Ukufunwa Ngamandla Konyango Notyando Ngaphandle Kwegazi

“Bonke abo basebenza ngegazi nabanyamekela abaguli abatyandiweyo bafanele bacingisise ngotyando ngaphandle kwegazi.”—UGqr. Joachim Boldt, unjingalwazi wecandelo lotyando, eLudwigshafen, eJamani.

INTLEKELE ebangelwa nguGawulayo iye yabangela ukuba izazinzulu noogqirha zithabathe amanyathelo athe chatha ngelokuzama ukwenza igumbi lotyando libe yindawo ekhuselekileyo. Lizicacele elokuba, oku kuye kwabangela ukuba igazi lihlolisiswe kakuhle. Kodwa iingcali zithi la manyathelo akathethi ukuba utofelo-gazi aluzi kuba nangozi kwaphela. Iphephancwadi iTransfusion lithi: “Nangona abantu bechitha imali eninzi ekwenzeni igazi likhuseleke kunangaphambili sicinga ukuba abaguli baya kuzama ukukuphepha ukutofelwa igazi elifana nelabo [elinikelweyo] kuba igazi alinakuze likhuseleke ngokupheleleyo.”

Akumangalisi ke ngoko ukuba, oogqirha abaninzi babe badiniwe kukutofela igazi. UGqr. Alex Zapolanski, waseSan Francisco, eKhalifoniya uthi: “Utofelo-gazi alulunganga, yaye senza konke okusemandleni ethu ukuthintela ukuba kungabikho mntu ulwenzayo.”

Nabantu ngokubanzi baya bebuqonda ubungozi botofelo-gazi. Eneneni, uhlolisiso lowe-1996 lwatyhila ukuba ama-89 ekhulwni abantu baseKhanada akhetha ezinye iindlela kunegazi elinikelweyo. IJournal of Vascular Surgery ithi: “Asingabo bonke abaguli abalayo ukutofelwa igazi lomnye umntu kanye njengamaNgqina kaYehova. Noko ke, ingozi yokudluliselwa kwezifo nokuphazanyiswa kwenkqubo yokuzikhusela kwizifo yenza kucace ukuba kufuneka sizame ezinye iindlela kubo bonke abaguli bethu.”

Enye Inkqubo Abayikhethayo

Siyayibulela into yokuba kukho enye indlela—unyango notyando ngaphandle kwegazi. Abaguli abaninzi abayijongi njengento abanokuphephela kuyo kodwa njengenkqubo abayikhethayo, yaye bafanele ukucinga ngolo hlobo. UStephen Geoffrey Pollard, ugqirha oyingcaphephe waseBritani uthi umlinganiselo wokwasulelwa zizifo nowokufa phakathi kwabo batyandwa ngaphandle kwegazi “ubuncinane uyafana nowabo batofelwa igazi, yaye kwiimeko ezininzi bona bayasinda kwizifo ezifumaneka emva kotyando ekudla ngokuthiwa zibangelwa ligazi.”

Lwaqala njani olu nyango lwezamayeza ngaphandle kwegazi? Ngandlel’ ithile lo mbuzo awuqhelekanga, ekubeni unyango ngaphandle kwegazi lwaqala ukusetyenziswa ngaphambi kolo lwegazi. Eneneni, ubugcisa bokutofela igazi buvele kutshanje ebutsheni benkulungwane yama-20, baza bahambela phambili de bayinto esetyenziswa ngokuqhelekileyo. Noko ke, kumashumi eminyaka yamvanje, icandelo lotyando ngaphandle kwegazi liye lathandwa gqitha. Ngokomzekelo, ebudeni beminyaka yee-1960 ugqirha odumileyo uDenton Cooley wenza utyando lokuqala lwentliziyo ngaphandle kokusebenzisa igazi.

Njengoko isifo sokudumba kwesibindi sathi sanda phakathi kwabantu abatofelwa igazi ngeminyaka yee-1970, oogqirha abaninzi baqalisa ukukhangela ezinye izinto ezithabatha indawo yegazi. Ngeminyaka yee-1980 amaqela amaninzi ezonyango asebenzisa utyando ngaphandle kwegazi. Emva koko, xa kwavela ubhubhane onguGawulayo, la maqela ancinwa ngokuphindaphindiweyo ngamanye awayefuna ukusebenzisa indlela efanayo. Ebudeni beminyaka yee-1990 izibhedlele ezininzi zavelisa iinkqubo zokunikela ngezinto ezithabathela indawo igazi kubaguli bazo.

