Mphamvu yamagetsi ya mtima ndi yofunika chifukwa imayendetsa mtima wamtima ndipo chifukwa chosawonongeka mu magetsi ndizo zimayambitsa matenda ambiri a mtima. Phunziro la EP electrophysiology (EP kuphunzira) ndiyeso yapadera yothandizira ma electrode catheters (mapulogalamu osinthika, osungunuka ndi zitsulo zamagetsi) amalowetsedwa mu mtima kuti aphunzire magetsi a mtima.
Kodi EP imapangidwa bwanji?
Ngati dokotala akukuuzani kuti mukufufuza pa EP, mudzabweretsedwa ku labotale ya electrophysiology (labotale yachipatala) ndikugona pa tebulo lofufuzira. Mudzapatsidwa mankhwala a anesthesia, ndipo mwinamwake wochepetsetsa pang'ono, ndiyeno magetsi a electrode adzalowetsedwa mu mitsempha imodzi kapena yambiri ya magazi. (Catheters amaloledwa kupyolera mu kapangidwe kakang'ono kapena pogwiritsa ntchito ndodo ya singano, kawirikawiri mu mkono, kubuula kapena khosi. Nthawi zambiri amagwiritsa ntchito catheters awiri kapena atatu, ndipo amatha kuyika pa malo amodzi.) Pogwiritsa ntchito fluoroscopy (mofanana ndi x-ray), catheters amapita patsogolo mitsempha ya mitsempha ndipo amaika m'madera ena mkati mwa mtima.
Kamodzi akayikidwa bwino, kathetti ya electrode amagwiritsidwa ntchito kuchita ziwiri zazikuluzikulu: kulemba zizindikiro zamagetsi zomwe zimapangidwa ndi mtima komanso kuyenda mofulumira mtima. (Pacing imachitika mwa kutumiza zizindikiro zazing'ono zamagetsi kupyolera mu catheter ya electrode.) Polemba ndi kuyendetsa kuchokera kumalo okondweretsa mkatikati mwa mtima, mitundu yambiri ya mtima wamaganizo imatha kuphunzira bwino.
Mukamaliza kukonza, catheter (s) ikuchotsedwa. Kutsekemera kumayang'aniridwa mwa kuyika kukakamiza pamalo ochepetsera malo kwa mphindi 30 mpaka 60.
Ndi mitundu yanji ya Arrhythmias yomwe EP ingaphunzire?
Kufufuza kwa EP kungawathandize kufufuza onse a bradycardias (ochedwa mtima arrhythmias) ndi tachycardias
Ngati kafukufuku wa EP amavumbula chinthu chofunika kwambiri cha bradycardia, pangakhale phokoso lokhazikika lokhazikika.
Tachycardias amafufuzidwa pogwiritsa ntchito njira zothandizira kupangira (kutanthauza, kuyamba) tachycardia. Ngati tachycardias ingasokonezedwe mkati mwa kufufuza kwa EP, ndiye powerenga zizindikiro zamagetsi zomwe zalembedwa kuchokera ku catheters electrode, chifukwa chodziwika bwino cha tachycardia chimatha kudziwika. Izi zikatha, mankhwala oyenera a tachycardia nthawi zambiri amakhala omveka bwino.
Kodi Phunziro la EP limathandiza bwanji Chithandizo cha Direct Arrhythmias?
Pali njira zingapo zophunzirira EP zingakuthandizeni inu ndi adokotala kupanga chisankho cha chithandizo. Njira zothandizira zomwe zingaganizidwe malinga ndi zotsatira za phunziro la EP zikuphatikizapo:
- Kuika phokoso la pacemaker: Ngati kufufuza kwa EP kukutsimikizira kukhalapo kwa chida cholimba, nthawi yowonjezereka imagwiritsidwa nthawi yomweyo, panthawi yomweyo.
- Ablation : Ngati mwapadera tachcardia (SVT) - ndi mitundu ina ya tricycardia (VT) - imapezeka, kuperewera kwa poizoni nthawi zambiri kumakhala chithandizo cha kusankha. Njira yobweretsera nthawi zambiri imakhala ikuchitika panthawi yomweyi, mwamsanga potsatira maphunziro a EP. Mukhoza kuwerenga zambiri zokhudza mankhwala opatsirana pogwiritsa ntchito Intaneti.
- Zomwe zimayambitsa matendawa : Ngati mitundu yofulumira ya VT ndi / kapena ventricular fibrillation (VF) imadziwika panthawi yophunzira EP, kaŵirikaŵiri chokhachokha chokhachokha ndicho mankhwala oyenera. Chipangizochi tsopano chikhoza kuikidwa mu labotale ya EP, mwamsanga pambuyo pa maphunziro a EP. Zaka zapitazo, kufufuza kwa EP kunagwiritsidwa ntchito pofuna kupeza mankhwala abwino kwambiri oletsa anti-arrhythmic mankhwala kwa odwala omwe ali ndi VT kapena VF, koma masiku ano amadziwika kuti palibe mankhwala otsutsana ndi magetsi omwe ali othandiza kuti athe kufa mosayembekezereka. arrhythmias.
Kodi ndizoopsa zotani pokhala ndi EP?
Zowopsa za kukhala ndi maphunziro a EP ndi ofanana ndi kukhala ndi catheterization ya mtima .
Ndondomekoyi ndi yotetezeka, koma chifukwa ndi njira zovuta zokhudzana ndi mtima, zingapo zingatheke. Musakhale ndi maphunziro a EP pokhapokha mutakhala ndi chidziwitso chodziwikiratu kuti zomwe mwapeza kuchokera ku ndondomekozi zidzakhala zopindulitsa kwambiri.
Zovuta zing'onozing'ono zimaphatikizapo kutuluka magazi pang'ono pa malo a catheter kuika, kusokonezeka kwapakati pa mtima chifukwa cha catheter kukwiyitsa mtima wa minofu ndi kusintha kwa kanthawi kozizira kwa magazi.
Zovuta zowonjezereka zimaphatikizapo kuwonongeka kwa khoma lamtima (kupha chiopsezo chotchedwa " kupopera mtima kwa mtima "), kutuluka kwa magazi kwambiri kapena (chifukwa chakuti zimakhala zoopsa kwambiri kumangidwa ) kumangidwa kwa mtima . Kuopsa kwa kufa pa phunziro la EP kulibe 1 peresenti imodzi.
Chitsime:
Rahimtoola, SH, Zipes, DP, Akhtar, M, et al. Msonkhano wovomerezeka wa Msonkhano wa Pulogalamu ya Art of Electrophysiologic Testing in Discover and Treatment of Patients with Cardiac Arrhythmias. Kuyendayenda 1987; 75: III3.