Ingabe uhlushwa ubuhlungu obukhulu, obuqhubekayo obungapheli naphezu kwayo yonke imithi nokwelashwa? Siyazi ukuthi kunzima kangakanani ukuphila nalolu hlobo lobuhlungu, ikakhulukazi emhlane, emilenzeni nasezingalweni. Ngakho-ke namuhla sizokhuluma ngedivayisi ekhethekile yezokwelapha engasiza ekulawuleni lolu hlobo lobuhlungu obukhulu.
Kalula nje, iyini le nto yokuvuselela umgogodla?
Isikhuthazi sentambo yomgogodla siyinto encane yezokwelapha udokotela wakho angayifakela emzimbeni wakho ngokuhlinzwa. Sisetshenziselwa ukulawula ubuhlungu obukhulu, besikhathi eside. Siphinde sisetshenziswe njengendlela engcono esikhundleni semithi enamandla yokudambisa izinhlungu, njenge-opioid, ngezinye izikhathi engaba umlutha.
Le divayisi inciphisa kanjani ubuhlungu?
Ukuze uqonde ukuthi lokhu kusebenza kanjani, udinga ukuba nomqondo omncane ngobuhlungu kanye nesimiso sethu sezinzwa.
Kuyini ubuhlungu?
Ubuhlungu buvame ukuba yindlela yokuzivikela. Busazisa uma ulimele noma kukhona okuzokwenzeka. Ubuhlungu buyisibonakaliso esikhulu sezifo eziningi.
Kodwa-ke, ubuhlungu abusiniki isivikelo ngaso sonke isikhathi. Ezinye izimo zezokwelapha zingabangela ubuhlungu obungabekezeleleki, noma kungaba ubuhlungu obuhlala njalo obungapheli. Lokhu sikubiza ngokuthi ubuhlungu obungapheli . Ukuphila nalolu hlobo lobuhlungu kungenza kube nzima ukulala noma ngisho nokwenza noma yini ewusizo. Ngokuhamba kwesikhathi, lokhu kungaba nomthelela omkhulu empilweni yakho yengqondo.
Umsebenzi wesimiso sezinzwa
Cabanga ngesimiso sakho sezinzwa njengenethiwekhi yezintambo zocingo ezigijima emzimbeni wakho wonke. Yilokho okuhambisa ulwazi phakathi kobuchopho bakho nomzimba wakho wonke. Ubuhlungu bufana "nocingo" oluvela kulolu cingo oluya ebuchosheni bakho.
Le ndlela, ebizwa ngokuthi i-neuromodulation, isebenzisa ugesi omncane kakhulu ukuvuselela imicu ethile yezinzwa emgogodleni wakho. Ngamanye amazwi, kufana nokwenza olunye "ucingo" kucingo olufanayo oluthola "ucingo" lobuhlungu bese lwenza umugqa ube matasa . Lokhu kuvimbela isignali yobuhlungu ukuthi ingafiki ebuchosheni. Yile ndlela umuzwa wobuhlungu oncishiswa ngayo.
Ubani odinga kakhulu lolu hlobo lokwelashwa?
Lokhu kwelashwa kuvame ukusetshenziswa lapho ezinye izindlela zokwelapha, njengephilisi, imijovo, kanye nokwelashwa ngokomzimba, zingaphumelelanga. Nakuba lezi zimo zivame kakhulu kubantu abadala, izingane ezincane ngezinye izikhathi zingadinga lokhu kwelashwa.
Ithebula elingezansi libonisa ezinye zezimo eziyinhloko eziphathwa ngale divayisi.
| Isimo sezokwelapha | Incazelo |
|---|---|
| Ukuhlungu obusemhlane | Ubuhlungu obungapheli bomhlane obungakelapheki ngezinye izindlela. |
| Ubuhlungu ngemva kokuhlinzwa emhlane | I-Persistent Spinal Pain Syndrome (PSPS), ikakhulukazi ubuhlungu obuqhubekayo ngemva kokuhlinzwa njenge-laminectomy. |
| Izinkinga zemizwa ezihlobene nesifo sikashukela | Ubuhlungu obubangelwa ukulimala kwemizwa ngenxa yesifo sikashukela (Diabetic Neuropathy). |
| Ubuhlungu be-Neuropathic | Ubuhlungu obubangelwa yiphutha ohlelweni lwezinzwa uqobo. |
| I-Complex Regional Pain Syndrome (CRPS) | Ubuhlungu obukhulu, obuhlala isikhathi eside engalweni noma emlenzeni ngemva kokulimala. |
Ngaphezu kwalokho, ucwaningo luyaqhubeka ukuze kubonwe ukuthi le ndlela ingaba usizo yini kwezinye izimo, njengobuhlungu besifuba (i-angina), ukulimala komgogodla, kanye nobuhlungu bemizwa ngemva kwe-herpes zoster (ama-shingles).
