Kunjani 'ukunikezwa' kwenhliziyo yakho? Ake sixoxe nge-'Coronary Flow Reserve (CFR)'!

Wake wazibuza ukuthi inhliziyo yakho ithola igazi eliningi elidingayo uma icindezelekile, njengalapho uzivocavoca? Inhliziyo yethu iyisitho esimangalisayo. Idinga ukuhlinzekwa kwegazi okuhle ukuze isebenze kahle. Yilokho esizokhuluma ngakho namuhla, futhi kusho okuningi ngempilo yenhliziyo yakho: `Coronary Flow Reserve` noma `CFR`. Ungakhathazeki, la magama angase azwakale eyinkimbinkimbi kancane, kodwa masigcine kulula.

Kuyini i-'Coronary Flow Reserve (CFR)'? Kalula nje...

Cabanga ngenhliziyo yakho njengenjini yemoto. Uma isebenza kahle, injini idinga inani elithile likaphethiloli. Kodwa uma ukhuphuka intaba, noma uhamba ngokushesha, injini idinga uphethiloli owengeziwe, akunjalo? Yileyo ndlela inhliziyo yethu eba ngayo. Uma siphumule, inhliziyo idinga inani elithile legazi. Kodwa uma sizivocavoca, sigijima, sigxuma, siphakamisa izinsimbi, noma sicindezelekile, inhliziyo idinga umoya-mpilo owengeziwe kanye nezakhamzimba . Ukuze kuhlangatshezwane nalesi sidingo esikhulayo, ukunikezwa kwegazi enhliziyweni kudingeka kwande.

Imithambo yegazi eyinhloko ethwala igazi enhliziyweni ibizwa ngokuthi imithambo yenhliziyo . I-Coronary Flow Reserve (CFR) iyisilinganiso sokuthi imithambo yakho yenhliziyo ingakwandisa kangakanani ukuphakelwa kwegazi lapho inhliziyo idinga igazi elengeziwe. Kufana nokubheka indawo yokugcina 'ukuphakelwa' kwenhliziyo.

Lokhu kubizwa nangokuthi 'i-Myocardial blood flow reserve'. Ngoba igazi ligeleza lisuka kule mithambo yenhliziyo liye emisipheni yenhliziyo yakho, okungukuthi, liye emisipheni yenhliziyo `(Myocardium)` . Ngakho-ke ngaleli nani le-CFR, odokotela bangahlola ukuthi imisipha yenhliziyo yakho ithola igazi elanele yini uma ilidinga.

Leli nani le-CFR libalwa kanjani?

Lokhu ukubala okulula kakhulu. Kodwa kudinga ukuhlolwa okukhethekile ukuze kwenziwe lokhu. Kalula nje, i-CFR ukugeleza kwegazi okuphezulu okungageleza ngemithambo yakho yenhliziyo , kuhlukaniswe ukugeleza kwegazi okuvamile okugeleza kuwe uma uphumule, ngaphandle kokuzikhandla .

Isibonelo, uma uphumule, inhliziyo yakho ipompa amamililitha angu-X egazi ngomzuzu. Uma uzikhandla kakhulu (noma uma leso simo sibangelwa ngokwenziwa), inhliziyo yakho ipompa amamililitha angu-Y egazi. Bese kuba yi-CFR = Y / X.

Yilokhu ukuthi inhliziyo yakho ingapompa igazi elingakanani kunelivamile.

Kukuziphi izimo lapho kwenziwa khona ukuhlolwa kwe-CFR?

Kunezizathu eziningana zokuthi kungani udokotela angase akuncomele ukuhlolwa kwe-CFR:

• Thola ukuthi unesifo semithambo yenhliziyo (CAD): Ngezinye izikhathi ubuhlungu besifuba (i-angina), ubunzima bokuphefumulaUma kuvela izimpawu ezinjengalezi, lokhu kuhlolwa kusiza ukuqinisekisa ukuthi imbangela iwukuvimbeka kwemithambo yenhliziyo.
• Hlola ubucayi be-CAD: Lokhu kubalulekile ukuqonda ukuthi ingakanani imithambo yegazi ethintekile nokuthi kungakanani ukugeleza kwegazi okuvimbekile kumuntu osevele ene-CAD.
• Bika ingozi yokuhlaselwa yinhliziyo esikhathini esizayo: Njengoba inani le-CFR lehla, ingozi yokuba nesifo senhliziyo noma esinye isifo senhliziyo esikhathini esizayo inganda.
• Linganisa impumelelo yokwelashwa: Lokhu kuhlolwa kungasetshenziswa futhi ukubona ukuthi ukugeleza kwegazi enhliziyweni sekubuyiselwe yini ngemva kokwelashwa okuthile (isib. i-angioplasty, ukuhlinzwa kwe-bypass).

