Siyazi ukuthi kunzima kangakanani ukulwa nomdlavuza. Ukwelashwa okutholayo, njengokwelashwa ngamakhemikhali kanye nemisebe, ngezinye izikhathi kungabangela ezinye izinkinga zempilo. Wake wacabanga ukuthi ukwelashwa komdlavuza kungaba nomthelela enhliziyweni yakho? Yilokho esikubiza ngezokwelapha ngokuthi i-Cardiotoxicity . Ungesabi uma uzwa leli gama. Lokhu akuyona into eyenzeka kuwo wonke umuntu. Kodwa kubaluleke kakhulu ukuqaphela lokhu. Ngakho-ke namuhla sizokhuluma ngalokhu kalula, ngendlela ongayiqonda.
Kalula nje, kuyini ukusha kwenhliziyo?
Ubuthi benhliziyo buwumonakalo obangelwa yimithi ethile yokwelapha umdlavuza. Cabanga ngomuthi obulala amangqamuzana omdlavuza njengeqhawe elinamandla kakhulu. Lapho leli qhawe lilwa namangqamuzana omdlavuza, ngezinye izikhathi amangqamuzana aphilile enhliziyweni yethu aseduze nawo angase alimale kancane. Yilokho ubuthi benhliziyo obuyikho.
Into eyinhloko engenzeka ukuthi inhliziyo iba nesikhathi esinzima sokupompa igazi emzimbeni wonke. Imisipha yenhliziyo ingaba buthaka. Kwezinye izimo ezinzima, lokhu kungaholela ngisho nasesimeni esibizwa ngokuthi i-Cardiomyopathy . Lokhu kusho ukuthi ikhono lemisipha yenhliziyo lokupompa igazi liyancipha kakhulu.
Into eyodwa eyingqayizivele ngalesi simo ukuthi ngezinye izikhathi singase senzeke eminyakeni eminingi ngemva kokuphela kokwelashwa komdlavuza. Le ngozi iphezulu kakhulu kubantu abadala abake baphathwa umdlavuza beseyizingane.
Ubani osengozini enkulu?
Nakuba noma ubani oke welashwa ngomdlavuza enethuba lokuthola lesi simo, akuwona wonke umuntu ositholayo. Kodwa-ke, abanye abantu basengozini enkulu kancane.
- Abantu abasebenzisa imithi ethile: Eminye imithi yokwelapha ngamakhemikhali kanye neminye imithi yokwelapha ingathinta inhliziyo. Sizoxoxa ngalokho kafushane.
- Abantu abathole ukwelashwa ngemisebe endaweni yesifuba: Uma kunikezwa ukwelashwa ngemisebe yomdlavuza wesifuba, isibonelo, umdlavuza webele, imisebe ingathinta nenhliziyo ngezinga elithile.
- Labo abathola ukwelashwa komdlavuza besebancane: Le ngozi iphakeme kancane kubantu abadala abathole ukwelashwa besebancane.
Ezinye izifundo zisikisela ukuthi abantu abadala abangafika ku -20% abathola ukwelashwa komdlavuza bangase babe nesifo senhliziyo, kanti phakathi kuka -7% no- 10% balaba bangase babe nesifo senhliziyo noma ukwehluleka kwenhliziyo.
Yimiphi imiphumela engaba khona ngenxa yokuphazamiseka kwenhliziyo nemithambo yegazi enhliziyweni?
