Аневризма и диссекция аорты

31.03.2012

aneurysma-a-disekce-aorty2.jpg - kopie
aneurysma-a-disekce-aorty2.jpg - kopie
Аневризма – выпуклость, выпячивание стенки сосуда. Возникает в какой угодно артерии, особенно серьзная, представляющая угрозу для жизни, может быть аневризма абдоминальной аорты. Диссекция означает рассечение стенки сосуда. при диссекции отдельные слои стенки сосуда отделяются друг от друга и кровь таким образом протекает двумя руслами

Аневризма и диссекция аорты

Аорта является самой большой артерией в человеческом теле. Аорта выходит из левого желудочка и заканчивается в брюшной полости, где делится на две большие ветви, которые снабжают кровью нижние конечности. Аорта – главная артерия, ветви которой снабжают кровью жизненно важные органы, такие как мозг, сердце и почки. Часть аорты, выходящая из левого желудочка, называется восходящей, потом она переходит в аортальную дугу и в продолжении – в нисходящую часть аорты. Различают грудную и брюшную аорту. Аневризмы обычно образовываются в брюшной части аорты, диссекции – в грудной части аорты, точнее – в ее восходящей части.

Аневризма аорты

Аневризма – выпуклость, выпячивание стенки сосуда. Возникает, таким образом, полость, которой протекает кровь. Аневризма возникает в месте ослабления стенки сосуда, причиной которого может быть воспаление стены сосуда, атеросклероз или высокое кровяное давление.

Симптомы и последствия аневризмы

Проблемой аневризм является то, что пока аневризма не лопнет (что проявится сильной болью), она может остаться незамеченной. Большие аневризмы могут быть осязаемы при пальпации живота как пульсирующие образования. Аневризмы могут давить на окружающие их органы, вызывать боль в животе и спине. Присутствие аневризмы является поводом к наблюдению у врача. Если аневризма достигает определенного размера, до 5 см, рекомендовано хирургическое вмешательство. В грудной части аорты аневризмы встречаются редко, чаще образуются в части брюшной. Опасность аневризмы так же состоит в возможном разрыве, когда кровь вытекает из аорты. Ввиду размера аорты и количества крови, которое ею проходит, а так же ввиду размера брюшной полости, существует опасность возникновения внутреннего кровотечения и нарушения кровообращения. Пациент может находиться в шоке – очень серьезном состоянии.

 Диагностика аневризмы аорты

Аневризму аорты нелегко диагностировать, так как размеры аневризм варьируются и обычно аневризма не вызывает никаких симптомов. В случае бóльших размеров можно нащупать в середине живота пульсирующее образование. Так же можно проверить свои подозрения при помощи стетоскопа – услышим … . достоверно подтверждает диагноз КТ или ультразвук. КТ или компьютерная томография – обследование, которое использует рентгеновское излучение для создания 3D изображения. Недостатком данного вида обследования является высокая доза излучения, которую получает тело. Ультразвук, напротив, является абсолютно безопасным методом обследования, так как используется проникновение звука и его поглощение разными типами ткани.

Лечение аневризмы аорты

Лечение аневризмы аорты состоит в санации факторов, которые принимают участие при возникновении данного заболевания. Используются лекарства из разных групп медикаментов. Необходимо снизить высокое кровяное давление и уровень холестерина в крови. Единственной возможностью избавления от аневризмы является хирургическое вмешательство. Чаще всего сначала в аорту вводят стенд, металлические укрепления, чтобы упрочнить сосуд. Существуют и другие методы укрепления стенки аорты в области выпячивания сосуда, которые однако более сложны и используются только специалистами в отделениях сосудистой хирургии.

Рассечение аорты

Рассечение аорты представляет собой разрыв стенки сосуда. Стена артерии состоит из трех слоев. При повреждении первого, внутреннего слоя, кровь проникает между первым и вторым слоем и возникает расслоение. В отличии от аневризмы, расслоение чаще возникает в грудной аорте. Причиной возникновения рассечения аорты может быть высокое кровяное давление, заболевания соединительной ткани стенки сосуда, в редких случаях так же – атеросклероз.

 Симптомы и последствия рассечения аорты

 Рассечение аорты представляет собой разрыв в ее стене, в области восходящей части аорты. Кровь скапливается в трещине и создает карман, подобный аневризме. Данное выпячивание может ограничивать проходимость крови аортой, которую может полностью закупорить. Так же может распространиться далее и затронуть артерии, которые выходят из аорты. Так же данные артерии могут быть сужены или закупорены. Рассечение аорты проявляется сильной неожиданной болью за грудиной, данное состояние может спонтанно устраниться. Ввиду возникновения рассечения аорты в области выхода аорты из сердца, где выходят и коронарные артерии, рассечение аорты может стать причиной инфаркта, или, например, повреждения аортального клапана. Так же могут быть повреждены артерии, снабжающие кровью мозг, что проявляется инсультом, возможен паралич некоторых частей тела. Могут быть повреждены почки, вследствие чего снизится объем мочи. В случае большой кровопотери развивается шок.

Диагностика рассечения аорты

Диагностика рассечения аорты состоит прежде всего в тщательном сборе подробного анамнеза с исключением острого инфаркта миокарда при помощи ЭКГ. Так же можно провести рентген грудной клетки, или эхокардиографии (ультразвуковое исследование сердца). Основным методом, который помогает обнаружить подавляющее большинство рассечений аорты, является трансэзофагеальная эхокардиография. Речь идет о ультразвуковом обследовании сердца, при котором зонд вводится через рот в пищевод и потом в желудок, что помогает точнее изобразить структуры сердца, включая аорту.

Лечение рассечения аорты

Рассечение аорты является опасным для жизни состоянием. Возможна однако временная и постоянная стабилизация данного состояния. Прежде всего она зависит от размера рассечения. Диссекция в области груди обязательна к операции, в то время как при рассечении брюшной аорты, при хорошем состоянии и без риска осложнений, операция не требуется.

 

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<a href=http://dp2.minzdravrso.ru/about/forum/user/37921/>http://dp2.minzdravrso.ru/about/forum/user/37921/</a>


Ведь раб не тот, кто стонет под кнутом,


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кто его знает


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Добрые люди подобны звездам, светилам того века, в котором они живут, озаряя свои времена.


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