Ukuhlinzwa kwenhliziyo yinkambu eyinkimbinkimbi edinga ukunemba nezinto ezinokwethenjelwa ukuze kuqinisekiswe imiphumela emihle yesiguli. Phakathi kwalezi zinto, ama-sutures adlala indima ebalulekile ekugcineni ubuqotho bokulungiswa kokuhlinzwa, ikakhulukazi ezinqubweni ezibucayi ezibandakanya imithambo yegazi nenhliziyo. Kulesi sihloko, sizohlola izinto ezingcono kakhulu ze-suture zokuhlinzwa kwenhliziyo nemithambo yegazi, sigxile ezintweni zazo, izinzuzo, kanye nezimo ezithile zokusebenzisa ukuze sisize ochwepheshe bezokwelapha benze izinqumo ezinolwazi.
Kungani Ukukhetha Indaba Elungile Ye-Suture Material
Ekuhlinzweni kwenhliziyo nemithambo yegazi, ukukhetha okufanelekile kwe-suture kubalulekile ngoba kuthinta ngqo impumelelo yokusebenza kanye nenqubo yokuphulukisa. Ama-Sutures kufanele abe namandla ngokwanele ukuze abambe izicubu ndawonye ngaphansi kwengcindezi ngenkathi futhi abe mnene ngokwanele ukuba angabangeli umonakalo. Ukwengeza, kufanele banikeze izici zokuphatha ezinhle kakhulu, ukusabela okuncane kwezicubu, nokuphepha okuhle kwefindo ukuvimbela izinkinga.
Izisetshenziswa eziphezulu ze-Suture zezinqubo zenhliziyo nemithambo yegazi
1.Ama-Polyester Sutures
I-Polyester iyinto yokwenziwa, engamunceki esetshenziswa kakhulu ekuhlinzeni kwenhliziyo nemithambo yegazi. Inikeza amandla aphakeme okuqina kanye nezakhiwo ezinhle kakhulu zokubamba, okuyenza ibe ilungele i-vascular anastomosis kanye nezinqubo zokushintsha ama-valve. Ama-polyester sutures athandwa kakhulu ngenxa yokuqina kwawo kanye nokusabela kwezicubu ezincane, okunciphisa ubungozi bokusabela kokuvuvukala. Isibonelo, ku-coronary artery bypass grafting (CABG), ama-polyester sutures asiza ukuqinisekisa ukuxhumana okuphephile nokuhlala isikhathi eside phakathi kokuxhunyelelwa nemikhumbi yomdabu.
2.I-Polypropylene Sutures
I-Polypropylene ingenye inketho ethandwayo yezinhlelo zenhliziyo nemithambo yegazi, eyaziwa ngokuguquguquka kwayo kanye nokuvumelana kwe-biocompatibility. Kuphinde kube yinto engamuncwa, enenzuzo ekuhlinzeni okudinga ukwesekwa kwezicubu zesikhathi eside. Indawo yayo ebushelelezi inciphisa ukuhlukumezeka kwezicubu ngesikhathi sokudlula, ikwenze ifanelekele ukulungiswa kwemithambo entekenteke. Ukumelana ne-polypropylene ekuthelelekeni kanye nokusebenza kabusha kwezicubu eziphansi kuyenza ibe umthungo okhethwayo wezinqubo ezifana nokulungiswa kwe-aortic aneurysm.
3.I-ePTFE (Expanded Polytetrafluoroethylene) Sutures
Ama-ePTFE sutures amelana kakhulu nokuguqulwa, okuwenza abe yisinqumo esihle kakhulu sokulungiswa kwenhliziyo nemithambo yenhliziyo. Ziwusizo ikakhulukazi ekuhlinzeni okubandakanya ukuxhunyelelwa kokwenziwa, njengoba kunikeza ukuhambisana okuhle kwezicubu nokungqubuzana okuphansi. Odokotela abahlinzayo bavame ukukhetha i-ePTFE ngekhono layo lokusingatha ama-anastomoses emithambo eyinkimbinkimbi ngaphandle kokusika izindonga zomkhumbi, ngaleyo ndlela kuvinjwe izinkinga zangemva kokuhlinzwa njengokuphuma kwegazi kwe-suture.
I-Absorbable vs. I-Non-Absorbable Sutures
Ukuqonda umehluko phakathi kwe-sutures edonsayo nengamunceki kubalulekile ekukhetheni izinto ezifanele zezinqubo zenhliziyo.
•I-Absorbable Sutures:Lawa ma-sutures aphuka kancane kancane emzimbeni futhi amuncwa ngokuhamba kwesikhathi. Ngokuvamile zisetshenziswa ezimeni lapho ukwesekwa kwenxeba kwesikhashana kwanele. Kodwa-ke, ekuhlinzeni kwenhliziyo nemithambo yegazi, ama-sutures adonsayo awavamile kangako ngoba awanikezi ukwesekwa okuhlala njalo okudingekayo ekulungiseni okubucayi.
