Isitho esimangalisayo kakhulu emzimbeni wethu yinhliziyo. Sisebenza ngaphandle kokuphumula, kusukela ngosuku esizalwa ngalo. Kodwa ngezinye izikhathi, kungakhathaliseki ukuthi kungenxa yokuhlaselwa yinhliziyo okukhulu, ngemva kokuhlinzwa okukhulu, noma ngenxa yesinye isimo senhliziyo esibi kakhulu, inhliziyo yethu ingaba buthakathaka kakhulu. Ngezikhathi ezinjalo, inhliziyo ayikwazi ukupompa igazi elanele emzimbeni. Lesi yisimo esibi kakhulu, ngisho nesisongela ukuphila. Ngakho-ke, ngezikhathi ezinjengalezi, sizokhuluma ngedivayisi ekhethekile odokotela abayisebenzisayo ukunikeza inhliziyo "ukuphumula" okuncane futhi bayisize yenze umsebenzi wayo.
Kalula nje, iyini le Intra-Aortic Balloon Pump (IABP)?
Nakuba leli gama lizwakala liyinkimbinkimbi kancane, umqondo ongemuva kwalo ulula kakhulu. I-Intra-Aortic Balloon Pump (IABP) iyithuluzi elide, elincane elifana nebhaluni. Lifakwa ku-aorta, umthambo wegazi omkhulu kunayo yonke emzimbeni wethu, othwala igazi lisuka enhliziyweni liye kuwo wonke umzimba. Cabanga ngalo njengebhaluni elide elifana nethubhu.
Leli bhaluni alikho nje kuphela lapho. Lixhunywe emshinini okhethekile. Lowo mshini uhlakaniphe kakhulu. Ufutha futhi ukhiphe umoya kuleli bhaluni ukuze lihambisane nesigqi senhliziyo yethu. Le nqubo yenza kube lula kakhulu ngenhliziyo ebuthakathaka ukupompa igazi. Ngokuvamile, leli thuluzi lishiywa emzimbeni izinsuku ezimbalwa kuphela. Okusho ukuthi, njengesekelo lesikhashana kuze kube yilapho inhliziyo inamandla ngokwanele ukuthi isebenze yodwa futhi.
Ake sibheke kabanzi ukuthi le phampu yebhaluni isebenza kanjani.
Ukuze uqonde lokhu, udinga ukuba nombono omncane wokuthi inhliziyo isebenza kanjani. Inhliziyo yethu ifana nephampu eyakhiwe ngamakamelo amabili.
1. Uma inhliziyo ifinyela (Ukufinyela/i-Systole): Uma inhliziyo ifinyela, igazi elingaphakathi kwayo liphampulwa emzimbeni wonke nge-aorta.
2. Uma inhliziyo iphumula (Ukuphumula/i-Diastole): Uma inhliziyo iphumula futhi, igcwala igazi futhi. Pompa ukuze uthole umjikelezo olandelayo.
Manje bheka ukuthi i-IABP isiza kanjani kulokhu. Isebenza ngokuphambene kakhulu nenqubo yenhliziyo.
- Uma inhliziyo ifinyela futhi ikhipha igazi, ibhaluni liyaphuma ngokushesha. Cabanga ngakho njengokususa ukuvaleka kwepayipi elikhulu. Khona-ke inhliziyo ebuthakathaka ingakhipha igazi kalula, ngaphandle kokusebenza kanzima kangaka.
- Uma inhliziyo ikhula futhi igcwele igazi, ibhaluni liyakhukhumala ngokushesha. Lokhu kusunduza igazi libuyele e-aorta. Lokhu kunezinzuzo ezimbili. Eyokuqala ukuthi igazi eliningi ligeleza liye emithanjeni yenhliziyo, ehlinzeka ngegazi emisipheni yenhliziyo, futhi inhliziyo ithola ukudla okunempilo okungcono. Eyokuqala ukuthi ukujikeleza kwegazi kwezinye izingxenye zomzimba, ikakhulukazi izingalo nemilenze, kuyathuthuka.
Le nqubo yokwanda nokuncipha ilawulwa ngokunembile yikhompyutha ngokwesigqi senhliziyo (ECG). Ngakho-ke, umsebenzi wenhliziyo usizwa kakhulu ngaphandle kokuphazanyiswa.
Kudingeka nini i-IABP?
Udokotela uzonquma ukusebenzisa le divayisi lapho inhliziyo yesiguli isibuthakathaka kangangokuthi ayikwazi ukunikeza igazi elanele ezithweni zomzimba. Ngokwezokwelapha, lesi simo sibizwa ngokuthi "ukushaqeka kwenhliziyo." Lesi yisimo esiphuthumayo kakhulu nesibucayi.
