Thoracic aortic aneurysm

Anurysm ke ho pharalla kapa ho putsoa ho sa tloaelehang ha karolo ea mothapo ka lebaka la bofokoli leboteng la methapo ea mali.

Aneurysm ea thoracic aortic e hlaha karolong ea mothapo o moholohali oa 'mele (aorta) o fetang sefubeng.

Lebaka le atileng haholo la aneurysm ea thoracic aortic ke ho thatafala ha methapo. Boemo bona bo atile haholo bathong ba nang le k’holeseterole e phahameng, khatello e phahameng ea mali ea nako e telele, kapa ba tsubang.

Mabaka a mang a kotsi bakeng sa aneurysm ea thoracic a kenyelletsa:

• Liphetoho tse bakiloeng ke lilemo
• Mathata a kopaneng a lisele tse kang Marfan kapa Ehlers-Danlos syndrome
• Ho ruruha ha aorta
• Kotsi ea ho oa kapa likotsi tsa makoloi
• Syphilis

Li -neurysms li hlaha butle butle ho feta lilemo tse ngata. Batho ba bangata ha ba na matšoao ho fihlela aneurysm e qala ho lutla kapa ho hola.

Matšoao a atisa ho qala ka tšohanyetso ha:

• Aneurysm e hola kapele.
• Meokho ea aneurysm e buleha (e bitsoang ho phatloha).
• Mali a dutla leboteng la aorta (aortic dissection).

Haeba aneurysm e hatella mehahong e haufi, matšoao a latelang a ka hlaha:

• Ho thothofala
• Ho metsa mathata
• Ho phefumoloha ho phahameng (stridor)
• Ho ruruha molaleng

Matšoao a mang a kenyeletsa:

• Sefuba kapa bohloko bo ka morao ba mokokotlo
• Letlalo la Clammy
• Ho nyekeloa le ho hlatsa
• Ho otla ha pelo ka potlako
• Kutloisiso ea kotlo e atamelang

Hangata tlhahlobo ea 'mele e tloaelehile ntle le haeba ho phatloha kapa ho dutla ho etsahetse.

Boholo ba li-aneurysms tsa thoracic aortic li fumanoa litekong tsa litšoantšo tse entsoeng ka mabaka a mang. Liteko tsena li kenyelletsa sefuba sa x-ray, echocardiogram, kapa sefuba sa CT scan kapa MRI.Sesebelisoa sa CT se sefubeng se bontša boholo ba aorta le sebaka se nepahetseng sa aneurysm.

Aortogram (setšoantšo se khethehileng sa litšoantšo tsa x-ray tse entsoeng ha dae e entsoe ka aorta) e ka khetholla aneurysm le makala afe kapa afe a aorta a ka amehang.

Ho na le kotsi ea hore aneurysm e ka buleha haeba u sa etsoa opereishene ea ho e lokisa.

Kalafo e latela sebaka sa aneurysm. Aorta e entsoe ka likarolo tse tharo:

• Karolo ea pele e ea holimo hloohong. E bitsoa aorta e nyolohang.
• Karolo e bohareng e kobehile. E bitsoa arch arch.
• Karolo ea ho qetela e ea tlase, ho ea maotong. E bitsoa aorta e theohang.

Bakeng sa batho ba nang le li-aneurysms tsa aorta e nyolohang kapa khoro ea aortic:

• Ho buuoa ho buoa sebaka sa aorta ho khothaletsoa haeba aneurysm e kholo ho feta lisenthimithara tse 5 ho isa ho tse 6.
• Sehiloeng se etsoa bohareng ba lesapo la sefuba.
• Aorta e nkeloa sebaka ke polasetiki kapa lesela le hlomathisitsoeng.
• Ena ke ts'ebetso e kholo e hlokang mochini oa pelo le matšoafo.

Bakeng sa batho ba nang le li-aneurysms tsa aorta ea thoracic e theohang:

• Ho etsoa opereishene e kholo ho khutlisa aorta ka ho hlomathisa lesela haeba aneurysm e kholo ho feta lisenthimithara tse 6.
• Ts'ebetso ena e etsoa ka lehlakoreng le letšehali la sefuba, le ka fihlelang ka mpeng.
• Endovascular stenting ke khetho e fokolang haholo. Stent ke tšepe e nyane kapa tube ea polasetiki e sebelisetsoang ho bula mothapo. Li-stents li ka kenngoa 'meleng ntle le ho itšeha sefuba. Leha ho le joalo, ha se batho bohle ba nang le li-aneurysms tsa thoracic tse batlang ho hlonama.

Pono ea nako e telele bakeng sa batho ba nang le aneurysm ea thoracic aortic e latela mathata a mang a bongaka, a kang lefu la pelo, khatello e phahameng ea mali le lefu la tsoekere. Mathata ana a kanna a baka kapa a tlatsetsa boemong bona.

Mathata a tebileng kamora ho buuoa ka aortic a ka kenyelletsa:

• Ho tsoa mali
• Ho kenya letsoho tšoaetsong
• Lefu la pelo
• Ho otla ha pelo ka tsela e sa tloaelehang
• Tšenyo ea liphio
• Ho shoa litho
• Leqeba

Lefu kapele kamora ts'ebetso le etsahala ho batho ba 5% ho isa ho 10%.

Mathata ka mor'a ho hlaseloa ke aneurysm a kenyelletsa tšenyo ea methapo ea mali e fang leoto, e ka hlokang ts'ebetso e ngoe.

Bolella mofani oa tlhokomelo ea bophelo haeba u na le:

• Nalane ea lelapa ea mathata a amanang le lisele (joalo ka Marfan kapa Ehlers-Danlos syndrome)
• Ho se utloise bohloko sefubeng kapa mokokotlong

Ho thibela atherosclerosis:

• Laola khatello ea mali le lipid.
• U SE KE UA tsuba.
• Ja lijo tse nepahetseng.
• Ikoetlise khafetsa.

Aneurysm ea aortic - thoracic; Syphilitic aneurysm; Aneurysm - thoracic aortic

• Ho lokisa mpa ea aortic aneurysm - ho bula - ho tsoa
• Ho lokisa aortic aneurysm - endovascular - ho tsoa

• Aortic aneurysm
• Ho phatloha ha aortic - x-ray sefubeng

Acher CW, Wynn M. Thoracic le aneurysms ea thoracoabdominal: kalafo e bulehileng ea ho buoa. Ka: Sidawy AN, Perler BA, bahlophisi. Rutherford's Vasculry and Endovascular Therapy. La 9th. Philadelphia, PA: Elsevier; 2019: khaolo ea 77.

Braverman AC, Schermerhorn M. Mafu a aorta. Ka: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Lefu la pelo la Braunwald: Buka ea bongaka ea meriana ea pelo. 11th ed. Philadelphia, PA: Elsevier; 2019: khaolo ea 63.

Lederle FA. Maloetse a aorta. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 69.

Singh MJ, Makaroun MS. Thoracic le thoracoabdominal aneurysms: kalafo ea methapo ea pelo. Ka: Sidawy AN, Perler BA, bahlophisi. Rutherford's Vasculry and Endovascular Therapy. La 9th. Philadelphia, PA: Elsevier; 2019: khaolo ea 78.