Ngaba wena okanye umntu osapho lwakho ucwangciselwe ukwenza utyando olukhulu lwentliziyo? Mhlawumbi ukhe weva oogqirha besithi uza kuqhagamshelwa "kumatshini wentliziyo-imiphunga." Kuqhelekile ukuba uzive usoyika kwaye unomdla xa usiva eli gama. Yintoni kanye kanye le matshini? Yintoni eyenzayo? Ngaba yinto yokoyika? Masithethe ngayo ngokulula nangokucacileyo.
Yintoni iCardiopulmonary Bypass?
Ngamafutshane, lo matshini usebenza okwethutyana endaweni yentliziyo nemiphunga yakho. Ngexesha lotyando, igazi lomzimba wakho liyajikeleziswa ngalo matshini endaweni yokuba liye entliziyweni nasemiphungeni yakho. Yiyo loo nto ibizwa ngokuba yi-"bypass."
Khawuthelekelele, lo matshini uthatha imisebenzi emibini ephambili eyenziwa yintliziyo yakho nemiphunga ngexesha lotyando:
1. Ukongeza ioksijini egazini (oku kudla ngokwenziwa yimiphunga).
2. Ukumpompa igazi elinomoya-mpilo omninzi emzimbeni wonke (oku kwenziwa yintliziyo).
Xa uqhagamshelwe kule matshini, oogqirha banokumisa intliziyo yakho okwethutyana ngokukunika iyeza elikhethekileyo elibizwa ngokuba yi-"Cardioplegia". Emva koko, ugqirha angasebenza ngokukhuselekileyo nangokulula kwintliziyo engabethiyo nengaphumiyo. Okwangoku, onke amanye amalungu omzimba wakho afumana igazi elineoksijini elifunekayo ngalo matshini. Oogqirha bakwabiza le meko ngokuthi "kwipompo."
Ngaba olu kunye notyando lwe-CABG ziyinto enye?
Ewe, ezi zinto zimbini zizinto ezimbini ezahlukeneyo. Kodwa ezi zimbini zihlala zisenzeka kunye. Abanye abantu bayawabhidanisa la magama mabini kuba omabini aqulethe igama elithi "bypass".
- I-CABG (Coronary Artery Bypass Grafting): Olu lutyando lokwenyani. Xa imithambo yentliziyo ehambisa igazi entliziyweni ivalwe ngamanqatha, kwenziwa indlela entsha (bypass) yokudlula ukuvaleka nokuvumela igazi ukuba lihambe.
- I-Cardiopulmonary Bypass: Le yindlela esetyenziswa ukunceda ugqirha otyandayo ngexesha lotyando lwe-CABG (okanye olunye utyando lwentliziyo). Ibandakanya ukuguqula ukuhamba kwegazi ejikeleze intliziyo nemiphunga.
Oko kukuthi, i-CABG lutyando. I-cardiopulmonary bypass yinkqubo yokuxhasa esetyenziselwa ukwenza olo tyando ngokukhuselekileyo.
Isebenza njani le matshini?
Ukuze siqonde oku, masiqale sikhumbule indlela eqhelekileyo igazi elihamba ngayo emzimbeni wethu. Igazi elingenaoksijini emzimbeni lingena kwicala lasekunene lentliziyo ngemithambo emibini emikhulu (i-vena cava). Ukusuka apho, elo gazi limpontshwa liye emiphungeni. Emiphungeni, igazi lifakwa ioksijini, kwaye elo gazi lityebileyo kwioksijini libuyela kwicala lasekhohlo lentliziyo. Okokugqibela, licala lasekhohlo lentliziyo elimpompa elo gazi licocekileyo liye kuwo wonke umzimba.
Umatshini we-cardiopulmonary bypass ususa okwethutyana le chakra emzimbeni.
1. Ngaphambi kokuba ingene entliziyweni, inxalenye yegazi engenaoksijini itsalwa kumatshini ngeetyhubhu (ii-cannula).
2. Inxalenye engaphakathi komatshini ebizwa ngokuba yi-"Oxygenator" yongeza ioksijini egazini.
3. Ipompo ekumatshini idibanisa kwakhona igazi elineoksijini kumthambo oyintloko (i-Aorta) osasaza igazi emzimbeni emva kwentliziyo.
Le yindlela umzimba ofumana ngayo ioksijini de utyando luphele.
| Iindawo eziphambili zomatshini | Umsebenzi ewenzayo |
|---|---|
| IiCannula | Iityhubhu eziqhagamshela kwimithambo yegazi yomzimba. Ezi zithwala igazi ziye kumatshini zize zibuyele emzimbeni. |
| Idama lolwandle | Itanki eqokelela igazi eliphelelwe yioksijini emzimbeni. |
| Isixhobo sokuhambisa umoya-mpilo | Lo ngumsebenzi wemiphunga yethu: yongeza ioksijini egazini kwaye isusa ikharbon diokside. |
| Impompo | Lo ngumsebenzi wentliziyo yethu. Ipompa igazi elineoksijini libuyele emzimbeni. |
Ngawaphi amanyathelo abandakanyekayo ngexesha lotyando?
