Kusokoneza mtima - chomwe chiri ndi momwe zingathandizire - mafunso ofunika kwa anthu omwe ali ndi matenda a mtima . Ndili ndi matendawa, opaleshoniyi ingakhale chiyembekezo chokha cha ntchito yonse.
Mtima wapitirira - ntchito iyi ndi yotani?
Pafupifupi zaka 45 zapitazo, palibe yemwe anali ndi funso: kusokoneza mtima - kodi ndi chiyani chomwe chikuchitika? Zomwe zinayamba kuchitika m'mbaliyi, zochitidwa ndi dokotala wa opaleshoni wa Soviet scientist-cardiac Kolesov VI, anakayikira ngakhale kuzunzidwa. Malingaliro a sayansi kuti pogwiritsa ntchito shunt ndi kotheka kupanga ntchito kuti m'malo mwa zombo zomwe zimakhudzidwa ndi atherosclerosis zimawoneka zosangalatsa. Mtima wa opaleshoni wa opaleshoni tsopano ukupulumutsa miyoyo zikwi makumi asanu chaka chilichonse. Ntchitoyi ndi yotchuka komanso yothandiza, choncho imayendetsedwa m'mayiko ambiri padziko lapansi.
Kumvetsetsa funso: kusokoneza mtima - chifukwa chake ndi chiyani, munthu ayenera kuganizira cholinga chake. Opaleshoni imagwiritsidwa ntchito pa matenda omwe amawononga mitsempha ya magazi ndikuphwanya magazi. Chofunikira cha kulowerera ndikugona pa kukhazikitsa njira yatsopano ya magazi, yomwe idzalowe m'malo mwa gawolo. Pa cholinga chimenechi, amagwiritsidwa ntchito kuchokera ku mitsempha ya wodwala kapena mitsempha. Kupewa mitsempha kumakhala kosavuta kulenga, komabe sizowonjezereka ndipo imatha kutsekedwa patatha mwezi mutatha opaleshoni. Ndi bwino kugwiritsa ntchito mankhwala osokoneza bongo, koma opaleshoniyi ndi yowonjezereka komanso sizingatheke.
Zolemba za Koronary
Cholesterol imaikidwa pamakoma a ziwiya zimachepetsa kuchepa kwa chombocho. Zotsatira zake, magazi amafika ku ziwalo zosakwanira. Ngati kuwala kwa mitsempha ya mtima kumakhala kochepa, kungayambitse angina ndi myocardial infarction. Kuwonjezera kuunika kwa zitsulo, mankhwala othandizira mankhwala, coronary angioplasty, ndi kugwilitsila nchito phokoso. Ngati vutoli liri lovuta, opaleshoni ya mtima akhoza kupita opaleshoni. Aortocoronary overp grafting amasonyezedwa m'nkhani zoterezi:
- Angina yaikulu, imene wodwala sangathe kudzitumikira yekha;
- mavuto ndi ziwiya zambiri zamakono nthawi imodzi (zoposa zitatu);
- zida zowonongeka ziposa 75%;
- kuphatikizapo atherosclerosis ndi mtima wodwalayo .
Nchifukwa chiyani ndizoopsa kudutsa mtima?
Pogwiritsa ntchito funsoli: Kusokoneza mtima, chomwe chiri, nthawi zambiri mumakhala funso lokhudza chitetezo cha njira iyi. Pamene opaleshoni ya opaleshoni ya opaleshoni amafunsidwa ngati ndi owopsa kupyola mtima, amavomereza kuti si owopsa kuposa ntchito zina. Ngakhale kuti kupaleshoni kotereku kuli kovuta, kupita patsogolo kwamakono mu zamankhwala ndi teknoloji kumapangitsa kuti zikhale zotheka kuzichita bwinobwino monga momwe zingathere. Mu nthawi yotsatira, chiopsezo cha mavuto chimakula kwa odwala omwe ali ndi co-morbidities:
- kunenepa kwambiri;
- shuga;
- mkulu wa cholesterol owopsa;
- kuthamanga kwa magazi;
- matenda aakulu a impso.
Malinga ndi momwe opaleshoniyo imakhalira komanso thanzi labwino, mavuto amatha kuchitika nthawi zina: kutupa ndi kuphulika pa msoko, kutuluka m'magazi, matenda a mtima. Zosavuta kwambiri, koma zovuta zingakhalepo:
- pericarditis - njira yotupa pa memphane ya mtima;
- zolephera mu mtima wamtima;
- vuto lalikulu la mtima;
- phlebitis - kutupa kwa makoma a mitsempha;
- kupweteka;
- Pleuritis - kutupa kwa pleura ya mapapo;
- kuchepa kwa lumen mu shunt.
