Cabanga ngenhliziyo yakho njengephampu yamanzi esebenza ngokungayeki. Ngaphakathi kwale phampu, kunezingxenye ezine ezincane ezifana nomnyango ezisiza ukugeleza kwegazi ohlangothini olulodwa kuphela. Ngokwezokwelapha, sibiza lawa ma-valve enhliziyo. Uma lawa ma-cango engavuli futhi engavali kahle, kuyinkinga enkulu, akunjalo? Ngokufanayo, namuhla sikhuluma ngokuhlinzwa okukhethekile okwenziwa lapho i-valve ye-mitral, enye yama-valve abaluleke kakhulu enhliziyweni yethu, ingavuli kahle futhi iba mncane.
Kuyini i-commissurotomy?
Kalula nje, i-commissurotomy inqubo yokuhlinzwa evumela igazi ukuthi ligeleze nge-valve enhliziyweni yakho. Ivame ukwenziwa ku-valve ye-mitral . I-valve ye-mitral itholakala phakathi kwegumbi eliphezulu kwesobunxele (i-atrium kwesobunxele) kanye negumbi elingezansi kwesobunxele (i-ventricle kwesobunxele).
Cabanga ukuthi lo mnyango awuvuli kahle futhi unamathele futhi unciphile. Lesi simo sibizwa ngokuthi i-mitral valve stenosis. Okwenzekayo ukuthi indlela yokugeleza kwegazi isuka ekamelweni eliphezulu iye ekamelweni elingezansi ivaliwe. Lokhu kubangela ukuthi igazi libuyele emuva futhi kubeke ukucindezeleka okukhulu enhliziyweni nasemaphashini. Ngokuhamba kwesikhathi, lokhu kungaholela ngisho nasezimweni ezimbi kakhulu njengokwehluleka kwenhliziyo.
Lokhu kuhlinzwa kwe-commissurotomy kusetshenziswa njengokwelashwa kwezigaba zokuqala ze-mitral valve stenosis. Kodwa uma ngikhuluma iqiniso, akwenziwa kaningi kulezi zinsuku. Ngoba kuvame ukwenziwa njengokuhlinzwa kwenhliziyo evulekile . Kunezingozi ezithile. Ngakho-ke, noma nini lapho kungenzeka, odokotela bazama ukusebenzisa izindlela ezilula nezingenangozi kakhulu. Enye yezindlela zokwelapha eziyinhloko ezitholakalayo njengamanje i -balloon valvuloplasty . Kulokhu, kufakwa ipayipi elincane bese kuthi okuthile okufana nebhaluni kugcwale umoya ngaphakathi kwe-valve encishisiwe, kuyenze inwebeke.
Kodwa-ke, kwabanye abantu, indlela yebhaluni ayinakwenziwa ngenxa yesimo senhliziyo yabo noma ezinye izizathu. Ezimweni ezinjalo, ukuhlinzwa kwe-commissurotomy kuyindlela engcono kakhulu.
Ubani ngempela odinga lokhu kuhlinzwa?
Uma une-mitral stenosis futhi kukhona okunye kwalokhu okulandelayo, udokotela wakho angancoma lokhu kuhlinzwa:
- Uma ungazange welashwe ngezinye izindlela zokwelapha.
- Uma ungakwazi ukwenza i-valvuloplasty yebhaluni.
Ngaphezu kwalokho, uma uke wahlinzwa inhliziyo ngezinye izindlela, lokhu kuhlinzwa kungenziwa ngesikhathi esifanayo.
Kodwa into eyodwa ebalulekile ukuyikhumbula. Akuwona wonke umuntu one-mitral valve stenosis ongenza lolu hlinzeko. Kuya ngokuthi imbangela ye-valve stenosis yakho ibangelwa yini.
Kunezizathu ezimbili eziyinhloko:
1. Umonakalo obangelwa yiSifo Senhliziyo Esibangelwa Amalunga:Umkhuhlane we-rheumatic, olandela ukutheleleka komphimbo ebuntwaneni, ungalimaza ama-valve enhliziyo eminyakeni eminingi kamuva.
