I-tamponade ye-cardiac yimeko esongela ubomi apho i- pericardial effusion (oko kukuthi, ukuqokelelwa kwexabiso elingaqhelekanga kwisikhwama se-pericardial) okanye ukuphuma kwi-sac pericardial, kuphazamisa umsebenzi oqhelekileyo wenhliziyo. I-tamponade ye-cardiac iyakubonakala ibonakalayo okanye iyakhula ngokuthe ngcembe. Kukho nawuphi na, iimpawu zivame ukuphazamisa, kwaye isisombululo sezimpawu sidinga ukususwa ngokukhawuleza kokuphuma kwamanzi kwipastiki ye-pericardial.
I-Cardiac Tamponade Yenziwe Kanjani?
I-tamponade ye-cardia iyenzeka xa uxinzelelo olungakumbi kwi-sac pericardial, ebangelwa ngumkhuhlane ogqithiseleyo, lanele ngokwaneleyo ukuzaliswa kwentliziyo ngexesha le- diastole . Ekubeni intliziyo ayikwazi ukuzalisa ngokupheleleyo, igazi elincinci lilahlwa yintliziyo nganye, kwaye intliziyo kufuneka isebenze nzima kunika izidingo zomzimba. Ukongezelela, igazi elinga ukungena entliziyweni lihlala libuyela emva, livelise ukudibanisa kwimiphunga nemiphunga.
Umlinganiselo we-pericardial fluid oyimfuneko ukuvelisa i-tamponade kuxhomekeke kumlinganiselo omkhulu ngokukhawuleza ukuba umbane uqokelele kangakanani. Ukuba i-pericardial fluid iyanda ngokukhawuleza, i-pericardium ayinaso ixesha "lokusula," kwaye uxinzelelo ngaphakathi kwendawo ye-pericardial inokunyuka kakhulu-nokuba neyincinci yamanzi. Ngakolunye uhlangothi, ukuba i-pericardial fluid iqokelela ngokuthe ngcembe (nithi, ngaphezu kwexesha leentsuku okanye iiveki), i-pericardium inexesha lokunweba ukulungiselela umbane ogqityiweyo.
Kule meko, uxinzelelo ngaphakathi kwendawo ye-pericardial ayikwazi ukunyuka kakhulu kwaze kwaba yilapho i-pericardial effusion ikhulu kakhulu, ukuya kwinqanaba apho i-pericardium ayinakukwazi ukulula.
Ziziphi Iingxaki zeCampyard Tamponade?
I-tamponade ye-cardiac ingabangelwa yiyiphi na imiqathango evelisa i-pericardial effusion.
Ezi ziquka:
- Pericarditis
- I-dressler's syndrome
- Izifo (i-virus, ibhakteria, okanye i-fungal)
- Izifo ezizimela ngokuzenzekelayo ezifana ne- lupus
- Ixinzelelo lwentlungu ngenxa yengozi okanye ukuxhatshazwa
- Cancer
- Ukunyanga kwamayeza kwindawo yesifuba
- Hypothyroidism
- I-Aortic dissection
- Izidakamizwa (ngokukodwa i-hydralazine, i-isoniazid, ne-procainamide)
Ziziphi iziganeko zeTaponade yeCardiac?
Udidi kunye nobukhulu beempawu kuxhomekeke ekubeni i-tamponade iye yavelisa ngokuthe ngqo okanye ngokuthe ngcembe. I-tamponade eqhelekileyo ibonakala ngokugqithisekileyo ngesifuba, ukuhlinzwa kwintliziyo okanye ezinye iinkqubo ezinobungozi zenhliziyo, ezinjenge- catheterization ye-cardia , okanye i- dissection ye-aortic . Kuzo zonke iimeko, igazi lingagcwalisa isigxobo se-pericardial kumcimbi wemizuzwana okanye imizuzwana, ukuvelisa ngokukhawuleza kwaye kunzima ukunyaniseka. Ngenxa yokuba umthamo ogqithiseleyo (oko kukuthi, igazi) kwisigxobo se-pericardial iqokelela ngokukhawuleza kule miqathango, i-tamponade ingahlakulela kunye nenani elincinci le-pericardial fluid. Iimpawu zibetha ngokukhawuleza kwaye zinzima. Intlungu yesifuba, ukuphefumula okufutshane, kunye ne- tachycardia kunye neepilpitations ziqhelekileyo. Uxinzelelo oluphantsi kakhulu lwegazi luya kwenzeka, kunye nolusu olupholileyo, ukukhwabanisa kwesikhumba kunye nokunciphisa umbane.
