Ngaba ugqirha wakho ukuxelele ukuba intliziyo yakho ibuthathaka kangangokuba ayikwazi ukupompa igazi ngokufanelekileyo? Okanye ngaba kukho umntu kusapho lwakho onale meko? Namhlanje sithetha ngesixhobo esikhethekileyo esisetyenziselwa ukunceda intliziyo kwiimeko zokungasebenzi kakuhle kwentliziyo. Oku kubizwa ngokuba yiVentricular Assist Device, okanye iVAD ngamafutshane.
Kalula nje, yintoni le VAD?
Cinga ngentliziyo yakho njengenjini encinci epompa igazi emzimbeni wakho wonke. Ngamanye amaxesha le injini iba buthathaka. Emva koko ayikwazi ukusebenza kakuhle. Ngelo xesha, i-VAD sisixhobo soomatshini esinceda intliziyo ipompe igazi lisuka entliziyweni liye emzimbeni wonke. Kufana nokongeza enye injini encinci ukunceda injini ebuthathaka.
Kukho iintlobo ezahlukeneyo ze-VAD. Makhe sijonge iintlobo eziphambili.
| Uhlobo lwe-VAD | Wenza ntoni? |
|---|---|
| Isixhobo soNcedo lweMiphunga yasekhohlo (i-LVAD) | Olu lolona hlobo lusetyenziswa kakhulu. Lusebenza kwicala lasekhohlo lentliziyo (i-ventricle yasekhohlo). Lunceda ekupompeni igazi elicocekileyo, elineoksijini ukusuka entliziyweni ukuya emzimbeni wonke. |
| Isixhobo soNcedo lweMithambo yasekunene (i-RVAD) | Oku kunceda icala lasekunene lentliziyo. Kunceda ekucoceni igazi elingcolileyo lomzimba (igazi elineoksijini ephantsi) ngokulithumela emiphungeni. |
| Isixhobo soNcedo lweBiventricular | Oku kunceda omabini amacala entliziyo. Oko kukuthi, omabini amacala asekhohlo nasekunene. |
| Ii-VAD zabantwana | Ezi zii-VAD ezincinci ezenzelwe ngokukodwa abantwana abancinci. Zingasetyenziswa ukusuka kusana olusandul’ ukuzalwa ukuya kumntwana omncinci. |
Kutheni ndifuna i-VAD?
Ukuba unesifo sentliziyo esiqhubekekayo kwaye intliziyo yakho ayikwazi ukupompa igazi elaneleyo emzimbeni wakho yodwa, unokufuna i-VAD. Inemisebenzi emithathu ephambili.
- Ibhulorho yokufakelwa: Abanye abantu bafanelekile ukufakelwa intliziyo. Kodwa kufuneka balinde ixesha elithile ukuze intliziyo efanayo ifumaneke. Ngeli xesha, le VAD isetyenziselwa ukunceda intliziyo yakho ebuthathaka. Ifana nebhulorho .
- Ibhulorho eya ekuchacheni: Ngamanye amaxesha intliziyo inokuba buthathaka okwethutyana. Ngonyango olufanelekileyo, intliziyo inokuchacha ekugqibeleni. Ide loo ntliziyo iphile, le VAD ingasetyenziselwa ukunceda.
- Unyango oluya kwindawo ethile: Abanye abaguli basenokungakwazi ukufakelwa intliziyo ngenxa yobudala okanye ezinye iimeko zempilo. Kwabo baguli, le VAD ingasetyenziswa njengesixhobo sokuxhasa intliziyo ubomi babo bonke. Oku kubavumela ukuba baphile ixesha elide benomgangatho ongcono wobomi.
Isebenza njani le matshini yeVAD?
Esi sixhobo sinamalungu aliqela. Amanye anamathele entliziyweni ngotyando kwaye angaphakathi emzimbeni. Amanye angaphandle komzimba.
| Inxalenye yesixhobo | Ingcaciso elula |
|---|---|
| I-cannula engenayo | Le yityhubhu encinci edibanisa igumbi lentliziyo. Igazi elisentliziyweni lingena kwimpompo yoomatshini ngale tyhubhu. |
| Impompo yoomatshini | Le yeyona nxalenye iphambili ye-VAD. Le mpompo yenza umsebenzi wokupompa intliziyo yakho. |
| I-cannula ephumayo | Le ikwayityhubhu. Ithwala igazi lisuka kwimpompo yomatshini ukuya kwimithambo yegazi ephambili yomzimba (i-aorta) okanye liye kwimithambo yegazi eya emiphungeni (umthambo wepulmonary). |
| Umgca wokuqhuba | Olu lucingo oluqinileyo oluphuma kwi-VAD ngaphakathi emzimbeni wakho naselusu lwakho. Kulapho i-VAD iqhagamshelwe khona kwisilawuli esingaphandle. |
| Umlawuli | Oku kufana nekhompyutha encinci. Ilawula ukusebenza kwe-VAD. Wena nogqirha wakho ningayijonga ukuze nibone ukuba i-VAD isebenza kakuhle na. |
| Ibhetri yangaphandle | Le yipakethi yebhetri ebonelela ngombane ofunekayo kwi-VAD. Kukho ibhetri ephambili kunye nebhetri yokuxhasa. I-VAD iqhagamshelwe kwezi bhetri ngesilawuli. |
Kwenzeka ntoni ngaphambi kotyando?
