I. Isingeniso
A. Iqhaza Elibalulekile Lokulethwa Kwezidakamizwa Okunembayo Ekunakekelweni Kwezempilo
Emithi yesimanje, ukulinganisa okunembile kwezidakamizwa kubaluleke kakhulu. Kungaba umehluko phakathi komphumela wokwelashwa ophumelelayo kanye nokulimala okungase kube khona esigulini. Kungakhathaliseki ukuthi inikezela ngemithi esindisa impilo, imithi yokwelapha ngamakhemikhali, noma ama-ejenti okulawula ubuhlungu, ukunemba kokulethwa kwezidakamizwa kuthinta ngokuqondile ukuphepha kwesiguli nokusebenza kokungenelela kwezokwelapha.
B. Ukwethulwa Kwabadlali Ababalulekile Ababili: iphampu yesirinji kanye namasirinji Esintu
Kokubili iphampu yesirinji kanye nemijovo yendabuko ikhona yonke indawo kuzilungiselelo zezokwelapha. Amasirinji, anomlando wawo omude, ajwayelekile emitholampilo, ezibhedlela, ngisho nasekunakekelweni kwezempilo kwasekhaya. Alula, abiza imali eningi, futhi bekuyindlela yokuya kuyo ukuze uthole imijovo eminingi. iphampu yesirinji, ngakolunye uhlangothi, imele indlela ethuthuke kakhulu futhi ethuthuke kakhulu yobuchwepheshe ekulethweni kwezidakamizwa. Ziya ngokuya ziba ukudla okuyisisekelo emayunithi okunakekela ababucayi, amagumbi okuhlinza, nanoma yisiphi isimo lapho ukumnika izidakamizwa okunembe nokulawulwayo kubalulekile. Ukuqonda umehluko kanye nezinzuzo phakathi kwalezi zindlela ezimbili kubalulekile kubahlinzeki bezempilo kanye neziguli ngokufanayo.
II. Indlela Asebenza Ngayo
A. Ukusebenza Kwangaphakathi kwephampu yesirinji
iphampu yesirinji isebenza ngomgomo oyinkimbinkimbi futhi ozenzakalelayo. Emgogodleni wabo, aqukethe injini, ngokuvamile i-stepper motor, elawulwa kahle yi-electronic system. Le moto ishayela i-screw mechanism exhunywe ku-syringe piston. Lapho iphampu yenziwe yasebenza, injini iyazungeza, okwenza isikulufu sijike. Njengoba isikulufu siphenduka, siphusha ipiston yesirinji phambili ngenani elilawulwayo, ikhipha uketshezi olungaphakathi kwesirinji futhi iluphoqelele ngeshubhu elinamathiselwe futhi ingene emzimbeni wesiguli. Isivinini kanye nevolumu yomjovo ingahlelwa ngokunemba okuphawulekayo, ngezinye izikhathi kuze kube yizingxenyana zemililitha ngehora. Leli zinga lokunemba lifinyelelwa ngenhlanganisela yezinzwa ezithuthukisiwe eziqapha ukuma kwepiston, ukucindezela kushubhu, nezinga lokugeleza koketshezi. Isibonelo, ezikhungweni zokunakekela izingane ezisanda kuzalwa, lapho izinsana zidinga imithamo emincane, elinganiswe ngokunembile yemithi, iphampu yesirinji ingasethwa ukuthi ilethe kancane nje ngo-0.1 ml ngehora, okuqinisekisa ibhalansi ethambile yezidakamizwa emizimbeni yabo emincane.
