Ƙaƙƙarwar ƙwarewar waje ta waje (EECP) wani nau'i ne na magunguna don angina . Yayin da yawancin binciken binciken asibiti ya nuna cewa wannan magani zai iya taimakawa wajen rage bayyanar cututtuka na angina a marasa lafiya da cututtukan cututtuka (CAD) , amma mafi yawan masu kwakwalwa ba su yarda da su ba, kuma ba su shiga cikin al'amuran aikin likita ba.
Menene EECP?
EECP wani hanya ne na injiniya wanda ake jigilar magunguna masu yawa (kamar jini na jini) suna kewaye da ƙafafuwan marasa lafiya. Yayin da mai haƙuri ya kwanta a kan gado, ana kwantar da ƙafafun kafa da kuma ƙaddara tare da kowace ƙyallen zuciya. Kwancen iska da karewa suna sarrafawa ta hanyar kwamfuta, wanda ke amfani da ECG na mai haƙuri don faɗakar da kumbura a farkon diastole (lokacin da zuciya ta koma kuma yana cike da jini), da kuma lalata kamar yadda systole (zuciya) ya fara. Rashin karfin furotin yana faruwa a hankali, daga ƙananan kafafu zuwa babba, don haka jinin a kafafu yana "juyawa" sama, zuwa ga zuciya.
EECP yana da akalla biyu abubuwa masu amfani a zuciya. Na farko, aikin shinge na ƙafafun kafa yana kara yawan jinin jini zuwa suturar jini a lokacin diastole . (Harsoyin jijiyoyin jini, ba kamar sauran suturar jiki a cikin jiki ba, suna karɓar jini a tsakiyar zuciya, maimakon a lokacin bugun zuciya). Na biyu, ta hanyar yin watsi da aikin kamar yadda zuciya ke farawa, EECP ya haifar da wani abu kamar kwatsam a cikin arteries, wanda ya rage aikin da tsohuwar ƙwayar zuciya zai yi a yaduwar jini.
Haka kuma an yi la'akari da cewa EECP na iya taimakawa wajen rage lalacewa na endothelial .
Ana gudanar da Hukumar ta EECP a matsayin jerin magunguna. Magunguna suna karbar sati biyar a kowane mako, na mako bakwai (domin cikakkiyar zaman zaman 35). Zamanin sa'a guda 35 da aka yi amfani da su don haifar da canje-canje mai dorewa a cikin tsarin siginan.
Yaya Yayi Kwarewa?
Yawancin karatu sun nuna cewa EECP na iya zama tasiri sosai wajen magance angina na ci gaba. Ƙananan gwajin da aka bazu ya nuna cewa EECP na inganta ingantattun cututtuka na angina (aunaccen ra'ayi) da kuma nuna haƙuri (ƙari mafi mahimmanci) a marasa lafiya tare da CAD. Har ila yau, Hukumar ta EECP, ta inganta ingantacciyar yanayin "rayuwa mai kyau", idan aka kwatanta da maganin wuribo. Sauran nazarin sun nuna cewa inganta cigaban bayyanar cututtuka bayan bin tafarkin EECP yana da alama har ya zuwa shekaru biyar (ko da yake 1 cikin 5 marasa lafiya na iya buƙatar wata hanya ta EECP don kulawa da ingantawarsu).
Yaya Yayi Ayyukan YAKE?
Hanyoyin da ake amfani da su a fili tare da EECP ba a sani ba. Akwai wasu shaidun da ke nuna cewa EECP zai iya taimaka wajen haifar da tasoshin kaya a cikin ɗigon maganin jini, ta hanyar motsawa da sakin nitric oxide da sauran abubuwan ci gaba a cikin suturar jini. Akwai kuma shaidar cewa EECP na iya zama wani nau'i na motsa jiki na "wucewa", wanda ke haifar da irin wadannan matsalolin da suke amfani da shi a cikin tsarin kulawa masu zaman kansu wanda ke gani tare da hakikanin motsa jiki.
Za a iya Yarda da Cutar?
Ƙungiyar ta EECP na iya zama mai sauƙi, amma ba kullum jin zafi.
A cikin nazarin, yawanci marasa lafiya sunyi tsayayyar hanya sosai.
Amma ba kowa zai iya samun EECP ba. Dole ne mutane ba su da EECP idan suna da isasshen rashin lafiya , ko kuma idan suna da kwarewar zuciya na zuciya , wani nau'in zuciya mai kwakwalwa irin su fibrillation mai tsanani, hauhawar jini mai tsanani, cututtuka na jijiyoyin jiki da ke ɗauke da ƙafafu, ko tarihin zurfin ƙwayar cuta . Ga duk wani, duk da haka, hanya tana bayyana lafiya.
