Isimo esiyingozi lapho inhliziyo ingakwazi ukupompa igazi: Konke mayelana ne-Cardiogenic Shock

Ingabe uke wazithola uphelelwa umoya, ubanda, futhi unesizungu? Ungase ucabange ukuthi ukukhathala nje. Kodwa, kungaba futhi uphawu lwesimo esiyingozi kakhulu. Kuyisimo lapho inhliziyo ingakwazi ukupompa igazi elanele emzimbeni. Kwezokwelapha, lokhu sikubiza ngokuthi i-Cardiogenic Shock. Lesi yisimo esidinga ukwelashwa okuphuthumayo futhi esingasongela ngisho nokuphila. Ngakho-ke ake sixoxe ngaso ngamazwi alula namuhla.

Kalula nje, kuyini i-Cardiogenic Shock?

Cabanga ukuthi bekuzokwenzekani uma injini epompa amanzi ethangini lamanzi lasekhaya lakho ingayeka ukusebenza ngokuzumayo? Bekungeke kube namanzi ethangini, bekungekho manzi okugeza noma okuphuza. Inhliziyo emzimbeni wethu ifana nale njini yamanzi. Umsebenzi oyinhloko wenhliziyo ukupompa igazi eligcwele umoya-mpilo nezakhamzimba kuwo wonke amaseli nezitho zomzimba.

I-Cardiogenic Shock yilapho inhliziyo, 'iphampu', iyeka ukusebenza kahle futhi ingakwazi ukupompa igazi elanele emzimbeni. Uma lokhu kwenzeka, izitho zethu ezinkulu, njengobuchopho, izinso nesibindi, azitholi umoya-mpilo eziwudingayo. Njengoba nje izihlahla zifa ngaphandle kwamanzi, ngaphandle komoya-mpilo, lezi zitho ziqala ukuhlupheka. Lesi yisimo esiphuthumayo sezokwelapha . Uma singelashwa, ukufa kungenzeka.

Ingabe kunezigaba ezahlukene zalesi simo?

Yebo, lesi simo asifinyeleli esicongweni saso sonke ngesikhathi esisodwa. Kunezikhathi lapho siba sibi kancane kancane. Odokotela basihlukanisa ngezigaba eziningana ngokuya ngobunzima baso. Uma sikuqonda lokhu, singathola umbono omuhle ngobunzima balesi simo.

Ungazibona kanjani? Izimpawu Zokushaqeka Kwenhliziyo

Uma unesinye noma ngaphezulu salezi zimpawu, ungazinaki. Kufanele uqaphele kakhulu ngalokhu, ikakhulukazi uma unesifo senhliziyo.

• Ukudideka noma ukulahlekelwa ukwazi: Lapho ukugeleza kwegazi ebuchosheni kuncipha, ukwazi kungase kuphazamiseke, kuphazamiseke, noma kozele.
• Ukuquleka: Ungalahlekelwa ingqondo ngokuzumayo bese uwe.
• Ubunzima bokuphefumula: Uketshezi lunganqwabelana emaphashini futhi lwenze kuzwakale sengathi unenkinga yokuphefumula.
• Ukwehla kokukhishwa komchamo: Uma ukugeleza kwegazi ezinso kwehla, inani lomchamo okhiqizwa umzimba liyancipha kakhulu.
• Izandla nezinyawo ezibandayo: Njengoba umzimba uzama ukuthumela igazi ezithweni zomzimba ezibalulekile, ukugeleza kwegazi ezindaweni ezikude njengezandla nezinyawo kuncipha. Ngenxa yalokho, ziyabanda futhi zijuluke.
• Umbala wesikhumba uyashintsha: Isikhumba siyaphaphatheka, mhlawumbe sibe luhlaza okwesibhakabhaka.
• Ukukhathala okukhulu nokukhathala: Umzimba uyakhathala kangangokuthi akunakwenzeka ukwenza lutho.
• Ukuvuvukala kwesisu nemilenze: Uketshezi luyanqwabelana emzimbeni futhi lubangele ukuvuvukala ngoba inhliziyo ayisebenzi kahle.
• I-Anorexia: Ukulahlekelwa yiso sonke isifiso sokudla.

Iyini imbangela eyinhloko yalokhu?

