Ukususa inhliziyo - ukuthi kuyini nokuthi kungasiza kanjani - imibuzo ebalulekile kubantu abanesifo senhliziyo . Njengoba isifo esinjalo, lo msebenzi ungaba yithemba elilodwa lomsebenzi ogcwele.
I-heart overpass - yimuphi lo msebenzi?
Eminyakeni engaba ngu-45 edlule, akekho owake waba nombuzo: ukugwema inhliziyo - kuyini nokuthi kwenzekani? Ukuthuthukiswa kokuqala kwalesi siqondiso, okwenziwa yi-Soviet scientist-cardiac ohlinzayo uColesov VI, kwaba nokungabaza ngisho nokuzingelwa. Ukusikisela kwesosayensi ukuthi ngosizo lwe-shunt kungenzeka ukudala umsebenzi wokushintsha izitsha ezithinteka yi-atherosclerosis kubonakala sengathi zihle kakhulu. Ukuhlinzeka ngokuhlinzwa kwenhliziyo e-Aortocoronary manje kusindisa amashumi ezinkulungwane zempilo njalo ngonyaka. Ukusebenza kuyathandwa futhi kuyasebenza, ngakho-ke kuqhutshwa emazweni amaningi emhlabeni.
Ukuqonda umbuzo: ukugxilisa inhliziyo - ukuthi yini nokuthi yikuphi, umuntu kufanele acabangele injongo yakhe. Ukusetshenziswa kusetshenziselwa izifo ezilimaza imithwalo yegazi futhi ziphule ukugeleza kwegazi. Okubalulekile kokungenelela kubangelwa ukudala indlela entsha yokugeleza kwegazi, okuzofaka endaweni engathintekayo ingxenye yesitja. Ngalesi sizathu, kusetshenziselwa ukuvinjelwa okwenziwa emithanjeni yesiguli noma emithanjeni. Ukuvinjelwa kusuka emithanjeni kulula ukudala, nakuba kungaphansi kokuthenjelwa futhi kungavalwa inyanga ngemuva kokusebenza. Kungcono ukusebenzisa izinyathelo zomzimba, kodwa lokhu kusebenza kunomsebenzi wezobuchwepheshe futhi akunakwenzeka ngaso sonke isikhathi.
Izinkomba ze-coronary bypass
I-cholesterol igxile ezindongeni zezitsha iholela ekunciphiseni kwesibani somkhumbi. Ngenxa yalokho, igazi liza ezithombeni ngokulingana okwanele. Uma isibani somkhumbi we-cardiac muscle sincane, singabangela ukungena kwe- angina ne- myocardial infarction. Ukwandisa isibani semikhumbi, ukwelapha izidakamizwa, i-coronary angioplasty, nokugcoba. Uma isimo sinzima, odokotela abahlinzayo benhliziyo bangasebenzisa ukuhlinzwa. Ukuhlanganiswa kwe-aortocoronary bypass kuboniswa kumacala anjalo:
- i-angina enamandla, lapho isiguli singakwazi ukukhonza khona;
- izinkinga ezinezakhi eziningi ze-coronary ngesikhathi esisodwa (ezingaphezu kwezingu-3);
- ukwehlukaniswa kwemikhumbi ye-coronary kudlula u-75%;
- ukuhlanganiswa kwe- atherosclerosis nge- aneurysm yenhliziyo.
Kungani kuyingozi ukweqa inhliziyo?
Kanye nombuzo: ukugxilisa inhliziyo, ukuthi kuyini, ngokuvamile kuvame umbuzo mayelana nokuphepha kwalendlela. Uma odokotela bezinyanga zokuhlinza bebuzwa ukuthi kuyingozi yini ukweqa inhliziyo, bayaphendula ukuthi akuyona into eyingozi ngaphezu kweminye imisebenzi. Nakuba lolu hlobo lokuhlinzeka ngokuhlinzwa luyinkimbinkimbi, intuthuko yesimanje kwezokwelapha nobuchwepheshe yenza kube lula ukuyenza ngendlela ephephile ngangokunokwenzeka. Esikhathini se-postoperative, ingozi yezinkinga ikhuphuka kwiziguli ezinokubambisana okunjalo:
- ukukhuluphala;
- isifo sikashukela mellitus;
- izinga eliphezulu le-cholesterol eyingozi;
- umfutho wegazi ophezulu;
- isifo esinzima sezinso.
Ngokuya ngekhwalithi yokusebenza okwenziwe kanye nempilo yonke, izinkinga zingenzeka ngezikhathi ezithile: ukuvuvukala nokubomvu emgodleni, ukuphuma kwegazi, ukuhlasela kwenhliziyo. Izinkinga ezingavamile kakhulu kodwa ezinokwenzeka zibandakanya:
- i-pericarditis - inqubo yokuvuvukala enkundleni ye-serous yenhliziyo;
- ukwehluleka kwenhliziyo yesigqi;
- ukuhluleka kwenhliziyo enzima;
- i-phlebitis - ukuvuvukala kwezindonga ze-vein;
- ukushaywa;
- I-Pleuritis - ukuvuvukala kwesikhala sephunga;
- ukwehla ku-lumen ku-shunt.