Iyini inani elimaphakathi le-CFR?

I-CFR yomuntu ophilile ivame ukuba phakathi kuka-2.0 no-2.5 ​​noma ngaphezulu . Lokhu kusho ukuthi uma usebenza kanzima, inhliziyo yakho ithola okungenani ukugeleza kwegazi okuphindwe kabili kunalapho uphumule. Umuntu ophilile angaba naleli nani eliphakeme njengo-3. Lokhu kusho ukuthi banekhono lokwandisa ukuphakelwa kwegazi labo kathathu.

Ucwaningo olulodwa luthole ukuthi abantu abane-CFR engaphezu kwemibili bathola ukululama okungcono ezinyangeni eziyisithupha ngemva kokuhlaselwa yinhliziyo. I-CFR engaphansi kwemibili ibonisa ingozi ephezulu yesifo senhliziyo.

Kodwa kubalulekile ukuqonda ukuthi leli nani "elijwayelekile" lingashintsha ngokweminyaka. Umuntu osemusha ophilile angase abe ne-CFR engu-5 noma engu-6. Kodwa ngisho nomuntu oneminyaka engu-80 onempilo angase abe ne-CFR engaphansi kuka-2. Futhi, ingane eye yahlinzwa ngenxa yesifo senhliziyo esizalwa naso ingaba ne-CFR ephansi. Ngakho-ke, udokotela wakho uzonquma ukuthi i-CFR yakho ijwayelekile noma cha, ngokusekelwe empilweni yakho iyonke kanye nezinye izici.

Ungayibhala kanjani i-CFR test? Ungakulungiselela kanjani?

Kunezindlela ezimbili eziyinhloko zokulinganisa i-CFR. Enye indlela yokuhlasela , ehilela ukufaka okuthile emzimbeni. Lokhu kuhilela into ebizwa ngokuthi i-'Cardiac Catheterization'. Enye indlela yokuhlasela , ehilela ukusebenzisa i-'Nuclear Stress Test' ekhethekile, okuyi-'Rubidium-82 Positron Emission Tomography (PET) scan'. Akuvamile ukuthi i-'Magnetic Resonance Imaging (MRI) scan' ingasetshenziswa ngale njongo.

Manje ake sibone ukuthi singazilungiselela kanjani lesi sivivinyo nokuthi kuzokwenzekani ngosuku lokuhlolwa.

Izinto okudingeka uzazi ngaphambi kokuhlolwa

• Tshela udokotela wakho ngemithi oyithathayo: okuhlanganisa imithi kadokotela, imithi ethengiswa ngaphandle kwemithi kadokotela, kanye namavithamini.Kufanele futhi utshele udokotela wakho nganoma yimiphi imikhiqizo yamakhambi oyiphuzayo, njengoba eminye imithi ingathinta ukujikeleza kwegazi.
• Sitshele nge-allergies yakho: Uma une-allergies kunoma yimiphi imithi, idayi yokuhlukanisa esetshenziswa ezivivinyweni, noma i-latex, sazise kusenesikhathi.
• Iseluleko Sokudla Neziphuzo: Uma uhlolwa nge-catheterization yenhliziyo noma nge-PET scan, buza udokotela wakho ukuthi kufanele uyeke ukudla noma ukuphuza amahora amangaki ngaphambi kokuhlolwa. Ngokuvamile, ngeke uvunyelwe ukudla noma ukuphuza noma yini amahora ayi-6 kuya kwangu-8 ngaphambi kokuhlolwa.

Yini ongayilindela ngosuku lokuhlolwa?

• Ukuze uhlolwe nge-MRI: Akufanele ube nezinto zensimbi (njengobucwebe noma amaphini ezinwele) emzimbeni wakho. Amanye amadivayisi ezokwelapha (njenge-pacemakers) angase angahambisani ne-MRI. Ngakho-ke uma unedivayisi enjalo, cela udokotela wakho kusengaphambili ukuze aqinisekise ukuthi iphephile kwi-MRI.
• Ukuhlanza Inhliziyo: Kule nqubo, kufakwa ipayipi elincane kakhulu (i-catheter) ngomthambo wegazi entanyeni yakho, esinqeni, noma engalweni emithanjeni yenhliziyo yakho. Uzonikezwa umuthi wokudambisa omnene ukuze uzizwe ungakhululekile.
• Umugqa we-IV: Kungakhathaliseki ukuthi iyiphi indlela yokuhlola, "umugqa we-Intravenous (IV)" uzoxhunywa emthanjeni osengalweni yakho. Lo mugqa we-IV yilapho kunikezwa khona umuthi (i-vasodilator) ukuze kukhuliswe ukugeleza kwegazi enhliziyweni futhi ngezinye izikhathi "udayi we-Contrast" ukuze kwenziwe imithambo yenhliziyo ibonakale kakhudlwana. Uma wenza i-"PET scan", umuthi we -radiotracer osebenzisa imisebe "i-Radiotracer" nawo unikezwa ngale IV.

