Mtima kulambalala opaleshoni. mtima kulambalala opaleshoni pambuyo vuto la mtima. Mtima kulambalala opaleshoni: wodwala ndemanga

Inatsekeratu mtsempha wamagazi kulambalala kumezetsanitsa (CABG) opaleshoni - opareshoni kuti Kwalamulidwa pa nkhani ya matenda a mitima. Kuchepetsa wa mitsempha kupereka mtima ndi magazi (stenosis) kumachitika chifukwa mapangidwe mipukutuyi atherosclerotic nawo zinadzala ndi mavuto aakulu wodwalayo. Pamene kusokonezedwa kotunga magazi a minofu mtima, myocardium amalandira zosakwana wofunikila uziyenda yachibadwa kuchuluka kwa magazi, zomwe mapeto kuwononga ndi kufooketsa. Pankhaniyi, pa zolimbitsa thupi munthu amakhala angina (chifuwa ululu).

The kudwala ambiri mwa matenda onse mtima amachita inatsekeratu matenda a mtima (CHD). Sakugwira yopuma kapena akazi kapena amuna. Kupanda kotunga magazi kungayambitse mbali ya mtima minofu necrosis - m'mnyewa wamtima infarction, zomwe okha amakumana mavuto aakulu kapena imfa. mtima kulambalala opaleshoni pambuyo vuto la mtima kuthetsa mavuto ake, chifukwa kupewa matenda a mtima komanso zinthu zina matenda a matenda ischemic mtima, mankhwala, ngati sikunali kotheka kuti tikwaniritse mothandizidwa ndi zotsatira ndiwofatsa chithandizo positive. Awa ndi kwakukulu, koma ambiri yoyenera njira ya kubwezeretsedwa kwa magazi. M'nkhaniyi tiona afotokoze chomwe ndi mtima inatsekeratu mtsempha wamagazi kulambalala opaleshoni ndi mmene yokonzekera.

ndicho opaleshoni

CABG angathe kuchitidwa pa zotupa limodzi kapena angapo a mitsempha. Pa ntchito mu zotengera kumene otaya magazi akusokoneza, kulenga shunts - workarounds. Izi zachitika mwa kuika munthu mtsempha wamagazi wathanzi kwa inatsekeratu. Chifukwa, otaya magazi ayenera kuzilambalala loko danga kapena stenosis. Mtima kulambalala opaleshoni, motero, ndipu zonse magazi kuwonjezera mtima minofu.

Kukonzekera opaleshoni

N'kofunika kuti bwino CABG kuposa akatswiri magulu a madokotala, Iwo ali abwino anthu mzimu pa zabwino zotsatira za mankhwala. Opaleshoni imeneyi si owopsa kwambiri kuposa zina opaleshoni, koma pamafunika yokonzekera waukuluwo. Choyamba, asanachite opareshoni aliyense mtima, wodekha ndi chitumidwa kwa anayendera, chomwe pochita ndi electrocardiogram, ultrasound, mayesero zasayansi ndi kusanthula komanso chikhalidwe ambiri oterewa. Komanso ayenera kupanga angiography (tikoronarografiyu). Izi ndondomeko matenda limachititsa kudziwa boma kudyetsa mitsempha mtima minofu kudziwa Malo mapangidwe zolengeza ndi digiri ya kuchepetsa. Kafukufuku ntchito rentgenapparatury (m'zotengera jekeseni radiopaque mankhwala, ndiyeno nkutenga chithunzi).

Mbali ya matenda njira ikuchitika mu chipatala, komanso ena - pa outpatient maziko. mwamuna anaika kuchipatala, kawirikawiri sabata pamaso opaleshoni, nthawi yomweyo ndi kukonzekera bwino amayamba. Mmodzi wa ake chofunika kwambiri magawo - chitukuko cha wapadera kupuma njira, yomwe kenako kwambiri zothandiza.

opareshoni

Monga tanenera kale, mitima kulambalala opaleshoni ikuchitika kulenga mothandizidwa ndi shunt ku msempha kwa mitsempha zina workarounds kuti zingakuthandizeni kuti kulambalala obstructed malo ndi kubwezeretsa magazi. Nthawi zambiri shunt amakhala mtsempha wamagazi thoracic, chifukwa ndi chifukwa mbali yake yapadera ali kukana wabwino kwa atherosclerosis ndipo ali ndi moyo wautali monga shunt a. Nthawi zina, ntchito mtsempha wamagazi zozungulira kapena saphenous mtsempha ntchafu.

