Ukuvula Isifuba Sotyando Lwentliziyo (Sternotomy): Oko Ufanele Ukwazi

Xa ugqirha wakho ekuxelela ukuba udinga utyando lwentliziyo, kwaye lubandakanya ukuvula isifuba sakho, ungaziva usoyika kwaye unexhala. Yinto eqhelekileyo leyo. Akukho mntu uthanda utyando. Kodwa yinto eyenziwa ngoogqirha bentliziyo rhoqo nangempumelelo. Ngoko ke akukho sizathu sokoyika. Kweli nqaku, siza kuthetha nje ngokuba yintoni i-sternotomy, kutheni yenziwa, yenziwa njani, kunye nento ekufuneka uyazi emva kotyando.

Ngokufutshane, yintoni i-sternotomy?

Ngamafutshane, i-sternotomy yinkqubo yotyando apho ithambo elisicaba eliphakathi kwesifuba sakho, i-sternum, lisikwa kubini ngenjongo yotyando. Abanye abantu bakubiza oku ngokuthi "i-median sternotomy."

Cinga ngayo, le sternum kunye neembambo zikho ukuze zikhusele amalungu abalulekileyo esifubeni sethu, njengentliziyo nemiphunga. Ifana nekheyiji yokhuseleko. Ngoko ke, xa kukho ingxaki entliziyweni yakho kwaye kufuneka uyilungise ngotyando, eyona ndlela ilungileyo nelula yokuba ugqirha otyandayo afikelele entliziyweni kukunqumla le sternum embindini aze enze indlela kumacala omabini.

Kukwakho nendlela ebizwa ngokuba yi-"mini sternotomy" apho i-sternum yonke inganqunyulwa, kodwa kwenziwa i-incision encinci. Kule ndlela, kwenziwa i-incision encinci emalunga ne-2-3 intshi.

Ingaba le yindlela otyando lwentliziyo oluvulekileyo olusebenza ngayo? Ngaba olu lutyando olukhulu?

Le yinto edida abantu abaninzi. I-sternotomy yinkqubo evula indlela yotyando lwentliziyo evulekileyo . Kufana nokuba xa ufuna ukulungisa into engaphakathi endlwini yakho, kufuneka uqale uvule ucango. Yiyo loo nto. I-sternotomy yinkqubo "evula ucango" ukuze ifikelele entliziyweni. Utyando lwentliziyo evulekileyo yinkqubo elungisa intliziyo ngaphakathi.

Ewe, olu lutyando luthathwa njengotyando olukhulu . Kuba kuthatha malunga neenyanga ezimbini ukuba ithambo liphole ngokupheleleyo kwaye liphinde linamathele emva kokusikwa. Kwaye kuba lwenziwa njengenxalenye yolunye utyando olukhulu, njengotyando lwentliziyo evulekileyo, lutyando olukhulu xa zombini ezi zinto zidibene.

Kutheni kufuneka wenze olu hlobo lotyando?

Ugqirha usebenzisa le ndlela ukufikelela kumalungu akhuselwe yi-sternum kunye neembambo. Ngokuyintloko:

• Intliziyo: Ngezinto ezinje ngokulungisa iivalvu zentliziyo kunye nokwenza utyando lwe-coronary artery bypass.
• I-Aorta: Xa kukho iingxaki nge-aorta, umthambo wegazi ophambili ophuma entliziyweni.
• Imithambo yemiphunga: Imithambo ethwala igazi esuka entliziyweni ukuya emiphungeni.

Utyando lwe-sternotomy aluyonyango lwaso nasiphi na isifo. Yinkqubo eyenziwayo ukuze kubekho indawo yamalungu omzimba ukuze ugqirha akwazi ukwenza umsebenzi wakhe ngokulula. Kwilizwe elifana neMelika, kwenziwa utyando olungaphezulu kwama-700,000 minyaka le. Yinto eqhelekileyo leyo.

Kwenzeka ntoni ngaphambi kotyando?

Ngaphambi kotyando lwakho, iqela lezonyango liza kukunika imiyalelo ethile, efana nale:

• Bakuxelela ukuba uhlambe kakuhle uze ucoceke ngaphambi kokuba uye esibhedlele.
• Ukuba uneenwele esifubeni sakho, ziya kususwa ngononophelo.
• Amayeza okubulala iintsholongwane aya kunikwa ukuthintela usulelo emva kotyando.
• Indawo yesifuba apho utyando luza kwenziwa khona ihlanjululwe kakuhle ngezisombululo ze-antiseptic.

Indlela olu tyando lwenziwa ngayo inyathelo ngenyathelo

Oku kusenokuvakala kusoyikisa kancinci kuwe, kodwa khumbula , konke oku kwenziwa emva kokuba unikwe i-anesthesia kwaye ulele ubuthongo. Ngoko awuyi kuva nto.

1. Okokuqala, ugqirha wenza utyando eluswini, eqala phakathi kwee-blades zamagxa akho aze aqhubeke ehla nge-sternum.

2. Emva koko, kusetyenziswa isixhobo esikhethekileyo sonyango esibizwa ngokuba yi-"sternal saw" ukusika i-sternum ngomgca ococekileyo ukusuka phezulu ukuya ezantsi.

