Uma udokotela ekutshela noma othile omaziyo ukuthi udinga ukuhlinzwa kwenhliziyo evulekile, kuvamile ukuzizwa ukhathazekile kancane. Cishe uke wezwa izindaba ezinjengokuthi "ukuhlinzwa kwenziwa ngemva kokuba inhliziyo ima." Kwenziwa kanjani lokho ngempela? Igazi ligeleza kanjani emzimbeni lapho inhliziyo ima? Ithola kanjani umoya-mpilo? Impendulo yaleyo mibuzo umshini wenhliziyo namaphaphu esizokhuluma ngawo, noma ngokwezokwelapha, i-Cardiopulmonary Bypass . Ake sixoxe ngalokhu kalula, ngendlela ongayiqonda.
Kuyini i-Cardiopulmonary Bypass?
Nakuba leli gama lingase libonakale lide kancane, incazelo ilula kakhulu. Ake silihlukanise ngamagama.
- I-Cardio ilungele inhliziyo yakho.
- I-Pulmonary ibhekisela emaphashini akho .
- Ukudlula kusho ukugwema okuthile.
Kalula nje, i-Cardiopulmonary Bypass inqubo lapho ukugeleza kwegazi emzimbeni kudlulwa khona okwesikhashana yinhliziyo namaphaphu ngesikhathi sokuhlinzwa kwenhliziyo futhi kuqondiswa ngomshini okhethekile ongaphandle komzimba. Lo mshini ubizwa nangokuthi umshini wenhliziyo namaphaphu .
Cabanga ngokulungiswa okukhulu komgwaqo. Ngaleso sikhathi, izimoto ziphambukiselwa kwenye indlela kuze kube yilapho umsebenzi usuqediwe? Yilokho okwenzekayo nalapha. Kulula ngodokotela ohlinzayo ukuhlinza inhliziyo uma inhliziyo ingashayi futhi ingagcwele igazi. Ngakho-ke lo mshini uthatha okwesikhashana umsebenzi wenhliziyo namaphaphu. Lokho kusho ukuthi:
- Iqoqa igazi eliphelelwe umoya-mpilo emzimbeni.
- I-oxygen entsha ifakwa kulelo gazi.
- I-carbon dioxide isuswa egazini .
- Leli gazi elihlanziwe, elinomoya-mpilo liyaphonswa libuyiselwe emzimbeni .
Ngale ndlela, igazi elinomoya-mpilo linikezwa njalo kuzo zonke ezinye izitho zomzimba kulo lonke ukuhlinzwa. Le nqubo ibizwa ngokuthi "i-on the pump." Ngokuvamile, ikhambi elikhethekile lomuthi elibizwa ngokuthi "i-cardioplegia" linikezwa ukuze limise inhliziyo.
Ingabe i-Cardiopulmonary Bypass kanye ne-CABG zihlukile?
Lokhu kuyinto abantu abaningi abadideka ngayo. Lokhu okubili akulona into efanayo, kodwa kuvame ukwenzeka ndawonye.
- I-CABG (Coronary Artery Bypass Grafting) yigama lokuhlinzwa . Lokhu ukuhlinzwa okudala indlela entsha (bypass) yokuthi igazi ligeleze ngemithambo yenhliziyo ehambisa igazi enhliziyweni lapho ivinjwa amafutha.
- I-Cardiopulmonary Bypass iyindlela esetshenziswa ngesikhathi sokuhlinzwa kwe-CABG (kanye nokunye ukuhlinzwa kwenhliziyo). Iyindlela esetshenziswa ukudlula inhliziyo namaphaphu ukusiza udokotela ohlinzayo ukuba enze ukuhlinzwa kwe-CABG kalula nangokuphepha.
Kalula nje, i-CABG ifana nokwakha injini yemoto. I-Cardiopulmonary Bypass ifana nokuxhuma ibhethri elihlukile ngaphandle kwemoto ukuze kusebenze izinto ezifana nezibani kanye ne-AC ngenkathi kwakhiwa injini.
Yiziphi izinhlobo zokuhlinzwa ezidinga le ndlela?
I-Cardiopulmonary Bypass ivame ukudingwa ekuhlinzeni okulandelayo:
- Ukufakelwa Kwemithambo Yenhliziyo Enemithambo Yenhliziyo (i-CABG)
- Ukuhlinzwa kwe-aneurysms
- Ukuhlinzwa kokufakelwa inhliziyo
- Ukuhlinzwa kwevalvu yenhliziyo (ukulungiswa noma ukushintshwa kwevalvu yenhliziyo)
- Ukuhlinzwa kokufakelwa amaphaphu
Lo mshini wokusebenza kwenhliziyo namaphaphu usebenza kanjani?
Lo mshini ufana nenhliziyo yesikhashana namaphaphu amabili angaphandle komzimba. Ake sibheke imisebenzi eyinhloko oyenzayo.
| Umsebenzi womshini | Kalula nje... |
|---|---|
| Ukususa igazi enhliziyweni | Igazi lomzimba eliphelelwe umoya-mpilo lidonswa emshinini. |
| Ukwengeza umoya-mpilo nokususa i-CO2 | Yilokhu kanye okwenziwa amaphaphu ethu. Anezela umoya-mpilo egazini futhi asuse i-carbon dioxide. |
| Ukulawulwa kokushisa kwegazi kanye namazinga e-electrolyte | Kusiza ekunciphiseni izinga lokushisa lomzimba noma ukuligcina lisezingeni elidingekayo ngesikhathi sokuhlinzwa. |
| Ukumpompa igazi elinomoya-mpilo emuva | Yilokhu kanye okwenziwa yinhliziyo yethu. Isabalalisa igazi elinomoya-mpilo emzimbeni wonke. |
| Ukunikeza izidakamizwa ezivimba inhliziyo | Ukuze kube lula ngodokotela ohlinzayo ukusebenza, udokotela uzonikeza imithi edingekayo (i-cardioplegia) ukuze amise inhliziyo okwesikhashana. |
Yiziphi izingxenye eziyinhloko zomshini?
Lo mshini uyinhlanganisela yezingxenye eziningana.
- Ama-Cannula: Lawa amapayipi akhethekile axhunywe emithanjeni yegazi yomzimba wakho futhi asetshenziselwa ukuqoqa igazi emshinini bese elibuyisela emzimbeni wakho.
- Idamu: Ithangi eliqoqa igazi eliphelelwe umoya-mpilo emzimbeni.
- I-oxygenator: Lena yingxenye esebenza njengephaphu lokwenziwa. Yilapho i-oxygen ifakwa khona egazini.
- Iphampu: Lena inhliziyo yokwenziwa. Iphampu igazi elinomoya-mpilo libuyele emzimbeni ngengcindezi efanele.
