Ingabe ngezinye izikhathi uzizwa sengathi inhliziyo yakho ishaya ngokushesha kakhulu futhi ngokungajwayelekile? Lesi simo, esizwakala sengathi kukhona okungahambi kahle esifubeni sakho, sibizwa ngokuthi i-Atrial Fibrillation (Afib) . Lokhu kuyinto engajwayelekile emsindweni wenhliziyo. Uma ungakunaki lokhu, kungase kudingeke ubhekane nezimo ezibucayi njenge-stroke ngokuhamba kwesikhathi. Ngakho-ke, namuhla sikhuluma ngendlela ephumelela kakhulu futhi yesimanje yokwelapha lesi simo se-Afib.
Kuyini Ukuhlukaniswa Kwemithambo Yephaphu (i-PVI)?
Kalula nje, i-Pulmonary Vein Isolation (PVI) inqubo esetshenziselwa ukwelapha i-atrial fibrillation (Afib). Luhlobo lokuhlinzwa kwenhliziyo, kodwa akuyona ukuhlinzwa okukhulu.
Cabanga nje, umsebenzi wenhliziyo yethu ulawulwa uhlelo lwezimpawu zikagesi. E-Afib, lezi zimpawu zikagesi ziyadideka bese ziya enhliziyweni ngendlela engajwayelekile. Ngokuvamile, lezi zimpawu ezinephutha ziqala emithanjeni yegazi emine ethwala igazi elinomoya-mpilo lisuka emaphashini liye e-atrium yesobunxele yenhliziyo, ebizwa ngokuthi imithambo yamaphaphu .
Ngakho-ke, lokhu kwelashwa kwe-PVI okwenziwayo ukuhlonza izindawo lapho kuvela khona lezo zimpawu zikagesi ezinephutha bese kudala izicubu ezincane kakhulu zezibazi kulezo zindawo. Lokhu kubizwa ngokuthi i-heart ablation . Le zicubu zezibazi zisebenza njengodonga futhi zivimba lezo zimpawu zikagesi ezinephutha ukuthi zingasabalali kwezinye izingxenye zenhliziyo. Bese inhliziyo ishaya ngendlela evamile futhi.
Ubani ofanele lolu hlobo lokwelashwa?
Lokhu kwelashwa akusikho okwawo wonke umuntu. Udokotela wakho ungumuntu ongcono kakhulu onganquma. Lokhu kwelashwa kuvame ukunconywa kubantu aba:
- Kulabo abasenazo izimpawu naphezu kokuthatha imithi yokulwa nokuphazamiseka kwemizwa ukulawula isimo sabo se-Afib.
- Kulabo imizimba yabo engakwazi ukubekezelela leyo mithi noma abathola imiphumela emibi evela kuyo.
Ezinye izifundo manje zithole ukuthi ezinye iziguli zithola imiphumela engcono uma zisebenzisa i-PVI njengokwelashwa kokuqala, ngaphambi kokuqala imithi. Kodwa-ke, lokhu akukabi ukwelashwa okujwayelekile futhi kusacwaningwa.
Wazi kanjani ukuthi lokhu kwelashwa kulungile kuwe?
Ngaphambi kokunquma ukuthi lokhu kulungile yini kuwe, udokotela wakho uzokuxilonga kahle. Uzobuyekeza umlando wakho wezokwelapha kanye nanoma yikuphi ukuhlolwa okwenzile. Ezinye zezivivinyo ezivame ukwenziwa ngale njongo yilezi:
- I-Echocardiogram (Echo): Lokhu ukuskena kwenhliziyo nge-ultrasound. Kungabheka isakhiwo kanye nomsebenzi wenhliziyo.
- I-Electrocardiogram (EKG): Ukuhlolwa okuqopha umsebenzi kagesi wenhliziyo.
- Isikrini se-Holter:Lena idivayisi encane oyigqoka emzimbeni wakho eqapha ukushaya kwenhliziyo yakho isikhathi eside, njengamahora angu-24 noma angu-48.
Yiziphi izindlela zokwelapha?
