Wake wazizwa sengathi inhliziyo yakho ishaya sengathi iyahlanya, ishaya ngokushesha futhi ngokungajwayelekile, futhi uzizwa sengathi unento engajwayelekile esifubeni sakho? Lokhu yilokho esikubiza ngokuthi i-Atrial Fibrillation (AFib) kwezokwelapha. Lokhu kuyisifo esivame kakhulu senhliziyo. Esikhathini esiningi, lesi simo singalawulwa ngemithi. Kodwa kwabanye abantu, kunzima ukusilawula ngemithi yodwa. Ngezikhathi ezinjalo, namuhla sizokhuluma ngokuhlinzwa okuphumelelayo kakhulu odokotela abakutusayo. Kubizwa ngokuthi i-Maze Procedure . Nakuba leli gama liyinqaba kancane, liye lakwazi ukwelapha izimpilo zabantu abaningi abane-AFib.
Kalula nje, iyini le nqubo ye-Maze?
Cabanga ngomdlalo we-maze. Kukhona indlela eyodwa kuphela yokungena, indlela eyodwa yokuphuma, kanye nendlela eyodwa kuphela efanele phakathi. Kodwa futhi kunezindlela eziningi ezingalungile eziholela emuva naphambili ngaphakathi kuwo. Kwenzeka into efanayo kwi-Maze Procedure.
Kalula nje, kule nqubo, udokotela ohlinzayo udala iphethini ethambile kakhulu nehleliwe yezicubu zesilonda ezicutshini zenhliziyo yakho. Kufana nokudala i-maze ngaphakathi kwenhliziyo.
Manje bheka, okwenzeka enhliziyweni yomuntu one-Atrial Fibrillation ukuthi izimpawu zikagesi ezilawula ukushaya kwenhliziyo ziqala ngendlela engahlelekile, ziqala endaweni eyodwa zisakazeke kuzo zonke izingalo ezine. Yingakho inhliziyo ilahlekelwa isigqi sayo bese iqala ukushaya ngokushesha.
Iphethini yezicubu zesilonda edalwe ku-Maze Procedure ivimba izindlela zezibonakaliso zikagesi ezingajwayelekile nezingalungile zokuhamba emuva naphambili . Ngesikhathi esifanayo, indlela okuwukuphela kwayo yesibonakaliso sikagesi esifanele ukushaya iyavulwa . Njengendlela efanele ku-maze. Lokhu kuvimbela zonke izimpawu ezingalungile futhi kuvumela izimpawu ezifanele kuphela ukuhamba. Ekugcineni, ukushaya kwenhliziyo yakho kubuyela esigqini esijwayelekile nesinempilo.
Odokotela basebenzisa izindlela ezimbili ukulungisa lesi silonda:
- I-Cryoablation: Isebenzisa ukubanda okukhulu (ukuqandisa) ukulimaza izicubu nokubanga izibazi.
- Amandla e-Radiofrequency: Amandla e-Radiofrequency asetshenziselwa ukushisa izicubu futhi abangele izibazi.
Le nqubo ngezinye izikhathi ingenziwa ngesikhathi esifanayo nezinye izihlinzeko zenhliziyo (njengokuhlinzwa kwe-bypass). Noma, ingenziwa yodwa. Namuhla, uhlobo olusha noluthuthuke kakhulu lwalolu hlinzeko, inqubo ye-Cox-maze IV , ibhekwa "njengendinganiso yegolide" ye-atrial fibrillation.
Kukuziphi izimo lapho lokhu kuhlinzwa kwenziwa khona?
Inqubo ye-Maze ayinconywa kubo bonke iziguli ze-AFIB. Udokotela wakho uzoxoxa nawe ngale nqubo uma:
- Ku-odelwe wenaUma imithi ingakwazi ukulawula ukushaya kwenhliziyo yakho, noma uma ungakwazi ukusebenzisa imithi ethile ngenxa yemiphumela emibi.
- Uma une-atrial fibrillation, okubangele ukwakheka kwamahlule egazi emzimbeni wakho futhi kwabangela izimo eziyingozi njenge-stroke .
- Uma uhlelelwe ukuhlinzwa kwesinye isimo senhliziyo (isib. ukulungiswa kwe-valve yenhliziyo, ukuhlinzwa kwe-bypass) , le ndlela ingasetshenziswa ukwelapha i-atrial fibrillation yakho ngesikhathi esifanayo nokuhlinzwa.
