Inhliziyo pacemaker: ukusebenza izindleko, ukubuyekezwa

Umzimba womuntu njalo ikhula, eziningi izitho zangaphakathi ubudala futhi bafake. Yingakho amasignali ubuhlungu ezizayo baxwayisa ngokuthi ezinye umzimba unika ukungasebenzi. Nokho, inhliziyo yomuntu ukugxila. ukukhathazeka ngempilo yakhe nobuhlungu benhliziyo noma ukusinda esifubeni is wadala. Njengoba yaziwa, ube nenhliziyo enempilo - impilo ende.

Ngaleso sikhathi samanje umuthi wenza konke ngempumelelo amasha emkhakheni wezokwelapha, ngakho manje wonke umuntu ungabheka inhliziyo yabo futhi ukukhomba izifo ezithize. High-ngokunemba ukuhlolwa amathuluzi ukuthola indlela ukuthi uhlulekile, ngakho udokotela wakho ayoyikhetha ukwelashwa okungcono futhi kufaneleka. Esinye sezipho ezinhle kakhulu ukulungiswa inketho esisiza alulame elahlekile inhliziyo umsebenzi pacemaker zenhliziyo. Ukusebenza, ukubuyekezwa lapho omuhle kakhulu, Uqeda iziguli zakuqala ziyini na? Zalesi. Baphila ukuphila ngokugcwele. Nezenhliziyo eMoscow itholakala ezingeni eliphezulu kakhulu. Ngonyaka belashwa amashumi ezinkulungwane abadala kanye nezingane, nakodokotela abaphambili ukunikeza izakhamizi yezwe impilo entsha egcwele.

Kodwa ngaphambi kokuba baqonde ukuthi pacemaker inhliziyo (izindleko ukusebenza zingahluka) futhi isebenza kanjani, udinga ukwazi nokwakheka physiology umzimba, njengenhliziyo.

Inhliziyo: isimo sawo futhi umsebenzi

Inhliziyo - isitho kwemisipha ukuthi ikwazi ukumpompa igazi wonke umzimba. Kuyo ukwahlukanisa ehlanganisa imisipha izicubu ehlukanisa inhliziyo ibe ingxenye kwesokudla noma kwesokunxele. Lezi zingxenye ezimbili nazo ezihlukaniswe ukwahlukanisa, engxenyeni engenhla ngokuthi le Atria, kanye aphansi - the ventricles. Atria futhi ventricles axhunyiwe ngu valve bokuphila lapho igazi eshayela phakathi kwezinye imisipha.

Igazi, kuyilapho isigamu kwesokudla ATRIUM ingena emaphashini lapho ecosha-mpilo ngenkuthalo. Ngaphezu kwalokho, leli gazi engena ventricle engakwesobunxele, bese ugelezela aorta, okuyinto ihlukaniswe i Umthambo. Ngenxa yalesi mshini elinomoya-mpilo egazini notshwala wonke umzimba ngokusebenzisa imithambo futhi ngaleyo ndlela kuthuthukisa zonke izicubu kanye izitho oxygen. Ngemva ukufinyela-mpilo umsebenzi uyabulawa, igazi eqoqwe emithanjeni sidla emuva inhliziyo, kuqala ngokufaka ATRIUM kwesokudla, bese ku-ventricle yangakwesokudla. igazi Arterial elicwile oksijini, kuzoba alula kakhulu kunomoya emithambo yegazi.

Ngenxa yokuthi lesi simiso yinhliziyo yomuntu isebenza kahle, igazi uyakwazi njalo ekucebiseni izakhi ne-oxygen ukuze zonke izicubu kanye izitho. Mshini yemvelo ukuthi uthola inhliziyo futhi enza kube ukumpompa igazi, kusekelwe supply inkanuko ekhethekile kagesi. Kwezokwelapha, lo msebenzi libizwa engeyokuqala itheku, inhliziyo zemvelo noma umshayeli. Itholakala inhliziyo, okungukuthi, isigamu kwesokudla ingxenye lakhe ATRIUM.

Itheku node linendima ebalulekile emsebenzini inhliziyo. It ulawula ukushaya kwenhliziyo, futhi kuye ngokuthi isimo kanye nezimo ezihlukahlukene ngesivinini ukushaya kwenhliziyo, noma okuphambene nalokho ukubambezela kubo. Ngokwesibonelo, uma usebenzisa inhliziyo ishaya ngokushesha kunokuba isimo yokwenziwa umzimba. Inhliziyo zemvelo azizwa umshayeli ukuthi kunesidingo ukumpompa igazi ngokushesha, ngakho imisipha yenhliziyo ekuvuseleleni ngejubane ngaphezulu yashesha lomsebenzi.

