Iimpawu zokuqala zokuhluleka kwentliziyo yintloko yesihloko. Ukuphelelwa yintliziyo kungabonwa:
• ukhathala okwenyukayo - ngokukodwa ngefomu elibi;
• Ukuphefumla okufutshane-okokuqala kubonakala kuphela ngokuzikhandla ngokomzimba, kodwa kwinqanaba lexesha elizayo lingafumaneka kwakhona;
■ ukukhwehlela nge-white detectoration emhlophe okanye ebomvu, enxulumene nokugcinwa kwamanzi kunye neziganeko zepommonary congestive;
• i-edema - ukuqokelelwa kwamanzi amaninzi; zihlala kwiimpawu zokuhamba kwezigulane kunye nommandla we-lumbosacral kunye nasezintanyeni - kwi-recumbent;
• ukulahleka kwesisindo - isifo sisoloko sihamba kunye nokunciphisa ukutya, isisongela kunye nokuhlanza;
• intlungu yesisu - inokubangelwa ngenxa yezinto ezinobunzima kwisibindi.
Ukungaphumeleli kwentliziyo kwenzeka xa intliziyo ibonakaliswe okanye ikhululiwe - umzekelo, ngesinye sezifo zilandelayo:
• Izifo zentliziyo yeCoronary - zihlala zihambelana nesilonda se-myocardium ye-ventricle yekhohlo yentliziyo;
• ukukhubazeka okungapheliyo kweentliziyo zomzimba - umzekelo, ngenxa yokusuleleka kwintsholongwane okanye utywala;
• uxinzelelo lwegazi - lukhokelela ekunciphiseni kwintambo eludongeni, oluyinkimbinkimbi yomsebenzi wenhliziyo;
• I-myocarditis enobuchule okanye engapheliyo (ukuvuvukala kwesisu senhliziyo) - inokuba yinkxalabo yokusuleleka kwe-virus kunye ne-bacteria;
■ iintsilelo zeentliziyo - utshintsho kwiintliziyo zevilves of nature, innenerative or due to damage;
• Ukunyanzeliswa kwe-aorta - isifo sokubeleka komntwana;
• ukungafani kwimizuzu emfutshane yenhliziyo ukuya kwiimfuno zomzimba - xa iqumrhu lisebenza nomthwalo ophezulu ukuzalisa iifom i-oxygen;
• Ukuphulwa komngcipheko wesibindi - umzekelo, ukuqina okungapheliyo kwe-pericardium kunciphisa igazi kwi-intliziyo, ngenxa yoko ukugcina ukusasazwa kusebenza ngokulayishwa okuphakanyisiweyo.
Imisebenzi yentliziyo
Inhliziyo iyimpompo ye-muscle ephinda igazi kwizitho zonke, izalise i-oxygen kunye nezondlo. Intliziyo yenza malunga ne-100,000 imivimbo emini, ukupompa ama-25-30 ilitha egazi ngomzuzu. Intliziyo ihlukaniswe kwiinqumfa ezisekhohlo kunye neyekunene, ngalinye liqukethe i-atrium kunye ne-ventricle. Igazi elibi li-oksijeni ephuma emithanjeni engenangena lingena kwi-atrium efanelekileyo. Ukusuka apha kuqhutyelwa i-ventricle efanelekileyo kwiinqanawa zemiphunga. I-atrium ekhohlo ifumana igazi elenziwe nge-oksijeni ukusuka kwimijikelezo ye-pulmonary, emva koko iyayifaka kwi-ventricle engasekhohlo, apho iqhutyelwa khona ukujikelezwa okukhulu. Iipilveshi zenhliziyo zikhusela ukubuyela kwegazi. Intliziyo yesisu inegalelo layo legazi, elibonelelwa ngamarriyari. Igobolondo elinezimbini ezifihla intliziyo kuthiwa yi-pericardium. Ukuxilongwa kwentsilelo yentliziyo eyenziwa ngesiseko seenkcukacha zeklinikhi, nangona kunjalo, uphando olongezelelweyo lunokucacisa izizathu zalo kwaye lukhethe unyango olungcono. Ukrokrela ukungaphumeleli kwentliziyo zibonakalisa iimpawu ezinjengokuphefumula nokuvuvukala.
