Vula ukuhlinzwa kwenhliziyo

Vula I-Heart Bypass Surgery e-Hyderabad

Ukuhlinzwa kwenhliziyo evulekile kungenye yokuhlinzwa kwenhliziyo okwenziwa ukuze kwelashwe izinkinga ezihlobene nenhliziyo. Ngalokhu kuhlinzwa, odokotela abahlinzayo bangakwazi ukufinyelela inhliziyo kalula. 

Kulokhu kuhlinzwa, odokotela abahlinzayo bavula udonga lwesifuba, banqume ithambo lesifuba, bese bendlala izimbambo ukuze bafinyelele inhliziyo. Lokhu kuhlinzwa kwenziwa kuma-valve, emithanjeni nasemisipha yenhliziyo. Ngokuvamile, le nqubo yaziwa ngokuthi "ukuqhekeka isifuba." 

Ukuhlinzwa kwenhliziyo evulekile kuyindlela eqhubekayo yokwelapha izifo zenhliziyo, kodwa kunconywa kulabo bantu abanamandla nabangakwazi ukuthwala ubuhlungu. 

Kudingeka Nini Ukuhlinzwa Kwenhliziyo Evulekile?

Ukuhlinzwa kwenhliziyo evulekile kwenziwa ukwelapha izimo zenhliziyo ezilandelayo:

• I-Arrhythmias - Ihlanganisa i-atrial fibrillation

• I-aneurysm ye-Thoracic aortic

• Ukuhluleka kwenhliziyo

• Isifo se-artery Coronary

• Isifo se-valve yenhliziyo

• Ukukhubazeka kwenhliziyo yokuzalwa - Lokhu kufaka imbobo enhliziyweni (i-atrial septal defect) kanye nezakhiwo zenhliziyo ezingathuthukisiwe (i-hypoplastic left heart syndrome)

Ukuhlelwa Kokuhlinzwa Kwenhliziyo Evulekile

Ukuhlinzwa kwenhliziyo evulekile kwenziwa ngezindlela ezimbili ezahlukene. Ngaphansi kunencazelo yalezi zindlela ezimbili:

• Empompini - Kulolu hlobo, umshini obizwa ngokuthi i-heart-lung bypass uxhunywe enhliziyweni. Lo mshini ulawula imisebenzi yamaphaphu nenhliziyo. Umshini ususa igazi enhliziyweni futhi uliqondise kuwo wonke umzimba. Ngenxa yalo mshini, udokotela ohlinzayo angayihlinza kalula inhliziyo njengoba iyeka ukusebenza. Ngemva kokuphothulwa kokuhlinzwa, umshini uyakhishwa, futhi inhliziyo iqala ukusebenza futhi.

• Iphampu - Lolu hlobo lokuhlinza inhliziyo evulekile lwaziwa nangokuthi ukuhlinzwa kwenhliziyo eshayayo. Ukuhlinzwa kwe-off-pump bypass kwenziwa enhliziyweni eqhubeka nokushaya futhi isebenza ngokwayo. Le ndlela iwusizo ekuhlinzweni kwe-CABG (coronary artery bypass grafting).

Izinqubo Ezisetshenziswa Ekuhlinzeni Inhliziyo Evulekile

Kunezinqubo ezihlukahlukene udokotela ohlinzayo angazithatha ukuze aphathe inhliziyo engenampilo. Lezi zinqubo zinikeza ukufinyelela okuqondile emithanjeni yegazi nenhliziyo. Izinqubo zingenziwa kusetshenziswa izindlela ezingalimazi kangako. Izinqubo ezenziwa ngenkathi kwenziwa ukuhlinzwa kwenhliziyo evulekile zibalwe ngezansi:

• Ukulungisa i-aneurysm

• Ukulungisa izinkinga zenhliziyo zokuzalwa

• Isifo se-coronary artery selashwa ngokuhlinzwa kwe-Coronary artery bypass grafting (CABG).

• Ukufakelwa kwenhliziyo ukwelapha ukuhluleka kwenhliziyo

• Ukushintshwa kwe-valve yenhliziyo yesifo se-valve yenhliziyo

• Ukubekwa kwenhliziyo yokwenziwa noma i-LAVD (idivaysi yokusiza i-ventricular yesobunxele) ukwelapha ukuhluleka kwenhliziyo.

Ezinye izinqubo nazo zenziwa odokotela abahlinzayo abasebenzisa ama-ICD (ama-cardioverter-defibrillators afakelwayo) noma ama-pacemaker ngenkathi behlinza inhliziyo evulekile.

Amalungiselelo Okuhlinzwa Kwenhliziyo Evulekile

Umuntu kufanele azilungiselele ngaphambi kokuhlinzwa kwenhliziyo. Kufanele athathe iseluleko sikadokotela wakhe mayelana:

• Incwadi kadokotela - Umuntu kufanele ayeke ukusebenzisa imithi noma izidakamizwa ngaphambi kokuhlinzwa. Kufanele bagweme imithi efana nama-NSAID (izidakamizwa ezilwa nokuvuvukala) ezidala ingozi yokopha kakhulu.

