Ukuphelelwa Ngaphandle kwegazi kunye nokuLondolozwa kweGazi

Njani kwaye Kutheni Izigulane Zikhetha Lo Okhethwayo

Ukulondolozwa kwegazi liqela lezakhono ezisetyenziselwa ukunciphisa isidingo segazi esetyenziswe ngexesha lotyando lwempilo. Kubantu abanqwenela ukuhlinzwa ngaphandle kwegazi, naluphina inkqubo yokuphanda apho kungekho mveliso yegazi ngaphandle kwesi sigulane esetyenziswayo, kubalulekile ukugcinwa kwegazi.

Amanyathelo okulondoloza igazi amaninzi afanelekileyo nabani na ofuna ukunciphisa amathuba okufuna ukumpontshelwa igazi ngexesha okanye emva kokuhlinzwa kwabo.

Kutheni i-Blood Conservation iqala kwiLebhu

Igazi elixhaswe ngumthombo oxabisekileyo. Yonke imihla inkqubo ixhomekeke kububele babantu abazimisele ukunikela ngexesha labo kunye negazi labo ukuze bancede abanye. Ukunciphisa ilahleko yegazi kuqondakala kwaye kuqala ngokuqokelela kunye nokusetyenziswa kwegazi.

Ngandlela-thile, iindlela zokulondolozwa kwegazi kwinqanaba lebhanki legazi lilingqiqo: sebenzisa igazi ngaphambi kokuba liphelelwe yisikhathi ngoko akudingeki ukuba lilahlwe, kuphuculwe ukuphathwa kwegazi kangangokuba akukho sizathu sokuyilahla, kwaye, ngokuqhelekileyo, baphathe igazi njengexabiso elixabisekileyo.

Ngokukhusela igazi elinikelweyo, sinokukwazi ukuba negazi elaneleyo xa umntu (okanye abantu abaninzi) benesidingo sokumpontshelwa okuncinci okanye okukhulu.

Izizathu Izigulane Zikhetha Ukulondolozwa Kwegazi kunye noPhephelo olungenanjongo

Zininzi izizathu zokuba umntu angakhetha ukwamkela igazi okanye iimveliso zegazi kumniki-mnikelo, kwaye kukho izizathu ezingakumbi zokuba igazi elilondolozayo lihlakaniphile ngombono ongokoqobo.

Kunengqiqo ukuphepha ukuxilongwa xa kunokwenzeka, njengoko kukho iingozi kungakhathaliseki uhlobo lwemveliso yegazi olunikeziwe.

Ukugcinwa kwegazi kwinqanaba lezononophelo lwezempilo lithatha iindidi ezininzi, kwaye izizathu zokuphepha igazi zihluka phakathi kwabantu. Ezinye izizathu eziqhelekileyo ziquka:

• Inkolo: Ezinye iicawa, kuquka iNgqina likaYehova, ziyakwenqabela okanye zidikibala igazi.

• Ukuphepha ingozi yokumpontshelwa igazi : malunga ne-1 kuzo zonke izigulane ezi-2,000 ezifumana ukuxilongwa ziya kuhlakulela intsholongwane yebhaktheriya ukusuka kuloo transfusion, kunye ne-1 isigulane kwi-100 iya kuvelisa umkhuhlane ekuphenduleni. Nangona kunqabile, kuqikelelwa ukuba ku-600 000 izigulane ezifakwe kwigazi ziza kufa ngenxa yokumpontshelwa igazi, ngokuqhelekileyo emva kokusongela ubomi obubizwa ngokuba yi-anaphylaxis. Uninzi lwabantu abanokufakela igazi alukho iingxaki ezivela kwinkqubo.
• Ukukhathazeka ngezifo ezithathelwanayo: Nangona igazi elifumaneka eUnited States likhuseleke kakhulu, kukho abantu bexesha elidlulileyo abaye banesifo sengqondo sokubulala ne- HIV kunye ne- HIV . Izifo ezinzulu ezibangelwa ukudluliselwa kwegazi ziqabile kakhulu. Amazwe amaninzi anikezelo lwegazi olukhuselekileyo, kodwa kukho amazwe amaninzi angenawo ulawulo olufanelekileyo lweendawo ekukhuseleni ukusuleleka.
• Ukusabela kwangaphambili kwegazi: Abantu abaye baphathwa kakubi ngegazi emva kokuba ukulawulwa kwegazi esikhathini esidlulileyo kungabi nako ukunyamezela ukuxilongwa, kungakhathaliseki ukuba kuyimfuneko kangakanani. Ukuba i-anaphylaxis, isifo esisongela ubomi, isabela ngenxa yokumpontshelwa igazi isiguli singacetyiswa ukuba singamkeli ukumpontshelwa kwixesha elizayo.