Ayingabo bonke abantu abaneengxaki zentliziyo ezinzima abanokuba ne-VAD. Ukuze kuqinisekiswe ukuba ungumntu ofanelekileyo na, uza kuvavanywa ngokwezonyango nangokwengqondo. Oku kuza kuquka ukuvavanywa ngokucokisekileyo kwentliziyo yakho kunye nezinye izitho ezibalulekileyo (ezifana nezintso nesibindi). Baza kujonga nezinye iimeko zempilo. Ezinye zeemvavanyo ezinokwenziwa ziquka:
- I-Electrocardiogram (ECG)
- I-Echocardiogram (I-Echo)
- Iskeni ye-computed tomography (CT)
- Uvavanyo lokuzilolonga
- Ukufakwa kwe-catheter kwintliziyo (uvavanyo olwenziwa ngokufaka i-catheter entliziyweni)
Kwakhona, wena nosapho lwakho niya kuba nolwazi olupheleleyo malunga nokuphila ne-VAD kunye nendlela yokuyinyamekela imihla ngemihla. Kubaluleke kakhulu ukubandakanya umntu onokukuxhasa, nokuba lilungu losapho okanye umntu osondeleyo kuwe, kule nkqubo.
Kwenzeka ntoni ngexesha lotyando?
Olu lutyando olukhulu. Ngamazwi alula, okwenzekayo ngexesha lalo ngolu hlobo lulandelayo:
1. I-Anesthesia: Okokuqala, uza kulaliswa ngokupheleleyo (i-anesthesia eqhelekileyo). Ngoko awuyi kuva nto kwaye awuyi kuba nankumbulo yotyando.
2. Uncedo lokuphefumla: Emva kotyando , nangeentsuku zokuqala ezimbalwa kwigumbi lokhathalelo oluphezulu (ICU), i-ventilator iya kukuphefumlela.
3. Utyando:Ugqirha wenza utyando phakathi kwesifuba sakho aze aye apho intliziyo yakho ikhoyo.
4. Umatshini wokudlula intliziyo nemiphunga: Okulandelayo, uza kuqhagamshelwa kumatshini okhethekileyo. Ubizwa ngokuba yi-'Cardiopulmonary Bypass Machine'. Ngexesha lotyando, umsebenzi wentliziyo nemiphunga wenziwa okwethutyana ngulo matshini. Uza kunikwa neyeza elibizwa ngokuba yi-'Heparin' ukuthintela ukujiya kwegazi.
5. Ukufakelwa kwe-VAD: Emva koko ugqirha uncamathisela isixhobo se-VAD kwiindawo ezifanelekileyo entliziyweni. Emva koko umgca wokuqhuba ususwa ngesikhumba sesisu.
6. Ukuvula umatshini: Nje ukuba i-VAD iqhagamshelwe, iyavulwa kwaye ususwa kumatshini okhethekileyo.
7. Ukugqitywa kotyando: Nje ukuba i-VAD isebenze ngokuzinzileyo, iyeza elibizwa ngokuba yi-'Protamine' linikwa ukunceda igazi lijiye kwakhona, ithambo lesifuba liphinde lifakwe iintambo, kwaye inxeba lesikhumba liyathungwa.
Zithini iingenelo zokusebenzisa i-VAD?
Abantu abaninzi baqala ukuva ezi zinto ngelixa bephila ne-VAD:
- Ukuphefumla lula: Ukudinwa kunye nokuphefumla kancinci kuncipha kakhulu.
- Ukusebenza kakuhle kwamalungu omzimba: Amanye amalungu omzimba afumana ukuhamba kwegazi okungcono, ngoko ke ukusebenza kwawo kuyaphucuka.
- Ukuvuselelwa: Ukudinwa okugqithisileyo okwakukho ngaphambili kuphelile, kwaye umzimba uziva unamandla amnandi.
Ngamafutshane, i-VAD inokuphucula kakhulu umgangatho wobomi bakho.
Ziziphi iingozi ezinxulumene noku?
Njengalo naluphi na utyando olukhulu, kukho iingozi ezibandakanyekileyo, kwaye nokuba kusetyenziswa esi sixhobo ubomi bonke, ezinye iingxaki zinokubakho.
