Utyando lwentliziyo luyintsimi entsonkothileyo efuna izixhobo ezichanekileyo nezithembekileyo ukuqinisekisa iziphumo ezilungileyo zesigulana. Phakathi kwezi zinto, i-sutures idlala indima ebalulekileyo ekugcineni ukuthembeka kokulungiswa kotyando, ngakumbi kwiinkqubo ezibuthathaka ezibandakanya imithambo yegazi kunye nentliziyo. Kweli nqaku, siza kuhlola izixhobo ze-suture ezilungileyo zotyando lwentliziyo, sigxile kwiimpawu zazo, iingenelo, kunye neendlela ezithile zokusetyenziswa ukunceda iingcali zonyango ukuba zenze ukhetho olunolwazi.
Kutheni Kubalulekile Ukukhetha Izinto Ezifanelekileyo Zokuthunga
Kwinkqubo yotyando lwentliziyo, ukukhetha izinto ezifanelekileyo zokuthunga kubalulekile kuba kuchaphazela ngqo impumelelo yotyando kunye nenkqubo yokuphiliswa. Iisuture kufuneka zomelele ngokwaneleyo ukubamba izicubu kunye phantsi koxinzelelo ngelixa zithambile ngokwaneleyo ukuba zingabangeli monakalo. Ukongeza, kufuneka zinike iimpawu ezilungileyo zokuphatha, ukusabela okuncinci kwezicubu, kunye nokhuseleko oluhle lwamaqhina ukuthintela iingxaki.
Izinto eziPhambili zokuSuture kwiinkqubo zentliziyo
1.Iimpahla zePolyester
I-Polyester yinto yokuthunga eyenziweyo, engafunxwayo esetyenziswa kakhulu kutyando lwentliziyo. Inika amandla aphezulu okutsalwa kunye neempawu ezintle zokuphatha, okwenza ukuba ilungele i-vascular anastomosis kunye neenkqubo zokutshintshwa kweevalvu. Ii-polyester sutures zithandwa kakhulu ngenxa yokuqina kwazo kunye nokusabela okuncinci kwezicubu, okunciphisa umngcipheko weempendulo zokudumba. Umzekelo, kwi-coronary artery bypass grafting (CABG), ii-polyester sutures zinceda ukuqinisekisa unxibelelwano olukhuselekileyo noluhlala ixesha elide phakathi kwee-grafts kunye nemithambo yegazi yendalo.
2.Ii-Polypropylene Sutures
I-Polypropylene lolunye ukhetho oludumileyo lokusetyenziswa kwentliziyo, eyaziwa ngokuguquguquka kwayo kunye nokuhambelana kwayo nezinto eziphilayo. Ikwayinto engafunxwayo, eluncedo kwiindlela zotyando ezifuna inkxaso yezicubu ixesha elide. Umphezulu wayo ogudileyo unciphisa ukwenzakala kwezicubu ngexesha lokuhamba, okwenza ifaneleke ukulungiswa kwemithambo yegazi ebuthathaka. Ukuxhathisa kwe-Polypropylene kwiintsholongwane kunye nokusebenza okuncinci kwezicubu kwenza ukuba ibe yindawo ekhethwayo yokuthunga kwiinkqubo ezifana nokulungiswa kwe-aortic aneurysm.
3.IiSutures ze-ePTFE (Expanded Polytetrafluoroethylene)
Ii-sutures ze-ePTFE ziyamelana kakhulu nokuguquguquka, nto leyo eyenza zibe lolona khetho lubalaseleyo lokulungisa uxinzelelo oluphezulu lwentliziyo. Ziluncedo kakhulu kwiindlela zotyando ezibandakanya ii-grafts ezenziweyo, njengoko zibonelela ngokuhambelana okuhle kwezicubu kunye nokungqubana okuncinci. Oogqirha botyando badla ngokukhetha i-ePTFE ngenxa yokukwazi kwayo ukuphatha ii-anastomoses ezintsonkothileyo zemithambo yegazi ngaphandle kokunqumla udonga lwemithambo yegazi, ngaloo ndlela kuthintelwe iingxaki emva kotyando ezifana nokopha kwe-suture line.
IiSutures ezifunxwayo kunye nezingenakufunxwa
Ukuqonda umahluko phakathi kwe-sutures ezifunxwayo nezingenakufunxwa kubalulekile ekukhetheni izinto ezifanelekileyo kwiinkqubo zentliziyo.
•IiSutures ezifunxwayo:Ezi suture ziyaqhekeka kancinci kancinci emzimbeni kwaye ziyafunxwa ngokuhamba kwexesha. Zihlala zisetyenziswa kwiimeko apho inkxaso yenxeba yexeshana yanele khona. Nangona kunjalo, kwiindlela zotyando lwentliziyo, ii-sutures ezifunxwayo azixhaphakanga kuba aziboneleli ngenkxaso esisigxina efunekayo ekulungisweni okubalulekileyo.
