Koj puas tau hnov tias ua tsis taus pa, lossis pom tias koj lub hauv siab nruj thaum koj siv zog lossis nce ntaiv? Tej zaum koj tus kws kho mob yuav hais tias koj muaj teeb meem nrog ib qho ntawm koj lub plawv valve. Thaum lub plawv valve tawv thiab tsis qhib zoo, peb hu qhov mob no ua 'stenosis.' Hnub no, peb yuav coj koj mus rau hauv ib txoj kev kho mob tshwj xeeb uas siv los kho qhov mob no. Vim tias qhov no yog ib qho tseem ceeb rau koj txoj kev noj qab haus huv, cia peb muab txhua yam faib ua cov lus yooj yim.
Hais yooj yim xwb, Commissurotomy yog dab tsi?
Cia peb pib nrog cov hauv paus. Koj lub plawv muaj plaub chav loj. Xav txog lawv zoo li plaub chav hauv ib lub tsev. Yuav kom cov ntshav ntws tau zoo los ntawm ib chav mus rau lwm chav, cov qhov rooj ntawm lawv yuav tsum qhib thiab kaw kom raug. Peb hu cov qhov rooj no ua cov qhov rooj plawv .
Ib qho 'commissurotomy' yog ib qho kev phais mob uas muaj feem cuam tshuam nrog koj lub Mitral ValveLub qhov cua no ua haujlwm ua lub qhov rooj ntawm koj lub plawv sab laug atrium (chav sab saud) thiab sab laug ventricle (chav sab qis). Lub qhov rooj no muaj ob lub flaps.
Vim muaj tej yam mob uas ua rau mob, tshwj xeeb tshaj yog Mitral Valve Stenosis , tej lub qhov rooj no yuav qhib tsis tau zoo, zoo li lub xauv uas raug kaw. Thaum qhov no tshwm sim, cov ntshav ntws los ntawm chav sab saud mus rau chav sab qis yuav raug txwv. Qhov no ua rau cov ntshav rov qab los, ua rau koj lub plawv thiab lub ntsws ntxhov siab heev. Yog tias tsis kho, qhov no yuav ua rau muaj teeb meem loj xws li lub plawv tsis ua haujlwm .
Ib qho 'commissurotomy' yog ib qho kev phais uas tus kws phais ua tib zoo txiav cov qhov me me kom cais cov npoo ntawm lub qhov valve uas tau sib xyaw ua ke (commissures) kom nws qhib tau tag nrho dua. Qhov no ua rau cov ntshav ntws zoo los ntawm koj lub plawv.
Leej twg xav tau qhov kev phais no tiag?
Qhov kev phais no tsis yog rau txhua tus. Koj tus kws kho mob yuav pom zoo kom ua qhov no vim ob peb qho laj thawj tseem ceeb:
- Yog tias koj tsis tau pom cov txiaj ntsig zoo los ntawm lwm yam kev kho mob (xws li tshuaj).
- Yog tias koj tsis yog tus neeg tsim nyog rau 'Balloon Valvuloplasty,' ib txoj kev kho mob uas siv lub npas los nthuav lub valve.
- Yog tias koj xav tau lwm yam kev phais plawv, cov txheej txheem no tuaj yeem ua tau tib lub sijhawm.
Txawm li cas los xij, qhov tseem ceeb tshaj plaws yog tias qhov kev phais mob no yuav ua tiav li cas nyob ntawm qhov ua rau koj lub mitral valve raug thaiv. Cia peb saib ob qho ua rau tseem ceeb.
