Tiyeni tiphunzire za 'makina a mtima ndi mapapo' (Cardiopulmonary Bypass) omwe amagwiritsidwa ntchito pochita opaleshoni ya mtima.

Kodi inuyo kapena wina m'banja mwanu mwakonzekera kuchitidwa opaleshoni yaikulu ya mtima? Mwina mwamvapo madokotala akunena kuti mudzalumikizidwa ku "makina a mtima ndi mapapo." Ndizachibadwa kumva mantha pang'ono komanso chidwi mukamva dzina ili. Kodi makina awa ndi chiyani kwenikweni? Amagwira ntchito yanji? Kodi ndi chinthu choopa? Tiyeni tikambirane mwachidule komanso momveka bwino.

Kodi Cardiopulmonary Bypass ndi chiyani?

Mwachidule, iyi ndi makina omwe amagwira ntchito kwakanthawi m'malo mwa mtima ndi mapapo anu. Pa opaleshoni, magazi a thupi lanu amayendetsedwa kudzera mu makinawa m'malo mopita ku mtima ndi mapapo anu. Ndicho chifukwa chake amatchedwa "bypass."

Tangoganizirani, makina awa amatenga ntchito ziwiri zazikulu zomwe mtima ndi mapapo anu amachita panthawi ya opaleshoni:

1. Kuonjezera mpweya m'magazi (nthawi zambiri izi zimachitika ndi mapapo).

2. Kupopa magazi okhala ndi mpweya wambiri m'thupi lonse (nthawi zambiri izi zimachitika ndi mtima).

Mukalumikizidwa ndi makina awa, madokotala amatha kuyimitsa mtima wanu kwakanthawi pokupatsani mankhwala apadera otchedwa ``Cardioplegia''. Kenako, dokotalayo amatha kuchita opaleshoni ya mtima yomwe sikugunda kapena kutuluka magazi mosavuta komanso mosatekeseka. Pakadali pano, chiwalo china chilichonse m'thupi lanu chimalandira magazi ochulukirapo omwe amafunikira kudzera mu makina awa. Madokotala amatchanso mkhalidwewu kuti "pa pampu."

Kodi opaleshoni iyi ndi ya CABG ndi chinthu chimodzi?

Inde, ziwirizi ndi zinthu ziwiri zosiyana. Koma ziwirizi nthawi zambiri zimachitika pamodzi. Anthu ena amasokoneza mawu awiriwa chifukwa onse ali ndi mawu oti "bypass".

• CABG (Coronary Artery Bypass Grafting): Iyi ndi opaleshoni yeniyeni. Pamene mitsempha ya mtima yomwe imapereka magazi kumtima yatsekedwa ndi mafuta ambiri, njira yatsopano (bypass) imapangidwa kuti idutse kutsekekako ndikulola magazi kuyenda.

• Kudutsa kwa Mtima ndi Mapapo: Iyi ndi njira yomwe imagwiritsidwa ntchito pothandiza dokotala wa opaleshoni panthawi ya opaleshoni ya CABG (kapena opaleshoni ina ya mtima). Imakhala yokhudza kusintha kwa magazi kuzungulira mtima ndi mapapo.

Kodi makina awa amagwira ntchito bwanji?

Kuti timvetse izi, choyamba tiyeni tikumbukire momwe magazi amayendera m'thupi lathu. Magazi omwe alibe mpweya m'thupi amalowa mbali yakumanja ya mtima kudzera m'mitsempha ikuluikulu iwiri (vena cava). Kuchokera pamenepo, magazi amenewo amapopedwa kupita ku mapapo. M'mapapo, magaziwo amadzazidwa ndi mpweya, ndipo magazi odzaza ndi mpweya amabwerera kumbali yakumanzere ya mtima. Pomaliza, mbali yakumanzere ya mtima ndi yomwe imapopetsa magazi oyerawo kupita ku thupi lonse.

Makina opumira a mtima amachotsa chakra iyi kwakanthawi m'thupi.