• Isondlo - Udokotela uzoncoma ukuthi ungaphuzi noma ungadli ngaphambi kokuhlinzwa njengoba i-anesthesia isebenza kangcono esiswini esingenalutho.

• Utshwala nokubhema - Isiguli senhliziyo kufanele siyeke ukuphuza utshwala futhi sigweme ukubhema ngoba lokhu kungadala izinkinga ngesikhathi sokuhlinzwa kwenhliziyo.

Izinkinga Zokuhlinzwa Kwenhliziyo Evulekile

Njengoba ukuhlinzwa kwenhliziyo evulekile kuyinqubo ebalulekile yokuhlinzwa, kunezingozi ezithile lapho kwenziwa. Lezi zinkinga zihlanganisa:

• Isifo sohlangothi noma isifo senhliziyo

• Ukushaya kwenhliziyo okungajwayelekile (arrhythmias)

• Ukuphuma ngokweqile

• Ubunzima bokuphefumula

• Ukutheleleka esifubeni

• Umkhuhlane ophansi kanye nobuhlungu besifuba

• Izinso noma ukwehluleka kwamaphaphu

• Ukulahleka kwenkumbulo

• Ihluli

• I-pneumonia

• Ukungezwani komzimba okubangelwa yi-anesthesia

Izinyathelo Zenziwe Ekuhlinzweni Kwenhliziyo Evulekile

Ngaphambi Kokuhlinzwa

Izinqubo ezithile noma ukuhlolwa kwenziwa ngaphambi kokuhlinzwa kwenhliziyo evulekile.

• Ukuhlola okufana ne-EKG (i-electrocardiogram), i-X-ray yesifuba, njll., kusiza odokotela abahlinzayo ukuthi banqume indlela yokuhlinzwa.

• Ukushefa kwesifuba.

• Indawo okuhlinzelwa kuyo inzalo ngensipho ebulala amagciwane.

• Ukuhlinzeka ngemithi noketshezi engalweni nge-IV (umugqa we-intravenous).

Ngesikhathi Sokuhlinzwa

Njengoba ukuhlinzwa kwenhliziyo evulekile kuwukuhlinzwa okuyinkimbinkimbi, kungase kuthathe amahora angu-6 noma ngaphezulu ukuqeda. Izinyathelo ezithathwe odokotela abahlinzayo ukuze benze lokhu kuhlinzwa zibalulwe ngezansi:

• Umuntu unikezwa i-anesthesia ukuze alale ngesikhathi ehlinzwa.

• Ukusika okude okungama-intshi angu-6 kuya kwangu-8 kwenziwa ngezansi phakathi kwesifuba.

• Udokotela ohlinzayo usika i-sternum (ithambo lesifuba) bese esakaza i-ribcage ukuze afinyelele inhliziyo kalula.

• Khona-ke, umshini we-heart-lung bypass uxhunywe enhliziyweni (uma ukuhlinzwa kwenhliziyo evulekile empompini kwenziwa). 

• Imithi ye-IV inikezwa isiguli ukumisa ukushaya kwenhliziyo yaso ukuze odokotela abahlinzayo bakwazi ukumqapha.

• Inhliziyo ilungiswa ngezinsimbi ezithile zokuhlinza.

• Igazi liqala ukugeleza enhliziyweni futhi liqala ukushaya futhi. Uma inhliziyo ingaphenduli kunikezwa ukushaqeka kagesi okuncane.

• Umshini we-heart-lung bypass uyahlukaniswa ngemuva kokwelapha inhliziyo.

• Kuthungwa ukuvala i-incision. 

Ngemva Kokuhlinzwa

Isiguli senziwa ukuthi sihlale e-ICU (iyunithi yokunakekela kakhulu) usuku noma ngaphezulu ngemva kokuphothulwa ngempumelelo kokuhlinzwa. Ngemva kokululama, ube eseyiswa ekamelweni elivamile lasesibhedlela. Ngesikhathi sokuhlala, ithimba lokunakekelwa kwezempilo lisiza isiguli ukuthi sinakekele ukusika kwaso. Unikezwa nomcamelo othambile ukuze avikele isifuba sakhe lapho ethimula, ekhwehlela, noma evuka embhedeni.

Isiguli singaphinda sibe nezinkinga ezifana nalezi:

• ukuqunjelwa

• Ukucindezeleka

• Insomnia

• Ukulahleka kwesifiso

• Ubuhlungu bemisipha endaweni yesifuba

• Ukuvuvukala okuncane, ubuhlungu, kanye nemihuzuko endaweni yokusikwa

Ukululama Ngemva Kokuhlinzwa Kwenhliziyo Evulekile

Isiguli singase sithathe amasonto angu-6 kuya kwangu-12 ukuze silulame ngemva kokuhlinzwa kwenhliziyo evulekile. Ithimba lokunakekela inhliziyo lizomazisa ukuthi yimiphi imisebenzi okufanele ayenze noma uhlobo luni lokudla okufanele aludle ukuze anakekele inhliziyo yakhe.

