Ukuhamba kwe-Valsalva kuyindlela ewusizo ekukhuliseni ngokweqile izwi le- vagus nererve , futhi ngokukhulisa ngokweqile ukucindezela emqaleni, ezonweni, nasezindlebeni zangaphakathi. Umqondisi weValsalva unezindlela eziningana ezisebenzayo kwezokwelapha, nasempilweni yansuku zonke.
Ngokwesibonelo, izazi ze-cardiologists zivame ukuphakamisa ukuphathwa kweValsalva ezigulini zabo ezineziqephu ze -tachycardia ezingaphezulu (SVT) , njengendlela yokuvimba i-arrhythmia uma kwenzeka.
Umshayeli we-Valsavla uyindlela ewusizo kubantu abahlukahlukene be-scuba, abantu abane-hiccups - nabanye abaningi.
Indlela I-Valsalva Maneuver Eyenziwa Ngayo.
Umshayeli weValsalva (obizwa ngokuthi u-AM Valsalva, owaqala ukuwuchaza eminyakeni engu-300 eyedlule njengendlela yokukhipha ukuphuma kwezindlebe), kwenziwa ngokuzama ukukhipha ngamandla emoyeni ovaliwe. Lokhu kungenziwa ngokugcina umlomo wakho uvaliwe futhi uphazamise impumulo yakho, kuyilapho uzama ukuphuma ngamandla. Lo mkhuba ngokushesha ukwandisa izingcindezi ezenzweni nasezindlebeni zangaphakathi. Ukufezekisa ukwanda kwezwi le-vagal, umzamo ophoqelekile wokukhipha kufanele ugcinwe imizuzwana engu-10 kuya kwangu-15.
Yini Okushiwo I-Valsalva Maneuver?
Ukuhamba kwe-Valsalva kwandisa kakhulu ukucindezela ngaphakathi kwezono zesisu, ikakhulukazi emgodini wesifuba. Ngamazwi alula, ukucindezela kwesifuba esiphakanyisiwe kushukumisa i-vagus nererve futhi kwandise ithoni ye-vagal. Kodwa-ke, umkhondo we-Valsalva ukhiqiza ngempela uchungechunge oluyinkimbinkimbi lwezenzakalo zomzimba odokotela abaye basebenza ngaphezu kweminyaka ukuze benze izinhloso eziningana.
Kusukela esimweni somzimba, umjikelezo wesibili we-Valsalva unezigaba ezine ezihlukene :
- Esigabeni soku-1 , ukuqhuma umoya ovaliwe ukwandisa umfutho ngaphakathi kwesikhumba esifubeni, okuyinto esheshayo ukuqhuma igazi ekujikelezeni kwe-pulmonary kuya kwe-atrium yenhliziyo. Ngakho, imizuzwana embalwa inani legazi eliqhunyiswa yinhliziyo landa. ( Funda mayelana namakamelo enhliziyo namagesi. )
- Esigabeni sesi-2 , inani legazi eliphambaniswa yinhliziyo liyehla ngokuzumayo. Lokhu kwehla ekuphumeni kwenhliziyo kwenzeka ngenxa yokuthi ingcindezi eyengeziwe emgodini wesifuba ivimbela noma yikuphi igazi elingabuyeli esifubeni kulo lonke umzimba, ngakho-ke ukubuyela enhliziyweni. Ukuze uhlawulele lokhu kwehla ekuphumeni kwenhliziyo, imithwalo yegazi yomzimba igxilile, futhi ukuphakama kwegazi kuphakama. Lokhu kuphakama kwengcindezi yegazi kuqhubeka isikhathi sokuhamba kwe-Valsavla.
- Isigaba sesi-3 senziwa ngokushesha lapho kuqala ukuphefumula okuvamile. Ukucindezela ngaphakathi kwesifuba kungazelelwe, futhi ukujikeleza kwepulmonary kuyaqhubeka futhi kugcwalise igazi futhi. Kodwa-ke, phakathi nalokhu kukhuliswa kwesifuba (okuyinto egcina imizuzwana engu-5 kuya kwangu-10), ukukhishwa komzimba kungase kwehle ngaphezulu.
