Izilinganiso Zedivaysi Yesivinini Isingeniso Senhliziyo, Inciphisa Ingozi Yokufa Okungazelelwe
I-defibrillator ehlongozwayo - ebizwa nangokuthi i-cardioverter defibrillator (ICD) engenakunyakaziswa - idivayisi yezokwelapha eyenziwe ngokuhlinzekwa ukuthi ihlolisise isigqi senhliziyo yakho futhi ihlinzekele ngokuzenzakalelayo ukwelashwa okusindisa impilo uma kwenzeka ngokuzumayo uhlakulele i- arrhythmias yenhliziyo eyingozi eyaziwa ngokuthi i -fibrillation ye- ventricular kanye ne- tricycardia ye-ventricular . Ama-ICD anconywa ngabantu abaziwa ukuthi banengozi enkulu yokufa ngokungazelelwe kusuka ekuboshiwe inhliziyo .
Yini i-ICD ebukeka?
Ama-ICD amaningi ahlanganisa i-titanium "generator" encane, encane, ethintekayo ebhethri ebizwa ngokuthi "generator," efakwe ngaphansi kwesikhumba ngaphansi kwe-collarbone, futhi "amabili" noma "izintambo" ezimbili ezinamathiselwe ku-generator. Izintambo zidluliselwa emithanjeni yegazi eziseduze futhi zibeke ezindaweni ezithile ngaphakathi kwenhliziyo.
Isithombe kuleli khasi siqhathanisa ubukhulu be-generator ejwayelekile ye-ICD engxenyeni.
Muva nje, i-ICD engaphansi komzimba ithuthukisiwe, lapho i-generator kanye nemikhombandlela ibekwe ngaphansi kwesikhumba, hhayi emifuleni yegazi nangenhliziyo. Uhlobo olusha, olungavumelekile lwe-ICD lunezinzuzo eziningana, kanye nezinye izinto ezingalungile, uma kuqhathaniswa ne-ICD ejwayelekile. Lesi sihloko sibhekisela ngqo kuma-ICD ajwayelekile, kodwa ungafunda mayelana ne-ICD engaphansi.
I-generator ye-ICD iqukethe ibhethri, ama-capacitors, ikhompuyutha nezinye izinto zobuchwepheshe eziyinkimbinkimbi. Imikhombandlela idlulisela izimpawu ezincane zamagesi (izinhlamvu ezilawula isigqi senhliziyo) emuva ku-generator, lapho zihlaziywa khona njalo.
Uma kutholakala i-arrhythmia eyingozi, i-ICD iyayiphatha ngokushesha ngokuhamba noma ukushaqisa inhliziyo ngenhla.
Iyini i-ICD?
Umsebenzi oyinhloko we-ICD ukuvimbela ukufa okungazelelwe kwe- cardiac ekuboshweni komzimba okubangelwa yi-ventricular tachycardia noma i-fibrication ye-ventricular.
I-ICD izothola ngokuzenzekelayo ukuqala okungazelelwe kwalezi zi-arrhythmias eziyingozi, futhi kungakapheli imizuzwana engu-10 kuya kwezingu-20 kuzonikezela ukukhishwa okukhulu kagesi (okungukuthi, ukushaqeka) enhliziyweni, okwenza u-arrhythmia futhi uvumele isigqi senhliziyo evamile ukubuya.
I-ICD iphumelela kakhulu. I-ICD efakwe kahle, esebenzayo kahle izoyeka lezi zigaba zokusongela ezingaphezu kuka-99% wesikhathi.
Ngaphezu kokuletha ukushaqeka okuvimbela ukuboshwa kwenhliziyo, ama-ICD angasebenza futhi njengama-pacemakers. Abakwa-Pacemakers basebenzisa ukukhishwa kwamagesi amancane ukukhuthaza inhliziyo ukuba ishaye uma izinga lenhliziyo lincane kakhulu. (Qaphela: isici se-pacemaker se-ICDs esincane sinomkhawulo - lokhu kungenye yezinkinga zalawa madivayisi angenayo.)
Kwezinye iziguli, umsebenzi we-pacemaker we-ICD ungasetshenziswa futhi ukuyeka iziqephu ze-tricycardia ye-ventricular (kodwa hhayi i-fibrillation ye-ventricular), ngaleyo ndlela igweme isidingo sokuphazamiseka. Okokugcina, amanye ama-ICD angaphinde ahlinzekele ukuphefumula komzimba (CRT) , okungathuthukisa izimpawu kubantu abanesifo senhliziyo .
