Chii chinonzi Vagus Nerve Stimulation? Chinangwa, Maitiro & Mhedzisiro

Vagus nerve stimulation (VNS) imishonga inoshandisa mabvunzwa emagetsi akapfava kumutsa vagus nerve yako, iyo yakaita semugwagwa mukuru wekukurukurirana wemuviri wako pakati peuropi hwako nenhengo. Fungidzira se pacemaker yeuropi hwako inobatsira kudzora mafungiro, kubatwa, uye mamwe mabasa akakosha. Mushonga uyu wabatsira zviuru zvevanhu kudzora mamiriro akaita se epilepsy uye depression kana dzimwe mishonga isina kushanda zvakanaka.

Chii chinonzi vagus nerve stimulation?

Vagus nerve stimulation imishonga inotumira zviratidzo zvemagetsi zvakapfava kune vagus nerve yako kuburikidza nechishandiso chidiki chakaiswa pasi peganda rako. Vagus nerve yako ndiyo tsinga refu kwazvo mumuviri wako, ichibva pa brainstem yako ichidzika mudumbu rako semugwagwa mukuru unotakura mameseji pakati peuropi hwako nenhengo huru.

Mushonga unoshanda nekutumira nguva dzose, dzakadzorwa dzemagetsi anobatsira kugadzirisa basa rehuropi risina kujairika. Mabvunzwa aya akapfava zvekuti vanhu vazhinji havatoanzwi kana vachijaira chishandiso. Kukurudzira kunoitika otomatiki zuva rese, kazhinji kwemasekonzi makumi matatu maminitsi mashoma ega ega.

VNS yakabvumidzwa neFDA kubvira 1997 yekurapa epilepsy uye kubvira 2005 yekurapa-inodzivirira depression. Munguva pfupi yapfuura, vanachiremba vari kuongorora mukana wayo kune mamwe mamiriro akaita se anxiety, kurwadziwa kusingaperi, uye kunyange zvirwere zvinopisa.

Nei vagus nerve stimulation ichiitwa?

VNS inonyanya kushandiswa kana mishonga yakajairika isina kupa zororo rakakwana kune mamiriro akakomba e neurological kana psychiatric. Chiremba wako angakurudzira mushonga uyu kana wakaedza mishonga yakawanda pasina kubudirira kana uine mhedzisiro yakakosha kubva kune dzimwe mishonga.

Chikonzero chikuru cheVNS i epilepsy isingapinduri zvakanaka kumishonga inodzivirira kubatwa nepfari. Vanhu vanenge chikamu chimwe muzvitatu vane epilepsy vanoramba vaine kubatwa nepfari kunyangwe vakaedza mishonga yakasiyana-siyana. Kune vanhu ava, VNS inogona kuderedza kuwanda kwekubatwa nepfari ne50% kana kupfuura muzviitiko zvakawanda.

Kune kuora mwoyo, VNS inofungwa kana wakaedza mishonga yakati wandei yekurwisa kuora mwoyo uye psychotherapy usingawani kupora. Rudzi urwu rwekuora mwoyo runonzi kurwisa kurapwa kwekuora mwoyo, uye rinokanganisa vanhu vanenge 30% vane major depressive disorder.

Vatsvakurudzi vari kudzidzawo VNS kune zvimwe zvirwere zvinosanganisira kurwadziwa kusingaperi, migraines, chirwere cheAlzheimer, uye autoimmune disorders. Kunyange zvazvo zvikumbiro izvi zvichiri kuongororwa, mhedzisiro yekutanga inoratidza vimbiso yekuwandisa kushandiswa kweVNS mune ramangwana.

Ndeipi nzira yekukurudzira tsinga ye vagus?

Maitiro eVNS anosanganisira kuisa chishandiso chidiki chine saizi yewachi pasi peganda munzvimbo yako yepamusoro yechipfuva. Iyi kuvhiyiwa kwevarwere kunowanzo tora 1-2 maawa uye kunoitwa pasi peanesthesia yakajairika ne neurosurgeon kana chiremba anovhiya akadzidziswa zvakakosha.

Munguva yekuvhiya, chiremba wako anovhiya anoita incision diki mumutsipa wako kuti awane tsinga ye vagus. Vanobva vaputira waya yakatetepa ine electrodes yakatenderedza tsinga uye vanotunela waya iyi pasi peganda rako kuti vaiise kune pulse generator muchipfuva chako. Zvichemo zvinovharwa nemashiti anonyungudika.

