Xav txog koj lub plawv zoo li lub twj tso dej uas ua haujlwm tsis tu ncua. Hauv lub twj tso dej no, muaj plaub lub qhov rooj me me zoo li qhov uas pab cov ntshav ntws mus rau ib qho kev taw qhia xwb. Hauv kev kho mob, peb hu cov qhov rooj plawv no. Yog tias cov qhov rooj no tsis qhib thiab kaw kom raug, nws yog ib qho teeb meem loj, puas yog? Ib yam li ntawd, hnub no peb tab tom tham txog kev phais tshwj xeeb uas ua thaum lub qhov rooj mitral, ib qho ntawm cov qhov rooj tseem ceeb tshaj plaws hauv peb lub plawv, tsis qhib kom raug thiab nqaim.
Commissurotomy yog dab tsi?
Hais yooj yim xwb, kev phais commissurotomy yog ib txoj kev phais uas cia cov ntshav ntws los ntawm lub valve hauv koj lub plawv. Feem ntau nws yog ua rau ntawm lub mitral valve . Lub mitral valve nyob nruab nrab ntawm lub chamber sab laug sab saud (lub atrium sab laug) thiab lub chamber sab laug sab qis (lub ventricle sab laug).
Xav txog tias lub qhov rooj no tsis qhib zoo thiab nws daig thiab nqaim. Peb hu qhov mob no ua mitral valve stenosis. Qhov uas tshwm sim yog tias txoj kev rau cov ntshav ntws los ntawm chav sab saud mus rau chav sab qis raug thaiv. Qhov no ua rau cov ntshav rov qab los thiab muab kev nyuaj siab rau lub plawv thiab lub ntsws. Raws li lub sijhawm dhau mus, qhov no tuaj yeem ua rau muaj cov mob hnyav xws li lub plawv tsis ua haujlwm.
Qhov kev phais mob commissurotomy no yog siv los kho cov theem thaum ntxov ntawm mitral valve stenosis. Tab sis qhov tseeb, nws ua tsawg dua niaj hnub no. Vim tias nws feem ntau ua raws li kev phais qhib lub plawv . Nws muaj qee qhov kev pheej hmoo. Yog li ntawd, thaum twg ua tau, cov kws kho mob sim siv cov txheej txheem yooj yim dua, tsis muaj kev pheej hmoo. Ib qho ntawm cov kev kho mob tseem ceeb tam sim no muaj yog balloon valvuloplasty . Hauv qhov no, ib lub raj nyias nyias raug ntxig thiab ib yam dab tsi zoo li lub balloon raug inflated sab hauv lub valve nqaim, ua rau nws dav dua.
Txawm li cas los xij, rau qee tus neeg, txoj kev siv lub npas ua tsis tau vim yog qhov chaw ntawm lawv lub plawv lossis lwm yam. Hauv cov xwm txheej zoo li no, kev phais mob commissurotomy yog qhov kev xaiv zoo tshaj plaws.
Leej twg xav tau qhov kev phais no tiag?
Yog tias koj muaj mitral stenosis thiab ib qho ntawm cov hauv qab no siv tau, koj tus kws kho mob yuav pom zoo kom phais mob no:
- Yog koj tsis tau kho los ntawm lwm yam kev kho mob.
- Yog tias koj tsis tuaj yeem ua balloon valvuloplasty.
Tsis tas li ntawd xwb, yog tias koj tau muaj lwm yam kev phais plawv, qhov kev phais no tuaj yeem ua tau tib lub sijhawm.
Tiam sis muaj ib qho tseem ceeb uas yuav tsum nco ntsoov. Tsis yog txhua tus neeg uas muaj mitral valve stenosis tuaj yeem ua qhov kev phais no. Nws nyob ntawm seb qhov ua rau koj lub valve stenosis yog dab tsi.
Muaj ob qho laj thawj tseem ceeb:
1. Kev puas tsuaj los ntawm Kab Mob Plawv Rheumatic:Mob ua pob qij txha, uas yog tom qab muaj kab mob caj pas thaum yau, tuaj yeem ua puas rau cov hlab plawv ntau xyoo tom qab.
