Uyazi nge-CRT (Cardiac Resynchronization Therapy), ebangela ukuthi amakamelo enhliziyo ashaye ndawonye?

Ingabe ngezinye izikhathi uzizwa ukhathele ngaphandle kwesizathu, noma unenkinga yokuphefumula lapho ukhuphuka izitebhisi? Mhlawumbe udokotela wakho ukutshelile ukuthi inhliziyo yakho isebenza kancane kancane, okusho ukuthi unesifo esibizwa ngokuthi 'Ukwehluleka Kwenhliziyo'. Into eyinhloko eyenzekayo ezimweni ezinjalo ukuthi amakamelo enhliziyo awashayi ngesikhathi esifanayo nangesigqi esifanayo. Ngenxa yalokhu, inhliziyo ayikwazi ukupompa igazi elidingwa ngumzimba ngendlela efanele. Lesi yisisombululo sale nkinga esikhuluma ngayo namuhla, lokhu kwelashwa okukhethekile okubizwa ngokuthi i-CRT.

Kalula nje, luyini lolu hlobo lokwelashwa kwe-CRT?

I-CRT isifinyezo se-'Cardiac Resynchronization Therapy'. Uma sikhuluma iqiniso, lena inqubo lapho kufakwa khona i-pacemaker ekhethekile enhliziyweni ngenqubo encane yokuhlinzwa. Elinye igama lalokhu 'yi-biventricular pacing'.

Cabanga nje, inhliziyo yethu inezindawo ezimbili ezingezansi, esizibiza ngokuthi ama-ventricle ngokwezokwelapha. Enhliziyweni enempilo, zombili lezi zindawo kufanele zifinyele ndawonye, ​​ngesikhathi esifanayo, ukuze zipompe igazi liye emzimbeni. Kodwa ezimweni ezifana nokwehluleka kwenhliziyo, lezi zindawo ezimbili zifinyele ngezikhathi ezahlukene. Lokhu kubizwa ngokuthi 'i-dyssynchrony.' Ngaleso sikhathi, lokho okwenziwa yile divayisi ye-CRT ukuthumela izimpawu zikagesi ezincane ukuze zenze zombili lezi zindawo zishaye ngesikhathi esifanayo, ngesigqi esifanayo. Okusho ukuthi, ivumelanisa kabusha ukushaya kwenhliziyo.

Isebenza kanjani le divayisi ye-CRT?

Cishe uke wezwa ngabapheki benhliziyo abavamile. Banophawu olulodwa noma ezimbili. Kodwa lo phawu lwenhliziyo lwe-CRT lunophawu oluthathu . Yilokhu okukhethekile.

Cabanga nje, enye yalezi zintambo ezintathu ixhunywe kwi-ventricle yesokudla yenhliziyo, kanti enye ixhunywe kwi-ventricle yesobunxele. Intambo yesithathu ixhunywe kwi-atrium yesokudla, okuyigumbi elingaphezulu kwenhliziyo. Ngakho-ke, isigqi senhliziyo siqashwa njalo ngalezi zintambo ezintathu. Uma kubonakala ukungahambi kahle kwesigqi, okungukuthi, uma amakamelo engashayi ndawonye, ​​le divayisi ithumela isignali encane kagesi ngesikhathi esifanele futhi yenza lawo makamelo asebenze ndawonye. Kufana nomqhubi we-orchestra, elawula wonke umuntu ngesigqi esisodwa.

Uyini umehluko phakathi kwe-CRT ne-ICD?

Kungenzeka ukuthi uke wezwa ngedivayisi ebizwa ngokuthi i-ICD. Ungazididanisi lezi ezimbili. Lezi ezimbili zenza imisebenzi emibili. Ake siqonde lokhu ngethebula.

Kodwa kukhona okunye. Ezinye iziguli zingase zibe nazo zombili lezi zinkinga. Okusho ukuthi, amakamelo enhliziyo awashayi ndawonye, ​​​​futhi kwenzeka izigqi ezisheshayo ngendlela eyingozi. Kubantu abanjalo, odokotela batusa ukufaka inhlanganisela yalezi zixhobo ezimbili (idivayisi ye-CRT-D) .

Ubani odinga lokhu kwelashwa?

Ngokuvamile, abantu abanezigqi zenhliziyo ezingajwayelekile (ama-arrhythmia) badinga lolu hlobo lwe-pacemaker. Kodwa-ke, ukwelashwa kwe-CRT kunconywa ngokukhethekile kubantu abahlangabezana nezindinganiso ezithile. Kungaba nezizathu eziningana zokuthi kungani inhliziyo ingaba buthakathaka noma ibe nesigqi esingajwayelekile.

• Ukwehluleka Kwenhliziyo: Inhliziyo ayikwazi ukupompa igazi elanele emzimbeni.
• Ukulimala kwenhliziyo okubangelwa ukuhlaselwa yinhliziyo kwangaphambilini .
• Ukusebenza kwenhliziyo kuyehla njengoba umuntu ekhula.
• Ngenxa yemithi ethile.
• Isifo senhliziyo esizalwa naso .
• Ukuphazamiseka ekudlulisweni kwezimpawu zikagesi enhliziyweni. Isibonelo, isimo esibizwa ngokuthi 'i-Bundle Branch Block' .

Kodwa khumbula, lapho imithi kanye nezinguquko zendlela yokuphila zehluleka ukulawula izinga lokushaya kwenhliziyo yakho, odokotela bazobheka i-CRT njengesinyathelo esilandelayo. Udokotela wakho wenhliziyo kuphela ongenza isinqumo sokugcina mayelana nokuthi lokhu kulungile yini kuwe.

