Ngamanye amaxesha ungaziva ngathi intliziyo yakho ayibethi ngesingqi, ngamanye amaxesha intliziyo yakho ibetha ngokukhawuleza kakhulu, ngathi iyatsiba, okanye ezinye izingqi ziyatsitywa. Olu hlobo lokubetha kwentliziyo okungaqhelekanga aluyonto yokuthatyathwa lula. Oku kubizwa ngokuba yi -Atrial Fibrillation (Afib) kwisayensi yezonyango. Namhlanje siza kuthetha ngenkqubo ekhethekileyo esetyenziswa njengonyango lwesi sifo.
Ngamafutshane, yintoni i-Pulmonary Vein Isolation (PVI)?
Ukwahlulwa kwemithambo yemiphunga yepulmonary yinkqubo ekhethekileyo esetyenziselwa ukunyanga ukubetha kwentliziyo okungahambelaniyo okubizwa ngokuba yi-Atrial Fibrillation (Afib). Ngamazwi alula, "iyahlukanisa" okanye yahlukanise iindawo apho kuvela khona imiqondiso yombane elawula isigqi sentliziyo.
Cinga ngale ndlela. Intliziyo yethu sisitho esimangalisayo. Ukubetha kwayo kulawulwa yinkqubo ethambileyo kakhulu yemiqondiso yombane. Kodwa kumntu onesi simo esibizwa ngokuba yi-Afib, amagumbi amabini aphezulu entliziyo (esiwabiza ngokuba yi-atria) aqala ukufumana imiqondiso yombane engalunganga nengacwangciswanga. Ezi miqondiso zingalunganga zibangela ukuba inxalenye ephezulu yentliziyo ibethe ngokukhawuleza, ngokungathi iyangcangcazela. Ukuba oku kuyaqhubeka, umngcipheko weemeko ezinzima ezifana nestroke uphezulu kakhulu.
Ngaba uyazi ukuba ezi mpawu zombane zingalunganga zihlala ziqala phi? Kukho imithambo emine ethwala igazi elicocekileyo, elineoksijini ukusuka emiphungeni yethu ukuya kwi-atrium yasekhohlo yentliziyo. Le yileyo siyibiza ngokuba yi-Pulmonary Veins . Kujikeleze loo mithambo mine apho imiqondiso engalunganga ebangela i-Afib ihlala iqala khona.
Unyango lwe-Pulmonary Vein Isolation (PVI) lubandakanya ukuchonga apho iimpawu ezingaqhelekanga ziqala khona kunye nokudala umqobo omncinci ukuze zingafikeleli kwezinye iindawo zentliziyo. Lo mqobo wenziwa ngokusebenzisa ubushushu obuthambileyo okanye ukubanda kakhulu ukwenza inani elincinci lezicubu ezibomvu kwezo ndawo. Ezi zicubu ezibomvu zithintela iimpawu zombane ezingaqhelekanga ukuba zingadluli kuloo ndawo. Kufana nokuvala indlela engalunganga. Emva koko intliziyo iqala ukubetha ngokuqhelekileyo kwakhona. Le nkqubo ibizwa ngokuba yi -Heart Ablation .
Ngubani ngokwenene odinga olu nyango?
Olu nyango alulungelanga wonke umntu. Ugqirha wakho uza kuqwalasela izinto ezininzi ngaphambi kokuba agqibe ukuba lukulungele na. Olu nyango ludla ngokuba lulungele abantu abalandelayo:
- Kwabo baseneempawu (ukubetha kwentliziyo okuphezulu, ukudinwa, ukuphefumla kancinci) nangona besebenzisa amayeza okulwa nokubetha kwentliziyo ukulawula imeko yabo ye-Afib.
- Ukuba la mayeza abangela iziphumo ebezingalindelekanga okanye ukuba umzimba awukwazi ukunyamezela amayeza.
Khumbula, oogqirha bacinga ngale nyathelo lilandelayo kuphela xa amayeza engaphumeleli ukulawula imeko.
Ngaba olu nyango lungenziwa ngaphandle kokusebenzisa amayeza?