2. Degenerative Mitral Stenosis: Raws li lub sijhawm dhau mus, lub valve maj mam qaug zog, nqaim zuj zus, thiab npog nrog cov calcium deposits.
Kev phais mob commissurotomy yog qhov tshwj xeeb tshaj yog pab tau rau cov neeg uas muaj kab mob plawv rheumatic . Hauv qhov mob no, ob lub ces kaum ntawm lub valve qhov twg ob daim ntawv sib ntsib, hu ua commissures , tuab thiab qee zaum lo ua ke.
Yuav kom nkag siab qhov no, xav txog nws li no. Mus rau pem hauv ntej ntawm daim iav thiab luag ntxhi nrog koj daim di ncauj kaw. Koj puas pom ob lub ces kaum uas koj daim di ncauj sab saud thiab sab qis sib ntsib? Cov ntawd yog cov commissures ntawm mitral valve. Tam sim no, sim qhib koj lub qhov ncauj los ntawm kev nias ob lub ces kaum ntawd nrog koj cov ntiv tes taw qhia kom lawv tsis tuaj yeem txav mus los. Nws nyuaj rau qhib koj lub qhov ncauj dav, puas yog? Qhov ntawd yog qhov tshwm sim thaum lub mitral valve nqaim. Vim tias ob lub ces kaum ntawm lub valve lo ua ke, nws tsis qhib kom zoo, thiab cov ntshav ntws tsis zoo.
Hauv kev phais mob commissurotomy, cov qhov me me raug ua rau ntawm ob lub ces kaum ntawm lub valve thiab lawv raug tso tawm. Tom qab ntawd lub valve pib qhib kom zoo dua. Txawm li cas los xij, rau cov neeg uas tau hnav lub valve vim muaj hnub nyoog, cov commissures feem ntau tsis puas. Hloov chaw, lwm qhov ntawm lub valve yuav tsum tau kho. Yog li ntawd, qhov kev phais mob no tsis haum rau lawv. Lawv yuav tsum tau dhau los ntawm lwm hom kev kho lub valve lossis hloov lub valve tag nrho (mitral valve replacement).
Muaj dab tsi tshwm sim ua ntej phais?
Kev npaj yuav pib ua ob peb lub lis piam, qee zaum ob peb lub hlis, ua ntej hnub phais koj. Koj pab neeg kho mob (koj tus kws kho mob hauv tsev neeg, kws kho mob plawv, thiab kws phais plawv) yuav tuaj ua ke los kuaj koj tus mob kom meej.
| Kev ntsuam xyuas thiab kev ntsuam xyuas ua ntej phais | |
|---|---|
| Kev kuaj lub cev | Tshawb xyuas kev noj qab haus huv ntawm koj lub cev. |
| Kev kuaj ntshav | Tshawb xyuas kev ua haujlwm ntawm cov kabmob xws li lub raum thiab lub siab thiab cov ntshav. |
| Cov tsos mob thiab keeb kwm ntawm tus kab mob | Tham txog qhov tsis xis nyob uas koj hnov thiab cov kab mob yav dhau los. |
| Kev kuaj mob plawv tshwj xeeb |
|
Yog koj muaj lus nug, kev ntshai, lossis kev tsis ntseeg txog qhov kev phais mob, nrog koj tus kws kho mob tham txog tej no. Tsis txhob khaws ib yam dab tsi rau koj tus kheej. Nws yog ib qho tseem ceeb heev uas yuav tsum paub txhua yam thiab mus rau hauv qhov kev phais mob nrog lub siab so.
Koj tus kws kho mob yuav muab cov lus qhia rau koj txog kev npaj rau kev phais mob, suav nrog thaum twg yuav tsum tsis txhob noj thiab haus dej ua ntej phais mob, thiab txhua yam kev hloov pauv rau koj cov tshuaj.
Qhov tseem ceeb tshaj plaws, yog tias koj haus luam yeeb, nws yog ib qho tseem ceeb uas yuav tsum tso tseg kev haus luam yeeb tag nrho ua ntej phais kom txo qhov teeb meem tom qab phais. Yog tias koj xav tau kev pab txog qhov no, nug koj tus kws kho mob.
