Myxoma wenhliziyo: ukuxilongwa kanye nokwelashwa

myxoma ingenye izimila ezivame kakhulu. Kwezinye izimo, lesi sifo kwenzeka ngenxa zofuzo nezici ezithile. Inhliziyo isimila - myxoma - okuvame kakhulu kwabesifazane abaphakathi kweminyaka engama iminyaka engu-40 futhi izinsizwa.

I pathogenesis lesi sifo

Okuvame kakhulu isimila ingozi wenhliziyo abadala - myxoma ezinganeni - rabdimioma.

Lesi sifo has variable ukubonakaliswa zokwelapha, ngoba izizathu ivela khona kungaba:

1. Human Papilloma Virus.

2. Epstein-Barr igciwane.

3. I-Herpes.

izimila senhliziyo ezingajwayelekile kakhulu. Ziyakwazi ezimbili zama:

1. izimila Primary Isekelwe emangqamuzaneni ezicutshini nesekelayo ezindongeni ventricles zenhliziyo. Iningi lazo awayona ingozi.

2. Secondary kwakhiwa uma kukhona izimila eduze inhliziyo. Futhi namangqamuzana alimazayo ongafinyelela emazikweni ezikude nge igazi.

Ngo-90% azo zonke amacala myxoma zendawo ATRIUM ngakwesokunxele. Kwezinye izimo, lokhu isifo kwenzeka ngokuhlanganyela nabanye, ezifana nesifo adrenal, noma ingozi isikhumba izimila.

Myxoma wenhliziyo kungenziwa ngofuzo, ngakho abantu engozini ivela khona kumele kube ucwaningo lonyaka.

Lwasemtholampilo isithombe lesi sifo

Izimpawu zahlukahlukene kakhulu futhi ancike indawo kanye nosayizi yesimila. Neoplasm kungaholela ukungasebenzi inhliziyo. Uma isimila itholakala ezindongeni ukuhluleka kwenhliziyo kungenzeka.

Izibonakaliso zakudala lesi sifo:

• izinkinga zokuphefumula unomphela;

• isiyezi;

• palpitations inhliziyo;

• dyspnea phakathi noma yimuphi umsebenzi ngokomzimba;

• ubuhlungu besifuba;

• paroxysmal dyspnea ebusuku;

• okungazelelwe ukufa.

Ungezwa ubuthakathaka jikelele. Ithumba kungathinta umsebenzi we valve inhliziyo, noma ingxenye encane yawo kungavela off, futhi ukugeleza kwegazi emaphashini, ubuchopho futhi uvimbele esibuthakathaka igazi. Kulokhu, isiguli ulindele unhlangothi - Yilesi isibonakaliso wokuqala ukuthi umuntu akha myxoma. Izimpawu ehlukile, lezi zimpawu ezilandelayo ezengeziwe kungenzeka:

• ukungakhululeki jikelele;

• umkhuhlane;

• ukuvuvukala noma iyiphi ingxenye yomzimba,

• ukukhwehlela;

• ubuhlungu bamalunga;

• iminwe ebucayi, ukushintsha imibala zabo;

• cyanosis kwesikhumba.

Futhi, uma kukhona ukushaya kwenhliziyo okungajwayelekile, yokufikelwa nesenzakalo okungenzeka nokuquleka. Kodwa zivela kakhulu kuyaqabukela.

Phakathi kwezisulu, eziye zathola ifomu lesibili lesi sifo, bekulokhu kwesisindo, kukhuphuke ajulukayo.

izindlela Basic uzingela isifo

Indlela engcono elula ukuxilongwa - ultrasound inhliziyo, ngokuthi emitameni ulimi echocardiography. Ngalo ungabona usayizi yesimila, indawo ehlanganisa nokuya nomaphi.

Kunezindlela ezimbili zalolu cwaningo zingokulandelayo:

1. Ngosizo uphenyo ultrasound ngokusebenzisa esifubeni. Indlela kufanelekile kahle ukuthola lapho myxoma inhliziyo. Sifo futhi inquma usayizi yesimila.