Lesi simo singabangela izinkinga zenhliziyo ezahlukahlukene. Akuzona zonke lezi zinto ezenzeka kuwo wonke umuntu, kodwa kubalulekile ukuqaphela izimbangela ezingaba khona. Bheka ithebula elingezansi.
| Isimo senhliziyo esingenzeka | Kalula nje... |
|---|---|
| I-cardiomyopathy | Imisipha yenhliziyo iba buthakathaka futhi ingakwazi ukupompa igazi ngendlela efanele. |
| Ukuhlaselwa Yinhliziyo / Ukuhlaselwa Yinhliziyo Okungapheli | Ukuvaleka komthambo ohambisa igazi enhliziyweni. |
| Ukwehluleka Kwenhliziyo | Inhliziyo ibuthakathaka futhi ayikwazi ukupompa igazi ukuze ihlangabezane nezidingo zomzimba. |
| Ukushaya kwenhliziyo okungajwayelekile (i-Arrhythmia) | Ukushaya kwenhliziyo okusheshayo, okushaya ngamandla, noma okungajwayelekile ngendlela engavamile. |
| Isifo Se-Valve Yenhliziyo | Ama-valve asebenza njengamasango angaphakathi kwenhliziyo awasebenzi kahle. |
| Umfutho Wegazi Ophakeme/Ophansi | Umfutho wegazi lakho uphakeme noma uphansi ngendlela engavamile. |
| Ukwakheka koketshezi oluzungeze inhliziyo | Ukuqongelela koketshezi olwelwesini oluncane olumboza inhliziyo, okubangela ingcindezi enhliziyweni. |
Yiziphi izimpawu ongase uzibone?
Izimpawu zenhliziyo ezihlobene nobuthi benhliziyo zingavela ngokuzumayo noma zikhule kancane kancane. Uma uthatha noma usanda kuqeda ukwelashwa komdlavuza, kubalulekile ukuqaphela lezi zimpawu.
Khumbula, lezi zimpawu zingabangelwa ezinye izinto, kodwa uma unesinye noma ngaphezulu kwalezi, qiniseka ukuthi ukhuluma nodokotela wakho.
| Isibonakaliso | Ungase uzizwe ngale ndlela. |
|---|---|
| Ubunzima bokuphefumula (i-Dyspnea) | Ngizizwa ngiphelelwa umoya futhi ngiphefumula kanzima uma ngihamba kancane, ngikhuphuka izitebhisi, noma ngisho ngima nje. |
| Ubuhlungu besifuba noma ukungakhululeki | Kuzwakala sengathi isifuba sakho siyacindezelwa, siyacindezelwa, noma sizwa ubuhlungu nje. |
| Ukuvuvukala kwemilenze (i-Edema) | Izindawo ezifana nemilenze, amaqakala, nezinyawo ziyavuvukala futhi zishaye uma zicindezelwa ngomunwe. |
| Ukushaya kwenhliziyo | Kuzwakala sengathi inhliziyo yakho ishaya ngamandla futhi ishaya ngokushesha, noma sengathi yeqa ukushaya. |
| Isiyezi kanye nokuquleka | Ukuphotha nokuphotha . Ukuphotha nokuphotha . |
| Ukuvuvukala kwesisu | Indawo yesisu ibonakala ivuvukele futhi ikhulisiwe ngenxa yokuqongelela koketshezi emzimbeni. |
Yiziphi izimbangela eziyinhloko zobungozi be-cardiotoxicity?
Nakuba kunezinhlobo eziningi zokwelapha umdlavuza, izinhlobo ezimbalwa eziyinhloko zinegalelo elikhulu kulesi simo.
1. Eminye imithi yokwelapha ngamakhemikhali
Ama-anthracycline ayizinhlobo zemithi ye-chemotherapy eyaziwa kakhulu ngalokhu. Isibonelo yi -Doxorubicin (Adriamycin®) . Lawa avame ukusetshenziswa ekwelapheni umdlavuza ofana ne-leukemia, i-lymphoma, umdlavuza webele, kanye ne-multiple myeloma.
2. Imithi Yokwelapha Eqondiwe
I-Trastuzumab (Herceptin®) iyisibonelo salo muthi. Isetshenziselwa ukwelapha umdlavuza webele kanye nomdlavuza wesisu. Kunengozi eyengeziwe ye-cardiomyopathy, ikakhulukazi uma lo muthi unikezwa kanye ne-anthracycline.
