I-Mitral (iValve) i-Endocardiosis kwiiNja

I-Mitral nocardiosis sisifo senhliziyo esixhaphakileyo kwizinja. I-Mitral insufficiency isoloko isetyenziswa njengesithethantonye, ​​ethi, ngokungqongqo, ayichanekanga ngokupheleleyo.

I-Mitral nocardiosis sisifo se-degenerative of the connective tissue of the mitral valve (ivalve ye-atrial phakathi kwe-atrium ekhohlo kwaye ishiya igumbi eliphambili), okubangela ukuba amaphecana e-valve "asonge". Izivalo zentliziyo zisebenza njengeevalvu ezingabuyiyo, okuthetha ukuba zivumela igazi ukuba lihambe kwelinye icala hayi kwelinye. Lo msebenzi ulahleka ngokuyinxenye xa i-leaflet yevalvu iqengqeleka, kwaye ivelufa iyavuza (okanye ayonelanga). Oku kusilela, ke, kubaluleke kakhulu ukuqhubela phambili kwesi sifo kunye nokuphuhliswa kweempawu zeklinikhi. Kwinqanaba lokugqibela, igazi liqokelelana emiphungeni nge-atrium yasekhohlo kunye ne-edema ye-pulmonary ("amanzi emiphungeni") eyenzekayo. Kwimeko embi kakhulu, i-mitral valve endocarditis ikhokelela ekungaphumeleli kwentliziyo yasekhohlo.

Ukongeza kwi-mitral endocarditis, kuhlala kukho i-tricuspid endocarditis - oko kukuthi isifo esiwohlokayo se-valve ye-atrial efanelekileyo. Kwinqanaba eliphezulu, igazi liyakwazi ukubuyisela kwi-systemic circulation kwaye ngenxa yoko kwisigxina sesisu ("ascites" okanye isisu esiswini) kunye nesifuba ("i-thoracic effusion" okanye "i-pleural effusion").

Zeziphi Izinja Ezigulayo?

Njengoko sele kukhankanyiwe, sesona sifo sixhaphakileyo sentliziyo ezinjeni, iikati azifane zisifumane. Esi sifo siqala ukubonakala kuninzi lwamatyala kwiinja ezincinci ukusuka kwiminyaka eyi-7 ukuya kwe-8. Okungafaniyo yiCavalier King Charles Spaniel, ehlala echaphazelekayo ukusuka kwiminyaka eyi-1.5 - 2 iminyaka. Izinja ezinkulu azifane zigule kunezinye ezincinci. Iintlobo zezinja ezidla ngokuchaphazeleka ziquka:

• UKumkani uCavalier Spaniel
• dachshund
• poodle encinci
• I-Yorkshire terrier

Zeziphi iimpawu eziphawulwa nguMnikazi?

Izinja ekuqaleni ukuya phakathi kwinqanaba azibonisi zimpawu. Ngeendlela ezahlukahlukeneyo zokulawula, umzimba udla ngokusibuyisela esi sifo kangangexesha elide. Ukusuka kwinqanaba elithile ngexesha, nangona kunjalo, umzimba awusakwazi ukulawula oku kwaye ukuthotywa kwenzeka. Ukususela kumzuzu we-decompensation, iimpawu zeklinikhi zibonakala kumnini. Ezona mpawu zixhaphakileyo ziquka:

• Isiqhamo
• Ukuphefumla ngokukhawuleza okanye ukuphefumla kancinci
• Ukusebenza ngaphantsi (kuphela kwinqanaba lokugqibela)
• imikhuhlane yokufa isiqaqa
• Ukubhitya kwenqanaba lokugqibela
• Ukwandiswa kwesisu (kuphela kwi-tricuspid endocarditis)

Ezi mpawu zingentla azingqalanga kwaye ke zinokuthi ziqaliswe zizifo ezahlukeneyo. Kungenxa yokuba isigulane sine-mitral valve endocarditis ayithethi ukuba iimpawu zabo zibangelwa yiloo meko ngokuzenzekelayo!

Ngokusisiseko, ukuba iimpawu zibangelwa sisifo senhliziyo, ziya kuqhubeka zisiba mbi ngexesha elifutshane.

Ngoko ke, ukukhwehlela kwenhliziyo okungaphathwa ngokufanelekileyo kuya kuba nzima ngakumbi kwiintsuku ezimbalwa okanye iiveki ezimbalwa kwaye ekugqibeleni kukhokelela ekuphefumleni ngokukhawuleza kunye nokuphefumula okufutshane.

Iimpawu ezinxulumene nentliziyo zihlala zibonisa ukuthambekela kokuba mandundu - ukuba nje akukho nyango lwaneleyo.