• Ukunakekela indawo yokusikwa

Kubaluleke kakhulu ukunakekela indawo yokusika. Izinyathelo zokuphepha ezilandelayo kufanele zithathwe ekunakekelweni kokusikwa.

• Gcina indawo yokusikeka yomile futhi ifudumele.

• Ungathinti indawo yokusikeka ngokuphindaphindiwe.

• Geza uma ingekho i-drainage endaweni yokusikwa.

• Sebenzisa amanzi ayisivivi ngenkathi ugeza.

• Ungashayi indawo yokusikeka ngokuqondile ngamanzi.

• Hlola indawo yokusikwa ukuze uthole izimpawu zezifo ezifana nomkhuhlane, ukuququzela, ububomvu nokufudumala okuzungeze lesi sikwele.

• Ukuphathwa kobuhlungu

Isivinini sokululama singanyuswa ngokunakekela izinhlungu. Ukulawulwa kobuhlungu kunciphisa izingozi zenyumoniya nokujiya kwegazi. Isiguli singase siphathwe izinhlungu zamashubhu esifubeni, izinhlungu ezindaweni ezisikiwe, imisipha noma emphinjeni. Ukwelapha lezi zinhlungu, udokotela uzonikeza imithi ethile okufanele iphuzwe ngesikhathi. Imithi enconyiwe kufanele iphuzwe kokubili ngaphambi kokulala nokusebenza komzimba kwansuku zonke.

• Ukulala okufanele

Iziguli zithola ubunzima bokulala ngemva kokuhlinzwa kwenhliziyo evulekile. Kodwa kubalulekile ukuphumula ngokwanele ukuze ululame ngokushesha. Ukuze uthole ubusuku obuhle bokulala, iziguli kufanele zilandele iseluleko esinikeziwe:

• Yidla imithi oyinikeziwe isigamu sehora ngaphambi kokulala.

• Sebenzisa imicamelo ethambile ukuze unciphise ubuhlungu bemisipha.

• Gwema ukuphuza ikhofi kusihlwa.

Ezinye iziguli azilali ngokwanele ngenxa yokukhathazeka noma ukucindezeleka. Ngenxa yalokhu, kufanele bathintane nodokotela bengqondo noma abelapha.

• Ukuthuthukisa impilo yenhliziyo

Ukuze silulame ngokushesha futhi sigcine inhliziyo iphilile, isiguli kufanele:

• Idla ukudla okunempilo.

• Ungadli ukudla okunamafutha amaningi, ushukela nosawoti.

• Qala ukuqhubeka nokwenza imisebenzi yabo yansuku zonke yomzimba.

• Gwema ukubhema nokuphuza utshwala

• Lawula i-cholesterol yabo ephezulu kanye nomfutho wegazi ophakeme.

Ezinye izindlela Zokuhlinza Inhliziyo Evulekile

Ngaphandle kokuhlinzwa kwenhliziyo, odokotela abahlinzayo bangase bakhethe ezinye izindlela zokwelapha inhliziyo kuye ngesimo sesiguli. Lezi zindlela yilezi:

• Ukuhlinzwa okusekelwe ku-catheter - Ngale ndlela, udokotela ohlinzayo uzoxhuma ishubhu elingenalutho, elincanyana elibizwa ngokuthi i-catheter enhliziyweni. Ngemva kwalokhu, amathuluzi okuhlinza afakwa nge-catheter ukuze enze ukuhlinzwa. Le nqubo ihlanganisa i-stenting, i-coronary angioplasty, ne-TAVR (i-transcatheter aortic valve replacement).

• I-VATS (ukuhlinzwa kwethoracic okusizwa ngevidiyo) - Ngale ndlela yokuhlinza, udokotela ohlinzayo ufaka i-thoracoscope (ikhamera yevidiyo encane) kanye nezinsimbi zokuhlinza ngokusebenzisa izimbotshana zesifuba. Inqubo isetshenziselwa ukwelapha i-arrhythmia, ukulungisa ama-valve enhliziyo nokubeka i-pacemaker.

• Ukuhlinza okusizwa ngamarobhothi - Le ndlela isetshenziselwa ukwelapha iziguli ezihlushwa izimila zenhliziyo, ukukhubazeka kwe-septal, i-atrial fibrillation, nesifo senhliziyo ye-valvular. 

Izibhedlela ZOKUNAKEKELA Zingasiza Kanjani?

Ezibhedlela ze-CARE, sihlinzeka ngezinketho zokwelashwa eziqondene nawe kanye nezinqubo ezingangeneleli kancane zokwelapha izifo zenhliziyo, okuhlanganisa nokuhlinzwa kwenhliziyo evulekile e-Hyderabad. Ithimba lethu lezokwelapha elinolwazi olunzulu lihlinzeka ngokunakekelwa okuphelele nesiqondiso ezigulini phakathi nesikhathi sokululama kwazo. Isibhedlela sisebenza ngokuvumelana nezinqubo zokwelapha zomhlaba wonke ukuze sinikeze imiphumela engcono.