Iyini i-Vagus Nerve futhi ingakwazi yini ukukhulisa ukulahlekelwa kwesisindo?
Kukhona indlela yokuhlinza ye-bariatric engaziwa njengegciwane lesipu , isisu se-esiswini noma ibhaluni yesisu. Ibizwa nge-vBloc futhi isebenza ngokuvimbela i-vagus nererve. Iyini i-vagus nererve? Yindlela emzimbeni wakho odlala indima ekuzweleni kwakho indlala. Futhi ingase ibambe isihluthulelo sokulahlekelwa isisindo eside isikhathi eside. Kodwa ochwepheshe abaningi basalokhu beqaphele ngokuncoma ukwelashwa.
Iyini Inhlanzi Ye-Vagus?
Futhi eyaziwa njenge-cranial nerve X, i-vagus nerve iyisisindo sakho seshumi nesikhathi eside kunayo yonke. I-vagus nererve ngezinye izikhathi ibizwa ngokuthi i-nerring wandering. Ivela kwezinye izingxenye ze-brain stem (i-medulla oblongata) kuzo zonke izitho entanyeni nasesifuba futhi ekugcineni zibe emgodini wakho nesisu sokugaya.
I-vagus nererve ithumela ukwaziswa okubalulekile ebuchosheni bakho mayelana nesimo somzimba wakho ngokomzimba nangokomzwelo. Ngokwenza kanjalo, kusiza ukulawula imisebenzi eminingana ye-parasympathetic (noma yokuzibandakanya). Ngezinye izikhathi ukuvuselelwa kwesibindi sevagus (VNS) kusetshenziselwa ukuphatha abantu ngezimo ezithile kuhlanganise nesifo sokuphuza, i-migraines, noma ukucindezeleka. Nakuba imiphumela yalezi zonyango ihlanganisiwe.
Ngakho-ke inzwa ye-vagus ihlobene kanjani nokulahleka kwesisindo? I-vagus nerve igxila ngaphakathi esiswini futhi iyasiza ukuxhumana nobuchopho bakho mayelana nesimo sakho satiety. Lokho kusho ukuthi le nerve ithumela izimpawu ebuchosheni bakho mayelana nendlala nokugcwala.
Ngokusekelwe kulezi zimpawu, ama-hormone afihliwe ukuthi angakhuthaza noma avimbele ukudla.
Kuyini Ukwelashwa Kwe-VBloc?
Abanye abacwaningi bakholelwa ukuthi uma uvimbela izimpawu ezithile ezithunyelwe yi-vagus nerve, ungashintsha ukusikisela okudlayo. Uhlelo lwe-vagus nerve stimulation system lube yinye yezindlela ezine zokuhlinza nge-bariatric kubantu abahlukunye nesisindo sabo.
Inkampani ebizwa ngokuthi i-EnteroMedics yamukelwa imvume ye-FDA yedivayisi ebizwa ngokuthi i-Maestro Rechargeable System esebenzisa ukwelashwa kwe-neurometabolic (noma i-vBloc therapy) yokulahlekelwa isisindo. Njengengxenye yokwelashwa, idivayisi ishintsha izimpawu zendlala ezithunyelwe ebuchosheni bakho futhi zingasiza isiguli sidle kancane.
Iziguli ezitholwa yi-vBloc therapy zinezicucu ezincane ezifakwe eduze kwesisu. Le divayisi nayo ihlanganisa ne-vagus nererve. Ngenxa yesikhuthazo esivela kudivayisi, isisu sanda kancane futhi sivumelanisa kaningi ngesikhathi sokugaya ukudla. Lokhu kusiza isiguli sizizwe sigcwele masinyane ukuze bangathandeki ekudleni ngokweqile. Ukukhuthazwa kuyaqhubeka amahora ayishumi nambili kulo lonke usuku.
Izindlela zokuhlinzwa zeBariatric ezifana ne-vBloc zithandwa ngoba azidingi ukuba uhlinzekwe ngokukhululekile futhi ngoba azibandakanyi ukuguqulwa kokuhlinzwa esiswini. I-vBloc isetshenziselwa ukusebenzisa i-laparoscope encane engavamile, ngokuvamile njengengxenye yenqubo yokuphulukisa iziguli ezingama-60 kuya kwangu-90. Kungasuswa noma kuvaliwe nganoma yisiphi isikhathi.
