Ukuvula Isifuba Sokuhlinzwa Kwenhliziyo (Sternotomy): Okudingeka Ukwazi

Uma udokotela wakho ekutshela ukuthi udinga ukuhlinzwa kwenhliziyo, nokuthi kuhilela ukuvula isifuba sakho, ungase uzizwe wesaba futhi wethukile. Lokho kuvamile. Akekho othanda ukuhlinzwa. Kodwa kuyinto eyenziwa odokotela abahlinza inhliziyo ngokuvamile futhi ngempumelelo. Ngakho-ke asikho isizathu sokwesaba. Kulesi sihloko, sizokhuluma nje ngokuthi kuyini ukuhlinzwa kwe-sternotomy, ukuthi kwenziwa kanjani, ukuthi kwenziwa kanjani, nokuthi yini okudingeka ukwazi ngemva kokuhlinzwa.

Kalula nje, kuyini i-sternotomy?

Kalula nje, i-sternotomy inqubo yokuhlinzwa lapho ithambo eliyisicaba eliphakathi kwesifuba sakho, i-sternum, lisikwa phakathi ngenhloso yokuhlinzwa. Abanye abantu bakubiza nangokuthi "i-median sternotomy."

Cabanga ngakho, lesi sinqe kanye nezimbambo zikhona ukuvikela izitho ezibaluleke kakhulu esifubeni sethu, njengenhliziyo namaphaphu. Kufana nekheji lokuphepha. Ngakho-ke, uma kunenkinga ngenhliziyo yakho futhi udinga ukuyilungisa ngokuhlinzwa, indlela engcono kakhulu nelula yokuthi udokotela ohlinzayo afike enhliziyweni ukusika lesi sinqe phakathi bese enza indlela ezinhlangothini zombili.

Kukhona nendlela ebizwa ngokuthi "i-mini sternotomy" lapho yonke i-sternum ingasikwa khona, kodwa kwenziwa i-incision encane. Kulokhu, kwenziwa i-incision encane engamasentimitha angu-2-3.

Ingabe lokhu yikho okwenziwa ukuhlinzwa kwenhliziyo okuvulekile? Ingabe lokhu ukuhlinzwa okukhulu?

Lokhu kuyinto edida abantu abaningi. I-sternotomy inqubo evula indlela yokuhlinzwa kwenhliziyo okuvulekile . Kufana nokuthi uma ufuna ukulungisa okuthile endlini yakho, kufanele uqale uvule umnyango. Yileyo ndlela. I-sternotomy inqubo "evula umnyango" ukuze ifike enhliziyweni. Ukuhlinzwa kwenhliziyo okuvulekile inqubo elungisa inhliziyo kusuka ngaphakathi.

Yebo, lokhu kubhekwa njengokuhlinzwa okukhulu . Ngoba kuthatha cishe izinyanga ezimbili ukuthi ithambo liphole ngokuphelele futhi liphinde linamathele ngemva kokusikwa. Futhi ngenxa yokuthi kwenziwa njengengxenye yokuhlinzwa okukhulu, njengokuhlinzwa kwenhliziyo evulekile, kuwukuhlinzwa okukhulu lapho lokhu kokubili kuhlanganiswa.

Kungani udinga ukwenza lolu hlobo lokuhlinzwa?

Udokotela usebenzisa le ndlela ukufinyelela izitho ezivikelwe yi-sternum kanye nezimbambo. Ngokuyinhloko:

• Inhliziyo: Yezinto ezifana nokulungisa ama-valve enhliziyo kanye nokwenza ukuhlinzwa kwe-coronary artery bypass.
• I-Aorta: Ngezinkinga nge-aorta, umthambo wegazi oyinhloko ophuma enhliziyweni.
• Imithambo ye-pulmonary: Imithambo ethwala igazi lisuka enhliziyweni liye emaphashini.

Ukuhlinzwa kwe-sternotomy akuyona ikhambi lanoma yisiphi isifo. Kuyinqubo eyenziwayo ukuze kuvuleke indawo yezitho zomzimba ukuze udokotela ohlinzayo akwazi ukwenza umsebenzi wakhe kalula. Ezweni elifana neMelika, kwenziwa lokhu kuhlinzwa okungaphezu kuka-700,000 minyaka yonke. Kuvamile kanjalo.

Kwenzekani ngaphambi kokuhlinzwa?

Ngaphambi kokuhlinzwa kwakho, ithimba lezokwelapha lizokunikeza imiyalelo ethile, efana nalokhu:

• Bakutshela ukuthi ugeze kahle bese uhlanza umzimba ngaphambi kokuya esibhedlela.
• Uma unezinwele esifubeni sakho, zizosuswa ngokucophelela.
• Ama-antibiotic azonikezwa ukuvimbela ukutheleleka ngemva kokuhlinzwa.
• Indawo yesifuba lapho kuzokwenziwa khona ukuhlinzwa ihlanzwa kahle ngezixazululo ze-antiseptic.

Indlela ukuhlinzwa okwenziwa ngayo isinyathelo ngesinyathelo

Lokhu kungase kuzwakale kusabisa kancane kuwe, kodwa khumbula , konke lokhu kwenziwa ngemva kokunikezwa i-anesthesia futhi ulele kahle. Ngakho ngeke uzwe lutho.

1. Okokuqala, udokotela ohlinzayo wenza i-incision esikhumbeni, eqala phakathi kwamahlombe akho bese eqhubeka phansi eduze kwe-sternum.

2. Bese, ithuluzi elikhethekile lezokwelapha elibizwa ngokuthi "isaha elingemuva" lisetshenziswa ukusika i-sternum ngendlela ehlelekile kusukela phezulu kuya phansi.

3. Izingcezu ezimbili zamathambo ezisikiwe zibekwa eceleni, bese kufakwa idivayisi ebizwa ngokuthi "i-retractor" ukuze kutholakale ukufinyelela enhliziyweni.

4. Okulandelayo, ulwelwesi oluvikelayo oluzungeze inhliziyo, i-pericardium, luyavulwa.

5. Manje udokotela ohlinzayo useyakwazi ukubona inhliziyo ngokucacile. Bese benza ukuhlinzwa okukhulu abafuna ukukwenza (isib. ukuhlinzwa kwe-bypass).

6. Ngemva kokuba ukuhlinzwa okuyinhloko sekuqediwe, izingxenye ezimbili ze-sternum ezisikiwe ziyahlanganiswa futhi ziboshwe kusetshenziswa izintambo zensimbi ezingaba ngu-8 noma 12 (izintambo ze-sternotomy) . Kufana nokubopha into ephukile.

7. Ekugcineni, izicubu zesifuba nesikhumba kuthungwa ndawonye, ​​bese kufakwa amafutha okubulala amagciwane enxebeni.

Yini ongayilindela ngemva kokuhlinzwa?

Ngemva kokuhlinzwa, uzohlala egunjini lokunakekelwa okujulile (ICU) usuku olulodwa noma ezimbili, bese udluliselwa egunjini elivamile.

• Ubuhlungu: Ungase uzwe ubuhlungu ngemva kokuhlinzwa, kodwa udokotela wakho uzokunika izinhlungu ukuze akusize ekulawuleni. Iningi labantu lingalawula ubuhlungu ngamaphilisi obuhlungu athengiswa ngaphandle kwemithi kadokotela njengeParacetamol.
• Amapayipi esifuba: Ipayipi elilodwa noma ngaphezulu lingafakwa esifubeni ukuze kukhishwe uketshezi oluningi kanye negazi elivela enxebeni. Lokhu kuzosuswa ezinsukwini ezimbalwa.
• Iseluleko esikhethekile kwabesifazane: Uma amabele akho makhulu impela, odokotela bakweluleka ukuthi ugqoke i-bra esekelwa kahle amahora angama-24 ngosuku isonto elilodwa kuya kwamabili ngemuva kokuphuma esibhedlela ukuze wehlise isisindo kanye nokucindezeleka enxebeni.

Yiziphi izinzuzo nezingozi zalokhu kuhlinzwa?

Njenganoma yikuphi ukuhlinzwa, lokhu kunezinzuzo kanye nezingozi ezincane.

Kuthatha isikhathi esingakanani ukululama? Ngingazinakekela kanjani ekhaya?

Kuthatha cishe amasonto ayisishiyagalombili ukuthi i-sternum iphole ngokuphelele. Phakathi nalesi sikhathi, kufanele unciphise ukunyakaza komzimba wakho ongaphezulu. Kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo.

• Gwema ukuphakamisa izinsimbi: Ungaphakamisi lutho olusinda ngaphezu kwamakhilogremu angu-10 (cishe amakhilogremu angu-4.5). Kalula nje, lokho kucishe kube yisisindo samalitha angu-4 obisi.
• Sebenzisa izandla zombili: Uma uphakamisa into ethile, sebenzisa zombili izandla ukuyiphakamisa ngokulinganayo. Ungaphakamisi isisindo ngesandla esisodwa nje.
• Gcina izingalo zakho ziseduze nomzimba wakho: Uma uphakamisa okuthile, gcina izingalo zakho ziseduze nomzimba wakho.

Mayelana nokushayela

Uzokwazi ukushayela futhi cishe inyanga ngemuva kokuhlinzwa. Kodwa ngaphambi kwalokho, kufanele nakanjani ucele imvume kudokotela wakho. Kuze kube yilapho i-sternum yakho iphola, kungcono ukuhlala esihlalweni sangaphambili somgibeli uma uhamba ngemoto. Ngisho noma uzizwa ungakhululekile lapho ibhande lesihlalo licindezela esifubeni sakho, qiniseka ukuthi ugqoka ibhande lesihlalo ngoba lizokuvikela uma kwenzeka ingozi.

Yiziphi izikhathi ezinhle kakhulu zokuya kudokotela?

Uzoba nezikhathi zokulandelela nodokotela wakho njalo. Kodwa-ke, uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, kufanele wazise udokotela wakho ngokushesha.

Ukukhetha indlela engcono kakhulu yokuhlinzwa kwenhliziyo yakho kuyisinqumo udokotela wakho azosenza ngokusekelwe esimweni sakho esithile. Ezimweni eziningi, i-sternotomy iyindlela engcono kakhulu yokufinyelela inhliziyo. Uma unemibuzo ngalokhu, ungangabazi ukubuza udokotela wakho.