Lub plawv zoo li lub cav ntawm peb lub cev. Yog li, kom lub cav no ua haujlwm tau, nws xav tau cov ntshav tas li, uas yog, oxygen thiab cov as-ham. Yuav kom lub plawv nqus cov ntshav mus rau tag nrho lub cev, muaj ib lub cev me me uas muab cov ntshav rau lub plawv. Peb hu cov no ua cov hlab ntsha hauv lub plawv (coronary artery). Ib tug tswv cuab tseem ceeb ntawm lub cev ntawd yog 'Circumflex Artery'. Hnub no, cia peb tham txog leej twg yog tus no, nws ua dab tsi, thiab yuav ua li cas yog tias nws muaj teeb meem.
Hais yooj yim xwb, Circumflex Artery yog dab tsi?
Zoo, xav txog nws li no. Peb muaj ob lub hlab ntsha loj uas nqa ntshav mus rau peb lub plawv. Sab xis thiab sab laug. Lub hlab ntsha loj sab laug no faib ua ob ceg tseem ceeb. Ib ceg ntawm cov ceg ntawd yog 'Circumflex Artery' (lwm ceg hu ua 'Left Anterior Descending (LAD) artery'). Cov kws kho mob qee zaum hu qhov no ua 'LCx artery' luv.
Lub luag haujlwm tseem ceeb ntawm cov hlab ntsha no yog muab cov ntshav huv, muaj pa oxygen rau cov chav twj ntawm sab laug ntawm peb lub plawv. Ntawd yog:
- Sab laug atrium - Qhov chaw uas cov ntshav oxygenated los ntawm lub ntsws pib sib sau ua ke.
- Sab laug ventricle - Lub chav loj thiab muaj zog tshaj plaws ntawm lub plawv uas tso ntshav mus rau tag nrho lub cev.
- Cov leeg nqaij papillary sab hauv sab laug ventricle.
Rau qee tus neeg, cov hlab ntsha 'circumflex' no muaj lwm txoj haujlwm tshwj xeeb. Qhov ntawd yog muab ntshav rau lub 'sinoatrial (SA) node', uas tswj lub plawv dhia, ua haujlwm zoo li 'lub tshuab ua pacemaker ntawm lub plawv.' Tab sis rau feem ntau ntawm cov neeg, txoj haujlwm no yog ua los ntawm cov hlab ntsha sab xis.
Cov leeg ntshav no nyob qhov twg? Puas nws ceg?
Cov hlab ntsha circumflex nyob hauv epicardium, uas yog txheej tiv thaiv sab nraud ntawm lub plawv. Nws khiav raws ib ntu zoo li qhov zawj ntawm cov chav sab saud thiab sab qis (atrium thiab ventricle) ntawm sab laug ntawm lub plawv.
Yog lawm, ib yam li cov ceg ntoo, cov leeg no kuj tawg ua cov ceg me dua. Tus naj npawb ntawm cov ceg no tuaj yeem sib txawv. Feem ntau muaj li peb ceg, hu ua 'obtuse marginal branches.' Cov ceg me me no mus rau sab nraud ntawm lub plawv sab laug.
'Dominance' hauv cov ntshav mus rau lub plawv yog dab tsi?
Qhov no yog ib qho kev kho mob me ntsis, tab sis nws yooj yim to taub. Muaj lwm txoj hlab ntsha tseem ceeb hu ua 'posterior descending artery (PDA)' uas muab ntshav mus rau tom qab ntawm peb lub plawv. Yog li, koj qhov 'coronary arterial dominance' yog txiav txim siab los ntawm seb qhov 'PDA' artery hauv koj lub cev tau txais ntshav los ntawm txoj cai coronary artery lossis ceg ntawm sab laug (piv txwv li 'Circumflex' lossis 'LAD').
Qhov no yog ib yam dab tsi uas txawv ntawm ib tus neeg mus rau ib tus neeg.
| Hom kev tswj hwm | Piav qhia yooj yim |
|---|---|
| Txoj cai-tswj hwm | Cov neeg feem coob (kwv yees li 85%) muaj qhov no. Ntawm no, cov hlab ntsha PDA tau txais ntshav los ntawm cov hlab ntsha sab xis. |
| Sab laug-dominant | Qhov no tshwm sim rau kwv yees li ib ntawm kaum tus neeg. Ntawm no, cov hlab ntsha PDA tau txais ntshav los ntawm Circumflex artery (lossis LAD artery). |
| Tus lej tseem ceeb | Kwv yees li ob ntawm kaum tus neeg tuaj yeem muaj txoj haujlwm no. Ntawm no, PDA tau txais cov ntshav los ntawm ob txoj leeg sab xis thiab sab laug (Circumflex lossis LAD). |
Cov kab mob dab tsi cuam tshuam rau Circumflex Artery?
