Zizindikiro za Khansa ya Mtima: Zomwe Muyenera Kuyembekezera

Zamkati

• Chidule
• Zizindikiro za khansa ya mtima
• 1. Kutsekeka kwa magazi
• 2. Kulephera kwa minofu ya mtima
• 3. Mavuto ogwirira
• 4. Embolus
• 5. Zizindikiro zadongosolo
• Zomwe zimayambitsa khansa yamtima
• Kuzindikira kwa khansa yamtima
• Njira zochizira khansa yamtima
• Zotupa za Benign
• Zotupa zoyipa
• Khansa yachiwiri yamtima
• Maonekedwe a zotupa za mtima
• Kutenga

Chidule

Zotupa zam'mtima zoyambira ndikukula kosazolowereka mumtima mwanu. Iwo ndi osowa kwambiri. Malingana ndi European Society of Cardiology (ESC), amapezeka pansi pa munthu mmodzi mwa anthu 2000 amene anafa.

Zotupa zam'mtima zoyambirira zimatha kukhala zopanda khansa (zotupa) kapena khansa (zoyipa). Zotupa zoyipa zimakula kukhala nyumba zapafupi kapena zimafalikira mbali zina za thupi (metastasize), koma zotupa zoyipa sizitero. Zotupa zambiri zam'mtima ndizabwino. ESC imangonena kuti 25% yokha ndioyipa.

Zotupa zina zoyipa ndi izi:

• sarcomas (zotupa zomwe zimayamba mu minofu yolumikizana ngati minofu yamtima ndi mafuta), monga angiosarcoma ndi rhabdomyosarcoma
• chachikulu mtima lymphoma
• matenda a mesothelioma

Zotupa zina zoyipa ndi izi:

• myxoma
• fibroma
• rhabdomyoma

Khansara ya sekondale yamtima yasintha kapena kufalikira pamtima kuchokera ku ziwalo zoyandikira Malinga ndi ESC, imachitika kangapo kawiri kuposa zotupa zamtima koma sizachilendo.

Khansa yomwe imafalikira kapena kufalikira pamtima nthawi zambiri ndi iyi:

• khansa ya m'mapapo
• khansa ya pakhungu (khansa yapakhungu)
• khansa ya m'mawere
• khansa ya impso
• khansa ya m'magazi
• lymphoma (izi ndizosiyana ndi zam'mimba zam'magazi zam'magazi momwe zimayambira mumatumbo, ndulu, kapena mafupa m'malo mwa mtima)

Zizindikiro za khansa ya mtima

Zotupa zamtima zoyipa zimakula msanga ndikuwononga makoma ndi mbali zina zofunika za mtima. Izi zimasokoneza kapangidwe ndi mtima wa mtima, zomwe zimayambitsa zizindikilo. Ngakhale chotupa chosaopsa cha mtima chimatha kuyambitsa mavuto akulu ndi zizindikilo ngati chikakamira pazinthu zofunika kapena pomwe chimasokoneza ntchito yamtima.

Zizindikiro zopangidwa ndi zotupa za mtima zimawonetsa komwe ali, kukula, kapangidwe kake, osati mtundu winawake wa chotupa. Chifukwa cha izi, zizindikiritso zamatenda amtima zimatsanzira zina, zofala, zamtima monga mtima kulephera kapena arrhythmias. Chiyeso chotchedwa echocardiogram chimatha kusiyanitsa khansa ndimatenda ena amtima.

Zizindikiro za khansa yayikulu yamtima zitha kugawidwa m'magulu asanu.

1. Kutsekeka kwa magazi

Chotupa chikamakula kukhala chipinda chimodzi cha mtima kapena kudzera pa valavu yamtima, chimalepheretsa magazi kudutsa mumtima. Zizindikiro zimasiyanasiyana kutengera komwe kuli chotupa:

• Atrium. Chotupa m'chipinda cham'mwamba cha mtima chimalepheretsa magazi kulowa muzipinda zapansi (ma ventricles), kutsanzira tricuspid kapena mitral valve stenosis. Izi zitha kukupangitsani kuti musamve mpweya komanso kutopa, makamaka mukamayesetsa.
• Mpweya wabwino. Chotupa mu ventricle chimalepheretsa magazi kutuluka mumtima, kutsanzira aortic kapena pulmonary valve stenosis. Izi zimatha kuyambitsa kupweteka pachifuwa, chizungulire komanso kukomoka, kutopa, komanso kupuma movutikira.

