Anastomosis imatanthawuza kulumikizana pakati pa mitsempha yambiri, kapena mitsempha yambiri yamagazi, kapena pakati pa mitsempha yambiri ya mitsempha. Amalola, pamene njira yaikulu ya mitsempha yatsekedwa, kuti apereke njira zachiwiri zoyendetsera magazi. Ntchito yake ndiye kuwonjezera kufalikira, kupanga njira yatsopano yotchedwa collateral circulation. Izi zimapangitsa kuti zikhale zotheka kuonetsetsa kuthirira kwa chiwalo, pamene njira yaikulu ya kayendedwe ka magazi sikugwiranso ntchito.

Tanthauzo la anastomosis

Anastomosis amatanthauza ziwalo za thupi zomwe zimalola kulankhulana pakati pa mitsempha yambiri, mitsempha yambiri ya magazi, kapena mitsempha yambiri ya mitsempha. Amapangitsa kuti zikhale zotheka, pamitsempha yamagazi, kuti apereke kuyendayenda kwa magazi njira yachiwiri yothirira ziwalo, mwamsanga pakakhala kutsekedwa kwa njira yaikulu. Kuphatikiza apo, titha kunenanso kuti anastomosis ndi kulumikizana pakati pa machubu awiri amtundu womwewo, kutanthauza kuti pakati pazigawo ziwiri za tubular zomwe zimakhala ndi ntchito yofanana.

Kodi ma anastomoses ali kuti?

Mitsempha ingapo imapereka minofu yambiri. Nthambi za mtsempha umodzi kapena ingapo zikafika pamodzi, zimapanga zimene zimatchedwa anastomosis. Chifukwa chake, ma anastomoses awa amatha kupezeka m'zigawo zambiri zathupi, ndipo amakhala ndi mawonekedwe ofanana ndi a mitsempha yamagazi kapena ma ducts omwe amalumikizana.

Kodi anastomosis imapangidwa ndi chiyani?

Choncho, ma anastomoses awa ali ndi malamulo ofanana ndi mitsempha ya magazi, kapena mitsempha, kapena mitsempha ya mitsempha yomwe imagwirizanitsa pamodzi: ndi mipope kapena machubu, motero amapangidwa ndi lumen, mwachitsanzo, dzenje limene madzi amazungulira (monga magazi kapena mitsempha ya mitsempha). ), ndi maselo omwe amazungulira, makamaka, kwa mitsempha ya magazi, khoma lopangidwa ndi maselo otchedwa endothelial, ophwanyika kwambiri.

Komanso, capillary yamagazi imapangidwa ndi magawo atatu:

• lupu ya capillary, yomwe imagwiritsidwa ntchito posinthana kagayidwe kachakudya;
• metarteriole (gawo lomaliza la arteriole, kapena mtsempha waung'ono), kuonetsetsa kuti magazi a venous abwereranso;
• ndi anastomosis, yomwe imawirikiza kawiri metarteriole iyi, ndikutsegula pokhapokha pakufunika.

Palinso dongosolo la anastomoses pamlingo wa ubongo: iyi ndi Willis polygon.

N'zothekanso kuchita opaleshoni ya anastomoses, makamaka makamaka ndi colostomy, yomwe imalola kuti colon ifike pamimba.

Njira zina zothirira minofu

Ntchito ya arterial anastomoses ndikupanga njira zina, motero m'malo mwa mitsemphayo ikatsekedwa. Kenako amatha kusunga ulimi wothirira wa minofu.

Chifukwa chake, zifukwa zingapo zimatha kuyimitsa magazi kwakanthawi kochepa, mwachitsanzo:

• nthawi yachibadwa kayendedwe compressing chotengera;
• ngati chotengera chamagazi chatsekedwa, chifukwa cha matenda kapena kuvulala, kapena panthawi ya opaleshoni.

Magalimoto sanadulidwe kwenikweni, makamaka chifukwa cha njira zolowa m'malozi, zomwe ndi njira zachikole.

Polygon ya Willis: vascularization ya ubongo

Willis polygon imatsimikizira kusinthika kwa ubongo. Ndi za bwalo la arterial lomwe lili m'munsi mwa ubongo, komanso ndi dongosolo la anastomotic, chifukwa chake limalowetsa m'malo. Choncho, amapereka magazi ku ubongo ngakhale ngati mitsempha imodzi ya mu ubongo yawonongeka kapena yotsekedwa.

Mitsempha yopanda anastomoses: mitsempha yomaliza

Pali mitsempha yomwe ilibe anastomoses: imatchedwa ma terminal. M'malo mwake, si matenda kapena anomaly. Komabe, pamene kufalitsidwa kwa mitsempha imeneyi popanda anastomosis watsekedwa, ulimi wothirira gawo lonse chiwalo ndiye anasiya kwathunthu, zomwe zimayambitsa necrosis ake, ndiko kuti imfa ya mbali iyi ya chiwalo. Nthawi zina, kuyendayenda kwachikole kungathenso kudutsa m'ziwiya zodutsa zomwe zimapereka gawoli.

Malformations anévrysmales

Willis polygon ndi mpando, nthawi zambiri, a aneurysm malformations, mwachitsanzo anastomosis anomalies, amene dilations kupanga mitundu ya mabaluni, matumba a magazi, amene ali mu mitsempha ya ubongo, makamaka pa mlingo kuchokera nthambi yawo. Aneurysm imakhudza 1 mpaka 4% ya anthu, chiopsezo cha kupasuka ndi chochepa kwambiri koma ndi chochitika choopsa kwambiri, chomwe chingathe kupha.

Pa mlingo wa njira zothandizira, anastomoses akhoza kuchitidwa ndi njira za opaleshoni, makamaka nkhani ya anastomosis pakati pa matumbo ndi pamimba, yotchedwa colostomy, yomwe munthu amachita mwachitsanzo pakakhala necrosis pamlingo wa mimba. matumbo, kapena a anastomosis pakati pa magawo awiri a matumbo, pambuyo pochotsa (ablation) ya necrotic gawo la matumbo, nthawi zambiri kutsatira mesenteric infarction inducing necrosis, kapena chotupa.

Angiography ndikuwunika kwa x-ray komwe kumakupatsani mwayi wowona mitsempha yamagazi. Zochitidwa ndi radiologist kapena angiologist, zimalola kuzindikira kusokonezeka kwa kayendedwe ka magazi. Kufufuza kumeneku kumapangitsa kuti zitheke kupeza zithunzi za mitsempha yamagazi zomwe sizikanawoneka pa X-ray yosavuta. 

• M'malo mwa vascularization anomalies mwa iwo okha omwe adzafunikire (mwachitsanzo, zolakwika pamlingo wa mitsempha ya m'mitsempha, kapena pamlingo wa venous network ya miyendo) kusiyana ndi a anastomoses omwe, omwe amatha kubwezera zolakwika izi. wa miyendo. kuthirira kwa minofu.
• Matenda a Aneurysm amathanso kuzindikirika, makamaka ndi MRI. Kudziwa bwino kwa mitsempha ya ubongo kumaloledwa chifukwa cha kupita patsogolo kwa kujambula, monga arteriography, MRI kotero, kapena computed tomography (scanner), kapena popanda jekeseni wa mankhwala osiyanitsa.