Ukudweba kwe-myocardium: incazelo yenqubo, ukuphikisana nezincomo

Ezweni lobuchwepheshe obuphezulu, isikhathi sesivele sesifikile lapho isayensi nemithi behamba ngezandla bese basizana ekuthuthukiseni. Ngokuyinhloko, lena yindlela entsha yokuhlola izifo, ukutholakala kwabo ezikhathini zangaphambili. Manje wonke umuntu uzwa ngokucabangela kwe-magnetic resonance (MRI), i-nuclear magnetic resonance (NMR), i-computed tomography (CT) kanye ne-positron emission tomography (PET). Kodwa isikhathi eside kunenye indlela yokubona ngeso lengqondo imvelo yangaphakathi yomzimba womuntu - ukudweba kwe-myocardium.

Izincazelo

I-Myocardial scintigraphy iyisifundo esikude, esingenasidingo senhliziyo esebenzisa izinhlayiyana ezivuthayo. Eqinisweni, lokhu kuyirekhodi lokusabalalisa kwedatha ye-isotope emzimbeni ekucubungulweni kwemisebe yabo.

I-Perfusion scintigraphy ye-myocardial ngokuyinhloko isifundo esifanayo njengoba kuchaziwe ngenhla, kodwa isebenzisa i-thallium e-radioactive. Ikhiqizwa kokubili ngokulayisha izivivinyo, futhi ngaphandle kwazo. Ivumela ukubeka ngokuqondile ukugxila kwe-ischemia, okwenza ukuthi ingabe ingenakwenzeka lapho kutholakala khona isifo se- coronary artery (ischemic disease disease).

Yilowo nalowo ngokuvumelana nezidingo

Kusukela ngo-2007, ukukhwabanisa sekuye kwasakazeka eU.SA, eNtshonalanga Yurophu nakwamanye amazwe asethuthukile. Le nkonzo yezokwelapha isizuze abantu abangaphezu kwezigidi eziyishumi nanhlanu. Kukhona inqubo evamile engavamile ukuthatha isikhathi esiningi nomzamo.

Esikhundleni seSoviet post isimo sihluke kakhulu. Okwamanje, cishe ama-gamma amakhamera angu-200 we-scintigraphy asebenza eRussia (uma kuqhathaniswa ne-US izinkulungwane eziyishumi nambili). Futhi ziyatholakala kuphela ezingeni lobuchwepheshe obukhethekile kakhulu.

Isebenza kanjani?

Ukulungele inqubo, isiguli sijova emgodini nge-indicator ye-izidakamizwa, equkethe i-molecule ye-vector kanye ne-isotopes e-radioactive. Umsebenzi wabo uhambelana, ngoba i-vector ine-tropism yamakhemikhali (indawo) eya emzimbeni othile noma izicubu zomzimba womuntu. Futhi i-isotopu iphuma emigqumeni ye-gamma endaweni esungeze kuyo. Ukubhaliswa kwalolu hlobo lwamagagasi kukuvumela ukuthi unqume izindawo zokuhlinzeka ngegazi ezinhle kunazo zonke.

Kuyini ukubonisa ukucacisa?

Ngenxa yalendlela yokubukwa, ungabuyekeza ngokucophelela futhi uhlolisise ukunikezwa kwegazi emzimbeni wenhliziyo, kokubili ngokugcwele nasezingxenyeni zayo. Ukuthola izindawo ezingenayo ukugeleza kwegazi, futhi ukuhlukanisa izindawo lapho izicubu zenhliziyo zifile, kulabo abangasindiswa. Ezigulini ze-postinfarction, izibazi kanye nezindawo ze-ischemia zibonakala kalula. Ngaphezu kwalokho, isazi singakwazi ukubikezela ngemiphumela yocwaningo ukuthi yiziphi izinkinga okufanele zilindeleke futhi maduzane.

Izinkomba zenqubo

Njengoba le nqubo iyinjabulo ebiza kakhulu, injongo yayo kufanele ibe necala. Lenziwa ngamacala alandelayo:

1. Ngabantu abaphilile ngaphambi kwemincintiswano ebalulekile yezemidlalo kanye nokungenelela okuhlinzekwe isikhathi eside ngaphansi kwe-anesthesia jikelele ukuze kungabikho ingozi yezinkinga noma ukulimala.

2. Ukutholakala kwe-IHD, uma kukhona konke okudingekayo ekuqalisweni kwalesi sifo.

3. Njengendlela yokuhlola ukuphumelela kokwelashwa: ukuguqulwa kwe-aortocoronary, i- angioplasty, ukwelapha izidakamizwa.