Zvinoitika panguva yekuvhiya:

1. Uchagamuchira general anesthesia kuti uve nechokwadi chekuti unonyatsogadzirwa
2. Chiremba anovhiya anoita 2-3 inch incision mumutsipa wako uye imwe diki muchipfuva chako
3. Tsinga ye vagus inonyatsozivikanwa uye electrode inoputirwa pairi
4. Waya inotunelwa pasi peganda rako kuti iite kune pulse generator
5. Chishandiso chinoedzwa kuti chive nechokwadi chebasa rakakodzera
6. Zvichemo zvinovharwa uye unoendeswa kunopora

Vanhu vazhinji vanoenda kumba musi mumwechete kana mushure mehusiku humwe. Muchina uyu unowanzoitwa mumasvondo 2-4 mushure mekuvhiyiwa kuti kupora kwakakodzera kuvepo.

Nzira yekugadzirira nzira yako yekukurudzira tsinga ye vagus?

Kugadzirira kuvhiyiwa kwe VNS kunosanganisira matanho akati wandei kuti uve nechokwadi chekuchengeteka kwako uye mhedzisiro yakanakisa. Chikwata chako chekurapa chichakutungamira kuburikidza nechikamu chega chega chekugadzirira uye kupindura chero mibvunzo yaungave uine.

Pamberi pekuvhiyiwa, unozofanira kurega kutora mishonga yakati wandei inogona kuwedzera njodzi yekubuda ropa. Chiremba wako achapa runyorwa rwakajeka, asi mishonga yakajairika yekudzivirira inosanganisira aspirin, ibuprofen, uye zvinoderedza ropa. Usamira chero mishonga usati wambotaura nechikwata chako chehutano.

Heano matanho makuru ekugadzirira aunozofanira kutevera:

• Pedzisa bvunzo dzeropa pamberi pekuvhiyiwa uye pamwe EKG kana X-ray yechipfuva
• Dzivisa kudya kana kunwa chero chinhu mushure mepakati peusiku pamberi pekuvhiyiwa kwako
• Gadzirira mumwe munhu kuti akuendesere kumba mushure mekuvhiyiwa
• Pfeka mbatya dzakasununguka, dzakakodzera dzine mabhatani kumberi
• Bvisa zvishongo zvose, polish yezvipikiri, uye makeup usati wasvika
• Uya nerunyorwa rwemishonga yako yose yazvino uye zviyero

Chiremba wako achakurukurawo njodzi nemabhenefiti newe uye achawana mvumo yako yakaziviswa. Iyi inguva yakanaka yekubvunza chero mibvunzo yekupedzisira nezve nzira kana maitiro ekupora.

Nzira yekuverenga mhedzisiro yako yekukurudzira tsinga ye vagus?

Mhedzisiro ye VNS inoyerwa zvakasiyana nemiedzo yakajairika yekurapa nekuti kurapwa uku kunoshanda zvishoma nezvishoma nekufamba kwenguva. Chiremba wako achatevera kufambira mberi kwako achishandisa mabhuku ekuongorora, ongororo yemanzwiro, uye mibvunzo yemhando yehupenyu panzvimbo yezvakakosha zvelaboratory.

Panyaya yechirwere chepfari, kubudirira kunowanzo tsanangurwa sekuderera kwe50% kana kupfuura mukufambisa kwemakakatanwa zvichienzaniswa nekutanga kurapwa. Zvisinei, kunyange kuderedzwa kuduku kunogona kuva kunoreva kana kuchivandudza upenyu hwenyu hwezuva nezuva. Vamwe vanhu vanosanganawo nemakakatanwa mapfupi, asina simba kunyange kana kufambisa kusina kuchinja zvakanyanya.

Kuvandudzwa kwekuora mwoyo kunoyerwa vachishandisa zviyero zvakajairika zvinoyera manzwiro, mazinga esimba, maitiro ekurara, uye kushanda kwese. Chiremba wenyu angashandisa maturusi akaita seHamilton Depression Rating Scale kana Beck Depression Inventory kuti atevere shanduko nekufamba kwenguva.