Ake ngichaze kabanzi ngokuthi i-CFR ilinganiswa kanjani...

Udokotela wakho uzosebenzisa amasu ahlukahlukene okuthwebula izithombe ukuze alinganise ukuhamba kwegazi emithanjeni yakho yenhliziyo lapho uphumule futhi ngesikhathi sokuzikhandla okukhulu. Emikhulu yile:

• `I-PET scan`: Kulokhu, lapho i-`Radiotracer` enikezwa nge-IV ifinyelela enhliziyweni, izimpawu ezikhishwa yiyo zithathwa yikhamera ekhethekile, futhi ngosizo lwekhompyutha, kutholakala izithombe ezicacile zokugeleza kwegazi enhliziyweni.
• ` I-MRI Yenhliziyo` : Lena futhi indlela yokuthwebula izithombe. Kodwa-ke, ayisetshenziswa njalo ukukala i-CFR.

Kubaluleke kakhulu ukuthi uhlale unganyakazi phakathi nalokhu kuskena, ngaphandle kwalokho izithombe ezitholiwe zingase zingacaci.

Indlela ye-`Cardiac Catheterization` ihlukile kancane. Ihilela:

1. Ngemva kokuba i-catheter ifakiwe emthanjeni wenhliziyo, kudlula intambo ekhethekile kuyo. Esiqongweni sale ntambo kukhona i-'Ultrasound transducer' (idivayisi encane ekhipha futhi yamukele amaza e-ultrasound). Lokhu kungalinganisa ijubane lokugeleza kwegazi ngaphakathi komthambo wenhliziyo.

2. Phakathi nale nqubo, umuthi obizwa ngokuthi 'i-Heparin' unikezwa nge-IV ukuvimbela ukujiya kwegazi.

3. Kunezinye izinhlobo zezintambo ezilinganisa ukugeleza kwegazi kusetshenziswa izinzwa ezimbili zokushisa kanye nomjovo we-saline.

Kwenzekani ngempela ngesikhathi sokuhlolwa?

Ngesikhathi sokuhlolwa kwakho, ithimba lezokwelapha lizokwenza okulandelayo:

1. Okokuqala, ukuhamba kwegazi emithanjeni yakho yenhliziyo kulinganiswa ngenkathi uphumule .

2. Ngemuva kwalokho, uhlobo lomuthi 'we-Vasodilator' (njenge-'Adenosine (Adenocard® noma i-Adenoscan®)') lunikezwa nge-IV yakho, okwandisa ukushaya kwenhliziyo nokugeleza kwegazi. Lomuthi wandisa ukugeleza kwegazi ngokuphindwe kane kuya kahlanu uma kuqhathaniswa nalapho uphumule. Kuthatha isikhathi esifushane, cishe imizuzu emibili kuya kwemithathu, ukuthi lo muthi usebenze. Lokhu kubizwa ngokuthi 'i-Cardiac Catheterization', futhi ngezinye izikhathi lo muthi unganikezwa nge-catheter esikhundleni se-IV.

3. Ngemva kokunikezwa umuthi, ukugeleza kwegazi emithanjeni yenhliziyo kuyalinganiswa futhi. Lokhu ukugeleza kwegazi okuphezulu kakhulu.

4. Okokugcina, inani lakho le-`Coronary Flow Reserve (CFR)` libalwa ngokuqhathanisa lokhu kugeleza kwegazi okuphezulu kanye nokugeleza kwegazi lakho eliphumuzayo .

Kwenzekani ngemva kokuhlolwa?

• Uma ufakwe i-catheter (ikakhulukazi embotsheni noma engalweni), kuzodingeka ugcine indawo yokusikwa iqonde ihora noma ngaphezulu ukuze uvimbele ukuphuma kwegazi.
• Udokotela wakho angase akutshele ukuthi uphuze amanzi amaningi ukuze akusize ukhiphe umbala ohlukile emzimbeni wakho.
• Uma unikezwe umuthi wokudambisa, ngeke ukwazi ukushayela ngalolo suku. Ngakho-ke, kuzodingeka ulethe umuntu ozokuthatha akuyise ekhaya .

