Chipangizo chokhazikitsidwa chimapangitsa kuti thupi likhale lopweteka kwambiri
Ngati muli ndi vuto la kuperewera kugona , mungakhale ndi chidwi chofufuza njira zothandizira opaleshoni. Chinthu chimodzi chotere ndicho chithunzithunzi cha hypoglossal nerve stimulator chotchedwa Inspire. Kodi Akulimbikitsanji? Ndani ayenera kugwiritsira ntchito ndi zotsatira zake? Phunzirani za Mpweya wopita kumtunda wa mphepo komanso ngati mungakhale mankhwala abwino kwa inu.
Ofunsidwa Kuti Akhale Osankhidwa Mwaulemerero
The Inspire stimulator ndi chipangizo chopangidwa ndi opaleshoni chomwe chimayambitsa mitsempha ya hypoglossal kuti imitsetse minofu ya lilime ndi mpweya wapamwamba pa nthawi ya tulo, kukonzanso mpweya wa mpweya ndi kuchepetsa kuperewera kwa kugona.
Amavomerezedwa kuti agwiritsidwe ntchito ndi anthu omwe ali ndi vuto la kugona mofulumira kwambiri ( apnea-hypopnea index kapena AHI> 15) omwe sagwirizana ndi CPAP mankhwala. Zimasonyezedwa kwa omwe ali ndi chiwerengero cha thupi (BMI) zosakwana 32, kupatulapo omwe ali ndi kunenepa kwambiri.
Pali zochepa zosiyana zokhudzana ndi kugwiritsira ntchito Inspire therapy. Ngati cholepheretsa kuti matenda obwera chifukwa cha mphuno ayambe kugona mu mphuno, chifukwa cha nthendayi kapena mpweya wotsekemera wa nasal , sizingatheke. Mofananamo, ziwalo zina zamatenda (monga kamphindi kakang'ono kapena kochepetsedwa) zingakhale zifukwa zopanda chithandizo. Ngati matayala akufutukuka, opaleshoni yomwe ikuwongolera izi zimakhala zoyenera. Mavuto ena omwe amachititsa kuti athe kumeza kapena kuyankhulana bwino angakhalenso kutsutsana. Ngati nthawi zambiri ma CRIs amafunika kuti adziwe matenda ena, chipangizocho sichiyenera kugwiritsa ntchito ndi maphunzirowa.
Mankhwalawa sakuvomerezedwa kuti agwiritsidwe ntchito kwa ana.
Kufotokozera za Opaleshoni Yofunikila Kuyika Kuyika Kwa Wopatsa Mphamvu
Kudandaula kuyenera kuikidwa pa opaleshoni ndi anesthesia wambiri m'chipinda chogwiritsira ntchito. Kukonzekera malowa, njira ina yotchedwa sleep-stimulated sleeping endoscopy ingagwiritsidwe ntchito kuti ione momwe thupi lanu likuyendetsera ndege komanso ngati chipangizocho chikhoza kukhala chogwira ntchito.
Odwala ena, omwe sali oyankha, sapindula ndi chithandizo. Izi zimakhala zovuta ngati ndege ikuoneka ngati ikugwa kuchokera kumbali zonse panthawi yopuma.
Mutatsimikiza mtima kukhala wodzitetezera, katswiri wodziŵa khutu, mphuno, ndi khosi (ENT) katswiri amachititsa opaleshoniyo ngati njira yothetsera matenda. Dothi lolimbikitsira limayikidwa kutsogolo kwa mitsempha ya hypoglossal ndipo imamangiriza nthambi yake yosiyana. Chingwe chachiwiri chowongolera chimayikidwa pambali pa nthiti kuti azindikire kupuma kotero kuti lilime la minofu ndi mpweya wathanzi likhoza kulimbikitsidwa panthawi yoyenera pamene mpweya umalowetsamo. Potsirizira pake, mpweya wokhawokha umayikidwa mkati mwa khoma lachifumu lapamwamba ndi kulumikizana ndi masensa . Njira yonse imatenga pafupifupi maola awiri.
