Kodi kudutsa pamtima ndi momwe zimagwirira ntchito

Zamkati

• Momwe imagwirira ntchito
• Zovuta zotheka

Cardiopulmonary bypass ndi njira yomwe imagwiritsidwa ntchito kwambiri pochita opareshoni ya mtima, monga m'malo mwa valavu, kumuika kapena kukonzanso minofu yamtima, chifukwa imalowetsa m'malo mwa ntchito yamapapu ndi yam'mapapo. Chifukwa chake, adotolo amatha kuchita opaleshoniyi osadandaula za kayendedwe ka magazi.

Kuphatikiza apo, njirayi imalepheretsanso magazi kudutsa m'mapapu, zomwe zimachepetsa mwayi wophatikizika m'mapapo, popeza palibe chiopsezo chazovuta pamtima zomwe zimayambitsa matumbo omwe amatha kupita nawo m'mapapu.

Momwe imagwirira ntchito

Kudutsa kwamitsempha yamthupi kumapangidwa ndi makina omwe amayesa kusintha ndikutsanzira magwiridwe antchito amagazi mthupi. Chifukwa chake, ndi njira yomwe imaphatikizapo magawo ndi zinthu zingapo:

1. Kuchotsa magazi amanjenje: catheter imayikidwa pafupi ndi mtima kuti ichotse magazi amanjenje omwe amachokera mthupi lonse, kuilepheretsa kufikira pomwe pamtima;
2. Mosungira: magazi omwe achotsedwa amasonkhanitsidwa mosungiramo pafupifupi masentimita 50 mpaka 70 pansi pamlingo wamtima, womwe umasungabe kuyenda kopitilira muyeso mwa makinawo zomwe zimaperekabe kuti dokotala awonjezere mankhwala kapena kuthiridwa magazi;
3. Mpweya wabwino: ndiye, magazi amatumizidwa ku chida chotchedwa oxygenator, chomwe chimachotsa kaboni dayokisaidi wochuluka m'magazi am'mapapo ndikuwonjezera mpweya kuti ukhale magazi am'magazi;
4. Woyang'anira kutentha: atachoka ku oxygenator, magazi amapita kwa woyang'anira kutentha, komwe kumamupatsa dokotala kuti azisunga kutentha kofanana ndi thupi kapena kuchepetsa, akafunika kuyambitsa mtima, mwachitsanzo;
5. Pump ndi fyuluta: isanabwerere mthupi, magazi amadutsa pampu yomwe imalowetsa mphamvu yamtima, kukankha magazi kudzera mu sefa yomwe imachotsa kuundana ndi mpweya wina womwe ungakhale ukupangika pakazungulira kunja kwa thupi;
6. Mafilimu: pambuyo pa fyuluta, palinso seti ya tinthu tating'onoting'ono tomwe timachotsa tinthu tating'onoting'ono, tomwe, ngakhale sitimayambitsa mavuto pakayendedwe ka thupi, titha kudutsa chotchinga magazi -ubongo ndikufika kuubongo;
7. Kubwereranso kwa magazi ochepa mthupi: Pomaliza, magazi amalowanso mthupi, molunjika mu aorta, ndikugawa thupi lonse.

Munthawi yonseyi, pali mapampu angapo omwe amathandizira magazi kuti aziyenda, kuti asayime ndikuwonjezera chiwopsezo cha kuundana.

Zovuta zotheka

Ngakhale ndi njira yogwiritsidwa ntchito kwambiri, yosavuta komanso yopindulitsa kwambiri pakuchita opaleshoni yamtima, kudutsa pamitsempha yam'mimba kumatha kubweretsa zovuta zina. Chimodzi mwamavuto omwe amapezeka kwambiri ndikukula kwamatenda amthupi, momwe thupi limayankhira ndimaselo amwazi kuti amenyane ndi matenda. Izi ndichifukwa choti magazi amakhudzana ndi mawonekedwe osakhala abwinobwino mkati mwamakina, omwe amatha kuwononga maselo angapo am'magazi ndikupangitsa kuyankha kotupa mthupi.

Kuphatikiza apo, chifukwa cha kusintha kwakuthamanga ndi kutentha komwe magazi amatha kulowa mu chipangizocho, kumawonjezeranso chiopsezo cha kuundana ndipo, chifukwa chake, pambuyo poti opareshoni yamtunduwu ndikofunikira kudziwa mawonekedwe a embolisms mu mapapo kapena ngakhale sitiroko. Komabe, popeza mukuyenera kukhala ku ICU mutachitidwa opaleshoni, nthawi zambiri zizindikilo zofunikira zimayang'aniridwa kuti mupewe zovuta zamtunduwu.