Wake wambona umuntu onezitho zakhe eziqhaqhazelayo futhi engakwazi ukuhamba kahle, okunzima ukulawula ukuxhuzula kwakhe ngemithi? Noma umuntu onesifo sokuxhuzula esingenakukwazi ukulawula ngisho nangemithi? Asikwazi ngisho nokucabanga ukuthi kunzima kangakanani ukuphila nezimo ezinjalo. Kodwa ngokuthuthuka kwesayensi yezokwelapha, manje sekukhona izindlela ezintsha zokwelapha ezinganikeza impumuzo ezigulini ezinjalo. Namuhla, sizokhuluma ngenye yezindlela zokwelapha ezikhethekile. Lokho yi-Deep Brain Stimulation, noma ukwelashwa kwe-DBS ngamafuphi.
Kalula nje, kuyini ukukhuthazwa kobuchopho obujulile (i-DBS)?
Leli gama lizwakala liyesabeka kancane, akunjalo? Ungase ucabange, "Ingabe kufana nokunikeza ugesi ebuchosheni?" Eqinisweni, lichazwa kalula kanje. I-DBS inqubo yokuhlinzwa ethumela izimpawu zikagesi ezicashile kakhulu engxenyeni ethile, ejulile yobuchopho. Njengoba nje i-pacemaker ifakwa ukuze kubuyiselwe ukusebenza kwenhliziyo okuvamile lapho inhliziyo ingajwayelekile, ungacabanga ngalokhu njenge -pacemaker efakwa ebuchosheni .
Okwenzekayo ukuthi izintambo ezincane kakhulu (ezibizwa ngokuthi ama-electrode) zifakwa ebuchosheni lapho inkinga ikhona khona. Izintambo zibe sezixhunywa kudivayisi encane efana nebhethri (ebizwa ngokuthi i-pulse generator) efakwe ngaphansi kwesikhumba eduze kwethambo lakho lentamo. Idivayisi ithumela izimpawu ezincane zikagesi ukuze ivuselele amangqamuzana obuchopho. Lezi zimpawu zikagesi zibangela ukuthi ubuchopho buqale ukusebenza ngendlela evamile futhi.
Kungani sidinga lokhu kwelashwa kwe-DBS?
Ubuchopho bethu buyindawo emangalisayo lapho izigidigidi zamaseli ezinzwa, noma ama-neurons, asebenza ndawonye. La ma-neurons axhumana wodwa ngezibonakaliso zikagesi nezamakhemikhali. Cabanga ukuthi uma ufuna ukuphakamisa isandla sakho, isignali ehambisanayo isuka ebuchosheni iye esandleni ngale nethiwekhi yama-neurons.
Kodwa-ke, ngenxa yezifo ezithile, ukusebenza kwala ma-neuron kwezinye izingxenye zobuchopho kwehla noma kuba okungajwayelekile. Ngemuva kwalokho, imisebenzi yomzimba elawulwa yileyo ngxenye ayikwazi ukwenziwa kahle. Isibonelo, uma ama-neuron engxenyeni elawula ukunyakaza engasebenzi kahle, izinto ezifana nokuthuthumela ezithweni zomzimba kanye nobunzima bokuhamba zingase zenzeke.
Ukwelashwa kwe-DBS kusebenza ngokuletha izimpawu zikagesi ezicashile ngokwenziwa ukuze kuvuseleleke la ma-neuron alele. Lokhu kunganikeza impumuzo ebalulekile ezimpawini. Kodwa-ke, abacwaningi basafunda ukuthi lokhu kwenzeka kanjani.
Yiziphi izimo eziphathwa ngempumelelo nge-DBS?
Ukwelashwa kwe-DBS kusetshenziselwa kakhulu ukwelapha izifo eziningana ezihlobene nokusebenza kobuchopho. Phakathi kwalezi zifo, lokhu kwelashwa kuye kwabonakala kusebenza kakhulu. Ake sibheke ukuthi ziyini.
