Tricuspid regurgitation 1 dhigirii - chii uye chii kurapwa?

Tricuspid regurgitation - mumwe chimiro chemwoyo, umo mune kudzoka ropa munguva systole uzvirasire kubva kurudyi ventricle kupinda mhango rwerudyi atrium. Chikonzero ichi ndicho tricuspid (tricuspid) vharafu, kureva. E. kukwana dzivharwe ayo musuo mashizha. Tricuspid vharafu regurgitation inogona kuwanwa kana vachiberekwa.

Nezvekwakabva shoko rokuti

Shoko "regurgitation" rinobva muchiLatin gurgitare - "mafashamo" - uye chivakashure va-, achiratidza vanetsane, kureva, inosanganisira zvevakomana kutungamirirwa dzose aibuda ... Panyaya iyi - iyo backflow ropa.

Zvinokonzera vachiberekwa tricuspid regurgitation

Vakawanda zvinokonzera vachiberekwa anomalies ndiwo:

• hypoplasia vharafu mapepa;
• zvemamiriro budiriro (nhamba) chezvinhu vharuvhu mapepa;
• dysplasia pamusoro connective tishu;
• Ehlers-Danlos urwere;
• Marfan urwere;
• Ebstein kuti anomaly.

Tricuspid regurgitation ari mudumbu ari zindoga hariwanikwi chaizvo, kakawanda kubatanidzwa nemamwe mwoyo kuremara. Izvi vharafu kutadza kungava chikamu mitral-kutsemuka-tricuspid urema.

Zvinokonzera vakatodzidza tricuspid regurgitation

Tricuspid vharafu regurgitation vawana zvakawanda zvinozivikanwa pane vachiberekwa. Ndiyo nesekondari. The chikuru zvinokonzera chirwere ichi zvinosanganisira rheumatism, kupindwa muropa, carcinoid syndrome.

1. Rheumatic fivha - ndicho chikonzero chinonyanya zvinowanzovapo chirwere ichi. Muna 20% nyaya, kureva idzokororo rheumatic endocarditis kunotungamirira deformation (thickening uye kupfupikisa) of vharuvhu ichibhabhamisa saizvozvo uye kuchinja mudzira shinda. Kakawanda chirwere ichi kwakabatana stenosis rwerudyi atrioventricular buri. Kubatana uku inonzi zvikabatanidzwa tricuspid urema.
2. Atsamwira pamusoro papillary tsandanyama Unogona tricuspid regurgitation. Makwanza aya rwakavapo myocardial infarctions, kana angava wakapona mavambo.
3. Carcinoid chirwere kungakonzera chirwere ichi. It unowanikwa dzimwe mhando kenza, akadai kenza duku ura, ovary, kana zvemapapu.
4. Rubvumo mishonga zvakaoma kazhinji kunotungamirira infective endocarditis, uye iyewo, kungaita tricuspid regurgitation.

Zvinokonzera yechipiri tricuspid insufficiency anotevera zvirwere vanowanzobatwa:

• dilation of annulus fibrosus, izvo unovapo pakati dilated cardiomyopathy;
• anokudzwa pakati pulmonary neBP;
• neutera rworudyi ventricle, izvo zvinowanikwa inonzi pulmonary mwoyo;
• chisingaperi mwoyo kutadza;
• myocarditis;
• myocardiodystrophy.

Zviratidzo muvana

Vachiberekwa tricuspid regurgitation mu vacheche muna 25% nyaya, hworatidza sezvo supraventricular tachycardia kana atrial fibrillation, anogona Papera zvinoratidza zvikuru mwoyo kukundikana.

In vana vakura, kunyange panguva shoma mutoro rinowanika kupfupika mweya uye palpitations. Mwana anganyunyuta kurwadziwa mumwoyo. Inogona kuchengetwa dyspeptic zvinetso (kuda kurutsa, kurutsa, flatulence), uye kurwadziwa kana kunzwa waziya zvakarurama hypochondrium. Kana paine kuzara ari systemic riparadzirwe, saka pane peripheral edema, ascites, hydrothorax kana hepatomegaly. Zvose izvi ndizvo chaizvo ezvinhu.

Zviratidzo zviri chirwere nedzevakuru

Kana zvokurwara inogona kuwanwa gare gare muupenyu, pane kutanga kwekupwanyiwa munhu pariri haagoni kunyange vakafungidzira. Zvishomanana tricuspid regurgitation rinowanikwa chete mune vamwe varwere, throbbing mutsinga mutsipa. Zvimwe zviratidzo murwere havasi kuzivikanwa. Tricuspid vharafu regurgitation 1 dhigirii anogona hakuiti unooneka. Kazhinji, zvokurwara ichi rinowanikwa netsaona munguva inotevera kuongorora zvokurapa. Patient kunosvika echocardiography, umo dzakaonekwa tricuspid regurgitation 1 dhigirii. Chii - ariwana kunze chete mushure bvunzo. Vanaamai vakadaro anowanzoshandurwa kupfeka rekodhi pedyo cardiologist uye varindi.

