Kutsegula Chifuwa Kuti Muchite Opaleshoni ya Mtima (Sternotomy): Zimene Muyenera Kudziwa

Dokotala wanu akakuuzani kuti mukufunika opaleshoni ya mtima, ndipo kuti imafuna kutsegula chifuwa chanu, mungamve mantha pang'ono komanso mantha. Zimenezo n'zachibadwa. Palibe amene amakonda opaleshoni. Koma ndi chinthu chomwe madokotala a opaleshoni ya mtima amachita nthawi zambiri komanso bwino. Choncho palibe chifukwa choopera. M'nkhaniyi, tingolankhula za tanthauzo la sternotomy, chifukwa chake imachitidwa, momwe imachitikira, komanso zomwe muyenera kudziwa mukatha opaleshoni.

Kodi opaleshoni ya sternotomy ndi chiyani, mwachidule?

Mwachidule, opaleshoni ya sternotomy ndi opaleshoni yomwe fupa lathyathyathya pakati pa chifuwa chanu, sternum, limadulidwa pakati kuti ligwiritsidwe ntchito opaleshoni. Anthu ena amatchanso opaleshoni iyi kuti "median sternotomy."

Taganizirani izi, sternum ndi nthitizi zilipo kuti ziteteze ziwalo zofunika kwambiri m'chifuwa mwathu, monga mtima ndi mapapo. Zili ngati khola lotetezera. Chifukwa chake, ngati pali vuto ndi mtima wanu ndipo muyenera kukonza opaleshoni, njira yabwino komanso yosavuta yomwe dokotala wa opaleshoni angafikire pamtima ndikudula sternum iyi pakati ndikupanga njira mbali zonse ziwiri.

Palinso njira yotchedwa "mini sternotomy" yomwe sternum yonse sidulidwa, koma kudula pang'ono kumapangidwa. Pachifukwa ichi, kudula pang'ono kwa mainchesi pafupifupi 2-3 kumapangidwa.

Kodi ichi ndi chomwe opaleshoni yotsegula mtima imachita? Kodi iyi ndi opaleshoni yayikulu?

Ichi ndi chinthu chomwe chimasokoneza anthu ambiri. Kutsegula sternotomy ndi njira yomwe imatsegula njira yochitira opaleshoni yotsegula mtima . Zili ngati mukufuna kukonza china chake m'nyumba mwanu, choyamba muyenera kutsegula chitseko. Umu ndi momwe zimakhalira. Kutsegula sternotomy ndi njira yomwe "imatsegula chitseko" kuti ifike pamtima. Kutsegula sternotomy ndi njira yomwe imakonza mtima kuchokera mkati.

Inde, opaleshoni imeneyi imaonedwa kuti ndi yaikulu . Chifukwa zimatenga pafupifupi miyezi iwiri kuti fupa lichiritsidwe bwino ndikulumikizananso pambuyo podula. Ndipo chifukwa chakuti imachitika ngati gawo la opaleshoni ina yayikulu, monga opaleshoni yotsegula mtima, ndi opaleshoni yayikulu pamene ziwirizi ziphatikizidwa.

N’chifukwa chiyani muyenera kuchitidwa opaleshoni yamtunduwu?

Dokotala amagwiritsa ntchito njira iyi kuti afikire ziwalo zotetezedwa ndi sternum ndi nthiti. Makamaka:

• Mtima: Pa zinthu monga kukonza ma valve a mtima ndi kuchita opaleshoni ya mitsempha ya mtima.
• Aorta: Pa mavuto a aorta, mtsempha waukulu wamagazi womwe umatuluka mumtima.
• Mitsempha ya m'mapapo: Mitsempha yomwe imanyamula magazi kuchokera mumtima kupita ku mapapo.

Kuchotsa sternotomy si mankhwala a matenda aliwonse. Ndi njira yomwe imachitika kuti ziwalo zilowe m'malo kuti dokotala wa opaleshoni azitha kugwira ntchito yake mosavuta. M'dziko ngati America, maopaleshoni opitilira 700,000 amachitidwa chaka chilichonse. Ndi chinthu chofala kwambiri.

Kodi chimachitika ndi chiyani opaleshoni isanachitike?

Musanayambe opaleshoni yanu, gulu lachipatala lidzakupatsani malangizo ena, monga:

• Amakuuza kuti usamba bwino ndipo uchite bwino usanapite kuchipatala.
• Ngati muli ndi tsitsi pachifuwa panu, lidzachotsedwa mosamala.
• Mankhwala opha tizilombo adzaperekedwa kuti apewe matenda pambuyo pa opaleshoni.
• Malo a pachifuwa pomwe opaleshoniyo idzachitikire amatsukidwa bwino ndi mankhwala ophera tizilombo toyambitsa matenda.

Momwe opaleshoni imachitikira sitepe ndi sitepe

Izi zingakuwopsyezeni pang'ono, koma kumbukirani kuti zonsezi zimachitika mutapatsidwa mankhwala oletsa ululu ndipo muli m'tulo tofa nato. Kotero simudzamva chilichonse.

