Kuyini Ukulungiswa Nokushintshwa Kwe-Pulmonary Valve? Inhloso, Inqubo & Nemiphumela

Ukulungiswa nokushintshwa kwe-pulmonary valve kuyizinqubo zokuhlinzwa kwenhliziyo ezilungisa izinkinga nge-valve ephakathi kwe-ventricle yakho engakwesokudla senhliziyo nomthambo we-pulmonary. Le valve ngokuvamile ivuleka futhi ivaleke ukuze ilawule ukuhamba kwegazi ukusuka enhliziyweni yakho kuya emaphashini akho, kodwa ngezinye izikhathi ayisebenzi kahle ngenxa yokukhubazeka okuzalwa nakho, izifo, noma ukuguga ngokuhamba kwesikhathi.

Lapho i-pulmonary valve yakho ingasebenzi kahle, inhliziyo yakho kumele isebenze kanzima ukuze ipompe igazi emaphashini akho ukuze lithole umoya-mpilo. Lezi zinqubo zingabuyisela ukuhamba kwegazi okuvamile futhi zisize inhliziyo yakho isebenze kahle, ngokuvamile ithuthukisa kakhulu izinga lempilo yakho.

Kuyini ukulungiswa nokushintshwa kwe-pulmonary valve?

Ukulungiswa kwe-pulmonary valve kusho ukuthi udokotela ohlinzayo ulungisa i-valve yakho ekhona ukuze ayisize isebenze kangcono. Lokhu kungabandakanya ukushintsha ukuma kwama-leaflet e-valve, ukususa izicubu ezinamanxeba, noma ukwandisa ukuvuleka okuncane. Ukulungiswa kuvame ukukhethwa uma kungenzeka ngoba ugcina izicubu zakho zangempela ze-valve.

Ukushintshwa kwe-pulmonary valve kubandakanya ukususa i-valve yakho elimele nokufaka entsha. I-valve eshintshwayo ingaba yomshini (yenziwe ngezinto eziqinile) noma yebhayoloji (yenziwe ngezicubu zezilwane noma zomuntu). Udokotela ohlinzayo uzoncoma inketho engcono kakhulu ngokusekelwe eminyakeni yakho, indlela yokuphila, kanye nesimo senhliziyo esithile.

Zombili izinqubo zihlose ukubuyisela ukuhamba kwegazi okuvamile phakathi kwenhliziyo yakho namaphaphu. Ukukhetha phakathi kokulungiswa nokushintshwa kuncike ekutheni i-valve yakho yonakele kangakanani nokuthi ingalungiswa ngempumelelo yini.

Kungani kwenziwa ukulungiswa nokushintshwa kwe-pulmonary valve?

Lezi zinqubo zokuhlinzwa zenziwa uma i-pulmonary valve yakho ingavuleki noma ivaleki kahle, okwenza inhliziyo yakho isebenze kanzima kunokuba kufanele. Izizathu ezivame kakhulu zihlanganisa ukukhubazeka kwenhliziyo okuzalwa nakho owazalwa nakho, izifo ezilimaze i-valve, noma izinkinga ezivela ekuhlinzweni kwenhliziyo kwangaphambilini.

Ungase udinge lokhu kuhlinzwa uma une-pulmonary stenosis, lapho i-valve incane kakhulu futhi ivimbela ukuhamba kwegazi emaphashini akho. Esinye isizathu esivamile yi-pulmonary regurgitation, lapho i-valve ingavali ngokuphelele futhi igazi livuza emuva enhliziyweni yakho.

Udkt wakho ngokuvamile uzoncoma ukuhlinzwa lapho izimpawu ezinjengokuphefumula kanzima, ukukhathala, noma ubuhlungu besifuba ziqala ukuthinta imisebenzi yakho yansuku zonke. Bangase futhi bakusikisela uma izivivinyo zikhombisa ukuthi inhliziyo yakho iyakhula noma iyabuthaka, ngisho noma ungenazo izimpawu ezisobala okwamanje.

Yini inqubo yokulungisa nokufaka esikhundleni se-pulmonary valve?

