Mitoo Yokurapa Yakanaka Ingashandiswa Munzvimbo Mokuisirwa Ropa
Iwe ungarangarira kuti, ‘Kuisirwa ropa kune ngozi, asi kune mimwe mitoo yokurapa ipi neipi yakanaka zvikuru ingashandiswa munzvimbo maro here?’ Mubvunzo wakanaka, uye cherekedza shoko rokuti “yakanaka.”
Munhu ari wose, kubatanidza Zvapupu zvaJehovha, anoda tarisiro yezvokurapa inobudirira yakanaka zvikuru. Dr. Grant E. Steffen akaona zvinhu zvikuru zviviri: “Tarisiro yezvokurapa yakanaka isimba ramativi etarisiro iyeyo rokuwana nharidzano dzapamutemo dzezvokurapa nedzisiri dzezvokurapa.” (The Journal of the American Medical Association, July 1, 1988) “Nharidzano dzisiri dzezvokurapa” dzaizobatanidza kusaputsa tsika kana kuti hana yakavakirwa paBhaibheri yomurwere.—Mabasa 15:28, 29.
Kune nzira dzapamutemo uye dzinobudirira dzokubata nadzo zvinetso zvakakomba zvezvokurapa pasina kushandisa ropa here? Nenzira inofadza, mhinduro ndeyokuti hungu.
Kunyange zvazvo vanachiremba vokuvhiya vazhinjisa vakataura kuti vakaisira ropa apo bedzi rakanga riri madikanwa chose chose, pashure pokunge murakatira weAIDS wamuka kushandisa kwavo ropa kwakaderera nokukurumidza. Chikamu chakanyorwa nomupepeti wenhau muMayo Clinic Proceedings (September 1988) chakataura kuti “imwe yebetsero shomanene dzomurakatira” yakanga iri yokuti iyo yaka“guma namazano akasiana-siana avarwere navanachiremba okudzivisa kuisirwa ropa.” Mumwe mukuru mukuru wenzvimbo inochengeterwa ropa anotsanangura, kuti: “Icho chakachinja ndiro simba reshoko, kugamuchira kwenyanzvi dzezvokurapa shoko racho (nemhaka yokunzwisiswa kwakawedzerwa kwengozi), uye kuraira kwokurangarirwa kwezvinotsiva.”—Transfusion Medicine Reviews, October 1989.
Cherechedza kuti, kune zvinotsiva! Ikoku kunova kunonzwisisika apo tinohwirudzura chikonzero nei ropa richiisirwa.
Hemoglobin iri mumasero matsvuku ine oxygen inodikanwa nokuda kwoutano hwakanaka noupenyu. Naizvozvo kana munhu arasikirwa neropa rakawanda, kungaratidzika kuva kune mufungo bedzi kuritsiva. Nguva dzose une anenge magiramu 14 kana 15 ehemoglobin mumacubic centimeter 100 ari ose eropa. (Mumwe mwero weyerero ihematocrit, uyo unowanzova unenge 45 muzana.) “Mutemo” unogamuchirwa wakanga uri wokuisira ropa murwere pamberi pokuvhiya kana hemoglobin yake yakanga iri pasi pe 10 (kana 30 muzana yehematocrit). Magazini yeVox Sanguinis yeSwitzerland (March 1987) yakashuma kuti “65% ye[nyanzvi dzokutindivadza] dzaida kuti varwere vaisirwe hemoglobin ine 10 gm/dl pamberi pokuvhiiwa kwokusakurumidzira.”
Asi pamusangano wa 1988 wapamusoro pokuisirwa ropa, Purofesa Howard L. Zauder akabvunza kuti, “Takawana Sei ‘Nhamba Yamashiripiti’?” Akataura nomutoo wakajeka, kuti: “Chisakiso chehosha chechinodikanwa chokuti murwere aisirwe magiramu 10 ehemoglobin (Hgb) pamberi pokugamuchira kutindivadzwa chakavanzwa mugamuchidzanwa, chakafukidzirwa mukudzikatidzika, uye hachisimbiswi noufakazi hwezvokurapa kana kuti hwokunzverwa kwemishonga.” Fungidzira zviuru zvavarwere avo vane kuisirwa ropa kwakaparirwa nechinodikanwa ‘chakadzikatidzika, chisingatsigirwi!’
