Ukuhlolwa kwe-2D Echo (i-Echocardiography): Lokho Okukubonisayo, Lokho Okungakwazi, Inqubo kanye Nemiphumela

Ukuthatha okhiye

• Ilinganisa: isakhiwo senhliziyo, umsebenzi we-valve kanye nokusebenza kahle kokupompa ngesikhathi sangempela, ngaphandle kwemisebe.
• Lokho ekuphuthelayo: ukuncipha kwemithambo yenhliziyo, ukuphazamiseka kwesigqi okufika kubuye kudlule, kanye nezimbangela eziningi zobuhlungu besifuba.
• Ubani okufanele: abantu abanenkinga yokuphefumula, ukukhononda, okusolwa ukuthi bane-valve noma isifo senhliziyo esinama-rheumatic, ukwehluleka kwenhliziyo, noma isifo senhliziyo esaziwayo esilandelwayo.
• Ikhwalithi yemiphumela iyahlukahluka: I-echo incike ku-opharetha futhi ikhwalithi yesithombe incike ekwakheni komzimba, isifo samaphaphu kanye nokuphefumula.
• Ukuchazwa kungokwezokwelapha: Izinombolo embikweni zisho izinto ezahlukene kubantu abahlukene, futhi udokotela ocele i-echo kuphela ongazifaka kumongo. Imiphumela iyahlukahluka kuye ngezimo zomtholampilo ngazinye.

Nge-shazi

Obeye aziwe njengo

• Ukuhlolwa kwe-Echo
• I-2D echocardiography, i-TTE, i-transthoracic echo
• I-sonography yenhliziyo, i-sonography yenhliziyo, i-ultrasound yenhliziyo
• I-Colour Doppler echo (uma kufakwe ucwaningo lokugeleza kwe-Doppler)
• "Dil ka echo" ekusetshenzisweni kwansuku zonke kwesiNdiya

Kuyini ukuhlolwa kwe-2D echo

Ukuhlolwa kwe-2D echo kusebenzisa amaza omsindo avame kakhulu avela ku-transducer ephethwe ngesandla ebekwe esifubeni. Amaza omsindo aveza imisipha yenhliziyo, ama-valve kanye negazi, bese umshini uguqula izimpawu ezibuyayo zibe izithombe ezihambayo ezinobukhulu obubili.

Iningi lezifundo ze-2D echo eNdiya zibikwa njenge-"2D echo ene-colour Doppler". Ingxenye ye-2D ikhombisa ukwakheka komzimba kanye nokunyakaza. I-Doppler ilinganisa ijubane kanye nesiqondiso sokugeleza kwegazi, okuvumela ukukala ukuncipha kwe-valve, ukuvuza kwe-valve kanye nokucindezela okuthile ngaphakathi kwenhliziyo. Ukulandelela kwe-M-mode kungafakwa futhi ekulinganisweni kwegumbi nodonga.

Kungani kwenziwa ukuhlolwa kwe-2D echo

• Ukuphefumula noma ukuvuvukala kwemilenze: ukubheka ukusebenza okunciphile kokumpompa, ama-ventricle aqinile, isifo se-valve noma uketshezi oluzungeze inhliziyo.
• Ukububula okuzwiwe ngesikhathi kuhlolwa: I-echo iyisivivinyo esiyinhloko sokubona izilonda ze-valve.
• Isifo senhliziyo esisolwayo noma esaziwayo: ukuhlola ukubandakanyeka kwe-mitral ne-aortic valve bese kulandelwa ngokuhamba kwesikhathi.
• Ukuhlolwa kokwehluleka kwenhliziyo: ukukala ingxenye yokukhipha amanzi nokuhlonza imbangela yesakhiwo esiyisisekelo.
• Ngemuva kokuhlaselwa yinhliziyo: ukuhlola umonakalo wemisipha, ukunyakaza kodonga kanye nezinkinga.
• Isifo senhliziyo esisolwayo sokuzalwa ezinganeni nakubantu abadala.
• I-stroke noma i-systemic embolism: ukufuna umthombo wenhliziyo, yize i-echo ye-transthoracic inokuzwela okulinganiselwe kwama-clots ku-appendage ye-atrial yesobunxele.
• Ngaphambi kokuhlinzwa okuthile noma i-chemotherapy okungathinta imisipha yenhliziyo, kanye nangesikhathi sokulandelela.
• Ukuhlolwa komfutho wegazi ophezulu wamaphaphu kanye nokuqapha, njengokulinganisa kuphela.