Yiziphi izingozi nemiphumela emibi yalolu vivinyo lwe-CFR?

Ukuhlolwa kwe-CFR ngokuvamile kuyindlela ephephile, kodwa njenganoma iyiphi inqubo yezokwelapha, kunezingozi ezincane.

• Ngenxa yokuthi ama-catheter nezintambo kufakwa emithanjeni yenhliziyo, akuvamile ukuthi igazi liqhekeke, kuqhume imithambo yegazi, noma kuphume igazi.
• Kukhona ingozi encane kakhulu yokulimala kwemithambo yegazi. Uma lokhu kwenzeka, kungase kudingeke ukuhlinzwa ukuze kulungiswe , akuvamile kakhulu.

Uma benikwa umuthi i-'Adenosine', abanye abantu bangase babe nemiphumela emibi elandelayo, ehlala imizuzwana embalwa kuphela:

• Isigqi senhliziyo esingajwayelekile
• Umfutho wegazi ophansi (i-Hypotension)
• Ukuphelelwa umoya
• Ukungakhululeki esifubeni

Okubalulekile: Lo muthi we-'Adenosine' awunikezwa abantu abane-asthma. Ngoba ungabangela i-bronchospasms. Ezimweni ezinjalo, udokotela angasebenzisa omunye umuthi we-IV ofana ne-'Dobutamine'.

Injani imiphumela? Isitshelani?

Ukuhlolwa kwakho kwe-CFR kukunikeza inombolo. Le nombolo ikutshela ukuthi imithambo yakho yenhliziyo ingakwandisa kangakanani ukugeleza kwegazi ngesikhathi sokuzikhandla.

Njengoba sesixoxile ngaphambili, leli nani lingancipha ngokuguga. Umuntu osemusha ophilile angase abe ne-CFR engu-5 noma engu-6. Kodwa umuntu omdala ophilile angase abe ne-CFR engaphansi kuka-2.

Ukwehla kokugeleza kwegazi (okungukuthi, isici esiyingozi) kungenzeka kunoma yiliphi inani le-CFR eliphakathi kuka-1.6 no-3.3. Okujwayelekile komunye umuntu kungase kungabi okuvamile komunye. Ngakho-ke, udokotela wakho kuphela ongachaza imiphumela yakho ngokunembile. Uzocabangela izici eziningi, njengobudala bakho, isimo sempilo, kanye nezimpawu, ukuze afinyelele esiphethweni.

Kuthatha isikhathi esingakanani ukwazi imiphumela?

Kungathatha izinsuku ezimbalwa ukuthi udokotela wakho ahlaziye imiphumela yokuhlolwa kwakho kwe-CFR futhi akwazise. Uma imiphumela yakho ingavamile, udokotela wakho angase afune ukuxoxa ngayo nabanye odokotela. Uma imiphumela yakho ibonisa ingozi yesifo senhliziyo, udokotela wakho uzokhuluma nawe ngohlelo lokunciphisa ingozi yakho.

Kufanele ngixhumane nini nodokotela?

Uma unemibuzo ngaphambi kokuba kuqale ukuhlolwa kwe-CFR, buza udokotela wakho. Futhi, uma uhlangabezana nanoma yiziphi izimpawu ezingavamile, imiphumela emibi, noma ukungakhululeki ngemva kokuhlolwa , yazisa udokotela wakho ngokushesha.

Umlayezo Wokuya Nawe Ekhaya

Ukuhlolwa kwe-'Coronary Flow Reserve (CFR)' kuwukuhlolwa okunikeza ulwazi olubalulekile mayelana nempilo yemithambo yenhliziyo enikeza igazi enhliziyweni yakho. Kungahlola ukuthi inhliziyo yakho ithola igazi elengeziwe elidingayo uma isebenza kanzima.

Inani eliphansi le-CFR lingaba uphawu lwesifo semithambo yenhliziyo. Lingakunikeza nombono wengozi yakho yesikhathi esizayo yokuhlaselwa yinhliziyo.

Uma kukhona ongakuqondi ngalolu vivinyo, ungesabi ukubuza udokotela wakho. Bazokuchazela konke futhi bakusize wenze ukuhlolwa kube lula ngangokunokwenzeka. Khumbula, ukunakekela inhliziyo yakho kubaluleke kakhulu!

'Isifo senhliziyo, imithambo yenhliziyo, ukunikezwa kwegazi, ukuhlolwa kwe-CFR, ukuhlaselwa yinhliziyo, impilo yenhliziyo, ukuhlolwa kwezokwelapha