Kusiyanitsa Pakati pa Kudutsa Kwachiwiri ndi Mitundu Yambiri Yopaleshoni ya Mtima
Kuchita opaleshoni kawiri ndi opaleshoni yovuta koma yofala kwambiri. Kuti mumvetsetse kawiri kawiri, muyenera kuyamba kumvetsa zinthu zina zokhudza mtima ndi matenda a mtima.
Momwe Mtima Ukugwirira Ntchito
Mitsempha ya magazi yomwe imapereka mtima ndi magazi ake omwe amatchedwa mitsempha ya coronary. Kwa anthu ena, mitsempha yamakono imatsekedwa.
Ngati kutsekemera kuli koopsa, kungathetsere kuthamanga kwa magazi kudera la mtima umene umadyetsedwa ndi chotengera cha magazi. Kutseka uku kumatha kuyambitsa matenda a mtima. Izi zimatchedwa kuti matenda a mitsempha ya mitsempha.
Kuchiza Kwa Coronary Artery Disease
Nthawi zambiri, matenda a mitsempha yam'thupi amatha kuchiritsidwa ndi mankhwala, kusintha kwa moyo ndi njira zina monga kukhazikitsidwa kwa mitsempha mu mitsempha yamakono mu mtima wonyansa. Kwa odwala omwe ali ndi vuto lalikulu, opaleshoni ikhoza kukhala yofunikira kuonetsetsa kuti mtima ukupitiriza kulandira magazi okwanira. Kuchita opaleshoniyi kumadziwika ngati mitsempha yamakono opitirira opaleshoni (CABG) .
Pakati pazitsulo ziwiri
Njira yowirikiza kawiri imachitidwa ndi dokotala wa opaleshoni, dokotala wochita opaleshoni amene amaphunzitsidwa kuchipatala cha matenda a chifuwa. Pachifukwa ichi, opaleshoni idzachitidwa ndi dokotala wa opaleshoni yemwe amadziwika kwambiri mu nkhani za mtima.
Ndondomekoyi imayamba ndi aesthesia ambiri operekedwa ndi munthu wodwala matenda opatsirana pogonana, kapena nthawi zina CRNA - namwino wopita patsogolo yemwe amapereka chithandizo cha mankhwala. Anesthesia yambiri imatanthauza kuti minofu ya thupi ili ndi ziwalo ndipo wodwala amakhala ndi chubu yopuma yomwe imayika kotero mpweya ungapereke mpweya.
Kachilombo kameneka kamaperekedwa, khungu la wodwalayo limakonzekera opaleshoni, zonsezi pachifuwa ndi mwendo. Izi ndichifukwa chakuti mitsempha ya mthupi imatengedwa kuchokera kumalo ena a thupi, makamaka mwendo, ndikuphatikizidwa ku chotengera cha mtima chomwe chimakhalapo musanatuluke. Mwazi ukutengekanso pafupi ndi kutseka mu chotengera. Nthawi zina, dokotalayo akugwira ntchito pachifuwa ndi wothandizira adzakhala akubwezeretsa mitsempha ya m'magazi. Khama lophatikizanali limathandiza kuchepitsa kutalika kwa opaleshoni ndikupanga njirayi kukhala yowonjezera.
Izi zimabweretsanso mitsuko ya magazi, yomwe imayendayenda, imathandiza kuti mtima ulandire magazi omwe amafunikira ndipo umathandiza kupewa kuwonongeka kwa mtima. Pofuna kuchita izi, njira yowonjezereka imafuna mtima kuimitsidwa kuti dokotalayo asagwire ntchito pamtima wopweteka. Mtima ukaimitsidwa, makina oyenda pamtima amagwiritsidwa ntchito kupatsa mpweya ndi magazi kwa thupi pamene mtima ulipobe.
Kamodzi kanyumba kakatha, makina a mtima-mapapo achotsedwa ndipo mtima wayambiranso. Sternum (breastbone) yathyoledwanso pamodzi ndipo kutsekedwa kwa khungu kumatsekedwa. Anthu ambiri adzakhala ndi ziphuphu zapachifuwa, zomwe nthawi zambiri zimagwirizana ndi kuyamwa bwino kapena madzi otentha, kuti athetse kumanga kwa magazi pamtima.
Pambuyo pa opaleshoniyo, wodwalayo adzatengedwera ku ICU kapena malo amodzi a mtima kuti akabwezere. Mosiyana ndi njira zambiri, anesthesia siinasinthidwe ndi mankhwala kuti amutse wodwalayo. M'malo mwake, anesthesia amaloledwa kuvala pang'onopang'ono kwa maola anayi kapena oposa, kulola wodwalayo kuti apume pang'onopang'ono ndi modzichepetsa m'malo mofulumira.
Njira Zina Zogwiritsira Ntchito Mtima Wodziwika Kwambiri
Monga mukudziwa kale, ngati zitsulo ziwiri zatsekedwa ndipo zikuyenera kudutsa, opaleshoniyo imatchulidwa kuti iwiridutsa chifukwa ma graft awiri amachitidwa. Ngati zipangizo zitatu zidadutsa opaleshoniyo imatchedwa katatu , kuzungulira kwina kumatchedwa kuti quadruple overpass, ndi zina zotero.
Zowonongeka kawiri, zomwe ndi zisanu ndi zisanu pozungulira pamtima, sizikusowa.
Kusiyana kwina pamtima kupyolera mu opaleshoni ndi "kuchoka pampopu" yomwe ndi njira yomwe mtima umapitirizabe kumenya panthawiyi, m'malo mogwiritsa ntchito makina oyenda pamtima. Odwala ocheperapo ndi oyenerera pa njirayi kuposa njira yowonjezera papepala.
Zotsatira:
> Kodi Coronary Artery Bypass Grafting? National Heart Lung ndi Magazi Institute. Inapezeka mu 2009. http://www.nhlbi.nih.gov/health/dci/Diseases/cabg/cabg_whatis.html