Kuqhelekile ukuba noloyiko xa ugqirha wakho ekuxelela okanye umntu omaziyo ukuba udinga utyando lwe-bypass. Olo loyiko luyanda ngakumbi xa usiva ukuba "intliziyo iya kuma ize iqhagamshelwe kumatshini." Kodwa ubusazi na ukuba kukho indlela ekhethekileyo enokusetyenziswa ukwenza olu tyando ngaphandle kokumisa intliziyo, oko kukuthi, ngelixa intliziyo isabetha? Yiloo nto siza kuthetha ngayo namhlanje, ebizwa ngokuba yi-'Off-Pump Bypass Surgery.'
Yintoni utyando lwe-Off-Pump Bypass?
Ngamafutshane, olu luhlobo lotyando lwe-bypass (Coronary Artery Bypass Graft - CABG) oludala indlela entsha ejikeleze umthambo wegazi ovalekileyo entliziyweni. Kutyando lwendabuko lwe-bypass (On-Pump CABG), ugqirha umisa intliziyo yesigulana okwethutyana ngelixa esenza utyando. Ngelo xesha, umsebenzi wentliziyo nemiphunga wenziwa ngumatshini okhethekileyo obizwa ngokuba yi-'Cardiopulmonary Bypass Machine'. Lo matshini uthabatha igazi emzimbeni, wongeze ioksijini kuwo, ukhuphe i-carbon dioxide, aze alibuyisele emzimbeni.
Kodwa kolu tyando 'olungekho kwiPump', intliziyo ayiyeki. Ugqirha wenza olu tyando ngelixa intliziyo ibetha. Yiyo loo nto ikwabizwa ngokuba yi- "Beating Heart Surgery."
Ngubani odinga olu tyando?
Olu tyando lwenziwa ikakhulu kubantu abanesifo semithambo yegazi yentliziyo (CAD), esibangela ukuhlaselwa yintliziyo.
Cinga ngemithambo emincinci ehambisa igazi ezintliziyweni zethu njengeendlela. Kwi-CAD, ingaphakathi lale ndlela livalekile ngamafutha kunye ne-cholesterol (ebizwa ngokuba yi-plaque). Oku kuthintela intliziyo ekufumaneni igazi eliyidingayo, okubangela iimpawu ezifana neentlungu zesifuba kunye nokuphefumla okuncinci . Ukuba oku kuvinjelwa kuphelele, kwenzeka uhlaselo lwentliziyo.
Ugqirha udla ngokucebisa utyando lwe-bypass xa utshintsho lwendlela yokuphila, amayeza, kunye nolunye unyango lungaphumeleli ukulawula imeko. Kwimeko ezinjalo, utyando lwe-'Off-Pump' lunokuba lukhetho olufanelekileyo kwabanye abaguli.
Ungayilungiselela njani utyando?
Iqela lakho lotyando liza kukunika yonke imiyalelo oyifunayo ngaphambi kotyando. Badla ngokuthi izinto ezifana nezi:
- Ukuba uyatshaya, yeka ngokupheleleyo.
- Usenokucelwa ukuba uyeke okwethutyana amanye amayeza owasebenzisayo, ingakumbi amayeza okuthintela ukugabha kwegazi.
- Uya kucetyiswa ukuba ungatyi okanye ungaseli nto ukususela ezinzulwini zobusuku ngomhla wotyando.
Eyona nto ibalulekileyo kukulandela imiyalelo kagqirha wakho ngokuchanekileyo. Ungalibali ukumxelela ngayo yonke imithi oyithathayo kunye nezinye izifo onazo.
Zeziphi iimvavanyo ezenziwayo ngaphambi kotyando?
Ugqirha uza kuyalela iimvavanyo ezininzi ukuqinisekisa ukuba usempilweni ngokwaneleyo ukuba utyando.
- Uvavanyo lwegazi
- I-X-reyi yesifuba
- I-Echocardiogram (I-Echo)
- I-ECG (i-Electrocardiogram - EKG)
- Uvavanyo olukhethekileyo olufana novavanyo loxinzelelo lwentliziyo lwenyukliya.
