Uma uye waba nesiqephu se-syncope (ukulahlekelwa okungahle kwenzeke esikhathini esizayo futhi kubhekiselwa njengokuphelelwa amandla), kubalulekile kuwe nodokotela wakho ukuthola ukuthi yini eyabangela isiqephu. Kunezimbangela eziningi ezingabangela i-syncope, futhi ngaphandle uma udokotela wakho esondela ekuxilongweni ngendlela ehlelekile, izinto zingadanisa ngokusheshisa. Lesi sihloko sixoxa ngendlela eqondile futhi ehlelekile yokuxilongwa kwe-syncope.
Izinto Zokuqala Okokuqala
Ekuhloliseni imbangela ye-syncope, udokotela wakho unombuzo osheshayo wokuphendula: Ingabe i-syncope eseceleni yakho ibonisa ingozi eyengeziwe yokufa okungazelelwe? Ngenhlanhla, ukufika empendulweni yalo mbuzo ngokuvamile kuyinto ecacile, futhi ngenhlanhla, kuningi lamacala impendulo yalo mbuzo ngu "Cha." Noma kunjalo, kubalulekile ukulungisa lo mbuzo ngokushesha. Njengoba i-syncope esongela ukuphila isivele isifo senhliziyo yakho, lokhu kusho ukuthi udokotela wakho udinga ukunquma ukuthi unayo, noma kungenzeka ukuthi ube nesimo senhliziyo ebalulekile. Uma udokotela wakho enquma ukuthi i-syncope yakho ingase ibe ngenxa yesimo senhliziyo, ukuhlolwa okusheshayo kuyadingeka - futhi kungase kudingeke ukunakekelwa kuze kube yilapho isifo esisongelayo singekho, noma ulashwa ngokwanele.
Uma (njengoba kunjalo kaningi njalo) udokotela wakho akatholi nhlobo uphawu lwesimo esisongela impilo, khona-ke angakwazi ukuhlola okusheshayo okusheshayo ukuze athole imbangela ye-syncope yakho, futhi ukulaliswa esibhedlela akudingeki nje kuphela.
Inqubo Ezimbili Ezihambelana Nokuhlola Ukuvumelanisa
Isigaba One - Umlando Wezokwelapha kanye noHlelo Lokudokotela
Lokhu, kude nokude, isinyathelo esibaluleke kakhulu ekutholeni imbangela ye-syncope. Umlando nokuhlolwa komzimba kunika izici ezibalulekile ekutholeni cishe zonke izimbangela ze-syncope. Kodwa-ke, kuyilapho bonke odokotela befundiswa lokhu, abaningi, ngeshwa, abakaze babonakale bayifunda.
Yingakho udinga ukuqaphela leli qiniso: Ezingxenyeni eziningi, udokotela kufanele abe nomqondo omuhle kakhulu mayelana nombangela we-syncope ngemuva kokukhuluma nawe nokukuhlola. Ngakho-ke uma udokotela wakho ehluleka ukwenza umlando wezokwelapha ngokuphelele (okuchazwe ngezansi), futhi wenza kuphela ukuhlolwa okungokwemvelo, bese engazi ukuthi yini eyenza i-syncope yakho, khona-ke kufanele ucabange ukubona omunye udokotela.
Ukuthatha umlando wezokwelapha ngokucophelela kufaka phakathi ukuthola imininingwane nganoma yimuphi umlando wenhliziyo ongase unayo, kuhlanganise: a) lonke ulwazi oluphathelene nomlando wangaphambili wesifo senhliziyo; b) uma ungenalo umlando wesifo senhliziyo, bese uhlola izici zakho ezingozini zokugula kwesifo senhliziyo ; futhi c) ukubuza nganoma yimuphi umlando womndeni ongase ube nesifo senhliziyo, ikakhulukazi noma yimuphi umlando womndeni wokufa okungazelelwe. Ngaphezu kwalokho, udokotela kufanele akucele imininingwane yeminye yeziqephu zakho ze-syncopal - konke okubuyela emuva ebuntwaneni, uma kunesidingo - kufaka phakathi ulwazi mayelana nokuthi kwenzekani ngalunye, okwenzayo ngaleso sikhathi, kungakhathaliseki ukuthi bekukhona noma yikuphi ukuxwayisa, kwahlala isikhathi eside kangakanani, kungakhathaliseki ukuthi uphinde waqaphela ngokushesha uma uwa phansi, nokuthi ngabe usutholile indlela yokukhipha iziqephu uma uzizwa ozayo.
Ukuhlola okungokwenyama kufanele kufaka phakathi izivivinyo ze-neurological and cardiac. Udokotela wakho kufanele athathe ingcindezi yakho yegazi ngengalo ngayinye, futhi kufanele alinganise ukucindezela kwegazi lakho bese ugaxa ngenkathi ulele phansi, futhi uma usulele.