Vamwe vangabvunza kuti, ‘Neiko mwero wehemoglobin we 14 uri wenguva dzose kana iwe uchigona kupfuurira kurarama une uri pasi zvikuru?’ Eya, nokudaro une simba rakati kuti rine oxygen yakachengetwa zvokuti wakagadzirira nokuda kwokurovedza muviri kana kuti kuita basa rinorema. Kunzverwa kwavarwere vane perevedzo yamasero matsvuku kunotoratidzira kuti “kwakaoma kuwana perevedzo musimba rokushanda kune perevedzo yehemoglobin yakaderera se 7 g/dl. Vamwe vakawana ufakazi hwokushanda kune mwero bedzi kwakashatiswa.”—Contemporary Transfusion Practice, 1987.
Nepo vakuru vane mwero wakaderera wehemoglobin, zvakadiniko navana? Dr. James A. Stockman III anoti: “Kunze kwavashomanene bedzi, vacheche vanoberekwa nguva isati yasvika vachava nederero muhemoglobin mumwedzi mumwe kusvikira kumitatu yokutanga . . . Ratidziro nokuda kwokuisirwa ropa munzvimbo dzinorererwa vana hadzirondedzerwi zvakanaka. Zvamazvirokwazvo, vacheche vazhinji vanoratidzika kuva vanoshivirira nomutoo mukuru mwero yakaderera yehemoglobin pasina zvinetso zvinoonwa nenyanzvi dzezvokurapa.”—Pediatric Clinics of North America, February 1986.
Mashoko akadaro haasati achireva kuti hapana chinhu chinofanira kuitwa apo munhu anorasikirwa neropa rakawanda mutsaona kana kuti mukati mokuvhiiwa. Kana kurasikirwa kwacho kuri kwokukurumidza uye kukuru, sundo yeropa yomunhu inoderera, uye iye angapera simba. Chinodikanwa zvikurukuru ndechokuti kubuda kweropa kumiswe uye huwandu huri mumuviri make hudzorerwe. Ikoko kuchabetsera kudzivisa kupera simba uye ndokuita kuti masero matsvuku asara nezvimwe zvinoumba ropa zvirambe zvichitenderera.
Kutsiviwa kwouwandu kunogona kuitwa pasina kushandisa ropa chairo kana kuti plasma yeropa.a Zvinoyerera zvine marudzi akasiana-siana zvisina ropa zvinowedzera huwandu nomutoo unobudirira. Yakapfava zvikuru imvura yesaline (yomunyu), iyo iri zvose zviri zviviri isingadhuri uye inowirirana neropa redu. Kunewo mvura dzine zvinhu chaizvo, zvakadai sedextran, Haemaccel, uye mvura dzeRinger’s lactate. Hetastarch (HES) ndeyokuwedzera huwandu itsva zvikuru, uye “inogona kurumbidzwa zvakanaka nokuda kwavarwere vaya [vakatsva] vanoramba zvinhu zvinogadzirwa neropa.” (Journal of Burn Care & Rehabilitation, January/February 1989) Mvura dzakadaro dzine betsero chaidzoidzo. “Mvura dzinonyunguduka [dzakadai semvura dzomunyu dzenguva dzose neRinger’s lactate], Dextran uye HES hadzina muchetura zvikuru uye hadzidhuri, dzinowanika nyore nyore, dzinogona kuchengetwa mutembiricha yomumba, hadzidi kunzverwa kwokuwiriraniswa neropa uye hadzitongorina ngozi yehosha inopfuuridzwa nokuisirwa ropa.”—Blood Transfusion Therapy—A Physician’s Handbook, 1989.
