Inhliziyo yethu iyisitho esimangalisayo. Ifana nephampu encane esebenza ngokungayeki. Le phampu inezingxenye ezine ezisiza ekuthumeleni igazi ohlangothini olulodwa kuphela, esilubiza ngokuthi ama-valve enhliziyo kwezokwelapha. Cabanga ukuthi bekuzokwenzekani uma ngisho nomnyango owodwa walezi zivalo ubuphukile, uma ungavuli noma ungavali kahle. Ukugeleza kwegazi emzimbeni wonke bekungaphazamiseka, akunjalo? Namuhla, sikhuluma ngokuhlinzwa okuyinkimbinkimbi kodwa okuphumelelayo kakhulu okwenziwa lapho i-valve ye-aortic, enye yama-valve ayinhloko enhliziyweni, iba nesifo.
Kalula nje, iyini inqubo kaRoss?
Lokhu ukuhlinzwa okukhethekile kakhulu. Odokotela bakubiza ngokuthi inqubo yokufakelwa kwe-pulmonary autograft. Lokhu kuyinto ekhethekile kakhulu eyenzeka lapha. Lokhu kuhlinzwa kwenziwa kusetshenziswa ingxenye yomzimba wakho.
Kalula nje, izinyathelo ezimbili eziyinhloko ezenzeka lapha yilezi:
1. Ivalvu yakho ye-aortic engasebenzi kahle iyasuswa bese ithathelwa indawo yivalvu yakho yamaphaphu enempilo.
2. Ngemuva kwalokho, ivalvu yamaphaphu enempilo (ivalvu yomnikeli) ethathwe kumuntu oshonile itshalwa endaweni engenalutho lapho kwakukhona khona ivalvu yamaphaphu.
Manje ungase ucabange, "Kungani ukwenza lokho? Ukususa enye bese ubeka enye, bese ubeka enye phezu kwalokho, lokho kuzwakala kuyinkimbinkimbi kancane, akunjalo?" Yebo, lokho kuyiqiniso. Kodwa kunesizathu esihle kakhulu salokho. Ake sikubheke.
Kungani lokhu kuhlinzwa kubalulekile? Kungani usebenzisa ivalvu yakho yamaphaphu?
Inhliziyo yethu ipompa igazi elihlanzekile, elinomoya-mpilo emzimbeni wonke nge-valve ebizwa ngokuthi i-aortic valve. Lena yi-valve eyinhloko. Futhi yi-valve evimba igazi ukuthi lingagelezi emuva ngenkathi inhliziyo ishaya.
Kodwa ngezinye izikhathi le valve ingavimbeka ngaphandle kokuvula kahle, esikubiza ngokuthi i-stenosis . Noma ayikwazi ukuvala kahle futhi igazi lingavuza emuva, esikubiza ngokuthi i-regurgitation . Uma lezi zimo ziqhubeka, amathuba okwehluleka kwenhliziyo nokutheleleka aphezulu kakhulu.
Ngakho-ke esimweni esinzima njengalesi, ivalvu eyonakele kufanele isuswe bese kufakwa entsha.
Ngakho-ke, kungani ushintsha ivalvu yakho yamaphaphu ngeyokwenziwa?
Kunezizathu eziningana zalokhu:
- Ukubekezelela ukucindezeleka: I-valve ye-aorta ingaphansi komfutho wegazi ophakeme. Ngakho-ke i-valve ebekwe lapho kudingeka ibe namandla kakhulu. Ngenxa yokuthi i-valve yakho yamaphaphu iyisicubu esiphilayo, ingamelana kahle nalolu mfutho ophezulu futhi ihlale isikhathi eside kakhulu kune-valve yokwenziwa.
- Ingozi encane yokuqhekeka kwegazi: Uma kufakwa ama-valve okwenziwa, kuba nengozi enkulu yokuqhekeka kwegazi. Ngakho-ke, kufanele bathathe imithi yokunciphisa igazi impilo yabo yonke. Kodwa uma besebenzisa izicubu zabo, leyo ngozi cishe ayikho.
- Indawo yevalvu yamaphaphu:Ivalvu yamaphaphu ingaphansi kokucindezeleka okuphansi, ngakho ivalvu yomnikeli evela kumuntu oshonile ngeke iguge ngokushesha. Futhi, ivalvu ye-aortic kanye nevalvu yamaphaphu kufana kakhulu ngobukhulu kanye nesimo.
Kalula nje, okwenziwa odokotela abahlinzayo ukufaka ivalvu yakho "yangempela" enamandla kakhulu engxenyeni ebaluleke kakhulu yenhliziyo, lapho ithwala khona isisindo esikhulu, bese ubeka ivalvu "yomnikeli" engxenyeni ethwala isisindo esincane kakhulu.
