Ake sifunde nge-Right Heart Catheterization?

Ingabe udokotela wakho ukutshelile ukuthi wenze lokhu kuhlolwa? Noma mhlawumbe umane nje ufuna ukwazi. Ake sibheke kalula ukuthi kuyini, kwenziwa kanjani, nokuthi kungani kwenziwa. Ungakhathazeki, ngizokuchazela konke.

Kuyini lokhu kufakwa kwe-catheter kwenhliziyo kwesokudla?

Kalula nje, lokhu ukuhlolwa okukhethekile okwenziwa ukuze kubonwe ukuthi inhliziyo yakho isebenza kahle kangakanani. Ngokukhethekile, kulinganisa umfutho wegazi kanye namazinga omoya-mpilo ohlangothini lwesokudla lwenhliziyo yakho nasemaphashini akho. Lokhu ngezinye izikhathi kubizwa ngokuthi i-pulmonary artery catheterization . Abanye bangase bakubize nangokuthi ukuhlolwa kwe-Swan-Ganz catheter .

Ukuze benze lokhu, odokotela basebenzisa ithubhu elincane neliguquguqukayo elibizwa ngokuthi i-catheter . Leli thubhu lifakwa emthanjeni omkhulu entanyeni yakho, embotsheni, noma engalweni, futhi lifakwa kancane kancane ohlangothini lwesokudla lwenhliziyo yakho kanye nasemzimbeni wegazi oyinhloko othwala igazi liye emaphashini akho , umthambo wamaphaphu . Cabanga ngakho njengokufaka ikhamera encane ngaphakathi, kodwa ilinganisa ingcindezi nomoya-mpilo.

Kungani lolu vivinyo lubaluleke kangaka? Luzokutholani?

Lokhu kuhlolwa kwe-"Right Heart Catheterization" kusiza odokotela ukuthola ulwazi mayelana nokuphatha izifo eziningi. Nazi izibonelo ezimbalwa:

• Ukushaqeka kwenhliziyo: Isimo esibi esenzeka lapho inhliziyo iyeka ukupompa igazi ngendlela efanele.
• I-Cardiomyopathy: Isifo lapho imisipha yenhliziyo iba buthakathaka noma ikhula khona.
• Isifo senhliziyo esizalwa naso: Abanye abantu bangazalwa benokukhubazeka okuthile kwenhliziyo. Hlola ukuthi bakhona yini.
• Ukwehluleka kwenhliziyo: Lapho inhliziyo ingakwazi ukupompa igazi elanele.
• Isifo se-valve yenhliziyo: Uma ama-valve enhliziyweni engasebenzi kahle.
• Umfutho wegazi ophezulu wamaphaphu: Ukwanda kwengcindezi emithanjeni yegazi ethwala igazi liye emaphashini.

Futhi, ngezinye izikhathi lokhu kuhlolwa kungadingeka ngaphambi noma ngemva kokufakelwa isitho, noma ngaphambi kokufaka idivayisi ekhethekile esiza inhliziyo, njenge- "Left Ventricular Assist Device" . Ngoba lokhu kunikeza odokotela isithombe esicacile sesimo esingaphakathi kwenhliziyo.

Uyini umehluko phakathi kokukwenza ngakwesokudla kwenhliziyo nokukwenza ngakwesokunxele?

Yebo, kunomehluko obalulekile phakathi kwalokhu okubili. Ake sibone ukuthi kuyini.

Ekufakweni kwe-catheter yenhliziyo yesokudla, udokotela ufaka ipayipi elincane (i-catheter) emthanjeni.Okusho ukuthi, kusuka emthanjeni othwala igazi elingcolile. Yilokhu okuya ohlangothini lwesokudla lwenhliziyo. Lokhu kulinganisa kakhulu ingcindezi e-atrium yakho yesokudla, i-ventricle yesokudla, kanye nomthambo wamaphaphu othwala igazi emaphashini akho.

