Uvavanyo lwe-2D Echo (i-Echocardiography): Oko Kuboniswayo, Oko Kungenakukwazi, Inkqubo kunye neziphumo

Ukuthatha okuphambili

• Ilinganisa ntoni: ulwakhiwo lwentliziyo, umsebenzi wevalvu kunye nokusebenza kakuhle kokumpompa ngexesha langempela, ngaphandle kwemitha.
• Oko ikuphosayo: ukuncitshiswa kwemithambo yentliziyo, ukuphazamiseka kwesingqisho okufika kubuye kuhambe, kunye nezizathu ezininzi zentlungu yesifuba.
• Ukuba ifanelekile: abantu abanengxaki yokuphefumla, ukugquma, isifo sentliziyo esirhanelwa ukuba sisifo se-valve okanye se-rheumatic, ukusilela kwentliziyo, okanye isifo sentliziyo esaziwayo siyalandelwa.
• Umgangatho wesiphumo uyahluka: I-echo ixhomekeke kumqhubi kwaye umgangatho womfanekiso uxhomekeke kulwakhiwo lomzimba, isifo semiphunga kunye nokuphefumla.
• Ukutolikwa kwezonyango: Amanani akwingxelo athetha izinto ezahlukeneyo kubantu abahlukeneyo, kwaye ngugqirha kuphela ocele i-echo onokuwabeka kwimeko ethile. Iziphumo ziyahluka ngokuxhomekeke kwiimeko zeklinikhi zomntu ngamnye.

Ngokukrwaqula kanye

Kwaziwa njenge

• Uvavanyo lwe-Echo
• I-2D echocardiography, i-TTE, i-transthoracic echo
• I-sonography yentliziyo, i-sonography yentliziyo, i-ultrasound yentliziyo
• I-Colour Doppler echo (xa kuqukwa uphando lokuhamba kweDoppler)
• Igama elithi "Dil ka echo" lisetyenziswa imihla ngemihla eIndiya

Yintoni uvavanyo lwe-2D echo

Uvavanyo lwe-2D echo lusebenzisa amaza esandi aphindaphindayo avela kwi-transducer ephathwa ngesandla ebekwe esifubeni. Amaza esandi abonakalisa izihlunu zentliziyo, iivalvu kunye negazi, kwaye umatshini uguqula imiqondiso ebuyayo ibe yimifanekiso ehambayo enamacala amabini.

Uninzi lwezifundo ze-2D echo eIndiya zibikwa njenge-"2D echo ene-colour Doppler". Icandelo le-2D libonisa i-anatomy kunye nentshukumo. I-Doppler ilinganisa isantya kunye necala lokuhamba kwegazi, nto leyo evumela ukuba kuqikelelwe ukuncitshiswa kwevalvu, ukuvuza kwevalvu kunye noxinzelelo oluthile ngaphakathi kwentliziyo. Iindlela ze-M-mode zingabandakanywa nakwiimilinganiselo zegumbi kunye nodonga.

Kutheni uvavanyo lwe-2D echo lwenziwa

• Ukuphefumla okanye ukudumba kwemilenze: ukukhangela ukusebenza okunciphileyo kokumpompa, ii-ventricle eziqinileyo, isifo sevalvu okanye ulwelo olujikeleze intliziyo.
• Ingxolo eviweyo xa kuhlolisiswa: I-echo luvavanyo oluphambili lokuchonga izilonda zevalvu.
• Isifo sentliziyo esirhanelwayo okanye esaziwayo: ukuvavanya ukubandakanyeka kwevalvu ye-mitral kunye ne-aortic kwaye uyilandele ngokuhamba kwexesha.
• Uvavanyo lokusilela kwentliziyo: ukulinganisa iqhekeza lokukhupha kunye nokuchonga unobangela osisiseko wolwakhiwo.
• Emva kokuhlaselwa yintliziyo: ukuvavanya umonakalo wezihlunu, intshukumo yodonga kunye neengxaki.
• Isifo sentliziyo esirhanelwayo sokuzalwa kubantwana nakubantu abadala.
• Istroke okanye i-systemic embolism: ukukhangela umthombo wentliziyo, nangona i-transthoracic echo inovakalelo olulinganiselweyo lwee-clots kwi-appendage ye-atrial yasekhohlo.
• Ngaphambi kotyando oluthile okanye i-chemotherapy ezinokuthi zichaphazele izihlunu zentliziyo, kwaye ngexesha lokulandelela.
• Ukuhlolwa kwe-pulmonary hypertension kunye nokubeka esweni, njengoqikelelo kuphela.

