Ngaba wakha wacinga ngendlela intliziyo yethu exabiseke ngayo kwaye isebenza kakuhle ngayo? Ngamanye amaxesha, kungekuphela nje intliziyo ngokwayo, kodwa nesigqubuthelo esikhuselayo esisijikelezileyo sinokuphazamisana nokusebenza kwentliziyo yonke. Leyo yimeko esiza kuthetha ngayo namhlanje, ebizwa ngokuba yi-`(Constrictive Pericarditis)`. Ungakhathazeki, masithethe ngale nto ngokulula.

Yintoni le (i-Constrictive Pericarditis)? Gqirha?

Ngamafutshane, intliziyo yakho ijikelezwe yinwebu encinci, njengomqamelo, eyikhuselayo. Siyibiza ngokuba yi-pericardium. Kwimeko enjalo, endaweni yokuba iguquguquke ngokuqhelekileyo, i-pericardium iyaqina ize iqine. Cinga ngayo njengepompo, intliziyo kufuneka ikwazi ukwanda nokufinyela ukuze ipompe igazi. Kodwa xa le pericardium iqina, intliziyo ayinandawo yaneleyo yokukhula nokuzaliswa ligazi. Kulapho ke iingxaki ziqala khona. Le yimeko enzima enokukhokelela ekusileleni kwentliziyo . Kodwa iindaba ezimnandi zezokuba inokunyangwa kwaye inyangeke, ingakumbi ukuba ifunyenwe kwangethuba .

Yintoni kanye kanye eyenzekayo kule meko?

Sithethe nge-pericardium. Ineeleya ezimbini, kwaye kukho ulwelo phakathi kwayo. Olu lwelo luyigcina intliziyo icocekile, xa kukho ingozi. Ngokwesiqhelo, le pericardium iyathamba kakhulu kwaye iguquguquka. Ke ngoko, akukho mqobo wokuyizalisa ngegazi ngelixa intliziyo ibetha.

Kodwa kumntu one-Constrictive Pericarditis, i-pericardium iba nkulu kwaye iqine. Ifana nebhendi yerabha endala, kwaye ayoluli. Emva koko intliziyo ayifumani thuba lokuzaliswa ligazi elaneleyo.

Xa intliziyo ingakwazi ukuzalisa igazi ngokufanelekileyo, iba nobunzima bokupompa igazi elaneleyo emzimbeni. Ukulungisa oku, uxinzelelo olungaphakathi entliziyweni luyanda. Ukuba oku kuyaqhubeka, kunokukhokelela ekusileleni kwentliziyo . Abanye abantu bakubiza oku ngokuthi `(Restrictive Pericarditis)`, kodwa ngoku igama elithi `(Constrictive Pericarditis)` lisetyenziswa kakhulu. Zombini zimeko efanayo.

Ngubani onokuthi afumane esi sifo?

Nangona nabani na enokuba nale meko (i-Constrictive Pericarditis), abanye abantu basengozini enkulu.

• Kwabo bakha batyandwa intliziyo ngaphambili.
• Kwabo bafumene unyango lwe-radiation kwindawo yentliziyo.
• Kwabo banokuvuvukala kwe-pericardium apho kungekho sizathu sifumanekayo (siyibiza ngokuba yi-"idiopathic pericarditis"`) okanye abo baye bavuvukala kwi-pericardium ngenxa yosulelo lwentsholongwane (``viral pericarditis``).
• Kumazwe asakhasayo, njengelizwe lethu umzekelo, isifo sephepha (TB) sisona sibangela siphambili.

Kunamathuba amabini ukuya kwamathathu okuba ikhule kumadoda kunakwabasetyhini. Ikwanqabile kakhulu nakubantwana abancinci.

Ixhaphake kangakanani le meko?

I-Constrictive Pericarditis yimeko engaqhelekanga kakhulu . Iyenzeka kubantu abamalunga ne-9% abane-acute pericarditis. Kwaye i-acute pericarditis ibonwa kubantu abamalunga ne-5% abeza kwigumbi longxamiseko beneentlungu zesifuba. Ngoko ungacinga ukuba inqabile kangakanani loo nto.

Zithini iimpawu zesi sifo?

