Yomthambo i-aorta ne-valve esikhundleni: ukusebenza, ukuxakeka kungenzeka, ukubuyekezwa

Kusukela imisipha yenhliziyo incike umuntfu lakhetsa kuphila ngato. Kodwa evamile kwegazi ungakwazi kuqinisekiswe kuphela uma valve inhliziyo tisebenta kahle. Umthwalo enkulu ewela valve yomthambo i-aorta, okwathi ngazo ezinye izifo odlule kungase kuphele ngendlela evamile. Ngakho nesifo senhliziyo, okuholela thuthuva sína kwegazi, futhi ngenxa yalokho lonke umzimba.

Yomthambo i-aorta ne-valve esikhundleni manje kungenzeka. Lesi sihloko sizosisiza sihlole ubufakazi salokhu, lapho wenziwa ukuhlinzwa futhi yiziphi nemiphumela yaso.

Izimbangela inkinga umsebenzi valve

Le valve yenza itholakala phakathi i-ventricle engakwesobunxele kanye aorta, okuyinto uyothwala wonke umzimba nomoya-mpilo egazini. Phakathi nenqubo ukugcwaliswa igazi imisipha yenhliziyo, lokhu umphini kumele ivalwe. Uma i-ventricle kuyehla, ivula futhi ivumela igazi elikuyi-aorta.

Esikhundleni yomthambo i-aorta inhliziyo umphini kuyadingeka uma ayikwazi ukusebenza kahle, okuholela kwegazi ompofu. Kwesinye isikhathi yomthambo i-aorta ne-valve deformity kwenzeka kusukela ekuzalweni - ozalwe. Kodwa kukhona izimo lapho iminyaka eminingi wasebenza njengoba evamile, bese uqala ayivulwanga ngokugcwele futhi ivaliwe, bese ukhuluma mayelana zokugula aluthola of valve yomthambo i-aorta. Lokhu kungenzeka ngenxa bafake ngeminyaka, okuholela ukwanda kwe-calcium ku-valve, futhi okwephula umsebenzi wakhe.

Ngu ukwephulwa wokusebenza umphini kungadala ezinye izifo, zihlanganisa:

• Izinkinga ngemva kokuba ukugula, ezifana strep ukutheleleka kungaba nomnqopho nomthelela ongemuhle ekusebenzeni kwe-valve.
• Endocarditis, lapho lesi sifo sithinta inhliziyo valve yayo.
• useshonile yomthambo i-aorta.
• Ukopha ogangeni yomthambo i-aorta.
• Yomthambo i-aorta ne-valve stenosis, lapho kunzima kangaka ukuthi ngisho ngaphansi kwengcindezi igazi akakwazi uyivule ngokuphelele.
• Isimo lapho valve akakwazi ukuvala ngokuphelele ngemva ejection wegazi, futhi amanye awo ubuyela ventricle.

Zonke lezi zifo nemibandela kungaholela yokuthi kuzodinga ukuhlinzwa ukuze esikhundleni valve yomthambo i-aorta.

Izici okusebenzela valve esikhundleni

Lolu hlobo lokuhlinzwa abhekwa siyisinqumo esinzima kunazo zonke. Ukwenza Ukuhlinzwa okukhulu kwenhliziyo ngaphandle abakwazi njalo udokotela ohlinzayo. Ukuze afeze sokungenela liyadingeka imishini yesimanje kanye ngodokotela abaqeqeshiwe.

Okwamanje, azikho imitholampilo ngokwanele kuleli zwe, ahlome nobuchwepheshe bamuva, ngakho ayikho indlela ukusiza bonke abantu abadinga usizo ngendlela okufika ngesikhathi imisebenzi enjalo. Ukubuyiselwa valve yomthambo i-aorta wenhliziyo - sikhona ukuze abaningi ithuba kuphela ukusindisa izimpilo, kodwa, ngeshwa, akuzona zonke elinde sako.