Ngubani ofanele afumane olu vavanyo

I-2D echo luvavanyo olujoliswe ngqo, aluyonto yokujonga impilo ngokubanzi. Cinga ngokuxoxa nge-echo nogqirha ukuba unayo:

• Ukungakwazi ukuphefumla xa usebenza nzima okanye xa ulele phantsi, okanye xa uvuka ungaphefumli ebusuku
• Ukudumba kweqakala okanye umlenze, okanye ukudumba kwesisu okungachazwanga
• Ukugquma, okanye imbali yangaphambili yomkhuhlane wamathambo okanye isifo sentliziyo samathambo esibhaliweyo
• Ukusilela kwentliziyo okwaziwayo, i-cardiomyopathy, isifo sevalvu okanye ivalvu yokufakelwa edinga ukulandelwa
• Uhlaselo lwentliziyo lwangaphambili, okanye i-atrial fibrillation esandula ukufunyanwa
• Ukubetha kwentliziyo okanye ukucima kombane apho kurhanelwa ukuba kukho ingxaki yesakhiwo sentliziyo
• Imbali yosapho ene-cardiomyopathy ezuzwe njengelifa okanye ukufa kwentliziyo ngequbuliso
• Isifo sentliziyo esizalwa naso, okanye umntwana ongondli kakuhle, ongakhuli kakuhle, onesiphene esiluhlaza okanye onesithukuthezi
• Uxinzelelo lwegazi oluhlala ixesha elide, isifo sezintso esingapheliyo okanye isifo seswekile apho kurhanelwa ukuba kukho utshintsho kwisimo sentliziyo ngokwezonyango

I-echo ayilovavanyo lokuqala olufanelekileyo kubo bonke abantu abaneentlungu esifubeni, kwaye i-echo eqhelekileyo kumntu oneempawu ayiphelisi uvavanyo.

Oko i-2D echo ingenakukwazi ukukubona okanye ukukukhuphela ngaphandle

• Isifo se-Coronary artery: I-2D echo ephumlayo ayibonisi imithambo yentliziyo okanye ibonise ukuvaleka. I-echo ephumlayo eqhelekileyo ayikhuphi isifo esibalulekileyo sentliziyo okanye ikhuphe i-angina.
• Uhlaselo lwentliziyo luyaqhubeka: I-echo ingabonisa udonga olungashukumi kakuhle, kodwa ayinakuqinisekisa okanye ikhuphe ingxaki yentliziyo ebukhali. I-ECG kunye ne-cardiac troponin zihlala zibalulekile.
• Iingxaki zesingqisho: I-echo ayilulo uvavanyo lwesingqisho. Ii-arrhythmias ezingaqhelekanga zifuna i-ECG, i-Holter okanye uqwalaselo olude lwesingqisho.
• Amaqhuqhuva amancinci kunye nezityalo: I-transthoracic echo ingayiboni imifuno emincinci ye-infective endocarditis kwaye idla ngokungakwazi ukubona i-left atrial appendage ngokwaneleyo; i-transoesophageal echo ingcono kakhulu kule mibuzo.
• Ukuqhekeka kweAortic: I-transthoracic echo inokubangela ukurhanelwa kodwa ayinakuyithintela ngokuthembekileyo into yokuqhekeka kwemithambo yegazi. Kufuneka i-CT aortogram okanye i-transoesophageal echo.
• I-Pulmonary embolism: I-echo ingabonisa uxinzelelo lwentliziyo ekunene kwi-emboli enkulu kodwa i-echo eqhelekileyo ayikhuphi i-pulmonary embolism.
• Uxinzelelo oluchanekileyo lwemithambo yemiphunga: I-Doppler inika uqikelelo olunokuba lungachanekanga; ukuxilonga nge-catheter yentliziyo yasekunene kuseyeyona ndlela isetyenziswayo.
• Izizathu zentlungu yesifuba ezinxulumene nemiphunga, umphimbo, imisipha kunye ne-asidi, eziqhelekile kwaye azizizo iziphumo eziphindaphindayo.

Ukufunyanwa "okungachazwanga" kwingxelo ye-echo kuthetha ukuba akubonwanga kolo phando, akuthethi ukuba akukho. Ukuba iimpawu zakho ziyaqhubeka okanye ziyanda nangona i-echo eqhelekileyo, buyela kugqirha wakho.

Iimviwo ezinxulumeneyo kodwa ezahlukeneyo

Loluphi uvavanyo oluza kuqala luxhomekeke kwingxaki

Akukho vavanyo lwentliziyo "lokuqala" oluqhelekileyo kwihlabathi liphela.

• Intlungu eqatha yesifuba ngequbuliso: I-ECG kunye ne-troponin ziza kuqala; i-echo iyaxhasa.
• Intlungu yesifuba eqhubekayo eneempawu ezizinzileyo: Inyathelo elilandelayo lidla ngokuba luvavanyo lwe-coronary anatomy okanye i-ischaemia, kungekhona nje ukuphumla.
• Ukuphefumla okanye ukudumba: I-echo iphakathi, idla ngokuhambisana ne-ECG, i-X-ray yesifuba kunye novavanyo lwe-natriuretic peptide apho lufumaneka khona.
• Ukumbombozela: I-echo luvavanyo olufanelekileyo.
• Ukubetha kwentliziyo okanye ukuquleka: ukulandelelana kwesingqisho, kunye nesandi sokujonga isifo sesakhiwo.

