11. Mavzu: Ilk va maktabgacha yoshdagi bolalarning yurak qon-tomir tizimining yosh hususiyatlari va kasalliklari. Reja

Davolash va parvarish qilish. Yurak tug‘ma nuqsonlarini davo­lashning hozirgi vaqtdagi asosiy yo‘li jarrohlik operatsiyasi hisoblanadi. i 90% ga yaqin hollarda yurak nuqsonlari operatsiya qilinadi. Operatsiyalar ikkiga: radikal va palliativ xillarga bo‘linadi. Bo‘lmalar va qorinchalar orasidagi to‘siq nuqsonlari, ochiq arterial yo‘l, aorta va o‘pka arteriyasi stenozlari hamda boshqa nuqsonlar munosabati bilan qilinadigan radikal operatsiyalardan keyin qon aylanishi asliga kelib, bolalar amalda sog‘ayib ketadi. Palliativ operatsiyalar esa ko‘pchilik bolalarning hayotini saqlab qoladi, ularning yashab ketish imkoniyatlarini bir qadar oshiradi.

³Tojsimon arteriyalar faqat yurak muskulini taminlaydi ular tezda aorta klapani tepasidagi aortadan paydo bo’ladi va ularning yirik tarmoqlari miokard bo’ylab yuboriladi va bu ularning tashqaridan yurak muskuliga kiradigan terminal tarmoqlai orqali yuz beradi.

Aortadan chiqqandan keyin o’ng tojsimon arteriya tojsimon egatchalarga kiradi. Avval o’ng yurak bo’lmasi ostida keyin o’ng yurak chegarasi atrofida yurak diafragmatik yuzasi tomonga tomonga xarakat qiladi. U orqa ichki qorincha tarmog’ida tugaydi. Qaysiki yurak apeksiga tomon harakat qiladi. (5.9 chizma)


Chap yurak bo’lmasi

Yuqori vena chuqurligiu

O’pka arteriyasi

O’ng yurak bo’lmasi

O’ng tojsimon

arteriya

O’pka venalari

Aorta

Chap tojsimon arteriya

O’ralgan tarmoq

Katta yurak venasi

Usuallyanother, thinner elastic membrane (membrana elastica externa) lies betweenthe middle and the outer coat.Arteries are distinguished by an especially well developed musclecoat, which contains a varying amount of elastic fiber according to itssite (predominantly elastic and predominantly muscular arteries). Thislayer is the driving force of the blood vessels (Fig. 5.17): by dilating (vasodilatation)and constricting (vasoconstriction) the diameter of theblood vessels, it regulates blood flow and blood pressure. The arteriesnear the heart contain a high proportion of elastic fibers and this createsan elastic recoil (Fig. 5.18a, b). The blood ejected during systole is partlystored by expansion of the arterial wall, and is then moved forward

during diastole by elastic recoil, thus achieving a continuous blood flow.Veins in general have wider lumina and thinner walls than arteries.The three coats are less well defined and the muscular coat is less welldeveloped. Most veins, with the exception of those close to the heart,contain venous valves (Fig. 5.17). These endothelial folds, projecting likepockets into the lumen of the vessel, act as one-way valves that guide theblood toward the heart and prevent backward flow.Structure of the CapillariesIn the smallest blood vessels, the capillaries, the coats are reduced toone, the tunica intima (Figs. 5.16 and 5.17); this facilitates the exchangeof fluids and gases. The exchange of substances basically occurs in bothdirections: from the blood through the endothelium and basementmembrane into the surrounding tissue, and in the reverse direction.
Yurak tug‘ma nuqsonlari bor bolalar doimiy dispanser kuzatuvida bo‘lishadi va 3 yoshgacha bo‘lgan davrda 6 oyda bir marta, 3 yoshdan oshganidan keyin yiliga bir marta tekshiruvdan o‘tkazib turiladi.

Kompensatsiya buzilganini ko‘rsatadigan alomatlar, keskin ifodalangan sianoz, hansirash - sianotik xurujlar bo‘lmagan hollarda bolalarning yasli va bolalar bog‘chalariga qatnashlariga ruxsat beriladi.

Bolalarning davolovchi fizkultura bilan shug‘ullanib turishlari maqsadga muvofiq hisoblanadi. Sianoz, kompensatsiya buzilganini ko‘rsatadigan belgilar bo‘lmasa, subyektiv shikoyatlari yo‘q paytlarda maktabdagi tayyorlov guruhlarida fizkultura bilan shug‘ullanisliga ham ruxsat beriladi, lekin ularni jismoniy jihatdan zo'riqtiradigan sport musobaqalari va o‘yinlarida qatnashishdan ozod qilish tavsiya etiladi.