I-Monitoring Devices ye-Device Monitor Rhythm, iyanciphisa Ubungozi bokufa ngokukhawuleza
I-defibrillator eyenziwe ngokutsha-ebizwa ngokuba yi-cardioverter defibrillator (i-ICD) -iyicandelo lezokwelapha elifakela ngokugqithiseleyo elisoloko lihlola intliziyo yakho isingqisho kwaye ngokuzenzekelayo ilondoloze unyango olusindisa ubomi xa unokukhawuleza uhlakulele i- hearthythmicas enobungozi ebizwa ngokuba yi- fibrillation ye- ventricular kunye ne- tachycardia ye-ventricular . Ama-ICD ayanconywa kubantu abaziwa ngokuba nomngcipheko omkhulu wokufa ngokukhawuleza kwintliziyo yokuboshwa .
Kukhangeleka njani i-ICD?
Uninzi lwama-ICD luquka i-titanium "encinci" encinci, esincinci, ebhetri eqhutywe ngebhetri, efakwe ngaphantsi kwesikhumba ngaphantsi kwe-collarbone, kwaye ezimbini okanye ezintathu "zikhokelela" (iingcingo) ezifakwe kwi-generator. Iifowuni zidluliselwa kwimithambo yegazi elisondeleyo kwaye zibeke kwindawo ezithile kwiintliziyo.
Umfanekiso kweli phepha uqhathanisa ubukhulu be-generator ye-ICD kwikota.
Kungekudala, i-ICD yangaphantsi yenziwe, apho i-generator kunye nezikhokelo zifakwa phantsi kwesikhumba, kungekhona kwimithambo yegazi kunye nentliziyo. Uhlobo olutsha oluncinci lwe-ICD lunemivuzo emininzi, kunye nezinye izinto ezingalunganga, xa kuthelekiswa ne-ICD epheleleyo. Eli nqaku likhankanya ngokukhawuleza kuphela ii-ICD eziqhelekileyo, kodwa unokufunda nge-ICD yangaphantsi.
I-generator ye-ICD iqulethe ibhetri, i-capacitors, ikhompyutheni kunye nezinye izinto zobuchwephesha. Izikhokelo zihambisa izibonakaliso ezincinane zombane (iimpawu ezilawula isigqi senhliziyo) kubuya kwi-generator, apho zihlaziywa khona rhoqo.
Ukuba i-arrhythmia eyingozi ifunyenwe, i-ICD iyayiphatha ngokukhawuleza okanye iyantyantya intliziyo ngokukhokelela.
Iyintoni i-ICD?
Umsebenzi oyintloko we-ICD kukukhusela ukufa kwegazi ngokukhawuleza ekubanjweni komzimba okubangelwa yi-tachycardia ye-ventricular okanye i-fibrillation ye-ventricular.
I-ICD izakufumana ngokuzenzekelayo ukuqala ngokukhawuleza kwezi nkunkuma eziyingozi, kwaye ngaphakathi kwemizuzwana eyi-10 ukuya kwe-20 izakuhambisa ngokuzenzekelayo ukukhutshwa kombane omkhulu (oko kukuthi, ukutshatyalaliswa) entliziyweni, okuyekelela ukulungelelanisa nokuvumela isigqithiso senhliziyo esivamile ukubuyela.
Ii-ICD ziphumelela kakhulu. I-ICD esebenze kakuhle, esebenzayo kakuhle iya kuyimisa i-arrhythmias esongela ubomi ngaphezu kwe-99% yexesha.
Ukongezelela ukuhambisa iintlungu ezithintela ukuboshwa kwentliziyo, ii-ICD ziyakwazi ukusebenza njengabaxhasi. Abakhi be-Pacemakers basebenzisa ukukhutshwa kwamandla ombane ukukhuthaza intliziyo ukuba ibetha xa izinga lentliziyo lincinci. (Qaphela: umgangatho we-pacemaker we-ICDs ongaphantsi kweyona nto ilinganiselwe - oku ngenye yezinto ezingenakulungelelaniswa kwezi zixhobo ezincinci.
Kwezinye izigulane, umsebenzi we-pacemaker we-ICD ungasetyenziselwa ukumisa iziqwenga ze-tachycardia (kodwa kungekhona i-fibrillation ye-ventricular), ngaloo ndlela ugweme isidingo sokuphazamiseka. Ekugqibeleni, ezinye ii-ICD zikwabonelela ngoncedo lwe-carnac remynchronisation (CRT) , oluya kuphucula iimpawu kubantu abanesifo senhliziyo .