3. Ukwelashwa ngemisebe endaweni yesifuba
Uma imisebe inikezwa esifubeni ngenxa yomdlavuza, njengomdlavuza webele noma i-Hodgkin's Lymphoma, imisebe ingadlula enhliziyweni. Ngokuhamba kwesikhathi, lokhu kungalimaza imithambo yegazi kanye nemisipha yenhliziyo.
Odokotela bakuthola kanjani lokhu?
Uma unezimpawu ezishiwo ngenhla, noma uma useqenjini elisengozini enkulu, udokotela wakho cishe uzoyala ukuhlolwa kokusebenza kwenhliziyo. Ukuhlolwa okuyinhloko ukuhlola ikhono lenhliziyo lokupompa. Lokhu kwenziwa kusetshenziswa isilinganiso esibizwa ngokuthi i-Left Ventricular Ejection Fraction (LVEF) . Kalula nje, leli yiphesenti legazi inhliziyo elimpompayo emzimbeni isikhathi ngasinye lapho ishaya.
Ngezansi kunezinye izivivinyo ezisetshenziswa ukukala lezi zinto.
| Ukuhlolwa | Wenzani ngalokhu? |
|---|---|
| I-Echocardiogram (i-Echo) | Lena yindlela evame ukusetshenziswa kakhulu. Amagagasi e-ultrasound (njengezikrini esizitholayo ukuze sibone izingane) asetshenziselwa ukubheka ukushaya kwenhliziyo, ubukhulu, ukuma kwayo, kanye nendlela epompa ngayo igazi. |
| I-MRI yenhliziyo | Ukusebenzisa omaginethi namagagasi omsakazoKuthatha izithombe ezicacile nezinemininingwane zenhliziyo. Lokhu kubhekwa njengendlela engcono kakhulu yokuthola ubuthi benhliziyo. |
| Ukuhlolwa Kokucindezeleka Kwenhliziyo | Balinganisa ukuthi inhliziyo yakho isabela kanjani ekuzivocavoceni ngokukwenza uhambe nge-treadmill noma ugibele ibhayisikili. |
| Ukuskena kwe-Multigated Acquisition (MUGA) | Inani le-LVEF lilinganiswa ngokufaka inani elincane lento ekhipha imisebe engenangozi emzimbeni bese kusetshenziswa ikhamera ukuyibuka ihamba enhliziyweni negazi. |
| I-CT Scan yenhliziyo | Isithombe senhliziyo esingu-3D senziwa kusetshenziswa ama-X-ray amaningi. Lokhu kungaba usizo kakhulu kubantu abaye bathola ukwelashwa ngemisebe. |
Lesi simo selashwa kanjani?
Indlela yokwelapha incike ekutheni inhliziyo yakho yonakele kangakanani kanye nembangela yako.
- Ukushintsha imithi: Uma kuqinisekiswa ukuthi ukwelashwa komdlavuza okwenzayo njengamanje kuthinta inhliziyo yakho, udokotela wakho angase anqume ukuyeka imithi, anciphise umthamo, noma akushintshele komunye umuthi.
- Imithi yenhliziyo: Udokotela wakho angase akunikeze imithi emisha ukusiza ekuthuthukiseni ukusebenza kwenhliziyo nokulawula izimpawu. Isibonelo:
- Ama-ACE Inhibitors: Lawa andisa imithambo yegazi futhi athuthukise ukugeleza kwegazi.
- Ama-Beta-blocker: Lawa alawula izinga lokushaya kwenhliziyo futhi anciphise ingcindezi enhliziyweni.
- Ama-diuretics: Asiza ekususeni uketshezi oluningi emzimbeni ngomchamo, okunciphisa ukuvuvukala.
- I-Digoxin: Ilawula ukushaya kwenhliziyo futhi yenza inhliziyo ipompe igazi ngendlela ephumelela kakhudlwana.
Ingabe lesi simo singalapheka ngokuphelele?
