Iyini inhloso futhi kwenziwa kanjani ukuhlinzwa okudlula?

-Delile

• Yini ukuhlinzwa okudlula?
• Kwenziwa kanjani ukuhlinzwa
• Ingabe ukuhlinzwa kuphazamisa ukujikeleza kwemilenze?
• Lulama kanjani
• Izingozi zokudlula

Ukudlula, okwaziwa nangokuthi i- ukudlula i-cardiac noma i-myocardial revascularization, luhlobo lokuhlinzwa kwenhliziyo lapho kufakwa khona ucezu lomthambo womlenze we-saphenous womlenze enhliziyweni, ukuhambisa igazi lisuke kwi-aorta lize liye emisipheni yenhliziyo.

Lolu hlobo lokuhlinzwa lwenziwa lapho kukhona ukuvinjelwa yimibhalo enamafutha emithanjeni yenhliziyo, okuyimithambo yegazi, engathuthuki nezinye izinhlobo zokwelashwa, ngakho-ke, inyusa ubungozi bezinkinga ezinkulu ezifana ne-infarction.

Yini ukuhlinzwa okudlula?

Inhliziyo isitho esibalulekile esimpompa igazi emzimbeni wonke, siyivumele ukuthi iphefumule igazi emaphashini iphinde inikeze wonke amaseli kwezinye izingxenye zomzimba. Kodwa-ke, ukuze isebenze kahle, inhliziyo idinga nokuhlinzeka imisipha yayo ngegazi eligcwele umoya-mpilo, ofika ngomthambo i-aorta ngemithambo yemisipha yenhliziyo, eyaziwa nangokuthi yimithambo yegazi.

Lapho le mithambo yegazi ivinjiwe, ngenxa yokuba khona kwamafutha ezindongeni zomkhumbi, ngokwesibonelo, igazi lidlula inani elincanyana liye emsipheni, ngakho-ke, kukhona ukwehla kwenani lomoya-mpilo ofinyelela kulawa maseli emisipha. Uma lokhu kwenzeka, inhliziyo ilahlekelwa yingxenye yekhono layo lokumpompa igazi emzimbeni, idale izimpawu ezifana nokuphefumula kancane, ukukhathala okulula ngisho nokuquleka.

Ngaphezu kwalokho, uma igazi liyeka ukudlula ngokuphelele, imisipha yenhliziyo iya ekufeni kweseli bese kuvela isifo senhliziyo, okungasongela impilo.

Ngakho-ke, ukugwema lolu hlobo lwezinkinga ezinkulu, udokotela wenhliziyo angaluleka ukuthi enze ukuhlinzwa okudlula, okubandakanya ukuthatha ucezu lomthambo we-saphenous emlenzeni nokwenza "ibhuloho" phakathi kwe-aorta nesiza ngokushesha ngemuva kwalokho. umthambo wenhliziyo. Ngale ndlela, igazi liyakwazi ukuqhubeka nokujikeleza ngemisipha yenhliziyo futhi inhliziyo igcina isebenza ngokujwayelekile.

Kwenziwa kanjani ukuhlinzwa

Ukuhlinzwa nge-Bypass kubucayi futhi kuthatha isilinganiso samahora ama-5. Izinyathelo zokuhlinzwa okudlula yilezi:

1. I-anesthesia ejwayelekile enesidingo seshubhu ku-trachea ukwenza ukuphefumula kube lula;
2. Ukususwa kwengxenye yomthambo we-saphenous emlenzeni;
3. Kusikeka esifubeni, ukufinyelela emithanjeni yenhliziyo;
4. Udokotela uhlola imithambo evinjiwe, echaza izindawo zokwenza amabhuloho;
5. Umthambo we-saphenous uthungelwe endaweni edingekayo;
6. Isifuba sivaliwe, kunama-suture akhethekile okusondela ku-sternum;

Ekupheleni kokuhlinzwa, ishubhu eliku-trachea ligcinwa phakathi namahora okuqala okululama.

Ingabe ukuhlinzwa kuphazamisa ukujikeleza kwemilenze?

