Aortic stenosis: ndi chiyani, zizindikiro ndi chithandizo

Zamkati

• Zizindikiro zazikulu
• Momwe mankhwalawa amachitikira
• 1. Mwa anthu opanda zizindikiro
• 2. Mwa anthu omwe ali ndi zizindikiro
• Mitundu yama valve yosinthira
• Zowopsa ndi zovuta zomwe zingachitike pakuchita opaleshoni
• Zomwe zimachitika mukapanda kuchiza aortic stenosis
• Zoyambitsa zazikulu

Aortic stenosis ndi matenda amtima omwe amadziwika ndi kuchepa kwa valavu ya aortic, yomwe imapangitsa kuti kukhale kovuta kupopera magazi mthupi, zomwe zimapangitsa kupuma pang'ono, kupweteka pachifuwa komanso kugundana.

Matendawa amayamba chifukwa cha ukalamba ndipo mawonekedwe ake owopsa kwambiri amatha kubweretsa kufa kwadzidzidzi, komabe, akawapeza msanga, amatha kuchiritsidwa pogwiritsa ntchito mankhwala ndipo, zikavuta, pochita opaleshoni kuti atenge valavu ya aortic. Dziwani momwe kuchira kumakhalira mutachita opaleshoni yamtima.

Aortic stenosis ndimatenda amtima pomwe valavu ya aortic ndi yocheperako kuposa yachibadwa, zomwe zimapangitsa kuti zikhale zovuta kupopera magazi kuchokera pamtima kupita mthupi. Matendawa amayamba chifukwa cha ukalamba ndipo mawonekedwe ake owopsa amatha kubweretsa kufa mwadzidzidzi, koma akawapeza munthawi yake amatha kuchiritsidwa kudzera mu opaleshoni kuti atenge valavu ya aortic.

Zizindikiro zazikulu

Zizindikiro za aortic stenosis zimayamba makamaka chifukwa cha matendawa ndipo nthawi zambiri zimakhala:

• Kumva kupuma pang'ono pochita masewera olimbitsa thupi;
• Kuuma pachifuwa komwe kumawonjezeka pazaka zambiri;
• Kupweteka pachifuwa komwe kumawonjezeka mukamayesetsa;
• Kukomoka, kufooka kapena chizungulire, makamaka pochita masewera olimbitsa thupi;
• Kugunda kwa mtima.

Kuzindikira kwa aortic stenosis kumachitika kudzera pakuwunika kwamankhwala ndi katswiri wamatenda ndi mayeso owonjezera monga chifuwa cha X-ray, echocardiogram kapena catheterization yamtima. Kuyesaku, kuphatikiza pakuzindikira kusintha kwa kagwiridwe ntchito ka mtima, kumawonetsanso chomwe chimayambitsa komanso kuuma kwa aortic stenosis.

Chithandizo cha aortic stenosis chimachitika kudzera mu opaleshoni, momwe valavu yoperewera imalowetsedwa ndi valavu yatsopano, yomwe imatha kukhala yopanga kapena yachilengedwe, ikapangidwa kuchokera ku nkhumba kapena minofu ya ng'ombe. Kuchotsa valavu kumapangitsa kuti magazi apopedwe moyenera kuchokera pamtima kupita mthupi lonse, ndipo zizindikilo za kutopa ndi kupweteka zidzatha. Popanda kuchitidwa opaleshoni, odwala omwe ali ndi aortic stenosis kapena omwe ali ndi zizindikilo amakhala ndi moyo zaka ziwiri.

Momwe mankhwalawa amachitikira

Chithandizo cha aortic stenosis chimadalira gawo la matendawa. Ngati palibe zisonyezo, ndipo matendawa adapezeka kudzera mayeso, sipafunika chithandizo chapadera. Komabe, pambuyo pakuwonekera kwa zizindikilo, njira yokhayo yothandizira ndi opareshoni m'malo mwa valavu ya aortic, pomwe valavu yolakwika imalowetsedwa ndi valavu yatsopano, yowongolera magawikidwe amwazi mthupi lonse. Kuchita opaleshoniyi kumawonetsedwa makamaka kwa odwala omwe ali ndi aortic stenosis yoopsa, popeza kuchuluka kwa anthu akufa. M'munsimu muli njira zothandizira:

1. Mwa anthu opanda zizindikiro

Chithandizo cha anthu omwe sakuwonetsa zizindikiro sizimachitika nthawi zonse ndi opareshoni, ndipo chitha kuchitika pogwiritsa ntchito mankhwala ndi kusintha kwa moyo, monga kupewa masewera ampikisano ndi zochitika zamaluso zomwe zimafunikira kulimbikira. Mankhwala omwe agwiritsidwa ntchito mgululi atha kukhala:

• Kupewa matenda opatsirana endocarditis;
• Kuchiza matenda okhudzana ndi aortic stenosis.

Odwala omwe alibe zizindikilo zomwe zitha kuwonetsedwa pakuchita opareshoni ngati ali ndi valavu yocheperako, kuchepa kwapang'onopang'ono kwa ntchito yamtima kapena kusintha kwakapangidwe kamtima.

