Cinga ngentliziyo yakho njengempompo yamanzi esebenza ngokungayekiyo. Ngaphakathi kule mpompo, kukho iindawo ezine ezincinci ezifana nomnyango ezinceda ukuhamba kwegazi kwicala elinye kuphela. Ngokwezonyango, sizibiza ezi valve zentliziyo. Ukuba ezi ngcango azivuli kwaye azivaleki kakuhle, yingxaki enkulu, akunjalo? Ngokufanayo, namhlanje sithetha ngotyando olukhethekileyo olwenziwa xa ivalvu ye-mitral, enye yezona valve zibalulekileyo entliziyweni yethu, ingavuli kakuhle kwaye iba mxinwa.
Yintoni i-commissurotomy?
Ngamafutshane, i-commissurotomy yinkqubo yotyando evumela igazi ukuba lihambe ngevalvu entliziyweni yakho. Idla ngokwenziwa kwivalvu ye-mitral . Ivalvu ye-mitral iphakathi kwegumbi eliphezulu lasekhohlo (i-atrium yasekhohlo) kunye negumbi elisezantsi lasekhohlo (i-ventricle yasekhohlo).
Khawucinge ukuba olu cango aluvuleki kakuhle kwaye lubambekile kwaye lunciphile. Le meko siyibiza ngokuba yi-mitral valve stenosis. Okwenzekayo kukuba indlela yegazi elihamba ngayo ukusuka kwigumbi eliphezulu ukuya kwigumbi elisezantsi ivaliwe. Oku kubangela ukuba igazi libuyele umva kwaye kubeke uxinzelelo olukhulu entliziyweni nasemiphungeni. Ekuhambeni kwexesha, oku kunokukhokelela nakwiimeko ezinzima ezifana nokusilela kwentliziyo.
Olu tyando lwe-commissurotomy lusetyenziswa njengonyango lwamanqanaba okuqala e-mitral valve stenosis. Kodwa ukuba ndithetha inyani, alwenziwa rhoqo kule mihla. Kuba ludla ngokwenziwa njengotyando lwentliziyo evulekileyo . Lunemingcipheko ethile. Ke ngoko, nanini na xa kunokwenzeka, oogqirha bazama ukusebenzisa iindlela ezilula nezingenabungozi kangako. Enye yeendlela eziphambili zonyango ezikhoyo ngoku yi- balloon valvuloplasty . Kule nto, kufakwa ityhubhu encinci kwaye into efana nebhaluni ivuthelwa ngaphakathi kwevalvu encitshisiweyo, iyenze yande.
Nangona kunjalo, kwabanye abantu, indlela yebhaluni ayinakwenziwa ngenxa yendawo yentliziyo yabo okanye ezinye izizathu. Kwimeko ezinjalo, utyando lwe-commissurotomy lolona khetho lufanelekileyo.
Ngubani ngokwenene odinga olu tyando?
Ukuba une-mitral stenosis kwaye kukho naziphi na kwezi zilandelayo ezisebenza, ugqirha wakho unokucebisa olu tyando:
- Ukuba awukanyangwa ngezinye iindlela zonyango.
- Ukuba awukwazi ukwenza i-balloon valvuloplasty.
Ukongeza, ukuba ukhe wenza olunye utyando lwentliziyo, olu tyando lungenziwa ngaxeshanye.
Kodwa kukho into ebalulekileyo ekufuneka uyikhumbule. Ayinguye wonke umntu one-mitral valve stenosis onokwenza olu tyando. Kuxhomekeke kwisizathu se-valve stenosis yakho.
Kukho izizathu ezibini eziphambili:
1. Umonakalo obangelwa sisifo sentliziyo esibizwa ngokuba yiRheumatic Heart Disease:Umkhuhlane werheumatic, olandela usulelo lomphimbo ebuntwaneni, unokonakalisa iivalvu zentliziyo emva kweminyaka.
2. I-Degenerative Mitral Stenosis: Ekuhambeni kwexesha, ivalvu iyaphela kancinci kancinci, inciphe, ize igqunywe zii-calcium deposits.
Utyando lwe-Commissurotomy luluncedo kakhulu kubantu abanesifo sentliziyo esibangelwa yi-rheumatic . Kule meko, iikona ezimbini zevalvu apho kudibana khona amaphecana amabini, abizwa ngokuba yi-commissures , ziyaqina kwaye ngamanye amaxesha ziyanamathelana.
Ukuze uqonde oku, cinga ngale ndlela. Yiya phambi kwesibuko uze uncume uvale imilebe yakho. Ngaba uyazibona iikona ezimbini apho imilebe yakho ephezulu nesezantsi idibana khona? Ezo ziindlela zevalvu ye-mitral. Ngoku, zama ukuvula umlomo wakho ngokucinezela ezo kona zimbini ngeminwe yakho yokwalatha ukuze zingakwazi ukuhamba. Kunzima ukuvula umlomo wakho ngokubanzi, akunjalo? Yiloo nto eyenzekayo xa ivalvu ye-mitral iba mxinwa. Ngenxa yokuba iikona ezimbini zevalvu zinamathelana, ayivuli kakuhle, kwaye ukuhamba kwegazi kuyaphazamiseka.
