Ngo-2020, i-COVID-19 idlangile. Muva nje, kuye kwavela izinhlobo eNdiya, eBrazil, e-United Kingdom nakwamanye amazwe, futhi imvamisa yokuguqulwa kwezakhi zofuzo ikhuphuke kancane kancane isuka ku-0.1 ngenkulungwane yaya ku-1.3 ngenkulungwane. Isimo sobhubhane kwamanye amazwe sisalokhu sibi kakhulu, futhi izwe alikwazi ukuyekethisa nakancane. Iziguli ezintathu zaqinisekiswa e-Anhui ngomhlaka-13-14. Ubhubhane alukaqedwa. Kusadingeka sikuthathe ngokungathi sína, sigeze izandla njalo, sigqoke imaski futhi sijove umuthi omusha wokugomela umqhele ngokushesha okukhulu.
Futhi uma kukhulunywa ngosizo lokuqala lweziguli ezine-COVID-19, i-ECMO ivame ukuvela endaweni ephuthumayo. Kuyini lokho?I-ECMOiyithuluzi lokwelapha i-oxygenation membrane yangaphandle komzimba, elaziwa kakhulu ngokuthi "amaphaphu okwenziwa". Umshini wokufakelwa inhliziyo namaphaphu uwubuchwepheshe bokusekela impilo obusebenzisa idivayisi ekhethekile yokwenziwa ukudonsa igazi libuyele enhliziyweni nasemithanjeni emzimbeni, lenze ukushintshana kwegesi, lilungise izinga lokushisa bese lihlunga, bese lilibuyisela emithanjeni yangaphakathi. Ngenxa yokuthi le divayisi ekhethekile yokwenziwa ithatha indawo yemisebenzi yenhliziyo namaphaphu yomuntu, ibizwa nangokuthi i-cardiopulmonary bypass. Lolu hlobo lwedivayisi yokwenziwa lubizwa ngokuthi umshini wokufakelwa inhliziyo namaphaphu. I-ECMO okwamanje iyindlela yokusekela eyinhloko yokwehluleka okukhulu kwenhliziyo namaphaphu, futhi ibizwa ngokuthi "ukwelashwa kokugcina" kweziguli ezigula kakhulu ezine-pneumonia entsha yenhliziyo.
Imishini eyisisekelo yomshini we-ECMO ihlanganisa:
（1）Iphampu yegazi: Ukuze kuqhutshwe ukugeleza kwegazi elinomoya-mpilo ngendlela eyodwa ngaphandle komzimba, libuyiselwa emithanjeni yangaphakathi ukuze lithathe indawo yengxenye eyinhloko yomsebenzi wokukhipha igazi enhliziyweni.
（2）Idivayisi yokugeleza kwegazi ene-oxygen eqondiswe ohlangothini olulodwa.
（3）I-Oxygenator: I-Oxygenator egazini lemithambo yegazi, ikhipha i-carbon dioxide, futhi ithathe indawo yamaphaphu ukuze kushintshwe igesi.
（4）I-Thermostat: Idivayisi esebenzisa izinga lokushisa lamanzi elijikelezayo kanye namapuleti okuhlukaniswa kwensimbi amancane ahambisa ukushisa ukunciphisa noma ukwandisa izinga lokushisa kwegazi. Ingaba khona njengengxenye ehlukile, kodwa ikakhulukazi ihlanganiswe ne-oxygenator.
（5）Isihlungi: Idivayisi eyakhiwe ngesikrini sesihlungi se-polymer esinezimbobo ezincane, esibekwe epayipini, isetshenziselwa ukuhlunga ngempumelelo ukungcola okuhlukahlukene, izinhlayiya, uthuli kanye nezinhlayiya ezincane. Isici sesihlungi se-Hengko esinezimbobo ezincane se-ventilator kanye ne-ECMO esenziwe ngensimbi engagqwali yezokwelapha engu-316, sinenzuzo yokunemba okuphezulu kokuhlunga, ukungena kahle komoya, umphumela omuhle wokuhlunga, ukumelana nothuli, iphephile futhi ayinabo ubuthi, ayinaphunga. Ingahlunga izinhlobo ezahlukene zezinhlayiya, kufaka phakathi amagciwane, amagciwane kanye namaconsi amanzi. Umklamo wokuvula ukhethekile futhi usatshalaliswa ngokulinganayo, ungasetshenziswa izikhathi eziningi ngaphandle kokuhlanza.