- Okokugcina, eSigaba 4 ukugeleza kwegazi kuya enhliziyweni nasemaphaphini kubuyela esimweni esijwayelekile, njengoba kwenza ukuphuma kwenhliziyo nomfutho wegazi.
Yini i-Valsalva Maneuver esetshenziselwa yona?
Odokotela bathola umkhondo we-Valsalva ewusizo ekuhlukaniseni phakathi kwezinhlobonhlobo zezifo zenhliziyo ye- valvular . Izinhliziyo eziningi zikhononda phakathi kwesigaba sesi-2 se-Valsalva, ngoba inhliziyo ayifuni igazi elikhulu ngalesi sikhathi. Kodwa ukukhononda okuhambisana naso kokubili i- mitral valve prolapse futhi i- hypertrophic cardiomyopathy izovame ukwanda ngesikhathi sesigaba sesibili se-Valsalva.
Uma ukhuluma kabanzi, ukusetshenziswa kwezokwelapha okuyinhloko kokwenza uValsalva ukukhulisa ngokungazelelwe ithoni ye-vagal (eyenzeka ngokuyinhloko ngesikhathi sesigaba 2). Ukwengeza ithoni ye-vagal kunciphisa ukuqhutshwa komfutho we-cardiac kagesi ngokusebenzisa i- AV node , futhi lokhu okuhamba kancane kwancipha ukuqhutshwa kuyasiza kakhulu ekuqedeni izinhlobo ezithile ze-SVT (ikakhulukazi i- AV-nodal reentrant tachycardia ne- atrioventricular reentrant tachycardia ). ( Funda ngesistimu kagesi yenhliziyo. )
Lokhu kusho ukuthi abantu abaneziqephu eziphindaphindiwe zalezi zinhlobonhlobo ze-SVT (okuyizinhlobo ezimbili ezivame kakhulu) zivame ukukwazi ukumisa ngokushesha futhi ngokuthembekile ukuyeka ukuhleleka lapho kwenzeka ngokusebenzisa umkhondo we-Valsalva.
Ukuhamba kwe-Valsalva kuvame ukusetshenziselwa abahlukumezi be-scuba ngesikhathi sokuzalwa, ukulinganisa izingcindezi ezisezindlebeni eziphakathi nezingcindezi eziphakeme eziphakeme ngaphansi kwamanzi.
Umqhubi we-Valsalva angasiza odokotela ukuba babone ukulimala emgodini wesibeletho somlomo wesibeletho. Lo mkhuba wandisa kancane ukucindezelwa kwe-intraspinal - ngakho-ke uma kunesisindo somjovo (isibonelo, ngenxa ye-disvertebral disc), noma yibuphi ubuhlungu obubangelwa ukulimala kungase kwande okwesikhashana.
Abakwa-Urologists bangasebenzisa umqhubi we-Valsavla ukubasiza ukuba bahlolisise ukungabi nokucindezeleka kokucindezeleka, ngoba ukucindezelwa kwesisu okuphakeme kule nqubo kuveza kungaphazamisa ukuvuza kwamanzi.
Futhi abantu abaningi bathola ukuthi bangakwazi ukuqeda isiqephu se-hiccups ngokwenza umkhondo we-Valsalva. Kungenzeka ukuthi lokhu kuyindlela ejwayelekile kakhulu futhi ewusizo kakhulu yokusebenza kwe-Valsalva.
Izwi elivela
Ukuhamba kwe-Valsalva kuyindlela yokwandisa ukucindezela ngokweqile phakathi kwezono nezindlebe eziphakathi, nokwenyuka kwe-vagal tone. Inezinhlelo zokusebenza eziwusizo emkhakheni wezokwelapha, nasekuphileni kwansuku zonke.
> Imithombo:
> Appelamu A, uRuben A, Mann C, et al. Ukuguqulwa kwe-Postural kuya ku-standard Valsalva Maneuver yokuPhepha okuPhezulu kweSpresventricular Tachycardias (REVERT): Isivivinyo esilawulwa ngokungahleliwe. Lancet 2015; 386: 1747.
> Ikhasi RL, Joglar JA, Caldwell MA, et al. Umhlahlandlela we-ACC / AHA / HRS we-Management of Patients Adult With Tachycardia Supraventricular: Umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice Guidelines kanye ne-Heart Rhythm Society. Ukujikeleza 2016; 133: e506.