Kodi chikuchitika ndi chiyani pa kugunda kwa mtima wanu? Tiyeni tiwone kuchokera kunyumba. Zonse zokhudza (Ambulatory Monitors)!

Kodi nthawi zina mumamva ngati pali vuto ndi mtima wanu? Mwina dokotala anakuyesani ndipo anati ayenera kuyang'anira momwe mtima wanu umagwirira ntchito kwa masiku angapo. Pamenepo ndi pomwe zida zazing'ono izi zotchedwa ``Ambulatory Monitors'' zingakuthandizeni. Chifukwa chake, tiyeni tikambirane za izi mwatsatanetsatane, mwachidule, lero.

Kodi Ambulatory Monitor ndi chiyani? Mwachidule...

Mwachidule, chowunikira chomwe chimayenda ndi chipangizo chaching'ono chomwe chimalemba momwe mtima wanu umagwirira ntchito, kapena kugunda kwa mtima, kwa nthawi yayitali, mukakhala kunyumba kapena mukuchita zinthu zanu zatsiku ndi tsiku. Taganizirani izi ngati ECG yomwe mumalandira kuchipatala, koma imakhala nanu kwa masiku ambiri, nthawi zina milungu ingapo. Izi ndizofunikira chifukwa matenda ena amtima nthawi zonse samasonyeza zizindikiro. Izi zikutanthauza kuti sangakhalepo mukapita kwa dokotala. Ndi njira yabwino yodziwira mavuto omwe amabwera mwadzidzidzi komanso kunja kwa chipatala .

Ndi mitundu iti ya matenda a mtima yomwe ingapezeke ndi chowunikira ichi?

Chowunikira ichi cha 'ambulatory' chimagwiritsidwa ntchito makamaka kuzindikira `(Arrhythmia)` kapena kugunda kwa mtima kosakhazikika. Ngakhale kuti zolakwika zina zitha kuzindikirika mosavuta ndi `(ECG)` yochitidwa kuchipatala, chowunikira ichi chimatha kusonkhanitsa zambiri komanso zambiri. Chifukwa chake, chimathandiza kuzindikira zolakwika zomwe simungadziwe, zomwe zimachitika mwadzidzidzi, kapena zomwe zimangotenga nthawi yochepa kwambiri .

Nazi zina mwa mitundu yofala kwambiri ya arrhythmia:

• `(Bradyarrhythmia)` (Bradycardia): Uku ndi kugunda kwa mtima kochedwa kwambiri. Kunena zoona, zimamveka ngati mtima ukugunda mofulumira kwambiri.
• Tachyarrhythmia: Apa ndi pamene mtima ukugunda mofulumira kwambiri. Tangoganizirani mtima wanu ukugunda ngati kugunda kwa mtima kothamanga.
• Kusakhazikika kwa mtima: "Supra" amatanthauza pamwambapa. "Ventricle" amatanthauza zipinda ziwiri zapansi pa mtima. Izi zikutanthauza kusakhazikika kwa zipinda ziwiri zapamwamba za mtima, atrium yakumanzere ndi atrium yakumanja.
• Kusakhazikika kwa mtima: Izi ndi zolakwika zomwe zimachitika m'zipinda ziwiri zapansi pa mtima.

Ndani adzatenga nawo mbali mu kafukufukuyu? Ndani adzakuthandizani?

Akatswiri angapo azachipatala amachita nawo mayesowa. Mwachitsanzo, akatswiri a zamaganizo, anamwino, ndi madokotala. Komabe, nthawi zambiri katswiri ndi amene amasanthula deta yomwe yasonkhanitsidwa ndikupanga matenda. Uyu akhoza kukhala katswiri wa zamtima kapena katswiri wa zamagetsi.

Kodi chowunikira ichi choyendera chimagwira ntchito bwanji? N'zodabwitsa, sichoncho?

Ma monitor onsewa amagwira ntchito chifukwa mtima wathu uli ndi makina akeake amagetsi. Tangoganizirani, kugunda kwa mtima kumayendetsedwa ndi zizindikiro zochokera ku makina awa amagetsi. Zizindikiro zamagetsi izi ndi zomwe zimapangitsa zipinda zinayi za mtima kuti zichepetse mwadongosolo komanso mosalekeza. Izi ndi zomwe zimathandiza mtima kupompa magazi mwadongosolo komanso moyenera.

Kodi sizodabwitsa? Ntchito yamagetsi iyi yomwe ili mumtima mwathu ndi yamphamvu kwambiri kotero kuti imatha kuzindikirika mosavuta ndi zida zomwe zayikidwa pamwamba kapena pansi pa khungu.