In zvikuru kukundikana vharuvhu pane chinokosha mumatenhere jugular mutsinga. Panyaya iyi, kana kurudyi kusvika jugular tsinga kuti ruoko, unogona kunzwa kuzununguka. In chakakomba zviitiko, zvokurwara kunoguma zvakanaka ventricular dysfunction, atrial fibrillation, kana mwoyo kukundikana kunogona kukonzera.

Diagnostics

Chirwere "tricuspid regurgitation 1 dhigirii" kana vamwe zvinogona chete kuitwa pashure kumbonyatsoongorora kuzviongorora murwere. Kuti aite izvi, pindai anotevera nzira:

• .. Physical kuongororwa nzira, kureva auscultation ane stethoscope pasi uye mwoyo ino- tsutsumwa;
• Echocardiography (echocardiography) - munhu cardiac Ultrasound, izvo rinozivisa chadzo uye morphological mamiriro mwoyo tsandanyama uye mavharuvhu;
• ECG, umo munogona kuona zviratidzo rworudyi atrium wakakurisa uye ventricle kwomwoyo;
• bhokisi X-ray - apo kudzidza unowanikwa yakawedzera zvakanaka ventricular kukura, mumwe anogona kuona zviratidzo pulmonary neBP uye deformation kuti mitral uye kutsemuka mavharuvhu;
• kubereka nokukanganisika ropa;
• kwakakwana ropa count;
• cardiac catheterization - ichi ichangoburwa invasive nzira inoshandiswa nechirwere ose cardiac pathologies uye kurapwa.

kupatsanura

Takaona kuti tricuspid vharuvhu regurgitation etiology kungava vachiberekwa kana akawana, chikuru (Organic) kana yechipiri (dzichipfekeka). Organic insufficiency akaratidza deformation valvular: thickening uye kuunyana vharuvhu mapepa kana calcification. Functional vanotaura kunoratidzwa apo vharuvhu dysfunction anokonzerwa zvimwe zvirwere, akaratidza atsamwira pamusoro papillary tsandanyama kana mudzira chords or the uye kutyora anulus.

kukura chirwere

Kusiyanisa 4 madhigirii zvirwere, izvo kubudikidza refu ropa kutsinga inozivikanwa harungashandurwi kuitika ndege iri mhango rwerudyi atrium.

Tricuspid regurgitation 1 dhigirii - chii? Panyaya iyi, kudzoka uzvirasire ropa riri chisingakoshi uye asiri kutsunga. Panyaya iyi, murwere pasinei haisi kunyunyuta. The kunotoda mufananidzo chisipo.

Apo chirwere kuti "mwero tricuspid regurgitation 2" neizvi ndege Kudzingwa ropa kunoitika mukati 2 cm kubva pavharuvhu masvingo. Clinic Panguva iyi chirwere hariwanzotaurwa, anogona havaratidzi akaratidza pulsation jugular mutsinga.

Regurgitation tricuspid vharafu 3 iri pakutsvaga mwero zvinopesana neizvi kuitika regurgitation ropa anopfuura 2 cm kubva tricuspid vharuvhu. Varwere kunze ripple mutsipa mutsinga vanganzwa palpitations, simba uye kuneta, kunyange zvishomanana kupfupika kufema zvingaitika pamwe yakaderera kurovedza muviri.

The chirwere kunoratidzwa zvikuru mugwaro 4 ndege neizvi ropa riyerere vachikandira kwenguva kure vharuvhu kupinda mhango rwerudyi atrium. In kwazvo zviratidzo zvikuru mwoyo nokukundikana uye pulmonary neBP murwere anogona kuonekwa (pulmonary uye tricuspid regurgitation). Panyaya iyi, zviratidzo pamusoro apa, vakabatana nevamwe. Kureva, rezasi muzvidimbu edema, ndichinzwa pulsation akasiya sternum, iyo inowedzera inspiratory, havachanyatsogoni mwoyo inonzwika, migumo inotonhora, kuwedzere chiropa, ascites (mvura kuunganidza ari abdominal mhango), abdominal kurwadziwa, uye nokuda rheumatic hunhu chirwere ichi chinogona kuonekwa kutsemuka kana mitral.

mabatiro

Marapirwo kuvimba kwokuomerwa chirwere, uyewo kana iri pamwe nemamwe mwoyo zvikanganiso uye abnormalities kana kwete. Apo chirwere "tricuspid vharafu regurgitation 1 dhigirii" kurapwa Kazhinji mhosva. Kwakadaro vanachiremba chirwere inokurukurwa sezvo hwandaiva musiyano. Kana tricuspid regurgitation 1 dhigirii nokuda vamwe chirwere, akadai zvemapapu chirwere, rheumatism kana infective endocarditis, chinofanira kuva kurapa zvirwere provocateur. Kana kubvisa runotikurudzira chirwere, uye kumisa zvakare deformation pamusoro tricuspid vharuvhu. Saka, tricuspid regurgitation 1 dhigirii - chii uye sei kurapa payo, iye zvino pachena. Chimbofunga inotevera pavaipfuura chirwere.