2. I-Degenerative Mitral Stenosis: Ngokuhamba kwesikhathi, ivalvu iyabuthaka kancane kancane, inciphe, bese imbozwa yi-calcium deposits.
Ukuhlinzwa kwe-commissurotomy kuyasiza kakhulu kubantu abanesifo senhliziyo esibangelwa amalunga . Kulesi simo, amakhona amabili evalvu lapho kuhlangana khona amapheshana amabili, abizwa ngokuthi ama-commissures , ayaqina futhi ngezinye izikhathi ayanamathelana.
Ukuze uqonde lokhu, cabanga ngale ndlela. Hamba phambi kwesibuko bese umomotheka uvale izindebe zakho. Uyawabona yini amakhona amabili lapho izindebe zakho ezingaphezulu nezingezansi zihlangana khona? Lezo yizindlela zokuxhuma zevalvu ye-mitral. Manje, zama ukuvula umlomo wakho ngokucindezela lawo makhona amabili ngeminwe yakho yokukhomba ukuze angakwazi ukunyakaza. Kunzima ukuvula umlomo wakho kabanzi, akunjalo? Yilokho okwenzekayo lapho ivalvu ye-mitral iba mncane. Ngenxa yokuthi amakhona amabili evalvu anamathelana, awavuli kahle, futhi ukuhamba kwegazi kuyaphazamiseka.
Ekuhlinzeni kwe-commissurotomy, kwenziwa imicu emincane emakhoneni amabili evalvu bese iyakhululwa. Bese ivalvu iqala ukuvula kahle futhi. Kodwa-ke, kubantu abanamavalvu agugile ngenxa yokuguga, ama-commissure ngokuvamile awawonakali. Kunalokho, ezinye izingxenye zevalvu zidinga ukulungiswa. Ngakho-ke, lokhu kuhlinzwa akufanelekile kubo. Kuzodingeka babhekane nohlobo oluhlukile lokulungiswa kwevalvu noma ukushintshwa kwevalvu ephelele (ukushintshwa kwevalvu ye-mitral).
Kwenzekani ngaphambi kokuhlinzwa?
Amalungiselelo aqala emavikini, ngezinye izikhathi izinyanga, ngaphambi kosuku lokuhlinzwa kwakho. Ithimba lakho lezokwelapha (udokotela womndeni wakho, udokotela wezifo zenhliziyo, kanye nodokotela ohlinza inhliziyo) bazohlangana ukuze bakuhlole ngokuphelele.
| Ukuhlolwa nokuhlolwa kwangaphambi kokuhlinzwa | |
|---|---|
| Ukuhlolwa komzimba | Ukuhlola impilo yomzimba wakho jikelele. |
| Ukuhlolwa kwegazi | Ukuhlola ukusebenza kwezitho zomzimba ezifana nezinso nesibindi kanye nesimo segazi. |
| Izimpawu nomlando wesifo | Ukukhuluma ngokuningiliziwe ngokungakhululeki okuzwayo kanye nokugula odlule kukho. |
| Ukuhlolwa kwenhliziyo okukhethekile |
|
Uma unemibuzo, ukwesaba, noma ukungabaza ngokuhlinzwa, khuluma nodokotela wakho ngakho. Ungafihli lutho kuwe. Kubaluleke kakhulu ukwazi konke bese ungena ekuhlinzeni ngengqondo ekhululekile.
Udokotela wakho uzokunikeza imiyalelo yokuthi ungalungiselela kanjani ukuhlinzwa, okuhlanganisa nokuthi ungayeka nini ukudla nokuphuza ngaphambi kokuhlinzwa, kanye nanoma yiziphi izinguquko emithini yakho.
Okubaluleke kakhulu, uma ubhema, kubalulekile ukuyeka ngokuphelele ukubhema ngaphambi kokuhlinzwa ukuze unciphise izinkinga ngemva kokuhlinzwa. Uma udinga usizo ngalokhu, buza udokotela wakho.
