Nahā Kūlohelohe O Ka Naʻau

ʻO ka maʻi sinus maʻi he ʻano o ka maʻi o ka naʻau. Hoʻopili ia i ka mea hoʻomaka kūlohelohe o ka naʻau (sinus node), ka mea e hoʻomalu ai i ka hahau ʻana o ka naʻau. Hoʻokumu ka maʻi sinus maʻi i nā hahau naʻau lohi, nā hoʻomaha (nā manawa lōʻihi ma waena o nā hahau naʻau) a i ʻole nā ​​hahau naʻau kūpono ʻole (arrhythmias).

He mea maʻamau ʻole ka maʻi sinus maʻi. Hoʻonui ka pilikia o ka loaʻa ʻana me ka makahiki. Nui nā kānaka me ka maʻi sinus maʻi e pono ai i kahi hāmeʻa i hoʻokomo ʻia i kapa ʻia he pacemaker e mālama ai i ka naʻau i kahi rhythm maʻamau.

Hiki ke kapa ʻia ka maʻi sinus maʻi ʻo ka hana ʻole o ka sinus node a i ʻole ka maʻi sinus node.

ʻO ka hapa nui o nā kānaka me ka maʻi sinus maʻi ʻaʻole nui a ʻaʻohe hōʻailona. Hiki ke māmā nā hōʻailona a i ʻole e hele mai a hele aku paha - e paʻakikī ai ka ʻike mua ʻana.

Hiki i nā hōʻailona a me nā hōʻailona o ka maʻi sinus maʻi ke komo pū me:

• Kahi manaʻo o nā hahau puʻuwai wikiwiki, lele (palpitations)
• ʻEha umauma a i ʻole ʻoluʻolu ʻole
• Huikau
• Nāwaliwali a i ʻole māmā ke poʻo
• Hiolo a kokoke i ka hiolo
• Luhi
• Pōkole o ka hanu
• Hoʻohaʻahaʻa o ka puʻuwai (bradycardia)

E kamaʻilio i kāu mea lawelawe ola kino inā loaʻa iā ʻoe kekahi mau hōʻailona a i ʻole nā ​​hōʻailona o ka maʻi sinus maʻi. He nui nā kūlana olakino e hiki ke hoʻokumu i kēia mau pilikia. He mea nui ia e loaʻa kahi ʻike pololei a kūpono hoʻi.

Inā loaʻa iā ʻoe ka ʻeha hou a wehe ʻole ʻia paha o ka umauma a manaʻo paha ʻoe e loaʻa ana iā ʻoe kahi hoʻouka naʻau, e kāhea koke i ke kōkua lapaʻau pilikia.

No ka hoʻomaopopo ʻana i ke kumu o ka maʻi sinus maʻi, he mea kōkua paha ke ʻike pehea ka holo mau ʻana o ka naʻau.

Ua hana ʻia ka naʻau mai nā keʻena ʻehā - ʻelua luna (atria) a me ʻelua lalo (ventricles). Hoʻokele ʻia ka leo o ka naʻau e ka sinus node, kahi wahi o nā sela kūikawā ma ke keʻena naʻau ʻākau luna (right atrium).

Hiki i ka maʻi sinus maʻi ke loaʻa i kēlā me kēia makahiki. ʻOi aku ka nui o ka loaʻa ʻana i nā kānaka i ko lākou mau makahiki 70 a ʻoi aku paha. Hiki i nā kumu pilikia maʻamau o ka maʻi naʻau ke hoʻonui i ka pilikia o ka maʻi sinus maʻi. ʻO nā kumu pilikia no ka maʻi naʻau, ʻo ia hoʻi:

• Ke kiʻekiʻe o ke koko
• Ke kiʻekiʻe o ka cholesterol
• Ke kaumaha nui o ke kino
• Ka nele o ka hoʻoikaika kino

Nā pilikia o ka maʻi sinus maʻi:

• Atrial fibrillation, kahi ʻano o ka puʻuwai ʻole (arrhythmia)
• Nalowale o ka naʻau
• Stroke
• Hoʻopau o ka naʻau

No ka hōʻoiaʻana i ka maʻi o ka sinus maʻi, e hana kekahi mea mālama ola i kahi hōʻoia kino a nīnau e pili ana i nā hōʻailona a me ka mōʻaukala lapaʻau.

ʻO nā hōʻailona o ka maʻi sinus maʻi - e like me ka dizziness, ka pōkole o ka hanu a me ka hāʻule ʻana - e kū mai wale nō ke kuʻi kūpono ʻole ka naʻau. ʻAʻole paha ʻoe e loaʻa nā hōʻailona i ka manawa o ke kūkā.

