Cabanga nje ukuthi ilungu lomndeni, umngane, noma wena ngokwakho unesifo sokuwa, noma ubulokhu uhlushwa ukucindezeleka okukhulu isikhathi eside. Kungakhathaliseki ukuthi uthatha imithi engakanani nokuthi uzama ukwelashwa okungakanani, kubonakala sengathi awukwazi ukulawula lesi simo. Odokotela bazame konke abangakwenza. Esimweni esinjalo, ungase uzwe ngokwelashwa okuhlukile kancane, okuthuthukile. Yilokho esikubiza ngokuthi i-VNS, noma i-Vagus Nerve Stimulation.
Kuyini ukukhuthazwa kwemizwa ye-vagus (VNS)?
Kalula nje, lokhu kuyindlela yokwelapha eshintsha indlela izinzwa ezisebenza ngayo. Uma sikhuluma iqiniso, kufana ne-pacemaker efakwe enhliziyweni. Yingakho abanye abantu beyibiza ngokuthi "i-pacemaker yobuchopho."
Lokhu kwelashwa kuhilela ukufakwa ngokuhlinzwa idivayisi encane ngaphansi kwesikhumba sesifuba sakho esingaphezulu. Le divayisi inocingo oluncane kakhulu oluxhunywe kumthambo okhethekile obizwa ngokuthi i-vagus nerve entanyeni yakho. Le divayisi bese ithumela ukushaya kukagesi okuthambile ngezikhathi ezithile. Lezi zimpawu zihamba nge-vagus nerve ziye esiqwini sobuchopho. Ukusuka lapho, lezi zimpawu zisatshalaliswa ezingxenyeni ezahlukene zobuchopho futhi ziqale ukushintsha indlela amangqamuzana obuchopho asebenza ngayo.
Ngokuvamile, udokotela uzocabangela ukwelashwa kwe-VNS lapho zonke ezinye izindlela zokwelapha zehlulekile. Okwamanje kuvunyelwe emhlabeni wonke ngenani elilinganiselwe leziguli ezine-epilepsy engamelani nokwelashwa kanye nokucindezeleka okungamelani nokwelashwa. Kuvunyelwe futhi njengosizo ekuvuseleleni ezinye iziguli ezisanda kuba nesifo sohlangothi.
Ikuphi i-Vagus Nerve? Yenzani?
Kunezinzwa eziyi-12 eziyinhloko ezithwala izimpawu zikagesi ezivela ebuchosheni bethu ziye ezingxenyeni ezahlukene zomzimba. Lezi sizibiza ngokuthi izinzwa ze-cranial. I-vagus nerve ingeyeshumi (X) yalezi zinzwa. Lona yi-cranial nerve ende kunazo zonke emzimbeni wethu.
Sinezinzwa ezimbili ze-vagus, eyodwa ohlangothini ngalunye lomzimba wethu. Zombili ziqala esiqwini sobuchopho. Bese zigijima entanyeni, ziye esifubeni, ziye esiswini. Kalula nje, i-vagus nerve iyingxenye yesekethe enkulu exhumanisa izitho ezisentanyeni, enhliziyweni, emaphashini nasesiswini nobuchopho.
Yiziphi izimo ezisetshenziswa ukwelashwa kwe-VNS?
Izinhlangano ezinkulu, njenge-U.S. Food and Drug Administration (FDA), okwamanje zivumile ukwelashwa kwe-VNS ngenxa yezimo ezintathu. Ake sibheke lolu lwazi ethebuleni.
| Isimo sezokwelapha | Indlela yokusebenzisa nokuthi ubani ofanelekela yona |
|---|---|
| Isifo Sokuxhuzula | Njengokwelashwa okungeziwe ezinganeni ezingaphezu kweminyaka engu-4 kanye nabantu abadala abane-focal seizures eziqala engxenyeni eyodwa yobuchopho futhi ezingalawulwa ngemithi. |
| Ukucindezeleka | Abantu abadala abaneminyaka engaphezu kwengu-18 ubudala abanokucindezeleka okukhulu kwesikhathi eside noma okuphindaphindiwe abangazange basabele okungenani emithini emine noma ngaphezulu ehlukene yokucindezeleka. |
| Ukuvuselelwa Kwesifo Sohlangothi | Njengosizo olwengeziwe ekuzilolongeni kokuvuselelwa kweziguli ezinokukhubazeka okuphakathi kuya kokubi kokusebenza kwesandla nengalo ngemuva kokuhlaselwa yisifo sohlangothi esibangelwa ukuvaleka komthambo wegazi. |
Isebenza kanjani le divayisi ye-VNS?
