Uyintoni umngcipheko wotyando kwaye uvavanyo lwangaphambi kokusebenza lwenziwa njani?

Umxholo

• Uvavanyo lwangaphambi kokusebenza lwenziwa njani
• 1. Ukuqhuba uviwo lweklinikhi
• 2. Ukuvavanywa kohlobo lotyando
• 3. Uvavanyo lomngcipheko wentliziyo
• 4. Ukuqhuba iimviwo eziyimfuneko
• 5. Ukwenza uhlengahlengiso lwangaphambi kokusebenza

Umngcipheko wotyando yindlela yokuvavanya imeko yeklinikhi kunye neemeko zempilo zomntu oza kwenziwa utyando, ukuze umngcipheko weengxaki uchongwe ngalo lonke ixesha laphambi, ngexesha nasemva kotyando.

Kubalwa kuvavanyo lweklinikhi kagqirha kunye nesicelo seemviwo ezithile, kodwa, ukwenza lula, kukho nezinye iiprotokholi ezikhokela ngcono ukuqiqa kwezonyango, njenge-ASA, uLee kunye ne-ACP, umzekelo.

Nawuphi na ugqirha angenza olu vavanyo, kodwa luhlala lusenziwa ngugqirha oqhelekileyo, ugqirha wentliziyo okanye ugqirha wobulali. Ngale ndlela, kunokwenzeka ukuba ukhathalelo oluthile luthathelwe umntu ngamnye ngaphambi kwenkqubo, njengokucela iimvavanyo ezifanelekileyo ngakumbi okanye ukwenza unyango ukunciphisa umngcipheko.

Uvavanyo lwangaphambi kokusebenza lwenziwa njani

Uvavanyo lonyango olwenziwe ngaphambi kotyando lubaluleke kakhulu ekuchazeni ukuba loluphi uhlobo lotyando umntu anokulwenza okanye angakwaziyo ukulwenza, kunye nokufumanisa ukuba ngaba ingozi ingaphezulu kwezibonelelo. Uvavanyo lubandakanya:

1. Ukuqhuba uviwo lweklinikhi

Uviwo lweklinikhi lwenziwa ngokuqokelelwa kwedatha emntwini, njengamayeza asetyenziswayo, iimpawu, izigulo abanazo, ukongeza kuvavanyo lomzimba, njengentliziyo kunye ne-pulmonary auscultation.

Ukusuka kuvavanyo lweklinikhi, kunokwenzeka ukuba ufumane uhlobo lokuqala lokuhlelwa kobungozi, olwenziwe yiAmerican Society of Anesthesiologists, eyaziwa ngokuba yi-ASA:

• Iphiko 1: umntu ophilileyo, ngaphandle kwezifo zenkqubo, usulelo okanye umkhuhlane;
• Iphiko 2: umntu onesifo se-systemic esincinci, njengolawulo lwegazi oluphezulu, isifo seswekile, ukutyeba, ubudala obungaphezulu kweminyaka engama-80;
• Iphiko 3: umntu onesifo esiqatha kodwa esingakhubazisiyo isifo esifana nesesistim, njengokuhlawulwa kwentliziyo, isifo sentliziyo ngaphezulu kweenyanga ezi-6, i-angina yentliziyo, i-arrhythmia, i-cirrhosis, isifo seswekile okanye uxinzelelo lwegazi;
• Iphiko 4: umntu onesifo esisongela ubomi esikhubaza izifo ezinje ngesifo sentliziyo, isifo sentliziyo esingaphantsi kweenyanga ezi-6, imiphunga, isibindi kunye nokusilela kwezintso;
• Iphiko 5umntu ogulela ukufa, engalindelanga ukuba aphile ngaphezulu kweeyure ezingama-24, nasemva kwengozi;
• Iphiko 6: umntu obhubhile ebuchotsheni, ngubani oza kuthi enze utyando ngomnikelo welungu.

Ukunyuka kwenani lokuhlelwa kwe-ASA, umngcipheko wokufa kunye neengxaki ezivela kotyando, kwaye umntu kufuneka avavanye ngononophelo ukuba loluphi uhlobo lotyando olunokuba luncedo kwaye lube luncedo emntwini.

2. Ukuvavanywa kohlobo lotyando

Ukuqonda uhlobo lwenkqubo yoqhaqho oluya kwenziwa nako kubaluleke kakhulu, kuba ubunzima kunye nokudla ixesha lotyando, kokukhona kuya kubakho umngcipheko wokuba umntu angabandezeleka kunye nokhathalelo ekufuneka luthathiwe.

Ke, iintlobo zoqhaqho zinokuhlelwa ngokomngcipheko weengxaki zentliziyo, ezinje:

3. Uvavanyo lomngcipheko wentliziyo

Kukho ezinye ii-algorithms ezilinganisela ngokuthe ngqo umngcipheko weengxaki kunye nokufa kutyando olungasebenziyo lwentliziyo, xa kusenziwa uphando ngemeko yeklinikhi yomntu kunye novavanyo oluthile.