Transmission endleleni electroimpulses

Lokusakaza pulses kagesi ufezwa yokuthi ngokufanele eduze kwezintambo zesivikelo sesifuba conductive, futhi kubangele Atria futhi ventricles kwinkontilaka phambi ishayela esilandelayo. Ngenxa isikhawu phakathi Kufinyeta, okungase ukumelana inhliziyo, kukhona "ukuphumula" of imisipha yenhliziyo.

Ngaphansi kwezimo ezithile, bokuphila zokucabanga okubangelwa isifo ukushaya kwenhliziyo osedonsa. Izizathu ngenxa okuyinto kubambezela ukushaya kwenhliziyo:

• isiyezi;
• nomfutho wegazi ophezulu;
• ikhanda;
• ukukhathala, ukucobeka;
• yokufikelwa;
• zokuphefumula ukwehluleka imvamisa.

Kwezokwelapha, isifo okuthiwa i-bradycardia. Isizathu sokuba ivela khona ukuthi kukhona kokunqotshwa engeyokuqala itheku, kulandele izinguquko ohlelweni conduction. isimo okunjalo kuholela ekuphikeni ukwehla ukuvama kwenhliziyo, esithinta esimiso senhliziyo nemithambo yegazi kanye umzimba wonkana, ngoba kunciphisa umoya-mpilo ezicutshini eziyishumi nemitshingo. Kamuva eba anoxia, futhi kulesi simo kuholela ukungasebenzi izitho eziningi ezibalulekile. Endaweni yokuqala ke aqale ukuhlushwa inhliziyo uqobo. Isiguli kungase ubuhlungu esifubeni, kanye kobukhulu inhliziyo. Uma umuntu akusho ukunaka izimpawu futhi musa ukwelapha lesi sifo, khona-ke iqala ahlupheke ubuchopho, noma kunalokho amangqamuzana obuchopho, okuyinto njalo adinga elilungile-mpilo saturation.

With ukuthuthukiswa inhliziyo block amaza ukuthi uhambisa engeyokuqala itheku akusho ngaso sonke isikhathi sifinyelele ventricles, futhi ngezinye izikhathi musa sifinyelele, okuholela ukuphazamiseka zokuvumelanisa operation Atria futhi ventricles.

Pathology ukusebenza kwenhliziyo

Azalwa naso inhliziyo isigqi thuthuva elihlobene ne-pathology kohlelo senhliziyo wengane, okusho nokudela yomzimba izinguquko ezingenakuhlehliswa (isifo senhliziyo). Isikhathi esining impela ukuhlukumeza okunjalo kunqunywa ultrasound ucwaningo fetus, kodwa ngezinye izikhathi lesi sifo kutholwa kuphela ngemva kokuzalwa kwengane.

Pediatric nezenhliziyo amadili nezingane ukwelashwa, eyathola izenzo ezimbi enhliziyweni, ngezinye izikhathi kuyadingeka ukwethula emzimbeni umshini wokulawula ukushaya kwenhliziyo ukulondoloza impilo yengane.

Ukwephula atholwe kwenhliziyo singenzeka ngenxa yezizathu eziningi:

• izinguquko ubudala;
• ngemva infarction we imisipha yenhliziyo;
• izifo ezithathelwanayo, anikeza ubunzima enhliziyweni;
• yofuzo;
• ukukhuluphala;
• ukubhema nokusebenzisa kabi utshwala.

Ukubuyiselwa isigqi inhliziyo

Lesi sifo kwezokwelapha singelashwa, izidakamizwa isuswe izimpawu kuphela, kodwa impilo lesiguli namanje engozini. Kuleli zinga-ke kuhle ukusebenzisa i pacemaker yokufakelwa. Kuyinto uphiko oluyisipesheli - umshini wokulawula ukushaya kwenhliziyo ukuthi kuvusa pulses inhliziyo ngokushelela, abangela Atria kanye ventricles ungenwa synchronously. Ukuze ufake umshini wokulawula ukushaya kwenhliziyo kwenhliziyo, izindleko ukusebenza kuyoba ephakeme futhi kuyoba nzima kakhulu isikhathi yokutakula, uma lesi sifo zingelashwa ngokushesha, futhi wasibeka ithuba.

Ukwakheka kohlelo pacemaker kagesi

Isakhiwo lisebenze luyindida kakhulu, it is etholakala zezindlu uphawu futhi siqukethe generator ishayela kanye electrode. Leli bhokisi siqukethe ingxubevange ekhethekile wezokwelapha (titanium), okwandisa izinga sokusinda ivuselela kubantu.

