Wake wazizwa sengathi inhliziyo yakho yaqala ukushaya ngokushesha okukhulu, noma ukuthi yayishaya ngaphandle kwesigqi? Noma uthola umuzwa ongavamile njengovemvane olundiza esifubeni sakho? Ngokwezokwelapha, lesi simo sibizwa ngokuthi 'i-Arrhythmia' noma ukushaya kwenhliziyo okungajwayelekile. Namuhla sikhuluma ngendlela yokwelapha ekhethekile, kodwa ethuthukisiwe kakhulu esetshenziswa odokotela lapho lokhu kungenakulawuleka ngemithi.
Kalula nje, kuyini ukususwa kwenhliziyo?
I-Cardiac Ablation (eyaziwa nangokuthi i-Catheter Ablation) iyindlela yokwelapha izigqi zenhliziyo ezingavamile (ama-arrhythmia). Cabanga ukuthi inhliziyo yethu inohlelo lukagesi, futhi yizimpawu eziyitholayo ezenza ishaye kahle. Ngezinye izikhathi, izindawo ezincane zalolu hlelo lukagesi zingakhiqiza ama-pulse kagesi angavamile. Le nqubo ifuna izindawo zezicubu ezithumela lezo zimpawu ezingavamile bese "izicima."
Lokhu akuyona inqubo enkulu. Kwenziwa udokotela wezifo zenhliziyo. Ufaka ipayipi elincane kakhulu (i-catheter) enhliziyweni yakho ngomthambo osesinqeni sakho, engalweni, noma entanyeni. Ngemuva kwalokho, ukushisa (i-radiofrequency ablation), ukubanda okukhulu (i-cryoablation), noma amaza amandla amafushane (i-pulsed field ablation) athunyelwa ngaleli payipi, okudala izibazi ezincane esicutshini lapho kuvela khona izimpawu ezingavamile. Lezi zibazi zivimba izimpawu zikagesi ezingavamile ukuba zingahambi, futhi isigqi senhliziyo sibuyiselwa esimweni esijwayelekile.
Phakathi nalokhu kwelashwa, ungase unikezwe umuthi wokudambisa noma uthole umuthi wokubulala izinzwa ojwayelekile. Lokhu kuzoqinisekisa ukuthi awuzizwa ungakhululekile. Izibazi ezibangelwa yile nqubo azithinti ukusebenza kwenhliziyo.
Yiziphi izinhlobo zezimo eziphathwa yilolu hlobo lokwelashwa?
Ukususwa kwenhliziyo kuyindlela yokwelapha ukushaya kwenhliziyo okusheshayo kakhulu (i-tachyarrhythmias). Kodwa-ke, ngokuvamile ayinikezwa njengokwelashwa kokuqala. Udokotela wakho angasikisela lokhu kwelashwa kuphela uma i-arrhythmia yakho ingenakulawuleka ngemithi. Udokotela wakho uzohlola inhliziyo yakho ngokucophelela kanye nempilo yakho iyonke ngaphambi kokunquma ukuthi lokhu kwelashwa kulungile yini kuwe.
Lokhu kwelashwa kuvame ukusetshenziswa kakhulu kulezi zimo ezilandelayo.
| Isimo | Incazelo elula |
|---|---|
| I-Atrial Fibrillation (i-Afib) kanye ne-Atrial Flutter | Amakamelo aphezulu enhliziyo (i-atria) ashaya ngokungajwayelekile nangokushesha. Lokhu kungandisa ingozi yokuqhekeka kwegazi kanye nesifo sohlangothi. |
| I-Supraventricular Tachycardia (SVT) | Inhliziyo iqala ukushaya ngokushesha okukhulu (kufika izikhathi ezingu-300 ngomzuzu). Uma lokhu kuqhubeka, kungalimaza inhliziyo. |
| I-Ventricular Tachycardia (VT) | Amakamelo angaphansi enhliziyo (ama-ventricle) ashaya ngokushesha okukhulu. Lokhu kungaba yisimo esiyingozi kakhulu , njengoba kungaholela ekumisweni kwenhliziyo. |
Ngaphezu kwalokho, lokhu kwelashwa kunganconywa nakulabo abasengozini enkulu yezimo ezisongela ukuphila njengokuma kwenhliziyo okungazelelwe noma i-Ventricular Fibrillation (V-Fib).