- Uma uke waphathwa nge- Catheter Ablation ngaphambilini kodwa ayizange iphumelele.
Uma singelashwa, isimo esibizwa ngokuthi i-atrial fibrillation singandisa kabili ingozi yokufa futhi sandise ingozi yokushaywa unhlangothi ngokuphindwe kahlanu kuya kwesikhombisa. Kungaholela nasekuhlulekeni kwenhliziyo okuqinile. Ngakho-ke, kubaluleke kakhulu ukuthola ukwelashwa okufanele kwalesi simo.
Kwenzekani ngaphambi kokuhlinzwa?
Awukwazi ukuya ohlinzweni olunje ngesikhathi esisodwa. Ngaphambi kwalokho, udinga ukuhlola kahle isimo somzimba wakho. Kuhilela ukuhlolwa okuningana kanye nokuvakashela udokotela.
- I-Transthoracic Echocardiogram: Lokhu kufana nokuskena kwenhliziyo nge-ultrasound. Kuhlola usayizi we-atrium yakho yangakwesobunxele nokuthi ngabe kukhona yini izinkinga zevalvu yenhliziyo.
- I-CT yesifuba (i-Computed Tomography) Scan: Kwenziwa i-CT scan yesifuba. Ngezinye izikhathi, uma uzokwenza ukuhlinzwa okuncane, kungadingeka futhi ukuthi uhlolwe i-CT yesisu kanye ne-pelvis.
- Ukuhlangana nodokotela: Udokotela wakho wenhliziyo, udokotela ohlinzayo, kanye nodokotela obulala izinzwa bazohlangana nawe ukuze bakuchazele ngokuhlinzwa, izingozi zako, kanye nendlela yokubulala izinzwa ezonikezwa ngayo. Buza noma yimiphi imibuzo ongase ube nayo ngalesi sikhathi.
- Ukunikeza imiyalelo: Uzonikezwa imiyalelo ecacile yokuthi yini okufanele uyidle, uyiphuze, uyeke ukuyithatha, kanye nemithi okufanele uyithathe ezinsukwini ezingaphambi kokuhlinzwa.
Kwenziwa kanjani ukuhlinzwa?
Inqubo ye-Maze ingenziwa ngezindlela ezimbili eziyinhloko. Udokotela wakho ohlinzayo uzonquma ukuthi iyiphi indlela engcono kakhulu esimweni sakho.
| Indlela yokuhlinzwa | Indlela yokukwenza ilula. |
|---|---|
| Ukuhlinzwa okuvulekile (indlela ye-Sternotomy) |
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| Ukuhlinzwa kwe-Keyhole (indlela ye-Thoracoscopic) |
|
Ngenxa yokuthi ukuhlinzwa kwe-keyhole (i-Thoracoscopic) kwenziwa ngokusika okuncane kakhulu, kunezinkinga ezimbalwa kanye nokuhlala isikhathi esifushane esibhedlela.
Yini eyenziwa ku-Left Atrial Appendage?
Lena yingxenye ebaluleke kakhulu yeNqubo ye-Maze. I-Left Atrial Appendage iyisikhwama esincane sezicubu esinomumo wendlebe esinamathele ku-atrium yesobunxele yenhliziyo. Lena yindawo eyinhloko yokwakheka kwamahlule egazi kubantu abane-atrial fibrillation.
Ucwaningo luthole ukuthi ama-90% amahlule egazi abangela isifo sohlangothi ezigulini ze-AFIB akheka kule ndawo encane.
Uma isigqi senhliziyo siphazamiseka, igazi elingena kulesi sitho liyama lapho, okwenza kube lula ukuthi kwakheke amahlule egazi. Uma ihlule legazi elakheka ngale ndlela liphuma futhi lihambe emithanjeni yegazi bese libhajwa emthanjeni ebuchosheni, lingabangela isifo sohlangothi.
Ngakho-ke, ngesikhathi senqubo ye-Maze, udokotela ohlinzayo uvala le Left Atrial Appendage esebenzisa izitishi, ama-staple, noma idivayisi ekhethekile, noma ayinqume ngokuphelele. Lokhu kunganciphisa kakhulu ingozi yakho yokuba nesifo sohlangothi esikhathini esizayo.