•I-Non-Absorbable Sutures:Njengoba igama liphakamisa, lawa ma-sutures aklanyelwe ukuthi ahlale emzimbeni unomphela noma aze akhishwe. Ama-sutures angamunceki afana ne-polyester, i-polypropylene, ne-ePTFE yizinketho ezijwayelekile zezinqubo zenhliziyo nemithambo yegazi, ezinikeza ukuzinza kwesikhathi eside futhi zinciphise ubungozi bokuvuleka kwe-aneurysmal.
Iqhaza Losayizi We-Suture Ekuhlinzweni Kwenhliziyo Nemithambo yegazi
Ukukhetha usayizi we-suture ofanele kubaluleke ngokulinganayo njengempahla ngokwayo. Ekuhlinzweni kwenhliziyo nemithambo yegazi, osayizi be-suture abacolekile (abafana no-6-0 noma 7-0) bavame ukusetshenziswa ngoba banciphisa ukuhlukumezeka kwezicubu futhi bathuthukise ukunemba, ikakhulukazi ezakhiweni zemithambo ezintekenteke. Kodwa-ke, osayizi abakhulu bangasetshenziswa ezindaweni ezidinga amandla engeziwe nokusekelwa, njengokulungiswa kwe-aortic.
I-Case Study: Impumelelo ku-Coronary Artery Bypass Grafting (CABG)
Ucwaningo olubandakanya iziguli ze-CABG lubonise ukusebenza kwe-polyester sutures ekuzuzeni ama-graft aphumelelayo. Odokotela abahlinzayo baqaphela ukuthi amandla e-polyester aqine kakhulu kanye nokusabela kwezicubu okuncane kube nomthelela emazingeni aphansi ezinkinga zangemva kokuhlinzwa kanye nokuthuthukiswa kokuqina kokuxhunyelelwa. Lobu bufakazi bugqamisa ukufaneleka kokubalulekile kwezinqubo ezibalulekile zenhliziyo nemithambo yegazi lapho ukuthungwa okuqinile nokuthembekile kubalulekile.
Amathiphu Okugcina Ubuqotho be-Suture
Ukuphatha kahle ama-sutures ngesikhathi sokuhlinzwa kungathinta kakhulu imiphumela. Odokotela abahlinzayo kufanele bagweme ukungezwani ngokweqile lapho bebopha amafindo, njengoba lokhu kungaholela ekulimaleni kwezicubu noma ukuphuka komthambo. Ukwengeza, ukuqinisekisa ukuphatha okuncane nokusebenzisa amasu afanelekile okubopha amafindo kungasiza ekugcineni ubuqotho besakhiwo se-sutures, kuthuthukise ukusebenza kwabo ngesikhathi sokuphulukisa.
Ikusasa Lezinto Ezibalulekile Ekuhlinzweni Kwenhliziyo
Intuthuko kubuchwepheshe be-suture ihlala ivela, ngokugxila ekuthuthukiseni ukuphepha kwesiguli kanye nokuthuthukisa imiphumela yokuhlinzwa. Ukuqanjwa okusha okufana nokugcotshwa kwe-antibacterial kanye ne-bioactive sutures ekhuthaza ukuphulukiswa okwamanje kuyahlolwa ekusetshenzisweni kwenhliziyo nemithambo yegazi. Lezi zinguquko zihlose ukunciphisa amazinga okutheleleka futhi zikhuthaze ukuhlanganiswa okungcono nezicubu, okuhlinzeka ngamathuba ajabulisayo ekusasa lokuhlinzwa kwenhliziyo nemithambo yegazi.
Ukukhetha i-suture material efanele yokuhlinzwa kwenhliziyo kuyisinqumo esibalulekile esingaba nomthelela omkhulu emiphumeleni yesiguli. Izinto ezifana ne-polyester, i-polypropylene, ne-ePTFE zinikeza amandla amahle kakhulu, ukuqina, nokusabela kwezicubu ezincane, okuzenza zilungele izinqubo eziyinkimbinkimbi zenhliziyo. Ngokuqonda izici eziyingqayizivele zalezi sutures nokucabangela izici ezifana nobukhulu be-suture nezindlela zokuphatha, odokotela abahlinzayo bangenza izinqumo ezinolwazi ezithuthukisa impumelelo yokuhlinzwa futhi zikhuthaze ukuphulukiswa okungcono.
Kochwepheshe bezokunakekelwa kwempilo abafuna ukuthuthukisa amasu abo okuhlinza kanye nemiphumela, ukutshala isikhathi ekukhetheni impahla ye-suture efanele kubalulekile. Kungakhathaliseki ukuthi ubhekene nokulungiswa okujwayelekile noma ukwakhiwa kabusha kwemithambo eyinkimbinkimbi, i-suture efanele ingenza umehluko.
Isikhathi sokuthumela: Nov-08-2024
