Koj lossis ib tug neeg uas koj paub lossis ib tug phooj ywg zoo puas tau raug kws kho mob hais tias koj muaj teeb meem nrog koj lub plawv 'Mitral Valve' thiab koj xav tau kev phais? Thaum peb hnov lo lus "phais plawv," ntau tus ntawm peb ntshai me ntsis, puas yog? Qhov ntawd yog ib txwm muaj. Vim peb tau hnov txog kev phais uas cuam tshuam nrog kev qhib lub hauv siab thiab ua kev phais loj. Tab sis koj puas paub, kev tshawb fawb kho mob tau nce qib ntau tam sim no. Yog li ntawd, muaj ib txoj hauv kev tshiab uas tuaj yeem hloov lub valve no yam tsis tau qhib lub hauv siab thiab los ntawm kev phais me me. Hnub no, peb yuav tham txog txoj kev kho mob uas tau ua rau ntau tus neeg zoo siab, hu ua 'Transcatheter Mitral Valve Replacement' lossis luv luv TMVR .
Hais yooj yim xwb, TMVR yog dab tsi?
Zoo, cia peb hais yooj yim xwb. TMVR yog ib txoj kev kho mob uas hloov lub mitral valve hauv koj lub plawv. Tab sis qhov tshwj xeeb txog nws yog tias nws tsis yog ua los ntawm kev qhib koj lub hauv siab tag nrho zoo li kev phais plawv qhib. Hloov chaw, ib lub raj nyias nyias (catheter) raug ntxig los ntawm ib qho kev phais me me, thiab lub valve tshiab tom qab ntawd raug ntxig rau hauv koj lub plawv.
Xav txog tias es tsis txhob tshem tawm lub qhov loj thiab hloov nws nrog lub tshiab, koj coj cov khoom ntawm lub qhov tshiab los ntawm lub qhov me me thiab kho lawv sab hauv. Qhov no yog ib qho kev phais mob tsawg dua li kev phais loj. Lub qhov tshiab uas raug ntxig rau hauv txoj kev no tuaj yeem yog cov khoom cuav. Los yog nws tuaj yeem yog lub qhov ua los ntawm nyuj, npua, lossis cov nqaij ntawm lub plawv tib neeg. Tom qab ntxig lub qhov tshiab, nws pib ua tib yam li koj lub qhov qub, uas muaj kab mob tau ua.
Leej twg xav tau kev kho mob TMVR no?
Yuav kom nkag siab qhov no, cia peb xub saib seb qhov 'mitral valve' no yog dab tsi thiab muaj dab tsi tshwm sim rau nws.
Peb lub plawv muaj plaub lub chav tseem ceeb. Ob lub rau sab saud thiab ob lub rau hauv qab. Lub mitral valve nyob nruab nrab ntawm sab laug atrium thiab sab laug ventricle. Nws zoo li lub qhov rooj ntawm ob chav. Lub qhov rooj no muaj ob lub flaps (leaflets). Txhua zaus lub plawv dhia, cov flaps no qhib thiab kaw. Qhov no tso cai rau cov ntshav ntws mus rau hauv ib qho kev taw qhia xwb, los ntawm lub chav sab saud mus rau lub chav hauv qab. Lub luag haujlwm tseem ceeb ntawm lub valve no yog tiv thaiv cov ntshav kom tsis txhob ntws rov qab.
Tiam sis qee zaum, txij thaum yug los lossis tom qab, ntau yam teeb meem tuaj yeem tshwm sim nrog lub valve no. Muaj ob hom teeb meem feem ntau.
