I-Quadruple Bypass ichazwe
I-overpass esinezinhlamvu ezine- inhliziyo evulekile yenqubo yokuhlinzeka eyenziwe ukuthuthukisa ukugeleza kwegazi okudla inhliziyo. Abantu abaningi bathola ukuthi banesifo senhliziyo-nesidingo sokuhlinzwa-ngemva kokuzwa ubuhlungu besifuba, ukuphefumula, noma izimpawu ezivamile njengengalo noma ubuhlungu bomhlathi.
Ukuze uqonde ngempela ukuthi kusho ukuthini ukuguqulwa kwe-quadruple, kubalulekile ukuqonda isisu senhliziyo nemiphumela yesifo senhliziyo.
I-Anatomy yenhliziyo
Imithambo ye-coronary yiyona imithwalo yegazi enikezela inhliziyo ngegazi layo; lezi zihlukile kunezitsha ezihlinzeka ngegazi ziphethwe yinhliziyo .
Ukuze kucace, inhliziyo iqhuma igazi kuwo wonke umzimba ngokusebenzisa iziphazamiso zomzimba ezigcina igazi lihamba. Inhliziyo, njengezo zonke izicubu zomzimba womuntu, idinga ukondliwa oksijini kanye nezakhi ezivela egazini. Izindwangu zegazi ezondla inhliziyo lokho okudingayo zibizwa ngokuthi imishanguzo ye-coronary futhi usayizi wabo omncane ungabasiza ukuba bavale kalula nge-plaque.
Siyakhathalela imishanguzo ye-coronary kakhulu ngoba, kwabanye abantu, imishanguzo ye-coronary ivinjelwe-isimo esaziwa ngokuthi isifo somzimba we-coronary-lapho i-plaque ikhiqiza khona esikebheni segazi.
Uma ukuvinjelwa emthonjeni we-coronary kunzima, kungavimbela ukugeleza kwegazi endaweni yengane edlalwa yisitsha segazi esigulayo, esibangela ubuhlungu besifuba, owaziwa nangokuthi angina.
Uma ukuvinjelwa kunzima ngokwanele futhi ukugeleza kwegazi kukwehla ngokuphawulekayo noma kumiswe ngokuphelele, ukuhlaselwa kwenhliziyo ngokuvamile kuwumphumela. Kungenzeka ukuthi ube nemithambo eminingi evinjiwe ngale ndlela, engaba yingozi enkulu enhliziyweni.
Ukuphambana kwe-quadruple kwenziwa uma izitsha ezine zegazi zivinjelwe futhi zidinga ukuba zithathwe.
Lokhu kusho ukuthi imingcele emine ehlukene idinga igazi ukuze liphinde lizungezwe.
Ukwelashwa Kwama-Coronary Artery Disease
Ezimweni eziningi, isifo se-artery coronary singelashwa ngemithi, izinguquko zendlela yokuphila, nezinqubo ezincane ezingenasidingo ezifana ne-angioplasty. Uma ingenakulingathwa ngezokwelapha ezingavamile noma lezo zokwelapha azivimbeli umonakalo kusuka ekwenzeni inhliziyo, noma ubuhlungu besifuba buqhubeka, ngokuvamile kuvumelekile ukucubungula ukuhlinzwa kokusebenza kwe-coronary bypass.
Ukuhlinzwa kunezingozi ezinkulu kunendlela encane engavamile, kuhlanganise nobungozi obuhlobene ne-anesthesia jikelele kanye nezingozi zokuhlinzwa kwenhliziyo evulekile , ngakho-ke le nqubo ngokuvamile iyindlela kuphela uma lesi sifo sinzima noma singaphenduli kwezinye izinhlobo zokwelashwa. Ukuhlinzekwa kwe-quadruple bypass kuyinkimbinkimbi enzima futhi izingozi zokuhlinzwa zikhuphuka nge-perpass graft ngayinye eyengeziwe.
Isibonelo, ukuhlinzekwa kabili kwe-bypass kunengozi encane kune-triple, futhi kathathu kunengozini encane kune-bypass encane. Nge-bypass ngayinye eyengeziwe eyadingeka ukuthi ukuhlinzeka isikhathi eside, kudinga isikhathi esengeziwe ngaphansi kwe-anesthesia, futhi kwenziwa ukuphatha isifo esibi kakhulu.
Phakathi nokuhlinzwa okuyisishiyagalolunye
Inqubo iqala nge-anesthesia ejwayelekile eyenziwa ngenkathi udokotela ohlinzayo noma omunye umhlinzeki wezempilo, njengomsizi wezokwelapha (PA) eqala inqubo ngokuvuna imithanjeni esuka emaphethelweni emiproseshini ye-bypass.
Ngesikhathi umsizi ephulukisa izitsha-futhi uma beqiniseka ukuthi izitsha zinekhwalithi enhle okumele zisetshenziswe ngesikhathi senqubo-udokotela ohlinzayo we-cardio-thoracic uvula isifuba futhi uqala ukulungiselela inhliziyo ngenqubo.
