Masifunde nge-Right Heart Catheterization?

Ngaba ugqirha wakho ukuxelele ukuba wenze olu vavanyo? Okanye mhlawumbi unomdla nje. Makhe sijonge nje ukuba yintoni, yenziwa njani, kwaye kutheni yenziwe. Ungakhathazeki, ndiza kukuchazela yonke into.

Yintoni le catheterization yentliziyo echanekileyo?

Ngamafutshane, olu luvavanyo olukhethekileyo olwenziwa ukuze kubonwe ukuba intliziyo yakho isebenza kakuhle kangakanani. Ngokukodwa, lulinganisa uxinzelelo lwegazi kunye namanqanaba eoksijini kwicala lasekunene lentliziyo yakho nakwimiphunga yakho. Oku ngamanye amaxesha kubizwa ngokuba yi-pulmonary artery catheterization . Abanye banokulubiza ngokuba luvavanyo lwe-Swan-Ganz catheter .

Ukuze benze oku, oogqirha basebenzisa ityhubhu encinci neguquguqukayo ebizwa ngokuba yi-catheter . Le tyhubhu ifakwa kumthambo omkhulu entanyeni yakho, emqolo, okanye engalweni, kwaye ifakwa kancinci kwicala lasekunene lentliziyo yakho nakwimithambo yegazi ephambili ethwala igazi ukuya emiphungeni yakho , umthambo wemiphunga . Cinga ngayo njengokufaka ikhamera encinci ngaphakathi, kodwa ilinganisa uxinzelelo kunye neoksijini.

Kutheni olu vavanyo lubaluleke kangaka? Luza kufumana ntoni?

Olu vavanyo lwe-"Right Heart Catheterization" lunceda oogqirha ukuba bafumane ulwazi malunga nokulawula izifo ezininzi. Nazi imizekelo embalwa:

• Ukothuka kwentliziyo: Yimeko embi eyenzeka xa intliziyo iyeka ukupompa igazi ngokufanelekileyo.
• I-Cardiomyopathy: Isifo apho izihlunu zentliziyo ziba buthathaka okanye zikhula.
• Isifo sentliziyo esizalwa naso: Abanye abantu banokuzalwa beneziphene ezithile zentliziyo. Zijonge.
• Ukusilela kwentliziyo: Xa intliziyo ingakwazi ukupompa igazi elaneleyo.
• Isifo sevalvu yentliziyo: Xa iivalvu entliziyweni zingasebenzi kakuhle.
• Uxinzelelo lwegazi oluphezulu kwimiphunga: Uxinzelelo oluphezulu kwimithambo yegazi ethwala igazi ukuya emiphungeni.

Kwakhona, ngamanye amaxesha olu vavanyo lunokufuneka ngaphambi okanye emva kokufakelwa ilungu, okanye ngaphambi kokufaka isixhobo esikhethekileyo esinceda intliziyo, esifana ne- "Left Ventricular Assist Device" . Kuba oku kunika oogqirha umfanekiso ocacileyo wemeko engaphakathi kwentliziyo.

Yintoni umahluko phakathi kokukwenza ngasekunene kwentliziyo nokukwenza ngasekhohlo?

Ewe, kukho umahluko obalulekileyo phakathi kwezi zimbini. Masibone ukuba ziyintoni na.

Kwi-catheterization yentliziyo yasekunene, ugqirha ufaka ityhubhu encinci (i-catheter) emthanjeni.Oko kukuthi, ukusuka kumthambo othwala igazi elingcolileyo. Oku kuya kwicala lasekunene lentliziyo. Oku kulinganisa uxinzelelo kwi-atrium yakho yasekunene, kwi-ventricle yasekunene, nakwi-pulmonary artery ethwala igazi ukuya emiphungeni yakho.

Kodwa kwi-catheterization yecala lasekhohlo, i-catheter ifakwa kwi-artery . Oko kukuthi, umthambo othwala igazi elicocekileyo. Umzekelo, umthambo we-femoral emlenzeni, umthambo we-brachial engalweni, okanye umthambo we-axillary ekhwapheni. Kulapho icala lasekhohlo lentliziyo liya khona. Oku kulinganisa uxinzelelo kwi-ventricle yasekhohlo, kujonga i-aorta kunye ne -valve yayo, kwaye kukhangelwe naziphi na izithintelo kwimithambo ye-coronary ehambisa igazi entliziyweni. Olu vavanyo lwecala lasekhohlo lukwabizwa ngokuba yi-cardiac catheterization okanye i-coronary angiography . Uyayiqonda umahluko?

Ngubani owenza olu vavanyo? Lwenziwa phi?