Izinyathelo kule nqubo ngesikhathi sokuhlinzwa
Lena inqubo ehlelwe kahle kakhulu eyenziwa yithimba lochwepheshe. Leli qembu lihlanganisa udokotela ohlinzayo, udokotela wezinzwa, kanye nodokotela ohlinzayo othole ukuqeqeshwa okukhethekile kokusebenzisa lo mshini.
| Izinyathelo | Kwenzekani? |
|---|---|
| 1. Ukulungiselela umshini | Akufanele kube namabhamuza omoya ngaphakathi kwamapayipi omshini. Uma ekhona, angangena emzimbeni futhi abangele isimo esiyingozi (i-air embolism). Ngakho-ke, umshini ugcwaliswa ngesisombululo esikhethekile bese umoya ususwa ngokuphelele. |
| 2. Ukunikeza imithi yokunciphisa igazi | Imithambo yethu yegazi inamaseli emvelo avimbela igazi ukuthi lingajiyi. Kodwa ngaphakathi kwamapayipi epulasitiki omshini, igazi lingajiyi kalula. Ukuze kuvinjelwe lokhu, kunikezwa umuthi wokunciphisa igazi njenge -heparin . |
| 3. Ukuxhuma emshinini | Ithimba lezokwelapha lizokuxhumanisa nomshini wenhliziyo namaphaphu. Ngalesi sikhathi, inhliziyo namaphaphu akho kusasebenza. Bazoqinisekisa ukuthi konke kusebenza kahle. |
| 4. Ukumiswa kwenhliziyo namaphaphu | Uma konke sekusebenza kahle, i-cardioplegia inikezwa ukuze kumiswe inhliziyo okwesikhashana. Umshini wokuphefumula oxhunywe kuwo nawo ucinyiwe. Umshini wenhliziyo namaphaphu manje usuthatha izintambo. |
| 5. Ukuqapha ngesikhathi sokuhlinzwa | Ngesikhathi udokotela ohlinzayo enza ukuhlinzwa, udokotela ohlinzayo uyaqhubeka nokuqapha umshini kanye nesimo somzimba wakho (izinga lokushisa, ingcindezi, njll.). |
| 6. Ukususa emshinini | Ngemva kokuhlinzwa sekuqediwe, ithimba lezokwelapha lizoyiqala kabusha ngokucophelela inhliziyo yakho futhi livumele amaphaphu akho ukuthi asebenze futhi. Ngemuva kwalokho, uzosuswa kancane kancane emshinini. |
Ingabe le ndlela iphephile? Ziyini izingozi?
Njenganoma yikuphi ukuhlinzwa, kunezingozi ezihilelekile kule nqubo. Kodwa kuyindlela ephumelela kakhulu eyenziwa nsuku zonke emhlabeni jikelele. Ithimba lakho lezokwelapha liqeqeshwe kahle ukuphatha lezi zingozi. Izingozi zincike empilweni yakho ngaphambi kokuhlinzwa kanye nobude besikhathi oxhunywe ngaso emshinini. Ngokuvamile, izingozi ziphansi uma usemshinini isikhathi esingaphansi kwamahora amathathu.
Ezinye zezinkinga ezingaba khona yilezi:
- Ukopha
- Ukujiya kwegazi
- Isifo sohlangothi
- Ukulimala ebuchosheni, emaphashini, noma ezinso
- Ukuvuvukala emzimbeni
- Ukwehluleka kwezitho eziningi - lokhu akuvamile kakhulu.
Uma unenkinga ngalezi zingozi, khuluma nodokotela wakho ngazo ngokukhululekile ngaphambi kokuhlinzwa ukuze ube nokuqonda okucacile.
Isikhathi sokululama kanye nesikhathi sokubonana nodokotela
Isikhathi sokululama ngemva kokuhlinzwa siyahlukahluka kuye ngomuntu nomuntu. Kuya ngohlobo lokuhlinzwa okwenzile, iminyaka yakho, kanye nempilo yakho iyonke. Kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo nokuya emihlanganweni yakho ngesikhathi.
Isimo esiphuthumayo!
Uma kuvela noma yiziphi izimpawu zesifo sohlangothi ezilandelayo, hamba ngokushesha uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze noma ushayele isevisi ye-ambulensi ku-1990.
- Ubunzima bokuhamba, ukulahlekelwa ibhalansi
- Ukuqaqamba noma ubuthakathaka ohlangothini olulodwa lomzimba
- Ukukhubeka okuncane lapho ukhuluma
- Ukudideka okungazelelwe
- Ubunzima bokubona ngokucacile
- Ubunzima bokuqonda lokho abanye abakushoyo
I-Cardiopulmonary Bypass ubuchwepheshe obumangalisayo obusiza ekusindiseni izimpilo nsuku zonke. Kuvamile ukuzizwa ukhathazekile kancane ngokuthi inhliziyo namaphaphu akho athathwe umshini onjengalona. Kodwa khuluma nodokotela wakho nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho ngale nqubo. Ungafunda kabanzi ngale nqubo lapha: ne_BODY:
Uma udokotela ekutshela noma othile omaziyo ukuthi udinga ukuhlinzwa kwenhliziyo evulekile, kuvamile ukuzizwa ukhathazekile kancane. Cishe uke wezwa izindaba ezinjengokuthi "ukuhlinzwa kwenziwa ngemva kokuba inhliziyo ima." Kwenziwa kanjani lokho ngempela? Igazi ligeleza kanjani emzimbeni lapho inhliziyo ima? Ithola kanjani umoya-mpilo? Impendulo yaleyo mibuzo umshini wenhliziyo namaphaphu esizokhuluma ngawo, noma ngokwezokwelapha, i-Cardiopulmonary Bypass . Ake sixoxe ngalokhu kalula, ngendlela ongayiqonda.
Kuyini i-Cardiopulmonary Bypass?
Nakuba leli gama lingase libonakale lide kancane, incazelo ilula kakhulu. Ake silihlukanise ngamagama.
- I-Cardio ilungele inhliziyo yakho.
- I-Pulmonary ibhekisela emaphashini akho .
- Ukudlula kusho ukugwema okuthile.
Kalula nje, i-Cardiopulmonary Bypass inqubo lapho ukugeleza kwegazi emzimbeni kudlulwa khona okwesikhashana yinhliziyo namaphaphu ngesikhathi sokuhlinzwa kwenhliziyo futhi kuqondiswa ngomshini okhethekile ongaphandle komzimba. Lo mshini ubizwa nangokuthi umshini wenhliziyo namaphaphu .
Cabanga ngokulungiswa okukhulu komgwaqo. Ngaleso sikhathi, izimoto ziphambukiselwa kwenye indlela kuze kube yilapho umsebenzi usuqediwe? Yilokho okwenzekayo nalapha. Kulula ngodokotela ohlinzayo ukuhlinza inhliziyo uma inhliziyo ingashayi futhi ingagcwele igazi. Ngakho-ke lo mshini uthatha okwesikhashana umsebenzi wenhliziyo namaphaphu. Lokho kusho ukuthi:
- Iqoqa igazi eliphelelwe umoya-mpilo emzimbeni.
- I-oxygen entsha ifakwa kulelo gazi.
- I-carbon dioxide isuswa egazini .
- Bese leli gazi elihlanziwe, elinomoya-mpilo libuyiselwaUkumpompa emzimbeni.
Ngale ndlela, igazi elinomoya-mpilo linikezwa njalo kuzo zonke ezinye izitho zomzimba kulo lonke ukuhlinzwa. Le nqubo ibizwa ngokuthi "i-on the pump." Ngokuvamile, ikhambi elikhethekile lomuthi elibizwa ngokuthi "i-cardioplegia" linikezwa ukuze limise inhliziyo.
Ingabe i-Cardiopulmonary Bypass kanye ne-CABG zihlukile?
Lokhu kuyinto abantu abaningi abadideka ngayo. Lokhu okubili akulona into efanayo, kodwa kuvame ukwenzeka ndawonye.
- I-CABG (Coronary Artery Bypass Grafting) yigama lokuhlinzwa . Lokhu ukuhlinzwa okudala indlela entsha (bypass) yokuthi igazi ligeleze ngemithambo yenhliziyo ehambisa igazi enhliziyweni lapho ivinjwa amafutha.