Ukhohlokhohlo, olwenzeka manqaphanqapha kumaxesha ngamaxesha, ke ngoko alunakubangelwa sisifo sentliziyo. Kuyafana nokuphefumla, okwenzeka ngokuphindaphindiweyo kwaye kunyamalale ngokwawo.

Iimpawu zibonwa kuphela ngumnini kwinqanaba lokugqibela, isifo sibuhlungu ngaphezu kwexesha elide ngaphandle kokubonisa iimpawu!

Abanini abaninzi bayamangaliswa xa inja yabo ngokukhawuleza ibonisa ukuphefumula okufutshane ngenxa ye-mitral endocarditis kuba kude kube ngoko babengazange baqaphele naluphi na utshintsho kwisilwanyana sabo!

Yintoni ebangela i-Endocarditis?

I-Endocarditis ibhekisela kwiinguqu eziguqukayo kwiivalve zentliziyo. Eyona nto ibangela ukuba azaziwa. Ukuvuvukala kwee-valve zentliziyo kwakuye kwaba yimbangela ixesha elide, kodwa le ngcamango iye yaphikiswa ixesha elide. Mhlawumbi sisiganeko sofuzo, esikwacetyiswa ngokwenzeka rhoqo kwiinja ezincinci ezifana neCavalier King Charles Spaniel. Ekugqibeleni, ukwakheka kunye nokwakhiwa kwezicubu ezidibeneyo ze-mitral kunye / okanye i-valve ye-tricuspid kunye ne-appendages yazo iyatshintsha. Iileya zethishu ezidibanisayo zikhulula umanyano lwazo, zibangela ukuba ivalve “iqengqeleke” kunye nenkangeleko yayo edla ngokuba yiklabhu kwi-ultrasound. Kwangaxeshanye, ezinye iiligamente ezimisiweyo zeevalvu zentliziyo (“chordate tendineae”) zinokukrazuka, okukhokelela ekunyukeni, oko kukuthi “ukugqobhoza” kwevalve ngokufanelekileyo. Oku kuya kwenza mandundu ngakumbi ukuvuza okukhoyo. Njengoko sele kuchaziwe, i-endocarditis eneneni ichaphazela kuphela iivalvu ezimbini ze-atrioventricular, okt i-mitral ne-tricuspid valves. Ivalve ye-mitral iyodwa ichaphazeleka kwi-60% yamatyala, ivalve ye-tricuspid kwi-10%, kwaye zombini iivalve ngama-30%.

Sifunyaniswa Njani Esi Sifo?

Ukuxilongwa kwangaphambili kunokwenziwa ngokufuthi ngesiseko sohlolisiso lwezonyango ngokuphulaphula (“auscultation”), apho ukumbombozela kwentliziyo kuphawulwa. Nangona kunjalo, ukumbombozela kwentliziyo AKUVUMI naziphi na izigqibo ukuba zenziwe malunga nobuzaza besi sifo! Ngokubambisana ne-X-reyi, nangona kunjalo, unokufumana umbono omhle weqondo lobunzima. Nangona kunjalo, esona sixhobo sichanekileyo sokuxilonga yintliziyo ye-ultrasound ebandakanya uvavanyo lweDoppler. Apha amagumbi ngamanye angalinganiswa ngokuchanekileyo kwaye i-morphology yeevalvu inokuhlolwa. Uvavanyo lwe-Doppler lukwakwenza kube lula ukubonisa kunye nokulinganisa ukubuya kwegazi. Ngaphezu koko, iingxelo zingenziwa apha malunga nomsebenzi wokupompa wamagumbi amakhulu kunye noxinzelelo lokuzaliswa kwe-intracardiac.

Siqhubela Njani Esi Sifo?

Ngokuqhelekileyo esi sifo sihamba kancinci. Izigulane ezine-mitral nocardiosis kufuneka zibekwe esweni rhoqo ukuze zikwazi ukuvavanya kakuhle ikhosi yesifo kwaye zikwazi ukungenelela ngonyango xa kuyimfuneko. Kukho rhoqo iminyaka emininzi phakathi kokufunyanwa kokuqala kwesi sifo kunye nokubonakala kweempawu zeklinikhi. Nangona kunjalo, oku akunakwenziwa ngokubanzi kwisigulana ngasinye. Izinja ezinkulu ngokukodwa zihlukile, ukuba isifo siqhubela phambili ngokukhawuleza apha. Ukuba isigulane sikwinqanaba lesiphelo kunye namanzi emiphungeni ("i-pulmonary edema"), ixesha lokusinda lihlala lingaphantsi konyaka.

Ngaba Likhona Ithuba Lokuchacha?

Ngelishwa, hayi. Esi sifo sinokunyangwa kuphela ngeempawu, kugxilwe apha ekuphuculeni umgangatho wobomi. Ngethamsanqa, izigulana ezininzi ziyagula xa sele zikhulile, ukuze zingaze zibe neempawu ngenxa yokuqhubeka kancinci kwesi sifo. Indlela yonyango yotyando (ukulungiswa kwevalvu) ngokwethiyori inokwenzeka kodwa ayikhange idlale indima kunyango lwezilwanyana ngenxa yeendleko ezinkulu.