Ukuhlinzwa kwenziwa kanjani?
Egumbini lokuhlinza, ithimba lezokwelapha lilandela lezi zinyathelo:
1. Okokuqala, uzonikezwa i-anesthesia futhi uzolaliswa kuze kube yilapho ukuhlinzwa kuqediwe. Ngeke uzwe ubuhlungu.
2. Okulandelayo, udokotela ohlinzayo wenza i-incision maphakathi nesifuba sakho, phansi kwethambo lesifuba (sternum). Lokhu kubizwa ngokuthi i-median sternotomy .
3. Uzoxhunywa emshinini we-cardiopulmonary bypass . Lo mshini uthatha okwesikhashana umsebenzi wenhliziyo namaphaphu akho ngesikhathi sokuhlinzwa. Lokhu kuvumela udokotela ukuthi enze ukuhlinzwa ngenkathi uthule, ngaphandle kokushaya kwenhliziyo yakho.
4. I-atrium yesobunxele yenhliziyo iyavulwa bese kuhlolwa i-valve ye-mitral.
5. Ngemuva kwalokho, kwenziwa izimbobo ezincane kakhulu emakhoneni amabili (ama-commissures) e-valve anamathele futhi ajiyile, ahlukanise omunye komunye futhi awakhulule.
6. Ngemva kokuba umsebenzi usuqediwe, uzokhishwa emshinini wenhliziyo namaphaphu futhi inhliziyo namaphaphu akho kuzoqala ukusebenza futhi.
7. Okokugcina, i-echocardiogram ye-transesophagealKwenziwa ukuskena okukhethekile ukuqinisekisa ukuthi ivalvu isebenza kahle yini nokuthi konke kusebenza kahle yini.
Ngezinye izikhathi, ezinye izindlela zokuhlinzwa kwenhliziyo, njengokulungisa ezinye izindlela zokuhlinzwa kwenhliziyo (i-aortic valve noma i-tricuspid valve), zingenziwa ngesikhathi esifanayo nale ndlela yokuhlinzwa. Uma lokhu kudingeka, ithimba lezokwelapha lizokuchazela lokhu kusenesikhathi.
Kwenzekani ngemva kokuhlinzwa?
Kuzodingeka uhlale esibhedlela cishe isonto elilodwa ngemuva kokuhlinzwa. Osukwini lokuqala noma ezimbili, uzogcinwa egunjini lokunakekelwa okujulile (ICU) futhi uqashwe ngokucophelela. Lokhu kwenzelwa ukusiza ekutholeni noma yiziphi izinkinga ezingase zivele ngemva kokuhlinzwa ngokushesha okukhulu.
Ngaphambi kokuba ubuyele ekhaya usuka esibhedlela, udokotela wakho uzokunikeza ulwazi mayelana nalokhu:
- Ukuvuselelwa Kwenhliziyo: Lokhu kuwusizo kakhulu kubantu abalulama ekuhlinzweni kwenhliziyo. Kukusiza ukuthi uthole amandla futhi uqale ukwenza imisebenzi evamile.
- Indlela yokunakekela inxeba: Kubaluleke kakhulu ukugcina inxeba lihlanzekile ukuze kuvinjelwe ukutheleleka futhi kupholiswe inxeba ngokushesha.
- Imikhawulo: Iseluleko sokuthi kufanele ulinde isikhathi esingakanani ngaphambi kokuthi uqale kabusha imisebenzi efana nokushayela noma ukwenza umsebenzi onzima.
Ngaphambi kokuba uye ekhaya, ungakhohlwa ukuhlela ukuthi othile akulande.
Yiziphi izinzuzo nezingozi zalokhu kuhlinzwa?
