Ke manaʻo nei ʻoe i kekahi manawa e kuʻi wikiwiki ana kou puʻuwai me ke kumu ʻole? Ke manaʻo nei ʻoe e like me ka manu e lele ana i kona mau ʻēheu i loko o kou umauma? He ʻike weliweli maoli kēia. ʻO kēia piʻi koke ʻana o ka puʻuwai ua kapa ʻia ʻo Supraventricular Tachycardia (SVT). I nā manawa e like me kēia, ma mua o ka hoʻohana ʻana i ka lāʻau lapaʻau, aia kekahi ʻano maʻalahi akā pono loa e hiki ke kōkua iā ʻoe e hoʻomaʻamaʻa i kou puʻuwai. I kēia lā ke kamaʻilio nei mākou e pili ana i nā 'Vagal Maneuvers'.
I ka ʻōlelo maʻalahi, he aha nā 'Vagal Maneuvers'?
E noʻonoʻo he 'brake' kūlohelohe ko kou kino e kāohi ana i ka wikiwiki o kou puʻuwai. Ua kapa ʻia kēlā brake ʻo 'Vagus Nerve'. He aʻalolo lōʻihi kēia e holo ana mai ko kākou lolo a i ko kākou ʻōpū. Kōkua kēia aʻalolo i ka hoʻokele ʻana i nā mea he nui, me ka wikiwiki o ko kākou puʻuwai a me ka hanu ʻana.
ʻO nā 'Vegal maneuvers' kekahi mau hana kino a mākou e hana ai me ka manaʻo. Hoʻoulu lākou i ke 'vagas nerve', ka mea e hoʻouna i kahi hōʻailona i ka pacemaker maoli o ka puʻuwai, ka mea e hoʻolohi i ka helu o ka puʻuwai. I ka ʻōlelo maʻalahi, eia kekahi mau ala e hoʻohana ai i ka 'brake' maoli o ko mākou kino e hoʻomālielie i ka puʻuwai wikiwiki. He mea kēia i hana ʻia ma lalo o ka nānā ʻana a ke kauka. Mai hoʻāʻo i kēia mau mea ma kāu iho me ka ʻole o ke kamaʻilio ʻana me kāu kauka.
No ke aha he mea nui kēia mau ʻano hana?
I ka mālama ʻana i kahi kanaka me ka puʻuwai wikiwiki (SVT), hoʻohana pinepine nā kauka i kēia mau 'vegal maneuvers' ma ke ʻano he koho mua . Aia kekahi mau kumu no kēia:
- Haʻahaʻa ka pilikia: ʻOi aku ka liʻiliʻi o ka pilikia o kēia mau ʻano ma mua o ka hāʻawi ʻana i ka lāʻau lapaʻau a i ʻole ka hāʻawi ʻana i nā haʻalulu uila (cardioversion).
- Kumukūʻai haʻahaʻa: ʻAʻole pono kēia i nā lako kūikawā a i ʻole nā lāʻau lapaʻau, no laila he mea kūʻai ʻole ke kumukūʻai.
- Nā hopena wikiwiki: Inā holomua, hoʻi ka helu o ka puʻuwai i ka maʻamau i loko o kekahi mau minuke. ʻO ka helu holomua ma waena o 20% a me 40%.
- Kōkua hōʻoia: I kekahi manawa, ma ka nānā ʻana i ke ʻano o ka pane ʻana o kou puʻuwai i kēia mau ʻano hana, hiki i kāu kauka ke hoʻoholo pono i ke ʻano o ka maʻi puʻuwai (arrhythmia) āu.
ʻO nā ʻano nui o nā 'vegal maneuvers' i hoʻohana ʻia e nā kauka
Aia kekahi mau ʻano hana. Hōʻike ka papa ma lalo nei i kekahi o nā ʻano hana i hoʻohana pinepine ʻia e nā kauka.
| Inoa Hana | Ua wehewehe maʻalahi ʻia |
|---|---|
| Hoʻokele Valsalva | Ke paʻa nei i kou hanu a me ke kani ʻana me he mea lā e kahe ana kāu koko. |
| Luʻu ʻana | Ke hoʻoluʻu koke nei i ka maka i loko o ke pola wai hau. |
| Lomilomi Sinus Carotid | (Na ke kauka wale nō) E lomilomi mālie i kahi kikoʻī ma ka ʻaoʻao o ka ʻāʻī. |
| ʻO ka pane ʻeha | Ke hoʻoulu ʻana i ka puʻu e hoʻoulu i ka luaʻi ʻana. |
| ʻŪhū | Ke loaʻa ʻana o ka ʻūhū leo nui a ʻino. |
Pehea ʻoe e hana ai i kēia mau ʻano hana?
Eia pehea e hana ai i ʻekolu o nā ʻano hana i hoʻohana pinepine ʻia. E hoʻomanaʻo, hana ʻia kēia mau mea ma lalo o ka nānā ʻana a ke kauka.
- Hana Valsalva: E noi ʻia ʻoe e moe i lalo ma kahi moe, e hanu hohonu, e pani i kou ihu a me kou waha, a e hanu i waho no 10-30 kekona, me he mea lā e hoʻāʻo ana ʻoe e puhi i loko o kahi paipu i paʻa. I kekahi manawa, hiki i ke kauka ke hoʻohaʻahaʻa i ke poʻo o ka moe i lalo a hāpai i kou mau wāwae i kou hanu ʻana.
