Cishe uke wezwa ngokuhlinzwa kwenhliziyo, akunjalo? Mhlawumbe othile emndenini wakho noma umngane kuye kwadingeka enze lolu hlobo lokuhlinzwa. Ngokuvamile, uma sikhuluma ngokuhlinzwa kwe-bypass, sicabanga ngokuhlinzwa okukhulu okuhilela ukumisa inhliziyo nokuyixhuma emshinini. Kodwa bewazi ukuthi kukhona nokuhlinzwa kwe-bypass okungenziwa ngaphandle kokumisa inhliziyo, okungukuthi, ngenkathi inhliziyo isashaya? Yilokho esikubiza ngokuthi "ukuhlinzwa kwe-Off-pump", noma "ukuhlinzwa kwenhliziyo okuhlulayo." Ake sixoxe ngalokhu ngamazwi alula namuhla.
Kulungile, yikuphi lokhu kuhlinzwa kwe-bypass okwenziwa ngaphandle kokuvimba inhliziyo?
Kalula nje, lolu uhlobo lwe-coronary artery bypass graft (CABG). Ekuhlinzeni kwe-bypass, kwakhiwa umthambo omusha ukuze udlule umthambo ovalekile (i-coronary artery) ohlinzeka ngegazi enhliziyweni. Lokhu kwenziwa kusetshenziswa umthambo wegazi ophilile (i-graft) othathwe kwenye ingxenye yomzimba, isibonelo, umlenze noma isifuba.
Cabanga nje, kunezimoto eziningi emgwaqweni, ngakho izimoto azihambi. Bese sakha umgwaqo odlulayo ukuze sigweme lezo zimoto. Lokhu kuqala ukujikeleza kwegazi enhliziyweni futhi.
Ekuhlinzeni kwe-bypass okuvamile (On-pump CABG) , odokotela abahlinzayo bamisa inhliziyo yesiguli ngokuphelele. Bese, umsebenzi wenhliziyo namaphaphu wenziwa ngomshini okhethekile kuze kube yilapho ukuhlinzwa sekuqediwe. Lokhu kubizwa ngokuthi umshini we-cardiopulmonary bypass. Lo mshini uthatha igazi emzimbeni, wengeze umoya-mpilo kuwo, ukhiphe i-carbon dioxide, bese upompa igazi elihlanzekile ulibuyisele emzimbeni.
Kodwa ku-CABG engekho empompini, umshini wenhliziyo namaphaphu awusetshenziswa. Udokotela ohlinzayo wenza ukuhlinzwa ngenkathi inhliziyo yakho ishaya . Yingakho kubizwa ngokuthi ukuhlinzwa "kwenhliziyo eshayayo".
Ubani odinga lokhu kuhlinzwa?
Lokhu kuhlinzwa kwenziwa kakhulu ezigulini ezinesifo semithambo yegazi yenhliziyo (CAD). Ku-CAD, ama-fatty deposits (i-plaque) aqoqana ngaphakathi kwemithambo yegazi yenhliziyo, okunciphisa ukugeleza kwegazi. Lokhu kungabangela izimpawu ezifana nobuhlungu besifuba kanye nokuphelelwa umoya. Uma le mithambo ivalekile ngokuphelele, ingozi yokuhlaselwa yinhliziyo iphezulu kakhulu.
Uma lesi sifo siba sibi kakhulu ukuba singalawulwa ngokushintsha indlela yokuphila, imithi, kanye nezinye izindlela zokwelapha, odokotela batusa ukuhlinzwa kwe-bypass. Lokhu kuhlinzwa kunganciphisa izimpawu, kunciphise ingozi yokuhlaselwa yinhliziyo, futhi kwandise ukusinda. Ngakho-ke, kwabanye iziguli ezinquma ukuhlinzwa kwe-bypass, le nqubo engasebenzisi iphampu ingaba inketho enhle.
Uzilungiselela kanjani ngaphambi kokuhlinzwa?
Uma uhlelelwe ukwenza lokhu kuhlinzwa, ithimba lakho lezokwelapha lizokunikeza imiyalelo yokuthi ungazilungiselela kanjani. Le miyalelo ingafaka:
- Uma ubhema, yeka ngokushesha.
- Udokotela wakho uzokweluleka ukuthi uyeke okwesikhashana ukuthatha imithi ethile, ikakhulukazi imithi yokunciphisa ukugabha kwegazi.