| Ua rau Mitral Valve Obstruction | Cov Lus Qhia thiab Kev Haum rau 'Commissurotomy' |
|---|---|
| Kab Mob Plawv Rheumatic | Kev puas tsuaj rau cov qhov plawv uas tshwm sim los ntawm tus mob rheumatic fever thaum yau. Qhov kev puas tsuaj no feem ntau tshwm sim ntau xyoo tom qab, ua rau 'fused commissures' (qhov twg cov ntawv qhia valve lo ua ke). Cov txheej txheem 'commissurotomy' yog qhov ua tau zoo tshaj plaws rau tus mob no. |
| Kev puas tsuaj ntawm Mitral Stenosis | Kev hnav thiab rhuav ntawm lub valve thaum koj laus. Hauv qhov no, nws tsis yog tsuas yog cov ntawv lo ua ke xwb, tab sis kuj ua rau lwm qhov ntawm lub valve puas tsuaj thiab. Yog li ntawd, commissurotomy feem ntau tsis haum rau cov neeg mob no, thiab lawv yuav xav tau kev kho lub valve lwm txoj lossis Mitral Valve Hloov . |
Txhais li cas rau cov ntawv qhia valve kom lo ua ke?
Nws yooj yim to taub heev. Xav txog koj sawv ntawm daim iav thiab luag ntxhi nrog koj daim di ncauj kaw. Saib ob lub ces kaum uas koj daim di ncauj sab saud thiab sab hauv qab sib ntsib; qhov ntawd zoo ib yam li ob lub flaps (leaflets) ntawm koj lub mitral valve sib koom ua ke ntawm 'commissures.' Tam sim no, xav txog ib tug neeg nias lub ces kaum ntawm koj daim di ncauj ua ke nrog lawv cov ntiv tes. Koj puas tuaj yeem qhib koj lub qhov ncauj kom raug? Koj ua tsis tau, puas yog? Qhov ntawd yog qhov tshwm sim thaum lub mitral valve raug thaiv. Ib qho txheej txheem 'commissurotomy' lub hom phiaj yog tso cov ces kaum fused kom tso cai rau lub valve ua haujlwm li qub dua.
Koj npaj li cas rau kev phais?
Vim qhov no yog ib qho kev phais loj, kev npaj yuav pib ua ntej ob peb lub lis piam. Koj pab neeg kho mob (tus kws kho mob plawv thiab tus kws phais plawv hauv siab) yuav ua qhov kev soj ntsuam tag nrho, suav nrog:
- Kev kuaj lub cev tag nrho
- Kev kuaj ntshav
- Kev sib tham txog koj cov tsos mob thiab keeb kwm kev kho mob
Tsis tas li ntawd xwb, txhawm rau xyuas seb koj lub mitral valve puas muaj kev thaiv thiab saib seb puas muaj kev thaiv hauv lwm cov hlab ntsha hauv lub plawv, cov kev ntsuam xyuas hauv qab no tau ua tiav:
- Echocardiography: Kev ntsuas ultrasound ntawm koj lub plawv.
- Kev luam theej duab CT
- Kev kuaj mob plawv
Yog tias koj muaj lus nug lossis ntxhov siab txog kev phais, thov nrog koj tus kws kho mob tham kom koj tsis txhob txhawj. Yog tias koj haus luam yeeb, koj yuav tsum tso tseg tag ua ntej phais, vim qhov no yuav txo tau kev pheej hmoo ntawm kev phais.
Muaj dab tsi tshwm sim thaum lub sijhawm phais?
Qhov no yog kev phais plawv qhib. Nov yog cov txheej txheem ib kauj ruam zuj zus hauv chav phais:
1. Koj yuav tau txais tshuaj loog kom koj tsaug zog tob.
2. Yuav muab ib qho kev phais raws nruab nrab ntawm koj lub pob txha hauv siab (sternum).
3. Koj yuav raug txuas nrog lub tshuab cardiopulmonary bypass. Thaum koj lub plawv nres ib ntus thaum lub sijhawm phais, lub tshuab no yuav tswj koj cov ntshav ntws thiab cov pa oxygen.
4. Tus kws phais yuav qhib lub plawv sab laug kom kuaj xyuas lub mitral valve.
5. Cov kev txiav me me yog ua los tso cov khoom sib xyaw (commissures) ntawm lub valve.
6. Tom qab ntawd, koj raug txiav tawm ntawm lub tshuab bypass, thiab koj lub plawv rov pib dua.
7. Thaum kawg, yuav tsum tau ua ib qho transesophageal echocardiogram kom paub tseeb tias lub valve ua haujlwm zoo.
Tom qab phais tas, muaj dab tsi tshwm sim?