Iqiniso liwukuthi, ososayensi abakaqiniseki ngokuphelele ukuthi le divayisi ye-VNS isebenza kanjani, kodwa banemibono emihle ngayo.
- Ukulawulwa kwesifo sokuwa: Uma kwenzeka ukuquleka kwesifo sokuwa, umsebenzi kagesi wobuchopho uyaphazamiseka. Kukholelwa ukuthi ukukhuthazwa kwe-VNS kwandisa ukugeleza kwegazi ezingxenyeni ezibalulekile zobuchopho, kushintsha leli phethini likagesi eliphazamisekile, futhi kwandise amazinga e-neurotransmitters ``norepinephrine'' kanye ``serotonin'' ebuchosheni, okusiza ukulawula isifo sokuwa.
- Ukulawula ukucindezeleka: I-VNS kucatshangwa ukuthi inciphisa izimpawu zokucindezeleka ngokushintsha amazinga ama-neurotransmitter athile alawula isimo sethu sengqondo.
- Ukuvuselelwa kwesifo sohlangothi: Lokhu kuvuselelwa kuvuselela i-motor cortex, ingxenye yobuchopho elawula ukunyakaza kwezingalo nezandla zethu. Lokhu kwenza kube lula ngobuchopho ukuthi buphinde bufunde lokho kunyakaza ngesikhathi sokuzivocavoca kokuvuselelwa.
Kuzwakala kanjani ukuba nedivayisi ye-VNS emzimbeni wakho?
Esikhathini esiningi, ngeke uqaphele nokuthi le divayisi ivuliwe. Kodwa-ke, abanye abantu bangase bazizwe umehluko omncane uma ukuvuselelwa kuvuliwe.
- Umuzwa wokukitaza emphinjeni noma entanyeni
- Ukuhosha okuncane kwezwi
- Ukukhwehlela okuncane kakhulu
Ngisho noma uzizwa ngale ndlela, uvame ukujwayela ngokuhamba kwesikhathi. Kodwa uma lokhu kukhuthaza kukukhathaza, khuluma nodokotela wakho ngokushesha. Angashintsha izilungiselelo kudivayisi futhi anciphise inani lokukhuthaza.
Ubani okungafanele athole ukwelashwa kwe-VNS?
Ukwelashwa nge-VNS kungase kungafaneleki kubantu abanezimo ezithile zempilo. Uma unezinye zezimo ezilandelayo, ungase ungabi umuntu ofanelekela i-VNS.
- Uma ukhulelwe .
- Uma unezinkinga zokuphefumula njenge- asthma noma i-sleep apnea .
- Uma unezilonda zesisu ezisebenzayo (isifo sesilonda se-peptic) .
- Uma unesifo sikashukela esincike ku-insulin .
- Uma une -vagus nerve eyodwa kuphela (abanye abantu bazalwa nayo).
- Uma unesifo esibizwa ngokuthi i-dysautonomias, okuwukungasebenzi kahle kwesistimu yezinzwa ezizimele.
- Uma usuvele uthola ezinye izindlela zokwelapha ezivuselela ubuchopho .
- Uma unezinkinga zesigqi senhliziyo (ukuphazamiseka kwenhliziyo) noma ezinye izifo zenhliziyo. Uma unomlando wesifo sengqondo njenge- schizophrenia noma i-schizoaffective disorder.
- Uma uke wasuswa ingxenye yomthambo wakho we-vagus kwesobunxele ekuhlinzweni kwangaphambilini.
Kwenzekani ngaphambi nangesikhathi sokuhlinzwa kwe-VNS?
Lokhu akuyona indlela enkulu neyesabisayo yokuhlinzwa. Ngokuvamile kuthatha cishe ihora nesigamu.
Ukulungiselela ukuhlinzwa
Ngaphambi kokuhlinzwa, udokotela wakho uzokwenza ukuhlolwa okuphelele ngokomzimba. Angase futhi enze ukuhlolwa kwegazi okuningana ukuqinisekisa ukuthi azikho ezinye izinkinga zempilo ezingaphazamisa ukuhlinzwa.
Indlela ukuhlinzwa okwenziwa ngayo
Ngosuku lokuhlinzwa kwakho, uzonikezwa ama-antibiotic ukuze unciphise ingozi yokutheleleka. Uzobe usunikezwa i-anesthesia. Ungazizwa ungenamizwa kuphela endaweni yentamo nesifuba lapho kuzokwenziwa khona ukuhlinzwa, noma unganikwa i-anesthesia ejwayelekile bese ulaliswa.