Kodwa ekufakweni kwe-catheter ohlangothini lwesobunxele, i-catheter ifakwa emthanjeni . Okungukuthi, umthambo othwala igazi elihlanzekile. Isibonelo, umthambo we-femoral emlenzeni, umthambo we-brachial engalweni, noma umthambo we-axillary ekhwapheni. Yilapho uhlangothi lwesobunxele lwenhliziyo luya khona. Lokhu kulinganisa ingcindezi e-ventricle yesobunxele, kubheka i-aorta kanye ne-valve yayo, futhi kubheka noma yikuphi ukuvinjelwa emithanjeni ye-coronary enikeza igazi enhliziyweni. Lokhu kuhlolwa ohlangothini lwesobunxele kuvame ukubizwa ngokuthi i-cardiac catheterization noma i-coronary angiography . Uyawuqonda umehluko?

Ubani owenza lolu vivinyo? Lwenziwa kuphi?

Lokhu kuhlolwa kwe-`(Right Heart Catheterization)` kwenziwa ekamelweni elikhethekile esibhedlela. Kubizwa ngokuthi i-`Cardiac Catheterization Laboratory` noma i-`cath lab` ngamafuphi. Kwenziwa yithimba lochwepheshe abaqeqeshiwe. Ngokuvamile kuholwa yi-`Advanced Heart Failure Cardiologist` noma i-`Interventional Cardiologist`. Ngakho-ke, ungaqiniseka ukuthi usezandleni ezinhle.

Kufanele uzilungiselele kanjani lokhu?

Udokotela wakho uzokunikeza imiyalelo ethile yokuthi ungalungiselela kanjani, kodwa ngokuvamile kuba yinto efana nale:

• Kufanele utshele udokotela wakho ngayo yonke imithi oyithathayo. Lokhu kufaka phakathi imithi kadokotela, izithasiselo, kanye nemithi etholakala ngaphandle kwemithi kadokotela. Eminye imithi, ikakhulukazi imithi yokunciphisa igazi/imithi yokunciphisa igazi , kungadingeka iyekwe izinsuku ezimbalwa. Lokhu kufanele kwenziwe njengoba nje udokotela wakho ekutshelile.
• Letha umuntu ozokuthatha akuyise ekhaya ngemva kokuhlolwa, njengoba kungaba yinto engakhululekile ngezinye izikhathi, noma uma unikezwa imithi ekwenza ulale, akuwona umqondo omuhle ukushayela.
• Sicela ususe noma yibuphi ubucwebe noma i-nail polish ongase ube nayo.
• Ungadli noma uphuze lutho amahora ayi-6 kuya kwayi-12 ngaphambi kokuhlolwa. Lokhu kubaluleke kakhulu, ngoba isisu esingenalutho senza ukuhlolwa kube lula, futhi ungalungela uma kwenzeka isimo esiphuthumayo.

Kubaluleke kakhulu ukulandela lezi zinto ngendlela efanele ukuze uphumelele esivivinyweni.

Kwenzekani ngaphambi kokuhlolwa?

Njengoba ukuhlolwa sekuzoqala, udokotela noma umhlengikazi uzokwenza okulandelayo:

• Uzocelwa ukuthi ugqoke ingubo yasesibhedlela bese uchama (ukhiphe isinyi sakho).
• Bakutshela ukuthi ulale embhedeni okhethekile.
• Zinamathisela izingcezu ezincane zezinto esifubeni sakho. Zibizwa ngokuthi ama-electrode . Lezi yizo eziqapha njalo ukusebenza kwenhliziyo yakho, njenge-ECG.

