Ngezinye izikhathi siba nobuhlungu obungapheli ngisho nangemva kokuthatha umuthi noma ukwenza noma yini. Ingabe ubulokhu uhlushwa ubuhlungu, ikakhulukazi ekhanda, entanyeni, esifubeni esingaphezulu, noma ezingalweni, isikhathi eside? Mhlawumbe imbangela yalokhu inkinga ethile ohlelweni lwakho lwezinzwa. Namuhla sizokhuluma ngendlela yokwelapha ekhethekile esetshenziswa odokotela ezimweni ezinjalo. Lokhu kubizwa ngokuthi i-Stellate Ganglion Block, noma i-SGB ngamafuphi.
Kalula nje, iyini i-Stellate Ganglion Block (SGB)?
Kalula nje, lokhu kungumjovo wokubulala izinhlungu. Kodwa lokhu akufani nomjovo ojwayelekile. Lo mjovo ufakwa enqwabeni yemizwa ekhethekile etholakala entanyeni yethu, ikakhulukazi ohlangothini ngalunye lwebhokisi lethu lezwi. Lo mjovo wemizwa ubizwa ngokuthi 'i-Stellate Ganglion'.
Cabanga ngesimiso sethu sezinzwa njengenethiwekhi yezintambo zocingo ezithwala imiyalezo. Ngezinye izikhathi, imiyalezo engafuneki (izibonakaliso zobuhlungu) ingathunyelwa ezingxenyeni ezithile zale nethiwekhi. Ngezikhathi ezinjalo, lokho okwenziwa yilo muthi wokugomela i-SGB "ukubeka" leso sibopho sezinzwa (i-ganglion) okwesikhashana ebuthongweni. Kufana nokuvala iswishi. Khona-ke izimpawu zobuhlungu ezingafuneki ezivela kulezo zinzwa ziya ebuchosheni ziyayeka. Lokhu kunganciphisa ubuhlungu ekhanda, entanyeni, ezingalweni, nasesifubeni esingaphezulu. Futhi, lokhu kwelashwa kusiza ukwandisa ukugeleza kwegazi ezingalweni.
Ngakho-ke, iyini le ganglion ehlakaniphile?
Leli yiqembu lemizwa elitholakala eduze kwezimbambo ezimbili zokuqala, ngaphansi nje kwethambo lentamo, ngaphambili kwentamo yethu. Sinenye yalezi ohlangothini ngalunye lwentamo yethu. Igama elithi 'stellate' lisho 'njengenkanyezi'. Ngakho-ke lesi sixha semizwa siqanjwe ngoba sifana nesimo senkanyezi.
Uhlelo lwezinzwa oluzwelanayo luyingxenye yesistimu yezinzwa ezizimele elawula imisebenzi yomzimba wethu esingayicabangi (isib. ukushaya kwenhliziyo, umfutho wegazi, ukujuluka). Ngakho-ke, iningi lezimpawu zemizwa ezizwelanayo eziya ekhanda, entanyeni, ezingalweni nasesifubeni esingaphezulu zivela kule ganglion ekhanyayo.
Iqiniso elithakazelisayo: Ama-80% kuphela abantu emhlabeni analo leli qembu lezinkanyezi elakhiwe ngokugcwele. Kwamanye, i-ganglion engaphansi yomlomo wesibeletho kanye ne-ganglion yokuqala yesifuba entanyeni azixhumene. Kodwa lokho akwenzi mehluko omkhulu.
Yiziphi izimo ezisetshenziswa ukwelashwa kwe-SGB?
