Mesenteric leeg ischemia

Mesenteric artery ischemia tshwm sim thaum muaj qhov nqaim lossis txhaws ntawm ib lossis ntau ntawm peb cov hlab ntsha tseem ceeb uas muab cov plab hnyuv me thiab loj. Cov no yog hu ua mesenteric arteries.

Cov hlab ntsha uas xa ntshav mus rau cov hnyuv khiav ncaj qha los ntawm aorta. Lub aorta yog cov hlab ntsha tseem ceeb ntawm lub siab.

Kev ua kom khov ntawm cov hlab ntsha tshwm sim thaum rog, cov roj cholesterol, thiab lwm yam khoom tsim ua ke rau ntawm cov hlab ntsha. Qhov no feem ntau muaj rau cov neeg haus luam yeeb thiab cov neeg muaj ntshav siab lossis ntshav siab.

Qhov no ua kom txoj hlab ntshav qis thiab txo cov ntshav ntws mus rau cov hnyuv. Zoo li txhua feem ntawm lub cev, ntshav nqa oxygen mus rau txoj hnyuv. Thaum cov pa oxygen tso tawm qeeb, cov tsos mob yuav tshwm sim.

Cov ntshav rau cov hnyuv yuav nres tam sim ntawd los ntawm ntshav txhaws (embolus). Cov ntshav txhaws feem ntau tuaj ntawm lub plawv lossis aorta. Cov ntshav khov no feem ntau pom nyob hauv cov neeg muaj lub plawv tsis xwm yeem.

Cov tsos mob tshwm sim los ntawm maj mam tawv ntawm cov leeg ntshav txhaws:

• Mob plab tom qab noj mov
• Zawv plab

Cov tsos mob cia li tshwm sim sai (mob) mesenteric artery ischemia vim yog ntshav ntoj ncig mus ncig muaj xws li:

• Cia li mob plab heev los yog tsam plab
• Zawv plab
• Ntuav
• Ua npaws
• Xeev siab

Thaum cov tsos mob pib dheev lossis dhau los ua mob hnyav, kev kuaj ntshav yuav qhia tias muaj cov qe ntshav dawb nce ntau ntxiv thiab cov lej hloov pauv hauv cov ntshav acid. Tej zaum yuav muaj ntshav hauv GI cov hnyuv.

Doppler ultrasound lossis CT angiogram scan yuav pom teeb meem nrog cov hlab ntsha thiab txoj hnyuv.

Daim phiajcim (mesenteric angiogram) yog ib txoj kev sim uas yuav siv ib cov xim tshwj xeeb rau hauv koj cov hlab ntshav kom pom cov leeg ntawm txoj hnyuv. Tom qab ntawd xoo hluav taws xob tau noj ntawm thaj chaw. Qhov no tuaj yeem qhia qhov chaw ntawm kev txhaws hauv txoj hlab ntshav.

Thaum cov ntshav nkag mus txhaws rau ib feem ntawm lub plawv, cov leeg yuav tuag. Qhov no yog hu ua plawv nres. Qhov kev raug mob zoo sib xws tuaj yeem ua rau txhua qhov ntawm cov hnyuv.

Thaum cov ntshav txaus dheev los ntawm ntshav txhaws, nws yog qhov xwm ceev. Kev kho mob tuaj yeem suav cov tshuaj kom yaj ntawm cov ntshav txhaws thiab qhib cov hlab ntsha.

Yog tias koj muaj cov tsos mob vim yog cov leeg ntawm cov leeg ntshav txhaws, muaj qee yam koj tuaj yeem ua los tswj cov teeb meem:

• Txiav kev haus luam yeeb. Kev haus luam yeeb nqaim cov hlab ntsha. Qhov no txo ​​qis kev muaj peev xwm ntawm cov ntshav nqa cov pa thiab ua rau muaj kev pheej hmoo ntawm kev txhaws (thrombi thiab emboli).
• Nco ntsoov tias koj cov ntshav siab yog tswj tau.
• Yog tias koj rog dhau lawm, txo koj qhov hnyav.
• Yog tias koj cov roj (cholesterol) siab, noj cov rog thiab cov zaub mov muaj roj tsawg.
• Saib xyuas koj cov ntshav qab zib kom qis yog tias koj muaj ntshav qab zib, thiab tswj nws.

