Ukuhlinzwa Kwezinhliziyo Ezivulekile

-Delile

• Kudingeka nini ukuhlinzwa kwenhliziyo evulekile?
• Kwenziwa kanjani ukuhlinzwa kwenhliziyo evulekile?
• Ziyini izingozi zokuhlinzwa kwenhliziyo evulekile?
• Ungakulungiselela kanjani ukuhlinzwa kwenhliziyo evulekile
• Kwenzekani ngemuva kokuhlinzwa kwenhliziyo evulekile?
• Ukululama, ukulandelela, nokuthi yini ongayilindela
• Ukunakekelwa kwe-incision
• Ukuphathwa kobuhlungu
• Lala ngokwanele
• Ukuvuselelwa
• Umbono wesikhathi eside wokuhlinzwa kwenhliziyo evulekile

Ukubuka konke

Ukuhlinzwa kwenhliziyo evulekile yinoma yiluphi uhlobo lokuhlinzwa lapho isifuba sinqunywa khona futhi kwenziwe imisipha, ama-valve, noma imithambo yenhliziyo.

Ngokusho kwe-coronary artery bypass grafting (CABG) uhlobo oluvame kakhulu lokuhlinzwa kwenhliziyo olwenziwa kubantu abadala. Ngalesi sikhathi sokuhlinzwa, umthambo noma umthambo ophilile uyaxhunyelelwa (unamathiselwe) emthanjeni we-coronary ovinjiwe. Lokhu kuvumela umthambo ohlangene ukuba "weqe" umthambo ovinjiwe futhi ulethe igazi elisha enhliziyweni.

Ukuhlinzwa kwenhliziyo evulekile kwesinye isikhathi kubizwa ngokuhlinzwa kwendabuko kwendabuko. Namuhla, izinqubo eziningi zenhliziyo zingenziwa ngokuqhekeka okuncane kuphela, hhayi ukuvuleka okubanzi. Ngakho-ke, igama elithi "ukuhlinzwa kwenhliziyo evulekile" lingadukisa.

Kudingeka nini ukuhlinzwa kwenhliziyo evulekile?

Ukuhlinzwa kwenhliziyo evulekile kungenziwa ukwenza i-CABG. Umthambo we-coronary bypass graft ungadingeka kubantu abanesifo senhliziyo.

Isifo senhliziyo esivela ku-Coronary senzeka lapho imithambo yegazi enikezela ngegazi nomoya-mpilo emisipheni yenhliziyo iba mincane futhi ibe lukhuni. Lokhu kuvame ukubizwa ngokuthi “ukuqina kwemithambo yegazi.”

Ukuqina kwenzeka lapho okunamafutha kwakha uqwembe ezindongeni zemithambo yegazi. Leli qweqwe linciphisa imithambo yegazi, okwenza kube nzima ngegazi ukungena. Lapho igazi lingakwazi ukugeleza kahle liye enhliziyweni, isifo senhliziyo kungenzeka.

Ukuhlinzwa kwenhliziyo evulekile kwenziwa naku:

• lungisa noma ushintshe ama-valve enhliziyo, avumela igazi ukuba lihambe ngenhliziyo
• lungisa izindawo ezilimele noma ezingezinhle zenhliziyo
• faka izinto zokwelapha ezisiza inhliziyo ishaye kahle
• buyisela inhliziyo eyonakele ngenhliziyo enikelwe (ukufakelwa inhliziyo)

Kwenziwa kanjani ukuhlinzwa kwenhliziyo evulekile?

Ngokusho kwe-CABG, kuthatha amahora amathathu kuya kwayisithupha. Ngokuvamile kwenziwa ngokulandela lezi zinyathelo eziyisisekelo:

• Isiguli sinikezwa i-anesthesia ejwayelekile. Lokhu kuqinisekisa ukuthi bazobe belele futhi bengezwa zinhlungu kukho konke ukuhlinzwa.
• Udokotela ohlinzayo usika u-8- kuya ku-10-intshi esifubeni.
• Udokotela ohlinzayo usika lonke noma ingxenye yesifuba sesifuba sesiguli ukuze aveze inhliziyo.
• Lapho inhliziyo isibonakala, isiguli singaxhunywa kumshini wokudlula wenhliziyo-lung. Umshini ususa igazi enhliziyweni ukuze udokotela akwazi ukuhlinza. Ezinye izinqubo ezintsha azisebenzisi lo mshini.
• Udokotela ohlinzayo usebenzisa umthambo noma umthambo onempilo ukwenza indlela entsha ezungeze umthambo ovinjiwe.
• Udokotela ohlinzayo uvale ithambo lesifuba ngocingo, ashiye ucingo ngaphakathi komzimba.
• Ukusika kwasekuqaleni kuthungiwe.

