Opaleshoni ya mtima

Opaleshoni yodutsa pamtima imapanga njira yatsopano, yotchedwa yolambalala, kuti magazi ndi mpweya ziziyenda mozungulira kuti zifike pamtima panu.

Musanachite opareshoni, mudzalandira mankhwala opatsirana. Mudzakhala mukugona (osadziwa kanthu) komanso osamva ululu pa opaleshoni.

Mukakomoka, dokotalayo amakupangitsani kudula pakati pa chifuwa ndi masentimita 20.5 mpaka 25.5. Chifuwa chanu chachifuwa chidzalekanitsidwa kuti chitsegule. Izi zimathandiza dotolo wanu kuwona mtima wanu ndi aorta, chotengera chachikulu chamagazi chotsogolera kuchokera pamtima kupita ku thupi lanu lonse.

Anthu ambiri omwe amachitidwa opaleshoni yolumikizana ndi coronary amalumikizidwa ndi makina opyola mtima-mapapu, kapena pampu yolambalala.

• Mtima wanu waimitsidwa mukalumikizidwa ndi makina awa.
• Makinawa amagwira ntchito yamtima ndi yamapapu pomwe mtima wanu umayimitsidwa kuchitidwa opaleshoni. Makinawo amawonjezera mpweya m'magazi anu, amayendetsa magazi mthupi lanu lonse, komanso amachotsa mpweya woipa.

Mtundu wina wa opaleshoni yodutsa samagwiritsa ntchito makina olowera pamtima ndi mapapo. Njirayi yachitika pomwe mtima wanu ukugunda. Izi zimatchedwa kuti-pump pump coronary artery, kapena OPCAB.

Kuti mupange kulumikiza kopitilira muyeso:

• Dokotala amatenga mtsempha kapena mtsempha kuchokera m'mbali ina ya thupi lanu ndikuugwiritsa ntchito kupatulira (kapena kumezanitsa) mozungulira malo otsekedwa mumtsempha wanu. Dokotala wanu amatha kugwiritsa ntchito mtsempha, wotchedwa saphenous vein, kuchokera mwendo wanu.
• Kuti mufike pamitsempha iyi, kudula opareshoni kumapangidwa mkati mwendo wanu, pakati pa bondo lanu ndi kubuula kwanu. Mapeto ena amtengowo adzasindikizidwa kumtunda wanu wamagazi. Mapeto ena adzasokedwa kutsegulira ku aorta yanu.
• Mitsempha yamagazi m'chifuwa mwanu, yotchedwa mkati mammary artery (IMA), itha kugwiritsidwanso ntchito kuphatikizira. Mapeto ena amtunduwu alumikizidwa kale kunthambi ya aorta yanu. Mapeto ena amaphatikizidwa ndi mtsempha wamagazi.
• Mitsempha ina itha kugwiritsidwanso ntchito pazomangirira pochita opaleshoni. Chofala kwambiri ndi mtsempha wamagazi m'manja mwanu.

Katemera atapangidwa, fupa lanu la pachifuwa lidzatsekedwa ndi mawaya. Mawaya awa amakhala mkati mwanu. Kudula opaleshoni kudzatsekedwa ndi zokopa.

Kuchita opaleshoniyi kumatha kutenga maola 4 kapena 6. Pambuyo pa opaleshoniyi, adzakutengerani kuchipinda cha anthu odwala mwakayakaya.

Mungafunike njirayi ngati mungatseke mitsempha yanu imodzi kapena zingapo. Mitsempha ya Coronary ndiyo zotengera zomwe zimapatsa mtima wanu mpweya ndi zopatsa thanzi zomwe zimanyamulidwa m'magazi anu.

Mitsempha yamitsempha yamtundu umodzi ikakhala yotseka pang'ono kapena pang'ono, mtima wanu sulandira magazi okwanira. Izi zimatchedwa matenda amtima wa ischemic, kapena matenda amitsempha yamagazi (CAD). Zitha kupweteketsa chifuwa (angina).

Mitsempha ya Coronary yodutsa opaleshoni itha kugwiritsidwa ntchito kupititsa patsogolo magazi mumtima mwanu. Dokotala wanu atha kuyesera kuti akuchitireni mankhwala. Mwinanso mwayesapo kuchita masewera olimbitsa thupi komanso kusintha kwa zakudya, kapena angioplasty ndikununkhira.

CAD ndiyosiyana ndi munthu ndi munthu. Momwe amapezera ndi kuthandizira amasiyana. Opaleshoni ya mtima ndi mtundu umodzi wokha wa chithandizo.

