Kusiyana kwezvinyorwa zvinyorwa uye kudarika Doppler kunogona kubatsira nekuongorora
Chiedza chekudzidzira chirwere chisingaitiki chinobvumira vanachiremba kuongorora kubuda kweropa kuburikidza nemoyo. Inowanzoshandiswa pamwe chete ne echocardiogram (mune izvo zviitiko vanachiremba vanowanzoidzaidza "kusiyana echocardiography,") kana kuongorora kwechirwere cheDoppler (TCD) . Bhuku rinodzidza rinowanzoitwa apo patent foramen ovale (PFO) inofungidzirwa.
Kubva Kwakaitwa Chidzidzo cheBhuzi
Bhuku rekudzidzira rinoshandiswa nekuti kana majeko ane ruzha akasangana nemhando dzakasiyana-siyana dzehupfumi-mune iyi nyaya yegesi vs mvura - inowedzera kune dzimwe nzvimbo, uye inoita "mamwe mafungu echo". Izvi zvinowedzera mazamu anoonekwa pane echocardiogram sezvakawedzerwa kuwanda .
Mune chimiro chekudzidza bubble, chirongwa che saline chinogwedezeka nesimba kuti chibudise mabhute maduku uye inobva yasvirwa muvhein. Sezvo mabhudzi achifamba nomumvuri uye kuruoko rworudyi rwemoyo, kuwedzerwa kwehuwandu hwavanobereka pamusana pezvinyorwa zvekuongorora mahara kunobvumira chiremba kutarisa mabheji achifamba mumakamuri emwoyo.
Kana mwoyo uri kushanda kazhinji, mabhudzi anoonekwa achipinda muchengeti chaiyo, ipapo inonzi right ventricle, ipapo kunze kwemapurmonary arteri uye mumapapu, uko inoshandiswa kunze kwekuparadzirwa.
Zvisinei, kana mabhudzi anoonekwa achipinda muruboshwe rwomwoyo, izvi zvinoratidza kuti pane kuvhura kusina kukwana pakati pemativi maviri e mwoyo- zvinonzi intracardiac shunt.
Izvi zvinogona kubudiswa, semuenzaniso, neFPO, iyo inrial septal defect , kana kuti inonzi ventricular septal defect.
Pari zvino, maitiro ezvokutengeserana e "bubbles" anowanikwa kuti ashandiswe panguva yekuongorora zvinyorwa. Izvozvi vashandi vatsva zvinowanzobatanidzwa neproteiniti shoma kana phospholipid casings iyo inopinza gesi. Ava vashandi vatsva vanoita kunge vakachengeteka, uye vanogona kupa zviratidzo zviri nani pane dzimwe nguva. Zvisinei, ivo vanodhura zvakanyanya kudhura kudarika chinogweda saline solution.
Bubble Studies For Patent Foramen Ovale
Chikonzero chikuru chekuita bubble kudzidza ndechokutsvaga PFO. Mune zvidzidzo izvi, apo mabhudzi ari kujowa mukati mouturu, murwere anobvunzwa kuti aite valsalva mufambiro (kureva, kubata sekuti ane chikwata chemuviri).
Iyo valsalva iri kufamba nenzira inonyorera inomutsa zvinetso mumativi akanaka emwoyo, kuitira kuti kana PFO iripo, mabhesi anowanzoonekwa achipinda kuruboshwe rweatrium. Mabhombe ari kuonekwa kuruboshwe rwechirwere panguva yekuedzwa inosimbisa kuvapo kwePPOO.
Chikonzero chikuru chikonzero vanachiremba vane hanya ne PFOs ndeyekuti vanogona kubvumira kuti ropa riyambukire kuruboshwe kuruboshwe kana mwoyo, iyo inogona kupinda mukati mekupararira kweuropi uye kubudisa marwadzo embolic .
Nenzira inofadza, nepo PFOs yakajairika (inowanzoita kusvika ku25% yevanhu vakuru), inotungamirira pakurohwa chete kazhinji.
Saka, nepo bubble rakadzidza rinogona kusimbisa kuvapo kwePPO, haritauri chiremba zvakanyanya pamusoro pemikana yekurohwa.
Nyanzvi dzakawanda dzinofunga kuti nzira iri nani yekuongorora kana PFO inogona kubudisa chirwere chekuita chirwere chekudzidzira Doppler kudzidza pamwe chete ne bubble kudzidza.
Muchidzidzo cheTCD, maitiro echo echo anoshandiswa kufungidzira mabhubu achifamba nemumutsipa weropa hweuropi. TCD yekudzidza inogona kuona kana mabheji akaiswa muvheji ari kunyanya kupinda muuropi kupararira. Kana zvakadaro, PFO inoratidzika kunge inogona kuwedzera mungozi yekurohwa, uye chiremba achave akakwanisa kukurudzira anticoagulation therapy , kana, kana chirwere chacho chave chaitika, zvichida kugadziriswa kwePOO.
> Sources:
> Mulvagh SL, Rakowski H, Vannan MA, et al. American Society of Echocardiography Consensus Mashoko pamusoro peKliniki Applications ye Ultrasonic Contrast Agents muEchocardiography. J Am Soc Echocardiogr 2008; 21: 1179.
> Romero JR, Frey JL, Schwamm LH, et al. Cerebral Ischemic Zviitiko Zvinosangana ne'Bhudzi Yokudzidza 'kweKutsvaga Kwekodzero Yokusara Kuruboshwe. Stroke 2009; 40: 2343.
> Parker JM, Weller MW, Feinstein LM, et al. Kuchengetedzwa kweVashandi Vanoparadzaniswa neAxsound muVirwere Vanozivikanwa kana Vanopomerwa Mwoyo Mutsvuku. Am J Cardiol 2013; 112: 1039.