E-artery coronary operation overpery - ebizwa nangokuthi i-coronary artery bypass grafting, noma abahlinzayo be-CABG bafaka umthambo onempilo noma umvuthwandaba emthonjeni we- coronary disease, ngaphesheya kwezindawo ezivinjiwe ngamacwecwe . Le nqubo ivumela igazi ukuba lidlule ingxenye engumuthi we-artery futhi ithuthukise ukuhlinzekwa kwegazi ensikeni yenhliziyo.
Ubani Okufanele Athole Ukuhlinzwa Kwama-coronary Artery Bypass?
Ukuhlinzeka nge-throughpass kuphumelela kakhulu ekuthuthukiseni izimpawu ze- angina uma unama- angina azinzile .
Uma unezinkinga ezinkulu ezinhlobonhlobo ze-coronary, noma ukuvalelwa komshini omkhulu we-coronary (okuyinto umthambo we-coronary ebaluleke kunazo zonke), noma isisu senhliziyo esibuthakathaka kakhulu (isimo esibizwa ngokuthi i- cardiomyopathy, ongayifunda ngawe lapha ), ukuhlinzwa ngokudlula kungandisa isikhathi sakho uma kuqhathaniswa nokwelapha nge-angioplasty kanye ne-stenting, noma ngemithi yokwelapha yedwa. Ukwelashwa kwe-bypass kungasiza futhi kubantu abane -syndrome eyingozi .
Ukuhlinzwa Kwezidakamizwa Kusenziwa Kanjani?
Ukuhlinzeka nge-bypass kwenziwa ngaphansi kwe-anesthesia jikelele. Udokotela ohlinzayo uhlukanisa isifuba ukuze avule isifuba, bese eyeka inhliziyo usebenzisa amakhemikhali noma amakhaza (okuthiwa i-hypothermia) ukuze akwazi ukunamathisela ama-grafts ngaphandle kwenhliziyo ehambahambayo. Ukujikelezwa kwegazi kugcinwa, kuyilapho inhliziyo ivaliwe, isebenzisa umshini we-cardiopulmonary bypass machine. Uma ama-graft esehlanganiswe nenhliziyo iqalwa futhi.
Ama-graft asetshenziswe ngesikhathi sokuhlinzeka nge-bypass ngokuvamile avela emithanjeni esuka emilenzeni (i-saphenous veins), noma umthambo ovela ohlangothini lwesifuba (i-inner mammary artery).
Ama-Grafts asebenzisa umthambo ngokuvamile ahlala isikhathi eside kunama-grafts esebenzisa imivimbo, futhi ama-graft artery akavame ukuhlakulela i-stenosis, njengama-graft we-vein enza. Ngakho-ke ama-artery engaphakathi angaphakathi asetshenziselwa ukugqoka ama-artery kufanele asetshenziswe njalo uma kungenzeka ukuthi enze kanjalo (njengoba kunqunywe isisu somzimba). Kuvame ukuvame ukuguqulwa kwe-vein ukuze kuthuthukiswe izivimbela ngenxa ye-atherosclerosis eminyakeni eyishumi kuya kweyishumi nambili yokuhlinzwa.
Eminyakeni yamuva amasu okuhlinzwa amasha asanda kuthuthukiswa abizwa ngokuthi "ukuhlinzwa okuncane okungenasidingo kokuhlinzwa." Lezi zinqubo ezincane ezingenasidingo zibandakanya imibono encane, futhi zigwema ukusebenzisa umshini we-bypass. Ngeshwa, ukuhlinzekwa okunciphisa umzimba okunciphisa umzimba kuwufanele kuphela iziguli ezinezifo ezigulayo ezingafinyeleleka kalula ngale ndlela.
Yiziphi Izinkinga Ezibaluleke Kakhulu?
I-coronary artery overpery iyindlela enkulu yokuhlinzwa, futhi iziguli ngokuvamile azibuyelanga "ezivamile" amasonto amaningi noma ngisho nezinyanga ngemva kokuhlinzwa. Kuvame ukuba nesifiso sokuntula ukudla, ubuthakathaka, nobuhlungu phezu kokungcoliswa kwamasonto ambalwa. Ukucindezeleka kubonakala kumunye weziguli ezintathu emva kokuhlinzwa, futhi ngaphandle uma ukucindezeleka kubonakala futhi kuphathwa, kungabangela isikhathi sokuphumula eside kakhulu.
Ezinye izixazululo ezinokwenzeka emva kokuhlinzwa kwe-bypass zihlanganisa ukungena kwe-myocardial ngesikhathi noma ngemva kokuhlinzwa (ngaphansi kweziguli ezingaphansi kuka-5%), ukwehliswa kwesisipha senhliziyo (okuyinto evame ukuba yesikhashana), ama-arrhythmias (ikakhulukazi ama-frictional atrial), ama-pleural effusions (ukuqoqwa kwamanzi okuphakathi kwamanzi amaphaphu kanye nodonga lwesifuba), ukutheleleka kwesitifiketi sokucubungula, nesifo sokucabanga (sokucabanga) esiye sabizwa ngokuthi " ikhanda lokupompa " (ngemuva kwe-cardiopulmonary bypass "pump" esekela ukujikeleza ngesikhathi senqubo yokuhlanganiswa, nokuthi abanye baye bacacisa ukuthi obhekene nalezi zinguquko zengqondo).
Ngenxa yokuthi ukuhlinzeka ngokweqile kubhekana nezingozi ezinkulu, ngokuvamile kuvunyelwe iziguli okungenzeka ziphile isikhathi eside ngokuhlinzwa noma labo abanezibonakaliso ze-angina ziqhubeka naphezu kwemizamo enobudlova yokwelashwa.
Imithombo:
> Eagle, KA, Guyton, RA, Davidoff, R, et al. I-ACC / AHA isibuyekezo somhlahlandlela wezi-2004 we-artery coronary bypass ukuhlinzekwa kokufakelwa kwe-graft: umbiko we-American College of Cardiology / American Heart Association Task Force on Iziqondiso Zokuzikhandla (Ikomidi Lokuvuselela Iziqondiso Zika-1999 ze-Coronary Artery Bypass Graft Surgery). Ukujikeleza kuka-2004; 110: e340.