Kwenzeka ntoni ngexesha lotyando?
Utyando luthatha iiyure ezininzi. Ugqirha uza kukuchazela kwangaphambili ukuba kuza kwenzeka ntoni. La ngamanyathelo adla ngokwenzeka.
1. Okokuqala, uza kufakwa i-anesthesia uze ulale ngokupheleleyo. Ngoko awuyi kuva ntlungu.
2. Okulandelayo, umthambo wegazi ophilileyo (i-graft) uyasuswa kwenye indawo yomzimba wakho, umzekelo, udonga lomlenze okanye lwesifuba . Lo mthambo wegazi usetyenziselwa ukudala indlela entsha eya kwindawo evalekileyo.
3. Emva koko, ulusu lunqunyulwa phakathi kwesifuba, kwaye isifuba sinqunyulwa kumacala omabini, sifikelele entliziyweni.
4. Ekubeni intliziyo ibetha, kusetyenziswa isixhobo esikhethekileyo (isizinzisi) ukunciphisa intshukumo yayo, kwaye yindawo apho utyando lwenziwa khona kuphela ezinzileyo ukuze ingashukumi.
5. Iyeka okwethutyana ukuhamba kwegazi kwimithambo yegazi evalekileyo.
6. Isiphelo esinye somthambo wegazi ophilileyo osusiweyo ngaphambili siqhagamshelwe kumthambo wegazi oyintloko wentliziyo (i-aorta), kwaye esinye isiphelo siqhagamshelwe kwindawo evaliweyo engezantsi. Oku kufana nokwenza indlela yokudlula kwindlela evaliweyo.
7. Emva kokuba indlela entsha yenziwe, ukuhamba kwegazi kuyabuyiselwa. Igazi ngoku liyadlula kuloo ngxaki lize lihambe ngendlela entsha.
8. Ekugqibeleni, isifuba siphinde sinamathele ngezinto ezifana nocingo kwaye ulusu luvalwe nge-suture.
Yeyiphi kwezi ndlela zimbini engcono?
Uphando lusaqhubeka malunga nokuba utyando olusebenzisa i-on-pump okanye olusebenzisa i-off-pump lungcono na. Ugqirha wakho uza kugqiba ukuba yeyiphi indlela efanelekileyo kuwe. Makhe sijonge iingenelo kunye nomahluko phakathi kwezi ndlela zimbini.
| Ingcali ekhethekileyo | I-CABG ekwiPompo | I-CABG Engaphakelwanga |
|---|---|---|
| Inzuzo kugqirha otyandayo | Kulula ukwenza olu tyando kuba intliziyo ayishukumi okanye ayophi. Lubonakala ngokucacileyo. | Ngenxa yokuba utyando lwenziwa kwintliziyo ebethayo, ngobuchwephesha lunzima ngakumbi. Kufuneka ugqirha onamava. |
| Iingenelo ezinokubakho kwisigulana | Indlela yendabuko nesetyenziswa kakhulu, nesele iqinisekisiwe. | Ixesha lokuhlala esibhedlele kunye nexesha lokuchacha linokuba lifutshane. Umngcipheko weengxaki ezifana nestroke, iingxaki zenkumbulo, usulelo, kunye nokubetha kwentliziyo okungaqhelekanga (i-arrhythmia) unokuncipha. |
| Ngubani ofanelekileyo kakhulu? | Le yindlela eqhelekileyo efanelekileyo kwizigulane ezininzi. | Ingalungela ngakumbi abo banezinye izifo ezifana nesifo sezintso, isifo semiphunga esingapheliyo, isifo sesibindi, kunye nabo bakha batyandwa nge-bypass ngaphambili. |
Zithini iingozi zolu tyando?
Njengakwezinye iintlobo zotyando olukhulu, kukho iingozi ezithile ezibandakanyekileyo. Kodwa uninzi lwabantu luyaphila ngempumelelo. Nazi ezinye zeengxaki ezinokubakho:
- Ukopha kakhulu.
