Utyando lwentliziyo

Umxholo

• Zithini iintlobo ezahlukeneyo zotyando lwentliziyo oludlula?
• Kutheni le nto umntu enokuthi afune ukuba intliziyo igqithe kutyando?
• Imiselwe njani imfuno yentliziyo ngokudlula kutyando?
• Buphi ubungozi bokugqitha kwentliziyo?
• Zeziphi ezinye iindlela zokuphelisa utyando lwentliziyo?
• I-balloon angioplasty
• Ukuphucula ukunyanzeliswa kwangaphandle (EECP)
• Amayeza
• Ukutya kunye notshintsho kwindlela yokuphila
• Ndiyilungiselela njani intando yentliziyo ngokudlula ngotyando?
• Iingcebiso zotyando lwentliziyo
  
• Yenziwa njani into yokugqitha kwentliziyo?
• Inyathelo lokuqala
• Ukuqhagamshela kumatshini wokudlula we-cardiopulmonary
• Ukudibanisa
• Amanyathelo okugqibela
• Ngubani oza kunceda ukwenza utyando lokudlula?
• Kunjani ukubuyela kwimeko yoqhaqho lwentliziyo?
• Ndimele ndimxelele nini ugqirha wam malunga nentlungu emva kotyando?
• Ngawaphi amayeza endiza kuwathatha emva kotyando lwentliziyo?
• Zithini iziphumo zexesha elide lotyando lokudlula?

Yintoni intliziyo ngokudlula ngotyando?

Utyando lokudlula kwentliziyo, okanye ugqirha we-coronary bypass graft (CABG), isetyenziselwa ukuphucula ukuhamba kwegazi entliziyweni yakho. Ugqirha usebenzisa imithambo yegazi ethathwe kwenye indawo emzimbeni wakho ukudlula imithambo eyonakeleyo.

Oogqirha benza malunga ne-200,000 yotyando e-United States minyaka le.

Olu tyando lwenziwa xa imithambo yegazi iyavalwa okanye yonakele. Ezi mithambo zinika intliziyo yakho igazi elineoksijini. Ukuba le mithambo ivaliwe okanye ukuhamba kwegazi kuthintelwe, intliziyo ayisebenzi kakuhle. Oku kunokukhokelela kukusilela kwentliziyo.

Zithini iintlobo ezahlukeneyo zotyando lwentliziyo oludlula?

Ugqirha wakho uya kuncoma uhlobo oluthile lotyando oludlula ngokuxhomekeka ekubeni zingaphi ii-artery zakho ezivaliweyo.

• Ukudlula okukodwa. Mnye kuphela umthambo ovalekileyo.
• Ukudlula kabini. Imithambo emibini ivalekile.
• Ukudlula kathathu. Imithambo emithathu ivalekile.
• Ukudlula kumacala amane. Iimithambo ezine zivaliwe.

Umngcipheko wokuba nesifo sentliziyo, ukusilela kwentliziyo, okanye enye ingxaki yentliziyo ixhomekeke kwinani leemithambo ezivaliweyo. Ukuvaleka kwimithambo emininzi kukwathetha ukuba utyando lunokuthatha ixesha elide okanye lube nzima ngakumbi.

Kutheni le nto umntu enokuthi afune ukuba intliziyo igqithe kutyando?

Xa umbandela osegazini lakho obizwa ngokuba yi-plaque wakhela phezu kweendonga zakho zemithambo, ligazi elincinci elihamba liye kwisihlunu sentliziyo. Olu hlobo lwesifo se-coronary disease (CAD) saziwa ngokuba yi-atherosclerosis.

Intliziyo kunokwenzeka ukuba iphelelwe ngamandla kwaye isilele ukuba ayifumani gazi laneleyo. I-atherosclerosis inokuchaphazela nayiphi na imithambo emzimbeni.

Ugqirha wakho unokucebisa ngentliziyo ngokudlula kutyando ukuba imithambo yegazi yakho iyancipha okanye ivalekile de ube semngciphekweni omkhulu wokuhlaselwa sisifo sentliziyo.

Ugqirha wakho uya kucebisa ngogqithiso lotyando xa ukuvaleka kunzima kakhulu ukulawula amayeza okanye ezinye iindlela zonyango.

Imiselwe njani imfuno yentliziyo ngokudlula kutyando?

Iqela loogqirha, kubandakanya ugqirha wezinto zentliziyo, achonge ukuba ngaba unganakho ukwenza utyando lwentliziyo oluvulekileyo. Ezinye iimeko zonyango zinokubanzima ukwenza utyando okanye ukuziphelisa njengezinokwenzeka.