Kev phais mob tuaj yeem ua yog tias qhov teeb meem loj.

• Qhov txhaws tawm thiab cov hlab ntsha rov txuas rau aorta. Ib qho kev hla ntawm kev thaiv kev yog lwm txheej txheem. Nws feem ntau yog ua nrog cov taub yas yas.
• Tso ntawm stent. Txoj kev siv quav tshuaj tuaj yeem siv los ua lwm txoj kev phais mob kom txhaws rau txoj hlab ntshav lossis xa cov tshuaj ncaj qha rau thaj chaw muaj kev puas tsuaj. Qhov no yog txheej txheem tshiab thiab nws yuav tsum tsuas yog ua los ntawm cov kws kho mob muaj kev paub zoo. Qhov tshwm sim feem ntau zoo dua nrog kev phais mob.
• Qee lub sijhawm, ib feem ntawm koj txoj hnyuv yuav tau tshem tawm.

Qhov pom ntawm tus mob mesenteric ischemia yog qhov zoo tom qab kev phais mob ua tiav. Txawm li cas los xij, nws yog ib qho tseem ceeb uas yuav tau hloov pauv kev ua neej los txhawm rau tiv thaiv cov tawv nqaij tawv kom txhob txhawm.

Cov neeg muaj hlab ntshav khov uas xa cov hnyuv feem ntau muaj teeb meem tib yam hauv cov hlab ntsha uas muab lub plawv, lub hlwb, lub raum, lossis ceg.

Cov neeg mob mesenteric ischemia feem ntau ua tsis tau zoo vim tias qee yam ntawm txoj hnyuv tuaj yeem tuag ua ntej kev phais mob tuaj yeem ua. Qhov no tuaj yeem ua rau neeg tuag taus. Txawm li cas los xij, nrog kev kuaj mob sai sai thiab kho mob, mob mesenteric ischemia tuaj yeem kho tau zoo.

Mob nqaij tuag vim tsis muaj ntshav txaus (ua rau ntshav tawm hauv cov hnyuv) yog qhov hnyav tshaj plaws ntawm mesenteric artery ischemia. Kev phais mob ntxiv kom tshem tawm qhov tuag.

Hu rau koj tus kws khomob yog koj muaj:

• Pauv plab hnyuv
• Ua npaws
• Xeev siab
• Mob plab heev
• Ntuav

Cov kev hloov hauv lub neej hauv qab no tuaj yeem txo koj txoj kev pheej hmoo rau txoj kev nqaim ntawm cov hlab ntsha:

• Ua kom ib ce muaj zog tas li.
• Ua raws li kev noj zaub mov zoo noj.
• Tau txais cov teeb meem plawv thaum kho tau.
• Tswj koj cov ntshav siab thiab ntshav qab zib cov ntshav kom tswj tau.
• Txiav Luam Yeeb.

Mesenteric vascular kab mob; Ischemic mob plab; Ischemic plob tsis so tswj - mesenteric; Tuag quav - mesenteric; Tuag tsam plab - mesenteric; Atherosclerosis - mesenteric leeg; Ua kom nruj ntawm cov hlab ntsha - mesenteric artery

• Mesenteric artery ischemia thiab infarction

Holscher CM, Reifsnyder T. Mob mesenteric ischemia. Hauv: Cameron AM, Cameron JL, eds. Kev Kho Mob Tam Sim NoCov. 13th ed. Philadelphia, PA: Elsevier; 2020: 1057-1061.

Kahi CJ. Vascular kab mob ntawm lub gastrointestinal ib ntsuj av. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: cha 134.

Lo RC, Schermerhorn ML. Mesenteric arterial disease: kev mob sib kis, pathophysiology, thiab tshuaj ntsuam xyuas. Hauv: Siavy AN, Perler BA, eds. Rutherford's Kev Kho Mob Ntshav Qab Zib thiab Kev Kho Mob EndovascularCov. 9le ed. Philadelphia, PA: Elsevier; 2019: chap 131.