Ngesikhathi usebenzisa uhlelo lwe-vagus nesisusa sokuvuselela, iziguli nazo zithola indlela yokuphila yokuqeqeshwa. Bakhuthazwa ukuba baxhumane ne-dietitian obhalisiwe ekululekeleni okukude okukodwa futhi banikezwe ngamathuluzi okulandelela nokufinyelela kwamanye amathuluzi oku-inthanethi afana namavidiyo kanye nezinto zokufundisa.
Kodwa-ke, ukuphazamiseka kwe-FDA kuvumela uhlobo lwesiguli esingathola i-vBloc. Abantu kuphela abane-BMI ( index mass body ) phakathi kuka-40 no-45 bayakwazi uhlelo. Uma unesiguli nge-BMI engama-35 kuya ku-39.9 futhi ube nesimo esithinta isisindo esinjenge-type 2 sikashukela noma umfutho wegazi ophezulu ungase uvumeleke ne-vBloc. Iziguli nazo zidinga ukukhombisa ukuthi ziye zazama uhlelo oluqondisiwe lokulahlekelwa isisindo ngaphandle kokuphumelela ukuze lufanelekele uhlelo.
Zingakanani Izindleko Zokwelashwa Kwemigomo Yegazi Eliyigugu?
Ngisho noma lokhu kungenye yezindlela zokuhlinza ezingenasisindo ezincane, akusona eshibhile kakhulu.
Ukulinganisela kufaka izindleko ze-vBloc cishe ama-$ 18,500. Izindleko zakho eziphelele zokuthola ukuvuselelwa kwesisindo se-electrophytic body for the loss of weight will depend on the hospital and surgeon oyikhethayo kanye nezinye izinto eziguquguqukayo.
Ngenxa yokuthi ukwelashwa kuyinto entsha, umshuwalense awukwazi ukumboza inqubo yakho. Ngakho, ngokuqhathanisa, lokhu kungase kube okunye okunye okunye okubizayo kokuhlinzwa kwesisindo. Izinketho ezifana ne- balloon yesisu nangomuthi we- AspireAssist isisu kakhulu. Kodwa i-EnteroMedics inikeza ukwelulekwa ezigulini ezinesithakazelo sokusiza ukuhamba ngenqubomgomo yomshuwalense ukuze kukhishwe.
Iphumelela kanjani i-vBloc?
Ingabe i-vBloc ingakusiza ngempela ukuba unciphise? Ijaji lingakapheli ukuthi ukuvuselelwa kwesisindo se-vagus noma cha kuyindlela ephumelelayo yokwelashwa kwesisindo. Ngokusho kwe-American Society ye-Metabolic and Bariatric Surgery (ASMBS), isikhathi eside isikhathi sokulahlekelwa kwesisindo semiphumela asikaziwa.
Ngokusho kwe-ASMBS, izifundo ezishicilelwe ngendlela yokulahlekelwa kwesisindo ziye zanikeza imiphumela ehlanganisiwe. Isivivinyo esisodwa sasihlanganisa izifundo ezingaba ngu-300. Zonke iziguli zazifakelwe idivaysi kodwa kuphela ezimbili kwezintathu zazivuselela. Idivayisi kwenye kwesithathu ishicilelwe. Ngemuva kwezinyanga eziyishumi nambili inani lokunciphisa ngokweqile elahlekile yiqembu eliqalisiwe futhi iqembu elivinjiwe lalilinganayo.
Kwesinye isifundo, iziguli ezinesisetshenziswa esisebenzisiwe zabonisa ukulahlekelwa kwesisindo esikhulu kunabo labo abafakwe kudivayisi yabo. Kodwa ukulahlekelwa isisindo kwakungeyona into emangalisayo njengoba abacwaningi babethemba. Iqembu elisetshenziselwa ukufakelwa (i-group group) lalahlekelwa ngamaphesenti angama-24.4 wesisindo sabo esiningi ngokweqile ngenkathi iqembu elivinjelwe (iqembu lamahloni) lilahlekelwa ngamaphesenti angu-15,9 wesisindo saso ngokweqile.
