Opaleshoni ya mtima ndi gawo lovuta lomwe limafuna zipangizo zolondola komanso zodalirika kuti zitsimikizire zotsatira zabwino za odwala. Pakati pa zipangizozi, ma suture amagwira ntchito yofunika kwambiri pakusunga umphumphu wa kukonza opaleshoni, makamaka pa njira zovuta zogwirira ntchito mitsempha yamagazi ndi mtima. M'nkhaniyi, tifufuza zida zabwino kwambiri zomangira ma suture a opaleshoni ya mtima, kuyang'ana kwambiri makhalidwe awo, ubwino wawo, ndi momwe amagwiritsidwira ntchito kuti athandize akatswiri azachipatala kusankha mwanzeru.
Chifukwa Chake Kusankha Zinthu Zoyenera Zokongoletsera N'kofunika
Mu opaleshoni ya mtima, kusankha nsalu yoyenera yomangira n’kofunika kwambiri chifukwa kumakhudza mwachindunji kupambana kwa opaleshoniyo komanso njira yochiritsira. Nsalu ziyenera kukhala zolimba mokwanira kuti zigwirizanitse minofu pamodzi pamene zikupanikizika komanso kukhala zofewa mokwanira kuti zisawononge. Kuphatikiza apo, ziyenera kukhala ndi makhalidwe abwino kwambiri ogwirira ntchito, kuchepetsa kukhudzana kwa minofu, komanso chitetezo chabwino cha mfundo kuti tipewe mavuto.
Zipangizo Zapamwamba Zotsukira Mitsempha ya Mtima
1.Zovala za Polyester
Polyester ndi chinthu chopangidwa, chosayamwa chomwe chimagwiritsidwa ntchito kwambiri mu opaleshoni ya mtima. Chimapereka mphamvu yolimba komanso mphamvu zabwino zogwirira ntchito, zomwe zimapangitsa kuti chikhale choyenera kwambiri pochiza matenda a mitsempha yamagazi komanso njira zosinthira ma valavu. Ma pulasitiki osokedwa ndi polyester amakondedwa kwambiri chifukwa cha kulimba kwawo komanso kuchepa kwa minofu, zomwe zimachepetsa chiopsezo cha kutupa. Mwachitsanzo, mu coronary artery bypass grafting (CABG), ma polyester sutures amathandiza kutsimikizira kulumikizana kotetezeka komanso kokhalitsa pakati pa ma grafts ndi mitsempha yamagazi yoyambira.
2.Zovala za Polypropylene
Polypropylene ndi njira ina yotchuka yogwiritsira ntchito matenda a mtima, yomwe imadziwika kuti ndi yosinthasintha komanso yogwirizana ndi thupi. Ndi chinthu chosayamwa, chomwe chingathandize pa opaleshoni yomwe imafuna chithandizo cha minofu kwa nthawi yayitali. Pamwamba pake posalala pamachepetsa kuvulala kwa minofu panthawi yopita, zomwe zimapangitsa kuti ikhale yoyenera kukonza mitsempha yamagazi mosavuta. Kukana kwa polypropylene ku matenda komanso kuchepa kwa magwiridwe antchito a minofu kumapangitsa kuti ikhale njira yabwino kwambiri yopangira opaleshoni monga kukonzanso aortic aneurysm.
3.Ma Suture a ePTFE (Expanded Polytetrafluoroethylene)
Ma suture a ePTFE ndi ofooka kwambiri pakusintha kwa mitsempha ya mtima, zomwe zimapangitsa kuti akhale chisankho chabwino kwambiri pakukonzanso mtima ndi mitsempha yamagazi. Ndi othandiza kwambiri pa opaleshoni yokhudza ma grafts opangidwa, chifukwa amapereka mgwirizano wabwino kwambiri ndi minofu komanso kupsinjika kochepa. Madokotala nthawi zambiri amasankha ePTFE chifukwa cha kuthekera kwake kuthana ndi ma anastomoses ovuta a mitsempha yamagazi popanda kudula makoma a mitsempha yamagazi, motero amaletsa mavuto pambuyo pa opaleshoni monga kutuluka magazi kudzera mu suture line.
Zovala Zoyamwa ndi Zosayamwa
Kumvetsetsa kusiyana pakati pa suture zomwe zimayamwa ndi zomwe sizimayamwa ndikofunikira posankha zinthu zoyenera zochizira matenda a mtima.
•Zovala Zomunyamulika:Ma strap awa amasweka pang'onopang'ono m'thupi ndipo amayamwa pakapita nthawi. Nthawi zambiri amagwiritsidwa ntchito pamene chithandizo cha mabala kwakanthawi chili chokwanira. Komabe, mu opaleshoni ya mtima, ma strap omwe amatha kuyamwa sapezeka kawirikawiri chifukwa sapereka chithandizo chokhazikika chofunikira pakukonza kofunikira.
