Okufanele Ukwazi Ngokuziphindaphinda Nge-Tricuspid

Iyini inkinga futhi nini?

Sibutsetelo

Ukuphindaphindiwe-i-valve "evulekile" i-tricuspid valve-isifo sokuxilonga inhliziyo senhliziyo evamile. Abantu abaningi abane-tricuspid regurgitation bamangala kakhulu lapho bezwa ukuthi banenkinga ye-valve yenhliziyo ngoba bazizwa behle. Odokotela babo bavame ukumangala njengoba kunjalo, futhi kungenzeka bangakwazi ukuthi benzeni ngakho.

Uma utshelwe ukuthi uvuselelekile, lokho kusho ukuthini?

Kufanele wena nodokotela wakho bacabange kanjani ngale nkinga futhi yini okufanele uyenze ngokulandelayo?

I-Valid Tricuspid ne-Tricuspid Regurgitation

I-valve ye-tricuspid ihlukanisa i-atrium efanele ukusuka kwe-ventricle efanele. Njengawo wonke amagagasi enhliziyo, inhloso ye-valve ye-tricuspid ukuqinisekisa ukuthi igazi ligeleza ngenhliziyo ngesikhathi esifanele nangendlela efanele. Ngakho-ke, lapho izinkontileka ze-atrium ezifanele, i-valve ye-tricuspid iphoqelelwe ivulekile, ukuvumela igazi ukuba ligijime ngaphakathi kwe-ventricle efanele. I-split yesibili kamuva, lapho i-ventricle efanelekile yokukhipha igazi layo emgodini we-pulmonary, i-valve ye-tricuspid igcina ukugcina igazi lingena emuva libuyele endaweni elungile.

• Funda mayelana namakamelo enhliziyo namagesi.

Ngokuziphindaphinda, i-valve ye-tricuspid ihluleka ukuvala ngokuphelele. Lokhu kuvumela okungenani igazi elithile ligijime emuva-okungukuthi, ukubuyisela emuva-ku-atrium efanele njengezinkontileka ze-ventricle.

Ingozi

Ukuze udokotela nje akhulume ngomuntu ukuthi abuyele emuva akusizi kakhulu, ngoba ukubaluleka kwalesi sifo se-valve kungashintsha phakathi kweyodwa noyedwa. Uma kutholakala ukuphindaphindiwe kwe-tricuspid, kubalulekile ukubona ukuthi kubaluleke kangakanani.

Okungenani ukuphindaphindiwe kwe-tricuspid kubonakala kumaphesenti angaba ngu-70 abantu abadala abavamile abaphethe ama- echocardiograms .

Njengenkontileka ye-ventricle efanele, kuthatha isikhashana noma ezimbili ukuze ivalve ye-tricuspid evamile ivaliwe ngokuphelele, futhi phakathi naleso sikhathi umfutho omncane wegazi uvuza emuva endaweni efanele. Ngokwebuchwepheshe bwanamuhla, i-echocardiogram ivame ukuzwela ngokwanele ukuthola ukuthi "isifo" esivamile segazi-nalaba bantu, ogama lawo amagagasi ajwayelekile, bavame ukutshelwa ukuthi baphinde bavuseleleke, ngakho-ke, inkinga ye-valve yenhliziyo. (Ngaphandle kwalokho, into efanayo eyenzeka ngezinga elithile nge-valve mitral, ehola abantu abaningi ukuba bangafaneleki "ukuxilongwa" nge- valve mitral noma i-MVP .)

Ngakho umbuzo wokuqala ozobuza uma utshelwe ukuthi unesizotha sokuphindaphindiwe ngu: Kunzima kangakanani? Uma impendulo "inomoya omnene kakhulu," kungenzeka ukuthi awunakho ukukhathazeka ngakho.

Kodwa-ke, uma ukuguqulwa kwe-tricuspid kukwahlulelwa njengokweqile noma okunzima, inkinga yenhliziyo ebaluleke kakhulu ukuba khona. Kulesi simo, ukuhlolwa kwenhliziyo kufanele kwenziwe ukuze kutholakale ukuthi kungani imbangela kanye nobukhulu be-tricuspid regurgitation.

