Kushandiswa kwechigadzirwa kunovandudza kuenzanisa kusvika pakurwara kwakanyanya kwepabonde
Kana iwe uine hupombwe hunoita kuti urege kurara , iwe unogona kuva nehanya nekuongorora nzira dzokurapa. Imwe nzira yakadaro ndiyo hypoglossal nerve stimulator inonzi Inspire. Chii chinonzi Inspire? Ndiani anofungidzire kuishandisa uye ndeipi migumisiro? Dzidza pamusoro peKufuridzira kwepamusoro-soro airway stimulator uye ingave ingangodaro kurapa kwakakodzera kwauri.
Vadzidzi vekuiswa kwekufuridzirwa
Iyo Inspirator stimulator inoshandiswa pakuvhiya inoshandisa iyo inoita kuti mutsara we hypoglossal usimbise mitsipa yerurimi nepamusoro yepamhepo panguva yehope, kuvandudza kutenderera kwemhepo nekuderedza kupora kwepabonde.
Inogamuchirwa kuti ishandiswe nevaya vane uwandu hwemapfupa ekudzivirira kubata ( apnea-hypopnea index kana AHI> 15) vasingawirirani neCPAP therapy. Inoratidzwa kune avo vane muviri-mass index (BMI) vasingapfuuri 32, kunze kweavo vane hutano hwakanyanya.
Kune zvishoma zvishoma zvinopesana zvinoshandiswa pakushandiswa kweEpris therapy. Kana kukanganisa kunokonzera kupererwa kwepabonde kunenge kuchiitika mukati memhino, nekuda kwechirwere chetachiona kana kuti chinoparadzaniswa seanus , inenge isisina basa. Saizvozvowo, dzimwe skeletal anatomy (yakadai sejaya duku kana rakaderedzwa rezasi ) inogona kuva chikonzero chekusatevera kurapwa. Kana matonho akawedzerwa, kuvhiyiwa kunobata maviri aya kunogona kuva yakakodzera. Zvimwe zvinokonzerwa neuromuscular zvinokanganisa kukwanisa kumedza kana kubatsira pakukutaurirana kusinganzwisisiki zvingavewo kupesana. Kana kazhinji maMMIs anodiwa kune mamwe marapirwo, chigadzirwa chacho hachina kuchengetedzeka kushandiswa nekuongorora uku.
Kurapa hakubvumirwi kushandiswa muvana.
Kurondedzera Kuvhiya Kunodiwa Kuiswa Kwemhepo Inokurudzirwa
Kufuridzirwa kunofanira kuiswa panguva yekuvhiyiwa nehukuru anesthesia mune imwe nzvimbo yekushandisa. Kugadzirira kuiswa, imwe nzira inonzi drug-induced sleep endoscopy inogona kuitwa kuti iongorore nzira yako yekufamba mumhepo uye kana chigadzirwa chacho chinogona kunge chakabudirira.
Vamwe varwere, vanonzi vasiri-mhinduro, havabatsiri nemishonga. Izvi zvinonyanya kuitika kana mhepo inofamba inoita seyo inopera zvachose kubva kumativi ose panguva yekuguma kwepiscopy.
Kana uchinge watsunga kuva mukana, nzeve yakadzidziswa yakakwana, nyanzvi, nehuro (ENT) nyanzvi inoita chirwere ichi sechirongwa chekubuda kunze. Tsvina yekusimudzira inoiswa kune inotungamirira musungo we hypoglossal uye inovhara imwe yematavi ayo akaparara. Chimwe chekutanga chinotarisa chinotarirwa pamubhedha wembambo kuti uone kufema kuitira kuti rurimi rwemumuviri uye mhepo dzomumhepo zvigadziriswe panguva yakakodzera sokufema kunotorwa mukati. Pakupedzisira, mutoo wacho pachawo unoiswa mukati mekodzero yepamusoro yebhokisi uye . Iyo yose inotora inenge inenge maawa maviri.
Mushure mekuvhiyiwa, varwere vanowanzoenda kumusha kana kusina kumbova nematambudziko. Vakawanda havadi kushandiswa kwemishonga yemarwadzo anonyadzisa. Zvinokurudzirwa kuti basa rakaoma rinofanira kudziviswa kwevhiki 2-3 mushure mekuvhiyiwa. Kudya nguva dzose kunogona kudyiwa pasina chero kudiwa kuchinja.
