I "Pump Head" Chaicho, Uye Inorevei?
Kwemakore akawanda, muchipinda chechiremba chechiremba (icho chaicho chiine zvizhinji zvakafanana nemamwe marudzi emakamuri ezereji), vanachiremba vane mwoyo vanogona kutaurirana mumwe mucherechedzo ivo vaigara vachinzi "pombi musoro." Pump musoro yaiva izwi rinoshandiswa ku kurondedzera kukanganiswa kwepfungwa mune dzimwe nguva dzimwe nguva vakaona varwere vavo mushure mekugadzirisa arteri nekuvhiya .
Icho chaiva nezita iri nokuti kufungidzira kwaiva kukanganisa kwepfungwa mushure mekuvhiyiwa kwepamusoro kwakange kwakabatana nekushandiswa kwema cardiopulmonary bypass pump munguva yekuita.
Kwemazuva mazhinji, kutaura pamusoro pechiitiko ichi hachina kumbopfuura nechepamusoro pekamuri yekodhi.
Asi muna 2001, chidzidzo kubva kuDuke University yakaratidzika kusimbisa izvo vanachiremba vakawanda vakanga vambofungidzirwa kwenguva refu, asi vakanga vasingadi kutaura zvekutaura pachena. Izvozvi, chikamu chakawanda chevanhu mushure mekugadziriswa kwechirwere chepamusoro pakushandiswa kwechiremba chinowanzoona kuoneka (asi kazhinji kazhinji kwenguva duku) kushaya simba mumagariro avo epfungwa. Chidzidzo ichi chakagamuchirwa zvakanyanya mushure mekubudiswa kwayo muNew England Journal of Medicine , uye chakakonzera kushungurudzika kukuru pakati pechiremba uye avo vangave varwere. Asi kushungurudzika kwakakurumidza kupera, uye vanhu vakawanda havana kunzwa zvakawanda pamusoro pacho kubva ipapo.
Zvisinei, mumakore akapfuura zvimwe zvakawanda zvakadzidzwa nezvekuchinja kwepfungwa mushure mokuvhiyiwa.
Nechinhu chimwe chete, chiitiko chacho chaicho. Kune imwe, haifaniri kunge yakabatana nekushandiswa kweputi pamaputi, asi pane kudaro, inowanzoenderana nekunetswa kwemidziyo yeropa yakawanda inodiwa panguva iyi yekuvhiya.
Kunyange zvazvo vanachiremba vachiri kuda kunge vasingafariri kutaura pamusoro payo pachena, kushandiswa kwepamusoro kwepfungwa kunetseka kwepfungwa kunowanzoitika kuti vanhu vane chirwere ichi uye vadiwa vavo vanofanira kufanirwa kuziva kare, naizvozvo vakagadzirira kurarama nazvo kana zvichiitika .
Ndezvipi Zvine Mwero Nokusaziva Kwepfungwa?
Kungotaura chete, "kuparara kwekufunga" ndiyo izwi rinotsanangurwa navanachiremba kune zvakasiyana-siyana zvinokonzerwa neurological izvo zvinogona kuonekwa mushure mokuvhiyiwa.
Izvi zvinogona kusanganisira chero ipi zvayo kana zvose zvinotevera: kusanyatsocherechedza nguva, kusakanganwa kwepfungwa, kusaruramisira kuita zvisarudzo, kusakwanisa kuisa pfungwa, kuderedza kufamba kwekufamba, uye kuora mwoyo kwakawanda mukukwanisa kufunga zvakajeka. Zvimwe zviratidzo zvakakomba zvakadai sepamusoro-soro zvinogona kuonekwa zvakare. Zviratidzo izvi zvinogona kuonekwa pakarepo mushure mekuvhiyiwa, uye zvinogona kutakura zvakanyanya mukusava nesimba kubva pakusakundikana kusvika zvisingaoneki (mune izvo zviitiko zvidzidzo zvisinganzwisisiki zvehutano zvinodiwa kuti zvizvione).
Kukanganisa kwepfungwa kunowanzogadzirisa zvishoma nezvishoma, kwemavhiki mashoma kana mwedzi, asi mune dzimwe nguva vanogona kuramba vachiita kwemakore.
Iyo Inowanzonzi Dambudziko Rakaita Sei?