Tom qab phais tas, koj yuav tsum tau nyob hauv tsev kho mob li ib lub lim tiam. Koj yuav raug saib xyuas ze hauv Chav Saib Xyuas Mob Hnyav (ICU) rau thawj hnub lossis ob hnub.
Ua ntej koj tawm hauv tsev kho mob, koj tus kws kho mob yuav muab cov lus qhia rau koj txog:
- Kev Kho Mob Plawv: Qhov no yuav pab koj rov qab muaj zog thiab rov qab mus rau koj txoj kev ua neej niaj hnub.
- Kev saib xyuas qhov txhab: Yuav ua li cas saib xyuas koj qhov kev txiav kom tiv thaiv kev kis kab mob thiab txhawb kev kho mob.
- Thaum twg koj rov qab ua tau tej yam xws li tsav tsheb thiab rov qab mus ua haujlwm tau.
Cov Txiaj Ntsig, Kev Pheej Hmoo, thiab Thaum Twg Yuav Mus Ntsib Kws Kho Mob
Tus nqi ua tiav ntawm kev qhib mitral commissurotomy siab heev. Nws ua rau cov ntshav ntws zoo dua thiab txo cov tsos mob feem ntau. Txawm li cas los xij, qhov no tsis yog qhov kev daws teeb meem kawg tas mus li. Ntau tus neeg mob uas tau ua qhov txheej txheem no yuav xav tau kev phais hloov lub valve rau qee lub sijhawm yav tom ntej.
Ib yam li kev phais mob, muaj qee yam kev pheej hmoo, suav nrog:
- Mitral regurgitation (lub valve xau)
- Los ntshav ntau dhau
- Kev kis kab mob
- Arrhythmia (lub plawv dhia tsis sib xws)
- Mob stroke
Txawm li cas los xij, cov kev pheej hmoo no raug txo qis thaum ua los ntawm cov kws phais neeg paub dhau los ntawm tsev kho mob loj. Yog tias koj muaj cov mob xws li ntshav qab zib, kab mob raum, lossis rog dhau, koj qhov kev pheej hmoo yuav siab dua me ntsis; thov tham qhov no nrog koj tus kws kho mob ntawm Nirogi Lanka.
Nrhiav kev kho mob tam sim ntawd yog tias koj muaj cov tsos mob no:
- Ua npaws
- Liab, o, lossis kua dej tawm ntawm qhov chaw txiav
- Mob hauv siab rov tshwm sim los yog muaj kev nyuaj siab
Yog tias koj muaj cov cim qhia tias koj lub plawv nres (mob hauv siab heev, ua pa nyuaj) lossis cov tsos mob ntawm tus mob stroke (hais lus tsis meej, ntsej muag poob qis), hu rau 911 tam sim ntawd lossis mus rau chav kho mob ceev ze tshaj plaws.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Ib qho 'commissurotomy' yog ib qho txheej txheem qhib lub plawv uas tsim los kho qhov mitral valve nqaim, cia nws ua haujlwm tau zoo dua.
- Tus mob no feem ntau yog tshwm sim los ntawm kev puas tsuaj rau lub plawv valve vim yog tus mob rheumatic fever thaum yau.
- Txawm hais tias qhov no yog ib qho txheej txheem ua tiav zoo heev, thov nco ntsoov tias nws feem ntau yog ib qho kev daws teeb meem ib ntus, thiab koj yuav xav tau hloov lub valve yav tom ntej.
- Kev koom nrog cov kev pab cuam kho mob plawv yog qhov tseem ceeb rau koj txoj kev zoo rov qab tom qab phais.
- Nws yog ib qho tseem ceeb heev uas yuav tau nrog koj tus kws kho mob Nirogi Lanka tham kom meej txog tej lus nug uas koj muaj txog koj tus mob, cov txheej txheem kho mob, lossis tej yam txaus ntshai uas cuam tshuam nrog.
Kev phais plawv, lub plawv mitral, mitral valve stenosis, commissurotomy, kab mob plawv, phais, kab mob plawv rheumatic, phais plawv qhib
