Kugunda kwa mtima kosakhazikika? Tiyeni tiphunzire zonse zokhudza chithandizo cha Pulmonary Vein Isolation (PVI)!

Nthawi zina mungamve ngati mtima wanu sukugunda motsatizana, nthawi zina mtima wanu ukugunda mofulumira kwambiri, ngati kuti ukudumphadumpha, kapena kugunda kwina kumadumphadumpha. Mtundu uwu wa kugunda kwa mtima kosakhazikika si chinthu choyenera kuonedwa mopepuka. Izi zimatchedwa Atrial Fibrillation (Afib) mu sayansi ya zamankhwala. Lero tikambirana za njira yapadera yomwe imagwiritsidwa ntchito ngati chithandizo cha vutoli.

Mwachidule, kodi Pulmonary Vein Isolation (PVI) ndi chiyani?

Kuika Mitsempha ya M'mapapo ndi njira yapadera yomwe imagwiritsidwa ntchito pochiza kugunda kwa mtima kosakhazikika kotchedwa Atrial Fibrillation (Afib). Mwachidule, "imalekanitsa" kapena kulekanitsa madera omwe zizindikiro zamagetsi zomwe zimalamulira kayendedwe ka mtima zimapangidwira.

Taganizirani izi motere. Mtima wathu ndi chiwalo chodabwitsa. Kugunda kwake kumayendetsedwa ndi dongosolo losavuta kwambiri la zizindikiro zamagetsi. Koma mwa munthu amene ali ndi vutoli lotchedwa Afib, zipinda ziwiri zapamwamba za mtima (zomwe timazitcha kuti atria) zimayamba kulandira zizindikiro zamagetsi zolakwika komanso zosakhazikika. Zizindikiro zolakwikazi zimapangitsa kuti gawo lapamwamba la mtima ligunde mwachangu kwambiri, ngati kuti likugwedezeka. Ngati izi zipitirira, chiopsezo cha matenda oopsa monga sitiroko chimakhala chachikulu kwambiri.

Kodi mukudziwa komwe zizindikiro zamagetsi zolakwikazi zimayambira nthawi zambiri? Pali mitsempha inayi yomwe imanyamula magazi oyera, okhala ndi mpweya kuchokera m'mapapo athu kupita ku atrium yakumanzere ya mtima. Izi ndi zomwe timatcha Mitsempha ya M'mapapo . Ndi kuzungulira mitsempha inayi yomwe zizindikiro zolakwika zomwe zimayambitsa Afib nthawi zambiri zimayamba.

Chithandizo cha Pulmonary Vein Isolation (PVI) chimaphatikizapo kuzindikira komwe zizindikiro zachilendo zimayambira ndikupanga chotchinga chaching'ono kuti zisafike mbali zina za mtima. Chotchinga ichi chimapangidwa pogwiritsa ntchito kutentha pang'ono kapena kuzizira kwambiri kuti apange minofu yaying'ono ya zipsera m'malo amenewo. Zipsera izi zimaletsa zizindikiro zamagetsi zachilendo kuti zisapitirire pamalo amenewo. Zili ngati kutseka njira yolakwika. Kenako mtima umayambanso kugunda bwino. Njirayi imatchedwa Heart Ablation .

Ndani kwenikweni amene akufunikira chithandizochi?

Chithandizo ichi si cha aliyense. Dokotala wanu adzaganizira zinthu zingapo asanasankhe ngati chili choyenera kwa inu. Chithandizochi nthawi zambiri chimakhala choyenera anthu otsatirawa:

• Kwa iwo omwe akadali ndi zizindikiro (kugunda kwa mtima kwambiri, kutopa, kupuma movutikira) ngakhale akumwa mankhwala oletsa kupweteka kwa mtima kuti achepetse vuto lawo la Afib.
• Ngati mankhwala awa amayambitsa zotsatirapo zoyipa kapena ngati thupi silingathe kupirira mankhwalawo.

Kodi chithandizochi chingachitike popanda kugwiritsa ntchito mankhwala?

