Inovhara Chidziro chePament Foramen Ovale Inodzivisa Kurwisa?
Isu tose taimbova nehunza mumwoyo yedu. Ropa rinoyerera zvakasiyana zvakasiyana kuburikidza nemuviri wemucheche asina kuberekwa uchienzaniswa nemunhu mukuru. Kune rimwe, ropa rinopinda nepakati pevheiri pakati peboshwe nechekurudyi rwemoyo kuburikidza nemuvhuro unonzi foramen ovale.
Nekufema kwekutanga kwemweya, kunyange zvakadaro, kushata kwepakati pakati pebato rekuruboshwe uye kurudyi kwemoyo kunoshanduka, uye chidimbu chezvisimbiso zvemuviri chinonzi foramen ovale.
Kubva panguva iyoyo zvichienda, ropa rinotenderera muchimiro chinowanikwa kune vose vanhu vakuru.
Dzimwe nguva, kunyange zvakadaro, inosenen ovale haisi chisimbiso zvachose, ichisiya izvo zvinonzi patent foramen ovale, kana PFO. Izvi chaizvoizvo zvakajairika uye zvakataurwa kuti zvinokanganisa neyese pavanhu vashanu.
Sezvinotyisa sezvo zvinonzwika kuva nehukama huri pakati pemativi maviri emoyo, tsvakurudzo dzakawanda dzinoratidza kuti PFOs haina ngozi pane imwe nguva. Vamwe vanachiremba, zvisinei, vanotenda kuti PFO inogona kuwedzera njodzi yekurohwa.
Chinoshanda sei?
Nheyo yacho inofamba seyiyi: mavara emagazi mumakumbo uye anofamba nenzira yehutachiona kusvika pamwoyo. Ropa kazhinji rinotumirwa kubva kurudyi rwomwoyo kusvika kumapapu kuti ribvise carbon dioxide uye rinotakura mumhepo. Mishonga yeropa iyo kushandiswa kwegesi inoitika yakawanda kwazvo, uye chero zvipfeko zvinofamba nemumota ( emboli ) zvingangodaro zvakasarudzwa mumapapu.
Izvi zvinokonzerwa nemafuta zvinogona kudarika, kunyange zvakadaro, kana ropa richikwanisa kufamba kubva kurudyi kusvika kuruboshwe rwemoyo pasina kuenda mumapapu. Izvo zvinogona kuita izvi kana pane gomba pakati pemakumbo emoyo akadai se PFO, uye kana kukanganiswa kwemaitiro kune dzimwe nguva kwakakwirira kune rumwe rutivi rworudyi rwemoyo kupfuura kuruboshwe (izvo zvisinganzwisisiki).
Pasi pemamiriro ezvinhu aya, ropa rinogona kufamba kune rumwe rutivi rworuboshwe rwemwoyo, iyo inoputirwa kunze mumuviri, kusanganisira uropi, apo chivharo chinoita kuti ropa riwedzere kuwedzera uye rinotungamirira kune chirwere chepfungwa . Chivharo chinofamba nenzira yakadaro chinonzi chibvumirano chinopesana, kubva par ((maviri) uye doxical (kurutivi).
Sarudzo
Kune zvikamu zviviri zvekuita apo mumwe munhu ane PFO ane chirwere chisina chikonzero chakajeka. Nzira yekutanga, sekukurudzirwa neAmerican College of Chest Physicians (ACCP) mirayiridzo yeChirungu, inoshandisa antiplatelet therapy seApirin. Kana thrombus iripo mumakumbo, anticoagulation nejandi rakafanana ne heparin kana warfarin inoshandiswa.
Nzira yechipiri yekuita ndeyekusimbisa PFO. Izvi zvinonyanya kufadza kune varwere vangobva vatora stroke uye vanogamuchira nhau dzinotyisa kuti kune "gomba mumwoyo yavo." Pasi pemamiriro ezvinhu aya, munhu angada kuita zvose zvaanokwanisa kuti ave neumwe, izvo zvingangove zvakanyanya, zvakanyanya.
