Anastomosis

Anastomosis

Anastomosis na-ezo aka na nkwurịta okwu n'etiti ọtụtụ irighiri akwara, ma ọ bụ ọtụtụ arịa ọbara, ma ọ bụ n'etiti ọtụtụ arịa lymphatic. Ha na-ekwe ka, mgbe a na-egbochi ụzọ isi nke arịa ọbara, inye ụzọ mgbasa ọbara nke abụọ. Ọrụ ya bụ imeju mgbasa, na-etolite ụzọ ọhụrụ a na-akpọ mgbasa ozi nkwekọrịta. Nke a na-eme ka o kwe omume iji hụ na ịgbasa mmiri nke akụkụ ahụ, mgbe ụzọ bụ isi nke mgbasa ọbara anaghịzi arụ ọrụ.

Kedu ihe bụ anastomosis?

Nkọwa nke anastomosis

Anastomosis na-ezo aka n'akụkụ ahụ nke na-enye ohere nkwurịta okwu n'etiti ọtụtụ irighiri akwara, ọtụtụ arịa ọbara, ma ọ bụ ọbụna ọtụtụ arịa lymphatic. Ha na-eme ka o kwe omume, n'ihe banyere arịa ọbara, inye mgbasa ozi ọbara ụzọ nke abụọ maka ịgbanye akụkụ ahụ mmiri, ozugbo enwere ihe mgbochi nke ụzọ isi. Site na ndọtị, anyị nwekwara ike ịsị na anastomosis bụ njikọ dị n'etiti ụzọ abụọ nke otu ọdịdị, ya bụ n'etiti akụkụ abụọ nke tubular nwere otu ọrụ.

Ebee ka anastomoses dị?

Ọtụtụ akwara na-enye ọtụtụ anụ ahụ. Mgbe alaka nke otu akwara ma ọ bụ karịa gbakọtara, ha na-etolite ihe a na-akpọ anastomosis. Ya mere, anastomoses ndị a nwere ike ịchọta n'ọtụtụ akụkụ nke ahụ, ha nwekwara usoro yiri nke arịa ọbara ma ọ bụ ducts ha na-ejikọta.

Kedu ihe anastomosis si eme?

Ya mere, anastomoses ndị a nwere otu iwu dị ka arịa ọbara, ma ọ bụ irighiri akwara, ma ọ bụ arịa lymphatic nke ha jikọtara ọnụ: ha bụ ọkpọkọ ma ọ bụ conduits, ya mere lumen kpụrụ, ya bụ oghere ebe mmiri na-ekesa (dị ka ọbara ma ọ bụ lymph). ), na site na mkpụrụ ndụ ndị gbara ya gburugburu, karịsịa, maka arịa ọbara, mgbidi nke sel mejupụtara nke a na-akpọ endothelial, gbawara agbawa nke ukwuu.

Ọzọkwa, capillary ọbara mejupụtara akụkụ atọ:

  • loop capillary, nke a na-eji maka mgbanwe metabolic;
  • metarteriole (akụkụ njedebe nke arteriole, ma ọ bụ obere akwara), na-eme ka nlọghachi nke ọbara venous;
  • na anastomosis, nke na-eme ka metateriole a okpukpu abụọ, ma na-emepe nanị mgbe ọ dị mkpa.

E nwekwara usoro nke anastomoses na ọkwa nke ụbụrụ: nke a bụ Willis polygon.

Ọ ga-ekwe omume ịme anastomoses n'ịwa ahụ, nke a bụ ihe gbasara colostomy, nke na-enye ohere ka eriri afọ ruo n'afọ.

Physiology nke anastomosis

Ụzọ ọzọ nke ịgba mmiri n'anụ ahụ

Ọrụ nke anastomoses arterial bụ imepụta ụzọ ndị ọzọ, si otú a dochie akwara akwara mgbe egbochiri ndị a. Ha na-eme ka o kwe omume ịnọgide na-enwe mmiri mmiri nke anụ ahụ.

Ya mere, ọtụtụ ihe na-akpata nwere ike ịkwụsị ịgba ọsọ ọbara nwa oge, dịka ọmụmaatụ:

  • n'oge nkịtị mmegharị compressing a arịa;
  • ọ bụrụ na egbochiri arịa ọbara, n'ihi ọrịa ma ọ bụ mmerụ ahụ, ma ọ bụ n'oge ịwa ahụ.