Iimeko ezinokubangela iingxaki zibandakanya:

• isifo seswekile
• emphysema
• isifo sezintso
• isifo se-arterial (PAD)

Xoxa ngale micimbi nogqirha wakho ngaphambi kokucwangcisa utyando lwakho. Uyakufuna kwakhona ukuthetha ngembali yakho yezonyango yosapho kunye nayo nayiphi na imigqaliselo kunye namayeza owathathayo. Iziphumo zotyando ezicwangcisiweyo zihlala zibhetele kunokuhlinzwa ngokukhawuleza.

Buphi ubungozi bokugqitha kwentliziyo?

Njengalo naluphi na utyando lwentliziyo oluvulekileyo, utyando lwentliziyo oludlula lubeka umngcipheko. Ukuqhubela phambili kwetekhnoloji kwangoko kuyiphucule inkqubo, kwandise amathuba otyando oluyimpumelelo.

Kusekho umngcipheko wezinye iingxaki emva kotyando. Ezi ngxaki zinokubandakanya:

• ukopha
• arrhythmia
• amahlwili egazi
• iintlungu zesifuba
• usulelo
• ukusilela kwezintso
• isifo sentliziyo okanye ukubetha

Zeziphi ezinye iindlela zokuphelisa utyando lwentliziyo?

Kule minyaka ilishumi idlulileyo, ezinye iindlela zokwenza utyando lwentliziyo ziye zafumaneka. Oku kubandakanya:

I-balloon angioplasty

I-balloon angioplasty yeyona ndlela enokucetyiswa ngoogqirha. Ngethuba lonyango, ityhubhu ifakwe kwi-artery yakho evaliweyo. Emva koko, ibhaluni encinci iyaphuphuma ukuze wandise umthambo.

Ugqirha ke ususa ityhubhu kunye nebhaluni. Iselfini encinci yesinyithi, ekwabizwa ngokuba yi-stent, iya kushiyeka endaweni. I-stent igcina umthambo ukusuka ekungeneni kwisivumelwano ukuya kubungakanani bayo bokuqala.

I-balloon angioplasty isenokungasebenzi njengokuhlinzwa ngokudlula kwentliziyo, kodwa ayinabungozi kangako.

Ukuphucula ukunyanzeliswa kwangaphandle (EECP)

Ukuphuculwa kwenyani yangaphandle (EECP) yinkqubo yezigulana ezingalaliswayo. Inokwenziwa ngokubhekisele kutyando lwentliziyo, ngokutsho okuphindaphindiweyo. Ngo-2002, yavunywa yi-Food and Drug Administration (FDA) ukuba isetyenziswe kubantu abane-congestive heart failure (CHF).

I-EECP ibandakanya ukunyanzelwa kwemithambo yegazi kwimilenze esezantsi. Oku kwandisa ukuhamba kwegazi kuye entliziyweni. Igazi elongeziweyo linikezelwa entliziyweni ngayo yonke intliziyo.

Ixesha elingaphezulu, eminye imithambo yegazi inokukhulisa "amasebe" ongezelelweyo aya kuzisa igazi entliziyweni, lube luhlobo "lokudlula kwendalo."

I-EECP ilawulwa yonke imihla kangangeyure enye ukuya kwezimbini kwisithuba seeveki ezisixhenxe.

Amayeza

Kukho amayeza onokuthi uwaqwalasele ngaphambi kokubhenela kwiindlela ezinje ngokuhlinzwa ngokudlula kwentliziyo. I-Beta-blockers inokukhupha i-angina ezinzileyo. Unokusebenzisa amayeza anciphisa i-cholesterol ekucothiseni i-plaque ekwakhiweni kwemithambo.

Ugqirha wakho unokuphinda ancome idosi yemihla ngemihla ye-aspirin yedosi ephantsi (umntwana aspirin) ukunceda ukuthintela ukuhlaselwa yintliziyo. Unyango lwe-Aspirin lusebenza kakhulu kubantu abanembali yangaphambili yesifo sentliziyo (njengokuhlaselwa sisifo sentliziyo okanye ukubetha).

Abo bangenayo imbali yangaphambili kufuneka basebenzise i-aspirin njengechiza lokuthintela ukuba:

• basemngciphekweni omkhulu wokuhlaselwa sisifo sentliziyo kunye nezinye izifo ze-atherosclerotic zentliziyo
• Unomngcipheko ophantsi wokopha

Ukutya kunye notshintsho kwindlela yokuphila

Elona nyathelo lilungileyo lothintelo “yindlela yokuphila esempilweni”, njengoko kumiselwe yiAmerican Heart Association (AHA). Ukutya ukutya okuphezulu kwi-omega-3 fatty acids kunye namafutha asezantsi agcweleyo kunceda intliziyo yakho ihlale isempilweni.

