Ngezinye izikhathi inhliziyo yethu ingaba buthakathaka kakhulu. Imisipha yenhliziyo ingakhathala kangangokuthi ayikwazi ukulawulwa ngemithi noma ezinye izindlela zokwelapha. Lesi simo sibizwa ngokuthi i-Advanced Heart Failure. Ngakho-ke, ubuwazi ukuthi ezikhathini ezinjengalezi, 'umsizi' omncane angafakwa enhliziyweni futhi omunye umsebenzi wenhliziyo ungabelwa wona? Le divayisi yilokho esikubiza ngokwezokwelapha ngokuthi i-Ventricular Assist Device, noma i-VAD ngamafuphi. Namuhla, ake sikuqonde kalula lokhu, njengokungathi sikhuluma nomngane.
Kalula nje, iyini i-VAD?
Cabanga ngenhliziyo yakho njengomshini opompa amanzi endlini. Uma lo mshini ungasebenzi, amanzi awagelezi endlini yonke, akunjalo? Kunjalo ngenhliziyo ebuthakathaka. I-VAD iyiphampu encane yomshini esetshenziselwa ukusiza inhliziyo ebuthakathaka. Ithatha igazi elivela e-ventricle yenhliziyo bese ilipompa liye kuwo wonke umzimba. Kufana nokwengeza injini encane eyengeziwe kumshini obuthakathaka.
Kunezinhlobo eziningana eziyinhloko zalezi zinhlobo ze-VAD.
| Uhlobo lwe-VAD | Umsebenzi owenziwayo |
|---|---|
| Idivayisi Yokusiza Nge-Ventricular Yesobunxele (LVAD) | Lolu uhlobo oluvame ukusetshenziswa kakhulu. Lusiza uhlangothi lwesobunxele lwenhliziyo ukuthi luhlanze igazi elinomoya-mpilo emzimbeni wonke. |
| Idivayisi Yokusiza Nge-Ventricular Yangakwesokudla (i-RVAD) | Kuyasiza ohlangothini lwesokudla lwephampu yenhliziyo futhi kuthumele igazi elingcolile emaphashini ukuze lihlanzwe. |
| Idivayisi Yokusiza Ye-Biventricular | Lokhu kusekela izinhlangothi zombili zenhliziyo (kwesobunxele nakwesokudla) ngasikhathi sinye. |
| Ama-VAD ezingane | Lezi zincane ngobukhulu, zenzelwe ngqo ukulingana nobudala obuhlukahlukene kusukela ezinganeni ezincane kuya kubantu abadala abasebasha. |
Hlobo luni lwabantu oludinga i-VAD?
Akuwona wonke umuntu onesifo senhliziyo esibi ozofakelwa i-VAD. Isetshenziswa kakhulu ngezinhloso ezintathu.
1. Njengebhuloho Lokululama: Ngezinye izikhathi inhliziyo ingaba buthakathaka okwesikhashana. Ezimweni ezinjalo, i-VAD isetshenziselwa ukunikeza inhliziyo ukuphumula nokuyisekela kuze kube yilapho isikwazi ukusebenza yodwa futhi.
2. Njengebhuloho eliya ekufakweni kwenhliziyo: Ezinye iziguli zidinga ukufakelwa inhliziyo. Kodwa kufanele zilinde isikhashana ukuze kutholakale inhliziyo ehambisanayo. Phakathi naleso sikhathi, i-VAD isetshenziswa ukusekela inhliziyo ukuze iqhubeke nokuphila.
3. Ukwelashwa Kwendawo Oya Kuyo: Kulabo abangafaneleki ukufakelwa inhliziyo ngenxa yokuguga noma ezinye izimo zezokwelapha, le VAD isetshenziswa unomphela ukuhlinzeka ngokusekelwa kwenhliziyo impilo yonke. Lokhu kubavumela ukuba baphile isikhathi eside futhi babe nempilo engcono.
Lo mshini usebenza kanjani?
Kunezingxenye eziningana kule divayisi. Ezinye zixhunywe enhliziyweni ngaphakathi komzimba, kanti ezinye zingaphandle komzimba.
- I-Inflow Cannula: Lena yipayipi elixhunywe ekamelweni lenhliziyo. Lithatha igazi enhliziyweni bese liliyisa ephampini lomshini.
- Iphampu Yomshini: Lona yiqhawe lendaba. Nguye owenza umsebenzi wokupompa inhliziyo.
- I-Outflow Cannula: Le tube ixhumanisa igazi elipompiwe emuva emthanjeni wegazi oyinhloko womzimba (i-aorta) noma ipayipi eliholela emaphashini.
- Umzila Wokushayela: Lena ikhebula elincane, eliqinile elixhumanisa iphampu engaphakathi komzimba nesilawuli esingaphandle komzimba. Liphuma ngesikhumba.
- Isilawuli: Lokhu kufana nobuchopho be-VAD. Ikhompyutha encane. Yilokhu okulawula ukusebenza kwe-VAD futhi kuvumela odokotela nesiguli ukuthi babuke ulwazi.
- Iphakethe Lebhethri Langaphandle: Lawa mabhethri anikeza amandla adingekayo kwi-VAD. Kukhona ibhethri eliyinhloko kanye nebhethri elisekelayo lezimo eziphuthumayo.
Kwenzekani ngaphambi kokuhlinzwa?
Ngenxa yokuthi lokhu kuwukuhlinzwa okungathi sína kakhulu, isiguli sikhethelwa ukuhlinzwa kwe-VAD ngemuva kochungechunge lokuhlolwa okubanzi kakhulu. Isimo samanje senhliziyo nezinye izitho zomzimba (njengezinso, isibindi) sihlolwa ngokucophelela.
Into ebaluleke kakhulu ukuthi lesi yisinqumo esenziwe yithimba lodokotela. Ukulungiselela kwesiguli ngokomzimba nangokwengqondo kubaluleke kakhulu lapha.
Ukuhlolwa okuvamile kufaka phakathi:
- I-Electrocardiogram (ECG)
- I-Echocardiogram (i-Echocardiogram)
- I-CT Scan
- Ukuhlolwa Kokuzivocavoca
- Ukufakwa kwe-Catheterization Yenhliziyo
Futhi, isiguli nomndeni bafundiswa kangcono ukuthi bangaphila kanjani ne-VAD nokuthi bangayisingatha kanjani. Kubaluleke kakhulu ukuba nelungu lomndeni noma umngane oseduze ongasiza isiguli.
Kwenziwa kanjani ukuhlinzwa?
Lokhu ukuhlinzwa kwenhliziyo evulekile. Kalula nje, nakhu okwenzekayo:
1. Uzofakwa ngaphansi kwe-anesthesia ejwayelekile. Ngakho ngeke uzizwe noma ukhumbule lutho.
2. Ngesikhathi sokuhlinzwa, uzonikezwa ukwesekwa kokuphefumula yi -ventilator .
3. Udokotela ohlinzayo wenza i-incision phakathi kwesifuba, eveza inhliziyo.
4. Uzobe usuxhunywe emshinini we-cardiopulmonary bypass . Lo mshini uzoqhubeka nokujikeleza igazi emzimbeni wakho noma ngabe inhliziyo yakho iye yama ngesikhathi sokuhlinzwa.
5. Okulandelayo, iphampu ye-VAD inamathiselwa endaweni efanele enhliziyweni, bese umugqa wokudonsa ususwa ngodonga lwesisu.
6. Ngemva kokusebenzisa i-VAD nokuqinisekisa ukuthi inikeza umzimba igazi elidingekayo, uzosuswa emshinini we-bypass.
7. Ekugcineni, ithambo lesifuba liphinde lixhunywe ngezintambo zensimbi, bese inxeba livalwa ngezithungo ezincibilikayo.
Yiziphi izinzuzo nezingozi?
Njenganoma yikuphi ukuhlinzwa okukhulu, i-VAD inezinzuzo kanye nezingozi.
| Izinzuzo | Izingozi |
|---|---|
|
|
Ithimba lakho lezokwelapha lizokuqapha njalo ukuze lilawule lezi zingozi.
Impilo injani nge-VAD?
Ukuphila ne-VAD kusho ukujwayela indlela entsha yokuphila.
- Imikhawulo: Awukwazi ukugeza noma ukubhukuda ngoba idivayisi ayimelani namanzi (kodwa uzofundiswa ukuthi ungageza kanjani ngesembozo esikhethekile). Futhi, kufanele ugweme imidlalo yokuthintana enengozi enkulu yokulimala.
- Ukulungisa: Gcina njalo umugqa wokushayela uhlanzekile lapho uphuma khona esikhumbeni. Shintsha amabhethri, bese ufunda ukuqonda ama-alamu avela kusilawuli.
- Imithi: Kuzodingeka uphuze imithi yokunciphisa igazi, njenge-Warfarin, impilo yakho yonke. Kuzodingeka futhi uphuze imithi yokulawula umfutho wegazi lakho.
- Ukubhekwa kwezokwelapha: Udinga ukubona udokotela njalo, uhlolwe igazi, futhi uhlole idatha ye-VAD. Nakuba kungase kudingeke uye esibhedlela njalo ekuqaleni, imvamisa izoncipha ngokuhamba kwesikhathi.
Ingabe udinga futhi ukucabanga ngempilo yengqondo?
Yebo, yebo. Abanye abantu bangase babe nokucindezeleka, ukucindezeleka, noma ukukhathazeka lapho bephila noshintsho olukhulu kangaka. Lokho kuvamile. Uma uzizwa ngaleyo ndlela, ungahlupheki wedwa, kodwa khuluma nodokotela wakho nakanjani. Kubaluleke kakhulu ukuthola usizo ngalokho.
Uma udinga ukukhuluma nodokotela
Uma uhlangabezana nezimpawu noma izinkinga ezilandelayo, yazisa ithimba lakho lezokwelapha ngokushesha.
| Inkinga | Okufanele ukunake |
|---|---|
| Izimpawu zomzimba |
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| Izinkinga zedivayisi |
|
I-VAD iyintuthuko emangalisayo kwezobuchwepheshe enganikeza impilo yesibili kumuntu obhekene nesifo senhliziyo esibi. Izinzuzo ezisindisa impilo ezinikezayo azinakuqhathaniswa. Kodwa ukuze uthole okuningi kulezo zinzuzo, kubalulekile ukuthi isiguli sizinakekele kahle sona kanye namadivayisi aso.
Umlayezo Wokuya Nawe Ekhaya
- Idivayisi Yokusiza Ama-Ventricular (VAD) iyiphampu yomshini esekela inhliziyo ebuthaka kakhulu.
- Lokhu kuyindlela enkulu yokuhlinzwa esindisa impilo futhi isetshenziswa ngaphambi noma njengesixazululo esihlala njalo sokufakelwa inhliziyo.
- Ukuphila ne-VAD kudinga ukuzibophezela impilo yonke, ukulandela imiyalelo yezokwelapha, kanye nokugcinwa kahle kwedivayisi.
- Lokhu kungathuthukisa kakhulu ikhwalithi yempilo ngezinto ezifana nokuphefumula okulula kanye namandla angeziwe omzimba.
- Uma ubona noma yikuphi ukukhubazeka emzimbeni wakho noma kudivayisi yakho, ungalokothi ukushaye indiva. Khuluma nethimba lakho lezokwelapha ngokushesha.
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