A valve inhliziyo: ukusebenza ngoba esikhundleni futhi kungenzeka wayethole isifo esithile

Izibilini nenhliziyo yomuntu has izimbotshana ezine. Ngamunye wabo ixhunyiwe ngokusebenzisa izimbobo ekhethekile - valve. Badinga aluka igazi emangqamuzaneni ngokulinganayo. Ngo yezifo valve inhliziyo, udinga usizo wenhliziyo. Kwezinye izimo, ukuqeda zokugula, ukuhlinzwa kuyadingeka. Izifo valve apharathasi kuholela ekuhlulekeni kwegazi. Uma kungekho senzo esithathwayo, lo zokugula kungaholela ekufeni.

Kuyini inhliziyo umphini?

Inhliziyo valve kudingeka ukuqinisekisa eyodwa igazi wamanje kusuka kwesinye isitokisi bazifake kwesinye. Zakhiwa isendlalelo engaphakathi komzimba - the endocardium. valve senhliziyo ukhonza iwindi phakathi izimbotshana. Siyabonga kuye, igazi ogeleza usuka ekamelweni omunye komunye njengoba kudingekile. ama-apharathasi Valvular siqukethe le izingxenye ezilandelayo:

1. I fibrosus annulus.
2. Imisipha kwezicubu nebhande.
3. Chord.

Letakhi zikhona zonke valve. indandatho Fibrotic kanye ngodonga phakathi izimbotshana akha uhlaka inhliziyo. Yena imelelwa Imicu yotshani obukhulu nokunwebeka kanye kuyi-collagen. I enezinto umphini ayadingeka ukuze kuqinisekiswe wokuvula yayo ngesikhathi systole. Igazi ziphonswe kusuka ephezulu ingcindezi ekamelweni inhliziyo kwenye. Ukuthi akukhona yayihlangana, le enezinto umphini naso isikhathi slam. Chord - a zezinzwa izicubu bands. Zikuxhuma valve ukuze imisipha papillary zenhliziyo. Umsebenzi wawo - ukuqinisekisa kwabantu phakathi iminyango.

Izinhlobonhlobo valve inhliziyo

Kukhona 2 izinhlobo valve: i atrioventricular futhi semilunar. Okokuqala - ukuhlinzeka interconnection okwakuphakathi kwamakamelo. valve Semilunar ayadingeka ukugcina efanele ukugeleza kwegazi ezitsheni ezinkulu inhliziyo - elikuyi-aorta ne-pulmonary Umthambo. Ngu ukuvuleka atrioventricular zihlanganisa lezi zinhlobo ezilandelayo valve:

1. Mitral.
2. Tricuspid.

Mitral inhliziyo umphini lebhokisi ATRIUM kwesokunxele bese ventricle. Siqukethe 2 amaphiko. valve Tricuspid itholakala emngceleni ilungelo inhliziyo emakamelweni. Ngokungafani kwesokunxele ukuvulwa atrioventricular, it has enezinto ezintathu. Igazi akhishwa ngokusuka enhliziyweni bonke izitsha umzimba, idinga yomthambo i-aorta inhliziyo valve. It has 3 emphethweni: kwesokudla, kwesokunxele emuva. Ukuvulwa isiqu yamaphaphu athambekele kwayo kuleyo ndawo yokuhweba kusukela ATRIUM kwesokudla. Ukuze ukusebenza kwegazi ezincane nezinkulu, kubalulekile ukuhlola ukusebenza kwazo zonke valve. Ukulimala omunye wabo kuholela ekuhlulekeni inhliziyo.

Izifo apharathasi valve

Valvular inhliziyo valve kungenzeka ibe ngaphansi kwegunya ukulimala ahlukahlukene. Kwezinye izimo isakhiwo olungalungile izimbobo okwakuphakathi kwamakamelo. Lokhu kubonisa khona kombungu esizalweni kwenhliziyo, okuyinto akhiwa phakathi kwezitho isibekisombhalo ku-fetus. Ukuze anomalies zibala:

1. Ventricular isici septal.
2. Patent ductus arteriosus.
3. Atrial isici septal.
4. stenosis yomthambo i-aorta ne-pulmonic.