Zvakakosha kunzwisisa kuti mabhenefiti eVNS anokura zvishoma nezvishoma, kazhinji achitora 12-24 mwedzi kuti asvike pakushanda zvizere. Kuvandudzwa uku zvishoma nezvishoma zvinoreva kuti muchada kugadzwa nguva dzose kuti muongorore kufambira mberi kwenyu uye mugadzirise marongero echishandiso sezvinodiwa.

Nzira yekuvandudza mhedzisiro yako yekufambisa tsinga ye vagus?

Kuvandudza mhedzisiro yeVNS kunosanganisira kushanda pamwe chete nechikwata chenyu chehutano kuti mugadzirise marongero echishandiso uye kuchengetedza tsika dzehupenyu hune hutano. Chishandiso chinogona kugadziriswa zvisina kupinda vachishandisa wand yekuronga panguva yekushanya muhofisi.

Chiremba wenyu achawedzera zvishoma nezvishoma simba rekufambisa kwemwedzi yakati wandei kuti awane marongero anoshanda zvakanyanya kune mamiriro enyu. Iyi nzira inonzi titration, uye inobatsira kuderedza mhedzisiro yezvinhu zvakashata panguva yekuwandisa mabhenefiti. Vanhu vazhinji vanoda 3-6 zvikamu zvekuronga mugore rekutanga.

Kunze kwekugadzirisa chishandiso, zvimwe zvinhu zvehupenyu zvinogona kuvandudza kushanda kweVNS:

• Chengetedza nguva yekurara yakafanana uye edza kurara maawa 7-9 usiku hwega hwega
• Ramba uchitora mishonga yakarairwa sezvakarairwa nachiremba wako
• Dzidzira nzira dzekudzora kushushikana senge kufungisisa kana kufema zvakadzama
• Roora muviri nguva dzose mukati mekwaniso yako yemuviri
• Dzivisa doro nemishonga inoshandiswa rekuzvivaraidza iyo inogona kukanganisa kurapwa
• Chengeta zvinyorwa zvakadzama zvezviratidzo kuti ubatsire chiremba wako kutevera kufambira mberi

Rangarira kuti VNS inowanzo shandiswa pamwe chete nemamwe marapirwo, kwete senzira yekutsiva. Chiremba wako anogona kukurudzira kuenderera mberi nemishonga, kurapa, kana mamwe maitiro kuti uwedzere kuvandudzwa kwako kwese.

Ndezvipi zvakanakisa zvekugadzirisa tsinga ye vagus?

Zvirongwa zvakanakisa zveVNS zvakanyanya kuenderana nemunhu nekuti munhu wese ane hurongwa hwetsinga hunopindura zvakasiyana nekukurudzira. Chiremba wako achashanda newe kuti awane musanganiswa wakakwana wekusimudzira simba, frequency, uye nguva iyo inopa mukana mukuru nemhedzisiro shoma.

Zvirongwa zvakajairika zvekutanga zvinosanganisira kusimudzira kwakaderera kunopihwa kwemasekonzi makumi matatu maminitsi mashanu ega ega. Mumwedzi mishoma, chiremba wako anogona zvishoma nezvishoma kuwedzera simba uye kugadzirisa nguva zvichienderana nekupindura kwako uye chero mhedzisiro yaunowana.

Maitiro ekuronga anosanganisira akati wandei akakosha ma paramita ayo chiremba wako achagadzirisa:

• Kubuda kwazvino (kuyerwa mumamilliamp) - kunosarudza simba rekukurudzira
• Pulse width (kuyerwa mumicroseconds) - kunokanganisa kuti pulse yega yega inogara kwenguva yakareba sei
• Frequency (kuyerwa muHz) - inodzora kuti mangani mapulses pasekondi
• Panguva - kuti kusimudzira kunogara kwenguva yakareba sei panguva yega yega
• Nguva yekudzima - nguva yekuzorora pakati pemitambo yekusimudzira

Kuwana zvirongwa zvako zvakakwana inzira zvishoma nezvishoma inoda moyo murefu uye kutaurirana pedyo nechikwata chako chekurapa. Vanhu vazhinji vanowana mhedzisiro yavo yakanakisa mushure memwedzi 6-12 yekugadzirisa zvakanyatso.