Lapho abacwaningi bebuyele leli qembu lokutadisha emva kwezinyanga ezingu-18, kodwa-ke, babona imiphumela ethembisayo. Iziguli ezinkampanini yokwelapha zalahlekelwa ngamaphesenti angu-23.5 wesisindo esiningi noma amaphesenti angu-8.8 esisindo sabo sonke. Iziguli eziqenjini leqembu lilahlekelwe ngamaphesenti angu-10.2 wesisindo esiningi noma 3.8 sesisindo sabo sonke.
Izingozi ze-vBloc kanye nemiphumela emibi
Lapho Ukuphathwa Kwezokudla Nezidakamizwa kuvunyelwe uhlelo lweMaestro Lokuvuseleleka noma idivaysi ye-vBloc, baqaphela ukuthi kungenzeka yini ukuthi bangakwazi ukubhekana nokulahlekelwa isisindo. Ngokusho kolwazi lokugunyazwa kweDivaysi ye-FDA, ezinye iziguli azenzi ukhetho oluhle endleleni yokulahlekelwa kwesisindo. Zihlanganisa iziguli ezinalo
- I-cirrhosis yesibindi
- Ukucindezela okwandayo emithanjeni ye-hepatic
- I-veated veins e-oophagus
- Ama-hernias ama-Hiatal asemqoka ngokomzimba futhi awakwazi ukulungiswa ngokuhlinzwa
Ngokusho kolwazi olwengeziwe oluhlinzekwe yi-FDA, izinkinga ezavela ngesikhathi ukuvivinywa kwemitholampilo yohlelo lwe-Maestro Lokuvuseleleka zazibandakanya isicanucanu, ukuhlanza, izinkinga zokuhlinzwa, ubuhlungu (kufaka phakathi ubuhlungu besifuba), ukuguquka kwenhliziyo, izinkinga zokugwinya nokugubha.
Ngenxa yokuhlola kwabo uhlelo lwe-vBloc, i-ASMBS iphetha ngokuthi "Ukuvinjelwa kwamagciwane okuguqulwa kwamagciwane okubuyiselwe kuye kwaboniswa ukuthi kunesimo esiphezulu sokuphepha nesigameko esincane sezehlakalo ezimbi kakhulu kanye nesilinganiso esiphezulu sokubuyekeza esikhathini esifushane. okudingekayo ukuthola ukunqunywa kwesikhathi eside kanye namazinga okuhlanzwa. " Ngamafuphi, inhlangano ibona isithembiso ngedivayisi kodwa ikwazi ukubona ukuthi kwenzekani neziguli ngaphezu kwesikhathi eside.
> Imithombo:
> Chae, MD, CF, FACS F. Ukwelashwa kwe-VBloc - konke okudingeka ukwazi - Umthombo wokuhlinzwa weBariatric. https://www.bariatric-surgery-source.com/vbloc-therapy.html.
> Klarer M, Arnold M, et al. Ama-Gut Vagal Ama-Afferents ahlukanisa ngokungafani ukukhathazeka nokungenwa kwesimo esingaziwa. I-Journal ye-NeuroScience . 2014; 34 (21): 7067-7076. i-doi: 10.1523 / i-JNEUROSCI.0252-14.2014. http://www.jneurosci.org/content/34/21/7067.
> Moore SK. I-Nagu yama-Vagus: Umnyango ongemuva wokukhwabanisa ubuchopho. Institute of Electronic and Electrical Engineers (IEEE). http://spectrum.ieee.org/biomedical/devices/the-vagus-nerve-a-back-door-for-brain-hacking
> Papasavas, MD P, El Chaar, MD M, et al. I-Vagal ivimbela ukwelashwa kokukhuluphala - umphakathi waseMelika ngokuhlinzwa okwenziwa ngamathambo kanye neBariatric. I-American Society ye-Surgery Metabolic neBariatric. https://asmbs.org/resources/vagal-blocking-therapy-for-obesity.
> Tewfik, MD TL. I-anatagular nerve anatomy: i-anatomy eningi, i-anatomy microscopic, ukuhlukahluka kwemvelo. I-Medscape . Agasti 2015. http://emedicine.medscape.com/article/1875813- ukubukwa kabusha