Mavambiro akaita oparesheni dzepamwoyo*

Harold Ellis

Muzvinazivo Emeritus pakuVhiya,

kuGuys, King’s ne St Thomas’ School of Biomedical Sciences London  


Gore rino ava makore zana negumi remakore kubva pakaitwa oparesheni yekutanga yepamwoyo yakabudirira. Kubvira munguva dzaGaleni, maronda epamwoyo aionekwa seasingarapike, achiita kuti munhu asaponeba. Nekuuya kwakaita rufimbi nerutsanana pakuvhiya munhu, machiremba anovhiya akabva aita chivindi chekuita oparesheni dzepadumbu, muchipfuva, padehenya nemakumbo. Asi mwoyo waive usingabatike, waizezesa.

       Theodor Billroth pachake, nyamunhange wesejari sekuziva kwatinoiita mazuva ano, aive wekuVhiyena akati Muvhiyi angade kuedza kusona chironda chepamwoyo anobva ashaya chimiro pakati pevamwe vake.’ Mumwe muvhiyi aive nemukurumbira, Stephen Paget wekuRandani akanyorawo muna 1896 kuti, ‘Hapana maitiro matsva kana kuti chimwewo chisinga zivikanwe mazuva ano chinga kurire zvipangamidzo zviripo pachironda chepamwoyo. Ichokwadi kuti kusona mwoyo kunombo taurwa zvichinzi inzira yekurapa mwoyo, kukamboitwa mumhuka, asi ndinoshaya angandiudze kuti kwati kwamboitwa mumumnhu here.’

       Mugore rabva ratevera, Ludvig Rehn [1849 – 1930], muzvinazivo pakuvhiya wekuFrankfurt am Main, akarondedzera nyaya yemumwe jaya akange abaiwa muchipfuva nechekuruboshwe, nepakati pembabvu yechina neshanu. Akasvika kuchipatara achitadza kufema, achena miromo nekupera ropa, avakupererwa nesimba. Rehn akapatsanura chipfuva nepaakanga abaiwa ipapo, pakati pembabvu yena neshanu, ndokudimbura mbabvu yeshanu achibvisa chidimbu, kuti anyatso penengura nhumba [pericardium] yemwoyo. Ropa rainyatso oneka richi pfachuka nepakange pabvaruka munhumba. Akapamhidza buri repanhumba iyoyo akaona ropa rakawanda chaizvo rakagwamba pamwe chete ne ronda rakareba 1.5 masendimita  mutsandanyama yemwoyo weruboshe.              Akanyora kuti: Ndaka sevenzesa shinda yesiriki yakatetepa chaizvo. Mwoyo pawairova ndaiti, paunenge wakaregerera, uchizorora, ndaibva ndapinza tsono zvakadzika munyama yakapota ronda, [wogwinha], paunozorora zvakare ndoisa pfundo. Ndichingo pedza musungo wekutanga, ropa rakabva ratanga kushomeka mabudiro aro. Ndakaita zvekukaka musungo wekutanga iwoyo, kuisa wechipiri zvikabva zvaita nyore. Zvaityisa kuona kuti pandai sunga pfundo mwoyo waibva waita sewambomira. Ndabva kuisa musungo wechitatu, uyu wakanetsa chaizvo nepamusana pekurova kwaiita mwoyo, kubuda ropa kwakabva kwato mira zvachose. Apa mwoyo wakaita sewanga wava kurova zvakanaka tika tangawo isusu kufema zvakana.’ Nzvimbo yaka kombera mwoyo yakapakirwa machira aive ne iodoform. Murwere uyu akaita zigurwa muchipfuva, rika tumburwa. Akazopona zvake zvakanaka. 

Rehn akanyora nezvaakange aita mugwaro rechiGirimaniArchives of Clinical Surgery‘ [Rehn, 1897a] nemuLancetmusoro wenyaya yake uri wekuti ‘The successful treatment of a wound of the heart’ [Rehn 1897b]. Mumashure mekubudirira kwakange kwaita Rehn, Parrozzani wekuRhomu, akanyorawo nezve kubudirira kwaakange aita, kuchibva kwava kwechipiri. GS Brock [1897] akanyora nezvazvo muLancetachibva apamhidza nekutiNgatitotenda kuti kumaTariana chete kunga wanikwa vavhiyi vanowana mikana yakawanda yekuti vavhiye pamwoyomikana inosakiswa kushandiswa kunoitwa bakatwa munyika iyi kana vanhu vava pakurwa, kunyanya vanhu vepasi pasi‘. Dai Brock aiona zviri kuitika mumigwagwa munyika ino [yeBhiriteni] iye zvino, aitii nazvo?

Mugore ra1910, kwangopfuura makore gumi chete kubva paakaita oparesheni yake, Rehn aka kokorodza zvinyorwa zvese pamusoro peoparesheni dzepamwoyo: aka wana oparesheni zana nemakumi mairi neina [124] dzekurapa kubaiwa pamwoyo.  Makumi mana muzana evanhu vakapona [40%]. Pane vakafa makumi mana anevana muzana [44%] vakafa nekupererwa neropa, vamwewo makumi mana muzana [40%] vakauraiwa neutachiwana. Akayambira kuti chibaiso chemwoyo, kana chichiripo chinofanirwa kusiiwa chiripo kusvikira pakuvhurwa kwenhumba yemwoyo. Akayambirawo kuti pakupatsanura chipfuva, muchekwa mumwechete unobvira kudundundu uchienda kurutivi unobatanidza nepapinda nechibaiso uchitevedza mbabvu uri nani pane zvaiita vamwe kuchekerera nepakuru vachivhura chipfuva. Pakadiwa mukana mukuru muchekwa unogona kudzikiswa kudundundu wakatevedza bvupa mbabvu dzichi dimburwa.

Kubudirira kwakaita Rehn nevamwewo masejeni kwakaita kuti vanhu vatange kufunga kuti mwoyo hauyerikuusona kunonetsa asi kunogoneka. Kwakazo tora makumi emakore vanhu vachingoedza nemaek’siperimendi akawanda pamhuka nekuedza murapo pavanhu, nemapimbirikisho ekuvhiya pamwoyo uchirova kuedza kugadzira mavharuvhu, nekuvaka muchina unoita basa remwoyo nemapapu, nekutonhodza muviri kuti mwoyo uwane mamisirwo, zvese izvi kuti kuvhiya mwoyo kuzove semazuva ano. Mazuva ano zvava nyore kuvhiya pamwoyo, hazvichatyisa vanhu nevanovhiya vacho, zvatova zvemazuva ose. Nhanho yekutanga yakatorwa makore zana negumi akapfuura.

 

Zvakaturikwa kubva muBritish Journal of Hospital Medicine 2007, 68(7): 392 

 

 

 

Ref:

 

Brock GS (1897) Penetrating wound of the pericardium and left ventricle; suture; recovery. Lancet ii: 260

Rehn L (1897a) Weber penetrirende herz-wunder und herznaht. Arch Klin Chir 55: 315-29

Rehn L (1897b) The successful treatment of a wound of the heart. Lancet i: 1306

 

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