Kusiyana kwa echocardiography ndi transcranial Doppler kungathandize kuthandizidwa
Kuphunzira kuphulika ndi mayeso osagonjetsa omwe amalola madokotala kuyesa kuyendayenda kwa magazi kudzera mu mtima. Kawirikawiri amagwiritsidwa ntchito mogwirizana ndi kafukufuku wopanga (nthawi yomwe madokotala nthawi zambiri amachitcha "kusiyana kofanana,") kapena kuphunzira kwa Doppler (TCD) . Kafukufuku wamaphunziro amachitika nthawi zambiri pamene chiwerengero cha patent foramen ovale (PFO) chikukayikira .
Momwe Phunziro la Bululu Linapangidwira
Kuphunzira kofikira kumapindula ndi mfundo yakuti pamene mafunde amphamvu akukumana ndi mitundu yosiyanasiyana ya zowonjezera zakuthupi - m'maganizo amenewa gasi vs madzi - amawombera ponseponse, ndipo amapanga mafunde ambiri "echo." Mafunde awa amavomereza phokoso lokhazikika .
Muphunziro lopangidwa ndi bulumu, njira ya saline imagwedezeka mwamphamvu kuti ikhale ndi mitsempha yaying'ono ndipo kenako imayikidwa mu mitsempha. Pamene mphukira zikuyenda m "mitsempha ndi kumbali yowongoka kwa mtima, kuwonjezeka kwachulukidwe kumene amapanga pazithunzi za echocardiography kumapangitsa dokotala kuti ayang'ane ming'omayo kudutsa m'zipinda za mtima.
Ngati mtima ukugwira ntchito bwino, ming'omayo idzawoneka kulowa muyeso yolondola, ndiye njira yowongoka bwino, kenako imatuluka m'mapapo, komwe imasankhidwa.
Komabe, ngati thovu zikuwonekera kulowa kumanzere kwa mtima, izi zimasonyeza kuti pali kutseguka kodabwitsa pakati pa mbali ziwiri za mtima-chomwe chimatchedwa intracardiac shunt.
Mtundu uwu wa shunt osakanikirana ukhoza kupangidwa, mwachitsanzo, ndi PFO, vuto la atrial septal , kapena chotupa cha septal defect.
Pakalipano, mitundu yamalonda ya "mavubu" amapezeka kuti azigwiritsidwa ntchito panthawi yophunzira. Omwe atsopanowa amakhala ndi mapuloteni ang'onoang'ono kapena phospholipid omwe amachititsa kuti pakhale mafuta. Othandizira atsopanowa amawoneka kuti ali otetezeka, ndipo amatha kupereka chithunzi chabwino pa zochitika zina. Komabe, zimakhala zodula kwambiri kuposa njira yothira mafuta.
Maphunziro a Ubongo Kwa Patent Foramen Ovale
Chifukwa chodziwika kwambiri chochita maphunziro opukutira ndi kufufuza PFO. M'maphunzirowa, pamene mabulosi akujambulidwa mu mitsempha, wodwalayo akufunsidwa kuti apange njira yogwiritsira ntchito mankhwala (kutanthauza kuti akukhala ndi matumbo).
Valsalva ikuyenda mofulumira imabweretsa mavuto omwe ali kumbali yowongoka kwa mtima, kotero kuti ngati PFO ilipo, ming'oma ikhoza kuwonedwa kulowa kumanzere kwa atrium. Mphuno yomwe ikuwonekera kumapeto kwa mayesero amatsimikizira kuti alipo PFO.
Chifukwa chachikulu chomwe madokotala amadandaula ndi PFOs ndizotheka kuti alole kuti magazi azidutsa kumbali yamanzere ngati mtima, kumene angalowe mu ubongo ndikupanga kupweteka kwapadera .
Mwamwayi, pamene PFOs ndizofala (zimachitika pakati pa anthu akuluakulu 25%), zimayambitsa kukwapula kokha.
Tsono, pamene kuphunzira bwino kwa bulble kungatsimikizire kukhalapo kwa PFO, sikumauza adokotala kuti akhoza kudwala matendawa.
Akatswiri ambiri amaganiza kuti njira yabwino yodziŵira kuti PFO ingathe kupha sitiroko ndiyo kupanga phunziro lapamwamba la kuphunzira Doppler pamodzi ndi kuphunzira kwa bubble.
Mu phunziro la TCD, njira zamakono zimagwiritsiridwa ntchito kuwonetsera mavubu oyendayenda m'mitsempha ya ubongo. Kuphunzira kwa TCD kumatha kudziwa ngati ming'oma yomwe imayikidwa mu mitsempha imalowa mkati mwa ubongo. Ngati ndi choncho, PFO imawoneka kuti ikuwopsa kwambiri, ndipo adokotala akhoza kuwalimbikitsa kuti adziwe mankhwala , kapena ngati mankhwalawa atha kale, mwina kutsekedwa kwa PFO.
> Zotsatira:
> Mulvagh SL, Rakowski H, Vannan MA, ndi al. American Society of Echocardiography Chigwirizano pa Zomwe Amayi Akuchipatala Akupanga Osiyanitsa Akupanga mu Zojambula Zojambulajambula. J Am Soc Echocardiogr 2008; 21: 1179.
> Romero JR, Frey JL, Schwamm LH, et al. Zochitika Zachibwibwi za Chiserezi Zogwirizana ndi 'Phunziro la Kuphulika' pofuna Kudziwika kwa Kulimbana Kumanzere Kumanzere. Stroke 2009; 40: 2343.
> Parker JM, Weller MW, Feinstein LM, et al. Chitetezo cha Odwala Osiyanitsa Opaleshoni Odwala Odwala Odzidzidzidwa Odzidzidzidwa Okhaokha a Cardiac. Am J Cardiol 2013; 112: 1039.