ʻOki kino bypass

Hoʻokumu kahi ʻoki bypass puʻuwai i kahi ala hou, i kapa ʻia he bypass, no ke koko a me ka oxygen e hele a puni kahi pā e hiki ai i kou puʻuwai.

Ma mua o kou ʻoki ʻana, e loaʻa ʻoe i ka anesthesia ākea. E hiamoe ʻoe (unconscious) a ʻaʻohe ʻeha i ka wā o ke kaha.

Ke ʻike maka ʻole ʻoe, e hōʻoki ka mea hōʻoki puʻuwai i 8 a 10-inch (20.5 a 25.5 cm) ma waena o kou umauma. E hoʻokaʻawale ʻia kou umauma e hana i kahi wehe. ʻAe kēia i kāu kauka lōkō e ʻike i kou puʻuwai a me ke aorta, ke kīʻaha koko nui e alakaʻi ana mai ka puʻuwai a i ke koena o kou kino.

ʻO ka hapa nui o ka poʻe i loaʻa i ke kīpoki by coronary e pili ana i ka mīkini bypass puʻuwai puʻuwai, a i ʻole pump pump.

• Kāohi ʻia kou puʻuwai ke pili ʻoe i kēia mīkini.
• Hana kēia mīkini i ka hana o kou puʻuwai a me kou mau māmā ʻoiai paʻa kou puʻuwai no ke ʻoki. Hoʻohui ka mīkini i ka oxygen i kou koko, neʻe i ke koko ma o kou kino, a hemo i ke kalapona kalapona.

ʻAʻole hoʻohana kahi ʻano ʻoki ʻalo i ka mīkini bypass puʻuwai-puʻuwai. Hana ʻia ke kaʻina hana i ka wā e kuʻi mau nei kou puʻuwai. Kāhea ʻia kēia i ka bypass pump-coronary artery bypass, a i ʻole OPCAB.

E hana i ka bypass graft:

• E lawe ke kauka i ka aa a i ʻole ke aʻa o kahi ʻāpana ʻē aʻe o kou kino a hoʻohana iā ia e hana i kahi kolo (a i ʻole ka hoʻopili ʻana) a puni ka wahi i ālai ʻia i kāu aʻa. Hiki paha i kāu kauka ke hoʻohana i kahi aa, i kapa ʻia ʻo ka saphenous vein, mai kou wāwae.
• E kiʻi i kēia aa, e hana ʻia kahi ʻokiʻoki ma loko o kou wāwae, ma waena o kou kuʻekuʻe wāwae a me kou ʻūlū. E humuhumu hoʻokahi hopena o ke kuhi i kou aʻa coronary. E humuhumu ʻia ka hopena ʻē aʻe i kahi wehe i hana ʻia i kāu aorta.
• ʻO kahi kīʻaha koko i loko o kou umauma, i kapa ʻia ʻo ka mammary artery (IMA), hiki ke hoʻohana ʻia ma ke ʻano he graft. Hoʻohui ʻia kahi hopena o kēia aʻa i kahi lālā o kāu aorta. Hoʻopili ka hopena ʻē i kāu aʻa korona.
• Hiki ke hoʻohana ʻia nā aʻa ʻē aʻe no nā grafts i ke kahakaha bypass. ʻO ka mea maʻamau ka ʻāpana radial i kou lima.

Ma hope o ka hana ʻia ʻana o ka graft, e pani ʻia kou umauma me nā kaula. Noho kēia mau kaula i loko ou. E pani ʻia ka ʻoki ooki me nā humuhumu.

Hiki i kēia ʻoki ke lawe i 4 a 6 mau hola. Ma hope o ke kahakaha ʻana, e lawe ʻia ʻoe i ka keʻena mālama maʻi nui.

