Aortic Dissection - Koj puas paub txog qhov mob txaus ntshai no?

Koj lub plawv yog lub hauv paus tseem ceeb rau koj lub cev tag nrho. Yog li ntawd, cov hlab ntsha loj tshaj plaws uas tawm hauv lub plawv thiab nqa cov ntshav huv uas muaj oxygen ntau thoob plaws koj lub cev hu ua aorta. Xav txog nws zoo li cov kav dej loj uas muab dej rau koj lub tsev. Aortic Dissection yog thaum phab ntsa ntawm cov hlab ntsha loj no tawg los ntawm sab hauv. Qhov no yog qhov xwm txheej txaus ntshai heev, ua rau tuag taus uas feem ntau tshwm sim sai sai, yam tsis muaj kev ceeb toom ua ntej.

Kev Phais Aortic yog dab tsi? Cia peb nkag siab yooj yim

Peb lub aorta yog ib txoj hlab ntshav uas muaj peb txheej. Nws zoo li ib phab ntsa peb txheej. Yog tias muaj qee qhov laj thawj, muaj kev tawg hauv txheej sab hauv ntawm phab ntsa no, cov ntshav ntws hauv qab kev siab siab nkag mus rau hauv qhov tawg thiab pib xau ntawm ob txheej ntawm phab ntsa. Thaum cov ntshav puv li no, ob txheej sib cais ntawm ib leeg. Qhov ntawd yog qhov peb hu ua kev txiav.

Xav txog nws zoo li txoj kev tawg ua ob ntu. Thaum qhov no tshwm sim, cov ntshav ntws mus rau ntau qhov ntawm lub cev raug cuam tshuam. Thiab qee zaum, cov hlab ntsha loj no tuaj yeem tawg tag (rupture).

Cov hom kev phais aortic tseem ceeb yog dab tsi?

Cov kws kho mob faib qhov mob no ua ob hom tseem ceeb, hu ua Stanford classification, uas yog raws li qhov twg qhov kua muag tshwm sim.

Cov tsos mob ntawm qhov no yog dab tsi? Yuav ua li cas thiaj paub txog nws?

Tus yam ntxwv tseem ceeb ntawm kev tawg ntawm lub plawv (aorta dissection) yog tias nws tshwm sim sai sai . Tsis muaj cov cim qhia ceeb toom. Nws tuaj yeem tshwm sim txhua lub sijhawm, xws li thaum koj pw tsaug zog, so, lossis ua haujlwm hnyav.

Cov no yog cov tsos mob uas pom tau feem ntau:

• Mob sai sai, tsis tuaj yeem ua tau, mob ntse hauv siab lossis sab nraub qaum. Muaj ntau tus neeg piav qhia tias nws yog qhov mob "ripping" lossis "stabbed" . Qhov no yog qhov tsos mob tseem ceeb thiab feem ntau tshwm sim.
• Mob plab heev.
• Ua pa nyuaj (Dyspnea).
• Kiv taub hau los yog kiv taub hau.
• Ntshav siab poob qis tam sim ntawd (ntshav siab qis).
• Lub plawv dhia tsis muaj zog thiab ceev.
• Tawm hws ntau dhau.
• Kev tsis meej pem.
• Tsis pom kev.
• Cov tsos mob ntawm tus mob stroke. Piv txwv li, qaug zog ib sab ntawm lub cev lossis hais lus tsis tau zoo.

Vim li cas qhov no thiaj tshwm sim? Cov yam uas ua rau muaj kev pheej hmoo yog dab tsi?

Qhov ua rau muaj kev tawg ntawm cov hlab ntsha aorta yog qhov uas cov phab ntsa ntawm cov hlab ntsha aorta qaug zog zuj zus raws sijhawm. Qhov qaug zog no tshwm sim zais cia rau ntau xyoo, thiab thaum kawg rhuav tshem ntawm qhov tsis muaj zog tshaj plaws.

Qhov tseem ceeb thiab feem ntau ua rau muaj qhov no yog ntshav siab uas tsis tuaj yeem tswj tau (Tshuaj Ntshav Siab) . Ntshav siab ua rau cov phab ntsa ntawm cov hlab ntsha puas tsuaj, ua rau lawv tsis yoog tau thiab tsis muaj zog.

