Unyango lwe-Electroconvulsive (ECT); Yintoni, Kutheni lufuneka, iingozi kunye neenzuzo

isishwankathelo

Unyango lwe-Electroconvulsive (ECT) lunyango oluqhutywa ngoogqirha phantsi kwe-anesthesia jikelele apho isigulana sifumana umbane oya engqondweni. Oku ngabom kubangela ukuxhuzula okufutshane . I-ECT inokubangela utshintsho kwi-chemistry yengqondo enokuguqula ngokukhawuleza iimpawu zeemeko ezithile zempilo yengqondo.

Le nkqubo ibonakalisiwe ineziphumo ezilungileyo ekunyangeni iingxaki zempilo yengqondo ezinzima nezinganyangekiyo . Imbali yayo isusela kwiminyaka engaphezu kwama-80, kwaye emva kophando oluninzi luye lwabonisa ukuba yindlela yonyango esebenzayo nekhuselekileyo. Ukuba uceba ukwenza olu nyango, qaphela ukuba alunantlungu kuba uza kuba phantsi kwe-anesthesia.

Rhoqo, abantu baneengcinga ezimbi xa kufikwa kunyango lwe-ECT. Oku kungenxa yokuba uninzi lwemiboniso bhanyabhanya, imiboniso kamabonakude, kunye namanye amajelo eendaba ayichaza ngendlela engafanelekanga indlela inkqubo eqhutywa ngayo, ivuselela uloyiko malunga nobuhlungu benkqubo, kwaye ibonise ukuba ayisebenzi. Ezi ngxelo aziyonyani kwaye azibonisi indlela inkqubo eqhutywa ngayo ngokukhuselekileyo nangobuntu ngoogqirha kunye neqela labo.

Zeziphi iimeko ezinyangwa ngeECT?

Oku kulandelayo ziimeko ezininzi ezinokunyangwa yi-ECT.

• ukudakumba: Kubantu abangaphezulu kweminyaka engama-60 ubudala.
• kwengqondo: Oku kubandakanya ezinye iimeko ze-schizophrenia-spectrum kunye ukuphazamiseka kwengqondo.
• I-bipolar disorder kunye nezinye iimeko ezinokubandakanya imania

Kutheni iECT yenziwa?

I-ECT ibonakaliswe ukubonelela ngokukhawuleza kunye nophuculo olubalulekileyo kwiimeko zakho zempilo yengqondo. Le nkqubo iye yasetyenziswa xa uninzi lolunye unyango luye lwasilela. Ngoku i-ECT isetyenziselwa ukunyanga:

1. Udakumba olunganyangekiyo kunyango: Imeko yokudakumba kakhulu engakhange ibonise naluphi na uphuculo ngamayeza.
2. Ukuxinezeleka okukhulu: Oku kubonakala ngokuhlukana kwinyani, ukwala ukutya, kunye nokufuna ukuzibulala.
3. I-mania enkulu: Ibonakala ngemeko yengqondo yokuphazamiseka kunye nokuxakeka. Oku kukwajongwa njengeseti ye-bipolar disorder.
4. Catatonia: Oku kubonakala ngokungabikho kokunyakaza kunye nentetho ngaphandle kwezinye iimpawu. Ngamanye amaxesha oku kunxulunyaniswa ne-schizophrenia kunye nezinye izifo zengqondo.
5. Ukuphazamiseka kunye ulwalamano kwizigulane ezine ngqondweni zingumngeni wokulawula nokunyanga kwaye zichaphazela kakubi umgangatho wobomi.

I-ECT ikwathathwa njengonyango olulungileyo lokhetho lwe

• Ukukhulelwa, xa kufakwa iziyobisi kunokwenzakalisa umntwana ongekazalwa ngaphakathi.
• Kubantu abakhetha i-ECT kunezinye iindlela zonyango.
• Abantu abadala abangakwaziyo ukunyamezela imiphumo emibi yeziyobisi.

Incwadi Ukutyunjwa

Ixhaphake kangakanani i-ECT?

Njengoko bekutshiwo ngaphambili, yinkqubo esebenzayo nekhuselekileyo kodwa yinkqubo engaqhelekanga. Nangona kunjalo, olu nyango lunconywa ngenxa yezizathu ezininzi ezibandakanya:

• Kunqabile ukuba ibe ngumgca wokuqala wonyango loxinzelelo
• Amayeza amaninzi amatsha akhoyo ukunyanga iimeko ezininzi zempilo yengqondo.
• Kukho izibhedlele ezimbalwa ezibonelela nge-ECT

Yeyiphi imingcipheko enxulumene ne-ECT?