Eminye imizekelo yee-algorithms ezisetyenzisiweyo zezi Isalathiso somngcipheko wentliziyo weGoldman, Isalathiso sikaLee esiHlaziyiweyo somngcipheko weentliziyo yi Ialgorithm ye Ikholeji yaseMelika yeCardiology (ACP), umzekelo. Ukubala umngcipheko, bajonga idatha yomntu, enje:

• Ubudala, osengozini engaphezulu kweminyaka engama-70 ubudala;
• Imbali ye-infyoction ye-myocardial;
• Imbali yentlungu yesifuba okanye i-angina;
• Ubukho be-arrhythmia okanye ukunciphisa iimpahla;
• I-oxygenation yegazi ephantsi;
• Ubukho beswekile;
• Ubukho bokungaphumeleli kwentliziyo;
• Ubukho be-edema yemiphunga;
• Uhlobo lotyando.

Ukusuka kwidatha efunyenweyo, kunokwenzeka ukumisela umngcipheko wotyando. Ke, ukuba liphantsi, kunokwenzeka ukuba ukhulule utyando, kuba ukuba umngcipheko wotyando uphakathi ukuya phezulu, ugqirha unokubonelela ngesikhokelo, alungelelanise uhlobo lotyando okanye acele iimvavanyo ezingaphezulu ezinceda ukuvavanya umngcipheko wotyando lomntu.

4. Ukuqhuba iimviwo eziyimfuneko

Uvavanyo langaphambi kokusebenza kufuneka lwenziwe ngenjongo yokuphanda naluphi na utshintsho, ukuba kukho urhano, olukhokelela kwingxaki yotyando. Ke ngoko, iimvavanyo ezifanayo azifanelanga kuyalelwa wonke umntu, kuba akukho bungqina bokuba oku kuyanceda ukunciphisa iingxaki. Umzekelo, kubantu abangenazimpawu, benomngcipheko ophantsi wotyando kwaye ngubani oza kwenziwa utyando olunomngcipheko ophantsi, akukho mfuneko yokwenza uvavanyo.

Nangona kunjalo, ezinye zeyona mvavanyo ziqhelekileyo ziceliweyo nezicetyiswayo zezi:

• Ubalo lwegazi: abantu abafumana utyando oluphakathi okanye olunomngcipheko omkhulu, abanembali yokuphazamiseka kwegazi, ngokurhanelwa okwangoku okanye ngezifo ezinokubangela utshintsho kwiiseli zegazi;
• Uvavanyo lokuqina: abantu abasebenzisa i-anticoagulants, ukusilela kwesibindi, imbali yezifo ezibangela ukopha, uqhaqho oluphakathi okanye olunobungozi obukhulu;
• Isilinganisi se-creatinine: abantu abanesifo sezintso, isifo seswekile, uxinzelelo lwegazi, isifo sesibindi, ukusilela kwentliziyo;
• I-X-ray yesifuba: abantu abanezifo ezifana ne-emphysema, isifo sentliziyo, abangaphezu kweminyaka engama-60, abantu abasemngciphekweni omkhulu wentliziyo, abanezifo ezininzi okanye abaza kutyandwa esifubeni okanye esiswini;
• Electrocardiogram: abantu abanesifo sokukrokrelwa sisifo sentliziyo, imbali yeentlungu zesifuba kunye nesifo seswekile.

Ngokubanzi, olu vavanyo lusebenza iinyanga ezili-12, ngaphandle kwesidingo sokuphindaphinda ngeli xesha, nangona kunjalo, kwezinye iimeko, ugqirha unokufumana kunyanzelekile ukuba aziphinde kwangaphambili. Ukongeza, abanye oogqirha banokuthi bakuthathe njengokubalulekileyo uku-odola ezi mvavanyo nakubantu ngaphandle kotshintsho abalukrokrelayo.

Olunye uvavanyo, olunje ngovavanyo loxinzelelo, i-echocardiogram okanye i-holter, umzekelo, inoku-odolwa kwezinye iintlobo ezintsokothileyo zotyando okanye zabantu abanesifo sentliziyo esikrokrelwayo.

5. Ukwenza uhlengahlengiso lwangaphambi kokusebenza

Emva kokwenza iimvavanyo neemviwo, ugqirha angalucwangcisa utyando, ukuba konke kulungile, okanye anganika izikhokelo ukuze umngcipheko weengxaki kutyando uncitshiswe kangangoko kunokwenzeka.

Ngale ndlela, angacebisa ukwenza olunye uvavanyo oluthe kratya, ukulungisa idosi okanye ukwazisa amayeza athile, ukuvavanya isidingo sokulungiswa kwentliziyo, ngoqhaqho lwentliziyo, umzekelo, ukukhokela imisebenzi yomzimba, ukunciphisa umzimba okanye ukuyeka ukutshaya, phakathi kwabanye .