Isifo Senhliziyo Ezinjeni Namakati

"Inja yami inokuthile enhliziyweni yayo" into ovame ukuyizwa, ikakhulukazi uma isilwane sesikhulile. Kodwa kumayelana nani? udokotela wezilwane uDkt Sebastian Goßmann-Jonigkeit unikeza ukuqonda ngezimpawu zesifo senhliziyo ezinjeni nasemakati futhi ubonisa izindlela zokwelapha ezingase zibe khona.

Isifo Senhliziyo… Kusho Ukuthini Lokho Empeleni?

Nakhu ukuvakasha okundiza ku-cardiology - isayensi yenhliziyo.
Inhliziyo inomsebenzi ofanayo kuzo zonke izilwane: iphampa igazi emzimbeni. Lokhu kuqinisekisa ukuthi umoya-mpilo oboshelwe emangqamuzaneni abomvu egazi utholakala kuwo wonke amangqamuzana omzimba ngobuningi obanele. Isidingo singahluka ukusuka kokuphansi kuye phezulu ngesikhathi sokuzikhandla ngokomzimba lapho uphumule - ukunxeshezelwa kwalokhu kuwela ngaphakathi kwendawo yenhliziyo yokuzibophezela.

Isakhiwo Senhliziyo

Ngaphandle kwezimbalwa ezimbalwa embusweni wezilwane, inhliziyo ngokwesakhiwo ifana kakhulu nesitho esisebenzayo esingenalutho. Kuzo zombili izinhlangothi kune-ventricle enkulu ngaphansi kwe-atrium encane, ehlukaniswe ngokucacile kusuka komunye nomunye nge-valve yenhliziyo esebenza njenge-valve yendlela eyodwa ukuze igazi ligeleze ohlangothini olulodwa kuphela. Igazi ligcinwa lijikeleza njalo phakathi nenqubo yokumpompa ngohlelo oluyinkimbinkimbi lokungezwani kwemisipha nokunyakaza kwamavalvu.
I-oxygen ephansi, igeleza ingene ngaphakathi kwesitho nge-afferent posterior vena cava. Ingena ku-ventricle engakwesokudla isuka ku-atrium engakwesokudla ngokusebenzisa okuthiwa i-tricuspid valve. Ukusuka lapho ngomthambo wamaphaphu kungene ohlelweni lwemithambo yamaphaphu, lapho amangqamuzana egazi abomvu egcwala umoya-mpilo omusha. Umthambo wamaphaphu uholela igazi ku-atrium yangakwesobunxele, ngokusebenzisa okuthiwa yi-valve ye-bicuspid ungene ku-ventricle yangakwesobunxele, bese ukhishwa lapho nge-aorta ungene ekujikelezeni kwesistimu, okugcwele umoya-mpilo.

Ulayini Wokuvuselela

Ukuze ukugeleza kwegazi kusebenze kanjena, ukufinyela kwemisipha yenhliziyo kufanele kulawulwe ngokunembile. I-node ebizwa ngokuthi i-sinus node ibeka ijubane lalokhu - ithumela umfutho kagesi ofinyelela kumangqamuzana emisipha yenhliziyo ngendlela efanele ukuze inkontileka ngokufana nomsebenzi wokupompa. Lokhu kuphuma kukagesi kungavezwa kusetshenziswa i-electrocardiogram (ECG) futhi kukhombisa ukuqhutshwa kwe-stimulus kumisipha yenhliziyo. Isetshenziselwa ukuthola i-arrhythmia engenzeka (isb. isikhathi esingalungile noma ukuqhutshwa okungalungile) okuthi, kungabonakali, kungaholela ekugelezeni kwegazi okwanele. Yingakho ukuqapha inhliziyo ngesikhathi sokubulala izinzwa kubaluleke kakhulu.