Ubani okufanele athole lolu vivinyo

I-2D echo iyisivivinyo esiqondisiwe, hhayi isengezo sokuhlola impilo jikelele. Cabanga ngokuxoxa nge-echo nodokotela uma une:

• Ukuphelelwa umoya uma uzikhandla noma ulele phansi, noma uvuka uphelelwe umoya ebusuku
• Ukuvuvukala kweqakala noma umlenze, noma ukuvuleka kwesisu okungachazeki
• Ukukhononda, noma umlando wangaphambilini womkhuhlane wamathambo noma isifo senhliziyo samathambo esibhalwe phansi
• Ukwehluleka kwenhliziyo okwaziwayo, i-cardiomyopathy, isifo se-valve noma i-valve yokufakelwa edinga ukulandelwa
• Ukuhlaselwa yinhliziyo kwangaphambilini, noma i-atrial fibrillation esanda kutholakala
• Ukushaya kwenhliziyo noma ukucima komoya lapho kusolwa khona inkinga yesakhiwo senhliziyo
• Umlando womndeni we-cardiomyopathy ezuzwe njengefa noma ukufa kwenhliziyo ngokuzumayo
• Isifo senhliziyo esizalwa naso, noma ingane engondli kahle, engakhuli kahle, enezimpethu eziluhlaza okwesibhakabhaka noma enokukhononda
• Umfutho wegazi ophakeme osekunesikhathi eside, isifo sezinso esingamahlalakhona noma isifo sikashukela lapho kusolwa khona ukuthi kukhona ushintsho lwesakhiwo senhliziyo ngokwezokwelapha

I-echo akuyona indlela yokuqala yokuhlola efanele wonke umuntu onezinhlungu esifubeni, futhi i-echo evamile kumuntu onezimpawu ayiqedi ukuhlolwa.

Lokho i-echo ye-2D engenakukubona noma ukukukhipha

• Isifo se-coronary artery: I-echo yokuphumula engu-2D ayiboni ngeso lengqondo imithambo yenhliziyo noma ibonise ukuvaleka. I-echo yokuphumula evamile ayikhiphi isifo esibalulekile senhliziyo noma isuse i-angina.
• Ukuhlaselwa yinhliziyo kuyaqhubeka: I-echo ingabonisa udonga olungahambi kahle, kodwa ayikwazi ukuqinisekisa noma ukukhipha ngokwethembeka isigameko senhliziyo esibuhlungu. I-ECG kanye ne-cardiac troponin kusabalulekile.
• Izinkinga zesigqi: i-echo akuyona ukuhlolwa kwesigqi. Ama-arrhythmia angavamile adinga i-ECG, i-Holter noma ukuqapha isigqi okweluliwe.
• Amaqhubu amancane nezimila: I-echo ye-transthoracic ingaphuthelwa yizitshalo ezincane ze-endocarditis ezithelelanayo futhi ngokuvamile ayikwazi ukubona kahle ingxenye ye-atrial yesobunxele; i-echo ye-transoesophageal ingcono kakhulu kule mibuzo.
• Ukuhlukaniswa kwe-aortic: I-echo ye-transthoracic ingase iphakamise ukusola kodwa ayikwazi ukuvimbela ngokuthembekile ukuqhekeka. I-CT aortogram noma i-transoesophageal echo iyadingeka.
• I-Pulmonary embolism: i-echo ingabonisa ukucindezeleka kwenhliziyo kwesokudla ku-emboli enkulu kodwa i-echo evamile ayikuvimbeli i-pulmonary embolism.
• Ukucindezeleka kwemithambo ye-pulmonary artery ngqo: I-Doppler inikeza izilinganiso ezingaba zingalungile; ukufakwa kwe-catheter yenhliziyo yesokudla kusalokhu kuyindinganiso ebhekiselwe kuyo.
• Izimbangela zobuhlungu besifuba ezihlobene namaphaphu, umphimbo, imisipha kanye ne-asidi, okuyizinto ezivamile futhi ezingezona izinto ezitholakele.

Ukuthola ukuthi "akutholakalanga" embikweni we-echo kusho ukuthi akubonwanga kulolo cwaningo, hhayi ukuthi akukho. Uma izimpawu zakho ziqhubeka noma ziba zimbi naphezu kwe-echo evamile, buyela kudokotela wakho.

Ukuhlolwa okuhlobene kodwa okuhlukile

Ukuthi yikuphi ukuhlolwa okuza kuqala kuncike enkingeni

Akukho ukuhlolwa kwenhliziyo "kokuqala" okutholakala emhlabeni wonke.

• Ubuhlungu obukhulu besifuba obungazelelwe: I-ECG ne-troponin ziza kuqala; i-echo iyasekela.
• Ubuhlungu besifuba obuqhubekayo obuhambisana nezimpawu ezizinzile: Isinyathelo esilandelayo ngokuvamile ukuhlolwa komzimba wenhliziyo noma i-ischaemia, hhayi nje kuphela.
• Ukuphelelwa umoya noma i-edema: I-echo iphakathi nendawo, ngokuvamile ihambisana ne-ECG, i-X-ray yesifuba kanye nokuhlolwa kwe-natriuretic peptide lapho kutholakala khona.
• Ukububula: i-echo iyisivivinyo esifanele.
• Ukushaya kwenhliziyo noma ukuquleka: ukuqapha isigqi, kanye ne-echo ukuhlola izifo zesakhiwo.

