Ukuhluka kwe-echocardiography kanye ne-transcranial Doppler kungasiza ekuxilongweni
Ukutadisha i-bubble kuyilingo elingavumelekile elivumela odokotela ukuba bahlole ukugeleza kwegazi ngenhliziyo. Kuvame ukusetshenziselwa ngokubambisana ne- echocardiogram (lapho kwenzeka odokotela bavame ukukubiza ngokuthi "ukuhlukanisa ama-echocardiography,") noma isifundo se-Doppler (Transcranial Doppler study) . Ukutadisha nge-bubble kuvame ukuqhutshwa uma kubonakala sengathi i- patent foramen ovale (PFO) .
Ukuthi Isifundo Sebhola Senziwe Kanjani
Ukufundwa kwe-bubble kunenzuzo yokuthi uma amagagasi omsindo ahlangana nezinhlobonhlobo zemidiya yemvelo - kulokhu i-gas vs liquid - ihlabeza ngokuzungezile, futhi idala ama-wave "ama-echo" amaningi. Lawa mazayi echokheni abonakala ku-echocardiogram njengokwanda okukhulu .
Esikhathini sokutadisha okuvamile, isisombululo se-saline sigxilile ngamandla ukuze kuvezwe ama-bubbles amancane bese ijojelwa emvuthweni. Njengoba ama-bubbles ahamba phakathi kwe-vein nasehlangothini lwesokudla senhliziyo, ukukhula okwenyukayo abakwenzayo emfanekisweni we-echocardiography kuvumela udokotela ukuba empeleni abukele amabhubhu adlula emagumbini enhliziyo.
Uma inhliziyo isebenza ngendlela evamile, ama-bubbles azobonakala ebona i-atrium elungile, khona-ke i-ventricle efanele, bese uphuma umthambo we-pulmonary kanye namaphaphu, lapho ehlungiwe khona.
Noma kunjalo, uma kubonakala ukuthi amabhubhu angena ohlangothini lwesobunxele senhliziyo, lokhu kubonisa ukuthi kukhona ukuvula okungavamile phakathi kwezinhlangothi zombili zenhliziyo-okuthiwa i-intracardiac shunt.
Loluhlobo lwe-shunt engavamile lungakhiwa, ngokwesibonelo, yi-PFO, i -septal defect ye - atrial , noma i-septric defect defect.
Njengamanje, izinhlobo zezentengiselwano ze "bubbles" zitholakalayo ukuthi zisetshenziswe ngesikhathi sokufunda kwe-bubble. Lawa mafutha amasha avame ukuqukethe amaprotheni amancane amaprotheni noma ama-phospholipid afaka igesi. Lawa ma-agent amasha abonakala ephephile, futhi anganikeza ukucabanga okungcono kwe-echo kwezinye izimo. Kodwa-ke, zibiza kakhulu kunesixazululo saline esizungezile.
Izifundo zeBlue For Patent Foramen Ovale
Isizathu esivamile kakhulu sokwenza isifundo se-bubble ukufuna i-PFO. Kulezi zifundo, kuyilapho lezi zinyosi zijova emgodini, isiguli siceliwe ukuba senze umkhondo we- valsalva (okungukuthi, ukwehla njengokungathi kukhona nokunyakaza kwesisu).
Ukuhamba kwe-valsalva kuphakamisa kancane kancane izingcindezi ngakwesokunene kwenhliziyo, ukuze uma i-PFO ikhona, ama-bubbles angabonakala efaka i-atrium kwesokunxele. Ama-bubbles avela e-atrium kwesokunxele ngesikhathi sokuhlolwa eqinisekisa ukuba khona kwe-PFO.
Isizathu esiyinhloko odokotela abakhathazeka ngayo nge-PFOs kungenzeka ukuthi bangavumela ukuba ama-blood clots angene ohlangothini lwesobunxele uma inhliziyo, lapho kungase kungene khona ukujikelezwa kobuchopho futhi kuvezwe ukushaywa komzimba .
Ngenhlanhla, kuyilapho ama-PFO ajwayelekile (okwenzeka kubantu abangaba ngu-25%), aholela ekushayweni okungajwayelekile.
Ngakho-ke, ngenkathi isifundo esihle se-bubble singase siqiniseke ukuthi kukhona i-PFO, ayitshele udokotela kakhulu ukuthi kungenzeka ukuthi unomdlavuza.
Ochwepheshe abaningi bacabanga ukuthi indlela engcono yokuhlola ukuthi i-PFO ingase idale isifo sokushaya isifo sokuqhuba isifundo seDoppler ngokuhambisana nesifundo se-bubble.
Esifundweni se-TCD, amasu echotsheni asetshenziselwa ukubona ngeso lengqondo amabhulebhu ahamba ngemithambo yegazi yobuchopho. Ucwaningo lwe-TCD lungathola ukuthi ama-bubbles ajojowe emthanjeni empeleni angena ekujikelezeni kobuchopho. Uma kunjalo, i-PFO ibonakala ingaba yingozi yokwehla kwesifo, futhi udokotela uzobe esenconywa ukuthi aphakamise ukwelashwa kwe-antiticoagulation , noma, uma isifo sesivele senzekile, kungenzeka ukuvalwa kwe-PFO.
> Imithombo:
> Mulvagh SL, uRakowski H, Vannan MA, et al. I-American Society of Echocardiography Isitatimende Sokuvumelanisa Ngezicelo Zomtholampilo Zama-Contractors ahlukeneyo e-Ultrasonic ku-Echocardiography. J Am Soc Echocardiogr 2008; 21: 1179.
> Romero JR, Frey JL, Schwamm LH, et al. Imicimbi ye-Ischemic Cerebral ehlanganiswa ne-'Blue Study 'Yokukhomba Ukunene KwamaKhokhi Okungakwesokunxele. Isigameko sika-2009; 40: 2343.
> Parker JM, Weller MW, Feinstein LM, et al. Ukuphepha kwama-Contrast Ultrasound ezigulini ezineziguli ezinqatshelwe noma ezinqatshelwe izinhliziyo. Am J Cardiol 2013; 112: 1039.