Abantu abathile banokuthi badinga ukudluliselwa ngexesha loPhengululo

Ezinye iintlobo zokulimala, iimeko zonyango kunye neyeza, zandisa amathuba okuba isigulane sidinga ukumpontshelwa ngexesha okanye emva kwenkqubo yokuhlinzwa. Zininzi iintlobo zokuhlinzwa zibangelwa ukulahlekelwa kwegazi elincinci, kodwa ezinye ziyaziwa ukuba zifuna ukuxilongwa.

• Umdala omdala: Umdala omdala unokufuna ukudluliselwa ngaphandle kwesigulane esincinane.
• I-Anemia : Isigulane esinomgangatho owehla weeseli ezibomvu zegazi, kungakhathaliseki isizathu, kusenokwenzeka ukuba sidinga ukumpontshelwa ngexesha okanye emva kokuhlinzwa.
• Izigulane kwigazi: Abangamayeza abathintela ama-blood clots kodwa kukhokelela ekuphumeni kwegazi xa kutyunjwa. Zivame ukuma phambi kokuhlinzwa okucwangcisiweyo.

• Ukubuyela kwi-OR: Izigulane ezenza utyando lwesibini ukulungisa iingxaki emva kwenkqubo yakutshanje.
• Ukuhlinzwa ngokukhawulezileyo : Ukuhlinzwa okungahlelelwe kwaye kungalindelekanga kuqhutyelwa kuphela kwisifo esisongela ubomi, ukuba ugula kakhulu kwandisa izinga lomngcipheko lophina uphando kunye nomngcipheko wokuphuma kwamanzi.
• Iimeko ezinobulunga okanye ezininzi zonyango ngaphezu kwesizathu sokuhlinzwa.
• Ukuvulwa kwentliziyo efuna ukusetyenziswa komshini we-lung-pulp machine.
• Iintsholongwane: Ezinye iintlobo zomhlaza zinganciphisa amandla omzimba wokuvelisa iiseli ezibomvu zegazi, kanti ezinye ziyanciphisa amandla omzimba okwenza izinto zokuqhawula ngesibindi - ezivumela igazi ukuba livale ngexesha lokuphuma.
• Utyando lwezentlungu: Ukulimala okubangelwa yimpembelelo ebalulekileyo, njengokonakala komonakalo omkhulu wemoto, ngokugqithiseleyo kubangele ukuphuma kwegazi ngaphezu kwezinye iintlobo zokulimala.
• Izigulane ezineengxaki zokuqhawula