Lona umbuzo abantu abaningi abanawo. Impendulo ithi, "Ngezinye izikhathi ungakwazi, ngezinye izikhathi awukwazi."
- Ubuthi benhliziyo obubangelwa yimithi efana neTrastuzumab (Herceptin®) buvame ukubuyiselwa esimweni saso . Lokhu kusho ukuthi ukusebenza kwenhliziyo kungabuyela esimweni esijwayelekile uma ukwelashwa sekumisiwe noma sekuqalwe omunye umuthi.
- I-Anthracyclines noma Ukwelashwa NgemisebeUmonakalo odalwe ngokuvamile awulungiseki . Ezimweni ezinjalo, kungadingeka uphuze imithi esekela inhliziyo futhi wenze izinguquko endleleni yokuphila impilo yakho yonke.
Yini engenziwa ukunciphisa ingozi?
Uma ngikhuluma iqiniso, ayikho indlela yokuvimbela ngokuphelele ubuthi benhliziyo. Ngoba lokho kwelashwa kubalulekile ekwelapheni umdlavuza. Kodwa into ebaluleke kakhulu ongayenza ukuqaphela lesi simo ngokushesha okukhulu.
- Khuluma nodokotela wakho: Ngaphambi kokuqala ukwelashwa komdlavuza, khuluma nodokotela wakho ngokukhululekile ngezinzuzo zokwelashwa, kanye nemiphumela emibi engaba khona, njengemiphumela enhliziyweni.
- Ukuhlolwa okuvamile: Ngesikhathi nangemva kokwelashwa komdlavuza, hlola inhliziyo yakho njalo (isib., ukuskena kwe-echo) njengoba kuqondiswe udokotela wakho. Lokhu kuzosiza ekutholeni noma yiziphi izinkinga kusenesikhathi bese uqala ukwelashwa.
Isikhathi sokuthola iseluleko sezokwelapha ngokushesha!
Uma uthola noma uke wathola ukwelashwa komdlavuza, futhi uhlangabezana nanoma yiziphi izimpawu ezilandelayo ezimbi, hamba ngokushesha eMnyangweni Wezimo Eziphuthumayo (ETU).
- Ukushaya kwenhliziyo okuqhubekayo noma okwandayo.
- Ukuzungeza, ukubona okufiphele, noma ukuquleka.
- Ukuphefumula okubi kakhulu noma ubuhlungu besifuba obuqhubeka ngokuzumayo.
- Ukuvuvukala kwezindebe noma umphimbo.
- Ukuvuvukala okungavamile kwemilenze noma izinyawo.
- Ukwanda kwesisindo okungaphezu kuka-1.5 kg (amakhilogremu angu-3) phakathi nesonto.
Lezi zimpawu zingaba uphawu lokuhlaselwa yinhliziyo okukhulu, ngakho ungalibali.
Umlayezo Wokuya Nawe Ekhaya
- Ubuthi benhliziyo buwumonakalo enhliziyweni obangelwa ukwelashwa komdlavuza. Lokhu akwenzeki kuwo wonke umuntu, kodwa kukhona ingozi.
- Hlala uqaphele izimpawu ezinjengobunzima bokuphefumula, ubuhlungu besifuba, kanye nokuvuvukala kwemilenze.
- Ngaphambi kokuqala ukwelashwa komdlavuza, khuluma nodokotela wakho ngezinzuzo nezinkinga kanye nemiphumela engaba khona enhliziyweni yakho.
- Kubaluleke kakhulu ukwenza ukuhlolwa kwenhliziyo njalo (njengokuphindaphindwa kwezwi) njengoba kunconywe udokotela wakho, kokubili ngesikhathi sokwelashwa nangemva kokwelashwa.
- Uma inkinga isheshe itholakale, kulapho amathuba okuba iphathwe ngempumelelo. Ungesabi, yaziswe, futhi usebenzisane eduze nodokotela wakho.
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