Chiwalo chodabwitsa kwambiri m'thupi lathu ndi mtima. Umagwira ntchito popanda kupuma, kuyambira tsiku lomwe tinabadwa. Koma nthawi zina, kaya chifukwa cha matenda aakulu a mtima, pambuyo pa opaleshoni yayikulu, kapena chifukwa cha vuto lina lalikulu la mtima, mtima wathu ukhoza kufooka kwambiri. Nthawi ngati zimenezi, mtima sungathe kupopera magazi okwanira m'thupi. Uwu ndi vuto lalikulu kwambiri, lomwe lingayambitse imfa. Chifukwa chake, nthawi ngati izi, tikambirana za chipangizo chapadera chomwe madokotala amagwiritsa ntchito kuti apatse mtima "mpumulo" pang'ono ndikuuthandiza kugwira ntchito yake.
Mwachidule, kodi Pumpu ya Balloon ya Intra-Aortic (IABP) iyi ndi chiyani?
Ngakhale dzinali likumveka lovuta pang'ono, lingaliro lake ndi losavuta kwambiri. Pumpu ya Balloon ya Intra-Aortic (IABP) ndi chipangizo chachitali, chopyapyala chonga baluni. Chimayikidwa mu aorta, mtsempha waukulu kwambiri wamagazi m'thupi lathu, womwe umanyamula magazi kuchokera mumtima kupita ku thupi lonse. Taganizirani ngati baluni yayitali ngati chubu.
Baluni iyi siili pomwepo. Yalumikizidwa ndi makina apadera. Makina amenewo ndi anzeru kwambiri. Amafumbitsa ndi kutulutsa mpweya m'baluni iyi kuti igwirizane ndi kayimbidwe ka mtima wathu. Njirayi imapangitsa kuti mtima wofooka uzitha kupopa magazi mosavuta. Nthawi zambiri, chipangizochi chimasiyidwa m'thupi kwa masiku ochepa okha. Izi zikutanthauza kuti, ngati chithandizo chakanthawi mpaka mtima utakhala wolimba mokwanira kuti ugwirenso ntchito wokha.
Tiyeni tiwone bwino momwe pampu ya baluni iyi imagwirira ntchito.
Kuti mumvetse izi, muyenera kukhala ndi lingaliro laling'ono la momwe mtima umagwirira ntchito. Mtima wathu uli ngati pampu yopangidwa ndi zipinda ziwiri.
1. Mtima ukakokana (Contraction/Systole): Mtima ukakokana, magazi omwe ali mkati mwake amapopedwa m'thupi lonse kudzera mu aorta.
2. Mtima ukapuma (Kupumula/Diastole): Mtima ukapumanso, umadzazanso ndi magazi. Pompani kuti mupite gawo lotsatira.
Tsopano onani momwe IABP imathandizira pa izi. Imagwira ntchito mosiyana kwambiri ndi momwe mtima umagwirira ntchito.
- Mtima ukakokana ndikutulutsa magazi, baluniyo imatuluka nthawi yomweyo. Taganizirani ngati kuchotsa chotseka mu chitoliro chachikulu. Kenako mtima wofooka ukhoza kutulutsa magazi mosavuta, popanda kugwira ntchito molimbika.
- Mtima ukakula ndikudzaza ndi magazi, baluniyo imadzaza nthawi yomweyo. Izi zimakankhira magazi kubwerera mu aorta. Izi zili ndi ubwino awiri. Choyamba ndi chakuti magazi ambiri amalowa mu mitsempha ya mtima, yomwe imapereka magazi ku minofu ya mtima, ndipo mtima umalandira zakudya zabwino. Chinanso ndi chakuti kuyenda kwa magazi m'malo ena a thupi, makamaka manja ndi miyendo, kumakula.
Njira yokulira ndi kufupika kwa mtima imeneyi imayendetsedwa bwino ndi kompyuta malinga ndi kayimbidwe ka mtima (ECG). Chifukwa chake, ntchito ya mtima imathandizidwa kwambiri popanda kulepheretsedwa.
Kodi IABP imafunika liti?
Dokotala angasankhe kugwiritsa ntchito chipangizochi pamene mtima wa wodwalayo wafooka kwambiri moti sungathe kupereka magazi okwanira ku ziwalo za thupi. M'mawu azachipatala, vutoli limatchedwa "cardiogenic shock." Ili ndi vuto ladzidzidzi komanso loopsa kwambiri.
