Ingabe unezinhlungu ezingapheli entanyeni yakho, ekhanda, engalweni, noma esifubeni esingaphezulu ezingapheli ngemithi? Ngezinye izikhathi, imbangela yalolu hlobo lobuhlungu ingaba yinkinga encane ohlelweni lwethu lwezinzwa. Namuhla, sizokhuluma ngendlela yokwelapha ekhethekile, ehlukile kancane esetshenziswa odokotela ezimweni ezinjalo. Lokhu kubizwa ngokuthi 'i-Stellate Ganglion Block'. Nakuba igama lingase lizwakale liyinkimbinkimbi kancane, ake siqonde ukuthi lokhu kwenzani.
Iyini i-Stellate Ganglion Block (SGB)?
Kalula nje, i-Stellate Ganglion Block (SGB) iwumjovo womuthi wokubulala izinzwa. Kodwa lokhu akuyona nje noma yimuphi umjovo ojwayelekile. Ufakwa eqenjini elikhethekile lezinzwa entanyeni yethu, ikakhulukazi kuzo zombili izinhlangothi zebhokisi lethu lezwi. Leli qembu lezinzwa libizwa ngokuthi 'i-Stellate Ganglion'.
Kunezinjongo ezimbili eziyinhloko zokuphatha lo muthi wokugoma:
1. Ukuqeda ubuhlungu obukhulu obungapheli ekhanda, entanyeni, ezingalweni ezingenhla kanye nasesifubeni esingaphezulu.
2. Ukujikeleza kwegazi ezandleni, okungukuthi, ukuthuthukisa ukugeleza kwegazi.
Kulungile, pho iyini le ganglion ehlakaniphile?
I-ganglion iyiqoqo lamaseli ezinzwa ahlangana ndawonye, njengendawo yokuhlangana esiteshini sesitimela, isikhungo lapho imiyalezo yezinzwa ithunyelwa khona naphambili.
I-stellate ganglioni ingenye yeqembu lezinzwa ezinjalo. Itholakala ngaphambili kwentamo yethu, ngaphansi nje kwethambo lentamo, eduze kombambo wokuqala. Sinezigebengu ezifana nalezi ezinhlangothini zombili zentamo yethu. Igama elithi 'stellate' lisho 'njengenkanyezi'. Lokhu kusho ukuthi ukuma kwaleli qembu lezinzwa kungafana nesimo senkanyezi.
Leli qembu lezinzwa lingelase-'Sympathetic Nervous System', eliyingxenye ye-Autonomic Nervous System yethu. Kalula nje, lolu uhlelo lomzimba wethu 'lokulwa noma lokubaleka', okungukuthi, uhlelo olusilungiselela ukulwa noma ukubaleka esimweni esiphuthumayo, lapho sesaba noma sikhathazekile. Luhilelekile ezintweni eziningi umzimba wethu ozilawulayo ngaphandle kokucabanga ngazo, njengokushaya kwenhliziyo, umfutho wegazi, nokujuluka. Ngakho-ke imiyalezo eminingi yezinzwa ezizwayo eya ekhanda, entanyeni, ezingalweni, nasesifubeni esingaphezulu ithunyelwa ngaleli qembu lezinzwa eliyinkanyezi.
Ingabe wonke umuntu unalo leli qembu le-Stellate Ganglion?
Lokhu futhi kuyamangaza kancane. Empeleni, leli qembu lezinkanyezi alikho emzimbeni womuntu wonke. Ukuze le qembu lezinkanyezi lakheke, amaqoqo amabili ezinzwa entanyeni yethu, okungukuthi 'iqembu lezinkanyezi eliphansi' kanye 'neqembu lezinkanyezi lokuqala lesifuba', kudingeka ahlangane.
Kodwa, abantu abangu -80% kuphela emhlabeniLezi zinqwaba ezimbili zemizwa ziyahlangana ngale ndlela ukuze zakhe i-ganglion evelele. Kwezinye izimo ezingama-20%, lezi zihlelwe ngendlela ehlukile, zihlukaniswe.
