Isikhathi sokufunda esilinganiselwe: 4 iminithi
Uhlu Lokuphakathi
Eminyakeni yakamuva, ukuhlola okunenjongo okwengeziwe kosayizi we-atrial yesokunxele ngenhloso ye Usayizi We-Atrial Yesokunxele Engemuva (VLAS) Indlela ebizwa ngokuthi i-cardiomegaly (ukwandiswa kwenhliziyo) futhi ikakhulukazi ukwandiswa kwe-atrium yangakwesobunxele (i-atrium yangakwesobunxele) yakhelwe ukuhlola okunembe kakhudlwana.
Iyini i-VLAS?
I-VLAS, isilinganiso sosayizi we-atrium yangakwesobunxele (LA) usebenzisa ireferensi ye-vertebral iyimethrikhi ehlinzekayo. Le ndlela isetshenziswa ezinjeni ukukhuliswa kwe-atrial kwesokunxele ukunquma futhi ukutholakala kusenesikhathi kwesifo se-mitral valve (MMVD) noma ezinye izifo zenhliziyo Ngokungeziwe esilinganisweni sakudala se-VHS (Vertebral Heart Score), i-VLAS ivumela ukuhlolwa okunembe kakhudlwana kwe-atrium yangakwesobunxele yenhliziyo.
Ikalwa kanjani i-VLAS?
I-Laterolateral (uhlangothi lwesokudla) x-ray i-projection isetshenziswa. Ukulinganisa kwenziwa ngezinyathelo ezilandelayo:
1. Iphuzu lokuqala linqunyiwe:
• I-Carina (i-bifurcation ye-trachea - iphuzu lokuhlukaniswa libe kabili) Leli yiphuzu ku-x-ray lapho uqhoqhoqho uhlukana ube ama-bronchi amabili amakhulu.
2. Iphuzu lokugcina linqunywa:
• Ingxenye ye-caudal (backmost) yomngcele ongemuva (ikhonta engemuva) ye-atrium yangakwesobunxele Lokhu kuvame ukunqunywa ngu i-protrusion eyindilinga ngemuva kwengxenye engezansi ye-bronchus eyinhloko kwesokunxele kubonakala njenge.
3. Ukukala kwenziwa:
• Ibanga phakathi kwala maphuzu amabili liyalinganiswa (kusuka ku-carina kuya emngceleni we-caudal we-atrium yangakwesobunxele).
4. Iguqulelwe kuyunithi yokulinganisa umgogodla:
• Leli banga, I-4th thoracic vertebra (Th4) iguqulwa ibe iyunithi yomgogodla ngokuya ngobude bayo.Okusho ukuthi, kubalwa ukuthi mangaki ama-vertebrae leli banga elihambisana ne-Th4.
Ivalu Ejwayelekile ye-VLAS Ezinjeni
• Umkhawulo ophezulu ojwayelekile: 2,4 umgogodla
• Uma i-VLAS Uma ingaphezulu kuka-2,4, lesi simo ukunwetshwa kwe-atrial yesokunxele (ukukhulisa i-atrium yangakwesobunxele) ihlolwa njenge.
• Umkhawulo obalulekile: 3,0 umgogodla (Ngokwemihlahlandlela ye-ACVIM)
• Imihlahlandlela ye-ACVIM (American College of Veterinary Internal Medicine), I-Mitral Valve Disease (MMVD) isigaba B2 njengendlela yokukhetha I-VLAS > 3,0uyamukela.
• Nokho, ngokusho kwabanye ochwepheshe, Umkhawulo ka-3,0 uyivelu ephezulu kakhulu Leli nani, nakuba licacisiwe, linokuzwela okuphansi. Lokhu kusho ukuthi izimo eziningi zokukhuliswa kwe-atrial kwesokunxele kungenzeka zingatholakali kulo mkhawulo.