- Ukubetha kwentliziyo okungaqhelekanga (iiArrhythmias)
- Ukopha
- Amahlwili egazi
- Usulelo
- Ukungasebenzi kakuhle kwesixhobo
- Ukusilela kwentliziyo kwicala lasekunene
- Ingozi yemithambo yegazi ( stroke )
Musa ukoyika ezi ngozi. Iqela lakho lezonyango lihlala likhangela ukuba zingathintelwa kwaye lizilawule ukuba ziyenzeka.
Izinto ekufuneka uziqwalasele xa uhlala ne-VAD
Emva kotyando, kuya kufuneka uhlale kwigumbi labagula kakhulu (ICU) kangangeentsuku ezimbalwa. Emva koko uya kudluliselwa kwigumbi eliqhelekileyo. Ngexesha lokuhlala kwakho esibhedlele, uya kuqeqeshwa ukuba uphile ngezi zixhobo.
Xa ufika ekhaya, qaphela ezi zinto zilandelayo:
- Thatha iyeza ngqo:Kubaluleke kakhulu ukusela amayeza okunciphisa igazi afana neWarfarin, enikwa ukuthintela ukuqhekeka kwegazi, ngokuchanekileyo nangexesha elifanelekileyo. Kufuneka uthathe namanye amayeza oxinzelelo lwegazi oluphezulu kunye nokulawula isantya sentliziyo ngokuchanekileyo.
- Ukhathalelo lweSixhobo: Uza kufundiswa indlela yokugcina isixhobo, ibhetri, kunye nomgca wokuqhuba ucocekile. Landela le miyalelo ngononophelo.
- Utshintsho kwindlela yokuphila:
- Esi sixhobo akufuneki sifakwe emanzini. Oku kuthetha ukuba awukwazi ukuhlamba okanye ukudada ngaso. Nangona kunjalo, siza kukubonisa indlela yokuhlamba isixhobo sigqunywe ngononophelo.
- Imidlalo yokuchukumisa umzimba mayingafanele ithintelwe kuba, ukuba uthatha amayeza okunciphisa igazi, nokuba yingozi encinci inokubangela ukopha okukhulu.
- Kufuneka usoloko uqhagamshelwe kwiibhetri okanye iplagi eludongeni.
- Indlela yokuphila enempilo yentliziyo: Kuphephe ukutshaya ngokupheleleyo. Yitya ukutya okunesondlo. Zilolonge ngendlela efanelekileyo njengoko ugqirha wakho ekucebisile.
Uzakumbona nini ugqirha
Ukuphila ne-VAD kuthetha ukuba kuya kufuneka uye kuhlolwa rhoqo ngugqirha. Nangona kusenokufuneka uye rhoqo ekuqaleni, amaxesha okuya rhoqo aya kuncipha njengoko imeko yakho iphucuka.
Ukuba unayo nayiphi na kwezi mpawu, fowunela ugqirha wakho ngokukhawuleza:
| Iimpawu emzimbeni | Iingxaki zezixhobo |
|---|---|
| - Iintlungu zesifuba - Ukopha - Umchamo omnyama - Umkhuhlane okanye ukubanda - Intlungu yamalungu - Ububomvu, ukudumba, kunye nentlungu apho kuvela khona imingxunya okanye umgca wokuhamba - Ukutyeba ngequbuliso okanye ukudumba kwezandla neenyawo | - Ukuba isilawuli, i-driveline, okanye ibhetri ibonakala yonakele - Ukuba isilawuli sibonisa imiyalezo yempazamo - Ukuba i-alamu iyakhala kwaye awazi ukuba ungayimisa njani |
Cinga nangempilo yengqondo
Kuqhelekile ukuziva udandathekile kwaye uxhalabile ngamanye amaxesha xa uphila notshintsho olukhulu kangaka. Kodwa musa ukuzigcina ezo mvakalelo kuwe. Akukho nto inokubangela iintloni ngayo. Ukuba uvakalelwa ngolu hlobo, ngokuqinisekileyo thetha nogqirha wakho ngayo.
Umyalezo Wokuya Ekhaya
- Isixhobo soNcedo lweVentricular (VAD) sisixhobo esisebenza ngomatshini esinceda intliziyo ebuthathaka kakhulu ekumpompeni igazi.
- Oku kungasetyenziswa njengenkxaso yobomi bonke de kufike ukufakelwa intliziyo, de intliziyo iphole, okanye ubomi bakho bonke.
- Nangona olu lutyando olukhulu, lunokunceda kakhulu ekwandiseni ubomi bakho kwaye luphucule umgangatho wobomi bakho.
- Xa uphila ne-VAD, kubaluleke kakhulu ukuyinyamekela ngokufanelekileyo le sixhobo, usele amayeza ngokuchanekileyo, kwaye ulandele imiyalelo kagqirha wakho.
- Ukuba ubona into engaqhelekanga emzimbeni wakho okanye kwizixhobo zakho, funa ingcebiso kagqirha ngoko nangoko. Kwakhona nyamekela impilo yakho yengqondo.
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