Gome ili m'munsimu likufotokoza zinthu zingapo zomwe zingayambitse kugwedezeka kwa mtima.
| Matenda | Kufotokozera kosavuta |
|---|---|
| Matenda a Mtima Oopsa | Pamene mtsempha wamagazi womwe umanyamula magazi kupita ku minofu ya mtima watsekeka kwathunthu, zomwe zimapangitsa kuti minofu ya mtima iwonongeke kwambiri. |
| Kulephera Kwambiri kwa Mtima | Mkhalidwe womwe mwadzidzidzi mtima umalephera kupopa magazi omwe thupi limafunikira. |
| Arrhythmias | Kugunda kwa mtima kosakhazikika. Nthawi zina mtima umagunda mofulumira kwambiri kapena pang'onopang'ono kwambiri ndipo supompa magazi moyenera. |
| Matenda a mtima (Myocarditis) | Kutupa kwa minofu ya mtima, komwe kumachitika chifukwa cha matenda monga kachilombo. Izi zingayambitse mtima kufooka. |
| Matenda a Mitsempha ya Mtima | Kuchepa kwa mitsempha yamagazi yomwe imapereka magazi kumtima. Nthawi zina, izi zikakula kwambiri, mtima umafooka. |
Kuphatikiza apo, IABP iyi imagwiritsidwa ntchito ngati mtima ukufunika thandizo pambuyo pa opaleshoni yayikulu ya mtima, kapena pambuyo pa chithandizo monga angioplasty (Percutaneous Coronary Intervention), chomwe chimatsegula mtsempha wamagazi wotsekedwa.
Kodi aliyense angagwiritse ntchito izi?
Ayi. Chipangizochi sichiyenera kugwiritsidwa ntchito ndi anthu omwe ali ndi matenda enaake chifukwa chingayambitse mavuto ambiri kuposa zabwino.
- Aneurysm ya mtsempha wamagazi: Ngati khoma la mtsempha wamagazi lafooka ndipo likutupa ngati baluni.
- Kuduladula kwa mtsempha wamagazi: Ngati magazi atuluka pakati pa khoma la mtsempha wamagazi ndipo ang'ambika.
- Kubwerera kwa mtsempha wamagazi: Pamene valavu ya mtsempha wamagazi m'mtima siitseka bwino, zomwe zimapangitsa kuti magazi atuluke m'mbuyo.
- Matenda Oopsa a Mitsempha Yam'mimba: Ngati mitsempha yomwe imanyamula magazi kupita ku miyendo yatsekeka kwambiri, zingakhale zovuta kuyika chipangizochi.
- Sepsis yosalamulirika: Ngati pali matenda oopsa omwe afalikira m'thupi lonse.
Kodi njira yolowetsa chipangizochi m'thupi imachitidwa bwanji?
Izi nthawi zambiri zimachitika ndi madokotala a mtima ndi gulu lawo, m'chipinda chosamalira odwala kwambiri (ICU) kapena m'chipinda chochitira opaleshoni cha chipatala.
Musanayambe ndondomekoyi
Ngati wodwalayo akuchitidwa kale opaleshoni ya mtima, adzakhala pansi pa mankhwala oletsa ululu ndipo sadzamva chilichonse. Kupanda kutero, ngati izi zitachitika padera, mankhwala oletsa ululu am'deralo adzaperekedwa kuti achepetse ululu m'dera la mwendo kumene chipangizocho chidzayikidwe. Kuti asamve kupweteka kulikonse.
Panthawi ya ndondomekoyi
Dokotala amatsatira njira izi:
1. Choyamba, chubu chaching'ono, chopanda kanthu chotchedwa catheter chimayikidwa mu mtsempha waukulu m'dera la chiberekero cha mwendo.
2. Kenako, kudzera mu catheter iyi, baluni yotuluka madzi imaperekedwa mosamala kwambiri mu aorta.
3. Izi zimachitika pogwiritsa ntchito ukadaulo wa X-ray kuti muwone mfundo yeniyeniyo, kutanthauza, mtsempha wamagazi womwe uli pansi pa mtima.
4. Baluni ikafika pamalo oyenera, mbali yakunja ya baluniyo imalumikizidwa ku kompyuta yapaderayi. Kenako makinawo amayamba kulamulira baluniyo malinga ndi kugunda kwa mtima.
Pambuyo pa ndondomekoyi
Chipangizocho chitayikidwa, wodwalayo ayenera kukhala pansi pa kuyang'aniridwa mwapadera mu chipinda chosamalira odwala kwambiri.
- Bola chipangizocho chili pamalo ake, muyenera kukhala pabedi. Sungani mutu wanu mmwamba pang'ono.
- Mwendo wokhala ndi katheta uyenera kukhala wowongoka . Ukaupinda, kathetayo ikhoza kuyendayenda.
- Pofuna kupewa kuundana kwa magazi, mankhwala ochepetsa magazi monga heparin amalowetsedwa m'mitsempha.
Kodi ubwino ndi zoopsa zake ndi ziti?
Monga chithandizo chilichonse chamankhwala, ichi chili ndi ubwino ndi zoopsa zake.