Indlela ukuhlinzwa okwenziwa ngayo

Kwenzekani ngaphambi kokuhlinzwa?

Ezinsukwini ezimbalwa ngaphambi kokuhlinzwa, udokotela wakho uzoyala ukuhlolwa okuningana ukuhlola ukusebenza kanye nokwakheka kwenhliziyo yakho. Isibonelo, ungase ucelwe ukuba uhlolwe inhliziyo nge-MRI noma i-Transthoracic Echocardiogram (TTE) . Uzonikezwa i-anesthesia ukuze uvimbele ukuthi uzwe ubuhlungu ngesikhathi sokuhlinzwa. Ungalaliswa futhi.

Ngesikhathi sokuhlinzwa...

1. Okokuqala, udokotela ufaka izintambo ezintathu ezikhethekile ezindaweni ezithile enhliziyweni yakho, kungaba ngomthambo osehlombe lakho noma mhlawumbe ethangeni lakho.

2. Okulandelayo, kwenziwa ukusika okuncane esikhumbeni esingaphansi kwehlombe ukuze kudalwe iphakethe elincane lokubamba idivayisi ye-pacemaker (ibhokisi elincane eliqukethe ibhethri kanye ne-circuitry).

3. Izintambo ezithunyelwa enhliziyweni zixhunywe kule divayisi bese zihlolwa ukuze kubonakale ukuthi isebenza kahle yini.

4. Uma konke kulungile, idivayisi ifakwa ngaphakathi kwephakethe elidaliwe, bese ukusika kwesikhumba kuvalwa ngezithungo ezincibilikayo.

Kwenzekani ngemva kokuhlinzwa?

• Kuzodingeka uhlale esibhedlela amahora ambalwa noma ubusuku bonke.
• Njengoba uke waphathwa i-anesthesia, ungashayeli ngemoto uye ekhaya. Kuzodingeka uhambe nomunye umuntu.
• Bakutshela ukuthi uvimbele ingalo yakho yesobunxele ukuthi inganyakazi kakhulu cishe amahora ayi-12 ngemva kokuhlinzwa kuze kube yilapho izintambo zingena endaweni yazo.
• Uzonikezwa ikhadi elikhethekile. Liqukethe imininingwane mayelana nedivayisi efakwe kuwe. Kubaluleke kakhulu ukugcina leli khadi nawe ngaso sonke isikhathi . Lokhu kuyadingeka ezindaweni ezifana nezikhumulo zezindiza.
• Kungase kudingeke uthathe i-X-ray ukuqinisekisa ukuthi izintambo zisendaweni efanele, noma kungadingeka wenze i -EKG (electrocardiogram) ukuhlola isigqi senhliziyo yakho.

Izinzuzo kanye nezingozi zokwelashwa kwe-CRT

Izinzuzo zokwelashwa

Uma lokhu kwelashwa kuphumelela, izinga lempilo yakho lingathuthuka kakhulu.

• Inani legazi elimpontshelwa yinhliziyo emzimbeni liyakhula.
• Ukusebenza kahle kwenhliziyo kuyanda.
• Izimpawu ezifana nokuphelelwa umoya nokukhathala ziyancipha.
• Kunciphisa ingozi yokushaya kwenhliziyo okungajwayelekile.
• Isikhathi sokuphila singase sande.
• Ngisho nezimo ezifana nokubuyela emuva kwe-mitral, lapho igazi ligeleza khona libuyela emuva nge-valve yenhliziyo, zingathuthuka.
• Ikhono lokuzivocavoca liyathuthuka.

Akukho yini ingozi kulokhu?

Njenganoma yikuphi ukuhlinzwa, kunezingozi ezithile. Kodwa-ke, lezi azivamile. Udokotela wakho uzoxoxa nawe ngazo futhi achaze izinzuzo nezingozi zokwelashwa.

• Izintambo ezifakiwe ziyaphuka noma ziyasuka endaweni yazo.
• Ukutheleleka endaweni yokuhlinzwa.
• Amahlule egazi .
• Ukusabela kokungezwani komzimba nemithi yokubulala izinzwa noma yini enye.
• Ukuba nenye inkinga yenhliziyo, njengokuhlaselwa yinhliziyo (okungavamile kakhulu).

Ukululama nokufuna iseluleko sezokwelapha

Ungaqhubeka nemisebenzi evamile zingakapheli izinsuku ezimbalwa ngemva kokuhlinzwa. Kodwa-ke, odokotela bakweluleka ukuthi ungenzi lutho olufana nokushayela noma ukuphakamisa izinsimbi isonto elilodwa noma amabili . Ibhethri elikulesi sixhobo sokulawula ijubane elifakiwe livame ukuhlala iminyaka engaba ngu-7-10. Uma ibhethri liba buthaka, lingashintshwa ngolunye ukuhlinzwa okuncane.

Kufanele ubonane nini nodokotela?

Uzoba ne-aphoyintimenti yokulandelela cishe inyanga ngemuva kokuhlinzwa. Ngemva kwalokho, kuzodingeka ubone udokotela kanye noma kabili ngonyaka. Bazohlola idivayisi, ibhethri, kanye nezintambo kukhompyutha ukuqinisekisa ukuthi zisebenza kahle.

Kubaluleke kakhulu: Uma uba nomkhuhlane, noma uma indawo lapho idivayisi ifakwe khona iba bomvu, ivuvukala, noma ibuhlungu, amasonto noma izinyanga ngemva kokuhlinzwa, shayela udokotela wakho ngokushesha. Lokhu kungaba uphawu lokutheleleka.