Intliziyo yethu sisitho esimangalisayo. Ifana nepompo encinci esebenza ngokungayekiyo. Le pump ineenxalenye ezine ezinceda ukuthumela igazi kwicala elinye kuphela, esizibiza ngokuba ziivalvu zentliziyo kunyango. Khawucinge ngento enokwenzeka ukuba nokuba nye kwezi ngcango iphukile, ukuba ayivuleki okanye ayivalwanga kakuhle. Ukuhamba kwegazi emzimbeni wonke kuya kuphazamiseka, akunjalo? Namhlanje, sithetha ngotyando olunzima kodwa oluphumelele kakhulu olwenziwa xa ivalvu ye-aortic, enye yeevalvu eziphambili entliziyweni, igula.
Ngamafutshane, yintoni iNkqubo kaRoss?
Olu lutyando olukhethekileyo kakhulu. Oogqirha balubiza ngokuba yinkqubo ye-pulmonary autograft. Le yinto ekhethekileyo kakhulu eyenzekayo apha. Olu tyando lwenziwa kusetyenziswa inxalenye yomzimba wakho.
Ngamafutshane, amanyathelo amabini aphambili ayenzeka apha ngala:
1. Ivalvu yakho ye-aortic engasebenzi kakuhle iyasuswa ize ithatyathelwe indawo yivalvu yakho yepulmonary esempilweni.
2. Emva koko, ivalvu yemiphunga ephilileyo (ivalvu yomnikeli) ethathwe kumntu oswelekileyo ifakwa kwindawo engenanto apho ivalvu yemiphunga yayikhona.
Ngoku usenokuba ucinga, "Kutheni usenza loo nto? Ukususa enye uze ufake enye, uze ubeke enye phezu kwayo, oko kuvakala kunzima kancinci, akunjalo?" Ewe, yinyani leyo. Kodwa kukho isizathu esivakalayo saloo nto. Makhe sijonge.
Kutheni olu tyando lubalulekile? Kutheni usebenzisa ivalvu yakho yemiphunga?
Intliziyo yethu ipompa igazi elicocekileyo, elineoksijini emzimbeni wonke ngevalvu ebizwa ngokuba yivalvu ye-aortic. Le yivalvu ephambili. Ikwayivalvu ethintela igazi ukuba lingabuyeli umva ngelixa intliziyo ibetha.
Kodwa ngamanye amaxesha le valve ingavalwa ngaphandle kokuvulwa kakuhle, nto leyo esiyibiza ngokuba yi-stenosis . Okanye ayinakuvaleka kakuhle kwaye igazi linokuvuza umva, nto leyo esiyibiza ngokuba yi-regurgitation . Ukuba ezi meko ziyaqhubeka, amathuba okuba intliziyo ingasebenzi kakuhle kunye nosulelo aphezulu kakhulu.
Ngoko ke kwimeko enzima efana nale, ivalvu eyonakeleyo kufuneka isuswe kuze kufakwe entsha.
Ngoko ke, kutheni utshintsha ivalvu yakho yemiphunga ngeyokwenziwa?
Kukho izizathu ezahlukeneyo zoku:
- Ukumelana noxinzelelo: Ivalvu ye-aorta iphantsi koxinzelelo lwegazi oluphezulu. Ngoko ke ivalvu ebekwe apho kufuneka ibe namandla kakhulu. Ngenxa yokuba ivalvu yakho yemiphunga iyisicwili esiphilayo, inokumelana noxinzelelo oluphezulu kakuhle kwaye ihlale ixesha elide kakhulu kunevalvu zokwenziwa.
- Umngcipheko omncinci wokuqhekeka kwegazi: Xa kufakwa iivalvu zokwenziwa, kukho umngcipheko ophezulu wokuqhekeka kwegazi. Ke ngoko, kufuneka bathathe amayeza okunciphisa igazi ubomi babo bonke. Kodwa xa besebenzisa izicwili zabo, loo mngcipheko awukho.
- Indawo yevalvu yepulmonary:Ivalvu yemiphunga iphantsi koxinzelelo oluphantsi, ngoko ke ivalvu yomnikelo evela kumntu oswelekileyo ayizukuguga ngokukhawuleza. Kwakhona, ivalvu ye-aortic kunye nevalvu yemiphunga ziyafana kakhulu ngobukhulu kunye nokuma.
Ngamafutshane, into eyenziwa ngoogqirha botyando kukubeka ivalvu yakho "yoqobo" enamandla kakhulu kwindawo ebaluleke kakhulu yentliziyo, apho ithwala khona ubunzima obukhulu, uze ubeke ivalvu "yomnikeli" kwindawo enobunzima obuncinci.
