Arterial embolism

Arterial embolism inoreva hohwa (embolus) iyo yakabva kune imwe nhengo yemuviri uye inokanganisa kukanganisika kweropa kuyerera kunhengo kana nhengo yemuviri.

"Embolus" izwi rinogwamba ropa kana chidimbu chinobata sechiuno. Izwi rekuti "emboli" rinoreva kuti pane zvinopfuura rimwechete kana chigamba. Kana iyo clot ichifamba kubva panzvimbo iyo yaakaumba ichienda kune imwe nzvimbo mumuviri, inonzi embolism.

Iyo arterial embolism inogona kukonzerwa neimwe kana akawanda kuwanda. Iwo mavhinga anogona kunamira mune tsinga uye kuvharidzira kuyerera kweropa. Iyo yekuvhara inoziya nenzara zvinyama zveropa uye oxygen. Izvi zvinogona kukonzeresa kukuvara kana tishu kufa (necrosis).

Arterial emboli inowanzoitika mumakumbo nemakumbo. Emboli inoitika muuropi inokonzera sitiroko. Izvo zvinoitika mumoyo zvinokonzeresa kurwara kwemoyo. Pasina kujairika nzvimbo dzinosanganisira itsvo, ura, uye maziso.

Njodzi zvinhu zvekumisidzana embolism zvinosanganisira:

• Abnormal moyo mutinhimira senge atrial fibrillation
• Kukuvadza kana kukuvara kumadziro etsinga
• Mamiriro ezvinhu anowedzera kuvhara kweropa

Chimwe chiitiko chinokonzeresa njodzi yekukanganisa (kunyanya kuuropi) ndeye mitral stenosis. Endocarditis (hutachiona hwemukati memoyo) inogona zvakare kukonzera arterial emboli.

Chinhu chakajairika senge embolus inobva kunzvimbo dzekuomarara (atherosclerosis) muaorta nemimwe mitsipa mikuru yeropa. Aya mavharo anogona kusununguka uye kuyerera pasi kusvika kumakumbo netsoka.

Kugumburwa kunokatyamadza kunogona kuitika kana jira mutsinga rikapinda kurudyi kwemoyo uye ndokupfuura nepaburi kuruboshwe. Iro clot rinogona kubva raenda kune tsinga ndokuvhara ropa kuyerera kuenda kuuropi (sitiroko) kana dzimwe nhengo.

Kana hovha ichifamba uye kunogara mumatsinga anopa ropa kuyerera mumapapu, inonzi pulmonary embolus.

Iwe unogona kunge usina chero zviratidzo.

Zviratidzo zvinogona kutanga nekukurumidza kana zvishoma nezvishoma zvichienderana nehukuru hwemboro uye yakawanda sei inovhara kuyerera kweropa.

Zviratidzo zvemberi embolism mumaoko kana makumbo zvinogona kusanganisira:

• Chando chinotonhora kana gumbo
• Yakadzikira kana isina kurova ruoko kana gumbo
• Kushaikwa kwekufamba ruoko kana gumbo
• Marwadzo munzvimbo yakakanganiswa
• Chiveve uye kurira ruoko kana gumbo
• Ruvara rweruoko kana gumbo (pallor)
• Kuneta kweruoko kana gumbo

Gare gare zviratidzo:

• Mapundu eganda anodyiswa neyakakuvara tsinga
• Kudurura (kutsvedza) kweganda
• Kugadzirwa kweganda (ulcer)
• Tissue rufu (necrosis; ganda rakasviba uye rakakuvara)

Zviratidzo zveganda munhengo zvinosiyana nenhengo inobatanidzwa asi inogona kusanganisira:

• Marwadzo mune chikamu chemuviri chinobatanidzwa
• Kwechinguva kwakadzikira nhengo yebasa

Anopa rubatsiro rwehutano anogona kuwana kudzikira kana kushaya kwekupomba, uye kuderera kana kusave neropa kweruoko kana gumbo. Panogona kunge paine zviratidzo zvekufa kwetishu kana ronda.