Mukuwedzera pakuva chidzidzo chekutanga kutarisa kunyatsoona ichi, chiitiko cheDuke chidzidzo cha2001 chakajekesawo kuti kushaya njere kwekuziva kunogona kushamisa nguva dzose, uye kunoramba kuchiripo. Muchidzidzo ichi vanhu 261 (avareji yemakore makumi matanhatu nemashanu) vane chirwere chepamusoro chekuvhiya vakanyatsoongororwa kuti vaongorore ruzivo rwavo rwekuziva (kureva kukwanisa kwepfungwa) panguva dzakasiyana-siyana: vasati vavhiyiwa, pamasvondo matanhatu, mwedzi mitanhatu, uye pamakore mashanu mushure mekuvhiyiwa kwemaawa.
Vatori vechikamu vakaonekwa seve nehutachiwana hukuru kana vakave nekuderera kwe20% mu test scores. Vatsvakurudza vakaona kuti 42% yevarwere vaiva nehotera ye20% mu test scores mushure mekuvhiyiwa, uye kuti muzviitiko zvakawanda kuderera kwekuziva kwakagadzirirwa kwemakore mashanu.
Kuwana kuti kushaya njere kunokonzerwa mushure mokuvhiyiwa kwepamusoro kwakanga kusishamisi kune ani zvake kutarisira vanhu ava. Chii chakanga chisishamisika chakanga chiri chiitiko chakakwirira chechinetso muDuke kudzidza, uye kushivirira kwayo. Ichi chidzidzo, zvakafanana, chakakonzera kuwanda kwekushaya simba pakati pechiremba nevamwe vanhu vose.
Duke kudzidza zvakanyatsoropodzwa nokuti yakange isisina boka rakarongedza rinodzora. Pane kudaro, vatsvakurudzi vakafananidza mitsva yavo nemigumisiro yekudzidza kwakafanana pakati pevarwere vane coronary artery disease (CAD) yezera rimwe chete iro risina kumbovhiyiwa. Vakaona kuti avo vakagamuchira kuperevhirwa kwaive nehuwandu hwekushaya njere kune vanhu vane CAD vasina kuvhiyiwa. Zvisinei, nokuti vanhu vanopfurikidza nekuvhiya kazhinji vanove vane CAD yakawanda, vanhu ava havakwanisi kuenzaniswa.
Kunyange zvakadaro, chidzidzo chaicho chaicho (umo vanhu vane CAD vaizovhiyiwa kwavo nechisarudzo chisina kuvhiyiwa chakaitwa nemaitiro) chingave chisingakwanise (kana chisina kuchinja). Kuti uedze kuratidza kuwanda kwechinetso chacho zvakanyatsotsanangurwa, zvimwe zvidzidzo zvakawanda zvechiitiko ichi zvakaitwa pamusoro pemakore anopindira, achishandisa nzira dzakasiyana-siyana dzekuongorora neurocognitve, maitiro akasiyana-siyana ekuperevhidza maitiro, uye nguva dzakasiyana-siyana yekutevera.
Kunyange zvazvo zvabuda kubva kune zvidzidzo izvi zvakasiyana-siyana (zvine chiitiko chekushaya njere kunopesana pakati pe3% uye 79%), hapana mubvunzo zvachose pamusoro pekuti chiitiko chacho chaicho kana kwete. Ndizvo. Uyezve, kukanganisika kwepfungwa kune ngozi chaiyo nekuvhiya kwepfungwa, nokuti chiitiko ichocho hachionekwi nemamwe marudzi ekuvhiyiwa kwemazamu, zvakadai sekuvhiyiwa kwepachiviri chevascular disease .
Chii Chinokonzera Kusakanganisika Kwekufungidzira Pashure Pokupererwa Kwechirwere?
Chikonzero chaiicho chekushaya njere kunotevera kushandiswa kwepamusoro kwekuvhiya hakuzivikanwi. Pano pane zvimwe zvinhu zvakawanda zvinogona kuzviunza.
Pakutanga yaifungidzirwa kuti inokonzerwa nekoduku kadiki yeropa kuuropi inobatanidza kushandiswa kwemwoyo-mapapu inoputika pombi. Zvisinei, zvidzidzo zvenguva pfupi zvakaratidza kuti kushandisa mamwe mazuva ano, "kubvisa pombi" kurapwa kwepabonde hakurevi kukanganisa kwekusagadzikana kwepfungwa.