Zonke ii-ICD "ziyakulungiswa," oko kuthetha ukuba ngecebo elithile leprogram elingenakuthetha ngokungahambisani ne-ICD, ugqirha unokukwazi ukutshintsha indlela indlela isebenza ngayo naziphi na izihlandlo zayo izilungiso zayo kufuneka zilungiswe.
Kodwa ngelixa ii-ICD ziyakwazi ukwenza zonke izinto ezihlukeneyo, umsebenzi wazo oyintloko kukukhusela ukufa ngokukhawuleza kwintliziyo kubantu abasengozini yokubanjwa kwenyama.
I-ICD ifakiwe njani?
Utyando olusungula i-ICD lubonwa njenge-minimally invasive, kwaye ludlalwa ngumntu we-cardiologist, usebenzisa i-anesthesia yendawo, kwi-laboratories ye-catheterization.
Isixhobo esincinci senziwe phantsi kwe-collarbone, kwaye izikhokelo zifakwe kwaye zifakwe entliziyweni zisebenzisa i-flouroscopy (i-video-x "ray") njengesikhokelo. Emva koko izikhokelo zifakwe kwi-ICD generator; ijeneretha ifakwa phantsi kwekhumba; kwaye isiza sivaliwe.
Xa i-ICD ifakiwe, ugqirha unokuvavanya idivayisi ukuqinisekisa ukuba iya kusebenza njengoko idibeneyo, ukuba kwaye xa kubanjwe intliziyo. Oku kwenziwa ngokubeka isigulane kwindawo yokulala ebuthongweni kunye ne-sedative-acting sedative, okwenyusa i-arrhythmia nokuvumela i-ICD ukuba ibone kwaye imise i-arrhythmia ngokuzenzekelayo.
Inkqubo yokufakela ngokuqhelekileyo ithatha malunga neyure okanye, kwaye kwiimeko ezininzi isigulane sinokubuyela ekhaya ngaloo mini.
Yintoni elandelwayo njenge-ICD?
Emva kokuba i-ICD ifakwe, ugqirha uya kubona isigulane kwiiveki ezine ukuya ezintandathu ukuqinisekisa ukuba indawo yokuhlinzwa iyaphiliswa ngokupheleleyo. Ukulandelelana kwexesha elide kufuna ukuba iofisi ihambele amabini amabini amaxesha amane ngonyaka. Ngethuba lezo zihlandlo, i-ICD ayixhaswanga "ngaphandle kwemibuzo" ngokusebenzisa umprofeti. Le ngxaki inikezela ugqirha ulwazi olubalulekileyo malunga nendlela i-ICD isebenza ngayo, imeko yebhetri yayo, isimo sekhokelo kunye nokuba kwaye kaninzi kangakanani i-ICD efunekayo ukunikezela unyango - kokubili unyango kunye nophatho olumangalisa.
Ama-ICD amaninzi anamandla okuthumela ngotshani lolu hlobo lwazi kumgqirha ekhaya, nge-Intanethi. Oku "ukuphenywa okude" kukuvumela ugqirha ukuba ahlole i-ICD yomntu xa kuyimfuneko, ngaphandle kokufuna isigulane ukuba ifike eofisini.
Funda kabanzi malunga nee-ICD:
- Ziziphi iingxaki nge-ICD?
- Ngubani omele afumane i-ICD?
- Ukuba ne-ICD kuthinte njani indlela yokuphila?
Imithombo:
Russo AM, Stainback RF, Bailey SR, et al. I-ACCF / HRS / AHA / ASE / HSE / HFSA / SCAI / SCCT / SCMR 2013 imigaqo yokusetyenziswa eyiyo yokufakela i-cardioverser-defibrillators kunye nokuphulukiswa kwe-cardiac-up-stability: ingxelo ye-American College of Cardiology Foundation, i-Heart Rhythm Society, i-American Heart Umbutho, i-American Society of Echocardiography, i-Heart Failure Society yaseMelika, uMbutho weeNqwelo zeMvakalelo zeMvakalelo kunye neNguqulelo, uMbutho wee-Cardiovascular Computed Tomography, kunye noMbutho we-Cardiovascular Magnetic Resonance. J Am Coll Cardiol 2013; 61: 1318.