Indlela yokulungiselela ukuhlolwa kwe-2D echo

Ukulungiselela i-echo ejwayelekile yokuphumula ye-2D ngokuvamile kuncane kakhulu. Izinqubo ziyahlukahluka phakathi kwezibhedlela nezikhungo zokuxilonga, futhi imiyalelo ebhaliwe enikezwa yiyunithi yakho ihlala iza kuqala kuneseluleko esijwayelekile.

• Izingubo: Gqoka into ekhululekile nenezicucu ezimbili; isifuba kumele sifinyeleleke kalula futhi abesifazane bavame ukunikezwa ingubo.
• Ukudla neziphuzo: Ukuzila ukudla ngokuvamile akudingeki ukuze kutholakale i-echo yokuphumula. Ukuzila ukudla ngokuvamile kuyadingeka ukuze kutholakale i-echo ye-transoesophageal kanye nezinye izindlela zokucindezeleka.
• Imithi: Qhubeka nemithi yakho oyinikezwe udokotela njengokujwayelekile ngaphandle kokuthi udokotela wakho akutshele okwehlukile. Ungayeki noma weqe noma yiliphi iphilisi ngokwakho; uma uceliwe ukuthi ugodle umuthi ngaphambi kokuba ukucindezeleka kuvele, lowo myalelo uvela kudokotela.
• Letha nawe: ukudluliselwa, imibiko yangaphambilini ye-echo kanye ne-ECG, amarekhodi e-angiography noma okuhlinzwa, kanye nohlu lwakho lwemithi lwamanje.
• Tshela ithimba ngalokhu: ukukhulelwa, i-pacemaker noma idivayisi efakwe, ukuhlinzwa kwe-valve kwangaphambilini, amanxeba esifubeni noma ukubopha, kanye nanoma iyiphi inqubo yesifuba yakamuva.

Izingane

I-echo yezingane ithatha isikhathi eside futhi ingadinga ukuba umzali abe khona, ancelise noma aphazamise. I-sedation isetshenziswa ngezinye izikhathi ezinganeni ezincane ezingabambisani futhi inqunywa icala ngalinye.

ukukhulelwa

I-echo kanina ye-2D ayibandakanyi imisebe futhi ivame ukwenziwa ngesikhathi sokukhulelwa lapho kunenkinga yenhliziyo. I-echocardiography yengane esanda kuzalwa ukuhlolwa okuhlukile okwenziwa ochwepheshe abaqeqeshwe ngemithi yengane esanda kuzalwa noma ochwepheshe bezifo zenhliziyo zezingane, futhi yonke i-ultrasound yokukhulelwa eNdiya ilawulwa yi-PC-PNDT Act, 1994; ukunqunywa kobulili akuvunyelwe ngumthetho.

Isifo sikashukela ekwelashweni kokwehlisa ushukela

I-echo yokuphumula ayidingi ukuzila ukudla, ngakho ukudla nemithi kuyaqhubeka ngendlela evamile. Uma iyunithi yakho ikucela ukuthi uzile ukudla ukuze uthole isifundo esihlanganisiwe noma sokucindezeleka, buza udokotela wakho ngqo ukuthi ungayiphatha kanjani i-insulin noma i-sulfonylureas, njengoba ukuzila ukudla ngale mithi kuyingozi yokwehla kwe-glucose egazini.

Ukwehluleka kwenhliziyo, isifo sezinso esithuthukile noma ukuvinjelwa koketshezi

Ukulala phansi kungase kungakhululeki uma uphefumula kanzima; tshela udokotela we-sonographer, njengoba ucwaningo oluningi lungenziwa lusekelwe noma luseceleni kwakho. Uma unqunyelwe uketshezi, ungandisi umthamo woketshezi kunoma yimiphi imiyalelo yokuskena ngaphandle kokuhlola udokotela wakho okwelaphayo.

Abantu abadala abadala

Ukuphendukela ohlangothini lwesobunxele kungaba nzima nge-arthritis noma ubuthakathaka. Usizo kanye nejubane eliphansi kuvamile, futhi ukuhlolwa kungashintshwa.

Kwenzekani ngesikhathi sokuhlolwa kwe-2D echo

• Isikhundla: Ulala kusofa, uvame ukuphendukela kwesobunxele sakho nengalo yesobunxele iphakanyisiwe, okusondeza inhliziyo odongeni lwesifuba.
• Amachashazi e-ECG: Ama-electrode amancane angase anamathele esifubeni ukuze alinganise izithombe ngokushaya kwenhliziyo.
• Ijeli kanye ne-transducer: Kusetshenziswa ijeli esuselwe emanzini bese i-probe ishukunyiswa phakathi kwezimbambo, ngaphansi kwethambo lesifuba kanye nasezansi kwentamo. Ukucindezela okuqinile kuyinto evamile futhi kungazizwa kungakhululekile, ikakhulukazi phezu kwezimbambo.
• Imiyalelo yokuphefumula: ungase ucelwe ukuba uphefumule futhi ubambe isikhashana ukuze uthuthukise ikhwalithi yesithombe.
• Imisindo ye-Doppler: uzozwa imisindo ekhalayo; lezi yizimpawu zokugeleza kwegazi, hhayi into engavamile.

