Ngaba ngamanye amaxesha uziva uphelelwa ngumphefumlo okanye uziva unzima esifubeni sakho xa udiniwe kancinci, okanye xa unyuka izinyuko? Mhlawumbi ugqirha wakho ukuxelele ngengxaki yevalvu entliziyweni yakho. Xa ivalvu yentliziyo ingavuli kakuhle kwaye ivalekile, siyibiza ngokuba yi-'stenosis'. Namhlanje siza kuthetha ngotyando olukhethekileyo olwenziwa njengonyango lwemeko enjalo. Ekubeni esi sisihloko sibaluleke kakhulu, masiqonde yonke into ngokulula.
Kalula nje, yintoni le 'commissurotomy'?
Kulungile, masiqale sikuqonde oku ngokulula. Intliziyo yakho inamagumbi amakhulu amane. Zicinge njengamagumbi amane. Ukuze igazi liphume kwelinye igumbi liye kwelinye, iingcango eziphakathi kwazo kufuneka zivuleke kwaye zivalwe kakuhle. Ezo ngcango zezo sizibiza ngokuba ziivalvu zentliziyo .
I-commissurotomy yinkqubo ebandakanya ivalvu ye-mitral entliziyweni yakho. Iphakathi kwamagumbi amabini entliziyo, i-atrium yasekhohlo kunye ne-ventricle yasekhohlo. Lo ngumnyango ophakathi kwamagumbi amabini. Lo mnyango uneziphatho ezimbini.
Ngenxa yeemeko ezithile zempilo, ingakumbi imeko ebizwa ngokuba yi -'Mitral Valve Stenosis' , ezi ngcango zimbini azivuli kakuhle. Kufana nocango oluxinzelelweyo. Kwenzeka ntoni ke ngoko? Ukuhamba kwegazi ukusuka kwigumbi eliphezulu ukuya kwigumbi elisezantsi kuyancitshiswa. Oku kubangela ukuba igazi libuyele umva, nto leyo ebeka uxinzelelo olukhulu entliziyweni nasemiphungeni. Ekuhambeni kwexesha, oku kunokukhokelela kwiimeko ezinzulu ezifana nokusilela kwentliziyo .
I-'commissurotomy' yinkqubo yotyando equka ukwenza umngxuma omncinci nokwahlula iindawo (ii-commissures) apho kufakwe khona amaphecana evalvu evalekileyo, okuvumela ivalvu ukuba ivuleke kakuhle kwakhona. Oku kuvumela igazi ukuba lihambe entliziyweni ngokulula kwakhona.
Ngubani ngokwenene odinga olu tyando?
Olu tyando alulungelanga wonke umntu. Kukho izizathu ezininzi eziphambili zokuba ugqirha wakho angacebisa olu tyando:
- Ukuba ezinye iindlela zonyango (ezifana namayeza) ozinikiweyo azizange zibe nemiphumo emihle.
- Ukuba awufanelekanga kwinkqubo ebizwa ngokuba yi-'Balloon Valvuloplasty', equka ukwandisa ivalvu ngebhaluni.
- Ukuba unolunye utyando lwentliziyo, ungenza olu tyando ngaxeshanye.
Kodwa eyona nto ibalulekileyo kukuba impumelelo yolu tyando ixhomekeke kwisizathu se-mitral valve stenosis yakho. Makhe sijonge izizathu ezibini eziphambili.
| Yintoni ebangela i-mitral valve prolapse? | Inkcazo kunye nokufaneleka kotyando lwe-'commissarotomy' |
|---|---|
| Isifo sentliziyo esineRheumatic | Ukonakala kwevalvu zentliziyo ngenxa yomkhuhlane wamathambo ebuntwaneni. Lo monakalo wenzeka emva kweminyaka. Kulapho ke amaphecana evalvu adibaniswa khona (i-fused commissures). Utyando lwe-'commissarotomy' luphumelela kakhulu kule meko. |
| I-Degenerative Mitral Stenosis (Ukwaluphala) | Njengoko abantu bekhula, iindawo ezithile zevalvu ziyawohloka. Kwimeko enjalo, ezinye iindawo zevalvu zonakele endaweni yokuba amaphecana evalvu anamathelene. Ke ngoko, utyando lwe-commissurotomy aluqhelekanga kwaba bantu. Bafuna ukulungiswa kwezinye iivalvu okanye ukutshintshwa ngokupheleleyo kwevalvu (Mitral Valve Replacement) . |
Kuthetha ukuthini xa izigqubuthelo zevalvu zinamathela?
Kulula kakhulu ukuyiqonda le nto. Khawucinge ukuba uncumile phambi kwesibuko imilebe yakho ivaliwe. Jonga iikona zemilebe yakho ephezulu nesezantsi. Kulapho kudibana khona iiflephu ezimbini zevalvu ye-mitral (ii-commissures). Ngoku khawucinge ukuba kukho umntu obambe iikona zemilebe yakho ngeminwe emibini. Ungawuvula kakuhle umlomo wakho? Hayi, awukwazi? Yiloo nto eyenzekayo xa ivalvu ye-mitral ivaliwe. I-'commissurotomy' yinkqubo yotyando ekhulula ezo kona zimbini.
Uzilungiselela njani ngaphambi kotyando?
Ekubeni olu lutyando olukhulu, amalungiselelo aqala kwiiveki ngaphambi kokuba kwenzeke. Iqela lakho lezonyango (ingcali yentliziyo, ugqirha wentliziyo) liza kukwenza uvavanyo olucokisekileyo.