Odokotela basebenzisa kakhulu lokhu kwelashwa ukuxilonga nokwelapha ubuhlungu besikhathi eside obuvela ohlelweni lwezinzwa (ubuhlungu obuvela ngozwelo) okungatholakali sizathu salo. Ngaphezu kwalokho, lokhu kwelashwa kungasetshenziswa kwezinye izifo ezahlukahlukene kanye nezimo zobuhlungu.
| Isimo sezokwelapha | Incazelo |
|---|---|
| I-Complex Regional Pain Syndrome (CRPS) | Ubuhlungu obukhulu, obuhlala isikhathi eside kanye nokuvuvukala engalweni noma emlenzeni ngemva kokulimala. |
| Ubuhlungu Bezitho Ezingajwayelekile | Ukuzwa ubuhlungu engalweni noma emlenzeni obususwe ngokuhlinzwa. |
| I-Postherpetic Neuralgia | Ubuhlungu bemizwa ngemva kwe-chickenpox (i-herpes zoster). |
| Isifo SikaRaynaud | Ukuncipha kokunikezwa kwegazi eminweni ngenxa yomkhuhlane noma ukucindezeleka. |
| Ukujuluka ngokweqile (i-Hyperhidrosis) | Ukujuluka ngokweqile ezindaweni ezinjengasezintendeni zezandla nasezinyaweni. |
| Ezinye izimo | Iphinde isetshenziswe ezinhlungwini zekhanda ezihlangene, ubuhlungu bobuso, ubuhlungu besifuba obungahlobene nesifo senhliziyo, kanye nezinkinga ezithile zesigqi senhliziyo (i-cardiac arrhythmias). |
Ukusetshenziswa kwe-SGB ezinkingeni zempilo yengqondo
Muva nje, kwenziwe ucwaningo ngemiphumela yokwelashwa kwe-SGB ezimweni zempilo yengqondo njenge-Post-Traumatic Stress Disorder (PTSD). Nakuba abanye abantu bebonise ukwehla kwezimpawu ze-PTSD, abanye abakabonisi. Ngakho-ke, lokhu kusesesigabeni socwaningo, futhi kuvame ukusetshenziswa kuphela "ngaphandle kwelebula" ngaphansi kokuqashwa okuseduze kukadokotela lapho ezinye izindlela zokwelapha zehlulekile.
Lokhu kwelashwa kwenziwa kanjani?
Kulungile, manje ake sibone ukuthi kwenzekani uma lo mjovo unikezwa. Akukho okufanele ukhathazeke ngakho, lokhu kuvame ukuthatha imizuzu engaphansi kwengu-30.
1. Ukulungiselela: Okokuqala, unganikwa umuthi omncane (i-IV sedation) emthanjeni osengalweni yakho ukuze ukusize uphumule. Ngemuva kwalokho, uzolaliswa ngomhlane etafuleni elikhethekile.
2. Ukuhlanza: Udokotela uzohlanza kahle futhi abulale amagciwane endaweni yentamo lapho kuzojovwa khona.
3. Ukuba ndikindiki: Okulandelayo, kusetshenziswa inaliti encane kakhulu ukufaka umuthi wokubulala izinzwa endaweni ethintekile yentamo yakho. Lokhu kuzokwenza ungabi ndikindiki ngenxa yobuhlungu.
4. Umjovo oyinhloko: Ngemuva kwalokho, esebenzisa ubuchwepheshe obuthuthukisiwe njenge-ultrasound noma i-fluoroscopic imaging ukuthola ngokunembile impande yemizwa, udokotela ufaka inalithi yesibili bese efaka umuthi oyinhloko wobuhlungu. Le ndlela inciphisa kakhulu ingozi yokufaka umuthi endaweni engafanele.
Ngemva kokwelashwa, uzobhekwa ngabasebenzi bezokwelapha cishe ihora. Uma konke sekuqinisekisiwe ukuthi kulungile, ungaya ekhaya. Kodwa-ke, kufanele ube nomuntu ozokuthatha akuyise ekhaya, njengoba ngeke ukwazi ukushayela ngalolo suku.
Injani imiphumela? Lokhu kuthatha isikhathi esingakanani?
Lokhu kuyinkinga yawo wonke umuntu. Imiphumela iyahlukahluka kuye ngomuntu. Kwabanye abantu, ubuhlungu buyaphela ngokushesha ngemva komjovo, kodwa ubuhlungu bungabuya emahoreni ambalwa ngemva kokuba umuthi oqeda izinhlungu usuphelile. Kwabanye, bungahlala amasonto noma izinyanga ngaphandle kobuhlungu.