Le nqubo ivame ukwenzeka ekamelweni lokuhlinzela esibhedlela ngaphansi kwe-anesthesia ejwayelekile, okusho ukuthi uzobe ulele ngokuphelele ngesikhathi sokuhlinzwa. Ithimba lakho lokuhlinzwa lizobheka inhliziyo yakho, ukuphefumula, nezinye izimpawu ezibalulekile ngokuqhubekayo ngesikhathi sokuhlinzwa.

Ukuhlinzwa okuningi kwe-pulmonary valve kwenziwa ngokuhlinzwa kwenhliziyo evulekile, lapho udkt wakho ehlinzayo enza ukusikeka esifubeni sakho ukuze afinyelele ngqo enhliziyweni yakho. Nakhu okwenzeka ngokujwayelekile ngesikhathi senqubo:

1. Udkt wakho ohlinzayo uvula isifuba sakho ngamathambo esifuba
2. Inhliziyo yakho imiswa okwesikhashana futhi umshini wenhliziyo namaphaphu uthatha ukujikeleza
3. I-pulmonary valve iyatholakala futhi ilungiswe noma ifakwe esikhundleni
4. Zonke izixhumi ziyahlolwa ukuze kuqinisekiswe ukusebenza kahle
5. Inhliziyo yakho iqalwa kabusha futhi isifuba sivalwa

Ezinye iziguli zingase zibe ngabazongenela izindlela ezingahlaseli kakhulu, njengokufakwa esikhundleni se-transcatheter pulmonary valve, lapho i-valve entsha ifakwa nge-catheter emlenzeni wakho. Le nketho ivame ukutholakala kubantu abake bahlinzwa inhliziyo ngaphambilini futhi bahlangabezane nemibandela ethile.

Yonke inqubo ngokuvamile ithatha amahora angu-3 kuya kwangu-5, kuye ngobunzima becala lakho nokuthi ngabe ezinye izilungiso zenhliziyo ziyadingeka ngesikhathi esifanayo.

Ungalungiselela kanjani ukulungiswa nokufakwa esikhundleni se-pulmonary valve?

Ukulungiselela kwakho kuzoqala emasontweni ambalwa ngaphambi kokuhlinzwa ngokuhlolwa okubanzi ukuqinisekisa ukuthi usukulungele inqubo. Lokhu ngokuvamile kufaka phakathi ukuhlolwa kwegazi, ama-X-ray esifuba, i-electrocardiogram, kanye nezithombe ezinemininingwane yenhliziyo ukusiza udokotela ohlinzayo ukuthi ahlele indlela engcono kakhulu.

Ithimba lakho lezokwelapha lizobuyekeza yonke imithi yakho yamanje futhi lingakucela ukuthi uyeke eminye, ikakhulukazi ama-blood thinners, cishe ngesonto elilodwa ngaphambi kokuhlinzwa. Uzophinde uhlangane nodokotela wakho we-anesthesiologist ukuze nixoxe ngomlando wakho wezokwelapha nanoma yiziphi izinkathazo mayelana ne-anesthesia.

Ezinsukwini eziholela ekuhlinzweni, uzodinga ukulandela imiyalelo ethile ukuze unciphise ingozi yokutheleleka:

• Geza ngensipho elwa namagciwane ngobusuku obandulela ukuhlinzwa nangakusasa ekuseni
• Ungadli noma uphuze lutho ngemuva kwamabili ngaphambi kwenqubo yakho
• Lungiselela othile ukuthi akuqhubele esibhedlela futhi ahlale nawe ngemuva kwalokho
• Pakisha izingubo ezinethezekile nezinto zomuntu siqu zokuhlala esibhedlela sakho

Ithimba lakho lezempilo lizophinde lixoxe ngalokho okungakulindela ngesikhathi sokululama futhi lihlele noma yiziphi izinsizakalo zokusekela ongase uzidinge ekhaya. Lokhu kulungiselela kusiza ukuqinisekisa ukuthi ulwela ukuzizwela nokululama okubushelelezi.

Ungazifunda kanjani imiphumela yakho yokuhlolwa kwe-pulmonary valve?