2. Eyesibili inketho - okubizwa ngokuthi transesophageal echocardiography. Lapho inqubo owethulwa uphenyo encane ultrasonic ngomlomo emphinjeni. Lokhu inhlolovo wenziwa ngaphansi izinzwa ukukhanya ukuvimbela ukuhlanza reflex. Le nqubo kufanelekile zokuba uchwepheshe wokuhlola izimila ebulalayo efana Sarcoma.

Okwamanje basuke ngokuya asesebenzisa ukusetshenziswa computer futhi magnetic resonance tomography luhlolo inhliziyo.

Ukuqinisekisa sitholakele myxoma atrial, odokotela batusa ukuba avivinywe eziningana:

• troponin;

• esifubeni X-ray;

• ECG;

• catheterization inhliziyo;

• ezingeni electrolyte egazini;

• ishayela oximetry.

ukuxilongwa umehluko

Myxoma wenhliziyo kudinga Ukuhlolisiswa ngudokotela. Kubandakanya isidingo ukwenza inqubo enjalo, njengoba ucwaningo of ukupholisa yamaphaphu futhi perfusion scan usebenzisa. It wenziwa ukuze kuvinjelwe embolism yamaphaphu njengoba kwezimbangela eziyinhloko sifo.

Imiphumela yaloku kuhlola okungenhla Ukwahlukaniswa liyadingeka ukuhlukanisa izimpawu ezinye izimo zezokwelapha, njenge:

• eyinhloko nomfutho wegazi ophezulu yamaphaphu;

• valve tricuspid;

• regurgitation mitral;

• stenosis mitral;

• stenosis tricuspid.

Vula ukuhlinzwa kwenhliziyo

The best futhi enengqondo kakhulu ezintweni indlela kwelashwa nokususwa ngokuphelele myxoma ngu ukuhlinzwa. Uma udokotela ukukunikeza eyohlinzwa, akumelwe kubonakalise lide kakhulu. Ukuze ugweme izinkinga ngemva kokuhlinzwa, ukwelashwa kufanele kwenziwe ngendlela esifike ngesikhathi.

Lolu hlobo lokuhlinzwa iyona ndlela ejwayeleke kakhulu. ukuhlinzwa Vula inhliziyo zihlanganisa:

1. ukuhlinzwa Dula.

2. Valvuloplasty.

3. Njengoba ezothatha isikhundla valve.

4. Ukufakelwa.

5. Ukuhlinzwa ngoba ukulungiswa yesifo senhliziyo azalwa naso.

E-United States, odokotela abahlinzayo enze mayelana 750,000 inhliziyo evulekile ukuhlinza njalo ngonyaka. Le nqubo kudinga ukubulawa kwezinzwa okuvamile futhi ukuhlala esibhedlela, okuyinto zokhahlamba kusuka izinsuku ezintathu kuya kweziyishumi, kuye ngokuthi ukusebenza. Kwezinye izimo, isiguli efakwa esibhedlela kuka ngenyanga eyodwa.

izinqubo kuhlinzwa

Ukuze evulekile kokuhlinzwa inhliziyo, udokotela ohlinzayo owenza imbobo eside ohlangothini longitudinal kanye phezulu sternum ngesikhumba kanye nezicubu ngaphansi, bese ezihluthulelwe ukungena ingaphakathi esifubeni. retractors Special uyibambe evulekile. Ukuze sifinyelele inhliziyo, udokotela ohlinzayo has ukuvula pericardium, esivikelo sac pericardial ezungeze inhliziyo.

Ngokuvamile, okungukuthi kwesokunxele endaweni evulekile isikhundla ngemuva kokuhlinzwa usuphothuliwe. Lokhu kuyadingeka ukuze banciphise isikhathi ukusebenza futhi kuncishiswe ingozi yezinkinga nasezinkingeni ezilandela ngemva kokuhlinzwa.

Ukuze kokungenela kuhlinzwa ukuze kwaneliswe kwale mibandela elandelayo:

• ukusetshenziswa dlula cardiopulmonary;

• Zonke izinto kumele inzalo.

