Phinh dong mach chu bung benh de gay tu vong

Thứ bảy, 28 Tháng mười hai 2002, 10:52 GMT+7


Phinh dong mach chu bung benh de gay tu vong
Dong mach chu bi phinh to, de vo.

Benh thuong gap o nguoi cao tuoi, xuat hien khi dong mach chu bung co duong kinh tren 3 cm (hoac lon gap ruoi so voi trang thai binh thuong). Theo thong ke cua BV Cho Ray, o nhom benh nhan co trieu chung, khoang 80% chet trong vong 1 nam va 30% chet trong vong 1 thang. Ty le nay thap hon o nhung nguoi khong co trieu chung.

Cac nguyen nhan chu yeu gay phinh dong mach chu bung gom:

- Thoai hoa thanh dong mach.

- Viem quanh dong mach hoac viem dong mach chu.

- Roi loan bam sinh (hoi chung Ehlers- Danlos, hoi chung Marfan ).

Khi dong mach chu bung tang kich thuoc, benh nhan co cac bieu hien sau:

- Co khoi u vung bung dap theo nhip tim: Day la dau hieu thuong thay cua benh. Tuy nhien, doi voi benh nhan beo phi hoac co tui phinh chua lon lam, trieu chung nay khong de phat hien.

- Dau bung: Dau bung doi ra sau lung, xay ra khi tui phinh dong mach chu co bien chung boc tach hoac doa vo.

- Bien chung tac dong mach o chan: Xay ra o mot so benh nhan do co cuc mau dong hay manh xo vua trong tui phinh bong ra.

- Nhiem trung duong tieu tren hoac than u nuoc: Bieu hien la dau lung, sot, roi loan tieu tien, xay ra khi tui phinh de vao nieu quan.

- Xuat huyet tieu hoa: Xay ra khi dong mach chu bi ro vao ta trang. Day la mot bien chung nang cua benh.

Co the xac dinh benh phinh dong mach chu bung bang cac phuong phap chan doan hinh anh hoc nhu sieu am mach mau, chup cat lop, chup X-quang dong mach va chup cong huong tu. Cac trieu chung dau bung dot ngot va ngat xiu la dau hieu cho thay tui phinh dong mach da vo. Neu khong duoc cap cuu kip thoi, benh nhan se tu vong nhanh chong. Phat hien som va dieu tri kip thoi la cac yeu to quan trong nhat giup ngan ngua tai bien ke tren.

Tat ca cac truong hop phinh dong mach chu bung co trieu chung hoac bien chung phai duoc phau thuat de cat bo tui phinh va thay the dong mach bang ong ghep nhan tao. Nhung benh nhan chua co trieu chung nhung dong mach chu co duong kinh tren 4 cm cung can duoc mo som de tranh nguy co vo, tac mach.

Hien nay, can benh nay con duoc dieu tri bang can thiep noi mach, dat ong ghep dong mach chu xuyen long mach. Sau khi dieu tri, qua trinh thoai hoa mach mau o benh nhan van tiep dien, khien benh tai phat neu khong duoc dieu tri du phong. Do do, benh nhan can tai kham dinh ky de duoc theo doi va dieu tri cac benh ly di kem.

Nhung truong hop chua co chi dinh dieu tri can thiep can duoc theo doi chat che de som phat hien bien chung. Benh nhan can tai kham va sieu am 6 thang mot lan. Phai nhap vien de mo som neu co cac trieu chung dau bung doi ra sau lung, tac dong mach hoac khi sieu am thay duong kinh dong mach chu bung tang hon 5 mm trong vong 6 thang.

Dong mach chu la mach mau lon nhat dua mau tu tim di nuoi toan bo co the. Dong mach chu bung la phan nam trong o bung cua mach mau tren.

TS Do Kim Que, Suc Khoe & Doi Song



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