Pono ʻoe i kēia kaʻina hana inā loaʻa kahi paʻa i hoʻokahi a ʻoi paha o nā aʻa o kāu coronary. ʻO nā aʻa coronary nā ipu e hoʻolako i kou puʻuwai me ka oxygen a me nā mea momona i lawe ʻia i kou koko.

Ke lilo kekahi a ʻoi paha o nā aʻa koronaʻi i hapa a i ʻole ālai ʻia, ʻaʻole lawa ke koko i kou puʻuwai. Kāhea ʻia kēia ʻo ka maʻi puʻuwai ischemic, a i ʻole ke maʻi aʻa coronary (CAD). Hiki iā ia ke hōʻeha i ka umauma (angina).

Hiki ke hoʻohana ʻia i ke kahakaha by coronary artery e hoʻomaikaʻi ai i ke kahe o ke koko i kou puʻuwai. Ua hoʻāʻo mua paha kāu kauka e mālama iā ʻoe me nā lāʻau. Ua hoʻāʻo paha ʻoe i ka hoʻoikaika kino a me nā loliʻai, a i ʻole angioplasty me ka stenting.

ʻOkoʻa ka CAD i kēlā me kēia kanaka. ʻO ke ala e ʻike ʻia ai a mālama ʻia e loli hoʻi. ʻO ke kīpoki bypass puʻuwai kahi ʻano lapaʻau wale nō.

Nā kaʻina hana ʻē aʻe i hiki ke hoʻohana ʻia:

• Hoʻonohonoho Angioplasty a me stent
• ʻOki kino bypass - minimally invasive

ʻO nā pōʻino no kēlā me kēia ʻoki pū me:

• Kahena
• Maʻi kīnā
• Make

Nā pilikia e hiki ke loaʻa mai ke ʻoki ʻana i ka coronary bypass:

• ʻO ka maʻi, me ka maʻi ʻeha o ka umauma, ka mea e ʻoi aku ka hopena inā he nui ʻoe, he diabetes, a i ʻole ua loaʻa mua i kēia ʻoki.
• Maʻi hohola
• Hahau
• Nā pilikia puʻuwai puʻuwai
• Hewa ʻole nā ​​hakuʻala
• Hoka maikaʻi ʻole
• Kaumaha a me ke ʻano o ka naʻau
• ʻO ke kuni haʻahaʻa, ka luhi, a me ka ʻeha o ka umauma, i kapa ʻia ʻo ka maʻi postpericardiotomy, kahi e hiki ai i nā mahina 6
• Ka nalowale ʻana o ka hoʻomanaʻo, ka nalowale ʻana o ka akāka noʻonoʻo, a i ʻole ka "noʻonoʻo fuzzy"

E haʻi mau i kāu mea mālama ola i nā lāʻau āu e lawe nei, ʻo nā lāʻau a lāʻau paha āu i kūʻai ai me ka ʻole o ka lāʻau.

I nā lā ma mua o kou ʻoki kino:

• No ka manawa he 1 mau pule ma mua o ke kahakaha ʻana, e noi ʻia paha ʻoe e haʻalele i ka lawe ʻana i nā lāʻau e paʻakikī ai i ke kō ʻana o kou koko. Hiki paha i kēia ke hoʻonui i ke kahe i ka wā o ke ʻoki. Hoʻopili lākou i ka aspirin, ibuprofen (e like me Advil a me Motrin), naproxen (e like me Aleve a me Naprosyn), a me nā lāʻau ʻē aʻe like. Inā ʻoe e lawe ana i ka clopidogrel (Plavix), e kamaʻilio me kāu kauka lā e pili ana i ka manawa hea e haʻalele ai iā ia.
• E nīnau i nā lāʻau āu e lawe ai i ka lā o ke ʻoki.
• Inā puhi ʻoe, hoʻāʻo e kū. E noi i kāu mea hāʻawi mai i kōkua.
• Kāhea aku i kāu mea hāʻawi inā loaʻa ʻoe i ke anu, flu, fever, breakout herpes, a i ʻole nā ​​maʻi ʻē aʻe.
• E hoʻomākaukau i kou home i hiki ai iā ʻoe ke neʻe maʻalahi ke hoʻi mai ʻoe mai ka haukapila.