Ngaphambi nangemva kokuhlinzwa kwakho, odokotela basebenzisa izivivinyo eziningana ukuze bahlole ukuthi i-pulmonary valve yakho isebenza kahle kangakanani. I-echocardiogram iyisivivinyo esivamile kakhulu, esisebenzisa amaza omsindo ukudala izithombe ezihambayo zenhliziyo yakho futhi silinganise ukugeleza kwegazi nge-valve.

Imiphumela yakho ye-echo izokhombisa i-valve gradient, elinganisela umehluko wengcindezi ngaphesheya kwe-valve yakho. Ama-gradient wengcindezi ajwayelekile ngokuvamile angaphansi kuka-25 mmHg, kuyilapho ama-gradient angaphezu kuka-50 mmHg ngokuvamile abonisa ukuncipha okukhulu okungase kudingeke ukwelashwa.

Lolu vivinyo futhi lulinganisa ukuhlanza, noma ukuthi ingakanani igazi elivuza emuva ngokuya ngevalvu. Lokhu kuvame ukuchazwa ngokuthi akukho, okuncane, okulula, okuphakathi nendawo, noma okukhulu. Udokotela wakho uzokuchazela ukuthi lokhu kulinganisa kusho ukuthini ngesimo sakho esithile kanye nempilo yenhliziyo iyonke.

Ezinye izilinganiso ezibalulekile zihlanganisa usayizi womgudu wakho wangakwesokudla kanye nomsebenzi, njengoba izinkinga ze-valve ezingapheli zingabangela ukuthi uhlangothi lwenhliziyo olungakwesokudla lukhule noma lube buthakathaka ngokuhamba kwesikhathi. Udokotela wakho uzoqapha lezi zilinganiso ukuze anqume isikhathi esingcono kakhulu sokuhlinzwa futhi aqaphe inqubekela phambili yakho ngemva kwalokho.

Ungayiphatha kanjani impilo yakho ngemva kokuhlinzwa kwe-pulmonary valve?

Ngemva kokuhlinzwa kwakho, ukuphatha impilo yakho kuhilela ukulandela imiyalelo kadokotela wakho ngokucophelela nokuhambela zonke izikhathi zokulandela. Ukululama kwakho kuzoba kancane kancane, abantu abaningi bebuyela emisebenzini evamile phakathi kwamasonto angu-6 kuya kwangu-8, nakuba wonke umuntu ephola ngejubane labo.

Uma uthole i-valve yomshini, uzodinga ukuthatha imithi yokunciphisa igazi impilo yakho yonke ukuze uvimbele amahlule egazi. Lokhu kudinga ukuhlolwa kwegazi njalo ukuze kuqinisekiswe ukuthi izinga lemithi lilungile. Ama-valve e-biological ngokuvamile awadingi ama-blood thinners esikhathi eside.

Uzodinga futhi ukuhlolwa njalo nodokotela wakho wenhliziyo ukuze uqaphe ukuthi i-valve yakho elungisiwe noma eshintshiwe isebenza kahle kangakanani. Lezi zivakashi ngokuvamile zihlanganisa ama-echocardiograms futhi zingancipha ngokuhamba kwesikhathi uma konke kuhamba kahle.

Ukugcina indlela yokuphila enempilo yenhliziyo kungasiza i-valve yakho entsha noma elungisiwe ukuthi ihlale isikhathi eside ngangokunokwenzeka. Lokhu kuhlanganisa ukudla ukudla okulinganiselayo, ukuhlala usebenza ngokomzimba njengoba kunconywe udokotela wakho, nokugwema ukubhema.

Ziyini izici eziyingozi zezinkinga ze-pulmonary valve?

Izinkinga eziningi ze-pulmonary valve zikhona kusukela ekuzalweni njengokukhubazeka kwenhliziyo okuzalwa nayo, okusho ukuthi uzalwa nazo. Lokhu kukhubazeka kwenzeka ngesikhathi sokukhula kwesisu futhi akubangelwa yinoma yini abazali abayenzile noma abangayenzanga ngesikhathi sokukhulelwa.

Noma kunjalo, ezinye izinto zingakhuphula ingozi yakho yokuthuthukisa izinkinga ze-pulmonary valve ngokuhamba kwesikhathi. Ukutheleleka kwenhliziyo kwangaphambilini, ikakhulukazi umkhuhlane we-rheumatic noma i-endocarditis, kungalimaza izicubu ze-valve futhi kuthinte ukuthi isebenza kahle kangakanani ngokuhamba kwesikhathi.