Iqela lezonyango liqhuba le nkqubo ngendlela ecwangcisiweyo kakhulu. Iqela eliquka ugqirha wotyando, ingcali yokubulala iintlungu, kunye nengcali yokukhupha igazi, ingcali eqeqeshwe ngokukodwa ukusebenzisa lo matshini, bayancedisa koku.
- Ukulungiselela umatshini: Okokuqala, umoya okwiityhubhu zomatshini ususwa ngokupheleleyo uze uzaliswe lulwelo olukhethekileyo (isisombululo sokuqhobosha). Kuba iqamza lomoya (`(Air Embolism)`) elingena emzimbeni liyingozi kakhulu.
- Ukukunika amayeza okuthintela ukuqhekeka kwegazi: Ngaphambi kokuba uqhagamshelwe kumatshini, uza kunikwa iyeza elinamandla lokunciphisa igazi elibizwa ngokuba yiHeparin ukuthintela ukuqhekeka kwegazi.
- Ukudibanisa nomatshini: Ngoku oogqirha baza kukudibanisa nomatshini. Intliziyo yakho nemiphunga isasebenza okwangoku.
- Ukuma kwentliziyo nemiphunga: Emva kokuqinisekisa ukuba yonke into isebenza kakuhle, intliziyo iyamiswa ngokunika iyeza elibizwa ngokuba yi-"Cardioplegia". Ngoku umatshini wentliziyo nemiphunga uthatha wonke umsebenzi.
- Utyando kunye nokubeka iliso: Ngelixa ugqirha otyandayo esenza utyando, iqela, kuquka nogqirha osebenzisa i-perfusionist, liyaqhubeka nokubeka iliso elibukhali kumatshini kunye nemeko yomzimba wakho (njengobushushu kunye noxinzelelo lwegazi).
- Ukulumla: Emva kokuba utyando lugqityiwe ngempumelelo, intliziyo yakho iqala kwakhona kancinci kancinci, imiphunga yakho ivunyelwe ukuphefumla, kwaye ukhutshwa kumatshini.
Zithini iingozi zale ndlela?
Njengakwezinye iintlobo zotyando olukhulu, kukho iingozi ezibandakanyekileyo kule nkqubo. Ezi ngozi zinokwahluka ngokuxhomekeke kubude bexesha oqhagamshelwe ngalo kumatshini kunye nemeko yakho yempilo ngaphambi kotyando.
Kodwa khumbula, iqela lakho lezonyango liqeqeshwe kakhulu kwaye linamava okulawula zonke ezi ngozi. Ezinye zeengxaki ezinokubakho ziquka:
- Amahlwili egazi
- Ukopha kakhulu
- Ukulimala kwengqondo okanye isifo sentliziyo
- Umonakalo wezintso okanye wemiphunga
- Ukudumba kunye nosulelo emzimbeni
Thetha ngokukhululekileyo nogqirha wakho malunga nale mingcipheko kunye namanyathelo onokuwathatha ukuze uziphephe ngaphambi kotyando lwakho.
Yintoni omawuyenze xa kukho imeko engxamisekileyo?
Xa uphuma esibhedlele emva kotyando, ugqirha wakho uza kukuchazela iintsuku ekufuneka ubuye ngazo kunye nemiyalelo ekufuneka uyilandele. Kubaluleke kakhulu ukulandela le miyalelo ngokuchanekileyo.
Okona kubaluleke kakhulu: Ukuba ufumana iimpawu zestroke, musa ukulibazisa umzuzwana. Yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele esikufutshane ngoko nangoko.
Iimpawu zesifo sohlangothi ngequbuliso zingabandakanya:
- Ubungqindilili okanye ubuthathaka kwelinye icala lomzimba
- Ubunzima bokuthetha, ukungakwazi ukuthetha kakuhle
- Ukudideka ngequbuliso
- Ubunzima bokuhamba, ukulahlekelwa yibhalansi
- Ubunzima bokubona
Umyalezo Wokuya Ekhaya
- I-Cardiopulmonary bypass yindlela eqhelekileyo esetyenziswa kakhulu kwaye ikhuselekileyo kwiindlela ezinkulu zotyando lwentliziyo. Musa ukoyika.
- Lo matshini uvumela ugqirha ukuba asebenze ngokulula nangokukhuselekileyo kwintliziyo engashayiyo, engenagazi.
- Le yinkqubo yexeshana nje. Emva kotyando, intliziyo yakho kunye nemiphunga ziya kusebenza ngendlela eqhelekileyo kwakhona.
- Njengakwezinye iintlobo zotyando, kukho iingozi, kodwa iqela lakho lezonyango liqeqeshwe kakhulu ukuzilawula.
- Xoxa ngayo nayiphi na imibuzo okanye iinkxalabo onokuba nazo nogqirha wakho ngaphambi kotyando. Oku kuya kukunceda uzive ukhululekile ngakumbi.
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