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مراقبت از پیس میکرو ICD – دکتر شیرین جوان گروه | متخصص بیماری های قلب و عروق
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مراقبت از پیس میکرو ICD

مراقبت از پیس میکرو ICD

October 13, 2019 by wordcamp
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امروزه پیس میکر توسط بی حسی موضعی و ازطریق شکاف کوچکی که درزیر ترقوه چپ یا راست ایجاد می کنند، کاشته می شود و نیازی به بیهوشی عمومی یا باز کردن قفسه سینه ندارد. مدت زمان لازم جهت کاشت یک پیس میکر حدود 30- 90 دقیقه است ومعمولاً مدت زمان لازم جهت بستری شدن فردبعد از تعبیه پیس میکرحدود 48 ساعت می باشد.
البته کاشتن پیس میکر ICD سه حفره ای غالباً زمان بری بیشتری دارد. طی48 ساعت اول بعد از عمل، باید از حرکات شدید دست خودداری کنید. در چند روز اول بعد ازعمل، محل شکاف کمی قرمز، متورم و دردناک می شود که یک حالت طبیعی محسوب می شود ولی بایستی بتدریج از قرمزی، تورم و درد آن کاسته شودو اگر غیراز این بود، بیمار باید پزشک خود را مطلع کند.
بعد از 48 تا 72 ساعت اول بعد از عمل، دیگر نیازی به پانسمان محل عمل نمی باشد و روز 4-5 بعد از عمل بیمار اجازه استحمام خواهد داشت و حداقل تا 10 روز پس از عمل مصرف آنتی بیوتیک الزامی است. و در صورت نیاز به کشیدن بخیه این کار دو هفته بعد انجام می گردد. (طبق دستور پزشک) بیمار باید 6 تا 8 هفته بعد از عمل از حرکات شدید دستی که پیس میکر در آن سمت تعبیه شده، پرهیز کند. در ضمن باید همیشه از هل دادن شدید و بلند کردن اجسامی که وزن آنها بیش از 5 تا 10 کیلوگرم باشد خصوصاً در 2 ماهه اول اجتناب گردد.
بعد از تعبیه پیس میکر در اغلب مواقع فرد می تواند تمام فعالیت های فیزیکی را که قبل از عمل انجام می داده، انجام دهد و محدودیت خاصی نخواهد داشت. چه بسا بعد از تعبیه پیس میکر، دلیل بهبود سرعت ضربان قلب و اکسیژن رسانی به بافته های بدن، تحمل فعالیتهای بهتر خواهد شد، محدودیت غذایی خاصی وجود ندارد و در فعالیتها از احتمال ضربه خوردن به پیس میکر و حرکات بالا برنده مداوم همان دستی که پیس میکر تعبیه شده است، لازم است اجتناب گردد. بعد از تعبیه پیس میکر، بیمار بایستی به طور مرتب و طبق برنامه ای که پزشک معالج تعیین می کند، برای پیگیری و کنترل عملکرد پیس میکر و انجام تغییرات احتمالی در برنامه آن مراجعه نماید.
در صورت رخ دادن علائم زیر به پزشک مراجعه کند.
1- وجود علایم عفونت در محل عمل از قرمزی و تورم بیش از حد و پیشرونده یا وجود ترشح از محل عمل
2- اشکالات تنفسی
3- سرگیجه یا افتادن بدون دلیل
4- ضعف و خستگی مستمر
5- درد قفسه سینه
6- سکسکه های تداوم دار
7- تورم پاها یا دست
طول عمر یک ژنراتور چقدر است؟
هر ژنراتور دارای یک منبع انرژی تمام شونده است و طبق یک قانون کلی، هر چقدر مصرف از این منبع انرژی بیشتر باشد، زودتر تمام خواهد شد.
اگر بیمار به طور مرتب و طبق برنامه ای که پزشک وی مشخص می کند تحت مراقبت و پیگیری قرار گیرد. تعویض ژنراتور در زمان مناسب انجام خواهد شد. بدون اینکه خطری جان بیمار را تهدید کند. در غیر این صورت ممکن است انرژی ژنراتور زودتر از موعد تمام شود وجان بیماری که وابستگی شدید به پیس میکر دارد به خطر افتد.
چک کردن عملکرد پیس میکر
یکی از ساده ترین راه های کنترل عملکرد پیس میکر شمارش سرعت نبض در عرض یک دقیقه می-باشد و بهتر است هر روز یکبار و سر ساعت مشخصی این کار انجام شود( که معمولاً نبایستی کمتر از 60- 50 ضربه در دقیقه باشد) ولی بهترین کار، ویزیت های منظمی است که توسط پزشک معالج صورت می گیرد و در صورت نیاز اقدام به ثبت نوار قلب و یا آنالیز عملکرد پیس میکر می-شود.
زندگی روزمره
1- خوردن و آشامیدن: محدودیتی وجود ندارد، مگر این که فرد بیمار زمینه ای خاص داشته باشد (مانند دیابت و پرفشاری خون)
2- ورزش: از نظر فعالیت های فیزیکی و ورزش محدودیت خاصی وجود ندارد ولی باید از انجام فعالیت هایی که ممکن است حین آنها ضربه به محل پیس میکر وارد شود(کاراته، فوتبال، بسکتبال و….) خودداری کند.
3- رانندگی: محدویت وجود ندارد ولی باید از لمس کردن موتور روشن یا سیستم الکتریکی اتومبیل خودداری کرد.
4- مسافرت: محدودیتی وجود ندارد ولی به دلیل اثراتی که ممکن است درهای ایمنی یا وسایلی که پلیس ها از آن جهت یافتن اشیاء فلزی استفاده می کنند روی پیس میکر بگذارد؛ بایستی با نشان دادن کارت پیس میکر آنان را از وجود دستگاه خود مطلع کرده و از آنها بخواهید که با دست اقدام به بازرسی بکنند.
5- کارکردن: محدودیت خاصی وجود ندارد ولی اگر در محل کار شمار وسایل الکتریکی زیادی وجود دارد به خصوص اگر ازنوع ولتاژ قوی باشند، باید از حضور در این میادین مغناطیسی اجتناب گردد و اگر شما نیاز به فعالیت فیزیکی شدیدی داشته باشید حتماً با پزشک خود مشورت نمایید.
6- وسایل برقی: استفاده از تلفن های بی سیم خانگی، اجاق های برقی مایکروویو- ماشین لباسشویی و خشک کن- یخچال و فریزر- تلویزیون – جاروبرقی – کامپیوتر – پرینتر – اسکنر – فکس بلامانع است و از نزدیک کردن وسایل آهن ربا دار به محل پیس میکراجتناب گردد.
7- هر گونه بررسی های تشخیص پزشکی جهت بیمارانی که پیس میکر دارند به غیر از MRI بلامانع است. در صورت نیاز به انجام MRI لازم است با پزشک در مورد امکان انجام آن در موارد خاص مشورت گردد.

He later also wrote photo scribe/ how to tell the stories behind your photos http://designbeep.com/2019/10/09/how-to-get-good-grade-in-high-school-guide-for-students.


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