Yuav ua li cas thiaj phais tau?
Hauv chav phais mob, pab neeg kho mob ua raws li cov kauj ruam no:
1. Ua ntej, koj yuav raug muab tshuaj loog thiab yuav raug muab tso pw tsaug zog kom txog thaum phais tiav. Koj yuav tsis hnov mob dab tsi li.
2. Tom ntej no, tus kws phais yuav txiav ib qho chaw hauv nruab nrab ntawm koj lub hauv siab, nqes mus rau ntawm lub hauv siab (sternum). Qhov no hu ua median sternotomy .
3. Koj yuav raug txuas nrog lub tshuab cardiopulmonary bypass . Lub tshuab no yuav ua haujlwm ntawm koj lub plawv thiab lub ntsws ib ntus thaum lub sijhawm phais. Qhov no tso cai rau tus kws kho mob ua qhov phais thaum koj tseem nyob twj ywm, yam tsis muaj koj lub plawv dhia.
4. Lub plawv sab laug qhib lawm thiab lub mitral valve raug kuaj xyuas.
5. Tom qab ntawd, cov kev txiav me me raug ua rau ntawm ob lub ces kaum (commissures) ntawm lub valve uas tau daig thiab tuab, cais lawv ntawm ib leeg thiab tso lawv tawm.
6. Tom qab ua tiav txoj haujlwm lawm, koj yuav raug txiav tawm ntawm lub tshuab plawv-ntsws thiab koj lub plawv thiab ntsws yuav pib ua haujlwm dua.
7. Thaum kawg, kev kuaj mob plawv los ntawm txoj hlab pasIb qho kev luam theej tshwj xeeb raug ua kom paub tseeb tias lub valve ua haujlwm zoo thiab seb txhua yam puas ua haujlwm zoo.
Qee zaum, lwm yam kev phais plawv, xws li kho lwm yam lub plawv valve (aortic valve lossis tricuspid valve), yuav ua tau tib lub sijhawm nrog kev phais no. Yog tias qhov no tsim nyog, pab pawg kho mob yuav piav qhia qhov no rau koj ua ntej.
Tom qab phais tas, muaj dab tsi tshwm sim?
Koj yuav tsum tau nyob hauv tsev kho mob li ib lub lim tiam tom qab phais. Rau thawj hnub lossis ob hnub, koj yuav raug khaws cia rau hauv chav saib xyuas mob hnyav (ICU) thiab saib xyuas ze heev. Qhov no yog los pab nrhiav cov teeb meem uas yuav tshwm sim tom qab phais sai li sai tau.
Ua ntej koj mus tsev los ntawm tsev kho mob, koj tus kws kho mob yuav muab cov ntaub ntawv rau koj txog:
- Kev Kho Mob Plawv: Qhov no muaj txiaj ntsig zoo rau cov neeg uas tab tom rov zoo los ntawm kev phais plawv. Nws pab koj rov qab muaj zog thiab pib ua tej yam li qub.
- Yuav saib xyuas qhov txiav li cas: Nws yog ib qho tseem ceeb heev uas yuav tsum ua kom qhov txiav huv si kom tiv thaiv kev kis kab mob thiab kho qhov txhab sai sai.
- Kev Txwv: Cov lus qhia txog yuav tos ntev npaum li cas ua ntej koj rov qab ua tej yam xws li tsav tsheb lossis ua haujlwm hnyav.
Ua ntej koj mus tsev, tsis txhob hnov qab npaj kom muaj ib tug neeg tuaj tos koj.
Cov txiaj ntsig thiab kev pheej hmoo ntawm kev phais mob no yog dab tsi?
Cov txiaj ntsig
Qhov kev phais no tuaj yeem txo cov tsos mob xws li ua tsis taus pa thiab qaug zog los ntawm kev nqaim ntawm lub mitral valve. Nws kuj tseem tuaj yeem tiv thaiv koj ntawm cov teeb meem loj uas yuav tshwm sim yav tom ntej. Qhov no yog kev kho mob zoo heev rau cov neeg uas muaj mob tsis hnyav txaus los hloov lub valve tag nrho thiab cov neeg uas tsis tau ua tiav nrog lwm yam kev kho mob.