Lwm yam uas ua rau muaj kev pheej hmoo yog:

• Atherosclerosis los yog cov roj cholesterol ntau.
• Kev siv cov khoom luam yeeb (haus luam yeeb).
• Aortic aneurysm.
• Cov kab mob ntawm lub plawv aortic valve.
• Cov teeb meem plawv yug los, piv txwv li, bicuspid aortic valve (ob lub valve es tsis yog peb lub li qub).
• Cov kab mob ntawm cov nqaij sib txuas, xws li Marfan syndrome thiab Ehlers-Danlos syndrome . Cov no yog cov mob uas tuaj yeem tau txais los ntawm noob caj noob ces.
• Yog tias ib tug neeg hauv tsev neeg tau muaj aortic dissection ua ntej.
• Raug mob hnyav rau hauv siab (piv txwv li, muaj xwm txheej tsheb sib tsoo hnyav).
• Muaj hnub nyoog ntawm 40 thiab 70 xyoo.
• Ntshav siab thaum cev xeeb tub.
• Kev siv cov tshuaj yeeb xws li cocaine.

Tus kws kho mob kuaj mob li cas?

Thaum koj mus rau tsev kho mob, tus kws kho mob yuav xav tias muaj tus mob no raws li koj cov tsos mob. Txawm li cas los xij, vim tias cov tsos mob no zoo ib yam li mob plawv nres lossis mob hlwb, yuav tsum tau kuaj ntau zaus sai sai kom paub tseeb tias nws yog.

• CT scan (Computed Tomography): Qhov no yog txoj hauv kev zoo tshaj plaws thiab ceev tshaj plaws los pom lub aorta kom meej meej thaum muaj xwm txheej ceev.
• Echocardiogram: Qhov no yog kev kuaj ultrasound. Ib qho transesophageal echocardiogram (TEE) tuaj yeem pom cov aorta meej dua li transthoracic echocardiogram.
• X-ray hauv siab: Yuav muab tau lub tswv yim ntxhib txog seb lub aorta puas nthuav dav.
• MRI (Magnetic Resonance Imaging): Txawm hais tias qhov no kuj tuaj yeem tsim cov duab meej heev, nws tsis tshua siv thaum muaj xwm txheej ceev vim nws siv sijhawm ntev dua li CT scan.

Yuav kho li cas?

Txoj kev kho mob nyob ntawm qhov chaw ntawm qhov kua muag (Hom A lossis Hom B) thiab tus neeg mob tus mob.

Kev phais thiab lwm yam kev kho mob

1. Kev Hloov Paug: Qhov no yog kev phais plawv qhib. Hauv kev phais no, tus kws phais yuav tshem tawm qhov puas tsuaj ntawm cov hlab ntsha aorta thiab hloov nws nrog ib qho khoom siv hluavtaws. Kev phais no yog ua raws li kev kho mob thaum muaj xwm txheej ceev rau kev phais hom A.

2. Kev Kho Mob Endovascular Stent-Graft: Qhov no suav nrog kev txiav me me rau hauv cov hlab ntsha hauv qhov chaw mos thiab siv cov xov hlau thiab cov catheter los xov ib lub raj hlau mesh (stent graft) rau hauv qhov chaw tsis muaj zog ntawm aorta. Qhov no ua rau phab ntsa tsis muaj zog los ntawm sab hauv. Txoj kev no feem ntau siv rau kev phais mob Hom B uas nyuaj.

3. Txoj Kev Sib Xyaws: Hauv qee kis uas nyuaj heev, ob qho kev phais qhib thiab txoj kev siv stent-graft yuav tsum tau siv ua ke.

Cov tshuaj (tshuaj)

Cov tshuaj feem ntau yog siv ua ntej phais, tom qab phais, thiab rau cov neeg mob Hom B uas tsis tas yuav phais.

• Cov tshuaj xws li beta-blockers tuaj yeem muab rau kom txo qhov plawv dhia thiab ntshav siab. Qhov no txo ​​qhov siab ntawm lub aorta thiab tiv thaiv qhov kua muag kom tsis txhob nthuav dav ntxiv.
• Koj yuav tsum noj tshuaj rau tas koj lub neej kom tswj tau koj cov ntshav siab.

Qhov no puas tiv thaiv tau?

Peb hloov tsis tau qee yam uas ua rau muaj kev pheej hmoo (piv txwv li, cov kab mob uas los ntawm noob caj ces). Txawm li cas los xij, muaj qee yam uas peb tswj tau.

• Tswj koj cov ntshav siab kom zoo.Yog koj muaj ntshav siab, noj cov tshuaj uas koj tus kws kho mob sau kom raug thiab txo koj cov ntsev noj.
• Yog koj haus luam yeeb, tsum tam sim ntawd.
• Tswj koj lub cev kom muaj qhov hnyav zoo.
• Yog tias muaj leej twg hauv koj tsev neeg (niam txiv, kwv tij neej tsa) tau muaj tus mob no, nrog koj tus kws kho mob tham txog nws thiab ua qhov kev kuaj mob tsim nyog.
• Kev siv txoj siv sia tuaj yeem tiv thaiv kev raug mob hauv siab hauv kev sib tsoo tsheb.