Yize ingxenye yomthambo we-saphenous isuswa emlenzeni, imvamisa, ayikho inkinga yokujikeleza kwemilenze, ngoba igazi lingaqhubeka lijikeleze ngeminye imithambo. Ngaphezu kwalokho, ngemuva kokukhipha ingxenye yomthambo, kwenzeka inqubo yemvelo ngokuphelele, eyaziwa ngokuthi i-revascularization, lapho kwakhiwa khona imikhumbi emisha yokuhlinzeka ngezidingo zomzimba futhi ithathe indawo yengxenye esusiwe yomthambo we-saphenous.

Yize ukudlula okuyisaphenous cishe njalo kuyindlela yokuqala yokuvuselelwa kwenhliziyo, kukhona ezinye izitsha emzimbeni ezingasetshenziselwa le njongo, ikakhulukazi imithambo yemammary, eyimikhumbi etholakala esifubeni. Uma lokhu kwenzeka, ukuhlinzwa kungaziwa ngokuthi "ibhuloho lesifuba".

Lulama kanjani

Ngemuva kokuhlinzwa, isiguli sidinga ukuhlala e-ICU izinsuku ezi-2 kuye kwezi-3, ukwenza ukuhlolwa okuqhubekayo kwezimpawu ezibalulekile nokugwema izinkinga ezikhona zokuhlinzwa. Ngemuva kokubhekwa njengokuzinza, ungaya egumbini lesibhedlela, lapho uzoqhubeka uphuze amaphilisi ezinhlungu ukugwema izinhlungu nokungahambi kahle esifubeni. Kulesi sigaba, kufanele uqale i-physiotherapy ngokuzivocavoca okulula, ukuhamba nokuphefumula.

Ukululama kulokhu kuhlinzwa kuhamba kancane futhi kungemuva kwezinsuku ezingama-90 lapho umuntu ezokwazi ukubuyela enkambisweni yakhe yansuku zonke.

Esikhathini sokuhlinzwa, imvamisa ngemuva kwezinsuku ezi-2 zokuhlinzwa, isibazi asisadingi ukugqokwa futhi kubalulekile ukusigcina sihlanzekile futhi singenamfihlo. Kuze kube amasonto ama-4 ngemuva kokuhlinzwa, akufanele ushayele noma uthwale isisindo esingaphezu kuka-10 kg.

Kubalulekile ukuthatha imishanguzo enconywe udokotela wenhliziyo futhi uye lapho kuqokwa khona ngemuva kokuhlinzwa, okuhlelelwe esibhedlela. Ngaphezu kwalokho, ngemuva kokululama, kubalulekile ukuqhubeka nempilo enempilo, ngokudla okunomsoco kanye nemisebenzi ejwayelekile yomzimba, ukuqinisekisa ukusebenza kahle kwenhliziyo nokugwema izithiyo ezintsha ekusakazeni kwemithambo yenhliziyo. Bona ukuthi yiziphi izinyathelo zokugcina inhliziyo yakho iphilile.

Izingozi zokudlula

Njengoba kungukuhlinzwa okude futhi okuyinkimbinkimbi, ngoba kuyadingeka ukuvula isifuba futhi kuphazamise ukusebenza kwenhliziyo, ukuhlinzwa kokudlula kunezingozi ezithile, njenge:

• Ukutheleleka;
• Ukopha;
• Isifo senhliziyo.

Kodwa-ke, lezi zinkinga zivame kakhulu kubantu asebevele babekeke engcupheni impilo, ngokuhluleka kwezinso, ezinye izifo zenhliziyo, noma lapho kwenziwa ukuhlinzwa ngokuphuthumayo.

Kodwa-ke, izingozi ziyancishiswa lapho isiguli sihlonipha yonke imihlahlandlela yezokwelapha engafaka ukulawulwa kokondliwa nokusetshenziswa noma ukumiswa kwemithi ethile ngaphambi kokuhlinzwa futhi, ngaphezu kwalokho, izinzuzo zokuhlinzwa zivame ukudlula ingozi yokuba nesifo senhliziyo. ukulimaza impilo.