Kodwa kukhona izikhungo angaphandle noma zenhliziyo abakulungele ukwamukela iziguli zakwamanye amazwe futhi abenzele ngosizo oludingekayo, ngaleyo ndlela esindisa izimpilo.

izinhlobonhlobo valve

Ngisho amathuba yesayensi yanamuhla nobuchwepheshe namanje akunakwenzeka ukwakha ichopho ephelele. Labo zinhlobo asetshenziswa manje, kukhona pluses kanye minuses. Ukuze bavale isikhala salo odokotela abahlinzayo zisebenzisa izinhlobo eziningana lokufakelwa kwezitho:

• valve Mechanical. Dala wesimanje namandla high Alloys yabo. Plus ukusebenza kwabo phakade yabo, kodwa isiguli kuzodingeka kukho konke ukuphila ukuthatha anticoagulants ukuvimbela amahlule.
• valve eziphilayo wokufakelwa owenziwe kusukela izilwane. Ngemva kokufaka kokumpontshelwa igazi thinners zabo azidingeki, kodwa sempilo sokwenziwa zeminyaka 10-15 kuphela, bese uzohlinzwa okwesibili kuyadingeka.
• Anikelelwe valve etholakala umuntu oshonile. valve okunje futhi kungaba ezingahlali phakade.

Lapho kudingeka yomthambo i-aorta ne-valve esikhundleni, kukhethwa zinhlobo kuxhomeke ezicini eziningana:

• Iqembu lobudala iziguli.
• isimo Jikelele zempilo.
• Ngesizathu esithile, engena esikhundleni valve.
• Ukuba khona kwamanye nezifo ezingamahlala khona.
• Kungakhathaliseki isiguli unethuba ukuthatha anticoagulants ukuphila.

Uma uhlobo valve bakhethwa ukuba babe ukusebenza kuyinkimbinkimbi ku esikhundleni sakhe.

Izinhlobo zokuhlinza

Kuze kube muva nje, ukuhlinzwa ukuze esikhundleni valve yomthambo i-aorta enhliziyweni ngempela zidinga kokumisa of imisipha yenhliziyo nemithambo ukuvula esifubeni. Lokhu lokho okuthiwa ukuhlinza evulekile. Phakathi ukuhlinzwa, ukuphila lesiguli alondolozwa a umshini heart-lung.

Kodwa manje emazweni athile imitholampilo Ungashintshanisa umphini yomthambo i-aorta ngaphandle kokuvula esifubeni. Lokhu ukuhlinzwa kancane koda, lapho inhliziyo ukwehluleka ayidingekile, kanye sebeziqhumbuza ezinkulu.

Yiqiniso, kumelwe kushiwo ukuthi imihlangano nezinqubo ezifana kuhlinzwa zidinga udokotela ohlinzayo amakhono yangempela. Ngokwesibonelo, emtholampilo Israeli idume inhliziyo yayo odokotela abahlinzayo, ngakho iziguli eziningi, uma imvume imithombo, ukuya ezweni afeze ukusebenza enjalo.

Ukulungiselela ukuhlinzwa

Yomthambo i-aorta ne-valve esikhundleni kudinga ukulungiselelwa ngokucophelela isiguli. Ngemva uya kudokotela isiguli ezinqunyiwe eziningi izifundo:

• Isinyathelo sokuqala ukuba uthole ukuthi ahlole udokotela wakho.
• Kuyakuba ukuhlolwa igazi.
• It wenza echocardiogram, lapho kubonakala ukuhamba inhliziyo valve yayo.
• Okwenziwe i electrocardiogram, ukulandelela kwenhliziyo yakho.
• Ingabe catheterization inhliziyo - ukwethulwa ngamapayipi mncane okuyothi ngalo ejenti umehluko injected, bese isithombe sithathwa, okuyinto ukunquma ukuba khona izinkinga ukusebenza valve yomthambo i-aorta.

Ezinsukwini ezimbalwa ngaphambi kokuba kokuhlinzwa, isiguli kufanele bagcine iziqondiso ezilandelayo:

• Ukuze ayeke nokusebenzisa izidakamizwa eqeda ukuvuvukala kanye aspirin.
• Ungathathi anticoagulants.
• Ngosuku olwandulela ukuhlinzwa ekudleni ukudla ukukhanya kuphela kufanele kube ingxenye.
• Ngosuku ukuhlinzwa ningelihlanganyele zonke.
• Nezingubo kufanele uzilungiselele akukhawuleli ukunyakaza.

