Reka tumenye neza imikorere y'amashanyarazi y'umutima wawe? (Inyigo ya Electrophysiology - Inyigo ya EP)

Ese wumva ikintu kidasanzwe mu mutima wawe, nk'aho uhuha? Hari igihe abaganga bavuga ko bagomba gukora ikizamini kugira ngo barebe neza imikorere y'amashanyarazi y'umutima wawe. Ni bwo tuvuga kuri iyi "Inyigo ya Electrophysiology", cyangwa nk'uko tuyita mu magambo ahinnye, "Inyigo ya EP". Ntutinye, reka tubiganireho mu buryo bworoshye.

Inyigo ya EP ni iki?

Mu magambo make, inyigo ya EP ni ikizamini gisesengura neza imikorere y'amashanyarazi mu mutima wawe. Tekereza, umutima wacu ukeneye ikimenyetso gito cy'amashanyarazi kugira ngo utere. Iyo ibyo bimenyetso bikora neza, umutima utera mu buryo buri ku murongo. Hari igihe haba hari ikibazo muri ibyo bimenyetso by'amashanyarazi, bivuze umutima utera mu buryo butari bwo ( arrhythmia ) . Icyo gihe ni bwo inyigo ya EP ikoreshwa kugira ngo hamenyekane ikibazo n'aho ikibazo giherereye.

Abaganga bakoresha catheter z'umutima (imiyoboro mito cyane) na mudasobwa kugira ngo babikore. Iyi miyoboro ishyirwa mu mutima wawe kandi igapima imikorere y'amashanyarazi y'umutima wawe uhereye aho. Ni nk'aho EKG ikoreshwa, ariko iyi miyoboro, ishyirwa mu mutima wawe, ishobora gutanga amakuru arambuye kandi nyayo kurusha iyo miyoboro ishyirwa inyuma mu gituza cyawe.

Tekereza nka bisi igenda mu nzira yayo isanzwe, mu gihe gikwiye, kandi mu buryo bunoze. Ariko umutima utera nabi (arrhythmia) ni nk'bisi itaragenda mu nzira yayo isanzwe, wenda itangiriye ahantu habi, isimbutse aho ihagarara, cyangwa ntijye mu nzira yose. Cyangwa ishobora kugenda vuba cyane, cyangwa ikagenda buhoro cyane. Ibyo ni byo bimenyetso bidasobanutse abaganga bagomba kureba. Icyo gihe ni bwo bashobora gufata icyemezo niba iki kibazo ari kibi n'uko bacyivura.

Ni gute wamenya iki gikorwa cy'umutima gishingiye ku mashanyarazi?

Laboratwari aho ubu '(EP Study)' bukorerwa ni nk'ibiro by'umupolisi. Umuganga w'inzobere ukora ibi ni '( Electrophysiologist )' uzi neza imiterere y'umutima. Ashobora kumenya uburyo ibice bitandukanye by'umutima bikora ukurikije imiterere itandukanye y'imiraba kuri kaseti ya '(EKG)'.

Aba baganga bize ku miraba ya EKG, uko isanzwe ikwiye kugaragara, n'icyo bivuze niba umuraba usa n'utandukanye. Bita cyane aho umutima utari mwiza utangirira n'aho ugarukira kuri EKG.

Hanyuma, batekereza bati “Sawa, ibi nibyo bishobora kuba.” Hanyuma babigerageza muri Laboratwari ya EP.Batanga imiti (nka Adenosine, Isoproterenol) kugira ngo yihutishe kandi igabanye umuvuduko w'umutima , hanyuma bakareba uburyo imikorere y'amashanyarazi y'umutima ihinduka muri icyo gihe. Ibi bikorwa hakurikijwe gahunda yihariye, atari ugukekeranya gusa. Bashingiye ku makuru yakusanyijwe, batekereza ku mpamvu nyinshi zishobora gutera, hanyuma bagakora ibizamini kugeza igihe bamenye neza ikibazo .

