Ngaba uneentlungu ezingapheliyo entanyeni, entloko, engalweni, okanye esifubeni sakho esingapheliyo nangona usela amayeza? Ngamanye amaxesha unobangela wentlungu enjalo unokuba yingxaki encinci kwinkqubo yethu yemithambo-luvo. Namhlanje sithetha ngendlela ekhethekileyo yonyango esetyenziswa ngoogqirha kwiimeko ezinjalo, eyahlukileyo kancinci. Oku kubizwa ngokuba yi-'Stellate Ganglion Block'. Nangona igama liyinkimbinkimbi kancinci, masiqonde ukuba oku kwenza ntoni ngendlela elula.
Yintoni iStellate Ganglion Block (SGB)?
Ngamafutshane, iStellate Ganglion Block (SGB) yinaliti ye-anesthetic. Kodwa le ayisiyonto nje eqhelekileyo. Ifakwa kwiqela elikhethekileyo lemithambo-luvo entanyeni yethu, ngakumbi kumacala omabini ebhokisi yethu yelizwi. Eli qela lemithambo-luvo libizwa ngokuba yi-'Stellate Ganglion'.
Kukho iinjongo ezimbini eziphambili zokusebenzisa olu gonyo:
1. Ukunciphisa iintlungu ezinzima nezingapheliyo entloko, entanyeni, ezingalweni eziphezulu, nasesifubeni esingaphezulu.
2. Ukujikeleza kwegazi ezandleni, oko kukuthi, ukuphucula ukuhamba kwegazi.
Kulungile, yintoni ke le ganglion idumileyo?
I-ganglion liqela leeseli zemithambo-luvo ezidibanayo, njengendawo edibana kuyo isikhululo sikaloliwe, iziko apho imiyalezo yemithambo-luvo ithunyelwa khona nangaphambili.
I-stellate ganglioni yenye yeendibanisela zemithambo-luvo ezinjalo. Ikwindawo engaphambili entanyeni yethu, ngaphantsi nje kwethambo lentamo, kufutshane nombambo wokuqala. Sinee-ganglioni ezinje kumacala omabini entamo yethu. Igama elithi 'stellate' lithetha 'njengeenkwenkwezi'. Oku kuthetha ukuba imilo yale qela lemithambo-luvo inokufana nemilo yenkwenkwezi.
Eli qela lemithambo-luvo liphantsi kwe-'Sympathetic Nervous System', eyinxalenye ye-Autonomic Nervous System yethu. Ngamafutshane, le yinkqubo yomzimba wethu 'yokulwa okanye yokubaleka', oko kukuthi, inkqubo esilungiselela ukulwa okanye ukubaleka kwimeko engxamisekileyo, xa sisoyika okanye sixhalabile. Ibandakanyeka kwizinto ezininzi ezilawulwa yimizimba yethu ngaphandle kokuba sicinge ngazo, ezifana nokubetha kwentliziyo, uxinzelelo lwegazi, kunye nokubila. Ngoko ke uninzi lwemiyalezo yemithambo-luvo ehambelanayo eya entlokweni, entanyeni, ezingalweni, nasesifubeni esingaphezulu ithunyelwa ngale stellate ganglion.
Ngaba wonke umntu unalo eli qela leembangi?
Oku kuyamangalisa kancinci. Enyanisweni, le ntlango yeenkwenkwezi ayikho emzimbeni womntu wonke. Ukuze le ntlango ikwazi ukwakheka, kufuneka kudibane imithambo-luvo emibini entanyeni yethu, ekuthiwa yi-'inferior cervical ganglion' kunye ne-'first thoracic ganglion'.
Kodwa, yi-80% kuphela yabantu emhlabeniEzi mithambo-luvo zimbini ziyadibana ngale ndlela ukuze zenze i-stellate ganglion. Kwezinye iimeko ezingama-20%, ezi zicwangciswe ngendlela eyahlukileyo, zahlulwe enye kwenye.