Iimpawu zesi sifo zibonakala kancinci kancinci. Ngamanye amaxesha zinokuvela ngequbuliso. Iimpawu eziphambili ezibonwayo zezi:

• Ubunzima bokuphefumla (ukuphelelwa ngamandla): Ukuziva uphelelwa ngumoya xa udiniwe kancinci, okanye umile nje ungashukumi.
• Intlungu yesifuba : Intlungu yokucinezela, ukucinezela.
• Ukudinwa, ukudinwa : Ukuziva udiniwe kangangokuba awukwazi kwenza nto.
• Ukudinwa : Uziva ngathi intloko yakho iyajikeleza, ngamanye amaxesha ngathi uza kulahlekelwa zingqondo.
• Ukudumba : Ulwelo luyaqokelelana luze ludumbe, ingakumbi kwiindawo ezifana nesisu nemilenze (ezijikeleze amaqatha).
• Ubuthathaka bemisipha kunye nokuphelelwa ngamandla : Umzimba ulahlekelwa bubunzima bemisipha.
• Ukuphelelwa ngumdla wokutya kunye nokuziva ugcwele kwanasemva kokutya kancinci : Awufuni kutya, kodwa uziva ugcwele kwanasemva kokutya kancinci.

Ngaba kukho iintlobo ezahlukeneyo zesi sifo?

Ewe, kukho iintlobo ezahlukeneyo ze-`(Constrictive Pericarditis)`. Makhe sibone ukuba zeziphi:

• Uhlobo olukhawulezileyo : Kolu hlobo, ukurhawuzelelwa kwe-pericardium kwenzeka ngokukhawuleza kakhulu, kwiintsuku ezimbalwa.
• Uhlobo lwe-Subacute : Olu hlobo lufana nohlobo lwe-acute, kodwa iimpawu azikho nzima kangako.
• I-Effusive-constrictive pericarditis : Olu hlobo lwe-pericarditis lubangelwa lulwelo oluqokelelana ngaphakathi kwi-pericardium (i-pericardial effusion). Njengoko olu lwelo luqokelelana, lubeka uxinzelelo entliziyweni. Oku kubizwa ngokuba yi-cardiac tamponade. Cinga ngayo njengebhaluni ngaphakathi kwibhaluni, kwaye ukuba uzalisa ibhaluni yangaphandle ngamanzi, ibhaluni engaphakathi iya kucinezelwa. Ekugqibeleni, intliziyo inokuyeka ukubetha. Ukuba ulwelo olongezelelweyo luyasuswa kodwa uxinzelelo olungaphakathi entliziyweni luhlala luphezulu, oku kubizwa ngokuba yi-effusive constriction.
• I-Transient constrictive pericarditis : Olu luhlobo oluqhelekileyo lwe-pericarditis ebukhali, oluyimeko apho i-pericardium ivuvukala ize inciphe. Inganyangwa ngamayeza okulwa nokuvuvukala .
• I-Occult constrictive pericarditis : Kwizonyango, igama elithi "occult" lithetha "ukufihlwa." Eli gama livela kwinto yokuba olu hlobo lomhlaza kunzima ukulubona. Ludla ngokufunyanwa ngengozi ngezinye iimvavanyo.

Yintoni ebangela oku?

I-Constrictive Pericarditis yimeko apho i-pericardium iba nkulu kwaye iqine. Oku kubangelwa ikakhulu zizicwili ezivela kwiimeko zonyango zangaphambili. Kukho izizathu ezahlukeneyo zokuba le pericardium iqine:

• Usulelo : Kumazwe asakhasayo, isifo sephepha lolona sulelo luxhaphakileyo lwebhaktiriya. Malunga nama-20% ukuya kuma-30% eemeko ze-pericarditis ezinxulumene nesifo sephepha zinokudlulela kule meko. Kumazwe aphuhlileyo, usulelo lwentsholongwane luxhaphake kakhulu.
• Isifo sentliziyo kunye neengxaki zenkqubo yokujikeleza kwegazi : Ukuhlaselwa yintliziyo okanye ezinye iimeko ezichaphazela imithambo yegazi emikhulu kufutshane nentliziyo.
• Ukonzakala : Ukudumba okubangelwa kukwenzakala esifubeni (njengokubethwa, inxeba lokuhlatywa, okanye inxeba lokudutyulwa) kunokujika kube ziingxwelerha kamva.
• Izifo zesistim somzimba okanye iimeko zokudumba : Umzekelo, izifo ezifana ne-`(Lupus)`, `(Rheumatoid arthritis)`, okanye `(Sjögren's syndrome)`.
• Izizathu zonyango : I-pericardium inokuba nkulu kwaye ibe namanxeba emva kotyando lwentliziyo, unyango lwemitha yomhlaza, okanye njengemiphumo emibi yamanye amayeza.
• Umhlaza : Umhlaza we-pericardium okanye umhlaza osasazeke kwenye indawo emzimbeni.
• Ezinye izizathu : Ngamanye amaxesha, akukho sizathu sifumanekayo se-"Constrictive Pericarditis." Oogqirha badla ngokucinga ukuba ezi zibangelwa lusulelo lwentsholongwane, okanye bahlanganisa izizathu ezingaziwayo kunye nezizathu zentsholongwane ndawonye kwizibalo.