Imbangela eyinhloko nevame kakhulu yokushaqeka kwenhliziyo ukuhlaselwa yinhliziyo okukhulu . Lapho kwenzeka ukuhlaselwa yinhliziyo, umthambo wegazi ohlinzeka ngegazi emisipheni yenhliziyo uyavaleka. Lokhu kulimaza imisipha futhi kungazelelwe kunciphisa ikhono lenhliziyo lokupompa.

Kodwa akusona isifo senhliziyo kuphela, kunezinye izizathu eziningi ezingathinta lokhu. Kalula nje, noma yini ephazamisa ukusebenza kwenhliziyo ingabangela lokhu.

• I-Myocarditis: Lapho imisipha yenhliziyo ivuvukala ngenxa yesifo esifana negciwane, inhliziyo ayikwazi ukufinyela kahle.
• Ukutheleleka kwe-valve yenhliziyo (i-Endocarditis): Lapho ama-valve enhliziyo etheleleka ngamagciwane, ayalimala futhi ukuhamba kwegazi kuyaphazamiseka.
• Ukungasebenzi kahle kwenhliziyo (i-Arrhythmia): Uma inhliziyo ishaya ngokushesha kakhulu noma kancane kakhulu, ayikwazi ukupompa igazi kahle.
• I-Cardiac Tamponade: Lapho indawo efana nesikhwama ezungeze inhliziyo igcwele uketshezi noma igazi , ukucindezela kuvimbela inhliziyo ukuthi ingafinyeleli futhi ipompe igazi.
• I-Pulmonary Embolism: Uma ihlule legazi, njengehlule lomlenze, liphuma bese lihlala emthanjeni wegazi omkhulu emaphashini, libeka ingcindezi enkulu enhliziyweni.
• Izinkinga zevalvu yenhliziyo: Ukuqhekeka kwevalvu yenhliziyo ngokuzumayo, noma ivalvu yokufakelwa engasebenzi kahle.
• Ukushaywa okukhulu esifubeni: Ukushaywa esifubeni ngenxa yengozi kungalimaza inhliziyo.

Odokotela bakuthola kanjani lokhu?

Uma uya esibhedlela, udokotela uzoqala athole umbono walokhu emibuzweni akubuza yona kanye nokuhlolwa komzimba.

Izinto ezibonwe ngesikhathi sokuhlolwa ngokomzimba:

• Ukuzwa ukushaya kwenhliziyo okubuthakathaka lapho ushaya.
• Isikhumba esizizwa sibanda futhi sithambile uma usithinta.
• Ukuba nomfutho wegazi ophansi kakhulu .
• Ukuzwa umsindo wenhliziyo ongajwayelekile (ukububula) lapho ulalele isifuba nge-stethoscope.

Ngemuva kwalokho, kwenziwa izivivinyo eziningana ukuqinisekisa ukuxilongwa nokuthola imbangela.

Yiziphi izivivinyo ezenziwayo?

• I-ECG (i-Electrocardiogram): Lokhu kulinganisa umsebenzi kagesi wenhliziyo. Kungasheshe kutholakale ukuthi kukhona yini ukuhlaselwa yinhliziyo noma ukushaya kwenhliziyo okungajwayelekile.
• I-Echocardiogram (Echo): Lokhu kufana nokuskena kwenhliziyo. Kungabona ngokucacile ukuthi inhliziyo ipompa igazi kahle kangakanani, ukuthi ngabe kukhona yini izinkinga ngama-valve, nokuthi ngabe kukhona yini umonakalo emisipheni yenhliziyo.
• I-X-ray yesifuba:I-X-ray yesifuba izohlola uketshezi emaphashini kanye nenhliziyo ekhuphukile.
• Ukuhlolwa Kwegazi: Amazinga e-oxygen egazini, ukusebenza kwezinso nesibindi, kanye namazinga e-enzyme yenhliziyo kuyahlolwa ukuze kubonakale ukuthi kukhona yini umonakalo enhliziyweni.
• I-Catheterization Yenhliziyo: Lokhu ukuhlolwa okuyinkimbinkimbi kancane. Ipayipi elincane lifakwa ngemithambo yegazi engalweni noma emlenzeni wakho bese liqondiswa enhliziyweni yakho ukuze kuhlolwe ukuvaleka kwemithambo yenhliziyo. Liphinde lilinganise ingcindezi engaphakathi kwenhliziyo yakho ukuze linqume ukuthi iphampa kahle kangakanani.

