Ntliziyo - ntoni na? Njani pacemaker? cost of operation

Ntliziyo - oluvela ngokwembono kugqirha? Okokuqala, le isixhobo elincinane elektroniki ukuba normalizes imisipha intliziyo. Heart pacemaker inika inani elilelona emanxebani eziyimfuneko ubomi obuqhelekileyo. Esi sixhobo ndinokukwazi ukuloyisa dissociation electrophysiological ye imithambo kunye ventricles, ebizwa ngokuba yi-block atrioventricular, yaye ngaloo ndlela uzinzo intliziyo.

History of indalo

Ntliziyo - oku ukuba komzimba? Njengoko esi sixhobo ezisetyenzisiweyo ngokwemiqathango igalelo kwiinkqubo zophendlo lwezifo kwi yegazi ngayo umzimba womntu? Ekusebenziseni pulses buthathaka zombane yangoku ukuphelisa arrhythmias abaphandi babezibuza kwi kwenkulungwane ye-19. Nangona kunjalo, ukunqongophala zobugcisa lokuvelisa ombane ethumela kwixabiso kuncitshiswe akavumelekanga ukuba baqale uphando kweli cala.

Kuphela kwisiqingatha sokuqala senkulungwane yama-20, bengqondo, oosonzululwazi uqale ukufunda ifuthe ngamaza ombane kumsebenzi entliziyweni. Omnye uvulindlela kule ndawo yaba ngumphandi Italian Luigi Galvani. physiologists kamva Russian N. E. Vvedensky kunye Yu. M. Chagovets liqalise uphando yethuba zokusebenzisa amandla ngobhobhozo electric current ukuba unyango lwezifo ezithile zentliziyo.

Ngowe-1927, i-cardiologist American Albert uHyman liqulunqe isixhobo electro-mechanical yokuqala lwehlabathi ukugcina isingqisho ezinzileyo intliziyo yomntu. Lo matshini ubunzima grams ngaphezu kwamakhulu amathathu, ifowuni lanqunyanyiswa ibhanti ekhethekileyo ifihliweyo phantsi kwengubo. Noko ke, kwesincedisi- leyo ukusebenza kakuhle, ngexesha elifutshane sele zifakiwe imveliso serial.

iziphumo zokuqala

Ntliziyo - ukuba ukuba Alberta Haymena, uMdali yunithi kunye noogxa bakhe ojongene arrhythmia intliziyo? Kuqala kwinto zonke, eli iba linyathelo lokuqala kwinkqubo elide ndifunda nobuchule zobunjineli yombane, nenokuthi azibekwa inkonzo amayeza.

isicelo Practical ngayo ivuselela uHyman kwimeko yongxamiseko kwenzeka ngo-1951, xa emva kokuba usebenzo unako ukusindisa umguli kunye phambili ezinqamlezayo block intliziyo kunye arrhythmia neziqephu. Noko ke, isiguli ixesha elide esibhedlele, njengoko wayengakwazi ukuhamba ngokukhululekileyo i izixhobo ngokwanelisayo enkulu emzimbeni kwaye, kananjalo, yaye ifuna kweliso lomgadi nabasebenzi bezonyango.

Ivuselela-uyofaka

World Cardiology Center ziye zadibana ukuze ukudala stimulator compact lombane, leyo nobunzima hayi ngaphezulu kwe 80 grams. Ngowe-1958, iqela lezazinzulu Swedish, ikhokelwa ngu Dr. Rune Elmqvist ukudala umfanekiso omncinane "Siemens-El." Stimulator wayevalelwe ngendlela izindlu obhityileyo-esibiyelwe ezenziwe titanium ingxubevange kwaye wafaka phantsi kwesikhumba. Nangona kunjalo, ukusetyenziswa amandla fyabo Swedish yayincinane - ibhetri inika ukubetha kwentliziyo kangangeenyanga ezili-18 kuphela, emva koko isigulane kwanyanzeleka ukuba enze umsebenzi endaweni umbane.

Ukudalwa EKS zasekhaya

Ekugqibeleni, elinye - yintoni ukusuka kwindawo Ngenxa izigulana ngokwabo? Kakade, esi sixhobo osindisayo, usinika ubomi izigulane kwentliziyo bathwaxwa ukuphazamiseka ezahlukeneyo entliziyweni isingqisho. Heart kwezihlunu abasebenza isandi ekunene - ngundoqo ukusebenza ezinzileyo kwinkqubo yokujikeleza iphela umzimba.