No ka hoʻoholo ʻana inā pili nā hōʻailona i nā pilikia me ka node sinus a me ka hana o ka naʻau, hiki i kekahi mea mālama ola ke hoʻohana i nā hoʻokolohua penei:

He hoʻokolohua maʻalahi ka electrocardiogram (ECG a EKG paha) e hoʻoholo ai pehea ke kuʻi ʻana o ka naʻau. Hoʻopaʻa nā mea hoʻolohe (electrodes) i kau ʻia ma ka umauma i nā hōʻailona uila o ka naʻau. Hōʻike ʻia nā hōʻailona ma ke ʻano o nā nalu ma kahi mīkini kamepiula a i ʻole mīkini paʻi i hoʻopili ʻia.

Hoʻohana ka mīkini kiaʻi Holter i nā electrodes a me kahi mea hoʻopaʻa e hahai i ke kuʻi ʻana o ka naʻau no 24 a 72 mau hola paha. Hiki i kekahi mea mālama ola ke paʻi i kahi kāʻei electrocardiogram me ka hoʻohana ʻana i ka ʻikepili ma ka mea hoʻopaʻa e ʻike i ke kuʻi ʻana o ka naʻau i ka wā i komo ʻia ai ka mīkini kiaʻi.

ʻAʻole pinepine ka hoʻohana ʻana i kēia hoʻokolohua, i kapa ʻia hoʻi he haʻawina EP, no ka nānā ʻana i ka maʻi sinus maʻi. Eia naʻe, hiki ke hana ʻia e nānā i ka hana o ka node sinus a e loiloi i nā waiwai uila ʻē aʻe o ka naʻau.

I ka wā o ka hoʻonaʻauao electrophysiologic (EP), ua kaula ʻia nā uea lahilahi, palupalu i uhi ʻia me nā electrodes ma nā kīʻaha koko i nā wahi like ʻole i loko o ka naʻau. Ke kau ʻia, hiki i nā electrodes ke palapala i ka hoʻolaha ʻana o nā hōʻailona uila ma o ka naʻau.

• Electrocardiogram (ECG a EKG paha). He hoʻokolohua maʻalahi kēia e ana i ka hana uila o ka naʻau. Hoʻopili ʻia nā mea hoʻolohe (electrodes) i ka umauma a me nā wāwae. Hoʻopili nā kaula i nā mea hoʻolohe i kahi kamepiula, kahi e hōʻike a paʻi paha i nā hopena. Hiki i ka electrocardiogram (ECG) ke haʻi i ka wikiwiki a lohi paha o ke kuʻi ʻana o ka naʻau. Hiki i kekahi mea mālama ola ke nānā i nā ʻano hōʻailona e hoʻoholo ai inā aia ka maʻi sinus maʻi.
• Mīkini kiaʻi Holter. Hiki ke komo ʻia kēia mea hana lawe lima no hoʻokahi lā a ʻoi aku paha i ka wā o nā hana o kēlā me kēia lā. Hoʻopaʻa ʻia e ia iho i ka hana o ka naʻau no 24 a 72 mau hola. Hiki i ke kanaka e komo ana i kahi mīkini kiaʻi ke mālama pū i kahi moʻolelo o nā hōʻailona.
• Mea hoʻopaʻa hanana. Hoʻolālā ʻia kēia mea hana lawe lima e komo no 30 mau lā a i ʻole a hiki i kou loaʻa ʻana i kahi kuʻi naʻau kūpono ʻole a i ʻole nā ​​hōʻailona. Maʻamau ʻoe e kaomi i kahi pihi ke kū mai nā hōʻailona.
• Nā mīkini kiaʻi ʻē aʻe. Hāʻawi kekahi mau mea hana pilikino, e like me nā wati akamai, i ka nānā ʻana i ka electrocardiogram. E nīnau i kāu mea mālama ola inā he koho kēia no ʻoe.
• Mea hoʻopaʻa loop implantable. Hoʻokomo ʻia kēia mea hana liʻiliʻi ma lalo pono o ka ʻili o ka umauma. Hoʻohana ʻia ia no ka nānā mau loa, lōʻihi o ka hana uila o ka naʻau, ʻoiai no nā poʻe i loaʻa nā hōʻailona pinepine ʻole.

ʻO nā pahuhopu o ka mālama ʻana i ka maʻi sinus maʻi, ʻo ia ka hoʻemi ʻana a i ʻole ka hoʻopau ʻana i nā hōʻailona a me ka mālama ʻana i nā kūlana olakino ʻē aʻe e kōkua ana.