Ukusebenza iyunithi wenziwa kuphela lezo zikhathi, uma iqala kancane inhliziyo ukuba ishaye noma avele zikhawu emsebenzini inhliziyo. Kulokhu, idivayisi esebenza mshini, okuthumela amaza kagesi kwemisipha yenhliziyo uqobo, okuholela esimweni saso esivamile. Lokhu umdwebo eyisibonelo kanjani elingenalo iwashi lenhliziyo. Ukusebenza izimpendulo iziguli egunjini lokuhlolwa kwezifo zenhliziyo, wathola omuhle. Bona ubilise phansi yokuthi iziguli ababuzwa okwengeziwe inhliziyo isigqi sifo, ukubuyela ekuphileni okuvamile.

izinhlobo

Okwamanje, kukhona izinhlobo ezintathu amadivaysi, okuyizinto pacemaker yokufakelwa.

1. Single-chamber elingenalo iwashi lenhliziyo. Ingabe electrode eyodwa kuphela, esemgwaqweni ventricle, banayo kuphela ikamelo elilodwa inhliziyo. ukusikwa atrial ke kwenziwe ngendlela ejwayelekile. Lolu hlobo lwe-apharathasi amaphutha eziyingozi, njengoba nje ngabaqaphi inhliziyo gumbi eyodwa kuphela. Ngezinye izikhathi kuyenzeka ukuthi ngenxa yaleli isigqi efanayo ventricular fibrillation, okuholela normal ukugeleza kwegazi ngokusuka enhliziyweni. Ngenxa efanele igazi atrial ngeke bakwazi aluka ngokugcwele i-ventricle phakathi ATRIUM, futhi ngenxa yalokho akusho ukuya phambili emgudwini wegazi.
2. Pacemaker ezimbili-chamber. It has electrode amabili, eyodwa elise-ventricle, kanti eyesibili - in the ATRIUM. Le divayisi izinzuzo umshini wokulawula ukushaya kwenhliziyo owodwa ekamelweni. Kulokhu, kukhona izintambo operation lesifanele futhi ephelele ukuvumelanisa ATRIUM futhi ventricle. Ngenxa outflow wegazi ngokusuka enhliziyweni kuyokwenzeka ngaphandle thuthuva, igazi uqobo lwawo ageleze ngenkathi esegazini imithetho ubudala, njengoba kwakunjalo womsebenzi enempilo inhliziyo.
3. Three-chambered elingenalo iwashi lenhliziyo. Le divayisi iyona eziphambili kakhulu emishinini kwenhliziyo umshayeli. It has electrode ezintathu, okuyinto zitholakala enhliziyweni linezingxenye ezintathu: i-ATRIUM, i-ventricle kwesokudla noma kwesokunxele. Ngenxa indawo ngemacebo physiologically igazi lesifanele sidlula zonke izigaba inhliziyo ekamelweni elilodwa olungenayo kwenye, falling ngokushelela ku imithambo yegazi. Rhythm ngesikhathi esifanayo kuyafana ukuthi we ube nenhliziyo enempilo.

Kuyini electrode, nokuthi isebenza pacemaker

Ngenxa unenkululeko eziphakeme electrode kalula ukugoba futhi twist, okuyinto ebaluleke kakhulu ngoba leli thuluzi, njengoba kukhona ukunyakaza ezahlukene ezingokomzimba, kanye kwenhliziyo. Umqhubi uyakwazi okuxhunyanwa pulses myocardium lapho edonsa ulwazi ukushaya kwenhliziyo. I electrode has a ikhanda ekhethekile ultrasensitive, okuyinto kwakha ukuxhumana imisipha yenhliziyo.

Inhliziyo pacemaker: ukusebenza, ukubuyekezwa

Kuleli qophelo isingeniso wokusebenza pacemaker kuyinto inqubo elula futhi okulula. Uthatha akukho amahora angaphezu kwamabili, kwenziwe odokotela abanolwazi uMnyango - nezenhliziyo. Izibuyekezo iziguli esikhathini postoperative zinhle, ngoba yokutakula kuqhathaniswa okusheshayo, kanye neziguli maduze kukhishelwa ekhaya. Pacemaker ithungwe emphongolweni endaweni subclavian ukuze phakathi isikhumba kanye muscle izicubu.

Electrode, ngaphambi kokuthi zibe ngalo ingaphakathi enhliziyweni, sidlula emkhondweni emthanjeni. Yonke inqubo ye electrode ukubekwa senzeka ngaphansi ultrasound observation. Ngu engxenyeni engaphandle ye-ingxenye inhliziyo iqinile zedivayisi ngokwayo - pacemaker inhliziyo. Ukusebenza Izibuyekezo iziguli abangenawo pacemaker yokufakelwa, uthola esihle. Siyabonga olwenziwa ukugxilisa kungakabiphi bangase uthole indlela yakho yokuphila yangaphambili. Nokho, namanje ngokuphazamisa futhi ukulinganiselwa ahlale. Kepha umzimba yethulwa kudivayisi esinzulu - umshini wokulawula ukushaya kwenhliziyo zenhliziyo. Izindleko wokusebenza incike nomkhiqizi wedivaysi kanye impahla electrode.

imithetho yokusebenza

Ukuze hhayi kwakukhona yenkinga ohlelweni pacemaker othomathikhi, kufanele ukuba ubambelele le mithetho elandelayo:

• engekho eduze high voltage izintambo zikagesi;
• Akuvunyelwe ukuba azungeze ezahlukene compilers amandla, ukudluliswa imibhoshongo yamakhambi amasignali omsakazo ne-TV;
• Akunakusetshenziswa asikwazi zihlolwe ngumuntu metal detector (esikhumulweni sezindiza, ezitolo).