B. Ubulula Bamasirinji Endabuko
Amasirinji endabuko, ngokuphambene, ancike ekusebenzeni ngesandla okuqondile. Ahlanganisa umgqomo, ngokuvamile owenziwe ngepulasitiki noma ingilazi, enezimpawu ezineziqu eceleni kwawo ukuze ubonise umthamo. I-plunger, efakwe kahle ngaphakathi emgqonyeni, isetshenziselwa ukudonsa nokukhipha uketshezi. Ukuze usebenzise isirinji yendabuko, umhlinzeki wezokunakekelwa kwempilo uqale adonsele inani elifunekayo lomuthi emgqonyeni ngokudonsela emuva ku-plunger. Lokhu kudala i-vacuum emunca uketshezi ngenaliti, exhunywe esihlokweni sesirinji. Uma isilinganiso esifanele sesikaliwe, isirinji ishuthekwa esigulini, bese iplunger iphushelwa phambili kancane kancane, icindezela uketshezi futhi ilukhiphe ngenkani bese ingena endaweni yomjovo. Ukuba lula kwalo mklamo kusho ukuthi awudingi umthombo wamandla wangaphandle noma izinto zikagesi eziyinkimbinkimbi. Ingasetshenziswa cishe kunoma yisiphi isilungiselelo, kusukela emtholampilo wendawo ekude enezinsiza ezilinganiselwe kuya endaweni yokunakekelwa kwezempilo yasekhaya. Nokho, ukunemba komthamo kuncike ngokuphelele ekhonweni nasekunakeni komuntu onikeza umjovo. Ukuthuthumela kancane esandleni noma ukufunda okungalungile kwezimpawu zevolumu kungaholela emaphutheni omthamo.
III. Izinzuzo zepompo yesirinji
A. Ukunemba Ekulethweni Kwezidakamizwa
Enye yezinzuzo ezibaluleke kakhulu zepompo yesirinji ukunemba kwayo okungenakuqhathaniswa ekulethweni kwezidakamizwa. Emkhakheni wezokwelapha ngamakhemikhali, isibonelo, iziguli zidinga imithamo eqondile yezidakamizwa ezinamandla ze-cytotoxic. Le mithi inefasitela elincane lokwelapha, okusho ukuthi ngisho nokweqisa kancane kungaholela ebuthini obunzima, kuyilapho ukwehlisa umthamo kungase kwenze ukwelashwa kungasebenzi. iphampu yesirinji ingahlelwa ukuthi ilethe imithi yokwelapha ngamakhemikhali ngokunemba kwezinga le-micron, iqinisekise ukuthi isiguli sithola inani elinembile elidingekayo ukuze liqondise amangqamuzana omdlavuza kuyilapho kunciphisa ukulimala ezicutshini ezinempilo. Leli zinga lokunemba cishe akunakwenzeka ukuthi lifinyelelwe ngokuhambisana namasirinji avamile, njengoba inqubo yokujova okwenziwa ngesandla ingaphansi kwephutha lomuntu kanye nokuhlukahluka kwejubane lomjovo.
B. Izici Ezilungisekayo Nezihlelekayo
iphampu yesirinji inikeza izinga eliphezulu lokulungiseka nokuhleleka okubalulekile ekunakekelweni kwezempilo kwanamuhla. Abahlinzeki bezempilo bangasetha kalula izinga lokumnika, umthamo, nobude besikhathi ngokuya ngezidingo eziqondile zesiguli. Ezilungiselelweni zokunakekelwa okubucayi, njenge-intensive care unit (ICU), iziguli zingase zidinge ukuthelwa ngokuqhubekayo kwemithi eminingi, ngayinye enezidingo zayo ezihlukile zokudosa. iphampu yesirinji ingahlelwa ukuthi ishintshane phakathi kwemithi nemithamo ehlukene ngezikhathi ezithile, igcine amazinga ezinzile emithanjeni yegazi lesiguli. Lokhu kuvumelana nezimo kuvumela izindlela zokwelapha eziqondene nawe ezingalungiswa ngesikhathi sangempela njengoba isimo sesiguli sishintsha. Isibonelo, esigulini esinokushaqeka kwe-septic, imishanguzo ye-vasopressor idinga ukucaciswa kahle ukuze kugcinwe umfutho wegazi. Ikhono lokuhlela iphampu yesirinji ukwenza izinguquko ezincane ngesilinganiso sokumnika ngokusekelwe ekufundweni komfutho wegazi wesiguli kungasindisa ukuphila.
C. Induduzo Yesiguli Ethuthukisiwe
Ukunethezeka kwesiguli kungenye indawo lapho iphampu yesirinji ihamba phambili. Ukumnika okunensayo nokunganyakazi okuhlinzekwa ngephampu yesirinji kunciphisa ubuhlungu nokungakhululeki okuhambisana nemijovo esheshayo. Uma imithi ijovwa ngokushesha okukhulu, iziguli zingase zizwe ukusha, ubuhlungu endaweni yomjovo, noma ngisho nokukhathazeka. iphampu yesirinji iletha izidakamizwa ngenani elilawulwayo, inciphisa le mizwa engajabulisi. Ekunakekelweni kwezingane, isibonelo, izingane zivame ukuzwela kakhulu ezinhlungwini futhi zingacindezeleka kakhulu ngesikhathi sokujova. Ngokusebenzisa iphampu yesirinji ukunikeza imithi enjengama-antibiotics noma ama-analgesics, inqubo ingenziwa ibekezeleleke kakhulu ezigulini ezisencane, okuholela ekuthotshelweni kwemithetho engcono kanye nesipiliyoni esincane esibuhlungu kakhulu.