Mtima kulambalala opaleshoni akhoza kukhala wosakwatiwa, pawiri, patatu ndi zina zotero. Izo zimatengera angati ziwiya inatsekeratu ndi chiletso. Mwa njira, mlingo wa zizindikiro za matendawo kuti sikudalira. Mwachitsanzo, wodwala ndi kwambiri aakulu inatsekeratu mtsempha wamagazi matenda kungafune ndi imposition wa mmodzi shunt ndi munthu yemwe ali kudwala amasonyeza zochepa - awiri kapena atatu. Opaleshoni ndi opaleshoni yotsegula mtima pogonekedwa ndi mankhwala ambiri, malingana ndi msinkhu cha kapangidwe, izo ukhoza kwa maola atatu sikisi.

Mitundu itatu ya CABG

1. Ntchito makina mtima m'mapapo. Ngati mugwiritse ntchito njirayi, mtima wodwalayo ali ndinayima.
2. Pa kumenyedwa mtima. Njira imeneyi zimathandiza kuti kumaliza ntchito mofulumira kwambiri ndi kuchepetsa mosavuta mavuto, koma pamafunika zinthu zambiri madokotala.
3. Asang'ambe mwayi olanda (ntchito makina mtima m'mapapo kapena ayi). Iyi ndi njira watsopano kuti limachititsa kuchepetsa kutaika kwa magazi pochita alowererepo, kuti kuchepetsa chiopsezo cha matenda oyamba matenda. Pambuyo pa CABG mtima akuchira msanga, pamene akukhala mu chipatala yafupika zisanu - masiku khumi.

Izo ziyenera kuti opaleshoni iliyonse mtima amanyamula mavuto ena. Komabe, zikomo kwa zipangizo zamakono, luso, analongosola chachikulu tiligwiritse ntchito amatha kuchepetsa izo. ntchito zabwino kwambiri mawu a zotsatira zabwino ndi mtima kulambalala opaleshoni. Reviews wa anthu ambiri akhudzidwa ndi amenewa opareshoni, ankawaviika mawu oyamikira kwa madokotala. Komabe, madokotala ananena zawo zimadalira makhalidwe munthu wodwalayo ndi chithunzi matenda a matenda.

Nthawi postoperative

Mwamsanga pambuyo opaleshoni munthu ali odwala kwambiri pamene amayamba kubwezeretsa yoyamba ya m'mapapo ndi minofu mtima. Nkofunika kuti pa izi nthawi ya opaleshoni bwino kupuma. Nthawi ya kukhala mu odwala mwakayakaya kungakhale masiku khumi, malingana ndi momwe ndondomeko wochititsidwa mtima kulambalala opaleshoni. Konzanso komanso akuyamba ku chipatala, ndipo kenako anapitiriza pakati pa konzanso. The matabwa kutsogolo ndi kumbuyo komwe anatenga mfundo shunt, kuti kupewa kuwola ndi kuipitsa osambitsidwa ndi antiseptics. Kupita nawo kwinakwake, pa tsiku lachisanu ndi chiwiri, pamene chilondacho bwino.

konzanso

M'madera panali matabwa, nthawi zina adzamva ululu ndi moto. Pamene mabala penapake yaitali (masabata limodzi kapena awiri), mtima amaloledwa kutenga shawa. Kwa machiritso a sternum fupa zochuluka nthawi - anayi miyezi isanu ndi umodzi. Mukhoza kuvala pachifuwa bandeji kuti imathandizira pa ntchito imeneyi. Mu masabata oyambirira anai mpaka asanu pa miyendo ayenera kuvala wapadera masitonkeni zotanuka kupewa kutupa. Panthawi imeneyi, tiyenera asale zolimbitsa thupi kwambiri.

