Kuvhiyiwa kwemoyo inzvimbo yakaoma inoda kurongeka uye zvinhu zvakavimbika kuti ive nechokwadi chemhedzisiro yemurwere. Pakati pezvishandiso izvi, sutures inoita basa rakakosha mukuchengetedza kutendeseka kwekugadziriswa kwekuvhiya, kunyanya mumaitiro akatetepa anosanganisira tsinga dzeropa nemoyo. Muchinyorwa chino, tichaongorora akanakisa suture zvinhu zvekuvhiyiwa kwemoyo, tichitarisa pazvinhu zvavo, mabhenefiti, uye chaiwo mashandisiro ekushandisa kubatsira nyanzvi dzekurapa kuita sarudzo dzine ruzivo.
Nei Kusarudza Zvakakodzera Suture Material Zvinhu
Mukuvhiya kwemoyo, kusarudza iyo yakakodzera suture zvinhu kwakakosha nekuti inokanganisa zvakananga kubudirira kwekushanda uye maitiro ekuporesa. Sutures inofanira kunge yakasimba zvakakwana kuti ibate matishu pamwe chete pasi pekumanikidzwa ukuwo ichipfava zvakakwana kuti isakonzere kukuvara. Pamusoro pezvo, ivo vanofanirwa kupa yakanakisa kubata maitiro, kushoma kwematishu maitiro, uye yakanaka knot chengetedzo kudzivirira matambudziko.
Pamusoro Suture Zvishandiso zveCardiovascular Procedures
1.Polyester Sutures
Polyester inogadzirwa, isingabatike suture zvinhu zvinoshandiswa zvakanyanya mukuvhiya kwemoyo. Iyo inopa yakakwira tensile simba uye yakanakisa kubata zvivakwa, zvichiita kuti ive yakanaka kune vascular anastomosis uye nzira dzekutsiva vharafu. Polyester sutures inonyanya kufarirwa nekuda kwekusimba kwavo uye kushoma kwematishu kuita, kuderedza njodzi yekuzvimba mhinduro. Semuenzaniso, mune coronary artery bypass grafting (CABG), polyester sutures inobatsira kuve yakachengeteka uye inogara kwenguva refu kubatana pakati pemagraft nemidziyo yekuzvarwa.
2.Polypropylene Sutures
Polypropylene imwe yakakurumbira sarudzo yemoyo midziyo yekushandisa, inozivikanwa nekushanduka kwayo uye biocompatibility. Izvo zvakare zvinhu zvisingabatike, izvo zvinobatsira mukuvhiya kunoda kutsigirwa kwenguva refu kwetishu. Nzvimbo yaro yakatsetseka inoderedza kukuvara kwetishu panguva yekufamba, zvichiita kuti ive yakakodzera kugadziriswa kwetsinga. Kuramba kwepolypropylene kuhutachiona uye kuderera kwetishu reactivity kunoita kuti ive suture inosarudzika yemaitiro akaita seaortic aneurysm kugadzirisa.
3.ePTFE (Yakawedzerwa Polytetrafluoroethylene) Sutures
ePTFE sutures inopokana zvakanyanya ne deformation, zvichiita kuti ive sarudzo yakanakisa yekusimbisa-kushushikana kwemoyo kugadzirisa. Iwo anonyanya kubatsira mukuvhiya kunosanganisira majekiseni ekugadzira, sezvo achipa kuenderana kwematishu uye kuderera kwakaderera. Vanachiremba vanovhiya vanowanzosarudza ePTFE pakukwanisa kwayo kubata yakaoma vascular anastomoses pasina kucheka nemadziro emidziyo, nokudaro kudzivirira matambudziko epashure ekuvhiya senge suture line kubuda ropa.
Absorbable vs. Non-Absorbable Sutures
Kunzwisisa misiyano pakati pezvinwiwa uye zvisingabatike sutures zvakakosha pakusarudza iyo yakakodzera zvinhu zvemoyo.
•Absorbable Sutures:Aya sutures zvishoma nezvishoma anoputsika mumuviri uye anotorwa nekufamba kwenguva. Iwo anowanzo shandiswa mumamiriro ezvinhu apo tsigiro yevanga kwenguva pfupi yakakwana. Nekudaro, mukuvhiyiwa kwemoyo, sutures inobatika haina kuwanda nekuti haipe rubatsiro rwechigarire runodiwa pakugadzirisa kwakakosha.