Isikhathi esithathayo: i-echo ejwayelekile ye-2D yokuphumula ene-Doppler yombala ivame ukuthatha cishe imizuzu eyi-15-45, okuhlanganisa nokuma kanye nokulinganisa. Amafasitela okuthatha izithombe ezinzima, ukuhlolwa kwe-valve okuningiliziwe, isifo senhliziyo esizalwa naso kanye nezifundo zezingane kuthatha isikhathi eside. Izifundo ze-transoesophageal kanye ne-stress echo zidinga ukulungiselela okwengeziwe, ukuqapha kanye nesikhathi sokululama, ngakho-ke hlela ukuvakasha isikhathi eside.

Ukuqonda umbiko wakho we-2D echo

Imibiko ye-Echo iyinkimbinkimbi futhi inobuchwepheshe. Izingxenye ezingezansi zichaza ukuthi izihloko ezivamile zibhekisela kuphi. Akukho nombolo embikweni eyisifo sokuxilongwa ngokwayo, futhi izilinganiso kumele zifundwe kanye nezimpawu zakho, ukuhlolwa kanye nezinye izivivinyo ngudokotela ocele i-echo.

Ingxenyeni yokukhipha i-ventricular yangakwesobunxele (LVEF)

Ingxenye yokukhipha igazi ilinganisa inani legazi elikhishwa kusuka ku-ventricle yesobunxele ngokushaya ngakunye. Kuyisilinganiso, hhayi isilinganiso esiqondile, futhi singahluka phakathi kwabasebenza, phakathi kwezindlela (ukulinganisa okubonakalayo uma kuqhathaniswa nomthamo we-biplane) kanye naphakathi kokuvakasha. Inani "lomngcele" embikweni owodwa kanye nenani elijwayelekile kolandelayo lingabonisa ukwehluka kokulinganisa kunokushintsha kwangempela. Iziphetho zomsebenzi ojwayelekile, oncishisiwe kancane futhi oncishisiwe kufanele zifundwe ngokumelene namanani okubhekisela acashunwe yilabhorethri yakho yokubika kanye nohlelo lwesiqondiso olusetshenziswayo.

Usayizi wekamelo kanye nobukhulu bodonga

Amakamelo avulekile noma izindonga ezijiyile zingase zikhombe umfutho wegazi ophakeme osekunesikhathi eside, i-cardiomyopathy, isifo se-valve noma, kwezinye izimo, ukuzivumelanisa nemidlalo. Ukulinganisa kuthonywa usayizi womzimba, okubaluleke kakhulu ezigulini zaseNingizimu Asia, ngakho-ke amanani anenkomba avame ukusetshenziswa.

Okutholakele kanye nokuhlolwa kwama-valve

Ukuncipha kwe-valve (stenosis) kanye nokuvuza (regurgitation) kuvame ukubhekwa njengokuncane, okumnene, okuphakathi noma okunzima. Lokhu kuhlolwa kuyisinqumo esihlanganisiwe esisekelwe ezilinganisweni eziningana ze-Doppler kanye nezithombe, futhi ngokwengxenye kuncike ekuziphatheni komuntu futhi kuncike emthwalweni, umfutho wegazi, izinga lokushaya kwenhliziyo, i-anemia kanye nokumuncwa kwamanzi konke kushintsha izinombolo. Ukuhlolwa kwe-tricuspid noma kwe-mitral "okuncane" noma "okuncane" kuyisifo esivame kakhulu ezinhliziyweni ezinempilo futhi ngokuvamile akudingi ukwelashwa nhlobo. Iziguli zivame ukufunda noma yiliphi izinga le-valve njengesifo esibi; izinga kumele lihunyushwe ngesithombe somtholampilo.

Umsebenzi we-Diastolic

Lokhu kuchaza ukuthi i-ventricle iphumula futhi igcwalise kahle kangakanani. Amaphethini abikiwe awaqondile, athonywa ubudala, isigqi kanye nezimo zomthwalo, futhi aphathwa kangcono njengobufakazi obubodwa kunokuba kube ukuxilongwa okuzimele.

Ukukhishwa kwe-Pericardial

Uketshezi oluzungeze inhliziyo lungachazwa njengoluncane, oluthambile, oluphakathi noma olukhulu. Ukubaluleka kuncike ekutheni luqoqeke ngokushesha kangakanani nokuthi lucindezela inhliziyo yini, hhayi ngobuningi kuphela.

Izingcindezi zamaphaphu

Umfutho wegazi osuka ku-Doppler uwukulinganisa, hhayi umfutho olinganisiwe, futhi uncike ekutholeni i-jet eyanele yokuvuselela. Ungalinganiswa ngokweqile noma kancane.