Hiki i ka mālama ʻana i ka maʻi sinus syndrome ke komo pū me:

Inā ʻaʻohe ou mau hōʻailona, ​​hiki i kāu mea mālama ola ke kuhikuhi wale i nā nānā olakino maʻamau e nānā i kou kūlana. Pono ka hapa nui o nā kānaka me nā hōʻailona e loaʻa kahi kaʻina hana e hoʻokomo i kahi mea hana e mālama i ka puʻuwai maʻamau (pacemaker).

Hiki i kekahi mau lāʻau lapaʻau, me nā mea i hoʻohana ʻia e mālama i ke koko kiʻekiʻe a i ʻole ka maʻi naʻau, ke hoʻopilikia i ka hana o ka sinus node. E nānā paha kāu mea mālama ola i nā lāʻau lapaʻau āu e lawe ai a hiki ke hoʻoponopono iā lākou a i ʻole ke kauoha i nā mea ʻē aʻe.

Hiki ke pono nā lāʻau lapaʻau e pale aku ai a i ʻole e hoʻomāmā i ka wikiwiki o ka puʻuwai.

Hiki ke kuhikuhi ʻia nā mea hoʻonāwaliwali koko (anticoagulants), e like me ka warfarin (Jantoven), dabigatran (Pradaxa) a i ʻole nā ​​mea ʻē aʻe, inā pili ka maʻi sinus syndrome me ka atrial fibrillation a i ʻole nā ​​rhythm puʻuwai kūpono ʻole e pili ana i ka hahau.

Pono ka hapa nui o nā kānaka me ka maʻi sinus syndrome i kahi mea hana mau e kaohi i ka rhythm puʻuwai (pacemaker). He mea liʻiliʻi, uila-powered ka pacemaker i hoʻokomo ʻia ma lalo o ka ʻili kokoke i ka collarbone i ka wā o kahi hana ʻoki liʻiliʻi. Hoʻoulu ka pacemaker (paces) i ka puʻuwai e like me ka pono e mālama iā ia e kuʻi mau.

Inā he māmā a pinepine ʻole paha nā hōʻailona o ka maʻi sinus syndrome, e hilinaʻi ka hoʻoholo e hoʻohana i ka pacemaker i nā hopena o nā electrocardiograms (ECGs), kou olakino holoʻokoʻa a me ka pilikia o nā pilikia ʻoi aku ka nui.

ʻO ke ʻano o ka pacemaker āu e pono ai e hilinaʻi i ke ʻano o ka rhythm puʻuwai kūpono ʻole āu i loaʻa ai. ʻO nā ʻano o nā pacemakers:

Inā kūpono ʻole nō kou puʻuwai ma hope o ka loaʻa ʻana o ka pacemaker, pono paha ʻoe i nā lāʻau lapaʻau a i ʻole kahi kaʻina hana catheter-based i kapa ʻia ʻo cardiac ablation e hoʻoponopono a i ʻole e kaohi iā ia. Hoʻohana ka cardiac ablation i ka wela a i ʻole ka ikehu anu e hana i nā ʻeha liʻiliʻi i ka puʻuwai e kāohi i nā hōʻailona hewa a hoʻihoʻi i ka puʻuwai maʻamau. Hana pinepine ʻia me nā tubo lahilahi, nā mea hoʻoheheʻe i kapa ʻia he catheters i hoʻokomo ʻia ma o nā veins a i ʻole nā ​​arteries. ʻAʻole pinepine, hana ʻia ka ablation i ka wā o ka hana naʻau. Hoʻohana pinepine ʻia kahi ʻano o ka cardiac ablation i kapa ʻia ʻo atrioventricular (AV) node ablation e kaohi i nā rhythm puʻuwai wikiwiki i nā kānaka me nā pacemakers.

I ka atrioventricular (AV) node ablation, hoʻohana kahi kauka naʻau i ka ikehu radiofrequency e luku i ka pilina uila ma waena o nā keʻena puʻuwai luna a lalo (node), e kāohi ana i nā impulses uila o ka puʻuwai. I ka manawa i luku ʻia ai ka node, a laila hoʻokomo ka kauka naʻau i kahi mea hana lapaʻau liʻiliʻi e mālama i ka rhythm puʻuwai (pacemaker).

Hoʻohana ka cardiac ablation i ka wela a i ʻole ka ikehu anu e hana i nā ʻeha liʻiliʻi i ka puʻuwai e kāohi i nā hōʻailona uila kūpono ʻole a hoʻihoʻi i ka rhythm puʻuwai. Hoʻokomo ʻia hoʻokahi a ʻoi aku paha nā tubo lahilahi, nā mea hoʻoheheʻe (catheters) ma o kahi artery, maʻamau ma ka groin, a alakaʻi ʻia i ka puʻuwai. Hoʻopili nā mea ʻike ma ka piko o nā catheters i ka wela a i ʻole ka ikehu anu. Hōʻike kēia kiʻi i nā catheters ablation e hoʻopili ʻia kokoke i nā veins pulmonary i kahi ʻano o ka cardiac ablation i kapa ʻia ʻo pulmonary vein isolation.