D. Ukunciphisa Ingozi Yamaphutha Emithi
Amaphutha emithi angaba nemiphumela emibi kakhulu, futhi iphampu yesirinji idlala indima ebalulekile ekunciphiseni lezi zingozi. Imvelo ezenzakalelayo yephampu yesirinji iqeda imithombo eminingi engaba khona yephutha lomuntu ehlotshaniswa nokusetshenziswa kwesirinji evamile. Ngesirinji, abahlinzeki bezempilo kufanele badwebe mathupha umthamo ofanele wemithi, bafunde izimpawu ngokunembile, futhi bajove ngesilinganiso esifanele. Ukukhathala, ukuphazamiseka, noma ukufunda kabi isikali sesirinji konke kungaholela ekudongeni okungalungile. iphampu yesirinji, ngakolunye uhlangothi, ithembele kuzilungiselelo ezihlelwe ngaphambilini, kunciphisa amathuba okuba namaphutha emithamo. Ngaphezu kwalokho, ipompo yesirinji eminingi yesimanje iza ifakwe izici zokuphepha ezakhelwe ngaphakathi njengama-alamu okuvalwa, ibhethri eliphansi, noma uhlelo olungalungile. Lezi zivikelo zinikeza isendlalelo esengeziwe sokuvikela, okuqinisekisa ukuthi inqubo yokulethwa kwezidakamizwa ihamba kahle futhi ngokuphepha.
IV. Izinzuzo zamasirinji Endabuko
A. Ukusebenza Kwezindleko
Enye yezinzuzo ezibaluleke kakhulu zamasirinji endabuko ukusebenza kahle kwawo kwezindleko. Ashibhile uma kuqhathaniswa ukuwakha, ikakhulukazi uma kuqhathaniswa nephampu yesirinji eyinkimbinkimbi futhi ethuthuke kakhulu ngokobuchwepheshe. Emikhankasweni eminingi yokugoma, isibonelo, lapho izigidi zemithamo zidinga ukunikezwa, izindleko zokusebenzisa imijovo esetshenziswa kanye ziyisici esibalulekile. Isipetu sepulasitiki esilula singabiza kancane njengamasenti ambalwa lilinye, okulenza libe inketho esebenzayo yemizamo emikhulu yokugoma ezilungiselelweni ezinomkhawulo wezinsiza. Lokhu kufinyeleleka kuvumela abahlinzeki bezempilo ukuthi bafinyelele isibalo sabantu abaningi ngaphandle kokuphula ibhange. Emazweni asathuthuka, lapho izabelomali zokunakekelwa kwempilo zivame ukuba nzima, imijovo yendabuko idlala indima ebalulekile ekuqinisekiseni ukuthi imigomo ebalulekile iyatholakala kubo bonke.
B. Ubulula kanye Nendawo yonke
Amasirinji endabuko aziwa ngobulula nokusetshenziswa kwawo kalula. Abadingi ukuqeqeshwa okuyisipesheli ukuze basebenze, ngaphandle kwamasu okujova ayisisekelo. Abasebenzi bezempilo, kusukela kodokotela abanolwazi kuya kumavolontiya ezempilo omphakathi, bangakwazi ngokushesha ukusebenzisa isirinji. Lokhu kulula futhi kusho ukuthi zingasetshenziswa ezindaweni ezihlukahlukene zezokwelapha, kusukela ezibhedlela zesimanje ezifakwe izinsiza zesimanje kuya emitholampilo ekude yasemakhaya enezinsiza ezilinganiselwe. Ezimweni eziphuthumayo, njengasenkundleni ngesikhathi senhlekelele noma endaweni yempi, lapho ukufinyelela kumishini yezokwelapha ethuthukisiwe kungase kuvinjelwe, imijovo kungase kuthenjelwe kuyo ukuze kunikezwe imithi esindisa ukuphila. Ukuphila kwazo zonke izindawo kuzenza zibe ithuluzi elibalulekile ku-toolkit yezokwelapha, ezihlale zilungele ukusetshenziswa lapho zidingeka.