Amagama avame ukukhathazeka iziguli ngokungadingekile

• "I-valve ye-aorta ye-sclerotic": ukuqina ngaphandle kokuvinjelwa okukhulu; kuvamile ngokweminyaka.
• "UMnumzane/u-TR Ongabalulekile": uhlobo olujwayelekile kubantu abaningi.
• "Ukungasebenzi kahle kwe-diastolic yebanga lokuqala": ngokuvamile kuhlobene nobudala futhi ngokuvamile akuyona imbangela yezimpawu.
• "Akukho ukungahambi kahle kokunyakaza kodonga lwesifunda": okuqinisekisayo ngokunyakaza kodonga okuphumuzayo, kodwa hhayi isitifiketi sokukhishwa kwemithambo yenhliziyo.

Uma imiphumela ye-2D echo ingadukisa

Okutholakele okungaba yihaba ngokungeyikho noma kubikwe ngokweqile

• Izinga lokuvuza kwevalvu liphakanyisiwe uma umfutho wegazi uphezulu, ukushaya kwenhliziyo kuyashesha, noma uma une-anemia nokukhulelwa lapho ukugeleza kwegazi kwanda khona.
• Izingcindezi zamaphaphu zilinganiswe ngokweqile kusuka ku-Doppler jet esezingeni eliphansi noma egobile.
• Ubukhulu bodonga obubizwa ngokuthi ngaphezulu ezindizeni zezithombe ezigobile noma lapho kufakwe imisipha ye-papillary.
• Ukugeleza okubonakalayo lapho amafutha e-pericardial noma iqoqo le-pleural liphambaniswa noketshezi.

Okutholakele okungancishiswa noma kuphuthelwe ngamanga

• Ingxenye yokukhipha igesi ayilinganiswanga kahle lapho i-peak yangempela ingabanjwanga (imibono efinyeziwe).
• Ubunzima be-stenosis abulinganiswanga kahle uma umsebe we-Doppler ungahambisani nejethi, noma ezimweni zokugeleza okuphansi lapho umsebenzi wokupompa ungasebenzi kahle.
• Izitshalo ezincane, amahlule amancane kanye nokukhubazeka okuncane kwe-septal akutholakalanga emafasiteleni anqunyelwe adlula esifubeni.
• Ucwaningo lonke luwohlokile kwi-emphysema kanye nesifo samaphaphu esingamahlalakhona, ukukhubazeka kodonga lwesifuba, imisipha yesifuba ejiyile, isisindo somzimba esiphezulu, ukuhlinzwa, ukungakwazi ukulala ngohlangothi, noma isigqi esingajwayelekile njenge-atrial fibrillation lapho amanani okushaya kuya kokushaya ehluka khona.

I-Echo incike ku-opharetha. Imibiko emibili enhliziyweni efanayo, ehlukene ngamasonto, ingahluka kancane ngaphandle koshintsho lwangempela enhliziyweni. Lapho isinqumo singenamkhawulo, udokotela wakho wenhliziyo angaphinda ucwaningo, acele uhlobo oluhlukile lwe-echo noma asebenzise i-MRI yenhliziyo.

Izingozi nokuphepha

I-echo ye-transthoracic 2D ephumulayo

I-echo ejwayelekile yokuphumula ayibandakanyi imisebe, ayinazinaliti futhi ayinazo imiphumela eyaziwayo yokulimaza izicubu ezindaweni zokuxilonga. Ukungakhululeki okuyinhloko ijeli ebandayo, ukucindezela kwe-probe phakathi kwezimbambo, ukucasuka kwesikhumba okuvela ezintikeni ze-ECG, kanye nokuphelelwa umoya uma kufanele ulale phansi. Isetshenziswa kabanzi ezinganeni ezisanda kuzalwa, ukukhulelwa kanye nabantu abadala.

I-Stress echocardiography

I-stress echo inezingozi zangempela, nakuba zingavamile, ngoba inhliziyo icindezelekile ngamabomu: ubuhlungu besifuba, ukungalingani kwenhliziyo, ushintsho oluphawulekayo lomfutho wegazi, kanye nezehlakalo ezingavamile ukuba zimbi kakhulu zenhliziyo. Kwenziwa ngokuqapha okuqhubekayo, izindawo zokuvuselela kanye nemvume ethile. Iphrofayili yokuphepha ye-echo yokuphumula ayisebenzi ezifundweni zokucindezeleka.

I-echo ye-transoesophageal

I-TEE iyahlasela. Izingozi zifaka phakathi ukungakhululeki komphimbo, ukuphefumula okuhlobene nokudambisa ubuhlungu kanye nemiphumela yomfutho wegazi, ukopha, kanye nokulimala noma ukubhoboka komphimbo okuvamile. Kudingeka ukuzila ukudla kanye nemvume esemthethweni.

