Pamwe wakambonzwa nezvekuvhiyiwa kwemoyo, handiti? Pamwe mumwe munhu mumhuri mako kana shamwari akambovhiyiwa rudzi urwu rwekuvhiyiwa. Kazhinji, patinotaura nezvekuvhiyiwa kwemoyo, tinofunga nezvekuvhiyiwa kukuru kunosanganisira kumisa moyo uye kuubatanidza nemuchina. Asi waizviziva here kuti kunewo kuvhiyiwa kwemoyo kunogona kuitwa pasina kumisa moyo, ndiko kuti, moyo uchiri kurova? Ndiko kwatinodaidza kuti "Off-pump" bypass surgery, kana kuti "Beating Heart Surgery." Ngatitaurei nezvazvo nemashoko akareruka nhasi.
Zvakanaka, chii chinonzi kuvhiyiwa kwe bypass kunoitwa pasina kumira kwemoyo?
Zvichitaurwa zviri nyore, iyi imhando ye coronary artery bypass graft (CABG). Mukuvhiyiwa kwebypass, tsinga itsva inogadzirwa kuti ipfuure tsinga yakavharika (coronary artery) inopa ropa kumoyo. Izvi zvinoitwa uchishandisa tsinga yeropa ine hutano (graft) inotorwa kubva kune imwe nhengo yemuviri, semuenzaniso, gumbo kana chipfuva.
Fungidzira, kune motokari dzakawanda mumugwagwa, saka mota hadzisi kufamba. Zvadaro tinovaka mugwagwa unodarika nepakati kuti tisafambiswe nemotokari. Izvi zvinotanga kutenderera kweropa kuenda kumoyo zvakare.
Mukuvhiya kwechinyakare kwepamusana (On-pump CABG) , vanachiremba vanomisa moyo wemurwere zvachose. Zvadaro, basa remwoyo nemapapu rinoitwa nemuchina wakakosha kusvika kuvhiya kwapera. Uyu unonzi muchina wepamusana wemwoyo. Muchina uyu unotora ropa mumuviri, wowedzera okisijeni mauri, wobvisa carbon dioxide, uye wopomba ropa rakachena mumuviri.
Asi muCABG isina pombi, muchina wemoyo nemapapu haushandiswi. Chiremba anovhiya anoita kuvhiya uku moyo wako uchirova . Ndosaka zvichinzi kuvhiya kwemoyo kunorova.
Ndiani anoda kuvhiyiwa uku?
Kuvhiyiwa uku kunonyanya kuitwa pavarwere vane chirwere chemwoyo (CAD). MuCAD, mafuta anoungana mukati metsinga dzeropa dzemwoyo, zvichiita kuti ropa riderere. Izvi zvinogona kukonzera zviratidzo zvakaita sekurwadziwa muchipfuva uye kushaya mweya. Kana tsinga idzi dzikavharika zvachose, njodzi yekurwara nemoyo yakanyanya.
Kana chirwere chacho chikanyanya kuoma zvekuti hachigone kudzorwa nekuchinja mararamiro, mishonga, uye mamwe marapirwo, vanachiremba vanokurudzira kuvhiyiwa kwe bypass. Kuvhiyiwa uku kunogona kuderedza zviratidzo, kuderedza njodzi yekurohwa nemoyo, uye kuwedzera kupona. Saka, kune vamwe varwere vanosarudza kuvhiyiwa bypass, nzira iyi yekuvhiyiwa pasina pombi inogona kuva sarudzo yakanaka.
Unogadzirira sei usati wavhiyiwa?
Kana wakarongerwa kuvhiyiwa uku, timu yako yezvekurapa ichakupa mirairo yekuti ungagadzirira sei. Mirairo iyi inogona kusanganisira:
- Kana ukasvuta, rega ipapo ipapo.
- Chiremba wako achakukurudzira kuti urege kutora mimwe mishonga kwenguva pfupi, kunyanya mishonga inorwisa ropa.
- Zuva risati rasvika rekuvhiyiwa, uchaudzwa kuti usadye kana kunwa chero chinhu kubva pakati pehusiku.