Kwaze kwaba yilapho sebeshiye yonke amalungiselelo adingekayo ukuze kokuhlinzwa, udokotela kufanele sithole isikhathi ukuhlinzwa, futhi ngeke kwenziwe yomthambo i-aorta ne-valve esikhundleni.

ukusebenza

Lapho isiguli etafuleni yokusebenza, unikezwa izinzwa jikelele, futhi ezumeka. Uma ukusebenza Kwenziwa ngokuvula esifubeni ke phakathi udokotela ohlinzayo kwenza imbobo, sikhohlwe esifubeni ukuze bewukwati athole umnyombo.

Dinga ukuboshwa inhliziyo, kwakunokwenzeka ukuba sifeze esikhundleni, ngakho isiguli ixhunywe umshini heart-lung. Udokotela wenza imbobo kule-aorta, susa valve bakhathale noma ilimele futhi esikhundleni salo isethi entsha. Ngemva le-aorta is sutured, inhliziyo imisipha siqala, esifubeni kanye axhunyiwe sutured.

Ngemva kokuhlinzwa esikhundleni valve yomthambo i-aorta

Uma ukusebenza usuphothuliwe, isiguli ithunyelwa Chamber of yokwelapha olunzulu. Lapha-ke esuswa izinzwa, futhi ukuqapha imisebenzi ebalulekile:

• Ezimisele kwenhliziyo.
• ukuphefumula elibukhali futhi wegazi.
• Ungene okuqukethwe oxygen egazini.
• Emlonyeni, futhi kulula ukufaka tube ukuze kungene umoya ezengeziwe.
• Ilingana ngokuchitha amanzi uketshezi lapho thorax.
• Isiguli lufakwa ipayipi ku esinyeni sokukhipha umchamo.
• Ingabe iqondiswa ngqo emthanjeni amaphilisi ezinhlungu, uketshezi electrolyte.

Ngemva yomthambo i-aorta ne-valve esikhundleni nesineke ngokuvamile uchitha 5-7 izinsuku esibhedlela, uma azikho izinkinga.

Izinkinga phakathi nokuhlinzwa

kokungenela Wasebenza ku inhliziyo - kuba njalo ingozi enkulu. Lapho esikhundleni nalehleliwe valve yomthambo i-aorta, ukuxakeka kungabandakanya:

• Ukutheleleka.
• ukopha Okungenzeka phakathi nokuhlinzwa.
• Ukubukeka amahlule, unhlangothi, noma uma kube nenkinga kanye nezinso.
• Izinkinga ngokusungula indlela yokubulala izinzwa.

Kunezici ukuthi kwandisa ingozi yokungenwa yezinkinga ngesikhathi ukuhlinzwa:

• Ukuba khona isifo senhliziyo.
• Lung isifo.
• Umfutho ophakeme wegazi.
• Ngifundise ngesifo sikashukela.
• Ukukhuluphala.
• Ukubhema.
• Ukuba khona ukutheleleka emzimbeni.

yezinkinga postoperative

Ukuze yimiphi dokotela Akubalulekile nje kuphela inqubo ukusebenza futhi umphumela wayo, kodwa futhi inkathi yokutakula, okuyinto kungase kuhambisane eziyingozi:

1. Overgrowth ka isibanda izicubu. Kukhona amacala lapho ngemuva kokuhlinzwa isiguli endaweni esikhundleni valve likhula ngokushesha fibrous isibanda izicubu. Le nqubo akuxhomekile izinhlobo valve futhi kungaholela thrombosis. Kodwa sibonga ubuchwepheshe banamuhla bokuhlinzwa, lokhu yinkinga lokhu ezingavamile.
2. Ukopha e seziguli ezithola anticoagulants. Futhi lesi simo singenzeka hhayi kuphela endaweni valve, kodwa futhi kuphi emzimbeni, ezifana esiswini.
3. Thromboembolism. Kungaba ukuqaphela izenzo ezilandelayo:

• Isiguli sinelungelo iphika.
• Ukudideka.
• Wakhohlwa kanye ukuzwa.
• Ukuba ndikindiki futhi ubuthaka emzimbeni.
• Isiyezi.