•IiSutures Ezingafunxwayo:Njengoko igama lisitsho, ezi suture zenzelwe ukuhlala emzimbeni ngonaphakade okanye zide zisuswe. Ii suture ezingafunxwayo ezifana ne-polyester, i-polypropylene, kunye ne-ePTFE zezona ndlela ziqhelekileyo zokucoca imithambo yegazi, ezibonelela ngozinzo lwexesha elide kunye nokunciphisa umngcipheko wokwanda kwe-aneurysmal.
Indima yobungakanani beSuture kwi-Cardiovascular Surgery
Ukukhetha ubungakanani obufanelekileyo bomthungo kubaluleke ngokulinganayo njengempahla ngokwayo. Kwiinkqubo zotyando lwentliziyo, ubukhulu bomthungo obuncinci (obufana no-6-0 okanye u-7-0) buhlala busetyenziswa kuba bunciphisa ukwenzakala kwezicubu kwaye buphucula ukuchaneka, ingakumbi kwizakhiwo ezibuthathaka zemithambo yegazi. Nangona kunjalo, ubukhulu obukhulu bungasetyenziswa kwiindawo ezifuna amandla ongezelelweyo kunye nenkxaso, njengakwindlela yokulungisa i-aorta.
Isifundo seTyala: Impumelelo kwiCoronary Artery Bypass Grafting (CABG)
Uphononongo olubandakanya izigulana ze-CABG lubonise ukusebenza kakuhle kwe-polyester sutures ekufezekiseni ii-grafts eziphumelelayo. Oogqirha botyando baqaphele ukuba amandla aphezulu okuxinana kwe-polyester kunye nokusabela okuncinci kwezicubu kunegalelo ekuncipheni kwamazinga eengxaki emva kotyando kunye nokuphucula ukuqina kwe-graft iyonke. Obu bungqina bubonisa ukufaneleka kwesixhobo kwiinkqubo ezibalulekileyo zentliziyo apho ii-sutures eziqinileyo nezithembekileyo zibalulekile.
Iingcebiso Zokugcina Ukunyaniseka Kwe-Suture
Ukuphathwa ngokufanelekileyo kwee-sutures ngexesha lotyando kunokubangela iziphumo ezibi kakhulu. Oogqirha botyando kufuneka baphephe ukuxinana kakhulu xa bebopha amaqhina, kuba oku kunokubangela umonakalo kwizicwili okanye ukwaphuka kwe-suture. Ukongeza, ukuqinisekisa ukuphathwa okuncinci kunye nokusebenzisa iindlela ezifanelekileyo zokubopha amaqhina kunokunceda ukugcina ukuqina kwesakhiwo se-sutures, kuphucule ukusebenza kwazo ngexesha lokuphiliswa.
Ikamva lezinto zokuthunga kwi-Cardiovascular Surgery
Uphuhliso kwitekhnoloji ye-suture luhlala lutshintsha, lugxile ekuphuculeni ukhuseleko lwesigulane kunye nokuphucula iziphumo zotyando. Izinto ezintsha ezifana neengubo ezilwa neentsholongwane kunye nee-sutures ezisebenzayo ezikhuthaza ukuphiliswa ziyahlolwa ngoku kwizicelo zentliziyo. Olu phuhliso lujolise ekunciphiseni amazinga osulelo kunye nokukhuthaza ukuhlanganiswa okungcono nezicubu, okubonelela ngamathuba anomdla kwixesha elizayo lotyando lwentliziyo.
Ukukhetha izixhobo ezifanelekileyo zokuthunga utyando lwentliziyo sisigqibo esibalulekileyo esinokuchaphazela kakhulu iziphumo zesigulana. Izixhobo ezifana ne-polyester, i-polypropylene, kunye ne-ePTFE zinika amandla amahle kakhulu, ukuqina, kunye nokusabela okuncinci kwezicubu, okwenza zibe zilungele iinkqubo ezinzima zentliziyo. Ngokuqonda iimpawu ezikhethekileyo zezi sutures kunye nokuqwalasela izinto ezifana nobukhulu bokuthunga kunye neendlela zokuphatha, oogqirha banokwenza ukhetho olunolwazi oluphucula impumelelo yotyando kwaye lukhuthaze ukuphiliswa okungcono.
Kwabo basebenza ngezempilo abafuna ukuphucula iindlela zabo zotyando kunye neziphumo, ukuchitha ixesha ekukhetheni izinto ezifanelekileyo zokuthunga kubalulekile. Nokuba usebenza ngokulungiswa rhoqo okanye ukulungiswa kwemithambo yegazi enzima, umthungo ofanelekileyo unokwenza umahluko omkhulu.
Ixesha leposi: Novemba-08-2024