Ib yam li lwm cov hlab ntsha hauv lub plawv, qhov mob tseem ceeb thiab txaus ntshai tshaj plaws uas cuam tshuam rau 'Circumflex Artery' yog kab mob hauv lub plawv (CAD) . Hais yooj yim xwb, nws yog kev thaiv cov hlab ntsha los ntawm cov rog thiab cov roj cholesterol.
Ib yam li cov av thiab xeb sib sau ua ke hauv cov kav dej raws sijhawm, cov rog thiab cov roj cholesterol sib sau ua ke hauv cov hlab ntsha no, tsim ib txheej hu ua '(plaque)'. Peb hu qhov no tias '(atherosclerosis).' Thaum cov txheej 'plaque' no maj mam loj hlob tuaj, cov ntshav ntws hauv cov hlab ntsha nqaim zuj zus. Thaum kawg, cov ntshav ntws raug thaiv.
Yog tias tus mob no tsis kho kom zoo, nws tuaj yeem ua rau muaj cov mob hnyav heev xws li mob plawv nres, mob plawv tsis ua haujlwm, lossis mob hlwb .
Koj yuav paub li cas yog tias cov leeg ntshav raug txhaws? Cov tsos mob yog dab tsi?
Angina tshwm sim thaum cov hlab ntsha nqaim thiab lub plawv tsis tau txais ntshav txaus.Tej zaum koj yuav mob hauv siab los yog nruj, hu ua angina. Qhov no tuaj yeem yog ib qho cim qhia tias koj lub plawv nres, yog li koj yuav tsum ceev faj txog cov tsos mob no.
Yog tias koj muaj ib lossis ntau yam ntawm cov tsos mob hauv qab no, nws yog xwm txheej ceev hauv kev kho mob . Koj yuav tsum mus rau chav kho mob ceev (ETU) ntawm tsev kho mob tam sim ntawd.
| Cov tsos mob | Kev piav qhia |
|---|---|
| Mob hauv siab/nruj nruj '(Angina)' | Xav tias nruj, raug zawm, thiab hnyav hauv nruab nrab ntawm lub hauv siab. |
| Qhov mob kis mus rau sab caj npab sab laug, xub pwg nyom, caj dab, thiab lub puab tsaig | Qhov mob pib hauv siab thiab kis mus rau cov cheeb tsam no. |
| Ua pa nyuaj | Ua tsis taus pa, ua pa nyuaj txawm tias tsis tau siv zog los xij. |
| Hnov txias thiab tawm hws | Hnov txias thiab tawm hws ntau yam tsis muaj laj thawj. |
| Kiv taub hau, zoo li koj tig ib ncig. | Hnov mob taub hau heev ua rau koj sawv tsis taus. |
| Qaug zog, tsis muaj zog | Muaj kev qaug zog sai sai thiab lub cev tsis muaj zog. |
Cov kws kho mob kuaj xyuas cov leeg ntshav li cas?
Cov kws kho mob siv ntau qhov kev kuaj tshwj xeeb los xyuas seb koj cov hlab ntsha hauv lub plawv puas noj qab haus huv, uas tseem hu ua cov hlab ntsha 'circumflex'.
- Kev Siv Tshuaj Rau Lub Plawv (Angiogram): Qhov no yog qhov kev kuaj tseem ceeb tshaj plaws. Ib lub raj me me raug ntxig los ntawm cov leeg ntshav hauv caj npab lossis ceg, xov rau cov hlab ntsha ntawm lub plawv, txhaj nrog cov kua tshwj xeeb, thiab thaij duab X-rays kom pom seb puas muaj qhov txhaws hauv cov leeg ntshav.
- Kev Siv Tshuaj Ntsuam Xyuas Lub Plawv Hauv Lub Plawv (Coronary Computed Tomography Angiogram - CCTA): Qhov no yog kev ntsuas CT tshwj xeeb uas tuaj yeem tsim cov duab peb-seem (3D) ntawm cov ntshav ntws hauv lub plawv.
