Eisenmenger chirwere: zviratidzo. Eisenmenger chirwere uye pamuviri. Varwere Eisenmenger urwere

Demonstrable mberi mune zvokurapa mumakore mashoma apfuura vasina zvakatungamirira unopinza kuwedzera upenyu anotarisirwa, kana kubviswa cardiac pathologies. Mukuwedzera, pakutanga kwezana XIX-XX emakore, masayendisiti zvinorondedzerwa zvirwere zvitsva zvakawanda. Zvikonzero vamwe vavo vachiri kuramba haanzwisisiki, zviratidzo - Blurred, uye kurapwa zvakaoma chaizvo. Eisenmenger urwere, vakatumidzwa nezita yeAustria wevana uye cardiologist, haagoni kunzi chakasviba. Rare zvokurwara akatambira rondedzero anenge 100 apfuura. Zvisinei, kunyange nhasi, hatifaniri kutaura pamusoro kunzwisisa kwayo etiology hwakajeka.

Vhuṱanzi

Syndrome (dzimwe nguva unonzi kunzwisisa) Eisenmenger - a zvokurwara ngozi chaizvo, kuripa kuna pulmonary uye cardiac hurongwa. Cardiac chirwere kunoratidzwa ne yaisanganisa ventricular septal kuremara , uye BP. chirwere kukura kunoita kuti vawedzere kumanikidzwa uye kuvhiringidza mune pulmonary riparadzirwe. Zvinoguma shunt, riri basa ropa stuffing kodzero kuruboshwe, izvo anenge kwomuzvarirwo pezvakaitwa hemodynamics.

Uyewo, pfungwa Eisenmenger chirwere zvinosanganisira chero mwoyo chirwere, dzinoratidzwa akazaruka atrioventricular Canal uye bvumidzwa ductus arteriosus, kuvapo ventricle rimwe chete. Pakati varwere zvemamiriro ventricular septal zvokurwara iri chirwere muna 10% nyaya. In sechivako vakaremara chikuru muviri tsandanyama Eisenmenger zvakaoma 3%.

Zvinokonzera kuti urwere kukura

Single zvinokonzera kukura chirwere, vanachiremba musaidzwa. Zvisinei, pane vakawanda etiological zvinoita kuti vawedzere mikana yokuva vana Eisenmenger urwere:

1. Enhaka kubatwa. Kutyorwa panguva Gene pamwero zvinogona kutapukira kubva mubereki mwana, nokudaro vachikonzera yakawedzerwa mukana dzichiri mwoyo chirwere.
2. Environmental zvinhu:

• kudhaka ari mudumbu ari utero;
• mazhinji kugarotamba remagetsi nemwaranzi;
• chisingaperi zvirwere mubereki;
• divi Migumisiro mishonga uye Mishonga zvokuwedzera anoshandiswa vakadzi panguva yepamuviri.

Zvinhu izvi hazvisi zvinowanzoitika chete Eisenmenger urwere, asi dzidziso vanogona kuva kukonzera pathologies siyana, kusanganisira uyu.

Sezvo chirwere hwapedyo?

Varwere Eisenmenger chirwere kazhinji regai kunyunyuta zvoutano. Saka, mangwanani chirwere hazvibviri nguva dzose. Mwana wokutanga kwakunoitwa compensatory zvenhengo asi pashure penguva chirwere anoratidza pacharo. Internal zviwanikwa ichipera, ari cardiac gadziriro iri kukundikana. Chii Eisenmenger urwere zviratidzo?

1. Inosimudzira muutera, kuipa pashure muviri.
2. Kurwadziwa parutivi chipfuva rworuboshwe.
3. Kuwedzera yamasikati blueness ganda.
4. Vaingoerekana syncope.
5. Yokurwiswa chikosoro pamwe reropa zvinoyerera.

Zviratidzo yakadaro kunetseka hamuzombonzwisisi zvose. The chirwere kwenguva yakareba kunogona kuva nokukurumidza. Kana chiremba uyo rinotarisira mwana, zvavakabvumirana zvakaitika wokuwedzera kuongororwa ari cardiology centre, havafaniri kuchengetwa.

Havana hanya panguva chirwere

vanachiremba Russian vanodavira kuti Eisenmenger chirwere uye pamuviri haawirirani. Saka, chero pavaipfuura mukadzi pamuviri inokurudzirwa. Dzavo Western vashandi vanofunga kudaro. Maererano navo, akabudirira zvizvarwa zvichauya pamusoro zvaidiwa mitemo uye kutevedzera.

