Uke uzizwe uphelelwa umoya, noma uqaphela umuzwa wokuqina esifubeni sakho uma uzikhandla noma ukhuphuka izitebhisi? Udokotela wakho kungenzeka ukuthi uke wathi unenkinga nge-valve yenhliziyo yakho. Uma i-valve yenhliziyo iba lukhuni futhi yehluleka ukuvula kahle, sibiza lesi simo ngokuthi 'i-stenosis.' Namuhla, sizokuhambisa ngenqubo ekhethekile esetshenziswa ukwelapha lesi simo. Ngenxa yokuthi lesi yisihloko esibaluleke kakhulu empilweni yakho, ake sihlukanise konke kube ngamagama alula.
Kalula nje, kuyini i-Commissurotomy?
Ake siqale ngezinto eziyisisekelo. Inhliziyo yakho inamakamelo amane amakhulu. Cabanga ngawo njengamakamelo amane endlini. Ukuze igazi ligeleze kahle lisuka kwelinye igumbi liye kwelinye, iminyango ephakathi kwawo kumele ivuleke futhi ivaleke kahle. Sibiza lezi zicabha ngokuthi ama-valve enhliziyo .
I-'commissurotomy' ukuhlinzwa okuhlobene ngqo ne -Mitral Valve yakho. Le valve isebenza njengomnyango ophakathi kwe-atrium yesobunxele yenhliziyo yakho (igumbi eliphezulu) kanye ne-ventricle yesobunxele (igumbi elingezansi). Lo mnyango unama-flaps amabili.
Ngenxa yezimo ezithile zezokwelapha, ikakhulukazi i-Mitral Valve Stenosis , izimbobo zalo mnyango zingase zingavuleki kahle, njengokukhiya okuvalekile. Uma lokhu kwenzeka, ukugeleza kwegazi kusuka ekamelweni eliphezulu kuya ekamelweni elingezansi kuyavinjelwa. Lokhu kubangela ukuthi igazi libuyele emuva, okubeka ingcindezi enkulu enhliziyweni nasemaphashini akho. Ngokuhamba kwesikhathi, uma kungelashwa, lokhu kungaholela ezinkingeni ezinkulu njengokwehluleka kwenhliziyo .
I-'commissurotomy' inqubo lapho udokotela ohlinzayo enza khona izimbobo ezincane ngokucophelela ukuze ahlukanise imiphetho ehlanganisiwe (ama-commissures) e-valve, evumela ukuthi ivuleke ngokugcwele futhi. Lokhu kubuyisela ukugeleza kwegazi okufanele enhliziyweni yakho.
Ubani ngempela odinga lokhu kuhlinzwa?
Lokhu kuhlinzwa akulona olwawo wonke umuntu. Udokotela wakho angase akuncome lokhu ngezizathu ezimbalwa eziyinhloko:
- Uma ungakaze uthole imiphumela ephumelelayo evela kwezinye izindlela zokwelapha (njengemithi).
- Uma ungeyena umuntu ofanelekela i-'Balloon Valvuloplasty,' inqubo lapho kusetshenziswa khona ibhaluni ukwandisa ivalvu.
- Uma udinga okunye ukuhlinzwa kwenhliziyo, le nqubo ingenziwa ngesikhathi esisodwa.
Kodwa-ke, into ebaluleke kakhulu ukuthi impumelelo yalokhu kuhlinzwa incike embangela eyisisekelo yokuvaleka kwe-mitral valve yakho. Ake sibheke izimbangela ezimbili eziyinhloko.
