Pulmonary Vienna. Anomalous pulmonary aa koko

Pulmonary Vienna (kiʻi i hoikeia ma lalo nei) - he ipu i lawe mai ua lako oukou me ka o oxygen i loko o nā maʻiʻaʻai i ka haʻalele atrium arterial koko.

E hoʻomaka ana mai o ka pulmonary capillaries merge i loko o kēia mau moku hou aa koko mea i hoouna aku ai i ka bronchi, laila Hoʻohana hapa iki, a me ka akemāmā nui ilpko o ka puka pā i hanaʻia (elua o kēlā me kēia kumu) i i kuhikuhi horizontally i loko o ka luna o ka atrium hema. Eia hou kekahi, kela mea keia mea o na barela komo i loko o ka hookaawale puka: haʻalele - ma kaʻaoʻao hema o ka haʻalele atrium, a me ka pono, mai ka akau. Pono pulmonary aa koko, i kēia atrial (hema) transversely intersect ka atrium akau (kona kua).

Mawaho pulmonary (pono) Vienna

Hana segmental aa koko Hoʻohana o ka waena a me ka hoaka o akemāmā lobes.

• R.apicalis (lala apical) - poe pōkole venous kumu, i ua aia ma ka hoaka o ka lobe (mediastinal kona ili) a me ka hāpai koko mai ka Hoʻohana kihi. Ma mua o ke komoʻana i loko o ka pono i oi pulmonary aa koko pinepine hui me ka segmental (hope) lala.
• R. posterior (hope lala) hāpai koko ohi mai i ka hope Hoʻohana. Kēia lālā - i ka loa o nā mea a pau i ka nui Vienna aa koko (segmental), a i aia i loko o ke keena lobe. Ma keia moku i kaʻawale kekahi mau māhele: vnutrisegmentarny poddolevoy Hoʻohana a me ka Hoʻohana i ka 'ohi i ke koko mai interlobar' ilikai āpana o kēlā 'oä.
• R.anterior (mua lala) hāpai koko mai ka luna o kaʻohiʻana kaʻana like ( 'ole anterior Hoʻohana). I kekahi manawa, hiki i ka hui pu iho i ka lala ke alo a me ka hope (ina e haule iho lakou iloko o ka hoʻomaopopo like kumu).
• R.lobi medii (waena lobe lala) loaʻa ke koko mai ka akau akemāmā Hoʻohana (kona awelika kaʻana like 'ana). Ma kekahi hihia, ua paa ia ia ka palapala o kekahi Vienna ka pahu, a kahe ana i loko o ka luna pono pulmonary aa koko, akā, pinepine ua hana wahi o nā māhele: ka medial a me ka kīloi paʻewa e omo pakahi medial a kīloi paʻewa Hoʻohana.

Lower pulmonary (pono) Vienna

Kēia moku i ke koko mai ka haʻahaʻa lobe (kona Hoʻohana 5) a i ka papa kuhikuhiE inflow mau: basal aa koko a me ka pono ole, keena lala.

Ka luna lala

, Ae waiho nei ma waena o ka basal a me ka luna Hoʻohana. Ua hana mai o ka hou a me ka papa kuhikuhiE aa koko, e e aku a me ka ia, maalo ae la oia ma ke kua o ka apical segmental bronchus. Keia lala o ka luna o nā mea a pau i nele i loko o ka lalo pono pulmonary aa koko.

Alaila bronchitis Vienna maupaʻa ka papa kuhikuhiE inflow ekolu: kīloi paʻewa, mauka medial, Aia i loko o ka hapanui o ka intersegmental akā, hiki ke holo a me ka vnutrisegmentarno.

Aie i ka mea hou koko outflow aa koko lawe e ka luna Hoʻohana (kona luna) i loko o ka'āina poddolevuyu segmental aa koko e kūkulu maluna lobe (kona posterior Hoʻohana).

Basal huina Vienna

He He pōkole venous kumu, i hanaʻia ma ka huina o ka lalo a me ka hoaka o basal aa koko ka papa kuhikuhiE mau lala i moe malalo iho mua, he pono ole ili.

Basal luna Vienna. I hanaʻia ma ka hoʻokuʻi pū o ka nui basal segmental aa koko a me ka aa koko e lawe aku i ke koko mai ka medial, anterior a me kīloi paʻewa Hoʻohana.

Basal lalo Vienna. Pili i ka nohona ma basal aa koko, mai kona haʻahaʻa ili hoʻi. I ka papa kuhikuhiE inflow o ka ipu - basal posterior lala i 'ohi i ke koko mai ka basal posterior Hoʻohana. Ma kekahi mau hihia, o ka lalo basal Vienna ke hoʻokokoke aku i ka luna o ka basal aa koko.

ADLV

He He congenital naau maʻi ma i hanana ua 'akomi i neanatomichnoe pulmonary aa koko i ka atrium (pono), ai pū ma ka polokalamu o ka vena cava.

Kēia pathology ua pu ma pinepine pneumonia, luhi, pokole o ka hanu, kali hou aku; o physical? Acaeoey, cardiacʻeha. E like me ka lapaʻau 'ana i hoʻohana: ECG, MRI, X-kukuna, cardiac catheterization, ultrasound, a me ventrikulo- atriografiyu, angiopulmonography.

ʻoki lāʻau lapaʻau lapaʻau kina hilinaʻi nui ma luna o konaʻano.

Overview

ADLV - congenital kina a me ka mea e pili ana i 1.5-3.0% o ka naau mā. Ka hapa nui o ka mea malama i kane nā mea maʻi.

Loa pinepine ua hui keia kina me ka'ololaha (hamama) window a me mā septum ma waena o nā ventricles. Iki emi (20%) - mai ka pono kumu koko, hypoplastic hemaʻaoʻao o ka naau, VSD, dextrocardia, tetralogy o Fallot, a me transposition o na moku nui, mau naʻau ventricle.

