Mu mitsempha yamakono opitirira opaleshoni - yomwe imatchedwanso kuti miyala yamakono yowonongeka, kapena CABG - opaleshoni amagwiritsa ntchito mitsempha yathanzi kapena mitsempha ku mitsempha yodwala matenda , kupyola m'madera omwe atsekedwa ndi zipika . Njirayi imalola kuti magazi azidutsa mbali yodwala ya mitsempha ndipo amathandiza kuti magazi aziperekedwa kumtima.
Kodi Ndani Ayenera Kupeza Opaleshoni Yopangidwira?
Kuchita opaleshoni yopitirira malire kumathandiza kwambiri kuti zizindikiro za angina zikhale bwino ngati muli ndi angina .
Ngati muli ndi mitsempha yambiri mu mitsempha yambiri yamtunduwu, kapena mitsempha yambiri yamakono yowongoka (yomwe ili mitsempha yofunikira kwambiri), kapena minofu ya mtima yofooka kwambiri (chikhalidwe chotchedwa cardiomyopathy, chimene mungathe kuchiwerenga apa ), kupyolera mu opaleshoni akhoza kutalikitsa moyo wanu poyerekeza ndi mankhwala ndi angioplasty ndi ouma, kapena ndi mankhwala okha. Kuchita opaleshoni yowonongeka kungathandizenso anthu omwe ali ndi matenda aakulu .
Kodi Opaleshoni Yopangidwira Imachitika Bwanji?
Kuchita opaleshoni yopitirira malire kumachitika pansi pa anesthesia wamba. Dokotala wa opaleshoni amagawanika pachifuwa kuti atsegule pachifuwa, kenako amasiya mtima pogwiritsa ntchito mankhwala kapena chimfine (wotchedwa hypothermia) kuti athe kuyika ma grafts popanda mtima woyendayenda. Kuyenda kwa magazi kumasungidwa, pamene mtima waimitsidwa, pogwiritsa ntchito makina oyendetsa galimoto. Pomwe ma grafts akugwirizanitsa mtima wayambanso.
Ma grafts omwe amagwiritsidwa ntchito popita opaleshoni nthawi zambiri amachokera ku mitsempha yochokera kumapazi (saphenous veins), kapena mitsempha yochokera kumpanda wa chifuwa (mkati mwa mammary).
Grafts pogwiritsa ntchito mitsempha nthawi zambiri amatenga nthawi yayitali kusiyana ndi kugwiritsira ntchito mitsempha, ndipo mitsempha yotchedwa artery si nthawi zambiri yomwe imakhala ndi stenosis, monga mitsempha ya mitsempha. Choncho mavitamini amkati amkati amatha kugwiritsidwa ntchito nthawi iliyonse ngati n'kotheka kutero (monga momwe thupi limayendera). Zimakhala zachizoloŵezi kuti mitsempha ya mitsempha ikhale yopangika chifukwa cha matenda a atherosclerosis mkati mwa opaleshoni 10 mpaka 12 ya opaleshoni.
M'zaka zaposachedwa njira zamakono zochitidwa opaleshoni zatsopano zikukonzedwa kuti zizitchedwe kuti "opaleshoni yochepa kwambiri yochitidwa opaleshoni." Njira zowonongekazi zimakhala zochepa, ndipo zimapewa kugwiritsira ntchito makina ozungulira. Mwamwayi, opaleshoni yochepa kwambiri yochitidwa opaleshoni ndi yabwino kwa odwala omwe amatha kukhala ndi mitsempha yowopsa mosavuta.
Kodi Ndi Vuto Liti Lofunika Kwambiri?
Mitsempha ya Coronary kupitirira opaleshoni ndiyo njira yaikulu yopaleshoni, ndipo odwala nthawi zambiri samabwerera ku "zachilendo" kwa milungu ingapo kapena miyezi itatha opaleshoni. N'chizoloŵezi chosoŵa chakudya chochepa, kufooka, ndi kupweteka pafupipafupi kwa masabata angapo. Kuvutika maganizo kumaonekera kwa mmodzi mwa odwala atatu atatha opaleshoni, ndipo pokhapokha ngati kuvutika maganizo kukuzindikiridwa ndi kuchiritsidwa, kungachititse kuti nthawi yowonjezera yayitali.
Zovuta zina zomwe zingatheke pambuyo poti opaleshoni zikuphatikizapo opaleshoni ya myocardial nthawi kapena opaleshoni (mwa odwala osachepera 5%), kufooka kwa minofu ya mtima (yomwe nthawi zambiri imakhala yochepa), arrhythmias mapaipi ndi khoma la chifuwa), matenda a malo osokoneza bongo, komanso matenda osokoneza maganizo omwe amatchedwa " mutu wa pampu " (pambuyo poti "mapopu" akuyendetsa pulogalamu yamtunduwu imathandizira kuyendayenda panthawi ya kusonkhanitsa, ndipo ena amati omwe amachititsa kusintha kwadzidzidzi).
Chifukwa kudutsa opaleshoni kumakhala koopsa kwambiri, kawirikawiri amagwiritsidwa ntchito kwa odwala omwe angakhale ndi moyo nthawi yayitali ndi opaleshoni kapena omwe zizindikiro za angina zimapitirizabe ngakhale akuyesera kuchipatala.
Zotsatira:
> Mphungu, KA, Guyton, RA, Davidoff, R, et al. ACC / AHA 2004 ndondomeko yowonjezereka yopangira opaleshoni yowonongeka: Kufotokozedwa kwa American College Association of Cardiology / American Heart Association Task Force on Practice Guidelines (Komiti Yowonjezera Malangizo a 1999 a Coronary Artery Bypass Graft Surgery). Chizungulire 2004; 110: e340.