Kuki urimo gukora ubu bushakashatsi bwa EP?

Inyigo ya EP ishobora kubwira muganga wawe byinshi ku gutera k'umutima kwawe kudasanzwe . Urugero:

• Ni ubuhe bwoko bw'indwara y'umutima (arrhythmia) ufite?
• Ni iyihe mpamvu y'iri hohoterwa rikabije?
• Iki kibazo gitangira he mu mutima?
• Ni iyihe mpamvu ikunze gutuma wumva umeze nk'ufite isereri kandi ukagira ingorane zo kurota ?
• Hitamo uburyo bwiza bwo kuvura ibi.
• Reba niba umuti urimo gufata ubu ukora neza .
• Menya niba ufite ibyago byo gupfa umutima utunguranye .

Umuganga afata icyemezo cyo gukora inyigo ya EP iyo adashoboye kubona amakuru ahagije mu bizamini nka ECG, Holter monitor (igikoresho gikurikirana umuvuduko w'umutima mu gihe uri mu buriri mu gihe cy'umunsi umwe cyangwa ibiri), icyuma gifata amashusho , ikizamini cy'imihangayiko (gikurikirana umutima mu gihe cy'imyitozo ngororamubiri), echocardiogram (isuzuma ry'umutima rya ultrasound), cyangwa angiogram (gikurikirana imitsi yo mu mutima).

Hari igihe, bitewe n'uburwayi bwawe n'amakuru yavuye mu bushakashatsi bwa EP, ubuvuzi bwitwa Catheter Ablation bushobora gukorwa icyarimwe . Ibi bivuze ko uduce duto mu mutima dutuma ibimenyetso by'amashanyarazi bidakora neza dushyirwa mu mutima binyuze muri catheter (umuyoboro) winjijwe mu mutima.

Wakwitegura ute kwiga EP?

Hari imyiteguro mike ugomba gukora mbere y'iki kizamini. Ntugahangayike, ibi ni ibintu bisanzwe.

• Teganya ko umuntu azaguherekeza ujya kwa muganga cyangwa uvayo. Ntuzashobora gutwara imodoka amasaha 24 nyuma yo gupimwa.
• Niba ufite ikibazo cyangwa impungenge kuri iki kizamini, nyamuneka ubiganireho na muganga.
• Tubwire niba ufite ubwivumbure kuri latex cyangwa warigeze kugira ikibazo cyo gusinziriza .
• Imyenda myizaNgwino wambaye.
• Kuraho amavuta yose yo kwisiga n'amavuta yo kwisiga inzara mbere yo kujya kwa muganga.
• Siga imitako y'agaciro nk'impeta, imikufi n'amasaha mu rugo. Zana indorerwamo zawe n'ibikoresho byo kumva niba ubifite.

Reka turebere hamwe imiti n'ibiribwa:

• Bwira muganga wawe imiti yose ufata (wandikiwe na muganga, utayiguze na muganga, imiti y'ibimera, vitamine) .
• Zana imiti yawe ihagije umunsi umwe. Ariko ntuyifate utaraganira na muganga wawe.
• Baza muganga wawe imiti ugomba gufata mbere yo kwipimisha, imiti ugomba guhagarika, igihe ugomba guhagarika, n'igihe ugomba kongera gutangira . Ntugahagarike imiti iyo ari yo yose muganga wawe atabikubwiye.
• Niba urwaye diyabete, baza uko wahindura imiti yawe ya diyabete .
• Ujye urya nk'uko bisanzwe ijoro ribanziriza ikizamini.
• Ntukarye, ntunywe cyangwa ngo uhekenya ikintu icyo ari cyo cyose nyuma ya saa sita z'ijoro mbere y'ikizamini. Ndetse nta n'impeke, utubuto cyangwa amazi. Ibi ni ingenzi cyane ku mutekano wawe.
• Niba ugomba gufata umuti, fata unywa amazi make cyangwa abiri gusa.
• Ntukanywe amazi mu gihe woza amenyo.