Indlela yokulungiselela uvavanyo lwe-2D echo

Ukulungiselela i-2D echo yokuphumla eqhelekileyo kudla ngokuba kuncinci. Iiprotokholi zahlukile phakathi kwezibhedlele kunye namaziko okuxilonga, kwaye imiyalelo ebhaliweyo enikwe yiyunithi yakho ihlala ibaluleke ngaphezu kweengcebiso ngokubanzi.

• Impahla: Nxiba into ekhululekileyo neneziqwenga ezimbini; isifuba kufuneka sifikeleleke kwaye abafazi badla ngokunikwa ilokhwe.
• Ukutya nesiselo: Ukuzila ukutya akusoloko kuyimfuneko ukuze umntu aphumle. Ukuzila ukutya kudla ngokufuneka ukuze umntu aphumle aphinde alale, kunye nezinye iindlela zoxinzelelo.
• Amachiza: qhubeka namayeza akho owanikwe ngugqirha njengesiqhelo ngaphandle kokuba ugqirha wakho ekuxelela ngenye indlela. Musa ukuyeka okanye ukutsiba nayiphi na ipilisi ngokwakho; ukuba uceliwe ukuba ungayisebenzisi iyeza ngaphambi kokuba kubekho uxinzelelo, loo myalelo uvela kugqirha.
• Zisa nawe: ukudluliselwa, iingxelo zangaphambili ze-echo kunye ne-ECG, iirekhodi ze-angiography okanye zotyando, kunye noluhlu lwakho lwangoku lwamayeza.
• Xelela iqela malunga noku: ukukhulelwa, isixhobo sokuncedisa umgudu wokugaya ukutya okanye isixhobo esifakelweyo, utyando lwevalvu lwangaphambili, amanxeba esifubeni okanye ukubotshwa, kunye nayo nayiphi na inkqubo yakutshanje esifubeni.

abantwana

I-echo yabantwana ithatha ixesha elide kwaye inokufuna ukuba umzali abe khona, ebanika ukutya okanye ebaphazamisile. I-sedation isetyenziswa ngamanye amaxesha kubantwana abancinci abangenantsebenziswano kwaye igqitywa ngokwemeko.

Ukukhulelwa

I-echo ye-2D yomama ayibandakanyi imitha kwaye idla ngokwenziwa ngexesha lokukhulelwa xa kukho ingxaki yentliziyo. I-echocardiography yosana olusandul’ ukuzalwa luvavanyo olwahlukileyo olwenziwa ziingcali eziqeqeshiweyo zonyango losana olusandul’ ukuzalwa okanye iingcali zentliziyo zabantwana, kwaye yonke i-ultrasound yosana olusandul’ ukuzalwa eIndiya ilawulwa nguMthetho we-PC-PNDT, ka-1994; ukuchonga isini akuvumelekanga ngumthetho.

Isifo seswekile kunyango lokwehlisa iswekile

I-echo yokuphumla ayifuni kuzila ukutya, ngoko ke ukutya namayeza ayaqhubeka ngokwesiqhelo. Ukuba iyunithi yakho ikucela ukuba uzile ukutya ukuze kwenziwe uphando oludibeneyo okanye olunexinzelelo, buza umcebisi ngqo indlela yokuphatha i-insulin okanye i-sulfonylureas, njengoko ukuzila ukutya kula mayeza kunokubangela i-hypoglycemia.

Ukusilela kwentliziyo, isifo sezintso esiphambili okanye ukunqongophala kolwelo

Ukulala phantsi kusenokungakhululeki ukuba awuphefumli kakuhle; xelela i-sonographer, kuba uninzi lophando lunokwenziwa uxhonywe okanye ubekwe ecaleni kwakho. Ukuba unqunyelwe kulwelo, musa ukwandisa ulwelo xa uthatha nayiphi na imiyalelo yeskeni ngaphandle kokujonga ugqirha wakho onyangayo.

Abantu abadala abadala

Ukujika uye kwicala lasekhohlo kunokuba nzima xa une-arthritis okanye ubuthathaka. Uncedo kunye nesantya esicothayo ziqhelekile, kwaye uvavanyo lunokutshintshwa.

Kwenzeka ntoni ngexesha lovavanyo lwe-2D echo

• Ukubekwa: Ulala esofeni, uhlala ujike ngasekhohlo kwakho, ingalo yasekhohlo iphakanyisiwe, nto leyo esondeza intliziyo eludongeni lwesifuba.
• Amachaphaza e-ECG: ii-electrode ezincinci zinokubambeka esifubeni ukuze zilinganise ixesha lokubetha kwentliziyo.
• Ijeli kunye ne-transducer: Kusetyenziswa ijeli esekwe emanzini kwaye iprobe ishukunyiswa phakathi kweembambo, ngaphantsi kwesifuba nakwisiseko sentamo. Uxinzelelo oluqinileyo luqhelekile kwaye lunokuvakala lungakhululekanga, ingakumbi phezu kweembambo.
• Imiyalelo yokuphefumla: ungacelwa ukuba uphefumle ngaphandle uze ubambe okwethutyana ukuze uphucule umgangatho womfanekiso.
• Izandi zeDoppler: Uza kuva iingxolo ezitshoyo; ezi ziimpawu zokuhamba kwegazi, asikokungaqhelekanga.