| Qhov xwm txheej ntawm lub valve | Hais yooj yim xwb, ua li cas lawm? |
|---|---|
| Kev kho mob ntawm lub mitral valve | Qhov tshwm sim ntawm no yog lub qhov cua tsis kaw zoo. Zoo li ob lub qhov rooj tsis kaw zoo thiab muaj qhov sib txawv me ntsis. Tom qab ntawd cov ntshav ntws rov qab mus rau hauv chav sab saud. |
| Kev kho mob ntawm lub plawv mitral stenosis | Qhov tshwm sim ntawm no yog tias lub qhov rooj nqaim lossis raug thaiv. Qhov ntawd txhais tau tias lub qhov rooj tsis qhib tag nrho. Tom qab ntawd cov ntshav uas xav tau ntws mus tom ntej raug thaiv. |
Thaum cov mob no hnyav zuj zus, lawv tuaj yeem ua rau muaj cov tsos mob xws li ua pa luv luv, qaug zog, thiab mob hauv siab. Lawv kuj tseem tuaj yeem ua rau muaj cov mob hnyav dua xws li atrial fibrillation (lub plawv dhia tsis xwm yeem), pulmonary hypertension (ntshav siab hauv lub ntsws), lossis lub plawv tsis ua haujlwm.
Txoj kev kho mob no, hu ua TMVR, feem ntau yog ib qho kev xaiv zoo heev rau cov neeg uas laus dua thiab muaj lwm yam mob thiab tsis tuaj yeem zam kev phais plawv loj.
TMVR thiab MitraClip puas yog tib yam?
Tsis yog. Txawm hais tias ob qho tib si yog kev kho mob uas tsis tshua mob rau cov teeb meem mitral valve, muaj qhov sib txawv ntawm ob qho no.
- TMVR yog kev hloov pauv tag nrho .
- MitraClip™ yog kev kho lub valve. Nws zoo li muab ib daim clip me me ntawm ob lub flaps ntawm lub valve xau, tiv thaiv qhov xau.
Koj tus kws kho mob plawv yuav txiav txim siab seb txoj kev kho mob twg zoo tshaj plaws rau koj.
Ua ntej kev kho mob TMVR, muaj dab tsi tshwm sim?
Ua ntej kev kho mob no, koj pab neeg kho mob yuav kuaj koj kom zoo zoo. Qhov no feem ntau yuav suav nrog cov kev kuaj mob hauv qab no:
- Echocardiogram: Qhov no yog kev ntsuas ultrasound ntawm lub plawv. Nws tuaj yeem pom tseeb tias cov chav plawv thiab cov valve ua haujlwm li cas.
- CT Scan: Qhov no thaij duab peb-seem (3D) ntawm lub plawv thiab cov hlab ntsha thiab pab npaj kev kho mob.
Siv cov ntaub ntawv los ntawm cov kev kuaj no, pab pawg kho mob npaj qhov loj me ntawm lub valve thiab txoj kev kho mob zoo tshaj plaws rau koj.
Ntxiv mus, tus kws kho mob anesthesiologist yuav nrog koj tham thiab txiav txim siab seb hom tshuaj loog zoo tshaj plaws los tiv thaiv koj kom tsis txhob mob thaum lub sijhawm ua haujlwm. Tej zaum yuav muab koj pw tsaug zog tag nrho (tshuaj loog dav dav), lossis tej zaum yuav muab koj pw tsaug zog thiab tsis hnov mob (tshuaj loog kom paub).
Ob peb hnub ua ntej koj txoj kev kho mob, koj tus kws kho mob yuav muab cov lus qhia meej rau koj txog kev npaj. Cov no yuav suav nrog:
- Qee cov tshuaj, xws li cov tshuaj ua kom cov ntshav nyias, yuav tsum tsis txhob siv li ob peb hnub.
- Thaum hnub kho mob, koj yuav raug hais kom yoo mov (tsis txhob noj lossis haus dej) rau ob peb teev.
- Tom qab kho mob tas, lawv thov kom npaj ib lub tsheb coj koj mus tsev ntawm tsev kho mob.
Muaj dab tsi tshwm sim thaum lub sijhawm kho mob TMVR?
Feem ntau cov txheej txheem tag nrho yuav siv sijhawm li ob mus rau peb teev thiab ua los ntawm pab pawg kws kho mob loj, suav nrog cov kws phais plawv, cov kws kho mob plawv, cov kws kho mob tshwj xeeb hauv kev thaij duab, thiab cov kws kho mob siv tshuaj loog.
Nov yog ib kauj ruam yooj yim uas piav qhia txog yam uas tshwm sim thaum lub sijhawm kho mob:
1. Ua ntej, qhov chaw uas yuav txiav (feem ntau yog qhov chaw mos lossis ib qho me me ntawm lub hauv siab) yuav tsum tau ntxuav thiab tshem cov plaub hau yog tias tsim nyog.
2. Tom qab ntawd, yuav muab ib lub cannula (kab IV) tso rau hauv cov leeg ntshav hauv koj txhais caj npab, uas yuav muab cov tshuaj thiab cov kua dej uas tsim nyog rau koj.
3. Tom ntej no, lub qhov dej tshiab raug txuas rau qhov kawg ntawm ib lub raj nyias nyias, yoog tau hu ua catheter .
4. Tam sim no, ib qho kev phais me me raug ua rau ntawm qhov chaw uas tau teem tseg hauv qhov chaw ntawm lub puab tais lossis hauv siab, thiab los ntawm qhov ntawd, cov catheter no raug ntxig rau hauv cov hlab ntsha.
5. Siv cov thev naus laus zis tshwj xeeb, xws li X-rays, cov kws kho mob ua tib zoo coj cov catheter no hla cov hlab ntsha mus rau lub mitral valve hauv lub plawv.
6. Thaum twg nyob hauv qhov chaw lawm, lub qhov dej tshiab yuav raug muab tso rau hauv lub qhov dej qub uas muaj kab mob.
7. Thaum lub qhov tshiab nyob hauv qhov chaw zoo lawm, lub catheter yuav raug tshem tawm kom zoo thiab qhov phais me me yuav raug kaw.
Thoob plaws lub sijhawm no, pab pawg kho mob yuav txuas ntxiv saib xyuas txhua yam los ntawm koj cov ntshav siab thiab cov pa oxygen hauv cov ntshav mus rau seb koj lub plawv ua haujlwm li cas siv echocardiogram.
Tom qab kho mob tas lawm, muaj dab tsi tshwm sim?
Tom qab kev kho mob tiav lawm, koj yuav raug coj mus rau chav kho mob rov zoo. Pawg neeg kho mob yuav saib xyuas koj zoo kom txog thaum koj rov zoo los ntawm kev siv tshuaj loog. Tej zaum yuav muaj ib txhia neeg yuav tsum tau nyob hauv chav saib xyuas mob hnyav (ICU) ib ntus. Feem ntau, koj yuav tsum tau nyob hauv tsev kho mob ob peb hnub.
Ua ntej koj mus tsev, cov kws kho mob yuav piav qhia meej txog yam koj yuav tsum ua tom ntej.
- Kev kho lub plawv kom rov zoo: Cov lus qhia txog kev tawm dag zog thiab kev hloov pauv hauv lub neej kom pab txhawb lub plawv dua.
- Kev teem caij ntsib kws kho mob tom qab: Cov hnub uas koj xav tau mus ntsib kws kho mob dua.
- Cov Tshuaj: Cov lus qhia txog cov tshuaj tshiab kom pib lossis cov tshuaj qub kom pib dua.
- Ua Haujlwm Li Qub: Thaum twg koj thiaj rov qab mus ua haujlwm thiab rov ua cov haujlwm li qub?
Cov txiaj ntsig ntawm kev kho mob TMVR yog dab tsi?
Piv rau kev phais plawv qhib, txoj kev catheter no muaj ntau qhov zoo.
- Kab mob Mitral valve tuaj yeem kho tau.
- Txo cov tsos mob los ntawm tus kab mob, xws li ua tsis taus pa thiab qaug zog.
- Txo qhov kev pheej hmoo ntawm cov teeb meem kev noj qab haus huv loj.
- Muaj peev xwm rov zoo sai dua li phais qhib.
- Txo qhov cuam tshuam rau lub cev thiab qhov mob.
Puas muaj tej yam txaus ntshai lossis teeb meem nrog kev kho mob no?
Yog. Txawm hais tias qhov kev pheej hmoo qis dua li kev phais plawv qhib, zoo li lwm yam kev kho mob, TMVR tuaj yeem muaj qee qhov kev pheej hmoo thiab teeb meem. Txawm li cas los xij, cov no tsis tshua muaj.
