Ukwelashwa Okungenanjongo Nokulondolozwa Kwegazi

Indlela futhi kungani iziguli zikhetha le ndlela yokuhlinzwa

Ukulondolozwa kwegazi yiqembu lamasu asetshenziselwa ukunciphisa isidingo segazi esetshenziselwa ukwelashwa kwesimo sempilo. Kubantu abafuna ukuhlinzwa ngaphandle kwegazi, okuyinto noma iyiphi inqubo yokuhlinzeka lapho kungekho khona imikhiqizo yegazi engaphandle kwesiguli isetshenziswa, ukulondolozwa kwegazi kuyadingeka.

Izindlela eziningi zokulondoloza igazi zifanelekile noma ubani ofuna ukunciphisa amathuba okudinga igazi ngesikhathi noma emva kokuhlinzwa kwabo.

Okwenza Ukugcinwa Kwegazi Kuqala KuLabhu

Igazi elinikelwe ngumthombo oyigugu. Nsuku zonke uhlelo luxhomeke ekuphepheni kwabantu abazimisele ukunikela ngokubili isikhathi sabo kanye negazi labo ukusiza abanye. Ukunciphisa ukuchithwa kwegazi kunengqondo futhi kuqala ngokuqoqwa nokusetshenzwa kwegazi.

Ngandlela-thile, amasu okulondolozwa kwegazi ezingeni lebhange legazi ayenengqondo: sebenzisa igazi ngaphambi kokuba liphelelwe yisikhathi ngakho akudingeki lilahlwe, kuthuthukiswe ukuphathwa kwegazi ukuze kungabi nesizathu sokuyilahla, futhi jikelele, uphathe igazi njengezinto eziyigugu okuyiyo.

Ngokuvikela igazi elinikeziwe, sinamathuba amaningi okuba negazi elanele uma umuntu (noma abantu abaningi) enesidingo sokumpontshelwa okuncane noma okukhulu.

Izizathu Iziguli Ezikhetha Ukulondeka Kwegazi Nokuhlinza Ngegazi

Kunezizathu eziningi zokuthi kungani umuntu angakhetha ukungamukeli igazi noma imikhiqizo yegazi evela kumnikeli, futhi kunezizathu ezingaphezu kwalokho ukuthi kungani ukugcina igazi kuhlakaniphile ngombono osebenzayo.

Kunengqondo kakhulu ukugwema ukumpontshelwa uma kunokwenzeka, njengoba kunezingozi kungakhathaliseki uhlobo lomkhiqizo wegazi olunikeziwe.

Ukongiwa kwegazi ezingeni lokunakekelwa kwezempilo kuthatha izinhlobo eziningi, futhi izizathu zokugwema igazi zihluka phakathi kwabantu. Ezinye izizathu ezivamile zihlanganisa:

• Inkolo: Ezinye izinkolo, kuhlanganise noFakazi BakaJehova, ziyakuvimbela noma zidikibe igazi.

• Ukugwema izingozi zokumpontshelwa igazi : Mayelana no-1 kuzo zonke iziguli ezingu-2,000 ezithola ukumpontshelwa igazi kuzokwandisa ukutheleleka kwebhaktheriya kusukela kulokhu kugonywa, futhi isiguli esisodwa ku-100 sizokhula nomkhuhlane ekuphenduleni ukumpompela. Nakuba kungavamile, kulinganiselwa ukuthi ku-1 000 ku-600 000 iziguli ezifakwe igazi ezizobulawa ngenxa yokumpontshelwa igazi, ngokuvamile ngemva kokubulawa kwesifo sofuzo okuthiwa i-anaphylaxis. Iningi labantu abanokumpontshelwa igazi alikho izinkinga ezivela kule nqubo.
• Ukukhathazeka ngezifo ezithathelwanayo: Nakuba ukunikezwa kwegazi e-United States kuphephe ngokweqile, kuye kwaba khona abantu esikhathini esidlule ababenesifo sofuba nesandulela ngculaza ngegazi . Izifo ezinzima ezibangelwa ukumpontshelwa yizinto ezingavamile kakhulu. Amazwe amaningi anegazi eliphephile ngokulinganayo, kodwa kunamazwe amaningi angenayo izilawuli ezifanele zekhwalithi endaweni ukuvimbela ukutheleleka.
• Ukusabela okumpompela kwangaphambili: Abantu abaye babhekana nokumpompela okukhulu emva kokuphathwa kwegazi esikhathini esidlule angeke bakwazi ukubekezelela ukumpontshelwa igazi, kungakhathaliseki ukuthi bangadingeka kangakanani. Uma i-anaphylaxis, isifo esasongela ukuphila, esenzeka ngenxa yokumpontshelwa igazi isiguli singase sitshelwe ukuthi singamukeli ukumpontshelwa esikhathini esizayo.