Udokotela ohlinzayo wenza imicu emibili emincane kakhulu: eyodwa ohlangothini lwesobunxele lwentamo (ukuze ifinyelele emthanjeni we-vagus) kanti enye ohlangothini oluphezulu lwesobunxele lwesifuba.
1. Intambo encane enama-electrode ifakwa ngokusikwa entanyeni bese igoqwa ngokucophelela emthanjeni we-vagus.
2. Bese ucingo lufakwa ngaphansi kwesikhumba luze luyosikwa esifubeni.
3. Kusukela ekusikeni esifubeni, okukhulu kancane kunohlamvu lwemali lwama-rupee amahlanu,Isikhuthazi esifana nebhethri (ijenereyitha yokushaya kwenhliziyo) sifakwa bese sibekwa endaweni encane eyakhiwe ngaphezu komsipha wesifuba.
4. Ekugcineni, ucingo oluvela entanyeni luxhunywe kulesi sikhuthazi.
Uma konke sekuxhunyiwe, udokotela ohlinzayo uzoyihlola idivayisi. Yibeke endaweni ephansi kakhulu bese uyiqhuba cishe imizuzwana engama-30-90 ukuze abone ukuthi ukuvuselelwa kusebenza kahle yini. Uma konke kulungile, ukusikwa kuzovalwa futhi kuzofakwa izitishi.
Kwenzekani ngemva kokuhlinzwa?
Ukusebenzisa nokulungisa idivayisi
Kuzodingeka ubone udokotela wakho futhi emavikini angu-2-4 ngemva kokuhlinzwa. Yilapho-ke idivayisi izosebenza kahle khona. Udokotela uzosebenzisa ikhompyutha kanye nedivayisi ekhethekile (induku yokuhlela) ukuze enze ngezifiso izilungiselelo zesimo sakho. (Isibonelo, ukuthi izosebenza isikhathi esingakanani, ukuthi izosebenza isikhathi esingakanani, ukuthi izosebenza isikhathi esingakanani, ukuthi izosebenza isikhathi esingakanani, njll.).
Awukwazi ukushintsha lezi zilungiselelo, kodwa uzonikezwa i-magnet ongayibamba ngesandla sakho .
- Kumuntu onesifo sokuwa: Uma ukuwa sekuseduze, lo magnet ungaswayipha phezu kwedivayisi esifubeni. Lokhu kuzonikeza ukukhuthazwa okwengeziwe futhi kungamisa ukuwa noma kunciphise ubukhali bako.
- Kumuntu othola ukwelashwa kwesifo sohlangothi: Uma uswayipha le magnet ngaphambi kokuqala ukuzivocavoca, ukuvuselelwa kuzosebenza imizuzu engama-30.
- Misa idivayisi okwesikhashana: Uma ubamba imagnethi phezu kwedivayisi, ukuvuselela kuzoma. Uma ususa imagnethi, izoqala ukusebenza futhi njengoba kuhlelwe udokotela.
Impilo yebhethri
Ibhethri ledivayisi livame ukuhlala iminyaka engaba ngu-6 (eminye ihlala unyaka owodwa kuya eminyakeni engu-15). Uma ibhethri seliphelile, lonke i-stimulator kumele lishintshwe. Lokhu kudinga nokuhlinzwa okuncane okwenziwa ngokusikwa okuncane esifubeni.
Kubaluleke kakhulu: Uma unedivayisi ye-VNS, kufanele nakanjani utshele udokotela wakho ngaphambi kokuba uskene, njenge-MRI, njengoba insimu enamandla kazibuthe yomshini we-MRI ingalimaza idivayisi ye-VNS.
Yiziphi izingozi nemiphumela emibi yokwelashwa kwe-VNS?
