I-aortic stenosis: kuyini, izimpawu nokwelashwa

-Delile

• Izimpawu eziyinhloko
• Yelashwa kanjani
• 1. Kubantu abangenazo izimpawu
• 2. Kubantu abanezimpawu
• Izinhlobo zokushintsha i-valve
• Izingozi nezinkinga ezingenzeka lapho uhlinzwa
• Kwenzekani uma ungaphathi i-aortic stenosis
• Izimbangela eziyinhloko

I-aortic stenosis yisifo senhliziyo esibonakala ngokuncipha kwe-aortic valve, okwenza kube nzima ukumpompa igazi emzimbeni, okuholele ekuphefumuleni, kubuhlungu esifubeni nokushaywa.

Lesi sifo sibangelwa ukuguga futhi isimo saso esibi kakhulu singaholela ekufeni okungazelelwe, kodwa-ke, uma sitholakale kusenesikhathi, singelashwa ngokusetshenziswa kwemithi futhi, ezimweni ezinzima, ngokuhlinzwa ukufaka i-aortic valve. Thola ukuthi kunjani ukululama ngemuva kokuhlinzwa inhliziyo.

I-aortic stenosis yisifo senhliziyo lapho i-aortic valve incane kunokujwayelekile, okwenza kube nzima ukumpompa igazi lisuke enhliziyweni liye emzimbeni. Lesi sifo sibangelwa ukuguga futhi isimo saso esibi kakhulu singaholela ekufeni okungazelelwe, kepha uma kutholakala ngesikhathi kungalashwa ngokuhlinzwa ukufaka i-aortic valve.

Izimpawu eziyinhloko

Izimpawu ze-aortic stenosis zivela ikakhulu ngesimo esibi sesifo futhi imvamisa:

• Ukuzwa ukuphefumula okuncane lapho wenza izivivinyo zomzimba;
• Ukuqina esifubeni okuya ngokuya kukhula ngokuhamba kweminyaka;
• Ubuhlungu besifuba obuba nzima lapho kwenziwa imizamo;
• Ukuquleka, ubuthakathaka noma isiyezi, ikakhulukazi lapho wenza izivivinyo zomzimba;
• Inhliziyo ishaya ngamandla.

Ukuxilongwa kwe-aortic stenosis kwenziwa ngokuhlolwa komtholampilo nodokotela wenhliziyo kanye nokuhlolwa okuhambisanayo okunjenge-X-ray yesifuba, i-echocardiogram noma i-catheterization yenhliziyo. Lokhu kuhlolwa, ngaphezu kokukhomba ushintsho ekusebenzeni kwenhliziyo, kukhombisa imbangela nobukhulu be-aortic stenosis.

Ukwelashwa kwe-aortic stenosis kwenziwa ngokuhlinzwa, lapho i-valve entulayo ifakwa esikhundleni se-valve entsha, engaba yokufakelwa noma eyemvelo, lapho yenziwe ngezingulube noma izicubu zezinkomo. Ukushintsha i-valve kuzodala ukuthi igazi lifuthwe kahle lisuke enhliziyweni liye emzimbeni wonke, futhi izimpawu zokukhathala nezinhlungu ziyonyamalala. Ngaphandle kokuhlinzwa, iziguli ezine-aortic stenosis enamandla noma ezinezimpawu zisinda ngokwesilinganiso seminyaka emi-2.

Yelashwa kanjani

Ukwelashwa kwe-aortic stenosis kuncike esigabeni sesifo. Lapho kungekho zimpawu, nesifo sitholwe ngezivivinyo, asikho isidingo sokwelashwa okuthile. Kodwa-ke, ngemuva kokuvela kwezimpawu, okuwukuphela kwendlela yokwelashwa ukuhlinzwa ukuze kuthathwe indawo ye-aortic valve, lapho i-valve enesici ithathelwa indawo yi-valve entsha, ejwayele ukwabiwa kwegazi emzimbeni wonke. Lokhu kuhlinzwa kuboniswa kakhulu ezigulini ezine-aortic stenosis enamandla, ngoba izinga lokufa liphezulu. Ngezansi kukhona izinketho zokwelashwa:

1. Kubantu abangenazo izimpawu

Ukwelashwa kwabantu abangazibonisi izimpawu akwenziwa ngaso sonke isikhathi ngokuhlinzwa, futhi kungenziwa ngokusetshenziswa kwemithi kanye nezinguquko endleleni yokuphila, njengokugwema ezemidlalo nokuncintisana kwemisebenzi yobungcweti edinga umzamo omkhulu womzimba. Izidakamizwa ezisetshenziswe kulesi sigaba zingaba:

• Ukugwema i-endocarditis esithathelwanayo;
• Ukwelapha izifo ezihambisana ne-aortic stenosis.

Iziguli ezingenazo izimpawu ezingakhonjiswa ngokuhlinzwa uma zine-valve encishiswe kakhulu, ukunciphisa okuqhubekayo kokusebenza kwenhliziyo noma izinguquko ezengeziwe ekwakhiweni kwenhliziyo.