Udokotela ohlinzayo uzophinde athathe isitsha esingeziwe esivela esifubeni sokunxele ukuze ahlanganise nemithanjeni etholakala emlenzeni, noma kwezinye izimo, izitsha ezivela engalo. Phakathi nokuhlinzwa, izitsha zegazi ezitholakale zihlanganiswa esikebheni senhliziyo esivele ngaphambi nangemva kokuvinjelwa. Akufani nendawo esheshayo ongayithatha ukuze ugweme ingozi, negazi ngokuphindaphindiwe lizungeza ingxenye engavinjelwe yesitsha.
Phakathi neningi lalabo abahlinzayo abane-bypass abahlinzayo, inhliziyo imisiwe ukuze udokotela ohlinzayo asebenze ekuhlosheni okuhambayo. Lokhu kwenziwa ngokusebenzisa umshini we- lung bypass machine , idivaysi yezokwelapha eyinkimbinkimbi ehlinzeka oksijini egazini esikhundleni samapayipi futhi ayiphambele emzimbeni njengoba inhliziyo ingavame ukuyenza. Lo mshini uvumela kokubili izinhliziyo namaphaphu ukuthi kube namanje futhi kwenza kube lula ukuqedela ingxenye yesigcawu sokuhlinzwa ngokushesha.
Ukubuyisela
Ukubuyiselwa ekuhlinzekeni kwenhliziyo evulekile akuyona esheshayo. Usuku lokuqala emva kokuhlinzwa luvame ukusetshenziswa ku-ICU noma insizakalo yokunakekela inhliziyo, lapho isiguli sivunyelwe ukuvuka kancane kancane kusuka ku-anesthesia. Ngokungafani nezinye izinhlobo zokuhlinzwa, isiguli asinikezwa imithi ukuba ivuke ngokushesha futhi esikhundleni sokulala imithi.
Ngokufanelekile, isiguli sizovuka, singenayo umoya futhi sihlezi esihlalweni esingaphansi kombhede ngaphandle kokuhlinzwa kwamahora angu-6 kuya kwangu-12. Lokhu kunganciphisa izingozi zezindaba ezivamile ezifana nama-blood clots kanye ne-pneumonia futhi ukuqala inqubo yokutakula ngokushesha ngangokunokwenzeka.
Iziguli zenhliziyo ezivame ukuchitha izinsuku ezintathu noma ngaphezulu esibhedlela ngaphambi kokuba zikhishwe. Ezinye iziguli zizodinga ukuvuselelwa kwenhliziyo, uhlelo oluhlelekile nolwokuhlola olwenzelwe ukuqinisa inhliziyo. Ukuphumula okujwayelekile kuqhubeka amasonto ayisithupha kuya kwangu-12, futhi iziguli eziningi ziyakwazi ukubuyela emisebenzini yazo evamile ngemuva kokuqedwa kwazo. Kulezi ziguli ezingenakwenziwa emisebenzini yazo ngobuhlungu besifuba noma ukukhathala okubangelwa yisifo senhliziyo, bangathola ukuthi bangakubekezelela kangcono umsebenzi ngemuva kokuhlinzwa kunangaphambili.
Izinzuzo ezinkulu isiguli zizobonakala kakhulu ekupheleni kwesigaba sokubuyisela lapho umsebenzi ungenziwa ngaphandle kobuhlungu noma ubuhlungu obuncane. Kwezinye iziguli imisebenzi elula njengokuhamba yayinganiselwe ubuhlungu ngaphambi kokuhlinzwa futhi ingenziwa ngaphandle kokubuhlungu ngemva kokuhlinzwa. Lokhu akusho ukuthi kulungile ukugijimela emisebenzini ngemuva kokuhlinzwa, kodwa kusho ukuthi abanye abantu bayakwazi ukusebenza ngokugcwele ngemva kokuthola kabusha.
Kubalulekile futhi phakathi nalokhu kuvuselela ukuze usebenze ngentshiseko ekuguqulweni kwendlela yokuphila okuzogcina ama-grafts amasha avule futhi enze kahle. Lokhu kusho inhliziyo yokudla okunempilo , nemingcele yamafutha agcwele kanye ne-cholesterol. Ukuzivocavoca kufanele futhi kufakwe ngaphakathi kokulinganiselwa okunikezwa udokotela ohlinzayo ngesikhathi sokutakula. Ngemuva kokuphothula kuqedile imikhawulo yokudla kufanele iqhubeke, kanye nohlelo lokuzivocavoca.
Izwi elivela
Ukuhlinzwa kwezinhliziyo ezine ngokuphindaphindiwe kuyinkambinkimbi enzima. Udokotela wakho ohlinzayo cishe uyasincoma uma kuzokwenza ngcono kakhulu impilo yakho kanye nekhwalithi yokuphila - futhi izingozi azikho ngaphezu kwemivuzo engaba khona. Kodwa-ke, lokhu kuhlinzeka akuyona isisombululo se-coronary artery disease eyedwa. Ngemuva kwenqubo, kuzodingeka ukuthi usebenzise izinguquko zokuphila ngendlela enempilo ukuze uthuthukise impilo yakho yonke.
Uma usuhlinzwa, izinguquko zendlela yokuphila zingase zibe phezu kokushisa ngemuva uma uzilungisa esimisweni sakho, kodwa ukudla nokuzivocavoca kuyodingeka isikhathi eside.
> Imithombo:
> Iyini i-Coronary Artery Bypass Grafting? I-National Heart Lung ne-Blood Institute.