I-ECT idla ngokuthathwa njengekhuselekileyo, kodwa ezinye zeengozi eziqhelekileyo ezinxulumene nale nkqubo zezi:

1. Ilahleko yenkumbulo: Ungaphuhlisa ukubuyisela umva amnesia apho uya kufumana ingxaki yokukhumbula imizuzu nje ngaphambi kokuba unyango okanye iziganeko zenzeke kwiinyanga ezimbalwa okanye iminyaka ngaphambili. Usenokuba nobunzima ekukhumbuleni unyango. Kodwa nangona ezi zinto, ukulahleka kwememori kuye kwabonwa ukuba kuphuculwe kwiiveki ezimbalwa ukuya kwiinyanga ezimbalwa emva kokunyanga.
2. Ukudideka: Ukubhideka ngumngcipheko oqhelekileyo onxulumene nokuba umdala. Usenokubhideka malunga nendawo okungqongileyo nje emva konyango. Oku kudla ngokuthatha imizuzu embalwa ukuya kwiiyure ezimbalwa emva konyango. Kwiimeko ezinqabileyo, kuye kwanikelwa ingxelo yokuba imeko yokubhideka iye yanda kangangeentsuku.
3. Iingxaki zonyango: Ezinye iingxaki zonyango zingabonwa, ezifana nokunyuka kwentliziyo kunye ifuthe legazi. Kwiimeko ezinqabileyo, iingxaki ezinzulu zentliziyo nazo zibonwa.

Yintoni onokuyilindela?

Ngaphambi kokuba uqale inkqubo ye-ECT, umboneleli wakho wezempilo uya kuchaza ngokubanzi malunga nenkqubo, iingozi zayo, kunye nendlela esebenza ngayo. Baya kuqinisekisa ukuba awunazo naziphi na iimeko zempilo ezisisiseko okanye naziphi na izizathu zokungafumani le nkqubo. 

Kwenzeka ntoni phambi kwenkqubo?

Ngaphambi kokuba uqale inkqubo, ugqirha wakho unokuncoma iimvavanyo ezininzi kuquka

• Uvavanyo lwegazi kunye nomchamo: Kusenokufuneka ukuba unike iisampuli zegazi kunye nomchamo kwezinye iimvavanyo kuquka ubalo lwegazi olupheleleyo, i iphaneli ye-metabolic esisiseko okanye ebanziumsebenzi wedlala lengqula, umsebenzi wezintso, kunye nabanye
• Uvavanyo lomfanekiso kukhakhayi, ingqondo, kunye nomqolo: Ezi mvavanyo zinokubandakanya ii-x-reyi kunye ne-computerized tomography (CT) scans.
• I-Electrocardiogram (ECG okanye EKG): Olu vavanyo lwenziwa ukujonga ukusebenza kwentliziyo yakho kwaye lunokubona nakuphi na ukungaqhelekanga okanye iingxaki kwinkqubo yombane yentliziyo yakho.

Izizathu zokuba kutheni ungayifumani i-ECT

Ngamanye amaxesha ugqirha wakho akanakuqhubeka nenkqubo ngenxa yeemeko ezithile kunye nezizathu, ezibizwa ngokuba yi-contraindications. Oku kuqwalaselwa ngoogqirha kwimeko nganye. Nangona kunjalo, ukuba unokuchasana nababoneleli bakho bezempilo banokuhlengahlengisa inkqubo ukuze ufumane i-ECT. I-contraindications ibandakanya:

• Ukuba uye wamva nje ukuhlaselwa yintliziyo okanye enye imeko yentliziyo engazinzanga
• Iimeko ezithile ezifana ne-intracranial xi nzelelo okanye amathumba ebuchotsheni anokonyusa uxinzelelo ngaphakathi kukhakhayi lwakho
• Istroke yamva nje, aneurysm, okanye ezinye izinto ezibangela ukopha kwengqondo
• Izifo zemiphunga ezinzima ezifana isifo esinganyangekiyo semiphunga (COPD)
• Ezinye iimeko ezibeka ubomi esichengeni 

Ukuyeka ukutya kunye nolwelo

Njengoko le nkqubo iqhutywe phantsi kwe-anesthesia jikelele, ugqirha wakho unokukucela ukuba uzile ukutya ngaphambi kwenkqubo. Oku kuthetha ukuba kufuneka uyeke ukutya ukutya okuqinileyo iiyure ezisibhozo kwaye ungaseli iiyure ezimbini phambi kwenkqubo.

