Uvavanyo olujonga intliziyo: Masifunde nge-Transesophageal Echocardiogram (TEE)!

Ngaba ugqirha wakho u-odole uvavanyo olukhethekileyo ukuze ajonge naziphi na iingxaki zentliziyo yakho? Lusenokuba luvavanyo lwe-`(Transesophageal Echocardiogram)`, okanye njengoko silubiza ngokuba luvavanyo lwe-`(TEE)`. Nangona lusenokuvakala lungaqhelekanga, yindlela ekuvumela ukuba ubone imeko yentliziyo yakho ngokucacileyo, ngaphakathi. Ngoko ke usenokuba noloyiko okanye unomdla wokubuza ngale nto. Ngoko ke masithethe ngolu vavanyo lwe-`(TEE)` ngokulula, ngendlela onokuyiqonda.

Luthini olu vavanyo (TEE)? Lwenziwa njani?

Ngamafutshane, i-Transesophageal Echocardiogram luvavanyo olusebenzisa amaza esandi ukuthatha imifanekiso yentliziyo yakho. Olu luvavanyo lwe-echo. Kodwa lwahlukile kancinci kwi-Transthoracic Echocardiogram (TTE) eqhelekileyo eyenziwa esifubeni. Oku kungenxa yokuba imifanekiso ithathwa ngaphakathi emzimbeni.

Ugqirha, isixhobo esibhityileyo, esifana netyhubhu ende, esibizwa ngokuba yi-"Endoscope," sifakwa ngononophelo emqaleni wakho kwipayipi yakho yokutya (esophagus). Ekupheleni kwale tyhubhu kukho i-"Transducer" encinci. Le "Transducer" ikhupha amaza esandi. La maza esandi abetha kwiindawo ezahlukeneyo zentliziyo aze abuye, njengesandi. I-"Transducer" ithatha loo maza abuyayo ize iwathumele kwikhompyutha. Ikhompyutha iguqula loo datha ibe yimifanekiso. Le mifanekiso ibonisa imo kunye nomsebenzi wentliziyo ngokweenkcukacha ezinkulu.

Ngamanye amaxesha oogqirha basebenzisa iindlela ezikhethekileyo ezibizwa ngokuba yiDoppler ultrasound kunye neColor Doppler kunye nolu vavanyo lwe-TEE. Ezi zinokulinganisa ngokuchanekileyo isantya kunye necala lokuhamba kwegazi entliziyweni.

Yintoni abayifumanayo oogqirha ngolu vavanyo (TEE)?

Olu vavanyo lwe-`(TEE)` lunokubonelela ngomfanekiso ocacileyo wesakhiwo sentliziyo, oko kukuthi, indlela amalungu ayo ahlelwe ngayo, kunye nendlela esebenza ngayo intliziyo. Oku kunokunceda ekuchongeni izifo ezahlukeneyo kunye nokuzilawula ngexesha lonyango. Nazi imizekelo embalwa:

• I-Aortic aneurysm: Oku kwenzeka xa udonga lomthambo wegazi omkhulu emzimbeni wethu (i-aorta) lubuthathaka kwaye luvuthuluka njengebhaluni.
• Amahlwili egazi entliziyweni: Abantu abane-atrial fibrillation, ngokukodwa, banamathuba amaninzi okuba namahlwili egazi kwigumbi eliphezulu lentliziyo (atria).
• Iithumba zentliziyo: Ezi zinokuba ngumhlaza okanye zingabi ngumhlaza.
• Isifo sentliziyo esizalwa naso: Oku kubhekisa kwizifo ezahlukeneyo zentliziyo ezikhoyo ekuzalweni.
• Isifo sevalvu yentliziyo: Umzekelo, isifo sevalvu ye-mitral. Le valve inokuba mxinwa (stenosis) okanye ivuza igazi ngasemva (regurgitation). Kwakhona, abantu abanevalvu zokufakelwa banokujongwa ukuba abanazo iingxaki ngeevalvu zabo, ezinje ngezifo okanye amahlwili egazi.
• Usulelo lwezicubu zentliziyo okanye iivalvu: Umzekelo, iimeko ezifana `(Infective endocarditis)`.
• Isifo sentliziyo: Oku kubhekisa kwizifo ezenzeka kwisingxobo esincinci (i-pericardium) esijikeleze intliziyo.