Kev Pheej Hmoo lossis Teeb Meem
Ib yam li lwm yam kev phais mob, muaj tej yam txaus ntshai. Qhov teeb meem feem ntau yog mitral valve regurgitation .
| Lwm yam teeb meem uas yuav tshwm sim tau |
|---|
| - Kev tsis haum tshuaj rau tshuaj loog. |
| - Lub plawv dhia tsis sib xws (arrhythmia). |
| - Los ntshav ntau dhau. |
| - Cov kua dej sib sau ua ke nyob ib puag ncig lub plawv (cardiac tamponade). |
| - Kev hloov pauv hauv kev xav lossis kev tsis meej pem. |
| - Mob plawv nres. |
| - Kev kis kab mob hauv qhov chaw txiav. |
| - Mob stroke. |
Ntau yam kev pheej hmoo no tuaj yeem txo tau los ntawm kev kho mob ntawm tsev kho mob loj uas muaj cov chaw thiab cov kws phais mob uas muaj kev paub dhau los hauv kev phais plawv.
Tom qab phais tas, qhov kev cia siab tom qab phais yog dab tsi?
Kev phais qhib lub qhov ntswg muaj feem ua tiav zoo heev. Feem ntau, kev phais no kho qhov nqaim ntawm lub qhov ntswg thiab rov qab ua kom cov ntshav ntws tau zoo.
Tiamsis nws yog ib qho tseem ceeb kom nkag siab tias qhov no tsis yog qhov kev daws teeb meem kawg. Ntau tus neeg uas tau phais qhov no yuav tsum tau phais hloov mitral valve tom qab hauv lub neej.
Koj tus kws kho mob yuav qhia tau koj zoo tshaj plaws txog koj txoj kev noj qab haus huv yav tom ntej. Txhua tus neeg rov zoo sib txawv. Muaj ntau yam uas cuam tshuam rau qhov no, suav nrog koj lub hnub nyoog, kev noj qab haus huv tag nrho, thiab qhov kev puas tsuaj rau koj lub valve ua ntej phais.
Thaum twg koj yuav tsum mus ntsib kws kho mob?
Yog tias koj muaj cov cim qhia tias koj muaj kab mob thaum koj tab tom rov zoo hauv tsev tom qab phais, hu rau koj tus kws kho mob tam sim ntawd.
- Mob hauv siab, nruj, lossis tsis xis nyob.
- Ua npaws.
- Xim liab los yog kua dej zoo li kua qaub tawm ntawm qhov chaw txiav.
Yog tias koj muaj ib qho ntawm cov tsos mob hnyav hauv qab no, hu rau koj tus xov tooj xwm txheej ceev hauv zos tam sim ntawd lossis mus rau Chav Kho Mob Xwm Ceev (ETU) ze tshaj plaws:
- Cov tsos mob ntawm tus kab mob plawv nres (mob hauv siab hnyav, ua pa nyuaj, ntuav, tawm hws).
- Cov tsos mob ntawm kev tuag tes tuag taw (nyuaj hais lus, ib sab ntawm lub ntsej muag poob qis, tsis muaj kev xav ntawm ib sab caj npab lossis ceg).
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Commissurotomy yog ib qho kev phais plawv qhib uas kho cov mitral stenosis.
- Qhov no yog qhov tshwj xeeb tshaj yog rau cov neeg uas muaj kev puas tsuaj ntawm lub plawv vim yog kab mob plawv rheumatic.
- Qhov no yog qhov kev xaiv zoo tshaj plaws thaum cov kev kho mob yooj yim xws li txoj kev siv lub npas tsis ua tau.
- Txawm hais tias qhov kev phais mob tau ua tiav zoo heev los xij, muaj qhov ua tau tias yuav tsum tau phais hloov lub valve yav tom ntej.
- Nws yog ib qho tseem ceeb heev uas yuav tsum ua raws li koj tus kws kho mob cov lus qhia ua ntej thiab tom qab phais. Kev paub txog cov cim ceeb toom uas yuav tshwm sim tom qab phais yog qhov tseem ceeb rau koj txoj kev nyab xeeb.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus