Kutuluka kwa magazi m'mitsempha ya mtima: Kodi izi ndi zinthu zodetsa nkhawa?

Kodi mudamvapo nkhani yokhudza 'madzi odzaza mumtima'? Mwina mnzanu wanu wakumanapo ndi izi. Kapena mwina inunso mwakhala mukumva kulemera pang'ono pachifuwa panu komanso kupuma movutikira masiku ano. Izi ndizowopsa pang'ono. Lero tikulankhula za vuto ili lotchedwa 'Pericardial Effusion' mu sayansi ya zamankhwala. Kodi ndi chiyani, chifukwa chiyani limachitika, kodi ndi loopsa, ndipo tiyenera kuchita chiyani, tiyeni tikambirane m'njira yosavuta yomwe mungamvetse.

Mwachidule, kodi Pericardial Effusion ndi chiyani?

Tiyeni timvetse izi motere. Mtima wathu si chiwalo chokha. Umazunguliridwa ndi thumba lopyapyala, ngati chophimba choteteza. Timatcha izi kuti ``Pericardium``. Mtima uli mkati mwa thumba ili. Nthawi zambiri, pamakhala madzi ochepa pakati pa thumba ili ndi mtima omwe amathandiza mtima kutsetsereka mosavuta popanda kumenyana ukagundana. Uli ngati mafuta mu injini.

Kutuluka kwa madzi m'thupi (pericardial effusion) kumachitika pamene, pazifukwa zina, madzi ambiri kuposa achizolowezi amasonkhana m'thumba ili.

Tangoganizirani kuti mukuyesera kupopera buluni mkati mwa botolo la madzi la pulasitiki. Botolo likapanda kanthu, muli ndi malo opopera buluni momwe mungathere. Koma ngati muwonjezera madzi pang'ono mu botolo, malo opopera buluni amachepa. Ngati mudzaza ndi madzi ambiri, pamapeto pake buluni silidzatha kupopera konse.

Chinthu chomwecho chimachitikanso ku mtima wathu. Mtima uli ngati buluni. Chikwama chozungulira icho ('pericardium') ndi botolo. Chikwama ichi chikadzaza ndi madzi (madzimadzi), malo oti mtima upompe momasuka ndikudzaza ndi magazi amachepa.

• Pamene madzi akuchulukana: Thumba lozungulira mtima limakhala ndi nthawi yotambasuka ndikukula. Choncho simungamve bwino mpaka madzi ambiri atasonkhana.
• Madzi akamasonkhana nthawi imodzi: Izi ndi zoopsa. Izi zitha kuchitika ngati ngozi. Kenako thumba silikhala ndi nthawi yotulutsa madzi. Ngakhale madzi ochepa angayambitse mtima kuuma ndikutaya ntchito yake.

Kodi ndi zinthu ziti zomwe zingakhale zoopsa?

Inde, vutoli nthawi zina limakhala ladzidzidzi lomwe lingayambitse imfa. Timalitcha kuti `Cardiac Tamponade` .

Mwachidule, `Cardiac Tamponade` ndi pamene mtima umadzaza ndi madzi, zomwe zimapangitsa kuti ukhale wopanikizika kwambiri kotero kuti ulibe malo oti usunthire kapena kudzaza ndi magazi. Tangoganizirani botololo ladzaza ndi madzi, ndipo buluni silikutuluka mpweya konse.

Ngati mtima sunadzazidwe ndi magazi, sungathe kupopera magazi kupita ku thupi lonse. Ngati magazi safika ku ubongo, impso, ndi chiwindi, ziwalo zimenezo zimataya ntchito yawo. Vutoli limatchedwa `Cardiogenic Shock`. Izi ndi zoopsa kwambiri. Ngati sitilandira chithandizo nthawi yomweyo, imfa imatha kuchitika mkati mwa mphindi zochepa kapena maola ochepa.

Kodi zizindikiro za vutoli ndi ziti?

