Imeko eyingozi apho intliziyo ingakwaziyo ukupompa igazi: Yonke into malunga neCardiogenic Shock

Ngaba ngequbuliso ukhe wazifumana uphelelwa ngumoya, ubanda, kwaye unesiyezi? Usenokucinga ukuba kukudinwa nje. Kodwa, inokuba luphawu lwemeko eyingozi kakhulu. Yimeko apho intliziyo ingakwazi ukupompa igazi elaneleyo emzimbeni. Kwizonyango, sibiza le Cardiogenic Shock. Le yimeko efuna unyango olungxamisekileyo kwaye inokuba yingozi kubomi. Ngoko ke masithethe ngayo ngokulula namhlanje.

Ngamafutshane, yintoni iCardiogenic Shock?

Khawucinge ukuba bekuya kwenzeka ntoni ukuba injini epompa amanzi kwitanki yamanzi yekhaya lakho ingayeka ukusebenza ngequbuliso? Bekungayi kubakho manzi etankini, kungabikho manzi okuhlamba okanye okusela. Intliziyo emizimbeni yethu ifana nale njini yamanzi. Umsebenzi ophambili wentliziyo kukupompa igazi elizele yioksijini kunye nezondlo kuyo yonke iseli kunye namalungu omzimba emzimbeni.

I-Cardiogenic Shock kuxa intliziyo, 'ipompo', iyeka ukusebenza kakuhle kwaye ingakwazi ukupompa igazi elaneleyo emzimbeni. Xa oku kusenzeka, amalungu ethu aphambili, anje ngengqondo, izintso, nesibindi, akafumani ioksijini ayidingayo. Njengokuba imithi ifa ngaphandle kwamanzi, ngaphandle kweoksijini, la malungu aqala ukubandezeleka. Le yingxamiseko yezonyango . Ukuba ayinyangwa, ukufa kunokwenzeka.

Ngaba kukho amanqanaba ahlukeneyo ale meko?

Ewe, le meko ayifikeleli kwincopho yayo yonke ngaxeshanye. Kukho amaxesha apho iba mandundu kancinci kancinci. Oogqirha bayahlulahlula ibe ngamanqanaba aliqela ngokobunzima bayo. Xa sikuqonda oku, sinokufumana umbono olungileyo wobunzima bemeko.

Ungazibona njani iimpawu zeCardiogenic Shock?

Ukuba unenye okanye ngaphezulu kwezi mpawu, musa ukuzityeshela. Kufuneka ulumke kakhulu ngale nto, ingakumbi ukuba unesifo sentliziyo.

• Ukudideka okanye ukulahlekelwa zingqondo: Xa ukuhamba kwegazi ukuya engqondweni kuncipha, ingqondo isenokuphazamiseka, iphazamiseke, okanye yozele.
• Ukuquleka: Ungalahlekelwa zingqondo ngequbuliso uze uwe.
• Ubunzima bokuphefumla: Ulwelo lunokuqokeleleka emiphungeni luze lukwenze uzive ngathi unengxaki yokuphefumla.
• Ukuncipha kokuphuma komchamo: Xa ukuhamba kwegazi ukuya kwizintso kuncipha, ubungakanani bomchamo oveliswa ngumzimba buyancipha kakhulu.
• Izandla neenyawo ezibandayo: Njengoko umzimba uzama ukuthumela igazi kwizitho zomzimba ezibalulekileyo, ukuhamba kwegazi kwiindawo ezikude njengezandla neenyawo kuyehla. Ngenxa yoko, ziyabanda kwaye zibile.
• Umbala wolusu uyatshintsha: Ulusu luyaphaphatheka, mhlawumbi lube luhlaza okwesibhakabhaka.
• Ukudinwa kakhulu nokudinwa: Umzimba uyadinwa kangangokuba akunakwenzeka ukwenza nantoni na.
• Ukudumba kwesisu nemilenze: Ulwelo luyaqokelelana emzimbeni luze lubangele ukudumba kuba intliziyo ayisebenzi kakuhle.
• I-Anorexia: Ukulahlekelwa yiminqweno yokutya.

Yintoni esona sizathu siphambili soku?

