Chokhazikika cha Cardioverter Defibrillator (ICD)

Zamkati

• Kodi chosinthira cha Cardioverter defibrillator ndi chiyani?
• Chifukwa chiyani ndikufunika chokhazikika cha Cardioverter defibrillator?
• Kodi chodulira cha mtima chosinthira chimagwira bwanji?
• Kodi ndingakonzekere bwanji?
• Nchiyani chimachitika panthawiyi?
• Ndi zoopsa ziti zomwe zimakhudzana ndi njirayi?
• Kodi chimachitika ndi chiyani pambuyo pa ndondomekoyi?
• Kodi chiyembekezo chanthawi yayitali ndichotani?

Kodi chosinthira cha Cardioverter defibrillator ndi chiyani?

An implantable cardioverter defibrillator (ICD) ndichida chaching'ono chomwe adotolo angayike pachifuwa chanu kuti muthandize kuwongolera kugunda kwamtima, kapena arrhythmia.

Ngakhale ndi yaying'ono kuposa kakhadi kakang'ono, ICD imakhala ndi batire ndi kompyutayi yaying'ono yomwe imayang'anira kugunda kwa mtima wanu. Kompyutayo imabweretsa zododometsa zazing'ono zamagetsi pamtima panu nthawi zina. Izi zimathandiza kuwongolera kugunda kwa mtima wanu.

Madokotala nthawi zambiri amaika ma ICD mwa anthu omwe ali ndi ziwopsezo zowopsa ndipo ali pachiwopsezo chomangidwa mwadzidzidzi ndi mtima, zomwe mtima umasiya kugunda. Arrhythmias imatha kukhala yobadwa (china chomwe munabadwa nacho) kapena chizindikiro cha matenda amtima.

Ma ICD amadziwikanso kuti zida zopangira mtima kapena zotetezera.

Chifukwa chiyani ndikufunika chokhazikika cha Cardioverter defibrillator?

Mtima wanu uli ndi atria awiri (zipinda zakumanzere kumanja ndi kumanja) ndi ma ventricles awiri (zipinda zamanzere kumanzere ndi kumanja). Ma ventricle anu amapopa magazi kuchokera mumtima mwanu kupita mthupi lanu lonse. Zipinda zinayi za mtima wanu zimalumikizana munthawi yake kupopera magazi mthupi lanu lonse. Izi zimatchedwa mungoli.

Mfundo ziwiri mumtima mwanu zimayendetsa kayendedwe ka mtima wanu. Node iliyonse imatumiza chidwi chamagetsi munthawi yake. Kutengeka kumeneku kumapangitsa minofu ya mtima wanu kugwedezeka. Choyamba mgwirizano wa atria, kenako ma ventricles contract. Izi zimapanga pampu.

Nthawi yakulakalaka izi itatha, mtima wanu sukupopa magazi moyenera. Mavuto amtundu wamtima muma ventricles anu ndi owopsa chifukwa mtima wanu umatha kupopera. Izi zitha kupha ngati simulandila chithandizo nthawi yomweyo.

Mutha kupindula ndi ICD ngati muli:

• mothamanga kwambiri komanso wowopsa pamtima wotchedwa ventricular tachycardia
• kupopera kosasunthika, komwe kumatchedwa kung'ung'uza kapena kutsekemera kwamitsempha yamagetsi
• mtima wofooka chifukwa cha mbiri ya matenda amtima kapena matenda amtima am'mbuyomu
• kukulitsa kapena kukulitsa minofu yamtima, yomwe imatchedwa kuti dilated, kapena hypertrophic, cardiomyopathy
• Matenda obadwa nawo amtima, monga QT syndrome, yomwe imapangitsa kuti mtima ugwedezeke
• kulephera kwa mtima

Kodi chodulira cha mtima chosinthira chimagwira bwanji?