Ngati kuchuluka kwa madzi omwe mwasonkhanitsa ndi ochepa, simungakhale ndi zizindikiro zilizonse. Komabe, kuchuluka kwa madziwo kukawonjezeka, kapena pakagwa mwadzidzidzi monga `Cardiac Tamponade`, zizindikiro zimawonekera.

Tiyeni tiwone zizindikiro zazikulu zomwe zili mu tebulo ili m'munsimu.

Kuphatikiza apo, madzi ozungulira mtima akachuluka kwambiri, amatha kukanikiza ziwalo zapafupi, monga mapapo, mitsempha, kapena mmero. Zizindikiro ngati izi zitha kuchitikanso:

• Kuvuta kumeza chakudya (Dysphagia)
• Ma Hiccups
• Kutsokomola kapena kusanza

N’chifukwa chiyani izi zikuchitika? Kodi zifukwa zake ndi ziti?

Palibe chifukwa chimodzi chomwe madzi amadzaza mumtima, pakhoza kukhala zifukwa zambiri. Nthawi zina palibe chifukwa chomwe chingapezeke. Koma pali zinthu zingapo zazikulu zomwe zimakhudza mtima.

• Matenda: Matendawa angayambitsidwe ndi matenda osiyanasiyana a mavairasi ndi mabakiteriya. Chifuwa chachikulu ndi chomwe chimayambitsa matendawa, makamaka m'maiko ngati Sri Lanka. Kutenga kachilombo ka HIV kungakhalenso chifukwa chake.
• Khansa: Khansa yomwe imachitika mumtima kapena khansa yomwe yafalikira kumtima (metastasis) kuchokera kwina m'thupi ikhoza kuwononga mkati mwa mtima ndikupangitsa kuti udzaze ndi madzi.
• Matenda a chitetezo chamthupi: Kutupa komwe kumachitika chifukwa cha matenda omwe amaukira maselo a thupi, monga lupus (SLE) ndi rheumatoid arthritis, kungayambitse madzimadzi kudziunjikira.
• Mavuto a mahomoni: Matenda monga hypothyroidism.
• Kuvulala pachifuwa: Kuvulala kwakukulu monga kuvulala pachifuwa chifukwa cha ngozi ya galimoto kapena bala lobayidwa.
• Matenda a mtima: Matenda monga matenda a mtima, matenda a valve ya mtima, kapena kusweka kwa mtsempha wamagazi.
• Zifukwa zina zachipatala: Zitha kuchitikanso pambuyo pa opaleshoni ya mtima, pambuyo pa chithandizo cha khansa pogwiritsa ntchito radiation, kapena ngati zotsatira zina za mankhwala ena.
• Matenda ena: Matendawa amathanso kuchitika chifukwa cha kuchuluka kwa madzi m'thupi chifukwa cha matenda monga kulephera kwa impso ndi matenda a chiwindi.

Kodi mwapeza bwanji izi, Dokotala?

Ngati muli ndi zizindikiro, dokotala wanu adzakufunsani mafunso ndikukufufuzani kuti adziwe ngati muli ndi vuto. Nthawi zina matendawa amapezeka mwangozi panthawi ya X-ray pachifuwa pazifukwa zina.

Dokotala adzalamula mayeso angapo kuti atsimikizire vutoli ndikupeza chomwe chikuyambitsa.

• Electrocardiogram (ECG): Imafufuza momwe magetsi a mtima amagwirira ntchito.
• Echocardiogram: Iyi ndi njira yofunika kwambiri yoyezera. Ili ngati scan ya mwana. Imatha kuwona bwino kuchuluka kwa madzi omwe ali pafupi ndi mtima komanso ngati ikukhudza momwe mtima ukugwira ntchito.
• X-ray ya pachifuwa: Ngati pali madzi ambiri, mthunzi wa mtima udzakhala waukulu.
• CT Scan kapena MRI Scan:Izi zingapereke chithunzi chatsatanetsatane cha mtima ndi kapangidwe kozungulira.
• Kuyezetsa magazi: Kuyezetsa magazi kungathandize kwambiri kupeza chomwe chikuyambitsa matendawa. Mwachitsanzo, `Complete Blood Count (CBC), `Troponin` (kuti muone ngati muli ndi matenda a mtima), kuchuluka kwa mahomoni a chithokomiro, ndi kuyezetsa matenda a chitetezo chamthupi.

