Me pēhea te tātaritanga i ngā mate manawa i roto i ngā kararehe
He mea whakararuraru te mate manawa, ehara i te mea mō te tangata anake, engari mō ngā kararehe hoki. Hei kaipupuri mōkai me ngā tohunga kararehe, he mea nui kia mōhio wawe tātou ki ngā mate manawa o ā tātou hoa kararehe, kia whiwhi ai rātou i te maimoatanga pai rawa atu. Ahakoa he kurī, he ngeru, he kararehe rānei te tūroro, ka taea te whakarite i te huarahi ki te tātaritanga, me te whakamahi i te ranunga o ngā taunakitanga haumanu me ngā tikanga tātaritanga matatau. Ka rukuhia e tēnei tuhinga ngā tikanga whānui e whakamahia ana hei tātaritanga i ngā mate manawa o ngā kararehe, me te whakahaere i te wawaotanga i te wā tika.
Te Mārama ki te Mate Manawa i roto i ngā Kararehe
Ko te mate ngakau i roto i ngā kararehe, pērā i te tangata, ka puta mai i ngā momo take maha, tae atu ki ngā hapa whānau, te pirau e pā ana ki te koroheketanga, ngā mate pāwera, ngā āhuatanga pūnaha rānei. Ka taea te whakarōpū whānuitia kia rua ngā wāhanga: te mate ngakau whānau (kei te whānau mai anō) me te mate ngakau whiwhi (ka whanake haere i roto i te wā). Ko ngā āhuatanga noa ko te mate ngakau valvular, te cardiomyopathy dilated, te cardiomyopathy hypertrophic, me te mate pericardial.
Te Mōhio ki ngā Tohu Hauora
Ko te taahiraa tuatahi ki te tautuhi i te mate manawa ko te mohio ki ngā tohu haumanu. Tērā pea ka whakaatuhia e ngā kararehe he mate manawa he maha ngā tohu, engari he iti noa iho i ētahi wā. Me tūpato ngā kaipupuri mōkai, me rapu awhina a te rata kararehe mēnā ka kitea e rātou tētahi o ēnei tohu e whai ake nei:
– Te maremare tonu: Ka kitea nuitia i muri i te whakakori tinana, i te pō rānei.
– Te Manawa Whakararuraru: Te tere o te manawa, te uaua rānei ki te manawa, e mōhiotia ana ko te dyspnea.
– Te Ngenge me te Ngoikore: He tino hekenga o ngā taumata mahi me te ngenge.
– Te ngoikore, te hinga rānei: Ngā wā o te koretake o te manawa nā te kore e rere o te toto ki te roro.
– Puku Pupuhi: He putunga wai i roto i te puku, e mōhiotia ana ko te ascites.
– Te Ngaronga o te Hiahia Kai me te Whakahekenga Taumaha: Te whakahekenga whānui o te kai e kainga ana me te whakahekenga taumaha kāore i te whakaarohia.
– Ngā kapia kikorangi: Te kiriuhi o te ihu, e tohu ana i te korenga o te hāora e uru ki roto i te toto.
– Te Āwangawanga ki te Whakakorikori Tinana: He uaua ki te whakakorikori tinana me te tere o te ngenge.
Whakamātautau Kararehe Tuatahi
Ina puta mai he kararehe e whakapaetia ana he mate manawa, he mea nui te tirotiro hōhonu a te rata kararehe. Ko te tikanga, ko ēnei:
1. Te tango i ngā hītori hauora: Te kohikohi i ngā taipitopito o te hītori hauora, me te tuhi i ngā tohu katoa i kitea e te rangatira mōkai, me ngā mate, ngā āhuatanga rānei o mua.
2. Whakamātautau Tinana: Te aromatawai i te āhua o te tinana, te tae o te kiriuhi mucous, me te wā whakakī anō i te capillary. He mea nui te whakarongo (te whakarongo ki te stethoscope) hei kite i ngā oro o te ngākau, ngā ngunguru, me ngā oro o te pukahukahu.
3. Whakamātautau i te Manawa: Mā te tirotiro i te kounga o te manawa, te tere, me te manawataki ka taea te whakarato tohu mō te āhua o te pūnaha manawa.
Whakamātautau Tātaritanga
Mēnā ka whakapaetia he mate ngakau, he maha ngā whakamātautau tātaritanga ka whakamahia hei whakaū i te mate me te whakatau i te kaha o te mate.
1. Whakaahua X-ray o te Uma
He taputapu matua ngā hihi-X o te uma hei aromatawai i te rahi, te āhua, me te kitea o te wai i roto i te pukahukahu (te edema pūkahukahu) i roto rānei i te pleural space (te pleural effusion). Mā te whakanui ake i te āhua o te ngakau, ngā rerekētanga o ngā oko pūkahukahu, me ētahi atu huringa i roto i te whakaahua X-ray ka tohu pea i te mate ngakau.
2. Te Whakamātautau i te Ngākau (Te Whakamātautau i te Ngākau)
Ko te echocardiography te paerewa koura mō te tautuhi i te mate manawa i roto i ngā kararehe. Mā tēnei tikanga whakaahua ka kitea ngā mōhiohio taipitopito mō te hanganga me te mahi a te manawa, tae atu ki te rahi o te rūma, te matotoru o te pakitara, te mahi takirere, me ngā tauira rere toto. He tino whai hua te Doppler echocardiography mō te aromatawai i te rere toto me te tautuhi i ngā tauira rere rerekē, ngā turuturu rānei (regurgitation).
