Ingabe wena noma othile emndenini wakho uhlelelwe ukuhlinzwa okukhulu kwenhliziyo? Cishe uke wezwa odokotela bethi uzoxhunywa "emshinini wenhliziyo namaphaphu." Kuvamile ukuzizwa wesaba futhi unelukuluku uma uzwa leli gama. Uyini ngempela lo mshini? Wenzani? Ingabe kuyinto okufanele uyesabe? Ake sixoxe ngayo kalula nangokucacile.
Kuyini i-Cardiopulmonary Bypass?
Kalula nje, lo mshini usebenza okwesikhashana esikhundleni senhliziyo namaphaphu akho. Ngesikhathi sokuhlinzwa, igazi lomzimba wakho liyaphambukiswa ngalo mshini esikhundleni sokuya enhliziyweni nasemaphaphu akho. Yingakho ubizwa ngokuthi "i-bypass."
Cabanga nje, lo mshini uthatha imisebenzi emibili eyinhloko eyenziwa yinhliziyo namaphaphu akho ngesikhathi sokuhlinzwa:
1. Ukwengeza umoya-mpilo egazini (lokhu kuvame ukwenziwa amaphaphu).
2. Ukupompa igazi elinomoya-mpilo emzimbeni wonke (lokhu kuvame ukwenziwa yinhliziyo).
Uma uxhumene nalo mshini, odokotela bangavimba inhliziyo yakho okwesikhashana ngokukunikeza umuthi okhethekile obizwa ngokuthi "i-Cardioplegia". Ngemuva kwalokho, udokotela ohlinzayo angahlinza inhliziyo engashayi futhi engaphumi igazi ngokuphepha nangokulula. Okwamanje, zonke ezinye izitho emzimbeni wakho zithola igazi elicebile ngomoya-mpilo elilidingayo ngalo mshini. Odokotela babiza lesi simo ngokuthi "empompini."
Ingabe lokhu kanye nokuhlinzwa kwe-CABG kuyinto efanayo?
Yebo, lezi zinto ezimbili zihlukile. Kodwa lezi zinto ezimbili zivame ukwenzeka ndawonye. Abanye abantu badidanisa la magama amabili ngoba womabili aqukethe igama elithi "bypass".
- I-CABG (Coronary Artery Bypass Grafting): Lokhu ukuhlinzwa kwangempela. Lapho imithambo yenhliziyo ehambisa igazi enhliziyweni ivinjwa yizinqwaba zamafutha, kwakhiwa indlela entsha (bypass) yokudlula ukuvinjelwa nokuvumela igazi ukuthi ligeleze.
- I-Cardiopulmonary Bypass: Lena inqubo esetshenziswa ukusiza udokotela ohlinzayo ngesikhathi sokuhlinzwa kwe-CABG (noma okunye ukuhlinzwa kwenhliziyo). Ihilela ukuguqula ukugeleza kwegazi enhliziyweni nasemaphashini.
Okusho ukuthi, i-CABG iwukuhlinzwa. I-cardiopulmonary bypass iwuhlelo lokusekela olusetshenziswa ukwenza lokho kuhlinzwa ngokuphephile.
Lo mshini usebenza kanjani?
Ukuze siqonde lokhu, ake siqale sikhumbule indlela evamile igazi eligeleza ngayo emzimbeni wethu. Igazi elingenawo umoya-mpilo emzimbeni lingena ohlangothini lwesokudla lwenhliziyo ngemithambo emibili emikhulu (i-vena cava). Ukusuka lapho, lelo gazi liphampulwa liye emaphashini. Emaphashini, igazi lifakwa umoya-mpilo, bese lelo gazi elicebile ngomoya-mpilo libuyela ohlangothini lwesobunxele lwenhliziyo. Ekugcineni, uhlangothi lwesobunxele lwenhliziyo oluphampula lelo gazi elihlanzekile liye kuwo wonke umzimba.
Umshini we-cardiopulmonary bypass ususa okwesikhashana le chakra emzimbeni.
1. Ngaphambi kokungena enhliziyweni, elinye igazi elingenawo umoya-mpilo lidonswa emshinini ngamapayipi (ama-cannula).
2. Ingxenye engaphakathi komshini ebizwa ngokuthi Oxygenator'' inezela umoya-mpilo egazini.
3. Iphampu emshinini ixhumanisa kabusha igazi elinomoya-mpilo nomthambo oyinhloko (i-Aorta) osabalalisa igazi emzimbeni ngemva kwenhliziyo.
Lena yindlela umzimba othola ngayo umoya-mpilo kuze kube yilapho ukuhlinzwa sekuphelile.
| Izingxenye eziyinhloko zomshini | Umsebenzi ewenzayo |
|---|---|
| Ama-Cannula | Amapayipi axhuma emithanjeni yegazi yomzimba. Lawa athwala igazi aliyise emshinini bese elibuyisela emzimbeni. |
| Idamu Lokugcina Imfucuza | Ithangi eliqoqa igazi eliphelelwe umoya-mpilo emzimbeni. |
| I-oxygenator | Lona umsebenzi wamaphaphu ethu: afaka umoya-mpilo egazini futhi asuse i-carbon dioxide. |
| Iphampu | Lona umsebenzi wezinhliziyo zethu. Upompa igazi elinomoya-mpilo libuyele emzimbeni. |
Yiziphi izinyathelo ezihilelekile ngesikhathi sokuhlinzwa?
