Shunting moyo. Kuvhiringidza mwoyo shure kwekurwadziwa kwepfungwa. Mwoyo unopfuura: murwere mhinduro

Chirongwa cheAorto-coronary parpass chirwere (CABG) chirwere chinorondedzerwa munyaya yechironary heart disease. Kuwedzerwa kwechiedza chemariti inopa moyo neropa (stenosis), inokonzerwa nokuumbwa kwe atherosclerotic plaques mavari, yakazara nemigumisiro yakaipa kumurwere. Apo ropa rinopa kumwoyo wemisumbu rinoparadzaniswa, myocardium iri pasi pehuwandu hweropa hunodikanwa pakuita basa, izvo zvinozopedzisira zvichitungamirira kukuvadza uye kupera simba. Muchiitiko ichi, panguva yebasa remuviri munhu anoona angina pectoris (kurwadziwa shure kwe sternum).

Chirwere chinowanzoonekwa pakati pezvirwere zvepfungwa dzose ischemic heart disease (IHD). Haana kurega vakadzi kana varume. Kusava neropa kunogona kutungamirira kune necrosis yechikamu chemoyo wemisvo - myocardial infarction, inotyisidzira zvinetso zvakakomba, kunyange rufu. Kuvhara mwoyo mushure mekurwa kwepfungwa kuitira kuti kubvisa migumisiro yaro, nekudzivirira kwepfungwa yepamwoyo, pamwe chete nezvimwe zvipatara zveHD, inorayirwa kana, nekubatsira kwekuchengetedza kwakagadzirisa, chiitiko chaicho chakanga chisina kubudirira. Iyi ndiyo inonyanya kushandiswa, asi iyo yakakwana nzira yekudzorera kuteura ropa. Muchikamu chino tichakutaurira kuti chii chinonzi aortocoronary pedo ye mwoyo uye kuti ungagadzirira sei.

Basa iri chii?

CABG inogona kuitika nematambudziko akawanda kana asina kuroorwa emirara. Munguva yekushanda mumidziyo iyo, apo ropa rinoputsika rakaputsika, zvigadzirisa kusavhara-mavara. Izvi zvinoitwa nekubatanidza mishonga inopa utano kumakoronary coronary. Somugumisiro, ropa rinoyerera rinofanira kudarika nzvimbo yekuvhara kana kupera. Kuderedza mwoyo, nenzira iyo, inobvumira kuzara kweropa zvakakwana kumutsipa wemwoyo.

Kugadzirira kushanda

Zvimwe zvakakosha kuti kubudirira kweCABG kupfuura basa reboka rechiremba, vane mafungire akanaka emunhu kune zvakaguma zvakanaka zvekurapa. Kuvhiya uku hakuna ngozi kupfuura mamwe maitiro ekupindira kwokuvhiya, asi inoda kutanga kugadzirira kugadzirira. Chokutanga, pamwe nepamusoro pehupi hupi hwehupenyu, murwere anotumirwa kunongororwa, iyo inosanganisira ECG, ultrasound, kuongororwa kwe laboratori uye kuongororwa, pamwe nekuongororwa kwemamiriro ose. Iwe uchazofanirawo kuita angiography (tickoronography). Iyi nzira yekuongorora inoita kuti zvikwanise kutsvaga mamiriro emaritiro ekudyisa mwoyo musungo, kuratidzira nzvimbo chaiyo yekuumbwa kwechidimbu uye dhigirii rekusimudzira. Tungamira chidzidzo uchishandisa X-ray midziyo (mumidziyo inorohwa X-ray kusiyanisa zvinhu, uye tora mufananidzo).

Chimwe chezviongorori zvinotarirwa zvinoitwa muchipatara, chikamu-kunze. Munhu anowanzoiswa muchipatara vhiki imwe isati yasvika, uye panguva imwe chete kugadzirira kwakagadzirira kunotanga. Chimwe chezvikamu zvaro zvakakosha ndeyekugadzirwa kwemuitiro unopfurikidza wokufema, uyo huchazotevera huripo.

