Kodi inuyo kapena wina m'banja mwanu muli ndi pacemaker kapena chipangizo china cha mtima? Ngati ndi choncho, mwina munamvapo za waya waung'ono womwe umayenda kuchokera pa chipangizocho kupita kumtima. Izi nthawi zambiri zimayikidwa moyo wonse. Komabe, nthawi zina zapadera, mawaya awa amafunika kuchotsedwa mosamala kapena kuchotsedwa mumtima. Ichi ndi chomwe timachitcha 'kuchotsa lead' mu mankhwala. Nchifukwa chiyani izi zimachitika? Kodi ndizoopsa? Tikambirana izi mwachidule lero, mwanjira yomwe mungamvetse.
Choyamba, tiyeni tiwone tanthauzo la mawu akuti 'lead'.
Mukaganizira za 'lead', musaganize za lead ya pensulo! Izi ndi zosiyana kwambiri. Mwachidule, ndi waya woonda kwambiri wokutidwa ndi insulation yapadera. Imayenda kuchokera ku chipangizo chanu chothandizira kupuma kapena ICD (implantable cardioverter-defibrillator) kupita mumtima mwanu.
Mukudziwa, zipangizozi zimagwiritsidwa ntchito pochiza matenda a mtima omwe amakhudza kagwiridwe kake ka mtima, komwe ndi pamene mtima ukugunda mofulumira kwambiri, pang'onopang'ono kwambiri, kapena mosakhazikika (arrhythmias). Choncho, kagwiridwe ka mtima kakalakwika, chizindikiro chamagetsi chaching'ono kuchokera ku chipangizochi chimayenda motsatira njira iyi kupita kumtima. Chizindikiro chimenecho ndi chomwe chimapangitsa mtima kugundanso bwino. Zili ngati kuyatsa TV ndi remote.
Ndiye kodi 'Lead Extraction' ndi chiyani?
Mwachidule, izi zikutanthauza opaleshoni yochotsa imodzi kapena zingapo mwa zingwe za 'lead' izi mkati mwa mtima.
Koma izi sizophweka monga momwe zikuonekera. Chifukwa chake n'chakuti waya uwu ukalowetsedwa mumtima, pakapita nthawi, thupi lathu limapanga minofu yopyapyala yozungulira. Minofu iyi imapangitsa wayawo kukhala wolimba ku mitsempha yamagazi ndi khoma lamtima. Izi zimapangitsa kuti zikhale zosatheka kuuchotsa mwachizolowezi. Kuchita izi kungawononge mitsempha yamagazi.
Choncho, zida zapadera komanso luso la katswiri wa matenda a mtima wodziwa bwino ntchito yake ndizofunikira kwambiri kuti aswe mosamala minofu ya chilonda ichi ndikutulutsa waya uwu popanda kuwononga mitsempha yamagazi.
Chabwino, n’chifukwa chiyani muyenera kuchotsa mawaya awa mwadzidzidzi?
Pali zifukwa zingapo zomwe zimapangitsa izi. Zina ndi zadzidzidzi, zina zimakonzedwa pasadakhale. Tiyeni tiwone zifukwa zazikulu.
| Chifukwa chochotsera | Kufotokozera kosavuta |
|---|---|
| Matenda mu chipangizo kapena waya | Ichi ndiye chifukwa chachikulu komanso chofala kwambiri . Matenda m'magazi (bacteremia) amatha kufalikira ku chipangizo ndi waya. Nthawi zina ma valve a mtima amathanso kutenga matenda (infective endocarditis). Pazochitika zotere, ndikofunikira kuchotsa dongosolo lonse (chipangizo ndi waya) kuti muchepetse matendawa. |
| Kusweka kwa waya kapena kulephera kugwira ntchito bwino | Pakapita nthawi, wayayo imatha kusweka mkati kapena kunja. Kenako chizindikiro chotumizidwa kuchokera ku chipangizocho sichifika pamtima bwino. Chifukwa chake, waya wosweka, womwe ndi wopanda ntchito, uyenera kuchotsedwa. |
| Kupangika kwa minofu yambiri (Chotseka Chotulukira) | Pamene mapeto a waya, kumene umalumikizana ndi mtima, akukhala okhuthala kwambiri ndi minofu ya zipsera, chizindikiro chamagetsi sichingadutse chotchinga chimenecho kupita ku mtima. Izi zimatchedwa 'exit block'. Izi zimapangitsa kuti chipangizocho chisagwire ntchito bwino. |
| Mavuto ena | Nthawi zina waya wokha ungayambitse kugunda kwa mtima kosasinthasintha. Komanso, magazi amaundana mozungulira wayawo, zomwe zimalepheretsa kuyenda kwa magazi. |
| Kukumbukira ndi wopanga | Kawirikawiri, wopanga amatha kubweza waya wamtundu winawake chifukwa cha vuto. Ngakhale zili choncho, amafunika kuchotsedwa. |
Kodi opaleshoniyi imachitidwa bwanji kwenikweni?
