UMary Allen
I-Mitral nocardiosis yisifo senhliziyo esivame kakhulu ezinjeni. Ukuntuleka kwe-Mitral kuvame ukusetshenziswa njengegama elifanayo, okusho ukuthi, empeleni, alilungile ngokuphelele.
I-Mitral nocardiosis yisifo esiwohlokayo sezicubu ezixhumeneyo ze-mitral valve (i-valve ye-atrial phakathi kwe-atrium yesokunxele nakwesokunxele kwegumbi eliyinhloko), okubangela ukuthi amapheshana e-valve "agoqe". Ama-valve enhliziyo asebenza njengama-valve angabuyi, okusho ukuthi avumela igazi ukuthi ligeleze liye kolunye uhlangothi hhayi kwenye. Lo msebenzi ulahleka kancane lapho i-valve leaflet igoqa, futhi i-valve iyavuza (noma inganele). Lokhu kungasebenzi, nakho, kubaluleke kakhulu ekuqhubekeleni phambili kwesifo kanye nokuthuthukiswa kwezimpawu zomtholampilo. Esigabeni sokugcina, igazi linqwabelana emaphashini nge-atrium yangakwesobunxele kanye ne-pulmonary edema ("amanzi emaphashini"). Ezimweni ezimbi kakhulu, i-mitral valve endocarditis iholela ekuhlulekeni kwenhliziyo kwesokunxele.
Ngaphandle kwe-mitral endocarditis, kuvame ukuba ne-tricuspid endocarditis - okungukuthi isifo esiwohlokayo se-valve ye-atrial efanele. Esigabeni esithuthukisiwe, igazi lingakwazi ukusekela ukuhamba kwesistimu futhi ngenxa yalokho lingene emgodini wesisu ("ascites" noma uketshezi lwesisu) nasesifubeni ("ukukhishwa kwethoracic" noma "i-pleural effusion").
Yiziphi Izinja Ezigulayo?
Njengoba sekushiwo, yisifo senhliziyo esivame kakhulu ezinjeni, amakati awasoze asithola. Lesi sifo siqala ukuvela ezimweni eziningi ezinhlotsheni zezinja ezincane kusukela eminyakeni engu-7 kuya kwengu-8. Okuhlukile yiNkosi yeCavalier uCharles Spaniel, evame ukuthinteka kusukela eminyakeni engu-1.5 - 2 iminyaka. Izinja ezinkulu mancane kakhulu amathuba okuthi zigule kunezinhlobo ezincane. Izinhlobo zezinja ezithinteka kakhulu zihlanganisa:
- Inkosi yaseCavalier uCharles Spaniel
- i-dachshund
- i-poodle encane
- I-Yorkshire terrier
Yiziphi Izimpawu Umnikazi Aziqaphelayo?
Izinja ekuqaleni kuya maphakathi nesiteji azibonisi zimpawu. Ngezindlela ezihlukahlukene zokulawula, umzimba ungakwazi ukunxephezela lesi sifo isikhathi eside. Kusukela esikhathini esithile ngokuhamba kwesikhathi, nokho, umzimba awukwazi ukuphatha lokhu futhi ukubola kwenzeka. Kusukela ngesikhathi sokubola, izimpawu zomtholampilo ziba sobala kumnikazi. Izimpawu ezivame kakhulu zihlanganisa:
- Isikhukhula
- Ukuphefumula ngokushesha noma ukuphelelwa umoya
- Ukungasebenzi kahle (ezigabeni zokugcina kuphela)
- ukuquleka
- Ukuyaluza kwesigaba sokugcina
- Ukukhula kwesisu (kuphela ku-tricuspid endocarditis)
Lezi zimpawu ezingenhla aziqondile futhi zingabangelwa ezinye izifo ezihlukahlukene. Ngenxa yokuthi isiguli sine-mitral valve endocarditis akusho ukuthi izimpawu zaso zibangelwa yileso simo ngokuzenzakalelayo!
Ngokuyisisekelo, uma izimpawu zibangelwa isifo senhliziyo, zizoqhubeka ziba zimbi kakhulu esikhathini esifushane.
Ngakho-ke, ukukhwehlela kwenhliziyo okungelashwa ngendlela efanele kuzoba kubi kakhulu ezinsukwini ezimbalwa noma amasonto ambalwa futhi ekugcineni kuholele ekuphefumuleni okusheshayo ngisho nokuphefumula.
Izimpawu ezihlobene nenhliziyo zihlala zibonisa ukuthambekela kokuba kubi kakhulu - inqobo nje uma kungekho ukwelashwa okwanele.
