He kī nui nā aʻa pulmonary: lawe lākou i ke koko mai ka ventricle ʻākau o ka puʻuwai i nā lobes pulmonary, kahi e oxygenated ai. Ma hope o ka phlebitis, hiki i kahi piʻi koko e piʻi i kēia aʻa a me ka waha: ʻo ia ka embolism pulmonary.

Hoʻomaka ke aʻa pulmonary mai ka ventricle ʻākau o ka puʻuwai. Piʻi ia ma kahi aʻe o ka aorta, a hōʻea i lalo o ke kia o ka aorta, ʻoki ʻia i ʻelua mau lālā:

Ma ka pae o ka hilum o kēlā me kēia māmā, mahele hou ʻia nā aʻa pulmonary i nā aʻa lobar i kapa ʻia.

• i ʻekolu mau lālā no ke aʻa pono pono o ka pulmonary;
• i nā lālā ʻelua no ke aʻa hema o ka pulmonary.

Ma kēia mau lālā e hoʻokaʻawale i nā lālā liʻiliʻi a liʻiliʻi, a lilo i capillaries o ka pulmonary lobule.

ʻO nā aʻa pulmonary nā aʻa nui. ʻO ka ʻāpana mua o ke aʻa aʻa, a i ʻole kumu, ke ana ʻia ma kahi o 5 cm e 3,5 cm ke anawaena. ʻO ka ʻāpana o ka pulmonary akau he 5 a 6 cm ka lōʻihi, kūʻē iā 3 cm no ke aʻa ʻūlū hema.

ʻO ke kuleana o ka aʻa pulmonary e lawe i ke koko i kipaku ʻia mai ka ventricle ʻākau o ka puʻuwai i nā ake māmā. ʻO kēia koko i kapa ʻia he venous koko, ʻo ia hoʻi non-oxygenated, a laila oxygenated i loko o nā akemāmā.

Emperor pulmonary

ʻO ka thrombosis hohonu (DVT) a me ka pulmonary embolism (PE) nā hōʻike maʻi lua o ka mea like, maʻi thromboembolic venous (VTE).

ʻO ka pulmona embolism e pili ana i ka ālai ʻia o ke aʻa puʻupuʻu e kahi kīʻaha koko i hana ʻia i ka manawa o phlebitis a i ʻole thrombosis venous, pinepine i nā wāwae. Haki kēia ʻōpala, hele a i ka puʻuwai ma o ke kahe o ke koko, a laila kipaku ʻia mai ka ventricle ʻākau a i kekahi o nā aʻa pulmonary e pau ai i ka keakea. ʻAʻohe o oxygenated ka ʻāpana o ka māmā. Hoʻokomo ka ʻōpala i ka puʻuwai kūpono e pauma i ka paʻakikī, i hiki ke hoʻonui i ka ventricle ʻākau.

Hōʻike ka pulmonary embolism iā ia iho i nā ʻoi aku a ʻoi aku paha o nā hōʻailona koʻikoʻi e pili ana i kona koʻikoʻi: ʻeha o ka umauma ma kekahi ʻaoʻao e hoʻonui ana i ka hoʻoulu, paʻakikī i ka hanu ʻana, i kekahi manawa me ka sputum me ke koko, a ma nā hihia ʻoi loa, ka liʻiliʻi o ka puʻuwai puʻuwai. mokuʻāina o ka pīhoihoi, ʻo ia hoʻi ka hopu ʻana i ka cardio-circulatory.

Pulmonary arterial hypertension (a i ʻole PAH)

ʻO kahi maʻi laha ʻole, hypertension arterial pulmonary (PAH) i ʻike ʻia e ke kahe o ke koko kiʻekiʻe ma loko o nā aʻa liʻiliʻi, ma muli o ka mānoanoa o ka uhi o nā aʻa pulmonary. No ka uku ʻana i ke kahe o ke kahe o ke kahe, pono i ka ventricle ʻākau o ka puʻuwai e hoʻoikaika hou. Ke kūleʻa ʻole hou ia, ʻike ʻia ka hanu hanu ma ka hoʻoikaika ʻana. I kahi pae holomua, hiki i ka mea hoʻomanawanui ke hoʻomāhuahua i ka naʻau ʻole.

Hiki i kēia maʻi ke hele a sporadically (idiopathic PAH), i loko o kahi ʻohana (PAM ʻohana) a i ʻole hoʻopilikia i ka papa o kekahi mau pathologies (maʻi puʻuwai congenital, hypertension portal, maʻi HIV).