Kwi-commissurotomy surgery, kwenziwa imingxunya emincinci kwiikona ezimbini zevalvu kwaye ziyakhululwa. Emva koko ivalvu iqala ukuvula kakuhle kwakhona. Nangona kunjalo, kubantu abaneevalvu ezigugileyo ngenxa yobudala, ii-commissures zihlala zingonakali. Endaweni yoko, ezinye iindawo zevalvu kufuneka zilungiswe. Ke ngoko, olu tyando alufanelekanga kubo. Kuya kufuneka benze uhlobo olwahlukileyo lokulungiswa kwevalvu okanye ukutshintshwa kwevalvu epheleleyo (ukutshintshwa kwevalvu ye-mitral).
Kwenzeka ntoni ngaphambi kotyando?
Amalungiselelo aqala kwiiveki, ngamanye amaxesha iinyanga, ngaphambi kosuku lotyando lwakho. Iqela lakho lezonyango (ugqirha wosapho lwakho, ingcali yentliziyo, kunye nogqirha wentliziyo) baya kudibana ukuze bakunike uvavanyo olupheleleyo lwezonyango.
| Uvavanyo kunye novavanyo lwangaphambi kotyando | |
|---|---|
| Uvavanyo lomzimba | Ukujonga impilo yomzimba wakho ngokubanzi. |
| Uvavanyo lwegazi | Ukujonga ukusebenza kwamalungu omzimba afana nezintso nesibindi kunye nemeko yegazi. |
| Iimpawu kunye nembali yesifo | Ukuthetha ngokweenkcukacha malunga nokungonwabi okuvayo kunye nezifo odlule kuzo. |
| Uvavanyo lwentliziyo olukhethekileyo |
|
Ukuba unemibuzo, uloyiko, okanye amathandabuzo malunga notyando, thetha nogqirha wakho ngalo. Musa ukufihlwa nto kuwe. Kubaluleke kakhulu ukwazi yonke into kwaye ungene kutyando unengqondo ekhululekileyo.
Ugqirha wakho uza kukunika imiyalelo yendlela yokulungiselela utyando, kuquka nexesha lokuyeka ukutya nokusela ngaphambi kotyando, kunye naluphi na utshintsho kumayeza akho.
Okubaluleke kakhulu, ukuba ungumtshayi, kubalulekile ukuyeka ngokupheleleyo ukutshaya ngaphambi kotyando ukuze kuncitshiswe iingxaki emva kotyando. Ukuba ufuna uncedo ngale nto, buza ugqirha wakho.
Lwenziwa njani olu tyando?
Kwigumbi lotyando, iqela lezonyango lilandela la manyathelo:
1. Okokuqala, uza kunikwa i-anesthesia kwaye uza kulaliswa ude utyando lugqitywe. Awuyi kuva ntlungu.
2. Emva koko, ugqirha wenza utyando phakathi kwesifuba sakho, ezantsi kwethambo lesifuba (sternum). Oku kubizwa ngokuba yi-median sternotomy .
3. Uza kuqhagamshelwa kumatshini we-cardiopulmonary bypass . Lo matshini uthatha okwethutyana umsebenzi wentliziyo yakho kunye nemiphunga ngexesha lotyando. Oku kuvumela ugqirha ukuba enze utyando ngelixa uhleli, ngaphandle kokubetha kwentliziyo yakho.
4. I-atrium yasekhohlo yentliziyo iyavulwa kwaye i-valve ye-mitral iyahlolwa.
5. Emva koko, kwenziwa imingxunya emincinci kakhulu kwiikona ezimbini (ii-commissures) zevalvu ezinamatheleyo zaza zaqina, zahlula enye kwenye kwaye zayikhulula.
6. Emva kokuba umsebenzi ugqityiwe, uza kukhutshelwa ngaphandle komatshini wentliziyo nemiphunga kwaye intliziyo nemiphunga yakho iza kuqalisa ukusebenza kwakhona.
7. Okokugqibela, i-transesophageal echocardiogramKwenziwa iskeni ekhethekileyo ukuqinisekisa ukuba ivalvu isebenza kakuhle na nokuba yonke into isebenza kakuhle na.
Ngamanye amaxesha, ezinye iindlela zotyando lwentliziyo, ezinje ngokulungisa ezinye iivalvu zentliziyo (ivalvu ye-aorta okanye ivalvu ye-tricuspid), zinokwenziwa ngaxeshanye nolu tyando. Ukuba oku kuyimfuneko, iqela lezonyango liza kukuchazela oku kwangaphambili.
Kwenzeka ntoni emva kotyando?
Kuya kufuneka uhlale esibhedlele kangangeveki emva kotyando. Kusuku lokuqala okanye ezimbini, uza kugcinwa kwigumbi lokhathalelo olunzulu (ICU) kwaye ujongwe ngononophelo olukhulu. Oku kukunceda ekufumaneni naziphi na iingxaki ezinokuvela emva kotyando ngokukhawuleza.