Kutheni olu vavanyo (TEE) lwenziwa? Ngawaphi amatyala?

Kukho izizathu ezahlukeneyo zokuba uvavanyo lwe-TEE lunokwenziwa. Makhe sijonge ukuba zeziphi:

1. Ukuba i-echocardiogram eqhelekileyo (TTE) ayanelanga: Emva kwe-echocardiogram eqhelekileyo (TTE) eyenziwe esifubeni sakho, ugqirha wakho unokufuna umbono ocacileyo noneenkcukacha ngakumbi wentliziyo yakho. Kwiimeko ezinjalo, uvavanyo lwe-TEE lunokwenziwa ukongeza kwi-TTE ukunceda ekufumaneni ingxaki yentliziyo okanye ukucwangcisa unyango.

Khawuthelekelele uhamba esitalatweni uze ubone iipleyiti ezintle evenkileni ngeglasi. Ungabona ukuba iipleyiti zineepateni zeentyatyambo, kodwa akucaci ukuba zeziphi iintyatyambo, zithini iinkcukacha, kuba kukho abantu abakufutshane kwaye kukho iglasi. Ngoko ke ungena ngaphakathi evenkileni uze ujonge iipleyiti kufutshane. Kulapho ubona khona ukuba ziirozi.

Yiyo loo ndlela i-echocardiogram eqhelekileyo (TTE) eyenziwa esifubeni efana nokujonga ngeglasi evenkileni. Ingakuxelela izinto ezininzi. Kodwa le TEE ifana nokungena evenkileni uze uthabathe ipleyiti. Amanye amalungu entliziyo, ingakumbi lawo angasemva, acacile kakhulu kule TEE. Ngenxa yokuba umphimbo wakho usemva kwentliziyo yakho, yindawo entle yokuba i-transducer ithumele kwaye ifumane amaza esandi.

Kufanelekile ukujonga ezi ndawo ngokukodwa:

* I-atrium yasekhohlo: Igumbi eliphezulu lasekhohlo lentliziyo.

* I-Left atrial appendage (LAA): Ingxowa encinci efana nendlebe kwi-atrium yasekhohlo. Kulapho ngamanye amaxesha kwakheka khona amahlwili egazi.

* I-Interatrial septum: Udonga olwahlula i-atria yasekhohlo neyasekunene.

* I-Thoracic aorta: Inxalenye ye-aorta edlula esifubeni.

Ngamanye amaxesha oogqirha benza i-TEE endaweni ye-TTE. Oku kungenxa yezizathu ezilandelayo:

• Ukuba isakhiwo sesifuba sikwindawo eyenza kube nzima ukwenza i-TTE.
• Ukuba unezifo zemiphunga (njengoko zinokusitha umbono wentliziyo).

2. Kwiimeko ezingxamisekileyo, ezisongela ubomi: Kwezinye iimeko ezingxamisekileyo, oogqirha kufuneka babone imeko yentliziyo ngokukhawuleza. Emva koko `(TEE)` iluncedo kakhulu. Umzekelo:

• Ukungazinzi kwe-Hemodynamic (uxinzelelo lwegazi kunye neengxaki zokujikeleza kwegazi)
• Uxinzelelo lwegazi oluphantsi (iHypotension)
• Ukwehla kwamanqanaba eoksijini (iHypoxia)
• Iimeko ezingxamisekileyo ezifuna uvavanyo olukhawulezileyo, ezifana nokuqhaqhwa kwe-aorta.
• Xa kurhanelwa ukuba kukho isifo sentliziyo.
• Iingxaki ngeevalvu zokufakelwa (ezifana nokuqhekeka kwegazi, usulelo).
• Ukulimala esifubeni.

