Puʻuwai kūpono ʻole? E kamaʻilio kākou e pili ana i ka mālama ʻana i ka CRT (Cardiac Resynchronization Therapy)

E noʻonoʻo i kou puʻuwai me he hui mele lā. Ke hana like nei nā mea a pau, i ka manawa like, hana ʻia nā mele nani. Akā i kekahi manawa, ʻoiai me nā kūlana e like me ka hāʻule ʻana o ka puʻuwai, hoʻomaka nā keʻena haʻahaʻa ʻelua o ka puʻuwai, ʻo nā ventricles, e hana kūʻē kekahi i kekahi, me ke kūlike ʻole. Ke kuʻi kekahi, ʻaʻole kekahi, a i ka wā e kuʻi ai kekahi, ʻaʻole ia. Ke huki ʻia nā keʻena ʻelua o ka puʻuwai, ʻaʻole hiki i ka puʻuwai ke pamu pono i ke koko. ʻO ia ka manawa e kōkua mai ai kahi lāʻau lapaʻau kūikawā i kapa ʻia ʻo Cardiac Resynchronization Therapy, a i ʻole CRT no ka pōkole, iā mākou.

I ka ʻōlelo maʻalahi, he aha kēia CRT?

He lāʻau lapaʻau ʻo CRT e hoʻihoʻi i ke ʻano o ka puʻuwai i ka maʻamau. Ua kapa ʻia hoʻi ʻo Biventricular Pacing. ʻO "Biventricular" ke ʻano o "nā keʻena ʻelua." ʻO ke ʻano kēia, ʻo kēia lāʻau lapaʻau ke kumu o nā keʻena haʻahaʻa ʻelua (ventricles) o ka puʻuwai e kuʻi pū i ka manawa like. No ka hana ʻana i kēia, e hoʻokomo kāu kauka i kahi mea liʻiliʻi ma lalo o ka ʻili o kou umauma.

He ʻokoʻa iki kēia mai kahi pacemaker maʻamau. Loaʻa i kahi pacemaker maʻamau hoʻokahi a ʻelua paha mau uea. Akā, he ʻekolu mau uea ko kēia mea CRT . Hoʻopili ʻia kēia mau uea ʻekolu i ʻekolu mau wahi kikoʻī ma ka puʻuwai.

• Hoʻokahi uea e hele ana i ke keʻena o luna o ka puʻuwai (atrium ʻākau)
• Hele ka lua o ke kaula i ke keʻena ʻākau haʻahaʻa o ka puʻuwai (ventricle ʻākau).
• ʻO ke kolu o ke kaula e hele ana i ke keʻena hema haʻahaʻa o ka puʻuwai (ventricle hema).

Hoʻouna kēia mau uea ʻekolu i nā hōʻailona uila maalea loa, e hana pū ana nā keʻena o ka puʻuwai, me ka hui like. Ua like ia me ke alakaʻi e noho ana i mua o kahi hui mele a hāʻawi i nā mea āpau i ka hōʻailona e pāʻani pū. Hoʻonui nui kēia i ka pono o ka puʻuwai.

ʻO wai ka mea e pono ai kēia lāʻau CRT?

ʻAʻole no nā kānaka āpau kēia lāʻau lapaʻau. E nānā kāu kauka i kekahi mau kumu ma mua o ka ʻōlelo ʻana aku.

• Ke Kūlana o ka Holo ʻAna o ka Puʻuwai: Nānā inā he holo ʻana o ka holo ʻana o ka puʻuwai ma ke ʻano kaulike a koʻikoʻi paha.
• Lapaʻau lāʻau: ʻOiai ma hope o ka hoʻohana ʻana i nā lāʻau lapaʻau maikaʻi loa no ka hāʻule ʻana o ka puʻuwai, ʻike mau ʻia nā hōʻailona (pōkole o ka hanu, luhi).
• Nā pilikia o ka puʻuwai: Ke nānā nei kahi hoʻokolohua ECG i ka lohi o ka hoʻoili ʻana o nā hōʻailona uila i loko o kou puʻuwai. Paipai pinepine ʻia kēia, ʻoi aku hoʻi no ka poʻe me ke ʻano e like me ka Left Bundle Branch Block .
• Ka mana o ka puʻuwai e hoʻokuʻu ai:E nānā pū ʻia kahi echocardiogram (heart scan) e ʻike inā haʻahaʻa ka hiki ke hoʻokahe koko o kou puʻuwai (ejection fraction).