| Isigaba sesifo | Incazelo nezibonelo |
|---|---|
| Izimo ezivunyelwe ukwelashwa kwe-DBS | |
| Isifo sikaParkinson | Lokhu kwelashwa kusebenza kahle kakhulu uma lesi sifo sesithuthukile futhi impendulo yemithi inciphile. Izimpawu ezifana nokuthuthumela ezithweni, ukuqina komzimba, kanye nobunzima bokuhamba ziyancipha kakhulu. |
| Ukuduma Okubalulekile | Lesi yisimo, njengesifo sikaParkinson, esibangela ukuthuthumela emzimbeni. Ukuthuthumela kuyanda, ikakhulukazi uma uzama ukwenza okuthile (njengokuphuza ingilazi yamanzi, ukubhala). I-DBS ingasiza ekulawuleni lesi simo. |
| I-Dystonia | Okwenzekayo kulesi simo ukuthi imisipha iyafinyela ngokuzenzakalelayo, okwenza umzimba uthathe ukuma okusontekile. Ukwelashwa kwe-DBS nakho kusetshenziswa ngempumelelo kulesi simo. |
| Isifo Sokuxhuzula Esimelana Nemithi | Ukwelashwa kwe-DBS kuyindlela enhle yeziguli ezingakwazi ukulawula ukuquleka kwazo naphezu kokusebenzisa imithi eminingana evamile. |
| I-OCD engamelani nemithi | Ukwelashwa kwe-DBS kuyasetshenziswa nasezimweni lapho isimo sengqondo i-Obsessive-Compulsive Disorder (OCD) sisezingeni elibi kakhulu futhi singenakulawulwa ngemithi. |
| Izifo okungaba usizo kuzo ukwelashwa kwe-DBS | |
| Ezinye izimo | Ucwaningo lusaqhubeka mayelana nokusebenza kahle kokwelashwa kwe-DBS ezimweni ezifana nobuhlungu obukhulu, i-Tourette syndrome, ukucindezeleka okukhulu, ukulutheka, kanye nesifo i-Alzheimer's. |
Into ebalulekile ukuthi i-DBS akuyona indlela yokwelapha eyodwa efanelana nazo zonke izinhlobo. Ithimba lochwepheshe bezokwelapha lizonquma ukuthi lokhu kwelashwa kukufanele yini, licabangela izici eziningi, njengesimo sakho, ubukhali baso, kanye nempendulo yakho emithini.
Kwenzekani ngaphambi kokuhlinzwa?
Uma unquma ukwenza ukuhlinzwa kwe-DBS, kunezinyathelo eziningana okudingeka uzithathe ukuze uzilungiselele.
1. Ingxoxo nodokotela: Okokuqala, udokotela wakho uzokuchazela zonke izinzuzo, ukungalungi, kanye nezingozi zalokhu kuhlinzwa. Lesi yisikhathi esihle kakhulu sokuthola izimpendulo zayo yonke imibuzo yakho.
2. Ukuhlolwa kwezokwelapha: Ukuhlolwa okuningana, okufana ne-MRI kanye ne-CT scan, kwenziwa ukuze kubonakale ukuthi umzimba wakho usesimweni esifanele yini salokhu kuhlinzwa. Udokotela ohlinzayo usebenzisa izithombe ezivela kulezi scan ukuze anqume indawo engcono kakhulu yokufaka i-electrode ebuchosheni bakho.
3. Ukwaziswa Ngemithi: Kufanele utshele udokotela wakho nganoma yimiphi imithi oyithathayo njengamanje, ikakhulukazi imithi yokunciphisa igazi. Angase akucebise ukuthi uyeke ukuthatha imithi ethile isikhashana ngaphambi kokuhlinzwa. Ungalokothi uyeke ukuthatha noma yimiphi imithi ngaphandle kokukhuluma nodokotela wakho kuqala.
4. Ukuzila Ukudla: Njengoba ukuhlinzwa kuzokwenziwa ngaphansi kwe-anesthesia ejwayelekile, uzokwaziswa ukuthi ungadli futhi ungaphuzi amahora ambalwa ngaphambi kokuhlinzwa (ukuzila ukudla).
Kwenzekani ngesikhathi sokuhlinzwa?
Ukwelashwa kwe-DBS akuyona ngempela ukuhlinzwa okukodwa. Ngokuvamile kuwuchungechunge lokuhlinzwa okubili noma okuthathu okwenziwa ngezinsuku ezahlukene.
Isinyathelo Sokuqala: Ukufaka Ama-Electrode Ebuchosheni
Lokhu ukuhlinzwa okubaluleke kakhulu.
- Okokuqala, izinwele zakho ziyagundwa. Ngemuva kwalokho, ikhanda lakho lifakwa ohlakeni olukhethekile ukuze lihlale linganyakazi. Unikwa umuthi wokudambisa ukuze uzizwe unesiyezi, ukuze ungakhumbuli.
- Ngemuva kwalokho, kwenziwa i-CT scan ukuze kutholakale indlela efanele yokufaka i-electrode.
- Udokotela ohlinzayo ufaka umuthi wokwenza isikhumba sekhanda kanye nogebhezi lungabi namizwa, bese enza imbobo encane kakhulu ogebhezini.
- Ngalesi sikhathi, ikakhulukazi uma welapha izinkinga zokunyakaza ezifana ne-Parkinson's,Ungase uvuke. Ungesabi lokhu. Ngeke uzwe ubuhlungu, ngoba ubuchopho bethu abukwazi ukubona ubuhlungu ngqo .