Ixesha elithathwayo: i-2D echo eqhelekileyo yokuphumla ene-Doppler yombala idla ngokuthatha malunga nemizuzu eli-15-45, kubandakanya indawo kunye nokulinganisa. Iifestile ezinzima zokuthatha imifanekiso, uvavanyo oluneenkcukacha lweevalvu, isifo sentliziyo sokuzalwa kunye nezifundo zabantwana zithatha ixesha elide. Izifundo ze-transoesophageal kunye ne-stress echo zifuna amalungiselelo angaphezulu, ukujonga kunye nexesha lokuchacha, ngoko ke cwangcisa utyelelo olude.

Ukuqonda ingxelo yakho ye-2D echo

Iingxelo ze-Echo zixinene kwaye zinobuchwephesha. Amacandelo angezantsi achaza ukuba izihloko eziqhelekileyo zibhekisa entwenini. Akukho nombolo kwingxelo iluxilongo ngokwayo, kwaye imilinganiselo kufuneka ifundwe kunye neempawu zakho, uhlolo kunye nezinye iimvavanyo ngugqirha ocele i-echo.

Iqhekeza lokukhutshelwa kwe-ventricular yasekhohlo (LVEF)

I-Ejection fraction iqikelela umlinganiselo wegazi elikhutshwa kwi-ventricle yasekhohlo ngokubetha ngakunye. Luqikelelo, alulo umlinganiselo ochanekileyo, kwaye lunokwahluka phakathi kwabaqhubi, phakathi kweendlela (uqikelelo olubonakalayo ngokuchasene nomthamo we-biplane) kunye naphakathi kokutyelela. Ixabiso "elinomda" kwingxelo enye kunye nexabiso eliqhelekileyo kwingxelo elandelayo linokubonisa umahluko womlinganiselo endaweni yotshintsho lokwenyani. Imida yomsebenzi oqhelekileyo, oncitshisiweyo kancinci kunye noncitshisiweyo kufuneka ifundwe ngokuchasene namaxabiso ereferensi acatshulwe yilabhoratri yakho yengxelo kunye nohlelo lwesikhokelo olusetyenziswayo.

Ubungakanani begumbi kunye nobukhulu bodonga

Amagumbi avulekileyo okanye iindonga ezijiyileyo zinokubonisa uxinzelelo lwegazi oluphezulu oluhlala ixesha elide, i-cardiomyopathy, isifo sevalvu okanye, kwezinye iimeko, ukuziqhelanisa nemidlalo. Ukulinganisa kuphenjelelwa bubungakanani bomzimba, nto leyo ebaluleke kakhulu kwizigulane zaseMzantsi Asia, ngoko ke amaxabiso achazwe ngokweenkcukacha ahlala esetyenziswa.

Iziphumo zeevalvu kunye nokubekwa kwamanqanaba

Ukuncitshiswa kwevalvu (stenosis) kunye nokuvuza (regurgitation) kudla ngokubekwa kwinqanaba elincinci, eliphantsi, eliphakathi okanye elinzima. Olu luhlu luluhlu oluhlanganisiweyo olusekwe kwiimilinganiselo ezininzi zeDoppler kunye nemifanekiso, kwaye luxhomekeke kwinxalenye ethile kwaye luxhomekeke kumthwalo, uxinzelelo lwegazi, izinga lentliziyo, i-anemia kunye nokufuma konke kutshintsha amanani. Ukuhlaziywa kwe-tricuspid okanye i-mitral "okuncinci" okanye "okuncinci" yinto eqhelekileyo kakhulu kwiintliziyo eziphilileyo kwaye rhoqo ayifuni nyango konke konke. Izigulana zihlala zijonga naluphi na udidi lwevalvu njengesifo esibi; uluhlu kufuneka lutolikwe ngomfanekiso weklinikhi.

Umsebenzi we-Diastolic

Oku kuchaza indlela i-ventricle ephumla kwaye izalise ngayo. Iipateni ezixeliweyo azingqalanga, ziphenjelelwa bubudala, isigqi kunye neemeko zomthwalo, kwaye kungcono ziphathwe njengobungqina obunye endaweni yokuxilongwa okuzimeleyo.

Ukukhutshwa kwePericardial

Ulwelo olujikeleze intliziyo lunokuchazwa njengoluncinci, oluthambileyo, oluphakathi okanye olukhulu. Ukubaluleka kuxhomekeke ekubeni luqokelele ngokukhawuleza kangakanani na nokuba lucinezela intliziyo, kungekhona ngomthamo kuphela.

Uxinzelelo lwemiphunga

Uxinzelelo lwemithambo yemiphunga oluvela kwi-Doppler luqikelelo, alungoxinzelelo olulinganisiweyo, kwaye luxhomekeke ekufumaneni i-jet efanelekileyo yokubuyela umva. Ingaqikelelwa ngaphezulu okanye ngaphantsi.