Ni iki wakwitega ku munsi w'inyigo ya EP?

Ikizamini cyawe kizakorerwa mu cyumba cyihariye cyitwa Laboratwari ya Electrophysiology (EP Laboratwari) cyangwa Laboratwari ya Catheterization .

Umaze kuryama ku buriri, umuganga n'ikipe ihari bazakora ibi bikurikira:

• Umugozi wo guterwa mu mitsi (IV) (usa n'umugozi wo mu bwoko bwa saline) uzashyirwa mu kuboko kwawe cyangwa mu kiganza cyawe. Aha niho uzahabwa imiti n'amazi mu gihe cyo gupimwa.
• Nibiba ngombwa, mu kwaha kwawe, mu maboko cyangwa mu ijosi ryawe hazakogoshwa kandi hasukurwe umuti wica udukoko.
• Uzatwikirwa igitambaro cyanduye kuva mu ijosi kugeza ku birenge.
• Kugira ngo wirinde ko amaboko yawe akora ku bice byanduye, uhambira umukandara mu rukenyerero hanyuma amaboko yawe arazamurwa.

Ni iki kibaho mu gihe cy'ubushakashatsi bwa EP?

Ubu ni cyo gihe cy'ingenzi cyane. Dore ibintu muganga azakora:

• Ikibuno cyawe, ijosi, cyangwa ukuboko kwawe (aho katheteri ishyirwa) bizashiramo umuti wihariye.
• Hanyuma, utu duce twinshi (imiyoboro mito) twinjizwa mu mutsi munini uri mu kibuno cyawe, mu ijosi, cyangwa mu kuboko.
• Ukoresheje `Fluoroscopy` (ibi bimeze nka videwo ya `X-ray`) na `Ultrasound`, izi catheter ziyoborwa neza mu mutima wawe, mu byumba byawo. Izi catheter zikoreshwa mu kumenya no gufata imikorere y'amashanyarazi y'umutima. Ibi bigufasha gusobanukirwa neza `Sisteme yo Gutwara Ingufu`, sisitemu inyuramo ibimenyetso by'amashanyarazi mu mutima wawe.
• Binyuze muri katheta imwe,Igikoresho cyitwa pacemaker cyohereza ibimenyetso bito by'amashanyarazi kugira ngo byihutishe umuvuduko w'umutima wawe. Muri iki gihe, ushobora kumva umutima wawe utera cyane.
• Bitewe n'uko umeze, niba hari aho imiyoboro y'amashanyarazi idakora neza, ishobora gufungwa hakoreshejwe uburyo bwitwa `Catheter Ablation` .

Igikuru ni uko niba wumva ikintu kikubangamiye cyangwa kidasanzwe mu gihe cy'inyigo ya EP, bibwira muganga cyangwa umuforomo aho ngaho.

Niba umutima wawe utera nabi, muganga azaguha imiti binyuze mu mitsi yawe kugira ngo arebe uburyo abigenza. Iyo bibaye ngombwa, bashobora no kuguha amashanyarazi make anyuze mu gace kari ku gituza cyawe kugira ngo bagufashe kugarura umutima wawe mu buryo busanzwe.

Muri iki kizamini cyose, itsinda ry’abaganga rizakoresha ibikoresho bitandukanye:

• Fluoroscopy: Imashini nini ya X-ray iri hejuru yawe. Ibi bituma muganga ahora akurikirana catheter iri mu mutima wawe akoresheje ecran ya X-ray.
• `Defibrillator / Pacemaker / Cardioverter`: Iyi ihujwe n'agace kari ku mugongo wawe n'agace kari ku gituza cyawe. Ishobora gutanga amashanyarazi kugira ngo yihutishe umutima utera buhoro cyangwa igahagarika umuvuduko uteje akaga.
• Electrocardiogram (EKG): Iyi ihujwe n'uduce twinshi dufata ku gituza cyawe, ndetse na catheter ziri mu mutima wawe. Itanga ishusho y'ibimenyetso by'amashanyarazi binyura mu mutima wawe.
• Intracardiac Echocardiogram: Iyi ni ultrasound nto. Ifasha kuyobora neza catheter mu gihe cyo gupima.
• Igikoresho cyo kugenzura umuvuduko w'amaraso: Iki gikoresho gifatanye n'agapira ko ku kuboko kwawe kandi kigakurikirana umuvuduko w'amaraso yawe mu gihe cyose cyo gupima.
• Oximeter Monitor: Aka ni agace gato ushyira ku rutoki rwawe. Gapima urugero rwa ogisijeni mu maraso yawe.

Ni iki wakwitega nyuma y'ikizamini?

Nyuma y'uko ubushakashatsi bwa EP burangiye, muganga azakuramo katheteri mu kibuno cyawe, ku kuboko, cyangwa mu ijosi hanyuma ashyire igitutu kuri ako gace mu gihe gito kugira ngo amaraso ahagarike. Hanyuma:

• Uzakenera kumara isaha imwe kugeza kuri ine mu buriri . Niba catheter yashyizwe mu kibuno, ugomba kugumisha ukuguru kwawe kugororotse uko bishoboka kose kandi nta kukwimura.
• Bitewe n'ibisubizo by'ibanze by'ikizamini cyawe, ushobora gukenera kuguma mu bitaro bibaye ngombwa .
• Agapfundikizo gato kadafite umwanda gashyirwa hejuru ya catheter. Gashobora gukurwaho umunsi ukurikiyeho. Kenshi na kenshi, kudoda ntibikenewe.
• Ahantu hakomeretse hagomba kubikwa hasukuye kandi humutse .
• Nyuma yo gupimwa, ushobora kurya no gufata umuti.
• Ushobora gukomeza imirimo yawe isanzwe umunsi umwe nyuma y'ikizamini.Ariko uzagomba kugabanya ibintu nko guterura ibiremereye mu gihe cy'icyumweru kimwe.

Ese hari ingaruka mbi zihari muri ibi?

Ubushakashatsi bwa EP muri rusange ni ikizamini cyizewe cyane. Ariko, kimwe n'ubundi buryo bwose bwo kwa muganga, hari ingaruka zimwe na zimwe. Muri zo harimo:

• Kwandura cyangwa kuva amaraso aho catheter yashyizwe.
• Umutima utari mwiza (Arrhythmia) .
• Udukoko tw'amaraso tuba kuri catheter maze tugafatana mu mitsi y'amaraso.
• Gukomereka k'umuyoboro w'amaraso, umuyoboro w'umutima, cyangwa icyumba cy'umutima.
• Indwara y'umutima.
• Indwara yo mu bwonko (stroke).

Ariko ntugire ikibazo, abaganga bawe barimo gukora ubu bushakashatsi bwa EP ahantu hagenzurwa neza. Kandi barimo gufata ingamba zidasanzwe zo kugabanya ibyago kuri wewe. Niba ufite ikibazo ku ngaruka n'ibyiza by'iki kizamini, vugana na muganga wawe.

Ni izihe nyungu zo kwiga EP?

Ushobora kubona inyungu zikurikira muri `(EP Study)`:

• Uzabona ibisubizo by'ibibazo byawe ku kibazo cy'umutima wawe.
• Wenda niba ikibazo gishobora gukemurwa hakoreshejwe "Catheter Ablation", dushobora kuba tudakeneye gukomeza gufata imiti imwe n'imwe.
• Ubuzima bwawe buzarushaho kuba bwiza.
• Ku ndwara zimwe na zimwe z’umutima, kuzivura hakoreshejwe "Catheter Ablation" bishobora kuba amahitamo ahendutse kurusha kubagwa "Arrhythmia".

Ubushakashatsi bwa EP muri rusange ni bwiza. Ingaruka zo gupfa bitewe na ibi ni nke cyane, hafi 1 kuri 5.000.