Ngubani ofanelekileyo kolu tyando, kwaye ngubani ongafanelekanga kuye?
Olu tyando alufanelekanga kuye wonke umntu. Oogqirha bahlola ngononophelo imeko yesigulana baze bagqibe kwelokuba bayafaneleka na okanye abafanelekanga. Makhe sijonge ngokuthe ngcembe le theyibhile ingezantsi.
| Ngubani ofanelekileyo kolu tyando? | Abantu abangafanelekanga kolu tyando |
|---|---|
| Ngokwesiqhelo kubantu abancinci nabasebancinci abangaphantsi kweminyaka engama-60 ubudala . | Abantu abanezifo zokuzikhusela komzimba ezifana ne-lupus kunye ne-rheumatoid arthritis. |
| Kwabo banesifo sokuqaqamba kwemithambo yegazi esibizwa ngokuba yi-aortic stenosis. | Abantu abaneengxaki zezicubu ezidityanisiweyo ezifana neMarfan syndrome. |
| Kwabo banesifo sezinye iintlobo zesifo se-aortic valve. | Abantu abanemivalo kwimithambo yegazi emithathu okanye ngaphezulu ehambisa igazi entliziyweni (isifo semithambo yegazi ye-coronary). |
| Kwabo bane-aortic valve endocarditis. | Kwabo baneengxaki zevalvu yemiphunga. |
Kwenzeka ntoni ngexesha lotyando?
Inkqubo kaRoss yinkqubo enobuchule kakhulu necoselelweyo ethatha iiyure ezininzi. Yenziwa liqela leengcali zotyando lwentliziyo. Makhe sijonge okwenzekayo ngexesha lenkqubo.
1. I-Anesthesia: Okokuqala, uza kufakwa phantsi kwe-anesthesia eqhelekileyo. Oku kuthetha ukuba uza kulala ubuthongo obunzulu de utyando luphele, ngoko awuyi kuva ntlungu. Awuyi kukhumbula nto ngotyando.
2. Ukudibanisa nomatshini wentliziyo nemiphunga: Okulandelayo, oogqirha baya kukuqhagamshela kumatshini okhethekileyo obizwa ngokuba yi-cardiopulmonary bypass machine. Lo matshini uthatha okwethutyana umsebenzi wentliziyo nemiphunga yakho ngexesha lotyando. Oku kuvumela oogqirha ukuba benze utyando ngokukhuselekileyo ngaphandle kokumisa intliziyo yakho.
3. Ukuvula isifuba: Oogqirha benza utyando phakathi kwesifuba sakho, bahlukanise ithambo lesifuba (sternum) kubini ukuze bafikelele entliziyweni. Le nkqubo ibizwa ngokuba yi-sternotomy .
4. Ukuhlolwa kwevalvu: Okulandelayo, ivalvu yemiphunga ihlolwa ngononophelo ukuze kubonwe ukuba isempilweni kwaye ifanelekile na ukufakelwa endaweni yevalvu ye-aortic.
5. Ukutshintshwa kwevalvu: Ukuba yonke into ihamba kakuhle, oogqirha botyando baya kuyisusa ivalvu ye-aortic eyonakeleyo baze bayifake ivalvu yakho yepulmonary. Emva koko, ivalvu yepulmonary ephilileyo evela kumntu oswelekileyo iyafakwa kwindawo engenanto apho ivalvu yepulmonary yangaphambili yayikhona.
6. Ukuvuselela intliziyo: Emva kokuba zombini iivalvu ezintsha zifakwe ngokufanelekileyo, oogqirha botyando baya kuyiqalisa kwakhona intliziyo yakho. Emva koko uya kususwa kancinci kancinci kumatshini wentliziyo nemiphunga.
7. Ukuhlolwa kokugqibela nokuvalwa: Iivalvu ezisandula ukufakwa ziyajongwa kwakhona ukuqinisekisa ukuba zisebenza kakuhle. Ukuba yonke into iphumelele, i-sternum ibotshelelwa kwakhona ngeengcingo, kwaye ukusika kwesifuba kuyathungwa kuvaliwe.
Ziziphi iingenelo kunye neengozi ezinokubakho zolu tyando?