Ndiyilungiselela njani intando yentliziyo ngokudlula ngotyando?

Ukuba ugqirha wakho ucebisa ngentliziyo ngokudlula kutyando, baya kukunika imiyalelo epheleleyo malunga nendlela yokulungiselela.

Ukuba utyando lucwangciswe kwangaphambili kwaye ayisiyo inkqubo yongxamiseko, uya kuba nexesha elininzi lokuqeshwa apho uza kubuzwa malunga nembali yakho yempilo kunye nosapho.

Uya kuphinda ufumane iimvavanyo ezininzi ukunceda ugqirha wakho ukuba afumane umfanekiso ochanekileyo wezempilo yakho. Oku kunokubandakanya:

• iimvavanyo zegazi
• X-reyi yesifuba
• electrocardiogram (ECG okanye EKG)
• angiogram

Iingcebiso zotyando lwentliziyo

• Funa ingcebiso kugqirha wakho nangaliphi na iyeza elichaphazela igazi lakho. Unyango oluninzi luthomalalisa kunye nonyango lwentliziyo luchaphazela ukujiya, ngenxa yoko kuya kufuneka uyeke ukuthatha.
• Yeka ukutshaya. Kubi entliziyweni yakho kwaye kwandisa ixesha lokuphilisa.
• Tshela ugqirha wakho ukuba unempawu zomkhuhlane okanye umkhuhlane. Ngokukodwa, umkhuhlane ungabeka uxinzelelo ngakumbi entliziyweni kwaye unokunyusa amathuba okuhlaselwa sisifo sentliziyo okanye wenze mandundu ukusilela kwentliziyo. Inokubangela i-myocarditis, i-pericarditis, okanye zombini. Ezi zizifo ezinesifo sentliziyo.
• Lungisa ikhaya lakho kwaye wenze amalungiselelo okuhlala esibhedlele iintsuku ezininzi.
• Ukunciphisa umngcipheko wosulelo, hlamba umzimba wakho ngesepha ekhethekileyo, njengeeHibiclens, kubusuku obungaphambi kotyando. Yenziwe nge-chlorhexidine, eya kuthi incede ugcine umzimba wakho ungenantsholongwane de utyando.
• Ngokukhawuleza, okubandakanya ukungaseli manzi, ukuqala ezinzulwini zobusuku ngaphambi kotyando.
• Thatha onke amayeza akunikwa ngugqirha wakho.

Yenziwa njani into yokugqitha kwentliziyo?

Phambi kotyando, uyakutshintsha ube yingubo yesibhedlele kwaye ufumane amayeza, ulwelo, kunye neanesthesia nge-IV. Xa i-anesthesia iqala ukusebenza, uya kuwela kubuthongo obunzulu, obungenabuhlungu.

Inyathelo lokuqala

Ugqirha wakho ogqirha uqala ngokwenza isisiko embindini wesifuba sakho.

Ubambo lwakho lusasazeka ngaphandle ukuze lubonakalise intliziyo yakho. Ugqirha wakho ugqirha unokukhetha ukwenza utyando oluncinci, olubandakanya ukusikwa okuncinci kunye nezixhobo ezizodwa ezenziweyo kunye neenkqubo zerobhothi.

Ukuqhagamshela kumatshini wokudlula we-cardiopulmonary

Unokuxhonywa kumatshini wokudlula we-cardiopulmonary ojikeleza igazi elinomoya ophefumlelweyo emzimbeni wakho ngelixa ugqirha wakho esebenza entliziyweni yakho.

Ezinye iinkqubo zenziwa "ngaphandle kwempompo," oko kuthetha ukuba ukunxibelelana nomatshini wokudlula kwi-cardiopulmonary akudingeki.

Ukudibanisa

Ugqirha wakho ugqirha ususa isitya segazi esisempilweni emlenzeni ukugqitha kwinxalenye evaliweyo okanye eyonakeleyo yomthambo wakho. Isiphelo esinye sokudibanisa siqhotyoshelwe ngaphezulu kokuvaleka kwaye esinye isiphelo singezantsi.

Amanyathelo okugqibela

Xa ugqirha wakho egqibile, umsebenzi wokudlula ujongiwe. Nje ukuba ukugqitha kusebenza, uya kuthungwa, ubotshwe i-bandage, kwaye usiwe kwigumbi lokunyamekela abagulayo (ICU) lokubeka iliso.

Ngubani oza kunceda ukwenza utyando lokudlula?

Ngalo lonke olu tyando, iintlobo ezininzi zeengcali ziqinisekisa ukuba inkqubo yenziwa ngokufanelekileyo. Itekhnoloji yokugcoba isebenza ngomatshini wokudlula kwi-cardiopulmonary.

