Qeto ea ho ba le opral stenosis opereishene ke e qhekellang, 'me e tlameha ho etsoa ka hloko ka bomong.
Haeba uena le ngaka ea hau le entse qeto ea hore nako ea ts'ebetso e tla ba teng, o tla be o lekanyelitse lintlha tse tharo tse ka sehloohong bakeng sa kalafo ea ho buuoa ea mitral stenosis: Ho tsoa ho e mengata ho ea ho e fokolang hangata e khothalletsoang, ke tsena:
- metral balloon valvotomy (PMBV)
- mitral commissurotomy
- phetolo ea mitral valve
Hase litsela tsena kaofela tse loketseng motho e mong le e mong ea nang le mitral stenosis.
Percutaneous Mitral Balloon Valvotomy
Ka mitral stenosis, li-leaflet valral (li-flap flexible tse bulehileng le tse koalang joaloka likonteraka tsa pelo) li kopantsoe hammoho, ho thibela valve ho bula ka ho feletseng. PMBV e leka ho arola makasine e mong ho e mong ho fokotsa tšitiso.
Ho PMBV, tube e telele, e lesesaane, e tenyetsehang (catheter) e nang le ballone e senyehileng e fetisitsoeng ho eona e fetisitsoe ka har'a valve ea mitral. Joale balune e atolosoa. Sepheo ke ho roba li-adhesion tse kopantseng li-leaftlet tsa mitral valve.
Hobane PMBV ke mokhoa oa ho thibela batho ba bang 'me ha ba buuoe ke pelo , e ke ke ea e-ba kotsi ho bakuli ho feta mekhoa e meng ea opral valve opereishene. Mathata a atisa ho ba a fokolang haholo, 'me hangata mokhoa ona oa ho hlaphoheloa o bonolo haholo.
PMBV e boetse e sebetsa haholo ha e etsoa ho batho ba khethiloeng hantle.
Ka kakaretso, PMBV ke mokhoa oa ho buuoa ngaka ea hau e tla khothaletsa ho rarolla mitral stenosis, ntle le haeba u na le:
- lefu la lejoe le letšehali la mali (left clot)
- matla a khalsiamo a kenang kapa haufi le valve ea hao ea mitral
- ho leka-lekana ho khutlela mokhoeng o moholo oa metral-ha mopral valve e sa koale hantle, e lumella mali hore a theohe ka har'a valve
Ho phaella moo, PMBV hangata hase khetho haeba mitral stenosis e tsamaisana le maemo a mang a maholo a pelo.
Ka mor'a mokhoa oa PMBV, ho ka khoneha hore mitral stenosis e qala ho mpefala butle-butle hape. Ka lebaka lena, esita le ka mor'a ho etsa ts'ebetsong ena, ke habohlokoa hore u be le litekanyetso tsa pelo tsa nako le nako ka li-cartoonography . Ho fihlela ho ba etsang karolo ea 21 lekholong ea bakuli ba nang le PMBV qetellong ba hloka phekolo ea bobeli.
Mitral Commissurotomy
Sepheo sa phetoho ea mitral e tšoana le PMBV-ho arola li-leaflets tse hlokomelaneng. Ho fapane le ts'ebetso ea metral, leha ho le joalo, ke hore mohato oa pelo o bulehileng o finyelle pakane ena ka tšebeliso ea lehare le bohale la ho buoa.
Hangata maikutlo a bophelo a fana ka liphello tse ntle haholo. Leha ho le joalo, u pepesehetse likotsi tsa ts'ebetso e kholo le nako e telele ea ho phomola ho feta ka PMBV, e leng se thibelang lingaka ho li buella e le khetho ea pele.
Hangata ho ba le khethollo e ntle ho batho ba tla be ba khethiloe ho PMBV ntle le ho ba teng ha thrombus ea lebaleng le letšehali, kalo ea li-valve kapa metral.
