Kungenzeka ukuthi awukaze uzwe ngochwepheshe ohlola ukuthi uhlelo lwakho lwezinzwa, oluhlanganisa ubuchopho bakho, intambo yomgogodla, kanye nenethiwekhi yezinzwa ezisebenza emzimbeni wakho wonke, lusebenza kahle yini. Njengochwepheshe ohlola ukuthi izintambo endlini yakho zisebenza kahle yini, zine-short ndawana thize, noma uma ugesi uphansi, lo dokotela uphinde ahlole "uhlelo lukagesi" lomzimba wakho. Namuhla sikhuluma ngalochwepheshe, i-Neurophysiologist.
Kalula nje, ubani i-Neurophysiologist?
Isazi sezinzwa singuchwepheshe ofunda ukusebenza kwesimiso sethu sezinzwa, ikakhulukazi umsebenzi waso kagesi , futhi ahlole futhi axilonge izifo ezihlobene naso.
Cabanga ngakho, umzimba wethu ungumshini oyinkimbinkimbi kakhulu. Igumbi lokulawula lalo mshini yisimiso sezinzwa. Okusho ukuthi, ubuchopho, umgogodla, kanye nemizwa ethwala ulwazi emzimbeni wonke. Konke okucabangayo, okuzwayo, nokwenzayo kulawulwa yilesi simiso. Kusukela ngesikhathi uphakamisa isandla sakho kuze kube yilapho inhliziyo yakho ishaya, konke kuyingxenye yaso.
Ngakho-ke uma kunenkinga ngalolu hlelo, kungakhathaliseki ukuthi kuyinkinga ngokuhamba kolwazi noma inkinga ngezibonakaliso zikagesi, udokotela wezinzwa uzosiza ekutholeni lokho.
Udokotela Wezinzwa kanye Nodokotela Wezinzwa - Uyini umehluko phakathi kwalaba ababili?
La magama amabili avame ukudidaniswa. Womabili angodokotela abasebenza ohlelweni lwezinzwa. Kodwa kunomehluko omncane. Ake siqonde lokhu ngesibonelo.
Ake sithi kunenkinga ngohlelo lokukhanyisa endlini yakho. Uzoqala ukhulume nochwepheshe kagesi ojwayelekile. Angabheka lonke uhlelo lokuxhuma izintambo endlini, abone ukuthi i-fuse ivuvukile, iswishi inephutha, isibani sishile, bese ethola isithombe esikhulu. Yilokho uDokotela Wezinzwa ayikho. Ungudokotela onolwazi olubanzi ngazo zonke izici zohlelo lwezinzwa, okungukuthi, isakhiwo salo, umsebenzi walo, nazo zonke izifo ezihlobene nalo. UDokotela Wezinzwa unikeza imithi yakho futhi uhlela ukwelashwa kwakho.
Manje ake ucabange ukuthi kunenkinga eyinkimbinkimbi kakhulu uchwepheshe kagesi angayitholi. I-voltage yamandla kagesi iyancipha, kubonakala sengathi kukhona ukuvuza okuncane ndawana thize. Bese uletha umuntu osebenzisa amamitha akhethekile, uchwepheshe wokugeleza kwamandla kagesi. Yilokho i- Neurophysiologist eyikho. Unguchwepheshe ekusebenzeni kwesimiso sezinzwa, ikakhulukazi endleleni izimpawu zikagesi ezihamba ngayo. Lokho akwenzayo ukwenza izivivinyo ezahlukahlukene, ukuhlaziya imiphumela, nokuthola ukuthi inkinga iyini ekusebenzeni kwezinzwa.
Kalula nje, uDokotela Wezinzwa uxilonga futhi elapha izifo. UDokotela Wezinzwa wenza izivivinyo ezikhethekile futhi anikeze idatha ebalulekile edingekayo kulokho kuxilonga. Kodwa ngokuvamile abanikezi ukwelashwa.
Izindima ezimbili eziyinhloko zesazi sezinzwa
Singahlukanisa odokotela bezinzwa ngezigaba ezimbili eziyinhloko, kuye ngendlela abasebenza ngayo.
