Kuvamile ukuzizwa wesaba kancane lapho udokotela wakho ekutshela noma othile omaziyo ukuthi udinga ukuhlinzwa kwe-bypass. Lokho kwesaba kuyanda nakakhulu uma uzwa ukuthi "inhliziyo izomiswa futhi ixhunywe emshinini." Kodwa bewazi ukuthi kukhona indlela ekhethekile engasetshenziswa ukwenza lokhu kuhlinzwa ngaphandle kokuvimba inhliziyo, okungukuthi, ngenkathi inhliziyo isashaya? Yilokho esizokhuluma ngakho namuhla, okubizwa ngokuthi 'Ukuhlinzwa Kwe-Off-Pump Bypass.'
Kuyini Ukuhlinzwa Kwe-Off-Pump Bypass?
Kalula nje, lolu futhi uhlobo lokuhlinzwa kwe-bypass (Coronary Artery Bypass Graft - CABG) oludala indlela entsha ezungeze umthambo wegazi ovinjiwe enhliziyweni. Ekuhlinzeni kwe-bypass okuvamile (On-Pump CABG), udokotela ohlinzayo umisa inhliziyo yesiguli okwesikhashana ngenkathi enza ukuhlinzwa. Ngaleso sikhathi, umsebenzi wenhliziyo namaphaphu wenziwa umshini okhethekile obizwa ngokuthi 'uMshini we-Cardiopulmonary Bypass'. Lo mshini uthatha igazi emzimbeni, ungeze umoya-mpilo kuwo, ukhiphe i-carbon dioxide, bese ulibuyisela emzimbeni.
Kodwa kulokhu kuhlinzwa 'Okungena-Pump', inhliziyo ayimiswa. Udokotela ohlinzayo wenza lokhu kuhlinzwa ngenkathi inhliziyo ishaya. Yingakho kubizwa nangokuthi "Ukuhlinzwa Kwenhliziyo Okushaywayo."
Ubani odinga lokhu kuhlinzwa?
Lokhu kuhlinzwa kwenziwa kakhulu kubantu abanesifo semithambo yenhliziyo (CAD), okuyimbangela ehamba phambili yokuhlaselwa yinhliziyo.
Cabanga ngemithambo emincane ehlinzeka ngegazi ezinhliziyweni zethu njengemigwaqo. Ku-CAD, ingaphakathi lale migwaqo livalekile ngamafutha kanye ne-cholesterol (ebizwa ngokuthi i-plaque). Lokhu kuvimbela inhliziyo ekutholeni igazi eliyidingayo, okubangela izimpawu ezifana nobuhlungu besifuba kanye nokuphelelwa umoya . Uma lokhu kuvinjelwa kuphelele, kuvela ukuhlaselwa yinhliziyo.
Udokotela uvame ukuncoma ukuhlinzwa kwe-bypass lapho izinguquko zendlela yokuphila, imithi, kanye nezinye izindlela zokwelapha zehluleka ukulawula lesi simo. Ezimweni ezinjalo, ukuhlinzwa 'kwe-Off-Pump' kungaba inketho enhle kwezinye iziguli.
Ungalungiselela kanjani ukuhlinzwa?
Ithimba lakho lokuhlinzwa lizokunikeza yonke imiyalelo oyidingayo ngaphambi kokuhlinzwa. Ngokuvamile bazosho izinto ezifana nalezi:
- Uma ubhema, yeka ngokuphelele.
- Ungase ucelwe ukuthi uyeke okwesikhashana eminye yemithi oyithathayo, ikakhulukazi imithi eqeda ukugabha kwegazi.
- Uzokwaziswa ukuthi ungadli noma uphuze lutho kusukela phakathi kwamabili ngosuku lokuhlinzwa.
Into ebaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo. Ungakhohlwa ukumazisa ngayo yonke imithi oyiphuzayo kanye nanoma yiziphi ezinye izifo onazo.
Yiziphi izivivinyo ezenziwa ngaphambi kokuhlinzwa?
Udokotela uzoyala ukuhlolwa okuningana ukuqinisekisa ukuthi uphilile ngokwanele ukuba uhlinzwe.
