Me pēhea te tātaritanga i te mate manawa i roto i ngā kararehe
Ehara i te mea ko te tangata anake te tangata e pāngia ana e te mate manawa, engari ko ngā kararehe hoki, ahakoa nō te kāinga, nō te ngahere hoki. Me whai huarahi whānui, pūnaha hoki te tātaritanga o te mate manawa i roto i ngā kararehe. I roto i tēnei tuhinga, ka matapakihia e mātou ngā tikanga me ngā taputapu e whakamahia ana hei tātaritanga i te mate manawa i roto i ngā kararehe, me ētahi tauira kēhi noa.
Pendahuluan
Ka pā mai te mate manawa i roto i ngā kararehe i ngā momo āhuatanga maha, tae atu ki ngā āhuatanga whānau hou, ngā mate pāwera, ngā tukanga pirau, me te momo noho. Ko te huarahi ki te tautuhi i tēnei mate me whai i ngā uiuinga me te rangatira o te kararehe, he whakamātautau tinana , te whakamahi i ngā taputapu tautuhi matatau, me ētahi whakamātautau taiwhanga.
Ka rerekē pea ngā tohu haumanu o te mate manawa i roto i ngā kararehe i runga i te momo mate me tōna taumata whanaketanga. Ko ētahi o ngā tohu noa ko te maremare, te uaua ki te manawa, te ngenge, te heke o te hiahia kai, me te pupuhi. Kei raro nei, ka matapakihia e mātou ngā mahi hei tautuhi i te mate manawa i roto i ngā kararehe me te taipitopito atu.
1. Te Whakamātautau i te Anamnesis
Ko te anamnesis te taahiraa tuatahi i roto i te tukanga tautuhi mate ngakau i roto i ngā kararehe. Tākuta kararehe ka kohia ngā mōhiohio mai i ngā kaipupuri mōkai e pā ana ki ēnei e whai ake nei:
– Hītori hauora: Ngā mōhiohio e pā ana ki te hītori hauora o mua, te āhua hauora o nāianei, me ngā tohu e pā ana.
– Ngā whanonga me ngā tikanga: Ngā mahi ā-tinana, ngā kai, me ngā huringa whanonga e pā ana ki ngā mate o te ngākau.
– Hītori whānau: He mea tuku iho ētahi mate manawa, nō reira he mea nui kia mōhio mēnā he rite tonu ngā mate i roto i te whānau o te kararehe.
2. Whakamātautau Tinana
I muri i te tātaritanga o te anamnesis, tākuta kararehe ka whakahaerehia he whakamātautau tinana hōhonu hei rapu i ngā tohu o te mate manawa. Ko ētahi o ngā āhuatanga i tirotirohia ko:
– Te pā me te whakarongo: Ka tirohia e te tākuta te tere o te manawa, ka whakarongo ki ngā oro o te manawa, ka rapu hoki mō ngā mea rerekē pēnei i te murmurs (ngā oro rerekē i roto i te manawa).
– Whakamātautau manawa: Ka tirohia e te tākuta te tere o te manawa, te tauira manawa, me ngā oro rerekē i roto i ngā pukahukahu e tohu ana pea i te pupuhi o te pukahukahu.
– Whakamātautau whānui: Te tirotiro i te tae o ngā kapia (hei aromatawai i te nui o te hāora i roto i te toto), te pā o te puku hei tirotiro mēnā he nui te ate, he wai kore utu rānei, me te tirotiro i ngā peka me ngā waewae mō te pupuhi.
3. Te Whakamātautau Ngākau (ECG)
He taputapu tātaritanga te ECG e whakarato ana i ngā mōhiohio e pā ana ki te ngohe hiko o te ngākau. I roto i ngā kararehe, ka whakamahia te ECG hei kite i ngā arrhythmias (ngā manawataki ngākau koretake) me ētahi atu huringa e tohu ana i te mate ngākau. Ko te tikanga o tēnei tikanga ko te whakanoho i ngā irahiko ki te tinana o te kararehe me te tuhi i te ngohe hiko o te ngākau.
4. Te hihi-X o te uma
He taputapu tātaritanga taketake te hihi-X o te uma e whakamahia ana hei aromatawai i te rahi me te āhua o te ngākau me te āhua o ngā pukahukahu. Ka taea e te hihi-X o te uma te āwhina ki te tautuhi i te ngākau kua nui, te wai e pupū ake ana i roto i te wāhi pleural, me ētahi atu huringa e tohu ana i te mate ngākau, i ngā raruraru pukahukahu rānei.
5. Te tirotiro i te ngākau
Ko te echocardiography whakamātautau ultrasound o te ngākau. Mā tēnei whakamātautau ka kitea ngā whakaahua taipitopito o te hanganga me te mahi o te ngākau. Mā te Echocardiography ka taea tākuta kararehe Mō:
– Aromātaihia te rahi me te āhua o ngā rūma o te ngākau.
– Te ine i te matotoru o ngā pakitara o te ngākau.
– Aromatawai i te mahi a te takirere o te ngākau.
– Te kimi me te aromatawai i ngā papatipu, i ētahi atu āhuatanga rerekē rānei o te hanganga.
– Aromatawai i te rere o te toto i roto i te ngākau mā te whakamahi i te Doppler.