Isakhi sesihlungi samaphaphu sokwenziwa se-HENGKO ECMOingavikela umjikelezo wokuphefumula wesiguli ekungcolisweni yigciwane futhi ivimbele izinhlayiya ezinkulu zothuli ukuba zingangeni emshinini bese zibangela umonakalo.
Amaphaphu okwenziwa awagcini nje ngokuphumelela ekusindiseni iziguli ezigula kakhulu ezine-pneumonia entsha yenhliziyo kodwa futhi anezindlela eziningi zokusebenzisa kwezokwelapha kwezempi. Isibonelo, i-US Air Force isungule ithimba lezokwelapha le-Extracorporeal Membrane Oxygenation (ECMO), elithunyelwa phesheya kwezilwandle ukwenza imisebenzi eyahlukene yezempi emhlabeni jikelele. Ibutho liyibutho elihlomile eliqinisekisa ukuphepha kwezwe. UMongameli uXi Jinping ugcizelele ngokuphindaphindiwe ukuthi "ibutho lisempini." Enkulumweni yakhe ngoMashi 9 kulo nyaka, uMongameli uXi Jinping ugcizelele ukuthi isimo samanje sokuphepha ezweni lami asizinzile futhi asiqinisekile. Kusukela "esikhuphukile" kuya "esikhulu", ubukhali besimo samanje budinga impi enzima. Kusukela "esikhuphukile" kuya "esikhulu", ubukhali besimo samanje budinga impi enzima. Ngakho-ke, ukubaluleka kwamaphaphu okwenziwa njengesiqinisekiso esibalulekile sezokwelapha sokwelashwa kwezempi kuyabonakala.
I-Medtronic e-United States, i-McCoy eJalimane, i-Solin eJalimane, i-Terumo eJapane, kanye ne-Fresenius eJalimane, zakha i-monopoly. Intengo yomshini wamaphaphu wokwenziwa ifinyelela ezigidini, kanti nezinto ezisetshenziswayo nazo zingeniswa. Ngenxa yobhubhane kanye nemingcele yamazwe ngamazwe yamanje e-China, ukungenisa izinto ezisetshenziswayo ezivela kwamanye amazwe akugcini nje ngokuba yingozi kodwa futhi nezinkampani eziningi zakwamanye amazwe ziyayimisa. Thumela e-China. Ukuthembela ekungenisweni isikhathi eside akuyona into enhle. Njengenye yamabhizinisi ase-China, izindinganiso zethu zihlanganisa umoya wokuma ekulungeni kwezwe, ukuphikelela emsebenzini onzima, kanye nokuzikhukhumeza okungapheli. Ngaphansi kocwaningo olujulile lwethimba lobuchwepheshe, kuye kwathuthukiswa imikhiqizo ehlukahlukene yokuhlunga esetshenziswa emaphashini okwenziwa, efana nemikhiqizo engenisiwe evela eYurophu nase-United States, kunciphisa izindleko zokugcinwa kwezibhedlela nezikhungo zezokwelapha, kanye nokusiza ekuthuthukisweni kwemboni yamadivayisi ezokwelapha ephezulu yase-China.
I-ECMO iwusizo kakhulu, kodwa kusenezinkinga ezithile ekusetshenzisweni kwe-ECMO eShayina. Isibonelo, umkhawulo wobuchwepheshe osetshenziswa yi-ECMO uphakeme kakhulu, imishini ibiza kakhulu, futhi zimbalwa izibhedlela zasekhaya ezinolwazi oluthe xaxa ekusebenziseni i-ECMO kanye nenani lamacala. Ingaphansi kwendlela yokuqeqesha ye-ECMO ejwayelekile. Izindleko ze-ECMO zibiza kakhulu, futhi azikho emkhakheni wokubuyiselwa kwemali yomshuwalense wezokwelapha. Izindleko zesiguli zokwenza i-ECMO zingama-yuan angu-300,000 kuya ku-400,000, okubiza kuzo izinto ezisetshenziswayo ezingenisiwe nazo ziyindleko enkulu, ngentengo yokuqala engu-yuan angu-40,000 kuya ku-80,000.
Nakuba kunezinkinga eziningi, sizozinqoba. Ngokuthuthuka okuphelele kanye nempumelelo ebalulekile yohlelo olukhulu lwe-"Made in China 2025", kuzosheshisa ukukhuthazwa kwezinga lokukhiqiza lilonke. Sikholelwa ukuthi i-ECMO yasekhaya izongena esibhedlela futhi ingene emtholampilo ukuze izuzise iziguli esikhathini esizayo.
Isikhathi sokuthunyelwe: Juni-04-2021
