Kodi jakisoni wapadera uyu m'khosi angathandize kuchepetsa ululu? Tiyeni tiphunzire za Stellate Ganglion Block.

Kodi mumakhala ndi ululu wosatha pakhosi, mutu, mkono, kapena pachifuwa chomwe sichimatha ndi mankhwala? Nthawi zina, chomwe chimayambitsa ululu woterewu chingakhale vuto laling'ono m'mitsempha yathu. Lero, tikambirana za njira yapadera, yosiyana pang'ono yochiritsira yomwe madokotala amagwiritsa ntchito pazochitika zotere. Izi zimatchedwa 'Stellate Ganglion Block'. Ngakhale dzinalo lingamveke lovuta pang'ono, tiyeni timvetse zomwe izi zimachita.

Kodi Stellate Ganglion Block (SGB) ndi chiyani?

Mwachidule, Stellate Ganglion Block (SGB) ndi jakisoni wa mankhwala oletsa ululu. Koma iyi si jakisoni wamba wamba. Imalowetsedwa mu gulu lapadera la mitsempha m'khosi mwathu, makamaka mbali zonse ziwiri za bokosi lathu la mawu. Gulu la mitsempha ili limatchedwa 'Stellate Ganglion'.

Pali zolinga ziwiri zazikulu zoperekera katemerayu:

1. Kuchepetsa ululu waukulu komanso wosatha m'mutu, pakhosi, m'manja, komanso pachifuwa.

2. Kuyenda kwa magazi m'manja, ndiko kuti, kusintha kwa kuyenda kwa magazi.

Chabwino, ndiye gulu la nyenyezi limeneli ndi chiyani?

Gulu la mitsempha ndi gulu la maselo a mitsempha omwe amasonkhana pamodzi, monga malo olumikizirana sitima, malo omwe mauthenga a mitsempha amatumizidwa mobwerezabwereza.

Gulu la mitsempha la stellate ndi gulu limodzi la mitsempha. Lili kutsogolo kwa khosi lathu, pansi pa khosi, pafupi ndi nthiti yoyamba. Tili ndi magulu a mitsempha ngati awa mbali zonse ziwiri za khosi lathu. Mawu oti 'stellate' amatanthauza 'ngati nyenyezi'. Izi zikutanthauza kuti mawonekedwe a gulu la mitsempha ili akhoza kufanana ndi mawonekedwe a nyenyezi.

Gulu la mitsempha ili ndi la 'Sympathetic Nervous System', lomwe ndi gawo la Autonomic Nervous System yathu. Mwachidule, iyi ndi njira ya thupi lathu 'yolimbana kapena kuthawa', ndiko kuti, njira yomwe imatikonzekeretsa kumenyana kapena kuthawa mwadzidzidzi, pamene tikuopa kapena kuda nkhawa. Imagwira ntchito pazinthu zambiri zomwe thupi lathu limalamulira popanda kuganizira za izo, monga kugunda kwa mtima, kuthamanga kwa magazi, ndi thukuta. Choncho mauthenga ambiri a mitsempha ya sympathetic omwe amapita kumutu, pakhosi, m'manja, ndi pachifuwa chapamwamba amatumizidwa kudzera mu gulu la nyenyezi ili.

Kodi aliyense ali ndi Stellate Ganglion iyi?

Izi ndizodabwitsa pang'ono. Ndipotu, gulu la nyenyezi la ganglion ili silili m'thupi la aliyense. Kuti gulu la ganglion ili lipangidwe, magulu awiri a mitsempha m'khosi mwathu, omwe ndi `gulu la khosi lotsika` ndi `gulu loyamba la khosi`, ayenera kugwirizana.

Koma, 80% yokha ya anthu padziko lonse lapansi ndiMitsempha iwiriyi imagwirizana mwanjira imeneyi kuti ipange gulu la nyenyezi. Mu 20% ina, izi zimakonzedwa mosiyana, zolekanitsidwa.

Chifukwa chiyani Stellate Ganglion Block imachitidwa? Ndi matenda ati?

Madokotala amagwiritsa ntchito chithandizochi pazifukwa ziwiri zazikulu.

1. Kuti mudziwe matenda: Pezani ngati ululu wina umayamba chifukwa cha ntchito ya dongosolo la mitsempha la sympathetic lomwe latchulidwa kale. Izi zimatchedwa `sympathetically mediated pain (SMP)`.

2. Monga chithandizo: Kuwongolera matenda osiyanasiyana opweteka, matenda a mitsempha, ndi mavuto a kayendedwe ka magazi.

Gome ili m'munsimu likuwonetsa zina mwa zinthu zomwe mankhwalawa amagwiritsidwa ntchito kwambiri.

Kuphatikiza apo, mankhwalawa amagwiritsidwanso ntchito pa matenda monga `Scleroderma`, `Ululu wa m'kamwa`, `Ululu wa pachifuwa`, ndi `Matenda a Ménière`.

Kodi izi zimagwiritsidwanso ntchito pa nkhani za thanzi la maganizo?

Inde, iyi ndi nkhani yomwe anthu ambiri akukamba pakali pano. Kafukufuku wakhala akuchitika kuyambira m'ma 1990, makamaka pa kugwiritsa ntchito SGB ngati chithandizo cha matenda amisala otchedwa Post-Traumatic Stress Disorder (PTSD) .

Koma zotsatira za kafukufukuyu ndi zosiyana. Anthu ena awona kuchepa kwakukulu kwa zizindikiro za PTSD, pomwe ena awona palibe kusintha kulikonse. Chifukwa chake, mabungwe monga U.S. Food and Drug Administration sanavomereze mwalamulo SGB ngati chithandizo cha PTSD. Komabe, ngati mankhwala ena (uphungu, mankhwala) sanagwire ntchito, dokotala angakambirane izi ndi wodwalayo ndikumupatsa ngati chithandizo 'chosagwiritsidwa ntchito'.

