Ukulungiswa kwe-cardiac yigama elibhekisela ekuguqulweni kwesayizi nenhliziyo okwenzekayo ekuphenduleni isifo senhliziyo noma ukulimala komzimba.
Uma odokotela bekhuluma ngokuthi "ukulungiswa," bavame ukukhuluma nge-ventricle engakwesokunxele, nakuba ngezinye izikhathi leli gama lisetshenziselwa amanye amakamelo enhliziyo .
Uma ulungisa kabusha indlu yakho, lokho kuvame ukubhekwa njengento enhle.
Okuphambene kuyiqiniso nokulungiswa kwenhliziyo. Ngokuvamile, ukwedlula izinga lokuvuselelwa kwe-ventricular, kubika ukuthi umphumela wesiguli uyingozi kakhulu.
Yini Ebangela Ukulungiswa?
Lapho i-ventricle engakwesokunxele ibonakalisiwe - isibonelo, nge- infarction ye-myocardial (ukushaya kwenhliziyo) noma nge- cardiomyopathy - izinguquko zivame ukuvela ngobukhulu nokuma kwe-ventricle. I-ventricle ijwayele ukukhuliswa, ukuma kwayo jikelele kuba i-globular futhi i-elliptical encane, futhi udonga lwama-muscular of ventricle luvame ukuba lukhulu kakhulu. Lokhu kulungiswa kubangelwa ukucindezeleka komshini kumisipha yenhliziyo eyenziwe yinkqubo engaphansi kwesifo.
Ekuqaleni kwesifo senhliziyo, ezinye izindlela zokulungisa kabusha zingasiza i-ventricle inxephezele umonakalo okwenzekile. Kodwa uma le nqubo yokuqala yokulungisa iqhubekela phambili, futhi izinguquko ngobukhulu nokuma kwe-ventricle zishisa kakhulu, umsebenzi wezinhliziyo uyawohloka futhi ukuhluleka kwenhliziyo kuqhubeka.
Isilinganiso Sokulungisa Ukulinganisa Silinganisani?
Odokotela bangahlola ukuthi ukulungiswa kwenhliziyo kukhona yini, futhi kungalandela izinga lokulungiswa ngokuhamba kwesikhathi, ngezifundo zokucabanga ezivumela ukuba zihlole ubukhulu, ukuma nokusebenza kwe-ventricle kwesokunxele. Ucwaningo oluvame ukusetshenziselwa ukulinganisa ukulungiswa yi- echocardiography ne- MRI .
Lezi zivivinyo aziyona engavamile futhi azivezi isiguli emisebeni, ngakho-ke zingaphindwa njalo uma kudingeka.
Isigaba esilusizo sokulungiswa kabusha yi- fraction ye-ventricular ejection (LVEF) . Ngokujwayelekile, njengoba ubukhulu be-ventricle buyanda, njengoba kuba nesimo sezulu esibonakalayo, futhi njengoba umsebenzi we-muscle womzimba wehla, i-LVEF iyaqhubeka. Uma ukuvuselela kuthuthuka, i-LVEF iphinde ithuthukise.
Kungani I-Concept of Remodeling Yibalulekile?
Nakuba sekuyaziwa ukuthi amashumi amaningi eminyaka ukukhuliswa komzimba kanye ne-LVEF encishisiwe kubi, umqondo wokuthi "ukuvuselelwa kwenhliziyo" kuye kwaba nokusetshenziswa okuvamile phakathi kwe-cardiologists kusukela ngawo-1990.
Lokhu kuboniswe ukuthi umqondo owusizo ngoba kusiza ukuchaza ukuthi kungani ezinye zokwelashwa kwenhliziyo ehlulekayo ngokujwayelekile zithuthukisa ukusinda kwenhliziyo, futhi kungani ezinye izindlela zokwelapha zingenzi.