Ekupheleni komlando nangokwenyama, udokotela wakho kufanele abe nomqondo omuhle kakhulu walokho okubangela i-syncope yakho. Ikakhulukazi, okungenani udokotela wakho kufanele azi ukuthi kungenzeka ukuthi unenkinga yenhliziyo ebangela i-syncope - uma kwenzeka, ukufa okungazelelwe kuyinkinga. Uma isifo senhliziyo singasolwa, khona-ke ngokuvamile udokotela wakho kuzodingeka alandise ukuhlolwa okungaphezulu kweyodwa noma ezimbili ukuqondisa ukusola kwakhe.
Kumele akwazi ukukutshela lokho acabanga ukuthi kuyinkinga, futhi kufanele akunike ngisho nomqondo wokuthi yini ezokwelapha.
Ngakolunye uhlangothi, uma udokotela wakho eseqedile nawe futhi emi lapho, ekhinyisa ikhanda lakhe, eyala ibhethri lonke lokuhlolwa nezinqubo, ukufana nesibhamu, okwenza kube nezinhlelo eziningi zezinhlaka, ngakho-ke nonke nisenzima kakhulu isikhathi. Lesi kungaba yisikhathi sokucabangela ukufuna umbono wesibili .
Isigaba sesibili - Ukuhlolwa okuqondisiwe
Ngemuva komlando nokuhlolwa komzimba:
- Uma udokotela wakho esolisa imbangela yomzimba ye-syncope yakho , ukuphanga kwe-cardiac okungavumelekile kufanele kwenziwe ngokushesha. Ezimweni eziningi, lo msebenzi uzoba ne- echocardiogram , futhi kwezinye izimo ukuhlolwa kokucindezeleka . Uma uhlobo oluthile lwezifo zenhliziyo ezivimbelayo luyatholakala (njenge- aortic stenosis ), khona-ke ukwelashwa ukuze kutholakale ukuvimbela kufanele kuhlelwe ngokushesha ngangokunokwenzeka. Uma lokhu kuhlolwa kokuqala kubonisa ukuhlelwa kwe- cardiac arrhythmia njengesizathu se-syncope yakho, ungadinga ukuhlolwa kwe-electrophysiologic . Kulesi simo, cishe kuzodingeka uhlale esibhekeni esibhedlela kuze kube yilapho uthola ukwelashwa okuqondile. Funda mayelana nezizathu zenhliziyo ze-syncope.
- Uma udokotela wakho esolisa imbangela yezinzwa, khona-ke cishe uzohlehlisa ukucwaninga kwe- CT yobuchopho noma i- electroencephalogram (i-EEG) , noma kwezinye izimo, i-angiography (ucwaningo lwama-dye ukuze ucabange ukuthi imithwalo yebuchopho ebuchosheni) ukuqinisekisa ukuxilongwa. I-Syncope ngenxa yezifo ze-neurological, noma kunjalo, akuvamile.
- Uma udokotela wakho esitholile noma esolisa kakhulu i-vasomotor syncope (okungukuthi, i- orthostatic hypotension , i- POTS , noma i- syncope ye-vasovagal ), ngokuvamile akudingeki ukuhlolwa okwengeziwe. Kwezinye izimo, ukutadisha ithala lokuthambisa kungahle kube usizo ekuqinisekiseni ukuxilongwa. Kodwa ngokuvamile, uma lolu hlobo lwe-syncope lubonakala, udokotela wakho angakwazi ukuthuthela ngokushesha ekumiseni ukwelashwa. Iningi labantu abano-syncope liba ne- vasovagal syncope .
- Uma udokotela wakho - naphezu kokuthatha umlando wezokwelapha ngokucophelela futhi enza ukuhlolwa okuphelele ngokomzimba - okwamanje akanakho incazelo enhle yokunciphisa i-syncope yakho, ngokuvamile umqondo omuhle ukwenza ukuhlolwa komzimba okungenasisindo ukulawula isifo senhliziyo ecashile. Lokhu kuhlolwa ngokuvamile kuyoba ne-echocardiogram, okuqapha ukuvame ukuvotela (lapho ugqoka umlenze womzimba ekhaya izinsuku eziningana noma amasonto), futhi nokuhlolwa kokucindezeleka okungenzeka. Ukutadisha ithebula elithambile kungasiza futhi. Uma i-syncope isalokhu ingatholakali ngemva kwalezi zifundo, ukuhlolwa kwe-electrophysiologic kungacatshangwa.
Isifingqo
Ukusebenzisa le ndlela ejwayelekile yezigaba ezimbili, kungenzeka ukuthi udokotela wakho uzokwazi ukuhlonza imbangela ye-syncope yakho ngokushesha futhi ngokunembile, futhi uzokwazi ukuqala ukwelashwa okufanele ngesikhathi esifushane.
Imithombo:
Strickberger SA, uBenson DW, Biaggioni I, et al. Isitatimende se-AHA / ACCF Scientific mayelana nokuhlolwa kwe-syncope: kusukela ku-American Heart Association Councils kwi-Clinical Cardiology, Nursing Cardiovascular, Izifo Zenhliziyo Nezingane, ne-Stroke, kanye neQiniso Lokunakekelwa Neziphumo Zokucwaninga Kwamaqembu Okusebenza; kanye ne-American College of Cardiology Foundation: ngokubambisana ne-Heart Rhythm Society: ivunywe yi-American Autonomic Society. Ukujikeleza kuka-2006; 113: 316.