•Non-Absorbable Sutures:Sezvinoratidzwa nezita racho, idzi sutures dzakagadzirirwa kuti dzirambe dziri mumuviri zvachose kana kusvika dzabviswa. Sutures isingabatike senge polyester, polypropylene, uye ePTFE ndiyo yakajairwa kusarudzwa kwemaitiro emoyo, inopa kugadzikana kwenguva refu uye kuderedza njodzi yeaneurysmal dilatation.
Basa reSuture Size muCardiovascular Surgery
Kusarudza saizi yakakodzera suture kwakakosha zvakaenzana sechinhu pachayo. Mukuvhiyiwa kwemoyo, saizi yakatsetseka yesuture (yakadai se6-0 kana 7-0) inowanzoshandiswa nekuti inoderedza kukuvadzwa kwetishu uye inosimudzira kurongeka, kunyanya mune dzakatetepa vascular zvimiro. Nekudaro, hukuru hukuru hunogona kushandiswa munzvimbo dzinoda imwe simba nerutsigiro, senge mukugadzirisa aortic.
Nyaya Yokudzidza: Kubudirira muCoronary Artery Bypass Grafting (CABG)
Ongororo yaisanganisira varwere veCABG yakaratidza kushanda kwepolyester sutures mukuwana magraft akabudirira. Vanachiremba vekuvhiya vakacherekedza kuti simba repolyester rakanyanya kusimba uye kushoma kwematishu kuita zvakakonzera kudzikira kwemazinga epashure-operative matambudziko uye kuvandudzwa kwese kugraft patency. Humbowo uhwu hunoratidza kukodzera kwechinyorwa chemaitiro akakosha emwoyo apo sutures yakasimba uye yakavimbika yakakosha.
Mazano Okuchengeta Suture Kuperera
Kubata kwakakodzera kwesutures panguva yekuvhiyiwa kunogona kukanganisa zvakanyanya mhedzisiro. Vanachiremba vanovhiya vanofanirwa kudzivirira kushushikana kwakanyanya kana vachisunga mapfundo, sezvo izvi zvichigona kukonzeresa kukuvara kwetishu kana kuputsika kwesuture. Pamusoro pezvo, kuve nechokwadi chekubata kushoma uye kushandisa nzira dzakakodzera dzekusunga mapfundo zvinogona kubatsira kuchengetedza kurongeka kwechimiro che sutures, kuwedzera mashandiro avo panguva yekupora.
Ramangwana reSuture Materials muCardiovascular Surgery
Kufambira mberi mune suture tekinoroji inogara ichishanduka, ine tarisiro yekusimudzira kuchengetedzwa kwevarwere nekuvandudza mhedzisiro yekuvhiya. Hutsva hwakadai senge antibacterial coatings uye bioactive sutures inokurudzira kuporeswa iko zvino kuri kuongororwa mumidziyo yemoyo. Zviitiko izvi zvinovavarira kudzikisa huwandu hwehutachiona uye kukurudzira kubatanidzwa zviri nani nematishu, zvichipa mikana inonakidza yeramangwana rekuvhiyiwa kwemoyo.
Kusarudza iyo chaiyo suture zvinhu zvekuvhiyiwa kwemoyo isarudzo yakakosha iyo inogona kukanganisa zvakanyanya mhedzisiro yemurwere. Zvishandiso zvakaita sepolyester, polypropylene, uye ePTFE zvinopa simba rakanakisa, kusimba, uye kushomeka kwematishu kuita, zvichiita kuti zvive zvakanakira kuomarara kwemoyo. Nekunzwisisa hunhu hwakasiyana hweaya sutures uye kufunga zvinhu zvakaita sehukuru hwesuture uye maitiro ekubata, vanachiremba vanovhiya vanogona kuita sarudzo dzine ruzivo dzinowedzera kubudirira kwekuvhiya uye kukurudzira kuporesa kuri nani.
Kune vashandi vehutano vari kutsvaga kuvandudza maitiro avo ekuvhiya uye mhedzisiro, kuisa nguva mukusarudza yakakodzera suture zvinhu zvakakosha. Kunyangwe iwe uri kutarisana nekugadzirisa maitiro kana kuomarara kwevascular reconstruction, iyo suture yakakodzera inogona kuita mutsauko wese.
Nguva yekutumira: Nov-08-2024