Ungabvunza, kunyange zvakadaro kuti, ‘Neiko mvura dzokutsiva dzisina ropa dzichishanda zvakanaka, sezvo ini ndichida masero matsvuku kuti ndiwane oxygen inopinda mumuviri wangu wose?’ Sezvadudzwa, une zvinotsiva simba zvinofambisa oxygen. Kana ukarasikirwa neropa, kushanda kunoshamisa kwokutsiva kunotanga. Mwoyo wako unopomba ropa rakawanda pakurova kumwe nokumwe. Sezvo ropa rarasika ratsiviwa nemvura dzakakodzera, ropa rawedzerwa mvura zvino rinoyerera zviri nyore zvikuru, kunyange mututsinga tuduku. Somuuyo wokuchinja kwamakemikari, oxygen yakawanda inovhurirwa kuti ipinde mututsinga. Idzi kodzerano dzinobudirira zvikuru zvokuti kana hafu bedzi yamasero matsvuku ako ikasara, kufambiswa kweoxygen kungava kunenge 75 muzana yenguva dzose. Murwere akazorora anoshandisa bedzi 25 muzana yeoxygen inowanikwa muropa rake. Uye zvinotindivadza zvose hazvo zvizhinjisa zvinoderedza kuda oxygen kwomuviri.
VANACHIREMBA VANOGONA SEI KUBETSERA?
Vanachiremba vane unyanzvi vanogona kubetsera munhu arasikirwa neropa nokudaro achiva namasero matsvuku mashomanene. Kana huwandu hwangodzorerwa, vanachiremba vanogona kumuisira oxygen yakawanda zvikuru. Ikoku kunoita kuti yakawanda yayo iwanike nokuda kwomuviri uye kazhinji kazhinji kwakava nemiuyo yakatanhamara. Vanachiremba veBritain vakashandisa iyoyi kumukadzi akanga arasikirwa neropa rakawanda zvikuru zvokuti “hemoglobin yake yakaderera kusvikira ku 1,8 g/dlitre. Akarapwa nomutoo unobudirira . . . [kupfurikidza] neoxygen yakawanda zvikuru inofuridzirwa uye kuisirwa huwandu hukuru hwemvura yegelatin [Haemaccel].” (Anaesthesia, January 1987) Mushumo wacho unotaurawo kuti vamwe vakava nokurasikirwa neropa kukuru vakarapwa nomutoo unobudirira munzvimbo dzokuisirwa oxygen dzine sundo huru.
Vanachiremba vanogonawo kubetsera varwere vavo kuumba masero matsvuku akawanda. Seiko? Kupfurikidza nokuvapa mishonga ine iron (inoiswa mutsandanyama kana kuti mutsinga), iyo inogona kubetsera muviri mukuita masero matsvuku nokukurumidza zvikuru nekane katatu kusvikira kune kana kupinda nguva dzose. Misi ichangobva kupfuura iyi imwe betsero yakava inowanika. Itsvo dzako dzinobudisa hormone inonzi erythropoietin (EPO), inonyandura mwongo wamapfupa kuumba masero matsvuku. Zvino mushonga weEPO (unogadzirwa murabhoritari) unowanika. Vanachiremba vangapa iwoyu kuvarwere vasina masero matsvuku, nokudaro vachivabetsera kuumba masero matsvuku okutsiva nokukurumidza zvikuru.
Kunyange mukati mokuvhiya, vanachiremba vokuvhiya vane unyanzvi navanongwarira nenyanzvi dzokutindivadza vanogona kubetsera kupfurikidza nokushandisa mitoo yakavandudzika yokuchengetedza ropa. Unyanzvi hwokuvhiya nokusanongwarira kwazvo, hwakadai sokuomesa mativi avhiiwa negetsi kuderedza kubuda kweropa, hahungagoni kunyanyosimbiswa. Padzimwe nguva ropa rinoyerera muronda rinogona kupombwa, kusvetwa, ndokudzorerwa mukutenderera.b
Varwere vari pamuchina unoshanda samapapu nomwoyo unotangwa nezvinoyerera zvisati zviri ropa vangabetserwa nokunyevenuka kweropa kunovapo somuuyo, masero matsvuku mashomanene achiva anorasika.