- I-Cardiopulmonary Bypass iyindlela esetshenziswa ngesikhathi sokuhlinzwa kwe-CABG (kanye nokunye ukuhlinzwa kwenhliziyo). Iyindlela esetshenziswa ukudlula inhliziyo namaphaphu ukusiza udokotela ohlinzayo ukuba enze ukuhlinzwa kwe-CABG kalula nangokuphepha.
Kalula nje, i-CABG ifana nokwakha injini yemoto. I-Cardiopulmonary Bypass ifana nokuxhuma ibhethri elihlukile ngaphandle kwemoto ukuze kusebenze izinto ezifana nezibani kanye ne-AC ngenkathi kwakhiwa injini.
Yiziphi izinhlobo zokuhlinzwa ezidinga le ndlela?
I-Cardiopulmonary Bypass ivame ukudingwa ekuhlinzeni okulandelayo:
- Ukufakelwa Kwemithambo Yenhliziyo Enemithambo Yenhliziyo (i-CABG)
- Ukuhlinzwa kwe-aneurysms
- Ukuhlinzwa kokufakelwa inhliziyo
- Ukuhlinzwa kwevalvu yenhliziyo (ukulungiswa noma ukushintshwa kwevalvu yenhliziyo)
- Ukuhlinzwa kokufakelwa amaphaphu
Lo mshini wokusebenza kwenhliziyo namaphaphu usebenza kanjani?
Lo mshini ufana nenhliziyo yesikhashana namaphaphu amabili angaphandle komzimba. Ake sibheke imisebenzi eyinhloko oyenzayo.
| Umsebenzi womshini | Kalula nje... |
|---|---|
| Ukususa igazi enhliziyweni | Igazi lomzimba eliphelelwe umoya-mpilo lidonswa emshinini. |
| Ukwengeza umoya-mpilo nokususa i-CO2 | Yilokhu kanye okwenziwa amaphaphu ethu. Anezela umoya-mpilo egazini futhi asuse i-carbon dioxide. |
| Ukulawulwa kokushisa kwegazi kanye namazinga e-electrolyte | Kusiza ekunciphiseni izinga lokushisa lomzimba noma ukuligcina lisezingeni elidingekayo ngesikhathi sokuhlinzwa. |
| Ukumpompa igazi elinomoya-mpilo emuva | Yilokhu kanye okwenziwa yinhliziyo yethu. Isabalalisa igazi elinomoya-mpilo emzimbeni wonke. |
| Ukunikeza izidakamizwa ezivimba inhliziyo | Ukuze kube lula ngodokotela ohlinzayo ukusebenza, udokotela uzonikeza imithi edingekayo (i-cardioplegia) ukuze amise inhliziyo okwesikhashana. |
Yiziphi izingxenye eziyinhloko zomshini?
Lo mshini uyinhlanganisela yezingxenye eziningana.
- Ama-Cannula: Lawa amapayipi akhethekile axhunywe emithanjeni yegazi yomzimba wakho futhi asetshenziselwa ukuqoqa igazi emshinini bese elibuyisela emzimbeni wakho.
- Idamu: Ithangi eliqoqa igazi eliphelelwe umoya-mpilo emzimbeni.
- I-oxygenator: Lena yingxenye esebenza njengephaphu lokwenziwa. Yilapho i-oxygen ifakwa khona egazini.
- Iphampu: Lena inhliziyo yokwenziwa. Iphampu igazi elinomoya-mpilo libuyele emzimbeni ngengcindezi efanele.
Izinyathelo kule nqubo ngesikhathi sokuhlinzwa
Lena inqubo ehlelwe kahle kakhulu eyenziwa yithimba lochwepheshe. Leli qembu lihlanganisa udokotela ohlinzayo, udokotela wezinzwa, kanye nodokotela ohlinzayo othole ukuqeqeshwa okukhethekile kokusebenzisa lo mshini.
| Izinyathelo | Kwenzekani? |
|---|---|
| 1. Ukulungiselela umshini | Akufanele kube namabhamuza omoya ngaphakathi kwamapayipi omshini. Uma ekhona, angangena emzimbeni futhi abangele isimo esiyingozi (i-air embolism). Ngakho-ke, umshini ugcwaliswa ngesisombululo esikhethekile bese umoya ususwa ngokuphelele. |
| 2. Ukunikeza imithi yokunciphisa igazi | Imithambo yethu yegazi inamaseli emvelo avimbela igazi ukuthi lingajiyi. Kodwa ngaphakathi kwamapayipi epulasitiki omshini, igazi lingajiyi kalula. Ukuze kuvinjelwe lokhu, kunikezwa umuthi wokunciphisa igazi njenge -heparin . |
| 3. Ukuxhuma emshinini | Ithimba lezokwelapha lizokuxhumanisa nomshini wenhliziyo namaphaphu. Ngalesi sikhathi, inhliziyo namaphaphu akho kusasebenza. Bazoqinisekisa ukuthi konke kusebenza kahle. |
| 4. Ukumiswa kwenhliziyo namaphaphu | Uma konke sekusebenza kahle, i-cardioplegia inikezwa ukuze kumiswe inhliziyo okwesikhashana. Umshini wokuphefumula oxhunywe kuwo nawo ucinyiwe. Umshini wenhliziyo namaphaphu manje usuthatha izintambo. |
| 5. Ukuqapha ngesikhathi sokuhlinzwa | Ngesikhathi udokotela ohlinzayo enza ukuhlinzwa, udokotela ohlinzayo uyaqhubeka nokuqapha umshini kanye nesimo somzimba wakho (izinga lokushisa, ingcindezi, njll.). |
| 6. Ukususa emshinini | Ngemva kokuhlinzwa sekuqediwe, ithimba lezokwelapha lizoyiqala kabusha ngokucophelela inhliziyo yakho futhi livumele amaphaphu akho ukuthi asebenze futhi. Ngemuva kwalokho, uzosuswa kancane kancane emshinini. |
Ingabe le ndlela iphephile? Ziyini izingozi?
Njenganoma yikuphi ukuhlinzwa, kunezingozi ezihilelekile kule nqubo. Kodwa kuyindlela ephumelela kakhulu eyenziwa nsuku zonke emhlabeni jikelele. Ithimba lakho lezokwelapha liqeqeshwe kahle ukuphatha lezi zingozi. Izingozi zincike empilweni yakho ngaphambi kokuhlinzwa kanye nobude besikhathi oxhunywe ngaso emshinini. Ngokuvamile, izingozi ziphansi uma usemshinini isikhathi esingaphansi kwamahora amathathu.
Ezinye zezinkinga ezingaba khona yilezi:
- Ukopha
- Ukujiya kwegazi
- Isifo sohlangothi
- Ukulimala ebuchosheni, emaphashini, noma ezinso
- Ukuvuvukala emzimbeni
- Ukwehluleka kwezitho eziningi - lokhu akuvamile kakhulu.
Uma unenkinga ngalezi zingozi, khuluma nodokotela wakho ngazo ngokukhululekile ngaphambi kokuhlinzwa ukuze ube nokuqonda okucacile.
Isikhathi sokululama kanye nesikhathi sokubonana nodokotela
Isikhathi sokululama ngemva kokuhlinzwa siyahlukahluka kuye ngomuntu nomuntu. Kuya ngohlobo lokuhlinzwa okwenzile, iminyaka yakho, kanye nempilo yakho iyonke. Kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo nokuya emihlanganweni yakho ngesikhathi.
