Ua manaʻo paha ʻoe i kou puʻuwai e kuʻi wikiwiki ana me ke kumu ʻole, a i ʻole ua manaʻo ʻoe i kahi manaʻo lele ʻē e like me nā pulelehua i loko o kou umauma? ʻO kēia mau ʻano loli i ke ʻano o ka puʻuwai (puʻuwai kūpono ʻole) he mea ia e hopohopo ai i kekahi manawa. I kēia lā, e kamaʻilio mākou e pili ana i kahi lāʻau lapaʻau kūikawā a nā kauka e hoʻohana ai e mālama i kēia ʻano puʻuwai kūpono ʻole.
I ka ʻōlelo maʻalahi, he aha ka Chemical Cardioversion?
I ka ʻōlelo maʻalahi, ʻo ke cardioversion kemika ka hoʻohana ʻana i nā lāʻau lapaʻau e hoʻihoʻi i ka wikiwiki a i ʻole ke ʻano maʻamau o kou puʻuwai i kahi ʻano maʻamau. ʻO ka holomua o kēia lāʻau lapaʻau e pili ana i ke kumu o kou puʻuwai puʻuwai maʻamau ʻole, pehea ka lōʻihi o kona noho ʻana, a me ke ʻano o ka lāʻau lapaʻau a kāu kauka e koho ai.
Kāhea pū mākou i kēia Pharmacologic Cardioversion. Hana nā lāʻau lapaʻau i hāʻawi ʻia i ka wā o kēia mālama ʻana i kekahi mau mea nui:
- Hoʻomaha ia i kou mau kīʻaha koko.
- Hāʻawi i ka hoʻomaha i nā ʻiʻo o ka puʻuwai.
- Hoʻemi i ka ukana hana ma ka puʻuwai.
- Hoʻokele ia i ka wikiwiki o ka haʻi ʻana o nā hōʻailona uila i ka puʻuwai e kuʻi.
E noʻonoʻo i ko kākou puʻuwai me he hale lā me kahi kaapuni uila paʻakikī. Loaʻa iā ia kahi kuapo nui, kahi a mākou e kapa nei i ka lāʻau lapaʻau ʻo ka node sinoatrial. Hoʻomaka ka hōʻailona uila e hoʻokuʻi ai i ka puʻuwai ma laila. A laila hele kēlā hōʻailona ma nā keʻena o luna o ka puʻuwai (Atria) a hiki i kahi hui ʻē aʻe (Atrioventricular node). ʻO ka hope loa, hiki kēia hōʻailona i nā keʻena o lalo o ka puʻuwai (Ventricles). Inā he hewa i kēia ala hōʻailona, hiki ke hoʻopilikia ʻia ka rhythm o ka puʻuwai.
Ke kūlike ʻole ke ʻano o ka puʻuwai, ʻaʻole ia e pamu i ke koko lawa ma ke kino holoʻokoʻa. Pono kēlā me kēia cell i loko o ko mākou kino, ʻoiai ka lolo, i ka lako mau o ka oxygen mai ke koko. Ke hoʻopilikia ʻia ke kahe koko ma kēia ʻano, hiki iā ʻoe ke ʻike i nā hōʻailona e like me ka poniuniu, ka luhi, ka pōkole o ka hanu, a me ka ʻeha o ka umauma .
No ke aha e hoʻohana ʻia ai kēia lāʻau lapaʻau a no nā maʻi hea?
Inā wikiwiki loa a ʻano ʻē paha kou puʻuwai, pono paha ʻoe i ka cardioversion kemika. Aia kekahi mau kumu e ʻano ʻē ai paha kou puʻuwai.