C. Ukuphatha Okusheshayo Nokuqondile
Ezimeni ezithile eziphuthumayo, isivinini kanye nokuqondisa kokuphathwa kwesirinji evamile kungaba indaba yokuphila nokufa. Ngokwesibonelo, ezimeni zokushaqeka kwe-anaphylactic, lapho umjovo osheshayo we-adrenaline ubalulekile, isirinji ivumela ukulethwa komuthi ngokushesha. Inqubo yokudweba imithi kanye nokuyijova ingaqedwa endabeni yemizuzwana, ngokushesha kakhulu kunokusetha nokuhlela iphampu yesirinji. Lesi sikhathi sokuphendula esisheshayo singaba umehluko phakathi kokululama kwesiguli kanye nomphumela obuhlungu. Ngokufanayo, emithini yenkundla yempi, lapho isivinini nobulula buwumongo, imijovo ivamise ukuba yindlela ekhethwayo yokunikeza imithi yezimo eziphuthumayo kumasosha alimele. Ikhono lokwenza ngokushesha nangokucacile ngesirinji lingasindisa izimpilo ezikhathini ezibucayi kakhulu.
V. Ukuhlaziya Ngokuqhathanisa
A. Umbukiso Wokunemba
Ocwaningweni oluqhathanisa ukunemba kwepompo yesirinji namasirinji endabuko ekuletheni i-heparin, i-anticoagulant evame ukusetshenziswa, iphampu yesirinji ibonise ukuvumelana okumangalisayo. Esikhathini samahora angu-24, iphampu yesirinji igcine izinga lokumnika ngaphakathi kuka-±1% yenani elimisiwe, iqinisekisa isilinganiso esizinzile nesinembile. Ngokuphambene, lapho abahlengikazi besebenzisa amasirinji endabuko ukuze banikeze inani elifanayo le-heparin, ukuhluka kwemithamo kwakuphezulu njengo-±10%, ikakhulukazi ngenxa yomehluko wejubane lomjovo kanye nesilinganiso sevolumu. Ekunakekelweni kwezingane ezisanda kuzalwa, lapho ngisho nokweqisa kancane kwemithi ethile kungaba nemiphumela emibi, iphampu yesirinji iyindinganiso yegolide. Isibonelo, endaweni yokunakekela izingane ezisanda kuzalwa, usana oluzalwa ngaphambi kwesikhathi lwaludinga ukuthelwa ngokuqhubekayo kwe-dopamine ukuze kusekelwe umfutho wegazi. Iphampu yesirinji yahlelelwa ukuthi ilethe umuthi ngenani elingu-0.5 ml ngehora ngokunemba okungu-±0.05 ml ngehora, inikeze ibhalansi ethambile edingekayo ohlelweni lokujikeleza kwegazi oluntekenteke lwengane. Amasirinji endabuko, ngokusebenza kwawo mathupha namandla okuba namaphutha omuntu, angadala ingozi engamukeleki esimweni esinjalo.
B. Ukusebenza kahle kanye Nokucatshangelwa kwesikhathi
Emnyangweni wezimo eziphuthumayo omatasa, isikhathi siwumongo. Uma kuziwa ekunikezeni imithi, iphampu yesirinji inganciphisa kakhulu isikhathi sokusetha uma siqhathaniswa namasirinji endabuko. Esigulini esisezinhlungwini ezinzima esidinga ukukhululeka ngokushesha, umhlengikazi angahlela ngokushesha iphampu yesirinji ukuze alethe isibulali-zinhlungu ngesilinganiso esinqunyiwe. Le nqubo ithatha amaminithi ambalwa kuphela, kuhlanganise nesikhathi sokulayisha isirinji bese usetha imingcele. Ngokuphambene, ukusebenzisa isirinji evamile kudinga ukudweba umthamo olungile, okungadla isikhathi futhi kuthambekele ekubeni namaphutha, ikakhulukazi endaweni ematasatasa. Esimeni sokunakekelwa okubucayi, njenge-ICU, lapho iziguli zivame ukudinga ukujova okuningi ngasikhathi sinye, ukuhleleka kwephampu yesirinji kuvumela uguquko olungenamthungo phakathi kwemithi ehlukene. Isiguli esinokwehluleka kwezitho eziningi singadinga inhlanganisela yama-vasopressor, ama-antibiotics, nama-sedative. Ikhono lokuhlela iphampu yesirinji ukuthi ishintshane futhi ilungise amazinga okumnika ale mithi ngokwezimpawu ezibalulekile zesiguli aligcini nje ngokusindisa isikhathi kodwa futhi lithuthukisa ukwelashwa kwesiguli. Ocwaningweni lokuqhathanisa, kutholwe ukuthi esimweni se-ICU esiyinkimbinkimbi, ukusebenzisa iphampu yesirinji kwehlisa isikhathi sokuphathwa kwemithi sisonke cishe ngo-30% uma kuqhathaniswa nokuncika kuphela kumasirinji endabuko.