ʻO ka lā ma mua o kou ʻoki ʻana:

• ʻO Shower a me ka shampoo maikaʻi.
• E noi ʻia ʻoe e holoi i kou kino holoʻokoʻa ma lalo o kou ʻāʻī me kahi kopa kūikawā. E ʻānai i kou umauma i 2 a i ʻole 3 mau manawa me kēia kopa.
• E ʻike pono e hoʻomaloʻo ʻoe iā ʻoe iho.

I ka lā o ke kaha:

• E noi ʻia ʻoe ʻaʻole e inu a ʻai paha i kekahi mea ma hope o ke aumoe i ka pō ma mua o kou ʻoki kino ʻana. E holoi i kou waha me ka wai inā e maloʻo, akā e akahele e ʻole e ale.
• E lawe i nā lāʻau i haʻi ʻia iā ʻoe e lawe me kahi wahi wai ʻuʻuku.

E haʻi ʻia ʻoe i ka wā e hōʻea ai i ka haukapila.

Ma hope o ka hana, e hoʻolimalima ʻoe i 3 a 7 mau lā i ka haukapila. E hoʻolilo ʻoe i ka pō mua ma kahi keʻena mālama nui (ICU). E hoʻoneʻe ʻia paha ʻoe i kahi lumi mālama maʻamau a hoʻololi paha ma waena o 24 a 48 mau hola ma hope o ke kaʻina hana.

ʻElua a ʻekolu paha mau paipu i loko o kou umauma e hoʻokahe i ka wai mai a puni kou puʻuwai. Lawe pinepine lākou iā 1 a 3 mau lā ma hope o ke kaha.

Loaʻa paha iā ʻoe kahi catheter (Tube Tube) i loko o kāu pēpē e hoʻokahe i ka mimi. Loaʻa paha iā ʻoe nā laina intravenous (IV) no nā wai. E hoʻopili ʻoe i nā mīkini e nānā i kāu pulse, ka mahana, a me ka hanu. E nānā mau nā kahu hānai i kāu mau mea nānā.

Loaʻa paha iā ʻoe nā kaula liʻiliʻi e pili ana i ka mea mālama i ka pacemaker, i huki ʻia ma mua o kou hoʻokuʻu ʻana.

E paipai ʻia ʻoe e hoʻomaka hou i kekahi mau hana a hoʻomaka paha ʻoe i kahi polokalamu rehona puʻuwai i loko o kekahi mau lā.

He 4 a 6 mau pule e hoʻomaka ai ka maikaʻi ma hope o ke kahakaha ʻana. E haʻi aku kāu mau mea lawelawe iā ʻoe pehea e mālama ai iā ʻoe iho ma ka home ma hope o ke ʻoki ʻana.

Loaʻa ka manawa i ke ola ʻana mai ke ʻoki kino. ʻAʻole paha ʻoe e ʻike i nā keu pono o kāu ʻoki ʻana no 3 a 6 mau mahina. I ka hapanui o ka poʻe i loaʻa i ka puʻuwai e kāpae i ka naʻau, noho hāmama nā grafts a hana maikaʻi no nā makahiki he nui.