Izimpawu Zesifo Senhliziyo Ezinjeni Nasemakati

Zonke izimpawu zokuhluleka kwenhliziyo zingachazwa ngokungasebenzi kahle kwenhliziyo. Esinye sezizathu eziyinhloko ze-aphoyintimenti ngesikhathi sokubonisana ukwehla okuphawulekayo ekusebenzeni - ngokuvamile lokhu kuqale kubonakale lapho amazinga okushisa angaphandle ephezulu ekuqaleni kwehlobo. Njengoba inhliziyo enenkinga yevalvu yenhliziyo ehlobene neminyaka ngokuvamile ingakwazi ukumboza kuphela isidingo somoya-mpilo entweni ephilayo, isiguli ngokuvamile sinyakaza kancane kakhulu noma sihamba kancane kunokujwayelekile. Ngokukhuphuka kwamazinga okushisa angaphandle, isimiso senhliziyo nemithambo yegazi sigcizelelwa nakakhulu, njengoba ingxenye enkulu yamandla omzimba igelezela ekulawuleni izinga lokushisa kanye nokunikezwa okuncane komoya-mpilo kuzo zonke izitho (ikakhulukazi ebuchosheni) akuqinisekisiwe ngaso sonke isikhathi. Lesi simo sibangela ukuwa okujwayelekile kwesiguli senhliziyo esingaziwa noma esingelashwa ngendlela efanele ngezinsuku ezishisayo zasehlobo.

Olunye uphawu kungaba ulwelwesi lwamafinyila oluluhlaza okwesibhakabhaka (i-cyanotic) (isib. i-conjunctiva esweni noma izinsini ezingenambala), okubangelwa ukuntuleka komoyampilo egazini.
Ezigabeni ezithuthukile, lokho okubizwa ngokuthi 'ukukhwehlela kwenhliziyo' kuvame ukwenzeka - lokhu i-pulmonary edema, isiguli esizama ukukhwehlela noma ukuminyanisa kodwa kwaba nhlanga zimuka nomoya. Kwenzeka lapho igazi elisuka ku-atrium yangakwesobunxele libuyela emaphashini futhi uketshezi oluqukethwe egazini lucindezelwa luphume ohlelweni lwemithambo luye ezikhaleni eziphakathi kwe-bronchi - uma lungelashwa, izilwane 'zingaminza' noma 'ziminze'.

Sifo

Kunezindlela eziningana zokuhlola inhliziyo. Okulula kakhulu ukulalela nge-stethoscope - okuthiwa yi-auscultation. Kule nqubo, imisindo yesibili yenhliziyo (ukushaya, ukugedla, njll.) inganqunywa ngamavalvu enhliziyo anesici. Ngesikhathi esifanayo, umuntu angakwazi ukubala ukushaya kwenhliziyo futhi mhlawumbe ezwe i-arrhythmia.

Endabeni ye-X-ray yenhliziyo (ngokuvamile engenzeka ngaphandle kokudambisa), izilinganiso ezivundlile neziqondile zesitho zisethwe ngokuphathelene nobukhulu be-thoracic vertebrae ukuze kubonakale ukuthi ikhulisiwe yini. Uma ikala ngaphezu kwengqikithi yemizimba engama-vertebral engu-10.5 enjeni, lokhu kubizwa ngokuthi ukukhuliswa kwenhliziyo okudinga ukwelashwa - le ndlela yokubala ibizwa ngokuthi i-VHS X-rays (Vertebral Heart Score).

Ukuze ukwazi ukuhlola ukusebenza kwama-valve ngaphandle kokungabaza, i-Doppler ultrasound izibonakalise yona. Ngaphezu kobukhulu bama-valve enhliziyo, noma yikuphi ukugeleza kwegazi okubuyela emuva ngenxa yokukhubazeka kungaboniswa ngombala.

I-DCM vs HCM

Lapho ukwehluleka kwenhliziyo kwenzeka ekugugeni, umzimba wezinja namakati ngokuvamile usabela ngendlela ehluke kakhulu. Njengoba ukugeleza kwegazi kuphazanyiswa amavalvu enhliziyo angasebenzi futhi kungancishiswa kwezinye izindawo, inhliziyo njengesikhungo sokumpompa kufanele yakhiwe kabusha futhi ishintshwe ngendlela efanele.