C. Ukuphepha Nokunciphisa Ubungozi
Ingozi ye-overdose kanye ne-underdose iyinkinga eqhubekayo ekulethweni kwezidakamizwa. iphampu yesirinji iza ifakwe izici eziningi zokuphepha ezinciphisa lezi zingozi. Ekhemisi lasesibhedlela, lapho ulungiselela imishanguzo ye-chemotherapy, ukusetshenziswa kwepompo yesirinji kugunyazwe ukuze kuqinisekiswe ukulethwa okunembile kwezidakamizwa ze-cytotoxic. Ama-alamu akhelwe ngaphakathi kanye nezivikelo kuvimbela ukweqisa ngephutha, okungaba nemiphumela eyinhlekelele esigulini. Esimeni lapho unesi efake ngephutha umthamo ongalungile empompini yesirinji, isofthiwe yephampu yabona ngokushesha umehluko futhi yaxwayisa abasebenzi, yagwema inhlekelele engase ibe khona. Ngakolunye uhlangothi, imijovo yendabuko ayinazo izivikelo ezizenzakalelayo. Emtholampilo wezempilo womphakathi, isiguli sathola umthamo ongalungile we-insulin ngenxa yokungafundwa kahle kwezimpawu zesirinji, okugqamisa ubungozi bezindlela zokujova ngesandla. Mayelana nengozi yokutheleleka, kuyilapho kokubili iphampu yesirinji namasirinji kudinga ukuvalwa inzalo okufanele, iphampu yesirinji, ikakhulukazi lezo ezinamasistimu avaliwe, zinciphisa ukuchayeka komuthi endaweni yangaphandle. Lokhu kunciphisa amathuba okungcola phakathi nenqubo yokumnika, kuvikela iziguli ezifweni ezingase zibe khona.
D. Ukusebenza Ezimeni Ezihlukene Zezokwelapha
Egunjini labagula kakhulu (ICU), lapho iziguli zigula kakhulu futhi zidinga ukuqapha okuqhubekayo, okunembayo kanye nokulethwa kwezidakamizwa, impompo yesirinji ibalulekile. Bangakwazi ukuphatha izinqubo eziyinkimbinkimbi ze-vasopressors, inotropes, kanye nezidakamizwa ezivame ukudingeka ukuze kuqiniswe iziguli. Esimeni sesiguli esinokushaqeka kwe-septic, iphampu yesirinji ilinganisa ngokunembile umthamo we-vasopressor ngokusekelwe kumfutho wegazi wesiguli, igcina ibhalansi ethambile ukuze isekele ukumpompela kwesitho. Ngokuphambene, endaweni yezokwelapha, njengendawo ekude yenhlekelele noma indawo yokulwa yezempi, amasirinji endabuko asebenza kakhulu. Ubulula bazo, ukuntuleka kwesidingo semithombo yamandla, kanye nokusebenziseka kalula kwazo kuzenza zifanelekele izimo eziphuthumayo lapho isivinini kanye nokusebenza okuyisisekelo kubalulekile. Udokotela osesigabeni anganikeza ngokushesha imithi esindisa impilo njenge-adrenaline noma i-morphine esebenzisa isirinji, ngaphandle kwesidingo sokusethwa kwemishini eyinkimbinkimbi. Emkhankasweni wokugoma ngobuningi, ukuphumelela kwezindleko kanye nokuba lula kwamasirinji endabuko kuwenza abe yinketho ekhethwayo. Angasatshalaliswa kalula futhi asetshenziswe amavolontiya aqeqeshiwe ukuze anikeze imithi yokugoma inani elikhulu labantu ngesikhathi esifushane. Kodwa-ke, ophikweni olukhethekile lwe-oncology yezingane, lapho izingane zidinga umthamo onembile wemithi yokwelapha ngamakhemikhali isikhathi eside, impompo yesipetu ibalulekile ukuze kuqinisekiswe ukusebenza kahle nokuphepha kokwelashwa.