A naghị ebipụ okporo ụzọ, kpọmkwem maka ụzọ ndị a nọchiri anya, bụ nke bụ ụzọ okporo ụzọ.

Polygon nke Willis: vaskụla ụbụrụ nke ụbụrụ

The Willis polygon na-eme ka vaskụla ụbụrụ nke ụbụrụ dị ike. Ọ bụ ihe gbasara akwara akwara nke dị na isi ụbụrụ, ma ọ bụkwa usoro anastomotic, ya mere nnọchi. Ya mere, ọ na-enye ọbara na-enye ụbụrụ ọbụna ma ọ bụrụ na otu n'ime akwara ndị dị n'ụbụrụ mebiri ma ọ bụ mechie.

Anomalies / pathologies

Ọkpụkpụ akwara na-enweghị anastomoses: akwara ndị na-akwụsị

Enwere akwara ndị na-enweghị anastomoses: a na-akpọ ha arteries njedebe. N'ezie, ọ bụghị pathology ma ọ bụ anomaly. Otú ọ dị, mgbe a na-egbochi mgbasa nke akwara ndị a na-enweghị anastomosis, a na-akwụsị ịgba mmiri nke akụkụ akụkụ ahụ dum, nke na-akpata necrosis ya, ya bụ ọnwụ nke akụkụ ahụ. Mgbe ụfọdụ, mgbasa ozi nwere ike ịgafe n'ọdụ ụgbọ mmiri na-ebunye akụkụ akụkụ a.

Malformations anevrysman

The Willis polygon bụ oche, ọtụtụ mgbe, nke aneurysm malformations, ie anastomosis anomalies, nke bụ dilations na-akpụ ụdị balloons, akpa nke ọbara, nke dị na cerebral arteries, tumadi na larịị si alaka ha. Aneurysm na-emetụta 1 ruo 4% nke ndị bi na ya, ihe ize ndụ nke mgbawa dị ntakịrị ma ọ bụ ihe omume dị oke njọ, nwere ike ịnwụ.

Ọgwụ

N'ogo nke ntinye aka, anastomoses nwere ike ime site na usoro ịwa ahụ, ọ bụ karịsịa ihe gbasara anastomosis n'etiti colon na afo, nke a na-akpọ colostomy, nke na-eme ihe atụ na ihe omume nke necrosis na ọkwa nke eriri afọ, ma ọ bụ nke anastomosis n'etiti akụkụ abụọ nke eriri afọ, mgbe resection (ablation) nke a necrotic akụkụ nke eriri afọ, ọtụtụ mgbe na-eso a mesenteric infarction inducing necrosis, ma ọ bụ a etuto.

diagnostic

Angiography bụ nyocha x-ray nke na-enye gị ohere iji anya nke uche hụ arịa ọbara. Onye dọkịta na-ahụ maka redio ma ọ bụ ọkà mmụta ọrịa angiologist na-eme ya, ọ ga-ekwe ka a chọpụta ihe na-adịghị mma nke mgbasa ọbara. Nlele a si otú a na-eme ka o kwe omume ịnweta onyonyo nke arịa ọbara nke a na-agaghị ahụ anya na X-ray dị mfe. 

  • Ọ bụ kama vascularization anomalies n'ime onwe ha ka a ga-achọ (dịka ọmụmaatụ, anomalies na ọkwa nke akwara obi, ma ọ bụ na ọkwa nke venous netwọk nke ụkwụ) karịa nke anastomoses n'onwe ha, nke na-emekarị na-akwụ ụgwọ maka ndị a abnormalities. nke ụkwụ. anụ ahụ ogbugba mmiri n'ubi.
  • A pụkwara ịchọpụta ihe na-adịghị mma nke aneurysm, karịsịa site na MRI. A na-ekwe ka ezi ihe ọmụma nke vaskụla ụbụrụ nke ụbụrụ na-enye ekele maka ọganihu na-ese onyinyo, dị ka arteriography, MRI ya mere, ma ọ bụ ọbụna computed tomography (scanner), na ma ọ bụ na-enweghị injection nke ngwaahịa dị iche.

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