Mukadzi wokutanga muchipatara yose nguva pamuviri. Pachipatara, vanachiremba vanofanira kuramba kuongorora mamiriro azvarwa uye kuyera kumanikidzwa iri pulmonary capillaries. Nezviratidzo kupfupika mweya rokutanga - okisijeni Masiki. Kutanga kubva rechipiri trimester basa kurapwa coagulants. Mazuva mashoma asati kutarisirwa musi panowanikwa mwana rakarumbidza kuvhunduka kurapa digitalis kuramba cardiac hurongwa. Delivery zvinogoneka chete takasununguka.

Kana mukadzi anofanira kuva zvose zvinodiwa vanachiremba, kuti ndingangokuvara zvakanaka mugumisiro mwana 50-90%. The kushurudzira hakusi inosimudzira amai. Ndokusaka, kana kusarudza kuenderera pamuviri, mumwe mukadzi anofanira kufunga dzingangoitika nengozi.

Medical ongororo

Zvinobudirira kurapa varwere vane Eisenmenger chirwere zvisingaiti kufungidzira pasina kuongorora chaiyo. Unogona chete kufamba kushandiswa makiriniki pamwe yakakodzera michina. Kana uchifungidzira kuti kuongorora chirongwa ichi zvokurwara inowanzoratidza:

• bhokisi radiograph (kufungidzira kuchinja pulmonary tsinga uye contours nomwoyo);
• angiography (vascular kudzidza);
• ECG (kuziva zvakavanzika mwoyo mutinhimira vachivavhiringidza);
• Echocardiography (Visualization of Kumwe kuchinja kunotanga mu masvingo ventricles);
• cardiac catheterization (tinyatsonzwisisa chirwere uye hunhu kukuvara, nokuyerwa kusanganiswa parameters huru tsandanyama).

Differential chirwere mutemo unoti Varwere vose vanofungidzirwa Eisenmenger syndrome. Pentad Fallot, tsinga stenosis, bvumidzwa ductus arteriosus - pfupi mazita pathologies kuti asava.

kurapa misimboti

Kuchinja mabatiro wevarwere kunobvira, asi kwete zvakanyanya. Ukuwo, kushandiswa kuvhiya kupindira hapasi nezvibereko zvakanaka. Naizvozvo, nhasi vanachiremba vari kuramba kushandisa wemishonga nzira.

Varwere vane raidudzwa kunotoda mufananidzo ikawanda hematocrit yakatarwa phlebotomy. The nzira inodzokororwa kusvikira katatu pagore, panguva imwecheteyo zvinokosha kuongorora parameters ropa simbi. Okisijeni kurapa uye anticoagulant kurapwa haawanzopiwi kushandiswa, ndingadaro zvokusarudza. The chikuru drawback maitirwo izvi anonzi vazhinji nemishonga, rinonyatsooneka pakati inova Hemorrhagic diathesis. Uyewo, varwere ndishandise zvinodhaka. "Epoprostenol" uye "Treprostinil" anovandudza hemodynamics uye "Traklir" kunoderedza vascular nemishonga.

Kuvhiya rinoitwa munyika dzakasiyana vaviri muchibereko chinodzora kurova, epurasitiki urema MPP. Apo Eisenmenger chirwere oparesheni anogona yekudyidzana kuvandudza fungidziro chirwere. Kana kurapwa izvi hadzibatsiri, anogona chete kubatsira mawa transplantation pamusoro mapapu uye mwoyo. Transplantation Kuvhiya iri chaizvo kunzwisisa, zvinoda guru zvemari mari. Ukuwo, hazvina kubvisa njodzi yematambudziko. Apo pasina dzimwe mhinduro, zvinhu mubvunzo akananga, kaviri nokuisazve anogona kuponesa upenyu. Asati ayo Implementation kunokosha kupfuura kuchipatara kuongorora yakaoma.

Sei varwere Eisenmenger chirwere?

Vanhu vaifanira kukurira chirwere ichi cardiac, kazhinji kushingaira upenyu. Zvisinei, vanofanira kuramba kuenda chiremba uye kuti akuteerere utano zviratidzo. Vanaamai vakadaro vanofanira kudzivisa kupera muviri, kwenguva refu uchinzwa kukwira zvirwere zvinotapuriranwa. Zvakakosha kuti kurega tsika dzakaipa uye nokutora mishonga anogona kukonzera ropa. Kana murwere inotevera nachiremba akarayira, kuti ndingangokuvara mukana kuti kurarama sezvinongoita inowedzerawo. Zvikasadaro, ropa okisijeni pamwero anogona inowira kutsoropodza nhanho kuti kurufu.