4. Ukuhlola inhliziyo emva kwe-infarction ye-myocardial (kodwa hhayi ngemuva kwayo, ngoba ukuhlaselwa kwenhliziyo okuphindaphindiwe kungase kwenzeke).

Njengomthetho, le ndlela ikuvumela ukuthi ubeke ngokucophelela ukuxilongwa kwezinto eziphezulu futhi uqinisekise.

Ukulungiselela isiguli ngenqubo

Ngaphambi kokwelashwa ngayinye noma inqubo yokuxilonga, isiguli sithola izincomo ezivela kudokotela, okuzogcinwa kuyo kuzosiza ukuqhuba isifundo ngokugcwele futhi kungadabuki kumuntu:

- Isifundo senziwa esiswini esingenalutho;
- Ngelinye ilanga ngaphambi kokuba singaphuzi ikhofi, i-Coca-Cola, itiye, kukhona ushokoledi;
- udinga ukuyeka ukuthatha imithi eqinisa inhliziyo;
- yenza i-ultrasound ukukhipha ukukhulelwa, futhi omama abahlengikazi kufanele balungiselele ubisi kusengaphambili, ngoba ingane ayikwazi ukunikwa ibele izinsuku ezimbili;
- Amadoda akufanele asebenzise amalungiselelo okuthuthukisa ukulungiswa kwawo ngosuku ngaphambi kokuhlolwa;
- Qinisekisa ukuthi utshela udokotela wakho mayelana nokuba khona kwe-asthma ye-bronchial.

Ukulungiselela ama-radionuclides

Ukukhwabanisa kwe-myocardium akukwazi ukuyenza ngaphandle kokusebenzisa izidakamizwa zemisakazo. Kunezinhlobo eziningi manje, kuye ngenhloso yocwaningo:

- I-MIBI, noma i-sestambi, isetshenziselwa ukutadisha umsebenzi wenhliziyo, inomsindo we-muscular.

I-Mono- ne-bisphosphonates inamathele amathambo, asetshenziselwa ukuxilonga umdlavuza kanye nezinkinga zabo, kanye nokulimala.

- I-Diethylenetriaminepentaacetic acid iveza ukukhubazeka kwezinso.

- I-Pertechnics isetshenziselwa ukutadisha igciwane le-thyroid.

- i-iodine-123 iklanyelwe ukubona ngeso lengqondo yegciwane.

Emakethe yemithi yesimanje, izidakamizwa sezivele zivele, ngenxa yokuthi kungenzeka ukuthi zihlolwe izinhlobo ezithile zezifo ezingokwemvelo. Emzimbeni womuntu, lezi zinto zilawulwa ngaphakathi, ngakho-ke udinga ukuthola ukuthi kusengaphambili ukuthi isiguli sinomsoco.

Ukulayisha ukuhlolwa

Ukucindezeleka-ukucacisa kwe-myocardium kwenziwa ngendlela efanayo nokuhlola okufanako kwi-electrocardiography. Ukwenza isimo esicindezelayo, isiguli sinikezwa ukuba sisebenze kuma-simulators (isitatimende sokuhamba ngezinyawo, ibhayisikili). Izinkomba zenqubo enjalo yizinguquko ezinokwethenjelwa ku-ECG, izikhalo ezijwayelekile zesifo senhliziyo. Enye yezinkinga eziyinkimbinkimbi yenqubo ukuthola ukuboniswa kwekhwalithi ye-ventricle kwesokunxele. Indlela yokwenza isampula enhle yilezi:

1. Ukukhishwa kwe-ejection ye-ventricle kwesokunxele akuyona engaphezu kwama-35%.
2. Ukwanda kwenkomfa ye-ejection ngesikhathi sokusebenza okukhulu kunama-5%.
3. Ukubonakaliswa okuthembekile kokuphulwa kwesivumelwano.
4. Ukuphazamiseka kwendawo yokuthengiswa kwe-cardiomyocytes ene-minimal load.

Imiphumela yesikhalazo

Ukucaciswa kwe-myocardium kuvumela ukuthola izinhlobo eziningana zezithombe zenhliziyo. Okokuqala, lezi ziyi-static, okuthiwa izithombe ezimisiwe. Leli mapayela amabili (dimensional) (flat) wesitho. Ngokuvamile kaningi ngale ndlela, bahlola amathambo, izigulane ze-endocrine, njalonjalo.