Abantu abake bahlinzwa inhliziyo ngaphambilini, ikakhulukazi beseyizingane, bangase bathuthukise izinkinga ze-pulmonary valve njengoba bekhula. Lokhu kuvamile ikakhulukazi kubantu abazalwa benokukhubazeka kwenhliziyo okuyinkimbinkimbi okudinga ukuhlinzwa okuningi.

Ngokuvamile, izimo ezithile zezokwelapha njenge-carcinoid syndrome noma ezinye izifo ze-autoimmune zingathinta i-pulmonary valve. Ukwelashwa ngemisebe endaweni yesifuba kwesinye isikhathi kungalimaza ama-valve enhliziyo ngemva kweminyaka yokwelashwa.

Ingabe kungcono ukulungisa noma ukushintshwa kwe-pulmonary valve?

Ukulungisa kuvame ukukhethwa uma kungenzeka ngoba ugcina izicubu zakho zangempela ze-valve, ezivame ukuhlala isikhathi eside futhi zisebenze ngokwemvelo kune-valve yokwenziwa. Ama-valve alungisiwe nawo awadingi imithi yokunciphisa igazi yesikhathi eside ezimweni eziningi.

Noma kunjalo, ukulungisa akwenzeki ngaso sonke isikhathi uma i-valve ilimele kakhulu noma ingahlelekile kahle. Kulezi zimo, ukushintshwa kuyadingeka ukuze kubuyiselwe ukusebenza kahle kwenhliziyo. Udokotela ohlinzayo uzohlola ngokucophelela isimo sakho esithile ukuze anqume ukuthi iyiphi inketho ekunikeza umphumela ongcono kakhulu wesikhathi eside.

Isinqumo sincike eminyakeni yakho, indlela yokuphila, nezinye izinto zempilo. Iziguli ezincane zingazuza kakhulu ekulungisweni uma kungenzeka, kuyilapho iziguli ezindala zingenza kahle ngokulinganayo nganoma iyiphi inketho kuye ngezimo zazo.

Ithimba lakho lokuhlinza lizoxoxa ngezinzuzo kanye nobubi bendlela ngayinye ngokusekelwe ecaleni lakho ngalinye. Zombili izinqubo zinamazinga aphumelelayo amahle uma zenziwa ngodokotela ohlinzayo wenhliziyo onolwazi.

Ziyini izinkinga ezingenzeka zezinkinga ze-pulmonary valve?

Uma izinkinga ze-pulmonary valve zingelashwa, zingaholela ezinkingeni ezinzima ngokuhamba kwesikhathi. Inkinga evame kakhulu ukuhluleka kwenhliziyo kwesokudla, lapho uhlangothi lwesokudla lwenhliziyo yakho lukhula futhi luba buthakathaka ngenxa yokusebenza kanzima kakhulu ukuze luphomphe igazi nge-valve engalungile.

Ungase futhi uthole ukushaya kwenhliziyo okungajwayelekile okubizwa ngokuthi ama-arrhythmias, angabangela ukushaya kwenhliziyo, isiyezi, noma ukuquleka. Lezi zinkinga zesigqi zenzeka ngoba imisipha yenhliziyo iba nokucindezeleka futhi uhlelo lukagesi luphazamiseka.

Ezinye izinkinga ezingaba khona zihlanganisa:

• Ukungabekezelelani nokuzivocavoca nokukhathala okukhulu
• Ukwakheka koketshezi emilenzeni yakho, esiswini, noma emaphashini
• Amaqhubu egazi akheka emagumbini enhliziyo akhulisiwe
• Ukufa okungazelelwe kwenhliziyo ezimweni ezingavamile, ezinzima

Izindaba ezinhle ukuthi lezi zinkinga zivame ukuvinjelwa noma zibuyiselwe ngemithi ngesikhathi esifanele. Ukuqapha njalo ngudokotela wakho wenhliziyo kusiza ukubamba izinkinga ekuqaleni lapho zilashwa kakhulu.

Ziyini izinkinga ezingaba khona zokuhlinzwa kwe-pulmonary valve?