- Luʻu ʻana: ʻOiai e noho ana, e paʻa i kou hanu a hoʻoluʻu i kou maka holoʻokoʻa i loko o kahi pola wai hau. E hoʻopaʻa i kou maka i loko o ka wai no ka lōʻihi e hiki ai. A i ʻole, hiki iā ʻoe ke paʻa i kahi ʻeke hau a i ʻole kahi kāwele pulu anu ma luna o kou maka.
- Lomilomi Sinus Carotid: He mea kēia e hiki i ke kauka ke hana. E hoʻomoe ʻia ʻoe ma luna o kahi moe, e huli kou poʻo i kekahi ʻaoʻao, a e kaomi mālie ke kauka i ka wahi i kapa ʻia ʻo 'Carotid Sinus' ma ka ʻaoʻao o kou ʻāʻī me kona mau manamana lima no 5-10 kekona.
No wai kēia ʻano hana i kūpono ʻole? (Nā kumu pilikia)
ʻAʻole kūpono kēia mau ʻano hana no nā kānaka a pau. ʻAʻole hoʻohana nā kauka i kēia mau ʻano hana inā 'paʻa ʻole' ke kūlana o ka mea maʻi, ʻo ia hoʻi inā loaʻa iā lākou nā hōʻailona penei:
- Haʻahaʻa loa ke koko(Ke koko haʻahaʻa)
- ʻEha umauma
- Pōkole o ka hanu
- ʻAʻole lawa ka oxygen i ke kino
- ʻO ke kūlana kahi i loaʻa ʻole ai ke koko i nā ʻōkana
No kēlā ʻano kanaka paʻa ʻole, hoʻohana ʻia ka cardioversion, ka mea e kaohi i ka puʻuwai me ka lāʻau lapaʻau a i ʻole ka haʻalulu uila, ma kahi o nā 'vagal maneuvers'.
Mea nui: Inā ʻike ʻoe i nā hōʻailona e like me ka ʻeha o ka umauma, ka pōkole o ka hanu, a i ʻole ka wikiwiki o ka puʻuwai, he pilikia ia. E hele koke i ka ʻOihana Pilikia o ka haukapila (ETU) .
Aia kekahi mau pilikia me kēia mau ʻano hana?
Ma keʻano laulā, he kakaikahi nā pilikia ke hana ke kauka i kēia kaʻina hana ma kahi kanaka kūpono. Inā loaʻa lākou, ʻo ka hapa nui o lākou he manawa pōkole wale nō.
- Ke koko haʻahaʻa (Hypotension)
- Ka puʻuwai lohi loa (Bradycardia)
- ʻO nā maʻi ʻē aʻe o ka puʻuwai e hiki ke hana pinepine ʻole ʻia e komo pū me ka Atrial Fibrillation, Ventricular Fibrillation, a me Ventricular Tachycardia.
ʻO ke ʻano kūikawā, ʻaʻole hiki i nā kānaka a pau ke hana i ke ʻano i kapa ʻia ʻo 'Carotid Sinus Massage'. ʻAʻole pono e hana ʻia e ka poʻe me kēia moʻolelo:
- No ka poʻe i loaʻa i ka hahau mua a i ʻole TIA (transient ischemic attack)
- No ka poʻe me ka maʻi ʻaʻa carotid
- No ka poʻe i loaʻa koke i ka hāʻule puʻuwai
- No nā keiki ma lalo o 10 mau makahiki
ʻO kēia ke kumu a mākou e ʻōlelo hou ai, mai hoʻāʻo i kēia mau ʻano hana, ʻoiai ke ʻano lomilomi ʻāʻī, ma kāu iho me ka ʻole o ke aʻo ʻana a ke kauka.
Leka Lawe-Home
- ʻO nā 'Vegal maneuvers' he mau hoʻoikaika kino maʻalahi i hoʻohana ʻia e kāohi i ka piʻi koke ʻana o ka puʻuwai puʻuwai (SVT).
- Hoʻohana nā kauka i kēia mau mea ma ke ʻano he laina mua o ka lāʻau lapaʻau no ka mea ʻaʻole lākou i pilikia nui.
- Mai hoʻāʻo i kēia ma ka home ke ʻole ke kuhikuhi ʻia e kāu kauka. ʻO ka Carotid Sinus Massage ma ke ʻano kūikawā e hana wale ʻia e ke kauka.
- Inā loaʻa iā ʻoe ka ʻeha o ka umauma, ka poniuniu, a i ʻole ka paʻakikī o ka hanu ʻana i ka wā e kuʻi wikiwiki ana kou puʻuwai, e hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila.
- Inā ʻaʻole hiki i kēia mau ʻano ke kaohi i kou puʻuwai, mai hopohopo. Loaʻa paha i kāu kauka nā lāʻau lapaʻau a i ʻole nā lāʻau lapaʻau ʻē aʻe (e laʻa me ka catheter ablation). E hahai mau i kāna mau kuhikuhi.
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