Loluphi Unyango Olunokunokukhethwa Ngalo?

Ngoku kukho ukubhideka okukhulu kulo mbandela. Ixesha elide, bekulisiko ukunyanga izigulane ezine-ACE inhibitors okanye amalungiselelo e-digitalis kuphela ngokwesiseko sokufunyaniswa kwe-wiretapping. Esi senzo siphelelwe lixesha. Ngaphambi kokuqala unyango, isigaba sesifo kufuneka sinqunywe nge-X-ray okanye, ngakumbi, i-ultrasound, kuba inkqubo yonyango eyongezelelweyo ixhomekeke kule nto.

La manqanaba alandelayo anokwahlulwa:

• IMPENDULO: Isigulana esisemngciphekweni: inja ayiguli, kodwa yenye yeentlobo ezilindelekileyo (umzekelo, inja encinci, endala, uKumkani uCharles Spaniel)
• I-B1: Inja ye-asymptomatic (okanye inja eneempawu ezingahambelani nesifo senhliziyo) kunye nesifo se-valvular ngaphandle kokwandiswa kwentliziyo
• I-B2: Inja ye-asymptomatic (okanye inja eneempawu ezingahambelani nesifo senhliziyo) kunye nesifo se-valvular kunye nokwandiswa kwentliziyo
• C: Inja ye-Symptomatic kwi-congestive heart failure (i-pulmonary edema) ngenxa yesifo se-valvular
• D: Inja ye-Symptomatic kwi-refractory congestive heart failure engaphenduliyo kunyango oluqhelekileyo

Inqanaba A

akukho ndlela yonyango

Inqanaba B1

Izinja ezingenayo intliziyo eyandisiweyo azifuni unyango. Oku kubonakala kungenakuqondakala kubanini abaninzi ekuqaleni, ekubeni isilwanyana sabo sinesifo senhliziyo, esingaphathwa. Nangona kunjalo, njengamayeza omntu, okwangoku akukho chiza elinokuthi libe nefuthe elibi kwindlela yesi sifo kweli nqanaba.

Inqanaba B2

Okwangoku, nangona kunjalo, kukho unyango olusebenzayo lwezinja ukusuka kwinqanaba eliphakathi apho kukho ukwandiswa kwentliziyo. Kwesinye sezona zifundo zikhulu zentliziyo yezilwanyana ukuza kuthi ga ngoku, i-pimobendan ibonakalise ukuba isebenza kakhulu. Ichiza likhokelela ekunciphiseni ubungakanani bemisipha yentliziyo kunye nokwandiswa okubalulekileyo kwexesha elingenazo iimpawu. I-Pimobendan ke iyeza elikhethiweyo kwizigulane ezineentliziyo ezandisiweyo.

Inqanaba C

Izigulana ezithotyiweyo ezine-edema ye-pulmonary ziphathwa ngokudityaniswa kweziyobisi zamanzi ("diuretics", furosemide okanye torasemide) kunye ne-pimobendan. Ukusetyenziswa kwengubo ye-ACE inhibitors njenge-benazepril okanye i-enalapril okanye i-mineralocorticoid antagonist spironolactone kufuneka ibuzwe ngokubalulekileyo kwaye kufuneka kugqitywe kwimeko-by-case basis.

Ngamanye amaxesha kukho i-cardiac arrhythmias yesibini, ekufuneka inyangwe nge-antiarrhythmic, ngokuxhomekeke kubukhulu bayo. Ngokuchasene neyeza lomntu, unyango olongezelelweyo lwe-anticoagulant aluyimfuneko kwizinja. Njengazo zonke ezinye izifo zentliziyo, emva kokuba unyango luqalisiwe, kufuneka luqhutyelwe ubomi babo bonke phantse kuzo zonke iimeko.

Inqanaba D

Ukongeza kumachiza akhankanywe kwisigaba C, ezinye i-diuretics ezifana ne-hydrochlorothiazide okanye i-spironolactone nazo zinokuqwalaselwa apha. Ngamanye amaxesha kuluncedo ukuthoba uxinzelelo lwegazi nge-amlodipine.

Iskimu esingezantsi sisishwankathelo esifutshane sezifundo zangoku kunye nezimvo zeengcali zamazwe ngamazwe malunga nesindululo sonyango jikelele kwi-mitral endocarditis. Kwiimeko zomntu ngamnye, nangona kunjalo, kunokuba yimfuneko ukutenxa kwisikimu sonyango esinikwe apha.

Ngaba kunengqiqo / kuyimfuneko ukutshintsha indlela yokutya?