Njenganoma yikuphi ukuhlinzwa okukhulu, izinqubo ze-pulmonary valve zithwala ezinye izingozi, nakuba izinkinga ezinzima zingavamile uma zenziwa ngodokotela ohlinzayo onolwazi. Izingozi ezisheshayo zihlanganisa ukopha, ukutheleleka, nokusabela ku-anesthesia.

Abanye abantu bangase babe nokushaya kwenhliziyo okungajwayelekile ngemva kokuhlinzwa, okuvame ukuxazululwa njengoba inhliziyo iphila. Kukhona futhi ingozi encane yokushaywa unhlangothi noma ukuhlaselwa yinhliziyo, ikakhulukazi kubantu abanezimo zenhliziyo ezinye noma izici eziyingozi.

Izinkinga zesikhathi eside zingahlanganisa:

• Ukuguga kwe-valve ngokuhamba kwesikhathi, ikakhulukazi ngama-valve e-biological
• Amaqhubu egazi ngama-valve emishini uma ama-blood thinners engalawulwa kahle
• Ukutheleleka kwe-valve yokwenziwa, okubizwa ngokuthi i-endocarditis
• Isidingo sokuhlinzwa okwengeziwe esikhathini esizayo

Iqembu lakho labahlinzeki lizoxoxa ngalezi zingozi nawe ngokuningiliziwe futhi lichaze ukuthi zisebenza kanjani esimweni sakho esithile. Abantu abaningi benza kahle kakhulu ngemva kokuhlinzwa futhi bathola ukuthuthuka okukhulu ezimpawini zabo kanye nekhwalithi yempilo.

Kufanele ngibone nini udokotela ngezinkinga ze-pulmonary valve?

Kufanele ubone udokotela uma uhlangabezana nezimpawu ezingase zibonise izinkinga ze-pulmonary valve, ikakhulukazi uma unokukhubazeka kwenhliziyo okwaziwayo noma umlando wokuhlinzwa kwenhliziyo. Izimpawu ezivamile zihlanganisa ukuphefumula kanzima ngesikhathi semisebenzi ejwayelekile, ukukhathala okungavamile, noma ubuhlungu besifuba.

Ezinye izimpawu zokuxwayisa zihlanganisa ukuquleka noma izigameko ezicishe zibe yiqiniso, ikakhulukazi ngesikhathi sokuzivocavoca noma umsebenzi womzimba. Ukuvuvukala emilenzeni yakho, amaqakala, noma isisu kungase futhi kubonise ukuthi inhliziyo yakho ayigxumisi ngempumelelo futhi idinga ukuhlolwa.

Uma unenkinga ye-pulmonary valve eyaziwayo, kufanele ufune ukunakekelwa kwezempilo ngokushesha uma uthola:

• Ukuphefumula kanzima okukhulu noma ubunzima bokuphefumula
• Ubuhlungu besifuba obungahambi ngokuphumula
• Ukushaya kwenhliziyo okungajwayelekile noma okusheshayo kakhulu
• Izimpawu zokutheleleka njengomkhuhlane, ikakhulukazi uma unomshini wokwenziwa

Abantu abanezinkinga zenhliziyo abazalwe nazo kufanele bagcine ukuhlolwa okuvamile nodokotela wenhliziyo ngisho noma bezizwa bekhululekile, njengoba izinkinga zingase zivele kancane kancane ngokuhamba kwesikhathi. Ukutholwa nokwelashwa kwasekuqaleni kuholela emiphumeleni emihle kakhulu.

Imibuzo evame ukubuzwa mayelana nokulungiswa nokushintshwa kwe-pulmonary valve

Q.1 Ingabe ukuhlinzwa kwe-pulmonary valve kulungile ekubekezeleni ukuzivocavoca?

Yebo, ukuhlinzwa kwe-pulmonary valve kuvame ukuthuthukisa kakhulu ukubekezela kokuzivocavoca kanye namazinga amandla ewonke. Abantu abaningi bathola ukuthi bangakwazi ukubuyela emisebenzini ababengakwazi ukuyenza iminyaka, okuhlanganisa ezemidlalo nokuzivocavoca umzimba.

