I-endocarditis iyisifo sokungena ngaphakathi kwenhliziyo (i-endocardial lining). I-endocarditis ivame ukubangelwa ukutheleleka kwebhaktheriya futhi ingabandakanya ukugcoba okungapheli kwamagundane enhliziyo kanye nesisindo senhliziyo ngokwayo. Ukunikeza ama-antibiotic ukuzama ukuvimbela i-endocarditis kubizwa ngokuthi "endocarditis prophylaxis."
I-Rationale Behind Endocarditis Prophylaxis
Ngenxa yokuthi i-endocarditis ingabhubhisa izinhliziyo ze-muscle nezinhliziyo ze-valve, njalo kuyinkinga enkulu futhi ngokuvamile isongela impilo.
Ngaphezu kwalokho, i-endocarditis ingaba nzima kakhulu ukwelapha, ngoba ukwelashwa kungadinga amasonto amaningana ama-antibiotic emithi, futhi ngezinye izikhathi kudinga ukuhlinzeka ngenhliziyo evulekile. Ngokusobala, kungcono ukuvimbela i-endocarditis kunokuyiphatha.
Nakuba izivivinyo ezinkulu zemitholampilo ezifakazela ukuthi ukusebenza kwe-endocarditis prophylaxis kuntuleka, kunezizathu ezinamandla zokwenza izinto.
I-Theory of Endocarditis Prophylaxis
Kubantu abaningi, lapho inamba encane yebhaktheriya ingena egazini, indlela yokuzivikela yomzimba ingasusa amabhaktheriya egazini ngokushesha nangempumelelo.
Kodwa-ke, kubantu abanezinkinga ezithile zenhliziyo, amabhaktheriya angabanjwa ngaphakathi kwegazi eligelezayo ngaphakathi kwenhliziyo, futhi "abambelele" emgqeni wokugcina, lapho bangabangela khona ukutheleleka.
Umqondo we-endocarditis prophylaxis ukusebenzisa ama-antibiotics ukubulala noma yiziphi amagciwane ezifaka igazi ngaphambi kokuba zithole ithuba lokusetha isifo ngaphakathi kwenhliziyo.
Ngenxa yalesi sizathu, ochwepheshe batusa ukuthi abantu abanengozi enkulu yokuthuthukisa i-endocarditis kufanele bathole imithi yokulwa ne-prophylactic ngaphambi kokuba benze izindlela zokwelapha ezingase zenze amabhaktheriya egazini.
Ingabe Kufanele Kusetshenziswe I-Prophylaxis?
Ubufakazi bamuva bubonisa ukuthi abantu abaningi abanezimo zenhliziyo empeleni basengozini enkulu yokugcina i-endocarditis kunalokho okukholelwa ngaphambili, ngakho-ke ayidingi i-endocarditis prophylaxis.
Imihlahlandlela iye yavuselelwa kakhulu yi-American Heart Association kanye ne-American College of Cardiology ukubonisa lokhu kuqonda okusha.
I-endocarditis prophylaxis manje inconywa kuphela kubantu abasengozini enkulu yokugcina i-endocarditis.
Lokhu kufaka:
- iziguli ezinezivalo zenhliziyo zokufakelwa
- iziguli eziye zalungiswa ngenhliziyo zisebenzisa izinto zokwelashwa (inothi: lokhu akubandakanyi i-coronary artery stents )
- iziguli ezinomlando wangaphambili we-endocarditis
- iziguli ezinesifo senhliziyo esingazalwa kahle noma esingenakulungiswa ngokuphelele
- iziguli eziye zafakelwa izinhliziyo ezakha izinkinga ze-valve yenhliziyo kamuva
Kufanele kuqaphele ukuthi imihlahlandlela yamanje ayincomo i-endocarditis prophylaxis yeziguli eziningi ezine- aortic stenosis , ukuvuselelwa kwe-aortic , noma isifo se-mitral valve (kuhlanganise nalabo abane- valve mitral valve ), noma iziguli ezine- cardiomyopathy hypertrophic .
Yiziphi izinqubo?
Iziqondiso ezintsha zincoma prophylaxis kuphela kulezi zindlela zokwelashwa:
- izinqubo zamazinyo ezihilela ukuphathwa kwezinsini noma izimpande zamazinyo, kuhlanganise nokuhlanzwa kwamazinyo okuvamile.
- izinqubo ezidinga ukucubungula noma iziqu zephefumula noma umlomo, njenge- tonsillectomy , noma i- bronchoscopy nge-biopsy.
- izinqubo ezihilela ukubhekwa kwezicubu ezinesifo.
Ngokuphawulekayo, i-antibiotic prophylaxis ayisasetshenziselwa izinqubo zezinqubo zamathunjini noma ze-genitourinary.
Yikuphi ama-Antibiotics?
Ngokuvamile, i- amoxicillin inconywa njenge-antibiotic yokukhetha uma i-prophylaxis iyadingeka. I-American Heart Association ine- guide to endocarditis prophylaxis ebala amanye ama-antibiotic uma kwenzeka i-amoxicillin ingasetshenziswa.
Imithombo:
Wilson W, Taubert KA, Gewitz M, et al. "Ukuvimbela i-endocarditis yokuphefumula: izinkombandlela ezivela ku-American Heart Association: isiqondiso esivela ku-American Heart Association Rheumatic Fever, Endocarditis, neKomishana Yezifo Ze-Kawasaki, uMkhandlu Wezifo Zezinhliziyo Ezinganeni, kanye noMkhandlu Wezokwelapha Kwezemithi, uMkhandlu Wokuhlinzwa Kwezinhliziyo Nezifo Zomzimba I-Anesthesia, neQiniso Yokunakekelwa Nemiphumela Imiphumela Yezokucwaninga Emisebenzini Yezokucwaninga. " Ukujikeleza. 2007 Oct 9; 116 (15): 1736-54.
Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA / ACC isiqondiso sokuphathwa kweziguli ezine-valvular isifo senhliziyo: umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice. J Am Coll Cardiol 2014; 63: e57.