Inhliziyo iyahamba - bangaki abaphila ngemva kokusebenza?
Iziguli ezitholwe ukuhlinzwa kwenhliziyo zihlala zinesithakazelo ukuthi bangaki abaphila ngemuva kokuhlinzwa kokuhlinzwa komzimba. Odokotela-odokotela abahlinzayo benhliziyo bathi isibalo esiphezulu seminyaka engu-15, kodwa ucacise ukuthi esikhathini esizayo konke kuncike kwisiguli nesimo sempilo yakhe. Nge-shunt yekhwalithi nokuhambisana nazo zonke izincomo, isiguli singaphila iminyaka engama-20-25. Ngemuva kwalokhu, ukuguqulwa kwe-coronary yenhliziyo kungadingeka futhi.
Inhliziyo idlula kanjani?
Ngaphambi kokuhlinzwa, isiguli sithinteka, i-tube itholakala ku-trachea ukulawula ukuphefumula, futhi isilondolozi sifakwa esiswini ukuze sigweme ukukhipha okuqukethwe kwe-esiswini kumaphaphu.
Okuqhubekayo ngezigaba ze-coronary bypass:
- Isifuba sivuliwe.
- Ekusebenzeni ngenhliziyo engenalutho, ukusabalalisa kwegazi okufakelwayo kuxhunyiwe, futhi uma isebenza, isifunda esinqunyiwe sisungulwe.
- Thatha umkhumbi ozosebenza njenge-shunt.
- Omunye umkhawulo womkhumbi uxhumeke e-aorta, enye eya emgodini we-coronary ngaphansi kwesendaweni ethintekile.
- Hlola ikhwalithi ye-shunt.
- Vala idivayisi yokujikeleza okufakelwayo.
- Sula le thorax.
I-Coronary igxila enhliziyweni
I-artery Coronary bypass grafts yinto yokusebenza ehilela ukusebenza okuyinkimbinkimbi nokude. Iningi lalezi zenzo zenziwa ngenhliziyo engeyona ukusebenza kanye nokusetshenziswa kwesistimu yokujikeleza yokufakelwa. Le ndlela ibhekwa njengendlela ephephile futhi eyamukelekile kunokuhlinzwa okuhlinzekwa inhliziyo, kodwa yandisa ingozi yokucindezeleka. Ukusetshenziswa kwedivayisi kungabangela ukusabela okunjalo komzimba:
- i-edema yamapulmari;
- izinkinga ze-hematological;
- ukuqubuka kwezinso nezitsha zobuchopho;
- ukungabi khona kwe-oxygen emsebenzini wezitho.
Ukuhlinzeka nge-Aortocoronary bypass enhliziyweni yokusebenza
I-aortocoronary bypass ngaphandle kokujikeleza okufakelwayo ivumela ukugwema izinkinga ezibangelwa ukusetshenziswa kwedivayisi yezokwelapha. Ukusebenza ngenhliziyo yokushaya kudinga ulwazi olujulile kanye nekhono elivela kumhlinzeki ohlinzayo. Ukuvuthwa kwamathambo e-coronary kwenziwa ngokwezimo zomzimba zenhliziyo, okunciphisa ingozi yokucindezeleka emva kwe-postoperative, okusheshisa ukutakula nokukhipha isiguli esibhedlela.
I-coronary bypass ngaphandle kokuvula kwe-thoracic
Ukuhlinzwa kwe-cardiac yomsindo we-cardiac kwenziwa ngaphandle kokwehliswa ubuqotho besifuba. Lezi zenzo zanamuhla futhi ziphephile futhi zivamile emitholampilo yaseYurophu. Ngemuva kokusebenza okunjalo, isilonda siphulukiswa ngokushesha futhi umzimba ubuyiselwe. Okuyinhloko yendlela yokwenza ukungenelela okuhlinzekwa ngokuhlinzekwa okuncane emthombeni. Ukwenza umsebenzi onjalo, kuyadingeka inqubo ekhethekile yokwelapha evumela ukuphathwa okuqondile ngaphakathi komzimba womuntu.
Ukuvuselelwa emva kokuhlinzwa kwe-carpass bypass
Ukukhuluma ngalokhu: ukuvala inhliziyo, ukuthi kuyini, odokotela basithinta ngokushesha isikhathi sokuvuselelwa, lapho izinga lokutakula lendoda lithembele khona.
Ukuvuselelwa emva kokuhamba komzimba kuhilela isenzo semisebenzi kanye nemisebenzi:
- Ukuzivocavoca umzimba. Yenziwe kusukela ezinsukwini zokuqala ngemva kokusebenza. Ibonisa usizo lokubuyisela umsebenzi wephaphu.
- Umsebenzi womzimba. Qala ngezinyathelo ezimbalwa esigceme phakathi nezinsuku zokuqala zokuthutha futhi kancane kancane ube nzima kakhulu.
