Aortic stenosis: yintoni, iimpawu kunye nonyango

Umxholo

• Iimpawu eziphambili
• Unyango lwenziwa njani
• 1. Kubantu abangenazo iimpawu
• 2. Kubantu abaneempawu
• Iindidi zevaluva zokutshintsha
• Umngcipheko kunye neengxaki ezinokuthi zenzeke kotyando
• Kwenzeka ntoni ukuba awuyinyanga i-aortic stenosis
• Izizathu eziphambili

I-aortic stenosis sisifo sentliziyo esibonakaliswa kukucuthwa kwesivalo somthambo, esenza ukuba kube nzima ukumpompa igazi emzimbeni, oku kubangela ukuphefumla okufutshane, iintlungu zesifuba kunye nokubetha.

Esi sifo ikakhulu sibangelwa kukuguga kwaye esona sifo sinzima singakhokelela ekufeni ngequbuliso, nangona kunjalo, xa sifunyenwe kwangoko, sinokuphathwa ngokusetyenziswa kwamayeza kwaye, kwiimeko ezinzima, ngoqhaqho endaweni yevalal aortic. Fumanisa ukuba kunjani kwakhona emva kotyando lwentliziyo.

I-aortic stenosis sisifo sentliziyo apho ivelufa ye-aortic imxinwa kunesiqhelo, isenza kube nzima ukumpompa igazi lisuka entliziyweni liye emzimbeni. Esi sifo ikakhulu sibangelwa kukwaluphala kwaye esona sifo siqatha singakhokelela ekufeni ngequbuliso, kodwa xa sifunyenwe kwangexesha sinokunyangwa ngoqhaqho ukubuyisela i-aortic valve.

Iimpawu eziphambili

Iimpawu ze-aortic stenosis zivela ikakhulu kwisimo esibi sesi sifo kwaye zihlala zi:

• Ukuziva uphefumla kancinci xa usenza imithambo yomzimba;
• Ukuqina esifubeni esiba mandundu ngaphezulu kweminyaka;
• Intlungu yesifuba esiba mandundu xa usenza iinzame;
• Ukudinwa, ubuthathaka okanye isiyezi, ngakumbi xa usenza umthambo;
• Ukubetha kwentliziyo.

Ukuchongwa kwe-aortic stenosis kwenziwa ngovavanyo lweklinikhi kunye nentliziyo kunye novavanyo olongezelelweyo njengesifuba se-X-ray, i-echocardiogram okanye i-catheterization yentliziyo. Olu vavanyo, ukongeza ekuchongeni utshintsho ekusebenzeni kwentliziyo, lukwabonisa unobangela kunye nobukrakra be-aortic stenosis.

Unyango lwe-aortic stenosis lwenziwa ngotyando, apho ivalve eshiyekileyo ithathelwa indawo yivelve entsha, enokuba yeyokuzenzela okanye yendalo, xa yenziwe ngeehagu okanye izicwili zomzimba. Ukutshintsha ivalve kuyakwenza ukuba igazi lipompwe ngokufanelekileyo lisuka entliziyweni liye kuwo wonke umzimba, kwaye iimpawu zokudinwa kunye neentlungu ziya kuthi shwaka. Ngaphandle kotyando, abaguli abane-aortic stenosis ebukhali okanye abaneempawu ezisinda kwi-avareji yeminyaka emi-2.

Unyango lwenziwa njani

Unyango lwe-aortic stenosis luxhomekeke kwinqanaba lesi sifo. Xa kungekho zimpawu, kwaye isifo safunyanwa kwiimviwo, akukho mfuneko yonyango oluthile. Nangona kunjalo, emva kokubonakala kweempawu, ekuphela kwendlela yonyango lutyando lokutshintsha i-aortic valve, apho ivalve enesiphene ithathelwa indawo yivalve entsha, ukubuyisela ukuhanjiswa kwegazi emzimbeni wonke. Olu tyando luboniswa ikakhulu kwizigulana ezine-aortic stenosis, kuba izinga lokufa liphezulu. Apha ngezantsi kukho iindlela zonyango:

1. Kubantu abangenazo iimpawu

Unyango lwabantu abangabonisi zimpawu alusoloko lwenziwa ngotyando, kwaye lunokwenziwa ngokusetyenziswa kwamayeza kunye notshintsho kwindlela yokuphila, njengokuthintela ukhuphiswano kwezemidlalo kunye nemisebenzi yobungcali efuna umgudu womzimba onamandla. Amachiza asetyenziswe kweli nqanaba anokuba:

• Ukuthintela i-endocarditis esosulelayo;
• Ukunyanga izifo ezinxulumene ne-aortic stenosis.

Izigulana ezingenazo iimpawu ezinokuthi ziboniswe kuqhaqho ukuba zinevalve encitshiswe kakhulu, ukunciphisa okuqhubekayo kwintsebenzo yentliziyo okanye utshintsho olwandileyo kulwakhiwo lwentliziyo.