Operation

Sezvatotaurwa, urongwa hwehutano huripo huchinyorwa huchiitwa nechinangwa chekuumba imwe nzira yakapfuura nenzira nerubatsiro rwekuvhara kubva kune aorta kuenda kune ariti, izvo zvichaita kuti zvikwanise kudarika nzvimbo yakachengetedzwa uye kudzorera ropa. Kazhinji kazhinji, shunt inova mishonga yemagetsi, nokuti ine kumira kwakanaka kune atherosclerosis nekuda kwezvakasiyana zvayo uye inogara kwenguva refu sey shunt. Mune zvimwe zviitiko, shandisa chirwere chema radial kana mutsara unopinza wehudyu.

Mwoyo unoputika unogona kuva usina imwe, kaviri, katatu nezvakadaro. Izvo zvinoenderana nekuti ingani midziyo yemakonononi kune iko kugadzirisa. Nenzira, izvi hazvirevi nehuwandu hwekuratidzwa kwechirwere. Nokudaro, murwere ane chirwere chakakomba chirwere chetachiona chingada kuiswa kwechimwe chete shunt, uye munhu ane utano husingagoni kunge ane maviri kana matatu. Kuvhima kunoitwa pamwoyo wakavhara pasi peanesthesia yakawanda, zvichienderana nehuwandu hwekuoma inogona kupedza maawa matatu kusvika matanhatu.

Mitatu mitatu yeCABG

1. Kushandisa zvigadzirwa zvekupararira kwekugadzira. Kana iri sarudzo inoshandiswa, ipapo mwoyo wemurwere wakamira.
2. Pamwoyo unoshanda. Iyi nzira inokubvumira kuti upedze kushanda nekukurumidza uye unoderedza mikana yezvinetso, asi zvinoda kuvapo kwechiremba chiremba zvakawanda.
3. Minimally invasive (kana kana pasina chimiro chekuparadzira maitiro). Iyi inyanzvi itsva, iyo inoita kuti zvikwanise kuderedza kurasikirwa kweropa panguva yekupindira, kuti kuderedze njodzi yezvinetso zvinotapukira. Pashure peCABG yakadaro, murwere anobva atorazve, nguva inoshandiswa muchipatara inopera kusvika mumazuva mashanu kusvika gumi.

Iko kunofanira kutaurwa kuti chero upi noupi hwekuvhiya mwoyo huine dzimwe njodzi. Zvisinei, nekuda kwezvigadzirwa zvemazuva ano, teknolojia yepamusoro uye kushandiswa kwakawanda, zvinogona kuderedzwa. Mwoyo wepachikapu unofadza zvakanaka kwazvo maererano nemigumisiro yakanaka. Maonero evanhu vakawanda avo vakashanda zvakadaro vanobatwa nemashoko ekuonga kuvanachiremba. Uye zvakadaro hurumende inobva kune mumwe munhu maitiro emuurwere uye kuchipatara chinyorwa chechirwere.

Postoperative period

Kamwe mushure mekuvhiyiwa, munhu ari mukutarisira kwakanyanya, ndiko kuripo kuti kunyanya kupora kwemapapu uye mwoyo musumbu inotanga. Zvinonyanya kukosha kuti panguva ino inoshanda yakanyatsofema. Nguva yekugara mukutarisira kwakasimba inogona kusvika kumasvi gumi, inobva pane kuti mwoyo wakanga wapfuura sei. Kuvandudza zvakare kunotanga muchipatara, uye zvino inopfuurira mune imwe nzvimbo yekuvandudza. Zvisungo pamapfupa uye pavakatora mashoko acho, zvinoshambidzwa nevanoridzivirira kuti vasaparara nekusvibiswa. Vanotorwa pane imwe nzvimbo pazuva rechinomwe, kana mavanga acho aporesa zvakabudirira.

Kuvandudza

Mune dzimwe nzvimbo kwaive nemakumbo, kwekanguva, kurwadziwa uye kupisa zvichaonekwa. Apo mavanga acho akangonoka (pashure pevhiki imwe chete kana maviri), murwere anobvumirwa kushamba. Zvinotora nguva yakawanda kurapa pfupa re sternum - mwedzi mana kusvika kumatanhatu. Iwe unogona kupfeka chikwama chechipfuva kuti uwedzere kuitika uku. Mumavhiki ekutanga mana kusvika manomwe pamakumbo, unofanirwa kupfeka zvikwaniro zvakasununguka zvisungo kuti urege kuzvimba. Panguva ino, iwe unofanirwa kuzvichengetedza kubva pakuedza kwakasimba mumuviri.