Indlela Yokukhetha Ukulondolozwa Kwegazi kunye noPhephelo olungenanjongo

1. Xelela ugqirha wakho. Ukuba uthe wagqiba ukuphepha okanye ukunciphisa ukumpontshelwa igazi ngexesha lotyando kufuneka uxelele ugqirha wakho kunye neqela lokugqirha ngokukhawuleza, ngokukhethekileyo xa uqala ukuxoxa ngethuba lokuhlinzwa. Ukuba ugqirha wakho akakwazi ukwenza utyando olungenagazi, cela ukuthunyelwa kumntu onako.
2. Fumana isibhedlele sakho. Azibona zonke izibhedlele zinika inkqubo epheleleyo yokulondoloza igazi okanye ukutyalwa ngaphandle kwegazi. Ngelixa ezininzi zobuchule ezisetyenziselwa ukunciphisa amathuba okudluliselwa kwegazi kunokwenzeka kwiindawo ezininzi, iindlela zokuhlinzwa ezingenazigazi azifumanekanga kuyo yonke indawo. Ngokomzekelo, ukufakelwa kwesibindi kufumaneka kwizibhedlele ezininzi kwilizwe lonke, kodwa zimbalwa izibhedlele zikwazi ukwenza ukufakelwa kwebindi.
3. Qaphela Ubulumko Bakho. Emva kokuba ufumene isibhedlele apho uza kutyunjwa khona, uya kufuneka uzalise iphepha elenza ukuba ufuna ukuba unqunyulwe ukunciphisa yonke imveliso yegazi ngelibhedlele. Le fomu luhlobo lomyalelo ohambileyo. Gcina ukhumbule ukuba isigulane sinelungelo lokunqaba unyango lwezo zonke iintlobo, kungekhona nje ukulawulwa kwegazi.
4. Bhalisa Ekuqaleni. Kuthatha ixesha ukucwangcisa ukuhlinzwa ngaphandle kwegazi. Into elula nje ngokuba kunyanga i-anemia yokunqongophala kwesinyithi ekulungiseleleni ukuhlinzwa ingathatha iiveki ezi-6 ukuya kwezi-12, ukuba imeko ayikho nzima. Xa i-anemia iphathwa, isigulane sinokufuna iiveki ezongezelelweyo ukuba zifakwe igazi kwaye zilondolozwe ukuxilongwa kwexesha elizayo. Oku kuthiwa yi- autologous blood transfusion . Ekugqibeleni, xa kugcinwe igazi elaneleyo, umzimba ufuna ixesha lokubuyisela nokuvuselela izitolo zegazi.

• Qinisekisa ukuba kukho umququzeleli ongenagazi kwindawo apho uya kutyunjwa khona. Lo mntu unokunceda ukucwangcisa unyameko olufunekayo ngexesha lonke loovulindlela.

Ukugcinwa kweGazi phambi koPhando

Ukucwangciswa kubalulekile ngaphambi kokuhlinzwa ngaphandle kwegazi. Ukuze isigulane sikwazi ukunyamezela ukuhlinzwa ngaphandle kwegazi, kufuneka sibe semeko engcono kakhulu yomzimba ngaphambi kwenkqubo. Oku kuthetha ukuba negazi elinempilo ukuze umzimba ungakwazi ukubekezelela ukulahlekelwa igazi ngexesha lotyando.

Le nkqubo iqala ngokuvavanya igazi lesigulane ukuze umgangatho wegazi uphuculwe, ukuba kuyimfuneko, kunye nokulahleka kwegazi okungadingekile kunokuthintelwa. Ukuba isigulane sinqwenela ukuba yi-anemia, oku kuthetha ukuba kunamaseli amangqomzana egazi obomvu, isizathu sokuthi le-anemia kufuneka imiselwe kwaye imeko ilungiswe ukuba kunokwenzeka. Oku kunokuthetha ukutshintsha kokutya kunye nokuxhaswa okanye ukuvavanywa kwexesha lonyango. I-Stool ingahlolwa igazini ukuqinisekisa ukuba akukho negazi elahlekile kwi-digestive tract. Abasetyhini abanesifo esinzima sokuphuma kwexesha bangathunyelwa kwingcali onokukunceda ukunciphisa ukulahlekelwa igazi kunye neyeza okanye inkqubo xa kuyimfuneko.

Xa igazi ludityaniswe ukuhlolwa kwebhubhile, ubuncinci bezinto ezincinci kunezinye eziqhelekileyo zitsalwa, ngamanye amaxesha zisebenzisa izinto zokuvavanya kunye nezixhobo ezijoliswe kubantwana abancinci. Isana esisandul 'ukuzalwa asikwazi ukunyamezela ixabiso elikhulu legazi elidityaniswa rhoqo, ngoko iimvavanyo zenzelwe ukusebenzisa iincinci zegazi kakhulu kunokuba zisetyenziselwa abadala.