Abantu Abakhulu Okungenzeka Bakudinga I-Transfusion Ngesikhathi Sokuhlinzwa

Izinhlobo ezithile zokulimala, izimo zezokwelapha nemithi, zingandisa amathuba okuthi isiguli sidinga ukumpontshelwa ngesikhathi noma emva kwenqubo yokuhlinzwa. Izinhlobo eziningi zokuhlinzwa zibangelwa ukulahleka kwegazi okuncane, kodwa abanye baziwa ukuthi badinga ukudluliselwa njalo.

• Ubudala: Umdala omdala kungenzeka ukuthi udinga ukumpontshelwa ukudlula isiguli esincane.
• I-anemia : Isiguli esinezinga elinciphile lamaseli abomvu egazi, kungakhathaliseki isizathu, cishe lifuna ukudluliselwa ngesikhathi noma ngemuva kokuhlinzwa.
• Iziguli ezithinta igazi: Le mithi ivimbela ama-blood clots kodwa futhi iholela ekuphuzeni okukhulu ngesikhathi sokuhlinzwa. Bavame ukumiswa ngaphambi kokuhlinzwa okuhleliwe.

• Ukubuyela ku-OR: Iziguli ezenza ukuhlinzwa kwesibili ukulungisa izinkinga emva kwenqubo yamuva.
• Ukuhlinzwa okuphuthumayo : Ukuhlinzwa okungahlelelwe futhi okungalindelekile kuvame ukwenziwa kuphela ngenxa yokugula okusongela ukuphila, ukugula kakhulu kwandisa izinga lokubeka ingozi kunoma yikuphi ukuhlinzwa kanye nengozi yokuphuma kwegazi.
• Izimo zempilo ezinzima noma eziningi ngaphezu kwesizathu sokuhlinzwa.
• Vula ukuhlinzwa kwenhliziyo okudinga ukusetshenziswa komshini we-heart-lung bypass.
• I-Cancer: Ezinye izinhlobo zomdlavuza zinganciphisa ikhono lomzimba lokukhiqiza amangqamuzana egazi abomvu, kanti amanye anciphisa ikhono lomzimba lokwenza izimbangela zesibindi esibindi - okuvumela igazi ukuba liguqulwe ngenkathi liphuma.
• Ukuhlinzeka ngengozi : Ukulimala okubangelwa umthelela omkhulu, njengengozi enkulu yemoto, ngokuvamile kuholela ekuphumeni okwedlula ukwedlula ezinye izinhlobo zokulimala.
• Iziguli ezine-disorder clotting