Mtima wapitirira - ndi angati omwe akukhala atatha opaleshoni?
Odwala amene amachitidwa opaleshoni ya mtima nthawi zonse amakhala ndi chidwi ndi angati omwe amakhala ndi moyo pambuyo pa opaleshoni ya mtima. Opaleshoni ya opaleshoni ya mtima imatcha chiwerengero chazaka khumi ndi zisanu, koma fotokozerani kuti m'tsogolomu chilichonse chimadalira wodwalayo komanso thanzi lake. Pokhala ndi khalidwe loyenerera komanso kutsatila malingaliro onse, wodwalayo akhoza kukhala ndi zaka 20-25. Pambuyo pa izi, chidziwitso cha mtima chimayesanso.
Kodi mtima umapitirira bwanji?
Asanayambe kugwira ntchito, wodwalayo amadzimangirira, chubu imayikidwa mu trachea kuti iwononge kupuma, ndipo kafukufuku amaikidwa m'mimba kuti asaponyedwe m'mimba m'mapapo.
Kuonjezera pazigawo zowonjezereka:
- Chifuwa chimatsegulidwa.
- Pochita opaleshoni pamtima wosayenerera, magetsi akugwiritsidwa ntchito, ndipo pamene ikugwira ntchito, dera lozungulira limayikidwa.
- Tengani chotengera chomwe chidzakhala ngati shunt.
- Mbali imodzi ya chombocho imagwirizanitsidwa ndi aorta, ina kumalo olowera pansi pa malo okhudzidwa.
- Onani mtundu wa shunt.
- Chotsani chipangizo chopangira makina.
- Sewani zitsamba.
Coronary ikudutsa mkati mwa mtima
Mitsempha ya Coronary yodutsa ma grafts ndi opaleshoni yomwe imakhudza ntchito zovuta komanso zautali. Zambiri mwa ntchitozi zimagwiritsidwa ntchito pamtima wosagwira ntchito pogwiritsira ntchito kayendedwe kozungulira. Njira imeneyi imaonedwa ngati yotetezeka komanso yovomerezeka kuposa opaleshoni yamtima, koma imapangitsa kuti pakhale mavuto. Kugwiritsira ntchito chipangizochi kungayambitse thupi kuti liwonongeke.
- mpweya;
- mavuto;
- kupsinjika kwa impso ndi ziwiya za ubongo;
- kusowa mpweya kwa ntchito za ziwalo.
Aortocoronary opitirira opaleshoni pa mtima wogwira ntchito
Kupititsa patsogolo magetsi popanda kubvomeleza kumapangitsa kupeŵa mavuto omwe amabwera chifukwa chogwiritsa ntchito chipangizo chamankhwala. Kugwira ntchito pa mtima wokonda kumafuna chidziwitso chakuya ndi luso lochokera kwa dokotalayo. Kusungunuka kwa mitsempha ya m'mimba kumapangidwira mthupi la mtima, zomwe zimachepetsa chiopsezo cha matenda omwe amachititsa kuti asamayambe kugwira ntchito, amachepetsa kupuma komanso kutulutsa wodwalayo kuchipatala.
Kuzungulira kwa Coronary popanda kutsegula kwa thoracic
Opaleshoni yochipatala yoposa ya opaleshoni imachitidwa popanda kusakhulupirika kwa chifuwa. Ntchitoyi ndi yamakono komanso yotetezeka ndipo imapezeka muzipatala za ku Ulaya. Pambuyo pa opaleshoni yotere, balala limachiritsidwa mwamsanga ndipo thupi limabwezeretsedwa. Chofunika kwambiri cha njirayi ndi kuchita opaleshoni kudzera muzitsamba zochepa. Pochita opaleshoni yotereyi, pamafunika njira yapadera yachipatala yomwe imalola kuti kugwiritsidwa ntchito moyenera mu thupi la munthu kukhale koyenera.
Kukonzanso pambuyo pochita opaleshoni ya mtima
Kufotokozera za: Kusokoneza mtima, chomwe chiri, madokotala amachititsa kuti nthawi yowonongeka ikwaniritsidwe, zomwe zimadalira momwe wodwalayo akuyendera.
Kukhazikitsidwa pambuyo pa mtima kumaphatikizapo masewero olimbitsa thupi ndi ntchito:
- Zochita zopuma. Kuyambira masiku oyambirira pambuyo pa opaleshoni. Zochita zothandizira kubwezeretsa mapapo.
- Zochita zathupi. Yambani ndi masitepe angapo m'dindo tsiku loyamba loperekera ntchito ndipo pang'onopang'ono kukhala zovuta.