Kuyedza kuongorora arterial embolism kana kuburitsa kunobva emboli kunogona kusanganisira:

• Angiography yemhedzisiro yakakanganiswa kana nhengo
• Doppler ultrasound bvunzo yemhedzisiro
• Duplex Doppler ultrasound kuongorora kwekupedzisira
• Echocardiogram
• MRI yeruoko kana gumbo
• Myocardial musiyano echocardiography (MCE)
• Plethysmography
• Transcranial Doppler bvunzo yetsinga kuuropi
• Transesophageal echocardiography (TEE)

Chirwere ichi chinogona kukanganisa mhedzisiro yemiedzo inotevera:

• D-dhiza
• Chinhu VIII kuyedza
• Isotope kudzidza yenhengo yakakanganiswa
• Plasminogen activator inhibitor-1 (PAI-1) chiitiko
• Platelet kuwanda bvunzo
• Tissue-mhando plasminogen activator (t-PA) mazinga

Arterial embolism inoda kurapwa nekukurumidza kuchipatara. Zvinangwa zvekurapa ndezvekudzora zviratidzo uye nekuvandudza kukanganiswa kweropa kuenda kunzvimbo yakakanganiswa yemuviri. Chikonzero cheganda, kana chikawanikwa, chinofanirwa kurapwa kudzivirira mamwe matambudziko.

Mishonga inosanganisira:

• Anticoagulants (senge warfarin kana heparin) inogona kudzivirira kugadzirwa kutsva
• Antiplatelet mishonga (yakadai saasipurini kana clopidogrel) inogona kudzivirira matsva matsva kubva pakuumba
• Marwadzo anopiwa kuburikidza netsinga (na IV)
• Thrombolytics (senge streptokinase) inogona kupwanya kugwamba

Vamwe vanhu vanoda kuvhiyiwa. Maitiro anosanganisira:

• Kupfuura kwetsinga (arterial bypass) kugadzira chechipiri sosi yeropa
• Kubvisa machira kuburikidza nebhatoni catheter yakaiswa mune yakashatirwa arteri kana kuburikidza neakavhurika akavhurika pane arteri (embolectomy)
• Kuvhura kwe arteri nebhaluni catheter (angioplasty) ine kana isina stent

Kuita zvakanaka kwemunhu kunoenderana nenzvimbo yechavhara uye kuti iro rakavhara sei rakavhara kuyerera kweropa uye kwenguva yakareba sei kuvharika kwave kuripo. Arterial embolism inogona kuve yakakomba kana ikasarapwa nekukurumidza.

Nzvimbo yakakanganiswa inogona kukuvara zvachose. Kudimurwa kunodiwa kusvika kune 1 mune ina makesi.

Arterial emboli inogona kudzoka kunyangwe mushure mekubudirira kurapwa.

Zvinetso zvinogona kusanganisira:

• Acute MI
• Utachiona mumaturu akanganiswa
• Sepic kuvhunduka
• Kurohwa (CVA)
• Kwechinguva kana kusingaperi kuderera kana kurasikirwa kweimwe nhengo yemitezo
• Yechinguva kana yekusingaperi itsvo kutadza
• Nyama kufa (necrosis) uye ronda
• Yenguva ischemic kurwisa (TIA)

Enda kuimba yekukurumidzira kana kufonera iyo yemuno emergency emergency (senge 911) kana iwe uine zviratidzo zvekumanikidza embolism.

Kudzivirira kunotanga nekutsvaga kunowanikwa sosi yeropa. Wako mupi anogona kunyorera vanotapira ropa (senge warfarin kana heparin) kudzivirira kugwamba kubva pakuumba. Antiplatelet zvinodhaka zvinogona zvakare kudikanwa.

Iwe une yakanyanya njodzi atherosclerosis uye kuwanda kana iwe:

• Chiutsi
• Ita zvishoma kurovedza muviri
• Iva neBP yakakwira
• Iva asina kujairika cholesterol mazinga
• Iva nechirwere cheshuga
• Wakanyanya kufuta
• Vanomanikidzwa

• Arterial embolism
• Kutenderera system

Aufderheide TP. Peripheral arteriovascular chirwere. Mune: Masvingo RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts uye Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: chits. 77.

Gerhard-Herman MD, Gornik HL, Barrett C, uye al. 2016 AHA / ACC nhungamiro pane manejimendi evarwere vane yakadzika yekumucheto ariperi arteri chirwere: Executive pfupiso: mushumo weAmerican College yeCardiology / American Heart Association Task Force paKiriniki Yekudzidzira Nhungamiro. J Ndiri Coll Cardiol. 2017; 69 (11): 1465-1508. PMID: 27851991 pubmed.ncbi.nlm.nih.gov/27851991/.

Goldman L. Kusvika kumurwere pamwe neanogona chirwere chemwoyo. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chitsama 45.

Kline JA. Pulmonary embolism uye yakadzika vein thrombosis. Mune: Masvingo RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts uye Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: chits. 78.

Wyers MC, Martin MC. Acute mesenteric arterial chirwere. Mune: Sidawy AN, Perler BA, eds. Rutherford Kuvhiya kweVascular uye Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019: chitsiko 133.