Akụ akwara akpa ume na-arụ ọrụ dị mkpa: ha na-ebuga ọbara site na ventricle ziri ezi nke obi gaa na lobes pulmonary, bụ ebe ikuku oxygen. Na-eso phlebitis, ọ na-eme na mkpụkọ ọbara na-agbago n'akụkụ akwara na ọnụ: ọ bụ embolism akpa ume.

Ọkpụkpụ akpa ume na-amalite site na ventricle aka nri nke obi. Mgbe ahụ, ọ na-ebili n'akụkụ aorta, na-erute n'okpuru archa nke aorta, na-ekewa n'ime alaka abụọ: akwara pulmonary ziri ezi nke na-aga n'akụkụ ngụgụ aka nri, na akwara akpa ume na-aga n'akụkụ aka ekpe.

N'ogo nke hilum nke ngụgụ ọ bụla, akwara pulmonary na-ekewa ọzọ n'ime ihe a na-akpọ akwara lobar:

• na alaka atọ maka akwara pulmonary ziri ezi;
• na alaka abụọ maka akwara akpa ume ekpe.

Alaka ndị a na-ekewa n'ime obere alaka ndị dị nta, ruo mgbe ha ghọrọ capillaries nke lobule pulmonary.

Eriri akwara bụ nnukwu akwara. Akụkụ mbụ nke akwara pulmonary, ma ọ bụ ogwe, ruru ihe dịka 5 cm na 3,5 cm na dayameta. Akwara akwara akpa ume ziri ezi bụ 5 ruo 6 cm ogologo, megide 3 cm maka akwara akpa ume ekpe.

Ọrụ nke akwara pulmonary bụ iweta ọbara a na-esi na ventricle ziri ezi nke obi banye na ngụgụ. Ihe a na-akpọ ọbara venous, ya bụ, enweghị oxygen, na-emezi oxygen na ngụgụ.

Ọrịa akpa ume

Ọkpụkpụ akwara miri emi (DVT) na embolism pulmonary (PE) bụ ngosipụta ụlọ ọgwụ abụọ nke otu ihe ahụ, ọrịa thromboembolic venous (VTE).

Embolim nke akpa ume na-ezo aka na mgbochi nke akwara akpa ume site na mkpụkọ ọbara nke emere n'oge phlebitis ma ọ bụ thrombosis venous, ọtụtụ mgbe na ụkwụ. Mkpụkọ a na-agbaji, na-aga n'obi ruo n'ọbara site na ọbara, wee si na ventricle aka nri chụpụ ya na otu n'ime akwara pulmonary nke na-emecha gbochie ya. Akụkụ nke ngụgụ adịkwaghị ikuku oxygen nke ọma. Mgbochi ahụ na-eme ka obi ziri ezi na-agbapụta nke ọma, nke nwere ike ime ka ventricle ziri ezi gbasaa.

Pulmonary embolism na-egosipụta onwe ya dị iche iche ma ọ bụ na-erughị nnukwu mgbaàmà dabere n'ịdị njọ ya: mgbu obi n'otu akụkụ na-abawanye na mkpali, ike iku ume, mgbe ụfọdụ ụkwara na sputum na ọbara, na n'ọnọdụ kachasị njọ, mmepụta obi dị ala, hypotension arterial na ọnọdụ nke ujo, ọbụna cardio-circulatory njide.

ọbara mgbali elu nke akwara pulmonary (ma ọ bụ PAH)

Ọrịa na-adịghị ahụkebe, ọbara mgbali elu na-adịghị ahụkebe (PAH) bụ nke e ji mara ọbara mgbali elu na-adịghị mma na obere akwara akpa ume, n'ihi oke nke mkpuchi nke akwara pulmonary. Iji kwụọ ụgwọ maka mbelata ọbara ọgbụgba, ventricle aka nri nke obi ga-agbasi mbọ ike. Mgbe ọ na-enwekwaghị ihe ịga nke ọma, ahụ erughị ala iku ume na mgbasi ike na-apụta. Na ọkwa dị elu, onye ọrịa nwere ike ịmalite nkụda mmụọ.

Ọrịa a nwere ike ime sporadically (idiopathic PAH), na ezinụlọ ezinụlọ (ezinụlọ PAH) ma ọ bụ gbagwojuru usoro nke ụfọdụ pathologies (congenital obi ọrịa, portal hypertension, nje HIV).