Kwenzekani ngaphambi kokuhlinzwa?
Lokhu akuyona indlela yokwelapha yokuqala. Lokhu kusho ukuthi kuyacatshangelwa uma zonke ezinye izindlela zokwelapha zehlulekile. Ngaphambi kokuhlinzwa, kuzodingeka wenze izinto eziningana, njengokuhlolwa kwegazi kanye nokuskena, ukuze ubone ukuthi uyakufanelekela yini.
Futhi, kuzodingeka ubone ochwepheshe abaningana.
- Udokotela Wezinzwa: Thola isimo esiqondile esibangela ubuhlungu bakho.
- Uchwepheshe Wokulawula Ubuhlungu:Qiniseka ukuthi ezinye izindlela zokwelapha azisebenzanga.
- Udokotela Wezinzwa: Nguye owenza ukuhlinzwa ukuze kufakwe le divayisi.
- Udokotela Wengqondo/Isazi Sengqondo: Ubuhlungu obungapheli bungaba nomthelela omkhulu empilweni yakho yengqondo, ngakho-ke kubalulekile ukunaka impilo yakho yengqondo.
- Udokotela Wokubulala Izinzwa: Khuluma ngakho ngoba ukuhlinzwa kwenziwa ngaphansi kwe-anesthesia.
Uma konke sekuhlelekile, uzothola imiyalelo yokuthi ungalungiselela kanjani ukuhlinzwa. Lokhu kuhlanganisa izinto ezifana nokutshela udokotela ngemithi oyiphuzayo kanye nokuzila ukudla ngaphambi kokuhlinzwa.
Kwenzekani ngesikhathi sokuhlinzwa?
Le nqubo ivame ukwenzeka ngezigaba ezimbili. Esokuqala inqubo "yokuzama". Uma lokho kuphumelele, isigaba sesibili yilapho idivayisi (i-pulse generator/ibhethri) ifakwa unomphela emzimbeni.
Kalula nje, le divayisi inezingxenye ezimbili: ama-electrode (ama-lead) abekwe eduze komgogodla kanye nebhethri ekhiqiza ama-pulse kagesi (i-pulse generator). Zombili zixhunywe ngocingo oluhamba ngaphansi kwesikhumba.
1. Inqubo Yokuqulwa Kwecala
Kule nqubo, unikezwa i-anesthesia ukuze ulale kancane. Bese, usebenzisa inqubo efana ne-X-ray (fluoroscopy), inaliti ifakwa esikhumbeni iye endaweni efanele emgogodleni wakho (isikhala se-epidural). Esinye isiphetho se-electrode sikhishwa esikhumbeni bese sixhunywa ebhethrini lesikhashana elingaphandle.
Lolu vivinyo luhlala izinsuku ezimbalwa kuya esontweni elilodwa noma amabili. Uma ubuhlungu bakho buncishisiwe ngaphezu kuka-50% phakathi nalesi sikhathi, uvivinyo lubhekwa njengoluphumelelayo. Uma kunjalo, isinyathelo esilandelayo ukuhlinzwa ukuze kufakwe idivayisi ehlala njalo.
2. Ukufakelwa kwedivayisi unomphela (Ukuhlinzwa Kokufakelwa)
Le nqubo yenziwa ngaphansi kwe-anesthesia ejwayelekile. Lapha, ama-electrode ahlala njalo abekwa endaweni efanayo naleyo esetshenzisweni. Ngemuva kwalokho, kwakheka isikhala esincane ngaphansi kwesikhumba bese kufakwa ibhethri (i-pulse generator) . Leli bhethri livame ukufakwa endaweni ongayilawula kalula, isibonelo, ohlangothini lwesisu noma ezinqeni.
