Ngamanye amaxesha intliziyo yethu inokuba buthathaka kakhulu. Izihlunu zentliziyo zinokudinwa kangangokuba azinakulawulwa ngamayeza okanye ngolunye unyango. Le meko siyibiza ngokuba yi-Advanced Heart Failure. Ngoko ke, ubusazi na ukuba ngamaxesha anje, 'umncedisi' omncinci unokufakwa entliziyweni kwaye umsebenzi othile wentliziyo unokwabelwa yona? Esi sixhobo yinto esiyibiza ngokwezonyango ngokuba yiVentricular Assist Device, okanye i-VAD ngamafutshane. Namhlanje, masiqonde oku ngokulula, ngokungathi sithetha nomhlobo.
Kalula nje, yintoni i-VAD?
Cinga ngentliziyo yakho njengenjini epompa amanzi aye endlwini. Xa le moto ingasebenzi, amanzi awahambi aye endlwini yonke, akunjalo? Kunjalo ke ngentliziyo ebuthathaka. I-VAD yipompo encinci yomatshini esetyenziselwa ukunceda intliziyo ebuthathaka. Ithatha igazi kwi-ventricle yentliziyo ize ilipompe liye emzimbeni wonke. Kufana nokongeza injini encinci eyongezelelweyo kwinjini ebuthathaka.
Kukho iintlobo ezininzi eziphambili zezi VAD.
| Uhlobo lwe-VAD | Umsebenzi owenziwayo |
|---|---|
| Isixhobo soNcedo lweMiphunga yasekhohlo (i-LVAD) | Olu lolona hlobo lusetyenziswa kakhulu. Lunceda icala lasekhohlo lentliziyo ukuba licoce igazi elinomoya-mpilo omninzi emzimbeni wonke. |
| Isixhobo soNcedo lweMithambo yasekunene (i-RVAD) | Inceda kwicala lasekunene lempompo yentliziyo kwaye ithumela igazi elingcolileyo emiphungeni ukuze lihlanjululwe. |
| Isixhobo soNcedo lweBiventricular | Oku kuxhasa amacala omabini entliziyo (ekhohlo nasekunene) ngaxeshanye. |
| Ii-VAD zabantwana | Ezi zincinci ngobukhulu, zenzelwe ngokukodwa ukulingana neminyaka eyahlukeneyo ukusuka kubantwana abancinci ukuya kubantu abadala abancinci. |
Ngabantu abanjani abafuna i-VAD?
Ayinguye wonke umntu onesifo sentliziyo esinzima oza kufakwa i-VAD. Isetyenziswa ikakhulu ngeenjongo ezintathu.
1. NjengeBridge eya ekuBuyiseni Ingqondo: Ngamanye amaxesha intliziyo inokuba buthathaka okwethutyana. Kwiimeko ezinjalo, i-VAD isetyenziselwa ukunika intliziyo ukuphumla nokuyixhasa ide ikwazi ukusebenza yodwa kwakhona.
2. NjengeBridge eya kwi-Heart Transplant: Abanye abaguli badinga ukufakelwa intliziyo. Kodwa kufuneka balinde ixesha elithile ukuze kubekho intliziyo ehambelanayo. Ngeli xesha, i-VAD isetyenziselwa ukuxhasa intliziyo ukuze kusindiswe ubomi.
3. Unyango Lokuya Kwindawo Ethile: Kwabo bangafanelekanga ukufakelwa intliziyo ngenxa yobudala okanye ezinye iimeko zempilo, le VAD isetyenziswa ngokusisigxina ukubonelela ngenkxaso yentliziyo ubomi bonke. Oku kubavumela ukuba baphile ixesha elide kwaye benomgangatho ongcono wobomi.
Isebenza njani le matshini?
Kukho iindawo ezininzi kwesi sixhobo. Ezinye zidibene nentliziyo ngaphakathi emzimbeni, ngelixa ezinye zingaphandle komzimba.
- I-Inflow Cannula: Le yityhubhu eqhagamshelwe kwigumbi lentliziyo. Ithatha igazi entliziyweni ize ilithumele kwimpompo yomatshini.
- I-Mechanical Pump: Eli liqhawe lebali. Nguye owenza umsebenzi wokupompa intliziyo.
- I-Outflow Cannula: Le tube idibanisa igazi elimpompiweyo libuyele kumthambo wegazi oyintloko womzimba (i-aorta) okanye umbhobho okhokelela emiphungeni.
- I-Driveline: Le yintambo encinci, eqinileyo edibanisa ipompo engaphakathi emzimbeni kunye nomlawuli ongaphandle komzimba. Iphuma ngesikhumba.
- Umlawuli: Oku kufana nobuchopho be-VAD. Ikhompyutha encinci. Oku kukulawula ukusebenza kwe-VAD kwaye kuvumela oogqirha kunye nesigulana ukuba babone ulwazi oluvela kuyo.
- Iphakheji yebhetri yangaphandle: Ezi bhetri zibonelela ngamandla afunekayo kwi-VAD. Kukho ibhetri ephambili kunye nebhetri yokuxhasa imeko-bume.
Kwenzeka ntoni ngaphambi kotyando?
Ngenxa yokuba olu lutyando olunzima kakhulu, isigulana sikhethwa ukuba sityandwe yi-VAD emva kovavanyo oluninzi kakhulu. Imeko yangoku yentliziyo kunye nezinye izitho zomzimba (ezifana nezintso nesibindi) ihlolwa ngononophelo.
Eyona nto ibalulekileyo kukuba esi sisigqibo esenziwe liqela loogqirha. Ukulungiselela komzimba nengqondo yesigulana kubaluleke kakhulu apha.