Olu vavanyo lwe-`(Right Heart Catheterization)` lwenziwa kwigumbi elikhethekileyo esibhedlele. Lubizwa ngokuba yi-`Cardiac Catheterization Laboratory` okanye `cath lab` ngamafutshane. Lwenziwa liqela leengcali eziqeqeshiweyo. Luhlala lukhokelwa yi-`Advanced Heart Failure Cardiologist` okanye i-`Interventional Cardiologist`. Ngoko ke, ungaqiniseka ukuba usezandleni ezilungileyo.

Ufanele ulungiselele njani oku?

Ugqirha wakho uza kukunika imiyalelo ethile malunga nendlela yokulungiselela, kodwa ngokuqhelekileyo yinto efana nale:

• Ufanele uxelele ugqirha wakho ngawo onke amayeza owasebenzisayo. Oku kuquka amayeza kagqirha, izongezo, kunye namayeza athengiswa ngaphandle kwemvume kagqirha. Amanye amayeza, ingakumbi amayeza okunciphisa igazi/anciphisa igazi , anokufuna ukuyeka ukusebenzisa iintsuku ezimbalwa. Oku kufuneka kwenziwe kanye njengoko ugqirha wakho ekuxelele.
• Zisa umntu oza kukuthatha akuse ekhaya emva kovavanyo, kuba ngamanye amaxesha kunokuba nzima kancinci, okanye ukuba unikwe amayeza akwenza ulale, ayilocebo lilungileyo ukuqhuba.
• Nceda ususe naziphi na izacholo okanye ipolishi yezinzipho onokuba uzinxibile.
• Musa ukutya okanye ukusela nantoni na kangangeeyure ezi-6 ukuya kwezili-12 ngaphambi kovavanyo. Oku kubaluleke kakhulu, kuba isisu esingenanto senza uvavanyo lube lula, kwaye ungakulungela xa kukho imeko engxamisekileyo.

Kubaluleke kakhulu ukulandela ezi zinto ngokuchanekileyo ukuze uphumelele uvavanyo ngempumelelo.

Kwenzeka ntoni ngaphambi kovavanyo?

Njengoko uvavanyo luza kuqala, ugqirha okanye umongikazi uza kwenza oku kulandelayo:

• Uza kucelwa ukuba unxibe ilokhwe yesibhedlele uze uchame (ukhuphe isinyi sakho).
• Bakuxelela ukuba ulale ebhedini ekhethekileyo.
• Zincamathelisa amaqhekeza amancinci ezinto esifubeni sakho. Zibizwa ngokuba zii-electrodes . Ezi zezona zinto zigcina rhoqo umsebenzi wentliziyo yakho, njenge-ECG.

Ixesha elininzi, olu luvavanyo olukhawulezayo olubizwa ngokuba yi-"Right Heart Catheterization", ngoko ke awufakwanga i-anesthesia ngokupheleleyo. Oku kuthetha ukuba uphilile engqondweni. Kodwa ngamanye amaxesha, ityhubhu encinci ebizwa ngokuba yi-"IV line" inokufakwa emthanjeni engalweni yakho, apho unokunikwa khona ulwelo okanye amayeza okuthomalalisa aza kukwenza uzive uzolile okanye ulele. Oku kwenzelwa ukunciphisa ukungakhululeki kwakho.

Kwenzeka ntoni ngexesha lovavanyo? Yintoni onokuyilindela?

Uvavanyo ngokwalo ludla ngokuthatha malunga neyure. Nangona kunjalo, ixesha lokulungiselela kunye nexesha lokuchacha emva kovavanyo lingathatha iiyure ezininzi. Ungakhathazeki, oku kuqhelekile.

Uza kuba uphaphile engqondweni kulo lonke uvavanyo. Ugqirha uza kwenza oku kulandelayo:

• Indawo apho i-catheter iza kufakwa khona (i-groin, ingalo, okanye intamo) iya kucocwa kwaye, ukuba kuyimfuneko, ezinye zeenwele apho ziya kuchetywa.
• Kufakwa i-anesthetic encinci yendawo ukuze kuthintelwe loo ndawo. Emva koko awuyi kuva ntlungu. Kuya kuvakala ngathi imbovane encinci iyakuluma xa unikwa i-anesthesia.
• Emva koko, kusetyenziswa inaliti ekhethekileyo okanye isixhobo esincinci, kwenziwa umngxuma omncinci emthanjeni. Oku kungaba ngumthambo we-femoral emlenzeni wakho, umthambo we-jugular entanyeni yakho, okanye umthambo ongalweni yakho.
• Ngoku, loo mbhobho mncinci, i-catheter , ifakwa kancinci kancinci ize isiwe kwiindawo ezahlukeneyo zentliziyo nemithambo yegazi. Awuyi kuyiva ngelixa isenziwa.
• Umlinganiselo uthathwa kwiindawo ezifunekayo, kwaye ngamanye amaxesha isampuli encinci yezicubu (isampuli yezicubu / i-biopsy) yentliziyo inokuthathwa, nto leyo eyenziwa ngale catheter.
• Ngamanye amaxesha ungaxelelwa ukuba uhlale ungashukumi, utshintshe indawo yomzimba wakho, okanye uphefumle ngendlela ethile.
• Kwezinye iimeko, ugqirha wakho unokukucela ukuba wenze umthambo omncinci (mhlawumbi ngokunyathela ipedali encinci ngonyawo lwakho). Oku kuya kujonga indlela isantya sentliziyo yakho esitshintsha ngayo ngexesha lomthambo.
• Unganika amayeza athile nge-IV engalweni yakho uze ubone indlela intliziyo yakho esabela ngayo kuwo.
• Ekugqibeleni, i-catheter iyakhutshwa kwaye inxeba elincinci liyavalwa.