Ngowe-1960, iSoviet academician A. N. Bakulev wajika ukuya phambili ngamaziko zobugcisa eSoviet Union ecetywayo nokudalwa iingcinga sinjalo intliziyo. Amagosa lokuqala basabela Design Bureau uphuhliso ichanekile ngezobunjineli, ebinezinto ubume lweshishini yokuzikhusela. Xa ixesha elifutshane iimvavanyo zobuchwepheshe xesha, yaye ngoDisemba 1961-ntliziyo Russian ezenziwe EX-2 yokuqala "Mosquito" yaye ingenisa kukho ukubandezeleka nomonde epheleleyo block intliziyo atrioventricular iisampulu EX abanamava zidalwe, kwenziwa ngempumelelo. Ntliziyo "Mosquito" yaveliswa kangangeminyaka eli-15, amawaka abantu abagulayo basindiswe isixhobo ethembekileyo efinyeziweyo.

Ipesenti ephezulu ukufa ngenxa izifo sentliziyo eSoviet Union kwaphawula ekupheleni kweminyaka engama-50, oko kwaqala ukuncipha. Kwesincedisi- wentliziyo, nto leyo kwakhona ukusuka izigulane lentsholongwane ngokubanzi, ngokukhawuleza wazuza ukuthandwa.

New rhoqo ngcono, iimpawu EKS lwasekhaya yaphucuka. Ekupheleni kuka-1962, iisampuli ezintsha, i-Ofisi yoMphathiswa wezeMpilo Kucetyiswa ukuba imveliso serial. Ngenxa yoko, wadala eRashiya entliziyweni ipacemaker, ukubuyekeza umgangatho apho lentsholongwane, baqalisa ukuvelisa kwiinkampani ezininzi kwiprofayili zonyango.

kardiostimulirovanie ngaphandle

Phambi umzila ka ipacemaker koko iye, isigulane angafumana uncedo lokuqala kunye isixhobo zoqhagamshelwano yenziwa amacwecwe amabini, okanye kumacala omabini esifubeni, omnye phambi kwe intliziyo omnye ngasemva, ngaphantsi maliwe igxalaba lasekhohlo. odlula angxamele ngokusebenzisa kwentamo, ebangela izihlunu kwamagingxi nesivumelwano macala omabini, kwakunye umsipha. Le ndlela ibangela ukungakhululeki isigulane, kodwa indlela okwexeshana nokuzinziswa izinga lentliziyo kufanelekile. Engxakini yokulola ubuchule yangaphandle iqulathe kwi yokuba isigulane kufuneka awusayi kushiywa ungahoywanga, ingakumbi xa yena zingqondweni. Ukufaka pacemaker yokusebenza ngokusisigxina, oko kufuna akukho uqeqesho olulodwa, nto leyo ethatha iiveki eziliqela.

ukuvusa endocardial Temporary

Umgaqo iziphumo ezifana kwi imisipha kwentliziyo ukuqaliswa uphenyo electrode em- entliziyweni. Kuba ezi imisebenzi kudala isethi engenazintsholongwane of umqhubi kunye uphenyo ngokwayo, apho unikelwa nge kwijelo lwemithambo intliziyo. Isiphelo electrode ifakiwe kule intendelezo ekunene, malunga, ekupheleni kwayo proximal le elidityaniswe ngaphandle kumthombo, yenza ngamaza ombane.

Ukufakela ipacemaker ngokungesosigxina ngokuqhelekileyo kusetyenziswa xa kungekho ixesha iindlela ezininzi olukhulu. Emva kuqheleke isigulana kwentliziyo nga phambili ukuya umzila kwisixhobo esisigxina.

Njengoko ingenisa pacemaker esisigxina

Ntliziyo ukuze umsebenzi umzila nto utyando encinane, yenzelwe ukusetyenziswa ixesha elide. Umzila ngokuqhelekileyo luqhutywa phantsi Ukubulawa yasekuhlaleni. Inkqubo yonke yahlulwe kwizigaba eziliqela. Okokuqala, imbobo ulusu kunye inyama kunye vein yodwa. Ke intliziyo lwenziwa inombolo oyifunayo electrode ezibekwe ngayo nasemagumbini entliziyweni. Emva ukuqaliswa izinikezeli spool zonke data: onovakalelo, zisembundwini ehambahamba, lungiselelo eyiyeyona zezingxoxo, pulses conductive. Emva koko nitrogen i electrode kwenzeka, elukhukweni kwenziwa ukuba nesenzi kunye nezixhobo ezifakiweyo.

