ʻO ka Anastomosis e pili ana i ke kamaʻilio ʻana ma waena o kekahi mau aʻalolo, a i ʻole kekahi mau kīʻaha koko, a i ʻole ma waena o kekahi mau moku lymphatic. ʻAe lākou, i ka wā i paʻa ai ke ala nui o nā kīʻaha koko, e hāʻawi i nā ala kahe koko lua. ʻO kāna kuleana a laila e hoʻohui i ke kaʻa, e hana i kahi ala hou i kapa ʻia ʻo collateral circulation. ʻO kēia ka mea e hiki ai ke hōʻoia i ka hoʻoinu ʻana o kahi okana, ke hana ʻole ke ala nui o ke kahe koko.

Wehewehe o anastomosis

ʻO ka Anastomosis e pili ana i nā ʻāpana o ke kino e hiki ai ke kamaʻilio ma waena o kekahi mau aʻalolo, nā kīʻaha koko, a i ʻole nā ​​moku lymphatic. Hiki iā lākou ke hāʻawi i ke kahe o ke koko i ke ala lua no ka hoʻoulu ʻana i nā ʻōpū, i ka wā e keakea ai ke ala nui. Ma ka hoʻonui, no laila hiki iā mākou ke ʻōlelo aku ʻo ka anastomosis ka pilina ma waena o nā conduit ʻelua o ke ʻano like, ʻo ia hoʻi ma waena o ʻelua mau tubular hale me ka hana like.

Aia ma hea nā anastomoses?

Hāʻawi kekahi mau aʻa i ka hapa nui o nā ʻiʻo. Ke hui pū nā lālā o hoʻokahi aʻoi aʻe paha, hana lākou i ka mea i kapa ʻia he anastomosis. No laila, hiki ke ʻike ʻia kēia mau anastomoses ma nā ʻāpana he nui o ke kino, a he ʻano like ko lākou me nā aʻa koko a i ʻole nā ​​auwai a lākou e hoʻopili ai.

He aha ka anastomosis?

No laila, ua like ke kumu o kēia mau anastomoses me nā kīʻaha koko, a i ʻole nā ​​aʻalolo, a i ʻole nā ​​kīʻaha lymphatic i hoʻohui pū ʻia: he mau paipu a i ʻole nā ​​auwai, no laila ua hana ʻia e ka lumen, ʻo ia hoʻi ka lua kahi e kahe ai ka wai (e like me ke koko a i ʻole ka lymph. ), a ma o nā pūnaewele e hoʻopuni ana iā ia, ʻo ia hoʻi, no nā kīʻaha koko, he pā i hana ʻia me nā cell i kapa ʻia endothelial, palahalaha loa.

Eia kekahi, he ʻekolu ʻāpana ka capillary koko:

• ka loop capillary, hoʻohana ʻia no ka hoʻololi metabolic;
• ka metarteriole (ka ʻāpana hope o ka arteriole, a i ʻole ke aʻa liʻiliʻi), e hōʻoia ana i ka hoʻi ʻana o ke koko venous;
• a me ka anastomosis, ka mea e papalua i keia metarateriole, a wehe wale i ka wa pono.

Aia kekahi ʻōnaehana anastomoses ma ka pae o ka lolo: ʻo ia ka Willis polygon.

Hiki nō hoʻi ke hana i nā anastomoses ma ke kaʻina hana, ʻo ia ka hihia me ka colostomy, e hiki ai i ke kolon ke hiki i ka ʻōpū.

ʻO nā ala ʻē aʻe o ka hoʻoinu ʻana i kahi kiko

ʻO ke kuleana o nā anastomoses arterial ka hana ʻana i nā ala ala ʻē aʻe, no laila ke hoʻololi nei i nā aʻa i ka wā e ālai ʻia ai kēia mau mea. A laila hiki iā lākou ke mālama i ka irrigation o ke kino.

No laila, hiki i kekahi mau kumu ke ho'ōki i ke kahe o ke koko no ka manawa pōkole, no ka laʻana:

• i ka wā o nā neʻe maʻamau e hoʻoomi ana i kahi moku;
• inā paʻa ke kīʻaha koko, ma muli o ka maʻi a i ʻole ka ʻeha, a i ʻole i ka wā ʻoki.

