Utyando lwe-Aortobifemoral Bypass: I-'Y-shaped bypass' enika ukuhamba kwegazi emilenzeni

Ngaba uziva neentlungu ezibukhali okanye ukurhawuzelelwa emilenzeni yakho xa uhamba umgama omfutshane? Ngaba iyaphela emva kokuba uyeke waphumla okwethutyana, ize intlungu ivele kwakhona xa uqala ukuhamba kwakhona? Le yingxaki abantu abaninzi abanayo. Isizathu esiphambili soku kukuvaleka kwemithambo yegazi ephambili ethwala igazi elineoksijini ukuya emilenzeni yakho. Namhlanje, sithetha ngotyando olubaluleke kakhulu nolukhulu olwenziwa kwimeko enjalo.

Yintoni i-Aortobifemoral Bypass?

Ngamafutshane, olu lutyando oluqhutywa ngoogqirha besisu sakho (esiswini). Njengokuba xa indlela ivaliwe, kwenziwa indlela entsha, ebizwa ngokuba yindlela 'edlulayo', olu tyando ludala indlela entsha yokudlula imithambo yegazi evaliweyo okanye enciphileyo (imithambo yegazi) emzimbeni wakho. Oku kuvumela igazi ukuba lihambe kakuhle liye emilenzeni yakho kwakhona.

Kule nkqubo, ugqirha ufaka umthambo wegazi owenziweyo, obizwa ngokuba yi-graft, esiswini sakho aze awudibanise nomthambo wegazi ovalekileyo. Lo mthambo wegazi owenziweyo udla ngokwenziwa ngezinto ezifana ne-polyester. Igama elithi "aortobifemoral" ngokwalo lithetha oku.

• "I-Aorto" yeyona mthambo wegazi mkhulu emzimbeni wethu, i-aorta . Iqala entliziyweni ize idlule esifubeni iye esiswini.
• Igama elithi "Femoral" libhekisa kwimithambo esemathangeni akho . Le mithambo iqala kwindawo yempumlo ize iye ngasemva kwedolo.
• Igama elithi "Bi" lithetha "ezimbini." Oko kuthetha ukuba lo mthambo wegazi owenziweyo uqhagamshela kwimithambo yegazi yomibini ye-femoral kwimilenze yakho yomibini.

Khawuthelekelele le graft, ``(Graft),'' ifana no "Y" ojonge phantsi. Inxalenye yayo ephezulu iqhagamshela kwi-aorta esiswini, kwaye amasebe amabini "Y" aqhagamshela kwimithambo ye-femoral emilenzeni.

Lolu hlobo luni lwemeko olu lwenzelwa lona olu tyando?

Olu tyando lwenziwa ikakhulu ukunyanga imeko ebizwa ngokuba yi -aortoiliac occlusive disease . Oku kwenzeka xa amafutha nezinye izinto (ezifana ne-plaque) zakhela eludongeni lwangaphakathi lwemithambo yegazi ephambili esiswini sakho nakwi-pelvis ngokuhamba kwexesha. Oku sikubiza ngokuba yi-'(Plaque)'. Oku kwakheka kwenzeka ngeendlela ezilandelayo:

• I-aorta yesisu: Le yinxalenye ye-aorta ehla ngesisu.
• Imithambo ye-Iliac: Le yimithambo ephuma kwi-aorta enkabeni (i-umbilicus) ize iye emilenzeni.

Xa imithambo yegazi incipha okanye ivalwe ngokupheleleyo yile mfumba yolwelo, umzimba wakho ongezantsi, ingakumbi imilenze, iinyawo, kunye namalungu esinqe, awafumani gazi lininzi ngeoksijini elifunekayo. Oku kunokukhokelela kwiingxaki ezinkulu.

Ingaba olu lutyando olukhulu? Ngaba kukho ezinye iindlela?

Ewe, oku kuthathwa njengotyando olukhulu kuba kufuna ukunqunyulwa okukhulu esiswini.

Kodwa kukho enye indlela engaphantsi kakhulu ebizwa ngokuba yi -aortoiliac stenting ene-bifurcation reconstruction (AISBR) . Oku kubandakanya ukubeka ityhubhu encinci ye-mesh ebizwa ngokuba yi-stent ngaphakathi kwe-artery evalekileyo kwaye uyivuthele ukuze uvule i-artery kwakhona. Ezinye izifundo zibonise ukuba le ndlela ineengxaki ezimbalwa kwaye ihlala ixesha elifutshane esibhedlele.

Ugqirha wakho uya kugqiba ukuba utyando oluvulekileyo okanye i-stenting ikulungele na. Nangona i-stenting idla ngokugcinelwa abantu abangakwaziyo ukunyamezela utyando olukhulu, ngenxa yenkqubela phambili kwezobuchwepheshe, ngoku isetyenziswa rhoqo endaweni yotyando oluvulekileyo. Nangona kunjalo, ngamanye amaxesha, ukuba i-stenting ayilulo ukhetho olufanelekileyo kuwe, okanye ukuba i-stent yangaphambili ayiphumelelanga, utyando oluvulekileyo lunokufuneka.