2. Kubantu abanezimpawu

Ekuqaleni, izidlo ezinjenge-Furosemide zingathathwa ukulawula izimpawu, kepha okuwukuphela kokwelapha okusebenzayo kubantu abanezimpawu ukuhlinzwa, njengoba imithi ingasenele ukulawula lesi sifo. Kunezinqubo ezimbili zokwelashwa kwe-aortic stenosis, ngokuya ngesimo sempilo sesiguli:

• Ukushintshwa kwe-valve yokuhlinzwa: inqubo ejwayelekile yokuhlinzwa kwesifuba esivulekile ukuze udokotela ohlinzayo afinyelele inhliziyo. I-valve engaphelele iyasuswa bese kufakwa i-valve entsha.
• Ukushintsha i-valve nge-catheter: eyaziwa ngokuthi i-TAVI noma i-TAVR, kule nqubo i-valve enesici ayisuswa futhi kufakwa i-valve entsha phezu kwale endala, kusuka kupayipi elibekwe emthanjeni wobufazi, ethangeni, noma okusikeni okwenziwe kwasondela enhliziyweni.

Ukufaka i-valve nge-catheter kuvame ukwenziwa ezigulini ezinesifo esikhulu namandla amancane okuhlula ukuhlinzwa kwesifuba esivulekile.

Izinhlobo zokushintsha i-valve

Kunezinhlobo ezimbili ze-valve zokufaka esikhundleni sokuhlinzwa kwesifuba okuvulekile:

• Ama-valve womshini: zenziwe ngezinto zokwenziwa futhi zihlala isikhathi eside. Ngokuvamile zisetshenziswa ezigulini ezingaphansi kweminyaka engama-60 ubudala, futhi ngemuva kokufakwa, lo muntu kuzodingeka ukuthi aphuze imishanguzo yokulwa nesifo nsuku zonke futhi ahlole igazi ngezikhathi ezithile impilo yakhe yonke.
• Amaphayiphu we-Biological: enziwe ngesicubu sesilwane noma somuntu, ahlala eminyakeni eyi-10 kuye kwengama-20, futhi kuvame ukunconywa iziguli ezingaphezu kweminyaka engama-65 ubudala. Ngokuvamile, asikho isidingo sokuthatha ama-anticoagulants, ngaphandle uma umuntu enezinye izinkinga ezidinga lolu hlobo lomuthi.

Ukukhethwa kwe-valve kwenziwa phakathi kukadokotela nesiguli, futhi kuya ngeminyaka, indlela yokuphila kanye nesimo somtholampilo ngamunye.

Izingozi nezinkinga ezingenzeka lapho uhlinzwa

Izingozi ezibangelwa ukuhlinzekwa kwe-aortic valve ukuhlinzwa yilezi:

• Ukopha;
• Ukutheleleka;
• Ukwakheka kwe-thrombi engavimba imithambo yegazi ebangela, isibonelo, isifo sohlangothi;
• Isifinyezo;
• Amaphutha ku-valve entsha ebekiwe;
• Isidingo sokuhlinzwa okusha;
• Ukufa.

Izingozi zincike ezintweni ezifana neminyaka, ukuqina kokuhluleka kwenhliziyo nokuba khona kwezinye izifo, njenge-atherosclerosis. Ngaphezu kwalokho, iqiniso lokuthi usesimweni sesibhedlela libuye libe nezingozi zezinkinga, ezifana ne-pneumonia kanye ne-nosocomial infection. Qonda ukuthi yini ukutheleleka esibhedlela.

Inqubo yokufaka esikhundleni se-catheter, ngokuvamile, inobungozi obuncane kunokuhlinzwa okujwayelekile, kepha kunethuba elikhulu lokutholwa kwe-cerebral embolism, okungenye yezimbangela zesifo sohlangothi.

Kwenzekani uma ungaphathi i-aortic stenosis

I-aortic stenosis engalashwa ingashintsha ngokuqina kokusebenza kwenhliziyo nezimpawu zokukhathala okukhulu, ubuhlungu, isiyezi, ukuquleka nokufa okungazelelwe. Kusukela ekubonakaleni kwezimpawu zokuqala, isikhathi sokuphila singaba yiminyaka emi-2, kwezinye izimo, ngakho-ke kubalulekile ukuxhumana nodokotela wenhliziyo ukuqinisekisa isidingo sokuhlinzwa nokusebenza okulandelayo. Bona ukuthi ukutakula kubukeka kanjani ngemuva kokufaka esikhundleni se-aortic valve.

Izimbangela eziyinhloko

Imbangela enkulu ye-aortic stenosis iminyaka: eminyakeni edlule, i-aortic valve iba nezinguquko ekwakhiweni kwayo, okulandelwa ukuqongelelwa kwe-calcium nokusebenza okungafanele. Ngokuvamile, ukuqala kwezimpawu kuqala ngemuva kweminyaka yobudala engama-65, kepha umuntu kungenzeka angazizwa lutho futhi angafa nokufa engazi ukuthi une-aortic stenosis.

Kubantu abasha, imbangela evame kakhulu isifo se-rheumatic, lapho kubonakala khona i-valve ye-aortic, futhi izimpawu ziqala ukuvela eminyakeni engama-50. Ezinye izimbangela eziyivelakancane ukukhubazeka kokuzalwa njenge-bicuspid aortic valve, systemic lupus erythematosus, cholesterol ephezulu nesifo samathambo. Qonda ukuthi i-rheumatism iyini.