ʻAʻole ʻoki ʻia ke kaʻahele, mahalo maoli i kēia mau ala pani, no laila he mau ala kaʻa kaʻa.

Polygon o Willis: vascularization o ka lolo

Mālama ka Willis polygon i ka vascularization o ka lolo. E pili ana ia i ka pōʻai arterial aia ma ke kumu o ka lolo, a he ʻōnaehana anastomotic nō hoʻi, no laila ke pani ʻia. No laila, hāʻawi ia i ka hāʻawi koko i ka lolo ʻoiai inā ʻeha a paʻa paha kekahi o nā aʻa o ka lolo.

ʻO nā aʻa me ka ʻole anastomoses: nā aʻa hope

Aia nā ʻaʻaʻa ʻaʻohe anastomoses: ua kapa ʻia lākou he ʻaʻaʻa hope. ʻO ka ʻoiaʻiʻo, ʻaʻole ia he pathology a he anomaly. Eia naʻe, ke pani ʻia ke kaʻa ʻana o kēia mau aʻa me ka ʻole anastomosis, a laila e hoʻopau loa ʻia ka hoʻoinu ʻana o kahi ʻāpana o ke kino holoʻokoʻa, ʻo ia ke kumu o kona necrosis, ʻo ia hoʻi ka make o kēia ʻāpana o ke kino. I kekahi manawa, hiki ke hele ka collateral circulation i loko o nā moku terminal e hāʻawi ana i kēia ʻāpana organ.

Malformations anévrysmales

ʻO ka Willis polygon ka noho, pinepine, o nā aneurysm malformations, ʻo ia hoʻi nā anomalies anastomosis, ʻo ia nā dilations e hana ana i nā ʻano baluna, nā ʻeke koko, aia i loko o nā aʻa cerebral, ka nui ma ka pae mai ko lākou lālā. Hoʻopilikia ka aneurysm i ka 1 a i ka 4% o ka heluna kanaka, haʻahaʻa loa ka pilikia o ka rupture akā he hanana koʻikoʻi loa ia, hiki ke make.

Ma ke kiʻekiʻe o nā hana, hiki ke hana ʻia nā anastomoses e nā ʻenehana ʻokiʻoki, ʻo ia hoʻi ke ʻano o ka anastomosis ma waena o ke kolonā a me ka ʻōpū, i kapa ʻia ʻo colostomy, kahi e hana ai no ka laʻana i ka wā o ka necrosis ma ke kiʻekiʻe o ka ʻōpū, a i ʻole ka anastomosis ma waena o nā ʻāpana ʻelua o ka ʻōpū, ma hope o ka ʻoki ʻana (ablation) o kahi ʻāpana necrotic o ka ʻōpū, ma hope pinepine o ka maʻi mesenteric e hoʻoulu ai i ka necrosis, a i ʻole ka ʻōpū.

ʻO ka angiography ka hōʻike x-ray e hiki ai iā ʻoe ke nānā i nā kīʻaha koko. Lawe ʻia e ka radiologist a i ʻole ka angiologist, e ʻae ia i ka ʻike ʻana i nā mea ʻino o ke kahe koko. ʻO kēia hoʻokolohua e hiki ai ke loaʻa nā kiʻi o nā kīʻaha koko i ʻike ʻole ʻia ma kahi X-ray maʻalahi. 

• ʻO nā anomalies vascularization i loko o lākou iho e ʻimi ʻia (no ka laʻana, nā anomalies ma ke kiʻekiʻe o nā ʻaʻa coronary, a i ʻole ke kiʻekiʻe o ka venous network o nā wāwae) ma mua o nā anastomoses iā lākou iho, ka mea e hoʻopiʻi i kēia mau abnormalities. o na wawae. ʻili wai.
• Hiki ke ʻike ʻia nā mea ʻino ʻole aneurysm, ʻo ia hoʻi e ka MRI. ʻAe ʻia ka ʻike maikaʻi o ka vascularization o ka lolo ma muli o ka holomua o ke kiʻi, e like me arteriography, MRI no laila, a i ʻole computed tomography (scanner), me ka ʻole a i ʻole ke ʻano o ka huahana like ʻole.