Kutheni iStellate Ganglion Block yenziwa? Zeziphi izifo?
Oogqirha basebenzisa olu nyango ngezizathu ezibini eziphambili.
1. Ukuxilongwa: Fumanisa ukuba kukho iintlungu ezibangelwa ngumsebenzi wenkqubo yemithambo-luvo enxulumene novelwano ekhankanyiweyo ngaphambili. Oku kubizwa ngokuba yi-'sympathetically mediated pain (SMP)'.
2. Njengonyango: Lawula iimeko ezahlukeneyo zentlungu, ukuphazamiseka kwemithambo-luvo, kunye neengxaki zokujikeleza kwegazi.
Itheyibhile engezantsi idwelisa ezinye zeemeko apho olu nyango lusetyenziswa kakhulu khona.
| Isifo/Intlungu | Ingcaciso elula |
|---|---|
| I-Complex Regional Pain Syndrome (CRPS) | Intlungu ebuhlungu, ehlala ixesha elide, etshisayo eyenzeka emva kwengozi engalweni okanye emlenzeni. |
| Isifo seMithambo yePheripheral | Iingxaki zokujikeleza kwegazi ezibangelwa kukucutheka kwemithambo yegazi ehambisa igazi ezandleni nasezinyaweni. |
| Intlungu Yemilenze Engaqhelekanga | Ndisaziva iintlungu engalweni okanye emlenzeni osuswe ngotyando. |
| I-Postherpetic Neuralgia | Intlungu yemithambo-luvo ehlala ihleli nasemva kokuba i-herpes zoster (ii-shingles) ipholile, ebangelwa yintsholongwane ye-herpes enxulumene ne-chickenpox. |
| I-Hyperhidrosis | Ukubila kakhulu kwiindawo ezifana neentende zezandla. |
| Isifo sikaRaynaud | Iminwe iba mdaka, ibe luhlaza okwesibhakabhaka, ize ibe ndindisholo xa ibekwe emakhazeni okanye kuxinzelelo. |
| Iintloko ezibuhlungu zeCluster | Intloko ebuhlungu kakhulu, ebuhlungu kakhulu. |
Ukongeza, olu nyango lukwasetyenziswa kwiimeko ezifana ne-'Scleroderma', 'iintlungu zomlomo', 'iintlungu zesifuba ezingaqhelekanga', kunye nesifo sikaMénière.
Ingaba oku kukwasetyenziselwa imiba yempilo yengqondo?
Ewe, le yingongoma abantu abaninzi abathetha ngayo ngoku. Uphando beluqhubeka ukusukela ngeminyaka yoo-1990, ingakumbi ekusebenziseni i-SGB njengonyango lwengxaki yengqondo ebizwa ngokuba yiPost-Traumatic Stress Disorder (PTSD) .
I-PTSD yimeko yengqondo eyenzeka emva kokufumana isiganeko esibuhlungu kakhulu. Abantu abanale meko banamanqanaba aphezulu ngokungaqhelekanga eekhemikhali ezithile engqondweni yabo, ezifana ne-'norepinephrine' kunye ne-'nerve growth factor'. Abaphandi bakholelwa ukuba olu tyando lunokunciphisa loo manqanaba kwaye lulawule ukusebenza rhoqo kwempendulo 'yokulwa okanye yokubhabha'.
Kodwa iziphumo zezi zifundo zixubene. Abanye abantu babone ukwehla okukhulu kweempawu ze-PTSD, ngelixa abanye bengakhange babone tshintsho. Ngenxa yoko, iiarhente ezifana ne-U.S. Food and Drug Administration azikayivumi ngokusemthethweni i-SGB njengonyango lwe-PTSD. Nangona kunjalo, ukuba ezinye iindlela zonyango (ingcebiso, amayeza) azisebenzanga, ugqirha unokuxoxa ngale nto nesigulana aze ayinike njengonyango 'olungekho kwileyibhile'.