Uye kune dzimwe nzira dzokubetsera nadzo. Kutonhodza murwere kuderedza zvinodikanwa zvake zveoxygen mukati mokuvhiiwa. Kutindivadza kunoderedza sundo yeropa. Kurapa kunovandudza kugwamba kweropa. Desmopressin (DDAVP) yokupfupikisa nguva yokubuda ropa. “Zvivhiyiso” zvemwaranzi yechiedza. Uchaona ndaza ichiwedzera sezvo vanachiremba navarwere vanoitira hanya vanotsvaka kudzivisa kuisirwa ropa. Tinokarira kuti hautongorasikirwi nechitsama chikuru cheropa. Asi kana ukadaro, kunobvira zvikuru kuti vanachiremba vane unyanzvi vanogona kukutarisira vasingashandisi kuisirwa ropa, uko kune ngozi zhinji zvikuru.
KUVHIYA, HUNGU—ASI KUSINA KUISIRA ROPA
Vanhu vazhinji nhasi havasati vachizogamuchira ropa. Nokuda kwezvikonzero zvoutano, vari kukumbira icho Zvapupu zvinotsvaka zvikurukuru nokuda kwezvikonzero zvorudzidziso: kutarisirwa kwezvokurapa kwakanaka kunoshandisa kumwe kurapa kusina ropa. Sezvataona, kuvhiya kukuru kuchiri kunobvira. Kana une panikiro dzipi nedzipi dzasara, humwe ufakazi hwakati hunobva muzvinyorwa zvezvokurapa hungadzipedza.
Nyaya inoti “Kuvhiiwa Kukuru Kuna Kwokudzorera Chipfundo Chapapfupa Kwakaitwa paMutezo weZvapupu zvaJehovha” (Orthopaedic Review, August 1986) yakataura nezvomurwere asina masero matsvuku ane “ruparadziko runoenderera mberi muzvose zviri zviviri mumabvi nomuhudyu.” Iron dextran yakashandiswa pamberi napashure pokuvhiiwa kwakarongwa, uko kwakabudirira. British Journal of Anaesthesia (1982) yakashuma pamusoro pechimwe Chapupu chine makore 52 ezera chaiva nemwero wehemoglobin uri pasi pe 10. Nokushandisa kutindivadza kunoderedza sundo yeropa kuderedza kurasika kweropa, akava nokuvhiiwa kwokudzorerwa kwakakwana kwehudyu nepfudzi. Chikwata chavanachiremba vokuvhiya chapaUniversity yeArkansas (U.S.A.) chakashandisawo uyu mutoo mukuvhiya kwokudzorera hudyu kune zana kwakaitwa paZvapupu, uye varwere vose vakanaya. Purofesa anotungamirira bato racho anotsinhira, kuti: “Zvatadzidza pavarwere (vari Zvapupu) ivavo, zvino tozvishandisa pavarwere vedu vose vatinovhiya kudzorera hudyu dzose zvakakwana pavari.”
Hana yezvimwe Zvapupu inozvibvumidza kugamuchira kuisirwa mitezo yomumwe munhu kana kuchiitwa pasina ropa. Mushumo wokuisirwa itsvo 13 wakagumisa, kuti: “Miuyo yose inokarakadza kuti kuisirwa itsvo kunogona kuitwa zvakanaka uye nomutoo unobudirira kuZvapupu zvaJehovha zvizhinjisa.” (Transplantation, June 1988) Nenzira yakafanana, kurambwa kweropa hakuna kudzivisa kunyange kuisirwa mwoyo kunobudirira.