Ndezvipi zvinhu zvinowedzera njodzi dzekuwana matambudziko kubva mukukurudzira tsinga ye vagus?

VNS inowanzoonekwa seyakachengeteka, asi semamwe maitiro ekuvhiya, inotakura njodzi dzinosiyana zvichienderana neutano hwako hwese nenhoroondo yekurapa. Kunzwisisa izvi zvinhu zvinowedzera njodzi zvinokubatsira kuti uite sarudzo ine ruzivo nezvekurapa.

Zvinhu zvinowedzera njodzi dzekuvhiya zvinosanganisira mamiriro anokanganisa kupora kana kuwedzera njodzi yekubuda ropa. Vanhu vane chirwere cheshuga, chirwere chemoyo, kana immune system yakakanganiswa vanogona kutarisana nenjodzi yakakwira zvishoma yekutapukirwa kana kupora kwemavanga kusina kunaka. Zera repamusoro harisi chipingamupinyi, asi rinogona kunonotsa kupora.

Heano zvinhu zvikuru zvinowedzera njodzi zvinogona kuwedzera mukana wako wekuwana matambudziko:

• Nhoroondo yekuvhiyiwa kwemutsipa kana radiation therapy kunzvimbo yemutsipa
• Matambudziko ekuumbwa kweropa kana kushandiswa kwazvino kwezvinodhaka zvinotetesa ropa
• Chirwere chemapapu chakakomba kana matambudziko ekufema
• Kutapukirwa kunoshanda chero kupi zvako mumuviri
• Kusagadzikana kwemoyo kwakanyanya
• Maitiro ekutanga ekugadzirisa kune anesthesia kana zvinhu zvekuvhiya

Chiremba wako achanyatsoongorora izvi zvinhu panguva yekuongorora kwako usati wavhiyiwa. Zvinhu zvakawanda zvinowedzera njodzi zvinogona kutarisirwa nekugadzirira kwakakodzera uye kuongorora, saka kuva nazvo hakukubvise iwe kubva mukurapa kweVNS.

Zviri nani here kuve nekukurudzira kwepamusoro kana kwakaderera tsinga ye vagus?

Iyo "yakanakisa" nhanho yekukurudzira tsinga ye vagus haina chekuita nekukwirisa kana kushoma, asi pane kutsvaga chiyero chakakodzera chemamiriro ako chaiwo uye kushivirira. Vanhu vazhinji vanobatsirwa kubva pakati nepakati pekurudzira mazinga anopa mhedzisiro yekurapa pasina kukonzera mhedzisiro isina kunaka.

Kutanga nekukurudzira kwakaderera kunobvumira muviri wako kuti uchinje zvishoma nezvishoma kunzwa uye kunobatsira kuderedza mhedzisiro yekutanga senge shanduko yezwi kana kusagadzikana kwehuro. Chiremba wako achawedzera zvishoma nezvishoma simba kwemwedzi yakati wandei zvichienderana nekupindura kwako uye kuvandudzwa kwezviratidzo.

Mazinga epamusoro ekukurudzira haafaniri kunge ari nani nekuti anogona kukonzera matambudziko akawanda pasina kupa mamwe mabhenefiti. Chinangwa ndechekuwana nzvimbo yako yekurapa inotapira - iyo yakaderera dose inoshanda iyo inopa rubatsiro rwezviratidzo zvine musoro.

Vamwe vanhu vanoda marongero epamusoro kuti vawane mhedzisiro yakanaka, nepo vamwe vachipindura zvakanaka kumazinga akaderera. Chiremba wako achanyatso tarisa kufambira mberi kwako uye achagadzirisa marongero zvichienderana nemaitiro ako ekupindura uye chero matambudziko aunowana.

Ndezvipi zvinogona kuitika zvekusimudzira tsinga ye vagus?

Matambudziko eVNS anowanzoitika uye anowanzo manejwa, asi zvakakosha kunzwisisa zvingaitika kuitira kuti uite sarudzo yekurapa ine ruzivo. Matambudziko mazhinji akapfava uye anogadziriswa ega kana nekugadzirisa nyore kumagadzirirwo echishandiso.

