Overview
Pane zvakawanda zvingasarudzwa zvino zvekurapa kuneta. Izvi zvinosanganisira kudya uye mararamiro ehupenyu, kuora-kurasikirwa nemishonga , uye zvigadziriswe uye nzira dzinotangira kubva mubhatric yakakwana yokuvhiya kusvika kune zvitsva, zvishoma zvishoma zvinoshandiswa.
Muzhizha ra 2016, US Food and Drug Administration (FDA) yakagamuchira chiremera chekurema-fuma chinonzi AspireAssist, chakatengeswa naApire Bariatrics.
Chii Chinonzi AspireAssist?
AspireAssist chirongwa chinorema-kurasikirwa chinogamuchirwa kurapa kuneta kwevanhu vakuru vane makore makumi maviri nemasere uye vane muviri wehuwandu hukuru (BMI) we 35 kusvika ku55. Chigadzirwa chinoita kuti vashandisi vabvise chikamu che dumbu ravo riri mumudumbu wepamu (inonzi gastrostomy tube) muimba yega mushure mekudya kwega.
Sangano re AspireAssist rakagadzirirwa kushandiswa kwenguva yakareba kuvanhu vakuru vakakodzera vasina kukwanisika kuwana kukwana kwakakwana kwemazivo kuburikidza nenzira dzisingashandisi nzira dzakadai sekuchinja mararamiro uye kuora-kurasikirwa nemishonga.
Iyo Inoshanda Sei
Sezvakataurwa pamusoro apa, AspireAssist inoshandisa bhaipi inowanikwa kuburikidza nekuzarura mudumbu, zvichibvumira kushandiswa kwemvura mukati mekudya. Muchikoro chekudzidza naSullivan uye vashandi pamwe chete navo, izvi zvakawanikwa zvichiita kuti kuderedzwa kwehuwandu hwekakori inogadziriswa inenge inenge 30 muzana.
AspireAssist device ine gastrostomy tube, sezvakataurwa pamusoro apa, pamwe nevhavhavha yegodhi, imwe yechipfuva ine ine connector, mudziyo wemvura, uye gomba remvura rine ganda.
Munenge maminitsi makumi maviri nemakumi matatu mushure mekudya, mushandisi weApireAssist device inosungira gastrostomy tube kuenda kune imwe kunze uye inovhura valve yechiputi, nokudaro ichibvumira mukati mechipfuti kupinda mukati meimba nechisimba.
Zvakakosha kucherechedza kuti kudya kunofanira kunge kwakadzingwa zvakakwana panguva yekudya kwepfuura kuitira kuti rikwanise kupinda mumugodhi wemvura, iyo yakareba mamita matanhatu chete.
Kana imwe mvura inopera, iyo AspireAssist user inofanirwa kuvhara tubhu uye mudumbu nemvura yakachena, inotyisa kubva mudziyo remvura inouya nechokushandisa.
Zvose izvi zvinotarisirwa kutora maminitsi mashanu kusvika ku10.
Kana iwe uri munhu anoshandisa iyi chigadziri, ramba uchiyeuka kuti zvichave zvakakodzera kuchengetedza nguva dzose kutevera-up appointment nechiremba wako, sezvo chibatanidza chinofanira kuchinjwa shure kwe 115 maitiro (anenge 5 kusvika kuvhiki 6).
Izvi zvinokoshawo pane izvi kutevedza kushanyira kusimbisa kuti AspireAssist device iri kushanda zvakanaka. Kureba kwehubhuti kunogonawo kudiwa kugadziriswa sezvo iwe uchinge uora uremu. Chiremba wako acharamba achienderera mberi kupa hutano uye hupenyu hwekupa mazano pane imwe nguva yekutevera.
Mutengo
Maererano neAradic Letter pamusoro pemishonga yeDrugs and Therapeutics, zvichibva pane zvinyorwa zvinobva kumugadziri, mari inosanganiswa yekutanga kutanga uye gore rokutanga rekutevera rinotarisirwa kuva $ 8,000 kusvika $ 13,000.
Kubudirira
Muzvinyorwa zvinyorwa zvakabudiswa mune zvekuwedzera kune pepanhau Gastroenterology , vatsvakurudzi vePATHWAY chekutsvaga vakawana kuti avo varwere avo vakagoverwa kurapwa neAspireAssist pamwe nekupa mazano ekurarama kwemakore anenge gore vakawana kurasikirwa kwehuwandu hwe 31.5 muzana yehuwandu hwehuwandu, zvichienzaniswa chete 9,8 muzana yehuwandu hunorema hwakarasikirwa muboka iro rakagoverwa mazano ekurarama mazano chete.
