Umfutho wegazi ophezulu wamaphaphu

Umfutho wegazi ophezulu we-pulmonary umfutho wegazi ophakeme emithanjeni yamaphaphu. Kwenza uhlangothi lwangakwesokudla lwenhliziyo lusebenze kanzima kunokujwayelekile.

Uhlangothi lwangakwesokudla lwenhliziyo ludonsa igazi emaphashini, lapho ilanda khona umoya-mpilo. Igazi libuyela ohlangothini lwesobunxele lwenhliziyo, lapho lufakwa kuwo wonke umzimba.

Lapho imithambo yegazi emincane (imithambo yegazi) yamaphaphu incipha, ayikwazi ukuthwala igazi elingaka. Uma lokhu kwenzeka, ingcindezi iyanda. Lokhu kubizwa ngokuthi umfutho wegazi ophakeme wamaphaphu.

Inhliziyo idinga ukusebenza kanzima ukuphoqa igazi ngemithambo ukulwa nale ngcindezi. Ngokuhamba kwesikhathi, lokhu kubangela ukuthi uhlangothi lwangakwesokudla lube lukhulu. Lesi simo sibizwa ukuhluleka kwenhliziyo emaceleni, noma i-cor pulmonale.

Umfutho wegazi ophezulu wamapulmonary ungabangelwa:

• Izifo ezizimele ezilimaza amaphaphu, njenge-scleroderma ne-rheumatoid arthritis
• Ukukhubazeka kokuzalwa kwenhliziyo
• Amahlule egazi emaphashini (embolism pulmonary)
• Ukwehluleka kwenhliziyo
• Isifo se-valve senhliziyo
• Ukutheleleka nge-HIV
• Izinga eliphansi le-oxygen egazini isikhathi eside (okungapheli)
• Isifo samaphaphu, njenge-COPD noma i-pulmonary fibrosis noma esinye isimo esibi esingalapheki samaphaphu
• Imithi (isibonelo, izidakamizwa ezithile zokudla)
• I-apnea yokulala evimbela

Ezimweni ezingavamile, imbangela yomfutho wegazi ophezulu wamaphaphu ayaziwa. Kulokhu, lesi simo sibizwa ngokuthi yi-idiopathic pulmonary arterial hypertension (IPAH). Idiopathic kusho ukuthi imbangela yesifo ayaziwa. I-IPAH ithinta abesifazane abaningi kunabesilisa.

Uma umfutho wegazi ophakeme wamaphaphu ubangelwa umuthi owaziwayo noma isimo sezokwelapha, kubizwa ngokuthi yi-secondary pulmonary hypertension.

Ukuphefumula noma ukuba nekhanda elikhanyayo ngesikhathi somsebenzi ngokuvamile kuyisibonakaliso sokuqala. Ukushaya kwenhliziyo okusheshayo (ukushaya kwenhliziyo) kungaba khona. Ngokuhamba kwesikhathi, izimpawu zenzeka ngomsebenzi olula noma ngisho nalapho uphumule.

Ezinye izimpawu zifaka:

• Ukuvuvukala kweqakala nemilenze
• Umbala we-Bluish wezindebe noma isikhumba (i-cyanosis)
• Ubuhlungu besifuba noma ingcindezi, imvamisa ngaphambili kwesifuba
• Isizungu noma ukuquleka
• Ukukhathala
• Usayizi wesisu owandisiwe
• Ubuthakathaka

Abantu abanesifo somfutho wegazi ophezulu wamaphaphu bavame ukuba nezimpawu eza futhi zidlule. Babika izinsuku ezinhle nezimbi.

Umhlinzeki wakho wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba abuze ngezimpawu zakho. Ukuhlolwa kungathola:

• Inhliziyo engajwayelekile izwakala
• Ukuzwa ukushaya ngamandla phezu kwethambo lesifuba
• Inhliziyo ibubula ngakwesokunene senhliziyo
• Imithambo emikhulu kunaleyo ejwayelekile entanyeni
• Ukuvuvukala kwemilenze
• Ukuvuvukala kwesibindi nobende
• Ukuphefumula okujwayelekile kuzwakala uma umfutho wegazi ophezulu we-pulmonary uyi-idiopathic noma ngenxa yesifo senhliziyo esizalwe naso
• Ukuphefumula okungavamile kuzwakala uma umfutho wegazi ophakeme wamaphaphu uvela kwezinye izifo zamaphaphu
  

Esigabeni sokuqala sesifo, ukuhlolwa kungahle kube okujwayelekile noma kucishe kujwayelekile. Lesi simo singathatha izinyanga ezimbalwa ukuxilonga. Isifuba somoya nezinye izifo kungadala izimpawu ezifanayo futhi kufanele kukhishwe inyumbazane.