Mhedzisiro yakajairika ine chekuita nekukurudzira pachako uye inowanzoita nani muviri wako uchigadzirisa kurapwa. Izvi zvinosanganisira shanduko yenguva pfupi yezwi, kusagadzikana kwehuro, kana kukosora panguva yekukurudzira cycles. Vanenge 1-2% yevanhu vanowana izvi zvinokanganisa kwenguva refu.

Heano matambudziko anogona kuitika akarongwa nekuti anowanzoitika sei:

Matambudziko akajairika (anokanganisa kusvika ku10% yevanhu) anosanganisira:

• Kukosora kwezwi kana shanduko panguva yekukurudzira
• Kurwadziwa kwehuro kana kusagadzikana
• Kukosora kana kuchenesa huro
• Kurwadziwa kwemutsipa kana kuoma
• Musoro
• Kutadza kumedza panguva yekukurudzira

Matambudziko asingawanzoitiki asi akakomba (anokanganisa 1-5% yevanhu) anosanganisira:

• Kutapukirwa panzvimbo yekuvhiya
• Kushanda zvisina kunaka kwechishandiso kuchida kutsiviwa
• Lead waya kuputsika kana kutamiswa
• Kugara zvachose shanduko yezwi
• Kufema kwakaoma panguva yekukurudzira
• Kusimba kwechiso kana kudonha

Matambudziko asingawanzoitiki asi akakomba (anokanganisa vanhu vasingasviki 1%) anosanganisira:

• Kuremara kusingaperi kwetambo yezwi
• Matambudziko makuru ekufema
• Kuchinja kwemoyo
• Maitiro akakomba ekurwara neallergies
• Kukuvadzwa kwetsinga kunze kwetsinga ye vagus

Matambudziko mazhinji anogona kugadziriswa nekugadzirisa marongero emudziyo, kutora mishonga, kana, mumamiriro ezvinhu asingawanzoitiki, kubvisa mudziyo. Chikwata chako chekurapa chichakutarisa zvakanyanya uye chichagadzirisa chero nyaya nekukurumidza.

Ndingafonere chiremba rini nekuda kwekunetseka kwekusimudzira tsinga ye vagus?

Unofanira kubata chiremba wako nekukasira kana ukaona chero shanduko dzakakomba kana dzemutsipa mushure mekuiswa kweVNS. Nepo mativi mazhinji emigumisiro ari nyoro uye anotarisirwa, zviratidzo zvakati wandei zvinoda kutariswa kwekurapa nekukurumidza kuti uve nechokwadi chekuchengeteka kwako.

Mamiriro ekukurumidzira anoda kutariswa kwekurapa nekukasira anosanganisira matambudziko akakomba ekufema, kurwadziwa muchipfuva, zviratidzo zvechirwere zvakaita sefivha uye kubuda kwemvura kubva pamavanga, kana shanduko dzemutsipa dzisingavandudzi kana kusimudzira kwakamira.

Bata chiremba wako nekukasira kana ukaona:

• Kufema kwakaoma kana kufema kwemhepo, kunyanya panguva yekusimudzira
• Kurwadziwa muchipfuva kana kurova kwemoyo kusina kujairika
• Zviratidzo zvechirwere zvinosanganisira fivha, kutsvuka, kudziya, kana kubuda kwemvura kubva kunzvimbo dzekuvhiya
• Kurwadziwa kwemutsipa kwakakomba, kwemutsipa kana kuoma
• Kuoma kusingaperi kumedza
• Kutanga kana kuwedzera kwezvirwere zvinoita sezvakasiyana nemaitiro ako akajairika

Unofanirawo kuronga nguva dzekutevera kana ukaona shanduko zvishoma nezvishoma muzviratidzo zvako kana migumisiro. Zvinhu zvisingakurumidze zvinoda kushanya kwechiremba zvinosanganisira shanduko dzemutsipa dzisingaperi, kuwedzera kusagadzikana kwehuro, kana mibvunzo pamusoro pebasa remudziyo.

Rangarira kuti chikwata chako chehutano chiripo kuti chikutsigire mukati merwendo rwako rweVNS. Usazeze kubata nemibvunzo kana kunetseka, kunyangwe zvichioneka sezviri zvidiki. Kutaurirana kare kazhinji kunodzivirira nyaya diki kubva pakuva matambudziko makuru.

Mibvunzo inowanzo bvunzwa pamusoro pekusimudzira tsinga ye vagus

Mubvunzo 1: Kusimudzira tsinga ye vagus kwakanakira kushushikana here?

