Chidule cha MAZE Mtima Process

1 -

Fungo la Atrial

Njira yothetsera vutoli ndi opaleshoni yomwe imagwiritsidwa ntchito poletsa mafinya oopsa, kapena "a-fib," mtima umene mtima umakhala wosasinthasintha. Ngati simungathe kuyendetsedwa ndi mankhwala kapena mankhwala ena, njira yothetsera vutoli ingakhale mankhwala oyenera. Icho chimatchedwa dzina ili ku zipsera zovuta zomwe zatsala pa opaleshoni yopita ku chipinda cha mtima, monga maze.

Kusagwiritsidwa ntchito mosagwiritsidwa ntchito pa matenda a atrial kungapangitse chiopsezo cha zilonda. Zingathandizenso munthu kukhala wofooka komanso wopanikizika kuyambira pamene mtima ukuponyera bwino.

Kuti mumvetse njirayi, nkofunika kudziwa kuti mtima uli ndi magetsi, omwe amayendetsa ntchito zosiyanasiyana za minofu ya mtima. Mu mtima wamba, magetsi amachititsa kuti atrium (kumtunda wamkati) azigwirizanitsa, kenako zitsulo zam'munsi.

Panthawi yogwiritsira ntchito mankhwala oopsa, chizindikirocho chimagawanika ngati kuti chimatenga njira zambiri mumsewu, zomwe zimapangitsa malo osiyanasiyana kuti agwirizane pa nthawi zosiyanasiyana pamene njira iliyonse imatenga nthawi yaitali kuti ikhale ndi chizindikiro. Izi zimayenda bwino, ndi mbali zosiyana siyana za atrium zochitika nthawi zosiyanasiyana, zimatchedwa fibrillation.

Njira yothetsera vutoli imalepheretsa kugwiritsira ntchito magetsi kuchotsa njira zambiri ndikugwiritsira ntchito njira imodzi, yomwe imalola kuti pulogalamuyo ikhale yogwirizana nthawi yomweyo.

Werengani zambiri: Mtima wa Munthu ndi Opaleshoni ya Mtima

2 -

Kufuna

Njira yowongoka siyifunika kuti ambiri a atrial fibrillation akudwala. Mankhwala amagwira ntchito bwino kwa anthu ambiri. Kwa odwala osathandizidwa ndi mankhwala okha, cardioversion angakhale sitepe yotsatira. Kutsegula mtima ndi njira yomwe magetsi amatumizidwira mumtima ndipo akhoza kubwezera wodwalayo ku chiyero chachizolowezi kwa nthawi yaitali.

Nthawi zina, odwala amasankha kukhala ndi zizindikiro zofatsa koma amaganizirani opaleshoni pamene zizindikiro zikuwonjezeka kapena zimakhala zowawa kwambiri kapena zonyalanyaza. Patapita nthawi, odwala angapeze kuti regimen yomwe inagwiritsidwa ntchito kale siidzatha kulamulira zizindikiro za matenda opatsirana pogonana. Ngati kusintha kwa mankhwala sikungapindule, njira yothetsera vutoli ingakhale yosankha, koma nthawi zambiri pokhapokha ngati zosankha zina zonse zakutha.

Ngati mwawona njirayi m'mbuyomu, kumbukirani kuti panopa pali njira zothandizira katheta zatsopano komanso zochepa kwambiri zomwe sizikusowa kuti zikhale zikuluzikulu zapamtima komanso makonzedwe a makina oyendetsa galimoto , ngakhale kuti njirayi ndi yatsopano osati amaperekedwa kuchipatala chonse. Nthaŵi zina, njira yothetsera vutoli ingagwirizane ndi njira zina, monga opaleshoni ya mtima (CABG).

3 -

Momwe Ikugwirira Ntchito

Njirayi ikhoza kuchitidwa opaleshoni yotseguka, kapena kudzera mwa njira yowonongeka yomwe imagwiritsira ntchito kathete yotsekedwa kudzera mu mitsempha yambiri ya magazi. Njira yowonongeka yochepa yomwe ikuchitika pakalipano ikuchitika m'zipatala zingapo komanso ndi zatsopano.

Mu njira ziwirizi, cholinga chake ndi kukonza kuphulika kumene kumayambitsa magawo osiyanasiyana a atrium kuti agwirizane pa nthawi zosiyana. Izi zimachitika mwa opaleshoni kukakamiza kugwedeza magetsi kukhala njira imodzi, zomwe zimachititsa kuti atrium aziwotcha bwino. M'malo motenga njira zingapo kudzera mu "maze" mpaka minofu ya atrium, chizindikiro cha magetsi chimakakamizidwa kutenga njira imodzi, kutsirizitsa kusintha kwake.

Izi zimachitika mwa kudula kapena kusowa njira zina. Mphamvu ya magetsi sitingathe kudutsa kapena njira zovuta, choncho opaleshoniyo amagwiritsa ntchito scalpel, abasi-frequency ablation (mtundu wa kutentha) kapena cryonics (ozizira) kuti asiye njira zosafuna.