Lokhu kwelashwa kwe-PVI kwenziwa kusetshenziswa indlela ebizwa ngokuthi i-catheter ablation . Okusho ukuthi, lokhu kwelashwa kwenziwa ngokudlulisa ithubhu elincane kakhulu neliguquguqukayo elibizwa ngokuthi i-catheter ngemithambo yegazi liye enhliziyweni. Kunezindlela ezimbili eziyinhloko zokulungisa izicubu zesibazi esikhulume ngazo ngaphambili.
| Indlela yokwelapha (Indlela Yokukhipha Isisu) | Indlela esebenza ngayo |
|---|---|
| Ukususwa Kwemisebe Yemisebe | Lena yindlela evame ukusetshenziswa kakhulu. Isebenzisa ukushisa okuvela kumaza omsakazo ukubhubhisa izicubu eziqondiwe. |
| Ukuhlanza | Lapha, ukubanda okukhulu kusetshenziselwa ukuqandisa okwesikhashana nokubhubhisa unomphela izicubu eziqondiwe. |
Akunakwenzeka ukusho ukuthi enye yalezi zindlela ezimbili ingcono kunenye. Imiphumela yazo zombili icishe ifane, futhi akukho mehluko omkhulu ekuphepheni. Udokotela wakho uzokuchazela ukuthi iyiphi indlela engcono kakhulu kuwe.
Kwenzekani ngesikhathi sokwelashwa?
Phakathi nalolu hlobo lokwelashwa, uzonikezwa i-anesthesia ephelele (i-anesthesia ejwayelekile), ngakho ngeke uzizwe ubuhlungu, uzobe ulele. Ngezinye izikhathi, kungasetshenziswa i-anesthetic yendawo kuphela. Uzokwaziswa ngalokhu kusenesikhathi.
Kalula nje, nakhu okwenzekayo:
1. Ngemva kokubulala izinzwa, kwenziwa ukusika okuncane kakhulu endaweni yesisu noma entanyeni.
2. Ngaleso simbozo, kudluliswa ama-catheter amabili ngomthambo wegazi aye e-atrium yesobunxele yenhliziyo.
3. I-catheter eyodwa ithola ngqo lapho kuvela khona izimpawu zikagesi ezinephutha.
4. Enye i-catheter ikhipha ukushisa noma ukubanda ukuze kudaleke izibazi kulezo zindawo.
5. Uma umsebenzi usuqediwe, ama-catheter amabili ayasuswa bese kuthi ukusikwa okuncane kuvalwe.
Inhliziyo yakho iqashwa kanjani ngesikhathi sokwelashwa?
Kuyo yonke inqubo yokwelapha, kuzosetshenziswa amadivayisi amaningana ukuqapha ukusebenza kwenhliziyo yakho kanye neminye imisebenzi yomzimba. Ungakhathazeki, konke lokhu kungenxa yokuphepha kwakho.
| Imonitha | Ukusetshenziswa |
|---|---|
| I-cardioverter | Isetshenziselwa ukulawula izinga lokushaya kwenhliziyo uma lehla noma likhuphuka. |
| I-Electrocardiogram (EKG) | Umsebenzi kagesi wenhliziyo uqashwa esikrinini ngezitika eziningana ezinamathiselwe esifubeni. |
| Isiqaphi Sokucindezeleka Kwegazi | Umfutho wegazi ulinganiswa njalo kusetshenziswa i-cuff enamathiselwe engalweni. |
| I-Oximeter Monitor | Isiqeshana esinamathiselwe emunweni silinganisa izinga lomoya-mpilo egazini. |
| I-Fluoroscopy | Into efana nomshini we-X-ray isetshenziswa ukuhlola ukuthi i-catheter ikuphi enhliziyweni. |
| I-Echocardiography ye-Intracardiac | Idivayisi encane ye-ultrasound edlula ku-catheter ibona kahle ingaphakathi lenhliziyo. |
Kuthatha isikhathi esingakanani ukwelashwa futhi ziyini izingozi?