1. Labo abasebenza ekuhlinzeni (Odokotela Bezinzwa Zokuhlinzwa)
2. Labo abaxilonga izifo emitholampilo (Clinical Neurophysiologists)
Ake sibheke indima yomuntu ngamunye kulaba bantu ngokwehlukana.
1. Indima Yodokotela Wezinzwa Ekuhlinzeni
Lena indawo ebaluleke kakhulu. Cabanga ngomuntu ohlinzwa kakhulu emgogodleni noma ebuchosheni. Ngesikhathi behlinzwa, odokotela abahlinzayo kudingeka baqaphe umonakalo wezinzwa. Uma kwenzeka iphutha elincane, umuntu angakhubazeka, alahlekelwe ukuzwa, noma ahlaselwe yisifo sohlangothi.
Yilapho-ke udokotela wezinzwa ejoyina iqembu lokuhlinzwa. Usebenzisa imishini ekhethekile ukuqapha umsebenzi kagesi wesimiso sezinzwa sesiguli kulo lonke ukuhlinzwa. Lokhu kubizwa ngokuthi i-Intraoperative Neurophysiology Monitoring (IONM) . Lapho inzwa ithinteke kancane, izimpawu zayo zikagesi ziyashintsha. Lapho nje udokotela wezinzwa ebona lolo shintsho, utshela udokotela ohlinzayo. Udokotela ohlinzayo angathatha izinyathelo ezidingekayo ngaphambi kokuba kwenzeke umonakalo.
| Uhlobo lokuhlinzwa | Indima yesazi sezinzwa |
|---|---|
| Ukuhlinzwa komgogodla | Ukuqapha umonakalo emgogodleni kanye nasezinzweni ezivela kuwo. Ukusiza ekuvimbeleni ukulahlekelwa yizitho zomzimba. |
| Ukuhlinzwa kobuchopho | Ukubona ukuthi izingxenye ezibalulekile zobuchopho, isibonelo, izingxenye ezihlobene nenkulumo, umbono, kanye nokunyakaza, zonakele yini. |
| Ukuhlinzwa kwendlebe, impumulo, nomphimbo (izinqubo ze-ENT) | Ukuvimbela ukulahlekelwa ukuzwa ngenxa yokulimala kwenzwa yokuzwa, ikakhulukazi ngesikhathi sokuhlinzwa kwendlebe. |
| Ukuhlinzwa kwemithambo yegazi | Ukuqapha umsebenzi wobuchopho ukuze kuvinjelwe umonakalo obangelwa ukwehla kokugeleza kwegazi ebuchosheni (ischemia). |
2. Udokotela wezinzwa owenza ukuxilongwa kwezokwelapha
Lona ngudokotela wezifo zengqondo esivame ukumbona, lowo udokotela wethu asithumela kuye. Basezibhedlela noma emitholampilo. Benza izivivinyo ezahlukahlukene ukuze babheke ukusebenza kwesimiso sezinzwa. Udokotela wakho wezifo zezinzwa uzonquma ukuthi yisiphi isimo obhekene naso ngokususelwa emiphumeleni yalezi zivivinyo.
Lezi ezinye zezivivinyo eziyinhloko abazenzayo:
- I-EMG (i-Electromyography): Lokhu kuhlolwa kubheka impilo yemisipha yakho kanye nezinzwa ezilawulayo. Uma une-numbness, ukuqaqamba, noma ubuthakathaka engalweni yakho, lokhu kuhlolwa kungasiza ekunqumeni ukuthi inkinga isemisipheni ngokwayo noma ezinzwa ezinikeza yona. Lokhu kubalulekile ekuxilongweni kwezimo ezifana ne -Carpal Tunnel Syndrome (i-pinched nerve esihlakaleni) kanye ne -Peripheral Neuropathy (umonakalo wezinzwa ezingalweni nasemilenzeni ngenxa yezimo ezifana nesifo sikashukela).
