I-Aortobifemoral Bypass

-Delile

• Inqubo
• Ukubuyiselwa
• Kungani kwenziwa
• Izinhlobo
• Izingozi nezinkinga
• Umbono nalokho ongakulindela ngemuva kokuhlinzwa

Ukubuka konke

Ukudlula kwe-Aortobifemoral kuyindlela yokuhlinza yokwakha indlela entsha ezungeze umthambo wegazi omkhulu, ovalekile esiswini sakho noma emgodini wakho. Le nqubo ihilela ukubeka isigxivizo ukuze kudlule umthambo wegazi ovinjiwe. Ukuxhunyelelwa kungumsele wokufakelwa. Omunye umkhawulo wokuxhunyelelwa uxhunywe ngokuhlinzwa kwi-aorta yakho ngaphambi kwesigaba esivinjiwe noma esigulayo. Eminye imikhawulo yokuxhunyelelwa inamathiselwe ngamunye komunye wemithambo yakho yobufazi ngemuva kwesigaba esivinjiwe noma esigulayo. Lokhu kuhlonywa kuqondisa kabusha ukugeleza kwegazi futhi kuvumela igazi ukuthi liqhubeke nokugeleza kudlule ukuvinjelwa.

Kunezinhlobo eziningi zezinqubo zokudlula. Ukudlula kwe-aortobifemoral kuhloselwe imithambo yegazi egijima phakathi kwe-aorta yakho nemithambo yabesifazane emilenzeni yakho. Le nqubo ibhekwa njengomthelela omuhle empilweni yakho. Kokunye ukuhlola, amaphesenti angama-64 alabo abahlinzwa nge-aortobifemoral bypass bathi impilo yabo jikelele ithuthukile ngemuva kokuhlinzwa.

Inqubo

Inqubo yokudlula kwe-aortobifemoral imi kanje:

1. Udokotela wakho angadinga ukuthi uyeke ukuthatha imishanguzo ngaphambi kwalokhu kuhlinzwa, ikakhulukazi leyo ethinta ukujiya kwegazi lakho.
2. Udokotela wakho angadinga ukuthi uyeke ukubhema ngaphambi kokuhlinzwa ukuze unciphise izinkinga ezingaba khona.
3. Uzofakwa ngaphansi kwe-anesthesia ejwayelekile.
4. Udokotela wakho uzokwenza imbobo esiswini sakho.
5. Okunye ukusikwa kuzokwenziwa endaweni yakho yokububula.
6. Ishubhu lendwangu elenziwe ngo-Y lizosetshenziswa njengesixhunyeleliso.
7. Umkhawulo owodwa webhubhu elenziwe ngo-Y uzoxhunyaniswa nomthambo esiswini sakho.
8. Imikhawulo emibili ephikisanayo yethubhu izoxhunywa emithanjeni emibili yabesifazane emilenzeni yakho.
9. Imikhawulo yeshubhu, noma ukufakelwa, izothungwa emithanjeni.
10. Ukugeleza kwegazi kuzoqondiswa kabusha kuxhunyelelwe.
11. Igazi lizogeleza ngokuxhunyelelwa bese lizungeza, noma lidlule, endaweni yokuvinjelwa.
12. Ukugeleza kwegazi kuzobuyiselwa emilenzeni yakho.
13. Udokotela wakho uzobe esevala okusikiwe bese uthathwa uyolulama.

Ukubuyiselwa

Nasi umugqa wesikhathi wokutakula ojwayelekile olandela ukudlula kwe-aortobifemoral:

• Uzohlala embhedeni amahora ayi-12 ngokushesha okulandela inqubo.
• Ipayipi lesinye lizohlala kuze kube yilapho uhamba khona - imvamisa ngemuva kosuku olulodwa.
• Uzohlala esibhedlela izinsuku ezine kuya kweziyisikhombisa.
• Ama-pulses asemilenzeni yakho azohlolwa ngehora ukuqinisekisa ukuthi ubuciko busebenza kahle.
• Uzonikezwa umuthi wezinhlungu lapho kudingeka.
• Uma usudedelwe, uzovunyelwa ukubuyela ekhaya.
• Kancane kancane uzokwandisa isikhathi nesikhathi ohamba ngaso usuku ngalunye.
• Imilenze yakho kufanele iphakanyiswe lapho uhleli phansi (isb., Ibekwe esihlalweni, kusofa, ku-ottoman, noma esitulweni).

Kungani kwenziwa

Ukudlula kwe-aortobifemoral kwenziwa lapho imithambo yegazi emikhulu esiswini sakho, emgodini, noma okhalweni ivinjiwe. Le mithambo yegazi emikhulu ingaba yi-aorta, nemithambo yabesifazane noma ye-iliac. Ukuvinjelwa kwemithambo yegazi kuvumela cha, noma okuncane kakhulu, ukuthi igazi lidlule emlenzeni noma emilenzeni yakho.

