Akụrụngwa akụrụngwa-defibrillator

Ihe akụrụngwa akụrụngwa-defibrillator (ICD) bụ ngwaọrụ nke na-achọpụta ihe ọ bụla na-eyi ndụ egwu, ngwangwa obi ngwa ngwa A na-akpọ obi mgbawa a na-adịghị mma arrhythmia. Ọ bụrụ na emee, ICD na-eziga ngwa ngwa eletriki n'obi. Jọ ahụ gbanwere ụda olu ahụ ka ọ daa nkịtị. A na-akpọ nke a defibrillation.

A na-eji ICD eme ihe ndị a:

• Igwe ihe ana-eme na pulse bu nha anya nke nnukwu elekere n'akpa uwe. O nwere batrị na sekit eletriki na-agụ ọrụ eletriki nke obi gị.
• Igwe eletriki ndị ahụ bụ wires, nke a na-akpọkwa ndu, nke na-esi na akwara gị abanye n’obi gị. Ha jikọọ obi gị na ngwaọrụ ndị ọzọ. ICD gị nwere ike ịnwe elekere 1, 2, ma ọ bụ 3.
• Imirikiti ICDs nwere pacemaker. Obi gị nwere ike ịchọ ịmagharị ma ọ bụrụ na ọ na-akụ nwayọ nwayọ ma ọ bụ oke ọsọ, maọbụ ọ bụrụ na ị nweela ujo sitere na ICD.
• Enwere ụdị ICD pụrụ iche akpọrọ ICD subcutaneous. Ngwaọrụ a nwere ndu nke a na-etinye n'ime anụ ahụ n'aka ekpe nke okpukpu obi karịa n'ime obi. Typedị ICD a enweghị ike ịbụ ihe na-eme ka obi na-akụ.

Onye na-ahụ maka ọrịa obi ma ọ bụ dọkịta na-awa ahụ na-etinyekarị ICD gị mgbe ị mụ anya. Mpaghara nke mgbidi obi gị n'okpuru eriri olu gị ga-agụba na anesthesia, yabụ ị gaghị enwe ihe mgbu. Onye dọkịta na-awa ahụ ga-eme mbepụ (belata) site na akpụkpọ gị ma mepụta ohere n'okpuru akpụkpọ gị na akwara maka igwe nrụpụta ICD. N’ọtụtụ ọnọdụ, a na-eme oghere a n’akụkụ ubu aka ekpe gị.

Dọkịta na-awa ahụ ga-etinye electrode n'ime akwara, wee banye n'ime obi gị. Emere x-ray pụrụ iche iji hụ n’ime obi gị. Mgbe ahụ dọkịta na-awa ga-ejikọ ndị electrodes na usu generator na pacemaker.

Usoro ahụ na-ewekarị 2 ruo 3 awa.

Fọdụ ndị nwere ọnọdụ a ga-enwe ngwaọrụ pụrụ iche na-agwakọta defibrillator na biventricular pacemaker enịm. Ngwaọrụ a nke ihe na-eme ka obi na-enyere aka tie aka n’ụzọ achikọtara ọnụ.

A na-etinye ICD na ndị nọ n'ihe ize ndụ nke ọnwụ mberede nke obi obi site na ụda obi na-adịghị mma nke na-eyi ndụ egwu. Ndị a gụnyere ventricular tachycardia (VT) ma ọ bụ ventricular fibrillation (VF).

Ihe kpatara ị nwere ike nọrọ na nnukwu nsogbu bụ:

• Had nweela akụkụ nke otu n'ime ụdị egwu ahụ na-adịghị mma.
• Obi gị adịghị ike, buru oke ibu, ma ọ naghị agbapụta ọbara nke ọma. Nke a nwere ike ịbụ site na nkụchi obi mbụ, nkụda obi, ma ọ bụ cardiomyopathy (ọrịa obi) ọrịa.
• Have nwere ụdị nsogbu ebumnuche (nke dị n'oge a mụrụ) nsogbu obi ma ọ bụ ọnọdụ ahụike mkpụrụ ndụ ihe nketa.

Ihe ize ndụ maka ịwa ahụ ọ bụla bụ:

• Ọbara na-ehicha mmadụ n’ụkwụ nke nwere ike ịga ngụgụ
• Nsogbu iku ume
• Obi ma ọ bụ ọrịa strok
• Mmeghachi omume nfụkasị na ọgwụ (anesthesia) eji n'oge ịwa ahụ
• Ofufe Ọrịa

Ihe ọghọm enwere ike ịwa ahụ bụ:

• Ọrịa ọnya
• Emerụ n'obi gị ma ọ bụ ngụgụ gị
• Obi arrhythmias dị egwu

Mgbe ụfọdụ ICD na-enye gị ihe ịtụnanya n'obi gị mgbe ị B needghị ha. Ọ bụ ezie na ujo na-adịru oge dị mkpirikpi, ị nwere ike ịnwe ya n'ọtụtụ ọnọdụ.

Nke a na nsogbu ICD ndị ọzọ enwere ike igbochi mgbe ụfọdụ site na ịgbanwe otu esi ahazi ICD gị. Enwere ike ịtọ ya ka ọ daa ụda ma ọ bụrụ na nsogbu dị. Dọkịta na-elekọta nlekọta ICD gị nwere ike ịhazi ngwaọrụ gị.

Na-agwa onye na-elekọta ahụike gị oge niile ọgwụ ndị ị na-a ,ụ, ọbụnadị ọgwụ ma ọ bụ ahịhịa ị zụtara na-enweghị ndenye ọgwụ.