Pali njira ziwiri zazikulu zochitira opaleshoniyi. Njira yodziwika kwambiri ndi kudzera mu mtsempha wa subclavian, womwe uli pansi pa collarbone (clavicle). Ngati sizingatheke, ingathenso kuchitika kudzera mu mtsempha wa m'mimba (femoral vein).
Nayi kufotokozera kosavuta kwa zomwe zimachitika panthawi ya opaleshoni:
1. Mankhwala Oletsa Kupweteka: Choyamba, mudzapatsidwa mankhwala oletsa kupweteka. Izi zikutanthauza kuti simudzamva chilichonse mpaka opaleshoniyo itatha, ndipo mudzakhala mukugona.
2. Kuyika chubu chapadera:Kenako dokotalayo amaika chubu chapadera chotchedwa 'sheath' kudzera mu imodzi mwa mitsempha yanu yamagazi ndikuchitsogolera ku 'lead' yomwe ili mumtima mwanu.
3. Kuphimba waya: Kenako, waya wakale umaphimbidwa kwathunthu ndi 'chidebe' ichi, monga momwe kuphimba chivundikiro cha cholembera ndi chivundikiro.
4. Kugwiritsa ntchito X-ray yamoyo: Zonsezi zimachitika pogwiritsa ntchito zithunzi za X-ray yamoyo (fluoroscopy). Kuti dokotala athe kuona bwino zomwe zikuchitika mkati mwa thupi.
5. Kuwononga minofu ya zipsera: Pogwiritsa ntchito zida zapadera kumapeto kwa 'chidebe', minofu ya zipsera yozungulira waya imasweka pang'onopang'ono, zomwe zimamasula waya. Nthawi zina, kuwala kwa laser kumagwiritsidwanso ntchito pa izi. Mphamvu ya laser imachotsa minofu ya zipsera ndi nthunzi.
6. Kuchotsa waya: Waya ukangotuluka chilonda, umachotsedwa mosamala m'thupi pamodzi ndi 'chidebe'.
7. Kutseka bala: Pomaliza, chotupacho chimatsekedwa ndi ma stitch ndikuphimbidwa ndi bandeji.
Kodi mudzayikanso mawaya atsopano?
Izi zimadalira chifukwa chochotsera waya. Tiyerekeze kuti chifukwa chake ndi matenda. Zikatero, matendawa ayenera kuchiritsidwa kwathunthu . Izi zingafunike masiku kapena milungu ingapo a maantibayotiki. Chipangizo chatsopano ndi waya zidzayikidwa pambuyo poti matendawa achira. Komabe, ngati chifukwa chake ndi waya wosweka, watsopano akhoza kuyikidwa nthawi yomweyo ndi opaleshoni yochotsa wakale.
Kodi ubwino ndi zoopsa zomwe zingabwere chifukwa cha opaleshoniyi ndi ziti?