Utshintsho lokutya lunokuba luncedo kwizigulane ezineziphumo eziphambili kakhulu, kwangaphambili mhlawumbi kunenzuzo encinci. Ukutya okunetyuwa kufuneka kupheliswe ekutyeni kwesilwanyana esigula kakhulu. Ngokunjalo, ukutya okuthambileyo, okunetyuwa encinci, okune-eneji ephezulu kunokunceda ukunciphisa ubunzima beempawu kunye nokuqinisekisa ukuthathwa kwamandla okwaneleyo. Enye ingxaki, nangona kunjalo, kukuba izilwanyana zethu zihlala zikwala ukutya okunetyuwa encinci. Emva koko kusoloko kulungele ukunika ukutya okuthandayo kunokunyanzelisa “ukutya kwentliziyo” engakutyiyo inja, kungenjalo iimfuno zamandla zesigulana azikwazi ukuhlangabezana nazo. Kwizilwanyana ezichaphazeleke kakhulu, ukusetyenziswa kwe-omega-3 fatty acids kunokunceda.

Kubalulekile ukuba uqaphele ukuba ngokuchasene nenkolelo eyaziwayo, izigulane ezinesifo senhliziyo esiphezulu AKUFANELE zinciphise umzimba. Ukuncipha kobunzima kukhokelela ekwandeni kokusweleka kwezigulana zentliziyo ezigula kakhulu. Ukunciphisa umzimba "ukukhulula inkqubo ye-cardiovascular" akulunganga kwizilwanyana ezinesifo esiphezulu!

Ngaba i-Electrolyte efana nePotassium okanye iMagnesium kufuneka yongezwe xa iNyangwa ngamayeza aphezulu okuphelelwa ngamanzi emzimbeni?

Ngokuqhelekileyo akukho. Isigulana esisela kunye nokutya ngokuqhelekileyo asidli ngokufuna i-electrolytes eyongezelelweyo njenge-potassium okanye i-magnesium. Indima ye-magnesium kunyango lwezilwanyana ayikacaciswa ngokucacileyo, kuba inqanaba le-magnesium emzimbeni kunzima ukulilinganisa, kwaye iimvavanyo zegazi eziqhelekileyo zihlala zingachanekanga kakhulu kule nto. Indima ye-magnesium inokulala kunyango lwe-arrhythmias enganyangekiyo kunyango, enokuthi yenzeke kumxholo we-mitral endocarditis. Nangona kunjalo, unyango olusisiseko kunye ne-magnesium kufuneka luphetshwe, kuba izigulane ezininzi ezinesifo sohudo zisabela kwi-electrolyte.

Inja yam iNyangwa ngamayeza okuphelelwa ngamanzi emzimbeni. Ngaba Ndifanele Ndinciphise Indlela Asebenzisa Ngayo Amanzi?

Impendulo emfutshane kuphela iyimfuneko apha: akukho meko!

Yintoni Onokuyenza NjengoMnikazi Wesigulana Esigulayo?

Ngokukodwa izigulane kwizigaba eziphambili zesifo zifuna ingqalelo ekhethekileyo kumnini. Ngokukodwa kwizilwanyana ezine-edema ye-pulmonary yangaphambili, kubaluleke kakhulu ukunikela ingqalelo kukukhohlela okwandayo kunye nokubala rhoqo izinga lokuphefumla kwesigulana sakho. Oku akufanele kube ngaphezu kokuphefumula kwe-45 ngomzuzu ekuphumleni (kubalulekile: musa ukubala emva kokusebenza, oku kwandisa ngokuzenzekelayo izinga lentliziyo). Kukwabalulekile ukuqaphela iintsingiselo. Ukuba izinga lokuphefumula liyenyuka - umzekelo, ubala i-20 / iminithi ekuseni, i-40 / iminithi emini, kunye ne-50 / iminithi emva kwemini - oku kungabonisa ukuqala kwe-edema ye-pulmonary kwaye kufuneka uqhagamshelane nodokotela wakho wezilwanyana ngokukhawuleza. .

Ngaba Kufuneka Ndinakekele Inja Yam?

Ubuninzi bezifo zentliziyo, umgaqo osisiseko kukuba izilwanyana ezichaphazelekayo zivumelekile ukuba zisebenzise ngaphakathi kwesakhelo abazinikelayo. Izinja ezigulayo zivumelekile ukuba zenze umthambo ngokuqhelekileyo, kodwa ukuba zifuna ukuthatha ikhefu kuqeqesho, oku kufuneka kwamkelwe.

Nangona kunjalo, uqeqesho oluqatha kakhulu okanye uqeqesho kubushushu obuphezulu kufuneka luthintelwe kwizilwanyana ezineziphumo ezinzima. Ukuba uyathandabuza, ugqirha wakho wentliziyo kufuneka akwazi ukukunika ulwazi.