Kwesinye isikhathi i-sternal plating yenziwa kubantu abasengozini enkulu, njengalabo asebenze ukuhlinzwa okuningi noma abantu asebekhulile. Ukufakwa kwangaphandle kulapho ithambo lesifuba lihlanganiswa khona namapuleti amancane e-titanium ngemuva kokuhlinzwa.

Ziyini izingozi zokuhlinzwa kwenhliziyo evulekile?

Izingozi zokuhlinzwa kwenhliziyo evulekile zifaka:

• ukutheleleka kwesilonda esifubeni (okuvame kakhulu kwiziguli ezinesisindo sokukhuluphala noma isifo sikashukela, noma labo abake baba ne-CABG phambilini)
• isifo senhliziyo noma isifo sohlangothi
• ukushaya kwenhliziyo okungajwayelekile
• ukwehluleka kwamaphaphu noma kwezinso
• ubuhlungu besifuba nomkhuhlane ophansi
• ukulahleka kwememori noma "ukungazi lutho"
• ihluli
• ukulahleka kwegazi
• ubunzima bokuphefumula
• inyumoniya

Ngokusho kwe-Heart and Vascular Center e-University of Chicago Medicine, umshini we-heart-lung bypass uhlotshaniswa nobungozi obandayo. Lezi zingozi zibandakanya izinkinga zokushaywa unhlangothi nezinzwa.

Ungakulungiselela kanjani ukuhlinzwa kwenhliziyo evulekile

Tshela udokotela wakho nganoma imiphi imishanguzo oyiphuzayo, ngisho nemithi ongayithenga, amavithamini, namakhambi. Bazise nganoma yiziphi izifo onazo, kufaka phakathi ukuqubuka kwe-herpes, umkhuhlane, umkhuhlane noma umkhuhlane.

Emasontweni amabili ngaphambi kokuhlinzwa, udokotela wakho angakucela ukuthi uyeke ukubhema futhi uyeke ukuthatha imishanguzo yokunciphisa igazi, njenge-aspirin, ibuprofen, noma naproxen.

Kubalulekile ukukhuluma nodokotela wakho mayelana nokuphuza kwakho utshwala ngaphambi kokulungiselela ukuhlinzwa. Uma ujwayele ukuba neziphuzo ezintathu noma ngaphezulu ngosuku bese uyeka ngaphambi nje kokuhlinzwa, ungangena ekuhoxisweni kotshwala. Lokhu kungadala izinkinga ezisongela impilo ngemuva kokuhlinzwa kwenhliziyo evulekile, kufaka phakathi ukuquleka noma ukuthuthumela. Udokotela wakho angakusiza ekuhoxisweni kotshwala ukunciphisa amathuba alezi zinkinga.

Ngosuku olungaphambi kokuhlinzwa, ungacelwa ukuthi uzigeze ngensipho ekhethekile. Le nsipho isetshenziselwa ukubulala amagciwane esikhunjeni sakho futhi izonciphisa ithuba lokutheleleka ngemuva kokuhlinzwa. Ungacelwa futhi ukuthi ungadli noma uphuze noma yini ngemuva kwamabili.

Umhlinzeki wakho wezokunakekelwa kwezempilo uzokunikeza imiyalo eningiliziwe lapho ufika esibhedlela uyohlinzwa.

Kwenzekani ngemuva kokuhlinzwa kwenhliziyo evulekile?

Uma uvuka ngemuva kokuhlinzwa, uzoba namashubhu amabili noma amathathu esifubeni sakho. Lokhu kuzosiza ukukhipha uketshezi endaweni ezungeze inhliziyo yakho. Ungaba nemigqa efakwa emithanjeni (IV) engalweni yakho ukukunikeza uketshezi, kanye nepayipi (ithubhu elincanyana) esinyeni sakho ukususa umchamo.

Uzobuye unamathiselwe emishinini eqapha inhliziyo yakho. Abahlengikazi bazoba seduze ukukusiza uma kufanele kuvele okuthile.

Imvamisa uzochitha ubusuku bakho bokuqala egumbini labagula kakhulu (i-ICU). Ngemuva kwalokho uzothuthelwa egumbini lokunakekelwa elijwayelekile izinsuku ezintathu kuya kweziyisikhombisa ezilandelayo.