2. Kulephera kwa minofu ya mtima

Chotupa chikamakulira m'makoma mwamtima, amatha kukhala ouma ndikulephera kupopera magazi bwino, kutsanzira mtima kapena kupindika kwa mtima. Zizindikiro zingakhale monga:

• kupuma movutikira
• miyendo yotupa
• kupweteka pachifuwa
• kufooka
• kutopa

3. Mavuto ogwirira

Zotupa zomwe zimakula mkati mwa minyewa yamtima mozungulira njira yoyendetsera mtima zimatha kukhudza momwe mtima umagunda mwachangu komanso pafupipafupi, kutsanzira arrhythmias. Nthawi zambiri, amaletsa njira yokhazikika pakati pa atria ndi ma ventricles. Izi zimatchedwa mtima block. Zimatanthawuza kuti atria ndi ma ventricles aliyense amakhala ndi mayendedwe awo m'malo mogwirira ntchito limodzi.

Kutengera ndi zoipa bwanji, mwina simungazione, kapena mungamve ngati mtima wanu ukudumpha kumenya kapena kumenya pang'onopang'ono. Ngati ichedwa kuchepa, mutha kukomoka kapena kumva kutopa. Ngati ma ventricles ayamba kugunda mwachangu pawokha, zimatha kubweretsa ma ventrikali fibrillation ndikumangidwa kwadzidzidzi kwamtima.

4. Embolus

Kachilombo kakang'ono kamene kamatuluka, kapena magazi amatuluka, amatha kuyenda kuchokera pamtima kupita mbali ina ya thupi ndikukhazikika mumitsempha yaying'ono. Zizindikiro zimasiyanasiyana kutengera komwe mapangidwe amathera:

• Mapapo. Kuphatikizika kwamapapu kumatha kupangitsa kupuma movutikira, kupweteka pachifuwa, komanso kugunda kwamtima kosazolowereka.
• Ubongo. Sitiroko yoyambira nthawi zambiri imayambitsa kufooka kapena kufooka mbali imodzi ya thupi, mbali imodzi ya nkhope, kugwa poyankhula kapena kumvetsetsa mawu oyankhulidwa kapena olembedwa, ndi chisokonezo.
• Dzanja kapena mwendo. Kuphatikizika kwam'mimba kumatha kubweretsa chiwalo chozizira, chopweteka, komanso chopanda mapapo.

5. Zizindikiro zadongosolo

Zotupa zingapo zoyambirira zamtima zimatha kuyambitsa zizindikilo zosafanana kwenikweni, kutsanzira matenda. Zizindikirozi zitha kuphatikiza:

• malungo ndi kuzizira
• kutopa
• thukuta usiku
• kuonda
• kupweteka pamodzi

Zilonda zam'mimba za khansa yachiwiri yamtima zimakonda kulowa munthawi yakunja kwa mtima (pericardium). Izi nthawi zambiri zimabweretsa kuchuluka kwa madzimadzi mozungulira mtima, ndikupanga kuwonongeka kowopsa kwa ziwopsezo.

Kuchuluka kwa madzimadzi kumawonjezeka, kumakankhira pamtima, kumachepetsa magazi omwe amatha kupopera. Zizindikiro zake zimaphatikizapo kupweteka kwakanthawi pachifuwa mukamapuma komanso kupuma pang'ono, makamaka mukamagona pansi.

Kupsyinjika pamtima kumatha kukwera kwambiri mpaka kupopera magazi pang'ono. Mkhalidwe wowopsawu umatchedwa mtima tamponade. Zitha kubweretsa ku arrhythmias, mantha, ndi kumangidwa kwamtima.

Zomwe zimayambitsa khansa yamtima

Madokotala sakudziwa chifukwa chomwe anthu ena amadwala khansa ya mtima pomwe ena satero. Pali zifukwa zochepa chabe zomwe zimadziwika pachiwopsezo cha zotupa zamtima:

• Zaka. Zotupa zina zimachitika pafupipafupi mwa akulu, ndipo zina zimachitika mwa makanda ndi ana.
• Chibadwa. Ochepa amatha kuthamanga m'mabanja.
• Matenda a khansa ya chibadwa. Ana ambiri omwe ali ndi rhabdomyoma ali ndi tubular sclerosis, matenda omwe amayamba chifukwa cha kusintha (kusintha) mu DNA.
• Kuwonongeka kwa chitetezo cha mthupi. Primary cardiac lymphoma imachitika nthawi zambiri mwa anthu omwe ali ndi chitetezo chamthupi chosagwira bwino ntchito.

