Kodi ndi liti ndipo ndi liti?
Mwachidule
Kuthamanga mofulumira-"chiphuphu" chotchinga-ndizofala kwambiri matenda a mtima. Anthu ambiri omwe ali ndi vutoli amadabwa kwambiri atadziwa kuti ali ndi vuto la mtima wa valve chifukwa amamva bwino. Madokotala awo nthawi zambiri amadabwa monga momwe alili, ndipo mwina sangadziwe choti achite.
Ngati muuzidwa kuti muli ndi chizoloŵezi chobwezeretsa, kodi izi zikutanthauza chiyani?
Kodi inu ndi dokotala wanu mukuganiza bwanji za vutoli ndipo muyenera kuchita chiyani kenako?
Valve ya Tricuspid ndi Tricuspid Kubwereranso
Vagu yotchedwa tricuspid imapatulira malo oyenerera kuchokera ku ventricle yoyenera. Monga magetsi onse a mtima, cholinga cha valve ya tricuspid ndikutsimikiza kuti magazi akuyenda pamtima pa nthawi yoyenera komanso m'njira yoyenera. Choncho, pamene malo ovomerezeka ali ndi mgwirizano, vivevuyi imakakamizidwa kutseguka, kuti magazi alowe mu ventricle yolondola. Kachigawo kamodzi kagawanika, pamene ventricle yoyenera kutulutsa magazi ake mu mitsempha ya pulmonary, valveti imatseka kuti magazi asabwerere kumbuyo kupita ku atrium yoyenera.
Pogwiritsidwa ntchito mofulumizitsa, vivevu yotchedwa tricuspid ikulephera kutseka kwathunthu. Izi zimalola kuti magazi ena aziyenda mobwerera-kutanthauza kuti, kubwezeretsanso-kulumikiza bwino monga mgwirizano wabwino.
Ngozi
Kwa dokotala kungotchula munthu wina kuti ali ndi kachilombo koyambanso sizothandiza, chifukwa kufunika kwa matendawa kumakhala kosiyana pakati pawo. Pamene kugwiritsidwa ntchito mobwerezabwereza kumatsimikizirika, ndikofunikira kudziwa momwe kulili kofunikira.
Zomwe zimachitika mofulumira kwambiri zimawonekera m'ma 70 peresenti ya anthu achikulire omwe ali ndi mayendedwe .
Monga mgwirizano wolondola, zimatenga mphindi kapena ziwiri kuti zitseke bwinobwino, ndipo panthawi yomweyi mphuno yaing'ono imathamangiranso. Ndi makanema amakono, echocardiogram nthawi zambiri amatha kuzindikira kuti "chizoloŵezi" cha nthenda ya magazi-ndi anthu awa, omwe ma valve awo ali ochibadwa, amauzidwa kuti ali ndi vuto lokhalanso, ndipo chifukwa chake, vuto la valve la mtima. (Monga pambali, chinthu chomwecho chikuchitika pamlingo wina ndi mitral valve, kutsogolera anthu ambiri kukhala osayenera "atapezeka" ndi mitral valve prolapse kapena MVP .)
Choncho funso loyamba limene mungapemphe ngati mwauzidwa kuti muli ndi vutoli ndilo: Kodi kuli kovuta bwanji? Ngati yankho liri "lofatsa kwambiri," mwina simungakhale ndi nkhawa.
Komabe, ngati kubwezeretsa kwachangu kumaweruzidwa kuti ndi kosavuta kapena koopsa, vuto lalikulu la mtima ndilopezekapo. Pachifukwa ichi, kufufuza kwa mtima kumayenera kuchitidwa kuti mudziwe chomwe chimapangitsa kuti chiwerengerochi chikhazikitsidwe.
Zimayambitsa
Kuwonongeka kwa vivevu yotchedwa tricuspid ngokhayo kungachititse kuti phokoso liziyambiranso. Zomwe zingasokoneze vivevu ya tricuspid ndi izi:
- Matenda opatsirana
- Myocardial infarction kukhudza ventricle yoyenera
- Mafinya a myxomatous a valve (ofanana ndi MVP)
- Kuvulazidwa kuchokera ku chithumwa cha pacemaker kapena chosakanikizika chowombera
- Matenda a Marfan
- Matenda a Carcinoid
- Matenda a mtima wamba
Komabe, chifukwa chodziwika kwambiri cha kugwiritsidwa ntchito mofulumira, kutalika, ndi "kusokoneza" kugwiritsidwa ntchito kwa valve yotchedwa tricuspid valve. Pogwiritsa ntchito mphamvu zowonongeka, valve yokha ndi yachibadwa. Kuthamanga kudutsa pa valve kumachitika chifukwa matenda a mtima amtundu wina amawasokoneza mtima-mwachitsanzo, pamene atrium yoyenera kapena ventricle yolondola imayamba kuchepetsedwa mwa njira yomwe imapangitsa kuti valvetiyo isatseke kwathunthu.
Matenda a mtima omwe amachititsa kuti ntchito zowonongeka zikhale zowonjezereka zikuphatikizapo:
- Kupanga mankhwala oopsa kwambiri
- Kulephera kwa mtima
- Mitral stenosis kapena mitral kubwerera
- Chikumbutso cha embolism
- Hyperthyroidism
Anthu ambiri omwe ali ndi vuto lachidziwitso kwambiri amatha kukhala ndi vuto limodzi lomwe limapangitsa kuti ntchito yowonongeka ikhale yowonongeka, ndipo kuunika kwathunthu kudzafunikanso kuzindikira vutoli.