Eyona nto iphambili neyona ixhaphakileyo yokuphazamiseka kwentliziyo kukuhlaselwa yintliziyo kakhulu . Xa kusenzeka ukuhlaselwa yintliziyo, umthambo wegazi ohambisa igazi kwizihlunu zentliziyo uyavaleka. Oku konakalisa izihlunu kwaye ngequbuliso kunciphisa amandla entliziyo okupompa.

Kodwa ayisosifo sentliziyo kuphela, zininzi nezinye izizathu ezinokuchaphazela oku. Ngamafutshane, nantoni na ephazamisa ukusebenza kwentliziyo inokubangela oku.

• I-Myocarditis: Xa izihlunu zentliziyo zivuvukala ngenxa yento efana nosulelo lwentsholongwane, intliziyo ayikwazi ukufinyela kakuhle.
• Usulelo lwevalvu yentliziyo (Endocarditis): Xa iivalvu zentliziyo zisuleleka yibhaktheriya, ziyabola kwaye ukuhamba kwegazi kuyaphazamiseka.
• Ukungasebenzi kakuhle kwentliziyo (i-Arrhythmia): Ukuba intliziyo ibetha ngokukhawuleza kakhulu okanye icotha kakhulu, ayikwazi ukupompa igazi ngokufanelekileyo.
• I-Cardiac Tamponade: Xa indawo efana nengxowa ejikeleze intliziyo izaliswe lulwelo okanye igazi , uxinzelelo luthintela intliziyo ekuncipheni nasekupompeni igazi.
• I-Pulmonary Embolism: Xa ihlwili legazi, njengehlwili lomlenze, liphuma lize lihlale emthanjeni omkhulu wegazi emaphashini, libeka uxinzelelo olukhulu entliziyweni.
• Iingxaki zeevalvu zentliziyo: Ukuqhekeka ngequbuliso kwevalvu yentliziyo, okanye ivalvu yokufakelwa engasebenzi kakuhle.
• Ukubethwa kakhulu esifubeni: Ukubethwa esifubeni ngenxa yengozi kungonakalisa intliziyo.

Oogqirha bayifumana njani le nto?

Xa usiya esibhedlele, ugqirha uya kuqala afumane umbono walo mbuzo kwimibuzo akubuza yona kunye novavanyo lomzimba.

Izinto ezibonwayo ngexesha lokuhlolwa komzimba:

• Ukuziva ubuthathaka xa ubetha ngentliziyo.
• Ulusu oluvakala lubanda kwaye luthambile xa luchukunyiswa.
• Ukuba noxinzelelo lwegazi oluphantsi kakhulu .
• Ukuva isandi sentliziyo esingaqhelekanga (ukumbombozela) xa umamele isifuba nge-stethoscope.

Emva koko, kwenziwa iimvavanyo ezininzi ukuqinisekisa ukuxilongwa nokufumanisa unobangela.

Zeziphi iimvavanyo ezenziwayo?

• I-ECG (i-Electrocardiogram): Le ilinganisa umsebenzi wombane wentliziyo. Ingafumanisa ngokukhawuleza ukuba kukho isifo sentliziyo okanye ukubetha kwentliziyo okungaqhelekanga.
• I-Echocardiogram (Echo): Oku kufana nokuskena kwentliziyo. Kungabona ngokucacileyo ukuba intliziyo ipompa igazi kangakanani na, ukuba kukho naziphi na iingxaki ngeevalvu, nokuba kukho nawuphi na umonakalo kwimisipha yentliziyo.
• I-X-ray yesifuba:I-X-ray yesifuba iya kujonga ulwelo olukwimiphunga kunye nentliziyo ekhulisiweyo.
• Uvavanyo lweGazi: Amanqanaba eoksijini egazini, ukusebenza kwezintso nesibindi, kunye namanqanaba eeenzyme zentliziyo ayahlolwa ukuze kubonwe ukuba akukho monakalo na entliziyweni.
• I-Catheterization yentliziyo: Olu luvavanyo oluntsonkothileyo kancinci. Ityhubhu encinci ifakwa ngemithambo yegazi engalweni okanye emlenzeni wakho ize ikhokelwe entliziyweni yakho ukujonga ukuvaleka kwemithambo yegazi yentliziyo. Ikwalinganisa uxinzelelo olungaphakathi entliziyweni yakho ukuze ibone ukuba iphefumla kakuhle kangakanani.

