Ukuhlinzwa kwenhliziyo kuyinkambu eyinkimbinkimbi edinga izinto ezinembile nezithembekile ukuqinisekisa imiphumela emihle yesiguli. Phakathi kwalezi zinto, izithungo zidlala indima ebalulekile ekugcineni ubuqotho bokulungiswa kokuhlinzwa, ikakhulukazi ezinqubweni ezibucayi ezihilela imithambo yegazi nenhliziyo. Kulesi sihloko, sizohlola izinto ezingcono kakhulu zokuthunga zokuhlinzwa kwenhliziyo, sigxile ezimpahleni zazo, izinzuzo, kanye namacala athile okusetshenziswa ukusiza ochwepheshe bezokwelapha benze izinqumo ezinolwazi.
Kungani Kubalulekile Ukukhetha Izinto Zokuthunga Ezifanele
Ekuhlinzeni kwenhliziyo nemithambo yegazi, ukukhetha izinto zokuthunga ezifanele kubalulekile ngoba kuthinta ngqo impumelelo yokuhlinzwa kanye nenqubo yokuphulukiswa. Ama-suture kumele abe namandla ngokwanele ukubamba izicubu ndawonye ngaphansi kwengcindezi ngenkathi futhi ethambile ngokwanele ukuba angadali umonakalo. Ngaphezu kwalokho, kufanele anikeze izici ezinhle kakhulu zokuphatha, ukusabela okuncane kwezicubu, kanye nokuphepha okuhle kwamafindo ukuvimbela izinkinga.
Izinto Zokuthunga Eziphezulu Zezinqubo Zenhliziyo Nemithambo Yegazi
1.I-Polyester Sutures
I-Polyester iyinto yokuthunga eyenziwe ngokwenziwa, engamuncwa esetshenziswa kabanzi ekuhlinzeni kwenhliziyo nemithambo yegazi. Inikeza amandla aphezulu okubamba kanye nezakhiwo ezinhle kakhulu zokuphatha, okwenza ibe yindawo ekahle kakhulu yokwelapha imithambo yegazi kanye nezinqubo zokufaka esikhundleni sama-valve. Ama-polyester sutures athandwa kakhulu ngenxa yokuqina kwawo kanye nokusabela okuncane kwezicubu, okunciphisa ingozi yokusabela kokuvuvukala. Isibonelo, ku-coronary artery bypass grafting (CABG), ama-polyester sutures asiza ukuqinisekisa ukuxhumana okuphephile nokuhlala isikhathi eside phakathi kwama-grafts nemithambo yegazi yendawo.
2.I-Polypropylene Sutures
I-Polypropylene ingenye indlela ethandwayo yokusetshenziswa kwenhliziyo nemithambo yegazi, eyaziwa ngokuguquguquka kwayo kanye nokuhambisana kwayo nezinto eziphilayo. Futhi iyinto engamuncwa, ewusizo ekuhlinzeni okudinga ukwesekwa kwezicubu isikhathi eside. Ubuso bayo obubushelelezi bunciphisa ukulimala kwezicubu ngesikhathi sokudlula, okwenza ifanelekele ukulungiswa kwemithambo yegazi okubucayi. Ukumelana kwe-Polypropylene nezifo kanye nokusabela kwezicubu okuphansi kwenza kube yindawo ekhethwayo yokuthunga izinqubo ezifana nokulungiswa kwe-aortic aneurysm.
3.I-ePTFE (Expanded Polytetrafluoroethylene) Sutures
Ama-suture e-ePTFE amelana kakhulu nokuguqulwa kwemithambo yegazi, okwenza abe ukukhetha okuhle kakhulu kokulungiswa kwenhliziyo nokucindezeleka okukhulu. Awusizo kakhulu ekuhlinzeni okubandakanya ukufakelwa okwenziwe, njengoba enikeza ukuhambisana okuhle kakhulu kwezicubu kanye nokungqubuzana okuphansi. Odokotela abahlinzayo bavame ukukhetha i-ePTFE ngenxa yekhono layo lokusingatha ama-anastomoses ayinkimbinkimbi emithambo yegazi ngaphandle kokusika izindonga zemithambo yegazi, ngaleyo ndlela kuvinjelwe izinkinga zangemva kokuhlinzwa njengokuphuma kwegazi emgqeni we-suture.
Izindwangu Ezingamuncwa Noma Ezingamuncwa
Ukuqonda umehluko phakathi kwe-sutures emuncwayo nengamuncwayo kubalulekile ekukhetheni izinto ezifanele zezinqubo zenhliziyo.
•Izicubu Ezimuncwayo:Lezi zithungo ziyaphuka kancane kancane emzimbeni futhi zimuncwa ngokuhamba kwesikhathi. Ngokuvamile zisetshenziswa ezimweni lapho ukusekelwa kwesikhashana kwenxeba kwanele. Kodwa-ke, ekuhlinzweni kwenhliziyo nemithambo yegazi, izithungo ezimuncwayo azivamile ngoba azinikezi ukusekelwa okuhlala njalo okudingekayo ekulungisweni okubucayi.