Pamusana pokurasikirwa kweropa, izvo zvakaitika panguva yekushanda, munhu angaita kuti anemia iwedzere. Zvisinei, hapana kunyanya kukodzera kunodiwa munyaya iyi. Zvakakwana kungotevera kudya kunobva pakushandiswa kwezvokudya zvinowedzera yakawanda yesimbi, uye mwedzi gare gare hemoglobin inodzokera kune yakajairika. Murwere anofanira kuedza kuedza kufema kufema. Kuti uite izvi, ita maitiro ekufema chaiwo, ayo akadzidziswa asati avhiyiwa. Uyewo nekubatsira kwavo unogona kudzivisa pneumonia.

Mushure mekuvhara kwemoyo, chifuva chinoonekwa. Usatya izvi. Kuchema ndicho chikamu chakakosha chekuvandudza. Inogona kuderedzwa nekusimudzira muchinwe kana bhora rinopikisana nebhokisi. Kushandurwa kakawanda muchinzvimbo chemuviri kuchakurumidza kuporesa. Vanachiremba vanowanzotsanangura nzira yekushandura uye mune zviitiko zvipi zvakakosha.

Kuvandudza kunowirirana nekuwedzera kuwedzera mukuita basa. Apo murwere anorega kutambudza angina, anopiwa motokari yemodhi inodiwa. Chokutanga, vanhu vanobvumirwa kufamba zvishoma (zuva kusvika kune imwe khilomitha) pamwe chete negwara rechipatara, uye zvishoma nezvishoma kuwedzera kwemitoro, uye mushure mechinguva zvinenge zvese zvibvumirano zvabviswa.

Mushure mekubuda

Vanhu avo vakave nemwoyo inopfuura kupora vanokurudzirwa kuti vashanyire sanatorium mushure mokuguma kwekurapa kwepati. Mushure mekupera kwehafu nehafu kumwedzi miviri, unogona kudzokera kubasa. Panguva imwe chete, kuedza kunetseka kunofanira kuitwa kuti uongorore hutano hwekudzivirirwa kwepamusoro uye kuona kuti mwoyo unopa sei oxygen. Kana pasina kuchinja kweEECG, murwere haanzwi kurwadziwa panguva yekuedzwa, zvinoreva kuti kudzorerwa kunogona kuonekwa sekubudirira.

Mwoyo unopfuura: mutengo

Basa racho rine unyanzvi hwepamusoro-soro, saka rine mari yakawanda yakakwana, iyo inobva pane nhamba inodikanwa yekudzivirira, nzira yekupindira, ikozvino hutano hwomurwere, chiyero chenyaradzo chichagoverwa mushure meCABG. Chimwe chikonzero chinokosha chemutengo ndicho chiyero chemakirini apo chirwere chepfungwa chinoshandiswa pakuvhiya chichaitwa. Zvechokwadi, zvichange zvisingabatsiri kuita chirwere mune chipatara chechipatara chenguva dzose pane mune imwe kliniki yega yega. Pakati peMoscow, mari yeCAB inofanirwa pakati peRubles 150 kusvika ku0000, muIsrael - 23-30 000 madhora, mumakiriniki muGermany mutengo wekuvhiya uku unotangira kubva kuma25 euro.

Mwoyo unopfuura: murwere mhinduro

Vanhu vazhinji vanocherechedza kuti kupora shure kweCABG kwakaoma. Varwere vanoona kuoma kufema, kunyanya usiku. Vamwe vanoti kwekanguva vakamanikidzwa kurara hafu-vagere. Asi mushure mechinguva, vanhu vanorega kunzwa kurwadziwa mushure mehumbu, pane imwe mwedzi kune kuwedzera kukuru muhurumende, simba idzodzo rinopfuurira. Varwere vakazovhiyiwa makore mashomanana apfuura vanonzi vanonzwa zvakanaka, pamwe chete nehutano. Vamwe vanonyunyuta kuti vaifanira kufungisisa mararamiro avo, kurega kusvuta, uye kutevera kudya. Asi kazhinji, kurega tsika dzakaipa dzinofanira kuteverwa nevanhu vose, uye kwete avo chete vakaitwa kuvhiyiwa mwoyo.

Mukupedzisa

Mune zvimwe zviitiko, chirwere chete chinogona kuponesa upenyu. Mwoyo wakaipisisa wakaitwa munguva unogona kudzivirira kurwisa kwemwoyo nemigumisiro yakakomba, dzorera munhu kune basa rakazara. Iva noutano!