6. Whakamātautau Toto
Ka taea e ngā whakamātautau toto te whakarato i ngā mōhiohio nui mō te hauora whānui o te kararehe, me te tautoko i te tautuhi i te mate manawa. Ko ētahi o ngā whakamātautau toto e mahia whānuitia ana ko:
– Hematology Katoa: Ka tirohia te maha o ngā toto whero, ngā toto mā, me ngā pereti toto.
– Paewhiri matū koiora: Aromatawai i te mahi a ngā whekau pēnei i te ate me ngā whatukuhu ka pāngia pea e te mate manawa.
– Ngā whakamātautau irahiko: Ka pāngia te mahi a te ngākau e ngā kore taurite o ngā irahiko.
– Ngā Tohu Koiora: Tērā pea ka piki ake ētahi pūmua motuhake pēnei i te peptide natriuretic i roto i ngā take o te ngoikore o te ngakau.
7. Ine i te Oximetry Pulse
He tikanga kore-whakaeke te pulse oximetry mō te ine i te kukū o te hāora i roto i te toto. Mā tēnei taputapu ka taea te aromatawai i te pai o te kawe o te hāora ki ngā kiko mā roto i te toto mai i ngā pukahukahu. I roto i ngā kararehe e mate ana te ngākau, ka heke pea te kukū o te hāora, inā koa mēnā he raruraru pukahukahu.
8. Holter Aroturuki
Ko te aroturukitanga holter he taputapu e hopu tonu ana i ngā mahi hiko o te ngākau mō ngā haora 24, neke atu rānei. He mea whai hua tēnei taputapu mō te kite i ngā arrhythmias kāore pea e kitea i te wā o te whakamātautau ECG poto. He maha ngā wā ka whakamahia te aroturukitanga holter i roto i ngā kararehe he tohu wā poto pēnei i te hemonga, te ngoikore ohorere rānei.
9. Whakamātautau ahotea
Ko te whakamātautau ahotea he aromatawai i te urupare a te ngākau ki ngā mahi ā-tinana, ki te ahotea rānei. Mō ngā kararehe, ka taea te whakahaere whakamātautau ahotea mā te whakamahi i te mīhini oma, i te whakaohooho rongoā rānei. Mā te urupare a te kararehe ki te ahotea ka taea te whakarato i ngā mōhiohio e pā ana ki te kaha mahi a te ngākau, me te tautuhi i ngā herenga kāore pea e kitea i te wā e okioki ana te kararehe.
10. Whakaahua Matatau
Mō ngā take uaua, me whakamahi pea i ngā tikanga whakaahua matatau pēnei i te CT scan, MRI rānei. Mā ēnei hangarau ka nui ake ngā taipitopito mō te hanganga me te mahi a te ngākau me ngā kiko e karapoti ana. Ka taea e te whakaahua matatau te tautuhi i ngā raruraru i ngaro i ngā tikanga tātaritanga taketake, pēnei i te toto totoka, ngā puranga rerekē, ngā āhuatanga whānautanga rānei.
Ngā Take Mate Manawa Noa i roto i ngā Kararehe
1. Te Whanuitanga o te Ngākau o te Ngākau (DCM)
Ko te DCM he momo mate ngakau e kitea nuitia ana i roto i ngā kurī momo nui. Ko te āhua o tēnei mate ko te whānui o te ventricle me te heke o te kaha o te ngākau. Tērā pea ka kitea e ngā kurī whai DCM ngā tohu pēnei i te maremare, te uaua ki te manawa, te ngenge, me te pupuhi.
2. Koha o te Ngākau Whānau
Ka puta pea ngā mate ngākau whānau i roto i ngā momo kararehe. Ko ētahi o ngā mate noa ko:
– Patent ductus arteriosus (PDA): Kāore te ara i waenganui i te aorta me te uaua pūkahukahu e kati i muri i te whānautanga, ka puta te rere o te toto rerekē me te pikinga o te kawenga ki te ngākau.
– Tetralogy of Fallot: He raupapa o ngā āhuatanga rerekē e whā e hua ake ai te rere o te toto rerekē, e kitea pinepine ana i roto i ngā ngeru me ngā kurī.
3. Mate noke ngākau
He mate pirinoa te mate noke ngākau e horapa ana mā roto i ngā ngau a te waeroa, ā, ka pā ki te ngākau me ngā uaua pūkahukahu o ngā kurī. He maha ngā wā ka kitea i ngā wāhi mahana, haumākū.
4. Te Matepukupuku Hipertrophic (HCM)
He mate manawa te HCM e kitea nuitia ana i roto i ngā ngeru, inā koa ko ngā Maine Coon me ngā Ragdoll. Ko tōna āhua he matotoru o ngā pakitara ventricular, ka whakararu i te kaha o te manawa ki te whakakī i te toto.
Te Katinga
Ko te tātaritanga o te mate manawa i roto i ngā kararehe me whakamahi i ngā tikanga me ngā taputapu tātaritanga maha. Mai i te hītori me te whakamātautau tinana tuatahi ki te whakamahinga o ngā hangarau matatau pēnei i te echocardiography me te whakaahua matatau, he mea nui ia taahiraa ki te whakarite i te tātaritanga tika. Mā te māramatanga hohonu ki ēnei tikanga tātaritanga ka āwhina i ngā tākuta kararehe ki te whakarato i te tiaki tika me te whai hua mō ā rātou tūroro mōkai. Mena kei te whakaatu tō mōkai i ngā tohu o ngā raruraru manawa, whakapā atu ki tō tākuta kararehe tonu mō te tātaritanga me te maimoatanga tika.