Uzilungiselela kanjani ngaphambi kokwelashwa?
Ngaphambi kwale nqubo, kuzodingeka wenze okulandelayo:
- Yeka ukuthatha imithi yokunciphisa igazi: Uma uthatha imithi efana ne-aspirin noma i-warfarin, ungase ucelwe ukuthi uyeke ukuyithatha izinsuku ezimbalwa. Kodwa yenza lokhu kuphela njengoba kuyalelwe udokotela wakho, futhi kusukela ngosuku akutshela ngalo. Ungayeki noma nini lapho uzizwa sengathi ufuna.
- Gwema ukudla noma ukuphuza: Uzocelwa ukuthi uyeke ukudla noma ukuphuza amahora ambalwa ngaphambi kwenqubo, ngokuvamile ngemva kwamabili. Udokotela wakho uzokunikeza imiyalelo eqondile ngalokhu.
- Umuntu ozokusiza ukuthi uye ekhaya: Hlela kusenesikhathi ukuthi othile akuyise ekhaya ngemva kwenqubo.
- Kufakwa umugqa we-IV: Umugqa we-IV (njengepayipi elisetshenziselwa ukukunikeza i-saline) ufakwa emthanjeni osengalweni yakho. Yilapho uzonikezwa khona imithi edingekayo kanye ne-anesthesia.
- Izingubo nezinto: Gqoka izingubo ezikhululekile. Kungcono ukushiya ubucwebe nezinto eziyigugu ekhaya.
Kwenzekani ngesikhathi sokwelashwa?
Nasi isibuyekezo sesinyathelo ngesinyathelo salokho okwenzekayo ngesikhathi senqubo yokukhipha isisu:
1. Okokuqala, indawo lapho kuzofakwa khona i-catheter (ngokuvamile i-groin) iyahlanzwa futhi isikhumba siyavaleka.
2. Okulandelayo, kufakwa ithubhu elincane (umgoqo) emthanjeni wegazi, okudala indlela yokungena kwe-catheter.
3. Ama-catheter amahle anama-electrode adluliselwa emgodleni kanye nasemithanjeni yegazi aye enhliziyweni. Lokhu kwenziwa ngaphansi kwesiqondiso sendlela efana ne-X-ray.
4. Uma sezifike enhliziyweni, la ma-catheter 'ahlela' umsebenzi kagesi wenhliziyo futhi akhomba lapho kuvela khona izimpawu ezingalungile.
5. Uma indawo enenkinga isitholakala, amaza okushisa, abandayo, noma amandla athunyelwa esuka esiqongweni se-catheter ukuze aphathe izicubu futhi avimbele izimpawu ezingalungile ukuthi zingangeni.
6. Ekugcineni, i-catheter kanye ne-sheath kuyasuswa ngokucophelela.
Le nqubo yonke ingathatha amahora amabili kuya kwamane, ngezinye izikhathi isikhathi eside.
Kwenzekani ngemva kokwelashwa?
Ngemva kwenqubo, uzoyiswa ekamelweni lokululama. Kuzodingeka uhlale lapho amahora ambalwa. Umhlengikazi uzoqhubeka nokuqapha isimo sakho, ukushaya kwenhliziyo, kanye nomfutho wegazi. Kuye ngesimo sakho, ungase ukwazi ukuya ekhaya ngalolo suku, noma kungadingeka uhlale esibhedlela ubusuku bonke.
Uma usubuyela ekhaya, uzonikezwa imiyalelo ecacile okufanele uyilandele ekhaya. Udokotela wakho uzokunikeza i-aspirin noma omunye umuthi onciphisa igazi ukuze kuvinjelwe ukuqhekeka kwegazi. Lokhu kungadinga ukuthathwa izinyanga eziningana noma ngaphezulu.
Izinzuzo kanye nempumelelo yokwelashwa
Lena inqubo engadingi ukungenelela okuningi engadingi ukuhlala isikhathi eside esibhedlela, futhi ingasiza ekubuyiseleni ukushaya kwenhliziyo okuvamile okungenakukwazi ukulawulwa ngemithi. Kwezinye izimo, kungaba ukwelashwa okusindisa impilo .