Ngoku oogqirha baphumelele ekutyandeni ngaphandle kwegazi nasekusebenziseni iindlela zonyango olungxamisekileyo ezazidla ngokufuna igazi ngokuqhelekileyo. KwiCanadian Journal of Anaesthesia, uD.H.W. Wong uthi: “Utyando lwentliziyo, lwemithambo, olwenziwa xa kunyangwa izifo zabafazi, olokubelekisa, nolwenkqubo yokuhamba komchamo lunokwenziwa ngempumelelo ngaphandle kokusebenzisa igazi okanye iimveliso zegazi.”

Enye ingenelo yotyando ngaphandle kwegazi kukuba lukhuthaza inyameko ekumgangatho ophezulu. UGqr. Benjamin J. Reichstein, umalathisi wezotyando eCleveland, eOhio uthi: “Kubaluleke gqitha ukuba ugqirha abe nobuchule ukuze athintele ukushokoxeka kwegazi.” Ulindixesha wezomthetho waseMzantsi Afrika uthi kwezinye iimeko utyando ngaphandle kwegazi “lunokukhawuleza ngakumbi, lucoceke luze lungadli mali ininzi.” Wongezelela ngelithi: “Ngokuqinisekileyo kwiimeko ezininzi unyango lwasemva kotyando luye lwangqineka lungadli mali ininzi yaye lusonga ixesha.” Ezi zezinye izizathu ezimbalwa zokuba ngoku izibhedlele ezili-180 ehlabathini lonke zibe neenkqubo ezijongene nonyango notyando ngaphandle kwegazi.

Igazi NamaNgqina KaYehova

Ngenxa yezizathu ezisekelwe eBhayibhileni, amaNgqina kaYehova ayala ukutofelwa igazi.a Kodwa amkela—aze aqhubeke efuna—unyango oluthabatha indawo yegazi. Xa wayengumalathisi wesibhedlele saseNew York, uGqr. Richard K. Spence wathi: “Ngokuzimisela, amaNgqina kaYehova afuna olona nyango lwezamayeza lusemgangathweni. Njengeqela, angabona baguli bafundileyo ugqirha anokusebenzisana nabo.”

Amaxesha amaninzi, oogqirha baye baphumelela ekwenzeni utyando ngaphandle kwegazi kumaNgqina kaYehova. Khawuve amava ogqirha wentliziyo uDenton Cooley. Kangangeminyaka engama-27, iqela lakhe liye lenza utyando lwentliziyo ngaphandle kwegazi kumaNgqina kaYehova angama-663. Iziphumo ziye zabonisa ngokucacileyo ukuba utyando lwentliziyo lunokuphumelela ngaphandle kwegazi.

Liyinyaniso elokuba, abaninzi baye bawagxeka amaNgqina kaYehova ngokwala kwawo ukusebenzisa igazi. Kodwa isikhokelo esapapashwa yiAssociation of Anaesthetists of Great Britain and Ireland sikubiza ukuma kwamaNgqina “njengomqondiso wokuhlonela ubomi.” Enyanisweni, ukuma okuqinileyo kwamaNgqina kuye kwanegalelo ngamandla ekufunyanweni konyango lwezamayeza olukhuselekileyo ebantwini bonke. UNjingalwazi Stein A. Evensen, weNorway’s National Hospital ubhala athi: “AmaNgqina kaYehova afuna utyando aye asibonisa indlela aza afaka ifuthe lokuba kuphuculwe icandelo lenkonzo yezempilo yaseNorway.”

Ngelokuncedisana noogqirha ekusebenziseni unyango ngaphandle kwegazi, amaNgqina kaYehova aye eza nenkqubo yonxibelelwano eluncedo. Ngoku, iiKomiti Zokunxibelelana Nezibhedlele ezingaphezu kwe-1 400 ehlabathini lonke zixhotyiselwa ukunika oogqirha nabaphengululi uncwadi lwezamayeza olusuka kuvimba wamanqaku angama-3 000 anxulumene nonyango notyando ngaphandle kwegazi. UGqr. Charles Baron, ongunjingalwazi kwiBoston College Law School uthi: “AsingomaNgqina kaYehova kuphela, kodwa abaguli ngokubanzi akusafane kwenzeke ukuba batofelwe igazi ngokungeyomfuneko ngenxa yomsebenzi weeKomiti Zokunxibelelana Nezibhedlele zamaNgqina.”b

Inkcazelo engonyango notyando ngaphandle kwegazi eye yaqokelelwa ngamaNgqina kaYehova iye yayingenelo kwabaninzi bezonyango. Ngokomzekelo, xa babelungiselela ukubhala incwadi ethi Autotransfusion: Therapeutic Principles and Trends, ababhali bacela amaNgqina kaYehova ukuba abanike inkcazelo ngezinto ezinokuthabathela indawo yotofelo-gazi. AmaNgqina asisabela isicelo sabo. Kamva bebulela, aba babhali bathi: “Njengoko besiphanda lo mbandela, asikhange khe sifumane umbandela omfutshane ngolu hlobo, uludwe olupheleleyo lwendlela yokuphepha utofelo-gazi.”

