Ingabe ngezinye izikhathi uzizwa inhliziyo yakho ishaya ngokushesha ngaphandle kwesizathu esibonakalayo? Uzizwa sengathi inyoni ishaya amaphiko ayo esifubeni sakho? Lokhu kuyinto eyesabekayo ngempela. Lokhu kwanda okungazelelwe kwesilinganiso senhliziyo kubizwa ngokuthi i-Supraventricular Tachycardia (SVT). Ezikhathini ezinjengalezi, ngaphambi kokusebenzisa imithi, kunendlela elula kodwa ewusizo kakhulu engakusiza ukuthi ulinganisele izinga lokushaya kwenhliziyo yakho. Namuhla sikhuluma 'nge-Vagal Maneuvers'.
Kalula nje, ayini ama-'Vagal Maneuvers'?
Cabanga ukuthi umzimba wakho 'unebhuleki' yemvelo elawula ijubane lenhliziyo yakho. Lelo bhuleki libizwa ngokuthi 'i-Vagus Nerve'. Lena inzwa ende egijima isuka ebuchosheni bethu iye esiswini sethu. Le nzwa isiza ukulawula izinto eziningi, okuhlanganisa ijubane lokushaya kwenhliziyo yethu nokuphefumula.
'Ukuzivocavoca kwe-Vegal' kuyimisebenzi ethile yomzimba esiyenza ngamabomu. Kuvuselela 'i-vagas nerve', ethumela isignali kumshini wenhliziyo wemvelo, onciphisa ukushaya kwenhliziyo. Kalula nje, lezi ezinye zezindlela zokusebenzisa 'ibhuleki' lemvelo lomzimba wethu ukuze uthulise inhliziyo eshaya ngokushesha. Lokhu kuyinto eyenziwa ngaphansi kokuqondisa kukadokotela. Ungazami lokhu wedwa ngaphandle kokukhuluma nodokotela wakho.
Kungani lezi zindlela zibaluleke kangaka?
Lapho belapha umuntu onesifo sokushaya kwenhliziyo okusheshayo (i-SVT), odokotela bavame ukusebenzisa lawa 'maqhinga e-vegal' njengokukhetha kwabo kokuqala . Kunezizathu eziningana zalokhu:
- Ingozi ephansi: Lezi zindlela azinangozi kangako kunokunikeza imithi noma ukunikeza ukushaqeka ngogesi (inhliziyo eguquguqukayo).
- Izindleko eziphansi: Lokhu akudingi imishini ekhethekile noma imithi, ngakho-ke kushibhile.
- Imiphumela esheshayo: Uma iphumelele, ukushaya kwenhliziyo kubuyela esimweni esijwayelekile ngemizuzu embalwa. Izinga lempumelelo livame ukuba phakathi kuka-20% no-40%.
- Usizo lokuxilonga: Ngezinye izikhathi, ngokubheka indlela inhliziyo yakho esabela ngayo kulezi zindlela, udokotela wakho anganquma ukuthi hlobo luni lwesifo senhliziyo (i-arrhythmia) onaso.
Izinhlobo eziyinhloko 'zokusebenzisa izindlela ze-vegal' ezisetshenziswa odokotela
Kunezindlela eziningana zalezi. Ithebula elingezansi libonisa ezinye zezindlela ezivame ukusetshenziswa odokotela.
| Igama Lendlela | Kuchazwe kalula |
|---|---|
| I-Valsalva Maneuver | Ukubamba umoya wakho nokuzikhandla sengathi uyakhipha indle. |
| I-Reflex Yokuntywila | Ngokungazelelwe wacwilisa ubuso esitsheni samanzi eqhwa. |
| Ukubhucungwa Kwesino Se-Carotid | (Ngudokotela kuphela) Ukuhlikihla ngobumnene indawo ethile ohlangothini lwentamo. |
| I-Gag reflex | Ukuvuselela umphimbo ukuze kubangele ukuhlanza. |
| Ukukhwehlela | Ukukhwehlela okukhulu nokunzima. |
Uzenza kanjani lezi zindlela?
Nansi indlela yokwenza ezintathu zezindlela ezivame kakhulu. Khumbula, lezi zenziwa ngaphansi kokuqondisa kukadokotela.
- Indlela Yokwenza I-Valsalva: Uzocelwa ukuba ulale embhedeni, uphefumule ngokujulile, uvale ikhala lakho nomlomo, bese ukhipha umoya imizuzwana eyi-10-30, njengokungathi uzama ukufutha ipayipi elivalekile. Ngezinye izikhathi, udokotela angase futhi athambekise ikhanda lombhede phansi futhi aphakamise imilenze yakho njengoba ukhipha umoya.