ICD ndi kachipangizo kakang'ono kamene kamaikidwa m'chifuwa. Gawo lalikulu, lomwe limatchedwa kuti pulse jenereta, limakhala ndi batire ndi kompyutala yaying'ono yomwe imayang'anira kulira kwa mtima wanu. Ngati mtima wanu ukugunda mofulumira kwambiri kapena mosasinthasintha, makompyuta amapereka mphamvu zamagetsi kuti athetse vutolo.

Mawaya omwe amatchedwa lead amatuluka kuchokera ku jenereta yamagetsi kupita kumadera ena amtima wanu. Izi zimatsogolera pamagetsi amagetsi omwe amatumizidwa ndi wopanga.

Kutengera matenda anu, dokotala angakulimbikitseni imodzi mwanjira zotsatirazi za ICD:

• Chipinda chimodzi cha ICD chimatumiza magetsi pamagetsi oyenera.
• Chipinda chamkati cha ICD chimatumiza zisonyezo zamagetsi ku atrium yoyenera ndi ventricle yakumanja.
• Chida chobisalira chimatumiza magetsi pama atrium oyenera komanso ma ventricle onse. Madokotala amagwiritsa ntchito anthu omwe ali ndi vuto la mtima.

ICD imaperekanso mitundu inayi yazizindikiro zamagetsi pamtima panu:

1. Kutaya mtima. Cardioversion imapereka mphamvu yamagetsi yamagetsi yomwe imatha kumva ngati kugundana pachifuwa. Imabwezeretsa kugunda kwa mtima kukhala wabwinobwino ikazindikira kugunda kwamtima kwambiri.
2. Kutsegula. Kutsekemera kumatumiza chizindikiro champhamvu kwambiri chamagetsi chomwe chimabwezeretsanso mtima wanu. Kumverera kumakhala kowawa ndipo kumatha kukugwetsani pansi koma kumatenga mphindi yokha.
3. Antitachycardia. Antitachycardia pacing imapereka mphamvu zochepa zomwe zimapangitsa kuti mtima ukhale wogunda. Nthawi zambiri, simumva kalikonse pomwe zimachitika. Komabe, mutha kumva kaphokoso kakang'ono pachifuwa chanu.
4. Bradycardia. Bradycardia pacing imabwezeretsa kuthamanga kwanthawi zonse kugunda kwamtima komwe kumachedwa kwambiri. Zikatero, ICD imagwira ntchito ngati pacemaker. Anthu omwe ali ndi ma ICD nthawi zambiri amakhala ndi mitima yothamanga kwambiri. Komabe, defibrillation nthawi zina imatha kupangitsa mtima kuchepa kufika pamlingo wowopsa. Bradycardia pacing imabweretsanso mayendedwe mwachibadwa.

Kodi ndingakonzekere bwanji?

Simuyenera kudya kapena kumwa chilichonse pakati pausiku patsiku lomwe musanachite. Dokotala wanu amathanso kukupemphani kuti musiye kumwa mankhwala ena, monga aspirin kapena omwe amasokoneza magazi. Musanachite izi, onetsetsani kuti muwauze adotolo zamankhwala, mankhwala owonjezera omwe mumalandira, komanso zowonjezera zomwe mumamwa.

Simuyenera kusiya kumwa mankhwala osalankhula ndi dokotala poyamba.

Nchiyani chimachitika panthawiyi?

Njira yokhazikitsira ICD imakhala yovuta kwambiri. Nthawi zambiri mumakhala mu labotale ya electrophysiology pomwe katswiri wamagetsi amaika chipangizocho. Nthawi zambiri, mudzakhala ogalamuka pochita izi. Komabe, mudzalandira mankhwala okutonthozerani kuti akupangitseni kugona ndi mankhwala oletsa ululu am'deralo kuti asokonezeke m'chifuwa.

Pambuyo pong'amba pang'ono, dokotalayo amawongolera zotsogolera kudzera mumitsempha ndikuziyika pazigawo zam'mimba mwanu. Chida chowunikira X-ray chotchedwa fluoroscope chingathandize kutsogolera dokotala wanu pamtima panu.

