Endocarditis ihutachiona hwemukati wehomwe yemwoyo (iyo yakagadziriswa yakagadzirwa). Endocarditis kazhinji inokonzerwa nehutachiona hwehutachiona uye inogona kusanganisira kupera kwekupedzisira kwemoyo wemagetsi uye yemwoyo mushuga pachako. Kupa maantibayoti kuedza kudzivirira endocarditis kunonzi "endocarditis prophylaxis."
Rationale Pakupedzisira Endocarditis Prophylaxis
Nemhaka yokuti endocarditis inogona kuparadza mwoyo musumbu nemagetsi emwoyo, inogara iri dambudziko rakakomba uye rinowanzotyisidzira upenyu.
Uyezve, endocarditis inogona kuva yakaoma kurapa, sezvo kurapa kunogona kutora mavhiki akawanda emishonga inorwisa mabhakitiriya, uye pane dzimwe nguva inoda kuvhiyiwa kushanda kwemoyo. Zviri pachena, zviri nani kudzivirira endocarditis pane kuitora.
Kunyange zvazvo miedzo yakakura yekliniki ichiratidza kuti kubudirira kwe endocarditis prophylaxis hakushayiki, kune zvikonzero zvakasimba zvezvikonzero zvekushandiswa kwayo.
The Theory of Endocarditis Prophylaxis
Muvanhu vazhinji, apo nhamba shoma yebhakitiriya inopinda muropa, miviri yekudzivirirwa kwemuviri inogona kubvisa mabhakitiriya kubva muropa nokukurumidza uye zvinobudirira.
Zvisinei, kune vanhu vane mamwe marudzi ezvinetso zvemwoyo, mabhakitiriya anokwanisa kubatanidzwa mukati mekushushikana kweropa kuderera mukati memwoyo, uyezve "kunamatira" kumakumbo endocardial, kwavanogona kukonzera utachiona.
Iko pfungwa ye endocarditis prophylaxis ndeyokushandisa ma antibiotics kuuraya chero mabhakitiriya anopinda muropa asati awana mukana wekugadzira chirwere mukati memwoyo.
Nokuda kwechikonzero ichi, nyanzvi dzinokurudzira kuti vanhu vane ngozi yakawanda yekudzivirira endocarditis vanofanira kugamuchira prophylactic antibiotics vasati vaine nzira dzekurapa dzinogona kuisa mabhakitiriya muropa.
Ndeipi Izvo Prophylaxis Ichishandiswa?
Uchapupu huchangobva kuratidza hunoti vanhu vakawanda vane mamiriro emwoyo ndivo vari pangozi yakaderera ye endocarditis kupfuura yekare yakatenda, saka havadi endocarditis prophylaxis.
Nhungamiro idzi dzave dzichinyatsotsanangurwa neAmerican Heart Association uye American College of Cardiology kuratidza hutsva hutsva.
Endocarditis prophylaxis ikozvino inokurudzirwa chete kune vanhu vari pangozi yakanyanya ye endocarditis.
Izvi zvinosanganisira:
- varwere vane mavheti emwoyo
- varwere vakagadziriswa nemwoyo vachishandiswa maitiro ephethiyasi (chinyorwa: izvi hazvirevi maronary artery stents )
- varwere vane nhoroondo yapfuura ye endocarditis
- varwere vane chimwe chinhu chisina kubhadharwa kana chisina kukwana chakagadzirisa chirwere chepfungwa chepfungwa
- varwere vakatsvaga mwoyo avo vanozogadzirisa matambudziko emagetsi emagetsi
Zvakakosha kuziva kuti mazano ezvino haakurudziri endocarditis prophylaxis kune vakawanda varwere vane aortic stenosis , aortic regurgitation , kana mitral valve chirwere (kusanganisira avo vane mitral valve prolapse ), kana kune varwere vane hypertrophic cardiomyopathy .
Ndezvipi Zvirongwa?
Aya mazano matsva anokurudzira prophylaxis chete nezvezviongorori izvi:
- maitiro ekurapa anosanganisira kushandiswa kwemajamu kana midzi yemeno, kusanganisira kugara uchichenesa mazino.
- mitemo inoda kusarudzwa kana zvipsies zvemufaro wekufuridzira kana muromo, zvakadai se tonsillectomy , kana kuti bronchoscopy ne biopsy.
- mitemo inosanganisira kusarudzwa kwezvirwere zvine utachiona.
Zvinonzwisisika, antibiotic prophylaxis haisati yakurudzirwa nokuda kwezvirongwa zvepamuviri kana maitiro ekudzivirira muviri.
Ndeapi Antibiotics?
Muzhinji, amoxicillin inokurudzirwa semishonga inorwisa mabhakitiriya sarudzo kana prophylaxis inodiwa. IAmerican Heart Association ine nhungamiro ye endocarditis prophylaxis inonyora mamwe maantibayoti apo kana amoxicillin isingashandisi.
Sources:
Wilson W, Taubert KA, Gewitz M, et al. "Kudzivirirwa kwehupombwe endocarditis: mirayiridzo inobva kuAmerican Heart Association: mutungamiri kubva kuAmerica Heart Association Rheumatic Fever, Endocarditis, uye Kawasaki Disease Committee, Council on Cardiovascular Disease in Young, uye Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, uye Unhu Hwokutarisira uye Zvikamu Zvokutsvakurudza Maitiro Evanhu Vanoshanda. " Circulation. 2007 Oct 9; 116 (15): 1736-54.
Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA / ACC mutungamiri wehutano hwevarwere vane chirwere chepfungwa chevurvular: mushumo weAmerican College of Cardiology / American Heart Association Task Force pamusoro pekushandisa mazano. J Am Coll Cardiol 2014; 63: e57.