I ka ʻōlelo maʻalahi, manaʻo nā kauka i kēia lāʻau lapaʻau no ka poʻe i loaʻa ka puʻuwai puʻuwai kūpono ʻole i paʻakikī ke kaohi me nā lāʻau lapaʻau a me nā loli o ke ʻano o ka nohona.

Pehea ʻoe e hoʻomākaukau ai ma mua o ka mālama ʻana?

ʻOiai he ʻoki kino liʻiliʻi kēia, pono ʻoe e hoʻomākaukau no ia ma mua. E haʻi aku kāu kauka iā ʻoe e hana i kēia mau mea:

• Nā hoʻāʻo: I kekahi mau lā ma mua o ke ʻoki kino, e noi ʻia ʻoe e hana i kahi echocardiogram , malia paha he MRI scan o ka puʻuwai , a me kekahi mau hoʻāʻo koko e hoʻoholo ai i ke kūlana pololei o kou puʻuwai.
• ʻAi ʻole: E aʻo ʻia ʻoe ʻaʻole e ʻai a inu paha i kekahi mea no 6 mau hola ma mua o ke ʻoki ʻana.
• Lāʻau lapaʻau: I ka wā o ke ʻoki ʻana, e hāʻawi ʻia ʻoe i ka lāʻau lapaʻau e hoʻopau i kou ʻeha a hoʻomoe iā ʻoe i ka hiamoe māmā, i ʻole ʻoe e manaʻo i kekahi mea.

Pehea e hana ʻia ai ke ʻoki kino?

He mau hola ka lōʻihi o kēia kaʻina hana. Eia ka mea e hana ʻia:

1. Ke hoʻokomo ʻana i nā kaula: ʻO ka mea mua, hoʻokomo ke kauka i ʻekolu mau kaula lahilahi loa ma o kahi aʻa koko ma kou poʻohiwi, a i ʻole kou ʻūhā paha. Hana ʻia kēia me ke akahele loa i ka nānā ʻana i kahi mīkini X-ray.

2. Ke hoʻouna ʻana i nā kaula i ka puʻuwai: A laila hoʻokomo ʻia kēia mau kaula ma o nā aa koko a kau ʻia ma nā wahi ʻekolu i koho ʻia o ka puʻuwai i kūkākūkā ʻia ma mua (atrium ʻākau, ventricle ʻākau, a me ka ventricle hema).

3. Ke hana ʻana i kahi no ka hāmeʻa: A laila, hana ʻia kahi ʻoki liʻiliʻi ma ka ʻili ma lalo o kou iwi ʻāʻī, e hana ana i kahi hakahaka liʻiliʻi (ʻeke) ma lalo o ka ʻili. Maanei e waiho ʻia ai ka hāmeʻa CRT.

4. Hoʻohui a me ka hoʻāʻo ʻana: Ua hoʻopili ʻia nā wēlau ʻē aʻe o nā kaula ʻekolu i hoʻouna ʻia i ka puʻuwai i kēia mea hana CRT. A laila, nānā lākou inā e hana pono ana a inā e hele pono ana nā hōʻailona.

5. Ke hoʻokomo ʻana o ka hāmeʻa: Inā pololei nā mea a pau, e waiho ʻia ka hāmeʻa CRT i loko o ka ʻeke i hana ʻia, e pani ʻia ka ʻoki, a e kau pono ʻia nā humuhumu.

He aha nā pōmaikaʻi a me nā pilikia o kēia lāʻau lapaʻau?