Zvimwe zvinowanzoitika kubva kuongororo dzenguva refu hazviwaniki, saka zvakaoma kuziva kuti ndezvipi zvinokonzerwa nemigumisiro yekurema kwehutano uye hupenyu hwehupenyu hwaizove neApireAssist.
Migumisiro Yechiri
MuPATHWAY kuongororwa kutaurwa pamusoro apa, vanenge 5 kubva muzana yevarwere vaiva nemigumisiro inobatanidzwa neApireAssist device.
Izvozvo zvinonzi migumisiro yechipfuva yaisanganisira kurwadziwa kwepamuviri, kushungurudza uye / kana kurutsira, kushanduka mumagadzirirwo emombe, nekuputika kana kutsamwa kunharaunda yegastrostomy tube. Dzimwe mimwe migumisiro yakave yakatorwa inosanganisira utachiona, kubuda ropa, uye / kana kubuda kunze kwekuvhura kusvika mudumbu.
Zvizhinji zvemigumisiro iyi yakaonekwa kuti inogadzirisa mukati memazuva makumi matatu.
Muna 4 kubva ku111 varwere vakabata naApireAssist mumutambo wePATHWAY, chigadzirwa chacho chaisanganiswa nezviitiko zvakakomba zvakashata, zvakadai sekudiwa kwechinzvimbo chegastrostomy tube, chirwere chemuviri, uye kuonda.
Zvinonzwisisika, mukudzokorora kwayo kwechigadzirwa chacho, Chiremba Inonzi Drugs and Therapeutics yakagumisa kuti: "Simba reAspireAssist harina kuvhiringidza kudarika chirongwa chekurapa kwekurapa kuneta uye chinogona kuva chakanakira kune vamwe varwere, asi inowanika dambudziko rakanyanyisa uye runyorwa rwezvinyorwa yakazara. "
Zvimwe Zvimwe Zvimwe Zvezvigadzirwa Zvekushandisa Kwekuremerwa Kweutoro
Chimwe chigadzirwa chave chiri pamusika wekurapa kwekuneta kwepamusoro kubva munaJanuary 2015. Izvi zvakagadziriswa neDWA, inozivikanwa seMaestro Rechargeable System , inoshanda nekutsvaga nzira yeropa pakati peuropi uye nedumbu iro rine simba rokutonga pamusoro pekunzwa nzara uye kuzara . Inoumbwa nemagetsi emagetsi anogadziridza anokwanisa kubhadhara, pamwe chete nematafura anotungamirira uye electrodes. Izvi zvinoshandiswa kuvhiyiwa mukati mamuviri. Iko zvino inotumira mafungiro emagetsi kune vagus nerve, iyo inobatsira kudzora mudumbu kubudisa uye kunotumira zviratidzo kuuropi kuti mudumbu inenge inonzwa isina chinhu kana izere.
Maererano neIngoMedics Inc., kambani inogadzira chigadzirwa, Maestro Rechargeable System inodzivirira zviratidzo kuti vagus nerve inowanzoendesa kuuropi, nokudaro kuderedza kunzwa kwenzara uye kuita kuti varwere vanzwe vakasununguka kare kupfuura zvavaizoita.
Musi waJuly 28, 2015, FDA yakaratidza kugamuchirwa kwechimwe chigadzirwa chekurapa kuneta: chigadzirwa chenguva duku cheBarononi chinonzi ReShape Integrated Dual Balloon System (ReShape Dual Balloon.
Kufanana neApireAssist device, reShape Dual Balloon inodawo nzira yekupedzisira yekuisa chigadzirwa, icho chinoiswa mudumbu kuburikidza nemuromo uye inophagus. Sezvakataurwa neDFA, "Chigadziro hachichinje kana kushandura chimiro chemuviri chechimiro," uye varwere vanokurudzirwa "kutevera chirongwa chinotarisirwa nemishonga uye chirongwa chekuita zvekurovedza kuwedzera kukura kwemaitiro avo" pavanenge vachishandisa chigadzirwa. Izvi zvinobatsira kuvimbisa kuti varwere vanogona kuchengetedza kuora kwemairi kana kambani yacho yabviswa.
Chigadzirwa chacho chinoreva kuti chinguva chiduku uye, maererano neCDA, inofanira kubviswa mwedzi mitanhatu mushure mokunge yatanga kuiswa.
Inofungidzirwa kuti ReShape Dual Balloon inoshanda nekutora nzvimbo mudumbu, izvo zvinogona kukonzera manzwiro ekuzadza, asi pangave kune dzimwe nzira dzebasa dzisati dzanzwisiswa.