Uzilungiselela njani ngaphambi kotyando?

Iqela lakho lezonyango liza kukucebisa ngendlela yokulungiselela utyando. Ezi zizinto ekufuneka uzinyamekele ngokubanzi.

• Yeka ukutshaya ngokupheleleyo: Ukuyeka ukutshaya ubuncinane iiveki ezi-3-4 ngaphambi kotyando kunokukunceda ufumane iziphumo ezilungileyo. Kubalulekile ukuqhubeka nokuyeka ukutshaya emva kotyando ngenxa yempilo yentliziyo yakho kunye nemithambo yegazi.
• Thetha nogqirha wakho ngamayeza: Ufanele uxelele ugqirha wakho ngamayeza owasebenzisayo ngoku. Angakucela ukuba uyeke ukusebenzisa amanye amayeza okanye utshintshe umthamo ngaphambi kotyando.
• Ukuzila Ukutya: Uya kucetyiswa ukuba uyeke ukutya okanye ukusela ukususela ezinzulwini zobusuku ngosuku olungaphambi kotyando.
• Uvavanyo lwezonyango: Uza kucelwa ukuba wenze uvavanyo oluninzi ngaphambi kotyando.
• Isalathisi se-Ankle-brachial
• I-ultrasound yemithambo yegazi (i-ultrasound scan yemithambo yegazi)
• Iiskeni ezijonga impilo yentliziyo kunye nemithambo yegazi yentliziyo.

Kwenzeka ntoni ngexesha lotyando?

Utyando lungathatha iiyure ezi-2 ukuya kwezi-6. La manyathelo alandelayo ayenzeka ngexesha lale nkqubo.

1. Uza kunikwa i-anesthesia ukuze ulale ngokupheleleyo.

2. Kwenziwa i-incision enkulu (i-laparotomy) kubude besisu sakho ukuze ugqirha afikelele kwi-aorta.

3. Kwenziwa imingxunya emibini kuzo zombini izihlunu ukuze kufikelelwe kwimithambo ye-femoral.

4. Kufakwa umthambo wegazi owenziweyo omile okwe-"Y" obizwa ngokuba yi-"(Graft)` , inxalenye ephezulu yawo iqhagamshelwe kwindawo evaliweyo ye-aorta evela phezulu, kwaye iindawo ezimbini ezisezantsi ziqhagamshelwe kwiindawo ezivaliweyo zemithambo emibini ye-femoral evela ngaphantsi, kwaye zithungwa kunye.

5. Okokugqibela, imingxunya esiswini nasemqolo ivalwa ngezititshi okanye izitapile.

Kwenzeka ntoni emva kotyando kwaye xa ubuyela ekhaya?

Kuya kufuneka uhlale esibhedlele iintsuku ezi-4 ukuya kwezi-7. Ngeli xesha, iqela lezonyango liza kukunyamekela kakuhle. Kwakhona, kungathatha malunga neenyanga ezi-2 ukuya kwezi-3 ukuba uphile ngokupheleleyo. Nangona kunjalo, emva kweeveki ezi-4 ukuya kwezi-6, uya kukwazi ukuqhubeka nemisebenzi yakho yesiqhelo kancinci kancinci.

Zikhathalele ezi zinto xa ufika ekhaya.

• Sela zonke iipilisi zokuthomalalisa iintlungu kunye nezinye iziyobisi ezichazwe ngugqirha wakho ngexesha.
• Gcina amanxeba ecocekile kwaye uwanyamekele njengoko ugqirha eyalele.
• Ukuzilolonga njengoko uyalelwe ngugqirha wakho. Ukunyusa kancinci umgama ohamba ngawo kunceda kwinkqubo yokuphiliswa. Kodwa musa ukuwugqithisa.
• Buza ugqirha wakho ngexesha elifanelekileyo lokuqalisa imisebenzi efana nokuqhuba imoto, ukuya emsebenzini, kunye nokuphakamisa iintsimbi.

Ixesha lokubona ugqirha ngoko nangoko uze uye kwiYunithi yoNyango oluNgxamisekileyo (ETU)

Kubaluleke kakhulu ukuba uqaphele xa kuvela naziphi na iingxaki ngexesha lokuchacha.

Ukuba kuvela iimpawu zokuhlaselwa yintliziyo okanye isifo sohlangothi, fowunela inkonzo ye-ambulensi yongxamiseko ngoko nangoko okanye uye kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele esikufutshane.

Iimpawu zokuhlaselwa yintliziyo:

• Intlungu yesifuba okanye ukungakhululeki
• Ubunzima bokuphefumla
• Isicaphucaphu, ukungonwabi esiswini
• Ukubetha kwentliziyo
• Ukudinwa (vertigo) okanye ukuquleka

Iimpawu zestroke:

• Ubungqindilili okanye ubuthathaka kwelinye icala lomzimba
• Ubunzima bokuthetha (i-Aphasia) okanye ukuthintitha
• Ukulahlekelwa kulawulo lwemisipha kwelinye icala lobuso
• Ukulahlekelwa ngequbuliso okanye ukufiphala kombono okanye ukuva