Kutshanje, uphando luqalile ngemiphumo ye-SGB kwezinye iimeko zengqondo, ezinje ngokudakumba kunye nokuxhalaba.
Yenziwa njani le Stellate Ganglion Block?
Khawucinge ukuba ugqirha ukunike olu nyango. Emva koko, ekliniki okanye esibhedlele, kwenzeka into efana nale:
1. Ukulungiselela: Okokuqala, uza kucelwa ukuba ulale ujonge ebhedini. Ukuze ukhululeke kwaye uphumle, unganikwa i-sedative encinci (i-sedative) ngomgca we-intravenous (IV).
2. Ukucoca: Ugqirha uza kucoca kakuhle indawo entanyeni yakho apho uza kunikwa khona inaliti ngesisombululo sokubulala iintsholongwane.
3. Inaliti yokuqala (ingasebenzi kakuhle):Okulandelayo, kufakwa isixa esincinci se-anesthetic yasekuhlaleni kule ndawo kusetyenziswa inaliti encinci kakhulu. Oku kuya kukunceda ungaziva iintlungu zenaliti elandelayo.
4. Inaliti ephambili: Emva koko inaliti ye-anesthetic ephambili iyafakwa. Kodwa oku akusiyo nje ingqikelelo. Ugqirha usebenzisa iskeni ye-'Ultrasound' okanye uhlobo oluthile lwe-X-ray olubizwa ngokuba yi-'Fluoroscopy' , ujonga indlela yenaliti kwisikrini, kwaye kuphela emva koko inaliti iyenzeka xa inaliti ikufutshane neqela lemithambo-luvo elibizwa ngokuba yi-stellate ganglion. Oku kunciphisa amathuba okuyifaka kwindawo engafanelekanga.
Le nkqubo yonke idla ngokuthatha ngaphantsi kwemizuzu engama-30 .
Kwenzeka ntoni emva kokufakwa inaliti?
Emva kokufakwa inaliti, uza kugcinwa kwigumbi lokuchacha okwethutyana. Ngokwesiqhelo malunga nemizuzu engama-40 ukuya kwengama-60, umongikazi okanye ugqirha uza kujonga imeko yakho (uxinzelelo lwegazi, ukubetha kwentliziyo). Nje ukuba yonke into iqinisekiswe, uza kunikwa imiyalelo ekufuneka uyilandele ekhaya uze uvunyelwe ukuba uye ekhaya.
Eyona nto ibalulekileyo: Emva kolu nyango, awuyi kukwazi ukuqhuba imoto ugoduke wedwa, ngoko ke kubalulekile ukuba kubekho umntu okuqhubela imoto ugoduke.
Lusebenza kangakanani olu nyango? Luhlala ixesha elingakanani?
Akukho mpendulo inye kulo mbuzo kuba uyahluka kakhulu kumntu nomntu.
- Kwabanye abantu, iintlungu ziyaphela kwangoko emva kokufakwa inaliti, kodwa iintlungu zinokubuya emva kweeyure ezimbalwa njengoko i-anesthetic iphela.
- Abanye bafumana isiqabu sentlungu kangangeentsuku okanye iiveki. Ngeli xesha, bayakwazi ukunciphisa amayeza abo entlungu baze bathathe inxaxheba kwimisebenzi efana nokuzilolonga nge-physiotherapy.
Ngokwesiqhelo, inaliti enye ayiniki kuphumla ngokupheleleyo. Ukuze ufumane isiqabu sexesha elide, kufuneka uthotho lweenaliti, nto leyo ethetha ukuba kufuneka ukwenze oku izihlandlo ezininzi. Ngamanye amaxesha ungafumana iziphumo kwiiseshoni ezimbini kuphela, ngelixa ezinye zisenokufuna ukukwenza izihlandlo ezingaphezu kweshumi. Kodwa iindaba ezimnandi zezokuba ngeseshoni nganye, ixesha lokuphelisa iintlungu linokwanda .