Tricuspid vharafu regurgitation giredhi 2 kazhinji haatarisiri kurapwa. Kana zvokurwara Rinobatanidzwa nevamwe malformations, kana cardiac zvirwere zvakadai congestive mwoyo kukundikana, zvinokosha kuti vaitirane kuchinja nzira. Nokuti chinangwa ichi, diuretics inoshandiswa kuderedza kuzvimba uye gadziriro, vakazorora kumeso tsandanyama rwengarava ropa (vasodilators). Other matanho tricuspid regurgitation giredhi 2 havadikanwi.

Mabatirwo mamakisi 3 uye 4 ndiverenge kubviswa hosha, regurgitation kunokonzerwa. Kana zvikasashanda, kuvhiya zvinoratidzwa. Kana ichi mapurasitiki zvinhu inopiwa vharafu ichibhabhamisa, avo annuloplasty (podshivanie kusanduka kana vanachandagwinyira zvindori uyewo zvichida vharuvhu suture mhete kuburikidza suturing) kana prosthesis.

mitral regurgitation

Kana kukundikana of mitral vharuvhu, kana ichibhabhamisa ayo dzakavharika zvakasimba zvakakwana, pane neizvi chokubuda ropa kubva ventricle rworuboshwe kupinda atrium kuruboshwe panguva systole. Ichi chirwere anonzi mitral regurgitation kana mitral vharafu prolapse. zvokurwara ichi sezvo tricuspid regurgitation vangava vachiberekwa kana vawana. Zvinokukonzera uye chirwere iri nechirwere kuti "mitral" uye "tricuspid regurgitation" kuri yakafanana. Kukura, kuona kukomba kwechirwere chacho, 4 chete, vanovimba chitsama ropa neizvi iyezvino:

• 1 dhigirii - zvishomanana mitral regurgitation;
• 2 dhigirii - mwero mitral regurgitation;
• 3 dhigirii - akaratidza kukosha mitral regurgitation;
• 4 dhigirii - zvikuru mitral regurgitation rinowanzoberekera hwevanhu vanorwara.

Kusakosha mitral, tricuspid regurgitation 1 dhigirii kukonzera hapana Chinangwa zvichemo murwere, hapana kurapwa kunodiwa. Yokurapwa rinoitwa munguva yakaoma chirwere, semuenzaniso, mwoyo mutinhimira nenyonganiso kana pulmonary neBP. Kuvhiya kupindira unoratidzwa zvakakomba kana zvakakomba mitral insufficiency, mune zviitiko izvi kuti mapurasitiki kana prosthetic vharafu.

Tikafunga mitral uye tricuspid insufficiency

Kazhinji mitral uye tricuspid regurgitation vari panoonekwa mune imwe murwere panguva iyoyowo. Cardiologist pashure uone kuongororwa uye kuongorora migumisiro kutora chisarudzo pamusoro zvidobi kwokurapa murwere. Kana kukundikana mavharuvhu vakaratidza zvishoma ngaparege kurapwa kunodiwa asi anofanira nguva kuonekwa munhu cardiologist uye zvakaitika zvakakodzera bvunzo.

Kana kuisa kuti pakati kukundikana mavharuvhu, zvichava kupiwa yokurapwa zvainanga kubvisa provocateur chirwere. Pasina zvakanaka emuchina kurapa inoratidzwa regurgitation surgically. Kazhinji ichi chiri mucherechedzo uye zvikuru chirwere.

Varwere ndavhiyiwa kuvhiya Mabatirwo vharafu insufficiency, kazhinji akagadzwa negashiro zvisina kunanga anticoagulants.

mataridzikiro

Secondary regurgitation ichaongororwa kupfuura prognostically zvisingafadzi.. Kazhinji kufa kwevarwere munyika iyi kunoitika kubva myocardial infarction, kuwedzera mwoyo kukundikana, mabayo kana pulmonary embolism.

Maererano nenhamba, pashure kuvhiya kurapwa mwoyo vharafu insufficiency murwere Kupona kusvika 5 makore anopfuura 65% mushure prosthesis uye 70% pashure annuloplasty.

Yakanaka fungidziro pa chirwere "tricuspid regurgitation 1 dhigirii." Chii, varwere kazhinji kuziva chete panguva chokudzivirira bvunzo. Kana zvishoma kukundikana zvakananga upenyu haisi mwoyo mavharuvhu.

mhedziso

Kudzivirira of mitral uye tricuspid insufficiency ndiyo kudzivirira zvirwere kuti vanotsamwisa kukundikana mavharuvhu. Kureva, Mabatirwo rheumatism uye nezvimwe zvirwere kukonzera kukuvara mwoyo mavharuvhu.