Ngaphambi kokuba ubuyele ekhaya uvela esibhedlele, ugqirha wakho uza kukunika ulwazi malunga noku:
- Unyango lwentliziyo: Oku kuluncedo kakhulu kubantu abachachayo emva kotyando lwentliziyo. Kukunceda ukuba ufumane amandla kwakhona kwaye uqale ukwenza imisebenzi eqhelekileyo.
- Indlela yokunyamekela inxeba: Kubaluleke kakhulu ukugcina inxeba licocekile ukuze kuthintelwe usulelo kwaye kupholiswe inxeba ngokukhawuleza.
- Imiqathango: Ingcebiso malunga nokuba ungalinda ixesha elingakanani ngaphambi kokuba uqalise imisebenzi efana nokuqhuba okanye ukwenza umsebenzi onzima.
Ngaphambi kokuba ugoduke, ungalibali ukulungiselela ukuba umntu akulande.
Ziziphi iingenelo kunye neengozi zalo tyando?
Iingenelo
Olu tyando lunokuphelisa iimpawu ezifana nokuphefumla kancinci kunye nokudinwa okubangelwa kukuncitshiswa kwevalvu ye-mitral. Lunokukukhusela nakwiingxaki ezinzulu ezinokubakho kwixesha elizayo. Olu lunyango oluhle kakhulu kubantu abanemeko engeyiyo embi ngokwaneleyo ukuba bangayitshintsha ngokupheleleyo ivalvu kwaye abangakhange baphumelele kwezinye iindlela zonyango.
Iingozi okanye iingxaki
Njengakwezinye iintlobo zotyando, kukho iingozi. Eyona ngxaki ixhaphakileyo kukubuyela kwe-mitral valve .
| Ezinye iingxaki ezinokubakho |
|---|
| - Impendulo engalunganga kwi-anesthesia. |
| - Ukungahambi kakuhle kwesingqisho sentliziyo (i-Arrhythmia). |
| - Ukopha kakhulu. |
| - Ukuqokelelana kolwelo olujikeleze intliziyo (i-cardiac tamponade). |
| - Utshintsho kwindlela yokucinga okanye ukudideka. |
| - Ukuhlaselwa yintliziyo. |
| - Iintsholongwane kwindawo yokusikwa. |
| - Istroke. |
Uninzi lwezi ngozi lunokunciphisa ngokufumana unyango kwisibhedlele esikhulu esineendawo zoncedo kunye noogqirha abanamava otyando lwentliziyo.
Injani imeko emva kotyando?
I-open commissurotomy inezinga eliphezulu lempumelelo. Olu tyando ludla ngokulungisa ukucutheka kwevalvu kwaye lubuyisele ukuhamba kwegazi.
Kodwa kubalulekile ukuqonda ukuba esi ayisosisombululo sokugqibela. Abantu abaninzi abenza olu tyando banokufuna utyando lokutshintshwa kwevalvu ye-mitral kamva ebomini.
Ugqirha wakho angakuxelela ngcono ngempilo yakho yexesha elizayo. Wonke umntu uyaphila ngokwahlukileyo. Zininzi izinto ezichaphazela oku, kubandakanya ubudala bakho, impilo iyonke, kunye nobungakanani bomonakalo kwivalvu yakho ngaphambi kotyando.
Udinga nini ukubona ugqirha?
Ukuba ufumana naziphi na iimpawu zosulelo ngelixa uphola ekhaya emva kotyando, fowunela ugqirha wakho ngoko nangoko.
- Intlungu yesifuba, ukuqina, okanye ukungonwabi.
- Ifiva.
- Ubomvu okanye ulwelo olufana nobovu oluphuma kwindawo yokusikwa.
Ukuba ufumana naziphi na kwezi mpawu zilandelayo eziqatha, fowunela inombolo yakho yongxamiseko yasekuhlaleni ngoko nangoko okanye uye kwiSebe lezeMpilo eziNgxamisekileyo lesibhedlele esikufutshane (ETU):
- Iimpawu zokuhlaselwa yintliziyo (iintlungu eziqatha esifubeni, ubunzima bokuphefumla, ukuhlanza, ukubila).
- Iimpawu zokukhubazeka (ubunzima bokuthetha, ukugoba kwelinye icala lobuso, ukulahlekelwa yimvakalelo engalweni okanye emlenzeni).
Umyalezo Wokuya Ekhaya
- I-Commissurotomy lutyando lwentliziyo oluvulekileyo olunyanga i-mitral stenosis.
- Oku kusebenza ngakumbi kwabo baneengxaki zeevalvu ngenxa yesifo sentliziyo esibangelwa yirheumatic.
- Olu lolona khetho lulungileyo xa unyango olulula olufana nendlela yebhaluni lungenakwenzeka.
- Nangona utyando lube yimpumelelo enkulu, kukho ithuba lokuba utyando lokutshintsha ivalvu luya kufuneka kwixesha elizayo.
- Kubaluleke kakhulu ukulandela imiyalelo kagqirha wakho ngaphambi nasemva kotyando. Ukuqaphela iimpawu ezilumkisayo ezinokwenzeka emva kotyando kubalulekile ukuze ukhuseleke.
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