Indlela Yokukhetha Ukulondolozwa Kwegazi Nokuhlinza Ngegazi

1. Tshela udokotela wakho odokotela. Uma unqume ukugwema noma ukuncipha ukumpontshelwa ngenkathi usuhlinzwa kufanele uxelele udokotela ohlinzayo kanye neqembu elihlinzayo ngokushesha ngangokunokwenzeka, okungcono uma uqala ukuxoxa ngokuthi kungenzeka ukuhlinzwa. Uma udokotela wakho ohlinzayo engakwazi ukwenza ukwelashwa ngaphandle kwegazi, cela ukudluliselwa kulowo ongakwazi.
2. Thola Isibhedlela Sakho. Akuzona zonke izibhedlela ezihlinzeka uhlelo olugcwele lokulondeka kwegazi noma ukuhlinzeka ngaphandle kwegazi. Nakuba izindlela eziningi ezisetshenziselwa ukunciphisa amathuba okumpompela kungenzeka ezindaweni eziningi, amasu okuhlinza ngaphandle kwegazi ayitholakali yonke indawo. Isibonelo, ukufakelwa kwesibindi kuyatholakala ezibhedlela eziningi ezinkulu ezweni lonke, kodwa izibhedlela ezimbalwa kakhulu ziyakwazi ukufaka ukufakelwa okungenasici kwegazi.
3. Bhala imibono yakho. Uma usuqala esibhedlela lapho uzohlinzwa khona, kuzodingeka uqedele iphepha elibhalisa izifiso zakho uma ukhetha ukunciphisa yonke imikhiqizo yegazi ngenkathi usesibhedlela. Leli fomu uhlobo lomyalelo ohambile. Khumbula ukuthi isiguli sinelungelo lokunqaba ukwelashwa kwazo zonke izinhlobo, hhayi nje ukuphathwa kwegazi.
4. Bhalisa kusenesikhathi. Kuthatha isikhathi ukuhlela ukuhlinzwa ngaphandle kwegazi. Into elula njengokuphatha ukunakekelwa kwe-anemia yensimbi ekulungiseni ukuhlinzwa ingathatha amaviki ayisithupha kuya kwangu-12, uma isimo singekho. Uma i-anemia iphathwa, isiguli singadinga amasonto engeziwe ukuze igazi lidonsa futhi ligcinwe ukukhishwa kwamandla esikhathini esizayo. Lokhu kubizwa nge- autologous igazi . Okokugcina, uma kugcinwa igazi elanele, umzimba udinga isikhathi sokubuyiselwa nokuvuselela izitolo zegazi.

• Thola ukuthi kukhona yini umxhumanisi wokuhlinza ngaphandle kwegazi endaweni lapho uzobe uhlinzwa khona. Lo muntu angasiza ukuhlela ukunakekelwa okudingekayo phakathi nakho konke ukuhlinzwa okuhlangenwe nakho.

Ukulondolozwa Kwegazi Ngaphambi Kokuhlinzwa

Ukuhlela kubalulekile ngaphambi kokuhlinza ngaphandle kwegazi. Ukuze isiguli sikwazi ukubekezelela ukuhlinzwa ngaphandle kwegazi, kumele sibe sesimweni esingcono kakhulu esingokomzimba ngaphambi kwenqubo. Lokhu kusho ukuthi ube negazi eliphilile ukuze umzimba ukwazi ukubekezelela ukulahlekelwa igazi ngesikhathi sokuhlinzwa.

Le nqubo iqala ngokuhlola igazi lesiguli ukuze ikhwalithi yegazi ingathuthukiswa, uma kunesidingo, nokulahleka kwegazi okungadingekile kungavinjelwa. Uma isiguli sinqume ukuba ne-anemic, okusho ukuthi sinamaseli amasha aphindaphindiwe wegazi, isizathu sokuthi leyo-anemia idinga ukunqunywa futhi isimo silungiswe uma kungenzeka. Lokho kungase kusho ukuguqulwa kokudla kanye nezithako noma ukuhlolwa kwezokwelapha esizayo. Isitokisi singase sihlolwe igazi ukuze siqiniseke ukuthi akukho igazi elahlekile endleleni yokugaya. Abesifazane abanesifo esinzima sokuphuma esikhathini bangathunyelwa kumchwepheshe ongasiza ekunciphiseni ukulahleka kwegazi nemithi noma inqubo uma kunesidingo.

Uma igazi ludonselwa ukuhlolwa kwebhu, amanani amancane kunejwayelekile avame ukudonsa, ngezinye izikhathi besebenzisa izinto zokuhlola kanye nemishini ehloselwe izingane ezincane. Izingane ezisanda kuzalwa azikwazi ukubekezelela igazi elikhulu elithathwa njalo, ngakho-ke izivivinyo zenzelwe ukuthi zisetshenziswe igazi elincane kakhulu kunelabo asetshenziswa abadala.