- Kev Siv Ultrasound Hauv Cov Hlab Ntshav (IVUS): Qhov no suav nrog kev muab ib lub cuab yeej ultrasound me me tso rau hauv cov hlab ntsha, ua rau pom qhov loj thiab qhov xwm txheej ntawm cov plaque txheej uas txuas rau ntawm phab ntsa cov hlab ntsha kom meej meej.
- Fractional Flow Reserve (FFR): Ib qho kev kuaj uas ntsuas ntshav siab ua ntej thiab tom qab kev txhaws hauv cov hlab ntsha kom paub tseeb tias qhov kev txhaws cuam tshuam rau kev ua haujlwm ntawm lub plawv npaum li cas.
Koj kho cov hlab ntsha uas raug txhaws li cas?
Txoj kev kho mob tseem ceeb uas siv los qhib cov hlab ntsha circumflex uas raug thaiv lossis lwm cov hlab ntsha hauv lub plawv yog angioplasty thiab stenting .
Hauv qhov no, ib lub raj me me uas muaj lub npas loj raug xa mus rau thaj chaw uas raug thaiv, ib yam li kev kuaj mob angiogram. Tom qab ntawd, lub npas loj raug cua kom thawb cov plaque mus rau ntawm phab ntsa ntawm cov hlab ntsha, ua rau cov ntshav ntws dav dua. Tom qab ntawd, ib lub raj me me hu ua stent raug muab tso rau hauv thaj chaw ntawd kom tiv thaiv thaj chaw nqaim kom tsis txhob nqaim dua. Qhov no pab tswj kom cov ntshav ntws zoo rau lub sijhawm ntev.
Kuv ua tau dab tsi kom kuv lub siab noj qab nyob zoo?
Muaj ntau yam uas koj ua tau kom koj lub plawv thiab cov hlab ntsha noj qab nyob zoo, tsis yog koj cov hlab ntsha circumflex xwb. Qhov zoo tshaj plaws uas yuav tsum ua yog siv cov no rau hauv koj txoj kev ua neej.
- Ua kom lub cev muaj zog: Ua kom lub cev muaj zog tsawg kawg yog 30 feeb feem ntau hnub hauv ib lub lim tiam. Kev taug kev, kev khiav, lossis kev ua luam dej yog cov kev xaiv zoo.
- Noj zaub mov kom lub plawv noj qab nyob zoo: Txo cov khoom noj uas muaj roj, ntsev, thiab qab zib ntau. Noj txiv hmab txiv ntoo, zaub, taum pauv, ntses me, thiab cov nplej tag nrho hauv koj cov zaub mov.
- Tswj koj qhov hnyav kom noj qab nyob zoo: Tswj koj qhov hnyav kom haum rau koj qhov siab yog qhov tseem ceeb heev.
- Tsis txhob haus luam yeeb kiag li: Kev haus luam yeeb yog ib qho ntawm cov yeeb ncuab loj tshaj plaws ntawm cov hlab ntsha hauv lub plawv.
- Tswj ntshav qab zib thiab ntshav siab: Yog tias koj muaj cov mob no, nrog koj tus kws kho mob tham kom noj cov tshuaj uas tau sau tseg thiab tswj kom zoo.
- Txo kev ntxhov siab: Sim ua kom koj lub siab so los ntawm kev ua yoga thiab kev xav.
Yog koj ua raws li cov no, koj yuav muaj sia nyob ntev nrog lub siab noj qab nyob zoo. Yog tias koj muaj lus nug txog koj txoj kev noj qab haus huv, nrog koj tus kws kho mob hauv tsev neeg tham kom tau lus qhia.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Lub 'Circumflex Artery' yog ib lub hlab ntsha tseem ceeb heev uas xa cov ntshav mus rau sab laug ntawm koj lub plawv.
- Cov rog tso rau hauv cov hlab ntsha no tuaj yeem ua rau nws raug thaiv (CAD), uas tuaj yeem ua rau muaj cov mob hnyav xws li mob plawv nres.
- Tsis txhob tso tseg cov tsos mob xws li mob hauv siab, ua pa nyuaj, txias, thiab tawm hws. Nws yog ib qho xwm txheej ceev. Mus rau chav kho mob ceev (ETU) ntawm tsev kho mob tam sim ntawd.
- Kev ua neej noj qab haus huv (kev noj zaub mov zoo, kev tawm dag zog, thiab kev tsis txhob haus luam yeeb) tuaj yeem tiv thaiv koj cov hlab ntsha.
- Yog koj muaj kev txhawj xeeb txog koj lub plawv txoj kev noj qab haus huv, nrog koj tus kws kho mob tham tsis txhob ncua.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus