Ukufakelwa kwenhliziyo

Ukufakelwa kwenhliziyo ukuhlinzwa ukuze kususwe inhliziyo eyonakele noma enesifo bese kuyifaka enikelayo enempilo.

Ukuthola inhliziyo yomnikeli kungaba nzima. Inhliziyo kumele inikelwe ngumuntu ongafile ebuchosheni kodwa osesekelwa ngempilo. Inhliziyo yomnikeli kufanele ibe sesimweni esivamile ngaphandle kwezifo futhi kufanele ifaniswe eduze ngangokunokwenzeka negazi lakho kanye / noma nohlobo lwethishu ukunciphisa amathuba okuthi umzimba wakho uyenqabe.

Ufakwa ebuthongweni obukhulu nge-anesthesia ejwayelekile, bese kusikwa ngethambo lesifuba.

• Igazi lakho ligeleza ngomshini wokudlula wenhliziyo nephaphu ngenkathi udokotela ohlinzayo esebenza enhliziyweni yakho. Lo mshini wenza umsebenzi wenhliziyo yakho namaphaphu ngenkathi emisiwe, futhi unikeza umzimba wakho ngegazi nomoya-mpilo.
• Inhliziyo yakho egulayo iyasuswa futhi nenhliziyo yomnikeli ithungiwe endaweni yayo. Umshini wamaphaphu wenhliziyo ube usunqanyulwa. Igazi ligeleza enhliziyweni etshalwe kabusha, ethatha isikhundla sokunikeza umzimba wakho ngegazi nomoya-mpilo.
• Amashubhu afakwa ukukhipha umoya, uketshezi, negazi esifubeni izinsuku ezimbalwa, nokuvumela amaphaphu ukuthi ande ngokuphelele.

Ukufakelwa kwenhliziyo kungenziwa ukwelapha:

• Ukulimala okukhulu kwenhliziyo ngemuva kokuhlaselwa yinhliziyo
• Ukwehluleka okukhulu kwenhliziyo, lapho imithi, ezinye izindlela zokwelapha, nokuhlinzwa kungasasizi
• Izinkinga zenhliziyo ezinzima ezazikhona ngesikhathi sokuzalwa futhi azikwazi ukulungiswa ngokuhlinzwa
• Ukushaya kwenhliziyo okungajwayelekile okusongela impilo noma izigqi ezingaphenduli kwezinye izindlela zokwelashwa

Ukuhlinzwa kokufakelwa kwenhliziyo kungenzeka kungasetshenziswa kubantu:

• Abondlekile
• Badala kuneminyaka yobudala engama-65 kuya kwengama-70
• Ngibe nesifo sohlangothi noma ukuwohloka komqondo okunzima
• Ngibe nomdlavuza ngaphansi kweminyaka engu-2 edlule
• Yiba nokutheleleka nge-HIV
• Iba nezifo, njenge-hepatitis, ezisebenzayo
• Unesifo sikashukela esincike ku-insulin kanye nezinye izitho, njengezinso, ezingasebenzi kahle
• Unesifo sezinso, samaphaphu, sezinzwa noma sesibindi
• Ungabi nosizo lomndeni futhi ungayilandeli imishanguzo yabo
• Unezinye izifo ezithinta imithambo yegazi entanyeni nasemlenzeni
• Unomfutho wegazi ophakeme wamaphaphu (ukuqina kwemithambo yegazi emaphashini)
• Ukubhema noma ukusebenzisa kabi utshwala noma izidakamizwa, noma ube neminye imikhuba yokuphila engalimaza inhliziyo entsha
• Azithembekile ngokwanele ukuthatha imishanguzo yazo, noma uma umuntu engakwazi ukuhambisana nokuvakashelwa nokuhlolwa okuningi kwezibhedlela kanye nezokwelapha

Izingozi ezivela kunoma iyiphi i-anesthesia yilezi:

• Ukusabela emithini
• Izinkinga ukuphefumula

Izingozi ezivela kunoma yikuphi ukuhlinzwa yilezi:

• Ukopha
• Ukutheleleka

Izingozi zokufakelwa zifaka:

• Amahlule egazi (i-venous thrombosis ejulile)
• Ukulimala kwezinso, isibindi, noma ezinye izitho ezivela emithini elwa nokwenqatshwa
• Ukuthuthukiswa komdlavuza kusuka emithini esetshenziselwa ukuvimbela ukwenqatshwa
• Isifo senhliziyo noma isifo sohlangothi
• Izinkinga zesigqi senhliziyo
• Amazinga aphezulu e-cholesterol, isifo sikashukela, nokuncipha kwamathambo ekusetshenzisweni kwemithi yokwenqaba
• Ingozi eyengeziwe yokutheleleka ngenxa yemithi elwa nokwaliwa
• Amaphaphu nezinso
• Kwenqaba inhliziyo
• Isifo se-coronary artery esibi
• Ukutheleleka kwamanxeba
• Inhliziyo entsha kungenzeka ingasebenzi nhlobo

Uma usuthunyelwe esikhungweni sokufakelwa kabusha, uzohlolwa yiqembu lokufakelwa kabusha. Bazofuna ukuqinisekisa ukuthi ungumuntu olungele ukhetho lokufakelwa kabusha. Uzovakasha kaningi emavikini ambalwa noma izinyanga. Uzodinga ukuthi udonswe igazi kuthathwe nama-x-ray. Lokhu okulandelayo kungenziwa futhi:

• Ukuhlolwa kwegazi noma kwesikhumba ukuhlola izifo
• Ukuhlolwa kwezinso zakho nesibindi
• Ukuhlolwa kokuhlola inhliziyo yakho, njenge-ECG, i-echocardiogram, kanye ne-catheterization yenhliziyo
• Uvivinyo lokubheka umdlavuza
• Izicubu nokuthayipha kwegazi, ukusiza ukuqinisekisa ukuthi umzimba wakho ngeke uyenqabe inhliziyo enikelwe
• I-Ultrasound yentamo nemilenze yakho

Uzofuna ukubheka isikhungo esisodwa noma eziningi zokufakelwa ukuze ubone ukuthi yikuphi okungakulungela:

• Babuze ukuthi zingaki izitshalo abazenzayo minyaka yonke nokuthi zithini amazinga abo okusinda. Qhathanisa lezi zinombolo nezinombolo ezivela kwezinye izikhungo. Konke lokhu kuyatholakala kwi-inthanethi ku-unos.org.
• Buza ukuthi yimaphi amaqembu okweseka abanayo nokuthi bangakanani usizo abalunikezayo ngohambo nangezindlu.
• Buza ngezindleko zemithi ozodinga ukuzithatha ngemuva kwalokho futhi uma kukhona usizo lwezezimali ekutholeni le mithi.

Uma iqembu lokufakelwa likholelwa ukuthi ungumuntu ozobhapathizwa kahle, uzobekwa ohlwini lokulinda lwesifunda ngenhliziyo:

• Indawo yakho ohlwini isuselwa ezicini ezithile. Izici ezibalulekile zifaka uhlobo nobukhali besifo senhliziyo yakho, nokuthi ugula kangakanani ngesikhathi ubalwa.
• Isikhathi osichitha ohlwini lokulinda imvamisa ASISONA isici sokuthi uyithola kanjani inhliziyo masinyane, ngaphandle kwezingane.

Iningi, kepha hhayi bonke, abantu abalinde ukufakelwa inhliziyo bagula kakhulu futhi badinga ukuba sesibhedlela. Abaningi bazodinga uhlobo oluthile lwedivayisi ukusiza izinhliziyo zabo zimpompe igazi elanele emzimbeni. Imvamisa, lokhu kuyinsiza ye-ventricular assist (VAD).

Kufanele ulindele ukuhlala esibhedlela izinsuku eziyi-7 kuye kwezingu-21 ngemuva kokufakelwa inhliziyo. Amahora okuqala angama-24 kuye kwangama-48 kungenzeka abe segunjini labagula kakhulu (i-ICU). Phakathi nezinsuku ezimbalwa zokuqala ngemuva kokufakelwa, uzodinga ukulandelelwa okuseduze ukuze uqiniseke ukuthi awutholi ukutheleleka futhi inhliziyo yakho isebenza kahle.

Isikhathi sokululama sicishe sibe yizinyanga ezi-3 futhi kaningi, iqembu lakho lokufakelwa izokucela ukuthi uhlale eduze kwesibhedlela ngaleso sikhathi. Uzodinga ukuhlolwa njalo ngokuhlolwa kwegazi, ama-x-ray, nama-echocardiograms iminyaka eminingi.

Ukulwa nokwenqatshwa kuyinqubo eqhubekayo. Amasosha omzimba abheka isitho esitshalwe kabusha njengomzimba wangaphandle futhi alwe naso. Ngalesi sizathu, iziguli ezifakela izitho zomzimba kumele zithathe izidakamizwa ezicindezela ukuphendula komzimba. Ukuvikela ukwenqatshwa, kubaluleke kakhulu ukuthatha le mithi futhi ulandele ngokucophelela imiyalelo yakho yokuzinakekela.

Ama-biopsies emisipha yenhliziyo avame ukwenziwa njalo ngenyanga phakathi nezinyanga zokuqala eziyi-6 kuye kwezingu-12 ngemuva kokufakelwa, bese kwenziwa kaningi ngemuva kwalokho. Lokhu kusiza ukunquma ukuthi umzimba wakho uyayilahla yini inhliziyo entsha, ngisho nangaphambi kokuba ube nezimpawu.

Kumele uthathe izidakamizwa ezivimbela ukwenqatshwa kokufakelwa impilo yakho yonke. Uzodinga ukuqonda ukuthi ungayithatha kanjani le mithi, futhi wazi nemiphumela engemihle yayo.

Ungabuyela emisebenzini yakho ejwayelekile ezinyangeni ezi-3 ngemuva kokufakelwa ngokushesha nje lapho uzizwa usanele, futhi ngemuva kokukhuluma nomhlinzeki wakho wezokunakekelwa kwempilo. Xhumana nomhlinzeki wakho uma uhlela ukuzivocavoca ngamandla.

Uma uba nesifo se-coronary ngemuva kokufakelwa kabusha, ungaba ne-catheterization yenhliziyo minyaka yonke.

Ukufakelwa kwenhliziyo kwandisa impilo yabantu abangafa ngenye indlela. Cishe ama-80% eziguli ezifakela inhliziyo ziyaphila eminyakeni emi-2 ngemuva kokuhlinzwa. Eminyakeni emi-5, iziguli ezingama-70% zisazobe zisaphila ngemuva kokufakelwa inhliziyo.

Inkinga enkulu, njengokunye ukufakelwa, ukwenqatshwa. Uma ukwenqatshwa kungalawulwa, ukusinda kuyanda kuya ngaphezu kweminyaka eyishumi.

Ukufakelwa komzimba; Ukufakelwa kabusha - inhliziyo; Ukufakelwa kabusha - inhliziyo

• Inhliziyo - isigaba phakathi nendawo
• Inhliziyo - ukubuka kwangaphambili
• I-anatomy ejwayelekile yenhliziyo
• Ukufakelwa kwenhliziyo - uchungechunge

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UJessup M, Atluri P, Acker MA. Ukuphathwa kokuhlinzwa kokuhluleka kwenhliziyo. Ku: Zipes DP, Libby P, Bonow RO, Mann, DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 28.

IKliegman RM, iSt. Geme JW, iBlum NJ, i-Shah SS, iTasker RC, iWilson KM. Ukufakelwa kwenhliziyo nengqondo yamaphaphu ezingane. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 470.

UMancini D, uNaka Y. Ukufakelwa kabusha kwenhliziyo. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 82.

UYancy CW, uJessup M, uBozkurt B, et al. Ukuvuselelwa Okugxilwe ku-2017 ACC / AHA / HFSA komhlahlandlela we-ACCF / AHA ka-2013 wokuphathwa kokuhluleka kwenhliziyo: umbiko we-American College of Cardiology / American Heart Association Task Force ku-Clinical Practice Guidelines kanye ne-Heart Failure Society of America. J Card Yehluleka. 2017; 23 (8): 628-651. I-PMID: 28461259 www.ncbi.nlm.nih.gov/pubmed/28461259.