Ukuba igazi liyakudingeka ngexesha lotyando, isigulane singakwazi "ukunikela" igazi labo, eligcinwa ukuze lifumaneke kamva ngexesha lotyando lomguli. Izigulane ezixhalabileyo ngeengozi zokumpontshelwa igazi kodwa zineenkcaso zokumpontshelwa ngokubanzi zingenza amalungu omndeni anikeze negazi labo kwinkqubo ezayo.

Kwezinye iimeko, amayeza anikwe ukunyusa inani leeseli ezibomvu zegazi phambi kwenkqubo. Ezi zonyango, kuquka i-erythropoietin, zingabiza kakhulu kwaye zigcinwa ngokugulisa kwizigulane ezine-anemia ezingaphenduli kwezinye iintlobo zonyango.

Ukugcinwa kweGazi ngexesha loPhando

Udokotela ogqirha owazi kakuhle ukuhlinzwa ngaphandle kwegazi kunye namava ekusebenziseni iindlela zokulondolozwa kwegazi ezisetyenziswe ngaphambili, ngexesha kunye nangemva kokutyunjelwa yingxenye ebaluleke kakhulu yokuphumelela kwegazi ngaphandle kwegazi. Utshintsho oluncinci kwiindlela zokugqirha lunokuhlawula umvuzo oncomekayo ngokulahlekelwa igazi. Ngokomzekelo, ukusika izicubu nge-scalpel kukhokelela ekuphumeni kwegazi, ngoko ke apho kunokwenzeka ukuba idivayisi ye-cautery yombane, eyenza ukusika kodwa isebenzisa ukushisa ukuyeka ukuphuma kwegazi, isetyenziswa rhoqo.

• Iinkqubo zeRbobotic: Uninzi lwe-operesheni lunokusetyenziswa ngokusebenzisa i-robotic technology, enokunciphisa inani lokuphuma kwegazi elilindelekileyo ngexesha lotyando.
• Amacandelo amancinci angenayo: Utyando lwe-Laparoscopic usebenzisa iincinci ezincinci kakhulu ukwenza inkqubo ngaphandle kwesicatshulwa esisodwa esasetyenziswa ngokuqhelekileyo. Le ndlela entsha kodwa ngokuqhelekileyo isetyenziswa ngokunciphisa ukuphuma kwegazi ngokugqithiseleyo kwindlela yobudala "evulekile".
• Umgcini wesilwanyana: Esi sixhobo esivumela ugqirha ukuba aqoke igazi elahlekile kwindawo yokuhlinzwa ngexesha lotyando. Emva kokuba iqokelelwe iphathwa ngegazi elincinci ukukhusela i-clotting kwaye xa kufanelekile igazi lingabuyiselwa kwisigulane njengopompile.
• Ukugcina ukushisa kwesigulane: Amagumbi amaninzi asebenzayo apholile, kwaye ngenxa yokushisa kwegumbi kunye noxa usaphila ngexesha lotyando, ubushushu bomzimba wesiguli bunciphisa ngexesha lotyando. Oku kwehla ekubuseni komzimba kunokukhokelela ekuphumeni kwegazi ukwenzela ukuba kugcinwe ukushisa kwesigulane kwizinga eliqhelekileyo.
• Ukubeka kwesigulane: Indlela umguli esetyenziswe ngayo kwithebhile kwigumbi lokusebenza unokuchaphazela ukuba kuvela phi ukuphuma kwegazi. Isikhundla esifanelekileyo siyahlukahluka kuxhomekeke ekutyunjweni kwenziwa.
• Amachiza ekunciphiseni ukuphuma kwamanzi: Kukho unyango onokunikwa ukukhusela nokunciphisa ukuphuma kwamanzi, njengetranexamic acid. Amachiza anokwanda kwamanzi aphepheka.
• Ukunyangwa kwe-incision: Ukunciphisa ukuphuma kwegazi kwisiza sokuqhawulwa, izikhonkwane zenyama zingasetyenziselwa ukukhutshwa njenge-powder okanye i-liquid. Iimbambo zikhuthaza igazi kwiziko ukuba livale kwaye liyeke ukuphaphaza ngokukhawuleza.