Izimbangela

Ukulimala ku-valve ye-tricuspid ngokwayo kungabangela ukuphindaphinda kwe-tricuspid. Izimo ezingalimaza i-valve ye-tricuspid zibandakanya:

• Isifo senhliziyo esiyinkimbinkimbi

• Endocarditis ezithathelwanayo
• I-infarction ye-myocardial ethinta i-ventricle efanele
• Ukufa kwe-Myxomatous ye-valve (efana ne-MVP)
• Ukulimala kusuka ku- pacemaker noma ukuholwa kwe-defibrillator
• I-Marfan syndrome
• I-carcinoid syndrome
• Isifo senhliziyo esiphumele

Kodwa-ke, imbangela evamile kakhulu yokuphindaphindiwe kwe-tricuspid, ekude, kuyisiphazamiso "sokusebenza" se-valve ye-tricuspid. Ngomsebenzi osebenzayo wokuphindaphinda, i-valve ngokwayo iyinto evamile. Ukuvuza okudlula i-valve kwenzeka ngoba isifo senhliziyo senye uhlobo siyaphazamisa inhliziyo-ngokwesibonelo, uma i-atrium efanele noma i-ventricle efanele ihlanjululwa ngendlela evimbela i-valve ye-tricuspid ukuvala ngokuphelele.

Izinkinga zenhliziyo ezivame ukubangela ukusebenza kahle ngokuphindaphindiwe kufaka phakathi:

• I-arteriary artery hypertension
• Ukuhluleka kwenhliziyo
• I-Mitral stenosis noma i- mitration yokuvuselelwa
• Ukubumbana kwamapulmonary
• Hyperthyroidism

Iningi labantu abanezibalo ezibucayi ngokuphindaphindiwe kuzoba neyodwa yalezi zinkinga ezikhiqiza ukusebenza ngendlela efanele, futhi kudingeke ukuthi kuhlolwe okugcwele ukukhomba inkinga ebalulekile.

Izimpawu

Iningi labantu abanezikhwama zokuhlaziywa kwe-tricuspid akunazo izimpawu ezingase zibhekiswe kulesi sifo se-valve ngokwayo. Noma yiziphi izimpawu, uma zikhona, zivame ukubangelwa isimo esibucayi esikhiqiza inkinga yokusebenza i-valve.

Kodwa-ke, uma ukuvuselelwa kwe-tricuspid kunzima, kungase kuvezwe ngokuqondile izimpawu. Lezi zingabandakanya umuzwa we-pulsation engavamile entanyeni, noma ubuhlungu besisu nokuvuvukala. Kodwa ngisho nangesifo esinzima sokuphindaphindiwe, izimpawu ngokuvamile zibangelwa izinkinga ezihlobene nenhliziyo.

Ukuxilongwa

Imibuzo emibili esemqoka emva kokuphindaphindiwe kwe-tricuspid kutholakala ukuthi kufanele kube:

1. Iyini imbangela eyimbangela?
2. Kakhulu kangakanani?

Yomibili yale mibuzo ibalulekile ekunqumeni ukuthi-futhi noma ngabe-ukuphatha inkinga ye-valve.

Ezimweni eziningi, le mibuzo emibili iphendulwa kalula uma udokotela enza umlando wezokwelapha ngokucophelela nokuhlolwa ngokomzimba, futhi uthola i-echocardiogram ephezulu. Ngaleso sikhathi, uhlelo lokuphathwa lungathuthukiswa.

Ukuphathwa

Isinyathelo esibaluleke kunazo zonke ekulawuleni ukuguqulwa kwe-tricuspid ukukhomba nokuphatha izimbangela. Lokhu kubaluleke kakhulu ngokusebenza kabusha kwe-tricuspid, lapho i-valve ye-tricuspid ngokwayo ijwayelekile.