Yintoni ekufuneka uyikhulule okanye uyisuse

Ugqirha wakho angakucela ukuba ukhuphe ubucwebe bakho, izixhobo zonyango, izixhobo zokuncedisa, okanye iiprosthetics ngaphambi kokuba wenze inkqubo. Imizekelo eqhelekileyo ibandakanya ukususa iiglasi zakho, iilensi zoqhagamshelwano, izixhobo zokuva , amazinyo okufakelwa , okanye iipleyiti zamazinyo, kunye nezinye. Xa ususa ezi zinto emzimbeni wakho, uphepha umngcipheko wokwenzakala okanye ukukrwitshwa.

Ukuyeka amayeza

Kukho amayeza athile anokuchaphazela indlela i-ECT ekuchaphazela ngayo, njengokusebenza konyango. Ugqirha wakho unokukucela ukuba uyeke amayeza athile okanye unciphise umthamo wakho. Noko ke, kungcono ukuba uyeke okanye uwatshintshe amayeza kuphela emva kwemiyalelo kagqirha.

Kwenzeka ntoni ngexesha lenkqubo?

Le nkqubo iqhutywa ngababoneleli beenkonzo zonyango abaninzi abafana neengcali zengqondo , i-anaesthesiology , kunye nabanye abasebenzi abaqeqeshwe ngokukodwa.

• I-anesthesia kunye namanye amalungiselelo: Njengoko le nkqubo isenziwa i-anesthesia jikelele, ikubeka ebuthongweni obunzulu kwaye inciphise nayiphi na imvakalelo yentlungu, ukungakhululeki, okanye ixhala ngexesha lenkqubo. Oogqirha banokukunika isihlunu sokuphumla ukuze ugweme nakuphi na ukulimala okanye ubunzima obunokuthi kwenzeke ngexesha lokubanjwa. Ugqirha usenokufaka umlindi wokulunywa emlonyeni wakho ukukhusela amazinyo akho kwaye inaliti efakwa emithanjeni ivumela ukufikelela ngokukhawuleza kwesitofu kwi-anesthesia.
• Ukubekwa kwe-Electrode: Ugqirha wakho unokubeka i-electrode - ezi ziindawo zoqhagamshelwano ukuze imisinga yombane uhambe ngayo - ngokuchasene nolusu lwentloko yakho. Ukubekwa kuxhomekeke kwiimfuno kwaye oogqirha baya kukhetha ukubeka i-electrode enethuba eliphantsi lokubangela umphumo wecala.
• Iimfuno zombane: Oogqirha banokuqala ngokuphulukana nedosi yombane wangoku kwaye bawunyuse kancinci de ube nesiphumo esifunekayo. Ixesha nalo lifutshane kwaye linokuhlala imizuzwana embalwa. Oku kubandakanya umsinga wombane omncinci kakhulu, ukuya kuthi ga kwi-0.4 amps.
• Ukubanjwa okubangelwayo: Le nkqubo isebenzisa umsinga wombane obangela ukuxhamla. Ukuxhuzula kwenzeka xa ugqabhuko lombane lwenzeka engqondweni yakho kwaye lubangela ukuba ingqondo echaphazelekayo ivuthe ngokukhawuleza. Oku kubangela utshintsho lombane kunye neekhemikhali kwingqondo echaphazelekayo ekhokelela ekuphuculeni indlela ezo ndawo zobuchopho zisebenza ngayo. Ngokuqhelekileyo, ukuxhuzula kuhlala naphi na phakathi kwe-30 ukuya kwi-90 imizuzwana. Ukuba ihlala ixesha elide, oogqirha banokunqanda ukuxhuzula ngeyeza elitofwayo.

Kwenzeka ntoni emva kwale nkqubo?

Emva kokuba ukuhlutha kuyeka kwaye i-anesthesia iphelile, oogqirha bajonga ukubaluleka kwakho kwaye bajonge iimpawu zaso naziphi na iziphumo zecala okanye ezinye izinto ezinxulumene ne-anesthesia enokuthi yenzeke. Uninzi lwabantu lunolwazi olupheleleyo kwimizuzu eyi-10 ukuya kweli-15 emva kwenkqubo kwaye banokuma ngeenyawo kwimizuzu engama-30.

iziphumo

Izigulana ezininzi ziqala ukuqaphela ukuphucuka okukhulu emva konyango olumalunga namathandathu nge-ECT. Ukuphuculwa okupheleleyo kunokuthatha ixesha elide, nangona kunjalo i-ECT ayinakusebenza kumntu wonke. Olu nyango luvelisa iziphumo ezikhawulezayo xa kuthelekiswa nempendulo kumayeza okudakumba kuthatha iiveki ezininzi okanye ngaphezulu.