Njenganoma yiluphi uhlobo lokwelashwa, i-VNS ingaba nezingozi ezithile kanye nemiphumela emibi. Iningi lalezi ngokuvamile alibi kakhulu futhi lizophela ngokuhamba kwesikhathi.
| Uhlobo lwengozi/umphumela ongemuhle | Incazelo |
|---|---|
| Imiphumela emibi evamile | |
| Ukushintsha izwi | Ukuhosha noma ukushintsha kwezwi |
| Umphimbo obuhlungu | Ukukhwehlela, umphimbo obuhlungu, noma ukusha |
| Ubunzima bokuphefumula | Ubunzima bokuphefumula (i-Dyspnea) |
| Okunye | Ubunzima bokugwinya (i-Dysphagia), ikhanda elibuhlungu |
| Imiphumela Emibi Engathi sína Kodwa Engavamile | |
| Ukulimala kwemizwa | Ukukhubazeka kwe-vocal cord, ubuthakathaka bemisipha engxenyeni engezansi yobuso |
| Izifo | Ukutheleleka ngokuhlinzwa |
| Izinkinga zemishini | Ukuphuka kwentambo noma ukungasebenzi kahle kwedivayisi |
Kuthatha isikhathi esingakanani ukuphulukiswa? Iyini imiphumela?
Ungaqhubeka nemisebenzi evamile ezinsukwini ezimbili (amahora angu-48) ngemva kokuhlinzwa. Izithungo ziyancibilika, ngakho-ke asikho isidingo sokuba zisikwe.
Kodwa kuthatha isikhathi ukubona imiphumela. Kungathatha unyaka noma ngaphezulu ukwazi ukuthi uzozuza kangakanani nge-VNS.
- Isifo Sokuxhuzula:I-VNS ayilaphi ngokuphelele isifo sokuwa. Ayikuvimbi ngokuphelele isifo sokuwa. Kuzodingeka uqhubeke uthatha imithi yakho yesifo sokuwa. Umgomo we-VNS ukunciphisa imvamisa, ubukhali, kanye nobude besifo sokuwa. Kokunye ukuhlola, cishe ama-43% eziguli abhekane nokwehla okungu-50% noma ngaphezulu kwemvamisa yokuwa phakathi neminyaka emithathu.
- Ukucindezeleka: Ukusebenza kahle kwe-VNS ekucindezelekeni kusacwaningwa. Ngakho-ke, kucatshangelwa kuphela ngemva kokuba imithi kanye nokwelashwa kwengqondo kwehlulekile. Kwezinye izifundo, yiziguli ezingama-20%-30% kuphela eziye zabhekana nokuthuthuka okukhulu.
- Ukuvuselelwa kwesifo sohlangothi: Kokunye ukuhlola, iziguli ezenze izivivinyo zokuvuselelwa nge-VNS stimulation zazithuthuke kakhulu ukunyakaza kwezingalo nezandla uma kuqhathaniswa nalabo ababezivocavoca ngaphandle kwe-VNS.
Ngingayibona nini udokotela?
Uma unezinye zezimpawu ezilandelayo, shayela udokotela wakho ngokushesha.
- Izimpawu zokutheleleka:
- Uma ukusikwa kubomvu, kuvuvukile, noma kubuhlungu uma kuthintwa.
- Uma isilonda sinuka kabi noma uketshezi olufana nobovu luphuma kuso.
- Uma uzizwa ushisa noma unesifo somkhuhlane.
- Ezinye izimpawu ezinkulu:
- Uma izwi liqhubeka nokuhoshozela.
- Uma ukushukunyiswa kubuhlungu, okubangela ubunzima bokuphefumula noma ukugwinya.
- Uma uzizwa ulele kakhulu.
- Uma idivayisi ibonakala ingasebenzi kahle noma kunesignali yokuthi ibhethri liphansi.
- Uma isimo sakho sezempilo (isithuthwane, ukucindezeleka) siba sibi kakhulu.
Umlayezo Wokuya Nawe Ekhaya
- I-VNS iyindlela yokwelapha ethuthukisiwe esetshenziselwa isifo sokuwa, ukucindezeleka, kanye nokuvuselelwa kwesifo sohlangothi esingenakulawulwa ngezinye izindlela zokwelapha.
- Lokhu kusebenza njenge-"pacemaker yobuchopho," kodwa akusiqedi ngokuphelele lesi sifo. Umgomo ukulawula izimpawu.
- Lokhu kudinga ukuthi kufakwe idivayisi emzimbeni ngokuhlinzwa okuncane.
- Imiphumela emibi, njengokushoshozela, ingase ivele, kodwa eminingi yayo ingalawulwa.
- Uma ufakwe idivayisi ye-VNS, kubalulekile ukuthi wazise bonke odokotela bakho ngaphambi kwanoma yikuphi ukuhlolwa kwezokwelapha noma ukwelashwa (ikakhulukazi ama-MRI scan).
- Uchwepheshe kuphela onganquma ukuthi lokhu kwelashwa kulungile yini kuwe, ngakho khuluma nodokotela wakho ukuze uthole ulwazi olwengeziwe.
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