Isimo esiphuthumayo!
Uma kuvela noma yiziphi izimpawu zesifo sohlangothi ezilandelayo, hamba ngokushesha uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze noma ushayele isevisi ye-ambulensi ku-1990.
- Ubunzima bokuhamba, ukulahlekelwa ibhalansi
- Ukuqaqamba noma ubuthakathaka ohlangothini olulodwa lomzimba
- Ukukhubeka okuncane lapho ukhuluma
- Ukudideka okungazelelwe
- Ubunzima bokubona ngokucacile
- Ubunzima bokuqonda lokho abanye abakushoyo
I-Cardiopulmonary Bypass ubuchwepheshe obumangalisayo obusiza ekusindiseni izimpilo nsuku zonke. Kuvamile ukuzizwa ukhathazekile kancane ngokuthi inhliziyo namaphaphu akho athathwe umshini onjengalona. Kodwa khuluma nodokotela wakho nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho ngale nqubo. Ungafunda kabanzi ngale nqubo lapha: ne_BODY:
Uma udokotela ekutshela noma othile omaziyo ukuthi udinga ukuhlinzwa kwenhliziyo evulekile, kuvamile ukuzizwa ukhathazekile kancane. Cishe uke wezwa izindaba ezinjengokuthi "ukuhlinzwa kwenziwa ngemva kokuba inhliziyo ima." Kwenziwa kanjani lokho ngempela? Igazi ligeleza kanjani emzimbeni lapho inhliziyo ima? Ithola kanjani umoya-mpilo? Impendulo yaleyo mibuzo umshini wenhliziyo namaphaphu esizokhuluma ngawo, noma ngokwezokwelapha, i-Cardiopulmonary Bypass . Ake sixoxe ngalokhu kalula, ngendlela ongayiqonda.
Kuyini i-Cardiopulmonary Bypass?
Nakuba leli gama lingase libonakale lide kancane, incazelo ilula kakhulu. Ake silihlukanise ngamagama.
- I-Cardio yakhoEnhliziyweni .
- I-Pulmonary ibhekisela emaphashini akho .
- Ukudlula kusho ukugwema okuthile.
Kalula nje, i-Cardiopulmonary Bypass inqubo lapho ukugeleza kwegazi emzimbeni kudlulwa khona okwesikhashana yinhliziyo namaphaphu ngesikhathi sokuhlinzwa kwenhliziyo futhi kuqondiswa ngomshini okhethekile ongaphandle komzimba. Lo mshini ubizwa nangokuthi umshini wenhliziyo namaphaphu .
Cabanga ngokulungiswa okukhulu komgwaqo. Ngaleso sikhathi, izimoto ziphambukiselwa kwenye indlela kuze kube yilapho umsebenzi usuqediwe? Yilokho okwenzekayo nalapha. Kulula ngodokotela ohlinzayo ukuhlinza inhliziyo uma inhliziyo ingashayi futhi ingagcwele igazi. Ngakho-ke lo mshini uthatha okwesikhashana umsebenzi wenhliziyo namaphaphu. Lokho kusho ukuthi:
- Iqoqa igazi eliphelelwe umoya-mpilo emzimbeni.
- I-oxygen entsha ifakwa kulelo gazi.
- I-carbon dioxide isuswa egazini .
- Leli gazi elihlanziwe, elinomoya-mpilo liyaphonswa libuyiselwe emzimbeni .
Ngale ndlela, igazi elinomoya-mpilo linikezwa njalo kuzo zonke ezinye izitho zomzimba kulo lonke ukuhlinzwa. Le nqubo ibizwa ngokuthi "i-on the pump." Ngokuvamile, ikhambi elikhethekile lomuthi elibizwa ngokuthi "i-cardioplegia" linikezwa ukuze limise inhliziyo.
Ingabe i-Cardiopulmonary Bypass kanye ne-CABG zihlukile?
Lokhu kuyinto abantu abaningi abadideka ngayo. Lokhu okubili akulona into efanayo, kodwa kuvame ukwenzeka ndawonye.
- I-CABG (Coronary Artery Bypass Grafting) yigama lokuhlinzwa . Lokhu ukuhlinzwa okudala indlela entsha (bypass) yokuthi igazi ligeleze ngemithambo yenhliziyo ehambisa igazi enhliziyweni lapho ivinjwa amafutha.
- I-Cardiopulmonary Bypass iyindlela esetshenziswa ngesikhathi sokuhlinzwa kwe-CABG (kanye nokunye ukuhlinzwa kwenhliziyo). Iyindlela esetshenziswa ukudlula inhliziyo namaphaphu ukusiza udokotela ohlinzayo ukuba enze ukuhlinzwa kwe-CABG kalula nangokuphepha.
Kalula nje, i-CABG ifana nokwakha injini yemoto. I-Cardiopulmonary Bypass ifana nokuxhuma ibhethri elihlukile ngaphandle kwemoto ukuze kusebenze izinto ezifana nezibani kanye ne-AC ngenkathi kwakhiwa injini.
Yiziphi izinhlobo zokuhlinzwa ezidinga le ndlela?
I-Cardiopulmonary Bypass ivame ukudingwa ekuhlinzeni okulandelayo:
- Ukufakelwa Kwemithambo Yenhliziyo Enemithambo Yenhliziyo (i-CABG)
- Ukuhlinzwa kwe-aneurysms
- Ukuhlinzwa kokufakelwa inhliziyo
- Ukuhlinzwa kwevalvu yenhliziyo (ukulungiswa noma ukushintshwa kwevalvu yenhliziyo)
- Ukuhlinzwa kokufakelwa amaphaphu
Lo mshini wokusebenza kwenhliziyo namaphaphu usebenza kanjani?
Lo mshini ufana nenhliziyo yesikhashana namaphaphu amabili angaphandle komzimba. Ake sibheke imisebenzi eyinhloko oyenzayo.
| Umsebenzi womshini | Kalula nje... |
|---|---|
| Ukususa igazi enhliziyweni | Igazi lomzimba eliphelelwe umoya-mpilo lidonswa emshinini. |
| Ukwengeza umoya-mpilo nokususa i-CO2 | Yilokhu kanye okwenziwa amaphaphu ethu. Anezela umoya-mpilo egazini futhi asuse i-carbon dioxide. |
| Ukulawulwa kokushisa kwegazi kanye namazinga e-electrolyte | Kusiza ekunciphiseni izinga lokushisa lomzimba noma ukuligcina lisezingeni elidingekayo ngesikhathi sokuhlinzwa. |
| Ukumpompa igazi elinomoya-mpilo emuva | Yilokhu kanye okwenziwa yinhliziyo yethu. Isabalalisa igazi elinomoya-mpilo emzimbeni wonke. |
| Ukunikeza izidakamizwa ezivimba inhliziyo | Ukuze kube lula ngodokotela ohlinzayo ukusebenza, udokotela uzonikeza imithi edingekayo (i-cardioplegia) ukuze amise inhliziyo okwesikhashana. |
Yiziphi izingxenye eziyinhloko zomshini?
Lo mshini uyinhlanganisela yezingxenye eziningana.
- Ama-Cannula: Lawa amapayipi akhethekile axhunywe emithanjeni yegazi yomzimba wakho futhi asetshenziselwa ukuqoqa igazi emshinini bese elibuyisela emzimbeni wakho.
- Idamu: Ithangi eliqoqa igazi eliphelelwe umoya-mpilo emzimbeni.