ʻO ka hypertension pulmonary thromboembolic maʻi (HTPTEC)

ʻO ia kahi ʻano laha ʻole o ka hypertension pulmonary, a hiki ke hopena ma muli o ka embolism pulmonary i hoʻonā ʻole ʻia. Ma muli o ka ʻaukā e ālai ana i ke aʻa o ka pulmonary, hoʻemi ʻia ke kahe o ke koko, kahi e hoʻonui ai i ke kahe o ke koko i loko o ke aʻa. Hōʻike ʻia ʻo HPPTEC e nā ʻōuli like ʻole, i hiki ke hōʻike ʻia ma waena o 6 mau mahina a me 2 mau makahiki ma hope o ka pulmonary embolism: ka liʻiliʻi o ka hanu, maule ʻana, edema i nā lālā, kahe me ka sputum koko, ka luhi, ka ʻeha o ka umauma.

Iapaau ana o ka pulmonary embolism

Aia ka mālama ʻana i ka embolism pulmonary i kona kiʻekiʻe o ka paʻakikī. ʻO ka Anticoagulant therapy ka lawa maʻamau no ka embolism pulmonary māmā. Hoʻokumu ʻia ia ma ka pahu o heparin no nā lā he ʻumi, a laila ka lawe ʻana o nā anticoagulants waha pololei. I ke kumu o ka pulmonary embolism kiʻekiʻe loa (haʻalulu a me / a i ʻole kuhiakau), hana ʻia kahi injection o ka heparin me thrombolysis (injection intravenous o kahi lāʻau e hoʻopau i ke koloka) a i ʻole, inā cont conticated ka hopena, e hoʻohana hou i nā māmā.

Iapaau ana o ka pulmonary arterial hypertension

ʻOiai nā holomua o ka lāʻau lapaʻau, ʻaʻohe lāʻau no PAH. Hoʻopili ʻia ka mālama multidisciplinary e kekahi o nā kikowaena mākaukau 22 i ʻike ʻia no ka mālama ʻana i kēia maʻi ma Palani. Hoʻokumu ʻia ia i nā ʻano lāʻau like ʻole (i ka nui o ka intravenous mau), ka lāʻau therapeutic a me ka hoʻololi ʻana o ka nohona.

ʻO ka mālama ʻana i ka hypertension pulmonary thromboembolic maʻi mau

Hana ʻia ka endarterectomy pulmonary surgical. Kuhi kēia hana e hoʻoneʻe i nā mea thrombotic fibrotic e ālai ana i nā aʻa pulmonary. Hoʻopaʻa pū ʻia ka lāʻau lapaʻau anticoagulant, pinepine no ke ola.

Hoʻokumu ʻia ke kuhi o ka pulmonary embolism ma luna o kahi hoʻokolohua hoʻokolohua piha e nānā ana, ʻo ia hoʻi, no nā hōʻailona o ka phlebitis, nā hōʻailona no ka embolism nui o ka pulmonary (ke kahe haʻahaʻa systolic a me ka wikiwiki o ka naʻau). Lawe ʻia nā hoʻokolohua like ʻole e like me ka hoʻokolohua hoʻokolohua e hōʻoia i ka hōʻoia a loiloi i ke koʻikoʻi o ka pulmonary embolism inā pono: kahi hōʻike koko no D-dimers (ke hōʻike nei ko lākou alo i ke kū ʻana o kahi ʻōpala, nā kinoea koko arterial. CT ʻo ka angiography o nā māmā ka pae gula no ka ʻike ʻana i ka thrombosis arterial

I ke kumu o ka kānalua o ke kiʻekiʻe o ka pulmonary hypertension, hana ʻia kahi ultrasound cardiac i mea e hōʻike ai i ka piʻi ʻana o ke kahe o ke aʻa a me kekahi mau maʻi kīnā ʻole o ka puʻuwai. Hui ʻia me Doppler, hāʻawi ia i ka ʻike ʻana i ke kahe o ke koko. Hiki i ka catheterization cardiac ke hōʻoia i ka hōʻailona. Hana ʻia me ka hoʻohana ʻana i ka catheter lōʻihi i hoʻolauna ʻia i loko o ke aa a piʻi i ka puʻuwai a laila i nā aʻa o ka pulmonary, hiki ke ana i ke kahe o ke koko ma ka pae o ka atria cardiac, ke kaomi o ke aʻa a me ke kahe o ke koko.

I kekahi manawa paʻakikī ka piʻi ʻana o ka thromboembolic pulmonary thromboembolic ma muli o kāna mau hōʻailona kūlike ʻole. Hoʻokumu ʻia kāna kuhi ma nā hoʻokolohua like ʻole: echocardiography e hoʻomaka me ka scintigraphy pulmonary a ʻo ka hopena kahi catheterization cardiac pono a me ka angiography pulmonary.