Le yingxaki abantu abaninzi abanayo. Abaphandi basaphanda ukuba i-PVI lolona nyango lungcono lodidi lokuqala kwabanye abaguli kunamayeza. Ezinye izifundo zibonise ukuba i-PVI isebenza ngcono kunamayeza. Kodwa ayikabi lolona nyango luqhelekileyo. Ngoko ke indlela ekhoyo ngoku kukuqala uzame amayeza uze uqwalasele i-PVI ukuba oko akusebenzi.
Uyazi njani ukuba olu nyango lukulungele?
Akunakwenzeka ukutsho kwangoko ukuba ufanelekile na koku. Kuya kufuneka uhlolwe ngokupheleleyo ngugqirha. Ugqirha uza kuqala akubuze ngembali yakho yezonyango aze enze uvavanyo lomzimba. Emva koko uza kuyalela iimvavanyo ezininzi ezinxulumene nentliziyo. Ezinye zazo zezi:
- I-Echocardiogram: Oku kunokubonelela ngomfanekiso ocacileyo womsebenzi kunye nolwakhiwo lwentliziyo.
- I-Electrocardiogram (EKG): Uvavanyo olurekhoda umsebenzi wombane wentliziyo.
- I-Holter Monitor: Le yi-EKG encinci enamathele emzimbeni wakho iiyure ezingama-24 okanye ezingama-48. Ingajonga indlela esitshintsha ngayo isingqisho sentliziyo yakho imini yonke.
Ugqirha uza kwenza isigqibo sokugqibela sokuba unyango lwe-PVI lufanelekile na kuwe ngokusekelwe kwiziphumo zezi mvavanyo.
Inyangwa njani i-PVI? Zeziphi iindlela eziphambili?
Ukwahlulwa kwemithambo yegazi yemiphunga luhlobo lonyango olubizwa ngokuba yi -Catheter Ablation . Oku kuthetha ukuba akwenziwa ngokwenza umngxuma omkhulu esifubeni njengotyando. Endaweni yoko, kwenziwa ngokufaka ityhubhu ende nebhityileyo (i-catheter) ngemithambo yegazi emikhulu emqolo okanye entanyeni nasentliziyweni.
Kukho iindlela ezimbini eziphambili zokulungisa izicubu zesilonda esizikhankanyileyo ngaphambili.
| Indlela yonyango | Inkcazo |
|---|---|
| Ukususwa kweRadiofrequency (kusetyenziswa ubushushu) | Le yeyona ndlela isetyenziswa kakhulu. Apha, amaza erediyo asetyenziswa kwincam ye-catheter ukuvelisa ubushushu, atshabalalise izicubu ezifumana imiqondiso engalunganga aze adale isilonda. |
| I-Cryoablation (ukusetyenziswa komkhuhlane ogqithisileyo) | Le ndlela isebenzisa ubanda obugqithisileyo ukuze ikhenkceze okwethutyana kwaye itshabalalise ngokusisigxina izicubu ezichaphazelekayo. |
Yeyiphi kwezi ndlela zimbini engcono?
Akukho ndlela yokutsho ukuba enye indlela ingcono kunenye. Zombini zineengenelo kunye neengxaki zazo. Uphando lubonise ukuba akukho mahluko mkhulu kwiziphumo kunye nokhuseleko lwale ndlela zimbini. Ugqirha wakho uza kukuchazela ngaphambi kokuba unyango lukuchazele ukuba yeyiphi indlela efanelekileyo kuwe.
Kwenzeka ntoni ngexesha lonyango? Ngaba ndiza kuziva iintlungu?
Ngokwesiqhelo, ngeli xesha lonyango, uthomalaliswa ngokupheleleyo yi-anesthesia (i-General Anesthesia) . Oku kuthetha ukuba uza kube ulele ngokupheleleyo. Ngenxa yoko, awuyi kuva ntlungu okanye ukungakhululeki ngexesha lonyango. Xa uvuka, yonke into iya kuba iphelile. Kwezinye iimeko ezikhethekileyo, oku kungenziwa ngokuvala kuphela indawo efanelekileyo (i-anesthetic yendawo). Ugqirha uza kukwazisa ngale nto kwangaphambili.