Amagama ahlala ekhathaza izigulane ngokungeyomfuneko

• "Ivalvu ye-aorta ye-Sclerotic": ukuqina ngaphandle kokuphazanyiswa okukhulu; kuqhelekile xa ukhula.
• "UMr/TR ongaqhelekanga": uhlobo oluqhelekileyo kubantu abaninzi.
• "Ukungasebenzi kakuhle kwe-diastolic yebanga loku-1": idla ngokubangelwa bubudala kwaye ayisoloko ibangela iimpawu.
• "Akukho ngxaki yokunyakaza eludongeni lwengingqi": ukuqinisekisa ngokuphumla kodonga, kodwa hayi isatifikethi sokususwa kwemithambo yentliziyo.

Xa iziphumo ze-2D echo zinokulahlekisa

Iziphumo ezinokugqithiswa ngokungeyonyani okanye zixelwe ngokugqithisileyo

• Umgangatho wokuvuza kwevalvu uphakanyisiwe xa uxinzelelo lwegazi luphezulu, isantya sentliziyo siyakhawuleza, okanye xa une-anemia kunye nokukhulelwa kunye nokuhamba kwegazi okwandileyo.
• Uxinzelelo lwemiphunga luqikelelwa ngokugqithisileyo ukusuka kwi-Doppler jet ekumgangatho ophantsi okanye egobileyo.
• Ubukhulu bodonga obubizwa ngokuba ngaphezulu kwiiplani zemifanekiso ezigobileyo okanye xa kufakwe umsipha we-papillary.
• Ukukhupha okubonakalayo apho amafutha e-pericardial okanye ingqokelela ye-pleural iphazanyiswe njengolwelo.

Iziphumo ezinokuncitshiswa okanye zingaphoswanga ngobuxoki

• Inxalenye yokukhupha ayiqikelelwanga ngokwaneleyo xa incopho yokwenyani ingabanjwanga (imibono efinyeziweyo).
• Ubunzima be-stenosis abuqikelelwanga ngokwaneleyo ukuba umqadi weDoppler awuhambelani nejethi, okanye kwiimeko zokugeleza kwamanzi okuphantsi apho umsebenzi wokumpompa ungasebenzi kakuhle.
• Izityalo ezincinci, amahlwili amancinci kunye neziphene ezincinci ze-septal azikho kwiifestile ezinqamlezileyo ezingaphaya kwesifuba.
• Uphononongo lonke lonakele kwi-emphysema kunye nesifo semiphunga esingapheliyo, ukukhubazeka kodonga lwesifuba, izihlunu zesifuba ezijiyileyo, ubunzima bomzimba obuphezulu, ukunxitywa ngotyando, ukungakwazi ukulala ecaleni, okanye isingqisho esingaqhelekanga njenge-atrial fibrillation apho amaxabiso okubetha ukuya ekubetheni ahluka khona.

I-Echo ixhomekeke kumqhubi. Iingxelo ezimbini kwintliziyo enye, iiveki ezahlukeneyo, zinokwahluka kancinci ngaphandle kotshintsho lokwenyani entliziyweni. Apho isigqibo singenamda, ugqirha wakho wentliziyo unokuphinda uphando, acele uhlobo olwahlukileyo lwe-echo okanye asebenzise i-MRI yentliziyo.

Iingozi kunye nokhuseleko

I-echo ye-2D ephumlayo engaphaya kwethoracic

I-echo eqhelekileyo yokuphumla ayibandakanyi imitha, akukho naliti kwaye akukho miphumo yaziwayo yokwenzakalisa izicubu kwiindawo zokuxilonga. Eyona nto ibuhlungu kakhulu yi-cold gel, uxinzelelo lwe-probe phakathi kweembambo, ukurhawuzelelwa lusu oluvela kwizitikha ze-ECG, kunye nokungakwazi ukuphefumla ukuba kufuneka ulale phantsi. Isetyenziswa kakhulu kwiintsana ezisandul' ukuzalwa, ukukhulelwa kunye nabantu abadala.

I-echocardiography yoxinzelelo

I-stress echo ineengozi zokwenyani, nangona zingaqhelekanga, kuba intliziyo ixinezelekile ngabom: iintlungu zesifuba, ukungalingani kwentliziyo, utshintsho oluphawulekayo loxinzelelo lwegazi, kunye neziganeko ezingaqhelekanga ezinzulu zentliziyo. Yenziwa ngokubekwa esweni rhoqo, izibonelelo zokuvuselela umzimba kunye nemvume ethile. Iprofayili yokhuseleko lwe-echo yokuphumla ayisebenzi kwizifundo zoxinzelelo.

I-echo ye-Transoesophageal

I-TEE iyahlasela. Iingozi ziquka ukungakhululeki emqaleni, ukuphefumla okunxulumene nokuthomalalisa kunye nemiphumo yoxinzelelo lwegazi, ukopha, kunye nokwenzakala okanye ukugqobhoka komphimbo rhoqo. Kufuneka ukuzila ukutya kunye nemvume esemthethweni.