Ili ndi vuto lomwe anthu ambiri ali nalo. Ofufuza akufufuzabe ngati PVI ndi mankhwala abwino kwambiri kwa odwala ena kuposa mankhwala. Kafukufuku wina wasonyeza kuti PVI ndi yothandiza kwambiri kuposa mankhwala. Koma si chithandizo chokhazikika. Chifukwa chake njira yomwe ilipo pano ndi kuyesa mankhwala kaye kenako kuganizira za PVI ngati sizikugwira ntchito.

Kodi mungadziwe bwanji ngati chithandizochi chili choyenera kwa inu?

Sizingatheke kunena nthawi yomweyo ngati ndinu woyenera kuchita izi. Muyenera kuyesedwa kwathunthu ndi dokotala. Dokotala adzayamba wafunsa za mbiri yanu yachipatala ndikukufufuzani mwakuthupi. Kenako adzalamula mayeso angapo okhudzana ndi mtima. Ena mwa iwo ndi awa:

• Echocardiogram: Izi zingathandize kudziwa bwino momwe mtima umagwirira ntchito komanso kapangidwe kake.
• Electrocardiogram (EKG): Kuyeza komwe kumalemba momwe magetsi a mtima amagwirira ntchito.
• Chowunikira cha Holter: Ichi ndi makina ang'onoang'ono a EKG omwe amamangiriridwa ku thupi lanu kwa maola 24 kapena 48. Amatha kuwona momwe kugunda kwa mtima wanu kumasinthira tsiku lonse.

Dokotala adzapanga chisankho chomaliza ngati chithandizo cha PVI chili choyenera kwa inu kapena ayi kutengera zotsatira za mayesowa.

Kodi PVI imachiritsidwa bwanji? Kodi njira zazikulu ndi ziti?

Kuchotsa mitsempha ya m'mapapo ndi mtundu wa chithandizo chotchedwa Catheter Ablation . Izi zikutanthauza kuti sichimachitika podula kwambiri pachifuwa monga opaleshoni. M'malo mwake, chimachitidwa poika chubu chopyapyala kwambiri (catheter) kudzera m'mitsempha yayikulu yamagazi m'khosi kapena m'khosi.

Pali njira ziwiri zazikulu zokonzera minofu ya chilonda yomwe tatchula kale.

Ndi njira iti mwa ziwirizi yomwe ndi yabwino kwambiri?

Palibe njira yoti tinganene kuti njira imodzi ndi yabwino kuposa inzake. Zonse ziwiri zili ndi ubwino ndi kuipa kwake. Kafukufuku wasonyeza kuti palibe kusiyana kwakukulu pa zotsatira ndi chitetezo cha njira ziwirizi. Dokotala wanu adzakufotokozerani musanalandire chithandizo njira yomwe ili yoyenera kwa inu.

Kodi chimachitika ndi chiyani panthawi ya chithandizo? Kodi ndikumva kupweteka?

Kawirikawiri, panthawi ya chithandizochi, mumapatsidwa mankhwala oletsa ululu (General Anesthesia) . Izi zikutanthauza kuti mudzakhala mukugona mokwanira. Chifukwa chake, simudzamva kupweteka kapena kusasangalala panthawi ya chithandizo. Mukadzuka, zonse zidzakhala zitatha. Nthawi zina zapadera, izi zitha kuchitika pongochotsa dzanzi pamalo oyenera (local anesthetic). Dokotala adzakudziwitsani izi pasadakhale.

Chimachitika pang'onopang'ono

1. Kukonzekera: Choyamba, mudzapatsidwa mankhwala oletsa ululu. Kenako, malo omwe ali m'mimba mwanu kapena pakhosi pomwe catheter idzalowetsedwa adzatsukidwa ndikuchotsedwa mano.

2. Kuika catheter: Dokotala adzaika ma catheter awiri owonda (machubu) kuchokera pamalo opanda dzanzi kudzera m'mitsempha yamagazi kupita ku atrium yakumanzere ya mtima.