Ukusebenza ngokuphindaphindiwe okusebenzayo kuvame ukubangelwa yi-arteriary artery hypertension. Ukwelapha umfutho wegazi ophezulu we-pulmonary kungaba ngcono kakhulu ukuvuselelwa kwe-tricuspid. Ngakho-ke, izimbangela eziguquguqukayo zomshukela ophezulu we-pulmonary-ikakhulukazi ukwehluleka kwenhliziyo, isifo se-mitral valve, noma i-pulmonary embolus-kufanele iphathwe kabi.

Uma ukuvuselelwa kwe-tricuspid kungasebenzi-okungukuthi, kubangelwa inkinga yangaphakathi ne-valve ye-tricuspid ngokwayo-ukuphathwa kuvame ukuxhomeke ekuqiniseni kokuphindaphindiwe kanye nanoma yiziphi izimpawu ezihambisanayo.

Abantu abanobuhlungu obuncane kakhulu bokuphindaphinda ngaphandle kwezinkinga ezithile zenhliziyo ngokuvamile amagagasi ama-tricuspid avamile, futhi, ngaphandle kwezivivinyo zokulandelela ngezikhathi ezithile, abadingi "ukuphathwa" nhlobo.

Ngisho noma ukuphindaphindiwe kwe-tricuspid kuyinto elinganiselayo noma enzima, uma nje kungekho izimpawu futhi i-echocardiogram ibonisa umsebenzi ovamile wenhliziyo nokucindezeleka kwenhliziyo evamile, akufanele kube khona ukukhawulelwa okubekiwe emisebenzini yomzimba. "Ukuphathwa" kwangempela kuphela ukuhlolwa kabusha ngezikhathi ezithile nomuntu we-cardiologist.

Ukwelapha

Kunezimo ezimbalwa lapho ukuhlinzekwa kwe-valve kufanele kubhekwe khona kubantu abane-tricuspid regurgitation.

Ukwelashwa kufanele kube yindlela yokukhetha uma ukuguqulwa kwe-tricuspid ngokwayo kukwahlulelwa ukuthi kubangela izimpawu ezibalulekile.

Ukuhlinzeka ngokuhlinzwa kwe-valve kunconywa futhi kubantu abanesifo esibucayi se-tricuspid futhi bahlinzwa ukuze bavuselele noma bashintshe i-mitral valve enezifo. Kulesi simo zombili iziphazamisi zibhekwa ngesikhathi sokuhlinzwa okulodwa. Lokhu, ngokude, yisizathu esivame kakhulu sokwenza ukuhlinzwa kwe-valve.

Ngokujwayelekile uma kudingwa ukuhlinzeka, noma nini lapho kulungiswa khona i-valve ye-tricuspid kunconywa esikhundleni sokuguqula i-valve.

Isifingqo

Uma utshelwe ukuthi unesihluku sokuphindaphinda, isihluthulelo sodokotela wakho ukucacisa imbangela eyinkimbinkimbi nobukhulu benkinga. Ngenhlanhla, lokhu ngokuvamile akuyona inqubo enzima noma echitha isikhathi.

Iningi labantu abatholwe ukuthi bane-tricuspid regurgitation bayoba nesimo esibucayi sesiyaluyalu, noma akukho nkinga yangempela nhlobo. Kulabo abahlukumezekayo ngokweqile kuba yinkinga ebalulekile, iningi lizoba nenkinga yokusebenza ye-valve ebangelwa enye ingozi yesifo senhliziyo-futhi ukwelashwa kwabo kuzodinga ukuhlukumeza ngokucindezela leyo nkinga engaphansi. Ukuhlinzwa kokuphindaphindiwe akudingeki njalo.

> Imithombo:

> Kara I, Koksal C, Erkin A, et al. Imiphumela Yokusebenza Okunciphisa Kakhulu Okulingene Okusebenzayo Kuziphindaphindiwe Ezigulini Ezibhekene Nemisebenzi Ye-Mitral Valve: I-Meta-Ukuhlaziywa kweziguli ezingu-2,488. U-Ann Thorac Surg 2015; 100: 2398.

> Nishimura RA, Otto CM, Bonow RO, et al. Umhlahlandlela we-AHA / ACC we-2014 we-Management of Patients nge-Valvular Heart Disease: Umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice. J Am Coll Cardiol 2014; 63: e57.