2. Mwa anthu omwe ali ndi zizindikiro

Poyamba, ma diuretiki monga Furosemide amatha kumwedwa kuti athetse zizindikilo, koma chithandizo chokhacho chothandiza kwa anthu omwe ali ndi zizindikilo ndi opaleshoni, popeza mankhwalawo salinso okwanira kuthana ndi matendawa. Pali njira ziwiri zochizira aortic stenosis, kutengera momwe thanzi la wodwalayo lilili:

• Kusintha kwa valavu pochita opaleshoni: Ndondomeko yoyeserera yotsegula pachifuwa kuti dokotalayo athe kufikira mtima. Valavu yolakwika imachotsedwa ndikuyika valavu yatsopano.
• Kusintha valavu ndi catheter: wodziwika kuti TAVI kapena TAVR, mu njirayi valavu yolakwika siyimachotsedwa ndipo valavu yatsopano imayikidwa pamwamba pa yakale, kuchokera ku catheter yoyikidwa mumtsempha wachikazi, ntchafu, kapena kuchokera pakadula komwe kali pafupi ndi mtima.

Valve m'malo mwa catheter nthawi zambiri imagwiritsidwa ntchito kwa odwala omwe ali ndi matenda owopsa komanso osakwanitsa kuthana ndi opaleshoni pachifuwa.

Mitundu yama valve yosinthira

Pali mitundu iwiri ya valavu yosinthira opaleshoni yotseguka pachifuwa:

• Mawotchi mawotchi: Zapangidwa ndi zinthu zopangidwa ndipo zimakhala zolimba kwambiri. Amagwiritsidwa ntchito kwa odwala ochepera zaka 60, ndipo atakhazikika, munthuyo amayenera kumwa mankhwala a anticoagulant tsiku lililonse ndikuyesa magazi nthawi ndi nthawi kwa moyo wawo wonse.
• Mavavu Tizilombo: zopangidwa ndi nyama kapena mnofu wa munthu, zimakhala zaka 10 mpaka 20, ndipo nthawi zambiri amalimbikitsidwa kwa odwala azaka zopitilira 65. Mwambiri, palibe chifukwa chomwa maanticoagulants, pokhapokha ngati munthuyo ali ndi mavuto ena omwe amafunikira mankhwala amtunduwu.

Kusankha kwa valavu kumapangidwa pakati pa dokotala ndi wodwalayo, ndipo zimadalira zaka, momwe moyo ulili komanso momwe wodwalayo alili.

Zowopsa ndi zovuta zomwe zingachitike pakuchita opaleshoni

Zowopsa zomwe zimachitika chifukwa cha opaleshoni ya aortic valve m'malo mwake ndi izi:

• Magazi;
• Matenda;
• Mapangidwe a thrombi omwe amatha kutseka mitsempha yamagazi yoyambitsa, mwachitsanzo, sitiroko;
• Kusokoneza;
• Zolakwika mu valavu yatsopano yoyikidwa;
• Kufunika kwa ntchito yatsopano;
• Imfa.

Ziwopsezo zimadalira zinthu monga msinkhu, kuuma kwa mtima komanso kupezeka kwa matenda ena, monga atherosclerosis. Kuphatikiza apo, kukhala mchipatala kumakhalanso ndi zovuta zina, monga chibayo ndi matenda a nosocomial. Mvetsetsani chomwe matenda achipatala ali.

Njira yothetsera catheter, makamaka, imakhala pachiwopsezo chochepa poyerekeza ndi kuchitira opareshoni, koma pali mwayi waukulu wopatsirana ubongo, chimodzi mwazomwe zimayambitsa sitiroko.

Zomwe zimachitika mukapanda kuchiza aortic stenosis

Aortic stenosis osachiritsidwa amatha kusintha ndikukula kwa mtima kugwira ntchito komanso zizindikilo za kutopa kwambiri, kupweteka, chizungulire, kukomoka ndi kufa mwadzidzidzi. Kuchokera pakuwonekera kwa zizindikilo zoyambirira, chiyembekezo chokhala ndi moyo chimatha kukhala zaka 2, nthawi zina, motero ndikofunikira kukaonana ndi akatswiri azachipatala kuti atsimikizire kufunikira kwa opaleshoni ndikuchita pambuyo pake. Onani momwe kuchira kumawonekera mutachotsa valavu ya aortic.

Zoyambitsa zazikulu

Choyambitsa chachikulu cha aortic stenosis ndi msinkhu: kwa zaka zambiri, valavu ya aortic imasinthasintha kapangidwe kake, kamene kamatsatiridwa ndi kudzikundikira kwa calcium ndikugwira ntchito molakwika. Mwambiri, kuyamba kwa zizindikilo kumayamba atakwanitsa zaka 65, koma munthuyo sangamve chilichonse ndipo atha kufa osadziwa kuti ali ndi aortic stenosis.

Kwa achinyamata, chomwe chimayambitsa matenda a rheumatic, komwe kuwerengetsa kwa aortic valve kumawonekeranso, ndipo zizindikilo zimayamba kuwonekera pafupifupi zaka 50. Zina mwazomwe zimayambitsa zovuta ndi kubadwa monga bicuspid aortic valve, systemic lupus erythematosus, cholesterol chambiri ndi matenda a rheumatoid. Mvetsetsani kuti rheumatism ndi chiyani.