Ma waho aʻeo ia mau mā, pinepine pu ADLV extracardiac pathology: umbilical hernias, mā ma ka iwi ho okumu a me ka endocrine nenoai, intestinal diverticula, horseshoe hakuʻala, polycystic hakuʻala maʻi a me ka hydronephrosis.

Mea Maluna anomalous pulmonary venous nōkahea (ADLV)

Ma ka hihia o ka confluence o na aa koko i loko o ka systemic holo ai i loko o ka atrium akau, ua kapaia keia kina o ka piha anomalous nōkahea, ina ma ka mea ma luna o nā hale a kahe ana i loko o kekahi a me kekahi mau aa koko, ua kapaia ka helehelena e like me ke kina.

I kulike ai me ka nui o ka confluence līkaia no kekahi kīnā nā koho:

• First Lolina: nadserdechny (suprakardialny). Ke pulmonary aa koko (e like me ka pono kumu a kaawale) kahe i loko o ke keʻena vena cava a me kona lālā.
• Koho elua: naau (intracardiac). Pulmonary aa koko moni loa i loko o ka coronary sinus a me ka atrium akau.
• Apanaʻano: podserdechny (welaʻula ole subcardial). Pulmonary aa koko kāhuakomo i ka nū a vena cava haʻahaʻa (nui emi mai i loko o ka lymphatic leki uea).
• Ka mea ha koho: hui. Pulmonary aa koko komo i loko o kekahi hale, a ma kekahi mau pae.

hiʻona hemodynamics

I uteroʻeleu kina ua IeAUPIIe, IAa IO i ike, no ka mea, o ka mea 'o fetal holo. i ka hanau ana o ke keiki ma hope o hemodynamic hoike ana i ho'ākāka 'ia no keia kina a me kona hui pu ana, a me nā congenital anomalies.

Ma ka hihia o ka huina anomalous nōkahea o hemodynamic kāna hana i olelo ia hypoxemia, hyperkinetic overload o ka naau pono, a pulmonary hypertension.

Ma ka hihia o ka hapa nōkahea hemodynamics like no ia me ASD. O ka hana e alakai pili ana i ka 'aʻe' ana o'āno'ē arteriovenous shunt, i hiki aku ai i ka hoomahuahua i loko o ke koko buke i loko o ka uuku kaiapili.

Symptoms o anomalous pulmonary venous nōkahea

Kids me keia kina pinepine koʻu hoomanawanui ana'ku ia recurrent huʻi naehana hanu mea hoʻomaʻi nā mea palahēhē a me pneumonia, ka mea, e olelo aku nei cough, haʻahaʻa ke kaupaonaʻana waiwai, tachycardia, pokole o ka hanu, naau eha, ka malamalama cyanosis a me ka luhi.

Ma ka hihia o pulmonary hypertension Ua akaka no ka puka ma ka liʻiliʻi makahiki ikea naau e hemahema, kaheaia cyanosis a me ka naau kuapuʻu.

lapaʻau '

Picture auscultation ma ADLV like ia ASD, i mea structurally lolelua ka auscultated systolic leo i loko o nā nā wānana waiwai o aa koko arteries (pulmonary aa koko) a me ka splitting o ka 2nd leo.

• Ke ECG na hoailona o ka pono naau overload, ka haiahū kūmau EOS akau blockade (kāpili), pono puolo me lālā hihia.
• I ka phonography hoailona o ASD.
• I radiography loaa kumu malamalama bulging pulmonary artery (kona piʻo), hoʻonui i ka pono cardiac palena, "Turkish saber" symptom.
• Echocardiography.
• Kaʻimiʻana cardiac cavities.
• Venography.
• Atriografiya (pono).
• Angiography.
• Ventriculography.

Palena pauʻike, o keia kina E hanaʻia nō ia.

• Lymphangiectasia.
• Aortic atresia / mitral kiwikā.
• na moku transposition.
• Mitral stenosis.
• Stenosis o ka akau / waiho pulmonary aa koko.
• Trehpredserdnym naau.
• Kaʻawale ASD.

lapaʻau

Ano o kaʻoki kino hapa nōkahea nānā 'ana kekahi kīnā, ka nui a me ka wahi ASD.

Atrial memo hoʻopau hoʻohana ea a suturing ASD. Na kamalii uuku mai a hiki i ka makahiki o ka ekolu i ka mea ma ka noho pilikia noho pilikia ana, lawe mai palliativeʻoki kino (paʻa atrioseptotomiyu), i ka pahuna ma hoʻonui interatrial kamaʻilio.

Total'ano'ē kina? Iaea (huina pepa) ka loaʻa o kekahi mau manipulations.

• Ligation pathological pou vascular aa koko.
• Hoʻokaʻawale o ka pulmonary aa koko.
• Panina o ASD.
• Anastomosis ma waena o ka haʻalele atrium a me pulmonary aa koko.

Ke no o ia mau hana i e: mahuahua o pulmonary hypertension maʻi pale, a me ka sinus wahi ole.

Time]

Ke prognosis o ka papa maoli o keia kina noho lakou malaila, mai 80% o nā mea maʻi e make i loko o ka makahiki mua o ke ola.

Nā mea maʻi i ke alo o ka hapa nōkahea ke ola mai a hiki i ka makahiki o kanakolu. I ka make ana o ka mea e hoomanawanui i ka loa pinepine me pulmonary nā mea palahēhē, a loa naʻau ole hou pili.

Hopena oʻoki lāʻau lapaʻau? Iaea o ke kina pinepine kupono, akā, i loko o neonatal lethality manawa ma hope oʻoki kino mea kiʻekiʻe paha.