Chifukwa kutaya magazi zimene zinachitika pa opaleshoni, magazi m'thupi angathe anthu. Komabe, aliyense chithandizo chapadera mu nkhani iyi si chofunika. kumangopitirira zakudya, ozikidwa pa ntchito mankhwala okhala yambiri yachitsulo, ndipo patatha mwezi umodzi, mlingo hemoglobin akubwerera mwakale. Wodwalayo adzayenera kuyesetsa kuti abwezeretse kupuma bwinobwino. Kuchita izi, zonyamula kunja wapadera kupuma kokoka, amene anaphunzitsidwa asanachite opareshoni. Komanso iwo angagwiritsidwe ntchito kupewa chibayo.

Pambuyo opaleshoni ya mtima kulambalala amapezeka chifuwa. Sikuti kuopa. Kutsokomola mmwamba - yofunika kwambiri konzanso. Mutsogolere zotheka ake ndi kukanikiza kanjedza kapena mpira kwa pamtima. Pafupipafupi Kusintha kwa malo a thupi imathandizira lipole. Madokotala zambiri tafotokozani momwe potembenuka pamene akufunika.

Konzanso limodzi ndi kuwonjezeka pang'onopang'ono zolimbitsa thupi. Pamene wodwala akasiya angina, izo akapatsidwa chofunika galimoto mode. munthu woyamba amaloledwa kuyenda mtunda waufupi (patsiku kwa kilometre imodzi) ku kulowera kuchipatala, ndiye pang'onopang'ono kuwonjezera katundu, ndipo patapita kanthawi pafupifupi onse zoletsa achotsedwa.

pambuyo kumaliseche

Anthu amene anali mtima kulambalala opaleshoni, Ndi bwino pambuyo kuchipatala chithandizo Ulendo achisangalalo. Pambuyo sanaonetse imodzi ndi theka kapena miyezi iwiri, ndipo mukhoza kupeza ntchito basi. Pa nthawi yomweyo ziyenera kuchitikira mayeso katundu chifukwa akuona patency wa grafts kulambalala chikangoperekedwa ndi kuona mmene anapanga mpweya okwanira wa mumtima. Ngati palibe kusintha pa ECG, wodwala safuna kumva ululu pa ndondomeko kuyezetsa, zikutanthauza kuti achire tinganene kuti mupambane.

Mtima kulambalala opaleshoni: mtengo

ntchito ndi mkulu, choncho ali ndi phindu mokwanira Kumwambamwamba, amene zimadalira chiwerengero Napempha kwa grafts, njira ya kuwasokoneza, boma panopa thanzi la wodwalayo, mlingo wa chitonthozo kuperekedwa pambuyo CABG. muyeso wina zofunika ndi mtengo - mlingo wa chipatala, amene adzachitidwa mtima kulambalala opaleshoni. Kumene, kuchita ntchito mu yachibadwa Mtima Hospital adzakhala mtengo kuposa chipatala apadera payekha. Pafupifupi mu Moscow mtengo wa CABG ranges kuchokera 150-500 zikwi rubles, mu Israel - madola 23-30 zikwi, mu zipatala za Germany mtengo opareshoni ngati akuyamba ku yuro 25 chikwi.

Mtima kulambalala opaleshoni: ndemanga mtima

Anthu ambiri ananena kuti ayambe pambuyo CABG akuthamanga molimbika. Odwala amene zinachitikira movutikira, makamaka usiku. Ena amanena kuti nthawi ina onse anali kugona theka mosapumira. Koma patapita kanthawi, anthu salinso kumva ululu kumbuyo breastbone ndi, kwinakwake mu mwezi pali kusintha kwambiri, wamphamvu zimenezi zikapitirira zina. Odwala amene opaleshoni zaka zingapo zapitazo, iwo akunena kuti iwo kumva bwino, pamodzi ndi wathanzi. Ena amadandaula kuti iwo anali kupendanso moyo wawo, kusuta, zakudya. Koma zoona, kusiya zizolowezi zoipa ziyenera anthu onse, osati anthu amene anali opaleshoni ya mtima.

pomaliza

Mu zina okha opaleshoni angapulumutse moyo. Nthaŵi mtima kulambalala opaleshoni chingalepheretse mtima ndipo zotsatira zake kwambiri, kubwerera munthu kuti ntchito zonse. Khalani wathanzi!