I-Anastomosis ibhekisela ekuxhumaneni phakathi kwezinzwa eziningana, noma imithambo yegazi eminingana, noma futhi phakathi kwemithambo ye-lymphatic eminingana. Bavumela, lapho indlela eyinhloko yemithambo yegazi ivinjiwe, ukunikeza izindlela zesibili zokujikeleza kwegazi. Khona-ke indima yayo iwukunezela ekujikelezeni kwegazi, kwakhiwe indlela entsha ebizwa ngokuthi i-collateral circulation. Ngakho-ke lokhu kwenza kube nokwenzeka ukuqinisekisa ukuchelela kwesitho, lapho indlela eyinhloko yokujikeleza kwegazi ingasasebenzi.

Incazelo ye-anastomosis

I-Anastomosis ibhekisela ezingxenyeni zomzimba ezivumela ukuxhumana phakathi kwezinzwa eziningana, imithambo yegazi eminingana, noma imikhumbi eminingana ye-lymphatic. Benza ukuthi, esimweni semithambo yegazi, ukunikeza ukujikeleza kwegazi umzila wesibili wokunisela izitho, ngokushesha nje lapho kukhona ukuvinjelwa komzila omkhulu. Ngokunwetshwa, ngakho-ke singasho futhi ukuthi i-anastomosis iwukuxhumana phakathi kwamapayipi amabili emvelo efanayo, okusho ukuthi phakathi kwezakhiwo ezimbili zamashubhu ezinomsebenzi ofanayo.

Aphi ama-anastomoses?

Imithambo eminingi ihlinzeka ngezicubu eziningi. Lapho amagatsha emithanjeni eyodwa noma ngaphezulu ehlangana, akha lokho okubizwa ngokuthi i-anastomosis. Lawa ma-anastomoses, ngakho-ke, angatholakala ezithweni eziningi zomzimba, futhi anesakhiwo esifana nalesi semithambo yegazi noma amapayipi axhumanayo.

Iyini i-anastomosis eyenziwe?

Ngakho-ke, lawa ma-anastomose anomthethosisekelo ofanayo nemithambo yegazi, noma imizwa, noma imithambo ye-lymphatic ayixhuma ndawonye: angamapayipi noma amapayipi, ngakho akhiwa yi-lumen, okungukuthi imbobo lapho uketshezi lujikeleza khona (njengegazi noma i-lymph. ), kanye namaseli ayizungezile, ikakhulukazi, emithanjeni yegazi, udonga olwakhiwe ngamaseli abizwa ngokuthi i-endothelial, olucaba kakhulu.

Futhi, i-capillary yegazi yakhiwa izingxenye ezintathu:

• i-capillary loop, esetshenziselwa ukushintshana komzimba;
• i-metarteriole (ingxenye yokugcina ye-arteriole, noma umthambo omncane), eqinisekisa ukubuya kwegazi eliyingozi;
• kanye ne-anastomosis, ephinda kabili le metarteriole, futhi ivuleke kuphela lapho kudingeka.

Kukhona nohlelo lwama-anastomoses ezingeni lobuchopho: lena i-Willis polygon.

Kungenzeka futhi ukwenza ama-anastomoses ngokuhlinzwa, lokhu ikakhulukazi nge-colostomy, evumela ukuthi ikholoni ifinyelele esiswini.

Ezinye izindlela zokunisela isicubu

Indima yama-arastial anastomoses ukudala ezinye izindlela, ngaleyo ndlela kufakwe imithambo lapho kuvinjelwe. Bese benza kube nokwenzeka ukugcina ukuchelela kwezicubu.

Ngakho, izimbangela eziningana zingamisa ukugeleza kwegazi isikhathi esifushane, isibonelo:

• ngesikhathi sokuhamba okujwayelekile ukucindezela umkhumbi;
• uma umkhumbi wegazi uvalekile, ngenxa yokugula noma ukulimala, noma ngesikhathi sokuhlinzwa.

I-traffic ayinqanyuliwe ngempela, ngenxa yalokho ngenxa yale mizila eshintshayo, eyindlela yokubambisa.

I-Polygon kaWillis: i-vascularization yobuchopho

I-Willis polygon iqinisekisa i-vascularization yobuchopho. Imayelana nendilinga ye-arterial etholakala phansi kobuchopho, futhi iyisistimu ye-anastomotic, ngakho-ke yokushintshwa. Ngakho-ke, inikeza ukunikezwa kwegazi ebuchosheni noma ngabe enye yemithambo ebuchosheni ilimele noma ivinjiwe.

Imithambo engenawo ama-anastomoses: imithambo esibulalayo

Kunemithambo engenawo ama-anastomose: ibizwa nge-terminal arteries. Eqinisweni, akuyona i-pathology noma i-anomaly. Kodwa-ke, lapho ukujikeleza kwale mithambo ngaphandle kwe-anastomosis kuvinjiwe, ukuchelela kwengxenye yesitho sonke bese kuyekwa ngokuphelele, okubangela i-necrosis yayo, okusho ukufa kwale ngxenye yesitho. Kwesinye isikhathi, ukujikeleza kwe-collateral kungaphinda kudlule emikhunjini yokugcina ehlinzeka ngale ngxenye yesitho.

Ukukhubazeka anévrysmales

I-Willis polygon iyisihlalo, kaningi, sokukhubazeka kwe-aneurysm, okungukuthi i-anastomosis anomalies, okungukuhlunga okwakha izinhlobo zamabhaluni, amaphakethe egazi, atholakala emithanjeni yobuchopho, ikakhulukazi ezingeni elivela egatsheni labo. I-aneurysm ithinta u-1 kuya ku-4% wabantu, ingozi yokuqhekeka iphansi kakhulu kodwa isenzakalo esibi kakhulu, esingase sibulale.

Ezingeni lokungenelela, ama-anastomoses angenziwa ngamasu okuhlinza, ikakhulukazi icala le-anastomosis phakathi kwekholoni nesisu, okuthiwa i-colostomy, okuyinto umuntu ayenza ngokwesibonelo uma kwenzeka i-necrosis ezingeni lesisu. amathumbu, noma lelo le-anastomosis phakathi kwezingxenye ezimbili zamathumbu, ngemva kokukhishwa kabusha (ukukhishwa) kwengxenye ye-necrotic yamathumbu, ngokuvamile kulandela i-mesenteric infarction ebangela i-necrosis, noma isimila.

I-Angiography ukuhlolwa kwe-x-ray ekuvumela ukuthi ubone ngeso lengqondo imithambo yegazi. Kwenziwa i-radiologist noma i-angiologist, izovumela ukutholakala kokungahambi kahle kwegazi. Lokhu kuhlola kwenza kube nokwenzeka ukuthola izithombe zemithambo yegazi ebezingeke zibonakale ku-X-ray elula. 

• Esikhundleni salokho okuzofunwa yi-vascularization anomalies (ngokwesibonelo, ukungahambi kahle ezingeni le-coronary arteries, noma ezingeni lenethiwekhi ye-venous yemilenze) kunalawo ama-anastomoses ngokwawo, avame ukunxephezela lokhu kungavamile. yemilenze. ukuchelela kwezicubu.
• Ukungajwayelekile kwe-aneurysm kungatholwa, ikakhulukazi nge-MRI. Ulwazi oluhle lwe-vascularization yobuchopho luvunyelwe ngenxa yentuthuko yezithombe, njenge-arteriography, ngakho-ke i-MRI, noma i-computed tomography (isithwebuli), ngomjovo noma ngaphandle komjovo womkhiqizo wokuqhathanisa.