Izici Ezandisa Inani le-VLAS
NguRob Kreuger, umdwebi wezithombe zezokwelapha, i-AMC, eNetherlands – uRob Kreuger, umdwebi wezithombe zezokwelapha, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=24373378
I-VLAS, ikakhulukazi izifo zenhliziyo ezibangela ukwanda kwe-atrium yesobunxele Kubalulekile ukuxilongwa kusenesikhathi kwezifo ezinjalo.
Izifo eziyinhloko ezandisa i-VLAS yilezi::
• Isifo se-Mitral valve (MMVD): Ukwanda kwenzeka ngenxa yokunqwabelana kwegazi ku-atrium yangakwesobunxele.
• I-Dilated cardiomyopathy (DCM)Ukwandiswa kwe-ventricular yesokunxele ngokuvamile nakho kukhulisa i-atrium yangakwesobunxele.
• I-Hypertrophic cardiomyopathy (HCM) (emakati): Ukwandiswa kwe-atrium yangakwesobunxele kuvamile ngenxa yokuqina kodonga lwe-ventricular kwesokunxele.
• I-arrhythmia yenhliziyo: Ukuhlanganisa igazi ku-atrium yangakwesobunxele ngesikhathi se-arrhythmias kungase kubangele ukukhuliswa.
• Ukuhluleka kwenhliziyo okungapheli (CHF)Ukuhluleka kwenhliziyo okungapheli kubangela ukukhuphuka komfutho we-atrial kwesokunxele, okuholela ekwandeni kwe-atrium yangakwesobunxele.
Ukubaluleka Komtholampilo kwe-VLAS
1. I-Mitral Valve Disease (MMVD) Isiteji:
• I-VLAS > 3,0, “Isiteji B2” kuzinkombandlela ze-ACVIM Lokhu kusho ukuthi ukwelashwa kufanele kuqalwe.
• Nokho, abanye ochwepheshe, Amanani angaphezu kuka-2,4 incoma ukungenelela kwangaphambili, kucatshangelwa
2. Ukuxilongwa Kwangaphambi Kokuqala:
• I-VLAS, ikwazi ukubona ukukhula kwe-atrial kwesokunxele kusenesikhathi, ngoba i-VHS ihlola usayizi wenhliziyo kuphela.
3. Ukulandelela Ukwelashwa:
• Ngemva kokuqala ukwelashwa, i-VLAS iyakalwa futhi. Uma i-VLAS incipha, lokhu kubonisa ukuthi ukwelashwa kuyasebenza.
4. Ukuhlola Inhloso:
• I-VLAS ihlinzeka ngokulinganisa okuhlosiwe ngaphandle kokuhlola okuzimele. Lokhu kwenza imitholampilo ikwazi ukuthola imiphumela ephindaphindekayo.
• I-VLAS, kuphela ukuhlola ubukhulu be-atrium yangakwesobunxele Kuyisilinganiso somgomo.
• Ukulinganisa, ibanga phakathi kwe-tracheal bifurcation kanye nomngcele ongemuva we-atrium yangakwesobunxele futhi leli banga lenziwa kusetshenziswa Kubalwa ngokusekelwe kusayizi we-4th thoracic vertebra.
• Umkhawulo ophezulu wokujwayelekile: ≤ 2,4 ama-vertebrae.
• ACVIM imihlahlandlela, ngenxa yesifo se-mitral valve I-VLAS > 3,0edinga ukwelashwa B2 isigaba uyamukela njenge.
• I-VLAS isetshenziselwa ukuxilongwa kokuqala kokwandiswa kwenhliziyo, ukulandelwa kwesifo kanye ukuqala ukwelashwa kusenesikhathi usebenzisa for.
Le ndlela inikeza inzuzo enkulu ekuhlonzweni kokuqala kwezifo zenhliziyo futhi ivumela ukuqaliswa kokuqala kokwelashwa kwe-mitral valve disease (MMVD).
Ezinye Izihloko Ongase Uzithande
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