I-tamponade eyiyo yimeko engxamisekileyo yonyango, kwaye ukufa ngokukhawuleza kunokwenzeka ukuba ayilulwanga ngokukhawuleza.
I-tamponade ye-cardiac ephumela kwiziganeko ngaphandle kwexinzelelo, iinkqubo zonyango okanye i-aortic dissection iqala ukukhula ngokuthe ngcembe ngakumbi, ngokuqhelekileyo ngaphezu kweentsuku okanye iiveki. Amacandelo enkcazo kulezi ziganeko "ezincinci" zihlala zikhulu kunamaxesha amacandelo avela kwi-pericardium ngokuqhelekileyo inexesha lokunweba ukulungiselela ukuqokelelwa kwamanzi. Iimpawu ziphantsi kakhulu. Izigulane ezine-tamponade ezincinci zivame ukufumana ukuzaliswa kwesifuba okanye ukungahambi kakuhle, ukukhathala kwamandla, ukuphefumula okufutshane kunye nomsebenzi omncinci, kunye ne- edema kwimilenze kunye neenyawo. Kodwa nangona iimpawu zingakhula ngokuncinci ngakumbi kunokuba zithinteke kakhulu, zingagcina ziba nzima kakhulu.
Olu hlobo oluthile lwe-tamponade yesifo lungaphinda lubulawe, kwaye unyango olukhawulezayo luyafuneka.
I-Cardiac Tamponade ifunyenwe njani?
Ugqirha ngokuqhelekileyo uyakrokraza i-heart tamponade ngokuphulaphula iimpawu zesigulane, ngeemeko zeklinikhi (njengokuba kukho ukukhankanywa ukuba kukho nayiphi na imeko yezokwelapha eyaziwayo ukuba yenze i-tamponade), kunye nokuhlolwa kwangokwenyama. Iinkcukacha ezongezelelweyo zingatholakala nge-x-ray esifubeni kunye ne- electrocardiogram . Xa le meko ikhunjulwa, ukuxilongwa kungaqinisekiswa ngokukhawuleza nge- echocardiogram .
I-Tamponade yeCardiac ithathwa njani?
Unyango lwe-tamponade yentliziyo kukuba kususwe i-pericardial fluid engaphezulu kwesikhwama se-pericardial. Ukukhutshwa komkhuhlane kunciphisa uxinzelelo ngaphakathi kwesikhwama se-pericardial kwaye kuvumela intliziyo ukuba iphinde iqhubeke nomsebenzi wayo oqhelekileyo.
Ukususwa kwe-pericardial fluid ngokuqhelekileyo kufezwa ngendlela ye- pericardiocentesis- oko kukuthi, ukukhenkceza i-fluid ngokusebenzisa i-catheter eguquguqukayo efakwe kwi-pericardial space. Ngenye indlela, ukususwa kwamanzi okucoca kungenziwa ngokusebenzisa inkqubo yokucoca amanzi. I-drainage yokupanda idla ngokuqhelekileyo xa kukho, ngaphezu kokucoca umbane, i-biopsy ye-pericardium iyadingeka kwizizathu zokuxilonga. Ukuba i-pericardial effusion ibuya emva kokuba idityanisiwe, i- pericardiectomy (ukususwa ngokukhawuleza kwe-pericardium) ingaba yimfuneko ukukhusela ukuphindaphinda kwakhona.
Nangona nje ifunyenwe ngokukhawuleza kwaye iqwalaselwe ngokukhawuleza, i-tamponade ye-cardia ihlala isingaphathwa kakuhle, kwaye umphumo wexesha elide ngokuqhelekileyo kuxhomekeka ngokukodwa kwiimeko kunye nobunzima becala lonyango.
Imithombo:
Maisch B, Seferovic PM, uRistic AD, et al. Izikhokelo zoLwazi kunye noLawulo lweZifo eziPhezulu zeSigqeba esiPhethekileyo; Iqela lokuSebenza kwiNgcaciso noLawulo lweePericardial Diseases ze-European Society of Cardiology. I-Eur Heart J 2004; 25: 587.
Spodick DH. I-Cardiac Tamponade. N Engl J Med 2003; 349: 684.