•Ama-Suture Angamuncwa:Njengoba igama lisho, lawa ma-suture aklanyelwe ukuhlala emzimbeni unomphela noma kuze kube yilapho esuswa. Ama-suture angamuncwa njenge-polyester, i-polypropylene, kanye ne-ePTFE yizinketho ezijwayelekile zezinqubo zenhliziyo, ezihlinzeka ngokuqina kwesikhathi eside futhi zinciphise ingozi yokwanda kwe-aneurysmal.
Indima Yosayizi We-Suture Ekuhlinzeni Kwenhliziyo Nemithambo Yegazi
Ukukhetha usayizi we-suture ofanele kubaluleke ngokulinganayo njengendwangu uqobo. Ekuhlinzeni kwenhliziyo nemithambo yegazi, ubukhulu be-suture obuncane (njengo-6-0 noma u-7-0) buvame ukusetshenziswa ngoba kunciphisa ukulimala kwezicubu futhi kuthuthukise ukunemba, ikakhulukazi ezakhiweni zemithambo yegazi ezibucayi. Kodwa-ke, ubukhulu obukhulu bungasetshenziswa ezindaweni ezidinga amandla engeziwe nokusekelwa, njengasekulungisweni kwe-aorta.
Ucwaningo Lwesibonelo: Impumelelo Ekuhlanganisweni Kwemithambo Yenhliziyo Ebuhlungu (i-CABG)
Ucwaningo oluhilela iziguli ze-CABG lubonise ukusebenza kahle kwe-polyester sutures ekufezeni i-graft ephumelelayo. Odokotela abahlinzayo baqaphele ukuthi amandla aphezulu okuthamba kwe-polyester kanye nokusabela okuncane kwezicubu kunegalelo emazingeni aphansi ezinkinga zangemva kokuhlinzwa kanye nokuthuthukiswa kwe-graft patency iyonke. Lobu bufakazi buqokomisa ukufaneleka kwale nto ezinqubweni ezibalulekile zenhliziyo nemithambo lapho i-sutures eqinile nethembekile ibalulekile.
Amathiphu Okugcina Ubuqotho Be-Suture
Ukuphathwa kahle kwe-sutures ngesikhathi sokuhlinzwa kungathinta kakhulu imiphumela. Odokotela abahlinzayo kufanele bagweme ukucindezeleka okukhulu lapho bebopha amafindo, njengoba lokhu kungaholela ekulimaleni kwezicubu noma ekuqhekekeni kwe-suture. Ngaphezu kwalokho, ukuqinisekisa ukuphathwa okuncane nokusebenzisa amasu afanele okubopha amafindo kungasiza ekugcineni ubuqotho besakhiwo se-sutures, kuthuthukise ukusebenza kwazo ngesikhathi senqubo yokuphulukiswa.
Ikusasa Lezinto Zokuthunga Ekuhlinzeni Inhliziyo Nemithambo Yegazi
Intuthuko kwezobuchwepheshe bokuthunga ishintsha njalo, kugxilwe ekuthuthukiseni ukuphepha kwesiguli kanye nokuthuthukisa imiphumela yokuhlinzwa. Izinto ezintsha ezifana nokugqoka okulwa namagciwane kanye nokuthunga okusebenzayo okukhuthaza ukuphulukiswa okwamanje kuyahlolwa ekusetshenzisweni kwenhliziyo. Lezi zinguquko zihlose ukunciphisa amazinga okutheleleka nokukhuthaza ukuhlanganiswa okungcono nezicubu, okunikeza amathuba ajabulisayo esikhathi esizayo sokuhlinzwa kwenhliziyo.
Ukukhetha izinto zokuthunga ezifanele zokuhlinzwa kwenhliziyo kuyisinqumo esibalulekile esingathinta kakhulu imiphumela yesiguli. Izinto ezifana ne-polyester, i-polypropylene, ne-ePTFE zinikeza amandla amahle kakhulu, ukuqina, kanye nokusabela okuncane kwezicubu, okwenza kube kuhle kakhulu ezinqubweni eziyinkimbinkimbi zenhliziyo. Ngokuqonda izakhiwo ezihlukile zalezi zithungo kanye nokucabangela izici ezifana nosayizi we-suture kanye namasu okuphatha, odokotela abahlinzayo bangenza izinqumo ezinolwazi ezithuthukisa impumelelo yokuhlinzwa futhi zikhuthaze ukuphulukiswa okungcono.
Kwabochwepheshe bezempilo abafuna ukuthuthukisa amasu abo okuhlinzwa kanye nemiphumela, ukutshala isikhathi ekukhetheni izinto zokuthunga ezifanele kubalulekile. Kungakhathaliseki ukuthi ubhekene nokulungiswa okuvamile noma ukulungiswa kabusha kwemithambo yegazi okuyinkimbinkimbi, ukuthunga okulungile kungenza umehluko omkhulu.
Isikhathi sokuthunyelwe: Novemba-08-2024
