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主动脉瘤和主动脉夹层

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ID: ANH12061chis
医学动画文字记录:主动脉是人体最大的动脉。心脏通过主动脉泵出新鲜的含氧血液,将氧气和营养输送到所有的器官和组织。主动脉分为两个主要部分,胸主动脉和腹主动脉。胸主动脉由四部分组成:主动脉根部、升主动脉、主动脉弓和降主动脉。主动脉壁由三层组成,即内膜或内层、中膜或中层和外膜或外层。弹性肌肉层可防止血液压力导致的管壁破裂。随着时间的推移,退行性疾病可能会导致中膜破裂,使主动脉壁变薄。血液泵向薄弱的区域可能会导致它像气球一样向外膨胀。当这种情况发生在胸部时,称为胸主动脉瘤。这些动脉瘤可发生在以下几处动脉之一,包括主动脉根部、升主动脉或降主动脉。大多数胸主动脉瘤没有症状,但当动脉瘤比较大时,就会出现各种症状,这取决于动脉瘤的严重程度和位置。稳定型胸主动脉瘤的症状包括呼吸短促、胸痛、背痛或腹痛、吞咽困难和声音嘶哑。如果动脉瘤破裂或发生动脉夹层,会出现更严重的症状,包括胸部撕裂感、肩胛区(肩胛骨之间的背部)剧烈疼痛、头晕、行走和说话困难。如果你出现这些症状,应该立即就医,因为这种情况是危及生命的。血液泵向薄弱的主动脉壁会导致另一种危及生命的情况,称为主动脉夹层,这种情况可能发生在动脉瘤内,也可能不会发生在动脉瘤内。最常见的主动脉夹层开始于内膜层的损伤。血液在内膜的缝隙中流动,将其与中膜分开,导致主动脉内壁出血。因此,在真主动脉管道和假主动脉管道之间形成了一个称为隔膜的瓣。从这里,血液可能会冲破主动脉壁的外层,立即危及生命,也可能会通过内膜的另一个裂口重新进入主动脉。随着时间的推移,假管道中可能会形成血块。主动脉夹层可根据其位置和症状持续时间进行分类。在Stanford分型中,如果升主动脉出现了主动脉夹层,称为A型夹层。所有其他的夹层称为B型。胸主动脉夹层最常见的症状是尖锐痛或刺痛,通常是突然和严重的胸痛。如果是A型夹层,最可能感到疼痛的部位是胸部。如果是B型夹层,更有可能感觉到背部疼痛,而不是胸部疼痛。如果你有这些症状,应该立即就医,因为这种情况可能会危及生命。

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