3. Jonga ukuba igazi alinamahlwili na ngaphambi kokuba kwenziwe naluphi na unyango: Xa kunyangwa iingxaki ezithile zesingqisho sentliziyo (i-arrhythmias), ezifana ne-catheter ablation okanye i-electrical cardioversion, kwenziwa i-TEE ukujonga ukuba igazi alinamahlwili na entliziyweni ngaphambi kokuba kwenziwe olu tyando. Oku kungenxa yokuba ukuba kukho ihlwili legazi, linokuphuma ngexesha lenkqubo lize livale umthambo wegazi (thromboembolism).

4. Ukunceda ngotyando kunye nezinye iinkqubo zonyango: I-TEE sisixhobo esibaluleke kakhulu ngexesha lotyando kunye neenkqubo zonyango. Isetyenziselwa ukubona ulwakhiwo lwentliziyo ngaphambi kotyando kunye nokuqinisekisa impumelelo yotyando emva kokuba lwenziwe. Imizekelo:

• Utyando lwesifo sentliziyo esizalwa naso.
• Ukulungiswa kwevalvu.
• Ukutshintshwa kwevalvu.

Kwakhona, kwezinye iindlela zonyango ezisekelwe kwi-catheter, oko kukuthi, unyango apho ityhubhu encinci idluliselwa ngemithambo yegazi iye entliziyweni, i-TEE isetyenziselwa ukujonga ngaphakathi emzimbeni kunye nokubonelela ngemifanekiso yexesha langempela ukukhokela inkqubo. Imizekelo:

• `(Ukutshintshwa kwevalvu ye-aortic ye-Transcatheter - TAVR)`
• `(Ukulungiswa kwevalvu ye-transcatheter mitral)`
• `(Ukulungiswa kwevalvu ye-transcatheter tricuspid)`
• `(Ukuvalwa kwe-Transcatheter left atria appendage)`

Ngaba uvavanyo lwe-TEE lwenziwa ngaphakathi emzimbeni? Ngaba kusetyenziswa i-anesthesia?

Ewe, i-TEE ithathwa njengovavanyo olungena emzimbeni kuba ibandakanya ukufaka isixhobo emzimbeni. Usenokuziva ungakhululekanga, kodwa umngcipheko weengxaki ezinkulu uphantsi.

Ixesha elininzi, uvavanyo lwe-TEE lufuna kuphela i-anesthesia yendawo kunye nokuthomalalisa okuphakathi . Oku kuthetha ukuba ugqirha uza kutshiza iyeza elibangela ukuba ungabi nazimvakalelo ngasemva komqala wakho. Uza kukunika neyeza le-intravenous (IV) ukukunceda uphumle.

Uninzi lwabantu aludingi i-anesthesia eqhelekileyo, kodwa licebo elihle ukuthetha nogqirha wakho malunga nokuba yintoni ekulungeleyo.

Ngaba ke ngoku siyalaliswa? Ngaba sisezingqondweni?

Ukuthomalalisa okulinganiselweyo kuya kukwenza uzive ulele kwaye kuya kukuvumela ukuba wenze uvavanyo ngaphandle kokungonwabi kakhulu. Abasebenzi bezonyango baya kuqhubeka bekujonga ukuze babone ukuba akukho nto ikuphazamisayo na. Banokukunika into engakumbi yokuthomalalisa ukuba kuyimfuneko.

Nokuba ubunokunikwa `(i-anesthesia eqhelekileyo)`, ubuya kuba ulele ngokupheleleyo kwaye ubungayi kukhumbula nto ngovavanyo. Nangona kunjalo, ukuba unikwa `(i-anesthesia eqhelekileyo)`, kuya kufuneka uqhagamshelwe `(kumatshini wokuphefumla).` Kwakhona, kuba ulele ubuthongo obunzulu, kuthatha ixesha elide ukuba uphile kunokuba usebenzise i-sedation ephakathi.

Olu vavanyo luthatha ixesha elingakanani?

Uvavanyo lwe-TEE lungathatha ukuya kuthi ga kwimizuzu engama-90 ukugqitywa. Nangona kunjalo,Ukufotwa kwefoto kudla ngokuthatha malunga nemizuzu eli-15.