Ithebula elingezansi libala izici eziningana ezingabangela ukushaqeka kwenhliziyo.
| Isimo sezokwelapha | Incazelo elula |
|---|---|
| Ukuhlaselwa Yinhliziyo Okubi Kakhulu | Uma umthambo wegazi othwala igazi uye emisipheni yenhliziyo uvaleka ngokuphelele, okubangela umonakalo omkhulu emisipheni yenhliziyo. |
| Ukwehluleka Kwenhliziyo Okukhulu | Isimo lapho inhliziyo ihluleka khona ukupompa inani legazi elidingwa ngumzimba. |
| I-Arrhythmias | Ukushaya kwenhliziyo okungajwayelekile. Ngezinye izikhathi inhliziyo ishaya ngokushesha kakhulu noma kancane kakhulu futhi ayipompi igazi kahle. |
| I-Myocarditis | Ukuvuvukala kwemisipha yenhliziyo, okubangelwa imbangela efana nokutheleleka ngegciwane. Lokhu kungabangela ukuba inhliziyo ibe buthaka. |
| Isifo Semithambo Yenhliziyo | Ukuncishiswa kwemithambo yegazi ehambisa igazi enhliziyweni. Kwezinye izimo, uma lokhu kuba nzima, inhliziyo iba buthakathaka. |
Ngaphezu kwalokho, le IABP isetshenziswa uma inhliziyo idinga ukwesekwa ngemva kokuhlinzwa okukhulu kwenhliziyo, noma ngemva kokwelashwa okufana ne -angioplasty (Percutaneous Coronary Intervention), okuvula umthambo wegazi ovalekile.
Ingabe wonke umuntu angakusebenzisa lokhu?
Cha. Le divayisi akufanele isetshenziswe ngabantu abanezimo ezithile zezokwelapha ngoba ingenza umonakalo omkhulu kunokuba ibe nenzuzo.
- I-Aortic Aneurysm: Uma udonga lwe-aorta lubuthakathaka futhi luvuvukala njengebhaluni.
- Ukuhlukaniswa kwe-Aorta: Uma igazi livuza phakathi kwezingqimba zodonga lwe-aorta futhi lidabukile.
- Ukubuyela kwe-Aortic: Lapho ivalvu ye-aortic enhliziyweni ingavali kahle, okubangela ukuba igazi livuza emuva.
- Isifo Esibi Semithambo Yegazi Engaphazamisi: Uma imithambo yegazi ethwala igazi iye emilenzeni ivalekile kakhulu, kungaba nzima ukufaka le divayisi.
- I-Sepsis Engalawulwa: Uma kukhona ukutheleleka okukhulu okusakazeke kuwo wonke umzimba.
Inqubo yokufaka le divayisi emzimbeni yenziwa kanjani?
Lokhu kuvame ukwenziwa odokotela benhliziyo kanye nethimba labo, egunjini lokunakekelwa okujulile esibhedlela (ICU) noma egumbini lokuhlinza.
Ngaphambi kwenqubo
Uma isiguli sesivele sihlinzwa inhliziyo, sizoba ngaphansi kwe-anesthesia futhi ngeke sizwe lutho. Ngaphandle kwalokho, uma lokhu kwenziwa ngokwehlukana, kuzonikezwa i-anesthetic yendawo ukuze kuncishiswe indawo yomlenze lapho kuzofakwa khona idivayisi. Ngakho ngeke sizwe ubuhlungu.
Ngesikhathi senqubo
Udokotela ulandela lezi zinyathelo:
1. Okokuqala, ithubhu elincane, elingenalutho elibizwa ngokuthi i-catheter lifakwa emthanjeni omkhulu endaweni ye-groin yomlenze.
2. Okulandelayo, ngale catheter, ibhaluni elikhishwe amanzi lidluliselwa ngokucophelela e-aorta.
3. Lokhu kwenziwa ngokusebenzisa ubuchwepheshe be-X-ray ukuze kubhekwe iphuzu, okungukuthi, i-aorta engaphansi kwenhliziyo.
4. Uma isisendaweni efanele, ingxenye engaphandle yebhaluni ixhunywe kwikhompyutha ekhethekile. Umshini ube usuqala ukulawula ibhaluni ngokwesilinganiso sokushaya kwenhliziyo.
Ngemva kwenqubo
Ngemva kokufakwa kwedivayisi, isiguli kuzodingeka sihlale siqashwe ngokukhethekile egunjini lokunakekelwa okujulile.
- Uma nje idivayisi isekhona, kufanele uhlale embhedeni. Gcina ikhanda lakho liphakeme kancane.
- Umlenze one-catheter kufanele uhlale uqondile . Uma uwugoba, i-catheter ingase ihambe.
- Ukuze kuvinjelwe ukuqhekeka kwegazi, kuqalwa uketshezi olunciphisa igazi olufana ne -heparin emthanjeni.
Yiziphi izinzuzo nezingozi?
Njenganoma yiluphi uhlobo lokwelashwa, lolu lunezinzuzo kanye nezingozi.