Yaushe An Yarda da EECP?
Dangane da abin da muka sani a yau, dole ne a yi la'akari da CEEC a duk wanda har yanzu yana da angina ba tare da maganin likita ba , kuma a cikinsa akwai tsinkayen magunguna ko hawan tiyata da ake zaton ba su da kyau.
Medicare ta amince da ɗaukar hoto na EECP ga marasa lafiya da angina wadanda suka gaji duk sauran zabukan su.
A shekara ta 2014, kungiyoyi masu sana'a (Kwalejin Kwalejin Kasuwancin Amirka, Ƙungiyar Zuciya ta Amirka, Ƙungiyar Amirka don Tashin Tashin Ƙasa, Ƙungiyar Nurses na Ƙunƙwarar Lafiya, Ƙungiyar Harkokin Cigaban Ƙwayoyin Cutar da Ƙwayoyin Cutar HIV, da Cibiyar Tsirarrun Turawa) sun yarda da wannan tunanin cewa EECP ya kamata a yi la'akari da marasa lafiya tare da maganin angina zuwa wasu jiyya.
Me yasa Ba a Amfani da Ƙasashen Yamma ba?
Bugu da ƙari, yawancin al'umma sun fi son yin watsi da irin wannan farfadowa, kuma mutane da yawa masu kwakwalwa sun kasa yin la'akari da sanya EECP a matsayin zaɓi na ilmin likita. Sakamakon haka, mafi yawan marasa lafiya wadanda angina basu ji labarin hakan ba.
Lalle ne, EECP dan kadan ne. Babu shakka ba ze kamuwa da ilimin zuciya ba. Babu wanda zai iya bayanin yadda yake aiki. Kuma, daga likitan zuciya, idan kun kwatanta kokarin dangi da dangin kuɗi na EECP zuwa wani abu kamar saka wani sutura (zangon 35 a cikin makonni 7 da saurin minti 30) babu shakka. Don tsammanin masu kwakwalwa su rungumi EECP tare da duk wani sha'awa da gaske ba su kula da dabi'ar mutum ba.
Duk da haka, a lokacin da magani na marasa lafiya na angina ya wanzu wanda yake da lafiya kuma an dakatar da shi, idan shaidar da aka samo (kamar yadda ya zama ajizai) yana da karfi da shawarar cewa magani yana da tasiri sosai a cikin marasa lafiya da yawa, kuma lokacin da mai kula da lafiyar zai iya fadawa kyakkyawa Tabbatar da ko dai maganin ya taimaka a cikin sha'anin su (ta hanyar kasancewa ko rashin raguwa a cikin alamun angina), ba ze da kyau don ba da damar marasa lafiya da angina su bar fitinar wannan farfadowa ba, watakila ko da ma kafin a tura su cikin farfadowa.
Idan ana bi da ku don ciwon sanyi kuma har yanzu suna da alamun cututtuka duk da farfadowa, yana da kyau a gare ku don samar da yiwuwar kokarin EECP. Dole likitanku ya kamata kuyi magana akan wannan yiwuwar tare da ku, da gangan kuma ba tare da nuna bambanci ba.
Sources:
Fihn SD, Blankenship JC, Alexander KP, et al. 2014 ACC / AHA / AATS / PCNA / SCAI / STS a mayar da hankali kan jagorancin maganin ganewa da kuma kula da marasa lafiya da cututtukan zuciya: Ƙungiyar {asar Amirka don Harkokin Turawa, Cibiyar Nazarin Nursoshin Tafiyar Lafiya, Cibiyar Nazarin Harkokin Ciwon Lafiyar Hoto da Tsarin Harkokin Cutar, da Cibiyar Nazarin Yanke Thoracic. J Am Coll Cardiol 2014; 64: 1929.
Arora RR, Chou TM, Jain D, et al. Binciken da ake gudanarwa game da ƙwarewar ƙwarewa na waje (MUST-EECP): tasiri na EECP a kan motsa jiki mai kwakwalwa ta hanyar zubar da ciki da kuma maganin anginal. J Am Coll Cardiol 1999; 33: 1833.
Soran O, Kennard ED, Kfoury AG, et al. Sakamakon gwaji na shekaru biyu bayan da aka ƙaddamar da kwayar cutar ta jiki (EECP) a cikin marasa lafiya tare da angina pectoris da ƙananan ƙwararrun ventricular (rahoto daga Asusun Sashin Saitunan EECP na kasa da kasa). Am J Cardiol 2006; 97:17.