Akukacaci ukuba i-ECT inceda njani ekunyangeni ukudakumba okukhulu kunye nezinye izifo zengqondo. Nangona kunjalo, kuyaziwa ukuba iinkalo ezininzi zeekhemikhali zobuchopho ziyatshintsha ngexesha nasemva kokuxhuzula. Olu tshintsho lweekhemikhali lunokuqokelelana kwaye lunokunciphisa iimpawu zokudakumba okukhulu okanye ezinye izifo zengqondo. Ke ngoko, i-ECT ithathwa njengeyona isebenzayo kubantu abafumana unyango olupheleleyo. Ukuba iimpawu zakho ziyaphucuka, usaya kufuna unyango oluqhubekayo lokudakumba ukuthintela ukuphinda kwenzeke kwakhona.

Zeziphi iingenelo zeECT?

Ngenxa yeengenelo zayo ezininzi, yenza isixhobo esibalulekileyo sokunyanga iimeko zempilo yengqondo:

•  Isebenza kakhulu: Iingcali ezininzi zinoluvo lokuba i-ECT lolona nyango luninzi lwezifo zengqondo ezifana nokudakumba. Ikwasebenza kakhulu ekuncedeni abantu abaneendlela zonyango ezixhathisa ukudakumba njengamayeza okanye unyango.
• Kukhuselekile: Njengoko oogqirha basebenzisa i-anesthesia olu nyango lukhuselekile ngokubanzi. Ezinye iindlela zokhathalelo lwangoku ziluphucule kakhulu ukhuseleko lwale nkqubo. Abantu abaneengxaki zentliziyo bahlala befumana i-ECT ngohlengahlengiso lwamayeza kunye nokujongwa ngokusondeleyo kweempawu zabo ezibalulekileyo.
• Ikhuselekile ngexesha lokukhulelwa: Ikhuselekile kuzo zontathu iitrimesters ze ukukhulelwa.
• Isebenza ngokukhawuleza: Emva konyango oluthathu ukuya kwentlanu, abantu baqaphela ukuphucuka kweempawu zabo, ngakumbi iimeko ezinje ngoxinzelelo olukhulu kunye neemeko ezinzima zempilo yengqondo ezinokubeka abaguli engozini.
• Inceda izigulana xa olunye unyango lungekho: kwiimeko ezithile, xa abantu bengakwazi ukuthatha amayeza, izizathu ezininzi, ngenxa yeemeko zempilo yengqondo basenokufumana i-ECT. Inkqubo inokwenza umahluko omkhulu kwizigulane ezinemiba yokusebenza kwamalungu
• Isebenza kakhulu xa idibene neyeza: Abantu abafumana i-ECT nabo bathatha amayeza okunyanga. Ngaloo ndlela, ukuphucula ngakumbi imeko yabo yempilo yengqondo.

Lithini ixesha lokubuyisela?

Abantu abafumana i-ECT balulama ngokukhawuleza kwaye bavuke kwimizuzu eyi-15 yenkqubo. Banokuba ngeenyawo kwimizuzu engama-30 yenkqubo. Inkqubo ibandakanya unyango oluninzi ngeveki kunye neeveki ezininzi. Ngokubanzi, abantu bafumana unyango olu-3 ngeveki.

Olunye unyango lokuvuselela ubuchopho

Ngaphandle kwe-ECT, kukho olunye unyango lokuvuselela ingqondo. Zimi ngolu hlobo lulandelayo:

• Uvuselelo lwemagnethi yeTranscranial (TMS): Le yinkqubo engasebenziyo enyanga ukudakumba okuxhathisayo kwezinye iindlela zonyango. Isebenzisa imagnethi etshintshana ngokukhawuleza ukuvuselela iindawo ezithile zobuchopho. Oku akubangeli ukubanjwa kwaye isigulane sihlala siphaphile kulo lonke inkqubo. Le nkqubo inokuba neziphumo ebezingalindelekanga ezinobuthathaka ezifana intloko, ukuxhuzula kwemisipha, kunye neentlungu kwindawo yokuvuselela. Ilawulwa ka-4 ukuya ka-5 ngeveki kwiiveki ezine ukuya kwezintandathu.
• Ukuvuselela iNerve yeVagus (VNS): Yaphuhliswa kakhulu njengonyango lwesifo sokuxhuzula kodwa ingasetyenziselwa ukunyanga uxinzelelo oluxhathisayo kwezinye iindlela zonyango. Kule nto, isigulane sifakwe kwi-electric pulse generator kwisifuba esithumela ukuvuselela umbane ophazamisayo kwi-nerve ye-vagus entanyeni.