Iphathwa njani?

Ekubeni le yingxamiseko, unyango luqala kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele okanye kwiYunithi yoKhathalelo oluNgxamisekileyo (ICU). Kukho iinjongo ezimbini eziphambili:

1. Ukuxhasa ukusebenza kwentliziyo.

2. Nciphisa umonakalo kwizitho zomzimba.

Unyango olungxamisekileyo

• Ukubonelela ngeoksijini: Ukubonelela umzimba ngeoksijini oyifunayo, kwaye kusenokufuneka uqhagamshelwe kwi-ventilator.
• Iintlobo zamayeza:
• Amayeza onyusa uxinzelelo lwegazi (iiVasopressors).
• Amayeza andisa amandla okupompa kwentliziyo (ii-Inotropes).
• I-Diuretics ngamayeza asusa ulwelo olugqithisileyo emzimbeni.
• Izixhobo zokuxhasa intliziyo: Ukuba imeko ayinakulawulwa ngamayeza odwa, kusetyenziswa isixhobo sokuxhasa intliziyo okwethutyana. Umzekelo sisixhobo esibizwa ngokuba yi-Intra-aortic balloon pump (IABP).

Unyango ngokwesizathu

Xa imeko yesigulana izinzile ngandlela ithile ngonyango olungxamisekileyo, ingxaki ebangela ukothuka kwentliziyo iyanyangwa.

• Ukuba kungenxa yokuhlaselwa yintliziyo: I-Angioplasty yenziwa ngoko nangoko. Oku kuthetha ukuba umthambo wegazi ovalekileyo uvulwa ngebhaluni kwaye kufakwa i- stent ukuthintela ukuba ungavaleki kwakhona.
• Ukuba kukho ingxaki yevalvu: Kwenziwa utyando lokulungisa ivalvu okanye ukufaka ivalvu entsha.
• Ukuba igazi liqhekekile emiphungeni: Kuza kunikwa amayeza okunyibilikisa igazi eliqhekekileyo.
• Ukuba kukho ulwelo olujikeleze intliziyo: Ulwelo lususwa ngenaliti.

Kwezinye iimeko ezinzima, ukuba intliziyo ayikwazi ukusebenza kwaphela, kusetyenziswa umatshini obizwa ngokuba yi -ECMO (extracorporeal membrane oxygenation) . Oku kwenziwa ngokongeza ioksijini egazini elingaphandle komzimba uze uyibuyisele emzimbeni. Oku kuthetha ukuba umsebenzi wentliziyo nemiphunga wenziwa okwethutyana ngulo matshini. Ukuba intliziyo ayilulami, kunokufuneka ufake isixhobo sexesha elide esibizwa ngokuba yi-LVAD (left ventricular assist device) okanye ude uye nakwindlela yokufakelwa intliziyo .

Ukubuyela esiqhelweni kunye nendlela eya phambili

Ukothuka okubangelwa yintliziyo yimeko embi kakhulu. Amathuba okusinda axhomekeke ekubeni unyango lukhawuleza kangakanani na. Okukhona ixesha elichithwa kwi-shock lifutshane, kokukhona umonakalo oncinci kumalungu omzimba.

• Ukuhlala esibhedlele: Ngokwesiqhelo, kuya kufuneka uhlale esibhedlele iveki okanye nangaphezulu.
• Ixesha lokuchacha: Kungathatha iiveki ezininzi ukuya kwiinyanga ezininzi ukuze uphile ngokupheleleyo emva kokubuyela ekhaya. Ukuba yinxalenye yeenkqubo zokuvuselela intliziyo kunokunceda kakhulu kwinkqubo yokuchacha.
• Ubomi obuzayo: Emva kwamava anje, kunokubakho iziphumo ezithile zomzimba nezengqondo. Ke ngoko, kubalulekile ukuthatha amayeza anikwe ngugqirha ngexesha, ukuya kwiikliniki ngemihla ebekiweyo, nokwenza utshintsho olufunekayo kwindlela yokuphila (ukuyeka ukutshaya, ukutya ukutya okunempilo, ukwenza umthambo).