Esikhathini esiningi, lokhu kuwukuhlolwa okusheshayo okubizwa ngokuthi "i-Right Heart Catheterization", ngakho-ke awuhlinzwanga ngokuphelele. Lokhu kusho ukuthi uqaphile. Kodwa ngezinye izikhathi, ithubhu elincane elibizwa ngokuthi "umugqa we-IV" lingafakwa emthanjeni engalweni yakho, lapho unganikezwa khona uketshezi noma imithi yokudambisa ezokwenza uzizwe uzolile noma ulele. Lokhu kwenzelwa ukunciphisa ukungakhululeki kwakho.

Kwenzekani ngesikhathi sokuhlolwa? Yini ongayilindela?

Ukuhlolwa ngokwako kuvame ukuthatha cishe ihora. Kodwa-ke, isikhathi sokulungiselela kanye nesikhathi sokululama ngemva kokuhlolwa kungathatha amahora amaningana. Ungakhathazeki, lokhu kuvamile.

Uzophaphama phakathi nokuhlolwa. Udokotela uzokwenza okulandelayo:

• Indawo lapho kuzofakwa khona i-catheter (isifuba, ingalo, noma intamo) izohlanzwa futhi, uma kudingeka, ezinye izinwele lapho zizogundwa.
• Kufakwa inani elincane le-anesthetic yendawo ukuze kuncishiswe indawo. Ngemuva kwalokho ngeke uzwe ubuhlungu. Kuzozwakala sengathi intuthwane encane iyakuluma lapho uthola umjovo.
• Bese kuthi, kusetshenziswa inaliti ekhethekile noma ithuluzi elincane, kwenziwe imbobo encane emthanjeni. Lokhu kungaba umthambo we-femoral emlenzeni wakho, umthambo we-jugular entanyeni yakho, noma umthambo ongalweni yakho.
• Manje, lelo payipi elincane, i-catheter , lifakwa kancane kancane futhi liqondiswa ezingxenyeni ezahlukene zenhliziyo nemithambo yegazi. Ngeke ulizwe ngenkathi lisenziwa.
• Izilinganiso zithathwa ezindaweni ezidingekayo, futhi ngezinye izikhathi kungathathwa isampula encane yezicubu (isampula yezicubu / i-biopsy) yenhliziyo, okwenziwa nangale catheter.
• Ngezinye izikhathi ungase utshelwe ukuthi uhlale unganyakazi, ushintshe ukuma komzimba wakho, noma uphefumule ngendlela ethile.
• Kwezinye izimo, udokotela wakho angase akucele ukuthi wenze ukuzivocavoca okuncane (mhlawumbe ngokunyathela iphiseli elincane ngonyawo lwakho). Lokhu kuzobheka ukuthi ukushaya kwenhliziyo yakho kushintsha kanjani ngesikhathi sokuzivocavoca.
• Unganikeza nemithi ethile nge-IV engalweni yakho bese ubona ukuthi inhliziyo yakho isabela kanjani kuyo.
• Ekugcineni, i-catheter iyakhishwa bese inxeba elincane livalwa.

Akukho okufanele ukwesabe, odokotela nabahlengikazi bonke banawe, uma uzizwa ungakhululekile, batshele.

Kwenzekani ngemva kokuhlolwa?

Ngemva kokuphela kokuhlolwa, ithimba lezokwelapha lasusa ama-electrode ayenamathele esifubeni sakhe.Bazokhipha i-IV bese beyifaka. Ngemuva kwalokho uzoyiswa ekamelweni elihlukile (igumbi lokululama) . Lapho bazobheka ngokucophelela okulandelayo:

• Ingabe kukhona igazi elivela lapho i-catheter ifakiwe khona?
• Ukushaya kwegazi.
• Isilinganiso senhliziyo.
• Izinga lokushisa lomzimba.

Uzoqashwa kuze kube yilapho konke lokhu kubuyela esimweni esijwayelekile.

Kuthatha isikhathi esingakanani ukululama?

Ithimba lezokwelapha lizokulinda amahora ambalwa. Abantu abaningi bangaya ekhaya ngemva kwalokho. Kodwa khumbula ukuthi othile akushayele ngoba ungase uzizwe ulele noma ukhathele.

