Opaleshoni yamtima ndi gawo lovuta lomwe limafunikira kulondola komanso zida zodalirika kuti zitsimikizire zotsatira zabwino za odwala. Pakati pazidazi, ma sutures amagwira ntchito yofunika kwambiri kuti maopaleshoni akonzedwe bwino, makamaka pochita zinthu zovuta zokhudzana ndi mitsempha yamagazi ndi mtima. M'nkhaniyi, tiwona zida zabwino kwambiri za suture zopangira opaleshoni yamtima, kuyang'ana kwambiri zomwe ali nazo, zopindulitsa, komanso momwe amagwiritsidwira ntchito kuti athandize akatswiri azachipatala kupanga zosankha mwanzeru.
Chifukwa Chake Kusankha Zoyenera Suture Material Nkhani
Mu opaleshoni ya mtima, kusankha suture yoyenera ndikofunikira chifukwa imakhudza mwachindunji kupambana kwa opaleshoniyo ndi machiritso. Ma sutures ayenera kukhala olimba mokwanira kuti agwirizanitse minofu pamodzi pansi pa kukakamizidwa komanso kukhala odekha kuti asawononge. Kuphatikiza apo, ayenera kupereka mawonekedwe abwino kwambiri ogwirira ntchito, kaphatikizidwe kakang'ono ka minofu, komanso chitetezo chabwino cha mfundo kuti apewe zovuta.
Zida Zapamwamba za Suture Zopangira Zamtima
1.Zovala za Polyester
Polyester ndi chinthu chopangidwa, chosasunthika chomwe chimagwiritsidwa ntchito kwambiri popanga maopaleshoni amtima. Imakhala ndi mphamvu zolimba kwambiri komanso magwiridwe antchito abwino kwambiri, ndikupangitsa kuti ikhale yabwino kwa vascular anastomosis ndi njira zosinthira ma valve. Ma polyester sutures amayamikiridwa makamaka chifukwa cha kukhazikika kwawo komanso kachitidwe kakang'ono ka minofu, kuchepetsa chiopsezo cha mayankho otupa. Mwachitsanzo, mu coronary artery bypass grafting (CABG), ma polyester sutures amathandiza kuonetsetsa kulumikizana kotetezeka komanso kokhalitsa pakati pa zomangira ndi ziwiya zakubadwa.
2.Polypropylene Sutures
Polypropylene ndi chisankho chinanso chodziwika bwino cha ntchito zamtima, chodziwika chifukwa cha kusinthasintha kwake komanso kuyanjana kwachilengedwe. Ndizinthu zomwe sizingatengeke, zomwe zimapindulitsa pa maopaleshoni omwe amafunikira chithandizo cha minofu yaitali. Kusalala kwake kumachepetsa kuvulala kwa minofu panthawi yodutsa, ndikupangitsa kuti ikhale yoyenera kukonzanso bwino kwa mitsempha. Kukana kwa polypropylene ku matenda komanso kutsika kwa minofu kumapangitsa kuti ikhale njira yabwino yopangira njira ngati kukonzanso kwa aortic aneurysm.
3.ePTFE (Expanded Polytetrafluoroethylene) Sutures
Ma ePTFE sutures amalimbana kwambiri ndi mapindikidwe, kuwapanga kukhala chisankho chabwino kwambiri pakukonza mtima kwamtima. Ndiwothandiza makamaka pa maopaleshoni ophatikizirapo, chifukwa amapereka kulumikizana kwabwino kwa minofu komanso kugundana kochepa. Madokotala ochita opaleshoni nthawi zambiri amasankha ePTFE kuti athe kuthana ndi zovuta za vascular anastomoses popanda kudula makoma a chotengera, motero amapewa zovuta zomwe zimachitika pambuyo pa opaleshoni monga kutuluka magazi kwa mzere wa suture.
Zosasunthika vs. Zosasunthika
Kumvetsetsa kusiyana pakati pa sutures absorbable and non-absorbable sutures n'kofunikira kuti musankhe zinthu zoyenera pamayendedwe a mtima.
•Absorbable Sutures:Ma sutures awa amawonongeka pang'onopang'ono m'thupi ndipo amatengeka pakapita nthawi. Amagwiritsidwa ntchito ngati chithandizo chanthawi yayitali chabala ndi chokwanira. Komabe, pochita maopaleshoni amtima, ma sutures otsekemera sakhala ofala chifukwa sapereka chithandizo chokhazikika chofunikira pakukonza zovuta.