Inkqubela eye yenziwa kwezamayeza iye yenza abaninzi bahlolisisa unyango notyando ngaphandle kwegazi. Yiyiphi enye inkqubela eya kulandela kwikamva? UNjingalwazi Luc Montagnier, owafumanisa intsholongwane kaGawulayo, uthi: “Ukutshintsha kwendlela esicinga ngayo ngalo mbandela kubonisa ukuba utofelo-gazi lumele luphele ngenye imini.” Okwangoku, izinto ezithabatha indawo yegazi sele zibusindisa ubomi.

[Imibhalo esemazantsi]

[Ibhokisi/Imifanekiso ekwiphepha 7]

Oko Kuthethwa Ngabanye Oogqirha

‘Utyando ngaphandle kwegazi asilolwamaNgqina kaYehova nje kuphela kodwa lolwabo bonke abaguli. Ndicinga ukuba gqirha ngamnye ufanele alusebenzise.’—UGqr. Joachim Boldt, unjingalwazi kwezotyando, eLudwigshafen, eJamani.

“Ngoxa utofelo-gazi lukhuselekile namhlanje kunangaphambili, lusenobungozi, luchaphazela nenkqubo yokuzikhusela kwizifo luze lubangele ukwasulelwa yi-‘hepatitis’ okanye izifo ezasulelwa ngeentlobano zesini.”—UGqr. Terrence J. Sacchi, isekela likanjingalwazi wezamayeza.

“Oogqirha abaninzi basabela ngendlela eqhelekileyo kutofelo-gazi yaye loo nto bayibonisa ngokukhululekileyo nangokungakhathali. Andinjalo ke mna.”—UGqr. Alex Zapolanski, umalathisi woqhaqho lwentliziyo eSan Francisco Heart Institute.

“Andisiboni isizathu sokuba utyando olwenziwa esiswini kumguli oqhelekileyo lwenziwe ngokutofela igazi.”—UGqr. Johannes Scheele, unjingalwazi wotyando, eJena, eJamani.

[Imifanekiso]

UGqr. Joachim Boldt

UGqr. Terrence J. Sacchi

[Ibhokisi/Imifanekiso ekwiphepha 8, 9]

Utyando Nonyango Ngaphandle Kwegazi

Ezinye Iindlela

Ulwelo: Umxube wobisi kaRinger, idextran, ihydroxyethyl starch neminye isetyenziselwa ukugcina igazi likumlinganiselo ofanelekileyo, ukuthintela uxinezeleko lwegazi. Ngoku olunye ulwelo oluhlolwayo lunokuhambisa ioksijini.

Amayeza: Iiprotini ezisebenzisana nemizila yemfuza zinokubangela ukuveliswa kweeseli ezibomvu zegazi (ierythropoietin), iplatelets zegazi (i-interleukin-11) nezinye iiseli ezimhlophe zegazi ezahlukeneyo (iGM-CSF, iG-CSF). Amanye amayeza akunciphisa kakhulu ukopha ebudeni botyando (iaprotinin, iantifibrinolytics) okanye anciphise ukopha ngokugqithiseleyo (idesmopressin).

Izinto zokuthintela ukopha ezingokwebhayoloji: Imicu elukiweyo yecollagen necellulose zisetyenziselwa ukunqanda ukopha ngokuthi zifakwe kuloo ndawo yophayo. Iglu nezinto zokutywina zefibrin zinokuwavala amanxeba adlabhukileyo okanye zigqume isicwili esopha kakhulu.

Ukulondoloza igazi: Oomatshini bokulondoloza igazi babuyisela igazi eliye laphuma ebudeni botyando okanye ebudeni bokwenzakala. Eli gazi liyacocwa lize lidluliselwe emzimbeni ngemibhobho evaliweyo. Kwiimeko ezinzima, kunokubuyiselwa iilitha zegazi kusetyenziswa le nkqubo.

Izixhobo zokutyanda: Ezinye izixhobo zinokusika ziphinde zingcibe imithambo yegazi ngaxeshanye. Ezinye izixhobo zinokungciba ukopha kwizicwili ezikhulu. Izixhobo ezingasikiyo zenza ukuba kungaphalali gazi xa kutyandwa, nto leyo ebinokwenzeka xa kusikwe kakhulu.