Ubwino waukulu ndi wakuti chipangizochi chimapulumutsa moyo. Pa vuto monga matenda a mtima, pamene mtima sungagwire ntchito wokha, chipangizochi chingathandize kwambiri kupulumutsa miyoyo mwa kupereka magazi ofunikira ku ziwalo zofunika monga ubongo ndi impso.
Komabe, pali zoopsa zina zomwe zingachitike. Zimatengera zinthu monga msinkhu wa wodwalayo komanso thanzi lake lonse. Gulu lachipatala nthawi zonse limadziwa za zoopsazi.
| Chiwopsezo chomwe chingakhalepo | Kufotokozera |
|---|---|
| Kutuluka magazi | Kutuluka magazi kungachitike kuchokera pamalo oikira catheter. |
| Kuvulala kwa Mitsempha ya Mtsempha | Pali mwayi wochepa kuti mtsempha wamagazi ungawonongeke chipangizocho chikayikidwa kapena pamalo pake. |
| Matenda | Majeremusi amatha kulowa m'thupi kudzera pamalo olowetsa catheter. |
| Magazi Oundana | Magazi amaundana mozungulira chipangizocho, ndichifukwa chake mankhwala ochepetsa magazi amaperekedwa. |
| Malo Olakwika a Baluni | Ngati diso likuyenda, limatha kuletsa kuyenda kwa magazi kupita ku ziwalo monga impso. |
| Kuphulika kwa Baluni | Izi zimachitika kawirikawiri. Mpweya wa helium umagwiritsidwa ntchito kudzaza baluni. Chifukwa chakuti ndi woopsa kwa thupi, ngakhale utalowa m'magazi mwangozi, sungayambitse vuto lalikulu. |
Kubwezeretsa ndi kuchotsa chipangizocho
IABP nthawi zambiri imasiyidwa pamalo ake kwa masiku ochepa okha. Madokotala akaganiza kuti mtima ukuchita bwino pang'ono, amaimitsa pampu kwa kanthawi ndikuwona. Kenako, ngati mtima ukugwira ntchito bwino wokha, dokotalayo amasankha kuchotsa chipangizocho.
Komabe, nthawi zina zoopsa, ngati mtima uli wofooka kwambiri, chipangizochi chingafunike kusiyidwa pamalo ake kwa milungu ingapo ngati njira yopititsira patsogolo chithandizo china, monga kuyika mtima wina.
Nthawi yoti muyimbire dokotala wanu
Ngati inu kapena munthu wina wapafupi nanu alandira chithandizo chamtunduwu ndipo akupeza zizindikiro zilizonse za mavuto atachoka kuchipatala, ndikofunikira kwambiri kudziwitsa dokotala wanu nthawi yomweyo.
| Zizindikiro zomwe zimafuna chithandizo chamankhwala mwachangu | |
|---|---|
| Kusintha kwa njira yodulira | Kufiira kwambiri, kutupa, kupweteka, kapena kutuluka mafinya kuchokera pamalo olowetsera catheter. |
| Malungo | Kungakhale chizindikiro chakuti pali matenda m'thupi. |
| Kusintha kwa kugunda kwa mtima | Kumva ngati mtima wako ukugunda mofulumira (kugunda kwa mtima). |
| Kuvuta kupuma (Dyspnea) | Ngati kupuma kukuvuta kwambiri. |
| Kutupa kwa thupi | Kutupa kwa akakolo, manja, kapena nkhope. |
| Kulemera | Ngati mwadzidzidzi mwawonjezera kulemera kwa makilogalamu opitilira 2-3 mkati mwa sabata imodzi (izi zitha kukhala chizindikiro cha kusunga madzi m'thupi). |
Uthenga Wopita Nawo Kunyumba
- Pumpu ya Baluni ya Mtima Yogwira Mtima (IABP) ndi chipangizo chakanthawi, chopulumutsa moyo chomwe chimathandiza mtima kupopa magazi pamene uli wofooka kwambiri.
- Izi zimagwira ntchito powongolera kugunda kwa mtima, kuchepetsa ntchito pamtima, komanso kukonza magazi kupita ku thupi ndi minofu ya mtima.
- Kawirikawiri izi zimayikidwa kudzera mu mtsempha wa mwendo, ndipo wodwalayo amasungidwa pansi pa kuyang'aniridwa m'chipinda chosamalira odwala kwambiri.
- Monga momwe zimakhalira ndi chithandizo chilichonse chamankhwala, pali zoopsa zina, koma zimayendetsedwa ndi gulu lachipatala poyang'anira wodwalayo mosamala.
- Ngati zizindikiro zachilendo zitachitika mutalandira chithandizochi, ndikofunikira kwambiri kuuza dokotala wanu nthawi yomweyo.











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