Ngokwesibonelo, ngesikhathi esisodwa ukusetshenziswa kwezidakamizwa ezino-inotropic kwakusakazeke ekuphatheni ukwehluleka kwenhliziyo. Lezi zidakamizwa zithuthukisa ikhono lobuhlungu bezinhliziyo zenhliziyo ukuze lusebenze ngokuqinile. Nakuba lezi zidakamizwa zenze ngcono ukusebenza kwenhliziyo yonke, kanye nezimpawu zokuhluleka kwenhliziyo, azizange zithuthukise ukusinda kwenhliziyo, futhi empeleni zishesha ukufa. Ngokuphawulekayo, izidakamizwa ezingenayo i-inotropic ngokuvamile aziphuculisi ukulungiswa kwenhliziyo.
Ngokuphambene nalokho, ezinye izinhlobo zokwelashwa kwe-heart - ngokwesibonelo, i- ACE inhibitors kanye nabavimbela i-beta - yenza ngcono kakhulu izimpawu kodwa futhi nokuphila kweziguli ezinesifo senhliziyo. Lezi zindlela zokwelapha nazo zikhawulela ukulungiswa, futhi lapho ukulungiswa sekuvele khona kungathuthukisa usayizi nokuma kwe-ventricle eyonakele.
Lekhono lokuthuthukisa ukulungiswa kwenhliziyo (isici esaziwa ngokuthi izazi ze-cardiologists ngokuvamile ezibhekisela ngokuthi "ukulungisa kabusha") manje sekucatshangwa ukuthi zibaluleke kakhulu ekwelashweni kwenhliziyo.
Abavimbela i-Beta mhlawumbe banikeza isibonelo esihle kakhulu salokhu kucabangela okusha.
Abavimbela i-Beta bathambekela ekunciphiseni amandla okuchotshozwa kwemisipha yomzimba, futhi ngenxa yalesi sizathu, sekuyisikhathi eside kucatshangwa ukuthi lezi zidakamizwa kufanele zigweme ngokuphelele kunoma ubani onokwehluleka kwenhliziyo. Kodwa i-beta blockers iphinde ithuthukise i-geometry ye-ventricle engakwesokunxele, futhi kuziguli ezinokuhluleka kwenhliziyo zivela ukuthi lezi zidakamizwa ziyanciphisa i-LVEF, zithuthukise izimpawu, futhi zandise isikhathi sokusinda.
Okuhlangenwe nakho nge-beta blockers manje kubhekisela kupharagramu entsha evelele ekwelapheni kwehluleka kwenhliziyo - izifo ezingcono kakhulu zokuhluleka kwenhliziyo kubonakala sengathi yizona ezenza ukunciphisa noma ukuguqula ukulungiswa kwe-ventricular.
Yikuphi Ukwelapha Okuthuthukisayo Ukulungiswa?
Ukuthola ukwelashwa okuvimbela noma ukuguqula ukulungiswa manje kuyisihloko esikhulu ekwelapheni ukuhluleka kwenhliziyo. Nasi uhlu lwezokwelapha zokwehluleka kwenhliziyo okuthuthukisa ukulungiswa kwenhliziyo:
- beta blockers
- ACE inhibitors nama-block receptor angiotensin II
- i-hydralazine ne-nitrate
- i-aldosterone inhibition ene-spironolactone
- ukuhlinzekwa ngokweqile noma ukugulisa iziguli ezine- carbohydri egijima
- ukwelapha ukuvuselelwa komzimba
> Imithombo:
> I-Cohn JN, iFerrari R, i-Sharpe N. Ukulungisa kabusha i-cardiac - imiqondo kanye nomthelela omtholampilo: iphepha lokuvumelana elivela esithangamini somhlaba jikelele ekuvuseleleni inhliziyo. Ngenhloso yeForamu Yomhlaba Wonke Yokuvuselelwa Kwezinhliziyo. J Am Coll Cardiol 2000; 35: 569.
> Hunt SA, Abraham WT, Chin MH, et al. Ukubuyekezwa okugxilwe konyaka ka-2009 kufakwe ku-ACC / AHA 2005 Imihlahlandlela Yokuthola Ukuhlolwa Nokuphathwa Kwehluleka Inhliziyo Kubantu Abadala: umbiko we-American College of Cardiology Foundation / i-American Heart Association Task Force on Iziqondiso Zokusebenza: lakhiwa ngokubambisana ne-International Society for Heart kanye nokufakelwa kwezitshalo. Ukujikeleza ngo-2009; 119: e391.