Pambuyo pa opaleshoni, odwala nthawi zambiri amapita kunyumba ngati palibe vuto lililonse. Ambiri safuna kugwiritsa ntchito mankhwala opweteka a mankhwalawa. Ndikoyenera kuti ntchito yovuta ipewedwe kwa masabata 2-3 pambuyo pa opaleshoni. Zakudya zowonongeka zimatha kudya popanda kusintha.
Mphamvu ya Kulimbikitsidwa ndi Yofunika Kuwunika Kufufuza
Kulimbikitsa kulimbikitsidwa kwa phokoso ndi njira yabwino kwambiri yothandizira kuti munthu asagone tulo tofa nthendayi pamene CPAP sichiloledwa.
Kafukufuku wasonyeza kuti pakatha miyezi 12 amachepetsa AHI kuyambira pa 29.3 mpaka 9.0 zochitika pa ora, pafupifupi, poyerekeza ndi kuchepetsa 68%. Tisaiwale kuti kuchepetsa AHI kumayimabe kupuma kochepa. Izi zingawathandize ngati mankhwalawa athandizidwa ndipo oyenererawo akudziwika. Zovuta zapadera za Epworth zakhala zikuwonjezeka kuyambira 11 mpaka 6 ndi mankhwala, zomwe zimapangitsa kuchepa kwa usana. Pamene chipangizocho chikuchotsedwa, kugona kwa mphuno kumabwerera makamaka.
Pali zovuta zochepa pakusungidwa kwa chipangizo cha Inspirator. Pafupifupi 25 peresenti ya odwala adandaula za ululu wochepa.
Pafupifupi 1/3 mwa odwala anadandaula kuti amalankhula malirime kapena abrasion, koma izi zimawoneka kuti zithetsa nthawi. Pafupifupi 1% anayamba matenda a khungu kapena kukhumudwa (cellulitis) kuchokera ku opaleshoni ndipo wina 1% amayenera kuchita opaleshoni ina kuti akonze chikhomocho.
Pambuyo pa opaleshoniyo, anamaliza kubwerera kudzaonana ndi dokotalayo kuti ayang'ane pa masiku 7-10. Chidacho chikugwiritsidwa pa mwezi umodzi. Tikulimbikitsidwa kuti mukhale ndi phunziro lapakatikati la kugona pa miyezi iwiri kuti muwone bwino ndikusintha machitidwe.
Mukayikidwa, chotsitsimutso cha inspirator chingakonzedwe musanagone. Kaŵirikaŵiri kuchedwa kwa mphindi 30 chisankhulidwe chimayamba. Mukadzuka usiku, chipangizocho chikhoza kupumidwa. Nthawi zambiri zimatsekedwa patatha maola 8.
Kodi ndalama zimagula ndalama zingati? Chotsogoleredwa tsopano chikuwononga madola 30,000 mpaka $ 40,000 kuti aikepo, kuphatikizapo ndalama zomwe zimagwiridwa ndi opaleshoni, ndipo kubwezeretsedwa kwa batri kungathe kulipira $ 17,000. Zomwezi zingawonongeke ndi inshuwalansi.
Ngati mukufuna kuphunzira zambiri za Mpweya wopita kumwambako monga chithandizo cha mankhwala, funsani munthu yemwe ali pafupi ndi inu kuti akambirane njirayi. Ophunzira ogona angaperekenso zambiri zokhudza njira zina zothandizira, kuphatikizapo kugwiritsa ntchito CPAP, zipangizo zamakono, ndi zina zothandizira.
> Zotsatira:
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> Kezirian, EJ et al . "Hypoglossal Nerve Stimulation Kukulimbikitsani Kulepheretsa Kugona Apnea." J Kugona . 2014; 23: 77-83.
> Safiruddin, F et al . "Zotsatira za Kuwongolera Kumtunda Kumtunda Wopanda Kulimbana Kwambiri Kugonana Kwapansi pa Kuthamanga Kwakuya." Eur Respir J. 2014 Sep.
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