•Zovala Zosaphwanyidwa:Monga momwe dzinalo likusonyezera, ma stitch awa adapangidwa kuti azikhalabe m'thupi kwamuyaya kapena mpaka atachotsedwa. Ma stitch osayamwa monga polyester, polypropylene, ndi ePTFE ndi omwe amagwiritsidwa ntchito kwambiri pochiza matenda a mtima, zomwe zimapangitsa kuti mtima ukhale wolimba kwa nthawi yayitali komanso kuchepetsa chiopsezo cha kufalikira kwa aneurysmal.
Udindo wa Kukula kwa Suture mu Opaleshoni ya Mtima
Kusankha kukula koyenera kwa suture n'kofunika mofanana ndi nsalu yokhayo. Mu opaleshoni ya mtima, makulidwe a suture ochepa (monga 6-0 kapena 7-0) nthawi zambiri amagwiritsidwa ntchito chifukwa amachepetsa kuvulala kwa minofu ndikuwonjezera kulondola, makamaka m'mitsempha yofewa. Komabe, makulidwe akuluakulu angagwiritsidwe ntchito m'malo omwe amafunikira mphamvu yowonjezera ndi chithandizo, monga pokonza aorta.
Phunziro la Nkhani: Kupambana mu Coronary Artery Bypass Grafting (CABG)
Kafukufuku wokhudza odwala a CABG adawonetsa kuti ma stitch a polyester amathandiza kwambiri pakukonza bwino ma stitch. Madokotala opaleshoni adawona kuti mphamvu yayikulu yogwira ntchito ya polyester komanso kuchepa kwa minofu kunathandizira kuchepetsa mavuto omwe amabwera pambuyo pa opaleshoni komanso kusintha kwa ma stitch onse. Umboni uwu ukuwonetsa kuti zinthuzo ndizoyenera kugwiritsa ntchito njira zofunika kwambiri zochizira matenda a mtima pomwe ma stitch olimba komanso odalirika ndi ofunikira.
Malangizo Osungira Umphumphu wa Suture
Kugwira bwino ntchito zomangira mano panthawi ya opaleshoni kungakhudze kwambiri zotsatira zake. Madokotala ayenera kupewa kupsinjika kwambiri akamamanga mfundo, chifukwa izi zingayambitse kuwonongeka kwa minofu kapena kusweka kwa mano. Kuphatikiza apo, kuonetsetsa kuti mano sakugwira bwino ntchito komanso kugwiritsa ntchito njira zoyenera zomangira mfundo kungathandize kusunga kapangidwe ka mano, ndikuwonjezera magwiridwe antchito awo panthawi yochira.
Tsogolo la Zida Zopangira Ma Suture mu Opaleshoni ya Mtima
Kupita patsogolo kwa ukadaulo wa suture kukusintha nthawi zonse, makamaka pakukweza chitetezo cha odwala ndikukweza zotsatira za opaleshoni. Zatsopano monga zophimba mabakiteriya ndi suture zogwira ntchito zomwe zimalimbikitsa machiritso zikufufuzidwa pakadali pano mu ntchito za mtima. Cholinga cha izi ndi kuchepetsa kuchuluka kwa matenda ndikulimbikitsa kulumikizana bwino ndi minofu, zomwe zikupereka mwayi wosangalatsa wamtsogolo wa opaleshoni ya mtima.
Kusankha nsalu yoyenera yopangira opaleshoni ya mtima ndi chisankho chofunikira chomwe chingakhudze kwambiri zotsatira za odwala. Zipangizo monga polyester, polypropylene, ndi ePTFE zimapereka mphamvu zabwino kwambiri, kulimba, komanso kuchepa kwa minofu, zomwe zimapangitsa kuti zikhale zoyenera kwambiri pakuchita opaleshoni yovuta ya mtima. Pomvetsetsa mawonekedwe apadera a nsalu iyi ndikuganizira zinthu monga kukula kwa nsalu ndi njira zogwirira ntchito, madokotala ochita opaleshoni amatha kupanga zisankho zodziwika bwino zomwe zimapangitsa kuti opaleshoni ipambane ndikulimbikitsa kuchira bwino.
Kwa akatswiri azaumoyo omwe akufuna kukonza njira zawo zochitira opaleshoni ndi zotsatira zake, kuthera nthawi posankha zinthu zoyenera zomangira n'kofunika. Kaya mukukonza nthawi zonse kapena kukonza mitsempha yamagazi, kumangirira bwino kungathandize kwambiri.
Nthawi yotumizira: Novembala-08-2024