Uviwo
Ngexesha lovavanyo lokuphandwa lulandelayo kuqhutywa:
• iimvavanyo zegazi - uphando olukhulu lwegazi, iimvavanyo ze-biochemical ukuvavanya umsebenzi wesibindi, izintso kunye ne-thyroid gland; ukuzimisela kwinqanaba le-enzymes yenhliziyo (nge-infyoction ye-myocardial yanda);
• I-X-ray yesifuba yesitho sesifuba-ukufumana ukwanda kwentsingiselo yentliziyo, ubukho bemithombo yamaphaphu, ukutywinwa kweendonga zeemitha;
• i-electrocardiogram (ECG) - kwizigulane ezinokukhubazeka kwentliziyo, utshintsho olungavamile lwe-ECG luvame ukugcinwa;
• I-echocardiography yinkqutyana ebalulekileyo ekuvavanyeni umsebenzi we-ventricle engasekhohlo, iipavini zomoya kunye ne-pericardium; umbala we-dopplerography - esetyenziselwa ukufundisisa isimo seentsimbi zentliziyo kunye nokuhamba kwegazi okungenayo i-intracardiac;
■ ukunyanyiswa komzimba - kukuvumela ukuba ulinganise uxinzelelo kwiinkamelo zentliziyo kunye neempahla eziphambili;
• Ukulayisha iimvavanyo - kukuvumela ukuba uhlolisise ukusabela kwenhliziyo kumthwalo ngokomzimba.
Izigulane ezinokukhubazeka kwentliziyo zivame ukuboniswa esibhedlele. Ukuba kunokwenzeka, phatha izifo ezibangelwa ukungaphumeleli kwentliziyo, njenge-anemia. Ukubonelela ukuphumla kwisigulane kunokunciphisa umthwalo entliziyweni, kodwa uhlale embhedeni kufuneka ulinganiselwe ukuba ugweme ukubunjwa kwamacandelo egazi kwiinqwelo zamalungu angaphantsi. Zonke iindlela zonyango ziyenziwa ngokufanelekileyo kwindawo ehleliyo, ingalali phantsi. Ukutya kufuneka kube ngamacandelo amancinci, kunye nokuthintela ityuwa. Utywala kunye nokutshaya akufakwanga. Ukunyanga ukuhluleka kwintliziyo, ezi ziyobisi zilandelayo: i-diuretics - ukwandisa umlinganiselo we-urine, ukunyuswa kwengcinezelo yegazi, ukunciphisa ukuvuvukala kunye ne-dyspnea; i-beta-blockers - yenzeke intliziyo, iyancipha intliziyo yesantya, kodwa ekuqaleni kokungena kwabo, ulawulo logqirha luyimfuneko; i-angiotensin-ukuguqula i-enzyme (ACE inhibitors) - inokuthintela ukuqhubela phambili kwesi sifo, kunye nokunciphisa ukufa okuvela kwintliziyo engapheliyo kunye ne-infyoction ye-myocardial. Ukukhethwa kokuqala kwenzalo kufuneka kuqhutywe phantsi kolawulo logqirha.
• ii-angiotensin ii-receptor antagonists-ezifanayo kwiziphumo zazo kwi-ACE inhibitors, kodwa zibe nemiphumo engaphantsi;
• i-digoxin - ibangele ibangele i-nausea, ngaphezu koko, kukho iimeko ezinzima ekukhethiweyo kwedoloji. Isetyenziselwa ngokuqhelekileyo ukulungelelanisa intliziyo yesigqibo kunye nama-arrhythmias.
Izigulane ezininzi ziboniswa unyango oluhlangeneyo kunye namachiza amaninzi. Ukungaphumeleli kwintliziyo kunokuhlakulela nanini na ubudala, kodwa kubonakala ngokugqithiseleyo kubantu abadala. Ukungaphumeleli kwintliziyo engapheli kubangelwa ngu-0.4 ukuya kwi-2% yabantu abadala. Xa uneminyaka yobudala, umngcipheko wokwehluleka kwentliziyo uyanda. Phakathi kwazo zonke izigulane eziya kumaziko ezonyango eRussia, ama-38.6% aneempawu zokungahlali kwintliziyo engapheliyo. Nangona uphuhliso lweendlela zokonyango, ukugxekwa kwezigulane ezinokukhubazeka kwentliziyo zihlala zingenakulungeleka. Iindleko zokusinda phakathi kwazo zibi kunokuba zinezinye iintlobo zesifo somhlaza. Phantse i-50% yezigulane ezinokukhubazeka kwentliziyo ziyafa zingakapheli iminyaka emibini ukususela ngomhla wokuxilongwa.