- Ukuhlolwa kwegazi
- I-X-ray yesifuba
- I-Echocardiogram (i-Echo)
- I-ECG (i-Electrocardiogram - i-EKG)
- Ukuhlolwa okukhethekile njengokuhlolwa kokucindezeleka kwenhliziyo yenuzi.
Kwenzekani ngesikhathi sokuhlinzwa?
Ukuhlinzwa kuthatha amahora amaningana. Udokotela ohlinzayo uzokuchazela kusengaphambili ukuthi kuzokwenzekani. Lezi yizinyathelo ezivame ukwenzeka.
1. Okokuqala, uzolaliswa ubuthongo ngokuphelele. Ngakho ngeke uzwe ubuhlungu.
2. Okulandelayo, umthambo wegazi ophilile (i-graft) uyasuswa kwenye ingxenye yomzimba wakho, isibonelo, udonga lwakho lomlenze noma lwesifuba . Lo mthambo wegazi usetshenziselwa ukudala indlela entsha eya endaweni evinjiwe.
3. Ngemuva kwalokho, isikhumba sinqunywa phakathi kwesifuba, bese ithambo lesifuba linqunywa nhlangothi zombili, lifinyelele enhliziyweni.
4. Njengoba inhliziyo ishaya, kusetshenziswa ithuluzi elikhethekile (isiqinisi) ukunciphisa ukunyakaza kwayo, futhi indawo lapho kwenziwa khona ukuhlinzwa kuphela eqiniswa ukuze ingashukumi.
5. Kumisa okwesikhashana ukugeleza kwegazi emthanjeni wegazi ovalekile.
6. Uhlangothi olulodwa lomthambo wegazi ophilile osususiwe ngaphambilini luxhunywe emthanjeni wegazi oyinhloko wenhliziyo (i-aorta), kanti olunye uhlangothi luxhunywe endaweni evinjiwe ngezansi. Lokhu kufana nokudala indlela yokudlula umgwaqo ovinjiwe.
7. Ngemva kokwakhiwa kwendlela entsha, ukugeleza kwegazi kuyabuyiselwa. Igazi manje liyadlula ekuvinjweni bese lihamba ngendlela entsha.
8. Ekugcineni, ithambo lesifuba liphinde lixhunywe ngezinto ezifana nentambo bese isikhumba sivalwa ngentambo.
Yikuphi kulezi zindlela ezimbili okungcono?
Ucwaningo lusaqhubeka ngokuthi ukuhlinzwa okuphampu noma okungaphampu kungcono yini. Udokotela wakho ohlinzayo uzonquma ukuthi iyiphi indlela engcono kakhulu kuwe. Ake sibheke izinzuzo nomehluko phakathi kwalezi zindlela ezimbili.
| Okukhethekile | I-CABG Ephampuni | I-CABG Engaphampu |
|---|---|---|
| Inzuzo kadokotela ohlinzayo | Kulula ukwenza lokhu kuhlinzwa ngoba inhliziyo ayinyakazi noma ayophi. Kuyabonakala kahle. | Ngenxa yokuthi ukuhlinzwa kwenziwa enhliziyweni eshayayo, kuyinselele kakhulu ngokobuchwepheshe. Kudingeka udokotela ohlinzayo onolwazi. |
| Izinzuzo ezingaba khona zesiguli | Indlela yendabuko futhi esetshenziswa kabanzi, eseyiqinisekisiwe isikhathi eside. | Isikhathi sokuhlala esibhedlela kanye nesikhathi sokululama singase sibe sifushane. Ingozi yezinkinga ezifana nesifo sohlangothi, izinkinga zokukhumbula, izifo, kanye nokushaya kwenhliziyo okungajwayelekile (i-arrhythmia) ingancishiswa. |
| Ubani ofaneleka kakhulu? | Lena yindlela ejwayelekile efanelekela iziguli eziningi. | Kungase kufanelane kangcono nalabo abanezinye izimo zezokwelapha ezifana nesifo sezinso, isifo samaphaphu esingamahlalakhona, isifo sokuqina kwesibindi, kanye nalabo abake bahlinzwa nge-bypass ngaphambilini. |
Ziyini izingozi zalokhu kuhlinzwa?
