I-Pericardial Effusion

Isikhwama esincane, esinezendlalelo ezimbili esibizwa ngokuthi i-pericardium sivikela inhliziyo. Lapho uketshezi oluningi lunqwabelana phakathi kwalezi zingqimba, odokotela babiza lesi simo ngokuthi i-pericardial effusion. I-pericardial effusion ibangela ukukhathala, ukuphefumula, nomuzwa oqhubekayo wokucindezela, okungathinta imisebenzi yansuku zonke. Lo mhlahlandlela ophelele uchaza konke iziguli okudingeka zazi mayelana nokuphuma kwe-pericardial. Uzofunda ngezimpawu nezimpawu zayo, izimbangela ezivamile, izindlela zokwelapha ezitholakalayo, nokuthi kufanele bafune usizo lwezokwelapha ngokushesha. 

Iyini i-Pericardial Effusion?

I-pericardial effusion iqala lapho uketshezi oluningi lunqwabelana esikhaleni esiphakathi kwezingqimba ezimbili ze-pericardium, isaka eliyisivikelo elizungeze inhliziyo. Lesi simo singakhula kancane kancane noma ngokuzumayo, ngasinye siveze izinselele ezihlukene ekusebenzeni kwenhliziyo.

Lapho uketshezi lwanda kancane, i-pericardium iba nesikhathi sokunwebeka futhi ifake uketshezi olwengeziwe. Kodwa-ke, ukunqwabelana okusheshayo kungaba yingozi kakhulu njengoba isikhwama se-pericardial singenaso isikhathi esanele sokuzivumelanisa nezimo. Kunoma yikuphi, ukuba khona koketshezi okweqile kungathinta kakhulu indlela inhliziyo esebenza ngayo.

Izimpawu ze-Pericardial Effusion

Iziguli eziningi aziboni izimpawu eziphawulekayo, ikakhulukazi lapho uketshezi lunqwabelana kancane. Izimpawu ezivamile ze-pericardial effusion zihlanganisa:

• Ukuphefumula kanzima, ikakhulukazi lapho ulele
• Ubuhlungu besifuba noma ingcindezi, ngokuvamile ngemuva kwethambo lesifuba
• Ukushaya kwenhliziyo okusheshayo
• Ubucwebe obukhanyayo noma ukuquleka
• Ukukhathala nokubuthakathaka
• Ukuvuvukala esiswini noma emilenzeni
• Inkinga yokugwinya
• Ukuhixa okuphikelelayo
• Ukukhwehlela noma ukuhayiza

Izimbangela Nezingozi Zokuphuma Kwe-Pericardial Effusion

Izimbangela eziyinhloko ze-pericardial effusion zihlanganisa:

• Amagciwane: Ukutheleleka ngegciwane kanye nebhaktheriya, okuhlanganisa i-HIV nesifo sofuba, kungabangela ukunqwabelana koketshezi. Emazweni asathuthuka, isifo sofuba siseyimbangela evame kakhulu.
• Izinkinga Ezihlobene Nomdlavuza: Zombili izimila zenhliziyo eziyinhloko kanye nomdlavuza osakazeka kwezinye izingxenye zomzimba zingathinta i-pericardium
• Izimo ze-Autoimmune: Izifo ezifana ne-lupus, i-rheumatoid sokuqaqamba kwamalunga, kanye ne-Sjögren's syndrome ingaholela ekuphumeni kwe-pericardial
• Izinqubo Zokwelashwa: Ukuhlinzwa kwenhliziyo, ukwelashwa ngemisebe yomdlavuza, kanye nemithi ethile ingabangela lesi simo

Izimo eziningana zesistimu ezingaphansi zingandisa ingozi yokuthuthukisa i-pericardial effusion. Lokhu kubandakanya: 

• Ukuhluleka kwenhliziyo
• Isifo sezinso ezingapheli
• Ukuqina kwesibindi
• Ukuphazamiseka kweHormonal, ikakhulukazi i-thyroid engasebenzi (hypothyroidism)
• Ukulimala kwesifuba ezingozini zezimoto noma amanxeba ezinto ezicijile 
• Izinkinga ezihlobene nenhliziyo ezifana nokuhlaselwa yinhliziyo, izifo ze-valve, noma i-aorta dissection 

Izinkinga ze-Pericardial Effusion

• I-Cardiac Tamponade: Inkinga enzima kakhulu yokukhishwa kwe-pericardial effusion yi-cardiac tamponade, isimo esisongela ukuphila esidinga ukunakekelwa kwezokwelapha ngokushesha. Lokhu kwenzeka lapho uketshezi oludlulele lubeka umfutho enhliziyweni, luyivimbele ekugcwaleni igazi ngokwanele.
• I-Pericardial Decompression Syndrome (PDS): I-PDS iyinkinga engavamile kodwa engathi sína engenzeka ngemva kokukhipha uketshezi okweqile. Lesi simo sithinta ikakhulukazi iziguli ezinokuphuma okukhulu kanye nezinkinga zenhliziyo ezingaphansi. I-PDS ingabangela ukuwohloka okungalindelekile esimweni sesiguli, ngisho nangemva kwalokho okubonakala kuwukwelashwa okuphumelelayo.