Sifanele sizilungiselele njani ngaphambi kovavanyo (lwe-TEE)?

Qiniseka ukuba uxoxa ngembali yakho yezonyango nogqirha wakho. Ezinye iimeko zonyango zingenza uvavanyo lwe-TEE lube yingozi. Qiniseka ukuba uxelele ugqirha wakho ukuba unayo nayiphi na kwezi meko zilandelayo:

• Umhlaza wesisu
• I-Gastritis
• I-GERD (i-reflux ye-asidi engapheliyo)
• I-hernia ye-Hiatal
• Imbali yokusebenzisa iziyobisi ngemithambo yegazi (ukusebenzisa iziyobisi nge-IV)
• Iingxaki zokuginya
• Ukuphelelwa ngamandla kokulala
• Umhlaza wesisu

Kwakhona, sixelele ukuba usebenzisa amayeza ezi zinto:

• Iingxaki zokulala
• Ixhala
• Intlungu

Ugqirha wakho uza kukunika imiyalelo eneenkcukacha malunga nendlela yokulungiselela uvavanyo lwe-TEE. Qiniseka ukuba uyilandela ngokuchanekileyo loo miyalelo. Ungoyiki ukubuza ukuba kukho into ongayiqondiyo. Imiyalelo iza kuquka oku kulandelayo:

• Ixesha lokuyeka ukutya nokusela (ngesiqhelo ubuncinane iiyure ezintandathu ngaphambi kovavanyo).
• Ufanele uwathathe nini amayeza akho aqhelekileyo?
• Musa ukusela iziselo ezinxilisayo kangangexesha elithile (mhlawumbi iintsuku ezimbalwa ngaphambi kovavanyo).
• Ezinye izinto ekufuneka uzenze okanye ungazenzi ngaphambi kokuba `(TEE)`.

Kwenzeka ntoni ngexesha lovavanyo (i-TEE)?

La ngamanyathelo adla ngokwenzeka ngexesha lovavanyo lwe-`(TEE)`:

1. Uza kunikwa ilokhwe yesibhedlele oza kuyinxiba.

2. Ugqirha uza kubeka izitikha ezincinci ezibizwa ngokuba yi-"Electrodes" esifubeni sakho. Ezi zingasetyenziswa ukujonga ukusebenza kombane kwentliziyo yakho ngexesha le-"TEE".

3. I-blood pressure cuff iza kubekwa engalweni yakho, kwaye i-pulse oximeter iza kuncamathiselwa emnweni wakho ukujonga amanqanaba e-oxygen yakho.

4. Uza kunikwa i-gargle ukuze uvale umlomo wakho. Ugqirha uza kutshiza iyeza emqaleni wakho. Le yi-anesthetic yendawo. Yiyo loo nto ungayi kuva ntlungu ngexesha le-TEE.

5. Uza kunikwa isithomalalisi semithambo (IV) ukukunceda uphumle.

6. Usenokufuna ityhubhu encinci (i-nasal cannula) efakwe empumlweni yakho ukuze ikunike ioksijini.

7. Uza kujika uye kwicala lasekhohlo letafile yovavanyo uze ulaliswe phantsi.

8. Ugqirha uza kufaka kancinci i-"Endoscope" (ityhubhu encinci, ende, neguquguqukayo) emlonyeni wakho. Kwincam yetyhubhu kukho i-"Transducer". Le tyhubhu yehla ngomqala wakho iye kwipayipi yakho yokutya. Ithanjiswe ukuze kube lula ukuhla. Ngamanye amaxesha uya kucelwa ukuba uginye ukuze uncede i-"Transducer" ifike kwindawo efanelekileyo. Oku kunokubonakala kungakhululeki kancinci, kodwa ugqirha uza kwenza oku ngononophelo olukhulu. Baza kukunika amayeza okuthomalalisa umqala wakho, ukuze ungabi nantlungu ingako.

9. Ugqirha uthatha imifanekiso. Usenokuziva iintlungu. Kodwa i-`(Transducer)` yahlukile.Usenokuziva uxinzelelo oluncinci esifubeni sakho xa usishukumisa. Eli candelo lithatha malunga nemizuzu eli-10-15.