Ukugcinwa kwegazi emva kokuPiliswa

Ngokwemfuneko, ukunyamezela kwinqanaba eliphantsi le-hemoglobin (inani elinciphile leeseli ezibomvu zegazi) liyadingeka emva kokuhlinzwa ngaphandle kwegazi. Oko akuthethi ukuba ukuphuma kwegazi kuya kutyeshwa kwaye kungakhange kulandelelwe ukuba kukho ukuphuma kwegazi emva kwenkqubo, kodwa kuthetha ukuba ukuphendula ngokuqhelekileyo ekulahlekelweni kwegazi kunokungafani.

Ukuhlaselwa kuya kuphathwa ngokunyanzeliswa kumzamo wokumisa ukulahleka kwegazi. Ngokomzekelo, ukuqhuma okuqhubekayo ukuphuma emva kokuhlinzwa kungaphathwa ngokukhawuleza kusetyenziswe ama-adhesives amathishu ukukhuthaza ukucima, uxinzelelo olugcinwe phezu kwe-incision ukunciphisa ukuphuma kwegazi kwaye ulindele ngokukodwa nasiphi na isibonakaliso sokuba isiguli sifuna ukubuyela kwi-OR ukufumanisa apho igazi livela.

Ubungozi Bokuguqulwa Ngaphandle Kwegazi

Ukulondolozwa kwegazi kunomngcipheko omncinci, njengoko ingcamango nje ukunciphisa inani legazi elisetyenziselwa unyango. Utyando olungenalo igazi, nangona kunjalo, lunobungozi, eninzi lwabantu abaqhelekileyo kubantu abanesifo semvelo.

Abantu abane-anemia, nokuba i- anemia ngenxa yokulahlekelwa igazi ngexesha lotyando okanye esinye isizathu, banokuvakalelwa iimpawu ze-anemia: ubuthathaka, ukukhathala, intloko, nokunyanzeliswa kokuzivocavoca. Xa izinga liphantsi ngokwaneleyo kangangokuthi liza kunyangwa ngokupakishwa, ukuphilisa kuya kwenzeka ngokukhawuleza kunokuba kumntu onamaqondo aphilileyo. Kwiimeko ezinzima ze-anemia, njengamazinga omzimba obomvu weeseli ezibonakalayo xa isigulane sinegazi elikhulu, umngcipheko wokufa ungokoqobo. Ngenhlanhla, umngcipheko wokufa uhlala uncinci ngenxa yezigulane ezininzi zokuhlinzwa ngaphandle kwegazi.

Amagama ambalwa malunga nokulondolozwa kwegazi kunye noPhephelo olungenanjongo

Kungenzeka ukuba ezinye zezicwangciso ezisetyenziselwa ukuthintela isidingo sokumpontshelwa okwenziweyo ngokuthe ngqo kwizigulane ezizimisele ukuba zingenayo igazi ngexesha lotyando ziya kuqala ukuba ziqheleke kwindawo eziqhelekileyo kuzo zonke izigulane ezilindele ukuhlinzwa. Oku kungenxa yokuba ezo zakhono (ikakhulukazi) ziphunyezwe lula kwaye zinokunciphisa umngcipheko jikelele ukuba isigulane sibhekane nokuba ukuxilongwa kungagwenywa.

> Imithombo:

> Ukuguqulwa kweGesi kunye nokuLondolozwa kweGciwane ekuPhengeni kweCardiac: I-Society of Thoracic Surgeons kunye noMbutho wee-Cardiovascular Anesthesiologists. I-Society of Thoracic Surgeons I-Blood Conservation Guideline Task Force. http://www.sts.org/sites/default/files/documents/pdf/BloodConservationGuidelinesFINAL.pdf.

> Ukulondolozwa kwegazi: Ukulungiswa kwegazi nge-Preoperative Autologous Blood Donation. http://www.uptodate.com/contents/surgical-blood-conservation-preoperative-autologous-blood-donation?source=see_link.