Ingabe ngezinye izikhathi uzizwa uphelelwa umoya noma uzizwa usinda esifubeni sakho uma ukhathele kancane, noma uma ukhuphuka izitebhisi? Mhlawumbe udokotela wakho ukutshelile ngenkinga yevalvu enhliziyweni yakho. Uma ivalvu yenhliziyo ingavuli kahle futhi ivalekile, siyibiza ngokuthi 'i-stenosis'. Namuhla sizokhuluma ngokuhlinzwa okukhethekile okwenziwa njengokwelashwa kwesimo esinjalo. Njengoba lesi kuyisihloko esibaluleke kakhulu, masiqonde konke kalula.
Kalula nje, kuyini lokhu 'kokuhlinzwa kokuhlinzwa'?
Kulungile, ake siqale sikuqonde lokhu kalula. Inhliziyo yakho inamakamelo amane amakhulu. Cabanga ngawo njengamakamelo amane. Ukuze igazi ligeleze lisuka kwelinye igumbi liye kwelinye, iminyango ephakathi kwawo kufanele ivuleke futhi ivalwe kahle. Leyo minyango yilokho esikubiza ngokuthi ama-valve enhliziyo .
I-commissurotomy inqubo ehilela i-valve ye-mitral enhliziyweni yakho. Itholakala phakathi kwamakamelo amabili enhliziyo, i-atrium yangakwesobunxele kanye ne-ventricle yangakwesobunxele. Lona umnyango ophakathi kwamakamelo amabili. Lo mnyango unama-flaps amabili.
Ngenxa yezimo ezithile zezokwelapha, ikakhulukazi isimo esibizwa ngokuthi 'i-Mitral Valve Stenosis' , le minyango emibili ayivuli kahle. Kufana nomnyango obhajwe. Kwenzekani-ke? Ukugeleza kwegazi kusuka ekamelweni eliphezulu kuya ekamelweni elingezansi kuyancishiswa. Lokhu kubangela ukuthi igazi libuyele emuva, okubeka ukucindezeleka okukhulu enhliziyweni nasemaphashini. Ngokuhamba kwesikhathi, lokhu kungaholela ezimweni ezibucayi njengokwehluleka kwenhliziyo .
I-'commissurotomy' inqubo yokuhlinzwa ehilela ukwenza ukusika okuncane nokuhlukanisa izindawo (ama-commissures) lapho kufakwe khona amapheshana e-valve evinjiwe, okuvumela i-valve ukuthi ivuleke kahle futhi. Lokhu kuvumela igazi ukuthi ligeleze enhliziyweni kalula futhi.
Ubani ngempela odinga lokhu kuhlinzwa?
Lokhu kuhlinzwa akulona olwawo wonke umuntu. Kunezizathu eziningana eziyinhloko zokuthi kungani udokotela wakho engase akuncome lokhu kuhlinzwa:
- Uma ezinye izindlela zokwelapha (njengemithi) ozinikiwe zingaphumelelanga.
- Uma ungafaneleki inqubo ebizwa ngokuthi 'i-Balloon Valvuloplasty', ehilela ukwandisa ivalvu ngebhaluni.
- Uma uphinda uhlinzwa inhliziyo, ungenza lokhu kuhlinzwa ngesikhathi esifanayo.
Kodwa into ebaluleke kakhulu ukuthi impumelelo yalokhu kuhlinzwa incike embangela ye-mitral valve stenosis yakho. Ake sibheke izimbangela ezimbili eziyinhloko.
| Yini ebangela i-mitral valve prolapse? | Incazelo kanye nokufaneleka kokuhlinzwa 'kwe-commissarotomy' |
|---|---|
| Isifo Senhliziyo Esibangelwa Yi-Rheumatic | Ukulimala kwama-valve enhliziyo ngenxa yomkhuhlane wamathambo ebuntwaneni. Lo monakalo wenzeka eminyakeni eminingi kamuva. Yilapho amapheshana ama-valve ehlangana khona (ama-commissure ahlanganisiwe). Ukuhlinzwa 'kwe-commissarotomy' kuphumelela kakhulu kulesi simo. |
| I-Degenerative Mitral Stenosis (Ukuguga) | Njengoba abantu bekhula, izingxenye zevalvu ziyawohloka. Kulesi simo, ezinye izingxenye zevalvu ziyalimala kunokuba amapheshana evalvu anamathele ndawonye. Ngakho-ke, ukuhlinzwa kwe-commissurotomy ngokuvamile akufaneleki kulaba bantu. Badinga ukulungiswa okunye kwevalvu noma ukushintshwa okuphelele kwevalvu (Mitral Valve Replacement) . |
Kusho ukuthini uma izembozo zevalvu zinamathela?
Kulula kakhulu ukukuqonda lokhu. Zicabange umamatheka phambi kwesibuko izindebe zakho zivaliwe. Bheka amakhona ezindebe zakho eziphezulu nezingezansi. Yilapho kuhlangana khona ama-flaps amabili e-mitral valve (ama-commissures). Manje cabanga ukuthi othile ubambe amakhona ezindebe zakho ngeminwe emibili. Ungakwazi yini ukuvula umlomo wakho kahle? Cha, awukwazi? Yilokho okwenzekayo lapho i-mitral valve ivaliwe. I-'commissurotomy' inqubo yokuhlinzwa ekhulula lawo makhona amabili.
Uzilungiselela kanjani ngaphambi kokuhlinzwa?
Njengoba lokhu kuwukuhlinzwa okukhulu, ukulungiselela kuqala emasontweni ambalwa kusengaphambili. Ithimba lakho lezokwelapha (udokotela wenhliziyo, udokotela ohlinza inhliziyo) lizokuhlola ngokuphelele.