3. Iziqwenga zamathambo ezimbini ezisikiweyo zibekwe ecaleni kwelinye, kwaye kufakwa isixhobo esibizwa ngokuba yi-"retractor" ukuze kungene intliziyo.

4. Emva koko, i-membrane ekhuselayo ejikeleze intliziyo, i-pericardium, iyavulwa.

5. Ngoku ugqirha otyandayo uyakwazi ukubona intliziyo ngokucacileyo. Emva koko benza utyando olukhulu abafuna ukulwenza (umz. utyando lwe-bypass).

6. Emva kokuba utyando oluphambili lugqityiwe, iindawo ezimbini ze-sternum ezisikiweyo ziyabuyiselwa ndawonye kwaye ziqiniswe kusetyenziswa iingcingo zentsimbi ezimalunga ne-8 okanye ezili-12 (iintambo ze-sternotomy) . Kufana nokubopha into ephukileyo.

7. Ekugqibeleni, izicubu zesifuba kunye nolusu zithungwa ndawonye, ​​kwaye kufakwa amafutha okubulala iintsholongwane enxebeni.

Yintoni onokuyilindela emva kotyando?

Emva kotyando, uza kuhlala kwigumbi labagula kakhulu (ICU) usuku olunye okanye ezimbini, uze emva koko udluliselwe kwigumbi eliqhelekileyo.

• Intlungu: Usenokuva iintlungu emva kotyando, kodwa ugqirha wakho uza kukunika iintlungu ukuze akuncede uzilawule. Uninzi lwabantu lunokulawula iintlungu ngeentlungu ezithengiswa ngaphandle kwemvume kagqirha ezifana neParacetamol.
• Iityhubhu zesifuba: Ityhubhu enye okanye ezingaphezulu zingafakwa esifubeni ukuze kukhutshwe ulwelo olugqithisileyo kunye negazi eliphuma enxebeni. Ezi ziya kususwa kwiintsuku ezimbalwa.
• Icebiso elikhethekileyo kubafazi: Ukuba amabele akho makhulu kakhulu, oogqirha bakucebisa ukuba unxibe ibra exhaswa kakuhle iiyure ezingama-24 ngosuku kangangeveki enye ukuya kwezimbini emva kokuphuma esibhedlele ukuze unciphise ubunzima kunye noxinzelelo kwinxeba.

Ziziphi iingenelo kunye neengozi zalo tyando?

Njengalo naluphi na utyando, olu luneengenelo kunye neengozi ezincinci.

Kuthatha ixesha elingakanani ukuchacha? Ndingazinyamekela njani ekhaya?

Kuthatha malunga neeveki ezisi-8 ukuba i-sternum iphole ngokupheleleyo. Ngeli xesha, kufuneka unciphise intshukumo yomzimba wakho ongasentla. Kubaluleke kakhulu ukulandela imiyalelo kagqirha wakho ngokuchanekileyo.

• Kuphephe ukuphakamisa izinto ezisindayo: Musa ukuphakamisa nantoni na enzima ngaphezu kweekhilogram ezili-10 (malunga neekhilogram ezi-4.5). Ngamafutshane, loo nto imalunga nobunzima beelitha ezi-4 zobisi.
• Sebenzisa izandla zombini: Xa uphakamisa into, sebenzisa izandla zombini ukuyiphakamisa ngokulinganayo. Musa ukuphakamisa ubunzima ngesandla esinye kuphela.
• Gcina iingalo zakho zikufutshane nomzimba wakho: Xa uphakamisa into ethile, gcina iingalo zakho zikufutshane nomzimba wakho.

Malunga nokuqhuba

Uza kukwazi ukuqhuba kwakhona emva kwenyanga emva kotyando. Kodwa ngaphambi koko, ngokuqinisekileyo kuya kufuneka ucele imvume kugqirha wakho. Ide i-sternum yakho iphole, kungcono ukuhlala kwisihlalo esingaphambili somkhweli xa uhamba ngemoto. Nokuba uziva ungakhululekanga xa ibhanti yesihlalo icinezela esifubeni sakho, qiniseka ukuba unxibe ibhanti yesihlalo kuba iya kukukhusela xa kwenzeka ingozi.

Ngawaphi amaxesha afanelekileyo okubonana nogqirha?

Uza kuba nentlanganiso yokulandelelana nogqirha wakho rhoqo. Nangona kunjalo, ukuba ufumana naziphi na iimpawu ezilandelayo, kufuneka wazise ugqirha wakho ngoko nangoko.

Ukukhetha eyona ndlela ifanelekileyo yotyando lwentliziyo yakho sisigqibo ugqirha wakho aza kusenza ngokusekelwe kwimeko yakho ethile. Kwiimeko ezininzi, i-sternotomy yeyona ndlela ilungileyo yokufikelela entliziyweni. Ukuba unemibuzo malunga noku, ungathandabuzi ukubuza ugqirha wakho.