2. Kubantu abaneempawu

Ekuqaleni, i-diuretics efana neFurosemide inokuthathwa ukulawula iimpawu, kodwa kuphela unyango olusebenzayo kubantu abaneempawu zotyando, njengoko amachiza engonelanga ukulawula isifo. Zimbini iinkqubo zonyango lwe-aortic stenosis, kuxhomekeka kwimeko yempilo yomguli:

• Ukutshintshwa kwevalve yotyando: Inkqubo evulekileyo yokuhlinzwa kwesifuba ukuze ugqirha akwazi ukufikelela entliziyweni. Ivalve enesiphene iyasuswa kuze kubekwe ivalve entsha.
• Ukutshintsha ivalve nge catheter: eyaziwa ngokuba yi-TAVI okanye i-TAVR, kule nkqubo ivalve enesiphene ayisuswanga kwaye kufakelwa ivalve entsha ngaphezulu kwale indala, isuka kwi-catheter ebekwe kumthambo wobufazi, ethangeni, okanye kwinxeba elisikiweyo elisondele entliziyweni.

Ukufakwa endaweni yevalve ngecatheter kuhlala kwenziwa kwizigulana ezinobukrakra besifo kunye nokukwazi ukoyisa utyando lwesifuba esivulekileyo.

Iindidi zevaluva zokutshintsha

Zimbini iintlobo zevalve zokutshintshwa kutyando lwesifuba oluvulekileyo:

• Ivaluva zoomatshini: zenziwe ngezinto zokwenziwa kwaye zihlala ixesha elide. Zihlala zisetyenziswa kwizigulana ezingaphantsi kweminyaka engama-60, kwaye emva kokumiliselwa, umntu kuyakufuneka athathe amayeza e-anticoagulant yonke imihla kwaye enze uvavanyo lwegazi ngamaxesha athile kubo bonke ubomi babo.
• Izivalo zebhayoloji: ezenziwe kwizilwanyana okanye izicubu zomntu, zihlala zivela kwi-10 ukuya kwi-20 iminyaka, kwaye zihlala zicetyiswa kwizigulana ezingaphezulu kweminyaka eyi-65. Ngokubanzi, akukho mfuneko yokuthatha ii-anticoagulants, ngaphandle kokuba umntu unezinye iingxaki ezifuna olu hlobo lonyango.

Ukhetho lwevalvu lwenziwa phakathi kogqirha nesigulana, kwaye kuxhomekeke kubudala, indlela yokuphila kunye nemeko yeklinikhi nganye nganye.

Umngcipheko kunye neengxaki ezinokuthi zenzeke kotyando

Imingcipheko ebangelwa luqhaqho lwevalvu ye-aortic yile:

• Ukopha;
• Usulelo;
• Ukuqulunqwa kwe-thrombi enokuvala imithambo yegazi ebangela, umzekelo, ukubetha;
• Isuntswana lomfanekiso
• Iziphene kwivelufa entsha ebekiweyo;
• Ufuna umsebenzi omtsha;
• Ukufa.

Imingcipheko ixhomekeke kwizinto ezinje ngeminyaka, ubungqongqo bokungaphumeleli kwentliziyo kunye nobukho bezinye izifo, ezinje nge-atherosclerosis. Ukongeza, into yokuba sesibhedlele ikwabeka emngciphekweni weengxaki, ezinje nge-pneumonia kunye nosulelo lwe-nosocomial. Qonda ukuba yintoni usulelo esibhedlele.

Inkqubo yokubuyisela i-catheter, ngokubanzi, ithatha umngcipheko omncinci kunokwenziwa kotyando oluqhelekileyo, kodwa kukho ithuba elikhulu lokuqunjelwa kobuchopho, sesinye sezizathu ezibangela ukubetha.

Kwenzeka ntoni ukuba awuyinyanga i-aortic stenosis

I-aortic stenosis enganyangekiyo inokuvela ngokwanda kokusebenza kwentliziyo kunye neempawu zokudinwa okukhulu, iintlungu, isiyezi, ukudinwa nokufa ngesiquphe. Ukusuka ekubonakaleni kweempawu zokuqala, ixesha lokuphila lingangaphantsi kweminyaka emi-2, kwezinye iimeko, ke kubalulekile ukuba uqhagamshelane nogqirha wezentliziyo ukuqinisekisa isidingo sotyando kunye nokusebenza okulandelayo. Jonga ukuba injani imeko yokuchacha emva kokutshintsha i-aortic valve.

Izizathu eziphambili

Esona sizathu siphambili se-aortic stenosis bubudala: kule minyaka idlulileyo, i-aortic valve yenzeka kutshintsho kulwakhiwo lwayo, olulandelwa kukuqokelelwa kwe-calcium kunye nokusebenza okungalunganga. Ngokubanzi, ukuqala kweempawu kuqala emva kweminyaka engama-65, kodwa umntu usenokungaziva nantoni na kwaye angafa engazi ukuba une-aortic stenosis.

Kubantu abancinci, oyena nobangela uqhelekileyo sisifo samathambo, apho ukubalwa kwevalvu ye-aortic nayo iyenzeka, kwaye iimpawu ziqala ukubonakala malunga neminyaka engama-50. Ezinye izizathu ezinqabileyo ziziphene zokuzalwa ezinjenge-bicuspid aortic valve, systemic lupus erythematosus, cholesterol ephezulu kunye nesifo samathambo. Qonda ukuba yintoni i-rheumatism.