- Ngesikhathi uphapheme, udokotela uzokucela ukuthi wenze izinto ezincane. Isibonelo, phendula imibuzo, ubuke izithombe, bese unyakazisa izingalo nemilenze yakho. Lokhu kwenzelwa ukuqinisekisa ukuthi ama-electrode asendaweni efanele ebuchosheni bakho.
- Uma i-electrode isibekwe kahle, ingxenye eveziwe ilethwa ngaphansi kwesikhumba ngemuva kwekhanda bese imbozwa okwesikhashana ngepulasitiki. I-incision ibe isithungwa ivalwe. Ngokuvamile uzohlala esibhedlela ubusuku bonke bese ukwazi ukuya ekhaya ngosuku olulandelayo.
Isinyathelo Sesibili: Ukufaka i-Pulse Generator
Lokhu kuhlinzwa kuvame ukwenziwa ngosuku oluhlukile ngemva kokuhlinzwa kokuqala. Uzonikezwa i-anesthesia ephelele.
- Udokotela ohlinzayo wenza ukusika okuncane esikhumbeni ngaphansi nje kwethambo lakho lentamo.
- Kudalwa isikhala esincane (isikhwama) ngaphansi kwesikhumba bese kufakwa ijeneretha yokushaya kwenhliziyo, efana nebhethri, ngaphakathi kwaso.
- Bese kuthi, kudlule enye intambo (intambo yokwandisa) ngaphansi kwesikhumba isuka ku-electrode ekhanda ukuze ixhunywe kule generator ye-pulse.
- Konke lokhu kuxhunyiwe futhi ukusikwa kuthungiwe. Njengoba lokhu kuyindlela elula yokuhlinzwa, ungaya ekhaya ngalolo suku.
Kwenzekani ngemva kokuhlinzwa?
Ngemva kokuphela kokuhlinzwa, ingxenye ebaluleke kakhulu iqala: ukuhlela idivayisi .
Emasontweni ambalwa ngemva kokuhlinzwa, udokotela wakho uzokubiza. Yilapho-ke ijeneretha yokushaya kwenhliziyo izovulwa futhi ihlelwe.
Lokhu kufana nokulungisa umsakazo esiteshini esithile. Udinga ukulungisa izilungiselelo zezimpawu zikagesi ukuze unikeze impumuzo enkulu yezimpawu zakho futhi unciphise imiphumela emibi. Lokhu kungadinga ukuvakashela udokotela kaningana.
Amabhethri akulezi zinjini zokukhiqiza ama-pulse avame ukuhlala iminyaka emi-3-5. Amanye angashajwa kabusha, futhi angahlala iminyaka efinyelela kweyi-9. Ukushintsha ibhethri nakho kudinga ukuhlinzwa okuncane, kodwa kulula kakhulu kunokuhlinzwa kokuqala.
Yiziphi izinzuzo zokwelashwa kwe-DBS?
- Inketho enhle yeziguli ezingakwazi ukulawulwa ngemithi: I-DBS iyithemba elihle lokuphila lapho imithi ingasebenzi noma imiphumela emibi yemithi ingabekezeleleki. Futhi iyasiza ekunciphiseni umthamo wemithi yeziguli ze-Parkinson.
- Ukwelashwa okushintsha impilo: Kumuntu obengakwazi ngisho nokwenza imisebenzi eyisisekelo ngenxa yezimpawu ezinzima, kuyinto enhle ukukwazi ukwenza umsebenzi wakhe eyedwa futhi.
- Okulungisekayo: Uma isimo sakho sishintsha ngokuhamba kwesikhathi, ungalungisa izilungiselelo zejeneretha ye-pulse ukuze zivumelane.
- Okungaguqulwa:Uma lokhu kwelashwa kungakufanele nganoma iyiphi indlela, noma uma uhlangabezana nemiphumela emibi engabekezeleleki, idivayisi ingasuswa ngokuphelele kolunye ukuhlinzwa.
Azikho yini izingozi nezinkinga ngalokhu kuhlinzwa?
Njenganoma yikuphi ukuhlinzwa, ukuhlinzwa kwe-DBS kungaba nezingozi nezinkinga. Udokotela wakho uzokuchazela lokhu ngokuningiliziwe.
| Uhlobo lwengozi | Izinkinga ezingaba khona |
|---|---|
| Izingozi ezihlobene nokuhlinzwa |
|
| Izinkinga ezihlobene nedivayisi | |
| Imiphumela emibi engaba khona yokukhuthaza | Lokhu kuvame ukwenzeka ngesikhathi sokuhlela futhi kuyanyamalala lapho izilungiselelo zishintshwa.
|
Isikhathi sokululama nezinto okufanele uziqaphele
Kungathatha amasonto ambalwa ukululama ngokuphelele ngemva kokuhlinzwa. Phakathi nalesi sikhathi, kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngokucophelela.