- Ngosuku olungaphambi kokuhlinzwa, uzotshelwa ukuthi ungadli noma uphuze lutho kusukela phakathi kwamabili.
Ngaphezu kwalokho, ungase futhi uhlolwe kaningana ukuze ubone ukuthi usesimweni esinempilo yini sokuhlinzwa:
- Ukuhlolwa kwegazi
- Ukuhlolwa kwe-X-ray yesifuba
- I-Echocardiogram (i-Echo)
- Ukuhlolwa kwe-ECG (i-Electrocardiogram)
- Ukuhlolwa okukhethekile okufana nokuhlolwa kokucindezeleka kwenhliziyo ye-Nuclear
Kwenzekani ngesikhathi sokuhlinzwa?
Udokotela wakho ohlinzayo uzokuchazela ukuthi kuzokwenzekani ngesikhathi sokuhlinzwa. Nazi ezinye izinto ezivame ukwenzeka:
1. I-Anesthesia: Ulaliswa ngokuphelele futhi ulaliswe nge-anesthesia ukuze ungezwa ubuhlungu.
2. Ukuvunwa Kwezingxenyana: Ingxenye yomthambo wegazi onempilo odingekayo ukuze kudlule ithathwa emlenzeni wakho, engalweni, noma esifubeni sakho sangaphakathi.
3. Ukusikwa: Ukusikwa kwenziwa phakathi kwesifuba, kushukunyiswa ngokucophelela ithambo lesifuba liye ohlangothini ngalunye. Ngezinye izikhathi, kuye ngokuthi umsele uvalekile, kungase kusikwe okuncane phakathi kwezimbambo ohlangothini lwesobunxele lwesifuba.
4. Ukuqinisa inhliziyo: Njengoba ukuhlinzwa kwenziwa ngesikhathi inhliziyo ishaya, kusetshenziswa ithuluzi elikhethekile elibizwa ngokuthi ``Stabilizer`` ukubamba indawo encane yenhliziyo ehlinzwayo ukuze inganyakazi. Lokhu kuvumela udokotela ohlinzayo ukuthi ahlale ethule futhi enze ukuhlinzwa ngokucacile.
5. Ukudlula: Ukugeleza kwegazi emthanjeni ovalekile kuyamiswa okwesikhashana, bese kuthi uhlangothi olulodwa lomthambo wegazi ophilile othathwe ngaphambilini luxhunywe ku-aorta kanti olunye uhlangothi luxhunywe emthanjeni wenhliziyo ongaphansi kokuvalwa. Lokhu kudala ukudlula okusha.
6. Ukuvalwa: Uma umsebenzi usuqediwe, ukugeleza kwegazi kuyamiswa okwesikhashana, ithambo lesifuba liphinde lixhunywe ngezintambo ezikhethekile, bese isikhumba siyathungwa futhi sivalwe.
Ingabe ukuhlinzwa kwendabuko (On-pump) noma le ndlela entsha (On-pump) kungcono?
Ucwaningo lusaqhubeka ukuze kutholakale ukuthi iyiphi kulezi zindlela ezimbili engcono esikhathini eside. Udokotela wakho ohlinzayo uzoxoxa nawe ukuthi iyiphi indlela engcono kakhulu kuwe. Ake sibheke umehluko omkhulu kanye nezinzuzo kanye nokubi kwalezi zindlela ezimbili.
| Okukhethekile | Indlela Yendabuko (Ephampuni) | Indlela "Yokushaya Inhliziyo" (Ngaphandle Kwephampu) |
|---|---|---|
| Isimo senhliziyo | Inhliziyo iyama ngesikhathi sokuhlinzwa. | Ukuhlinzwa kwenziwa ngesikhathi inhliziyo ishaya. |
| Umshini wenhliziyo namaphaphu | Ukusebenzisa. | Akusetshenzisiwe. |
| Inzuzo kadokotela ohlinzayo | Ukuhlinzwa kungenziwa ngokucacile ngoba akukho ukunyakaza noma igazi. | Kunzima kakhulu ngokobuchwepheshe. Kudinga ukuqeqeshwa okukhethekile. |
| Izinzuzo ezingaba khona zesiguli | Indlela ejwayelekile, evame ukusetshenziswa. | Ukusikwa okuncane, ukuhlala esibhedlela isikhathi esifushane, ukululama okusheshayo. Kunganciphisa ingozi yezinkinga ezifana nokulahlekelwa yinkumbulo, isifo sohlangothi, kanye nokutheleleka. |
Into ebaluleke kakhulu ukuthi akuwona wonke umuntu ongenza lokhu kuhlinzwa okungavimbi inhliziyo. Futhi, ukuze wenze lokhu kuhlinzwa, udinga udokotela ohlinzayo onolwazi olukhethekile kukho.
Ziyini izingozi zalokhu kuhlinzwa?
Njenganoma yikuphi ukuhlinzwa okukhulu, kunezingozi ezithile ezihilelekile. Kodwa-ke, abantu abaningi baba nemiphumela ephumelelayo. Izingozi ezingaba khona zifaka:
- Ukopha
- Amahlule egazi (okungabangela isifo sohlangothi noma ukuhlaselwa yinhliziyo)
- Izinkinga ezibangelwa ukubulala izinzwa
- Izifo
- Ukushaya kwenhliziyo okungajwayelekile (i-Arrhythmia)
- Ukwehluleka Kwezinso
Kuthatha isikhathi esingakanani ukululama?
Isikhathi sokululama ngemva kokuhlinzwa sincike ezintweni eziningana, njengobudala bakho, impilo yakho iyonke, kanye nosayizi wesilonda. Ngokuvamile kuba kanje:
- Ungaqala ukuphuza uketshezi kanye nokudla 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.
- Kubalulekile impela ukuba nomuntu ozokusiza ezinsukwini ezimbalwa zokuqala ngemva kokuba ubuyele ekhaya.
- Izithungo zizosuswa cishe emavikini ayishumi.
- Kungcono ukungaphakamisi noma yiziphi izinsimbi amasonto ambalwa.
- Kungathatha amasonto ambalwa noma ngaphezulu ukululama ngokuphelele.
- Odokotela bazokweluleka ukuthi uhlanganyele ohlelweni lokuvuselela inhliziyo ukuze wakhe kabusha amandla akho.
Kukuziphi izimo lapho kufanele ufune khona iseluleko sezokwelapha ngokushesha?
Ngesikhathi sokululama kwakho, kuzodingeka uvakashele umtholampilo ngezinsuku ezihleliwe bese ubona udokotela wakho. Kodwa-ke, uma uba nanoma yiziphi izimpawu ezilandelayo, shayela udokotela wakho ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
| Izimpawu okufanele uziqaphele |
|---|
| Ubuhlungu besifuba noma ubuhlungu besisu obungapheli. |
| Ukuzizwa ubanda noma ujuluka kakhulu. |
| Umuzwa wethambo lesifuba linyakaza noma lenza umsindo "wokuchofoza". |
| Ukushaya kwenhliziyo okusheshayo noma okungajwayelekile. |
| Ukucanuzela noma ukuhlanza. |
| Ubunzima bokuphefumula. |
| Izimpawu zokutheleleka (umkhuhlane, ukubomvu eduze kwesilonda, ukuvuvukala, ukuphuma kobomvu). |
| Ukukhuluphala okungazelelwe (ngaphezu kwama-2 kg ngesonto). |
Umlayezo Wokuya Nawe Ekhaya
- Ukuhlinzwa kwe-bypass ngaphandle kwephampu uhlobo olukhethekile lokuhlinzwa kwe-bypass okwenziwa enhliziyweni eshayayo ngaphandle kokumisa inhliziyo.
- Ezinye iziguli zingazuza kule ndlela, njengokunciphisa ukuhlala esibhedlela, ukululama okusheshayo, kanye nokunciphisa ingozi yezinkinga ezithile.
- Lokhu kuhlinzwa akufaneleki kubo bonke iziguli. Kubalulekile ukunquma ukuthi isiguli siyakufanelekela yini lokhu nokuthi udokotela ohlinzayo uqeqeshwe ngokukhethekile ngakho.
- Uma udinga ukuhlinzwa kwe-bypass, xoxa nodokotela wakho wezifo zenhliziyo ukuthi indlela yendabuko (esebenzisa i-on-pump) noma le ndlela (esebenzisa i-off-pump) ikulungele yini.
- Ukulandela imiyalelo yezokwelapha ngokucophelela ngemva kokuhlinzwa kubalulekile ukuze umuntu alulame ngokushesha nangendlela ephumelelayo.
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