Ukululama, ukulandelela, nokuthi yini ongayilindela

Ukuzinakekela ekhaya ngokushesha ngemuva kokuhlinzwa kuyingxenye ebalulekile yokutakula kwakho.

Ukunakekelwa kwe-incision

Ukunakekelwa kwe-incision kubaluleke kakhulu. Gcina indawo yakho yokusika ifudumele futhi yomile, futhi ugeze izandla zakho ngaphambi nangemva kokuyithinta. Uma ukusika kwakho kuphulukisa kahle futhi kungekho manzi, ungageza. Ishawa akufanele ibe ngaphezu kwemizuzu eyi-10 ngamanzi afudumele (hhayi ashisayo). Kufanele uqinisekise ukuthi indawo yokusika ayishaywa ngqo ngamanzi. Kubalulekile futhi ukuhlola njalo amasayithi akho okusika ukuthola izimpawu zokutheleleka, okubandakanya:

• ukukhuphuka kwamanzi, ukuphuma, noma ukuvula esizeni sokusika
• ububomvu bezungeza imbobo
• imfudumalo emgqeni wokusika
• imfiva

Ukuphathwa kobuhlungu

Ukuphathwa kobuhlungu nakho kubaluleke ngendlela emangalisayo, ngoba kungakhuphula isivinini sokutakula futhi kwehlise amathuba okuba nezinkinga ezinjengamahlule egazi noma inyumoniya. Ungase uzwe ubuhlungu bemisipha, ubuhlungu bomphimbo, ubuhlungu ezindaweni zokusika, noma ubuhlungu bamashubhu wesifuba. Udokotela wakho cishe uzokunika imithi yezinhlungu ongayithatha ekhaya. Kubalulekile ukuthi uthathe njengokuyalelwa. Abanye odokotela batusa ukuphuza imishanguzo yobuhlungu ngaphambi kokuzivocavoca umzimba nangaphambi kokuba ulale.

Lala ngokwanele

Ezinye iziguli ziba nenkinga yokulala ngemuva kokuhlinzwa kwenhliziyo evulekile, kepha kubalulekile ukuthola ukuphumula ngangokunokwenzeka. Ukuze uthole ukulala okungcono, unga:

• thatha imithi yakho yezinhlungu isigamu sehora ngaphambi kokulala
• hlela imicamelo yokwehlisa ubunzima bemisipha
• gwema i-caffeine, ikakhulukazi kusihlwa

Esikhathini esedlule, abanye baphikise ngokuthi ukuhlinzwa kwenhliziyo evulekile kuholela ekwehleni kokusebenza kwengqondo. Kodwa-ke, ucwaningo lwakamuva luthole ukuthi akunjalo. Yize ezinye iziguli zingase zihlinzwe inhliziyo futhi zivuleke ngokwengqondo ngokuhamba kwesikhathi, kucatshangwa ukuthi lokhu kungenzeka kakhulu ngenxa yemiphumela yemvelo yokuguga.

Abanye abantu babhekana nokudangala noma ukukhathazeka ngemuva kokuhlinzwa kwenhliziyo evulekile. Umelaphi noma isazi sokusebenza kwengqondo singakusiza ukuphatha le miphumela.

Ukuvuselelwa

Iningi labantu ababene-CABG bayazuza ngokuhlanganyela ohlelweni oluhlelekile, olunzulu lokuvuselela. Lokhu kuvame ukwenziwa ngaphandle kwesiguli ngokuvakashelwa kaningana ngesonto. Izinto ezisehlelweni zifaka ukuzivocavoca umzimba, ukunciphisa izinto ezinobungozi, nokubhekana nengcindezi, ukukhathazeka nokudangala.

Umbono wesikhathi eside wokuhlinzwa kwenhliziyo evulekile

Lindela ukululama kancane kancane. Kungathatha cishe amasonto ayisithupha ngaphambi kokuba uqale ukuzizwa ungcono, futhi kufika ezinyangeni eziyisithupha ukuzwa izinzuzo ezigcwele zokuhlinzwa. Kodwa-ke, umbono ulungele abantu abaningi, futhi ama-graft angasebenza iminyaka eminingi.

Noma kunjalo, ukuhlinzwa akuvimbeli ukuvinjelwa kwemithambo ukuthi kungenzeki futhi. Ungasiza ukuthuthukisa impilo yenhliziyo yakho ngoku:

• ukudla ukudla okunempilo
• ukunciphisa ukudla okunosawoti omningi, amafutha noshukela
• ehola indlela yokuphila esebenzayo
• ukungabhemi
• ukulawula umfutho wegazi ophakeme kanye ne-cholesterol ephezulu