Amanye amabhethri angavulwa/acinywe nge-remote. Amanye angashajwa. Udokotela wakho uzochaza konke lokhu kuwe.
Yiziphi izinzuzo kanye nokungalungi kwalokhu kwelashwa?
Njenganoma iyiphi indlela yezokwelapha, lena inezinzuzo kanye nokungalungi.
| Izinzuzo | Izingozi nezinkinga |
|---|---|
| Ukukwazi ukwelapha ubuhlungu obungazange buqedwe ngezinye izindlela. | Ingozi yokutheleleka: Uma ukutheleleka kuvela eduze kwedivayisi, kungadinga ukuhlinzwa okwengeziwe ukuze kususwe. |
| Ukukwazi ukunciphisa ukuthembela emithini yobuhlungu. | Ukufuduka kwe-electrode: Lapho umzimba uhamba, i-electrode ingase isuke endaweni yayo yokuqala. |
| Ukuhlolwa kungenziwa ngaphambi kokuhlinzwa unomphela. | Ukungasebenzi kahle kwedivayisi: Ama-electrode angaphuka noma ibhethri lingahluleka. Amabhethri kungadingeka ukuthi ashintshwe njalo eminyakeni embalwa. |
| Ukukwazi ukwelapha izinhlobo eziningi zobuhlungu bemizwa. | Ukubuyela kobuhlungu: Amandla okulawula ubuhlungu angase anciphe ngokuhamba kwesikhathi. |
Kufanele ubonane nini nodokotela ngokushesha?
Uzonikezwa ama-aphoyintimenti okulandelela ngemva kokuhlinzwa. Qiniseka ukuthi uyaya kulawo ma-aphoyintimenti. Kodwa-ke, uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo eziyisixwayiso , kufanele uye esibhedlela noma eMnyangweni Wezimo Eziphuthumayo (ETU) ngokushesha .
- Ikhanda elibuhlungu eliqhubekayo elivela lapho umi noma uhleli bese linyamalala lapho ulele: Lokhu kungaba uphawu lokuvuza koketshezi lomgogodla (CSF).
- Izimpawu zokutheleleka endaweni yokuhlinzwa: ukubomvu, ukuvuvukala, ubuhlungu, noma ukuphuma koketshezi olunuka kabi oluvela enxebeni.
- Ukuqala ngokuzumayo kokuba ndikindiki, ukulahlekelwa umuzwa, noma ubuthakathaka bemisipha emzimbeni ongezansi: Lokhu kungaba uphawu lomonakalo womgogodla obangelwa ukunyakaza okuqondile kusuka endaweni ye-electrode.
- Izimpawu ze-sepsis: Umkhuhlane ophakeme, ukubanda, ubunzima bokuphefumula, kanye nokudideka. Lesi yisimo esiphuthumayo esisongela impilo.
Ngokuvamile, kuthatha cishe amasonto ama-4-6 ukuthi idivayisi ehlala njalo iphole ngokuphelele futhi ibuyele emisebenzini evamile. Udokotela wakho uzokweluleka ukuthi ugweme ukuphakamisa okunzima nokugoba kanzima phakathi nalesi sikhathi.
Umlayezo Wokuya Nawe Ekhaya
- Ukuvuselelwa Kwentambo Yomgogodla kuyindlela yesimanje esetshenziselwa ubuhlungu obungapheli obungazange buqedwe ngezinye izindlela zokwelapha.
- Lokhu kusebenza ngokuvimbela ukudluliselwa kwezimpawu zobuhlungu ebuchosheni ngokusebenzisa ugesi omncane.
- Ngaphambi kokufaka idivayisi unomphela, kwenziwa isivivinyo sesikhashana ukuze kubonakale ukuthi iyakufanelekela yini.
- Ngenxa yokuthi le ndlela yokwelapha inezinzuzo kanye nezingozi, kubaluleke kakhulu ukuxoxa ngayo kahle nodokotela wakho ngaphambi kokwenza noma yiziphi izinqumo.
- Uma kuvela izimpawu eziyisixwayiso ngemva kokuhlinzwa, funa iseluleko sezokwelapha ngokushesha.
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