Mitsempha ya jugular ili m'khosi: ndi mitsempha yamagazi yomwe imachotsedwa mpweya kuchokera kumutu kupita kumtima. Mitsempha ya jugular ndi inayi mu chiwerengero, choncho ili m'mbali mwa khosi. Pali mtsempha wapanja wapanja, mtsempha wakunja wapanja, wamtsempha wakumbuyo ndi wamkati wamkati. Mawuwa amagwiritsidwa ntchito ndi Rabelais, m'buku lake garntuan, mu 1534, pansi pa mawu akuti “venizo jugulares", Koma amachokera ku Chilatini"pakhosiZomwe zimatanthawuza "malo omwe khosi limakumana ndi mapewa". Matenda a mitsempha yam'mitsempha ndi osowa: kokha milandu yapadera ya thrombosis idanenedwa. Momwemonso, ma compresses akunja amakhalabe ochepa. Pakakhala kutupa, kuumitsa kapena kupweteka kwa khosi, kusiyanitsa kwa thrombosis kungapangidwe, kapena m'malo mwake kutsutsidwa, pogwiritsa ntchito kujambula kwachipatala komwe kumayenderana ndi mayesero a labotale. Pakakhala thrombosis, chithandizo cha heparin chidzayambika.

Mitsempha ya jugular ili mbali zonse za mbali zofananira za khosi. Etymologically, mawuwa amachokera ku liwu lachilatini pakhosi kutanthauza "pakhosi", choncho kwenikweni ndi "malo omwe khosi limakumana ndi mapewa".

Mtsempha wamkati wa jugular

Mtsempha wamkati wa jugular umayambira pansi pa chigazacho, usanatsikire ku kolala. Kumeneko, ndiye amalumikizana ndi subclavia mtsempha ndipo motero amapanga brachiocephalic venous thunthu. Mtsempha wamkati wa m'khosi umenewu uli mkati mwa khosi, ndipo umalandira mitsempha yambiri kumaso ndi khosi. Mitsempha ingapo ya dura, yomwe ili ndi nembanemba yolimba komanso yolimba yozungulira ubongo, imathandizira kupanga mtsempha wamkati wamkati mwa jugular.

Mtsempha wakunja wa jugular

Mtsempha wakunja wa jugular umachokera kuseri kwa nsagwada zapansi, pafupi ndi ngodya ya mandible. Kenako imalumikizana pansi pa khosi. Pamlingo uwu, imadutsa mumtsempha wa subclavia. Mtsempha wakunja uwu umakhala wodziwika bwino m'khosi pamene kuthamanga kwa venous kukuwonjezeka, monga momwe zimakhalira ndi chifuwa kapena kupsinjika, kapena pakumangidwa kwa mtima.

Mitsempha yam'mbuyo ndi yapambuyo ya jugular

Izi ndi mitsempha yaying'ono kwambiri.

Pamapeto pake, mtsempha wakunja wakunja wakumanja komanso mtsempha wakumanja wamkati wamkati zonse zimalowa mumitsempha yolondola ya subclavia. Mtsempha wa kumanzere wamkati wa jugular ndi mtsempha wakumanzere wakumanzere zonse zimapita kumanzere kwa subclavia. Kenaka, mitsempha ya kumanja ya subclavia imalumikizana ndi mitsempha ya kumanja ya brachiocephalic, pamene mitsempha ya kumanzere ya subclavia imalowa kumanzere kwa brachiocephalic mitsempha, ndipo mitsempha ya brachiocephalic ya kumanja ndi yakumanzere idzabwera pamodzi kupanga pamwamba pa vena cava. Vena cava yayikulu komanso yayifupi iyi ndi yomwe imayendetsa magazi ambiri opanda oxygen kuchokera ku mbali ya thupi pamwamba pa diaphragm kupita ku atrium yoyenera ya mtima, yomwe imatchedwanso kuti atrium yoyenera.

Mitsempha ya jugular imakhala ndi ntchito ya thupi yobweretsa magazi kuchokera kumutu kupita ku chifuwa: motero, udindo wawo ndi kubweretsa magazi a venous, omwe akusowa mpweya, kubwerera kumtima.

Mtsempha wamkati wa jugular

Makamaka, mtsempha wamkati wa jugular umatenga magazi kuchokera ku ubongo, mbali ya nkhope komanso gawo lakunja la khosi. Simavulazidwa kawirikawiri kuvulala kwa khosi chifukwa cha malo ake akuya. Pamapeto pake, imakhala ndi ntchito yokhetsa ubongo, komanso ma meninges, mafupa a chigaza, minofu ndi minyewa ya nkhope komanso khosi.

Mtsempha wakunja wa jugular

Ponena za jugular yakunja, imalandira magazi omwe amakhetsa makoma a chigaza, komanso mbali zakuya za nkhope, ndi zigawo zapambuyo ndi zam'mbuyo za khosi. Ntchito yake imakhala yokwanira bwino pakukhetsa scalp ndi khungu la mutu ndi khosi, minofu yapakhungu ya nkhope ndi khosi komanso pakamwa pakamwa ndi pharynx.