Ngaphezu izici umphini kungabonakala nasemkhakheni ukuvaleka yegazi eyinhloko, indawo yabo engalungile, akukho emakamelweni inhliziyo, nokunye .. Kwezinye izimo, kwatholakala ukuthi nginesifo inhlanganisela sisakubona eziningana.

Izifo apharathasi valve angayizuza. Bona senziwe zangokwasemuva zezinhlelo ezingamahlalakhona ezithathelwanayo isifo senhliziyo, izinqubo letindzala ukuvuvukala. Izizathu eziyinhloko for kumiswa ukukhubazeka zihlanganisa: endo- futhi myocarditis, imfiva ye-rheumatism, isifo sokuqina kwemithambo yegazi, njll ngu iziyaluyalu atholwe zihlanganisa stenosis futhi esingamahlalakhona of valve ... Lezi zifo zivame kutholakala seziguli ezisencane kanye oseqinile.

Izinkomba ukuhlinzwa

Uma sinqamukile ukuxhumana phakathi izimbotshana inhliziyo, idinga esikhundleni valve inhliziyo. Ukusebenza kuzosiza ukugwema ukuthuthukiswa ukwehluleka kwegazi. ukuhlinzwa okunjalo - lena inqubo sina ukuthi kuphela yakhetha lapho yingaba yini engakusiza Ungasingenisi umphumela. Kukhona izimpawu ezilandelayo ukuhlinzwa:

1. Sikuveze valve esingamahlalakhona. Libhekene ngalolo iqabunga buthakathaka futhi kalula Olwandisekayo.
2. Stenosis of valve. Kuyinto ukuze unciphise amathuba okwakuphakathi kwamakamelo zenhliziyo.

Prosthetics wenziwa ezimweni lapho valve kuyinto izicubu kanzima kahle futhi ubuyisele oyiyo akunakwenzeka. Ngokuvamile, it is waphawula in iziguli stenosis ezinzima. ukwelashwa Steel kuyadingeka uma isiguli uye izimpawu yinhliziyo uxilongwe ezinzima. Izimpawu zalesi sifo zihlanganisa: iphika lapho esephumule, nakwisyncope, angina. Futhi, esikhundleni valve ekhiqizwa uma umgodi waso ayisesemikhulu ezingaphezu kuka-50% kanye esingaphansi 1 cm. Sokwenziwa wenza lokhu ikakhulukazi ezimweni lapho kukhona calcification we amapheshana noma imisipha papillary.

Yini ebangela inhliziyo valve esingamahlalakhona?

Valve esingamahlalakhona eba ku isizinda isifo senhliziyo. It kuholela izinguquko ukugeleza kwegazi futhi regurgitation - reverse esishiywe dengwane. Ukwehluleka ukuxilonga lapho valve inhliziyo akusho uvale ngokuphelele. Kulokhu, lo iqabunga ziphelelwa nokunwebeka. Ezimweni eziningi, valve ezivamile yomthambo i-aorta ne-mitral.

Ukuze bathole ukuthi inhliziyo enze valvuloplasty. Ezimweni ezimbi kakhulu, a sokwenziwa valve. esingamahlalakhona yomthambo i-aorta kuholela ukubuya igazi iphonswe ventricle engakwesobunxele. Ngenxa yalokhu ekamelweni inhliziyo kancane kancane yandisa futhi ilahlekelwa contractility yayo. Ukwehluleka of valve mitral libhekene regurgitation wegazi phakathi komgodi we ATRIUM ngakwesokunxele. Ngayinye yalezi pathologies kuholele yokumelwa yinhliziyo.