I-echo ethuthukisiwe yokuqhathanisa

Ama-ultrasound contrast agents ngokuvamile abekezelelwa kahle kodwa angabangela ukusabela kwe-hypersensitivity futhi asetshenziswa ngokuqapha ezimweni ezithile zenhliziyo kanye namaphaphu. Izifundo ze-saline ezivuvukele zidinga i-cannula efakwa emthanjeni.

Izimo ezikhethekile

ukukhulelwa

I-echo yomama isetshenziswa uma kukhona ukuphelelwa umoya okungaphezu kwalokho obekulindelekile ekukhulelweni, ukububula, isifo esaziwayo se-valve noma ukuhlinzwa kwenhliziyo kwangaphambilini. Ukukhulelwa okuvamile ngokwako kwandisa umthamo wegazi nokugeleza kwegazi, okungashintsha kancane ubukhulu begumbi kanye ne-Doppler gradients; imibiko kufanele ifundwe ngalokho engqondweni. Ukuhlolwa kwenhliziyo yengane esanda kuzalwa kuwukuhlolwa okuhlukile futhi kulawulwa ngaphansi koMthetho we-PC-PNDT, 1994.

Izingane kanye nezinsana ezisanda kuzalwa

I-Paediatric echo iyisethi yamakhono ahlukile agxile ku-anatomy yokuzalwa. Amafasitela ezithombe ezinganeni ngokuvamile amahle kakhulu. Okutholakele njenge-patent ductus kosana olusanda kuzalwa noma i-septal defect encane kudinga ukuchazwa kwe-cardiology yezingane, njengoba eziningi zivala noma zihlala zingenangozi.

Abantu abadala abadala

Ukuqina kwevalvu okuhlobene nobudala, izinguquko ezincane ze-diastolic kanye nokwanda kwezimpande ze-aorta encane kuvamile futhi akusona isifo ngokuzenzakalelayo. Ukulinganiselwa kokubekwa kanye nezinguquko zamaphaphu kunganciphisa ikhwalithi yesithombe.

I-fibrillation ye-atrial kanye ne-rhythms engajwayelekile

Ukwehluka kwe-beat-to-beat kwenza izilinganiso ezilodwa zingathembeki; isilinganiso sama-beat amaningi siyadingeka, futhi ama-gradients angase angacaci.

Isifo sezinso esingamahlalakhona kanye ne-dialysis

Isimo soketshezi sithinta kakhulu ubukhulu begumbi, ukucindezela kanye ne-gradients yama-valve. Ama-echo enziwa ngaphambi nje nangemva nje kwe-dialysis angabonakala ehluke kakhulu, ngakho-ke isikhathi kufanele siqoshwe.

Ukuhluleka kwenhliziyo

Ama-echoes alandelanayo asetshenziswa ukulandelela ukusebenza kwe-ventricular kanye nesifo se-valve. Izinguquko ezincane engxenyeni yokukhipha phakathi kwezifundo zingaba ukushintshashintsha kokulinganisa; izinqumo zokwelashwa zisekelwe kumkhuba kanye nezimpawu.

Amadivayisi afakwe kanye nokuhlinzwa kwangaphambilini

Abenzi be-pacemaker, ama-valve okufakelwa kanye nokuhlinzwa kwe-past bypass noma i-valve akuvimbeli ukuzwakala kwe-echo, kodwa kushintsha izithombe futhi kudinga ukuthi udokotela wenhliziyo obikayo azi umlando wokuhlinzwa. Uma i-MRI yenhliziyo icatshangwa kamuva, ama-implant adinga ukuhlolwa kokuphepha kwe-MRI kunokuba kuthathwe njengokungaphephile.

Ukuhlolwa kwe-2D echo kumongo waseNdiya

• Isifo senhliziyo esibizwa ngokuthi i-rheumatic heart siseyinkomba ebalulekile. ENdiya, i-echo iyisivivinyo esiyinhloko sokuhlola umonakalo we-mitral kanye ne-aortic valve ngemuva komkhuhlane we-rheumatic, ukuhlela i-balloon valvotomy noma ukuhlinzwa, kanye nokulandelela. Noma ubani onomlando womkhuhlane we-rheumatic kanye nokuphelelwa umoya okusha kufanele ahlolwe kunokuqinisekiswa umbiko omdala.
• I-anemia ivamile futhi ithinta umbiko. I-anemia yokuntuleka kwensimbi kanye nesici se-thalassemia kwandisa ukuphuma kwenhliziyo, okungenza ukugeleza kwegazi kube kukhulu futhi ama-Doppler gradients kanye nokuvuza kwe-valve kubonakale kuvelele kakhulu kunasesimweni esilungisiwe.
• Isifo se-metabolic esiphansi kwe-BMI. Abantu baseNingizimu Asia baba nomfutho wegazi ophakeme, isifo sikashukela kanye noshintsho lwesakhiwo senhliziyo ezisindweni zomzimba eziphansi, ngakho-ke ukwakheka "okubukeka kujwayelekile" akwenzi isifo senhliziyo singabi yinto engenzeka.
• Amagama ozowazwa endaweni yakini: "ukuhlolwa kwe-echo", "i-colour Doppler echo", "i-sonography yenhliziyo", "i-2D echo ene-Doppler". Lokhu kuvame ukubhekisela ocwaningweni olufanayo lokuphumula oludlula esifubeni.
• Umthetho wezithombe zangaphambi kokuzalwa: Noma iyiphi i-ultrasound eyenziwa ngesikhathi sokukhulelwa, okuhlanganisa ne-echocardiography ye-fetal, ingaphansi koMthetho we-PC-PNDT, ka-1994. Ukunquma noma ukudalula ucansi lwe-fetus akuvumelekile.
• Ukukhangisa kanye nezimangalo: Izimangalo zokukhushulwa mayelana nokuhlolwa kokuxilonga eNdiya zivinjelwe yi-Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954, kanye nemigomo yokuziphatha yobungcweti. Qaphela ngamaphakheji athembisa "ukuqeda isifo senhliziyo" ngokuzwakalayo kuphela.
• Ubumfihlo bedatha: Izithombe nemibiko ephindaphindayo kuyidatha yezempilo ebucayi; ukuphathwa kwedatha yomuntu siqu yizibhedlela nezikhungo zokuxilonga eNdiya kulawulwa uMthetho Wokuvikelwa Kwedatha Yomuntu Siqu Yedijithali, ka-2023.

