Pacemaker - kuyini? kuyinto pacemaker kanjani? izindleko ukusebenza

Pacemaker - okungukuthi ngokombono wezokwelapha? Okokuqala, it is a idivayisi miniature electronic ukuthi normalizes imisipha yenhliziyo. Inhliziyo pacemaker inikeza inombolo elikhulu ukusikeka kudingekile ekuphileni okuvamile. Insimbi uyakwazi ukunqoba dissociation electrophysiological we Atria futhi ventricles, okubizwa ngokuthi block atrioventricular, futhi ngaleyo ndlela usimamise inhliziyo.

Umlando sokudalwa

Pacemaker - lokhu kungenxa physiologist? Njengoba lokhu idivaysi ingasetshenziswa ngokuya umthelela izinqubo sokugembula e esimiso senhliziyo nemithambo yegazi yomzimba womuntu? On isicelo ababuthakathaka pulses kagesi lamanje ukuqeda arrhythmias abacwaningi wazibuza ngasekupheleni kwekhulu le-19. Nokho, ukuntuleka ubuchwepheshe odala kagesi uthumela ku value lincishisiwe akavunyelwe ngisho uqale ucwaningo kule siqondiso.

Kuphela engxenyeni yokuqala yekhulu lama-20, izazi zokusebenza kwengqondo, ososayensi angaqala ukufunda umthelela amaza kagesi emsebenzini inhliziyo. Iphayona kule ndawo kwaba umcwaningi Italian Luigi Galvani. Kamuva Russian physiologists N. E. Vvedensky futhi Yu. M. Chagovets eseqala ukutadisha le kungenzeka yokusebenzisa ababuthakathaka kagesi osenyameni zamanje for ekwelapheni izifo ezithize inhliziyo.

Ngo-1927, i-wenhliziyo American Albert Hyman aklame idivayisi lokuqala ubuxhakaxhaka obuzisebenzela emhlabeni ukulondoloza isigqi uzinze kwenhliziyo yomuntu. Umshini kuhlaziywe amagremu abangaphezu kwamakhulu amathathu, idivayisi okwesikhashana ibhande akhethekile ezifihlakele ngaphansi izingubo. Nokho, pacemaker sase sisebenza kahle, ngesikhashana esifushane Sekuqaliswe ukukhiqizwa serial.

Imiphumela yokuqala

Pacemaker - kungcono ngoba Alberta Haymena, ungumdali iyunithi nozakwabo ekubhekaneni arrhythmia inhliziyo? Okokuqala, lokhu kuyisinyathelo sokuqala inqubo eside ukutadisha amasu kagesi ubunjiniyela, okungase ukubekwa inkonzo imithi.

ngokoqobo ivuselela Hyman esimweni esiphuthumayo senzeka ngo-1951, lapho emva kokuhlinzwa wakwazi ukusindisa isiguli eziphambili transverse inhliziyo block kanye arrhythmia iziqephu. Noma kunjalo, isiguli isikhathi eside esibhedlela, njengoba wayengasakwazi ukunyakazisa ngokukhululekile nge apharathasi sasivumela okukhulu emzimbeni futhi, ngaphezu kwalokho, ngiswele ebhekiwe kwabasebenzi bezokwelapha.

Ivuselela-nolwelwesi

Umhlaba nezenhliziyo Centre ziye zazibandakanya ukudala stimulator compact kagesi, okuyinto uyocabangela akukho kuka-80 grams. Ngo-1958 iqembu lososayensi Swedish, eholwa uDkt Rune Elmqvist ukudala miniature "Siemens-El." Stimulator waboshelwa izindlu mncane-ngodonga eyenziwe titanium ingxubevange futhi kungaba itshalwe ngaphansi kwesikhumba. Nokho, amandla ukusetshenziswa kokusunguliwe Swedish lalilincane - ibhethri ihlinzeka ishayela izinyanga ezingu-18 kuphela, ngemva kwalokho isiguli ukuba ngikwenze eyohlinzwa ukuze esikhundleni kwamandla.

Ukudalwa EKS yasekhaya

Ekugcineni, umshini wokulawula ukushaya kwenhliziyo - kuyini kusukela umbono iziguli ngokwabo? Yiqiniso, lena ithuluzi ukonga, yelula ukuphila iziguli inhliziyo abaphethwe ahlukahlukene inhliziyo isigqi thuthuva. Senhliziyo esilimele obusayo ithoni kwesokudla - kuyisihluthulelo operation esitebeleni of lonke isimiso sokujikeleza kwegazi zomzimba.