• Nānā maʻamau

• Nā lāʻau lapaʻau

• Nā kaʻina hana Catheter

• Hana ʻoki e hoʻokomo i kahi mea hana e mālama i ka puʻuwai maʻamau (pacemaker)

• Pacemaker keʻena hoʻokahi. ʻO kēia ʻano maʻamau e lawe i nā hōʻailona uila i ka keʻena puʻuwai lalo ʻākau (ventricle) o ka puʻuwai.

• Pacemaker keʻena pālua. Hoʻoulu kēia ʻano i ka keʻena puʻuwai lalo ʻākau (ventricle) a me ka keʻena puʻuwai luna ʻākau (atrium) kaʻawale. Loaʻa ka pōmaikaʻi o ka hapa nui o nā kānaka me ka maʻi sinus syndrome mai nā pacemakers pālua-keʻena.

• Pacemaker Biventricular. ʻO ka biventricular pacing, i kapa ʻia hoʻi ʻo ka cardiac resynchronization therapy, no nā kānaka i loaʻa ka maʻi naʻau a me nā pilikia puʻuwai. Hoʻoulu kēia ʻano o ka pacemaker i nā keʻena puʻuwai lalo ʻelua (ka ʻākau a me ka hema ventricles) e hana i ka puʻuwai e kuʻi hou aku.

He mea nui ka lawe ʻana i nā hana e hoʻoemi ai i ka pilikia o ka maʻi naʻau. E ho'āʻo i kēia mau hana olakino naʻau:

• E ʻai i ka ʻai olakino. E koho i nā ʻāpana nui o nā huaʻai ʻaʻohe o ka palaoa, nā hua a me nā huaola holoʻokoʻa a me nā ʻāpana liʻiliʻi o ka iʻa, nā ʻiʻo momona ʻole, nā manu a me ka waiū.
• E hoʻoikaika kino a mālama i ke kaumaha olakino. Ke nui ke kaumaha, e hoʻonui ʻia ka pilikia o ka loaʻa ʻana o ka maʻi naʻau. Ke ʻole kāu mea lawelawe e haʻi aku iā ʻoe i kahi ʻē aʻe, e pahuhopu i ka liʻiliʻi o 30 mau minuke o ka hana kino waena i kēlā me kēia lā. E nīnau i kāu mea lawelawe olakino i ka nui o ke kaumaha āu e pono ai.
• E mālama i ke kaomi koko a me ka cholesterol ma lalo o ke kaohi. E hana i nā loli nohona a lawe i nā lāʻau lapaʻau e like me ke kauoha ʻia e hoʻokele i ke kaomi koko kiʻekiʻe a i ʻole ka cholesterol kiʻekiʻe.
• Mai puhi paka. Inā ʻoe e puhi paka a ʻaʻole hiki iā ʻoe ke haʻalele ma kāu iho, e kamaʻilio me kāu mea lawelawe olakino e pili ana i nā ala a i ʻole nā ​​papahana e kōkua ai e wāwahi i ka maʻi puhi paka.
• Inā ʻoe e inu, e hana pēlā me ka mālie. No kekahi mau kūlana, ua ʻōlelo ʻia e pale loa i ka waiʻona. E nīnau i kāu mea lawelawe olakino no ka ʻōlelo aʻoaʻo kūikawā i kāu kūlana. Inā ʻaʻole hiki iā ʻoe ke kaohi i kāu hoʻohana ʻana i ka waiʻona, e kamaʻilio me kāu mea lawelawe e pili ana i kahi papahana e haʻalele ai i ka inu ʻana a hoʻokele i nā ʻano ʻē aʻe e pili ana i ka hoʻohana ʻana i ka waiʻona.
• Mai hoʻohana i nā lāʻau lapaʻau kū kānāwai ʻole. E kamaʻilio me kāu mea lawelawe e pili ana i kahi papahana inā pono ʻoe i ke kōkua e haʻalele ai.
• E kaohi i ke kaumaha. ʻO ka loaʻa ʻana o ka hoʻoikaika kino hou aku, ka hoʻomaʻamaʻa ʻana i ka noʻonoʻo a me ka hoʻopili ʻana me nā poʻe ʻē aʻe i nā hui kākoʻo he mau ala ia e hoʻemi ai i ke kaumaha.
• E hele i nā nānā manawa. E loaʻa i nā nānā kino maʻamau a e hōʻike i kekahi mau hōʻailona a i ʻole nā ​​hōʻailona i kāu mea lawelawe olakino.