- I-NCS (Ucwaningo Lokuqhutshwa Kwezinzwa): Lokhu kulinganisa ukuthi kuthatha isikhathi esingakanani ukuthi isignali kagesi ihambe nge-nerve nokuthi ihamba ngesivinini esingakanani. Uma i-nerve yonakele, isivinini esihamba ngaso leso signali siyancipha. Ngokuvamile, kokubili ukuhlolwa kwe-EMG kanye ne-NCS kwenziwa ndawonye.
- I-EEG (i-Electroencephalogram): Kungenzeka ukuthi uke wezwa ngalokhu. Lokhu kuhilela ukunamathisela ama-electrode amancane ekhanda bese uqopha umsebenzi kagesi wobuchopho . Lokhu kuhlolwa kubalulekile ekuxilongeni izimo ezifana nesifo sokuwa nokuthola ukuthi imbangela ikuphi ebuchosheni.
- Ukuhlolwa Okungenzeka Okuvuswe: Lokhu kuhilela ukunikeza isikhuthazo, njengokukhanya emehlweni noma umsindo ezindlebeni, kanye nokulinganisa umsebenzi kagesi ebuchosheni nasentanjeni yomgogodla ngokuphendula kuwo. Okusho ukuthi, kulinganisa ukuthi lokho okubonayo ngamehlo akho kufinyelela ngokushesha kangakanani ebuchosheni, nokuthi lokho okuzwayo ngezindlebe zakho kufinyelela ngokushesha kangakanani ebuchosheni.
- Ucwaningo lokulala (Ucwaningo lokulala / i-Polysomnography):Abanye abantu banezinkinga ezifana nokuhona, ukuhamba ubuthongo, kanye nokuhona ngesikhathi sokulala. Ukuze kutholakale lezi zinkinga zokulala, isiguli siyalaliswa esibhedlela futhi imisebenzi ehlukahlukene yomzimba (amaza obuchopho, ukuphefumula, kanye nokushaya kwenhliziyo) iqashwe ubusuku bonke. Lokhu kwenziwa futhi yi-Neurophysiologist.
Ungaba kanjani i-Neurophysiologist?
Lolu uhambo olude kakhulu noluzinikele. Udokotela wezifo zengqondo ungudokotela. Ngakho-ke, kufanele uqale ubhalise esikoleni sezokwelapha bese uqedela iziqu zezokwelapha (MD/MBBS).
Bese:
- Kumelwe uqedele i-internship yonyaka owodwa.
- Ngemva kwalokho, udinga ukuqeqeshwa iminyaka eminingana (i-Residency/MD) ukuze uthole ulwazi olukhethekile ku-neurology.
- Ngemva kwalokho kuqeqeshwa, uzofunda ngokujulile ukusebenza kwesimiso sezinzwa bese uthola ukuqeqeshwa kochwepheshe ababizwa ngokuthi i-Neurophysiology.
Lokhu kudinga isikhathi esiningi, ukutadisha, kanye nokuzinikela.
Ngakho-ke uma udokotela wakho ekuthumelela ukuhlolwa okufana ne-EMG noma i-EEG, manje usuyazi ukuthi uzobona i-Neurophysiologist. Ungumuntu ozohlola isimiso sakho sezinzwa ngokujulile futhi akusize wenze ukuxilongwa okunembile kakhulu kwesimo sakho. Ngakho ungesabi, buza lowo dokotela noma yimiphi imibuzo noma ukukhathazeka ongase ube nakho. Bakhona ukukusiza.
Umlayezo Wokuya Nawe Ekhaya
- Isazi sezinzwa ngudokotela ogxile emsebenzini kagesi wesimiso sethu sezinzwa (ubuchopho, imizwa).
- Udokotela wezinzwa welapha izifo zezinzwa, kanti udokotela wezinzwa uyasiza ekuxilongeni lezo zifo ngokuhlolwa okukhethekile (njenge-EMG, i-EEG).
- Ngesikhathi sokuhlinzwa okukhulu (umgogodla, ubuchopho), usizo lukadokotela wezinzwa lubalulekile ukuqinisekisa ukuthi imizwa ayonakaliswa.
- Uma uthunyelwa ukuhlolwa okufana ne-EMG, i-NCS, noma i-EEG, uzohlolwa yi-Neurophysiologist. Ungesabi ukubuza udokotela wakho ngakho.
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