Joaloka ka mokhoa oa PMBV, mitral stenosis e ka boela ea khutla morao ho latela ts'ebetso ea boipheliso. Batho ba nang le ts'ebetso ena ba boetse ba hloka tlhahlobo ea pelo ea nako le nako.
Phetoho ea Mitral Valve
Phetoho ea Mitral valve ke khetho ea ho qetela, hobane e na le kotsing e kholo ea mathata ho feta PMBV kapa ts'ebetso ea bophelo. Phetolo ea li-valve e hlokahala ha metral stenosis e entse hore valve ea mitral e senyehe haholo kapa e behoe, e leng ho etsang hore mekhoa e 'meli e meng e se ke ea etsahala.
Ka motlakase ea mitral, motlakase o nkeloa sebaka ke valve ea maiketsetso . Li-valve tsa sehlahisoa li ka fetoha lihlahisoa tse entsoeng ke batho (li-valve tsa mechine), kapa li ka etsoa ho tsoa pelong ea valve ea phoofolo, hangata kolobe (valve ea bioprosthetic).
Ho etsa qeto ea mofuta ofe oa valve oa maiketsetso oo u lokelang ho o sebelisa ho itšetlehile ka lilemo tsa hau le hore na u ka nka mali a tšabehang Coumadin .
Lisebelisoa tsohle tsa pelo tsa maiketsetso li na le matla a eketsehileng a ho theha mali. Leha ho le joalo, ho koala mali ha ho na bothata le bioprosthetic ho feta li-valve tsa mechine, kahoo batho ba nang le mefuta ea pele ba ka 'na ba se ke ba nka phekolo e sa foleng ea Coumadin; ba nang le li-valve tsa mechine ba etsa joalo.
Leha ho le joalo, ka tloaelo li-valve tsa mechine li nka nako e telele ho feta li-valve tsa bioprosthetic. Haeba o hloka setral valve sebaka, ba ka tlaase ho lilemo tse 65, 'me u ka nka Coumadin, ngaka ea hau e ka' na ea khothaletsa sephahla sa mechine. Haeba u se u le moholo ho feta 65, kapa u monyenyane empa u sa khone ho nka Coumadin, sephahla sa bioprosthetic se atisa ho buelloa.
Your Surgral Stenosis Surgery Qeto
Haeba u na le mitral stenosis, u tla lokela ho sebetsa haufi le setsebi sa hau sa lefu la pelo ho etsa qeto ea hore na ho buuoa ho tla hlokahala neng le ha ho hlokahala, ebe u khetha mokhoa oa ho buoa o lumellanang hantle le litlhoko tsa hau ka bomong. Ha batho ba bangata ba e-na le lefu la lefu la pelo le ho hlokomela tlhokomelo ea pelo, ba bangata ba nang le metral stenosis kajeno ba ka lebella ho phela bophelo bo tloaelehileng.
Lisebelisoa:
Bonow, RO, Carabello, BA, Chatterjee, K, le al. 2008 Tlhahiso-taba e kenyelletsoeng e kenyelitsoe ho tataiso ea ACC / AHA 2006 bakeng sa tsamaiso ea bakuli ba nang le lefu la pelo ea valvular: tlaleho ea American College of Cardiology / American Heart Association Mosebetsi oa Mekhatlo ea Tsamaiso ea Koetliso (Komiti ea ho Ngola ho Hlahloba Litaelo tsa 1998 tsa Tsamaiso ea Bakuli ba nang le Mafu a Pelo a Valvular): ba lumelloa ke Mokhatlo oa Mahlaba a Maiketsetso a Anesthesiologists, Mokhatlo oa Lipelo Tsa Meriana oa Maiketsetso le Mesebetsi, le Mokhatlo oa Thoracic Surgeons. Tsamaiso ea 2008; 118: e523.
Ben Farhat M, Ayari M, Maatouk F, et al. Phallo ea li-percutaneous ka ho buoa e koetsoe ebile e bulehile ka matla a metral: liphello tse latelang tsa lilemo tse supileng tsa teko e sa lebelloang. Ho potoloha 1998; 97: 245.