•Sutures Osatengeka:Monga momwe dzinalo likusonyezera, ma sutures awa amapangidwa kuti akhalebe m'thupi kwamuyaya kapena mpaka atachotsedwa. Ma sutures osasunthika monga poliyesitala, polypropylene, ndi ePTFE ndizomwe zimasankhidwa pamayendedwe amtima, zomwe zimapereka kukhazikika kwanthawi yayitali komanso kuchepetsa chiopsezo cha kufalikira kwa aneurysmal.
Udindo wa Suture Size mu Opaleshoni Yamtima
Kusankha kukula koyenera kwa suture ndikofunikira mofanana ndi zinthu zomwezo. Pochita maopaleshoni amtima, makulidwe abwino kwambiri (monga 6-0 kapena 7-0) amagwiritsidwa ntchito nthawi zambiri chifukwa amachepetsa kuvulala kwa minofu ndikuwongolera kulondola, makamaka m'mitsempha yolimba. Komabe, zazikuluzikulu zitha kugwiritsidwa ntchito m'malo omwe amafunikira mphamvu zowonjezera ndi chithandizo, monga kukonza kwa mtsempha.
Nkhani Yophunzira: Kupambana mu Coronary Artery Bypass Grafting (CABG)
Kafukufuku wokhudza odwala a CABG adawonetsa mphamvu ya ma polyester sutures kuti akwaniritse bwino ma grafts. Madokotala adawona kuti kulimba kwamphamvu kwa polyester komanso kuchepa kwa minofu kumathandizira kuchepetsa zovuta zomwe zimachitika pambuyo pa opaleshoni komanso kukulitsa luso la graft patency. Umboniwu ukuwonetsa kuyenera kwa zinthuzo pamayendedwe ovuta amtima pomwe ma sutures olimba komanso odalirika ndi ofunikira.
Malangizo Osunga Umphumphu wa Suture
Kusamalira bwino sutures panthawi ya opaleshoni kungakhudze kwambiri zotsatira. Madokotala ochita opaleshoni ayenera kupewa kumangika kwambiri pomanga mfundo, chifukwa izi zingayambitse kuwonongeka kwa minofu kapena kusweka kwa mtsempha. Kuonjezera apo, kuwonetsetsa kugwiritsira ntchito kochepa komanso kugwiritsa ntchito njira zoyenera zomangira mfundo kungathandize kusunga umphumphu wa ma sutures, kupititsa patsogolo ntchito yawo panthawi ya machiritso.
Tsogolo la Suture Zipangizo mu Opaleshoni Yamtima
Kupita patsogolo kwaukadaulo wa suture kukukula mosalekeza, ndikungoyang'ana pakulimbikitsa chitetezo cha odwala ndikuwongolera zotsatira za opaleshoni. Zatsopano monga zokutira za antibacterial ndi ma bioactive sutures omwe amalimbikitsa machiritso akufufuzidwa pakugwiritsa ntchito mtima. Zomwe zikuchitikazi cholinga chake ndi kuchepetsa kuchuluka kwa matenda ndikulimbikitsa kulumikizana bwino ndi minofu, kupereka mwayi wosangalatsa wamtsogolo wa opaleshoni yamtima.
Kusankha suture yoyenera ya opaleshoni yamtima ndi chisankho chofunikira chomwe chingakhudze kwambiri zotsatira za odwala. Zida monga poliyesitala, polypropylene, ndi ePTFE zimapereka mphamvu zabwino kwambiri, zolimba, komanso kaphatikizidwe kakang'ono ka minofu, zomwe zimapangitsa kuti zikhale zoyenera pazochitika zovuta zamtima. Pomvetsetsa mawonekedwe apadera a sutures awa ndikuganiziranso zinthu monga kukula kwa suture ndi njira zogwirira ntchito, madokotala ochita opaleshoni amatha kupanga zisankho zomwe zimapititsa patsogolo opaleshoni ndikulimbikitsa machiritso abwino.
Kwa akatswiri azachipatala omwe akufuna kukonza njira zawo zopangira opaleshoni ndi zotulukapo zawo, kuyika nthawi pakusankha suture yoyenera ndikofunikira. Kaya mukulimbana ndi kukonzanso kwachizoloŵezi kapena kukonzanso mitsempha yowonongeka, suture yoyenera ingapangitse kusiyana konse.
Nthawi yotumiza: Nov-08-2024