Kungani kwenziwa i-Stellate Ganglion Block? Yiziphi izifo?
Odokotela basebenzisa lokhu kwelashwa ngezizathu ezimbili eziyinhloko.
1. Ukuze uthole ukuxilongwa: Thola ukuthi ubuhlungu obuthile bubangelwa yini ukusebenza kwesimiso sezinzwa esinozwela okukhulunywe ngaso ekuqaleni. Lokhu kubizwa ngokuthi 'ubuhlungu obuvela ku-sympathetically mediated pain (SMP)'.
2. Njengokwelashwa: Lawula izimo ezahlukahlukene zobuhlungu, ukuphazamiseka kwemizwa, kanye nezinkinga zokujikeleza kwegazi.
Ithebula elingezansi libala ezinye zezimo lapho lokhu kwelashwa kusetshenziswa khona kakhulu.
| Ukugula/Ubuhlungu | Incazelo elula |
|---|---|
| I-Complex Regional Pain Syndrome (CRPS) | Ubuhlungu obukhulu, obuhlala isikhathi eside, obushisayo obuvela ngemva kwengozi engalweni noma emlenzeni. |
| Isifo Semithambo Yegazi Engaphandle | Izinkinga zokujikeleza kwegazi ezibangelwa ukuncipha kwemithambo yegazi ehambisa igazi ezandleni nasezinyaweni. |
| Ubuhlungu Bezitho Ezingajwayelekile | Ngisazizwa ubuhlungu engalweni noma emlenzeni owasuswa ngokuhlinzwa. |
| I-Postherpetic Neuralgia | Ubuhlungu bemizwa obuqhubeka ngisho nangemva kokuba i-herpes zoster (ama-shingles) isipholile, obubangelwa yigciwane le-herpes elihlobene ne-chickenpox. |
| I-Hyperhidrosis | Ukujuluka ngokweqile ezindaweni ezinjengasezintendeni zezandla. |
| Isifo SikaRaynaud | Iminwe iyashintsha ibe mhlophe, ibe luhlaza okwesibhakabhaka, futhi ibe ndikindiki uma ibhekene nomkhuhlane noma ukucindezeleka. |
| Ubuhlungu Bekhanda Beqembu | Ikhanda elibuhlungu kakhulu, elibuhlungu. |
Ngaphezu kwalokho, lokhu kwelashwa kusetshenziselwa nezimo ezifana ne-'Scleroderma', 'ubuhlungu bomlomo', 'ubuhlungu besifuba obungavamile', kanye ne-'Ménière's disease'.
Ingabe lokhu kusetshenziselwa nezinkinga zempilo yengqondo?
Yebo, lesi yisihloko abantu abaningi abakhuluma ngaso njengamanje. Ucwaningo belulokhu luqhubeka kusukela ngawo-1990, ikakhulukazi ngokusetshenziswa kwe-SGB njengokwelashwa kwesimo sengqondo esibizwa ngokuthi i-Post-Traumatic Stress Disorder (PTSD) .
I-PTSD yisimo sengqondo esiqala ngemva kokubhekana nesenzakalo esibuhlungu kakhulu. Abantu abanalesi simo banamazinga aphezulu kakhulu amakhemikhali athile ebuchosheni babo, njenge-'norepinephrine' kanye ne-'nerve growth factor'. Abacwaningi bakholelwa ukuthi lo mjovo unganciphisa lawo mazinga futhi ulawule ukusebenza okuqhubekayo kwempendulo 'yokulwa noma yokubaleka'.
Kodwa imiphumela yalezi zifundo ixubile. Abanye abantu babone ukwehla okukhulu kwezimpawu ze-PTSD, kanti abanye ababonanga shintsho. Ngakho-ke, izinhlangano ezifana ne-U.S. Food and Drug Administration azikayivumeli ngokusemthethweni i-SGB njengokwelashwa kwe-PTSD. Kodwa-ke, uma ezinye izindlela zokwelapha (ukwelulekwa, imithi) zingasebenzi, udokotela angaxoxa ngalokhu nesiguli futhi akunikeze njengokwelashwa 'okungekho ku-label'.