Ugqirha we-cardiovascular surgeon wenza inkqubo kwaye i-anesthesiologist iqinisekisa ukuba i-anesthesia ihanjiswa emzimbeni wakho ngokufanelekileyo ukuze uhlale ungazi nto ngexesha lenkqubo.

Iingcali zokulinganisa zinokubakho ukuthatha i-X-ray okanye ukunceda ukuqinisekisa ukuba iqela linokujonga indawo yotyando kunye nezicubu ezijikelezileyo.

Kunjani ukubuyela kwimeko yoqhaqho lwentliziyo?

Xa uvuka entliziyweni ugqitha utyando, uya kuba netyhubhu emlonyeni wakho. Unokuziva uziva iintlungu okanye uneziphumo ebezingalindelekanga ezivela kwinkqubo, kubandakanya:

• iintlungu kwindawo yokucheba
• iintlungu ngemiphunga enzulu
• iintlungu ukhohlela

Uya kuba kwi-ICU usuku olunye okanye ezimbini ukuze imiqondiso yakho ebalulekileyo ibekwe esweni. Nje ukuba uzinze, uya kusiwa kwelinye igumbi. Zilungiselele ukuhlala esibhedlele iintsuku ezininzi.

Ngaphambi kokuba uphume esibhedlele, iqela lakho lonyango liya kukunika imiyalelo ngendlela onokuthi uzikhathalele ngayo, kubandakanya:

• ukukhathalela amanxeba akho okusikwa
• ukufumana ukuphumla okuninzi
• ukuphepha ukuphakamisa okunzima

Ngaphandle kwengxaki, ukubuyela kwimeko yoqhaqho lwentliziyo kunokuthatha iiveki ezi-6 ukuya kwezi-12. Elo lelona xabiso lincinci elithathayo ukuze ithambo lakho lesifuba liphile.

Ngeli xesha, kuya kufuneka uphephe ukusebenza nzima. Landela imiyalelo yakho ugqirha malunga nomsebenzi womzimba. Kwakhona, akufuneki uqhube ude ufumane imvume kugqirha wakho.

Ugqirha wakho uya kuncoma ukulungiswa kwentliziyo. Oku kuyakubandakanya irejimeni yokujongwa ngononophelo kwemithambo yomzimba kunye novavanyo loxinzelelo ngamanye amaxesha ukubona indlela ephola ngayo intliziyo yakho.

Ndimele ndimxelele nini ugqirha wam malunga nentlungu emva kotyando?

Tshela ugqirha wakho malunga nayiphi na intlungu engapheliyo okanye ukungonwabi ngexesha lokuqeshwa kwakho kokulandela. Kuya kufuneka ubize ugqirha wakho ukuba unamava:

• Umkhuhlane ongaphezulu kwe-100.4 ° F (38 ° C)
• ukwanda kwentlungu esifubeni sakho
• ukukhawuleza kwentliziyo
• ububomvu okanye ukukhupha ujikeleze ukusikwa

Ngawaphi amayeza endiza kuwathatha emva kotyando lwentliziyo?

Ugqirha wakho uya kukunika amayeza okunceda ukulawula iintlungu zakho, ezinje nge-ibuprofen (Advil) okanye i-acetaminophen (iTylenol). Unokufumana i-narcotic yeentlungu ezibi kakhulu.

Ugqirha wakho uya kukunika amayeza okukunceda kwinkqubo yakho yokufumana kwakhona. Oku kuya kubandakanya iziyobisi ezichasene negazi kunye nezinye iziyobisi ezimiselwe ngugqirha wakho.

Thetha nogqirha wakho malunga nokuba zeziphi izicwangciso zonyango ezifanelekileyo kuwe. Oku kubaluleke ngakumbi ukuba uneemeko ezikhoyo ezinje ngesifo seswekile okanye iimeko ezichaphazela isisu okanye isibindi.

Zithini iziphumo zexesha elide lotyando lokudlula?

Emva kwentliziyo ephumeleleyo yotyando, iimpawu ezinjengokuphefumla kancinci, ukuqina kwesifuba, kunye noxinzelelo lwegazi oluphezulu ziya kuphucuka.

Ukudlula kunokunyusa ukuhamba kwegazi kuye entliziyweni, kodwa kuya kufuneka utshintshe imikhwa ethile ukukhusela isifo sentliziyo esizayo.

Iziphumo ezilungileyo zotyando ziyajongwa kubantu abenza utshintsho olusempilweni. Thetha nogqirha wakho malunga nokutya kunye nolunye utshintsho kwindlela yokuphila emva kokwenziwa kotyando.