Mosiyana ndi pleural mesothelioma yomwe imapezeka m'kati (mesothelium) ya m'mapapo, kulumikizana pakati pa kukhudzana kwa asbestosi ndi pericardial mesothelioma sikunakhazikitsidwe.

Kuzindikira kwa khansa yamtima

Chifukwa chakuti ndi osowa kwambiri ndipo zizindikiro nthawi zambiri zimakhala zofanana ndi zomwe zimachitika pamtima, zotupa za mtima zimakhala zovuta kuzizindikira.

Mayeso omwe amagwiritsidwa ntchito pofufuza khansa yamtima ndi awa:

• Zojambulajambula. Kuyesaku kumagwiritsa ntchito mawu kupanga chithunzi chosuntha chosonyeza momwe mtima ukugwirira ntchito. Ndimayeso omwe amagwiritsidwa ntchito kwambiri pofufuza, kukonzekera zamankhwala, komanso kutsatira chaka chilichonse.
• Kujambula kwa CT. Zithunzi izi zitha kusiyanitsa zotupa zoyipa komanso zoyipa.
• MRI. Kujambula uku kumapereka chithunzi chatsatanetsatane cha chotupacho, chomwe chingathandize dokotala kudziwa mtundu wake.

Chitsanzo cha minofu (biopsy) nthawi zambiri sichipezeka chifukwa kujambula kumatha kudziwa mtundu wa chotupa, ndipo njira ya biopsy imatha kufalitsa maselo a khansa.

Njira zochizira khansa yamtima

Ngati kuli kotheka, kuchotsedwa kwa opaleshoni ndi chithandizo chazisankho pamatumbo onse oyambira mtima.

Zotupa za Benign

• Zambiri mwa izi zitha kuchiritsidwa ngati chotupacho chitha kuchotsedwa.
• Ngati chotupa chimakhala chachikulu kwambiri kapena pali zotupa zingapo, kuchotsa gawo lake lomwe silili mkati mwamakoma amtima kumatha kusintha kapena kuthetsa zizindikilo.
• Mitundu ina imatha kutsatiridwa ndi ma echocardiograms apachaka m'malo mochita opareshoni ngati sakuyambitsa zizindikilo.

Zotupa zoyipa

• Chifukwa amakula msanga ndikuwononga zofunikira za mtima, zimakhala zovuta kuzichiza.
• Tsoka ilo, ambiri sapezeka mpaka kuchotsedwa kwa opaleshoni sikungatheke.
• Chemotherapy ndi radiation radiation nthawi zina amagwiritsidwa ntchito poyesa kuchepetsa kukula kwa chotupa ndikusintha zizindikiritso (chisamaliro chothandizira), koma pafupipafupi sizothandiza pa khansa yoyamba yamtima.

Khansa yachiwiri yamtima

• Pomwe mitsempha ya mtima imapezeka, khansa imafalikira ku ziwalo zina nawonso ndipo siyichiritsidwa.
• Matenda a metastatic mumtima sangathe kuchotsedwa opaleshoni
• Kusamalira mwachangu ndi chemotherapy ndi radiation radiation nthawi zambiri ndiyo njira yokhayo.
• Ngati phulusa la pericardial likukula, limatha kuchotsedwa poika singano kapena kukhetsa pang'ono mumtsuko wamadzi (pericardiocentesis).

Maonekedwe a zotupa za mtima

Malingaliro ake ndiabwino pazotupa zoyipa zoyipa zamtima. Kafukufuku wina adawonetsa ziwerengero zotsatirazi (kuchuluka kwa anthu amoyo patapita nthawi):

• chaka chimodzi: 46 peresenti
• zaka zitatu: 22%
• zaka zisanu: 17 peresenti

Malingaliro ake ndiabwino kwambiri pazotupa zabwino. Wina anapeza kuti pafupifupi kupulumuka kunali:

• Miyezi 187.2 ya zotupa zabwino
• Miyezi 26.2 ya zotupa zoyipa

Kutenga

Khansa yapamtima yayikulu imatha kukhala chotupa chosaopsa kapena choyipa kapena chotupa chachiwiri cham'mimba. Zizindikirozo zimadalira kukula ndi chotupacho ndikutsanzira momwe mtima umakhalira.

Khansa yoyipa yam'mtima yoyipa imakhala ndi malingaliro olakwika koma ndiyosowa kwambiri. Zotupa za Benign ndizofala ndipo zimatha kuchiritsidwa ndi opareshoni.