Ichi ndi chomwe timachidziwa kuti `(ECG)`, chomwe chimalemba zochitika zamagetsi izi. Koma ndi kwa kanthawi kochepa. Ngati pali vuto m'mbali ina ya mtima, ntchito zamagetsi m'mbali imeneyo zimasintha. Dokotala wodziwa bwino ntchito amatha kudziwa momwe ziwalo zosiyanasiyana za mtima zikugwirira ntchito. `(ECG)` nthawi zambiri imachitikira kuchipatala kapena kuchipatala, mkati mwa mphindi zochepa.

Ma monitor oyendera ma ambulatory amagwira ntchito mofananamo. Komabe, awa amawunika momwe mtima wanu ukuyendera kwa masiku, milungu, ndipo nthawi zina zaka . Amatha kujambula momwe mtima wanu ukuyendera pamene mukugona, mukugwira ntchito, kapena mukuchita zinthu zanu za tsiku ndi tsiku.

Ndi mitundu iti ya ma ambulatory monitors yomwe ilipo? Ndi iti yomwe ili yoyenera kwa inu?

Ma monitor ambiri oyendera ndi zida zonyamulika zomwe mungathe kunyamula. Amayesa kugunda kwa mtima wanu pogwiritsa ntchito masensa otchedwa ma electrode. Ma electrode awa amamangiriridwa pakhungu lanu ndi guluu wapadera. Ambiri mwa ma monitor awa ndi ofanana ndi kukula ndi kulemera kwa foni wamba.

### Zowunikira Zakunja

• `(Chowunikira cha Holter): Ichi chimagwiritsidwa ntchito kwambiri polemba zochitika za mtima kwa tsiku limodzi kapena awiri. Komabe, zowunikira zina zamtunduwu zimatha kulemba deta kwa sabata imodzi kapena ziwiri.
• Chowunikira zochitika: Zipangizozi zimalemba zochitika za mtima pokhapokha ngati pali mwayi waukulu wa kugunda kwa mtima kosasinthasintha. Ma chowunikira ena amatha kuyatsidwa mukamva zizindikiro. Ena amangomvera "kugunda kwa mtima wanu ndikuyamba kujambula okha akazindikira kugunda kwa mtima kosasinthasintha. Pali mitundu iwiri ikuluikulu:
• `(Kutsegula)`: Zipangizozi zili ndi `kumbuyo`. Izi zikutanthauza kuti, mphindi zingapo zapitazo ndi mphindi zingapo mtsogolo zimasungidwa mu memori iyi. `yoyatsidwa` ikagwiritsidwa ntchito, deta yakale imachotsedwa pamene deta yatsopano imawonjezedwa. Ngati `muyatsegula`, mphindi zingapo zapitazo ndi mphindi zochepa pambuyo `yoyatsegula` zimasungidwa kuti ziwonekere mtsogolo.
• `(Non-looping)`: Izi zimangolembedwa kwa nthawi inayake pambuyo `activation`. Zina mwa zowunikira izi zimakulolani kusiya `electrodes` yoyatsidwa. Zizindikiro zikayamba, mutha kulumikiza `electrodes` ndikuyiyambitsa kuti mujambule kugunda kwa mtima.
• `(Real-time monitor)` (Real-time monitor): Izi zikufanana kwambiri ndi `(Event monitor)`. Komabe, izi zimatha kutumiza deta yokhudza momwe mtima umagwirira ntchito ku malo owunikira kuti dokotala athe kuziwona nthawi yomweyo. Izi zimatha kutumiza deta yokha akazindikira vuto, kapena zitha 'kuyambitsidwa' kuti zitumize deta mukamva zizindikiro. Izi ndizothandiza kwambiri pakakhala zovuta zazikulu ndipo upangiri wachangu wamankhwala umafunika.