Okwesibili, kunezithombe ezinamandla noma ezihambayo, okuvumela ukuhlola umsebenzi wezitho ezingenalutho. Zitholakala njengomphumela wokungeziwe kwezithombe eziningana ezisekhona. Zisetshenziswa ukuhlola isibindi, izinso, inhliziyo, imithwalo yegazi.

Uhlobo lwesithathu lokubhaliswa kwesifundo ukuvumelanisa kwe-ECG. Ukususwa okungeziwe kwe-cardiogram kukuvumela ukuba uqhathanise umsebenzi nokudweba kwendawo yokulimala komzimba.

Abanye ochwepheshe, lapho benza umdwebo we-myocardial, bafaka i-Ophtex (ukukhishwa kwama-photon angamakhompyutha ambalwa) ukuthola izithombe ezintathu zesitho esingaphenywa nophenyo. Ngokuvamile lokhu kwenziwa ngokusola ngesifo senhliziyo noma ebuchosheni.

Ingabe indlela iphephile?

ERussia, kuphela ezimweni ezivelele, ukukhishwa kwe-myocardium kwenziwa. Ukuqhathaniswa kwalolu cwaningo kulula: ukungabi nokuzwela komuntu ngamunye kumuthi we-radioisotope. Ngaphezu kwalokho, inqubo iyaphikisana:

- omama abakhulelwe nabancenga;

- abantu abanezifo ezinzima zezinye izitho nezinhlelo (lokhu kungadala izinkinga phakathi nocwaningo usebenzisa umthwalo);

- iziguli ezine-sepsis nomkhuhlane;

- nge-myocarditis, ukutholakala kwezinkinga zenhliziyo nangemva kokuhlasela kwenhliziyo yakamuva.

Indlela ngokwayo ayibuhlungu futhi ingabi nengozi. Ngezinye izikhathi iziguli zithola imiphumela emibi emithonjeni noma ngokuzikhandla ngokomzimba, kodwa njengomthetho, ukungahambi kahle kuhamba ngokushesha, futhi abantu babuyela ekuphileni okuvamile.

Indlela yokufinyelela esifundweni

Ngingayenza kuphi ukudweba kwe-myocardial? Okokuqala, kuyadingeka ukuba uhlolwe ku-polyclinic noma esibhedlela sokwelashwa ukuze ubone ukuthi kunesidingo sokutadisha okubi kakhulu. Izifo zenhliziyo eziningi zingabonakala ngezindlela ezitholakalayo.

Njengoba sekushiwo ngenhla, endaweni yokuthunyelwa kweSoviet kungenzeka ukuthi ukuqhuba ukuhlolwa okunjalo kutholakala kuphela emadolobheni amakhulu. Ukunyatheliswa kwe-Myocardial eMoscow kuqhutshwa emitholampilo eminingi yangasese, kanye ne-SPC yokuhlinzeka ngokwezinhliziyo, ku-Research Institute of Gerontology ye-Ministry of Health ye-Russian Federation, i-Cardiovascular Surgery Center. AN Bakulev nasemnyangweni wezinkinga zokuhlola imisebe ye-Clinical Center of MMA okuthiwa emva. I. M. Sechenov.

Inqubomgomo yentengo ezikhungweni zezempilo zomphakathi nezizimele ingahluka, ngezinye izikhathi ngisho nakakhulu kakhulu. Ngakho-ke, kunengqondo ukutadisha ngokucophelela izinsizakalo ezithile ezihlinzeka esibhedlela bese unquma, uhlele inani eliceliwe lokutadisha njengokwakheka kwe-myocardial scintigraphy. Intengo eMoscow ingahluka ngokuya kwenani lenqubo kanye nendawo. Izindleko kukhona endaweni ethile phakathi kuka-ruble ayisikhombisa nesishiyagalombili. Lokhu kungokwesifundo esilula. Kodwa kukhona iziguli ezidinga ukudweba kwe-myocardial ngokuzivocavoca. Intengo yayo izoba okungenani kabili phezulu. Kusukela kuma-ruble ayizinkulungwane eziyishumi nanhlanu, ngokulandelana. Noma kunjalo, le ndlela inikeza udokotela isithombe esiphelele sesimo sempilo yesiguli, futhi kusiza ukukhetha ama-tactics asebenza kahle.

Ukukhwabanisa kwe-Myocardial kuyindlela entsha, engavamile, ephephile nengenabuhlungu yokuhlola imisipha yenhliziyo. Ngokuhlanganisa ukuphumelela kobuchwepheshe bamuva bekhompuyutha kanye nokutholakala emkhakheni wezinto ezinomsakazo, kwaba khona ukuhlola ukuthi isifo se-ischemic lungakanani ekuqaleni.