Ingaba oku kuyasulela?

Hayi. Nangona i-Constrictive Pericarditis inokubangelwa zizifo (ezinye zazo ziyasulelana), le meko ngokwayo ayisulelani .

Oogqirha bayibona njani le nto?

Ugqirha angaxilonga le meko ngokujonga iimpawu zakho, imbali yakho yezonyango (ezifana nezifo zangaphambili, utyando), uvavanyo lomzimba, kunye novavanyo oluthile olukhethekileyo. Ngamanye amaxesha kunokuba nzima ukuxilonga, ingakumbi ukuba iimpawu zakho azinzima kakhulu okanye ukuba unezinye iimeko ezineempawu ezifanayo.

Zeziphi iimvavanyo ezenziwayo koku?

Ukuba ugqirha ukrokrela ukuba une-Constrictive Pericarditis, angenza olu vavanyo lulandelayo:

• Uvavanyo lweSifo sePhepha .
• Uvavanyo lwegazi ukujonga izifo zenkqubo yomzimba yokuzikhusela .
• I-Echocardiogram (njenge-ultrasound scan yentliziyo).
• I-Electrocardiogram (ECG) (uvavanyo olujonga ukusebenza kombane kwentliziyo).
• I-X-ray yesifuba .
• I-CT scan yentliziyo .
• Iskeni se-MRI (i-magnetic resonance imaging yentliziyo) .
• Ukufakwa kwe-catheter yentliziyo ngasekhohlo nasekunene (uvavanyo olulinganisa uxinzelelo ngokungenisa umbhobho omncinci entliziyweni).

Indlela yokunyanga oku?Ngaba inganyangeka?

Le meko idla ngokunyangwa , kwaye idla ngokunyangeka.

Kwiimeko ezininzi, kulandelwa imigaqo emibini ephambili ukuze kulungiswe oku:

• Ukunciphisa uxinzelelo entliziyweni ngenxa yokungakwazi kwentliziyo ukufinyela.
• Ukunyanga izizathu ezisisiseko okanye iimpawu ezinxulumene noko.

Ngawaphi amayeza kunye nonyango loku?

Amaxesha amaninzi, ezi zilandelayo ziindlela zonyango zesi sifo:

• Utyando : Utyando olubizwa ngokuba yi-pericardiectomy lususa yonke i-pericardium. Le yeyona ndlela isebenzayo yokunyanga le meko. I-Pericardiectomy ayinyanzelekanga ukuze usinde . Uninzi lwabantu luyaphola emva kotyando ngaphandle kweengxaki okanye iziphumo zexesha elide.
• Amayeza : Ngokuxhomekeke kwisizathu kunye neempawu ezisisiseko, amayeza ahlukeneyo angasetyenziswa ukunyanga iimpawu zale meko ngokuthe ngqo, okanye ukuzama ukuyinyanga ngokuthintela unobangela. Kwezinye iimeko, inokunyangeka ngamayeza odwa ngaphandle kwesidingo sotyando, okanye kwabo bangenako utyando, amayeza anokunceda ukulawula iimpawu.

Luhlobo luni lwamayeza asetyenziswayo?

Amayeza asetyenziswa kakhulu ukunyanga le meko ngala:

• I-Diuretics : La mayeza anceda izintso zakho zisuse ulwelo olungaphezulu emzimbeni wakho.
• Ii-NSAID (Amayeza angengo-steroidal alwa nokuvuvukala) : La anciphisa ukudumba kwaye athomalalise iintlungu. Imizekelo ibandakanya `(Ibuprofen)` okanye `(Naproxen)`.
• IiSteroids : Iimpawu zala mayeza zokulwa nokuvuvukala ziyanceda ekunyangeni le meko.
• Amayeza athile abangela esi sifo : Umzekelo, amayeza okubulala iintsholongwane kwiintsholongwane ezifana nesifo sephepha.