Kwezinye iimeko, koko iye akuthethi bendelisele iingcambu ngoko nangoko, oko kusenokuba uyalahlwa kancinane, kodwa komtshiso oko ngokukhawuleza etsha phantsi kweempembelelo zeziyobisi eqhelekileyo, kwaye isigulane uqhubeka uphila ubomi obuqhelekileyo eziqhelekileyo.

Eyona engundoqo Imisebenzi kwesincedisi-

Le fowuni i kwizixhobo ze-elektroniki kufakwa izindlu metal compact. Yavulel sisebenzisa ibhetri eyenzelwe iminyaka embalwa. Umgaqo nokusebenza EKS zasekhaya kukuba siziphendule nokungabikho ucutheko rhoqo intliziyo yesihlunu lomguli. Kwesincedisi- yenzelwe ukuze ukubetha wathumela ingqondo yakhe elektroniki, phantse kade - umahluko ixesha a hundredths ezimbalwa owesibini.

Ngexesha ukusebenza okuqhelekileyo isixhobo intliziyo uziphethe akanandaba - uthumela akukho ukubetha. Kukho iqela pacemakers ukuba uyakwazi ukumelana amaza. Xa ezinjalo isixhobo esihlangeneyo sensor, olunenkathalo utshintsho kumsebenzi yesigulane. Enyanisweni, lo woluvo ukukhawulezisa, i accelerometer, ezisabela utshintsho parameters ECG kunye nezinga zokuphefumla. Ngexesha umthambo pacemaker intliziyo uthumela azilawule ukuze ikhawuleziswe ngokukhawuleza.

Imifuziselo ezintsha ECS bayakwazi ukugcina iinkcukacha umsebenzi entliziyweni, leyo ke ibe imveliso esweni okanye amajelo enkcazelo ukwenzela uhlalutyo. Olu phawu ivumela ugqirha ukuba abele unyango unyango kangangoko, ngokunjalo ukukhetha i parameters yokusebenza pacemaker le. Uhlaziyo ngezixhobo kufuneka zibanjwe ubuncinane kanye qho emva kweenyanga ezintandathu. Ntliziyo, ixabiso ufakelo leyo efumaneka lula kumntu yengeniso-avareji nge usikhutshelwe xa kuyimfuneko.

Transesophageal ugijima

Kuba lokufunyaniswa iziganeko arrhythmia kwindlela izigulane zovavanyo lisetyenziswa nge probe. umqhubi ezizodwa incam ngombane conductive lifakwa kuvuleke iminxunya. I-probe iyakuvingca kwindawo zoqhagamshelwano intliziyo, okanye mandithi intendelezo ekhohlo, kunye emphinjeni. generator, ezisa la mandla frequency owahlukileyo ngoko zingacinywanga. Intsingiselo phando kukuchonga ubukho nesifo sentliziyo. Iyangongoza phantsi kweempembelelo pulses zombane ingabonisa ukwaliwa umthwalo kwentliziyo kwezihlunu.

Transesophageal ehambahamba jikelele ngokwaneleyo, yi nga ku pfuna ku ukuxilonga iintlobo zezifo inhliziyo. Kwezinye iimeko Tees kuvumela unyango: kudubula paroxysmal tachycardia, ukumbamba enomoya atrial, enze ukuvuselela okwethutyana kunye bradyarrhythmias, ephelekwa ukubetha yimiyalezo, ukuze kupheliswe abagulayo sinus syndrome. Ezinye zazo kunokwenzeka kuphela kwindawo uphenyo nzulu emphinjeni.

Ntliziyo: iindleko zokusebenza

pacemaker Ifakela eRashiya zinokubiza ukusuka engange-65 ukuya 650 lamawaka. Le mali ibandakanya eyona iindleko isixhobo ngokwawo, ukuba iindleko zokwakha umzila kunye nexesha postoperative. Pacemaker ngokwayo, ixabiso okumisiweyo ngumvelisi, kunokuba zisezantsi xa zithelekiswa (20 amawaka. Hlikihla.). Ukukhethwa imifuziselo iyafumaneka kwi isigulane. Kungcono ukufumana ipacemaker, ncomo ikakhulu okulungileyo. Oku iinkampani isixhobo Medtronic, StJudeMedical, Guidant kunye Biotronic.