Ukukhwehlela, okwenzeka ngezikhathi ezithile, ngakho-ke akunakubangelwa isifo senhliziyo esingaphansi. Okufanayo kusebenza ekuphefumuleni, okwenzeka ngokuphindaphindiwe futhi kunyamalale ngokwako.
Izimpawu zibonwa ngumnikazi kuphela ngesikhathi sekwephuzile, lesi sifo siba sibi kakhulu isikhathi eside ngaphandle kokubonisa izimpawu!
Abanikazi abaningi bayamangala lapho inja yabo ngokuzumayo ibonisa ukuphelelwa umoya ngenxa ye-mitral endocarditis ngoba kuze kube yileso sikhathi bebengakaqapheli izinguquko esilwaneni sabo!
Yini Ebangela I-Endocarditis?
I-Endocarditis ibhekisela ekushintsheni okuwohlokayo kuma-valve enhliziyo. Isizathu esiqondile asikaziwa. Ukuvuvukala kwama-valve enhliziyo kwakuyimbangela isikhathi eside, kodwa le mbono iye yaphikiswa isikhathi eside. Cishe isenzakalo sofuzo, esiphinde siphakanyiswe ukwenzeka njalo ezinhlotsheni ezithile zezinja ezincane njengenkosi yeCavalier uCharles Spaniel. Ekugcineni, ukwakheka nokwakheka kwezicubu ezixhumeneyo ze-mitral kanye/noma i-valve ye-tricuspid nama-appendages azo kuyashintsha. Izendlalelo zezicubu ezixhumeneyo zixegisa isibopho sazo, okwenza ivalvu “igoqeke” kanye nokubukeka kwayo okuvame ukufana neklabhu ku-ultrasound. Ngesikhathi esifanayo, eminye imigqa yokumiswa yama-valve enhliziyo (“chordate tendineae”) ingadabula, okuholela ekuqhumeni, okungukuthi “ukubhoboza” kwevalvu efanele. Lokhu kuzophinde kubhebhethekise ukuvuza okukhona. Njengoba sekuchaziwe, i-endocarditis empeleni ithinta kuphela amavalvu amabili e-atrioventricular, okungukuthi i-mitral ne-tricuspid valves. I-mitral valve iyodwa ithinteka ku-60% wamacala, i-valve ye-tricuspid ngo-10%, futhi womabili ama-valve ku-30%.
Sitholakala Kanjani Isifo?
Ukuxilongwa kokuqala ngokuvamile kungenziwa ngesisekelo sokuhlolwa komtholampilo ngokulalela (“i-auscultation”), lapho kuphawulwa khona ukububula kwenhliziyo. Nokho, ukububula kwenhliziyo ngokuvamile AKUKUvumeli ukuba kufinyelelwe esiphethweni mayelana nobukhulu besifo! Ngokuhambisana ne-X-ray, noma kunjalo, usungathola umbono omuhle wezinga lobunzima. Kodwa-ke, ithuluzi elinembile kakhulu lokuxilonga i-ultrasound yenhliziyo kuhlanganise nokuhlolwa kwe-Doppler. Lapha amakamelo ngamanye angalinganiswa ngokunembile futhi i-morphology yama-valve ingahlolwa. Ukuhlolwa kwe-Doppler nakho kwenza kube nokwenzeka ukubonisa nokulinganisa ukugeleza kwegazi okubuyayo. Ngaphezu kwalokho, izitatimende zingenziwa lapha mayelana nomsebenzi wokupompa wamagumbi amakhulu kanye nezingcindezi zokugcwalisa i-intracardiac.
Sithuthuka Kanjani Isifo?
Ngokuvamile lesi sifo siqhubeka kancane kancane. Iziguli ezine-mitral nocardiosis kufanele ziqashwe njalo ukuze zikwazi ukuhlola kangcono inkambo yesifo futhi zikwazi ukungenelela ngokwelashwa uma kunesidingo. Kuvame ukuba neminyaka eminingana phakathi kokutholwa kokuqala kwalesi sifo kanye nokuvela kwezimpawu zomtholampilo. Nokho, lokhu akukwazi ukwenzeka kubo bonke isiguli. Izinja ezinkulu ikakhulukazi zihlukile, njengoba lesi sifo siqhubeka ngokushesha kakhulu lapha. Uma isiguli sisesigabeni sokugcina sinamanzi emaphashini (“pulmonary edema”), isikhathi sokusinda ngokuvamile singaphansi konyaka.
Ingabe Likhona Ithuba Lokululama?
Ngeshwa, cha. Lesi sifo singelashwa kuphela ngezimpawu, kugxilwe lapha ekuthuthukiseni izinga lempilo. Ngenhlanhla, iziguli eziningi zigula lapho sezikhulile, ukuze zingalokothi zibe nezimpawu ngenxa yokuqhubeka kancane kancane kwesifo. Indlela yokwelapha yokuhlinzwa (ukulungisa ama-valve) iyenzeka ngokwethiyori kodwa ayikaze ibe nendima ekwelashweni kwezilwane ngenxa yezindleko ezinkulu.