Njenganoma yikuphi ukuhlinzwa okukhulu, kunezingozi ezithile ezihilelekile. Kodwa abantu abaningi bayalulama ngempumelelo. Nazi ezinye zezinkinga ezingaba khona:
- Ukopha ngokweqile.
- Amahlule egazi (okungabangela isifo sohlangothi noma ukuhlaselwa yinhliziyo).
- Izinkinga ezibangelwa yi-anesthesia.
- Izimo ezithathelwanayo.
- Ukungajwayelekile kwenhliziyo.
- Ukwehluleka kwezinso.
Kuthatha isikhathi esingakanani ukululama?
Isikhathi sokululama sincike eminyakeni yakho, impilo yakho iyonke, kanye nanoma yiziphi izinkinga eziphakama ngemva kokuhlinzwa. Ngokuvamile, inqubo yokululama ibukeka kanje.
- Ungaqala ukuphuza uketshezi nokudla ukudla okuncane ngosuku olufanayo noma ngosuku olulandelayo ngemva kokuhlinzwa.
- Phakathi nosuku lokuqala noma ezimbili, uzokwazi ukuhlala esihlalweni ngosizo bese uhamba kancane.
- Kufanele uhlale esibhedlela izinsuku ezimbalwa.
- Uzodinga umuntu ozokusiza ezinsukwini ezimbalwa zokuqala ngemuva kokubuyela ekhaya uvela esibhedlela.
- Izithungo zizosuswa cishe ngesonto noma eshumini.
- Kufanele ugweme ukuphakamisa izinsimbi amasonto ambalwa .
- Kungathatha amasonto ambalwa noma ngaphezulu ukululama ngokuphelele.
- Udokotela wakho uzokweluleka ukuthi uhlanganyele ohlelweni lokuvuselela inhliziyo ukuze kusize ekwakheni kabusha amandla akho.
Yiziphi izimpawu zokuthi kufanele ubonane nodokotela ngokushesha?
Uzonikezwa usuku lokubonana nodokotela wakho ngesikhathi sokululama kwakho. Kodwa-ke, uma uba nanoma yiziphi izimpawu ezilandelayo, kufanele ufune iseluleko sezokwelapha ngokushesha . Ngaphandle kwalokho, iya eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
- Ubuhlungu besifuba obuqhubekayo noma ubuhlungu besisu.
- Ukuzizwa ubanda noma ujuluka kakhulu.
- Uma ithambo lakho lesifuba lizwakala sengathi liyanyakaza noma lenza umsindo 'wokuchofoza'.
- Isilinganiso senhliziyo esisheshayo kakhulu noma esingajwayelekile.
- Ukucanuzela noma ukuhlanza.
- Ubunzima bokuphefumula.
- Izimpawu zokutheleleka, njengokubomvu, ukuvuvukala, ubomvu obuphuma endaweni yomthungo, noma umkhuhlane.
- Ukwanda kwesisindo okungazelelwe okungaphezu kwama-2-3 kg phakathi nesonto.
Umlayezo Wokuya Nawe Ekhaya
- Ukuhlinzwa kwe-Off-Pump Bypass kuyindlela yokuhlinzwa kwe-bypass eyenziwa ngenkathi inhliziyo ishaya, ngaphandle kokuyimisa.
- Kwabanye iziguli, le ndlela ingase inciphise isikhathi esichithwa esibhedlela, isheshise ukululama, futhi inciphise ingozi yezinkinga ezithile.
- Lokhu kuhlinzwa akufanele wonke umuntu. Udokotela wakho ohlinzayo uzonquma ukuthi iyiphi indlela engcono kakhulu kuwe ngokusekelwe esimweni sakho.
- Ukululama kuyinqubo eyenzeka kancane kancane. Kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo futhi uhlanganyele ezinhlelweni zokuvuselela inhliziyo.
- Uma kuvela izimpawu eziyisixwayiso ngemva kokuhlinzwa, ungalibali bese ubona udokotela ngokushesha.
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