Kodwa-ke, uma ukuhlolwa kuthola into engathi sína, kungadingeka ukuthi uhlolwe okwengeziwe, uthole ukwelashwa, noma uhlale esibhedlela. Udokotela uzokutshela ngalokhu.

Ingabe lokhu kuhlolwa kubuhlungu?

Lona umbuzo abantu abaningi abawubuzayo. Tshela udokotela ukuthi uzizwa kanjani phakathi nokuhlolwa.

Ngokuvamile, uzozwa ubuhlungu obuncane lapho kunikezwa umjovo wokwenza kube nezinzwa. Ungase uzizwe nokucindezeleka okuncane lapho kufakwa i-catheter. Ngaphezu kwalokho, abanye abantu bangase babhekane nalokhu okulandelayo:

• Njengoba i-catheter ishaya izindonga zenhliziyo yakho, ungase uzizwe uqhuma esifubeni sakho noma weqe ukushaya. Lokhu kuvamile, ngakho ungakhathazeki.
• Abanye abantu bangase baphathwe yikhanda .
• Ungase uzizwe unesiyezi (ubuhlanya) .
• Kungase kube nesicanucanu .
• Ungase uzizwe ucindezelekile kancane njengoba i-catheter idlula emithanjeni yegazi.
• Ungase uzizwe unesifiso sokukhwehlela .
• Eminye imithi ingabangela umuzwa omncane wokufudumala noma ukusha .

Noma ngabe uzizwa kanjani, tshela udokotela noma umhlengikazi. Bazokusiza.

Ingabe kukhona izingozi ezihilelekile kulolu vivinyo?

`(Ukuhlikihla Inhliziyo Efanele)` ngokuvamile kuyindlela yokuhlola ephephile . Kodwa-ke, njenganoma yikuphi ukuhlolwa kwezokwelapha, kungaba nezingozi ezithile. Ngenxa yokuthi kuyinqubo ehlaselayo , kubalulekile ukwazi ukuthi yiziphi lezo zingozi:

• Ukusabela kokungezwani komzimba nemithi noma izinto ezisetshenziswayo.
• Ukuphazamiseka kwenhliziyo `(Arrhythmia)` .
• Umonakalo omncane emithanjeni yegazi (Umonakalo wemithambo yegazi) (lokhu akuvamile ukwenzeka).
• Ukopha noma ukuklwebheka kungase kwenzeke endaweni lapho kufakwe khona i-catheter.
• Kungase kube namahlule egazi (lokhu nakho akuvamile kakhulu).
• Akuvamile kakhulu, i-tamponade yenhliziyo ,Kungaba yinto efana nokuhlaselwa yinhliziyo noma isifo sohlangothi . Lokhu akuvamile kakhulu, kodwa kubalulekile ukuqaphela.
• Ukutheleleka kungenzeka.
• Iphaphu eliwile (lokhu nakho akuvamile kakhulu).

Into ebalulekile ukuthi iningi lalezi zingozi lincane kakhulu. Odokotela benza lokhu kuhlola kuphela uma becabanga ukuthi izinzuzo zinkulu kakhulu kunezingozi ezincane. Uma unemibuzo ngalokhu, ungesabi ukubuza udokotela wakho.

Ngizoyazi nini imiphumela yokuhlolwa?

Esikhathini esiningi, udokotela uzokhuluma nawe ngemiphumela ngaphambi kokuba uye ekhaya. Noma, bazokucela ukuthi ubuye ngosuku oluhlukile ukuzoxoxa ngemiphumela ('i-aphoyintimenti yokulandelela') . Kodwa-ke, uzonikezwa incazelo ecacile yemiphumela.

Kufanele ngizinakekele kanjani ngemva kokuhlolwa?