Muva nje, ucwaningo seluqalile ngemiphumela ye-SGB kwezinye izimo zengqondo, njengokucindezeleka nokukhathazeka.
Le Stellate Ganglion Block yenziwe kanjani?
Ake sithi udokotela ukunikeze lo muthi. Bese kuthi emtholampilo noma esibhedlela, kwenzeke into efana nale:
1. Ukulungiselela: Okokuqala, uzocelwa ukuba ulale ubheke phezulu embhedeni. Ukuze uthole induduzo nokuphumula, unganikezwa umuthi wokudambisa omnene (umuthi wokudambisa) ngomjovo we-intravenous (IV).
2. Ukuhlanza: Udokotela uzohlanza kahle indawo entanyeni yakho lapho kuzofakwa khona umjovo ngesisombululo sokubulala amagciwane.
3. Umjovo wokuqala (ongazwakali):Okulandelayo, kufakwa inani elincane le-anesthetic yendawo endaweni kusetshenziswa inaliti encane kakhulu. Lokhu kuzokusiza ukuthi ungazizwa ubuhlungu bomjovo olandelayo.
4. Umjovo oyinhloko: Kube sekufakwa umuthi wokubulala izinzwa oyinhloko. Kodwa lokhu akusikho nje ukuqagela. Udokotela usebenzisa i-'Ultrasound' scan noma uhlobo olukhethekile lwe-X-ray olubizwa ngokuthi 'i-Fluoroscopy' , ubheka indlela yenaliti esikrinini, bese kuba yilapho umjovo uvela khona lapho inaliti iseduze neqembu lezinzwa elibizwa ngokuthi i-stellate ganglion. Lokhu kunciphisa amathuba okuyifaka endaweni engafanele.
Le nqubo yonke ivame ukuthatha imizuzu engaphansi kwengu-30 .
Kwenzekani ngemva komjovo?
Ngemva komjovo, uzogcinwa ekamelweni lokululama isikhashana. Ngokuvamile cishe imizuzu engama-40 kuya kwengama-60, umhlengikazi noma udokotela uzoqapha isimo sakho (umfutho wegazi, ukushaya kwenhliziyo). Uma konke sekuqinisekisiwe, uzonikezwa imiyalelo okufanele uyilandele ekhaya bese uvunyelwa ukuya ekhaya.
Into ebaluleke kakhulu: Ngemva kwalokhu kwelashwa, ngeke ukwazi ukushayela ekhaya wedwa, ngakho-ke kubalulekile ukuba othile akushayele ekhaya.
Kusebenza kangakanani lokhu kwelashwa? Kuthatha isikhathi esingakanani?
Ayikho impendulo eyodwa kulo mbuzo ngoba uyahlukahluka kakhulu kumuntu nomuntu.
- Kwabanye abantu, ubuhlungu buyaphela ngokushesha ngemva komjovo, kodwa ubuhlungu bungabuya ngemva kwamahora ambalwa njengoba umuthi wokubulala izinzwa uphela.
- Abanye bathola ukukhululeka ebuhlungwini izinsuku noma amasonto. Phakathi nalesi sikhathi, bayakwazi ukunciphisa imithi yabo yobuhlungu futhi bahlanganyele emisebenzini efana nokuzivocavoca umzimba.
Ngokuvamile, umjovo owodwa awuvamile ukunikeza impumuzo ephelele. Ukuze uthole impumuzo yesikhathi eside, kudingeka uchungechunge lwemijovo, okusho ukuthi kufanele ukwenze lokhu izikhathi eziningana. Ngezinye izikhathi ungathola imiphumela ngezifundo ezimbili kuphela, kanti ezinye zingadinga ukukwenza izikhathi ezingaphezu kweshumi. Kodwa izindaba ezinhle ukuthi ngesifundo ngasinye, isikhathi sokuqeda ubuhlungu singanda .