Le nqubo yokuhlinza ivame ukwenziwa kuphela uma usengozini yokulahlekelwa isitho somzimba noma uma unezimpawu ezinzima noma ezibalulekile. Lezi zimpawu zingafaka:

• izinhlungu zomlenze
• ubuhlungu emilenzeni
• imilenze ezwakala isisinda

Lezi zimpawu zibhekwa njengezimbi ngokwanele kule nqubo uma zenzeka lapho uhamba nalapho uphumule. Ungadinga futhi inqubo uma izimpawu zakho zikwenza kube nzima ukuqedela imisebenzi eyisisekelo yansuku zonke, unegciwane emlenzeni wakho othintekile, noma izimpawu zakho azithuthuki nezinye izindlela zokwelapha.

Izimo ezingadala lolu hlobo lokuvinjelwa yilezi:

• isifo se-peripheral arterial (PAD)
• isifo se-aortoiliac
• imithambo evinjelwe noma encishiswe kakhulu

Izinhlobo

Ukudlula kwe-Aortobifemoral kuyindlela engcono kakhulu yokuvinjelwa okuvimba ukugeleza kwegazi kuye emthanjeni wesifazane. Kodwa-ke, kunenye inqubo ebizwa nge-axillobifemoral bypass engasetshenziswa kwezinye izimo.

Ukudlula kwe-axillobifemoral kubeka ukucindezeleka okuncane enhliziyweni yakho ngesikhathi sokuhlinzwa. Akudingi nokuthi kuvulwe isisu sakho ngesikhathi sokuhlinzwa. Lokhu kungenxa yokuthi isebenzisa ukufakelwa kweshubhu lepulasitiki futhi ixhuma imithambo yabesifazane emilenzeni yakho nomthambo we-axillary ehlombe lakho. Kodwa-ke, ukufakelwa okusetshenzisiwe kule nqubo kusengozini enkulu yokuvinjelwa, ukutheleleka, nezinye izinkinga ngoba kuhamba ibanga elide futhi ngoba umthambo we-axillary awulikhulu njenge-aorta yakho. Isizathu salokhu kukhuphuka kwengozi yezinkinga kungenxa yokuthi ukuxhunyelelwa kungangcwatshwa ngokujulile ezicutshini nangenxa yokuthi ukuxhunyelelwa kuncane kule nqubo.

Izingozi nezinkinga

Ukudlula kwe-aortobifemoral akutholakali kuwo wonke umuntu. I-anesthesia ingadala izinkinga ezinkulu kulabo abanezimo ezinzima zamaphaphu. Labo abanezimo zenhliziyo kungenzeka bangayifanelekeli le nqubo ngoba ibeka ingcindezi enkulu enhliziyweni. Ukubhema kungakhuphula nobungozi bezinkinga ngesikhathi kudlula i-aortobifemoral. Uma ubhema, kufanele ume ngaphambi kwalokhu kuhlinzwa ukuze unciphise izinkinga.

Inkinga enkulu kakhulu yale nqubo ukuhlaselwa yinhliziyo. Udokotela wakho uzokwenza izivivinyo eziningana ngaphambi kokuhlinzwa ukuze aqinisekise ukuthi awunaso isifo senhliziyo noma yiziphi izimo ezingakhuphula ubungozi bokuhlaselwa yisifo senhliziyo.

Ukudlula kwe-aortobifemoral kunesilinganiso sokufa samaphesenti ama-3, kepha lokhu kungahluka ngokuya ngempilo yakho nokuqina kwakho ngesikhathi sokuhlinzwa.

Ezinye izinkinga ezingathi sína kakhulu zingafaka:

• ukutheleleka enxebeni
• ukutheleleka kokuxhunyelelwa
• ukopha ngemuva kokuhlinzwa
• i-vein thrombosis ejulile
• ukungasebenzi ngokocansi
• unhlangothi

Umbono nalokho ongakulindela ngemuva kokuhlinzwa

Amaphesenti ayisishiyagalombili okuhlinzwa okwedlula i-aortobifemoral avula ngempumelelo umthambo futhi aqede izimpawu zeminyaka eyishumi ngemuva kwenqubo. Ubuhlungu bakho kufanele buqedwe lapho uphumule. Ubuhlungu kufanele futhi buphele noma buncishiswe kakhulu lapho uhamba. Umbono wakho ungcono uma ungabhemi noma uyeka ukubhema ngaphambi kokuhlinzwa okwedlula.