- ʻO kekahi o nā lāʻau lapaʻau āu e hoʻohana ai
- Nā maʻi lele e like me ka maʻi pneumonia
- Maʻi hohola
- Nā loli i ke ʻano o ka puʻuwai
- ʻO ka embolism pulmonary
- Ka hāʻule ʻana o ka puʻuwai paʻa
- Nā maʻi puʻupuʻu e like me COPD a i ʻole Emphysema
Hoʻohana nui ʻia ka Chemical Cardioversion e mālama i nā kūlana puʻuwai kūpono ʻole:
| Inoa o ke kūlana olakino (Huaʻōlelo Pelekania) | He wehewehe maʻalahi |
|---|---|
| ʻO ka Fibrillation Atrial (Afib) | ʻO ka atrial fibrillation kahi kūlana kahi e kuʻi wikiwiki ai a kūlike ʻole nā keʻena o luna o ka puʻuwai. ʻO kēia ke kūlana puʻuwai kūpono ʻole. |
| Ka Lele ʻAtrial | Ua kuʻi wikiwiki aʻe nā keʻena o luna o ka puʻuwai akā ʻoi iki aʻe ka pinepine o ka kuʻi ʻana ma mua o ka fibrillation. |
| ʻO ka Tachycardia Supraventricular (SVT) | He puʻuwai wikiwiki loa e hoʻomaka ana ma luna o nā keʻena haʻahaʻa o ka puʻuwai. |
| ʻO ka Tachycardia Ventricular (VT) | He puʻuwai wikiwiki e hoʻomaka ana ma nā keʻena haʻahaʻa o ka puʻuwai. Hiki i kēia ke lilo i mea weliweli i kekahi manawa. |
He aha ka mea e hana ʻia ma mua o ka lāʻau lapaʻau?
Na kāu kauka e hoʻoholo i ka lāʻau lapaʻau kūpono loa iā ʻoe (lāʻau lapaʻau a i ʻole ka cardioversion uila). Inā haʻahaʻa loa kou koko, hiki i kāu kauka ke koho i ka cardioversion uila.
- ʻAi a me ka Mea Inu: E aʻo ʻia ʻoe e kāohi i ka ʻai ʻana a i ʻole ka inu ʻana no kahi o 8 mau hola ma mua o kēia lāʻau lapaʻau.
- Nā hoʻāʻo: Inā loaʻa iā ʻoe kahi puʻuwai puʻuwai kūpono ʻole (atrial arrhythmia) no nā lā ʻelua a ʻoi aku, hiki i kāu kauka ke hana i kahi hoʻāʻo i kapa ʻia ʻo Transesophageal Echocardiogram (TEE) . ʻO kēia ke nānā i nā ʻōpū koko i loko o ka puʻuwai. Hiki i kēia ke hana i kahi hahau inā haki ke koko i ka wā o ka mālama ʻana.
- Lāʻau lapaʻau: Ma kēlā me kēia lāʻau lapaʻau āu e lawe ai, me nā lāʻau lapaʻau i kūʻai ʻole ʻia ma ke kauka, nā huaora, a me nā lāʻau Sinhala.Pono ʻoe e haʻi i kāu kauka. Hiki ke noi ʻia ʻoe e hoʻomaka e lawe i nā anticoagulants ʻekolu pule ma mua o ka mālama ʻana e hōʻemi i ka pilikia o nā ʻōpū koko.
He aha ka mea e hana ʻia i ka wā o ka mālama ʻana?
Hana pinepine ʻia kēia lāʻau lapaʻau ma ka ʻāpana mālama koʻikoʻi (ICU) o kahi haukapila a i ʻole ma kahi lumi kūikawā i hoʻokaʻawale ʻia no ia mea. ʻO kēia no ka mea he liʻiliʻi ka pilikia o nā ʻano puʻuwai ʻē aʻe i ka wā e hāʻawi ʻia ai ka lāʻau lapaʻau, no laila pono ʻoe e kiaʻi pono ʻia.
ʻAʻole ʻoe hoʻokahi i kēia manawa. Aia nā kauka a me nā kahu ma kou ʻaoʻao, e nānā mau ana i kou koko a me ka helu o ka puʻuwai (ECG). Ua mākaukau nā lako pono a pau (e like me ka defibrillator) inā loaʻa kahi pilikia.
Hāʻawi ʻia ka lāʻau lapaʻau iā ʻoe ma ke ʻano he pila āu e ale ai a i ʻole ma o kahi IV i loko o kahi aʻa koko ma kou lima . I kekahi manawa, inā ʻaʻole holo pono ka mahele mua o ka lāʻau lapaʻau, hiki ke hāʻawi ʻia kekahi mahele ʻē aʻe.