I-echo ephuculweyo yokwahlulahlula

Ii-ultrasound contrast agents zihlala zinyamezela kodwa zinokubangela ii-hypersensitivity reactions kwaye zisetyenziswa ngononophelo kwiimeko ezithile zentliziyo kunye nemiphunga. Izifundo ze-saline ezivuthuzayo zifuna i-cannula efakwa kwi-intravenous.

Iimeko ezikhethekileyo

Ukukhulelwa

I-echo yomama isetyenziswa xa kukho ukungakwazi ukuphefumla okungaphaya koko bekulindelwe xa ekhulelwe, ukurhawuzelela, isifo esaziwayo sevalvu okanye utyando lwentliziyo lwangaphambili. Ukukhulelwa okuqhelekileyo ngokwako kwandisa umthamo wegazi kunye nokuhamba kwegazi, okunokutshintsha kancinci ubukhulu begumbi kunye ne-Doppler gradients; iingxelo kufuneka zifundwe kukhunjulwe oko. Uvavanyo lwentliziyo ye-fetal luvavanyo olwahlukileyo kwaye lulawulwa phantsi koMthetho we-PC-PNDT, ka-1994.

Abantwana kunye nabantwana abasandul' ukuzalwa

I-Paediatric echo yiseti yezakhono ezikhethekileyo ezigxile kumzimba wokuzalwa. Iifestile zemifanekiso kwiintsana zihlala zibalasele. Izinto ezifunyenweyo ezifana ne-patent ductus kwintsana esandul' ukuzalwa okanye isiphene esincinci se-septal zifuna ukutolikwa kwe-cardiology yabantwana, njengoko ezininzi zivala okanye zihlala zingenabungozi.

Abantu abadala abadala

Ukuqina kwevalvu okunxulumene nobudala, utshintsho oluncinci lwe-diastolic kunye nokwanda kweengcambu ze-aortic ziqhelekile kwaye azizizo izifo ngokuzenzekelayo. Ukunqongophala kwendawo kunye notshintsho lwemiphunga kunokunciphisa umgangatho womfanekiso.

I-Atrial fibrillation kunye ne-irregular rhythms

Ukwahluka kwe-beat-to-beat kwenza imilinganiselo enye ingathembeki; i-avareji kwii-beats ezininzi iyafuneka, kwaye i-gradients isenokuba ayichanekanga.

Isifo sezintso esingapheliyo kunye ne-dialysis

Imeko yolwelo ichaphazela kakhulu ubungakanani begumbi, uxinzelelo kunye ne-gradients zevalvu. Ii-echo ezenziwe ngaphambi nasemva kwe-dialysis zinokubonakala zahlukile, ngoko ke ixesha kufuneka lirekhodwe.

Ukumelwa yintliziyo

Ii-serial echoes zisetyenziselwa ukulandelela ukusebenza kwe-ventricular kunye nesifo se-valve. Utshintsho oluncinci kwi-ejection fraction phakathi kwezifundo lunokuba ngumahluko wokulinganisa; izigqibo zonyango zisekelwe kwimikhwa kunye neempawu.

Izixhobo ezifakelweyo kunye notyando lwangaphambili

Iipacemakers, iivalvu zokufakelwa kunye notyando lwe-past bypass okanye ivalvu azithinteli i-echo, kodwa zitshintsha imifanekiso kwaye zifuna ukuba ingcali yentliziyo enika ingxelo yazi imbali yotyando. Ukuba i-MRI yentliziyo iqwalaselwa kamva, ii-implants zifuna uvavanyo lokhuseleko lwe-MRI endaweni yokuba zithathwe njengezingakhuselekanga.

Uvavanyo lwe-2D echo kumxholo waseIndiya

• Isifo sentliziyo esibizwa ngokuba yi-rheumatic heart diseyimbonakaliso ebalulekileyo. EIndiya, i-echo luvavanyo oluphambili lokuvavanya umonakalo wevalvu ye-mitral kunye ne-aortic emva komkhuhlane we-rheumatic, ukucwangcisa i-balloon valvotomy okanye utyando, kunye nokulandelela. Nabani na onembali yomkhuhlane we-rheumatic kunye nokungakwazi ukuphefumla kufuneka ahlolwe endaweni yokuqinisekiswa yingxelo endala.
• I-anemia ixhaphakile kwaye ichaphazela ingxelo. I-anemia yokunqongophala kwe-iron kunye nophawu lwe-thalassemia kwandisa ukuphuma kwentliziyo, nto leyo enokwenza ukuba i-flow murmurs ibe phezulu kwaye i-Doppler gradients kunye nokuvuza kwevalvu kubonakale kucace ngakumbi kunokuba kunjalo kwimeko elungisiweyo.
• Isifo se-metabolic kwi-BMI ephantsi. Abantu baseMzantsi Asia baba noxinzelelo lwegazi oluphezulu, isifo seswekile kunye notshintsho kwisimo sentliziyo xa umzimba uphantsi, ngoko ke ukwakheka "okuqhelekileyo" akwenzi ukuba isifo sentliziyo singabi yinto enokwenzeka.
• Amagama olwimi oza kuwava apha ekuhlaleni: "uvavanyo lwe-echo", "i-colour Doppler echo", "i-sonography yentliziyo", "i-2D echo ene-Doppler". Ezi zihlala zibhekisa kuphononongo olufanayo lokuphumla olungaphaya kwesifuba.
• Umthetho womfanekiso wangaphambi kokuzalwa: Naluphi na uhlobo lwe-ultrasound olwenziwe ngexesha lokukhulelwa, kuquka ne-echocardiography ye-fetal, luphantsi koMthetho we-PC-PNDT, ka-1994. Ukumisela okanye ukutyhila isondo se-fetal akusemthethweni.
• Intengiso kunye namabango: Amabango okukhuthaza malunga novavanyo lokuxilonga eIndiya athintelwe nguMthetho weDrugs and Magic Remedies (Iintengiso ezingachasekiyo), ka-1954, kunye nemigaqo yokuziphatha yobungcali. Lumka malunga neepakethi ezithembisa "ukususa isifo sentliziyo" ngesandi sodwa.
• Ubumfihlo bedatha: imifanekiso kunye neengxelo ze-echo ziyidatha yezempilo ebucayi; ukuphathwa kwedatha yobuqu zizibhedlele kunye namaziko okuxilonga eIndiya kulawulwa nguMthetho woKhuseleko lweDatha yoBuqu yeDijithali, ka-2023.