Ni gute nabona ibisubizo? Ni iki nzakora nyuma yaho?

Nyuma yo gupimwa, muganga azakubwira ibisubizo by'ibanze . Ashingiye kuri ibyo bisubizo, azafata icyemezo niba ushobora gutaha cyangwa niba ukeneye kuguma mu bitaro. Muganga ashobora kugusaba kugaruka ku wundi munsi kugira ngo muganire ku bisubizo bya EP Study ndetse n'uburyo wavuwe.

Niba ibisubizo bigaragaza ikintu kidasanzwe, muganga wawe ashobora guhita avura akoresheje "Catheter Ablation". Bitabaye ibyo, bashobora gukenera gutegura ubundi buryo bwo kuvura cyangwa kukwandikira imiti. Hari abantu bashobora gukenera ubundi buryo bwo kuvura, nka "Pacemaker" , ndetse na nyuma yo gukoresha "Catheter Ablation".

Ni ryari ugomba kubonana na muganga?

Iyo ugiye mu rugo nyuma yo gupimwa, ugomba guhamagara muganga wawe niba ubonye kimwe muri ibi bimenyetso:

• Niba aho catheter iri hatukura, habyimbye, cyangwa hari amazi asohokamo.
• Niba ugize ikibazo cy'ibinure cyangwa ikintu icyo ari cyo cyose kidasanzwe mu kuboko cyangwa ku kuguru aho catheter yashyizwe.
• Haba mu kuboko cyangwa ku kuguru aho catheter yashyizweNiba intoki zawe zikonje, zitakibona, cyangwa zigahindura ibara.
• Niba ugiye kuruka.
• Niba ubabara mu gatuza .

Hamagara 1990 kugira ngo uhabwe ubuvuzi bwihutirwa, cyangwa ujye ku bitaro bikwegereye, niba uhuye n'ibi bikurikira:

• Iyo kuva amaraso bitahagaze ndetse no nyuma yo gukanda no gufata aho catheter iri.
• Iyo ububyimbe bukikije igikomere bwiyongera mu buryo butunguranye.

Ibindi bibazo bike kuri wewe.

Ese tuba turi maso iyo dukora inyigo ya EP?

Yego. Urahabwa imiti binyuze mu muyoboro wa IV kugira ngo utuze kandi wumve usinziriye gato. Ariko ntabwo usinziriye burundu.

Inyigo ya EP bifata igihe kingana iki?

Ubusanzwe bifata isaha imwe kugeza kuri ine .

Ese ubushakashatsi bwa EP bubabaza?

Uzahabwa umuti wo kugabanya ububabare kugira ngo utagomba kumva ububabare ubwo aribwo bwose. Ariko, ushobora kumva utuntu duto ku ruhu aho catheter yashyizwe.

Ibintu by'ingenzi cyane ugomba kwibuka

Iyo usabwe gukora inyigo ya EP, bishobora gusa nkaho ari ikintu gikomeye kurusha ikindi gipimo cy'umutima wigeze ukora mbere. Ariko muganga wawe arimo kugitegeka kubera impamvu runaka. Abikora kugira ngo amenye neza ibirimo kuba mu mutima wawe no kugufasha . Inyigo ya EP ikubiyemo gushyira ibikoresho mu mutima wawe, ariko ni ikizamini cyiza. Giha muganga wawe amakuru akeneye kugira ngo avure umutima wawe utari umeze neza.

Wibuke ko itsinda ry’abaganga rizakora uko rishoboye kose kugira ngo rigufashe kwisanzura mu gihe cyo gupimwa. Baganire ku bibazo cyangwa impungenge ushobora kuba ufite. Ibi bizagufasha kumva wisanzuye.

Igipimo cy'umutima , inyigo ya EP, indwara z'umutima, catheter, imikorere y'amashanyarazi y'umutima, arrhythmia, ibizamini by'umutima