Ukuxilongwa kwe-Pericardial Effusion

Phakathi nokuhlolwa kokuqala, odokotela balalela ngokucophelela imisindo yenhliziyo besebenzisa i-stethoscope ukuze bathole ukungahambi kahle.

Izivivinyo eziningana zokuxilonga zisiza ukuqinisekisa ubukhona nobukhulu be-pericardial effusion:

• I-Echocardiogram: Leli thuluzi eliyinhloko lokuxilonga lisebenzisa amaza omsindo ukuze enze izithombe zenhliziyo ezinemininingwane, ebonisa inani loketshezi kanye nomthelela walo ekusebenzeni kwenhliziyo
• I-Electrocardiogram (ECG): Lokhu kuhlola kukala umsebenzi kagesi wenhliziyo futhi kungaveza amaphethini aphakamisa i-tamonade yenhliziyo
• I-X-ray yesifuba: Nakuba ingazweli kangako, ingabonisa izimpawu zenhliziyo ekhulisiwe uma ukukhishwa kukhulu
• Ukufanekisa Okuthuthukile: I-CT scans kanye ne-MRI inikeza ukubukwa okuningiliziwe kwenhliziyo futhi ikwazi ukubona ukuphuma kwe-pericardial, nakuba ngokuvamile isetshenziswa uma ezinye izimo zisolwa.

Ukwelashwa

Lezi zindlela ezilandelayo zokwelapha i-pericardial effusion:

• Linda futhi Ubuke: Odokotela bangase batuse ukuqapha isimo ezimweni ezithambile ngaphandle kwezimpawu ngenkathi belapha imbangela ewumsuka. 
• Imithi:
  • Izidakamizwa ezilwa nokuvuvukala ukunciphisa ukuvuvukala
  • I-Colchicine ehlanganiswe nokwelapha okuvamile (Le ndlela yokwelapha iboniswe ukunciphisa izimpawu phakathi kwamahora angu-72 ku-88.3% wamacala)
  • Ama-antibiotics okutheleleka nge-bacterial
  • I-Corticosteroids yamacala angaphenduli kwezinye izindlela zokwelapha
• Izinqubo zokuhlinza nokukhipha amanzi:
  • I-Pericardiocentesis: Inqubo evamile lapho odokotela basebenzisa i-catheter nenaliti ukukhipha uketshezi oluningi. Le nqubo ibonise izinga lempumelelo elingama-95%.
  • I-Pericardiectomy: Le nqubo ihilela ukukhishwa kokuhlinzwa kwengxenye noma yonke i-pericardium lapho ezinye izindlela zokwelapha zihluleka.
  • Ukuhlinzwa kwethoracic okusizwa ngevidiyo (i-VATS): Idala iwindi le-pericardial ukuvumela ukugeleza kwamanzi

Uzoyibona Nini Udokotela

Ukunakekelwa okuphuthumayo okuphuthumayo kubalulekile uma iziguli zithola noma yiziphi zalezi zimpawu eziyisixwayiso:

• ubuhlungu besifuba
• Ukuphefumula kanzima noma ukuphefumula ngokushesha
• Isikhumba siphenduka sibe mnyama, sibempunga noma sibe luhlaza okwesibhakabhaka
• Ukuquleka noma isiyezi esinzima
• I-palpitations yenhliziyo
• Ukushaya kwenhliziyo okuphumuzayo okudlula amabhithi ayi-100 ngomzuzu

Prevention

Odokotela batusa amasu amaningana okunciphisa ingozi yokuthuthukisa i-pericardial effusion:

• Ukwelashwa Ngokushesha Kwezifo: Ukubhekana nezifo kusenesikhathi kungavimba ukuthi zingathinti inhliziyo
• Ukuphepha Ngesikhathi Semisebenzi: Ukusebenzisa izinto zokuvikela ezifanele ngesikhathi semidlalo nemisebenzi yangaphandle ethwala izingozi zokulimala
• Ukuphatha Izimo Eziyisisekelo: Ukwelashwa okusebenzayo kwezimo zempilo ezikhona njengezifo ezizimele noma umdlavuza kunganciphisa ubungozi
• Ukuqapha Ukwelashwa Kwemisebe: Iziguli ezithola imisebe yesifuba kufanele zihlolwe njalo ngezimpawu zokuphuma kwe-pericardial
• Ukuhlolwa Kwezempilo Okuvamile: Ukugcina izikhathi ezihleliwe nodokotela ukuze kuqashwe njalo
• Indlela Yokuphila Enempilo: Ukulandela a Ukudla okunazo zonke, ukuvivinya umzimba njalo, nokugcina isisindo esinempilo
• Ukulinganisa Utshwala: Ukunciphisa ukusetshenziswa kotshwala ukuvimbela izinkinga ezihlobene nenhliziyo
• Ukuhlolwa kofuzo: Abantu abanomlando womndeni bangase bazuze ekwelulekweni ngofuzo

Isiphetho

I-Pericardial effusion idinga ukunakwa ngokucophelela nokungenelela kwezokwelapha ngokushesha lapho kuvela izimpawu. Nakuba isimo singaba sibi, izindlela zokwelapha zesimanje zinikeza izixazululo ezisebenzayo, amazinga empumelelo afinyelela ku-95-100%, kuye ngenqubo ekhethiwe. Iziguli ezibona noma yiziphi izimpawu eziyisixwayiso akufanele zingabaze ukufuna usizo lwezokwelapha. Isenzo esisheshayo, ikakhulukazi uma uzwa ubuhlungu besifuba noma ubunzima bokuphefumula, kunganqanda izinkinga ezinkulu njenge-tamponade yenhliziyo. 

Indlela yokuphila enempilo enempilo kanye nokuphathwa okufanele kwezimo ezingaphansi kunikeza iziguli ithuba elingcono kakhulu lokuvimbela ukuphuma kwe-pericardial. Ukuhlolwa njalo kwezokwelapha, ukwelashwa kusenesikhathi kwezifo, nokuqapha ngokucophelela izimo zempilo ezikhona kusiza ukunciphisa ingozi yokuba nalesi sifo senhliziyo. Iziguli zingakwazi ukuphatha ngempumelelo i-pericardial effusion futhi zigcine impilo yazo yenhliziyo ngokuqwashisa okufanele nokunakekelwa kwezokwelapha okufika ngesikhathi.

Imibuzo Evame Ukubuzwa

1. Kuvame kangakanani ukuphuma kwe-pericardial?

Ucwaningo lubonisa ukuthi ukukhishwa kwe-pericardial kuthinta ingxenye enkulu yabantu. Emazweni aseNtshonalanga, lesi simo sinezigameko ezilinganiselwa ku-3% kanye nokusabalala phakathi kuka-5.7% no-9%. Lesi simo singathinta abantu banoma ibuphi ubudala noma isizinda, sikwenze kube ukukhathazeka okuvamile okuhlobene nenhliziyo.

2. I-pericardial effusion ihlala isikhathi esingakanani?

Ubude be-pericardial effusion buhluka kakhulu phakathi kweziguli. Amarekhodi ezokwelapha abonisa ukuthi amacala angahlala noma yikuphi kusukela ezinyangeni eziyisi-6 kuye eminyakeni eyi-15, ubude besikhathi obumaphakathi buyiminyaka emi-3. Ukuthuthumela okuncane okungabangeli izimpawu kungase kuqhubeke isikhathi eside, kuyilapho ukuphuma okukhulu okudinga ukwelashwa ngokushesha kuvame ukuxazulula ngokushesha okukhulu ngokungenelela kwezokwelapha okufanele.

3. Uyini umehluko omkhulu phakathi kwe-cardiac tamponade kanye ne-pericardial effusion?

Nakuba i-pericardial effusion ibhekisela ekuqongeleleni uketshezi oluzungeze inhliziyo, i-cardiac tamponade iyinkinga engathi sína engavela kuyo. Umehluko obalulekile uhlanganisa:

• I-tamonade yenhliziyo yenzeka lapho uketshezi ludala umfutho ophakeme ovimbela ukusebenza kahle kwenhliziyo
• Ku-tamponade, amagumbi enhliziyo ayawa ngesikhathi se-diastole ngenxa yokucindezela okukhulu
• I-pericardial effusion evamile ingase ibekezelelwe kahle, ikakhulukazi uma ikhula kancane
• I-Tamponade idinga ukungenelela kwezokwelapha ngokushesha

UDkt. Nitin Modi

MBBS, MD, DNB, DM
Izibhedlela ze-CARE CHL, e-Indore

Ukuze Ubhukhe Isikhathi, shayela:

+91 406 810 6585