- I-oxygenator: Lena yingxenye esebenza njengephaphu lokwenziwa. Yilapho i-oxygen ifakwa khona egazini.
- Iphampu: Lena inhliziyo yokwenziwa. Iphampu igazi elinomoya-mpilo libuyele emzimbeni ngengcindezi efanele.
Izinyathelo kule nqubo ngesikhathi sokuhlinzwa
Lena inqubo ehlelwe kahle kakhulu eyenziwa yithimba lochwepheshe. Leli qembu lihlanganisa udokotela ohlinzayo, udokotela wezinzwa, kanye nodokotela ohlinzayo othole ukuqeqeshwa okukhethekile kokusebenzisa lo mshini.
| Izinyathelo | Kwenzekani? |
|---|---|
| 1. Ukulungiselela umshini | Akufanele kube namabhamuza omoya ngaphakathi kwamapayipi omshini. Uma ekhona, angangena emzimbeni futhi abangele isimo esiyingozi (i-air embolism). Ngakho-ke, umshini ugcwaliswa ngesisombululo esikhethekile bese umoya ususwa ngokuphelele. |
| 2. Ukunikeza imithi yokunciphisa igazi | Imithambo yethu yegazi inamaseli emvelo avimbela igazi ukuthi lingajiyi. Kodwa ngaphakathi kwamapayipi epulasitiki omshini, igazi lingajiyi kalula. Ukuze kuvinjelwe lokhu, kunikezwa umuthi wokunciphisa igazi njenge -heparin . |
| 3. Ukuxhuma emshinini | Ithimba lezokwelapha lizokuxhumanisa nomshini wenhliziyo namaphaphu. Ngalesi sikhathi, inhliziyo namaphaphu akho kusasebenza. Bazoqinisekisa ukuthi konke kusebenza kahle. |
| 4. Ukumiswa kwenhliziyo namaphaphu | Uma konke sekusebenza kahle, i-cardioplegia inikezwa ukuze kumiswe inhliziyo okwesikhashana. Umshini wokuphefumula oxhunywe kuwo nawo ucinyiwe. Umshini wenhliziyo namaphaphu manje usuthatha izintambo. |
| 5. Ukuqapha ngesikhathi sokuhlinzwa | Ngesikhathi udokotela ohlinzayo enza ukuhlinzwa, udokotela ohlinzayo uyaqhubeka nokuqapha umshini kanye nesimo somzimba wakho (izinga lokushisa, ingcindezi, njll.). |
| 6. Ukususa emshinini | Ngemva kokuhlinzwa sekuqediwe, ithimba lezokwelapha lizoyiqala kabusha ngokucophelela inhliziyo yakho futhi livumele amaphaphu akho ukuthi asebenze futhi. Ngemuva kwalokho, uzosuswa kancane kancane emshinini. |
Ingabe le ndlela iphephile? Ziyini izingozi?
Njenganoma yikuphi ukuhlinzwa, kunezingozi ezihilelekile kule nqubo. Kodwa kuyindlela ephumelela kakhulu eyenziwa nsuku zonke emhlabeni jikelele. Ithimba lakho lezokwelapha liqeqeshwe kahle ukuphatha lezi zingozi. Izingozi zincike empilweni yakho ngaphambi kokuhlinzwa kanye nobude besikhathi oxhunywe ngaso emshinini. Ngokuvamile, izingozi ziphansi uma usemshinini isikhathi esingaphansi kwamahora amathathu.
Ezinye zezinkinga ezingaba khona yilezi:
- Ukopha
- Ukujiya kwegazi
- Isifo sohlangothi
- Ukulimala ebuchosheni, emaphashini, noma ezinso
- Ukuvuvukala emzimbeni
- Ukwehluleka kwezitho eziningi - lokhu akuvamile kakhulu.
Uma unenkinga ngalezi zingozi, khuluma nodokotela wakho ngazo ngokukhululekile ngaphambi kokuhlinzwa ukuze ube nokuqonda okucacile.
Isikhathi sokululama kanye nesikhathi sokubonana nodokotela
Isikhathi sokululama ngemva kokuhlinzwa siyahlukahluka kuye ngomuntu nomuntu. Kuya ngohlobo lokuhlinzwa okwenzile, iminyaka yakho, kanye nempilo yakho iyonke. Kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo nokuya emihlanganweni yakho ngesikhathi.
Isimo esiphuthumayo!
Uma kuvela noma yiziphi izimpawu zesifo sohlangothi ezilandelayo, hamba ngokushesha uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze noma ushayele isevisi ye-ambulensi ku-1990.
- Ubunzima bokuhamba, ukulahlekelwa ibhalansi
- Ukuqaqamba noma ubuthakathaka ohlangothini olulodwa lomzimba
- Ukukhubeka okuncane lapho ukhuluma
- Ukudideka okungazelelwe
- Ubunzima bokubona ngokucacile
- Ubunzima bokuqonda lokho abanye abakushoyo
I-Cardiopulmonary Bypass ubuchwepheshe obumangalisayo obusiza ekusindiseni izimpilo nsuku zonke. Kuvamile ukuzizwa ukhathazekile kancane ngokuthi inhliziyo namaphaphu akho athathwe umshini onjengalona. Kodwa khuluma nodokotela wakho nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho ngale nqubo. Ungafunda kabanzi ngale nqubo lapha: ne_BODY:
Uma udokotela ekutshela noma othile omaziyo ukuthi udinga ukuhlinzwa kwenhliziyo evulekile, kuvamile ukuzizwa ukhathazekile kancane. Cishe uke wezwa izindaba ezinjengokuthi "ukuhlinzwa kwenziwa ngemva kokuba inhliziyo ima." Kwenziwa kanjani lokho ngempela? Igazi ligeleza kanjani emzimbeni lapho inhliziyo ima? Ithola kanjani umoya-mpilo? Impendulo yaleyo mibuzo umshini wenhliziyo namaphaphu esizokhuluma ngawo, noma ngokwezokwelapha, i-Cardiopulmonary Bypass . Ake sixoxe ngalokhu kalula, ngendlela ongayiqonda.
Kuyini i-Cardiopulmonary Bypass?
Nakuba leli gama lingase libonakale lide kancane, incazelo ilula kakhulu. Ake silihlukanise ngamagama.
- I-Cardio ilungele inhliziyo yakho.
- I-Pulmonary ibhekisela emaphashini akho .
- Ukudlula kusho ukugwema okuthile.
Kalula nje, i-Cardiopulmonary Bypass inqubo lapho ukugeleza kwegazi emzimbeni kudlulwa khona okwesikhashana yinhliziyo namaphaphu ngesikhathi sokuhlinzwa kwenhliziyo futhi kuqondiswa ngomshini okhethekile ongaphandle komzimba. Lo mshini ubizwa nangokuthi umshini wenhliziyo namaphaphu .
Cabanga ngokulungiswa okukhulu komgwaqo. Ngaleso sikhathi, izimoto ziphambukiselwa kwenye indlela kuze kube yilapho umsebenzi usuqediwe? Yilokho okwenzekayo nalapha. Kulula ngodokotela ohlinzayo ukuhlinza inhliziyo uma inhliziyo ingashayi futhi ingagcwele igazi. Ngakho-ke lo mshini uthatha okwesikhashana umsebenzi wenhliziyo namaphaphu. Lokho kusho ukuthi:
- Iqoqa igazi eliphelelwe umoya-mpilo emzimbeni.
- I-oxygen entsha ifakwa kulelo gazi.
- I-carbon dioxide isuswa egazini .