E like me nā lāʻau lapaʻau āpau, loaʻa iā CRT nā pono a me nā pilikia. He mea nui e kūkākūkā pono i kēia mau mea me kāu kauka.

He aha ka mea e hana ʻia ma hope o ka lāʻau lapaʻau?

Pono ʻoe e noho ma ka haukapila no hoʻokahi lā ma hope o ke ʻoki ʻana.

• Ma ke ala e hoʻi ai i ka home: No ka mea, ua hāʻawi ʻia ʻoe i nā lāʻau hiamoe, ʻaʻole hiki iā ʻoe ke hoʻokele kaʻa . No laila, he mea nui e lawe mai i kekahi e lawe iā ʻoe i ka home.
• Ka neʻe ʻana o ka lima: Pono e noho mālie ka lima ma ka ʻaoʻao kahi i hoʻokomo ʻia ai ka hāmeʻa (ʻo ka lima hema maʻamau) a ʻaʻole e hāpai ʻia no kahi o 12 mau hola . ʻAe kēia i nā kaula i hoʻokomo ʻia e noho pono i loko o ka puʻuwai.
• Kāleka Kūikawā: E hāʻawi ʻia ʻoe i kahi kāleka kūikawā, nona nā kikoʻī āpau o kēia hāmeʻa ma luna. He mea nui loa e mālama mau i kēia kāleka i loko o kāu ʻeke kālā.
• Hoʻōla: Hiki iā ʻoe ke hoʻi hou i nā hana maʻamau i loko o kekahi mau lā, akā ʻaʻole ia e ʻōlelo ʻia e hoʻokele a hāpai paha i nā mea kaumaha no kahi o hoʻokahi pule.
• Nānā hou: Ma mua o kou hoʻouna ʻia ʻana i ka home, hiki ke lawe ʻia kahi X-ray a i ʻole ECG e nānā i ka paʻa ʻana o nā uea.

He aha ka ʻokoʻa ma waena o CRT a me ICD?

He mea kēia e huikau ai nā kānaka he nui. ʻElua ʻano hāmeʻa ʻo CRT a me ICD.

• CRT (Cardiac Resynchronization Therapy): E like me kā mākou i kūkākūkā ai, hoʻohana ʻia kēia e hoʻonohonoho i ka puʻuwai. ʻO ia hoʻi, hana ia i nā keʻena o ka puʻuwai e hana pū, ma ke ʻano hoʻokahi. He mana holomua ia o kahi pacemaker.
• ICD (Implantable Cardioverter-Defibrillator): Hana kēia i kahi mea ʻokoʻa. Inā e kuʻi wikiwiki ana ka puʻuwai, ʻike ia iā ia a hāʻawi i kahi haʻalulu uila liʻiliʻi e hoʻihoʻi iā ia i ka maʻamau . He mea hoʻōla ola kēia.

Akā pinepine, hiki i ka poʻe me ka maʻi puʻuwai ke loaʻa i kēia mau pilikia ʻelua. ʻO ia ke kumu e hoʻokomo ai nā kauka i hoʻokahi mea hana nona nā hiki ʻelua, he CRT-D (CRT me Defibrillator) .

I ka manawa hea e kamaʻilio ai me ke kauka

Ma hope o ke kau ʻana o kahi hāmeʻa CRT, aia kekahi mau mea e pono ai ʻoe e makaʻala.

Eia kekahi, pono ʻoe e hele i nā lā o ka hale lapaʻau i hoʻonohonoho ʻia.

• ʻO ka hoʻomaʻamaʻa mua ʻana e hana ʻia ma kahi o hoʻokahi mahina ma hope o ke kaʻina hana.
• Ma hope o kēlā, e noi lākou e ʻike iā ʻoe i hoʻokahi a ʻelua paha i ka makahiki.

Ma kēia mau keʻena lapaʻau, nānā ke kauka i ke kūlana o ka hāmeʻa, kona pila, a me nā uea. Nānā pū ʻo ia i ka nui o ka hoʻomaikaʻi ʻana o ka hana o kou puʻuwai ma muli o kēia hāmeʻa.