Izindleko kanye nomshuwalense eNdiya

I-2D echo ephumuzayo ene-color Doppler ingenye yezivivinyo zokuthwebula izithombe zenhliziyo ezingabizi kakhulu, ngokuvamile ezibiza kancane kakhulu kune-CT coronary angiography noma i-cardiac MRI. Amanani ahluka kakhulu phakathi kwamadolobha, phakathi kwezikhungo zikahulumeni nezizimele, kanye naphakathi kwezikhungo zokuxilonga ezizimele kanye nezibhedlela eziphakeme. Cela inkokhelo yamanje lapho ubhukha; noma yiliphi inani elicashunwe ku-inthanethi liyinkomba kuphela futhi kungenzeka lingabonisi ukuthi ukhokhiswa malini.

Izici ezishintsha intengo:

• Uhlobo locwaningo, ukuphumula kwe-2D echo vs. stress echo, i-transoesophageal echo, i-3D echo, i-contrast echo noma i-fetal echocardiography, ezisebenzisa kakhulu imithombo.
• Ukuthi udokotela wenhliziyo wenza futhi ubika ucwaningo mathupha
• Isiguli esilaliswe esibhedlela, esiphuthumayo, esiseceleni kombhede noma echo ye-ICU uma kuqhathaniswa nocwaningo oluhleliwe lwesiguli esingalaliswa esibhedlela
• Uhlobo lwedolobha kanye nesikhungo, kanye nesimo sokugunyazwa
• Izifundo zezingane kanye nezokuzalwa, ezithatha isikhathi eside
• Amaphakheji okuhlola impilo noma enhliziyo ahlanganisiwe, angafaka phakathi i-ECG, ukuhlolwa kwe-treadmill kanye nokubonisana
• Izaphulelo zokuphinda noma zokulandelela ucwaningo, lapho kunikezwa khona

Umshwalense: ukuhlolwa kokuxilonga okwenziwa nje kuphela njengoba uphenyo lwesiguli sangaphandle luvame ukungakhokhwa ngaphansi kwezinqubomgomo zempilo ezijwayelekile zokunxephezela ngaphandle kokuthi inqubomgomo ifaka phakathi izinzuzo zesiguli sangaphandle noma zokuxilonga. I-echo eyenziwa ngesikhathi sokungeniswa esibhedlela esimboziwe, esimboziwe ivame ukuba yingxenye yesimangalo. Ukumbozwa ngaphansi kwezinhlelo zikahulumeni kanye nezinhlelo zabaqashi kuyahlukahluka. Qinisekisa nomshwalense wakho noma ideski lomshwalense wesibhedlela ngaphambi kokuhlolwa, bese ugcina umuthi wesiguli bese ubika nganoma yisiphi isimangalo.

Izinganekwane namaqiniso

Imibuzo ejwayelekile ukubuzwa

Ingabe i-2D echo iyalimaza?

I-echo ye-2D ephumuzayo ayibuhlungu kubantu abaningi. Ijeli izwakala ibanda futhi i-probe icindezelwa ngokuqinile phakathi kwezimbambo, ezingaba mnene, ikakhulukazi uma isifuba sakho sibuhlungu noma unciphile. Tshela i-sonographer uma ingcindezi ingakhululeki, njengoba i-engeli ingashintshwa njalo.

Kuthatha isikhathi esingakanani i-2D echo kusukela ekuqaleni kuze kube sekupheleni?

Ukuskena ngokwako kuvame ukuthatha imizuzu eyi-15-45. Engeza isikhathi sokubhalisa, ukushintsha nokulinda. Izifundo zokuzalwa, zezingane kanye nezinzima ngokobuchwepheshe zithatha isikhathi eside, kanti ukucindezeleka noma i-transoesophageal echo kudinga ukuqapha nokululama, okungandisa ukuvakasha kube amahora ambalwa.