1. Magazi ena omwe alibe mpweya wabwino amakokedwa mu makina asanalowe mumtima kudzera mu machubu (cannulas).

2. Chigawo chomwe chili mkati mwa makina otchedwa ``Oxygenator'' chimawonjezera mpweya m'magazi.

3. Pampu yomwe ili mumakinayi imalumikizanso magazi okhala ndi mpweya ku mtsempha waukulu (Aorta) womwe umagawa magazi kupita ku thupi pambuyo pa mtima.

Umu ndi momwe thupi limalandirira mpweya mpaka opaleshoniyo itatha.

Kodi njira zotani zomwe zimachitika panthawi ya opaleshoni ndi ziti?

Gulu lachipatala limachita izi mwadongosolo kwambiri. Gulu lomwe lili ndi dokotala wa opaleshoni, katswiri wogonetsa anthu ogonetsa, ndi katswiri wopaka mafuta m'thupi, katswiri wophunzitsidwa bwino kugwiritsa ntchito makinawa, limathandiza pa izi.

• Kukonzekera makina: Choyamba, mpweya womwe uli m'machubu a makinawo umachotsedwa kwathunthu ndikudzazidwa ndi madzi apadera (madzi oyeretsera). Chifukwa thovu la mpweya (`(Air Embolism)`) lolowa m'thupi ndi loopsa kwambiri.
• Kukupatsani mankhwala oletsa magazi kuundana: Musanalumikizidwe ndi makina, mudzapatsidwa mankhwala amphamvu ochepetsa magazi otchedwa Heparin kuti mupewe magazi kuundana.
• Kulumikiza ku makina: Tsopano madokotala akulumikizani ku makina. Mtima ndi mapapo anu akugwirabe ntchito pakadali pano.
• Kuima kwa mtima ndi mapapo: Pambuyo poonetsetsa kuti chilichonse chikugwira ntchito bwino, mtima umayimitsidwa popereka mankhwala otchedwa ``Cardioplegia''. Tsopano makina a mtima ndi mapapo amatenga ntchito yonse.
• Opaleshoni ndi kuyang'anira: Pamene dokotala akuchita opaleshoniyi, gululo, kuphatikizapo katswiri woona za opaleshoni ya magazi, likupitiriza kuyang'anira makinawo ndi momwe thupi lanu lilili (monga kutentha ndi kuthamanga kwa magazi).
• Kusiya kuyamwa: Opaleshoniyo ikatha bwino, mtima wanu umayambiranso pang'onopang'ono, mapapu anu amaloledwa kupuma, ndipo mumachotsedwa mu makina.

Kodi zoopsa za njira iyi ndi ziti?

Monga momwe zimakhalira ndi opaleshoni yaikulu iliyonse, pali zoopsa zomwe zimachitika mu njirayi. Zoopsazi zimatha kusiyana malinga ndi nthawi yomwe mwalumikizidwa ndi makinawo komanso thanzi lanu musanachite opaleshoniyo.

Koma kumbukirani kuti gulu lanu lachipatala lili ndi maphunziro apamwamba komanso luso lothana ndi zoopsa zonsezi. Zina mwa zovuta zomwe zingachitike ndi izi:

• Magazi amaundana
• Kutuluka magazi ambiri
• Kuvulala kwa ubongo kapena sitiroko
• Kuwonongeka kwa impso kapena mapapo
• Kutupa ndi matenda m'thupi

Lankhulani momasuka ndi dokotala wanu za zoopsazi ndi njira zomwe mungachite kuti mupewe izi musanachite opaleshoni.

Chochita pakakhala ngozi?

Mukatuluka kuchipatala mutachita opaleshoni, dokotala wanu adzakufotokozerani masiku omwe muyenera kubwerera komanso malangizo omwe muyenera kutsatira. Ndikofunikira kwambiri kutsatira malangizo awa molondola.

Zizindikiro zadzidzidzi za sitiroko zingaphatikizepo:

• Kufooka kapena kusawona bwino mbali imodzi ya thupi
• Kuvuta kulankhula, kusalankhula bwino mawu
• Kusokonezeka mwadzidzidzi
• Kuvuta kuyenda, kutayika bwino
• Kuvuta kuona