### Mitundu ina yapadera ya ma monitor

Pali mitundu ina iwiri ya ma monitor omwe amagwira ntchito mofanana ndi omwe atchulidwa pamwambapa, koma ali ndi kusiyana pang'ono:

• Chojambulira mapaketi: Izi zili ngati chigamba chomwe mumachimangirira pakhungu lanu. Komabe, zili ndi zonse zomwe mukufunikira kuti muzindikire, kujambula, ndikusunga zomwe mtima wanu ukuchita. Zitha kuvalidwa kwa milungu iwiri. Ndi zazing'ono mokwanira kuti zisawonekere bwino pansi pa T-sheti.
• Zipangizo zojambulira za loop zomwe zimayikidwa: Izi ndi zida zazing'ono kwambiri zomwe zimatha kuyikidwa pansi pa khungu. Zimatha kuyang'anira momwe mtima ukugwirira ntchito kwa nthawi yayitali, mwina mpaka zaka ziwiri. Zitha kujambula zokha kapena pamene wovalayo azigwiritsa ntchito. Deta ikhoza kutsitsidwa popanda waya ku chipatala kapena ku ofesi ya dokotala. Ubwino waukulu wa izi ndikuti simuyenera kuda nkhawa kuti muyiyambitse, ndipo sizimayambitsa mavuto mukasamba kapena kusambira.

Kodi mungayembekezere chiyani musanayese mayeso? Kodi mungakonzekere bwanji?

Dokotala, nthawi zambiri katswiri, adzakufotokozerani njira zomwe mungayesere mayeso anu ndikukupatsani mtundu wa chowunikira chomwe chikugwirizana bwino ndi zosowa zanu. Izi zidzaganizira zinthu monga ntchito yanu ndi zomwe mumakonda.

### Momwe mungakonzekerere mayeso

Ndibwino kusamba musanayese mayeso. Kutengera ndi chowunikira chomwe mukugwiritsa ntchito, zingatenge tsiku limodzi kapena awiri musanasambenso mutachotsa ma electrode. Komabe, ndikofunikira kusunga khungu pachifuwa chanu loyera.

• Musamapaka mafuta, mafuta odzola, kapena kirimu pakhungu la pachifuwa. Izi zingalepheretse ma electrode kuti asamamatire bwino pakhungu ndipo zingalepheretse mtima kugwira ntchito bwino.
• Komanso, valani shati yosavuta kuvala ndi kuvula. Mwanjira imeneyi, zidzakhala zosavuta kumangirira ma electrode.

Kodi chimachitika n’chiyani tsiku limene chowunikiracho chaikidwa?

Katswiri kapena katswiri wina wa zaumoyo adzakufotokozerani momwe mungagwiritsire ntchito chipangizochi, momwe mungachigwiritsire ntchito, komanso momwe mungachotsere ndikulumikizanso ma electrode, kutengera chipangizocho, mukatha kusamba kapena kusambira.

Adzakuuzaninso momwe mungapewere zinthu zomwe zingasokoneze chowunikira, monga zipangizo zina zamagetsi ndi zida zokhala ndi maginito. Angakupatseni mndandanda wa zipangizo zotere, kapena mungapemphe chimodzi.

Mu ma monitor omwe amagwiritsa ntchito ma electrode, malo omwe ma electrode amalumikizidwa amatsukidwa ndi mowa. Ngati pali tsitsi m'derali, amachotsedwa. Pokhapokha ma electrode amatha kumamatira bwino ndipo chizindikiro chomveka bwino chimalandiridwa.

Kodi zimakhala bwanji nditavala chowunikira? Ndiyenera kusamala ndi chiyani?

Mayeso a ambulatory monitor ndi otetezeka kwambiri komanso osapweteka . Nthawi zambiri, chomwe muyenera kuchita ndikuvala ndikugwiritsa ntchito monitor monga momwe mwalangizidwira. Opereka chithandizo chamankhwala, kuphatikizapo akatswiri ndi anamwino, adzakuuzani zonse zomwe muyenera kudziwa mukamavala monitor.

Kodi mumatani nthawi yoyezetsa ikatha?

Mayeso akatha, mutha kuchotsa ma electrode (ngati chipangizocho chili nawo) ndikubwezera chipangizocho. Ndi ma monitor akunja, mutha kumva kuyabwa pang'ono kapena kufiira (kukwiya pakhungu) kwa masiku angapo pomwe ma electrode adayikidwa. Izi nthawi zambiri zimatha pakatha masiku ochepa. Ngati izi zitachitika, mutha kufunsa dokotala wanu ngati pali chilichonse chomwe mungachite kuti muchire mwachangu.

Kodi pali zoopsa zilizonse ndi zipangizozi? Tiyeni tidziwe pang'ono.

Kawirikawiri, zotsatira zoyipa kwambiri za ma ambulatory monitors ndi kuyabwa pakhungu kapena kufiira . Izi nthawi zambiri zimachitika chifukwa cha guluu lomwe limagwiritsidwa ntchito polumikiza ma electrode pakhungu. Ngati muli ndi khungu lofewa kapena mukudziwa (kapena mukukayikira) kuti muli ndi vuto la zomatira, muyenera kuuza dokotala wanu musanagwiritse ntchito ma electrode.