Uma igazi lingase lidingeke ngesikhathi sokuhlinzwa, isiguli singakwazi "ukunikela" igazi labo, bese ligcinwa ukuze litholakale kamuva ngesikhathi sokuhlinzwa kwesiguli. Iziguli ezikhathazekile ngezingozi zokumpontshelwa igazi kodwa azikho ukuphikisana nokumpompela ngokujwayelekile zingamalungu omndeni anikeze igazi lawo ngenqubo yesikhathi esizayo.

Kwezinye izimo, kunikezwa imithi yokwandisa inani lamaseli abomvu abomvu ngaphambi kwenqubo. Le mithi, kuhlanganise i-erythropoietin, ingaba eqolo kakhulu futhi ngokuvamile igcinelwe iziguli ezine-anemia ezingaphenduli kwezinye izinhlobo zokwelapha.

Ukulondolozwa Kwegazi Phakathi Nokuhlinzwa

Udokotela ohlinzayo owazi kahle ekuhlinzeni ngaphandle kwegazi futhi onolwazi ekusetshenzisweni kwamasu okulondoloza igazi asetshenziswe ngaphambi, ukuhlinzwa ngesikhathi nangemva kwalokho yingxenye ebaluleke kunazo zonke yokuphumelela kokuphumelela kwegazi. Izinguquko ezincane kumasu okuhlinzeka zingakhokha izibusiso ezinhle ngokulahlekelwa igazi. Isibonelo, ukusika izicubu nge-scalpel kuholela ekusenikeni, ngakho-ke lapho kungenzeka khona idivayisi ye-cautery kagesi, eyanqunywa kodwa futhi isebenzisa ukushisa ukuyeka ukuphuma kwegazi, kuvame ukusetshenziswa.

• Izinqubo ze-Robotic: Ukuhlinzwa okuningi kungenziwa ngokusebenzisa ubuchwepheshe be-robotic, okungase kunciphise inani lokuphuma kwegazi elilindeleke ngesikhathi sokuhlinzwa.
• Amasu amancane amancane: Ukuhlinzeka nge-Laparoscopic kusebenzisa ukucubungula okuncane kakhulu ukwenza inqubo esikhundleni sokuzibandakanya okukhulu okujwayelekile okuye kwasetshenziswa. Le nqubo entsha kodwa manje ejwayelekile ngokuvamile iyanciphisa ukuphuma kwegazi ngokuphawulekayo phezu kwamasu asekudala "avulekile".
• Umsizi weselula: Le idivayisi evumela ukuthi udokotela ohlinzayo aqoqe igazi elahlekile endaweni yokuhlinzeka ngesikhathi sokuhlinzwa. Emva kokuqoqwa kuphathwa ngegazi elincane ukuvimbela ukugaya futhi uma kufanelekile igazi lingabuyiselwa isiguli njengokumpompela.
• Ukulondoloza ukushisa kwesiguli: Amakamelo amaningi okusebenza ayapholile, futhi ngenxa yokushisa kwamakamelo kanye nokuhlala kakhulu ngesikhathi sokuhlinzwa, izinga lokushisa lomzimba wesiguli ngokuvamile liyancipha ngesikhathi sokuhlinzwa. Lokhu kwehla ekushiseni komzimba kungaholela ekukhuleni okwandayo ngakho kwenziwa imizamo yokugcina izinga lokushisa kwesiguli endaweni ejwayelekile.
• Ukubekwa kwesiguli: Indlela isiguli esibekwa ngayo etafuleni egumbini lokusebenza lingathonya ukuthi kuvela kangakanani ukuphuma kwegazi. Isikhundla esihle sihlukahluka kuye ngokuthi ukuhlinzwa kwenziwa.
• Imithi yokwehlisa ukuphuma kwegazi: Kukhona imithi enganikezwa ukuvimbela nokunciphisa ukuphuma kwegazi, njenge-tranexamic acid. Imithi eyenza ukwanda kwegazi nayo igwenywe.
• Ukwelapha ukuchotshozwa: Ukunciphisa ukuphuma kwegazi endaweni yokuhlinzeka, izinamathisela zomzimba zingasetshenziswa ekukhunjweni njengephunga noma uketshezi. Ama-adhesives akhuthaza igazi esiteshini ukuze livale futhi liyeke ukuphuma ngegazi ngokushesha.