VI. Izicelo Zomhlaba Wangempela Nezifundo Zezenzakalo
-A. Iphampu yesirinji ye Emayunithi Okunakekelwa Okubalulekile
Ezindaweni eziphakeme kakhulu zeyunithi yokunakekela kakhulu (ICU), iphampu yesirinji iyisisekelo sokunakekelwa kwesiguli. Cabanga ngendaba yesiguli esine-sepsis enzima. Lo muntu udinga ibhalansi ethambile yemithi eminingi, okuhlanganisa ama-vasopressors ukuze alondoloze umfutho wegazi, ama-antibiotics ukuze alwe nokutheleleka, kanye nezidakamizwa zokulawula ubuhlungu nokuyaluza. iphampu yesirinji ivumela ithimba lezokwelapha ukuthi lifake kahle umuthi ngamunye ngokwezimpawu ezibalulekile zesiguli kanye nemiphumela yelebhu. Ucwaningo olwenziwa e-ICU yesibhedlela esikhulu sasemadolobheni luthole ukuthi ukusetshenziswa kwepompo yesirinji kwehlisa izehlakalo zeziqephu ze-hypotensive ngamaphesenti angama-30 uma kuqhathaniswa nesikhathi lapho imijovo yendabuko isetshenziselwa ukuphathwa kwe-vasopressor. Lokhu kwabalelwa ekhonweni lamaphampu okugcina izinga lokumuselwa lingaguquki, ukuvimbela ukwehla kungazelelwe komfutho wegazi. Kwesinye isigameko, isiguli esilimele ekhanda sasidinga ukuthelwa ngokuqhubekayo kwe-mannitol ukuze kuncishiswe ingcindezi ye-intracranial. Iphampu yesirinji yahlelwa ukuthi ilethe umuthi ngesilinganiso esithile, iqinisekise ukuthi ukucindezela kulawulwa ngokuphumelelayo ngaphandle kokulayisha ngokweqile isimiso sokujikeleza kwegazi sesiguli. Ukulawula okunembile okuhlinzekwa yiphampu kwakubalulekile ekuvimbeleni ukulimala okwengeziwe kobuchopho futhi kuthuthukiswe amathuba okuba isiguli silulame.
B. Amasirinji Endabuko Emikhankasweni Yokugoma Inqwaba
Ngesikhathi sobhubhane lomkhuhlane womhlaba wonke, isidingo sokugonywa kwabantu abaningi ngokushesha siba yinto ehamba phambili. Imijovo yendabuko idlala indima ebalulekile ezimeni ezinjalo. Emkhankasweni omkhulu wokugoma ezweni elisathuthuka, abasebenzi bezempilo bakwazi ukugoma izinkulungwane zabantu ngosuku besebenzisa amasirinji alula, alahlwayo. Ukuba lula kanye nokuphumelela kwezindleko zalezi zijovo kwenze kwaba nokwenzeka ukufinyelela ezindaweni ezikude kanye nabantu abasengozini. Esigodini sasemaphandleni, ithimba labahlengikazi namavolontiya bakha umtholampilo wokugoma wesikhashana. Behlome ngamabhokisi amasirinji asetshenziswa kanye kanye nezitsha zokugoma, bakwazile ukushutha ngokushesha nangempumelelo. Ukuntuleka kwesidingo semishini eyinkimbinkimbi noma imithombo yamandla kwakusho ukuthi bangasebenza ezindaweni ezinengqalasizinda elinganiselwe. Lingakapheli isonto, base begome abantu abangaphezu kuka-90% bendawo, banikeza isivikelo esibalulekile ekubhebhethekeni kwaleli gciwane. Emkhankasweni ofanayo emijondolo yasemadolobheni, ukusetshenziswa kwemijovo yendabuko kwenza ukuba kusheshe kuphendulwe, amaqembu ezokwelapha asuka kwenye indawo eya kwenye, egoma abantu ezikoleni, ezikhungweni zomphakathi, ngisho nasemigwaqweni. Isivinini kanye nobuqotho bokulawulwa kwesirinji bekubalulekile ekuzuzeni ukutholakala kokugoma okuphezulu ngesikhathi esifushane.