Kodi mankhwala ochizira izi ndi otani?

Chithandizocho chimadalira momwe vuto lanu lilili lalikulu komanso chomwe chikuyambitsa vutoli.

Komabe, ngati kuchuluka kwa madzi m'thupi kukukwera mofulumira, muli ndi zizindikiro, kapena ngati vuto ladzidzidzi monga cardiac tamponade layamba, chithandizo chachangu chikufunika.

Pali njira ziwiri zazikulu zochizira:

1. Kuchotsa madzi pakagwa ngozi

Izi zimaphatikizapo kuchotsa madzi ochulukirapo ozungulira mtima, zomwe zimathandiza kuti mtima ugwire ntchito momasuka.

• Pericardiocentesis: Pa opaleshoniyi, khungu la pachifuwa limafooka, singano yopyapyala imayikidwa m'thumba lozungulira mtima motsogozedwa ndi echocardiogram, ndipo madzi ochulukirapo amachotsedwa pogwiritsa ntchito sirinji. Nthawi zina chubu chaching'ono chingasiyidwe pamalopo kwa masiku angapo kuti madziwo apitirire kutuluka.
• Kuchotsa madzi m'thupi pogwiritsa ntchito opaleshoni: Nthawi zina opaleshoni ndi yofunika. Mu njira yotchedwa ``Video-assisted thoracic surgery (VATS),`` kamera imayikidwa kudzera mu kabowo kakang'ono ndipo "zenera" laling'ono limapangidwa m'thumba lozungulira mtima. Madzi ochulukirapo amatuluka m'bowo lalikulu lozungulira mapapo, komwe amalowa m'thupi.

2. Kuchiza chifukwa chachikulu

Madziwo akachotsedwa, kuti madziwo asadzazenso, chifukwa chake chiyenera kuchiritsidwa.

• Ngati pali matenda, maantibayotiki amaperekedwa.
• Ngati ndi chifukwa cha kutupa, mankhwala oletsa kutupa amaperekedwa.
• Ngati ndi chifukwa cha khansa , mankhwala a chemotherapy kapena radiation amagwiritsidwa ntchito.
• Ngati muli ndi matenda a impso, mungafunike kuchitidwa dialysis .

Kodi chimachitika ndi chiyani munthu akalandira chithandizo? Zimatenga nthawi yayitali bwanji kuti achire?

Kuchira msanga komanso nthawi yomwe imatenga kuti munthu achire kumadalira zinthu zingapo:

• Chifukwa cha kudzazidwa kwa madzi.
• Kuopsa kwa vutoli.
• Chithandizo chomwe mudalandira.
• Thanzi lanu lonse.

Pakagwa vuto ladzidzidzi monga `Cardiac Tamponade`, mudzayamba kumva bwino kwambiri madzi ozungulira mtima akangochotsedwa. Dokotala wanu nthawi zambiri amakhala munthu wabwino kwambiri woti akupatseni lingaliro la nthawi yomwe mukuchira.

Ngati vutoli layamba chifukwa cha vuto lalikulu, monga khansa kapena ngozi, mwayi wochira ukhoza kukhala wochepa. Komabe, ngati chifukwa chake sichingapezeke, kapena ngati chayamba chifukwa cha matenda wamba, mwayi wochira kwathunthu ndi wokwera kwambiri.

Kodi ndi liti pamene mwadzidzidzi muyenera kupita ku ETU?

Iyi ndi gawo lomwe muyenera kusamala kwambiri . Ngati mukudziwa kuti muli ndi `Pericardial Effusion`, kapena ngati mwadzidzidzi mwayamba kukhala ndi chimodzi mwa zizindikiro zotsatirazi, pitani ku chipatala cha Emergency Department (`ETU`) nthawi yomweyo. Izi zitha kukhala zizindikiro za `Cardiac Tamponade`.

Samalani kwambiri ndi zizindikiro izi. Chithandizo cha panthawi yake chingakupulumutseni.