Ngo-1960, iSoviet academician A. N. Bakulev waphendukela ehola izikhungo lobuchwepheshe zaseSoviet Union ngaphandle kokuphazanyiswa ezihlongozwayo ukudalwa amadivayisi yokululama inhliziyo. La maphoyisa abamukela Design Bureau ukuthuthukiswa olunembile e isiqoqi sama-softwe owawunesihloko isimo ibhizinisi ukuzivikela. Esikhathini esifushane ukuhlolwa zobuchwepheshe, futhi ngo-December 1961 pacemaker Russian ezenziwe lokuqala EX-2 "Mosquito" waba Wawufaka isiguli ephelele inhliziyo atrioventricular block EX amasampula wazibonela zadalwa, kwenziwa ngempumelelo. Pacemaker "Mosquito" Yenziwa iminyaka engu-15, izinkulungwane zabantu abagulayo basinda ngu okunokwethenjelwa kudivayisi yesikhumbuzo.

Inani eliphakeme nokufa ngenxa izifo zenhliziyo eSoviet Union kwaphawula ukuphela kweminyaka engu-50, ke kwaqala ukuncipha. Pacemaker kwenhliziyo, okuyinto libuyekeza ezigulini kwakungukwamukeliswa ngokuvamile omuhle, ngokushesha kwakuqala ukwanda.

New njalo ngcono, izici EKS yasekhaya ngcono. Ekupheleni 1962, amasampula entsha, Ministry of Health Kunconywa ukukhiqizwa serial. Ngakho, wadala enhliziyweni Russia pacemaker, ukubuyekezwa mayelana izinga okuyinto yaba mihle, baqala ukunyathelisa ngo yizinkampani ezimbalwa iphrofayli wezokwelapha.

kardiostimulirovanie Ngaphandle

Ngaphambi zokwakha ka pacemaker nolwelwesi, isiguli singase sithole usizo kwangaphambilini nge contact kudivayisi yangaphandle ehlanganisa plate amabili lapho zitholakala nhlangothi zombili kwesifuba, omunye phambi inhliziyo kanye nezinye ngemuva, ngezansi kwesokunxele isiphanga. Ukudlula Impulse ngokusebenzisa sternum, kubangela imisipha bushelelezi ungenwa nhlangothi zombili, kanye senhliziyo esilimele. Le ndlela ebangela ukungakhululeki isiguli, kodwa njengoba indlela yesikhashana yokululama of kwenhliziyo kuyafaneleka. Ububi zangaphandle ukushukuma amasu liqukethe yokuthi isiguli akufanele zishiywe, ikakhulukazi uma aquleke. Ukufaka pacemaker zokusebenza ngokugcwele, kudingeka baqeqeshwe ngokukhethekile, okuyinto ethatha amasonto ambalwa.

Okwesikhashana ukushukuma endocardial

Isimiso yemiphumela enjalo ku imisipha yenhliziyo iyisingeniso we electrode uphenyo kule ingaphakathi inhliziyo. Ukuze le misebenzi kudala isethi oyinyumba ka umqhubi futhi probe ngokwayo, okuyinto akhulula nge isiteshi emithambo yegazi ukuze inhliziyo. Ukuphela electrode efakwe kule ATRIUM kwesokudla, futhi okuphambene, ukuphela kwayo proximal we exhunywe ngaphandle emthonjeni, edonsa amaza kagesi.

Ukufaka umshini wokulawula ukushaya kwenhliziyo nsuku yesikhashana ngokuvamile lisetshenziswa uma kungekho isikhathi izindlela eziwukweqisa. Ngemva ukuzinza isiguli inhliziyo ungakwazi uqhubekele yenzeka sedivayisi unomphela.

Njengoba ezifakelwa umshini wokulawula ukushaya kwenhliziyo unomphela

Pacemaker umsebenzi yenzeka okuyinto ukuhlinzwa encane, yenzelwe ukusetshenziswa eside. Yenzeka ngokuvamile eyenziwa ngaphansi izinzwa wendawo. Yonke inqubo ihlukaniswe izigaba eziningana. Okokuqala, imbobo kwesikhumba futhi kwezicubu vein atihambi todvwa. Khona-ke inhliziyo wenziwa inombolo oyifunayo electrode ukuthi ezibekwe emakamelweni inhliziyo. Ngemva isingeniso babashayeli is kokuhlola yonke idatha: ukuzwela, sivinini nombundu, ilungiselelo elikhulu sendikimba, pulses conductive. Khona-ke nenkanuko edlulele we electrode kwenzeka, kwakheka ngombhede kuyisikhumbuzo ngoba pacemaker kanye idivayisi ezifakelwa kumuntu.