Njira zina zomwe zingagwiritsidwe ntchito:

• Kukhazikitsidwa kwa Angioplasty ndi stent
• Opaleshoni ya mtima - yowopsa pang'ono

Zowopsa za opaleshoni iliyonse ndi monga:

• Magazi
• Matenda
• Imfa

Zowopsa zomwe zingachitike chifukwa chakuchita opaleshoni yodutsa ndi monga:

• Matenda, kuphatikizapo matenda a chifuwa cha chifuwa, omwe amatha kuchitika ngati muli onenepa kwambiri, muli ndi matenda ashuga, kapena mwachita kale opaleshoniyi
• Matenda amtima
• Sitiroko
• Mavuto amtundu wamtima
• Impso kulephera
• Kulephera kwa mapapo
• Kukhumudwa komanso kusinthasintha kwamaganizidwe
• Kutentha kwambiri, kutopa, ndi kupweteka pachifuwa, zonse zomwe zimatchedwa postpericardiotomy syndrome, zomwe zimatha miyezi 6
• Kutha kukumbukira, kutaya kumvetsetsa kwamaganizidwe, kapena "kuganiza moperewera"

Nthawi zonse uzani wothandizira zaumoyo wanu mankhwala omwe mukumwa, ngakhale mankhwala osokoneza bongo kapena zitsamba zomwe mwagula popanda mankhwala.

M'masiku asanachitike opaleshoni yanu:

• Pakadutsa sabata imodzi musanachite opareshoni, mwina mungafunsidwe kuti musiye kumwa mankhwala omwe amalepheretsa magazi anu kuphimba. Izi zingayambitse magazi ochulukirapo panthawi yochita opareshoni. Amaphatikizapo aspirin, ibuprofen (monga Advil ndi Motrin), naproxen (monga Aleve ndi Naprosyn), ndi mankhwala ena ofanana nawo. Ngati mukumwa clopidogrel (Plavix), lankhulani ndi dokotala wanu wamankhwala za nthawi yomwe muyenera kusiya kumwa.
• Funsani mankhwala omwe muyenera kumwa patsiku la opareshoni.
• Ngati mumasuta, yesetsani kusiya. Funsani omwe akukuthandizani kuti akuthandizeni.
• Lumikizanani ndi omwe amakupatsani ngati muli ndi chimfine, malungo, malungo, kapena matenda ena aliwonse.
• Konzani nyumba yanu kuti muziyenda mosavuta mukamabwera kuchokera kuchipatala.

Dzulo lisanachitike opaleshoni yanu:

• Sambani ndi shampu bwino.
• Mutha kupemphedwa kuti musambe thupi lonse pansi pa khosi lanu ndi sopo wapadera. Tsukani chifuwa chanu kawiri kapena katatu ndi sopo.
• Onetsetsani kuti mukudziumitsa.

Patsiku la opaleshoniyi:

• Mudzafunsidwa kuti musamwe kapena kudya kalikonse pakati pausiku usiku usanachitike opaleshoni yanu. Muzimutsuka m'kamwa ndi madzi ngati mukuuma, koma samalani kuti musameze.
• Tengani mankhwala aliwonse amene mwauzidwa kuti mumwe ndikumwa madzi pang'ono.

Mudzauzidwa nthawi yobwera kuchipatala.

Pambuyo pa opaleshoniyi, mutha kukhala masiku atatu mpaka 7 muchipatala. Mugona usiku woyamba m'chipinda cha odwala mwakayakaya (ICU). Mwinanso mungasamutsidwe kuchipinda chosamalirako kapena chosandulika mkati mwa maola 24 mpaka 48 mutachitika.

Machubu awiri kapena atatu azikhala m'chifuwa mwanu kuti muthe madzi mumtima mwanu. Nthawi zambiri amachotsedwa masiku 1 kapena 3 atachitidwa opaleshoni.

Mutha kukhala ndi catheter (chubu chosinthika) mu chikhodzodzo chanu kukhetsa mkodzo. Muthanso kukhala ndi mizere yolowa (IV) yamadzi. Mudzaphatikizidwa ndi makina omwe amayang'anira kugunda kwanu, kutentha kwanu, komanso kupuma kwanu. Anamwino nthawi zonse amayang'anira oyang'anira anu.

Mutha kukhala ndi zingwe zing'onozing'ono zomwe zimalumikizidwa ndi pacemaker, zomwe zimatulutsidwa musanatuluke.

Mudzalimbikitsidwanso kuyambiranso zochitika zina ndipo mutha kuyambiranso pulogalamu yokonzanso mtima m'masiku ochepa.