- Leli gazi elihlanziwe, elinomoya-mpilo liyaphonswa libuyiselwe emzimbeni .
Ngale ndlela, igazi elinomoya-mpilo linikezwa njalo kuzo zonke ezinye izitho zomzimba kulo lonke ukuhlinzwa. Le nqubo ibizwa ngokuthi "i-on the pump." Ngokuvamile, ikhambi elikhethekile lomuthi elibizwa ngokuthi "i-cardioplegia" linikezwa ukuze limise inhliziyo.
Ingabe i-Cardiopulmonary Bypass kanye ne-CABG zihlukile?
Lokhu kuyinto abantu abaningi abadideka ngayo. Lokhu okubili akulona into efanayo, kodwa kuvame ukwenzeka ndawonye.
- I-CABG (i-Coronary Artery Bypass Grafting) yigama lokuhlinzwa.Lokhu ukuhlinzwa okudala indlela entsha (ukudlula) ukuze igazi ligeleze ngemithambo yenhliziyo ehambisa igazi enhliziyweni lapho ivinjwa amafutha amaningi.
- I-Cardiopulmonary Bypass iyindlela esetshenziswa ngesikhathi sokuhlinzwa kwe-CABG (kanye nokunye ukuhlinzwa kwenhliziyo). Iyindlela esetshenziswa ukudlula inhliziyo namaphaphu ukusiza udokotela ohlinzayo ukuba enze ukuhlinzwa kwe-CABG kalula nangokuphepha.
Kalula nje, i-CABG ifana nokwakha injini yemoto. I-Cardiopulmonary Bypass ifana nokuxhuma ibhethri elihlukile ngaphandle kwemoto ukuze kusebenze izinto ezifana nezibani kanye ne-AC ngenkathi kwakhiwa injini.
Yiziphi izinhlobo zokuhlinzwa ezidinga le ndlela?
I-Cardiopulmonary Bypass ivame ukudingwa ekuhlinzeni okulandelayo:
- Ukufakelwa Kwemithambo Yenhliziyo Enemithambo Yenhliziyo (i-CABG)
- Ukuhlinzwa kwe-aneurysms
- Ukuhlinzwa kokufakelwa inhliziyo
- Ukuhlinzwa kwevalvu yenhliziyo (ukulungiswa noma ukushintshwa kwevalvu yenhliziyo)
- Ukuhlinzwa kokufakelwa amaphaphu
Lo mshini wokusebenza kwenhliziyo namaphaphu usebenza kanjani?
Lo mshini ufana nenhliziyo yesikhashana namaphaphu amabili angaphandle komzimba. Ake sibheke imisebenzi eyinhloko oyenzayo.
| Umsebenzi womshini | Kalula nje... |
|---|---|
| Ukususa igazi enhliziyweni | Igazi lomzimba eliphelelwe umoya-mpilo lidonswa emshinini. |
| Ukwengeza umoya-mpilo nokususa i-CO2 | Yilokhu kanye okwenziwa amaphaphu ethu. Anezela umoya-mpilo egazini futhi asuse i-carbon dioxide. |
| Ukulawulwa kokushisa kwegazi kanye namazinga e-electrolyte | Kusiza ekunciphiseni izinga lokushisa lomzimba noma ukuligcina lisezingeni elidingekayo ngesikhathi sokuhlinzwa. |
| Ukumpompa igazi elinomoya-mpilo emuva | Yilokhu kanye okwenziwa yinhliziyo yethu. Isabalalisa igazi elinomoya-mpilo emzimbeni wonke. |
| Ukunikeza izidakamizwa ezivimba inhliziyo | Ukuze kube lula ngodokotela ohlinzayo ukusebenza, udokotela uzonikeza imithi edingekayo (i-cardioplegia) ukuze amise inhliziyo okwesikhashana. |
Yiziphi izingxenye eziyinhloko zomshini?
Lo mshini uyinhlanganisela yezingxenye eziningana.
- Ama-Cannula: Lawa amapayipi akhethekile axhunywe emithanjeni yegazi yomzimba wakho futhi asetshenziselwa ukuqoqa igazi emshinini bese elibuyisela emzimbeni wakho.
- Idamu: Ithangi eliqoqa igazi eliphelelwe umoya-mpilo emzimbeni.
- I-oxygenator: Lena yingxenye esebenza njengephaphu lokwenziwa. Yilapho i-oxygen ifakwa khona egazini.
- Iphampu: Lena inhliziyo yokwenziwa. Iphampu igazi elinomoya-mpilo libuyele emzimbeni ngengcindezi efanele.
Izinyathelo kule nqubo ngesikhathi sokuhlinzwa
Lena inqubo ehlelwe kahle kakhulu eyenziwa yithimba lochwepheshe. Leli qembu lihlanganisa udokotela ohlinzayo, udokotela wezinzwa, kanye nodokotela ohlinzayo othole ukuqeqeshwa okukhethekile kokusebenzisa lo mshini.
| Izinyathelo | Kwenzekani? |
|---|---|
| 1. Ukulungiselela umshini | Akufanele kube namabhamuza omoya ngaphakathi kwamapayipi omshini. Uma ekhona, angangena emzimbeni futhi abangele isimo esiyingozi (i-air embolism). Ngakho-ke, umshini ugcwaliswa ngesisombululo esikhethekile bese umoya ususwa ngokuphelele. |
| 2. Ukunikeza imithi yokunciphisa igazi | Imithambo yethu yegazi inamaseli emvelo avimbela igazi ukuthi lingajiyi. Kodwa ngaphakathi kwamapayipi epulasitiki omshini, igazi lingajiyi kalula. Ukuze kuvinjelwe lokhu, kunikezwa umuthi wokunciphisa igazi njenge -heparin . |
| 3. Ukuxhuma emshinini | Ithimba lezokwelapha lizokuxhumanisa nomshini wenhliziyo namaphaphu. Ngalesi sikhathi, inhliziyo namaphaphu akho kusasebenza. Bazoqinisekisa ukuthi konke kusebenza kahle. |
| 4. Ukumiswa kwenhliziyo namaphaphu | Uma konke sekusebenza kahle, i-cardioplegia inikezwa ukuze kumiswe inhliziyo okwesikhashana. Umshini wokuphefumula oxhunywe kuwo nawo ucinyiwe. Umshini wenhliziyo namaphaphu manje usuthatha izintambo. |
| 5. Ukuqapha ngesikhathi sokuhlinzwa | Ngesikhathi udokotela ohlinzayo enza ukuhlinzwa, udokotela ohlinzayo uyaqhubeka nokuqapha umshini kanye nesimo somzimba wakho (izinga lokushisa, ingcindezi, njll.). |
| 6. Ukususa emshinini | Ngemva kokuhlinzwa sekuqediwe, ithimba lezokwelapha lizoyiqala kabusha ngokucophelela inhliziyo yakho futhi livumele amaphaphu akho ukuthi asebenze futhi. Ngemuva kwalokho, uzosuswa kancane kancane emshinini. |
Ingabe le ndlela iphephile? Ziyini izingozi?
Njenganoma yikuphi ukuhlinzwa, kunezingozi ezihilelekile kule nqubo. Kodwa kuyindlela ephumelela kakhulu eyenziwa nsuku zonke emhlabeni jikelele. Ithimba lakho lezokwelapha liqeqeshwe kahle ukuphatha lezi zingozi. Izingozi zincike empilweni yakho ngaphambi kokuhlinzwa kanye nobude besikhathi oxhunywe ngaso emshinini. Ngokuvamile, izingozi ziphansi uma usemshinini isikhathi esingaphansi kwamahora amathathu.