Iindlela zokutyanda: Ukucetywa kakuhle kotyando, kuquka ukunxibelelana neengcali zezonyango ezinamava, kunceda iqela elityandayo liphephe iingxaki. Kubalulekile ukuba kukhawulezwe kunqandwe ukopha. Ukulibazisa de kudlule iiyure ezingama-24 kunokubangela ukufa kwabantu abaninzi. Ukwahlulahlula utyando olukhulu lube ngamacandelo amancinane kunciphisa umlinganiselo wokuphalala kwegazi.

[Ibhokisi/Imifanekiso ekwiphepha 10]

Unyango Ngaphandle Kwegazi—Indlela Entsha “Yokunyamekela Esemgangathweni”?

UVUKANI! ukhe waxubusha iingenelo zonyango notyando ngaphandle kwegazi neengcaphephe ezine kweli candelo.

Ngaphandle kwabaguli abangalufuniyo utofelo-gazi ngenxa yezizathu zonqulo, ngoobani abanye abanokuba nomdla kunyango ngaphandle kwegazi?

UGqr. Spahn: Kumaziko ethu abo bacela unyango ngaphandle kwegazi idla ngokuba ngabaguli abafunde gqitha.

UGqr. Shander: Ngowe-1998 inani labaguli abale utofelo-gazi ngenxa yezizathu zobuqu lingaphezu kwenani labaguli abale utofelo-gazi ngezizathu zonqulo.

UGqr. Boyd: Ngokomzekelo kukho abaguli abanomhlaza. Amaxesha amaninzi kuye kwabonakala ukuba xa bengatofelwa igazi, bachacha kakuhle yaye asibahlaseli rhoqo esi sifo.

UGqr. Spahn: Ngokufuthi xa sinyanga oonjingalwazi baseyunivesithi neentsapho zabo asilisebenzisi igazi. Nezinye iingcali zamayeza ziyasicela ukuba singalisebenzisi igazi! Ngokomzekelo, enye ingcali yeza nomfazi wayo, ekwakufuneka etyandiwe. Yathi: “Niqiniseke nje ngento enye—ningamtofeli igazi!”

UGqr. Shander: Abo basebenza nam kwicandelo lokudoma bathi: ‘Aba baguli bangalamkeliyo igazi baqhuba kakuhle kakhulu. Kutheni kufuneka sibe neendlela ezimbini zonyango? Ukuba le yeyona ndlela ifanelekileyo yonyango, sifanele siyisebenzise kumntu wonke.’ Ngoko ngoku sinethemba lokuba unyango ngaphandle kwegazi lunyango olusemgangathweni.

UMnu. Earnshaw: Liyinyaniso elokuba unyango ngaphandle kwegazi luwafanele amaNgqina kaYehova. Noko ke, sifuna ukubaphatha ngale ndlela bonke abantu

Ngaba olu nyango ngaphandle kwegazi lubiza imali eninzi okanye luyafikeleleka?

UMnu. Earnshaw: Longa imali.

UGqr. Shander: Unyango ngaphandle kwegazi lungaphantsi ngama-25 ekhulwini.

UGqr. Boyd: Xa kusiziwa kumbandela wemali uwodwa nje, asinakungalusebenzisi.

Sele sihambele phambili kangakanani ekusetyenzisweni konyango ngaphandle kwegazi?

UGqr. Boyd: Ndicinga ukuba sele sihambele phambili kakhulu. Akukazi kuphela. Sihlandlo ngasinye sikhangela, sifumana isizathu esitsha sokungalisebenzisi igazi.

[Imifanekiso]

UGqr. Donat R.Spahn unjingalwazi wecandelo lokudoma ebudeni botyando, eZurich, eSwitzerland

UGqr. Aryeh Shander isekela lengcungela yonjingalwazi kwicandelo lokudoma, eUnited States

UMnu. Peter Earnshaw, FRCS, ugqirha ongumalathisi kwicandelo lotyando lwamathambo, eLondon, eNgilani

UGqr. Mark E. Boyd unjingalwazi kwicandelo lokubelekisa nezigulo nococeko lwabafazi, eKhanada

[Ibhokisi ekwiphepha 11]

Indima Yomguli

▪ Thetha nogqirha wakho ngezinto ezinokuthabathela indawo igazi ngaphambi kokuba kufuneke unyangwe. Oku kubaluleke kakhulu kumabhinqa akhulelweyo, abazali abanabantwana abancinane, nabantu abasele bekhulile.

▪ Yibhale phantsi iminqweno yakho, ingakumbi ukuba kukho uxwebhu olusemthethweni lokwenjenjalo.

▪ Ukuba ugqirha wakho akafuni kukunyanga ngaphandle kwegazi, funa ugqirha oya kuvumelana neminqweno yakho.

▪ Ekubeni ezinye izinto ezithabathela indawo igazi zithabatha ixesha ukuze zisebenze, musa ukulubekela amangomso unyango ukuba kufuneka utyandiwe.