Ixabiso kunye ne-inshurensi eIndiya

I-2D echo ephumlayo ene-colour Doppler yenye yeemvavanyo ze-cardiac imaging ezingabizi kakhulu, ezidla ngokubiza imali encinci kakhulu kune-CT coronary angiography okanye i-cardiac MRI. Amaxabiso ahluka kakhulu phakathi kwezixeko, phakathi kwezibonelelo zikarhulumente nezabucala, kunye naphakathi kwamaziko okuxilonga azimeleyo kunye nezibhedlele zesithathu. Cela intlawulo yangoku kwindawo yokubhukisha; naliphi na inani elicatshulwe kwi-intanethi libonisa kuphela kwaye alinakubonisa ukuba uhlawuliswa malini.

Izinto ezitshintsha ixabiso:

• Uhlobo lophando, ukuphumla kwe-2D echo ngokuchasene ne-stress echo, i-transoesophageal echo, i-3D echo, i-contrast echo okanye i-fetal echocardiography, ezisebenzisa izixhobo ezininzi ngokuthe ngcembe.
• Nokuba ingcali yentliziyo yenza kwaye ixela uphando ngokwayo
• Isigulane esilaliswayo, imeko kaxakeka, ecaleni kwebhedi okanye i-ICU echo xa kuthelekiswa nophando olucwangcisiweyo lwesigulane esingalaliswanga
• Uhlobo lwesixeko kunye nohlobo lwesakhiwo, kunye nemeko yokuvunywa
• Izifundo zabantwana kunye nezokuzalwa, ezithatha ixesha elide
• Iiphakheji zovavanyo lwempilo okanye zentliziyo ezihlanganisiweyo, ezinokubandakanya i-ECG, uvavanyo lwe-treadmill kunye nokubonisana
• Izaphulelo zokuphinda okanye zokulandelela uphando, apho zinikezelwa khona

I-inshurensi: uvavanyo lokuxilonga olwenziwa kuphela njengoko uphando lwezigulane zangaphandle ludla ngokungahlawulwa phantsi kwemigaqo-nkqubo yempilo esemgangathweni ngaphandle kokuba ipolisi ibandakanya izibonelelo zonyango lwangaphandle okanye zokuxilonga. I-echo eyenziwa ngexesha lokungeniswa esibhedlele, egqunywe yi-inshurensi idla ngokuba yinxalenye yebango. Ukhuseleko phantsi kweenkqubo zikarhulumente kunye nezicwangciso zomqeshi ziyahluka. Qinisekisa ne-inshurensi yakho okanye idesika ye-inshurensi yesibhedlele ngaphambi kovavanyo, kwaye ugcine umyalelo kwaye unike ingxelo ngayo nayiphi na ibango.

Iintsomi nezibakala

Imibuzo ebuzwa qho

Ngaba i-2D echo ibuhlungu?

I-2D echo ephumlayo ayibuhlungu kubantu abaninzi. Ijeli ivakala ibanda kwaye iprobe icinezelwe ngokuqinileyo phakathi kweembambo, ezinokuba zithambile, ngakumbi ukuba isifuba sakho sibuhlungu okanye ubhityile. Xelela i-sonographer ukuba uxinzelelo alukhululeki, njengoko i-engile inokulungiswa rhoqo.

Ithatha ixesha elingakanani i-2D echo ukusuka ekuqaleni ukuya ekugqibeleni?

Iskeni ngokwayo idla ngokuthatha malunga nemizuzu eli-15-45. Yongeza ixesha lokubhalisa, ukutshintsha nokulinda. Izifundo zokuzalwa, ezabantwana kunye nezobuchwephesha ezinzima ziqhuba ixesha elide, kwaye uxinzelelo okanye i-transoesophageal echo ifuna ukujongwa nokubuyiselwa kwimeko yesiqhelo, nto leyo enokwandisa utyelelo ukuya kwiiyure ezimbalwa.