isiphelo

Izigulane ezininzi ziqwalasela ukuphuculwa okuphawulekayo emva kwenkqubo yesine okanye yesithandathu ye-ECT. Ukuphucula ngokupheleleyo kuya kuthatha ixesha elide kakhulu. Nangona kungekho mntu uqinisekileyo ukuba i-ECT isebenza njani kunye nendlela eluncedo ngayo ekuphatheni iimeko ezahlukeneyo zempilo yengqondo ezifana nokudandatheka okukhulu, iingxelo zibonise ukuba i-chemistry yengqondo ibonakala ishintshile emva kokungeniswa kwe-seizure. Ngaphezu koko, ukubanjwa ngakunye kwakha phezu kotshintsho kwikhemistri yengqondo ephunyeziweyo kwiseshoni yangaphambili, ekugqibeleni kubangele isikhundla esiphuculweyo ukuya ekupheleni kwekhosi epheleleyo yonyango.

Njengoko unyango alupheli apha, kuya kufuneka uqhubeke kunye namayeza kwaye mhlawumbi neenkqubo ze-ECT ezibuthathaka kwixesha elizayo.

Imibuzo ebuzwa qho

Ngaba i-ECT ibuhlungu?

I-ECT ayibuhlungu njengoko oogqirha bethoba izigulane nge-anesthesia.  

Ngaba i-ECT ikhuselekile?

Ewe, le nkqubo ikhuselekile kakhulu ngenxa yokuqhubela phambili kwamayeza anamhlanje. Ukuba unenkxalabo malunga nale nkqubo, kungcono uthethe nogqirha wakho . Kwaye ugqirha wakho angaqwalasela ezinye iimeko zempilo okanye imeko yakho aze alungise inkqubo ngokufanelekileyo.

Lithini izinga lempumelelo yonyango lwe-electroconvulsive? 

Ezi ziphucula ukudakumba kufutshane ne-70 ukuya kwi-90 yeepesenti yezigulane kwaye izinga lokuphendula likhulu kunelo lamayeza okudakumba. Nangona kunjalo, i-ECT iyasebenza, izibonelelo zayo zifutshane.

Sesiphi isigulo sengqondo esiphathwa yi-ECT?

Ngoku i-ECT isetyenziselwa ukunyanga:

• Udakumba olunganyangekiyo kunyango: Imeko yokudakumba kakhulu engakhange ibonise naluphi na uphuculo ngamayeza.
• Ukudakumba okukhulu: Oku kubonakaliswa yi-detachment evela kwinyani, ukwala ukutya, kunye nokufuna ukuzibulala.
• I-mania enkulu: Ibonakala ngemeko yengqondo yokuphazamiseka kunye nokuxakeka. Oku kukwajongwa njengeseti ye-bipolar disorder.

Funda kwakhona malunga: Ingxaki yokungakhathali kakuhle

• Catatonia: Oku kubonakala ngokungabikho kokunyakaza kunye nentetho ngaphandle kwezinye iimpawu. Ngamanye amaxesha oku kunxulunyaniswa ne-schizophrenia kunye nezinye izifo zengqondo.
• Ukuphazamiseka kunye nobundlongondlongo kwizigulana ezinesifo sengqondo esixhalabisayo zingumceli mngeni wokulawula nokunyanga kwaye zichaphazela kakubi umgangatho wobomi.

Ngaba bayayicheba intloko yakho nge-ECT?

Unyango lwe-Electroconvulsive (ECT) yinkqubo eyenziwa ngoogqirha phantsi kwe-anesthesia jikelele apho isigulane sifumana imisinga yombane kwingqondo.

Ngaba i-ECT inokukwenza ube mandundu?

Hayi, inkqubo ye-ECT inceda ukunciphisa iimpawu zokudakumba kunye nezinye iimeko zempilo yengqondo.

Ngaba i-ECT ibangela ukuxhalabisa?

Kukho oogqirha bengqondo abaxhalabileyo ukuba nangona i-ECT inokunceda ekunciphiseni iimpawu zokudakumba, inokwenza iimpawu zokuxhalaba zibe mandundu, kuquka iingcinga ezigqithisileyo okanye ukuhlaselwa luloyiko.

Ngaba inkumbulo ibuya emva kwe-ECT?

Abanye abantu balahlekelwa yinkumbulo. Kwezinye iimeko, imemori ibuya emva kwexesha elifutshane kwaye ngamanye amaxesha isigulane sinokuba nokulahlekelwa kwimemori ixesha elide.