Monga momwe zimakhalira ndi njira ina iliyonse yachipatala, pali ubwino ndi zoopsa zake. Zoopsa zake zimatha kuchepetsedwa ngati opaleshoniyi ichitidwa ndi gulu lachipatala lodziwa bwino ntchito.
| Ubwino waukulu | |
|---|---|
| ✅ | Ngati panali matenda, amatha kuchiritsidwa kwathunthu. |
| ✅ | Kubwezeretsa mphamvu ya chipangizo mwa kusintha waya wosweka kapena wosagwira ntchito bwino ndi waya watsopano, wogwira ntchito bwino. |
| ✅ | Kuthetsa mavuto monga kusayenda bwino kwa kugunda kwa mtima ndi magazi kuundana chifukwa cha waya. |
Chofunika kwambiri ndi kusankha dokotala wa mtima wophunzitsidwa bwino komanso wodziwa bwino ntchito yake komanso chipatala, chifukwa opaleshoni imeneyi ndi yovuta kwambiri.
| Zoopsa zomwe zingachitike (zosowa kwambiri) | |
|---|---|
| ⚠️ | Kuwonongeka kwa mtsempha wamagazi kapena khoma la mtima komanso kutuluka magazi ambiri. |
| ⚠️ | Ukachotsedwa, waya umasweka ndipo chidutswa chaching'ono chimatsala mkati mwa thupi. |
| ⚠️ | Magazi akusonkhana mozungulira mtima. |
| ⚠️ | Mavuto okhudzana ndi mankhwala oletsa ululu. |
Kodi ndiyenera kukhala m'chipatala nditachita opaleshoni?
Inde, nthawi zambiri mumayenera kukhala m'chipatala kwa tsiku limodzi kapena awiri. Zingatenge nthawi yayitali. Panthawi imeneyo:
- Mpumulo: Muyenera kugona pabedi ndikupuma kwa maola angapo, makamaka ngati opaleshoniyo idachitika kudzera m'chiuno.
- Kupereka mankhwala opha tizilombo toyambitsa matenda: Ngati opaleshoniyo idachitika chifukwa cha matenda, mankhwala opha tizilombo toyambitsa matenda m'mitsempha adzapitirira.
- X-ray: X-ray ya pachifuwa imachitidwa m'mawa wotsatira kuti ione ngati mawaya atsopano ali pamalo oyenera.
Mukapita kunyumba, ndi nthawi ziti zomwe muyenera kulankhula ndi dokotala?
Ndikofunikira kwambiri kuyang'anira kusintha kwa thupi lanu ngakhale mutapita kunyumba. Ngati mukukumana ndi zizindikiro zotsatirazi, imbani dokotala wanu nthawi yomweyo kapena pitani ku chipatala chapafupi cha Emergency Department (ETU) .
- Ngati mukuvutika kupuma.
- Ngati mukuyamba kutentha thupi (kupitirira madigiri 101 Celsius) .
- Ngati pali kutupa, kutuluka magazi ambiri, kapena madzi ofanana ndi mafinya akutuluka pamalo ochitira opaleshoni.
- Ngati muwona kutupa kosazolowereka m'zala zanu kapena zala zanu.
Musanyalanyaze zizindikiro izi. Kulandira chithandizo msanga kungalepheretse mavuto aakulu.
Uthenga Wopita Nawo Kunyumba
- Kuchotsa lead ndi opaleshoni yapadera yomwe imachotsa mawaya a pacemaker kapena zida za ICD mumtima.
- Chifukwa chachikulu cha izi ndi matenda mu chipangizo kapena waya. Kuphatikiza apo, wayayo ikhoza kusweka kapena kusokonekera.
- Uwu ndi opaleshoni yovuta yomwe iyenera kuchitidwa mosamala kwambiri ndi dokotala wodziwa bwino ntchito yake, chifukwa minofu ya zipsera imapangika mozungulira waya pakapita nthawi.
- Ndikofunikira kwambiri kudziwa zizindikiro zochenjeza (malungo, kupuma movutikira, kutupa) zomwe zingachitike mutachita opaleshoni ndikupempha upangiri wa dokotala nthawi yomweyo ngati vuto lotere litachitika.
- Ngati muli ndi nkhawa kapena mantha okhudza izi, kambiranani momasuka ndi dokotala wanu wa mtima. Adzakufotokozerani zonse.
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