Kwenzeka ntoni inyathelo ngenyathelo
1. Ukulungiselela: Okokuqala, uza kufakwa i-anesthesia. Emva koko, indawo esesinqeni sakho okanye entanyeni apho i-catheter iza kufakwa khona iya kucocwa kwaye ivalwe.
2. Ukufakwa kwe-catheter: Ugqirha uza kufaka ii-catheter ezimbini ezincinci (iityhubhu) ezivela kwindawo engenanto ngemithambo yegazi ukuya kwi-atrium yasekhohlo yentliziyo.
3. Ukuchonga imiqondiso: I-catheter ibonisa ngqo apho kuvela khona imiqondiso yombane engalunganga.
4. Ukukhupha igazi: Enye i-catheter inika ubushushu (iRadiofrequency) okanye umkhuhlane (iCryoablation) esithethe ngayo, itshabalalisa izicubu ezifanelekileyo kwaye idale isilonda.
5. Ukugqitywa: Emva kokuba unyango lugqityiwe ngempumelelo, ugqirha ususa ngononophelo zombini ii-catheter aze abeke ibhandishi encinci phezu kweendawo zokufakelwa.
Intliziyo yam iza kuhlolwa njani ngexesha lonyango?
Iqela lezonyango liza kuqhubeka nokujonga ukusebenza kwentliziyo yakho nomzimba wakho ngalo lonke ixesha uphantsi kwe-anesthesia, lisebenzisa izixhobo ezahlukeneyo.
| Isixhobo | Ukusebenza kakuhle |
|---|---|
| I-Cardioverter | Oku kunokujonga izinga lokubetha kwentliziyo yakho ukuba liphantsi kakhulu okanye liphezulu kakhulu. Liqhagamshelwe kwizitikha ezibini ozincamathisela esifubeni nasemqolo. |
| I-Electrocardiogram (EKG) | Ungahlala ujonga ukusebenza kombane kwentliziyo yakho ngesixhobo sokubona esisebenzisa izitikha ezimbalwa ozincamathisela esifubeni sakho. |
| Ukujonga Uxinzelelo Lwegazi | Uxinzelelo lwakho lwegazi luhlala lulinganiswa nge-cuff enamathele engalweni yakho. |
| I-Oximeter Monitor | Inqanaba leoksijini egazini lijongwa ngekliphu encinci enamathele emnweni. |
| I-Fluoroscopy | Oku kufana nomatshini omkhulu we-X-reyi. Oku kuvumela ugqirha ukuba abukele i-catheter idlula entliziyweni kwisikrini. Ngamanye amaxesha ulwelo olukhethekileyo (idayi engafaniyo) lunokufakwa ukuze imithambo yegazi ibonakale ngokucacileyo. |
| I-Echocardiography ye-Intracardiac | Isixhobo esincinci se-ultrasound esifakwa entliziyweni nge-catheter. Oku kuvumela umbono ocacileyo wezakhiwo ezingaphakathi entliziyweni kunye nalapho i-catheter ichukumisa khona udonga lwentliziyo. |
Yonke le nkqubo ingathabatha naphi na ukusuka kwiiyure ezine ukuya kwezintandathu , ngoko ke licebo elihle ukwazisa usapho lwakho kwangethuba. Kusenokufuneka uhlale esibhedlele ubusuku bonke emva konyango.
Kwenzeka ntoni emva konyango?
Emva kokuba unyango luphelile, ugqirha uza kuthetha nawe nosapho lwakho malunga neziphumo. Kuya kufuneka uphumle ebhedini malunga neeyure ezine ukuya kwezisibhozo. Abahlengikazi baza kujonga izinga lentliziyo yakho kunye nesingqisho sayo ubusuku bonke. Kwiimeko ezininzi, uya kukwazi ukuya ekhaya kusasa olulandelayo. Ngaphambi kokuba ugoduke, abahlengikazi baza kujonga iindawo ze-catheter baze basuse amabhandeji baze bawacoce.