- Ukuphumula: Gwema noma yimuphi umsebenzi onzima cishe amasonto amabili ngemva kokuhlinzwa kokubili. Ungaphakamisi lutho olusinda ngaphezu kwamakhilogremu angu-2.5.
- Ukuzivocavoca: Gwema ukuzivocavoca noma umsebenzi onzima amasonto angu-4-6.
- Qaphela: Gwema ukuphakamisa izingalo zakho izinsuku ezimbalwa ngemva kokufakwa kwejeneretha yokushaya kwenhliziyo.
- Ukugcina inxeba lihlanzekile: Gcina amanxeba ekhanda nasesifubeni ehlanzekile futhi omile. Shintsha ibhandeji njengoba kuqondiswe udokotela. Sebenzisa isihlanzi esithambile njengeshampu yengane lapho ugeza. Ungaklwebhi inxeba.
Isikhathi sokubona udokotela ngokushesha
Njengoba i-DBS iwukuhlinzwa kobuchopho, kufanele uqaphele kakhulu izimpawu ezithile eziyisixwayiso. Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, shayela udokotela wakho ngokushesha, noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze nawe.
* Ikhanda elibuhlungu elingapheli, elinzima neliqhubekayo.
* Ukopha ngenxa yokusikeka.
* Ubomvu, ukuvuvukala, noma ukufudumala okungavamile okuzungeze inxeba (lezi yizimpawu zokutheleleka).
* Ushintsho oluzumayo embonweni (ukubona kabili, ukubona okufiphele).
* Umkhuhlane ongu-38.3 Celsius (101 Fahrenheit) noma ngaphezulu.
Eminye imibuzo evamile mayelana ne-DBS
Angikwazi yini ukusebenzisa amadivayisi kagesi uma ngine-DBS?
Ngokuvamile, izinto zasendlini ezifana nama-microwave, amakhompyutha, kanye nama-smartphone azibangeli izinkinga. Kodwa-ke, izinto zokuthola insimbi ezikhumulweni zezindiza kanye nezikena ezilwa nokwebiwa kwezinye izitolo zingase zithinteke yile divayisi. Udokotela uzokunikeza ikhadi lomazisi elikhethekile ongalisebenzisa ezimweni ezinjalo.
Okubaluleke kakhulu: Ngemva kokufakwa kwedivayisi ye-DBS, ukuhlolwa kwezokwelapha kanye nokwelashwa okufana nokuskena kwe-MRI, ukukhuthazwa kwe-transcranial magnetic (TMS), kanye ne-diathermy akukwazi ukwenziwa.
Ingabe i-DBS iyayelapha ngokuphelele lesifo?
Cha. I-DBS ayilona ikhambi, iyindlela yokwelapha . Isetshenziselwa ukulawula izimpawu. Izimo eziningi eziphathwa ngale ndlela yokwelapha zingokuphila konke.
Ngingayeka yini ukuthatha imithi ngemva kwe-DBS?
Ungase ukwazi ukunciphisa umthamo wemithi oyithathayo, kodwa akuvamile ukuthi uyeke ngokuphelele. Ukwelashwa kwe-DBS kusebenza kahle kakhulu uma kusetshenziswa kanye nemithi kanye nezinye izindlela zokwelapha.
Umlayezo Wokuya Nawe Ekhaya
- Ukukhuthazwa Kobuchopho Obujulile (i-DBS) kuyindlela yokwelapha ethuthukisiwe elawula izimpawu zesifo sikaParkinson kanye nesifo sokuwa ngokuletha izimpawu zikagesi ezicashile ezindaweni ezithile zobuchopho.
- Lokhu kufana ne-pacemaker efakwe ebuchosheni. Ngokuvamile kunconywa iziguli ezinesifo sokuwa okunzima ukuzilawula ngemithi.
- Lokhu kuqukethe ukuhlinzwa okubili, futhi ngemva kokufakelwa idivayisi, kubalulekile ukuyihlela ukuze ivumelane nesiguli.
- I-DBS akuyona ikhambi lesifo, kodwa iyindlela yokwelapha elawula izimpawu futhi ithuthukise ikhwalithi yokuphila.
- Kubaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha uma kuvela izimpawu eziyisixwayiso (ikhanda elibuhlungu, umkhuhlane) ngemva kokuhlinzwa.
- Ithimba lochwepheshe bezokwelapha kuphela elinganquma ukuthi lokhu kwelashwa kukufanele yini, ngakho-ke uma ufuna ukwazi okwengeziwe ngalokhu, khuluma nodokotela wakho.
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