Inzuzo enkulu ukuthi lena ithuluzi elisindisa impilo. Esimweni esifana nokushaqeka kwenhliziyo, lapho inhliziyo ingakwazi ukusebenza yodwa, le divayisi ingaba usizo olukhulu ekusindiseni izimpilo ngokunikeza igazi elidingekayo ezithweni ezibalulekile njengobuchopho nezinso.
Kodwa-ke, kunezingozi ezithile ezingase zenzeke. Kuncike ezintweni ezifana nobudala besiguli kanye nempilo yaso iyonke. Ithimba lezokwelapha lihlala liqaphela lezi zingozi.
| Ingozi engaba khona | Incazelo |
|---|---|
| Ukopha | Ukopha kungase kwenzeke endaweni yokufaka i-catheter. |
| Ukulimala Kwemithambo Yegazi | Kunethuba elincane lokuthi umthambo wegazi ungase wonakale uma idivayisi ifakwa noma isendaweni yayo. |
| Ukutheleleka | Amagciwane angangena emzimbeni ngendawo yokufaka i-catheter. |
| Amahlule egazi | Amahlule egazi angakheka eduze kwedivayisi, yingakho kunikezwa imithi yokunciphisa igazi. |
| Indawo Engalungile Yebhaluni | Uma iso linyakaza, lingavimba ukugeleza kwegazi ezithweni ezifana nezinso. |
| Ukuqhuma Kwebhaluni | Lokhu kwenzeka kaningi kakhulu. Igesi ye-Helium isetshenziselwa ukufutha ibhaluni. Ngenxa yokuthi ayinangozi emzimbeni, noma ngabe ingena ngengozi egazini, ngeke idale inkinga enkulu. |
Ukubuyisa kanye nokususwa kwedivayisi
I-IABP ivame ukushiywa endaweni yayo izinsuku ezimbalwa kuphela. Uma odokotela becabanga ukuthi inhliziyo yenza kangcono kancane, bayayimisa ipompo isikhashana bese bebona. Ngemuva kwalokho, uma inhliziyo isebenza kahle yodwa, udokotela unquma ukuyisusa leyo divayisi.
Kodwa-ke, kwezinye izimo ezinzima, uma inhliziyo ibuthakathaka kakhulu, le divayisi ingadinga ukushiywa endaweni yayo amasonto amaningi njengebhuloho eliya kolunye ukwelashwa, njengokufakelwa inhliziyo.
Ukushayela nini udokotela wakho ucingo
Uma wena noma othile oseduze nawe ethola lolu hlobo lokwelashwa futhi eba nanoma yiziphi izimpawu zezinkinga ngemuva kokubuyela ekhaya evela esibhedlela, kubaluleke kakhulu ukwazisa udokotela wakho ngokushesha.
| Izimpawu ezidinga usizo lwezokwelapha ngokushesha | |
|---|---|
| Izinguquko ezizungeze umgwaqo wokusika | Ukubomvu okweqile, ukuvuvukala, ubuhlungu, noma ukuphuma kobomvu endaweni yokufaka i-catheter. |
| Imfiva | Kungaba uphawu lokuthi kukhona ukutheleleka emzimbeni. |
| Ukushintsha kwesilinganiso senhliziyo | Ukuzizwa sengathi inhliziyo yakho ishaya ngokushesha (ukushaya kwenhliziyo). |
| Ubunzima bokuphefumula (i-Dyspnea) | Uma ukuphefumula kuba nzima kakhulu. |
| Ukuvuvukala komzimba | Ukuvuvukala kwamaqakala, izandla, noma ubuso. |
| Ukwanda kwesisindo | Uma ngokuzumayo ukhuluphala ngaphezu kwamakhilogremu angu-2-3 ngesisindo phakathi nesonto (lokhu kungaba uphawu lokugcinwa kwamanzi emzimbeni). |
Umlayezo Wokuya Nawe Ekhaya
- I-Intra-Aortic Balloon Pump (IABP) iyithuluzi lesikhashana, elisindisa impilo elisiza inhliziyo ukuthi ipompe igazi uma ibuthakathaka kakhulu.
- Lokhu kusebenza ngokulawula izinga lokushaya kwenhliziyo, ukunciphisa umthwalo womsebenzi enhliziyweni, nokuthuthukisa ukuhlinzekwa kwegazi emzimbeni kanye nasemisipheni yenhliziyo uqobo.
- Lokhu kuvame ukufakwa ngemithambo yegazi emlenzeni, futhi isiguli sigcinwa siqashwe egunjini lokunakekelwa okujulile.
- Njengakuyo yonke imithi yokwelapha, kunezingozi ezithile, kodwa ziphathwa yithimba lezokwelapha ngokuqapha isiguli eduze.
- Uma kuvela izimpawu ezingavamile ngemva kwalokhu kwelashwa, kubaluleke kakhulu ukwazisa udokotela wakho ngokushesha.
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