Into ebalulekile ukuthi ngokuvamile udinga uchungechunge lwemijovo ukuze uthole imiphumela emihle kakhulu. Ngezinye izikhathi ungathola imiphumela ngemijovo emibili kuphela, kanti abanye abantu bangadinga engaphezu kweyishumi. Izindaba ezinhle ukuthi isikhathi sokungabi nabuhlungu sivame ukwanda uma uthola imijovo ngokulandelana.
Ingabe kukhona imiphumela emibi kanye nezingozi?
Njenganoma yikuphi ukwelashwa kwezokwelapha, i-SGB inemiphumela emibi emincane kanye nezinkinga ezinkulu ezingavamile.
| Uhlobo lwesifo | Izinto ezingenzeka |
|---|---|
| Imiphumela emibi evamile yesikhashana (iyaphela emahoreni ambalwa) | |
| Indawo yokujova | Ukulimala noma ubuhlungu obuncane. |
| Amehlo nekhala | Amajwabu amehlo athambile, amehlo abomvu, amehlo anamanzi, nekhala elicijile. |
| Umphimbo nezwi | Izwi elihoshozelayo, ukuzizwa sengathi kukhona okubhajwe emphinjeni, ubunzima bokugwinya. |
| Isandla | Ukuzwa ukufudumala noma ukungakhululeki esandleni. |
| Izinkinga ezinkulu ezingavela kaningi kakhulu | |
| Izingozi Eziyinhloko | Ukutheleleka, ukuphuma kwegazi emthanjeni wegazi owonakele, ukulimala kwemizwa, ukulimala kwamaphaphu (i-pneumothorax), i-Horner's syndrome (isimo sesikhashana). |
Amathuba alezi zinkinga ezinkulu aphansi kakhulu , ngoba odokotela benza lokhu kwelashwa ngokucophelela besebenzisa ubuchwepheshe obufana ne-ultrasound.
Kufanele ubonane nini nodokotela?
Ngemva kokwelashwa, uma uba nanoma yiziphi izimpawu ezintsha, isibonelo , izimpawu zokutheleleka endaweni yomjovo (ukuvuvukala, ukubomvu, ubuhlungu obukhulu, umkhuhlane) noma uma ubunzima bokugwinya buqhubeka, shayela udokotela wakho ngokushesha.
I-SGB iyindlela yokwelapha ewusizo enganikeza impumuzo ebuhlungwini besikhathi eside. Kodwa-ke, ayisebenzi kuwo wonke umuntu. Uma unemibuzo noma ukungabaza ngalokhu kwelashwa, ungagodli lutho futhi ukhulume ngokukhululekile nodokotela wakho. Uzophendula yonke imibuzo yakho.
Umlayezo Wokuya Nawe Ekhaya
- I-Stellate Ganglion Block (SGB) iwumjovo oqeda ubuhlungu ofakwa esikhungweni esikhethekile sezinzwa entanyeni.
- Lokhu kunikeza impumuzo ebuhlungwini obungapheli, ikakhulukazi ekhanda, entanyeni, ezingalweni nasesifubeni esingaphezulu.
- Lokhu ukwelashwa okungenziwa ngokushesha kakhulu (ngaphansi kwemizuzu engama-30) futhi kuphephile kakhulu ngoba kusebenzisa ubuchwepheshe obufana ne-ultrasound.
- Kungase kube nemiphumela emibi emincane ephela emahoreni ambalwa, kodwa izinkinga ezinkulu azivamile.
- Kungadingeka uchungechunge lwemijovo ukuze uthole imiphumela emihle kakhulu.
- Xoxa njalo nodokotela wakho ukuthi lokhu kwelashwa kulungile yini kuwe nokuthi yiziphi izinzuzo nezinkinga zako.
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