Uma usubuyele ekhaya, udokotela wakho noma umhlengikazi uzokunikeza imiyalelo yokuthi ungahlala kanjani, ukuthi wenzeni, nokuthi ungakwenzini. Ngokuvamile basho izinto ezinjengalezi:

• Gwema ukugoba, ukuphakamisa, ukusunduza, noma ukudonsa amahora amaningana, noma ngisho nezinsuku. Lokhu kungathinta indawo ye-catheter.
• Uma unikezwe umuthi wokudambisa okwenza ulale, ungashayeli noma usebenzise imishini esindayo isikhashana.
• Phuza amanzi amaningi. Kuyasiza ekukhipheni amagciwane emzimbeni futhi kuyasiza nomuthi ukuthi uphume emzimbeni.
• Gcina ibhandishi lapho kufakwe khona i-catheter usuku olulodwa noma ezimbili. Lishintshe njengoba kuqondiswe udokotela wakho.
• Ungabeka iphakethe leqhwa endaweni ukuze unciphise ubuhlungu noma ukuvuvukala .
• Ungagezi amahora angama-24 kuya kwangu-48 ngemva kokuhlolwa. Gwema ukugeza kuze kube yilapho inxeba selipholile ngokuphelele.
• Uma inxeba limanzi, liphathe kancane, ngaphandle kokuhlikihla ngamandla.

Ukulandela le miyalelo ngokucophelela kubaluleke kakhulu ukuze ululame ngokushesha.

Udinga ukukhuluma nodokotela ngasiphi isikhathi ngemva kokuhlolwa?

Uma uhlangabezana nanoma yiziphi zalezi zimpawu ngemva kokuhlolwa, kufanele ubonane nodokotela noma uye esibhedlela ngokushesha:

• Uma kukhona ukuphuma kwegazi endaweni ye-catheter, noma uma kuvele iqhubu elikhulu lapho.
• Uma ukushaya kwenhliziyo kushesha noma kungajwayelekile.
• Uma umlenze noma ingalo lapho kufakwe khona i-catheter ibuhlungu, iphenduka ibe luhlaza okwesibhakabhaka, izwa ibanda, noma izwa indikindiki.
• Ukulahlekelwa ukwazi.
• Izimpawu zokuhlaselwa yinhliziyo:Ubuhlungu besifuba noma ingcindezi, ukujuluka ngokweqile, ukuphelelwa umoya.
• Izimpawu zokutheleleka: Umkhuhlane, ukubomvu, ukuphuma koketshezi okufana nobomvu, ukuvuvukala, kanye nokufudumala endaweni ye-catheter.

Uma kwenzeka into efana nale, funa iseluleko sezokwelapha ngokushesha.

Ngakho-ke, umyalezo wokugcina okufanele uwuthathe uye ekhaya:

Kulungile, ngakho-ke ngithemba ukuthi usunokuqonda okungcono kokuhlolwa esikhulume ngakho okubizwa ngokuthi "i-Right Heart Catheterization".

Kalula nje, lokhu ukuhlolwa okulinganisa ingcindezi emthanjeni we-atrium kwesokudla, we-ventricle, kanye nowe-pulmonary. Lokhu kusiza odokotela ukuxilonga nokwelapha izifo zenhliziyo namaphaphu.

Uma udokotela ekutshela ukuthi wenze lokhu kuhlolwa, udokotela uzokuchazela konke, okuhlanganisa nokuthi kungani kwenziwe, ukuthi ulungiselela kanjani, nokuthi imiphumela izosho ukuthini. Ungesabi, buza uma unemibuzo. Into ebaluleke kakhulu ukuqaphela impilo yakho.

Ukufakwa kwe -catheter kwenhliziyo, ukuhlolwa kwenhliziyo, umfutho wegazi ophakeme emaphashini, isifo senhliziyo, ilabhorethri yokwelapha, impilo yenhliziyo, ukuhlolwa kwezokwelapha