezinhliziyo esifushane kakhulu isikhathi kanye nokulaliswa esibhedlela nasezinkingeni ezilandela ngemva kokuhlinzwa.