‘Zvakadiniko nokuvhiya kwamamwe marudzi kusina ropa rinoshandiswa?’ ungabvunza kudaro. Medical Hotline (April/May 1983) yakataura nezvokuvhiiwa kwe“Zvapupu zvaJehovha zvakava nokuvhiiwa kukuru kwezvirwere zvavakadzi uye kwokusunungusa mwana [paWayne State University, U.S.A.] pasina kuisirwa ropa.” Pepanhau racho rakashuma, kuti: “Kwakanga kusichinazve nzufu dzakawanda nezvinetso kupfuura vakadzi vakava nokuvhiiwa kwakafanana vachiisirwa ropa.” Pepanhau racho ipapo rakatsinhira, kuti: “Miuyo yeiyi nzvero ingabvumira murangariro mutsva pakushandiswa kweropa nokuda kwavakadzi vose vanovhiiwa pakusununguka mwana napazvirwere zvavakadzi.”
Pachipatara chapaGöttingen University (Germany), varwere 30 vakaramba ropa vakavhiiwa nomutoo wakarovedzeka. “Hapana zvinetso zvakamuka zvisati zvaigonawo kumuka kuna varwere vakagamuchirwa kuisirwa ropa. . . . Kuti kutendeukira kukuisirwa ropa hakubviri kunofanira kusarangarirwa mukunyanyisa, uye nokudaro hakufaniri kutungamirira kukuramba kuvhiiwa kuri madikanwa uye kwakarurama mune zvokuvhiya.”—Risiko in der Chirurgie, 1987.
Kunyange kuvhiiwa kwouropi pasina kushandisa ropa kwakaitwa pavanhu vakura vasingaverengeki navana, somuenzaniso, paNew York University Medical Center. Muna 1989 Dr. Joseph Ransohoff, mutungamiriri wokuvhiiwa kwouropi, akanyora, kuti: “Kwakajeka zvikuru kuti mune zvinoitika zvizhinjisa kudziviswa kwezvinhu zvinogadzirwa neropa kunogona kuitwa nengozi dukusa muvarwere vane zvitendero zvinorwisana nokushandiswa kweizvi zvinhu, zvikurukuru kana kuvhiiwa kuchigona kuitwa nomutoo wokusanongwarira uye munhambo pfupi zvikuru yokuvhiya. Rinofadza zvikuru ndiro idi rokuti ndinowanzokanganwa kuti murwere Chapupu kutozosvikira panguva yokubuda muchipatara apo izvo zvinondionga nokuda kwokuve ndakaremekedza zvitendero zvazvo zvorudzidziso.”
Pakupedzisira, ko kuvhiiwa kwakaoma zvikuru kwomwoyo nokwetsinga kunogona kuitwa pavanhu vakura navana pasina ropa here? Dr. Denton A. Cooley akanga ari wokutanga kuita izvozvo chaizvo. Sezvaunogona kuona munyaya yezvokurapa yakatsikirirwazve iri muWedzero, pamapeji 27-9, yakavakirwa pakunzvera kwapakuvamba zvikuru, mhedziso yaDr. Cooley yakanga iri yo“kuti ngozi yokuita kuvhiya muvarwere veboka reZvapupu zvaJehovha haina kuva huru zvikuru kupinda dzavamwe.” Zvino, pashure pokuita 1 106 kwouku kuvhiya, anonyora, kuti: “Muchinoitika chiri chose bvumirano yangu kana kuti chitenderano nomurwere chinochengetwa,” ndiko kuti, kusashandisa ropa.
Vanachiremba vokuvhiya vakacherekedza kuti chimiro chakanaka ndichimwe chinhu chine Zvapupu zvaJehovha. “Chimiro chaava varwere chave chiri chomuenzaniso,” akanyora kudaro Dr. Cooley muna October 1989. “Hazvina rutyo rwezvinetso kana kuti kunyange rufu urwo varwere vazhinjisa vanarwo. Zvine kutenda kukuru uye kunogara narini muchitendero chazvo uye muna Mwari wazvo.”
Ikoku hakusati kuchireva kuti zvinotsigira maruramiro okufa. Zvinoronda nomutoo wokushingaira kutarisirwa kwakanaka nemhaka yokuti zvinoda kunaya. Zvinopwiswa kuti kuteerera mutemo waMwari pamusoro peropa kuchenjera, murangariro uyo une simba rakananga pakuvhiya kusingashandisi ropa.