Akukho nto yokoyika, oogqirha kunye nabahlengikazi bonke bakunye nawe, ukuba uziva ungakhululekanga, baxelele.

Kwenzeka ntoni emva kovavanyo?

Emva kokuba uvavanyo lugqityiwe, iqela lezonyango lasusa ii-electrode ezazinamathele esifubeni sakhe.Baza kuyikhupha i-IV baze bayifake. Emva koko uza kusiwa kwigumbi elahlukileyo (igumbi lokuchacha) . Apho baza kujonga ngokusondeleyo oku kulandelayo:

• Ngaba kukho igazi elivela apho i-catheter ifakwe khona?
• Ifuthe legazi.
• Inqanaba lentliziyo.
• Ubushushu bomzimba.

Uza kubekwa esweni de konke oku kubuyele esiqhelweni.

Kuthatha ixesha elingakanani ukuchacha?

Iqela lezonyango liza kukulinda iiyure ezimbalwa. Uninzi lwabantu lunokubuyela ekhaya emva koko. Kodwa khumbula ukuba umntu akuqhubele kuba ungaziva ulele okanye udiniwe.

Nangona kunjalo, ukuba uvavanyo lufumanise into enzulu, kunokufuneka wenze olunye uvavanyo, ufumane unyango, okanye uhlale esibhedlele. Ugqirha uza kukuxelela ngale nto.

Ingaba olu vavanyo lubuhlungu?

Lo ngumbuzo obuzwa ngabantu abaninzi. Xelela ugqirha ukuba uziva njani kulo lonke uvavanyo.

Ngokwesiqhelo, uya kuziva iintlungu ezincinci xa unikwa inaliti yokudambisa iintlungu. Ungaziva noxinzelelo oluncinci xa kufakwa i-catheter. Ukongeza, abanye abantu banokufumana oku kulandelayo:

• Njengoko i-catheter ibetha eludongeni lwentliziyo yakho, usenokuziva ushukuma esifubeni sakho okanye ubetha kancinci . Oku kuqhelekile, ngoko ungakhathazeki.
• Abanye abantu banokuba nentloko ebuhlungu .
• Usenokuziva unesiyezi (unentloko ekhaphukhaphu) .
• Kunokubakho isicaphucaphu .
• Usenokuziva uxinezelekile kancinci njengoko i-catheter ingena kwimithambo yegazi.
• Usenokuziva unqwenela ukukhwehlela .
• Amanye amayeza anokubangela ubushushu okanye ukurhawuzelelwa kancinci.

Nokuba uziva njani na, xelela ugqirha okanye umongikazi. Baza kukunceda.

Ngaba kukho naziphi na iingozi ezibandakanyekayo kolu vavanyo?

`(I-Right Heart Catheterization)` luvavanyo olukhuselekileyo ngokubanzi. Nangona kunjalo, njengalo naluphi na uvavanyo lwezonyango, lunokuba neengozi ezithile. Ngenxa yokuba luyinkqubo yokungenelela , kubalulekile ukwazi ukuba zeziphi ezo ngozi:

• Iimpendulo ze-allergy kumayeza okanye kwizinto ezisetyenzisiweyo.
• Ukuphazamiseka kwentliziyo `(Arrhythmia)` .
• Umonakalo omncinci kwimithambo yegazi (Umonakalo wemithambo yegazi) (oku akwenzeki rhoqo).
• Ukopha okanye ukukrweleka kusenokwenzeka kwindawo apho i-catheter ifakwe khona.
• Amahlwili egazi anokwenzeka (oku nako kunqabile kakhulu).
• Kunqabile kakhulu, i-cardiac tamponade ,Isenokuba yinto efana nokuhlaselwa yintliziyo okanye isifo sohlangothi . Ezi aziqhelekanga kakhulu, kodwa kubalulekile ukuba uqaphele.
• Usulelo lunokwenzeka.
• Umphunga owileyo (oku nako kunqabile kakhulu).