| Imbangela Yokuvinjelwa Kwe-Mitral Valve | Imininingwane kanye nokufaneleka kwe-'Commissurotomy' |
|---|---|
| Isifo Senhliziyo Esibangelwa Yi-Rheumatic | Ukulimala kwama-valve enhliziyo okubangelwa umkhuhlane wamathambo ngesikhathi sobuntwana. Lo monakalo uvame ukuvela eminyakeni eminingi kamuva, okuholela 'ekuhlanganeni okuhlanganisiwe' (lapho amapheshana e-valve enamathelana khona). Inqubo 'ye-commissurotomy' iphumelela kakhulu kulesi simo. |
| I-Degenerative Mitral Stenosis | Ukuguguleka kwevalvu njengoba ukhula. Kulesi simo, akuzona nje izincwajana ezinamathelana ndawonye, kodwa futhi nomonakalo kwezinye izingxenye zevalvu. Ngakho-ke, i-commissurotomy ngokuvamile ayifaneleki kulezi ziguli, futhi zingadinga ukulungiswa kwevalvu okunye noma ukushintshwa kwe-Mitral Valve . |
Kusho ukuthini ukuthi amapheshana e-valve anamathele ndawonye?
Kulula kakhulu ukukuqonda. Zicabange umi phambi kwesibuko futhi umomotheka izindebe zakho zivaliwe. Bheka amakhona amabili lapho izindebe zakho ezingaphezulu nezingezansi zihlangana khona; lokho kufana nendlela ama-flaps amabili (amapheshana) e-valve yakho ye-mitral ahlangana ngayo 'kuma-commissures.' Manje, cabanga ngomuntu ecindezela amakhona ezindebe zakho ngeminwe yakhe. Ungakwazi yini ukuvula umlomo wakho kahle? Awukwazi, akunjalo? Yilokho okwenzekayo lapho i-valve ye-mitral ivinjiwe. Inqubo ye-'commissurotomy' ihlose ukukhulula lawo makhona ahlanganisiwe ukuze i-valve isebenze kahle futhi.
Ulungiselela kanjani ukuhlinzwa?
Ngenxa yokuthi lokhu kuwukuhlinzwa okukhulu, amalungiselelo aqala emasontweni ambalwa kusengaphambili. Ithimba lakho lezokwelapha (udokotela wenhliziyo kanye nodokotela ohlinzayo wenhliziyo) lizokwenza ukuhlolwa okuphelele, okuhlanganisa:
- Ukuhlolwa okuphelele ngokomzimba
- Ukuhlolwa kwegazi
- Ingxoxo eningiliziwe mayelana nezimpawu zakho kanye nomlando wezokwelapha
Ngaphezu kwalokho, ukuhlola isimo se-valve yakho ye-mitral nokubona ukuthi kukhona yini ukuvinjelwa kweminye imithambo yenhliziyo, kwenziwa izivivinyo ezilandelayo:
- I-Echocardiography: Ukuhlolwa kwenhliziyo yakho nge-ultrasound.
- Ukuskena kwe-CT
- I-Angiography ye-Coronary
Uma unemibuzo noma uzizwa ukhathazekile ngokuhlinzwa, sicela uxoxe ngayo nodokotela wakho ukuze ukhululeke. Uma ubhema, kuyimpoqo ukuyeka ngokuphelele ngaphambi kokuhlinzwa, njengoba lokhu kunciphisa kakhulu izingozi zokuhlinzwa.
Kwenzekani ngesikhathi sokuhlinzwa?
Lokhu ukuhlinzwa kwenhliziyo evulekile. Nansi inqubo yesinyathelo ngesinyathelo egumbini lokuhlinza:
1. Uzonikezwa i-anesthesia ukuze ulale ubuthongo obukhulu.
2. Kwenziwa i-incision maphakathi nethambo lesifuba sakho (sternum).
3. Uzoxhunywa emshinini we-cardiopulmonary bypass. Ngenkathi inhliziyo yakho ima okwesikhashana ngesikhathi sokuhlinzwa, lo mshini uzophatha ukugeleza kwegazi lakho kanye nokuhlinzekwa komoya-mpilo.
4. Udokotela ohlinzayo uzovula i-atrium yesobunxele yenhliziyo yakho ukuze ahlole i-valve ye-mitral.
5. Kwenziwa ukuhlikihla okuncane ukuze kukhishwe izingxenye ezihlanganisiwe (ama-commissures) evalvu.
6. Ngemva kwalokho, unqanyuliwe emshinini we-bypass, bese inhliziyo yakho iqala kabusha.
7. Ekugcineni, kwenziwa i-transesophageal echocardiogram ukuqinisekisa ukuthi ivalvu isebenza kahle.
Kwenzekani ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, kuzodingeka uhlale esibhedlela cishe isonto lonke. Uzoqashwa eduze eYunithi Yokunakekelwa Okujulile (ICU) usuku lokuqala noma ezimbili.