Ingabe i-2D echo ingayibona imithambo yegazi evalekile noma ibikezele ukuhlaselwa yinhliziyo?

Cha. I-2D echo ephumuzayo ayibonisi imithambo yenhliziyo futhi ayikwazi ukubikezela ukuhlaselwa yinhliziyo esikhathini esizayo. Ingabonisa ukulimala kwemisipha ngenxa yokuhlaselwa kwangaphambilini. Uma kusolwa isifo senhliziyo, udokotela wakho uzokhetha ukuhlolwa kwe-ischemia noma isithombe senhliziyo esikhundleni sokuthembela ku-echo.

Ingabe ngidinga ukuzila ukudla ngaphambi kokuba ngithole i-2D echo?

Ukuzila ukudla ngokuvamile akudingeki ukuze kutholakale i-echo yokuphumula. Ukuzila ukudla ngokuvamile kuyadingeka ukuze kutholakale i-echo ye-transoesophageal kanye nezinye izindlela zokucindezeleka. Landela imiyalelo ebhaliwe evela eyunithi yakho, futhi uma uthatha i-insulin noma eminye imithi yokwehlisa ushukela, buza udokotela ukuthi angayiphatha kanjani uma kucelwa ukuzila ukudla.

Ingabe i-echo ye-2D iyafana ne-ECG?

Cha. I-ECG iqopha umsebenzi kagesi wenhliziyo ngemizuzu embalwa futhi ikhombisa isigqi kanye namaphethini athile e-ischemic noma okucindezeleka. I-2D echo ikhiqiza izithombe ezihambayo zesakhiwo kanye nomsebenzi wokupompa. Lezi zivivinyo ezimbili ziphendula imibuzo ehlukene futhi zivame uku-oda ndawonye.

Ngizowuthola nini umbiko wami we-echo, futhi kuthiwani uma ungavamile?

Isikhathi sokubika sincike esikhungweni kanye nokuthi udokotela wenhliziyo ubuyekeza izithombe yini ngesikhathi esifanayo. Ukuthola okungajwayelekile kuyisiqalo, hhayi isinqumo: udokotela wakho uzokulinganisa ngokwezimpawu zakho kanye nokuhlolwa kwakho futhi angase aphinde aphindaphinde i-echo, engeze ezinye izivivinyo, noma aqale ukwelashwa.

Ingabe kufanele ngithole i-2D echo ekuhlolweni kwempilo okuvamile?

I-echo iwusizo kakhulu uma kukhona umbuzo othize, ukuphelelwa umoya, ukububula, isifo senhliziyo esaziwayo, i-ECG engavamile. Kubantu abangenazo izimpawu noma izinkomba, ukuhlolwa kwe-echo okuvamile kuvame ukuveza imiphumela engalindelekile. Xoxa nodokotela ukuthi i-echo ingeza yini noma yini esimweni sakho.

Kufanele kwenziwe kangaki i-echo yokulandelela?

Ukuvama kuncike esimweni kanye nobunzima baso. Isifo se-valve esithambile nesizinzile singabuyekezwa ngezikhathi ezinde; isifo se-valve esibi, i-cardiomyopathy noma ukwelashwa komdlavuza okuthinta inhliziyo kudinga ukulandelwa eduze. Udokotela wakho wenhliziyo kuphela ongabeka isikhathi, ngokusekelwe ocwaningweni lwakho lokugcina kanye nezimpawu zamanje.

Ngingakwazi yini ukushayela bese ngibuyela emsebenzini ngemva kwe-2D echo?

Ngemva kokuphumula ungaqhubeka nomsebenzi ojwayelekile, ukushayela nokusebenza ngokushesha; asikho isikhathi sokululama. Ngemva kokuphumula nge-transoesophageal echo kanye nokuthulisa, akumelwe ushayele futhi uzodinga umuntu ozokuphelezela. Ukucindezeleka kudinga isikhathi sokubheka ngaphambi kokuba uhambe.

Imithombo

• I-American Society of Echocardiography, iziqondiso zokulinganisa ikamelo, ukubuyiselwa kwe-valvular kanye nokuhlolwa kwe-stenosis [Qinisekisa uhlelo lwamanje, KUZOQINISEKISWA]
• I-European Association of Cardiovascular Imaging, izincomo mayelana ne-transthoracic, ukucindezeleka kanye ne-transoesophageal echocardiography [Qinisekisa uhlelo lwamanje, KUZOQINISEKISWA]
• Iziqondiso ze-European Society of Cardiology / American College of Cardiology mayelana nokwehluleka kwenhliziyo nesifo senhliziyo se-valvular [Qinisekisa uhlelo lwamanje, KUZOQINISEKISWA]
• Isiqondiso seNhlangano Yezempilo Yomhlaba mayelana nomkhuhlane wamathambo