Zvokuvhiya Zvokushandisa Kurasikirwa Kwemafuro
Zvimwe zvinopesana uye zvinowanzogadzirwa pakushambadzira zvinowanzowa pasi peboka rekuvhiyiwa kwevana, uye zvinogona kusanganisira chirwere chepamusoro chekuvhima, gastric banding (lap band), uye sleeve gastrectomy (gastric sleeve), pakati pevamwe.
Kuti ave mukana wekuvhiyiwa kwevanhu, munhu anofanira kuva neBMI ye40 kana kupfuura, kana BMI ye 35 kana mukuru kune munhu ane mamwe marapirwo (anozivikanwa se "comorbid conditions") anokonzerwa nokuneta. .
Chirwere chinonzi kurasikirwa-kurasikirwa kunowanzova shanduro yekugadzira gumbo, kana sleeve gastrectomy. Zvechokwadi, zvikurukuru nekuda kwekubudirira kwayo nekuchengeteka kana zvichienzaniswa nedzimwe nzira, maererano neBariatric Surgery Purogiramu, chirongwa chemukati sleeve zvinoonekwa sechinyanya kuwedzera gastric zvakapfuura se "itsva yegoridhe" inorongwa.
Sleeve gastrectomy operation inotarisira kuti varwere vaderedze kudya, uye nokudaro kurerutsa kuora. Mune nzira iyi, inenge 60 muzana yemudumbu inobviswa (kazhinji laparoscopically ), zvokuti chikamu chinosara chemuviri chinotora chimiro chebhuku kana sleeve.
Nemhaka yokuti mudumbu idiki duku mushure mekushanda, chirwere chemukati chemukati chinonzwa chichikurumidza uye chisina kudyiwa. Pamusana pezvikonzero izvi, chirongwa chemukati sleeve chinozivikanwa se "chigadzirisa" chirongwa che chirongwa chebhaatric.
Nzira Yokukurukura Nechiremba Wako
Kana iwe uine kuneta uye uchinzwa wakatoedza nzira dzakasiyana-siyana dzokurapa pamwe nekudya uye mararamiro ehupenyu, uye izvi hazvina kukushandira iwe, kurukurai zvimwe zvamunogona kuita nachiremba wenyu. Zvakakosha kuisa pfungwa zhinji nekufungisisa mune chero chisarudzo chekuenderera mberi nekuvhiyiwa kwekuita, kunyanya kuvhima-kurasikirwa kwekureruka kana nzira.
Chiremba wako anogona kutaura newe iwe zvingasarudzwa sei kuti uve sarudzo yakanaka kwauri somumwe munhu, wakapiwa yako BMI nezvimwe zvirwere zvisingaperi iwe unogona kuva nazvo. Mukukurukurirana uku, iwe unogona kuverenga zvose zvinowedzera uye zvinopera zvevamwe vanogona kurapa-kurasikirwa nekurasikirwa kana nzira.
Zvinonyanya kukosha kuti uve nechokwadi chokuti iwe unokurukura uye unoziva nezvemigumisiro yemimwe nzira, chirongwa, kana chigadziro chaunenge uchitarisa, sezvo sarudzo imwe neimwe inouya nemamwe emigumisiro, zvimwe zvingave zvakakomba.
Kune rumwe rutivi, kana iwe uri mukana akanaka kune imwe nhamo-kurasikirwa kurasikirwa kana nzira, uye iwe unonyatsoruzivo uye wakagadzirira kutevera pamwe neboka rako rezvechiremba kana rekuvhiya nguva dzenguva dzese dzakarongwa zvichienderana nenzira, chirwere chekuora-kurasikirwa inogona kuva nehutano hwehutano huzhinji, kusanganisira kurapa chirwere cheshuga uye kuwedzerwa kweropa pamwe nekuderedza chirwere chemwoyo.
Sources:
AspireAssist-chigadzirwa chitsva chekurema. Med Lett Zvinodhaka Ther. 2016; 58: 109-110.
Durkin M. Kuyera zvingasarudzwa nokuda kwekuitwa chirongwa chebhaatric. ACP Internist 2016; 36 (1): 1.
FDA News Release. FDA inobvumira chipinhi chenguva duku chisina kushandiswa kuti chirape kuneta. Inowanika paIndaneti pa http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm456296.htm musi waJuly 29, 2015.
Sullivan S, Stein R, Jonnalagadda S, Mullady D. Edmundowicz S. Kurapa kwepiritsi kunokonzera kuora kurasikirwa mune zvidzidzo zvakanyanya: chidzidzo chekufambisa. Gastroenterology. 2013; 145: 1245.
Thompson CC et al. AspireAssist ibasa rinobudirira mukurapa kwekirasi yechipiri uye chikamu III kuneta kwepamusoro: migumisiro yegore rimwe rekuongorora kliniki. Gastroenterology. 2016; 150 (suppl1): S86, abstract 381.