Ma pathologies a mitsempha ya jugular amakhala osawerengeka. Chifukwa chake, chiwopsezo cha thrombosis ndi chosowa kwambiri komanso kupsinjika kwakunja ndikwapadera kwambiri. Thrombosis ndi mapangidwe a magazi kuundana m'mitsempha. M'malo mwake, zomwe zimachititsa pafupipafupi venous thrombosis, malinga ndi wasayansi Boedeker (2004), ndi izi:

• chifukwa chokhudzana ndi khansa (50% ya milandu);
• para-infectious chifukwa (30% ya milandu);
• kuledzera kwa mankhwala osokoneza bongo (10% ya milandu);
• mimba (10% ya milandu).

Pamene venous thrombosis ya jugular ikuganiziridwa, zidzakhala zofunikira:

• yambitsani heparinization ya wodwalayo (makonzedwe a heparin omwe amathandizira kuchepetsa magazi kuundana);
• perekani ma antibayotiki ambiri.

Ndi kutupa, kuumitsa, kapena kupweteka kwa khosi, dokotala ayenera kuganizira, pamene akupanga matenda osiyanasiyana, kuti akhoza kukhala venous thrombosis m'dera limenelo la thupi. Choncho ndikofunikira kuchita kafukufuku wozama. Chifukwa chake, kukayikira kwachipatala kwa pachimake mtsempha wamagazi thrombosis kuyenera kutsimikiziridwa mwachangu kwambiri:

• ndi kujambula kwachipatala: MRI, scanner yokhala ndi zinthu zosiyana kapena ultrasound;
• popimidwa m’ma labotale: izi ziphatikizepo ma D-dimers osadziwika bwino koma ozindikira kwambiri a thrombosis, komanso zolembera zotupa monga CRP ndi leukocyte. Kuonjezera apo, miyambo ya magazi iyenera kuchitidwa kuti azindikire matenda omwe angakhalepo komanso kuti athe kuwachiritsa mokwanira komanso moyenera.

Kuphatikiza pa chithandizo chanthawi zonse, venous thrombosis ya mitsempha ya jugular imafuna kufufuza kosasintha kwa vuto lomwe lilipo. Choncho m'pofunika kupitiriza makamaka kufunafuna chotupa choopsa, chomwe chingakhale chifukwa cha paraneoplastic thrombosis (ndiko kunena kuti amapangidwa chifukwa cha khansa).

Kumayambiriro kwa makumi awiri^e m'ma, anauzira mu mzinda wa Lyon mphepo mosayembekezeka kuti anabala, ndiye kwambiri patsogolo, mtima opaleshoni. Apainiya anayi odziwika ndi mayina a Jaboulay, Carrel, Villard ndi Leriche anadzisiyanitsa okha pankhaniyi, motsogozedwa ndi kupita patsogolo ... Njira yawo yoyesera inali yolimbikitsa, mwachiwonekere kuti apanga zinthu zazikulu monga kulumikiza mitsempha kapenanso kuika ziwalo. Dokotala wa opaleshoni Mathieu Jaboulay (1860-1913) anali wodziwikiratu wofesa malingaliro enieni: motero analenga ku Lyon zoyamba za opaleshoni ya mitsempha, panthawi yomwe palibe kuyesa kunachitika. Iye adatulukira njira yolumikizira kutha kwa arterial anastomosis (kulumikizana kokhazikitsidwa ndi opaleshoni pakati pa ziwiya ziwiri), lofalitsidwa mu 1896.

Mathieu Jaboulay adawoneratu ntchito zambiri zomwe zitha kuchitidwa ndi arteriovenous anastomosis. Pofuna kutumiza magazi opangidwa ndi arterialized ku ubongo popanda carotid-jugular anastomosis, adapempha Carrel ndi Morel kuti achite kafukufuku woyesera, agalu, pamapeto-to-mapeto anastomosis ya jugular ndi carotid yoyamba. Zotsatira za kuyesaku zidasindikizidwa mu 1902 m'magazini Lyon Medical. Izi ndi zomwe Mathieu Jaboulay adawulula: "Ndine amene ndinapempha Bambo Carrel kuti asinthe mitsempha ya carotid ndi mtsempha wamtundu wa galu. Ndinkafuna kudziwa chomwe chingapereke opaleshoniyi moyesera ndisanayambe kuigwiritsa ntchito kwa anthu, chifukwa ndimaganiza kuti ikhoza kukhala yothandiza pakapanda ulimi wothirira wokwanira chifukwa cha thrombosis kufewetsa, kapena kumangidwa kwa chitukuko.".

Carrel adapeza zotsatira zabwino mwa agalu: "Patatha milungu itatu opaleshoniyo, mtsempha wa m’khosi unali kugunda pansi pa khungu ndipo ukugwira ntchito ngati mtsempha wamagazi.Koma, mwa mbiri, Jaboulay sanayesepo opaleshoni yotereyi pa anthu.

Pomaliza, tikumbukirenso kuti mafanizo okongola nthawi zina amagwiritsidwa ntchito ndi olemba ena kuzungulira jugular iyi. Sitidzalephera kutchula, mwachitsanzo, Barrès yemwe, mu zake Mayankho, analemba kuti: “Ruhr ndi mtsempha wamtsempha waku Germany“… Ndakatulo ndi sayansi zolumikizana nthawi zina zimapanganso ma nuggets okongola.