Uma kuphumelele, kuncike ohlotsheni lwe-arrhythmia onayo.
- Izimo ezifana ne-SVT zinezinga eliphezulu lempumelelo elingu- 90% - 95% .
- Ezimweni ezifana ne-Afib kanye ne-VT, izinga lempumelelo liphakathi kuka- 60% - 80% .
Yiziphi izingozi nezinto okufanele uzazi?
Izingozi zokususwa kwenhliziyo ziphansi kakhulu. Izinkinga azivamile, ikakhulukazi esibhedlela lapho lolu hlobo lokwelashwa lwenziwa khona njalo. Kodwa-ke, kunezingozi ezithile ezingaba khona okufanele uziqaphele:
- Amahlule egazi
- Ukulimala kwe-catheter emithanjeni yegazi noma kuma-valve enhliziyo
- Ukutheleleka noma ukuphuma kwegazi
- Isifo sohlangothi
- Kudingeka ukuthi kufakwe i-pacemaker ehlala njalo
Uma ungumama okhulelwe, khuluma nodokotela wakho mayelana nokuthi lokhu kwelashwa kungahlehliswa yini kuze kube yilapho umntwana esezelwe.
Ngezinye izikhathi ukwelashwa okukodwa kokukhipha isisu kungase kungayiqedi ngokuphelele leso simo. Uma izimpawu zibuya, kungase kudingeke okunye ukwelashwa kokukhipha isisu esikhathini esizayo. Futhi, imiphumela yokwelashwa ingase ingabi khona ngokushesha. Ezinye izimpawu zingase ziqhubeke amasonto amaningana ngenkathi izicubu zenhliziyo zelapheka.
Ukululama kanye nesikhathi sokubonana nodokotela
Kungathatha amasonto amaningana ukuphulukiswa ngokuphelele. Gwema ukuphakamisa isisindo esingaphezu kwama-5 kg noma ukwenza ukuzivocavoca okunzima okungenani isonto lonke ngemva kwenqubo. Buza udokotela wakho ukuthi ungabuyela nini emsebenzini bese ushayela.
Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, shayela udokotela wakho ngokushesha.
| Izimpawu ezidinga usizo lwezokwelapha ngokushesha | |
|---|---|
| Ukopha noma ukuvuvukala okufana neqhubu lapho kufakwe khona i-catheter | Ubuhlungu besifuba |
| Isiyezi noma ukuquleka | Ukuzwa ukuthi inhliziyo ishaya ngokushesha |
| Ukuvuvukala (i-edema) noma ubuhlungu lapho kufakwe khona i-catheter | Ukuba ndikindiki emlenzeni (uma kwenzeka kusukela embotsheni) |
| Isimo Esiphuthumayo! - Yiya ku-ETU ngokushesha: ukugoba kolunye uhlangothi lobuso, ubuthakathaka engalweni noma emlenzeni, ubunzima bokukhuluma (lokhu kungaba yizimpawu zokuhlaselwa yisifo sohlangothi). | |
Umlayezo Wokuya Nawe Ekhaya
- I-Cardiac Ablation iyindlela yokwelapha ephephile, engangenisi umfutho yokushaya kwenhliziyo okungajwayelekile (ama-arrhythmia).
- Lokhu kuvame ukunconywa uma lesi sifo singenakukwazi ukulawulwa ngemithi.
- Kuzothathwa izinyathelo ezidingekayo ukuqinisekisa ukuthi awuzizwa ubuhlungu ngesikhathi sokwelashwa.
- Kuzothatha amasonto ambalwa ukuphulukiswa ngokuphelele, futhi phakathi naleso sikhathi, kufanele ugweme ukuphakamisa okunzima nomsebenzi onzima.
- Qaphela izimpawu eziyisixwayiso ezingase zivele ngemva kokwelashwa. Uma unenkinga, yazisa udokotela wakho ngokushesha.
- Kuvamile ukuzizwa wesaba uma uzwa ngenqubo yenhliziyo. Kodwa lokhu kuyindlela yokwelapha enobungozi obuphansi futhi ephumelelayo. Ungesabi ukukhuluma nodokotela wakho nganoma yimiphi imibuzo onayo.
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