Iphathwa kanjani?

Njengoba lokhu kuyisimo esiphuthumayo, ukwelashwa kuqala eYunithi Yokwelapha Esiphuthumayo (ETU) yesibhedlela noma eYunithi Yokunakekela Okujulile (ICU). Kunemigomo emibili eyinhloko:

1. Ukusekela ukusebenza kwenhliziyo.

2. Nciphisa umonakalo ezithweni zomzimba.

Ukwelashwa okuphuthumayo

• Ukuhlinzeka ngomoya-mpilo: Nikeza umzimba umoya-mpilo owudingayo, futhi kungadingeka uxhunywe kumshini wokuphefumula.
• Izinhlobo zemithi:
• Imithi ekhulisa umfutho wegazi (ama-Vasopressors).
• Imithi ekhulisa ikhono lokupompa kwenhliziyo (i-Inotropes).
• Ama-diuretics yimithi esusa uketshezi oluningi emzimbeni.
• Amadivayisi okusekela inhliziyo: Uma lesi simo singenakulawuleka ngemithi yodwa, kusetshenziswa idivayisi ukusekela inhliziyo okwesikhashana. Isibonelo idivayisi ebizwa ngokuthi i-Intra-aortic balloon pump (IABP).

Ukwelashwa ngokwembangela

Uma isimo sesiguli sesizinzile ngezinga elithile ngokwelashwa okuphuthumayo, inkinga eyisisekelo ebangele ukushaqeka kwenhliziyo iyalashwa.

• Uma kungenxa yokuhlaselwa yinhliziyo: I-Angioplasty yenziwa ngokushesha. Lokhu kusho ukuthi umthambo wegazi ovalekile uvulwa ngebhaluni bese kufakwa i- stent ukuze uvimbele ukuthi ungavaleki futhi.
• Uma kunenkinga yevalvu: Kwenziwa ukuhlinzwa ukuze kulungiswe ivalvu noma kufakwe ivalvu entsha.
• Uma ihlule legazi lihlala emaphashini: Kuzonikezwa imithi yokuncibilikisa ihlule.
• Uma kukhona uketshezi oluzungeze inhliziyo: Uketshezi lususwa ngenaliti.

Kwezinye izimo ezinzima, uma inhliziyo ingakwazi ukusebenza nhlobo, kusetshenziswa umshini obizwa nge -ECMO (extracorporeal membrane oxygenation) . Lokhu kwenziwa ngokufaka umoya-mpilo egazini elingaphandle komzimba bese ulibuyisela emzimbeni. Lokhu kusho ukuthi umsebenzi wenhliziyo namaphaphu wenziwa okwesikhashana yilo mshini. Uma inhliziyo ingalulami, kungadingeka ukufaka idivayisi yesikhathi eside ebizwa ngokuthi i-LVAD (left ventricular assist device) noma ngisho nokufakelwa inhliziyo .

Ukululama kanye nendlela eya phambili

Ukushaqeka kwenhliziyo kuyisimo esibi kakhulu. Amathuba okusinda ancike ekutheni ukwelashwa kutholwa ngokushesha kangakanani. Uma isikhathi esichithwa ekushaqekeni sifushane, kulapho umonakalo omncane ezithweni zomzimba.

• Ukuhlala esibhedlela: Ngokuvamile, kuzodingeka uhlale esibhedlela isonto noma ngaphezulu.
• Isikhathi sokululama: Kungathatha amasonto amaningana kuya ezinyangeni eziningana ukululama ngokuphelele ngemva kokubuyela ekhaya. Ukubamba iqhaza ezinhlelweni zokuvuselela inhliziyo kungasiza kakhulu inqubo yokululama.
• Impilo yesikhathi esizayo: Ngemva kokuhlangenwe nakho okufana nalokhu, kungase kube nemiphumela ethile yomzimba neyengqondo. Ngakho-ke, kubalulekile ukuthatha imithi oyinikezwe udokotela ngesikhathi, ukuya emitholampilo ngezinsuku ezihleliwe, nokwenza izinguquko ezidingekayo endleleni yokuphila (ukuyeka ukubhema, ukudla okunempilo, ukuzivocavoca).