Ndi makina ojambulira ma loop omwe amaikidwa m'thupi, zotsatirapo zina kapena zovuta zina zimatha kuchitika - koma zambiri zimakhala zazing'ono:

• Ululu kapena kusasangalala pamalo obayira: Izi nthawi zambiri zimakhala bwino zokha patangopita masiku ochepa.
• Matenda: Nthawi zambiri, matenda amatha kuchitika pamalo pomwe chipangizocho chili. Izi nthawi zambiri zimachiritsidwa ndi maantibayotiki. Komabe, nthawi zina chipangizocho chingafunike kusunthidwa kupita kwina.
• Kusamva bwino kwa zinthu: Chinthu china chosowa kwambiri ndi kusamva bwino kwa zinthu zomwe zimagwiritsidwa ntchito mu chipangizocho. Ngati izi zitachitika, chipangizocho chidzafunika kuchotsedwa ndipo mtundu wina wa chowunikira udzafunika kugwiritsidwa ntchito.
• Chizindikiro choipa: Nthawi zina zipangizozi sizingathe kuzindikira bwino momwe magetsi amagwirira ntchito m'mbali zina za mtima. Ngati zimenezo zitachitika, chipangizocho chingafunike kusunthidwa kupita kwina komwe chingapeze chizindikiro chomveka bwino.

Kodi zotsatira zake zimapezeka bwanji? Kodi zikutiuza chiyani?

Mukabweza chowunikira, akatswiri ndi ogwira ntchito zachipatala ena adzatsitsa detayo ndikuiyika mu fayilo yanu yachipatala kuti dokotala wanu ayiwunikenso. Dokotala akawunikanso detayo, adzatha kupeza matenda. Kenako, kutengera zomwe mukufuna komanso njira zochizira, mudzadziwitsidwa pafoni kapena mwanjira ina. Panthawiyo, dokotalayo adzakufotokozerani zomwe zotsatira zake zawonetsa komanso zomwe muyenera kuchita kenako. Nthawi zina, mungapemphedwe kuti mubwererenso kudzachezanso ndi dokotala wina kapena, ngati pakufunika kutero, kukutumizirani kwa katswiri wina.

Kodi muyenera kuyimbira dokotala liti? Dziwani zinthu izi.

Dokotala wanu ndi antchito ake adzakuuzani nthawi yoti muyimbire ofesi yawo. Angakupatseninso nambala yapadera ya foni yomwe imatsegulidwa maola 24 kuti muyimbire ngati muli ndi mafunso okhudza chowunikiracho.

Ngati muli ndi chojambulira cha loop chomwe chimayikidwa m'thupi (ILR) ndipo muli ndi zizindikiro zotsatirazi za matenda , muyenera kuyimbira foni dokotala wanu nthawi yomweyo:

• Kumva kutentha thupi, kumva kuzizira komanso kunjenjemera.
• Kumva kutentha mukakhudza malo omwe chipangizocho chayikidwa.
• Pali kutupa kapena kufiira m'dera limenelo.
• Madzi kapena magazi ofanana ndi mafinya omwe akutuluka mu chotupacho.

Kodi zimatenga nthawi yayitali bwanji kuti mudziwe zotsatira za mayeso?

Nthawi yomwe imatenga kuti muwone zotsatira imasiyana. Zimatengera mtundu wa chowunikira chomwe chagwiritsidwa ntchito, nthawi yowunikira, komanso nthawi yachipatala ndi dokotala. Mutha kuwafunsa kuti zitenga nthawi yayitali bwanji kuti apeze zotsatira.

Uthenga Wopita Nawo Kunyumba

Kotero, "chowunikira cha ambulatory" ichi ndi mayeso ofunikira kwambiri komanso otetezeka. Makamaka, ndi othandiza kwambiri pozindikira kusakhazikika kwa kugunda kwa mtima komwe kumachitika mwadzidzidzi ndipo kumachitika tsiku ndi tsiku. Ngati dokotala wanu akupemphani kuti muchite mayesowa, palibe chifukwa choopera. Ndikukhulupirira kuti nkhaniyi yakuthandizani kumvetsetsa bwino. Ngati muli ndi mafunso, lankhulani ndi dokotala wanu kuti mudziwe zambiri. Khalani ndi thanzi labwino!

Matenda a mtima , chowunikira choyendera, kugunda kwa mtima, kusakhazikika kwa mtima, chowunikira cha Holter, mayeso a mtima, ECG