Uhlobo lwe-echocardiography kunye ne-transcranial Doppler lunokunceda ukuxilongwa
Uvavanyo lwebhola luvavanyo olungabonakaliyo oluvumela ukuba oogqirha bahlole ukuhamba kwegazi ngentliziyo. Ngokuqhelekileyo isetyenziselwa ngokubambisana ne- echocardiogram (kwimeko apho oogqirha bahlala bebiza "ukuchasanisa i-echocardiography,") okanye i- transcranial Doppler study (TCD) . Ukufundwa kwebhola kufuthi kwenziwa xa i- patent foramen ovale (PFO) ikhunjulwa.
Indlela Yokufundiswa Kwebhola Eyenziwa Ngayo
Ukufundwa kwebhola kuyasetyenziswa kukuba xa amaza omsindo ehlangene neentlobo ezahlukeneyo zemidiya yenyama - kule gesi i-liquid vs - ithawula ngokubanzi, kwaye idala "amanqabana echotshiweyo". Amanqaku afana nawo avela kwi-echocardiogram njengoko ukwanda kwamanani .
Kwisifundo sombhobho oqhelekileyo, isisombululo se-saline sishukunyiswa ngamandla ukuze kuveliswe amabhulu amancinci kwaye i-injini ibe yifakwe kwi-vein. Njengoko iibhola zihamba nge-vein nasekunene kwintliziyo, ukunyaniseka okwenyukayo ekuveliseni umfanekiso we-echocardiography kuvumela ugqirha ukuba abukele ngokugqithiseleyo iimbumba zihamba ezinkampini zentliziyo.
Ukuba intliziyo isebenza ngokuqhelekileyo, iimbumba ziya kubonakala zingene kwi-atrium efanelekileyo, ngoko-ventricle efanelekileyo, emva koko uphume kompempiyeri uze uphume emiphakeni, apho ihlongozwe khona.
Nangona kunjalo, ukuba iibhola zibonwa ukungena kwicala lasekhohlo lentliziyo, oku kubonisa ukuba kukho ukuvula okungavumelekanga phakathi kwamacala amabini entliziyo-okubizwa ngokuba yi-intracardiac shunt.
Olu hlobo lwe-shunt intracardiac lungenziwa, umzekelo, yi-PFO, i-defect septal defect , okanye i-defricular septal defect.
Okwangoku, iifom zezorhwebo "zamabhule" ziyafumaneka ukuze zisetyenziswe ngexesha lovavanyo lwama-bubble. La majelo amatsha ngokuqhelekileyo aqukethe iiprotheni ezincinci okanye i-phospholipid casings efaka i-gas. Ezi nkonzo zitsha zibonakala zikhuselekile, kwaye zinokubonelela ngeengcamango ezingcono kwiimeko ezithile. Nangona kunjalo, zixabisa kakhulu kunesisombululo se-saline.
Izifundo zeBlue kwi-Patent Foramen Ovale
Isizathu esiqhelekileyo sokuqhuba isifundo sebhola kukujonga i-PFO. Kulezi zifundo, ngelixa iimbumba zijojowe emthanjeni, isigulane siceliwe ukuba senze i- valsalva maneuver (oko kukuthi, ukunyuka njengokungathi kunentshukumo yokuhamba).
I-valsalva maneuver ngokukhawuleza iphakamisa uxinzelelo kwicala lokunene lentliziyo, ukwenzela ukuba ukuba iPPOO ikhona, iimbumba zingabonwa ngokungena kwi-atrium ekhohlo. Bubbles ezibonakala kwi-atrium ekhohlo ngexesha lokuvavanya ziqinisekisa ukuba khona kwe-PFO.
Isizathu esona sizathu sokuba oogqirha banenkxalabo malunga ne-PFOs kukuba kungenzeka ukuba avumele ukuba igazi liwelele kwicala lasekhohlo ukuba intliziyo, apho ingangena khona ukujikeleza kwengqondo kwaye ivelise isifo sobomi .
Ngethamsanqa, ngelixa i-PFO ziqhelekileyo (ezenzeka kuma-25% abantu abadala), zikhokelela ekubetheni nje kuphela.
Ngoko, ngelixa i-bubble study inokuthi ingqinisisa ukuba khona kwe-PFO, ayixeleli ugqirha kakhulu malunga nokuxhamla.
Uninzi lweengcali zicinga ukuba indlela engcono yokuvavanya ukuba i-PFO inokuvelisa i-stroke kukuba iqhube isifundo seDoppler ngokubambisana ne-bubble study.
Kuhlolisiso lwe-TCD, ubuchule be-echo zisetyenziselwa ukujonga iibhola ezihamba ngeemitha zegazi zengqondo. Ucwaningo lwe-TCD lunokufumanisa ukuba iibhobho ezifakwe kwi-vein ziyangena empilweni yomjikelezo. Ukuba kunjalo, i-PFO ibonakala inokunyusa umngcipheko wesifo, kwaye ugqirha uya kuba nocetyiso lwe-antiticoagulation yonyango , okanye, ukuba kukho ukubetha, mhlawumbi ukuvalwa kwe-PFO.
> Imithombo:
> Mulvagh SL, uRakowski H, Vannan MA, et al. I-American Society of Echocardiography Inkcazo yokuBambisana ngeeNkcukacha zeeKliniki ze-Ultrasonic Contrast Agents kwi-Echocardiography. J Am Soc Echocardiogr 2008; 21: 1179.
> Romero JR, Frey JL, Schwamm LH, et al. Iziganeko zeCerebral Ischemic Associated with 'Study Bulletin' ukuchongwa kweNkundla yokuHlola. Stroke 2009; 40: 2343.
> Parker JM, Weller MW, Feinstein LM, et al. Ukukhuselwa kwama-Contrast Distents Agents kwizigulane ezinokuthi ziyaziwa okanye zixhatshazwe. InguJ Cardiol 2013; 112: 1039.