4. Ukutheleleka enikeziwe valve. Ngisho valve oyinyumba, kanye ngaphakathi, kungenzeka zibe ngaphansi kwe ukutheleleka. Yingakho, lapho ngokungazelelwe lokushisa lomzimba liyaphuma, zikhona izinkinga zokuphefumula, kubalulekile ukuba ngokushesha azise udokotela ukuhlaziya nekugwema valve ukutheleleka.

5. Hemolytic igazi. Uma kukhona ukulimala inqwaba erythrocyte ngesikhathi ukuxhumana impahla valve. Kukhona ubuthakathaka namandla, ukukhathala ukuthi ingahambi emva ukuphumula.

Njengomthetho, phambi yesifo senhliziyo yesiguli has iqembu ethile ukukhubazeka. Konke lokhu kunqunywa umsebenzi okhethekile odokotela. Uma esikhundleni valve yomthambo i-aorta, ngenxa yokukhubazeka, ungeke ingasuswa uma umkhandlu lodokotela ekholelwa ukuthi uwena izinzuzo enempilo futhi obalulekile kusuka ngomhla ka isimo awudingi. Kwezinye izimo, shiya 3 iqembu.

Isikhathi nasezinkingeni ezilandela ngemva kokuhlinzwa

Izinsuku ezimbalwa isiguli emva kokuhlinzwa ukuze umphini esikhundleni imijovo umuthi wezinhlungu okudambisa ubuhlungu. Kodwa ngemva kwesikhathi esithile ukuchithwa kwabo. Ngaphezu kwalokho, isiguli kusengenzeka uhlangabezana nezinkinga ezilandelayo:

• emkhawulweni edema.
• Ubuhlungu endaweni imbobo.
• Ukuvuvukala endaweni lapho imbobo senziwa.
• Isicanucanu.
• Ukujoyina ukutheleleka.

Uma zonke lezi zimpawu ukuqhubeka isikhathi eside, kufanele utshele udokotela wakho. ukuba esikhundleni yomthambo i-aorta ukuhlinzwa umphini (izibuyekezo nesineke uma ukhuluma nayo ngokuzibulala) zibangela nentuthuko ephawulekayo amaviki ambalwa. Ngaphawula ushintsho oluhle Obalulekile kwenzeka ezinyangeni ezimbalwa.

Ngemva kokuhlinzwa, odokotela batusa ukuthi umbuso umsebenzi futhi ukuphumula futhi ngokuqinile dosed umthwalo ngokomzimba.

Okuhle kunakho konke ukuthi, uma isikhathi ekululameni kwesiguli ngeke ekhaya futhi izikhungo, efana esibhedlela noma nezenhliziyo Recreation Centre.

Lapho, ngaphansi kokuqondisa odokotela ukubuyiselwa emzimbeni, ngalinye akhethiwe Uhlelo ngabanye. Ukuvuselelwa kungathatha obuphelele ezahlukene isikhathi. Zonke kuncike isimo jikelele isiguli, yinkimbinkimbi ukusebenza namakhono okuzivuselela i umzimba.

Nakanjani udokotela isiguli emva kokuhlinzwa ebekiwe izidakamizwa. Ukuthatha kubo kudingeka liqalise ngokuqinile isikimu bese ukhansela bangakuqinisa siqu cha.

Uma udinga ezihlukahlukene ukuze athole ukwelashwa komzimba, kokungenela yezokwelapha ke qiniseka ukukwazisa kusuke kukufanelekele yokufakelwa valve yomthambo i-aorta.

Uma kukhona zihlobene nesifo senhliziyo, bese esikhundleni sabo umphini asisona isisombululo sazo, ngakho-ke kuyadingeka ukuba uvakashele wenhliziyo kanye nokuqalisa yokwelapha ezifanele.

ukwelashwa Ukuvuselelwa ekhaya

Uma isiguli ayinakho indlela ukuya ukuthola ukusuka zokuhlinza esibhedlela, kubalulekile ukuba ngokuqinile ukuhambisana nayo yonke izincomo udokotela ekhaya.