Pamusoro pezvo, unogona zvakare kuongororwa kakawanda kuti uone kana uri mumamiriro akanaka ekuvhiyiwa:
- Kuongororwa kweropa
- Kuongororwa kweX-ray pachipfuva
- Echocardiogram (Echo)
- Kuongororwa kweECG (Electrocardiogram)
- Miedzo yakakosha yakaita seNuclear Cardiac Stress Test
Chii chinoitika panguva yekuvhiyiwa?
Chiremba wako achakutsanangurira zvichaitika panguva yekuvhiyiwa. Heano zvimwe zvinhu zvinowanzoitika:
1. Anesthesia: Unoradzikwa zvachose uye unorapwa kuti usarwadziwe.
2. Kuunganidza Graft: Chidimbu chetsinga yeropa ine hutano chinodiwa pakubvisa ropa chinotorwa kubva pagumbo, ruoko, kana chipfuva chako.
3. Kuchekwa: Kuchekwa kunoitwa pakati pechipfuva, uchifambisa pfupa rechipfuva nokungwarira kumativi ese. Dzimwe nguva, zvichienderana nenzvimbo yemugero wakavharika, kucheka kudiki kunogona kuitwa pakati pembabvu dziri kuruboshwe rwechipfuva.
4. Kudzikamisa moyo: Sezvo kuvhiyiwa uku kuchiitwa mwoyo uchirova, mudziyo unonzi ``Stabilizer`` unoshandiswa kubata nzvimbo diki yemoyo iri kuvhiyiwa kuitira kuti isafambe. Izvi zvinoita kuti chiremba arambe akanyarara uye aite kuvhiyiwa kwacho zvakajeka.
5. Kupfuura nepakati: Kuyerera kweropa kuburikidza netsinga yakavharika kunomiswa kwenguva pfupi, uye mugumo mumwe wetsinga yeropa yakambotorwa ine hutano wakabatana neaorta uye mumwe mugumo kune tsinga yemoyo iri pasi pekuvhara. Izvi zvinogadzira nzira itsva yekupinda nepakati.
6. Kuvhara: Kana basa rapera, kuyerera kweropa kunomira kwenguva pfupi, pfupa repachipfuva rinosungirirwazve newaya dzakakosha, uye ganda rinosukwa uye rinovharwa.
Kuvhiyiwa kwechivanhu (Panoda kuvhiyiwa) kana nzira itsva iyi (Panoda kuvhiyiwa) zviri nani here?
Tsvagiridzo ichiri kuenderera mberi yekuona kuti ndeipi yenzira mbiri idzi iri nani kwenguva refu. Chiremba wako achakurukura newe kuti ndeipi nzira yakakunakira. Ngatitarisei misiyano mikuru, zvakanakira nezvakaipira zvenzira mbiri idzi.
| Hunyanzvi | Nzira Yechinyakare (Papombi) | Nzira ye "Kurova Mwoyo" (isiri papombi) |
|---|---|---|
| Dambudziko remwoyo | Mwoyo unomira panguva yekuvhiyiwa. | Kuvhiyiwa kunoitwa mwoyo uchirova. |
| Muchina wemwoyo nemapapu | Kushandisa. | Hazvina kushandiswa. |
| Zvakanakira chiremba wekuvhiya | Kuvhiyiwa uku kunogona kuitwa zvakajeka nekuti hapana kufamba kana ropa. | Zvinonetsa zvikuru. Zvinoda kudzidziswa kwakakosha. |
| Mabhenefiti angangowanikwa kumurwere | Nzira yakajairika, inoshandiswa zvakanyanya. | Kuchekwa kudiki, kugara muchipatara kwenguva pfupi, kupora nekukurumidza. Zvinogona kuderedza njodzi yematambudziko akadai sekukanganwa, sitiroko, uye hutachiona. |
Chinhu chinonyanya kukosha ndechekuti havasi vese vanogona kuita kuvhiyiwa uku kusingamise mwoyo. Zvakare, kuti uite kuvhiyiwa uku, unoda chiremba ane ruzivo rwakakosha.