Ephambi kwezinduna pacemaker esishunyekiwe banqatshelwe odlulayo ucwaningo lwezokwelapha:

• Ultrasound kwesifuba;
• MRI (ucwaningo);
• ukwelashwa fiziokabinete e ezahlukene wavelength amabanga: yokwelapha kazibuthe, electrotherapy;
• electrocoagulation kuphela kwemvume udokotela ukuba khona.

Ekuphileni kwethu kwansuku zonke kufanele futhi banamathele emithethweni ethile:

• Gwema ukuthinta ugesi;
• musa ukuthutha emshinini zabo siqu, hhayi ukumshaya;
• ukhuluma ngomakhalekhukhwini, wasibeka indlebe yesokunene;
• usebenzisa iyashaya, sokuprakthiza kudingeka uqaphe kakhulu;
• hhayi ukuba nzima imisipha esifubeni;
• ejimini ukuze kukhawulwe umthwalo leli qembu imisipha.

Izindleko zokusebenza intengo pacemaker

Ngokuvamile, lapho operation inhliziyo izindleko sizihlanganisa naso elingenalo iwashi lenhliziyo. Ngenxa yalokho, intengo yokugcina yakhiwa iqoqo izinqubo kanye nemisebenzi. Lezi zihlanganisa:

• kokuhlinzwa inhliziyo evulekile;
• izindleko pacemaker;
• Intengo electrode;
• inkathi kokuhlala nezenhliziyo, ukuvuselelwa.

Kubalulekile ukucacisa ukuthi uhlobo olunjani pacemaker, njengoba nje iye electrode iyiphi umenzi. Kuye lokhu, phakathi inhliziyo ukuhlinzwa izindleko ziyahlukahluka kusuka okuncane kakhulu nakanjani okusezingeni eliphezulu. Inani lentengo elawula ukushaya kwenhliziyo:

• olulodwa ekamelweni uhlobo idivayisi (production ezifuywayo) ka 10 500 kuya 55 000, ukungenisa - ruble 80 000;
• chamber double - kusuka ku-80 000 kuya ku-250 ruble 000; yokungenisa Analogue - ruble 250 000;
• emithathu chambered - phakathi 300 000 nangaphezulu, futhi amazwe okuyisilinganiso sabangu-ruble 450.000.

Nokho, kufanele licaciswe ukuthi lokhu akubandakanyi intengo electrode. Intengo electrode yasekhaya kuyoba ruble 2000 kuya 4500, ukungenisa - ruble 6000. Ngakho-ke kulula ukubala malini kuzobiza pacemaker kwenhliziyo, izindleko ukusebenza kuyoba kusukela ku15 000 kuya ku-500 000.

Ukufaka umshini wokulawula ukushaya kwenhliziyo

Nezenhliziyo Centre itholakala enhloko-dolobha, ngakho-ke ephatha nabakhe emizini ezihlukahlukene zezwe.
Inombolo yomhlaba wonke yesikhungo ukhiqiza ekwelapheni abadala kanye nezingane. Kuyaphawuleka ukuthi kukhona kuwo, futhi ezikhethekile nezenhliziyo ezingane. imishini yesimanje isetshenziswa ekwelapheni iziguli kanye uphethwe. ifakwe igatsha "nezenhliziyo" futhi ezihlukahlukene amadivayisi aphakeme. Ukuxilongwa kwenziwa izisebenzi eziqeqeshiwe. Ukwelashwa kungase kube ngemithi nangokushintsha instrumentally. Ngemva yokutakula, iziguli banikwa ukudlula nokuvuselelwa. Nezenhliziyo eMoscow itholakala ezingeni eliphezulu, ngakho-ke ungakwazi ungesabi empilweni yazo.

Izindleko zokwelashwa nezenhliziyo isikhungo

Kuye uphethwe ezibucayi kanjani, izintengo zingahluka. Uma isiguli iya ngaphansi quota, yena bangathembela isevisi khulula kunoma iyiphi emkhakheni wezokwelapha: ukuhlinzwa, nezenhliziyo. kuleli cala, amanani ngeke besakwazi sokukhathazeka ukuthi kuyazuzisa kakhulu futhi ngesikhathi esifanayo enokwethenjelwa.