Dambudziko nderokuti kunyange kuisa chisimbiso che PFO chaizoratidzika sechinhu chinonzwisisika kuita, kutsvakurudza kwakawanda hakuna kuratidza kubatsira kwakakwana kune izvi zvinopesana.
Nzira inonyanyozivikanwa yekuisa chisimbiso patent foramen ovale ine nzira yakasiyana-siyana.
Mumwe chiremba akarovedzwa anoisa catheter kuburikidza nemakumbo emuviri mumoyo, uko chigadzirwa chinoshandiswa kusimbisa PFO. Imwe nzira inosanganisira kuvhiyiwa kwakawanda.
Zvidzidzo zvikuru zvePFO yekuvhara muhurongwa hwekurohwa hazvibatsiri kune imwe nzira. Chimwe chezvinhu zvakanakisisa miedzo, zvakakodzera zita rinonzi CHIKAMU 1, chakatarisa vanhu vasati vava nemakore makumi matanhatu nemapfumbamwe vane PFO avo vakatambura chirwere chekurohwa kana kupedzisira kusvikidzika . Kwete chete kwakanga kusina rubatsiro pashure pemakore maviri, asi vanhu vaiita izvi zvaiwanzova nematambudziko makuru evascular kana frill fibrillation kupfuura avo vakangogamuchira kurapwa kwechiremba.
Zvigumisiro zvavo zvaishungurudza kuvanhu vainge vaona kuti kune vamwe, vasina simba vanoongorora kuvharwa kwegadziro kwaive kuchiita kushanda. Kungofanana nechiedzo chipi nechipi, KUTANGA 1 kwaiva nezvikanganiso. Vatsoropodzi vakaratidza kuti zvichida chidimbu chakanaka chingave chakaderedza njodzi yezvinetso, kana kuti kukosha kwekuenzanisa kwakanga kusina kukwana. Izvozvo zvakati, CHITSAUKO 1 chine uchapupu hunopfuura hupi hwehupi hupi hwekutanga, uye zvigumisiro zvinowedzera. nepo vamwe vakataurirana kuti kufambira mberi muhutano hunoshandiswa mukuvhara PFO kunogona kururamisa kushandiswa kwayo, iyo inopikisa ndeyokuti kurapwa kwezvechiremba iri kufambira mberi, uye inogona kuramba ichikwikwidza kugadziriswa kwe PFO.
Mhedziso
IAmerican Academy of Neurology uye yakawanda yakagumisa kuti hapana kubatsiridza muitiro muPPO, kunyange kugadziriswa kwega kwega kunenge kuchiri kukodzera mumhando dzisina kunyanya uye dzakaoma zvekukurukurirana pakati pekumativi uye kurudyi kumativi emoyo. Mhosva dzakadaro dzinosanganisira kukanganisa kukuru kweatrial septal.
Kunezve vanachiremba vakakomberedza avo vanoda kuita izvi nenzira yeavo vanoomerera kuva ne patent foramen ovale yakavharwa. Vamwe vanhu havagoni kufunga nezvekuti pane gomba mumwoyo, kunyange kana iri gomba redu tese tine, uye vanhu vazhinji vanoramba vachive vasina matambudziko. Kune avo vanoramba vachifarira pasinei nekushayikwa kwebatsiro rakaratidza, zvinokosha kuwana maonero kubva kune chiremba uyo asina mari yekubhadhara mukuita iyo nzira.
Sources:
Furlan AJ, Reisman M, Massaro J, et al. Kuvhara kana kurapwa kwechiremba kwe cryptogenic stroke ne patent foramen ovale. N Engl J Med 2012; 366: 991.
Hagen PT, Scholz DG, Edwards WD. Kuwedzera uye ukuru hwepentent foramen ovale mumakore gumi ekutanga ehupenyu: chidzidzo che autopsy che 965 moyo yakakwana. Mayo Clin Proc. 1984; 59: 17-20.
Lansberg MG, O'Donnell MJ, Khatri P, et al. Antithrombotic uye thrombolytic therapy ye ischemic stroke: Antithrombotic Therapy uye Prevention of Thrombosis, 9th ed: American College of Chest Physicians Zviratidzo-Based Clinical Practice Guidelines. Chest 2012; 141: e601S.