- Inhalation ngosizo lwe-nebulizer nge-add bronchodilators noma ama-mucolytics.
- I-laser intravenous noma i-ozone therapy.
- Izinhlobo ezahlukene zokusikhipha.
- I-Ultravonotrophy ne-Pantovegin noma i-Lidase.
- I-Magnetotherapy yomthelela ezingxenyeni zomngcele.
- Amanzi okugeza abiziwe.
I-coronary artery bypass grafts - isikhathi se-postoperative
Ngemuva kokuhlinzwa enhliziyweni, isiguli siqashwe ngokucophelela izinyanga ezingu-2-3. Isiguli singahlala esiqenjini sokunakekelwa okujulile kwezinsuku eziyishumi zokuqala, okuxhomeke ekuvinjeni kokuphumula, inhlalakahle nokungabi khona kwezinkinga. Esikhathini lapho i-anesthesia isebenza kahle, isiguli sigxilwe yimilenze ukugwema ukunyakaza okungazelelwe okuyingozi. Amahora okuqala ngemva kokuhlinzwa isiguli singaphefumula ngosizo lwedivayisi, esuswa ngokuphela kosuku lokuqala.
Esibhedlela, amalunga asetshenzwa nsuku zonke futhi isimo sabo sihlolwe. Ubuhlungu obuncane, ubomvu kanye nomuzwa wesikhumba sesikhumba esakhiweni somthunzi zivamile kule nkathi. Uma umthambo we-coronary ukwedlula ukuhlinzekwa kwe-graft waphumelela, ke ngosuku lwesishiyagalolunye nesikhombisa isiguli sisusiwe kusuka ku-sutures. Ngemva kwalokhu isiguli singavunyelwa ukugeza. Ukuze kube lula ukuphulukiswa kwamathambo e-sternum, isiguli sinconywa ukuba sigqoke i-corset izinyanga eziyisithupha, ukulala phakathi nale nkathi kungenzeka kuphela ngemuva.
Ukuphila emva kokuhlinzwa kokuguqulwa kwe-coronary
Umthambo we-coronary overpass grafting ubhekwa ngempumelelo uma isiguli sibuyela esimweni esivamile sokuphila ngemva kwezinyanga ezimbili.
Isikhathi kanye nekhwalithi yokuphila kuyoxhomeka ekuthobeleni udokotela kadokotela:
- Thatha imishanguzo enqunywe udokotela futhi ungenzi imithi.
- Ungabhemi.
- Yamukela ekudleni okunconywayo.
- Ngemuva kokusebenza kokugubha, futhi kanye ngonyaka ngiphatha ukwelashwa endaweni yokuhlanza.
- Yenza umsebenzi oyenzekayo, ugweme ukukhululeka.
Ukudla ngemuva kokuhlinzwa kokuhlinzwa komzimba
Esikhathini sokuhamba emva kwesikhathi, iziguli ezithola umthambo we-coronary bypass ukuhlanganiswa kufanele ziqaphe ngokucophelela ukudla kwazo. Kule nkinga, kuncike eminyakeni engakanani yokuphila abangayiphila ngayo. Ukudla kufanele kuklanyelwe ngendlela yokuvimbela ukubonakala kwesisindo esiningi nokufakwa kwe-cholesterol eyingozi ezindongeni zezimpahla.
Ngemuva kokuhlinzwa, iziguli zeluleka ukulandela iseluleko esinjalo:
- Nciphise inani leshukela, lithathe esikhundleni se-stevia.
- Imikhiqizo yobisi kufanele ibe namafutha aphansi.
- Kusukela kulesosi kunesidingo sokwenza okuthandwa yizinyosi zokudla kanye ne-tofu.
- Kusuka inyama, inyama ye-soy, inkukhu emhlophe, i-turkey, ne-low fat fat.
- Izitshalo zingaba manga kodwa ilayisi.
- Ngaphezu kwalokho, sebenzisa amafutha wezinhlanzi.
- Kusukela ezinhlanzi, ungadla izinhlanzi ezinamafutha aphansi namanye ama-medium.
- Ngamafutha, kuyadingeka ukuyeka konke kodwa amafutha omnqumo anamanzi omnqumo abandayo acindezelekile.
- Kutuswa ukunciphisa inani losawoti.
- Kuyasiza ukudla imifino nezithelo ezintsha.
Imenyu eseduze nsuku zonke
- Ukudla kwasekuseni - i-omelet yamaqanda okwenziwa abamhlophe, isaladi lesithelo kanye ne-yogurt engenamafutha.
- Isidlo sasekuseni sesibili sinama -cottage cheese angenamafutha.
- Isidlo sesinkwa semifino esinompheme omnyama omisiwe, isitshalo semifino.
- Ama- apula asezinyosi.
- Isidlo - ama-pancake avela emifino, izinhlanzi ezinamahloni ezinhlobonhlobo ezinamafutha aphansi noma inyama yenkukhu emhlophe.