Ubani lo kuhlinzwa okufanelekelayo, futhi ubani okufanelekelayo?
Lokhu kuhlinzwa akufanele wonke umuntu. Odokotela bahlola ngokucophelela isimo sesiguli bese benquma ukuthi bayakufanelekela yini lokhu noma cha. Ake sibheke ithebula elingezansi.
| Ubani ofanelekela lokhu kuhlinzwa? | Abantu abangafaneleki kulolu hlinzwa |
|---|---|
| Ngokuvamile kubantu abasebasha nasebekhulile abangaphansi kweminyaka engama-60 ubudala . | Abantu abanezifo ezihlasela amasosha omzimba njenge-lupus kanye ne-rheumatoid arthritis. |
| Kulabo abahlushwa yi-aortic stenosis yokuzalwa. | Abantu abanezinkinga zezicubu ezixhumeneyo njenge-Marfan syndrome. |
| Kulabo abahlushwa ezinye izinhlobo zesifo se-aortic valve. | Abantu abanokuvinjelwa kwemithambo yegazi emithathu noma ngaphezulu eyinhloko ehambisa igazi enhliziyweni (isifo semithambo yegazi ye-coronary). |
| Kulabo abane-aortic valve endocarditis. | Kulabo abanenkinga ye-pulmonary valve. |
Kwenzekani ngesikhathi sokuhlinzwa?
Inqubo kaRoss iyindlela ebucayi kakhulu futhi ecophelelayo ethatha amahora amaningana. Yenziwa yithimba lodokotela abangochwepheshe benhliziyo. Ake sibheke ukuthi kwenzekani phakathi nenqubo.
1. I-Anesthesia: Okokuqala, uzofakwa ngaphansi kwe-anesthesia ejwayelekile. Lokhu kusho ukuthi uzolala ubuthongo obujulile kuze kube yilapho ukuhlinzwa kuphelile, ngakho ngeke uzwe ubuhlungu. Ngeke ukhumbule lutho ngokuhlinzwa.
2. Ukuxhuma emshinini wenhliziyo namaphaphu: Okulandelayo, odokotela bazokuxhuma emshinini okhethekile obizwa ngokuthi umshini we-cardiopulmonary bypass. Lo mshini uthatha okwesikhashana umsebenzi wenhliziyo namaphaphu akho ngesikhathi sokuhlinzwa. Lokhu kuvumela odokotela abahlinzayo ukuthi benze ukuhlinzwa ngokuphephile ngaphandle kokuvimba inhliziyo yakho.
3. Ukuvula isifuba: Odokotela abahlinzayo benza ukusika phakathi kwesifuba sakho, bahlukanise ithambo lesifuba (sternum) libe kabili ukuze bafinyelele enhliziyweni. Le nqubo ibizwa ngokuthi i-sternotomy .
4. Ukuhlolwa kwevalvu: Okulandelayo, ivalvu yamaphaphu ihlolwa ngokucophelela ukuze kubonakale ukuthi iphilile yini futhi ifanelekile yini ukufakelwa esikhundleni sevalvu ye-aorta.
5. Ukufakwa kwevalvu: Uma konke kuhamba kahle, odokotela abahlinzayo bazosusa ivalvu ye-aorta eyonakele bese beyishintsha ngevalvu yakho yamaphaphu. Ngemuva kwalokho, ivalvu yamaphaphu enempilo evela kumuntu oshonile iyatshalwa endaweni engenalutho lapho kwakukhona khona ivalvu yamaphaphu yangaphambili.
6. Ukuvuselela inhliziyo: Ngemva kokuba ama-valve amasha womabili efakwe kahle, odokotela abahlinzayo bazoyiqala kabusha inhliziyo yakho. Ngemuva kwalokho uzokhishwa kancane kancane emshinini wenhliziyo namaphaphu.
7. Ukuhlolwa kokugcina nokuvalwa: Amavalvu asanda kufakwa ayahlolwa futhi ukuqinisekisa ukuthi asebenza kahle. Uma konke kuphumelele, i-sternum ixhunywa kabusha ngezintambo, bese ukusika kwesifuba kuthungwa kuvalwe.
Yiziphi izinzuzo kanye nezingozi ezingaba khona zalokhu kuhlinzwa?