Ukulondolozwa Kwegazi Ngemva Kokuhlinzwa

Ngesidingo, ukubekezelelana kwezinga eliphansi le-hemoglobin (izinombolo ezincishisiwe zamaseli abomvu obomvu) kuyadingeka emva kokuhlinzwa ngaphandle kwegazi. Lokho akusho ukuthi ukuphuma kwegazi kuyothathwa futhi kungaphathwa kabi uma kukhona ukuphuma ngemuva kwenqubo, kodwa kusho ukuthi impendulo evamile ekulahlekelweni kwegazi ingase ihluke.

Ukukhipha igazi kuzokuphathwa kabi ngenhloso yokumisa ukulahleka kwegazi. Isibonelo, ukuqhuma okuqhubekayo ukuphuma emva kokuhlinzwa kungase kuphuthwe ngokushesha usebenzisa iziqu zomzimba ukuze kukhuthazwe ukucindezela, ukucindezelwa kubanjwe phezu kwenqwaba yokunciphisa ukuphuma kwegazi futhi kuqaphelisise noma yiziphi izimpawu ukuthi isiguli sidinga ukubuyela ku-OR ukuthola ukuthi igazi livela.

Izingozi Zokuhlinza Ngaphandle Kwegazi

Ukulondeka kwegazi kunezingozi ezimbalwa, njengoba umqondo nje ukunciphisa inani legazi elisetshenziselwa ukwelashwa kwesiguli. Ukuhlinzwa ngaphandle kwegazi, noma kunjalo, kunezingozi, eziningi zazo ezivamile kubantu abanesifo semfuyo.

Abantu abane-anemia, kungakhathaliseki ukuthi i- anemia ngenxa yokulahlekelwa kwegazi ngesikhathi sokuhlinzwa noma esinye isizathu, bangase bazizwe izimpawu zokuntula i-anemia: ubuthakathaka, ukukhathala, ukuphathwa ikhanda nokungahambisani nokuzivocavoca. Uma izinga liphansi ngokwanele ukuthi lizophathwa ngokumpompela, ukuphulukiswa kuzokwenzeka kancane kancane kunomuntu onamazinga anempilo. Ezimweni ezinzima ze-anemia, njengamazinga amangqamuzana egazi elibomvu elibonakalayo lapho isiguli siphume kakhulu, ingozi yokufa ingokoqobo. Ngenhlanhla, ubungozi bokufa buhlala buncane kubantu abahlinzeka abaningi abangenasici.

Amazwi ambalwa mayelana nokulondolozwa kwegazi nokuhlinza okungenanjongo

Kungenzeka ukuthi amanye amasu asetshenziselwa ukuvimbela isidingo sokumpontshelwa okuhlangene ngqo ezigulini ezizimisele ukungenaki igazi ngesikhathi sokuhlinzwa zizoqala indawo evamile kuzo zonke iziguli ezilindele ukuhlinzwa. Lokhu kungenxa yokuthi lezi zindlela (ikakhulukazi) ziyasebenza kalula futhi zinganciphisa ingozi enkulu ukuthi isiguli sibheke uma ukugonywa kungagwenywa.

> Imithombo:

> Ukumpontshelwa Igazi Nokumelana Negazi Ekuhlinzekeni Kwezinhliziyo: I-Society of Thoracic Surgeons ne-Society of Cardiovascular Anesthesiologists Guideline Practice Guideline. I-Society of Thoracic Surgeons I-Blood Conservation Guideline Task Force. http://www.sts.org/sites/default/files/documents/pdf/BloodConservationGuidelinesFINAL.pdf.

> Ukulondeka kwegazi: Preoperative Autologous Blood Donation. http://www.uptodate.com/contents/surgical-blood-conservation-preoperative-autologous-blood-donation?source=see_link.