Into ebalulekileyo kukuba uninzi lwale mingcipheko mincinci kakhulu. Oogqirha benza olu vavanyo kuphela xa becinga ukuba iingenelo zinkulu kakhulu kuneengozi ezincinci. Ukuba unemibuzo malunga noku, ungoyiki ukubuza ugqirha wakho.

Ndiza kuzazi nini iziphumo zovavanyo?

Ixesha elininzi, ugqirha uza kuthetha nawe ngeziphumo ngaphambi kokuba ugoduke. Okanye, baza kukucela ukuba ubuye ngenye imini ukuze nixoxe ngeziphumo ('intlanganiso yokulandelela') . Nangona kunjalo, uza kunikwa ingcaciso ecacileyo ngeziphumo.

Ndingazinyamekela njani emva kovavanyo?

Wakuba ugodukile, ugqirha wakho okanye umongikazi uza kukunika imiyalelo yokuba ungahlala njani, into omawuyenze, kunye nento ongamele uyenze. Badla ngokuthi izinto ezinje:

• Kuphephe ukugoba, ukuphakamisa, ukutyhala, okanye ukutsala kangangeeyure ezininzi, okanye iintsuku. Oku kunokuchaphazela indawo ye-catheter.
• Ukuba unikwe iyeza lokuthomalalisa elikwenza wozele, musa ukuqhuba okanye ukusebenzisa oomatshini abanzima okwethutyana.
• Sela amanzi amaninzi. Anceda ekukhupheni iintsholongwane emzimbeni kwaye anceda nokuba iyeza liphume emzimbeni.
• Gcina ibhandeji kwindawo apho i-catheter ifakwe khona usuku okanye ezimbini. Yitshintshe njengoko ugqirha wakho eyalele.
• Ungabeka ipakethe yomkhenkce kuloo ndawo ukunciphisa nayiphi na intlungu okanye ukudumba .
• Musa ukuhlamba iiyure ezingama-24 ukuya kwezingama-48 emva kovavanyo. Kuphephe ukuhlamba de inxeba liphole ngokupheleleyo.
• Ukuba inxeba limanzi, liphathe kancinci, ungalikhuhli ngamandla.

Ukulandela le miyalelo ngononophelo kubaluleke kakhulu ukuze uphile ngokukhawuleza.

Ufuna ukuthetha nogqirha nini emva kovavanyo?

Ukuba ufumana naziphi na kwezi mpawu emva kovavanyo, kufuneka ubone ugqirha okanye uye esibhedlele ngoko nangoko:

• Ukuba kukho ukopha okuvela kwindawo ye-catheter, okanye ukuba kukho iqhuma elikhulu apho.
• Ukuba ukubetha kwentliziyo kuyakhawuleza okanye akuhambelani kakuhle.
• Ukuba umlenze okanye ingalo apho kufakwe khona i-catheter ibuhlungu, ijika ibe luhlaza okwesibhakabhaka, ivakala ibanda, okanye ivakala ngathi ayisebenzi.
• Ukulahlekelwa yingqondo.
• Iimpawu zokuhlaselwa yintliziyo:Intlungu okanye uxinzelelo esifubeni, ukubila kakhulu, ukuphelelwa ngumphefumlo.
• Iimpawu zosulelo: Umkhuhlane, ukubomvu, ukuphuma okufana nobovu, ukudumba, kunye nokufudumala kwindawo ye-catheter.

Ukuba kwenzeka into efana nale, funa ingcebiso kugqirha ngokukhawuleza.

Ngoko ke, umyalezo wokugqibela oza kugoduka nawo:

Kulungile, ngoko ke ndiyathemba ukuba ngoku uyiqonda ngcono le vavanyo esithethe ngayo ebizwa ngokuba yi-"Right Heart Catheterization".

Ngamafutshane, olu luvavanyo olulinganisa uxinzelelo kwi-atrium yasekunene, kwi-ventricle, nakwi-pulmonary artery. Oku kunceda oogqirha ukuba baxilonge baze banyange izifo zentliziyo nemiphunga.

Ukuba ugqirha ukuxelela ukuba wenze olu vavanyo, ugqirha uza kukuchazela yonke into, kuquka isizathu sokwenziwa kwalo, indlela yokululungiselela, kunye nokuba iziphumo ziya kuthetha ntoni. Musa ukoyika, buza ukuba unemibuzo. Eyona nto ibalulekileyo kukwazi impilo yakho.

Ukufakwa kwe -catheter kwintliziyo, uvavanyo lwentliziyo, uxinzelelo lwegazi oluphezulu lwemiphunga, isifo sentliziyo, ilebhu yonyango, impilo yentliziyo, uvavanyo lwezonyango