Swan-Ganz - catheterization yamtima yolondola

Catheterization ya Swan-Ganz (yomwe imadziwikanso kuti catheterization yamtima woyenera kapena catheterization yamapapo yam'mapapo) ndikudutsa kachubu kakang'ono (catheter) mbali yakumanja ya mtima ndi mitsempha yolowera m'mapapu. Zimachitika kuwunika momwe mtima ukugwirira ntchito komanso kuthamanga kwa magazi komanso kupsinjika mkati ndi mozungulira mtima.

Kuyesaku kumatha kuchitika mutagona m'chipinda cha odwala mwakayakaya (ICU) kuchipatala. Zitha kuchitikanso m'malo ena apadera monga labotale ya mtima yothetsera catheterization.

Mayeso asanayambe, mutha kupatsidwa mankhwala (ogonetsa) okuthandizani kupumula.

Mudzagona pa tebulo lokutidwa. Dokotala wanu adzaphulika mumtsinje pafupi ndi kubuula kapena m'manja mwanu, kapena m'khosi. Chubu chosinthika (catheter kapena sheath) chimayikidwa kudzera pobowola. Nthawi zina, zimayikidwa mwendo kapena m'manja mwanu. Mudzakhala ogalamuka panthawiyi.

Catheter yayitali imayikidwa. Kenako amasunthidwa mosamala mchipinda chapamwamba chakumanja kwa mtima. Zithunzi za X-ray zitha kugwiritsidwa ntchito kuthandiza wothandizira zaumoyo kuwona komwe catheter iyenera kuyikidwa.

Magazi atha kuchotsedwa mu catheter. Magazi awa amayesedwa kuti aone kuchuluka kwa mpweya m'mwazi.

Munthawi imeneyi, mtima wanu umayang'anitsitsa nthawi zonse pogwiritsa ntchito electrocardiogram (ECG).

Simuyenera kudya kapena kumwa chilichonse kwa maola 8 mayeso asanayambe. Mungafunike kukhala mchipatala usiku woti ayesedwe. Kupanda kutero, mutha kukafika kuchipatala m'mawa wa mayeso.

Mudzavala mkanjo wachipatala. Muyenera kusaina fomu yovomerezera musanayesedwe.Wothandizira anu adzafotokozera njirayi ndi kuopsa kwake.

Mutha kupatsidwa mankhwala okuthandizani kupumula musanachitike. Mudzakhala ogalamuka ndipo mutha kutsatira malangizo mukamayesedwa.

Mutha kukhala osasangalala pamene IV imayikidwa m'manja mwanu. Muthanso kumva kukakamizidwa pamalopo pomwe catheter imayikidwa. Kwa anthu omwe akudwala kwambiri, catheter imatha kukhala m'malo masiku angapo.

Mutha kukhala osasangalala pamene dera la mtsempha ladzaza ndi mankhwala oletsa kupweteka.

Njirayi imachitika kuti muwone momwe magazi amayendera (amazungulira) mwa anthu omwe ali ndi:

• Zovuta zachilendo mumitsempha yamtima
• Kutentha
• Matenda amtima obadwa nawo
• Mtima kulephera
• Matenda a impso
• Mavavu amtima wotayikira
• Mavuto am'mapapo
• Kusokonezeka (kuthamanga kwambiri kwa magazi)

Zitha kuchitidwanso kuti muwone zovuta zamatenda amtima. Zimasonyezanso momwe mankhwala ena amtima amagwirira ntchito.

Catheterization ya Swan-Ganz itha kugwiritsidwanso ntchito kuzindikira kuti magazi amayenda bwino pakati pa magawo awiri amtima omwe nthawi zambiri samalumikizidwa.

Zomwe zitha kupezekanso kapena kuyesedwa ndi Swan-Ganz catheterization ndi monga:

• Tamponade yamtima
• Matenda amtima obadwa nawo
• Matenda oopsa
• Kuletsa mtima kapena kuchepa kwa mtima

Zotsatira zoyeserera izi ndi izi:

• Chizindikiro cha mtima ndi malita 2.8 mpaka 4.2 pamphindi pa mita mita imodzi (ya padziko lapansi)
• Kupsyinjika kwamitsempha yama pulmonary systolic kuthamanga ndi 17 mpaka 32 millimeter a mercury (mm Hg)
• Mitsempha yama pulmonary imatanthauza kupanikizika ndi 9 mpaka 19 mm Hg
• Kupsyinjika kwa diastolic m'mapapo ndi 4 mpaka 13 mm Hg
• Kupsyinjika kwa capillary wedge kuthamanga ndi 4 mpaka 12 mm Hg
• Kupanikizika kwamatenda oyenera ndi 0 mpaka 7 mm Hg

Zotsatira zachilendo zitha kukhala chifukwa cha:

• Mavuto amtundu wamagazi, monga mtima kulephera kapena mantha
• Matenda a valavu yamtima
• Matenda am'mapapo
• Mavuto azomangamanga ndi mtima, monga shunt yochokera ku atrial kapena ventricular septal chilema

Zowopsa za njirayi ndi monga:

• Kukhwimitsa mozungulira dera lomwe kateti idalowetsedwa
• Kuvulaza mtsempha
• Kubowola m'mapapo ngati khosi kapena chifuwa cha minyewa zigwiritsidwa ntchito, ndikupangitsa kugwa kwamapapo (pneumothorax)

Mavuto osowa kwambiri ndi awa:

• Matenda a mtima omwe amafunikira chithandizo
• Tamponade yamtima
• Embolism yoyambitsidwa ndi magazi kumapeto kwa catheter
• Matenda
• Kuthamanga kwa magazi

Kumanga catheterization yamtima; Catheterization - mtima wamanja

• Swan Ganz catheterization

Hermann J. Catheterization yamtima. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: mutu 19.

Kapur NK, Sorajja P. Wowopsa wa hemodynamics. Mu: Sorajja P, Lim MJ, Kern MJ, olemba., Eds. Buku la Kern's Cardathe Catheterization. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2020: mutu 4.

Shreenivas SS, Lilly SM, Herrmann HC. Zowonjezera pakuwopsa kwamtima. Mu: Topol EJ, Teirstein PS, olemba. Buku Lophunzitsira la Cardiology. 8th ed. Philadelphia, PA: Elsevier; 2020: mutu 22.