3. Te Whakamātautau Ngākau (ECG/EKG)
Ka tuhia e te ECG ngā mahi hiko o te ngākau, ā, he mea nui ki te tautuhi i ngā arrhythmias, ngā raruraru kawe hiko, me ētahi atu āhuatanga rerekē o te hiko. He tikanga tere, kāore e pokanoa, e whakarato ana i ngā mōhiohio whai hua mō te tere o te ngākau me te manawataki.
4. Ngā Whakamātautau Toto
Ka āwhina ngā whakamātautau toto ki te aromatawai i te hauora whānui me te tautuhi i ngā āhuatanga ka whai wāhi atu ki te mate manawa, ka puta mai rānei i te mate manawa. Ko ngā whakamātautau matua ko:
– Ngā Tohu Koiora: Ko ngā taumata o ētahi whākōkī ngākau (pēnei i te troponin) ka tohu pea i te whara o te uaua ngākau.
– Peptide Natriuretic Momo-B (BNP): Ko te nui o ngā taumata BNP he tohu pea nō te ngoikore o te ngākau.
– Te Tatau Toto Katoa (CBC) me te Paewhiri Matū Koiora: Ka taea e ēnei whakamātautau te whakaatu i te anemia, te mahi a te whatukuhu, me ngā taurite kore o ngā electrolytes.
5. Te Ine i te Pēhanga Toto
Ka taea e te toto toto tiketike te whakararu i te mate ngakau, ā, ka waiho hei hua anō hoki. He mea nui te ine i te toto toto, inā koa mō ngā kararehe kua pakeke ake, mō te hunga rānei e whakaatu ana i ngā tohu o te mate pūnaha.
6. Aroturukitanga Holter
Mō te hopu ECG tonu mō ngā haora 24, neke atu rānei, ka taea te whakamahi i tētahi aroturuki Holter. He tino whai hua tēnei mō te tautuhi i ngā arrhythmias ā-wā kāore pea e kitea i te wā o te ECG paerewa.
7. Ngā Tikanga Whakaahua Matatau
I ētahi wā, ka whakamahia pea ngā tikanga whakaahua matatau ake pērā i te MRI o te ngākau, te CT scan rānei hei whakarato i ngā mōhiohio taipitopito mō te hanganga tinana, inā koa mēnā me tautuhi tika i ngā āhuatanga rerekē o te hanganga.
Nga Whakamātautau Motuhake
I runga i ngā kitenga, ka tika pea ētahi atu whakamātautau motuhake:
– Te Tātānga o te Manawa: He tikanga whakaeke e ine tika ana i te pēhanga i roto i ngā rūma o te manawa me ngā oko toto.
– Angiography: He tikanga whakaahua hei tiro i te rere o te toto i roto i ngā uaua ngakau me ngā ruma o te ngākau.
Te Whakamāori i ngā Hua me te Whakarite i tētahi Tātaritanga
He mea nui te whakauru i ngā raraunga mai i ngā whakamātautau tātaritanga maha hei tātaritanga tika i te mate manawa o ngā kararehe. Ka hono te rata kararehe i ngā kitenga haumanu ki ngā hua o te whakamātautau hei whakatau i te momo me te kaha o te mate manawa.
Te maimoatanga me te Whakahaere
Kia whakaūtia te tautuhi mate, ka hangaia he mahere maimoatanga kua whakaritea mōna. Ko ngā kōwhiringa maimoatanga pea ko:
– Ngā Rongoā: Ngā rongoā hei whakahaere i ngā tohu, hei whakapai ake i te mahi a te ngākau, hei rongoā hoki i ngā mate taketake (hei tauira, ngā rongoā diuretic, ngā aukati ACE, ngā aukati beta).
– Ngā Huringa Kai: Te whakahaere i ngā kai totika, tae atu ki ngā kai motuhake i hangaia mō te hauora o te ngākau.
– Ngā Whakarerekētanga Āhua Noho: Te whakarerekē i ngā taumata mahi a te kararehe me te taiao hei whakaiti i te ahotea ki te ngākau.
– Ngā Wawaotanga Pokanga: I ētahi wā, ka hiahiatia pea he pokanga hei whakatika i ngā āhuatanga rerekē o te hanganga.
Opaniraa
He tukanga maha-āhuatanga te tātaritanga o ngā mate manawa i roto i ngā kararehe e whakawhirinaki ana ki te mōhio ki ngā tohu haumanu, te mahi i ngā whakamātautau whānui a ngā kararehe, me te whakamahi i ngā taputapu tātaritanga. He mea nui te tātaritanga wawe me te wawaotanga ki te whakahaere i te mate manawa me te whakapai ake i te kounga o te oranga mō ā tātou kararehe. Mā te mārama ki ngā tikanga me ngā huarahi hei tātaritanga i ngā mate manawa, ka taea e ngā kaipupuri mōkai me ngā tohunga kararehe te mahi tahi ki te whakarato i te tiaki pai rawa atu mō ngā kararehe e pāngia ana e te mate manawa.