Njengalo naluphi na utyando, utyando lukaRoss luneengenelo kunye neengozi zalo. Iingozi zingancitshiswa kakhulu ngokwenziwa unyango phantsi kogqirha onamava amaninzi kolu tyando kwaye olwenza rhoqo olu tyando.
| Iinzuzo | Iingozi |
|---|---|
| Akunyanzelekanga ukuba usele amayeza okunciphisa igazi ubomi bakho bonke. | Ukwandiswa kwe-aorta ngokuzenzekelayo (ukwandiswa kwe-aorta kufutshane nevalvu esandul' ukufakwa). |
| Ungaphila ubomi obuxakekileyo ngaphandle kwemiqathango, wenze izinto ezifana nokuzilolonga nokuqhuba imoto. | Ukuphazamiseka kwentliziyo (i-Arrhythmia). |
| Abafazi abaceba ukukhulelwa banokuzala umntwana ngokukhuselekileyo. | Ukuhlaselwa yintliziyo. |
| Ukuhamba kwegazi emzimbeni wonke kukwinqanaba elihle kakhulu (i-hemodynamics egqwesileyo). | Ukopha kakhulu (Ukopha igazi). |
| Kungekudala emva kotyando, iimpawu ziyaphela kwaye uqala ukuziva uphila ngokukhawuleza . | Usulelo. |
| Ngenxa yokuba sisicwili sayo, ukuqina kwayo kuphezulu kakhulu. | Ivalvu yentliziyo evuzayo. |
Linjani ixesha lokuchacha emva kotyando?
Emva kotyando, uza kuvuka ukwi-Cardiac ICU. Kwiiyure ezimbalwa zokuqala, ungaqhagamshelwa kwi-ventilator ukukunceda uphefumle. Ukusebenza kwentliziyo yakho kuya kuhlolwa rhoqo. Ngokwesiqhelo uza kuhlala kwi-ICU malunga neentsuku ezi-5.
Kungathatha iinyanga ezininzi ukuba uphile ngokupheleleyo emva kokuba ubuyele ekhaya. Ngeli xesha, kuqhelekile ukuba ube nezinto ezifana nezi:
- Ukuqhinwa
- Izifo zengqondo ezifana nokudakumba
- Ukungalali
- Umnqweno wokutya
- Ubungqindilili kunye nokudumba okujikeleze i-incision yotyando
Ngeli xesha, kubaluleke kakhulu ukulandela imiyalelo kagqirha wakho ngokuchanekileyo kwaye uye kwiikliniki ngemihla ebekiweyo.
Ngaba unyango oluhlala luhleli luya kufuneka?
Ewe. Emva kwenkqubo kaRoss, kuya kufuneka ube phantsi kweliso likagqirha ubomi bakho bonke. Kuya kufuneka wenze iiskeni rhoqo ukuze ujonge ukuba iivalvu ezimbini ezifakelweyo zisebenza kakuhle na.
Khumbula, ukufakelwa kwevalvu yemiphunga yomnikeli akuhlali ubomi bonke. Kusenokufuneka itshintshwe kwakhona, ngesiqhelo emva kweminyaka eli-15-20. Kodwa ungakhathazeki. Kwiimeko ezinjalo, oogqirha badla ngokuyitshintsha ivalvu besebenzisa iindlela ezingaphantsi kakhulu, ngaphandle kokwenza umsi omkhulu. Ke ngoko, ixesha lokuchacha lifutshane kakhulu.
Ufanele uye nini kugqirha?
Kubaluleke kakhulu ukuqaphela naziphi na iimpawu zeengxaki xa ubuyela ekhaya emva kotyando. Ukuba ufumana naziphi na kwezi mpawu zilandelayo, fowunela ugqirha wakho ngoko nangoko.
- Iintlungu zesifuba
- Ukuba uziva umkhuhlane okanye umkhuhlane
- Ukuba uziva unesizungu okanye amehlo akho ajika abe luhlaza okwesibhakabhaka
- Ukuba ukhwehlela igazi
- Ukuba unemivumbo engaqhelekanga okanye ukopha
- Ukuba ukuhlanza kwenzeka
- Ukuba amalungu akho abuthathaka
- Ukuba isitulo sibomvu ngokuqaqambileyo
Umyalezo Wokuya Ekhaya
- Utyando lukaRoss lunyango oluphumelele kakhulu kubantu abanesifo se-aortic valve esinzima.
- Ngenxa yokuba ivalvu yakho yemiphunga isetyenziswa apha, iziphumo zilungile kakhulu kwaye zihlala ixesha elide.
- Enye yezona nzuzo zinkulu zolu tyando kukuba akufuneki usele amayeza okunciphisa igazi ubomi bakho bonke.
- Emva kotyando, uya kukwazi ukuphila ubomi obuxakekileyo ngaphandle kwemiqobo.
- Ngenxa yokuba olu lutyando oluntsonkothileyo kakhulu, kubaluleke kakhulu ukufuna unyango kugqirha onamava amaninzi kweli candelo.
- Ukuhlolwa nokuvavanywa kwezonyango ubomi bonke emva kotyando kuyadingeka.
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