Kubudirira Kwekufuridzirwa uye Kunodiwa Kutevera Kuongorora
Kufuridzirwa kwemhepo kunokonzera kushandiswa kwakanyatsoshanda kurapwa kwekuenzanisa kunokonzera kubvumira kubata kwepnea apo apo CPAP isingabvumiri.
Dzidzo dzakaratidza kuti pamwedzi gumi nemaviri dzinoderedza AHI kubva pa 29.3 kusvika ku 9.0 zviitiko nenguva, pamwero, inomirira 68% kuderedza. Inofanira kuonekwa kuti kusara kweAHI kunoramba kuchiratidza kubata kwepnea. Izvi zvingagadziridzwa sezvo chirwere ichi chakanatsiridzwa uye avo vakakodzera vanoonekwa vanoonekwa. Zvikamu zvehutano hweEpworth dzakasununguka kubva pa11 kusvika ku6 nekurapa, zvichiratidza kuderedzwa kwekurara kwemasikati. Kana iyo shandiswa ichidzimwa, kubata apnea kunowanzodzoka.
Pane zvipingamupinyi zvishomanana kune kuiswa kweChirungu chekufuridzirwa. Inenge 25% yevarwere vakanyunyuta nezvekurwadziwa kwakanyanya.
Inenge 1/3 yevarwere vakanyunyutira nerurimi kusagadzikana kana kubvisa, asi izvi zvakaita sekugadzirisa kwenguva. Vanenge 1% vakave nehutachiona hweganda kana kushungurudzwa (cellulitis) kubva pakuvhiyiwa uye imwe 1% yaifanira kuva neimwe yekuvhiya kugadzirisa kuiswa kwechigadzirwa.
Mushure mekuvhiyiwa kwapera, varwere vanodzoka kuzoona chiremba chiremba chekuongorora kwemashure mazuva manomwe. Iyo shanduro inoshandiswa pa 1 mwedzi. Zvinokurudzirwa kuva ne-kati yekudzidzira kurara pamwedzi miviri kuti uongorore kubudirira kwayo uye kugadzirisa zvirongwa.
Kana yaiswa, iyo Inspire stimulator inogona kushandiswa tisati tarara. Iko kune kazhinji kunonoka kwemaminitsi makumi matatu kusati kwatanga kukurudzira. Kana iwe ukamuka usiku, shanduro yacho inogona kumiswa. Inowanzogadzirirwa kuvhara mushure memaawa masere.
Mari yacho inodhura zvakadini? Ikozvino Inspirator inoita mari inodhura madhora 30,000 kusvika $ 40,000 kuisa, kusanganisira mari inosangana nekuvhiyiwa, uye kubhadhara bhateri kunogona kutenga imwe $ 17,000. Izvi zvinogona kuvharwa ne inshuwarisi.
Kana iwe uchida kudzidza zvakawanda pamusoro peKufuridzira kwepamusoro-soro airway stimulator sekurapa kwaunosarudza iwe, taura nemunhu anenge ari pedyo newe kuti ataure nezvesarudzo iyi. Vadzidzisi vehope vanogona kupawo ruzivo pamusoro pemishonga yakasiyana-siyana, kusanganisira kushandiswa kwakashandiswa kweCPAP, midziyo yemuromo, uye dzimwe mishonga.
> Sources:
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> "Shingairira Kuwedzerwa Kwemhepo."
> Kezirian, EJ et al . "Hypoglossal Nerve Stimulation Inovandudza Kuvhiringidza Kubata Apnea." J Kurara . 2014; 23: 77-83.
> Safiruddin, F et al . "Migumisiro Yokumhanya-mhanya Kwemhepo Inokurudzira Kuvhara Nhope Yokurara Pamhepo Inopenya." Eur Respir J. 2014 Sep.
> Strohl, KP et al . "Physiologic Basis of Therapy yeApnea yokurara." Am Rev Respir Dis . 1986 Oct; 134 (4): 791-802.
> Strollo, PJ uye a . "Kukwidza kwepamusoro-soro kwekuvhiringidzika kwepabonde Apnea yokurara." N Eng J Med . 2014; 370: 139-149.