Yiziphi Izindlela Zokwelapha Ezikhona?
Kumanje kukhulu ukudideka ngale ndaba. Isikhathi eside, kwakuyisiko ukwelapha iziguli ngama-ACE inhibitors noma amalungiselelo e-digitalis kuphela ngesisekelo sokutholwa kwe-wiretapping. Lo mkhuba usuphelelwe yisikhathi. Ngaphambi kokuqala ukwelashwa, isigaba sesifo kufanele sinqunywe nge-X-ray noma, okungcono nakakhulu, i-ultrasound, ngoba inqubo yokwelapha eyengeziwe incike kulokhu.
Izigaba ezilandelayo zingahlukaniswa:
- IMP: Isiguli esisengcupheni: inja ayiguli, kodwa ingenye yezinhlobo ezilindelekile (isb. inja encane, endala, Inkosi yeCavalier uCharles Spaniel)
- B1: Inja engabonakali (noma inja enezimpawu ezingahlobene nesifo senhliziyo) enesifo se-valvular ngaphandle kokwandiswa kwenhliziyo
- B2: Inja engabonakali (noma inja enezimpawu ezingahlobene nesifo senhliziyo) enesifo se-valvular ngokukhula kwenhliziyo
- C: Inja ye-Symptomatic ekuhlulekeni kwenhliziyo ehlangene (i-pulmonary edema) ngenxa yesifo se-valvular
- D: Inja ye-Symptomatic ekuhlulekeni kwenhliziyo ye-refractory congestive engaphenduli ekwelashweni okujwayelekile
Isiteji A
ayikho indlela yokwelapha
Isiteji B1
Izinja ezingenayo inhliziyo ekhulisiwe azikudingi ukwelashwa. Lokhu kubonakala kungaqondakali kubanikazi abaningi ekuqaleni, ngoba isilwane sabo sinesifo senhliziyo, esingalashwa. Kodwa-ke, njengasemithini yabantu, okwamanje awukho umuthi ongathonya kahle inkambo yesifo kulesi sigaba.
Isiteji B2
Nokho, okwamanje, kukhona ukwelashwa okuphumelelayo kwezinja kusukela esigabeni esilinganiselwe lapho kukhona ukukhuliswa kwenhliziyo. Kolunye lwezifundo ezinkulu zenhliziyo yezilwane kuze kube manje, i-pimobendan ibonakale iphumelela kakhulu. Umuthi uholela ekunciphiseni usayizi wemisipha yenhliziyo kanye nokwandiswa okubalulekile kwesikhathi esingenazo izimpawu. Ngakho-ke i-Pimobendan iyisidakamizwa esikhethwayo ezigulini ezinezinhliziyo ezikhulisiwe.
Isiteji C
Iziguli ezincishisiwe ezine-edema yamaphaphu ziphathwa ngenhlanganisela yezidakamizwa zokudonsa amanzi (“diuretics”, furosemide noma torasemide) kanye ne-pimobendan. Ukusetshenziswa kwengubo yokulala yama-ACE inhibitors njenge-benazepril noma i-enalapril noma i-mineralocorticoid antagonist spironolactone kumele kubuzwe ngokujulile futhi kufanele kunqunywe ngokwesisekelo secala ngalinye.
Kwesinye isikhathi kuba nama-secondary arrhythmias enhliziyo, okumele alashwe nge-antiarrhythmic, kuye ngobunzima bawo. Ngokuphambene nemithi yabantu, ukwelashwa okwengeziwe kwe-anticoagulant akudingekile ezinjeni. Njengazo zonke ezinye izifo zenhliziyo, uma ukwelashwa sekuqaliwe, kufanele kuqhutshekwe impilo yonke cishe kuzo zonke izimo.
Isiteji D
Ngaphezu kwezidakamizwa ezishiwo esigabeni C, amanye ama-diuretics afana ne-hydrochlorothiazide noma i-spironolactone nawo angacatshangelwa lapha. Kwesinye isikhathi kuyasiza futhi ukwehlisa umfutho wegazi nge-amlodipine.
Uhlelo olungezansi luyisifinyezo esifushane sezifundo zamanje nemibono yochwepheshe bamazwe ngamazwe ngesincomo sokwelapha esijwayelekile se-mitral endocarditis. Ezimweni ngazinye, nokho, kungase kudingeke ukuba uchezuke ohlelweni lokwelapha olunikezwe lapha.
Ingabe Kunengqondo/Kudingekile Ukushintsha Ukudla?