Ngemuva kokuhlinzwa okuphumelelayo, inhliziyo yakho ingapompa igazi emaphashini akho ngempumelelo enkulu, okusho ukuthi umzimba wakho uthola umoya-mpilo owudingayo ngesikhathi sokuzivocavoca. Abantu abaningi baqaphela ukuthuthuka emandleni abo okuzivocavoca ezinyangeni ezimbalwa ngemuva kokuhlinzwa njengoba inhliziyo yabo ilulama futhi ivumelana nomsebenzi othuthukisiwe we-valve.

Q.2 Ingabe i-pulmonary valve regurgitation ibangela ukwehluleka kwenhliziyo kwesokudla?

Yebo, i-pulmonary valve regurgitation engathi sína ingaholela ekwehlulekeni kwenhliziyo kwesokudla ngokuhamba kwesikhathi uma ingelashwa. Lapho i-valve ingavali kahle, igazi livuza emuva lingene ku-ventricle yesokudla, okubangela ukuthi lisebenze kanzima futhi ekugcineni likhule futhi libe buthakathaka.

Nokho, le nqubo ngokuvamile ithatha iminyaka ukuthi ithuthuke, futhi ukuhlinzwa ngokuvamile kungavimbela noma kulungise izinkinga zenhliziyo yesokudla uma kwenziwa ngesikhathi esifanele. Yingakho ukuqapha njalo nge-echocardiograms kubaluleke kakhulu kubantu abane-pulmonary valve regurgitation.

Q.3 Zingahlala isikhathi esingakanani izitho zokufaka i-pulmonary valve?

Ukuphila kwe-pulmonary valve replacement kuncike ohlotsheni lwe-valve olusetshenzisiwe. Ama-valve emishini angahlala iminyaka engama-20-30 noma ngaphezulu, kuyilapho ama-valve e-biological ngokuvamile ehlala iminyaka eyi-10-20, nakuba lokhu kuhluka kakhulu phakathi kwabantu.

Iziguli ezincane zingase zidinge izitho eziningi zokufaka i-valve ngesikhathi sokuphila kwazo, kuyilapho iziguli ezindala zingase zidinge esisodwa kuphela. Udokotela ohlinzayo uzoxoxa ngokuphila okulindelekile ngokusekelwe eminyakeni yakho kanye nohlobo lwe-valve olunconyelwe isimo sakho.

Q.4 Ngingaba nezingane ngemva kokuhlinzwa kwe-pulmonary valve?

Abesifazane abaningi bangaba nezingane ngokuphepha ngemva kokuhlinzwa kwe-pulmonary valve, nakuba ukukhulelwa kudinga ukuqapha ngokucophelela udokotela wakho wenhliziyo kanye nodokotela obhekele ukubeletha. Izinto ezibalulekile okufanele zicatshangelwe ukuthi i-valve yakho isebenza kahle kangakanani nokuthi ngabe uthatha imithi yokunciphisa igazi.

Uma unevalvu yomshini futhi usebenzisa ama-blood thinners, ukuphathwa kwemithi kuba nzima kakhulu ngesikhathi sokukhulelwa. Ithimba lakho lezempilo lizosebenzisana ukuqinisekisa ukuthi wena nomntwana wakho nihlala ninempilo enhle ngesikhathi sokukhulelwa nokubeletha.

Umbuzo 5. Yimiphi imisebenzi okufanele ngiyigweme ngemva kokuhlinzwa kwe-pulmonary valve?

Ngemva kokululama, abantu abaningi bangakwazi ukubuyela emisebenzini yabo evamile, okuhlanganisa ukuzivocavoca okulinganiselwe nemidlalo. Kodwa-ke, uma unevalvu yomshini, kufanele ugweme imisebenzi enobungozi obukhulu bokulimala okungase kubangele ukopha okukhulu, njengemidlalo yokuxhumana noma imisebenzi enobungozi obukhulu bokuwa.

Udokotela wakho uzohlinzeka ngemihlahlandlela ethile esekelwe esimweni sakho ngasinye nohlobo lwevalvu. Abantu abaningi bayamangala ukuthi banemikhawulo embalwa kangakanani uma sebeke balulama ngokugcwele emsebenzini wokuhlinzwa.