- Kutsegula m'mimba mothandizidwa ndi nebulizer ndi kuwonjezereka kwa mankhwala opweteka kapena opanga mankhwala.
- Laser intravenous or ozone therapy.
- Mitundu yosiyanasiyana ya kusisita.
- Ultravonotrophy ndi Pantovegin kapena Lidase.
- Magnetotherapy chifukwa cha zotsatira za padera.
- Dry carbonic baths.
Mitsempha ya Coronary imadutsa ma grafts - nthawi yotsatira
Pambuyo pa opaleshoni pamtima, wodwalayo akuyang'anitsitsa mosamala kwa miyezi 2-3. Wodwalayo akhoza kukhalabe m'chipinda cholandirira kwambiri masiku 10 oyambirira, zomwe zimadalira msanga, kupuma komanso kusakhala ndi mavuto. Mu nthawi imene anesthesia ikugwira ntchito, wodwalayo amaikidwa ndi miyendo kuti asatenge kayendedwe kosayembekezereka. Maola oyambirira pambuyo pa opaleshoni wodwalayo akhoza kupuma ndi chithandizo cha chipangizochi, chomwe chimachotsedwa pamapeto a tsiku loyamba.
Mu chipatala, ziwalo zimakonzedwa tsiku ndi tsiku ndipo chikhalidwe chawo chimayang'aniridwa. Kupweteka pang'ono, kufiira ndi kumverera kwa khungu khungu pamalo otsekemera ndi zachilendo kwa nthawiyi. Ngati mitsempha yamakono yowonjezereka opaleshoni yazitsulo idawayendera bwino, ndiye pa tsiku la 7-8 wodwalayo achotsedwa ku sutures. Pambuyo pa izi, wodwalayo akhoza kuloledwa kusamba. Pofuna kuchiritsa mafupa a sternum, wodwalayo akulimbikitsidwa kuvala corset kwa miyezi isanu ndi umodzi, kugona panthawiyi n'kotheka kumbuyo.
Moyo pambuyo pa opaleshoni yopitirira malire
Mitsempha ya Coronary yowonongeka kumtengowo imapindula ngati wodwalayo abwerera ku miyoyo miyezi ingapo pambuyo pake.
Nthawi ndi umoyo wa moyo zidzadalira kumatsatira lamulo la dokotala:
- Tengani mankhwala omwe dokotala akuuzidwa ndipo musamadzipange mankhwala.
- Musasute.
- Gwiritsani ntchito zakudya zoyenera.
- Pambuyo pa opaleshoni, ndikubweranso kamodzi pa chaka kupita kuchipatala.
- Chitani zochitika zomwe zingatheke, pewani kuwonjezera.
Kudya pambuyo pa mtima kupyolera opaleshoni
Panthawi yomwe akugwira ntchito, odwala omwe amagwiritsa ntchito mitsempha yowonjezereka, amafunika kuyang'anira bwino zakudya zawo. Pachifukwa ichi, zimadalira zaka zambiri za moyo zomwe angathe kukhala nazo. Zakudyazi ziyenera kupangidwa kuti zisawonongeke kulemera kwakukulu komanso kuikidwa kwa cholesterol choipa pamakoma a zombo.
Pambuyo pa opaleshoni, odwala amalangizidwa kutsatira malangizo awa:
- Pezani kuchuluka kwa shuga, m'malo mwake mukhale ndi stevia.
- Mafuta ayenera kukhala otsika kwambiri.
- Kuchokera ku tchizi ndikofunikira kupereka choyenera kwa zakudya za tchizi ndi tofu.
- Kuchokera ku nyama, nyama ya soya, nkhuku yoyera, nkhuku, ndi mafuta ochepa amaloledwa.
- Nkhosa zimangokhala manga koma mpunga.
- Kuwonjezera apo, gwiritsani ntchito mafuta a nsomba.
- Kuchokera ku nsomba, mukhoza kudya nsomba zonenepa komanso nthawi zina zamchere.
- Za mafuta, ndi zofunika kusiya zonse koma masamba aamwali azitona mafuta ozizira.
- Ndi bwino kuchepetsa kuchuluka kwa mchere.
- Ndi bwino kudya masamba ndi zipatso zatsopano.
Maulendo pafupi tsiku lililonse
- Chakudya cham'mawa - omelo opangidwa ndi azungu, saladi ya chipatso ndi yogamu wopanda mafuta.
- Chakudya chamadzulo chachiwiri ndi kanyumba kanyumba kosakhala mafuta.
- Chakudya ndi supu ya zamasamba ndi mkate wakuda wakuda, mphodza za masamba.
- Maapulo ophika mikate.
- Mgonero - zikondamoyo za masamba, nsomba za mafuta ochepa kapena nkhuku zoyera.