ọbara mgbali elu pulmonary thromboembolic na-adịghị ala ala (HTPTEC)

Ọ bụ ụdị ọbara mgbali elu nke akpa ume na-adịghị ahụkebe, nke nwere ike ime n'ihi ụbụrụ akpa ume na-edozighị ya. N'ihi mkpụkọ nke na-emechi akwara pulmonary, ọbara na-ebelata, nke na-abawanye ọbara mgbali na akwara. A na-egosipụta HPPTEC site na mgbaàmà dị iche iche, nke nwere ike ịpụta n'etiti ọnwa 6 na afọ 2 mgbe pulmonary embolism gasịrị: mkpụmkpụ ume, ịda mbà n'obi, edema na ụkwụ, ụkwara na sputum ọbara, ike ọgwụgwụ, mgbu obi.

Ọgwụgwọ nke pulmonary embolism

Nlekọta nke embolism nke akpa ume na-adabere n'ogo ya dị njọ. Usoro ọgwụgwọ mgbochi ọrịa na-ezukarị maka mgbakasị akpa ume dị nro. Ọ na-adabere na injection nke heparin maka ụbọchị iri, mgbe ahụ, ịṅụ ọgwụ mgbochi ọnụ. Ọ bụrụ na e nwere nnukwu ihe ize ndụ nke embolism akpa ume (ujo na / ma ọ bụ hypotension), a na-eme heparin injections na thrombolysis (intravenous injections nke ọgwụ nke ga-agbaze mkpụkọ) ma ọ bụ, ọ bụrụ na nke ikpeazụ bụ contraindicated , ịwa ahụ pulmonary embolectomy. ka ngwa ngwa megharịa ngụgụ.

Ọgwụgwọ ọbara mgbali elu nke akpa ume

N'agbanyeghị ọganihu ọgwụgwọ, ọ dịghị ọgwụgwọ maka PAH. A na-ahazi nlekọta multidisciplinary site na otu n'ime ụlọ ọrụ ikike iri abụọ na abụọ amara maka njikwa ọrịa a na France. Ọ na-adabere na ọgwụgwọ dị iche iche (karịsịa na-aga n'ihu na intravenous), mmụta ọgwụgwọ na mgbanwe nke ndụ.

Ọgwụgwọ ọbara mgbali elu pulmonary thromboembolic na-adịghị ala ala

A na-eme endarterectomy pulmonary ịwa ahụ. Ntinye aka a bu n'obi wepu ihe thrombotic fibrotic na-egbochi akwara pulmonary. A na-enyekwa ọgwụgwọ ọgwụ mgbochi ọrịa, ọtụtụ mgbe maka ndụ.

Nchoputa nke pulmonary embolism dabeere na nyocha ụlọ ọgwụ zuru oke na-ele anya, karịsịa, maka ihe ịrịba ama nke phlebitis, ihe ịrịba ama na-akwado nnukwu ọrịa pulmonary embolism (ọbara mgbali elu systolic dị ala na ọnụ ọgụgụ obi accelerated). A na-eme nyocha dị iche iche dị ka nyocha ụlọ ọgwụ si dị iji gosi na nchoputa ahụ ma chọpụta ịdị njọ nke embolism pulmonary ma ọ bụrụ na ọ dị mkpa: nyocha ọbara maka D-dimers (ọnụnọ ha na-egosi ọnụnọ nke clot, arterial gas gas. CT). angiography nke ngụgụ bụ ọkọlọtọ ọla edo maka ịchọpụta thrombosis arterial, mmetụta na arụ ọrụ nke ngụgụ, ultrasound nke akụkụ ụkwụ ala iji chọọ phlebitis.

Ọ bụrụ na a na-enyo enyo maka ọbara mgbali elu nke akpa ume, a na-eme ultrasound nke obi iji gosi ịrị elu nke akwara akpa ume na ụfọdụ adịghị ike nke obi. Ejikọta ya na Doppler, ọ na-enye ọhụụ nke mgbasa ọbara. Catheterization nke obi nwere ike kwado nchoputa ahụ. Emere ya site na iji ogologo catheter abanye n'ime akwara wee na-arịgo n'obi wee banye na akwara pulmonary, ọ na-eme ka o kwe omume ịlele ọbara mgbali elu n'ogo nke obi atria obi, mgbali akwara akwara na ọbara eruba.

Ọrịa ọbara mgbali elu thromboembolic na-adịghị ala ala na-esiri ike ịchọpụta mgbe ụfọdụ n'ihi mgbaàmà ya na-ekwekọghị ekwekọ. Nchọpụta ya dabere na nyocha dị iche iche: echocardiography ịmalite na pulmonary scintigraphy na n'ikpeazụ a ziri ezi catheterization obi na pulmonary angiography.