Ezinye zezinkinga ezingaba khona yilezi:
- Ukopha
- Ukujiya kwegazi
- Isifo sohlangothi
- Ukulimala ebuchosheni, emaphashini, noma ezinso
- Ukuvuvukala emzimbeni
- Ukwehluleka kwezitho eziningi - lokhu akuvamile kakhulu.
Uma unenkinga ngalezi zingozi, khuluma nodokotela wakho ngazo ngokukhululekile ngaphambi kokuhlinzwa ukuze ube nokuqonda okucacile.
Isikhathi sokululama kanye nesikhathi sokubonana nodokotela
Isikhathi sokululama ngemva kokuhlinzwa siyahlukahluka kuye ngomuntu nomuntu. Kuya ngohlobo lokuhlinzwa okwenzile, iminyaka yakho, kanye nempilo yakho iyonke. Kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo nokuya emihlanganweni yakho ngesikhathi.
Isimo esiphuthumayo!
Uma kuvela noma yiziphi izimpawu zesifo sohlangothi ezilandelayo, hamba ngokushesha uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze noma ushayele isevisi ye-ambulensi ku-1990.
- Ubunzima bokuhamba, ukulahlekelwa ibhalansi
- Ukuqaqamba noma ubuthakathaka ohlangothini olulodwa lomzimba
- Ukukhubeka okuncane lapho ukhuluma
- Ukudideka okungazelelwe
- Ubunzima bokubona ngokucacile
- Ubunzima bokuqonda lokho abanye abakushoyo
I-Cardiopulmonary Bypass ubuchwepheshe obumangalisayo obusiza ekusindiseni izimpilo nsuku zonke. Kuvamile ukuzizwa ukhathazekile kancane ngokuthi inhliziyo namaphaphu akho athathwe umshini onjengalona. Kodwa khuluma nodokotela wakho nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho ngale nqubo. Ungafunda kabanzi ngale nqubo lapha: ne_BODY:
Uma udokotela ekutshela noma othile omaziyo ukuthi udinga ukuhlinzwa kwenhliziyo evulekile, kuvamile ukuzizwa ukhathazekile kancane. Cishe uke wezwa izindaba ezinjengokuthi "ukuhlinzwa kwenziwa ngemva kokuba inhliziyo ima." Kwenziwa kanjani lokho ngempela? Igazi ligeleza kanjani emzimbeni lapho inhliziyo ima? Ithola kanjani umoya-mpilo? Impendulo yaleyo mibuzo umshini wenhliziyo namaphaphu esizokhuluma ngawo, noma ngokwezokwelapha, i-Cardiopulmonary Bypass . Ake sixoxe ngalokhu kalula, ngendlela ongayiqonda.
Kuyini i-Cardiopulmonary Bypass?
Nakuba leli gama lingase libonakale lide kancane, incazelo ilula kakhulu. Ake silihlukanise ngamagama.
- I-Cardio ilungele inhliziyo yakho.
- I-Pulmonary ibhekisela emaphashini akho .
- Ukudlula kusho ukugwema okuthile.
Kalula nje, i-Cardiopulmonary Bypass inqubo lapho ukugeleza kwegazi emzimbeni kudlulwa khona okwesikhashana yinhliziyo namaphaphu ngesikhathi sokuhlinzwa kwenhliziyo futhi kuqondiswa ngomshini okhethekile ongaphandle komzimba. Lo mshini ubizwa nangokuthi umshini wenhliziyo namaphaphu .
Cabanga ngokulungiswa okukhulu komgwaqo. Ngaleso sikhathi, izimoto ziphambukiselwa kwenye indlela kuze kube yilapho umsebenzi usuqediwe? Yilokho okwenzekayo nalapha. Kulula ngodokotela ohlinzayo ukuhlinza inhliziyo uma inhliziyo ingashayi futhi ingagcwele igazi. Ngakho-ke lo mshini uthatha okwesikhashana umsebenzi wenhliziyo namaphaphu. Lokho kusho ukuthi:
- Iqoqa igazi eliphelelwe umoya-mpilo emzimbeni.
- I-oxygen entsha ifakwa kulelo gazi.
- I-carbon dioxide isuswa egazini .
- Leli gazi elihlanziwe, elinomoya-mpilo liyaphonswa libuyiselwe emzimbeni .
Ngale ndlela, igazi elinomoya-mpilo linikezwa njalo kuzo zonke ezinye izitho zomzimba kulo lonke ukuhlinzwa. Le nqubo ibizwa ngokuthi "i-on the pump." Ngokuvamile, ikhambi elikhethekile lomuthi elibizwa ngokuthi "i-cardioplegia" linikezwa ukuze limise inhliziyo.
Ingabe i-Cardiopulmonary Bypass kanye ne-CABG zihlukile?
Lokhu kuyinto abantu abaningi abadideka ngayo. Lokhu okubili akulona into efanayo, kodwa kuvame ukwenzeka ndawonye.
- I-CABG (Coronary Artery Bypass Grafting) yigama lokuhlinzwa . Lokhu ukuhlinzwa okudala indlela entsha (bypass) yokuthi igazi ligeleze ngemithambo yenhliziyo ehambisa igazi enhliziyweni lapho ivinjwa amafutha.
- I-Cardiopulmonary Bypass iyindlela esetshenziswa ngesikhathi sokuhlinzwa kwe-CABG (kanye nokunye ukuhlinzwa kwenhliziyo). Iyindlela esetshenziswa ukudlula inhliziyo namaphaphu ukusiza udokotela ohlinzayo ukuba enze ukuhlinzwa kwe-CABG kalula nangokuphepha.
Kalula nje, i-CABG ifana nokwakha injini yemoto. I-Cardiopulmonary Bypass ifana nokuxhuma ibhethri elihlukile ngaphandle kwemoto ukuze kusebenze izinto ezifana nezibani kanye ne-AC ngenkathi kwakhiwa injini.
Yiziphi izinhlobo zokuhlinzwa ezidinga le ndlela?
I-Cardiopulmonary Bypass ivame ukudingwa ekuhlinzeni okulandelayo:
- Ukufakelwa Kwemithambo Yenhliziyo Enemithambo Yenhliziyo (i-CABG)
- Ukuhlinzwa kwe-aneurysms
- Ukuhlinzwa kokufakelwa inhliziyo
- Ukuhlinzwa kwevalvu yenhliziyo (ukulungiswa noma ukushintshwa kwevalvu yenhliziyo)
- Ukuhlinzwa kokufakelwa amaphaphu
Lo mshini wokusebenza kwenhliziyo namaphaphu usebenza kanjani?
Lo mshini ufana nenhliziyo yesikhashana namaphaphu amabili angaphandle komzimba. Ake sibheke imisebenzi eyinhloko oyenzayo.
| Umsebenzi womshini | Kalula nje... |
|---|---|
| Ukususa igazi enhliziyweni | Igazi lomzimba eliphelelwe umoya-mpilo lidonswa emshinini. |
| Ukwengeza umoya-mpilo nokususa i-CO2 | Yilokhu kanye okwenziwa amaphaphu ethu. Anezela umoya-mpilo egazini futhi asuse i-carbon dioxide. |
| Ukulawulwa kokushisa kwegazi kanye namazinga e-electrolyte | Kusiza ekunciphiseni izinga lokushisa lomzimba noma ukuligcina lisezingeni elidingekayo ngesikhathi sokuhlinzwa. |
| Ukumpompa igazi elinomoya-mpilo emuva | Yilokhu kanye okwenziwa yinhliziyo yethu. Isabalalisa igazi elinomoya-mpilo emzimbeni wonke. |
| Ukunikeza izidakamizwa ezivimba inhliziyo | Ukuze kube lula ngodokotela ohlinzayo ukusebenza, udokotela uzonikeza imithi edingekayo (i-cardioplegia) ukuze amise inhliziyo okwesikhashana. |
Yiziphi izingxenye eziyinhloko zomshini?