Kwenzekani ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, uzogcinwa egunjini lokunakekelwa okujulile (ICU) ukuze uhlolwe usuku olulodwa noma ezimbili, bese udluliselwa egunjini elivamile. Uma uke wahlinzwa okunye, ukuhlala kwakho esibhedlela kungase kuthathe isikhathi eside. Ngokuvamile, umuntu oke wahlinzwa imbobo yokhiye angaya ekhaya cishe ezinsukwini ezine. Uma uke wahlinzwa ovulekile, kungadingeka uhlale cishe isonto.
Ngisho noma usubuyele ekhaya, kuzodingeka uphuze imithi ethile izinyanga eziningana.
- Ama-anticoagulant (ama-blood thinner): Kuzodingeka uthathe le mithi (isib. i-warfarin, i-apixaban) okungenani izinyanga ezintathu ukuze uvimbele ukuqhekeka kwegazi. Ngemva kwalokho, udokotela wakho uzonquma ukuthi udinga yini ukuqhubeka nokusebenzisa le mithi.
- Imithi yokulawula izinga lokushaya kwenhliziyo: Le mithi ingadingeka ukulawula ukushaya kwenhliziyo okungajwayelekile okungenzeka ngesikhathi sokuqala kokululama kwenhliziyo.
- Ama-Diuretics: Le mithi inikezwa ukunciphisa ukunqwabelana koketshezi okungadingekile emzimbeni.
Ngezinye izikhathi, i-AFIB ayixazululeki ngokuphelele ngemva kwenqubo ye-Maze. Ezimweni ezinjalo, kungase kudingeke ukususwa kwe-catheter okwengeziwe. Ngakho-ke, kubaluleke kakhulu ukuhlala uthintana nodokotela wakho wenhliziyo ngemva kwenqubo.
Yiziphi izinzuzo nezingozi zalokhu kuhlinzwa?
| Izinzuzo | Izingozi Nezinkinga |
|---|---|
|
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Kuthatha isikhathi esingakanani ukuphulukiswa?
Ngokuvamile kuthatha amasonto amathathu kuya kwayisithupha ukubuyela emisebenzini yakho evamile yansuku zonke. Uma uke wahlinzwa imbobo yokhiye, isikhathi sakho sokululama sizoshesha kakhulu ngoba akukho ukusikwa okukhulu esifubeni sakho.
Kunini lapho udinga ukuphinde ubonane nodokotela wakho?
Uma uphinda uzwa izimpawu ze-AFIB ngemva kokuhlinzwa, yazisa udokotela wakho wenhliziyo ngokushesha. Ngaphezu kwalokho, kuzodingeka ugcine isimiso esithile sokuhlolwa kanye nama-aphoyintimenti.
- Ngaya ekhaya ngivela esibhedlela ngemva kwesonto.
- Bonana nodokotela wenhliziyo cishe ngemva kwenyanga.
- Ukuhlolwa kwe-Electrocardiogram (EKG) ezinyangeni ezi-3, ezi-6, kanye nezi-12 ngemva kokuhlinzwa, bese kuba kanye ngonyaka.
- Isivivinyi se-Holter (idivayisi eqapha ukusebenza kwenhliziyo amahora angama-24) sihlolwa ezinyangeni eziyi-6 neziyi-12 ngemva kokuhlinzwa.
Kubaluleke kakhulu ukuthi zonke lezi zivivinyo zenziwe ngendlela efanele ukuqinisekisa impilo yakho.
Umlayezo Wokuya Nawe Ekhaya
- Inqubo ye-Maze iyindlela yokuhlinzwa ephumelela kakhulu ye-Atrial Fibrillation (AFib), isimo okunzima ukusilawula ngemithi.
- Lokhu kuhilela ukudala iphethini efana 'ne-maze' yezicubu zesibazi ukuvimba izimpawu zikagesi ezingalungile enhliziyweni.
- Lokhu kuhlinzwa kwenza isigqi senhliziyo yakho sibe sijwayelekile futhi kunciphisa kakhulu ingozi yokushaywa yisifo sohlangothi.
- Kunezindlela ezimbili: ukuhlinzwa okuvulekile kanye nokuhlinzwa kwembobo yokhiye. Isikhathi sokululama ngemva kokuhlinzwa kwembobo yokhiye sishesha kakhulu.
- Sicela uxoxe nodokotela wakho ukuthi ngabe lokhu kuhlinzwa kulungile yini kuwe nokuthi yiziphi izinzuzo nezingozi.
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