1. Choyamba, dokotalayo amadula khungu pakhungu, kuyambira pakati pa mapewa anu mpaka kutsika pansi pa sternum.

2. Kenako, chida chapadera chotchedwa "sternal saw" chimagwiritsidwa ntchito kudula sternum molunjika bwino kuyambira pamwamba mpaka pansi.

3. Zidutswa ziwiri za mafupa odulidwa zimayikidwa moyandikana, ndipo chipangizo chotchedwa "retractor" chimayikidwa kuti chilowetse mtima.

4. Kenako, nembanemba yoteteza yozungulira mtima, pericardium, imatsegulidwa.

5. Tsopano dokotala wa opaleshoni amatha kuona mtima bwino. Kenako amachita opaleshoni yaikulu yomwe akufuna kuchita (monga opaleshoni ya bypass).

6. Opaleshoni yayikulu ikatha, magawo awiri a sternum omwe adadulidwa amabwezeretsedwanso pamodzi ndikumangidwa pogwiritsa ntchito mawaya achitsulo pafupifupi 8 kapena 12 (mawaya a sternotomy) . Zili ngati kumanga chinthu chosweka.

7. Pomaliza, minofu ya pachifuwa ndi khungu zimasokedwa pamodzi, ndipo mafuta opha tizilombo amapakidwa pabala.

Kodi mungayembekezere chiyani mutachita opaleshoni?

Pambuyo pa opaleshoni, mudzakhala m'chipinda chosamalira odwala kwambiri (ICU) kwa tsiku limodzi kapena awiri, kenako mudzasamutsidwira ku chipinda chogona chachizolowezi.

• Ululu: Mutha kumva ululu mukatha opaleshoni, koma dokotala wanu adzakupatsani mankhwala ochepetsa ululu kuti akuthandizeni kuuchepetsa. Anthu ambiri amatha kuchepetsa ululu pogwiritsa ntchito mankhwala ochepetsa ululu omwe amagulitsidwa kunja kwa ofesi ya dokotala monga Paracetamol.
• Machubu a pachifuwa: Chubu chimodzi kapena zingapo zitha kuyikidwa pachifuwa kuti zitulutse madzi ochulukirapo ndi magazi kuchokera pachilonda. Izi zidzachotsedwa patatha masiku ochepa.
• Malangizo apadera kwa akazi: Ngati mabere anu ndi akuluakulu, madokotala amakulangizani kuti muvale bra yothandizidwa bwino maola 24 patsiku kwa sabata imodzi kapena ziwiri mutatuluka kuchipatala kuti muchepetse kulemera ndi kupanikizika pa bala.

Kodi ubwino ndi zoopsa za opaleshoniyi ndi ziti?

Monga opaleshoni iliyonse, opaleshoni iyi ili ndi ubwino ndi zoopsa zazing'ono.

Kodi zimatenga nthawi yayitali bwanji kuti ndichire? Kodi ndingadzisamalire bwanji kunyumba?

Zimatenga pafupifupi milungu 8 kuti sternum ichire bwino. Panthawiyi, muyenera kuchepetsa kuyenda kwa thupi lanu lakumwamba. Ndikofunikira kwambiri kutsatira malangizo a dokotala wanu molondola.

• Pewani kunyamula zolemera: Musanyamule chilichonse cholemera kuposa mapaundi 10 (pafupifupi makilogalamu 4.5). Mwachidule, kulemera kwake ndi pafupifupi malita 4 a mkaka.
• Gwiritsani ntchito manja onse awiri: Mukanyamula chinthu, gwiritsani ntchito manja onse awiri kuti muchinyamule mofanana. Musanyamule cholemeracho ndi dzanja limodzi lokha.
• Sungani manja anu pafupi ndi thupi lanu: Mukanyamula chinthu, sungani manja anu pafupi ndi thupi lanu.

Zokhudza kuyendetsa galimoto

Mudzatha kuyendetsanso galimoto patatha mwezi umodzi kuchokera pamene opaleshoniyo inachitidwa. Koma musanachite zimenezo, muyenera kupempha chilolezo kwa dokotala wanu. Mpaka sternum yanu itatha, ndi bwino kukhala pampando wakutsogolo wa munthu mukamayendetsa galimoto. Ngakhale mutakhala osasangalala lamba wapampando akakukanikiza pachifuwa, onetsetsani kuti mwavala lamba wapampando chifukwa adzakutetezani ngati ngozi yachitika.

Kodi nthawi zabwino zokaonana ndi dokotala ndi ziti?

Mudzakhala ndi nthawi yokumana ndi dokotala wanu nthawi zonse. Komabe, ngati mukukumana ndi zizindikiro zotsatirazi, muyenera kudziwitsa dokotala wanu nthawi yomweyo.

Kusankha njira yabwino kwambiri yochitira opaleshoni ya mtima wanu ndi chisankho chomwe dokotala wanu angapange kutengera momwe mulili. Nthawi zambiri, opaleshoni ya sternotomy ndiyo njira yabwino kwambiri yofikira mtima. Ngati muli ndi mafunso okhudza izi, musazengereze kufunsa dokotala wanu.