Ziziphi iingozi ezinokubakho?
I-PVI ngokubanzi lunyango olukhuselekileyo kakhulu. Nangona kunjalo, njengakwezinye iinkqubo zonyango, kukho umngcipheko omncinci. Izinto ezinjalo azifane zenzeke.
- I-allergy kwidayi yomahluko esetyenziselwa i-X-rays.
- Usulelo kwindawo efakwe kuyo i-catheter.
- Umonakalo eludongeni lwentliziyo (malunga ne-1%).
- Umonakalo wemithambo yemiphunga (malunga ne-1%).
- Istroke (umngcipheko omalunga ne-0.5%).
Musa ukoyika ezi ngozi. Iqela lakho lezonyango liza kwenza konke okusemandleni alo ukuthintela oku kungenzeki. Ugqirha wakho uza kukuchazela konke oku ngaphambi kokuba unyango luqale.
Ixesha lokuchacha kunye nokhathalelo lokulandelela
Kwiintsuku ezimbini zokuqala (iiyure ezingama-48) emva konyango, ungaziva ubuhlungu kancinci, udiniwe, okanye ungonwabanga esifubeni. Oku kuqhelekile. Emva koko, ungaqhubeka kancinci kancinci nemisebenzi yakho yesiqhelo. Nangona kunjalo , kungathatha iiveki ezimbalwa ngaphambi kokuba uqalise imisebenzi enzima, efana nokuzilolonga.
Into ebalulekileyo kukuba kuthatha iiveki ezininzi ukuba inxeba lokukhupha igazi liphole ngokupheleleyo kwaye libonise iziphumo. Ngoko ke izinga lentliziyo yakho aliyi kubuyela esiqhelweni emva konyango. Usenokuba neempawu ze-Afib kwiiveki ezili-10 zokuqala okanye nangaphezulu. Amaxesha amaninzi, imeko yakho isenokuba mandundu ngaphambi kokuba ibe ngcono. Ngoko ke musa ukoyika.
Emva konyango, uya kunikwa amayeza aliqela kangangeenyanga eziliqela:
- Amayeza okulwa nokubetha kwentliziyo: Lawula isingqisho sentliziyo de kufumaneke iziphumo zokususwa kwentliziyo.
- Izinto ezithintela ukugabha kwegazi (izinto ezinciphisa igazi): Zinciphisa umngcipheko westroke. Kusenokufuneka uqhubeke nokusebenzisa la mayeza.
Uza kuba nentlanganiso yakho yokuqala yokulandelela emva kweenyanga ezintathu ukuya kwezine emva konyango, kwaye elandelayo emva konyaka. Ngexesha leentlanganiso, ugqirha wakho unokuphinda iimvavanyo ezifana ne-CT scan, i-echocardiogram, okanye i-EKG ukujonga imeko yentliziyo yakho.
Umyalezo Wokuya Ekhaya
- I-Pulmonary Vein Isolation (PVI) lunyango oluphumelelayo lwesifo sentliziyo esingalawulekiyo esibizwa ngokuba yi-Atrial Fibrillation (Afib).
- Oku kwenziwa kwabo bangenakulawulwa ziimpawu zabo ngamayeza.
- Olu asilotyando olukhulu. Lunyango apho i-catheter (ityhubhu encinci) idluliselwa entliziyweni ngemithambo yegazi.
- Kungathatha iiveki okanye iinyanga ezininzi ukuze uphile ngokupheleleyo kwaye ubone iziphumo emva konyango. Musa ukukhathazeka.
- Nokuba emva konyango, kubalulekile ukuthatha amayeza anikwe ngugqirha (ingakumbi amayeza okunciphisa igazi) njengoko eyalelwe kwaye uye kwiikliniki ngemihla ebekiweyo.
- Ukuba ufumana iimpawu ezifana neentlungu zesifuba, ukuphefumla okunzima, okanye isiyezi, yazisa ugqirha wakho ngoko nangoko.
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