Ngemva kokuphothulwa ukuhlinzwa, udokotela ohlinzayo ubuyisela igazi ukugeleza ngokusebenzisa inhliziyo inqubo. Odokotela ukunciphisa izinga lokushisa lomzimba ukubambezela ukusebenza komzimba. Khona-ke encishisiwe kwegazi nokushaya kwenhliziyo. Udokotela ohlinzayo ubeka emalungeni lapho kudingekile (bayoba ebonakala eminyakeni embalwa).

Uma ekhishiwe ukuhlinzwa myxoma inhliziyo kwaba yimpumelelo, isiguli ithunyelwa lesigceme ukuyohlolwa olwengeziwe.

Yini yezinkinga kungavuka iziguli?

Ukuhlinzwa ngaso sonke isikhathi ngaphandle izinkinga. Ngezinye izikhathi, uzohlinzwa okwesibili kuyadingeka. Ukususwa kwezimiso myxoma kudingeka iqembu ezinhle odokotela abahlinzayo nababulala abanye odokotela, ngakho konke kwaba ezingeni eliphezulu kakhulu.

Izinkinga phakathi nokuhlinzwa:

1. Ukopha ngenxa anticoagulation.

2. Air embolism ngesikhathi dlula cardiopulmonary engaholela unhlangothi.

3. Nobunzima yokutakula kwenhliziyo.

4. Iphutha ohlinzayo.

5. anomalies Okungalindelekile yokwakheka ongakayisebenzisi itholiwe.

yezinkinga Jikelele singenzeka ngisho nangemva kokuhlinzwa:

1. Ukopha endaweni yokusebenza noma phezu sutures kuhlinzwa.

2. Ukutheleleka.

3. Amahlule ukuthi kungabangela embolism yamaphaphu, unhlangothi.

4. Arrhythmia.

5. Umfutho ophakeme wegazi kanye yokumelwa yinhliziyo.

Ukuze lisabela ngokushesha noma yiziphi izinkinga ezingase zivele ngenhla, isiguli ishiywa ngaphansi kokuqondisa izisebenzi zezokwelapha ukuhlinzwa inhliziyo labagula amahora 12-48.

Kuzokwenzekani uma aziphendukeli ukuhlinzwa?

Iziguli eziningi senqabe ukuhlinzwa. Empeleni isizathu ukuhluleka ukwesaba ukufa etafuleni kuhlinzwa. Kodwa uma akaphinde asibalele, myxoma wenhliziyo kuholele inombolo yezinkinga:

1. embolism neuropathy.

2. Arrhythmia.

3. edema yamaphaphu.

Lesi sifo izimila benign kuthiwa yenziwe yaba yasendaweni ngaphakathi inhliziyo. Bunake izimpawu, ngoba kungaholela emiphumeleni engathí sina.

Nakuba Ithumba kungavamile ukuba ingozi, akusho ukuthi akudingekile ukuba aphathe. Ukwanda izimila ngaphakathi inhliziyo Ingakhawulela ukugeleza kwegazi ngokusebenzisa valve mitral futhi kubangele ezihlukahlukene izinkomba stenosis mitral.

Uma wena noma ilungu lomndeni wakho ahlangabezana izimpawu zesifo, xhumana nodokotela wakho ngokushesha.

Outlook kanye yokuphila izinguquko

Emisebenzi emva Ukuhlinzwa okukhulu kwenhliziyo ngaphandle kuxhomeke kakhulu imbangela ayehlasela. Abantu abaningi kakade ngemuva kwezinyanga ezimbili ukubuya imisebenzi evamile, kodwa uma uya kudokotela kuyadingeka. The kungenzeka yezinkinga kuyehla ngokuhamba kwesikhathi.

Abaningi, kunalokho, kubalulekile ukuba wenze izinguquko ezithile endleleni yokuphila. Ngokuvamile, kuziwa ukudla nokuvivinya umzimba. Nangodokotela bababhekene nezifo zenhliziyo uncoma ukudla Ukudla futhi afeze ukuqeqeshwa nsuku zonke, okuyinto zinqunywa ngamunye.