Uvavanyo oluqhelekileyo luquka:
- I-Electrocardiogram (ECG)
- I-Echocardiogram (i-Echocardiogram)
- Iskena se-CT
- Uvavanyo Lokuzilolonga
- Ukucoca Intliziyo
Kwakhona, isigulana kunye nosapho bafundiswa ngcono indlela yokuphila ne-VAD kunye nendlela yokuyinyamekela. Kubaluleke kakhulu ukuba nelungu losapho okanye umhlobo osenyongweni onokumnceda isigulana.
Lwenziwa njani utyando?
Olu lutyando lwentliziyo evulekileyo. Kalula nje, nantsi into eyenzekayo:
1. Uza kufakwa phantsi kwe-anesthesia eqhelekileyo. Ngoko awuyi kuva okanye ukukhumbula nantoni na.
2. Ngexesha lotyando, uza kunikwa inkxaso yokuphefumla ngumatshini womoya .
3. Ugqirha wenza utyando phakathi kwesifuba, eveza intliziyo.
4. Emva koko uza kuqhagamshelwa kumatshini we-cardiopulmonary bypass . Lo matshini uza kuqhubeka nokujikeleza igazi emzimbeni wakho nokuba intliziyo yakho iye yema ngexesha lotyando.
5. Okulandelayo, ipompo ye-VAD iqhotyoshelwe kwindawo efanelekileyo entliziyweni, kwaye umgca wokuqhuba ususwa ngodonga lwesisu.
6. Emva kokusebenzisa i-VAD nokuqinisekisa ukuba inika umzimba igazi elifunekayo, uza kususwa kumatshini we-bypass.
7. Ekugqibeleni, ithambo lesifuba liphinda libotshelelwe ngeengcingo zesinyithi, kwaye inxeba livalwa ngezititshi ezinyibilikayo.
Zithini iingenelo kunye neengozi?
Njengalo naluphi na utyando olukhulu, i-VAD ineenzuzo kunye neengozi.
| Iinzuzo | Iingozi |
|---|---|
|
|
Iqela lakho lezonyango liza kukubeka esweni rhoqo ukuze lilawule ezi ngozi.
Bunjani ubomi nge-VAD?
Ukuphila ne-VAD kuthetha ukuqhela indlela entsha yokuphila.
- Imida: Awunakuhlamba okanye uqubhe kuba isixhobo asikwazi ukumelana namanzi (kodwa uya kufundiswa indlela yokuhlamba ngesiciko esikhethekileyo). Kwakhona, kufuneka uphephe imidlalo enokuchukumisa umzimba enobungozi obukhulu bokwenzakala.
- Ulondolozo: Soloko ugcina umgca wokuqhuba ucocekile apho uphuma khona eluswini. Tshintsha iibhetri, kwaye ufunde ukuqonda ii-alamu ezivela kumlawuli.
- Amayeza: Kuya kufuneka usele amayeza okunciphisa igazi, njengeWarfarin, ubomi bakho bonke. Kuya kufuneka uthathe amayeza okulawula uxinzelelo lwakho lwegazi.
- Ukujonga ugqirha: Kufuneka ubone ugqirha rhoqo, wenze uvavanyo lwegazi, kwaye ujonge idatha ye-VAD. Nangona kusenokufuneka uye esibhedlele rhoqo ekuqaleni, ukuphindaphinda kuya kuncipha ngokuhamba kwexesha.
Ngaba nawe kufuneka ucinge ngempilo yengqondo?
Ewe, ewe. Abanye abantu banokuba noxinzelelo, ukudakumba, okanye ixhala xa bephila notshintsho olukhulu kangaka. Yinto eqhelekileyo leyo. Ukuba uziva ngaloo ndlela, musa ukubandezeleka wedwa, kodwa ngokuqinisekileyo thetha nogqirha wakho. Kubaluleke kakhulu ukufumana uncedo ngaloo nto.
Xa kufuneka uthethe nogqirha
Ukuba ufumana ezi mpawu okanye iingxaki zilandelayo, yazisa iqela lakho lezonyango ngoko nangoko.
| Ingxaki | Yintoni ekufuneka uyiqwalasele |
|---|---|
| Iimpawu zomzimba |
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| Iingxaki zesixhobo |
|
I-VAD yinkqubela phambili emangalisayo kwezobuchwepheshe enokunika ubomi besibini kumntu ojamelene nesifo sentliziyo esinzima. Iingenelo ezisindisa ubomi ezizibonelelayo azinakuthelekiswa nanto. Kodwa ukuze ufumane okuninzi kwezo zibonelelo, kubalulekile ukuba isigulana sizikhathalele kakhulu sona kunye nesixhobo saso.
Umyalezo Wokuya Ekhaya
- Isixhobo soNcedo lweVentricular (VAD) yimpompo yoomatshini exhasa intliziyo ebuthathaka kakhulu.
- Olu lutyando olukhulu olusindisa ubomi kwaye lusetyenziswa ngaphambi okanye njengesisombululo esisisigxina sokufakelwa intliziyo.
- Ukuphila ne-VAD kufuna ukuzibophelela ubomi bonke, ukulandela imiyalelo yezonyango, kunye nokugcinwa ngokufanelekileyo kwesixhobo.
- Oku kunokuphucula kakhulu umgangatho wobomi ngezinto ezifana nokuphefumla lula kunye nokwandisa amandla omzimba.
- Ukuba ubona nayiphi na into engaqhelekanga emzimbeni wakho okanye kwisixhobo sakho, ungaze uyityeshele. Thetha neqela lakho lezonyango ngoko nangoko.
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