Zizindikiro
Ambiri mwa anthu omwe ali ndi vuto lopangidwanso sakhala ndi zizindikiro zomwe zingachitike chifukwa cha matendawa. Zizindikiro zilizonse, ngati zilipo, zimayambitsidwa ndi vuto lomwe limayambitsa vuto la valve.
Komabe, ngati kugwiritsidwa ntchito mofulumira kumakhala koopsa, kungabweretse mwachindunji zizindikiro. Izi zingaphatikizepo kumverera kwachilendo chosazolowereka m'khosi, kapena kupweteka m'mimba ndi kutupa. Koma ngakhale ndi vuto lalikulu lachidziwitso, zizindikiro zimayambitsa mavuto okhudzana ndi mtima.
Kudziwa
Mafunso awiri ofunikira pambuyo pa kugwiritsidwa ntchito mobwerezabwereza akupezeka kuti ayenera kukhala:
- Kodi chifukwa chachikulu n'chiyani?
- Zili zovuta motani?
Mafunso awiriwa ndi ofunikira posankha momwe angagwiritsire ntchito vutoli.
Nthawi zambiri, mafunso awiriwa amayankhidwa mosavuta pamene dokotala amachita mbiri yachipatala mosamala ndi kuunika kwa thupi, ndipo amapeza echocardiogram yapamwamba kwambiri. Panthawi imeneyo, ndondomeko yoyendetsera ntchito ingakonzedwe.
Utsogoleri
Chinthu chofunikira kwambiri pakuyendetsa chizoloŵezi choyambiranso ndi kuzindikira ndi kusamalira chifukwa choyambitsa. Izi ndizofunikira makamaka pogwiritsidwa ntchito mofulumizitsa bwino, pomwe pali valavu yomwe imakhala yachibadwa.
Ntchito yogwiritsidwa ntchito mofulumira nthawi zambiri imayambitsidwa ndi mitsempha yamatenda opatsirana kwambiri. Kuchiza matenda a mpweya wambiri kungathandize kwambiri kusintha kwapadera. Choncho, zizindikiro zomwe zimayambitsa matenda a m'magazi, makamaka mtima, mitral valve, kapena pulmonary embolus-ayenera kuchitiridwa mwamphamvu.
Ngati tricuspid kubwezeretsa si ntchito-ndiko, chifukwa cha vuto lalikulu ndi tricuspid valve palokha-kasamalidwe kawirikawiri zimadalira kuuma kwa kubwezeretsedwa ndi zizindikiro zilizonse zofanana.
Anthu omwe ali ndi mtima wofatsa kwambiri omwe amatha kusintha nthawi zina popanda mavuto ena amtima nthawi zambiri amakhala ndi ma valves omwe ali achilendo, ndipo, kupatula nthawi yowunika zotsatila, samasowa "kasamalidwe" konse.
Ngakhale ngati chizoloŵezi choyambitsanso chizoloŵezi chimakhala chodziŵika kapena cholimba, malinga ngati palibe zizindikilo ndipo echocardiogram imasonyeza ntchito yachibadwa ya mtima ndi zovuta za mtima, siziyenera kukhala zoperewera zomwe zimaikidwa pa zochitika zathupi. "Otsogolera" enieni okhawo amawerengedwanso kawirikawiri ndi katswiri wa mtima.
Chithandizo
Pali zochitika zingapo zomwe opaleshoni ya valve iyenera kuganiziridwa mwa anthu omwe ali ndi vuto lokonzanso.
Kuchita opaleshoni kuyenera kukhala njira ngati chithunzithunzi chokha chitembenuzidwa chokha chimayesedwa kuti chikuchititsa zizindikiro zazikulu.
Kuchita opaleshoni ya valve kumalimbikitsidwanso kwa anthu omwe ali ndi vuto lalikulu lokhalanso ndi opaleshoni ndipo akuchitidwa opaleshoni yokonzanso kapena kusintha valve ya mitral. Momwemonso ma valve amachitidwa pa opaleshoni imodzi. Izi, mpaka kutali, ndilo chifukwa chofala kwambiri chochitira opaleshoni ya valve opaleshoni.
Kawirikawiri pamene opaleshoni imafunika, nthawi iliyonse kukonzekera kwa valveti yonyamulira imasankhidwa m'malo wotsitsimutsa.
Chidule
Ngati mwauzidwa kuti muli ndi vutoli, chinsinsi ndi dokotala wanu kuti adziwe chomwe chimayambitsa vutoli ndi vuto lake. Mwamwayi, izi nthawi zambiri sizovuta kapena nthawi yowononga nthawi.
Ambiri mwa anthu omwe amapezeka kuti ali ndi chizoloŵezi choyambiranso kudzakhala ndi khalidwe lofatsa, kapena palibe vuto lenileni. Mwa anthu omwe amayambiranso kukhala ndi vuto lalikulu, ambiri amakhala ndi vuto la valve lomwe limayambitsa matenda ena a mtima - ndipo mankhwala awo amafunika kuti azichita mwankhanza kuti athetse vutoli. Kuchita opaleshoni ya kubwezeretsa chifuwa sikukufunikanso.
> Zotsatira:
> Kara I, Koksal C, Erkin A, et al. Zotsatira za Ntchito Zowonongeka Zomwe Zimagwira Ntchito Zowonongeka Pomwe Odwala Akugwira Ntchito ya Mitral Valve: A Meta-Analysis of 2,488 Odwala. Ann Thorac Surg 2015; 100: 2398.
> Nishimura RA, Otto CM, Bonow RO, ndi al. 2014 AHA / ACC Chitsogozo cha Ulamuliro wa Odwala ndi Valvular Heart Disease: Lipoti la American College of Cardiology / American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014; 63: e57.