Ngaba kukho naziphi na iziphumo ebezingalindelekanga okanye iingozi koku?
Njengakwezinye iindlela zonyango, kukho iziphumo ebezingalindelekanga ezincinci kunye neengxaki ezingaqhelekanga kakhulu.
| Iziphumo ebezingalindelekanga eziqhelekileyo, zexeshana (ziphela kwiiyure ezimbalwa) | |
|---|---|
| Ukugruzuka okanye iintlungu kwindawo yokuhlatywa inaliti | Ijwabu eligobileyo |
| Ubomvu bamehlo | Iinyembezi ziphuma emehlweni |
| Ukuxinana kwempumlo | Ukurhawuzela kwelizwi |
| Ndivakalelwa ngathi kukho iqhuma emqaleni | Ubunzima bokuginya ukutya |
| Ukuziva ubushushu okanye ukungakhululeki esandleni okanye entendeni yesandla | |
Ezi mpawu zikhankanyiweyo apha ngasentla zihlala ziphela ngokupheleleyo kwiiyure ezimbalwa, kodwa kukwakho neengxaki ezinkulu ezinokwenzeka rhoqo .
- Iimeko ezichaphazelayo
- Ukopha ngenxa yokugqobhozwa kwenaliti kwimithambo yegazi (umz. umthambo we-carotid)
- Ukonakala kwezinye iimithambo-luvo (i-vagus nerve, i-recurrent laryngeal nerve)
- Umonakalo wemiphunga (iPneumothorax)
- Ukonakala kwi-thyroid gland, kwi-esophagus, okanye kwi-trachea
Amathuba okuba ezi zinto zenzeke mancinci kakhulu, ingakumbi xa ugqirha onamava esenza olu nyango esebenzisa ubuchwepheshe obufana ne-ultrasound.
Kuphantsi kweziphi iimeko apho kufuneka ndibize ugqirha?
Emva kokuba ubuyele ekhaya emva kokufakwa inaliti, ukuba ufumanisa naziphi na iimpawu ezintsha okanye ukrokrela naziphi na iingxaki , fowunela ugqirha wakho ngoko nangoko. Ingakumbi:
- Ukuba indawo efakwe kuyo inaliti iyadumba, ibomvu, okanye ibe nomkhuhlane (iimpawu zosulelo).
- Ukuba ubunzima bokuginya buyaqhubeka emva kweeyure ezimbalwa.
- Ukuba unengxaki yokuphefumla.
Musa ukoyika okanye ungathandabuzi ngolu nyango. Thetha nogqirha wakho ngalo ngokukhululekileyo. Eyona nto ibalulekileyo kukumamela zonke izinto ezikuxhalabisayo uze wenze isigqibo esinolwazi.
Umyalezo Wokuya Ekhaya
- I-Stellate Ganglion Block (SGB) lunyango olubandakanya ukufaka i-anesthetic kwi-nerve cluster ekhethekileyo entanyeni.
- Oku kusetyenziswa kakhulu kwiintlungu ezingapheliyo kunye neengxaki zokujikeleza kwegazi entloko, entanyeni, ezingalweni, nakwisifuba esingaphezulu.
- Ikwasetyenziswa kuphando lweemeko zengqondo ezifana ne-PTSD, kodwa iziphumo ziyahluka kumntu nomntu.
- Impumelelo yolu nyango kunye nobude bexesha lokuphelisa iintlungu zahlukile kakhulu kumntu nomntu, kwaye kufuneka uthotho lweenaliti.
- Iziphumo ebezingalindelekanga zexeshana ezifana nokurhawuzelela nokugoba kwamehlo zinokwenzeka, eziya kuphela emva kweeyure ezimbalwa. Umngcipheko weengxaki ezinkulu uphantsi kakhulu.
- Eyona nto ibalulekileyo kukuthetha nogqirha wakho ngale nto, ubuze yonke imibuzo yakho, uze wenze isigqibo esinolwazi olupheleleyo.
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