ʻAʻole hiki i kēia ʻoki ke pale i ka paʻa ʻana o ke aʻa koronary mai hoʻi mai. Hiki iā ʻoe ke hana i nā mea he nui e lohi ai i kēia kaʻina hana, me:

• ʻAʻole puhipaka
• ʻO ka ʻai ʻana i ka papaʻai olakino puʻuwai
• Ke kiʻi i ka hoʻoikaika kino maʻamau
• Ka mālama ʻana i ke koko kiʻekiʻe
• Ka mālama ʻana i ke kō kō (inā he maʻi diabetes ʻoe) a me ke kiʻekiʻe o ke kō

Holo i ke aʻa aʻa coronary pēpē i waho; OPCAB; ʻOki kino puʻuwai; ʻOki kino Bypass - puʻuwai; CABG; Corpassary artery bypass graft; ʻOki kino by Coronary artery bypass; ʻOki kino Coronary; ʻO ka maʻi ahulau coronary - CABG; CAD - CABG; Angina - CABG

• Angina - hoʻokuʻu
• Angina - he aha e nīnau aku ai i kāu kauka
• Angina - ke loaʻa iā ʻoe ka ʻeha o ka umauma
• Angioplasty a me stent - puʻuwai - hoʻokuʻu
• Nā lāʻau Antiplatelet - nā mea kūpaka P2Y12
• ʻO ka aspirin a me ka maʻi puʻuwai
• Ka palekana i ka lumipaku no nā mākua
• Ke hana nei ma hope o ka hōʻeha o kou puʻuwai
• Ke hana nei inā loaʻa ka maʻi puʻuwai
• ʻO ka pata, ka margarine, a me nā aila kuke
• Catheterization Cardiac - hoʻokuʻu
• ʻO Cholesterol a me ka nohona
• Cholesterol - lāʻau lapaʻau
• Ke kaohi nei i kou kiʻekiʻe o ke koko
• Ua wehewehe ʻia nā momona momona
• ʻLelo aʻoaʻo ʻai wikiwiki
• Puʻuwai puʻuwai - hoʻokuʻu
• Ka hōʻeha puʻuwai - he aha e nīnau aku ai i kāu kauka
• ʻOki kino bypass - hoʻokuʻu
• Maʻi maʻi puʻuwai - nā mea weliweli
• Hoʻomaʻamaʻa i ka puʻuwai - hoʻokuʻu
• Pehea e heluhelu ai i nā lepili ʻai
• Papaʻai paʻakai haʻahaʻa
• Papaʻai Mediterranean
• Pāleʻa ka pale ʻana
• Mālama ʻeha ʻeha - wehe
• Ke loaʻa ka nausea a me ka luaʻi

• Puʻuwai - ʻike mua
• Nā aʻa puʻuwai posterior
• Nā aʻa puʻuwai mua
• Atherosclerosis
• ʻOki kino bypass - moʻo
• ʻOki ʻoki ʻoki by Heart

Al-Atassi T, Toeg HD, Chan V, Ruel M. Coronary artery bypass grafting. I: Sellke FW, del Nido PJ, Swanson SJ, eds. ʻO Sabiston lāua ʻo Spencer Surgery o ka umauma. 9th ed. Piladelapia, PA: Elsevier; 2016: chap 88.

Hillis LD, Smith PK, Anderson JL, et al. 2011 ACCF / AHA alakaʻi no ka coronary artery bypass graftʻoki: kahi hōʻike o ka American College of Cardiology Foundation / American Heart Association Task Force ma nā Kumu Alakaʻi. Kaapuni. 2011; 124 (23): e652-e735. PMID: 22064599 pubmed.ncbi.nlm.nih.gov/22064599/.

Kulik A, Ruel M, Jneid H, et al. ʻO ka pale ʻana i ke kula kiʻekiʻe ma hope o ke kahakaha ʻana o ke aniani coronary: kahi ʻōlelo ʻepekema mai ka American Heart Association. Kaapuni. 2015; 131 (10): 927-964. PMID: 25679302 pubmed.ncbi.nlm.nih.gov/25679302/.

ʻApōpō DA, de Lemos JA. Maʻi maʻi ischemic paʻa. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: kahi puke o ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 61.

ʻO Omer S, Cornwell LD, Bakaeen FG. Loaʻa i ka maʻi puʻuwai: ka lawa ʻole o ka coronary. I: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery. 20 ouk. Piladelapia, PA: Elsevier; 2017: chap 59.