Ukushintsha indlela yokudla kungaba wusizo ezigulini ezinemiphumela ethuthuke kakhulu, ngaphambi kwalokho cishe akuzuzisi kangako. Ukudla okunosawoti kufanele kususwe ekudleni kwesilwane esigula kakhulu. Ngokufanayo, ukudla okuncane, okunosawoti omncane, okunamandla aphezulu kungasiza ekunciphiseni ukuqina kwezimpawu futhi kuqinisekise ukutholakala kwamandla okwanele. Enye inkinga, nokho, ukuthi izilwane ezifuywayo zivame ukwenqaba ukudla okunosawoti omncane. Khona-ke kungcono ngaso sonke isikhathi ukunikeza ukudla okuthandayo kunokuba ugcizelele "ukudla kwenhliziyo" inja engadli, ngaphandle kwalokho izidingo zamandla esiguli azikwazi ukuhlangabezana nazo. Ezilwaneni ezithinteke kakhulu, ukusetshenziswa kwe-omega-3 fatty acids nakho kungasiza.
Kubalulekile ukuqaphela ukuthi ngokuphambene nenkolelo evamile, iziguli ezinesifo senhliziyo esithuthukisiwe AKUMELE zehlise isisindo. Ukuncipha kwesisindo kubangela ukwanda kokufa ezigulini ezigula kakhulu zenhliziyo. Ukunciphisa umzimba ukuze "ukhulule uhlelo lwenhliziyo" akulungile ezilwaneni ezinesifo esithuthukile!
Ingabe Ama-Electrolyte Afana Ne-Potassium Noma I-Magnesium Kufanele Engezwe Uma Yelashwa Ngezidakamizwa Zokuqeda Umthamo Ophakeme?
Ngokuvamile cha. Isiguli esiphuzayo futhi esidlayo ngokuvamile asidingi ama-electrolyte engeziwe njenge-potassium noma i-magnesium. Indima ye-magnesium ekwelashweni kwezilwane ayikacaciswa ngokucacile, njengoba izinga le-magnesium emzimbeni linzima ukulikala, futhi ukuhlolwa kwegazi okuvamile kuvame ukungaqondakali kakhulu kulokhu. Indima ye-magnesium ingase ilale ekwelapheni i-arrhythmias engazweli ekwelapheni, engenzeka kumongo we-mitral endocarditis. Kodwa-ke, ukwelashwa okuyisisekelo nge-magnesium kufanele kugwenywe, njengoba iziguli eziningi ezihudo zisabela ku-electrolyte.
Inja Yami Yelashwa Ngomuthi Wokuphelelwa Amanzi. Ingabe Kufanele Ngikukhawulele Ukusebenzisa Kwakhe Amanzi?
Impendulo emfushane kuphela iyadingeka lapha: akukho cala!
Yini Ongayenza Njengomnikazi Wesiguli Esigulayo?
Ikakhulukazi iziguli ezisezigabeni eziphambili zesifo zidinga ukunakwa okukhethekile kumnikazi. Ikakhulukazi ezilwaneni ezine-edema yamaphaphu yangaphambilini, kubaluleke kakhulu ukunaka ukukhwehlela okwandayo nokubala njalo izinga lokuphefumula kwesiguli sakho. Lokhu akufanele kube ngaphezu kokuphefumula okungu-45 ngomzuzu lapho uphumule (okubalulekile: ungabali ngemva kokuzikhandla, lokhu kwandisa izinga lokushaya kwenhliziyo ngokuzenzakalelayo). Kubalulekile futhi ukuqaphela izitayela. Uma izinga lokuphefumula likhuphuka - isibonelo, ubala 20/min ekuseni, 40/min emini, futhi 50/min ntambama - lokhu kungase kubonise ukuqala kwe-pulmonary edema futhi kufanele uxhumane nodokotela wakho wezilwane ngokushesha ngangokunokwenzeka. .
Ingabe Kufanele Nginakekele Inja Yami?
Ngeningi lezifo zenhliziyo, umthetho oyisisekelo wukuthi izilwane ezithintekile zivunyelwe ukuzivocavoca ngaphakathi kohlaka ezizinikela ngalo. Izinja ezigulayo zivunyelwe ukuzivocavoca ngokujwayelekile, kodwa uma zifuna ukuthatha ikhefu ekuziqeqesheni, lokhu kufanele kwamukelwe.
Kodwa-ke, ukuqeqeshwa okunamandla kakhulu noma ukuqeqeshwa ekushiseni okuphezulu kufanele kugwenywe ezilwaneni ezinemiphumela emibi kakhulu. Uma ungabaza, udokotela wakho wenhliziyo kufanele akwazi ukukunikeza ulwazi.