Njenganoma yikuphi ukuhlinzwa, ukuhlinzwa kukaRoss kunezinzuzo nezingozi zako. Izingozi zingancishiswa kakhulu ngokuthola ukwelashwa ngaphansi kodokotela ohlinzayo onekhono onolwazi olukhulu kulokhu kuhlinzwa futhi owenza le nqubo njalo.
| Izinzuzo | Izingozi |
|---|---|
| Akudingeki ukuthi uthathe imithi yokunciphisa igazi impilo yakho yonke. | Ukwanda kwe-aorta ye-aorta (ukwanda kwe-aorta eduze kwevalvu esanda kufakelwa). |
| Ungaphila impilo esebenzayo ngaphandle kwemingcele, wenze izinto ezinjengokuzivocavoca umzimba nokushayela. | Ukuphazamiseka kwenhliziyo (i-Arrhythmia). |
| Abesifazane abahlela ukukhulelwa bangazala umntwana ngokuphephile. | Isifo senhliziyo. |
| Ukugeleza kwegazi emzimbeni wonke kusezingeni elihle kakhulu (i-hemodynamics enhle kakhulu). | Ukopha kakhulu (Ukopha igazi). |
| Ngemva nje kokuhlinzwa, izimpawu ziyaphela bese uqala ukuzizwa ululama ngokushesha . | Ukutheleleka. |
| Ngenxa yokuthi iyizicubu zayo, ukuqina kwayo kuphakeme kakhulu. | Ivalvu yenhliziyo evuzayo. |
Sinjani isikhathi sokululama ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, uzovuka use-Cardiac ICU. Emahoreni ambalwa okuqala, ungase uxhunywe kumshini wokuphefumula ukuze ukusize uphefumule. Ukusebenza kwenhliziyo yakho kuzoqashwa njalo. Ngokuvamile uzohlala e-ICU cishe izinsuku ezi-5.
Kungathatha izinyanga eziningana ukululama ngokuphelele ngemva kokubuyela ekhaya. Phakathi nalesi sikhathi, kuvamile ukuzwa izinto ezifana nalezi:
- Ukuqunjelwa
- Izinkinga zengqondo ezifana nokucindezeleka
- Ukungalali
- Isifiso sokudla
- Ukuba ndikindiki nokuvuvukala eduze kokuhlinzwa
Phakathi nalesi sikhathi, kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo futhi uye emitholampilo ngezinsuku ezihleliwe.
Ingabe ukwelashwa impilo yonke kuzodingeka?
Yebo. Ngemva kwenqubo kaRoss, kuzodingeka ube ngaphansi kokuqashwa kwezokwelapha impilo yakho yonke. Kuzodingeka ukuthi uhlolwe njalo ngezikhathi ezithile ukuze uhlole ukuthi ama-valve amabili afakwe endaweni entsha asebenza kahle.
Khumbula, ukufakelwa kwevalvu yamaphaphu yomnikeli akuhlali impilo yonke. Kungase kudingeke ukuthi kufakwe enye futhi, ngokuvamile ngemva kweminyaka eyi-15-20. Kodwa ungakhathazeki. Ezimweni ezinjalo, odokotela bavame ukushintsha ivalvu besebenzisa amasu angangenisi kakhulu, ngaphandle kokwenza i-incision enkulu. Ngakho-ke, isikhathi sokululama sifushane kakhulu.
Kufanele ubonane nini nodokotela?
Kubaluleke kakhulu ukuqaphela noma yiziphi izimpawu zezinkinga lapho ubuyela ekhaya ngemva kokuhlinzwa. Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, shayela udokotela wakho ngokushesha.
- Ubuhlungu besifuba
- Uma uzizwa ushisa noma umkhuhlane
- Uma uzizwa unesiyezi noma amehlo akho ephenduka aluhlaza okwesibhakabhaka
- Uma ukhwehlela igazi
- Uma unemivimbo noma ukopha okungavamile
- Uma kwenzeka ukuhlanza
- Uma izitho zakho zingasasebenzi
- Uma indle ibomvu ngokugqamile
Umlayezo Wokuya Nawe Ekhaya
- Ukuhlinzwa kukaRoss kuyindlela yokwelapha ephumelela kakhulu kubantu abanesifo esibi se-aortic valve.
- Ngenxa yokuthi i-valve yakho yamaphaphu isetshenziswa lapha, imiphumela mihle kakhulu futhi ihlala isikhathi eside.
- Enye yezinzuzo ezinkulu zalokhu kuhlinzwa ukuthi akudingeki ukuthi uphuze imithi yokunciphisa igazi impilo yakho yonke.
- Ngemva kokuhlinzwa, uzokwazi ukuphila impilo esebenzayo ngaphandle kwezithiyo.
- Ngenxa yokuthi lokhu kuyindlela yokuhlinzwa eyinkimbinkimbi kakhulu, kubaluleke kakhulu ukufuna ukwelashwa kudokotela ohlinzayo onolwazi oluningi kulo mkhakha.
- Ukuhlolwa kwezokwelapha impilo yonke kuyadingeka ngemva kokuhlinzwa.
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