Izinja zivame ukuthuthukisa lokho okwaziwa ngokuthi i-dilated cardiomyopathy (DCM). Lokhu ukukhuliswa kwesitho esingabonakala kalula kuma-X ray. Umthamo wawo womabili amakamelo ubonakala ukhuphuke kakhulu ukuze kuhanjiswe inani elikhulu kakhulu legazi ngokushaya kwenhliziyo ngayinye. Inkinga ngalokhu kujwayela ukuthi imisipha yenhliziyo iba mncane kakhulu endaweni yamagumbi - ayinawo amandla okusebenzela isitho esikhulisiwe ngokufanele.

Amakati, ngakolunye uhlangothi, aba ne-hypertrophic cardiomyopathy (HCM) cishe ikakhulukazi ebudaleni uma kukhona ukukhubazeka okuhambisanayo kwe-valve. Ngalolu hlobo lwesinxephezelo, imisipha yenhliziyo iqina kakhulu ngokuncipha okuphawulekayo kobukhulu bamagumbi enhliziyo. Ngakho-ke, inani elincane legazi elingampontshwa ngokushaya kwenhliziyo ngayinye futhi inhliziyo kufanele ishaye kaningi ukuze ihambise inani elincane legazi.

Therapy

Emuva nje lapho izimpawu zesifo senhliziyo ezichazwe ngenhla zivela ezinjeni nasemakatini, udokotela wezilwane kufanele athintwe ngokushesha ngangokunokwenzeka ukuze ahlolwe inhliziyo.

Njengoba ama-valve enhliziyo eguga kancane kancane, iningi lazo zonke izinja namakati lizoba nezimpawu ezihambisanayo futhi lidinga ukwelashwa. Ukuze kunxeshezelwe ukuhluleka kwenhliziyo okuwumphumela, imithi yesimanje yezilwane isebenzisa izinsika ezine zenhliziyo (imithi yenhliziyo):

1. Ukwehlisa umthwalo ongemuva ngama-ACE inhibitors (ngokwandisa imithambo yegazi, kuba lula ngenhliziyo ukupompa ngokumelene nomfutho wegazi okhona)
2. Ukunciphisa noma ukubuyisela emuva inqubo yokulungisa kabusha okwenzeka ku-dilated noma hypertrophic cardiomyopathy
3. Ukuqinisa amandla enhliziyo enemisipha ngesithako esisebenzayo esithi 'pimobendan' ezinjeni
4. Ukukhipha amaphaphu ngokuvula ukusebenza kwezinso ngezithako ezisebenzayo 'Furosemide' noma 'Torasemide' lapho kukhona i-edema yamaphaphu.

Ngaphezu kwalokho, ama-ejenti akhuthaza ukujikeleza kwegazi njenge-propentofylline angasetshenziswa endaweni yezindlela zokugeleza ezibulalayo.

Iyiphi into esebenzayo esetshenziswa lapho isiguli kufanele sinqunywe ngesisekelo semiphumela etholakalayo kanye nezimpawu. Ukwenza okujwayelekile akunakwenzeka.

Isiphetho

Eminyakeni embalwa edlule, isifo senhliziyo ezinjeni nasemakati, ikakhulukazi amacala ahlobene neminyaka, kwakubhekwa njengento enzima kakhulu. Ngakolunye uhlangothi, ngenxa yokuthi ukukhethwa kwemithi kwakulinganiselwe kakhulu futhi, ngakolunye uhlangothi, umuthi okwakunzima ukuwuthatha (isb. ushevu we-foxglove ebomvu) wawutholakala.

Ikakhulukazi, ukuqinisa umphumela we-pimobendan kulethe inqubekelaphambili enkulu ekwelapheni izinja ezinesifo senhliziyo eminyakeni yamuva.
Namuhla, isikhathi sokuphila kwesiguli senhliziyo esilungiswe kahle futhi esiqashwe ngendlela efanele singaba phezulu njengesiguli esinempilo - inqobo nje uma kuthathwa isinyathelo kusenesikhathi.