1. Uma valve mechanical, kufanele kube impoqo ukuthatha anticoagulants, futhi ukukwenza abe nokuphila.
2. Uma kufanele kokungenela zamazinyo noma ezinye izinqubo zokuhlinza, qinisekisa ukuthi uya phambi kwabo imithi elwa namagciwane ukuvimbela ukuvuvukala endaweni ka-valve.
3. Ngempela kubalulekile ukulawula ibhalansi uketshezi emzimbeni.
4. Ukuze wenze ukuzivocavoca esikhethekile udokotela izincomo ukusiza kujwayeleke umsebenzi zokuphefumula.
5. Ukwenza hardware zokuvimbela i-pneumonia.

ukuhambisana kuphela nazo zonke izincomo udokotela kuyokwenza ukuphila ngemva yomthambo i-aorta ne-valve esikhundleni evamile futhi wanelisa.

Kugucula tindlela tekuphila

Noma yimuphi ukuhlinzwa ku imisipha yenhliziyo kudinga wokubuyekeza eyisisekelo indlela yokuphila. Yomthambo i-aorta ne-valve esikhundleni (izibuyekezo kuphela uqinisekise lesi) - iyathinteka. Iziguli zinamathuba emva kokuhlinzwa:

1. Ukuphungula ekuphileni kwakhe yonke imikhuba emibi, ngaphandle-ke, umgwaqo ukuphila. Ukubhema, nophuzo oludakayo, futhi ukusetshenziswa eliningi caffeine ayihambelani nge umphini yokufakelwa, futhi ngempela nge kwezinso zenhliziyo.
2. Kuyodingeka kusukela ekudleni kwakho cishe ukuqeda ukudla okunamafutha.
3. Ukunciphisa kusawoti ngelanga akuyona ezingaphezu kuka 6 amagremu.
4. Ukudla kufanele silinganisele futhi zihlanganisa nezinhlobo ezingaphezu nezithelo nemifino eminingi.
5. Phuza amanzi okumsulwa ngokwanele, kodwa akukho igesi.
6. Kancane kancane ukwethula umthwalo, ozokusiza ukuqinisa imisipha yenhliziyo.
7. Nsuku zonke, kungakhathaliseki ukuthi isimo sezulu nihambahambe emoyeni opholile.
8. Ukuphungula ezisuke epilweni yabo sindisa psycho-ngokomzwelo, ukucindezeleka.
9. Yiba kanye esimisweni usuku udokotela futhi unamathele kuso.
10. Yidla mzimba ukulondoloza amaminerali ibhalansi.

Uma ukubuka Izibuyekezo ekubulaleni iziguli ezigulela Ngahlinzwa for umphini esikhundleni, singabona ukuthi ingxenye enkulu wakwazi ukubuyela ukuphila okuvamile. Sezadlula lezo zimpawu ezingemnandi ukuthi enganikanga ukuphumula umsebenzi inhliziyo evamile.

Yomthambo i-aorta ne-valve esikhundleni (izibuyekezo uqinisekise lesi) akusona isithiyo ngoba ukukhulelwa esizayo. Abesifazane abaningi abaphethwe isifo senhliziyo, ngisho wayenethemba lokuba ezidunjini ezomisiwe, futhi lo msebenzi ibanika ukuthi ithuba.

Kulesi simo, into esemqoka - ukuthola isazi abanekhono, khona-ke ungaqiniseka e umphumela omuhle wokusebenza. Isayensi yanamuhla futhi imithi enze kube nokwenzeka ukuba ningabeki isikhubekiso ukuphila kwakhe esiphambanweni, ngisho nalapho kukhona kwezinso sína inhliziyo, ngakho ungadikibali. Omunye kumele njalo ithemba engcono, futhi isimangaliso kwenzeka - inhliziyo yakho izosebenza eside futhi enokwethenjelwa. Zinakekele futhi uhlale unempilo.