Zimatenga masabata 4 mpaka 6 kuti muyambe kumva bwino mukachita opaleshoni. Omwe akukuthandizani adzakuuzani momwe mungadzisamalire kunyumba mukatha opaleshoni.

Kuchira opaleshoni kumatenga nthawi. Simungathe kuwona zabwino zonse za opaleshoni yanu kwa miyezi 3 mpaka 6. Mwa anthu ambiri omwe ali ndi mtima wodutsa opaleshoni, ma grafts amakhala otseguka ndipo amagwira ntchito bwino kwazaka zambiri.

Kuchita opaleshoniyi sikulepheretsa mitsempha yamtendere kuti isabwerere. Mutha kuchita zinthu zambiri kuti muchepetse izi, kuphatikiza:

• Osasuta
• Kudya chakudya chopatsa thanzi pamtima
• Kuchita masewera olimbitsa thupi nthawi zonse
• Kuchiza kuthamanga kwa magazi
• Kulamulira shuga wambiri wamagazi (ngati muli ndi matenda ashuga) komanso cholesterol

Kutulutsa pampu kwamitsempha yamitsempha yodutsa; OPCAB; Kumenya opaleshoni yamtima; Kuchita opaleshoni yolambalala - mtima; CABG; Mitsempha ya Coronary imadutsa kumezanitsa; Mitsempha ya Coronary imadutsa opaleshoni; Opaleshoni ya Coronary; Mitsempha ya Coronary matenda - CABG; CAD - CABG; Angina - CABG

• Angina - kumaliseche
• Angina - zomwe mungafunse dokotala wanu
• Angina - mukakhala ndi ululu pachifuwa
• Angioplasty ndi stent - mtima - kutulutsa
• Mankhwala osokoneza bongo - P2Y12 inhibitors
• Aspirin ndi matenda amtima
• Chitetezo cha bafa cha akulu
• Kukhala wachangu mutadwala matenda amtima
• Kukhala achangu mukakhala ndi matenda amtima
• Batala, majarini, ndi mafuta ophikira
• Catheterization yamtima - kutulutsa
• Cholesterol ndi moyo
• Cholesterol - mankhwala osokoneza bongo
• Kulamulira kuthamanga kwa magazi
• Mafuta azakudya anafotokoza
• Malangizo achangu
• Matenda a mtima - kutulutsa
• Matenda a mtima - zomwe mungafunse dokotala wanu
• Opaleshoni ya mtima - kutulutsa
• Matenda a mtima - zoopsa
• Mtima pacemaker - kutulutsa
• Momwe mungawerenge zolemba za chakudya
• Zakudya zamcherecherere
• Zakudya zaku Mediterranean
• Kupewa kugwa
• Chisamaliro cha bala la opaleshoni - chotseguka
• Mukakhala ndi nseru ndi kusanza

• Mtima - kuwonera kutsogolo
• Mitsempha yamtima yakumbuyo
• Mitsempha yamkati yamkati
• Matenda a m'mimba
• Opaleshoni ya mtima - mndandanda
• Kuchita opaleshoni yodutsa pamtima

Al-Atassi T, Toeg HD, Chan V, Ruel M. Coronary mitsempha yodutsitsa kumtengowo. Mu: Sellke FW, del Nido PJ, Swanson SJ, olemba. Opaleshoni ya Sabiston ndi Spencer pachifuwa. 9th ed. Philadelphia, PA: Elsevier; 2016: chap 88.

Hillis LD, Smith PK, Anderson JL, ndi al. Chitsogozo cha ACCF / AHA cha 2011 chazitsulo zopitilira muyeso pochita opaleshoni yomata: lipoti la American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. Kuzungulira. 2011; 124 (23): e652-e735. PMID: 22064599 adatulutsidwa.ncbi.nlm.nih.gov/22064599/.

Kulik A, Ruel M, Jneid H, ndi al. Kupewa kwachiwiri pambuyo pa mtsempha wamagazi kupitilira opaleshoni yomata: mawu asayansi ochokera ku American Heart Association. Kuzungulira. 2015; 131 (10): 927-964. (Adasankhidwa) PMID: 25679302 pubed.ncbi.nlm.nih.gov/25679302/.

Morrow DA, de Lemos JA. Khola matenda amtima ischemic. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: mutu 61.

Omer S, Cornwell LD, Bakaeen FG. Matenda amtima opezeka: osakwanira. Mu: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Buku Lopanga Opaleshoni. Wolemba 20th. Philadelphia, PA: Elsevier; 2017: mutu 59.