Kenako amalumikiza kumapeto ena akutsogolera ku jenereta yamagetsi. Dotolo amatumbula pang'ono ndikuyika chipangizocho m'thumba la khungu pachifuwa, nthawi zambiri pansi paphewa lanu lamanzere.

Njirayi imatenga pakati pa ola limodzi kapena atatu. Pambuyo pake, mudzakhala mchipatala kwa maola osachepera 24 kuti muchiritse ndikuwunika. Muyenera kumva kuti mwachira patadutsa milungu inayi kapena isanu ndi umodzi.

Dokotala amathanso kuyika ICD opaleshoni pansi pa anesthesia wamba. Poterepa, nthawi yochira kuchipatala imatha kukhala mpaka masiku asanu.

Ndi zoopsa ziti zomwe zimakhudzana ndi njirayi?

Monga opaleshoni iliyonse, njira yokhazikitsira ICD imatha kuyambitsa magazi, kupweteka, komanso matenda pamalowo. N'zothekanso kuti thupi lanu likhale ndi vuto linalake chifukwa cha mankhwala omwe mumalandira mukamachita izi.

Mavuto ena akulu okhudzana ndi njirayi ndi osowa. Komabe, atha kuphatikiza:

• kuundana kwamagazi
• kuwonongeka kwa mtima wanu, mavavu, kapena mitsempha
• madzimadzi ozungulira mtima
• matenda amtima
• mapapo anakomoka

Ndizothekanso kuti chida chanu nthawi zina chimasokoneza mtima wanu mosafunikira. Ngakhale zodabwitsazi ndizachidule komanso zopanda vuto, mwina mungamve. Ngati pali vuto ndi ICD, electrophysiologist wanu angafunikire kuyikonzanso.

Kodi chimachitika ndi chiyani pambuyo pa ndondomekoyi?

Kutengera ndi momwe zinthu ziliri, kuchira kumatha kutenga masiku angapo kapena milungu ingapo. Pewani zochitika zowononga kwambiri ndikukweza zolemetsa kwa mwezi umodzi mutatha kuchita.

American Heart Association ikuletsa kuyendetsa galimoto kwa miyezi isanu ndi umodzi mutayendetsa kachitidwe ka ICD. Izi zimakupatsani mwayi kuti muwone ngati mantha anu angakupangitseni kukomoka. Mutha kulingalira zoyendetsa galimoto ngati mupita nthawi yayitali osadandaula (miyezi 6 mpaka 12) kapena ngati simukomoka mukagwidwa ndi mantha.

Kodi chiyembekezo chanthawi yayitali ndichotani?

Kukhala ndi ICD ndikudzipereka kwamuyaya.

Mukachira, dokotala wanu adzakumana nanu kuti apange pulogalamu yanu. Muyenera kupitiliza kukumana ndi dokotala pafupifupi miyezi itatu kapena isanu ndi umodzi iliyonse. Onetsetsani kuti mukumwa mankhwala omwe akupatsani ndikutsatira momwe moyo wanu umasinthira zakudya zomwe dokotala akukulimbikitsani.

Mabatire mu chipangizocho amakhala zaka zisanu mpaka zisanu ndi ziwiri. Mufunika njira ina kuti musinthe mabatire. Komabe, njirayi ndiyovuta pang'ono kuposa yoyambayo.

Zinthu zina zimatha kusokoneza momwe makina anu amagwirira ntchito, chifukwa chake muyenera kuzipewa. Izi zikuphatikiza:

• machitidwe achitetezo
• zida zina zamankhwala, monga makina a MRI
• magudumu amagetsi

Mungafune kunyamula khadi muchikwama chanu kapena kuvala chibangili chazachipatala chomwe chimafotokoza mtundu wa ICD womwe muli nawo.

Muyeneranso kuyesa kusunga mafoni ndi mafoni ena osachepera mainchesi sikisi kuchokera ku ICD yanu.

Uzani dokotala wanu ngati mukukumana ndi vuto lililonse ndi chida chanu, ndipo itanani dokotala wanu nthawi yomweyo ngati defibrillator yanu ikudabwitsani kuyambiranso mtima wanu.