Lokhu kwelashwa kuvame ukuthatha amahora amane kuya kwayisithupha.Kungathatha isikhathi. Kungumqondo omuhle ukwazisa umndeni wakho ukuthi uzoba sesibhedlela usuku lonke, njengoba kuzothatha isikhathi ukulungiselela nokululama. Kuzodingeka uhlale esibhedlela ubusuku bonke ngemva kokwelashwa.
Njenganoma yikuphi ukuhlinzwa kwenhliziyo, kunezingozi ezincane kakhulu . Kodwa-ke, kuyindlela ephephile kakhulu. Izinkinga ezingaba khona zifaka:
- Ukutheleleka endaweni yokusikwa.
- Kunethuba elincane lokulimala okuncane kwemizwa ngesikhathi se-cryoablation.
- Ukubhoboka kwenhliziyo (ingozi engu-1%).
- Ukulimala kwemithambo yamaphaphu (ingozi engu-1%).
- Isifo sohlangothi (ingozi engu-0.5%).
- Ukulimala komphimbo (ingozi engu-0.25%).
Ukululama kanye nokunakekelwa kwangemva kokwelashwa
Ungase uzizwe ungakhululekile, ukhathele, noma ubuhlungu besifuba phakathi namahora okuqala angu-48 ngemva kokwelashwa. Lokhu kuvamile. Ungabuyela emisebenzini evamile ngemva kwezinsuku ezimbalwa. Kodwa-ke, kuzothatha amasonto ambalwa ngaphambi kokuba uqale ukwenza imisebenzi enzima njengokuzivocavoca umzimba.
Into ebaluleke kakhulu ukuthi ngemva kokwelashwa, kuzokwakheka izicubu zesilonda futhi kuzothatha amasonto ambalwa ukuthi imiphumela ephelele ibonakale. Phakathi naleso sikhathi, ungase uzwe ukushaya kwenhliziyo okungajwayelekile futhi. Ngezinye izikhathi, ungase uzizwe sengathi izimpawu zakho ziba zimbi kakhulu ngaphambi kokuba zibe ngcono. Lokhu kuvamile, ngakho ungakhathazeki ngakho.
Kuzodingeka uphuze imithi eminingana izinyanga eziningana ngemva kokwelashwa.
- Imithi yokulwa nokushaya kwenhliziyo: Lawula ukushaya kwenhliziyo kuze kube yilapho izicubu ezintsha zesilonda sezisebenza ngokugcwele.
- Ama-anticoagulant (ama-blood thinner): Lawa abalulekile ekunciphiseni ingozi yokushaywa yisifo sohlangothi.
Kuzodingeka uye kuma-aphoyintimenti okulandelela ezinyangeni ezi-3-4 kanye nonyaka.
Umlayezo Wokuya Nawe Ekhaya
- I-Pulmonary Vein Isolation (PVI) iyindlela yokwelapha ephephile kakhulu futhi ephumelelayo ye-Atrial Fibrillation (Afib), ikakhulukazi kulabo abanenkinga yokulawula isimo sabo ngemithi.
- Lokhu kuhilela ukudala izibazi ezincane enhliziyweni ukuze kuvinjwe izindlela lapho kuvela khona izimpawu zikagesi ezinephutha.
- Lokhu ukwelashwa okwenziwa nge-catheter ngaphandle kokusikwa okukhulu.
- Kungathatha amasonto ambalwa ukuze kutholakale ukululama okuphelele futhi kubonakale imiphumela. Kuvamile ukuthi izimpawu ziphinde zivele phakathi naleso sikhathi.
- Nakuba lokhu kungase kulawule izimpawu, akulona ikhambi. Kubaluleke kakhulu ukuqhubeka nokuthatha imithi yokunciphisa igazi enikezwa udokotela wakho ukuze unciphise ingozi yakho yokushaywa yisifo sohlangothi.
- Uma uzwa noma yikuphi ukungakhululeki, ubuhlungu besifuba, noma ubunzima bokuphefumula, bonana nodokotela wakho ngokushesha.
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