Izinhlobo zokuhlinza

Kuthiwani uma ezilimele inhliziyo umphini? Ukusebenza wenziwa ezimweni nezinkinga ephawulekayo yeminyaka emzimbeni. Uma inhliziyo ukwehluleka inxephezelwa, nokwelapha olandelanayo. Izifo apharathasi valve akuzona izinkomba emkhakheni wezitho zokwenziwa. Kwezinye izimo inkinga luqedwe ngaphandle ukwethulwa milisa. Ukuze izinqubo kuhlinzwa inhliziyo zihlanganisa lokhu okulandelayo:

1. Ibhaluni valvuloplasty. Kugcinelwe ekwandiseni ayisesemikhulu valve stenosis.
2. Annuloplasty. Iwukubuyisela uzimele esebenzisa indandatho valve ukwesekwa. Inkomba kulo msebenzi, kukhona ukunwetshwa emgodini okwakuphakathi kwamakamelo kubangelwa ukwehluleka.
3. Prosthetic inhliziyo umphini - Kwenziwa ezimeni umonakalo futhi calcification of amapheshana.

Kukhethwa ukuhlinzwa incike ngobucayi isici kulo, yobudala kanye isimo jikelele isiguli.

Technique valvuloplasty

Igama elithi "valvuloplasty" libhekisela imisebenzi ehlukahlukene on the valve yenhliziyo. ukuhlinzwa okunjalo wenziwa njengoba e azalwa naso anomalies umzimba, futhi esimweni lwesici kuluthola. Valvuloplasty wenziwa, uma kukhona stenosis noma esingamahlalakhona umphini ngaphandle umonakalo yokulandelana kwayo ngokohlu. Futhi, le ndlela yokwelashwa kuhlinzwa wenziwa khona contraindications emkhakheni wezitho zokwenziwa.

Okuvame kakhulu ukuhlinzwa inhliziyo ka stenosis yomthambo i-aorta noma kwesokunxele atrioventricular ukuvulwa kubhekwa ukuvuleka valvuloplasty. Siqukethe wethula wire ekhethekile ngokusebenzisa Umthambo femoral. Lapho tube ifinyelela kuvulwa valve, ibhaluni ngokufanele ekupheleni kwayo, umoya injected. Ngemva kwalokho, ipayipi iyasuswa. Ukusebenza wenziwa ngaphansi angiography control. Akudingi ukubulawa kwezinzwa okuvamile, bese uxhuma isiguli womoya-mpilo.

Kwezinye izimo, stenosis commissurotomy enze. Ihlala ku asike izidumbu zabantu lamapheshana tho.

Annuloplasty wenziwa uma ukwehluleka valve. Inkomba kuyinto ukunwetshwa enezinto ngaphandle kokulimaza organic. Udokotela ohlinzayo ukhetha usayizi ukwesekwa indandatho edingekayo futhi elungisa yona endothelium esebenzisa ezivuzayo.

Prosthetic inhliziyo valve

Ukusebenza ukufaka esikhundleni valve inhliziyo wenziwa ukuvala orifice atrioventricular 1.5 cm, yomthambo i-aorta -. 1 cm ukusebenzisa izinto ezihlukahlukene njengoba lokufakelwa kwezitho. Kwezinye izimo, inhliziyo iziguli zidluliselwa valve izilwane - izingulube noma izinkomo. Kukholakala ukuthi ingozi ukwenqaba lokufakelwa kwezitho enjalo ingaphansi kwe zokwenziwa izinto. Enye nokuhlinzwa ukufakelwa umphini yamaphaphu esikhundleni ezilimele orifice yomthambo i-aorta. Inqubo efanayo wenziwa kuphela iziguli abasebasha, ngoba ubhekisela nezinqubo ngokomthetho inselele kuhlinzwa.

Life ngemva kokuhlinzwa inhliziyo

Naphezu kweqiniso lokuthi ukuhlinzwa inhliziyo ezibhekwa okuyingozi, ngokuvamile basuke indlela kuphela ukuze asindise ukuphila kwayo le ndoda. Ngemva valve wokufakelwa isimo ukulawula njalo isiguli sidinga. Iziguli othola ukuhlinzwa kufanele ngiphuze umuthi wokuphila, igazi thinning. izidakamizwa "Warfarin" libhekisela izidakamizwa ezinjalo. Lokhu kuyadingeka ukuze kuvinjelwe ukwakheka amahlule e valve yokufakelwa.