C. Izindaba Zempumelelo Nezifundo Ezifundiwe
Egunjini labagula kakhulu, usana oluzalwe ngaphambi kwesikhathi lwalunenkinga yokukhubazeka kwenhliziyo. Ithimba lezokwelapha lasebenzisa iphampu yesirinji ukuze lilawule uhlobo oluyinkimbinkimbi lwemithi, kuhlanganise ne-prostaglandin ukuze kugcinwe i-ductus arteriosus ivulekile kanye ne-inotropes ukusekela ukusebenza kwenhliziyo. Umthamo onembile onikezwe iphampu ube nesandla ekuqiniseni isimo sosana. Ngokulungisa ngokucophelela amazinga okumnika ngokusekelwe ekugcwalisweni komoyampilo wengane nomfutho wegazi, abasebenzi bezokwelapha bakwazi ukuthenga isikhathi kuze kube yilapho kwenziwa ukungenelela kokuhlinzwa. Leli cala ligqamise amandla okusindisa impilo epompo yesirinji ezigulini ezintekenteke kakhulu. Ngakolunye uhlangothi, kuye kwaba nezifundo ezitholakele ekusetshenzisweni ngendlela engafanele kwemijovo evamile. Emtholampilo wezempilo womphakathi, umhlengikazi ufunda kabi izimpawu zesirinji ngenkathi enikeza i-insulin esigulini esinesifo sikashukela. Isiguli sathola i-overdose, okuholele esiqeshini se-hypoglycemic. Lesi sigameko sigcizelele ukubaluleka kokuqeqeshwa okufanele kanye nokuhlolwa kabili lapho kusetshenziswa imijovo yendabuko. Kwesinye isigameko, ngesikhathi somcimbi wokugoma ngobuningi, inqwaba yemijovo yatholakala inama-plungers anephutha. Lokhu kuholele ekuthathweni kwemithamo okungalungile kanye nokumoshakala komgomo okungenzeka. Ukulawulwa kwekhwalithi okuqinile nezinqubo zokuhlola zabe sezisetshenziswa ukuze kunqandwe izinkinga ezinjalo emikhankasweni yesikhathi esizayo. Lezi zibonelo zomhlaba wangempela zibonisa ukubaluleka okubalulekile kokukhetha indlela efanele yomjovo nokuyisebenzisa ngendlela efanele ukuze kuqinisekiswe ukuphepha kwesiguli kanye nokwelashwa okuphumelelayo.
VII. Isiphetho
Njengoba ubuchwepheshe buqhubeka nokuthuthuka, kokubili iphampu yesirinji namasirinji endabuko kuzovela ukuze kuhlangatshezwane nezidingo ezikhulayo zokunakekelwa kwezempilo. iphampu yesirinji izohlakanipha kakhulu futhi ixhumeke, ihlanganiswe ngaphandle komthungo namanye amadivaysi ezokwelapha kanye nezinhlelo zokuphatha idatha yesiguli. Lokhu kuzokwenza ukuthi imithi yomuntu siqu ifinyelele izinga eliphezulu, lapho ukulethwa kwezidakamizwa kufanelana nezidingo ezihlukile zesiguli ngasinye. Amasirinji endabuko nawo azobona ukuthuthuka, abe nobungane ngokwemvelo futhi asebenziseke kalula. Ngokuzayo, ukuphilisana kanye nokusetshenziswa okuhambisanayo kwalawa mathuluzi womabili kuzoba nomthelela ohlelweni lokunakekelwa kwezempilo olusebenza kahle, olunembe, nolufinyeleleka kalula. Ngokukhetha okulungile nokwenziwa okusha okuqhubekayo, singabheka phambili ekusaseni lapho ukwelashwa kuphephe kakhudlwana, kusebenza kahle, futhi ekugcineni kuholele empilweni engcono kubo bonke.