- Uvavanyo olupheleleyo lomzimba
- Uvavanyo lwegazi
- Ukuthetha ixesha elide malunga neempawu zakho kunye nembali yakho yezonyango
Uza kuvavanywa kwakhona ukuze kubonwe ukuba kukho naziphi na izithintelo kwivalvu yakho ye-mitral kunye neminye imithambo yegazi entliziyweni yakho, efana nale:
- I-Echocardiography - Olu luvavanyo lwentliziyo.
- Iiskeni ze-CT
- I-Angiography yeCoronary
Ukuba unemibuzo okanye iinkxalabo malunga notyando, thetha nogqirha wakho uze ukhululeke.Ukuba ungumntu otshayayo, kubalulekile ukuyeka ngokupheleleyo ngaphambi kotyando. Oku kunokunciphisa kakhulu iingozi zotyando.
Lwenziwa njani utyando?
Olu lutyando lwentliziyo evulekileyo. Nantsi indlela ezenzeka ngayo izinto kwigumbi lotyando:
1. Uza kunikwa i-anesthesia ukuze ulale ngokupheleleyo.
2. Kwenziwa ukusika embindini wethambo lesifuba (sternum).
3. Uza kuqhagamshelwa kumatshini we-cardiopulmonary bypass . Oku kwenzelwa ukubonelela umzimba wakho ngegazi kunye neoksijini oyidingayo ngelixa intliziyo yakho imile ngexesha lotyando.
4. Ugqirha uvula i-atrium yasekhohlo yentliziyo aze ahlole i-valve ye-mitral.
5. Kwenziwa imingxunya emincinci kwiikhomishini zevalvu ukuze zikhululeke.
6. Emva koko uza kususwa kumatshini wentliziyo nemiphunga kwaye intliziyo yakho iza kuqaliswa kwakhona.
7. Okokugqibela, kwenziwa i-transesophageal echocardiogram ukuqinisekisa ukuba ivalvu isebenza kakuhle.
Kwenzeka ntoni emva kotyando?
Emva kotyando, kuya kufuneka uhlale esibhedlele kangangeveki. Kangangosuku lokuqala okanye ezimbini, uza kugcinwa kwigumbi lonyango olunzima (ICU) kwaye ujongwe ngononophelo olukhulu.
Ngaphambi kokuba uphume esibhedlele, ugqirha wakho uza kukucebisa ngezi zinto zilandelayo:
- Unyango lweCardiac: Oku kunceda kakhulu ekubuyiseleni amandla nokuqhelana nobomi obuqhelekileyo emva kotyando.
- Indlela yokunyamekela inxeba: Oku kubaluleke kakhulu ukuthintela usulelo nokuphilisa inxeba ngokukhawuleza.
- Malunga nexesha onokuqala ngalo ukuqhuba uphinde usebenze kwakhona .
Iziphumo, iingozi, kunye nexesha lokubona ugqirha
Utyando lwe-open mitral commissurotomy lunezinga eliphezulu lempumelelo. Luphucula ukuhamba kwegazi kwaye lunciphisa kakhulu iimpawu. Nangona kunjalo, alusosisombululo esihlala sihleli. Abantu abaninzi abenza olu tyando banokufuna utyando lokutshintshwa kwevalvu ngaxa lithile kwixesha elizayo.
Njengakuyo yonke into yotyando, kukho iingozi ezithile.
- Ukubuyela kwiMitral Regurgitation
- Ukopha kakhulu
- Iintsholongwane
- Ukungahambi kakuhle kwentliziyo (i-Arrhythmia)
- Istroke
Nangona kunjalo, ezi ngozi ziyancitshiswa kwisibhedlele esikhulu esinoogqirha abanamava. Ukuba uneengxaki zempilo ezifana nesifo seswekile, isifo sezintso, okanye ukutyeba kakhulu, umngcipheko unokuba phezulu kancinci. Thetha nogqirha wakho ngale nto.
Ukuba ufumana ezi mpawu, xelela ugqirha wakho ngoko nangoko:
- Ifiva
- Ubomvu, ukudumba, okanye ubomvu kufutshane nendawo etyumkileyo
- Intlungu yesifuba okanye uxinzelelo oluphindaphindayo
Ukuba ufumana iimpawu zokuhlaselwa yintliziyo ngequbuliso (iintlungu eziqatha esifubeni, ubunzima bokuphefumla) okanye iimpawu zestroke (ukuthetha okungacacanga, ukugoba kwelinye icala lobuso), fowunela u-1990 ngoko nangoko uze uye kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele.
Umyalezo Wokuya Ekhaya
- 'I-commissarotomy' lutyando lwentliziyo oluvulekileyo olwenziwa ukubuyisela ukusebenza kakuhle kwivalvu ye-mitral evalekileyo.
- Eyona nto ibangela le meko kukonakala kweevalvu zentliziyo ngenxa yomkhuhlane wamathambo ngexesha lobuntwana.
- Nangona olu lutyando oluphumelele kakhulu, ludla ngokuba sisisombululo sexeshana kwaye ivalvu inokufuneka itshintshwe kwixesha elizayo.
- Iinkqubo zokulungisa intliziyo zibaluleke kakhulu ekupholeni ngokupheleleyo emva kotyando.
- Kubaluleke kakhulu ukubuza ugqirha wakho nayiphi na imibuzo onokuba nayo malunga nemeko yakho, utyando, kunye neengozi zalo.
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