10. Ugqirha uza kuyisusa ityhubhu emqaleni wakho aze aqhubeke nokujonga uxinzelelo lwegazi, ukubetha kwentliziyo, kunye namanqanaba eoksijini.

11. Linda ude ugqirha athi ungagoduka.

Yintoni endinokuyilindela emva kovavanyo (lwe-TEE)?

Uza kufuna umntu oza kukuyisa ekhaya emva kovavanyo lwe-TEE. Awuyi kukwazi ukuqhuba iiyure ezingama-24 ngenxa yemiphumo yemithi yokuthomalalisa. Ungalindela oku kulandelayo:

• Umphimbo wakho uza kuba ndindisholo kangangeyure. Uza kuncipha emva kwexesha elithile. Musa ukutya okanye ukusela nantoni na de kube ndindisholo iphele. Ukuba utya okanye usela ngokukhawuleza, unokukrwitshwa.
• Usenokuba nomphimbo obuhlungu kangangeentsuku ezimbini. Oku kuqhelekile kwaye kuya kuphela kwiintsuku ezimbalwa. Nangona kunjalo, ukuba intlungu iyaqhubeka okanye iba mandundu, thetha nogqirha wakho.

Ngaba kukho naziphi na iingozi kwinkqubo (ye-TEE)?

Abanye abantu baqala ukuba buhlungu emqaleni emva kokwenza i-TEE. Inokuhlala iiyure ezimbalwa okanye ukuya kuthi ga kwiintsuku ezintathu ukuya kwezintlanu.

Ezinye iingxaki azixhaphakanga, kodwa zinokwenzeka:

• Iimpendulo ze-allergy kumayeza.
• I-pneumonia yokuphefumla ibangelwa kukutya okanye ulwelo olungena kwindlela yokuphefumla.
• Iingxaki zoxinzelelo lwegazi okanye isigqi sentliziyo.
• Ukopha okuncinci kwindlela yokugaya ukutya.

Ngaphambi kokuba wenze olu vavanyo, kubalulekile ukuthetha nogqirha wakho malunga neengozi ze-TEE.

Ndizifumana njani iziphumo zovavanyo (i-TEE)?

Ugqirha wakho uza kuthetha nawe ngeziphumo zovavanyo lwakho. Ungazithatha njengenxalenye yerekhodi yakho yezonyango ye-elektroniki (inkqubo ekwi-intanethi apho unokubona khona ulwazi lwakho lwezonyango). Thetha nogqirha wakho malunga nokuba uza kuzifumana nini iziphumo kunye nendlela yokuzinyamekela.

Kuqhelekile ukuba abanye abantu bazive benoloyiko okanye besoyika xa kufikwa kuvavanyo lwezonyango. Nangona kunjalo, uvavanyo olufana ne-Transesophageal Echocardiogram (TEE) lunokudlala indima enkulu ekukugcineni usempilweni okanye ekunyangeni iingxaki ezivelayo. I-TEE luvavanyo oluqhelekileyo olungenamngcipheko mkhulu weengxaki. Ukuba une-TEE, thetha nogqirha wakho malunga nendlela yokuyilungiselela kunye nento onokuyilindela.

Okokugqibela, khumbula oku.

Uvavanyo lwe-TEE yindlela ekhethekileyo ekuvumela ukuba ubone ngaphakathi kwentliziyo yakho ngokucacileyo. Nangona lusenokubonakala lungakhululeki kancinci, luluncedo kakhulu ekuxilongeni izifo zentliziyo nasekuzinyangeni ngokufanelekileyo. Eyona nto ibalulekileyo kukuba ukuba unemibuzo okanye amathandabuzo, thetha nogqirha wakho ngazo. Emva koko unokujongana nolu vavanyo ngaphandle koloyiko nangokuzithemba.

I- Transesophageal echocardiogram, i-TEE, uvavanyo lwentliziyo, intliziyo, i-endoscope, uvavanyo lwe-echo, i-esophagus