Izinzuzo
Lokhu kuhlinzwa kungaqeda izimpawu ezifana nokuphelelwa umoya kanye nokukhathala okubangelwa ukuncishiswa kwevalvu ye-mitral. Kungakuvikela nasezinkingeni ezinkulu ezingase zenzeke esikhathini esizayo. Lokhu kuyindlela yokwelapha enhle kakhulu kubantu abanesimo esingesibi ngokwanele ukuba bashintshe ngokuphelele ivalvu futhi abangaphumelelanga kwezinye izindlela zokwelapha.
Izingozi noma Izinkinga
Njenganoma yikuphi ukuhlinzwa, kunezingozi. Inkinga evame kakhulu ukuvuselelwa kwe-valve ye-mitral .
| Ezinye izinkinga ezingaba khona |
|---|
| - Ukusabela okubi ekubulaweni yizinzwa. |
| - Ukungalingani kwesigqi senhliziyo (i-Arrhythmia). |
| - Ukopha ngokweqile. |
| - Ukuqongelela koketshezi oluzungeze inhliziyo (i-cardiac tamponade). |
| - Izinguquko ekucabangeni noma ekudidekeni. |
| - Isifo senhliziyo. |
| - Ukutheleleka endaweni yokusikwa. |
| - Isifo sohlangothi. |
Eziningi zalezi zingozi zingancishiswa ngokuthola ukwelashwa esibhedlela esikhulu esinezikhungo kanye nodokotela abanolwazi ekuhlinzeni inhliziyo.
Uyini umbono ngemva kokuhlinzwa?
I-open commissurotomy inezinga eliphezulu lempumelelo. Lokhu kuhlinzwa kuvame ukulungisa ukuncishiswa kwevalvu futhi kubuyisele ukugeleza kwegazi.
Kodwa kubalulekile ukuqonda ukuthi lesi akusona isisombululo sokugcina. Abantu abaningi abenza lokhu kuhlinzwa kungadingeka bahlinzwe kabusha nge-mitral valve kamuva ekuphileni.
Udokotela wakho angakutshela kangcono ngempilo yakho yesikhathi esizayo. Wonke umuntu uyalulama ngendlela ehlukile. Izinto eziningi zithinta lokhu, okuhlanganisa iminyaka yakho, impilo iyonke, kanye nobukhulu bomonakalo ku-valve yakho ngaphambi kokuhlinzwa.
Kunini lapho udinga ukubonana nodokotela?
Uma uthola izimpawu zokutheleleka ngesikhathi usalulama ekhaya ngemva kokuhlinzwa, shayela udokotela wakho ngokushesha.
- Ubuhlungu besifuba, ukuqina, noma ukungakhululeki.
- Imfiva.
- Ukubomvu noma uketshezi olufana nobovu oluphuma endaweni yokusikwa.
Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo ezinzima, shayela ngokushesha inombolo yakho yezimo eziphuthumayo yendawo noma uye eMnyangweni Wezimo Eziphuthumayo wesibhedlela esiseduze (i-ETU):
- Izimpawu zokuhlaselwa yinhliziyo (ubuhlungu obukhulu esifubeni, ubunzima bokuphefumula, ukuhlanza, ukujuluka).
- Izimpawu zokukhubazeka (ubunzima bokukhuluma, ukugoba kolunye uhlangothi lobuso, ukulahlekelwa umuzwa engalweni noma emlenzeni).
Umlayezo Wokuya Nawe Ekhaya
- I-Commissurotomy iwukuhlinzwa kwenhliziyo okuvulekile okwelapha i-mitral stenosis.
- Lokhu kusebenza kakhulu kulabo abanomonakalo we-valve ngenxa yesifo senhliziyo esibangelwa yi-rheumatic.
- Lena inketho engcono kakhulu lapho ukwelashwa okulula njengendlela yebhaluni kungenzeki.
- Nakuba ukuhlinzwa kube yimpumelelo enkulu, kungenzeka ukuthi kuzodingeka ukuhlinzwa kokufaka ama-valve esikhathini esizayo.
- Kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngaphambi nangemva kokuhlinzwa. Ukuqaphela izimpawu eziyisixwayiso ezingase zenzeke ngemva kokuhlinzwa kubalulekile ukuze uphephe.
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