Ngaba i-2D echo ingayibona imithambo evalekileyo okanye ixele kwangaphambili ukuhlaselwa yintliziyo?

Hayi. I-2D echo ephumlileyo ayibonisi imithambo yentliziyo kwaye ayinakuqikelela ukuhlaselwa yintliziyo kwixesha elizayo. Ingabonisa umonakalo wezihlunu ngenxa yohlaselo lwangaphambili. Ukuba kurhanelwa ukuba isifo sentliziyo sinesifo, ugqirha wakho uya kukhetha uvavanyo lwe-ischaemia okanye umfanekiso wentliziyo endaweni yokuxhomekeka kwi-echo.

Ngaba kufuneka ndizile ukutya ngaphambi kokuba ndifumane i-2D echo?

Ukuzila ukutya akusoloko kuyimfuneko ukuze uphumle. Ukuzila ukutya kudla ngokufuneka kwi-transoesophageal echo kunye nezinye iindlela zoxinzelelo. Landela imiyalelo ebhaliweyo evela kwiyunithi yakho, kwaye ukuba uthatha i-insulin okanye amanye amayeza okwehlisa i-glucose, buza umcebisi ukuba angayilawula njani xa uceliwe ukuba uzile ukutya.

Ingaba i-2D echo iyafana ne-ECG?

Hayi. I-ECG irekhoda umsebenzi wombane wentliziyo kwimizuzu embalwa kwaye ibonise isigqi kunye neepateni ezithile ze-ischemic okanye zoxinzelelo. I-2D echo ivelisa imifanekiso eshukumayo yesakhiwo kunye nomsebenzi wokumpompa. Ezi mvavanyo zimbini ziphendula imibuzo eyahlukeneyo kwaye zihlala zicwangciswa kunye.

Ndiza kuyifumana nini ingxelo yam ye-echo, kwaye kuthekani ukuba ayiqhelekanga?

Ixesha lokunika ingxelo lixhomekeke kwiziko kunye nokuba ingcali yentliziyo ihlola imifanekiso kwiseshoni enye na. Ukufunyanwa okungaqhelekanga yindawo yokuqala, hayi isigqibo: ugqirha wakho uya kuyilinganisa ngokweempawu zakho kunye novavanyo kwaye unokuphinda i-echo, wongeze ezinye iimvavanyo, okanye aqalise unyango.

Ngaba kufuneka ndifumane i-2D echo xa ndijongwa impilo rhoqo?

I-Echo iluncedo kakhulu xa kukho umbuzo othile, ukungakwazi ukuphefumla, ukurhawuzelela, isifo sentliziyo esaziwayo, i-ECG engaqhelekanga. Kubantu abangenazo iimpawu okanye iimpawu, ukuhlolwa kwe-echo rhoqo kuvelisa iziphumo ezingalindelekanga. Xoxa nogqirha wakho malunga nokuba i-echo yongeza nantoni na kwimeko yakho.

Kufuneka kwenziwe kangaphi i-echo elandelayo?

Ukuphindaphinda kuxhomekeke kwimeko kunye nobunzima bayo. Isifo sevalvu esincinci nesizinzileyo sinokujongwa rhoqo; isifo sevalvu esinzima, i-cardiomyopathy okanye unyango lomhlaza oluchaphazela intliziyo lufuna ukulandelwa ngokusondeleyo. Ngugqirha wakho wentliziyo kuphela onokumisela ixesha, ngokusekelwe kuphando lwakho lokugqibela kunye neempawu zangoku.

Ndingakwazi ukuqhuba imoto ndize ndibuyele emsebenzini emva kwe-2D echo?

Emva kwe-echo yokuphumla ungaqalisa kwakhona imisebenzi eqhelekileyo, ukuqhuba kunye nokusebenza ngoko nangoko; akukho xesha lokuchacha. Emva kwe-echo ye-transoesophageal kunye ne-sedation, akufuneki uqhube kwaye uya kufuna umntu oza kukupheleka. I-echo yoxinzelelo ifuna ixesha lokujonga ngaphambi kokuba uhambe.

imithombo

• I-American Society of Echocardiography, izikhokelo malunga nokulinganiswa kwegumbi, ukubuyiselwa kwevalvu kunye novavanyo lwe-stenosis [Qinisekisa uhlelo lwangoku, LUZA KUQINISEKISWA]
• I-European Association of Cardiovascular Imaging, iingcebiso malunga ne-transthoracic, uxinzelelo kunye ne-transoesophageal echocardiography [Qinisekisa uhlelo lwangoku, LUZA KUQINISEKISWA]
• Izikhokelo ze-European Society of Cardiology / American College of Cardiology malunga nokusilela kwentliziyo kunye nesifo sentliziyo se-valvular [Qinisekisa uhlelo lwangoku, LUZA KUQINISEKISWA]
• Isikhokelo se-World Health Organisation malunga nomkhuhlane wamathambo