Ingabe kukhona imiphumela emibi noma izingozi kulokhu?
Njenganoma yikuphi ukwelashwa kwezokwelapha, kunemiphumela emibi emincane kanye nezinkinga ezinkulu ezingavamile.
| Imiphumela emibi evamile yesikhashana (iyaphela phakathi namahora ambalwa) | |
|---|---|
| Ukulimala noma ubuhlungu endaweni yokujova | Ijwabu leso eligobile |
| Ukubomvu kwamehlo | Izinyembezi ziphuma emehlweni |
| Ukuminyana kwekhala | Ukuhosha kwezwi |
| Ukuzwa sengathi kukhona iqhubu emphinjeni | Ubunzima bokugwinya ukudla |
| Ukuzwa ukufudumala noma ukungakhululeki esandleni noma entendeni yesandla | |
Izimpawu ezishiwo ngenhla zivame ukunyamalala ngokuphelele emahoreni ambalwa, kodwa futhi kunezinkinga ezinkulu ezingavela kaningi .
- Izimo ezithathelwanayo
- Ukopha okubangelwa ukubhobozwa kwenaliti emthanjeni wegazi (isb. umthambo we-carotid)
- Ukulimala kwezinye izinzwa (i-vagus nerve, i-recurrent laryngeal nerve)
- Ukulimala kwamaphaphu (i-Pneumothorax)
- Ukulimala kwendlala yegilo, umphimbo, noma umphimbo
Amathuba okuba lezi zinto zenzeke mancane kakhulu, ikakhulukazi uma udokotela onolwazi enza lokhu kwelashwa esebenzisa ubuchwepheshe obufana ne-ultrasound.
Kukuziphi izimo lapho kufanele ngishayele udokotela ucingo?
Ngemva kokubuyela ekhaya ngemva komjovo, uma uba nezimpawu ezintsha noma usola ukuthi kukhona izinkinga , shayela udokotela wakho ngokushesha. Ikakhulukazi:
- Uma indawo yomjovo ivuvukala, ibomvu, noma ishisa (izimpawu zokutheleleka).
- Uma ubunzima bokugwinya buqhubeka ngemva kwamahora amaningana.
- Uma unenkinga yokuphefumula.
Ungesabi noma ungabaze ngalokhu kwelashwa. Khuluma nodokotela wakho ngakho ngokukhululekile. Into ebaluleke kakhulu ukulalela zonke izinkinga zakho bese wenza isinqumo esinolwazi.
Umlayezo Wokuya Nawe Ekhaya
- I-Stellate Ganglion Block (SGB) iyindlela yokwelapha ehilela ukufaka umuthi wokubulala izinzwa eqoqweni elikhethekile lemizwa entanyeni.
- Lokhu kusetshenziselwa kakhulu ubuhlungu obungapheli kanye nezinkinga zokujikeleza kwegazi ekhanda, entanyeni, ezingalweni nasesifubeni esingaphezulu.
- Iphinde isetshenziswe ocwaningweni lwezimo zengqondo ezifana ne-PTSD, kodwa imiphumela iyahlukahluka kumuntu nomuntu.
- Impumelelo yalokhu kwelashwa kanye nobude besikhathi sokuqeda ubuhlungu kuyahlukahluka kakhulu kumuntu nomuntu, futhi kuvame ukudingwa imijovo eminingana.
- Imiphumela emibi yesikhashana efana nokuhosha nokugoba kwamehlo kungase kwenzeke, okuzophela phakathi namahora ambalwa. Ingozi yezinkinga ezinkulu iphansi kakhulu.
- Into ebaluleke kakhulu ukukhuluma nodokotela wakho ngalokhu, ubuze yonke imibuzo yakho, bese wenza isinqumo esinolwazi oluphelele.
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