- Amahlwili egazi (anokubangela isifo sohlangothi okanye ukuhlaselwa yintliziyo).
- Iingxaki ezibangelwa yi-anesthesia.
- Iimeko ezibangela usulelo.
- Izingqisho zentliziyo ezingahambelaniyo.
- Ukungasebenzi kakuhle kwezintso.
Kuthatha ixesha elingakanani ukuchacha?
Ixesha lokuchacha lixhomekeke kwiminyaka yakho, impilo yakho iyonke, kunye nazo naziphi na iingxaki ezivelayo emva kotyando. Ngokubanzi, inkqubo yokuchacha ibukeka ngolu hlobo.
- Ungaqala ukusela ulwelo nokutya ukutya okuncinci ngosuku olunye okanye ngosuku olulandelayo emva kotyando.
- Kwiintsuku zokuqala okanye ezimbini, uya kukwazi ukuhlala esitulweni ngoncedo uze uhambe kancinci.
- Kuya kufuneka uhlale esibhedlele iintsuku ezimbalwa.
- Uza kufuna umntu oza kukunceda kwiintsuku zokuqala emva kokuba ubuyele ekhaya uvela esibhedlele.
- Izititshi ziya kususwa kwiveki okanye kwishumi.
- Ufanele ukuphephe ukuphakamisa iintsimbi kangangeeveki ezimbalwa .
- Kungathatha iiveki ezininzi okanye ngaphezulu ukuze umntu aphile ngokupheleleyo.
- Ugqirha wakho uza kukucebisa ukuba uthathe inxaxheba kwinkqubo yokuvuselela intliziyo ukuze akuncede wakhe kwakhona amandla akho.
Ziziphi iimpawu zokuba ufanele uye kugqirha ngoko nangoko?
Uza kunikwa umhla wokubona ugqirha wakho ngexesha lokuchacha kwakho. Nangona kunjalo, ukuba ufumanisa naziphi na iimpawu ezilandelayo, kufuneka ufune iingcebiso zonyango ngoko nangoko . Kungenjalo, yiya kwiSebe leNgxamiseko (i-ETU) lesibhedlele esikufutshane.
- Intlungu yesifuba engapheliyo okanye intlungu yesisu.
- Ukuziva ubanda okanye ubila kakhulu.
- Ukuba isifuba sakho sivakala ngathi siyashukuma okanye senza isandi 'sokunqakraza'.
- Isantya sentliziyo esikhawulezayo kakhulu okanye esingaqhelekanga.
- Isicaphucaphu okanye ukuhlanza.
- Ubunzima bokuphefumla.
- Iimpawu zosulelo, ezinje ngokuba bomvu, ukudumba, ukuphuma kobofu kwindawo yokuthungwa, okanye umkhuhlane.
- Ukunyuka kobunzima ngequbuliso okungaphezulu kwe-2-3 kg ngeveki.
Umyalezo Wokuya Ekhaya
- Utyando lwe-Off-Pump Bypass lutyando lwe-bypass oluqhutywa ngelixa intliziyo ibetha, ngaphandle kokuyimisa.
- Kwabanye abaguli, le ndlela inokunciphisa ixesha elichithwa esibhedlele, ikhawulezise ukuchacha, kwaye inciphise umngcipheko weengxaki ezithile.
- Olu tyando alufanelekanga kuye wonke umntu. Ugqirha wakho uza kugqiba ukuba yeyiphi indlela efanelekileyo kuwe ngokwemeko yakho.
- Ukuchacha yinkqubo ethatha ixesha. Kubaluleke kakhulu ukulandela imiyalelo kagqirha wakho ngokuchanekileyo kwaye uthathe inxaxheba kwiinkqubo zokulungisa intliziyo.
- Ukuba kukho naziphi na iimpawu ezilumkisayo emva kotyando, musa ukulibazisa kwaye ubone ugqirha ngokukhawuleza.
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