Ukuphambana kwe-quintuple yindlela yokuhlinzwa enhliziyo evulekile eyenziwe ukuphatha imishanguzo evinjiwe kakhulu edla inhliziyo. Inqubo yinkimbinkimbi, futhi ukuqonda ngokucacile ukuguqulwa kwe-quintuple , kubalulekile ukuqonda isisu senhliziyo nemiphumela yesifo senhliziyo.
I-Coronary Arteries
Imithambo ye-coronary yiyona imithwalo yegazi enikezela inhliziyo ngegazi layo; lezi zihlukile kunezitsha ezihlinzeka ngegazi ziphethwe yinhliziyo .
Kwamanye abantu, imishanguzo ye-coronary ivinjelwe, isimo esaziwa ngokuthi isifo se-coronary artery .
Kungenzeka ukuba nemithambo eyodwa noma ngaphezulu ivinjelwe ngale ndlela, engaba yingozi enkulu enhliziyweni. Isibonelo, uma izitsha ezimbili zivinjiwe, ukuhlinzwa kuthiwa yi- bypass kabili . Uma izitsha ezine zivinjiwe, ukuhlinzekwa kubizwa ngokuthi yi- bypass encane . Ngakho-ke, ukwehla kwe-quintuple kubonisa ukuthi zonke izitsha ezinkulu ezinhlanu ezinhliziyweni ziyagula.
Kungani Kuvinjelwe Imishanguzo YaseKoronary?
Uma ukuvinjelwa kungathí sina ngokwanele, kungavimbela noma kunciphise ukugeleza kwegazi engxenyeni yenhliziyo edlalwa yisitsha segazi esifile, okwenza ubuhlungu besifuba kanye nokulimala kwemisipha.
Lapho imishanguzo ye-coronary ivinjiwe ngokuphelele, imisipha eyenza inhliziyo ibulawa yomoya-mpilo. Lokhu kunciphisa oksijini kubangela ubuhlungu obukhulu, futhi ukulimala kwenhliziyo okukhulunywa ngayo kubizwa ngokuthi ukuhlasela kwe- heart noma infarction ye-myocardial (MI).
Ukwelashwa kwe-Coronary Artery Disease
Kwezinye izimo, isifo se-aronary coronary singelashwa ngemithi, izinguquko zokuphila ezifana nokudla nokuzivocavoca, nezinqubo ezingenasidingo ezincane, kuhlanganise nokubekwa kwama-stents. Kodwa-ke, kwezinye iziguli, ukuvimbela noma ukuvimbela kunzima kangangokuthi ukuhlinzwa kuyadingeka ukuqinisekisa ukuthi inhliziyo iyaqhubeka nokuthola ukugeleza kwegazi okwanele.
Le nqubo yokuhlinzwa iyayaziwa ngokuthi i- coronary artery bypass ukuhlinzwa kwe-graft (CABG) .
I-Quintuple Bypass
Inqubo ye- CABG ingenziwa njengezinqubo eziphuthumayo, lapho isiguli sifika ekamelweni eliphuthumayo kanye nobuhlungu obuningi besifuba futhi sitholakale sinezinkinga zokuvimbela umcibisholo ezinzima. Ngokujwayelekile, ukuhlinzwa kwe- cardiac catheterization kwenziwa, khona-ke ukuhlinzwa kwe- CABG kulandela uma udokotela ohlinzayo ezwa ukuthi kuyosebenza futhi kuyadingeka ekwelapheni.
Iningi lezinqubo ze-CABG, kuhlanganise ne-quotesple bypass, zihlelwe kusengaphambili. Lokhu kuvumela isikhathi sokuhlolwa kwangaphambi kokuhlinzeka okusiza ukuthi sinqume ukuthi yiziphi izinyathelo ezidingekayo, uma isiguli sinempilo ngokwanele yokubekezelela ukuhlinzwa, kanye nesimo sabo sempilo jikelele.
Lokhu kulinda kunika isikhathi sesiguli ukukhulisa impilo yabo ngaphambi kwenqubo, ngokudla inhliziyo edla ngokudla okunempilo, ukuyeka ukubhema nokuthola ushukela wegazi ngaphansi kokulawula. Lezi zinhlobo zezindlela zingathuthukisa umphumela wokugcina ngemuva kokuhlinzwa futhi kuyithuba elihle lokunciphisa izingozi ezihlobene nokuhlinzwa.
Ukuthola Izitsha ZikaMzi Zesivinini Esine-Quadruple Bypass
Inqubo yenziwa ngaphansi kwe-anesthesia ejwayelekile futhi iqala ngemithwalo yegazi ethathwe kwenye indawo yomzimba, ngokuvamile umlenze, futhi ifakwe emthonjeni wenhliziyo okhona ngaphambi nangemva kokuvinjelwa.
I-quipplepass quintuple idinga izitsha ezingaphezu kwanoma iyiphi enye inqubo, ngakho-ke amasayithi amaningi, kuhlanganise nengalo, i-Left Internal Mammary Artery (LIMA), nezinye izitsha zingasetshenziswa.
Ukuthola izitsha ezifanele zokusebenzisa ama-grafts kungaba yinye yezici ezinzima kunazo zonke zenqubo; uma izitsha ezinhliziyweni zigula, kungenzeka ukuthi izitsha kwezinye izifunda zomzimba nazo zithintekile. Lezi zitsha ziyasetshenziselwa igazi elizungeze ukuvinjelwa endleleni eya enhliziyweni, ngegazi ngokwemvelo lihanjiswa ngokuzungezile (lidlule) ingxenye evinjiwe yomkhumbi.
Uma izitsha zidinga ukuthi lezi zihlahla zivunwe, ingxenye yesifuba yokuhlinzwa iqala nge-sternotomy, ukuvuthwa okuvula isifuba futhi kwahlukanisa i-sternum (isifuba) ngesigamu ukuvumela udokotela ohlinzayo ukufinyelela enhliziyweni.
Inqubo ivame ukuqhutshwa "ngepompo" besebenzisa umshini we- cardiopulmonary bypass ukwenza okwesikhashana umsebenzi wenhliziyo namaphaphu, okuvumela udokotela ohlinzayo ukuba ayeke inhliziyo futhi enze ukuhlinzwa ngaphandle kokunyakaza okuqhubekayo kwenhliziyo ukushaya. Kwezinye izimo inqubo isenziwa "off pomp," kodwa lokhu kuvame kakhulu.
> Umthombo:
> Iyini i-Coronary Artery Bypass Grafting? I-National Heart Lung ne-Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/cabg/cabg_whatis.html