Izivivinyo ezinga-odwa zifaka:

• Ukuhlolwa kwegazi
• I-catheterization yenhliziyo
• I-x-ray yesifuba
• I-CT scan yesifuba
• I-Echocardiogram
• ECG
• Ukuhlolwa kwemisebenzi yamaphaphu
• Ukuskena kwamaphaphu enyukliya
• I-arteriogram yamaphaphu
• Ukuhlolwa kokuhamba kwemizuzu engu-6
• Isifundo sokulala
• Ukuhlolwa kokuhlola izinkinga ezizimele

Alikho ikhambi lomfutho wegazi ophakeme wamaphaphu. Inhloso yokwelashwa ukulawula izimpawu nokuvimbela ukulimala kwamaphaphu okwengeziwe. Kubalulekile ukwelapha ukuphazamiseka kwezokwelapha okubangela umfutho wegazi ophakeme wamaphaphu, njengokuvimbela ukuphefumula kokulala, izimo zamaphaphu, nezinkinga ze-valve yenhliziyo.

Izinketho eziningi zokwelashwa komfutho wegazi ophakeme wamaphaphu ziyatholakala. Uma unikezwa imithi enqunyiwe, ingathathwa ngomlomo (ngomlomo), itholwe ngomthambo (nge-intravenous, noma i-IV), noma iphefumulelwe (ihogelwe).

Umhlinzeki wakho uzonquma ukuthi imuphi umuthi olungele wena. Uzobhekwa ngeso elibukhali ngesikhathi sokwelashwa ukuze ubuke imiphumela engemihle futhi ubone ukuthi uwuphendula kahle kangakanani umuthi. UNGAYEKISI ukuthatha imishanguzo yakho ngaphandle kokukhuluma nomhlinzeki wakho.

Ezinye izindlela zokwelashwa zingafaka:

• Abanciphisa igazi ukunciphisa ubungozi bamahlule egazi, ikakhulukazi uma une-IPAH
• Ukwelashwa kwe-oxygen ekhaya
• Amaphaphu, noma kwezinye izimo, ukufakelwa inhliziyo nenhliziyo, uma imithi ingasebenzi

Amanye amathiphu abalulekile ongawalandela:

• Gwema ukukhulelwa
• Gwema imisebenzi esindayo yomzimba nokuphakamisa
• Gwema ukuya ezindaweni eziphakeme kakhulu
• Thola umuthi wokugomela umkhuhlane waminyaka yonke, kanye neminye imigomo efana nomuthi wokugomela i-pneumonia
• Yeka ukubhema

Wenza kahle kangakanani kuya ngokuthi yini ebangele isimo. Imithi ye-IPAH ingasiza ukunciphisa isifo.

Njengoba ukugula kuya kuba kubi kakhulu, kuzodingeka wenze izinguquko ekhaya lakho ukukusiza ukuzulazula endlini.

Shayela umhlinzeki wakho uma:

• Uqala ukuthuthukisa ukuphefumula okuncane lapho usebenza
• Ukuphefumula kubi kakhulu
• Uba nobuhlungu besifuba
• Uba nezinye izimpawu

Umfutho wegazi ophakeme we-pulmonary; Umfutho wegazi ophakeme wamaphaphu oyinhloko; Umfutho wegazi ophakeme wamaphaphu oyinhloko; Idiopathic pulmonary arterial hypertension; Umfutho wegazi ophezulu wamaphaphu; I-PPH; Umfutho wegazi ophakeme wamaphaphu; Cor pulmonale - umfutho wegazi ophakeme wamaphaphu

• Uhlelo lokuphefumula
• Umfutho wegazi ophezulu wamaphaphu
• Ukufakelwa kwenhliziyo namaphaphu - uchungechunge

UChin K, uChannick RN. Umfutho wegazi ophezulu wamaphaphu. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, abakwa-eds. Incwadi kaMurray neNadel Yemithi Yokuphefumula. Umhlaka 6. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 58.

UMclaughlin VV, uHumbert M. Pulmonary hypertension. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 85.