- I-Diving Reflex: Ngesikhathi uhleli, bamba umoya wakho bese ucwilisa ubuso bakho bonke esitsheni samanzi eqhwa. Gcina ubuso bakho emanzini isikhathi eside ngangokunokwenzeka. Ngaphandle kwalokho, ungabamba iphakethe leqhwa noma ithawula elimanzi elibandayo ebusweni bakho.
- Ukuhlikihla i-Carotid Sinus: Lokhu kuyinto engenziwa udokotela kuphela. Uzolaliswa embhedeni, ikhanda lakho liphendukele ohlangothini olulodwa, bese udokotela ecindezela ngobumnene indawo ebizwa ngokuthi 'i-Carotid Sinus' ohlangothini lwentamo yakho ngeminwe yakhe imizuzwana emi-5-10.
Ngubani le ndlela engafanele? (Izici eziyingozi)
Lezi zindlela azifanele wonke umuntu. Odokotela abazisebenzisi lezi zindlela uma isimo sesiguli 'singazinzile', okusho ukuthi uma sinezimpawu ezilandelayo:
- Umfutho wegazi ophansi kakhulu(Umfutho wegazi ophansi)
- Ubuhlungu besifuba
- Ukuphelelwa umoya
- Ukungatholi umoya-mpilo owanele emzimbeni
- Isimo lapho izitho zomzimba zingatholi igazi elanele
Kumuntu ongazinzile kanjalo, kusetshenziswa i-cardioversion, elawula ukushaya kwenhliziyo ngemithi noma ngogesi, esikhundleni se-'vagal maneuvers'.
Okubalulekile: Uma uzwa izimpawu ezifana nobuhlungu besifuba, ukuphelelwa umoya, noma ukushaya kwenhliziyo okusheshayo, kuyisimo esiphuthumayo. Yiya eMnyangweni Wezimo Eziphuthumayo wesibhedlela (ETU) ngokushesha.
Ingabe zikhona izingozi ngalezi zindlela?
Ngokuvamile, izinkinga azivamile lapho udokotela enza le nqubo kumuntu ofanele. Uma zenzeka, eziningi zazo zingezesikhashana.
- Umfutho wegazi ophansi (i-Hypotension)
- Ukushaya kwenhliziyo okuhamba kancane kakhulu (i-Bradycardia)
- Ezinye izinkinga zesigqi senhliziyo ezingavela kaningi zifaka phakathi i-Atrial Fibrillation, i-Ventricular Fibrillation, kanye ne-Ventricular Tachycardia.
Ikakhulukazi, indlela ebizwa ngokuthi 'i-Carotid Sinus Massage' ayinakwenziwa yiwo wonke umuntu. Akufanele yenziwe yilabo abanomlando olandelayo:
- Kulabo abake baba nesifo sohlangothi noma i-TIA (ukuhlaselwa kwe-ischemic okudlulayo)
- Kulabo abanesifo semithambo ye-carotid
- Kulabo abasanda kuba nokuhlaselwa yinhliziyo
- Kwabantwana abangaphansi kweminyaka eyi-10 ubudala
Yingakho siphinda sithi, ungalokothi uzame lezi zindlela, ikakhulukazi indlela yokuhlikihla intamo, wedwa ngaphandle kweseluleko sikadokotela.
Umlayezo Wokuya Nawe Ekhaya
- 'Ukuzivocavoca kwe-Vegal' kuwukuzivocavoca okulula okusetshenziselwa ukulawula i-atrial fibrillation (SVT).
- Odokotela basebenzisa lokhu njengomugqa wokuqala wokwelashwa ngoba akunangozi kangako.
- Ungazami lokhu ekhaya ngaphandle kokuthi uyalelwe udokotela wakho. I-Carotid Sinus Massage ikakhulukazi kufanele yenziwe udokotela kuphela.
- Uma unezinhlungu esifubeni, isiyezi, noma ubunzima bokuphefumula ngenkathi inhliziyo yakho ishaya ngokushesha, hamba uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela ngokushesha.
- Uma lezi zindlela zingalawuli ukushaya kwenhliziyo yakho, ungesabi. Udokotela wakho angase abe nemithi noma ezinye izindlela zokwelapha (isib., ukususwa kwe-catheter). Landela njalo imiyalelo yakhe.
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