- Ukuhlolwa okuphelele ngokomzimba
- Ukuhlolwa kwegazi
- Ukukhuluma kabanzi ngezimpawu zakho kanye nomlando wezokwelapha
Uzohlolwa futhi ukuze kubonakale ukuthi kukhona yini ukuvinjelwa kwe-valve yakho ye-mitral kanye neminye imithambo yegazi enhliziyweni yakho, njenge:
- I-Echocardiography - Lokhu ukuskena kwenhliziyo.
- Ukuskena kwe-CT
- I-Angiography ye-Coronary
Uma unemibuzo noma ukukhathazeka mayelana nokuhlinzwa, xoxa ngakho konke nodokotela futhi ukhululeke.Uma ubhema, kubalulekile ukuyeka ngokuphelele ngaphambi kokuhlinzwa. Lokhu kunganciphisa kakhulu izingozi zokuhlinzwa.
Kwenziwa kanjani ukuhlinzwa?
Lokhu ukuhlinzwa kwenhliziyo evulekile. Nansi indlela okwenzeka ngayo egunjini lokuhlinza:
1. Uzonikezwa i-anesthesia ukuze ulale ngokuphelele.
2. Kwenziwa i-incision maphakathi nethambo lesifuba (sternum).
3. Uzoxhunywa emshinini we-cardiopulmonary bypass . Lokhu kwenzelwa ukunikeza umzimba wakho igazi nomoya-mpilo owudingayo ngesikhathi inhliziyo yakho imile ngesikhathi sokuhlinzwa.
4. Udokotela ohlinzayo uvula i-atrium yesobunxele yenhliziyo bese ehlola i-valve ye-mitral.
5. Kwenziwa ukuhlikihla okuncane ezindaweni eziseduze kwevalvu ukuze kukhululwe.
6. Ngemuva kwalokho uzosuswa emshinini wenhliziyo namaphaphu bese inhliziyo yakho iqala kabusha.
7. Ekugcineni, kwenziwa i-transesophageal echocardiogram ukuqinisekisa ukuthi i-valve isebenza kahle.
Kwenzekani ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, kuzodingeka uhlale esibhedlela cishe isonto lonke. Osukwini lokuqala noma ezimbili, uzogcinwa egunjini lokunakekelwa okujulile (ICU) futhi uqashwe ngokucophelela.
Ngaphambi kokuba uphume esibhedlela, udokotela wakho uzokweluleka ngalokhu okulandelayo:
- Ukuvuselelwa Kwenhliziyo: Lokhu kusiza kakhulu ekubuyiseleni amandla nokujwayela impilo evamile ngemva kokuhlinzwa.
- Indlela yokunakekela inxeba: Lokhu kubaluleke kakhulu ukuvimbela ukutheleleka nokuphulukisa inxeba ngokushesha.
- Mayelana nokuthi ungaqala nini ukushayela nokusebenza futhi .
Imiphumela, izingozi, kanye nesikhathi sokubonana nodokotela
Ukuhlinzwa kwe-open mitral commissurotomy kunezinga eliphezulu lempumelelo. Kuthuthukisa ukugeleza kwegazi futhi kunciphisa kakhulu izimpawu. Kodwa-ke, akusona ikhambi elihlala njalo. Abantu abaningi abenza le nqubo bangase badinge ukuhlinzwa kokushintsha i-valve ngesikhathi esithile esikhathini esizayo.
Njengakuyo yonke imishanguzo, kunezingozi ezithile.
- Ukuvuselelwa kwe-Mitral
- Ukopha okukhulu
- Izifo
- Ukuphazamiseka kwenhliziyo (i-Arrhythmia)
- Isifo sohlangothi
Kodwa-ke, lezi zingozi ziyancishiswa esibhedlela esikhulu esinodokotela abangochwepheshe. Uma unezimo zezokwelapha ezifana nesifo sikashukela, isifo sezinso, noma ukukhuluphala ngokweqile, ingozi ingase ibe phezulu kancane. Khuluma nodokotela wakho ngalokhu.
Uma uhlangabezana nalezi zimpawu, tshela udokotela wakho ngokushesha:
- Imfiva
- Ubomvu, ukuvuvukala, noma ubomvu eduze kwesilonda
- Ubuhlungu besifuba obuphindaphindayo noma ingcindezi
Uma uzwa izimpawu zokuhlaselwa yinhliziyo ngokuzumayo (ubuhlungu obukhulu esifubeni, ubunzima bokuphefumula) noma izimpawu zokuhlaselwa yisifo sohlangothi (inkulumo engacacile, ukugoba kolunye uhlangothi lobuso), shayela u-1990 ngokushesha bese uya e-Emergency Treatment Unit (ETU) yesibhedlela.
Umlayezo Wokuya Nawe Ekhaya
- 'I-commissarotomy' ukuhlinzwa kwenhliziyo okuvulekile okwenziwa ukubuyisela ukusebenza okufanele ku-valve ye-mitral evinjiwe.
- Imbangela eyinhloko yalesi simo ukulimala kwama-valve enhliziyo ngenxa yomkhuhlane wamathambo ngesikhathi sobuntwana.
- Nakuba lokhu kuyindlela yokuhlinzwa ephumelela kakhulu, ngokuvamile kuyisisombululo sesikhashana futhi ivalvu kungadingeka ishintshwe esikhathini esizayo.
- Izinhlelo zokuvuselela inhliziyo zibaluleke kakhulu ukuze umuntu alulame ngokuphelele ngemva kokuhlinzwa.
- Kubaluleke kakhulu ukubuza udokotela wakho noma yimiphi imibuzo ongase ube nayo ngesimo sakho, ukuhlinzwa, kanye nezingozi zako.
💬 Comments (0)
No comments yet. Be the first to share your thoughts here.
Add Your Comment