Kwezinye izimo, nolwelwesi akuthathi impande ngokushesha, kungaba ngisho ayenqaba okuncane, kodwa ukuvuvukala kwadamba ngokushesha ngaphansi kwethonya izidakamizwa ezivamile, kanti isiguli uyaqhubeka nokufezekisa evamile yokuphila ajwayelekile.

Imisebenzi esemqoka pacemaker

Idivayisi kuyinto zobuchwepheshe ekhona metal izindlu ezihlangene. Microprocessor lusekelwa ngamandla ebhethri eyenzelwe eminyakeni embalwa. Umgomo we operation ye EKS basekhaya ukuphendula engekho ukusikwa evamile ye imisipha yenhliziyo isiguli. Pacemaker yakhelwe ukuze ishayela wathumela ingqondo yakhe electronic, cishe Akalokothi ephuze - isikhathi umehluko kuyinto ambalwa yesibili.

Phakathi operation evamile idivayisi inhliziyo liziphatha akanandaba - ithumela kungekho ishayela. Kukhona iqembu elawula ukushaya kwenhliziyo ukuthi babe nekhono ukuzivumelanisa imvamisa. Ngo ezifana idivayisi inzwa ehlangene, ebucayi yezinguquko umsebenzi lesiguli. Eqinisweni, le inzwa ukushesha, i Accelerometer, ezisabela izinguquko ECG imingcele futhi ulinganisele zokuphefumula. Phakathi umsebenzi inhliziyo pacemaker ithumela amaza speeded up.

Izindlela zakamuva of ECS bayakwazi ukulondoloza idatha ku umsebenzi inhliziyo, okungase kube okukhiphayo qapha noma zasemoyeni ahlolwe. Lesi sici sivumela udokotela yokunika yokwelapha yezokwelapha ezifanele, kanye ukukhetha nemingcele yokusebenza elingenalo iwashi lenhliziyo. Kubuyeketa zomculo ezifana kufanele ubanjwe okungenani kanye njalo ezinyangeni eziyisithupha. Pacemaker, intengo ukufakwa lapho lutholakala kalula umuntu nge komholo ojwayelekile ungayithola enye uma kunesidingo.

Transesophageal EHAMBAHAMBA

Ukuze sitholakele arrhythmia izenzakalo iziguli ukuhlolwa uhlelo isetshenziswa nge-probe. umqhubi ekhethekile nge ithiphu kagesi conductive ufakwa emphinjeni. Uphenyo wayeka ngesikhathi iphuzu contact kwenhliziyo, noma kunalokho ATRIUM ngakwesokunxele, kanye emphinjeni. generator, eletha pulses of imvamisa ehlukene ke luvulwe. Okwakushiwo cwaningo ukuba uthole ukuthi iyini khona isifo senhliziyo. Palpitations ngaphansi kwethonya pulses kagesi ongabonisa ukwenqaba umthwalo senhliziyo esilimele.

Transesophageal sivinini ngokwanele jikelele, kungasiza ukuxilonga ezihlukahlukene izifo zenhliziyo. Kwezinye izimo Tees avumele ukuphathwa: ukudubula paroxysmal tachycardia, ukubopha flutter atrial, enze ukushukuma yesikhashana nge bradyarrhythmias, ephelezelwa ishayela ukungasebenzisi, ukuqeda ukugula itheku syndrome. Ezinye manipulations zingenzeka kuphela ezijulile Uphenyo indawo emphinjeni.

Pacemaker: izindleko ukusebenza

Ukufaka pacemaker eRussia kungadla ruble 65 kuya kwezingu-650. Le mali ifaka phakathi izindleko zedivayisi ngokwayo, ukuba izindleko zokwakha umzila nesikhathi nasezinkingeni ezilandela ngemva kokuhlinzwa. Pacemaker ngokwayo, intengo kwalo kunqunywa ngumkhiqizi, kungaba elithe ongaphakeme (20 eziyinkulungwane. Deda.). Kukhethwa onobuhle iyatholakala esigulini. Kungcono ukuthola umshini wokulawula ukushaya kwenhliziyo, izibuyekezo ikakhulukazi okuhle. Lokhu izinkampani kudivayisi Medtronic, StJudeMedical, Guidant futhi Biotronic.