Nā lāʻau lapaʻau i hoʻohana pinepine ʻia
ʻOkoʻa ke ʻano o ka lāʻau lapaʻau i hāʻawi ʻia iā ʻoe ma muli o kou kūlana. ʻO kekahi o nā lāʻau lapaʻau i hoʻohana pinepine ʻia:
- ʻAmiodarone (Cordarone®)
- Procainamide
- ʻIbutilide
- ʻO Flecainide
- ʻO Propafenone (Rythmol®)
- ʻO Sotalol (Betapace®)
- Nā mea pale beta e like me metoprolol (Lopressor®)
- Nā mea pale i ke kahawai calcium e like me diltiazem (Cardizem®)
- ʻAdenosine (Adenocard®)
He aha nā pōmaikaʻi a me nā pōʻino o ka lāʻau lapaʻau?
Hiki ke mālama ʻia ʻoe i loko o ka haukapila no ka nānā ʻana no 24 a 48 mau hola ma hope o ka mālama ʻana. Hiki i kekahi poʻe ke luhi iki a ʻoluʻolu ʻole paha mai kēia lāʻau lapaʻau.
Nā Pōmaikaʻi:
- Hiki ke hoʻihoʻi ʻia ka puʻuwai i kahi mele maʻamau.
- Hoʻemi ʻia nā hōʻailona e like me ka poniuniu a me ka luhi.
- Hiki ke hoʻohana ʻia ma ke ʻano he koho ʻē aʻe i ka cardioversion uila.
Nā Pōʻino a me nā Pilikia:
- Ka hoʻomaka ʻana o kahi puʻuwai puʻuwai kūpono ʻole hou a i ʻole ka ʻino ʻana o kahi puʻuwai e kū nei.
- Hiki i kahi ʻūpā koko ke haki a hoʻoulu i ka hahau ʻana .
- Nā hopena ʻaoʻao e like me ka nausea a me ka luhi.
- Hiki i kekahi mau lāʻau lapaʻau ke hala i nā mahina e hana ai.
- Inā ʻaʻole holomua kēia lāʻau lapaʻau, pono paha ʻoe e hoʻohana i nā lāʻau lapaʻau ʻē aʻe e like me ka electroconvulsive therapy a i ʻole ka catheter ablation.
- ʻAʻole like ka hana a nā lāʻau lapaʻau no nā kānaka a pau. I kekahi manawa, ʻo ka nui o ka holomua no ka wā lōʻihi ma kahi o 50%.
Āhea ʻoe e ʻimi koke ai i ke aʻo lapaʻau?
Inā ʻike ʻoe i kekahi o nā hōʻailona ʻē aʻe ma hope o ka cardioversion kemika, e hele koke i ka haukapila kokoke loa i ka Emergency Department (ETU):A i ʻole e kelepona i ka lawelawe ambulance ma 1990. Mai lawe māmā i kēia mau mea.
- Nā palpitations o ka puʻuwai
- ʻO ka poniuniu nui
- Māmā ke poʻo
- Ka nāwaliwali o ke kino
- Ka hou koke ʻana
- ʻEha umauma
- Paʻakikī ka hanu ʻana
- Nā hōʻailona alerika e like me ka hives
E lawe i nā lāʻau lapaʻau a pau a kāu kauka e kuhikuhi ai, ma mua a ma hope o ka mālama ʻana, pololei a i ka manawa kūpono. Inā he mau nīnau kāu, mai makaʻu e nīnau i kāu kauka.
Leka Lawe-Home
- ʻO ka cardioversion kemika kahi lāʻau lapaʻau e hoʻohana ana i nā lāʻau lapaʻau e hoʻihoʻi i ka puʻuwai puʻuwai kūpono ʻole i ka maʻamau.
- ʻO kāu kauka wale nō ke hoʻoholo inā kūpono kēia lāʻau iā ʻoe.
- Hana ʻia kēia ma ka haukapila, ma lalo o ka mākaʻikaʻi koʻikoʻi a ke kauka, no laila ʻaʻohe pono e makaʻu.
- ʻOiai hāʻawi kēia i nā pono he nui, hiki iā ia ke hana i kekahi mau pilikia a me nā hopena ʻaoʻao.
- Inā ʻike ʻoe i nā hōʻailona e like me ka ʻeha o ka umauma, ka poniuniu nui, a i ʻole ka paʻakikī o ka hanu ʻana ma hope o ka mālama ʻana, e hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila.
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