Dzidziso iyo inonyanya kushandiswa mazuva ano ndeyokuti kushandiswa kwemwoyo uye aorta kunogona kubudisa maduku maduku eropa, anonzi microemboli, anogona kuenda kuuropi ndokukonzera kukanganisa ikoko. Zvidzidzo zvekuchera maitiro zvinoshandisa nzira dzakasiyana-siyana dzakagadziriswa dzakagadzirisa kuti mvura inoshandiswa neuropiyopi muuropi inowanzovapo panguva yekuvhiyiwa kwepamusoro, uye zvimwe zvidzidzo zvinoshandiswa kushandiswa kwema-pre-uye-post-operative MRI zvikwangwani zvakaratidza zviduku zvinyorwa zveschemic (zviduku zvishoma) muhuro hwevanhu vanoona kunzwisisa kunonoka. Zvisinei, kunyange zvidzidzo izvi zvakabereka migumisiro yakavhenganiswa, uye basa rekubatsira kwe microemboli harisati raonekwa.
Zvimwe zvinokonzera zvinokonzera, zvakadai sedonhe muropa, hyperthermia (yakakwirira masimba emhepo), nekuderedza kwenguva refu kwemajini mukati meropa, izvo zvose zvinogona kuitika panguva yekuvhiyiwa kwemoyo kana pakarepo mushure mekuita, zvinogonawo kuita basa.
Izvo zvatinoziva ndezvekuti vanhu vane zviitiko zvakakonzerwa nehutachiona hwechirwere chetachiona zvinowanzoita kuti vasaziva kushaya njere. Izvi zvinokonzerwa nematambudziko zvinosanganisira zvirwere zvemakaroti e-carotid , makore akwegura, hypertension , uye nhoroondo yepfungwa yakapfuura.
Shoko Rinobva
Paunenge uchiita zvisarudzo zvikuru pamusoro pekurapa kwako, iwe unoda kuva nechokwadi chokuti chiremba wako ari kufunga nezvezvinogona kukanganisa uye zvigaro-kunyange izvo zvisingafadzi kutaura nezvazvo, zvakadai sedambudziko rekushaya njere.
Kana chiremba wako ari kukurudzira chirongwa chegoniyard inpass surgery, unofanira kufunga kuti une mhinduro dzemibvunzo inotevera:
- Kuvhiyiwa kwacho kunogona kuwedzera nguva yako yokurarama here, kana kuti kuri kuitwa nenzira yakanakisisa kungobvisa zviratidzo?
- Pane imwe nzira inogona kubatsira, yakadai semishonga , kana stent ?
- Ndezvipi zvinokonzera kukanganisa uye kubatsirwa kwezvimwe nzira?
- Kana iwe ukavhiyiwa uye uchiziva zviratidzo zvekuziva, chii chinonzi chiremba wako kuti uite navo, kukubatsira kuti uwanezve, nekukubatsira iwe nevadiwa vako kurarama kusvikira zviratidzo zvenyu zvichivandudza?
Kana chirwere ichi chiri kukurudzirwa uye hachina kufungidzirwa sechiitiko chekukurumidzira, ichi ndicho chisarudzo chekuti iwe unogona kufunga zvakasimba kuwana mhinduro yechipiri .
Kana iwe ukasarudza kuve nekuvhiyiwa kwepamusoro, ramba uchiyeuka kuti vazhinji vevanhu mune zvizhinji zvezviongorori izvi vakanga vasisina kuora simba kwavo kwepfungwa zvokuti vakaiona muhupenyu hwavo hwezuva nezuva, uye mune vazhinji vavo avo vakaita, kukanganisa kwavo kwekuziva kwakaguma kwakagadziriswa.
> Sources:
> Fontes MT, Swift RC, Phillips-Bute B, et al. Zvinyorwa zvekare zvekuziva nezvekugadzirisa shure kwekuvhiya kwechimiro. Anesth Analg 2013; 116: 435.
> Newman MF, Kirchner JL, Phillips-Bute B, et al. Yakareba kare Kuongorora kweEurocognitive Function Pashure peCoronary-artery Bypass Surgery. N Engl J Med 2001; 344: 395.
> Rudolph JL, Schreiber KA, Culley DJ, et al. Chiyero chePost-operative Cognitive Disfection After Cardiac Surgery: A Review System. Acta Anaesthesiol Scand 2010; 54: 663.
> Selnes OA, Grega MA, Bailey MM, et al. Cognition 6 Makore mushure mekuvhiya kana kurapa Kurapa kweCononary Artery Disease. Ann Neurol 2008; 63: 581.