Wonke ama-ICD "alungiswa," okusho ukuthi ngedivaysi ekhethiwe yokwenza ucingo engaxhunywanga ne-ICD, udokotela angashintsha kalula indlela idivayisi isebenza ngayo noma nini lapho izilungiselelo zayo kudingeka zilungiswe.
Kodwa ngenkathi ama-ICD ekwazi ukwenza zonke lezi zinto ezihlukene, umsebenzi wabo oyinhloko ukuvimbela ukufa okungazelelwe komzimba kubantu abasengozini yokuboshwa komzimba.
I-ICD ifakiwe kanjani?
Ukuhlinzekwa ukufaka i-ICD kubhekwa njengento encane, futhi kuvame ukuqhutshwa ngumuntu we-cardiologist, usebenzisa i-anesthesia yendawo, ekliniki ye-catheterization cardiac.
Ukucubungula okuncane kwenziwa ngaphansi kwe-collarbone, futhi imikhombandlela ifakwe futhi ibekwe enhliziyweni usebenzisa i-flouroscopy (i-x-ray "ividiyo") njengesiqondiso. Khona-ke umkhombandlela unamathele ku-generator ye-ICD; i-generator ifakwa ngaphansi kwesikhumba; futhi ukukhishwa kuvaliwe.
Lapho i-ICD isetshenzisiwe, udokotela angase avivinye idivayisi ukuqinisekisa ukuthi izosebenza njengoklanyelwe, uma ngabe ukuboshwa komzimba kwenzeka noma nini. Lokhu kwenziwa ngokubeka isiguli ukulala okuncane ngokubambezela okufutshane, bese kunciphisa i-arrhythmia futhi kuvumela i-ICD ukuthi ithole futhi imise i-arrhythmia ngokuzenzekelayo.
Inqubo yokungenisa ngokuvamile ithatha cishe ihora noma ngaphezulu, futhi ezimweni eziningi isiguli singaya ekhaya ngosuku olufanayo.
Kuyini Ukulandelwa Okufana Ne-ICD?
Ngemuva kokuba i-ICD isetshenziswe, udokotela uzobona isiguli emavikini amane kuya kweyisithupha ukuqinisekisa ukuthi indawo yokuhlinzwa iphiliswe ngokugcwele. Ukulandelwa kwesikhathi eside kudinga ukuthi ihhovisi lihambele izikhathi ezimbili kuya kwezine ngonyaka. Kuzo zonke lezi zihambeli, i-ICD ingena "ngaphandle kokucutshungulwa" ngaphandle kokusebenzisa umlimi. Lokhu kuphazamisa udokotela ulwazi olubalulekile mayelana nokuthi i-ICD isebenza kanjani, isimo sebhethri, isimo semikhombandlela nokuthi ngabe i-ICD idinga kangakanani futhi kaningi kangakanani ukuletha ukwelapha - kokubili ukwelashwa okuqhubekayo kanye nokwelapha okushaqisayo.
Ama-ICD amaningi anamuhla angakwazi ukuthumela lolu hlobo lwolwazi ngodokotela ekhaya, nge-intanethi. Lesi sici esikude "sokuphenya" sivumela udokotela ukuba ahlole i-ICD yomuntu uma kunesidingo, ngaphandle kokuthi isiguli sifinyelele ehhovisi.
Funda kabanzi mayelana nama-ICD:
- Yiziphi Izinkinga Zama-ICD?
- Ubani Okufanele Athole i-ICD?
- Ukuthi Ukuba ne-ICD kuthinta kanjani indlela yakho yokuphila?
Imithombo:
Russo AM, Stainback RF, Bailey SR, et al. I-ACCF / HRS / AHA / ASE / ASE / HFSA / SCAI / SCCT / SCMR 2013 indlela efanele yokusetshenziswa ye-cardioverter-defibrillators ne-cardiac resynchronization therapy: umbiko we-American College of Cardiology Foundation efanelekayo yokusebenza, iqembu le-Heart Rhythm Society, i-American Heart Umhlangano, i-American Society of Echocardiography, i-Heart Failure Society of America, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, kanye neNhlangano Yezinhliziyo Zomzimba I-Magnetic Resonance. J Am Coll Cardiol 2013; 61: 1318.