Zithini iingxaki okanye iziphumo ebezingalindelekanga zonyango?

Iingxaki ezinokubakho ziyahluka ngokuxhomekeke kunyango kunye namayeza. Isizathu okanye uhlobo lwe-Constrictive Pericarditis nalo luyayichaphazela le nto. Ugqirha wakho ngumntu ofanelekileyo ukuthetha nawe malunga nemiphumo emibi okanye iingxaki ezinokubakho, ingakumbi ngamayeza. Oku kungenxa yokuba angakunika ulwazi oluhambelana nemeko yakho ethile. Uya kukuxelela nento omawuyilindele, indlela yokulawula ezi ngxaki, kunye nento onokuyenza ukuthintela zonke.

Ezinye zeengxaki ezinokubakho ngenxa yotyando zezi:

• Ukumelwa yintliziyo .
• Ukubetha kwentliziyo okungaqhelekanga (`Arrhythmias`) .
• Usulelo kunye ne-sepsis (ityhefu egazini).
• Ukufa (oku kunqabile kakhulu).

Ndingazilawula njani iimpawu ukuba andizinyamekeli?

I-Constrictive Pericarditis ayisiyonto omele uyinyange okanye uyilawule wedwa , njengoko uvavanyo kunye neeskeni zibalulekile ukuyixilonga. Oku kubaluleke kakhulu kuba ezinye zeempawu zesi sifo zinokuvela nakwiimeko ezisongela ubomi ezifana ne-cardiac tamponade okanye ukuhlaselwa yintliziyo. Ke ngoko, kufuneka uqale uthethe nogqirha kwaye ufumane isikhokelo malunga nento onokuyenza ngale meko.

Ndiza kuziva bhetele nini emva konyango?

Ngokuxhomekeke kwisizathu semeko kunye nonyango olufumanayo, kungathatha iintsuku ezimbalwa okanye iiveki ezimbalwa ukuba uzive ungcono. Ukuba utyando, kuya kufuneka wongeze ixesha lokuchacha emva kotyando kwixesha elithathayo ukuze uzive ungcono. Uninzi lwabantu luziva lungcono kwiinyanga ezintathu , kodwa abanye abantu banokuthatha iinyanga ezininzi ukuze baphile ngokupheleleyo.

Ndingayithintela le nto okanye ndiyinciphise ingozi?

I-Constrictive Pericarditis yimeko eyenzeka ngequbuliso, ngoko ke ayinakuthintelwa. Into onokuyenza ukunciphisa umngcipheko wokuba nale meko kukuphepha iimeko ezinokukhokelela kuyo. Umzekelo, ukuba unentsholongwane ebangelwa yibhaktheriya, funa unyango ngokukhawuleza. Enye into kukunciphisa umonakalo kwi-pericardium yakho ngabasebenzi bezonyango ukuba ufumana unyango lwemitha.

Ndingalindela ntoni ukuba ndinayo le meko? Ngaba le nto inganyangeka?

Imbono yakho kule meko ixhomekeke kwisizathu, ubukhali bemeko yakho, unyango, kunye nezinye iimeko zempilo onazo. Ugqirha wakho ngumntu ofanelekileyo ukukuxelela into omawuyilindele kule meko kunye nokuba imeko yakho iya kuba njani.

Ngenxa yokuba le meko idla ngokubangelwa okanye ibangelwa zizifo ezinzulu okanye ezisongela ubomi, imeko inokuba mbi. Oku kuyinyani ngakumbi ukuba ibangelwa lunyango lwemitha, okanye ukuba unayo:

• Isifo sezintso esiqhubekekayo okanye ukungasebenzi kakuhle kwezintso .
• Ukumelwa yintliziyo .
• Isifo sesibindi .
• Uxinzelelo lwegazi oluphezulu lwemiphunga .