Ithimba lezokwelapha lenza le nqubo ngendlela ehlelwe kahle kakhulu. Ithimba elihlanganisa udokotela ohlinzayo, udokotela wezinzwa, kanye nodokotela ohlinzayo, uchwepheshe oqeqeshwe ngokukhethekile ukusebenzisa lo mshini, liyasiza kulokhu.
- Ukulungiselela umshini: Okokuqala, umoya osemapayipini omshini ususwa ngokuphelele bese ugcwaliswa ngoketshezi olukhethekile (isisombululo sokuqandisa). Ngoba ibhamuza lomoya ((Air Embolism)) elingena emzimbeni liyingozi kakhulu.
- Ukukunikeza umuthi wokuvimbela amahlule egazi: Ngaphambi kokuba uxhunywe emshinini, uzonikezwa umuthi onamandla wokunciphisa igazi obizwa ngokuthi i-Heparin ukuvimbela amahlule egazi.
- Ukuxhuma emshinini: Manje odokotela bazokuxhuma emshinini. Inhliziyo namaphaphu akho kusasebenza okwamanje.
- Ukuma kwenhliziyo namaphaphu: Ngemva kokuqinisekisa ukuthi konke kusebenza kahle, inhliziyo iyamiswa ngokunikeza umuthi obizwa ngokuthi "i-Cardioplegia". Manje umshini wenhliziyo namaphaphu uthatha wonke umsebenzi.
- Ukuhlinzwa Nokuqapha: Ngesikhathi udokotela ohlinzayo enza ukuhlinzwa, ithimba, kuhlanganise nodokotela ohlinza nge-perfusion, liyaqhubeka nokuqapha umshini kanye nesimo somzimba wakho (njengokushisa nomfutho wegazi).
- Ukukhumula: Ngemva kokuba ukuhlinzwa sekuqediwe ngempumelelo, inhliziyo yakho iqala kabusha kancane kancane, amaphaphu akho avunyelwe ukuphefumula, bese ukhishwa emshinini.
Ziyini izingozi zale ndlela?
Njenganoma yikuphi ukuhlinzwa okukhulu, kunezingozi ezihilelekile kule nqubo. Lezi zingozi zingahluka kuye ngobude besikhathi oxhunywe ngaso emshinini kanye nesimo sakho sempilo ngaphambi kokuhlinzwa.
Kodwa khumbula, ithimba lakho lezokwelapha liqeqeshwe kakhulu futhi linolwazi ekuphatheni zonke lezi zingozi. Ezinye zezinkinga ezingase zenzeke zifaka:
- Amahlule egazi
- Ukopha okukhulu
- Ukulimala kobuchopho noma isifo sohlangothi
- Ukulimala kwezinso noma kwamaphaphu
- Ukuvuvukala nokutheleleka emzimbeni
Khuluma nodokotela wakho ngokukhululekile ngalezi zingozi kanye nezinyathelo ongazithatha ukuze uzigweme ngaphambi kokuhlinzwa kwakho.
Yini okufanele uyenze uma kunesimo esiphuthumayo?
Uma uphuma esibhedlela ngemuva kokuhlinzwa, udokotela wakho uzokuchazela izinsuku okudingeka ubuye ngazo kanye nemiyalelo okudingeka uyilandele. Kubaluleke kakhulu ukulandela le miyalelo ngqo.
Okubaluleke kakhulu: Uma uzwa izimpawu zesifo sohlangothi, ungalibali umzuzwana. Yiya eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze ngokushesha.
Izimpawu eziphuthumayo zesifo sohlangothi zingafaka:
- Ukuba ndikindiki noma ubuthakathaka ohlangothini olulodwa lomzimba
- Ubunzima bokukhuluma, ukungakwazi ukukhuluma kahle
- Ukudideka okungazelelwe
- Ubunzima bokuhamba, ukulahlekelwa ibhalansi
- Ubunzima bokubona
Umlayezo Wokuya Nawe Ekhaya
- I-cardiopulmonary bypass iyindlela ejwayelekile esetshenziswa kabanzi nangokuphephile ekuhlinzweni okukhulu kwenhliziyo. Ungesabi.
- Lo mshini uvumela udokotela ohlinzayo ukuthi ahlinze inhliziyo engashayi, engenagazi kalula nangokuphephile.
- Lena inqubo yesikhashana nje. Ngemva kokuhlinzwa, inhliziyo namaphaphu akho kuzophinde kusebenze ngendlela evamile.
- Njengakuzo zonke izinhlobo zokuhlinzwa, kunezingozi, kodwa ithimba lakho lezokwelapha liqeqeshwe kahle ukuzilawula.
- Xoxa nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho nodokotela wakho ngaphambi kokuhlinzwa. Lokhu kuzokusiza uzizwe ukhululekile kakhudlwana.
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