Lo mshini uyinhlanganisela yezingxenye eziningana.
- Ama-Cannula: Lawa amapayipi akhethekile axhunywe emithanjeni yegazi yomzimba wakho futhi asetshenziselwa ukuqoqa igazi emshinini bese elibuyisela emzimbeni wakho.
- Idamu: Ithangi eliqoqa igazi eliphelelwe umoya-mpilo emzimbeni.
- I-oxygenator: Lena yingxenye esebenza njengephaphu lokwenziwa. Yilapho i-oxygen ifakwa khona egazini.
- Iphampu: Lena inhliziyo yokwenziwa. Iphampu igazi elinomoya-mpilo libuyele emzimbeni ngengcindezi efanele.
Izinyathelo kule nqubo ngesikhathi sokuhlinzwa
Lena inqubo ehlelwe kahle kakhulu, eyenziwa yithimba lochwepheshe. Udokotela ohlinzayo, udokotela wezinzwa, kanye nodokotela ohlinzayo othole ukuqeqeshwa okukhethekile kokusebenzisa lo mshini.Umuntu othile ungowaleli qembu.
| Izinyathelo | Kwenzekani? |
|---|---|
| 1. Ukulungiselela umshini | Akufanele kube namabhamuza omoya ngaphakathi kwamapayipi omshini. Uma ekhona, angangena emzimbeni futhi abangele isimo esiyingozi (i-air embolism). Ngakho-ke, umshini ugcwaliswa ngesisombululo esikhethekile bese umoya ususwa ngokuphelele. |
| 2. Ukunikeza imithi yokunciphisa igazi | Imithambo yethu yegazi inamaseli emvelo avimbela igazi ukuthi lingajiyi. Kodwa ngaphakathi kwamapayipi epulasitiki omshini, igazi lingajiyi kalula. Ukuze kuvinjelwe lokhu, kunikezwa umuthi wokunciphisa igazi njenge -heparin . |
| 3. Ukuxhuma emshinini | Ithimba lezokwelapha lizokuxhumanisa nomshini wenhliziyo namaphaphu. Ngalesi sikhathi, inhliziyo namaphaphu akho kusasebenza. Bazoqinisekisa ukuthi konke kusebenza kahle. |
| 4. Ukumiswa kwenhliziyo namaphaphu | Uma konke sekusebenza kahle, i-cardioplegia inikezwa ukuze kumiswe inhliziyo okwesikhashana. Umshini wokuphefumula oxhunywe kuwo nawo ucinyiwe. Umshini wenhliziyo namaphaphu manje usuthatha izintambo. |
| 5. Ukuqapha ngesikhathi sokuhlinzwa | Ngesikhathi udokotela ohlinzayo enza ukuhlinzwa, udokotela ohlinzayo uyaqhubeka nokuqapha umshini kanye nesimo somzimba wakho (izinga lokushisa, ingcindezi, njll.). |
| 6. Ukususa emshinini | Ngemva kokuhlinzwa sekuqediwe, ithimba lezokwelapha lizoyiqala kabusha ngokucophelela inhliziyo yakho futhi livumele amaphaphu akho ukuthi asebenze futhi. Ngemuva kwalokho, uzosuswa kancane kancane emshinini. |
Ingabe le ndlela iphephile? Ziyini izingozi?
Njenganoma yikuphi ukuhlinzwa, kunezingozi ezihilelekile kule nqubo. Kodwa kuyindlela ephumelela kakhulu eyenziwa nsuku zonke emhlabeni jikelele. Ithimba lakho lezokwelapha liqeqeshwe kahle ukuphatha lezi zingozi. Izingozi zincike empilweni yakho ngaphambi kokuhlinzwa kanye nobude besikhathi oxhunywe ngaso emshinini. Ngokuvamile, izingozi ziphansi uma usemshinini isikhathi esingaphansi kwamahora amathathu.
Ezinye zezinkinga ezingaba khona yilezi:
- Ukopha
- Ukujiya kwegazi
- Isifo sohlangothi
- Ukulimala ebuchosheni, emaphashini, noma ezinso
- Ukuvuvukala emzimbeni
- Ukwehluleka kwezitho eziningi - lokhu akuvamile kakhulu.
Uma unenkinga ngalezi zingozi, khuluma nodokotela wakho ngazo ngokukhululekile ngaphambi kokuhlinzwa ukuze ube nokuqonda okucacile.
Isikhathi sokululama kanye nesikhathi sokubonana nodokotela
Isikhathi sokululama ngemva kokuhlinzwa siyahlukahluka kuye ngomuntu nomuntu. Kuya ngohlobo lokuhlinzwa okwenzile, iminyaka yakho, kanye nempilo yakho iyonke. Kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo nokuya emihlanganweni yakho ngesikhathi.
Isimo esiphuthumayo!
Uma kuvela noma yiziphi izimpawu zesifo sohlangothi ezilandelayo, hamba ngokushesha uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze noma ushayele isevisi ye-ambulensi ku-1990.
- Ubunzima bokuhamba, ukulahlekelwa ibhalansi
- Ukuqaqamba noma ubuthakathaka ohlangothini olulodwa lomzimba
- Ukukhubeka okuncane lapho ukhuluma
- Ukudideka okungazelelwe
- Ubunzima bokubona ngokucacile
- Ubunzima bokuqonda lokho abanye abakushoyo
I-cardiopulmonary bypass ubuchwepheshe obumangalisayo obusiza ekusindiseni izimpilo nsuku zonke. Kuvamile ukuzizwa ukhathazekile kancane ngokuthi inhliziyo namaphaphu akho athathwe umshini onjengalona. Kodwa khuluma nodokotela wakho nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho. Lapho ufunda okwengeziwe ngale nqubo, uvalo lwakho luyancipha ngosuku lokuhlinzwa kwakho.
Umlayezo Wokuya Nawe Ekhaya
- I-Cardiopulmonary Bypass inqubo esebenzisa umshini ukuze uthathe okwesikhashana umsebenzi wenhliziyo namaphaphu ngesikhathi sokuhlinzwa okukhulu kwenhliziyo.
- Lokhu kuvumela udokotela ohlinzayo ukuthi enze ukuhlinzwa ngokuphephile nangokulula enhliziyweni engenagazi futhi engashayi.
- Lo mshini uhlinzeka ngegazi elinomoya-mpilo emzimbeni njalo ngesikhathi sokuhlinzwa.
- Ngenxa yalokhu, ithimba lodokotela abangochwepheshe (udokotela ohlinzayo, udokotela obulala izinzwa, nodokotela ohlinzayo ngegazi) lisebenzisana.
- Njengakuyo yonke imishanguzo, kunezingozi, kodwa ithimba lezokwelapha liqeqeshwe ukuzilawula.
- Kubaluleke kakhulu ukukhuluma nodokotela wakho nganoma yimiphi imibuzo noma ukwesaba ongase ube nakho ngaphambi kokuhlinzwa.
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