Ngenxa yezi ngozi, iziphumo ezilungileyo zifumaneka ngokuxilongwa kwangethuba kunye nonyango . Nokuba kukwimo yexeshana, iziphumo ezilungileyo zinokwenzeka ngakumbi. Nangona kunjalo, malunga ne-5% - 10% yabantu abenza utyando basenokungasindi (iziphumo zihlala zingcono kwizibhedlele ezikhethekileyo kwizifo zentliziyo).

Nangona kunjalo, abantu abaninzi bayachacha kwaye bayaphila kakuhle . Malunga nama-80% abantu abenza utyando ngenxa yesi simo baphila ubuncinci iminyaka emihlanu, kwaye malunga nama-60% baphila ubuncinci iminyaka elishumi.

Kuza kuthatha ixesha elingakanani oku? Ndiza kukwazi nini ukuqhubeka nemisebenzi yam yesiqhelo?

Ukuba le meko ihlala ixesha elingakanani kuxhomekeke kuhlobo, unobangela, kunye nonyango olufumanayo. Kwezinye iimeko, le meko iyaphela ngokwayo okanye ngamayeza. Ihlala ithatha iiveki ezimbalwa ukuya kwiinyanga ezimbalwa. Okukhona imeko okanye unobangela unzima, kokukhona kuya kuthatha ixesha elide ukuba uphile.

Ndingazinyamekela njani?

Ukuba unale meko, kubaluleke kakhulu ukulandela imiyalelo kagqirha wakho. Oku kuquka:

• Sela amayeza njengoko kuyalelwe : Amayeza anikwe le meko kufuneka athathwe njengoko kuyalelwe, kwaye ayingombono ulungileyo ukuyeka phakathi kuba nje uzive ungcono.
• Landela icebiso lokutya : Abantu abaninzi kuya kufuneka banciphise ukutya ityuwa. I-sodium ekwityuwa inokubangela ukugcinwa kolwelo emzimbeni, nto leyo enokuyenza le meko ibe mandundu.
• Nciphisa umsebenzi womzimba ukuba kuyimfuneko : Oku kunceda ukunciphisa uxinzelelo entliziyweni yakho kunye nokuthintela nokunciphisa umonakalo kwimisipha yentliziyo.

Ndifanele ndimbone nini ugqirha wam? Ndifanele ndifune nini uncedo lwezonyango?

Uninzi lwabantu kuya kufuneka luqhubeke lubonana nogqirha walo de luphile kule meko. Njengoko imeko yakho iphucuka, ugqirha wakho uya kucebisa ukuba unciphise inani leetyelelo zakho.

Ukuba uziva iimpawu zakho zibuya, okanye ukuba iimpawu zakho zitshintsha kwaye ziqala ukuchaphazela imisebenzi yakho yesiqhelo, kufuneka ufowunele ugqirha wakho okanye wenze idinga.

Ndingaya nini kwiSebe leeNgxamiseko (i-ETU) ?

Iimpawu ezininzi zesi sifo zinokuvela nakwiimeko ezingxamisekileyo zonyango ezisongela ubomi. Ngoko ke, kufuneka ufune uncedo lwezonyango ngokukhawuleza ukuba unezinye zezi mpawu zilandelayo:

• Ubunzima bokuphefumla (i-Dyspnea) .
• Iintlungu zesifuba .
• Ukuba nesiyezi okanye ukuziva ukhathazekile .
• Ukuquleka okanye ukuquleka .

Okokugqibela, izinto ekufuneka uzikhumbule

I-Constrictive Pericarditis sisifo esingaqhelekanga nesingenakuxelwa kwangaphambili. Iimpawu zaso zifana nezinye izifo ezininzi, ngoko ke ngamanye amaxesha kunokuba nzima ukusifumanisa. Ngethamsanqa, ngokuhambela phambili kwesayensi yezonyango kunye netekhnoloji, ngoku kulula kakhulu ukufumanisa esi sifo ngeeskeni ezithile. Unyango lwesi sifo nalo luye lwaphucuka kakhulu. Oku kuthetha ukuba kwiimeko ezininzi, esi sifo sinokunyangwa, kwaye ngamanye amaxesha sinyangeke ngokupheleleyo. Ke ngoko, ukuba unale mpawu, kungcono ukubona ugqirha kwaye ufune iingcebiso ngaphandle koloyiko.

I- Constrictive Pericarditis, ukuxinana kwe-pericardium, isifo sentliziyo, iintlungu zesifuba, ukuphefumla okufutshane, utyando lwentliziyo, i-pericardiectomy