Ndeipi njodzi dzekuvhiyiwa uku?
Sekunge kune chero kuvhiyiwa kukuru, kune dzimwe njodzi dzinobatanidzwa. Zvisinei, vanhu vazhinji vanowana mhedzisiro inobudirira. Njodzi dzingangoitika dzinosanganisira:
- Kubuda ropa
- Kugwamba kweropa (izvo zvinogona kukonzera sitiroko kana kurwara nemoyo)
- Matambudziko anokonzerwa neanesthesia
- Utachiona
- Kurova kwemoyo kusina kurongeka (Arrhythmia)
- Kukundikana kweitsvo
Zvinotora nguva yakareba sei kuti munhu apore?
Nguva yekupora mushure mekuvhiyiwa inoenderana nezvinhu zvakati wandei, zvakaita sezera rako, hutano hwako, uye saizi yekukuvara kwacho. Zvinowanzoita seizvi:
- Unogona kutanga kutora zvinwiwa uye chikafu chidiki pazuva rimwe chete kana zuva rinotevera mushure mekuvhiyiwa.
- Mukati mezuva rekutanga kana maviri, uchakwanisa kugara pachigaro uchibatsirwa uye kufamba zvishoma.
- Unofanira kugara muchipatara kwemazuva mashoma.
- Zvakakosha kuva nemumwe munhu anokubatsira mumazuva mashoma ekutanga mushure mekunge waenda kumba.
- Misono yacho ichabviswa mukati memavhiki angangoita gumi.
- Zvakanakisisa kusasimudza zvinhu zvinorema kwemavhiki mashoma.
- Zvinogona kutora mavhiki akati wandei kana kupfuura kuti munhu apore zvizere.
- Vanachiremba vachakupa mazano ekuti utore chikamu muchirongwa chekurapa mwoyo kuti uvandudze simba rako.
Muzviitiko zvipi zvaunofanira kutsvaga rubatsiro rwechiremba nekukasika?
Paunenge uchipora, uchafanirwa kushanyira kiriniki pamazuva akarongwa uye kuona chiremba wako. Zvisinei, kana ukaona chimwe chezviratidzo zvinotevera, fonera chiremba wako nekukasika kana kuenda kuEmergency Department (ETU) yechipatara chiri pedyo.
| Zviratidzo zvekuchenjerera |
|---|
| Kurwadziwa pachipfuva kana mudumbu kusingapere. |
| Kunzwa kutonhora kana kudikitira zvakanyanya. |
| Kunzwa kwepfupa repachipfuva richifamba kana kuita ruzha rwekuti "rinodzvanya". |
| Kurova kwemoyo kunokurumidza kana kusina kurongeka. |
| Kusvotwa kana kurutsa. |
| Kutadza kufema zvakanaka. |
| Zviratidzo zvehutachiona (fivha, kutsvuka pedyo nepaburi, kuzvimba, kubuda kwehurwa). |
| Kuwedzera huremu kamwe kamwe (kupfuura 2 kg pasvondo). |
Mharidzo Yekuenda Nayo Kumba
- Kuvhiya kwepanze kwepanze kwepanze (off-pomp bypass surgery) rudzi rwakakosha rwekuvhiya kwepanze kunoitwa pamoyo unorova pasina kumira kwemoyo.
- Vamwe varwere vanogona kubatsirwa nenzira iyi, zvakaita sekudzikira kwekugara muchipatara, kukurumidza kupora, uye kudzikira kwenjodzi yemamwe matambudziko.
- Kuvhiyiwa uku hakuna kukodzera murwere wese. Zvakakosha kuona kana murwere akakodzera uye kana chiremba wezvekuvhiya akadzidziswa basa iri.
- Kana uchida kuvhiyiwa kwe bypass, kurukura nachiremba wako wemwoyo kana nzira yechinyakare (on-pomp) kana nzira iyi (off-pomp) ndiyo yakakunakira.
- Kutevera mirayiridzo yekurapa nekungwarira mushure mekuvhiyiwa kwakakosha kuti munhu apore nekukurumidza uye zvinobudirira.
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