Mune chirwere chegononiyasi inoshandiswa pakuvhiyiwa - inonziwo chirongwa chegoni inoputirana, kana CABG - vashandi vanovhiya vanobatanidza mishonga ine utano kana mvere kune chirwere chinorwara chine chirwere , kune dzimwe nzvimbo dzakachengetedzwa nemakanda . Iyi nzira inobvumira ropa kudarika chikamu chetachiona chetari uye inovandudza kugoverwa kweropa kusvika pamwoyo wemisungo.
Ndiani Anofanira Kuwana Coronary Artery Bypass Surgery?
Kuvhiyiwa kwepamusoro kunoshanda zvikuru mukuvandudza zviratidzo zvema angina kana iwe wakagadzikana angina .
Kana iwe uine mazamu akakura mumaketari akawanda emakoronary, kana kuvhara mukati mutsva remakoroni (coronary artery) yakasara (iyo ndiyo inonyanya kukosha yerinari), kana kuti yakaoma mwoyo musumbu (chirwere chinonzi cardiomyopathy, chaunogona kuverenga pamusoro apa ), kupfurikidza nekuvhiya inogona kureba hupenyu hwako kana ichienzaniswa nekurapa neangioplasty uye kunhuwa, kana kuti kurapa kurapwa chete. Kuvhiyiwa kwepabonde kunogona kubatsirawo kune vanhu vane acon coronary syndrome .
Nzira Dzokuvhiya Inogadzirwa Sei?
Kuvhiyiwa kwepabonde kunoitwa pasi pesheti yeanesthesia. Chiremba anovhiya chifukidzo chechifuva kuti azarure chifukidzo, zvino inodzivisa mwoyo kushandisa makemikari kana kutonhora (kunonzi hypothermia) kuitira kuti aigona kuisa ma grafts pasina mwoyo unofamba-famba. Kupararira kweropa kunochengetedzwa, apo mwoyo wakamira, uchishandisa cardiopulmonary bypass machine. Kamwe kamashidziro akabatanidzwa mwoyo inotanga zvakare.
Mishonga inoshandiswa panguva yekuvhiyiwa inowanzobva mumakumbo kubva kumakumbo (saphenous veins), kana arteri kubva mudanda rechifuva (mukati mamamita arteri).
Graft anoshandisa arteri kazhinji inopera kwenguva yakareba kupfuura mabashani anoshandisa mitsetse, uye arteri grafts haigoni kukura stenosis, sezvinoita mifananidzo yemagetsi. Saka mukati memamita arteri grafts inofanira kushandiswa nguva dzose kana zvichikwanisika kuita izvi (sekusarudzwa nemararamiro emurwere). Izvo zvakajairika kune vein grafts kukudziridza zviputika nekuda kwehutachiona hwehutachiona mumakore gumi kusvika kune gumi nemaviri ekuvhiya.
Mumakore achangobva kupfuura maitiro matsva ekuvhiya anovandudzwa ari kubudiswa "anowanzosvitsa chirwere chekuvhiya." Izvi zvishoma nezvishoma zvinopindira zvinosanganisira zviduku zviduku, uye dzinodzivisa kushandiswa kwemashandisi ekudhinda. Zvinosuruvarisa, zvishoma nezvishoma kuvhiringidzika kwepamusoro kwekuvhiya kwakakosha chete kune varwere vane artholo dzinorwara dzinogona kusvika nyore nyore nenzira iyi.
Ndezvipi Zvinetso Zvikuru Zvikuru?
Arteri yeCononary kupfurikidza nekuvhiyiwa ndiyo nzira huru yekuvhiya, uye varwere kazhinji havazodzokere ku "chimiro" kwemavhiki akawanda kana mwedzi mushure mekuvhiyiwa. Zvinowanzosangana nehurombo husina simba, utera, uye kurwadziwa pamusoro pekuvharwa kwevhiki shomanana. Kushungurudzika kunoonekwa kune mumwe wevatatu vatatu mushure mekuvhiyiwa, uye kunze kwekunge kuora mwoyo kuchizivikanwa uye kuchibatwa, kunogona kutungamirira kune nguva yakareba yekudzikinura nguva.
Zvimwe zvinetso zvinogona kuitika mushure mokuvhiyiwa kwepamusoro pemapurisa zvinosanganisira myocardial infarction munguva kana kuti mushure mekuvhiyiwa (muzasi pe5% yevarwere), kuora mwoyo kwemutsipa wemwoyo (uyo unowanzova wenguva pfupi), arrhythmias (zvikurukuru inery fibrillation), chiremera chisingaiti (kushanduka kwemvura pakati pe mapapu uye rusvingo rwechifuva), utachiona hwekudzivirira nzvimbo, uye chirwere chekufunga (kufunga) chirwere chakanzi " mupombi " (mushure mokunge "cardiopulmonary" pp "pump" inotsigira kupararira panguva yekubatanidza, uye kuti vamwe vakafunga kuti ane mutoro wezvinhu izvi zvinonzwisisika).
Nokuti kupfurikidza nekuvhiyiwa kune njodzi dzakakomba dzakadaro, kazhinji zvinowanikwa kune varwere vanogona kunge vaine hupenyu hwavo kwenguva yakareba nekuvhiyiwa kana avo vane zviratidzo zvema angina vanoramba vachitsvaga pasinei nekuedza kwechisimba pakurapa.
Sources:
> Eagle, KA, Guyton, RA, Davidoff, R, et al. ACC / AHA 2004 nhungamiro inoshandiswa pakugadzirisa arteri pamusana pekuvhiyiwa kwekutsvaga: chiitiko cheAmerican College of Cardiology / American Heart Association Task Force pamusoro pekushandisa mazano (Komiti yekuvandudza Mirayiridzo ye1999 yeCononary Artery Bypass Graft Surgery). Circulation 2004; 110: e340.