Posachedwapa, kafukufuku wayamba pa zotsatira za SGB pa matenda ena amisala, monga kuvutika maganizo ndi nkhawa.

Kodi Stellate Ganglion Block iyi imapangidwa bwanji?

Tangoganizani kuti dokotala wakupatsani chithandizo ichi. Kenako, kuchipatala kapena kuchipatala, chinthu chonga ichi chimachitika:

1. Kukonzekera: Choyamba, mudzapemphedwa kugona chafufumimba pabedi. Kuti mukhale omasuka komanso omasuka, mungapatsidwe mankhwala ochepetsa ululu (ochepetsa ululu) kudzera mu mtsempha (IV).

2. Kuyeretsa: Dokotala adzayeretsa bwino malo omwe ali pakhosi panu pomwe jakisoni adzaperekedwa ndi mankhwala opha tizilombo toyambitsa matenda.

3. Jakisoni yoyamba (yosagwira ntchito):Kenako, mankhwala oletsa ululu pang'ono amalowetsedwa m'derali pogwiritsa ntchito singano yopyapyala kwambiri. Izi zikuthandizani kuti musamve kupweteka kwa jakisoni wotsatira.

4. Jakisoni wamkulu: Kenako jakisoni wamkulu amabayidwa. Koma izi sizongoganizira chabe. Dokotala amagwiritsa ntchito `Ultrasound` scan kapena mtundu wapadera wa X-ray wotchedwa `Fluoroscopy` , amawona njira ya singano pa sikirini, ndipo pokhapo jakisoniyo amachitikira pamene singano ili pafupi ndi gulu la mitsempha lotchedwa stellate ganglion. Izi zimachepetsa mwayi wobayira jakisoni pamalo olakwika.

Njira yonseyi nthawi zambiri imatenga mphindi zosakwana 30 .

Kodi chimachitika ndi chiyani mukalandira jakisoni?

Mukalandira jakisoni, mudzasungidwa m'chipinda chochiritsira kwa kanthawi. Nthawi zambiri kwa mphindi pafupifupi 40 mpaka 60, namwino kapena dokotala adzayang'anira vuto lanu (kuthamanga kwa magazi, kugunda kwa mtima). Zonse zikatsimikizika, mudzapatsidwa malangizo oti mutsatire kunyumba kenako mudzaloledwa kupita kunyumba.

Kodi chithandizochi chimagwira ntchito bwanji? Chimatenga nthawi yayitali bwanji?

Palibe yankho limodzi la funsoli chifukwa limasiyana kwambiri kuchokera kwa munthu ndi munthu.

• Kwa anthu ena, ululu umatha nthawi yomweyo akangolandira jakisoni, koma ululuwo ukhoza kubwerera patatha maola ochepa pamene mankhwala oletsa ululu amatha.
• Ena amamva kupweteka kwa masiku kapena milungu ingapo. Panthawiyi, amatha kuchepetsa kumwa mankhwala opweteka ndikuchita nawo zinthu monga kuchita masewera olimbitsa thupi.

Kawirikawiri, jakisoni imodzi nthawi zambiri sipereka mpumulo wathunthu. Kuti munthu apumule kwa nthawi yayitali, amafunika jakisoni wotsatira, zomwe zikutanthauza kuti muyenera kuchita izi kangapo. Nthawi zina mumatha kupeza zotsatira m'magawo awiri okha, pomwe ena angafunike kuchita izi kangapo. Koma nkhani yabwino ndi yakuti ndi gawo lililonse, nthawi yochepetsera ululu imatha kuwonjezeka .

Kodi pali zotsatirapo kapena zoopsa zilizonse pa izi?

Monga momwe zimakhalira ndi chithandizo chilichonse chamankhwala, pali zotsatirapo zazing'ono komanso zovuta zina zazikulu zomwe sizimachitika kawirikawiri.

Zizindikiro zomwe tatchulazi nthawi zambiri zimatha kwathunthu mkati mwa maola ochepa, komanso palinso mavuto akuluakulu omwe samachitika kawirikawiri .

• Matenda opatsirana
• Kutuluka magazi chifukwa cha kubowoledwa kwa singano m'mitsempha yamagazi (monga mtsempha wa carotid)
• Kuwonongeka kwa mitsempha ina (mitsempha ya vagus, mitsempha yobwerezabwereza ya laryngeal)
• Kuwonongeka kwa mapapo (Pneumothorax)
• Kuwonongeka kwa chithokomiro, m'mero, kapena m'khosi

Mwayi woti zinthuzi zichitike ndi wochepa kwambiri, makamaka pamene dokotala wodziwa bwino ntchito yake akuchita chithandizochi pogwiritsa ntchito ukadaulo monga ultrasound.

Ndi nthawi ziti zomwe ndiyenera kuyimbira dokotala?

Mukapita kunyumba mutalandira jakisoni, ngati mukupeza zizindikiro zatsopano kapena mukuganiza kuti pali zovuta zilizonse , imbani dokotala wanu nthawi yomweyo. Makamaka:

• Ngati malo obayira jakisoni atupa, kufiira, kapena kutentha thupi (zizindikiro za matenda).
• Ngati vuto la kumeza likupitirira pakatha maola angapo.
• Ngati mukuvutika kupuma.

Musachite mantha kapena kukayikira za chithandizochi. Lankhulani ndi dokotala wanu za ichi momasuka. Chofunika kwambiri ndikumvetsera nkhawa zanu zonse ndikupanga chisankho chodziwa bwino.