VNS inoratidza vimbiso yekurapa kushushikana, kunyangwe isati yatenderwa neFDA zvakananga kune matambudziko ekushushikana. Vanhu vazhinji vane kushushikana kunodzivisa kurapwa vanogamuchira VNS vanoshumawo kuvandudzwa muzviratidzo zvavo zvekushushikana, izvo zvine musoro nekuti tsinga ye vagus inotamba basa rakakosha mukudzora mhinduro yemuviri wako yekushushikana.

Miedzo yekiriniki parizvino iri kudzidza VNS kune akasiyana mamiriro ekushushikana anosanganisira generalized anxiety disorder uye post-traumatic stress disorder. Mhedzisiro yekutanga inoratidza kuti kurapa kunogona kubatsira kuderedza zviratidzo zvekushushikana nekusimudzira kutaurirana kuri nani pakati peuropi hwako nemuviri wemuviri wekuzorora.

Mubvunzo 2: Kusimudzira tsinga ye vagus kunokonzera kuwedzera uremu here?

VNS kazhinji haikonzeri kuwedzera kukuru kwemuviri, uye vamwe vanhu vanotoona kurasikirwa uremu. Tsinga ye vagus inobatsira kudzora kugaya uye chido, saka kusimudzira kunogona kukanganisa mabasa aya mune chero nzira zvichienderana nemhinduro yako yega.

Kana iwe ukaona shanduko dzehuremu mushure meVNS implantation, anogona kunge akabatana nekugadzirisa mamiriro ako ari pasi pane kusimudzira pachako. Semuenzaniso, vanhu vane kushushikana kunovandudzika vanogona kuve nechido chakawedzera uye simba, zvichikonzera kuwedzera uremu sezvavanopora.

Mubvunzo 3: Ndingave neMRI ne vagus nerve stimulator here?

Hongu, unogona kuve neMRI scans ine VNS mudziyo, asi matanho akakosha anodiwa. VNS yako inofanirwa kudzima isati yaitwa MRI uye inogona kudzoserwa zvakare mushure. Zvinodiwa chaizvo zvekuchengetedza MRI zvinoenderana nemhando yako yemudziyo uye nguva yakaiswa.

Nguva dzose zivisa yako MRI technologist uye radiologist nezve yako VNS mudziyo usati waita chero scan. Vachabatana nenyanzvi yako yetsinga kuti vaone kuti mudziyo unogadziriswa nemazvo uye kuti MRI inoitwa zvakachengeteka.

Q4: Bheteri re vagus nerve stimulator rinogara kwenguva yakareba sei?

Mabheteri e VNS anowanzo gara makore 5-10, zvichienderana nemagadzirirwo ako ekukurudzira uye kuti unoshandisa kazhinji sei zvinhu zvakaita semagineti. Miviri yekukurudzira yakakwira uye kushandiswa kazhinji kuchapedza bheteri nekukurumidza.

Kana bheteri rapera, unozoda nzira iri nyore yekubvisa murwere kuti utsive jenareta repulse. Kuvhiyiwa uku kunokurumidza kupfuura kuisa kwekutanga nekuti waya inotungamira haiwanzo fanira kutsiviwa, ingobviswa uye yobatana zvakare kune chishandiso chitsva.

Q5: Vagus nerve stimulation inogona kubatsira kurwadziwa kusingaperi here?

VNS iri kudzidzwa kune akasiyana mamiriro ekurwadziwa kusingaperi, aine mhedzisiro yekutanga inokurudzira. Vagus nerve inopesvedzera kunzwisiswa kwerwadziwa uye kuzvimba, saka kukurudzira kunogona kubatsira kuderedza ese ari maviri kusimba kwerwadziwa uye mhinduro yekuzvimba kwemuviri.

Tsvagiridzo yazvino inotarisa pamamiriro akaita se fibromyalgia, rheumatoid arthritis, uye kurwadziwa kwemusoro kusingaperi. Kunyange zvazvo izvi zvikumbiro zvisati zvabvumirwa neFDA, vamwe vanhu vanoshuma kuvandudzwa kwerwadziwa sechinhu chechipiri pavanogamuchira VNS kune mamiriro akabvumirwa se epilepsy kana kuora mwoyo.