Ngaphambi kokuba ukhishwe esibhedlela, udokotela wakho uzokunikeza imiyalelo mayelana nalokhu:
- Ukuvuselelwa Kwenhliziyo: Lokhu kuzokusiza kakhulu ekutholeni amandla futhi ubuyele esimisweni sakho esivamile sansuku zonke.
- Ukunakekelwa kwenxeba: Indlela yokunakekela ukusikwa kwakho ukuze uvimbele ukutheleleka futhi ukhuthaze ukuphulukiswa.
- Uma ungaqhubeka nemisebenzi, njengokushayela nokubuyela emsebenzini.
Imiphumela, Izingozi, kanye Nesikhathi Sokubona Udokotela
Izinga lempumelelo le-open mitral commissurotomy liphezulu kakhulu. Lithuthukisa kakhulu ukugeleza kwegazi futhi linciphisa izimpawu eziningi. Kodwa-ke, lokhu akulona ikhambi lokugcina elihlala njalo. Iziguli eziningi ezenza le nqubo zingadinga ukuhlinzwa kokushintsha ivalvu esikhathini esithile esizayo.
Njenganoma yikuphi ukuhlinzwa, kunezingozi ezithile, okuhlanganisa:
- Ukubuyela kwe-Mitral (i-valve evuzayo)
- Ukopha ngokweqile
- Ukutheleleka
- I-Arrhythmia (ukushaya kwenhliziyo okungajwayelekile)
- Isifo sohlangothi
Kodwa-ke, lezi zingozi ziyancishiswa uma zenziwa odokotela abanolwazi esibhedlela esikhulu. Uma unezimo ezifana nesifo sikashukela, isifo sezinso, noma ukukhuluphala ngokweqile, iphrofayili yakho yengozi ingase ibe phezulu kancane; sicela uxoxe ngalokhu nodokotela wakho eNirogi Lanka.
Funa usizo lwezokwelapha ngokushesha uma uhlangabezana nalezi zimpawu:
- Imfiva
- Ukubomvu, ukuvuvukala, noma ukuphuma kobomvu endaweni yokusikwa
- Ubuhlungu besifuba obuphindaphindayo noma ingcindezi
Uma uzwa izimpawu zokuhlaselwa yinhliziyo (ubuhlungu obukhulu esifubeni, ubunzima bokuphefumula) noma izimpawu zokuhlaselwa yisifo sohlangothi (inkulumo engacacile, ukugoba kobuso), shayela u-911 ngokushesha noma uqhubekele emnyangweni wezimo eziphuthumayo oseduze nawe.
Umlayezo Wokuya Nawe Ekhaya
- I-'commissurotomy' inqubo yenhliziyo evulekile eyenzelwe ukulungisa i-valve ye-mitral encishisiwe, evumela ukuthi isebenze kahle futhi.
- Lesi simo sivame ukubangelwa ukulimala kwama-valve enhliziyo ngenxa yomkhuhlane wamathambo ebuntwaneni.
- Nakuba lokhu kuyinqubo ephumelela kakhulu, sicela ukhumbule ukuthi ngokuvamile kuyisixazululo sesikhashana, futhi ungadinga ukushintshwa kwevalvu esikhathini esizayo.
- Ukuzibandakanya ezinhlelweni zokuvuselela inhliziyo kubalulekile ukuze ululame ngemva kokuhlinzwa.
- Kubaluleke kakhulu ukukhuluma nodokotela wakho waseNirogi Lanka ukuze ucacise noma yimiphi imibuzo onayo mayelana nesimo sakho, inqubo, noma izingozi ezihambisana nayo.
Ukuhlinzwa kwenhliziyo, i-mitral valve, i-mitral valve stenosis, i-commissurotomy, isifo senhliziyo, ukuhlinzwa, isifo senhliziyo esinama-rheumatic, ukuhlinzwa kwenhliziyo okuvulekile
