Mphuno ya mitral ndi matenda a mtima, pomwe malo otsika a atrioventricular afupika. Matendawa amatanthauza mtundu umodzi wa matenda a mtima. Matendawa amachititsa kusokonezeka kwa magazi a diastolic, omwe amadyetsedwa kuchokera kumanzere kumanzere kupita kumanzere. Mafupa angakhale pamtundu wokhawokha, komanso pamalo omwe atchulidwa, koma palinso zoopsa zina zina.
Malingana ndi chiwerengero, nthawi zambiri stenosis ya valve mitral imapezeka mwa amayi. Kuchokera pa 100,000 anthu, amapezeka anthu 80.
Zizindikiro zimawonetsedwa ali ndi zaka pafupifupi 50 ndipo zimakhala pang'onopang'ono. Kugonana kwachilendo n'kosawerengeka.
Zomwe zimayambitsa ndi etiology ya stenosis ya mitral orifice
Zina mwa zifukwa zazikulu za stenosis ya valve mitral ndi ziwiri:
- Kawirikawiri, izi zimayambitsa matendawa - 80% za matendawa amachititsa matenda a mtima.
- Nthawi zina, ndipo izi ndi 20 peresenti, chifukwa chake ndi matenda opatsirana (pakati pawo ndi kuvulala kwa mtima, kupweteka kwa matenda otchedwa endocarditis ndi ena).
Matendawa amapangidwa ali aang'ono, ndipo amakhala ndi kuphwanya ntchito ya valve yomwe ili pakati pa ventricle ndi atrium. Kuti mumvetsetse kuti matendawa ndi otani, m'pofunika kudziwa kuti valveyi imatsegulira mu diastole, ndipo ndiyomwe magazi owopsa a atrium kumanzere akulowera ku ventricle kumanzere. Mitsempha iyi imakhala ndi ma valve awiri, ndipo pamene pali stenosis, ma valve amathamanga, ndi dzenje lomwe magazi amatha, amachepetsa.
Chifukwa chaichi, kuponderezedwa kwa atrium kumanzere kumawonjezeka - magazi kuchokera kumanzere atrium alibe nthawi yotulutsa kunja.
Hemodynamics ndi mitral stenosis
Pamene kupweteka kwa atrium kumanzere kumawonjezeka, motero, kumawonjezereka bwino, komanso m'mitsempha ya pulmonary, ndikupeza mkhalidwe wapadziko lonse, m'magazi aang'ono. Chifukwa cha kuthamanga kwapamwamba, kachipatala kameneka kumanzere a atrium hypertrophies. Atrium chifukwa cha izi zimagwira ntchito yolimbikitsidwa, ndipo ndondomekoyi imasamutsidwa ku malo abwino. Komanso, kupanikizika kumatuluka m'mapapo ndi m'mitsempha ya pulmonary.
Zizindikiro za mitral stenosis
Zizindikiro ndi stenosis ya valve mitral poyamba zimadziwonetsera okha ngati mawonekedwe a mpweya wochepa chifukwa cha kugawanika kwa mapapo mu njira iyi, ndiye pali:
- Kuthamanga kwa mphumu ya mtima chifukwa cha kusokonezeka kwa kusinthana kwa mafuta;
- chifuwa, chomwe chingakhale ndi manyowa kapena phlegm;
- kufooka, mapeto;
- "Mtima hump" - ukuwombera pamtima pamtima - umachitika chifukwa cha hypertrophy ya ventricle yoyenera.
Kuzindikira kwa mitral stenosis
Mitral stenosis imapezeka pogwiritsa ntchito njira zotsatirazi:
- Kuyezetsa X - kumaphatikizapo kufotokozera kuwonjezeka kwa zipinda za mtima ndikudziŵa momwe ziwiyazo zilili.
- Electrocardiogram - amathandiza kuzindikira hypertrophy ya ventricle yoyenera ndi kuchoka pa atrium, komanso kudziwa mtundu wa mitima nyimbo.
- Phonocardiogram ndi kofunika kuti mudziwe kukula kwake kwa mawu osankhidwa.
- Echocardiogram - imatsimikiza kuyenda kwa mitral valve flaps, mlingo wa kutseka kwa valve mitral ndi kukula kwa mpando wa atrium wamanzere.
Kuchiza kwa mitral stenosis
Kuchiza kwa stenosis ya valve mitral si yeniyeni, ndipo imayesetsanso kusamalira mtima ndi kagayidwe kake ka magazi, komanso kuika magazi magazi.
Mwachitsanzo, ngati palibe kusowa kwa magazi, ACE inhibitors, glycosides mtima, diuretics, mankhwala omwe amachititsa kuti mchere wamchere ukhale wogwiritsidwa ntchito.
Ngati pali njira zowonongeka, amasiya kugwiritsa ntchito mankhwala oletsa antirheumatic.
Pamene mankhwala sakubweretsa zotsatira zoyenera, ndipo pali ngozi ku moyo, ndiye opaleshoni ikuwonetsedwa - mitral commissurotomy.