3. Kuzindikira zizindikiro: Catheter imawonetsa komwe zizindikiro zamagetsi zolakwika zikuchokera.

4. Kuchotsa chilonda: Katheta ina imapereka kutentha (Radiofrequency) kapena kuzizira (Cryoablation) komwe tinakambirana, kuwononga minofu yoyenera ndikupanga chilonda.

5. Kumaliza: Pambuyo poti chithandizo chatha bwino, dokotala amachotsa mosamala ma catheter onse awiri ndikuyika bandeji yaying'ono pamalo olowetsera.

Kodi mtima wanga udzayang'aniridwa bwanji panthawi ya chithandizo?

Gulu lachipatala lidzapitiriza kuyang'anira momwe mtima wanu ndi thupi lanu zimagwirira ntchito nthawi yonse yomwe mukugwiritsa ntchito mankhwala oletsa ululu, pogwiritsa ntchito zipangizo zingapo.

Ntchito yonseyi ingatenge maola anayi mpaka asanu ndi limodzi , choncho ndi bwino kuuza banja lanu pasadakhale. Mungafunikenso kukhala m'chipatala usiku wonse mutalandira chithandizo.

Kodi chimachitika ndi chiyani mukalandira chithandizo?

Pambuyo pa chithandizo, dokotala adzakambirana nanu ndi banja lanu za zotsatira zake. Muyenera kupuma pabedi kwa maola pafupifupi anayi mpaka asanu ndi atatu. Anamwino adzayang'anira kugunda kwa mtima wanu ndi kugunda kwa mtima wanu usiku wonse. Nthawi zambiri, mudzatha kupita kunyumba m'mawa wotsatira. Musanapite kunyumba, anamwino adzayang'ana malo omwe ali ndi catheter ndikuchotsa mabandeji ndikutsuka.

Kodi zoopsa zomwe zingachitike ndi ziti?

PVI nthawi zambiri ndi njira yotetezeka kwambiri yothandizira. Komabe, monga momwe zimakhalira ndi njira ina iliyonse yachipatala, pali chiopsezo chochepa. Zinthu zotere zimachitika kawirikawiri.

• Kutupa kwa utoto wosiyana womwe umagwiritsidwa ntchito pojambula X-ray.
• Matenda opatsirana pamalo pomwe catheter imayikidwa.
• Kuwonongeka kwa khoma la mtima (pafupifupi chiopsezo cha 1%).
• Kuwonongeka kwa mitsempha ya m'mapapo (pafupifupi chiopsezo cha 1%).
• Stroke (chiopsezo cha pafupifupi 0.5%).

Musaope zoopsa izi. Gulu lanu la zachipatala lidzachita zonse zomwe lingathe kuti izi zisachitike. Dokotala wanu adzakufotokozerani zonsezi musanalandire chithandizo.

Nthawi yochira ndi chisamaliro chotsatira

M'masiku awiri oyambirira (maola 48) mutatha kulandira chithandizo, mungamve kupweteka pang'ono, kutopa, kapena kupweteka pachifuwa. Izi ndi zachilendo. Pambuyo pake, mutha kuyambiranso pang'onopang'ono zochita zanu zachizolowezi. Komabe , zingatenge milungu ingapo kuti muyambenso kuchita zinthu zolemetsa, monga kuchita masewera olimbitsa thupi.

Mukalandira chithandizo, mudzapatsidwa mankhwala angapo kwa miyezi ingapo:

• Mankhwala oletsa kupweteka kwa mtima: Yesetsani kugunda kwa mtima mpaka zotsatira za kuchotsedwa kwa mtima zitapezeka.
• Mankhwala Oletsa Kutsekeka kwa Magazi (ochepetsa Kutsekeka kwa Magazi): Amachepetsa Chiwopsezo cha Matenda a Sitiroko. Mungafunike kupitiriza kumwa mankhwala awa.

Mudzakhala ndi nthawi yanu yoyamba yokumana ndi dokotala miyezi itatu kapena inayi mutalandira chithandizo, ndipo yotsatira patatha chaka chimodzi. Pa nthawi imeneyi, dokotala wanu angabwereze mayeso monga CT scan, echocardiogram, kapena EKG kuti aone momwe mtima wanu ulili.