4 -

Opaleshoni

Opaleshoni imayambira ndi anesthesia ambiri . Pamene anesthesia ikayamba kugwira ntchito ndipo wodwala atsekedwa (kupuma mothandizidwa ndi makina), dokotalayo akhoza kuyamba mwa kupanga chotsitsimutsa chamuyaya, kutengeka pa sternum (breastbone). Sternum imadulidwa mu magawo awiri pogwiritsa ntchito macheka, ndikuphwanyika fupa. Izi zimathandiza dokotalayo kuti afike molunjika pamtima.

Dokotalayo amatha kugwiritsa ntchito zipangizo zingapo panthawiyi kuti asamawononge njira zosafunika zomwe zimayambitsa magetsi a mtima, monga scalpel, kapena chida chotentha kapena chozizira kwambiri. Dokotala ataganizira kuti njira zonsezi zawonongeka, sternum, kapena breastplate, imatsekedwa ndipo amagwiritsa ntchito waya wothandizira, wothandizana palimodzi kuti athe kuchiritsa bwino.

Nthaŵi zina, zing'onozing'ono zingagwiritsidwe pansi pa chifuwa, ndipo zikhomo za chifuwa zimayikidwa kuchotsa magazi aliwonse omwe angapangidwe pamtima. Miphikayi imagwirizanitsidwa ndi chipangizo chosungirako chobera kuti magazi atha kuyesedwa, kapena nthawi zina, magazi amatha kubwezeretsedwa kwa wodwalayo pambuyo pa opaleshoniyo.

5 -

Kubwezeretsa

Pambuyo pa ndondomekoyi, mukhoza kuyembekezera kuthera masiku amodzi kapena ochuluka mu ICU kapena malo osamalira mtima. Mosiyana ndi opaleshoni zambiri, palibe mankhwala omwe amapatsidwa kuti am'dzutse wodwalayo. M'malo mwake, anesthesia amaloledwa kuvala maola angapo.

Panthawi ya ICU, ntchito yogwiritsira ntchito magetsi idzayang'aniridwa mosamala kuti mudziwe ngati ndondomekoyo ili bwino. Pamene anesthesia ikatha, budu lopuma lidzachotsedwa, ndipo kawirikawiri mkati mwa opaleshoni 12 odwala amathandizidwa ku mpando. Ngakhale zingawoneke zachilendo kukhala ndikuyenda mofulumira pakatha opaleshoni, izi ndi mbali yofunikira ya kuchira ndipo zimathandiza kupewa mavuto monga magazi ndi chibayo.

Pakhoza kukhala mawaya a pacemaker osakhalitsa omwe amachokera ku incision kotero kuti pacemaker yapansi ingagwiritsidwe ntchito ngati mwadzidzidzi. Nthawi zambiri, izi sizili zofunikira-mawaya ndiwo njira yothetsera vuto ngati pacemaker ikufunika pakuthandizidwa.

Nthawi zambiri, phokoso la pacemaker lingafunike, makamaka ngati njira yamagetsi imene yasiyidwayo siimapangitsa kuti atrium ayambe kuganiza bwino. Chombo cha pacemaker chimatumiza magetsi omwe amayamba ndi mtima ndipo amalinganiza kuti atumize chizindikiro kwa atrium kapena onse awiri, malingana ndi malo ndi chikhalidwe cha vutoli.

Odwala omwe ali ndi njira zochepa zomwe zimawonongeka ndizochitika ku ICU kwa masiku angapo kuti athe kufufuza koma akhoza kubwerera kuntchito yachizolowezi ndikugwira ntchito mofulumira kuposa odwala omwe ali ndi njira yowonekera mtima. Panthawiyi, ndi masabata otsatirawa, kusamalidwa ndikofunika kwambiri kuti muteteze matenda .

Kuchokera kwa opaleshoni ya mtima yotseguka ndi masabata asanu ndi atatu kapena kuposerapo, pamene njira yowonongeka yochepa imakhala yochepa kwambiri. Pafupifupi 90 peresenti ya odwala omwe ali ndi njirayi amapewa mpumulo ku zizindikiro za matenda opatsirana pogonana atatha kuchira. Odwala ena angafunikire kutenga nawo mbali pamtima pambuyo pa opaleshoni, kuti adzipezenso mphamvu ndi mphamvu.

> Zotsatira:

> Kuperekera kwa Atrial Fibrillation Ablation. Mchipatala cha Mayo. Kufikira April, 2009 http://www.mayoclinic.org/atrial-fibrillation-ablation/

> Kodi Ndondomeko ya Cox-Maze ndi yotani? Kampani ya Cleveland. Mwezi wa April, 2009 http://my.clevelandclinic.org/heart/disorders/electric/surgtx.aspx