Qhov tseem ceeb tshaj plaws, yog tias muaj xwm txheej ceev tshwm sim thaum lub sijhawm kho mob, pab pawg kho mob npaj txhij hloov mus rau kev phais plawv qhib tam sim ntawd yog tias tsim nyog.
Nov yog qee qhov teeb meem tseem ceeb uas tuaj yeem tshwm sim:
- Cov Ntshav Txhaws: Yog tias cov ntshav txhaws no mus rau lub hlwb, mob stroke tuaj yeem tshwm sim.
- Kev puas tsuaj rau cov nqaij: Tej zaum yuav raug mob ib phab ntsa ntawm lub plawv (lub plawv sab laug tawg) lossis ib txoj hlab ntshav uas xa ntshav mus rau lub plawv (coronary artery).
- Kev thaiv txoj hlab ntshav tawm ntawm lub plawv sab laug: Lub qhov valve tshiab thaiv txoj kev ntshav ntws tawm ntawm lub plawv sab laug qis.
- Kev txav ntawm lub valve: Kev txav ntawm lub valve los ntawm nws qhov chaw ruaj khov.
Qee qhov teeb meem yuav xav tau kev kho mob ntxiv lossis phais.
Yuav siv sijhawm ntev npaum li cas thiaj rov zoo?
Feem ntau cov neeg tuaj yeem rov qab mus ua lawv tej dej num li qub thiab ua haujlwm tau hauv ob peb lub lis piam. Txawm li cas los xij, nws yuav siv sijhawm ob mus rau peb lub hlis kom rov zoo tag nrho . Qhov tseem ceeb tshaj plaws yog ua raws li koj tus kws kho mob cov lus qhia kom zoo. Tsis txhob maj ua haujlwm hnyav lossis ua ub ua no hnyav.
Muaj tej yam xwm txheej twg uas koj yuav tsum nrhiav kev pab kho mob tom qab kho tas?
Qhov no yog ib feem tseem ceeb heev. Thaum koj mus tsev tom qab kho mob tas, koj yuav tsum tau ua tib zoo saib xyuas qhov kev hloov pauv hauv koj lub cev. Muaj qee cov tsos mob, yog tias lawv tshwm sim, koj yuav tsum nrhiav kev pab kho mob yam tsis muaj kev ncua .
| Xwm txheej ceev: Yog tias koj muaj cov tsos mob no, mus rau chav kho mob ceev (ETU) ntawm tsev kho mob tam sim ntawd! | |
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| Cov tsos mob ntawm tus mob stroke yuav muaj xws li: | |
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| Cov tsos mob ntawm kev mob plawv nres yuav muaj xws li: | |
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| Lwm yam uas yuav tsum tau ceev faj: Tham nrog koj tus kws kho mob yog tias koj muaj cov no. | |
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TMVR yog ib txoj kev kho mob zoo heev rau cov neeg uas muaj kab mob mitral valve uas tsis tuaj yeem phais plawv qhib. Yog tias koj muaj lus nug ntxiv txog qhov no, thov koj nrog koj tus kws kho mob tham. Nws yuav piav qhia tau qhov kev kho mob zoo tshaj plaws rau koj.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- TMVR yog ib txoj kev kho mob niaj hnub uas hloov lub plawv lub mitral valve los ntawm kev phais me me, yam tsis tau qhib lub hauv siab.
- Qhov no tsim nyog tshwj xeeb rau cov neeg mob uas muaj teeb meem nyiaj mus phais plawv qhib.
- Kev rov zoo sai dua thiab qhov cuam tshuam rau lub cev tsawg dua li kev phais qhib.
- Ib yam li txhua yam kev kho mob, muaj qee qhov kev pheej hmoo, thiab nws yog ib qho tseem ceeb uas yuav tsum tham txog cov no nrog koj tus kws kho mob.
- Tom qab kho mob tas, yog tias muaj cov tsos mob ntawm tus mob stroke lossis mob plawv nres, koj yuav tsum mus rau tsev kho mob tam sim ntawd.
- Tsuas yog koj tus kws kho mob plawv thiaj li muab tau cov lus qhia tseeb tshaj plaws txog kev kho mob twg zoo tshaj plaws rau koj.
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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