Purofesa Dr. V. Schlosser, wechipatara chokuvhiya paUniversity yeFreiburg (Germany), akati: “Pakati peiri boka ravarwere, chinoitika chokubuda ropa mukati menhambo yapamberi neyapashure pokuvhiiwa chakanga chisiri chikuru zvikuru; zvinetso, kana zvaitongovapo, zvaiva zvishomanene zvikuru. Murangariro chaiwo wechirwere, unowanwa zvikurukuru muZvapupu zvaJehovha, wakanga une simba rakananga mumuitiro wapamberi napashure pokuvhiiwa.”—Herz Kreislauf, August 1987.
[Mashoko Omuzasi]
a Zvapupu hazvigamuchiri kuisirwa ropa rose, masero matsvuku, masero machena, maplatelet, kana kuti plasma yeropa. Kana ari mativi madukusa, akadai seglobulin yegadziriro yedziviriro yomuviri, ona Nharireyomurindi yaJune 1, 1990, mapeji 30, 31.
b Nharireyomurindi yaMarch 1, 1989, mapeji 30-1, inorangarira nheyo dzeBhaibheri dzine chokuita nemitoo yokuchengetedza ropa nomuchina (uri kunze kwomuviri) wokutenderedza ropa.
[Bhokisi riri papeji 13]
Tinofanira kugumisa kuti munguva ino kune varwere vakawanda vari kugamuchira zvinoumba ropa vasina banza rokubetserwa nokuisirwa ropa (ropa haridikanwi) asi vachine ngozi huru yomuuyo usingadikanwi. Hakuna chiremba angaratidzira noune murwere kukurapa kusingagoni kubetsera asi kungakuvadza, asi ikoko ndiko kunoitika chaizvoizvo apo ropa rinoisirwa zvisiri madikanwa.”—“Transfusion-Transmitted Viral Diseases,” 1987.
[Bhokisi riri papeji 14]
“Dzimwe nyanzvi dzakataura kuti mipimo yehemoglobin iri pasi pa 2 kusvikira ku 2,5 gm. pa 100ml. ingagamuchirika. . . . Munhu ane utano angarasikirwa nehwerengedzo yamasero matsvuku ane 50 muzana ndokuva anenge asina zviratidzo zvehosha chose chose kana kurasikirwa neropa kukaitika pashure penhambo yakati kuti yenguva.”—“Techniques of Blood Transfusion,” 1982.
[Bhokisi riri papeji 15]
“Mifungo yekare pamusoro pokuendeswa kwe“oxygen” kutsinga, kupora kweronda, uye ‘ukoshi hunotsigira’ hweropa zviri kusiiwa. Chinoitika kuvarwere vari Zvapupu zvaJehovha chinoratidzira kuti kushaikwa kwamasero matsvuku kwakakomba kungasanoshivirirwa.”—“The Annals of Thoracic Surgery,” March 1989.
[Bhokisi riri papeji 16]
Kunoitwawo kuvana vaduku here? “Mitoo ine makumi mana nemisere yokuvhiya mwoyo inotsausa kutenderera kweropa yakaitwa kupfurikidza nounyanzvi hwokusashandisa ropa pasinei hapo nokuoma zvikuru kwokuvhiya kwacho.” Vana vacho vaiva vaduku vachirema mapaundi 10,3 (makirogiramu 4,7). “Nokuda kworubudiriro runopfuurira muZvapupu zvaJehovha uye idi rokuti kuisirwa ropa kune ngozi yezvinetso zvakakomba, munguva ino tiri kuita kuzhinjisa kwokuvhiya kwedu mwoyo yavana tisingaisiri ropa.”—“Circulation,” September 1984.
[Mufananidzo uri papeji 15]
Muchina unoshanda samapapu nomwoyo wave uchibetsera zvikuru pakuvhiiwa kwemwoyo pavarwere vasingadi ropa