Beforebọchị tupu ịwa ahụ gị:

• Mee ka onye na-eweta gị mara banyere oyi ọ bụla, flu, fever, herpes breakout, ma ọ bụ ọrịa ndị ọzọ ị nwere ike ịnwe.
• Werlọ na ncha ntutu nke ọma. Enwere ike ịgwa gị ka ị were ncha pụrụ iji sachaa ahụ gị niile dị n’okpuru gị.
• Enwere ike ịgwa gị ka ị were ọgwụ mgbochi, ka ị ghara ibute ọrịa.

N'ụbọchị ịwa ahụ:

• A ga-ajụkarị gị ka ị ghara ị drinkụ ma ọ bụ rie ihe ọ bụla mgbe etiti abalị abalị tupu ịwa ahụ gị. Nke a gụnyere ịta chịngọm na iku ume. Jiri mmiri sachaa ọnụ gị ma ọ bụrụ na ọ dị nkụ, ma kpachara anya ka ị ghara ilo ihe.
• Were ọgwụ ndị a gwara gị ka ị were obere mmiri ara.

A ga-agwa gị mgbe ị ga-abata n'ụlọ ọgwụ.

Imirikiti ndị nwere etinyere ICD nwere ike ịla ụlọ ọgwụ n'ụlọ 1 ụbọchị. Ọtụtụ na-alaghachi ngwa ngwa na ọkwa ọrụ ha. Mgbake zuru oke na-ewe ihe dị ka izu 4 ruo 6.

Jụọ onye na-enye gị ego ole ị nwere ike iji ogwe aka dị n'akụkụ ahụ gị ebe etinyere ICD. Enwere ike ịgwa gị ka ị ghara ibuli ihe ọ bụla dị arọ karịa kilogram 10 ruo 15 (kilogram 4.5 ruo 6.75) ma zere ịkwanye, dọpụta, ma ọ bụ ịgbagọ aka gị maka izu 2 ruo 3. Enwere ike ịgwa gị ka ị ghara ibuli aka gị n’elu ubu gị ọtụtụ izu.

You hapụ ụlọ ọgwụ, a ga-enye gị kaadị idere n’akpa gị. Kaadị a depụtara nkọwa nke ICD gị ma nwee ozi ịkpọtụrụ maka ihe mberede. Ikwesiri iburu kaadi obere akpa a mgbe niile.

Ga-achọ nlele oge niile ka enwere ike nyochaa ICD gị. The eweta ga-elele na-ahụ ma:

• Ngwaọrụ ahụ na - achọpụta ụda obi gị
• Ego ole ka egwula
• Ego ole ike batrị na batrị.

ICD gị ga-enyocha obi gị mgbe niile iji hụ na ha kwụ ọtọ. Ọ ga - ebute ihe na - awụ akpata oyi n’ahụ n’obi mgbe ọ hụrụ ụda egwu na - eyi ndụ egwu. Imirikiti ngwaọrụ ndị a nwekwara ike ịrụ ọrụ dịka ihe mgbochi obi.

ICD; Nkọwapụta

• Angina - ihapu
• Angina - mgbe ị nwere ihe mgbu obi
• Antiplatelet ọgwụ - P2Y12 inhibitors
• Pụ Ọgwụ Aspirin na ọrịa obi
• Butter, majarin, na mmanụ oriri
• Cholesterol na ndụ
• Rollingchịkwa ọbara mgbali elu gị
• A kọwara abụba ndị na-eri nri
• Ndụmọdụ nri ngwa ngwa
• Mwakpo obi - nhapu
• Ọrịa obi - ihe egwu
• Obi odida - ihapu
• Otu esi agu aha nri
• Nri obere nnu
• Nri Mediterranean
• Nlekọta ọnya ịwa ahụ - emeghe

• Akụrụngwa akụrụngwa-defibrillator

Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. Ntuziaka 2017 AHA / ACC / HRS maka njikwa nke ndị ọrịa nwere arrhythmias nke ventricular na mgbochi nke ọnwụ obi mberede: akụkọ nke American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2018: 72 (14): e91-e220. PMID: 29097296 pubmed.ncbi.nlm.nih.gov/29097296/.

Epstein AE, DiMarco JP, Ellenbogen KA, et al. Nchịkọta 2012 ACCF / AHA / HRS gbakwunyere na ntuziaka ACCF / AHA / HRS 2008 maka usoro ọgwụgwọ nke ngwaọrụ nke ọrịa ọgbụgba obi: akụkọ nke American College of Cardiology Foundation / American Heart Association Task Force na ụkpụrụ omume na Heart Rhythm Otu. J Am Coll Cardiol. Ọrịa. 2013; 61 (3): e6-e75. PMID: 23265327 pubmed.ncbi.nlm.nih.gov/23265327/.

Miller JM, Tomaselli GF, Zipes DP. Usoro ọgwụgwọ maka ọrịa obi arrhythmias. Na: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Ọrịa Obi Braunwald: Akwụkwọ ọgụgụ nke Ọgwụ Ọrịa Cardiovascular. Nke 11. Philadelphia, PA: Elsevier; 2019: isi 36.

Pfaff JA, Gerhardt RT. Ntụle nke ngwaọrụ akụrụngwa. Na: Roberts JR, Custalow CB, Thomsen TW, eds. Usoro ọgwụgwọ Clinical nke Roberts na Hedges na Medicine Mberede na Nnukwu Nlekọta. Nke 7. Philadelphia, PA: Elsevier; 2019: isi 13.

Swerdlow CD, Wang PJ, Zipes DP. Ndị na-eme mkpọtụ na ndị na-emegharị obi-defibrillators. Na: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Ọrịa Obi Braunwald: Akwụkwọ ọgụgụ nke Ọgwụ Ọrịa Cardiovascular. Nke 11. Philadelphia, PA: Elsevier; 2019: isi 41.