Ngenhlanhla, ukwelashwa kwe-ECT kushintshe kakhulu kusukela ekusetshenzisweni kwabo kokuqala ngasekupheleni kweminyaka yama-30s. Kunokuba anyamalale kuzikhali zokwelapha, asasetshenziselwa ukwelapha ukucindezeleka okukhulu noma izimo ezithile ze-schizophrenia ikakhulukazi.

I-Electroconvulsive therapy noma i-seismotherapy, evame ukubizwa ngokuthi i-electroconvulsive therapy (ECT) namuhla, ihlanganisa ukuthumela amandla kagesi ebuchosheni ukuze kwakheke ukuquleka (isithuthwane). Intshisekelo isekelwe kulo mkhuba wokuphila: ngokuzivikela kanye ne-survival reflex, ngesikhathi senhlekelele yokuquleka ubuchopho buzokhipha ama-neurotransmitters ahlukahlukene kanye nama-neurohormones (i-dopamine, i-norepinephrine, i-serotonin) ehilelekile ekuphazamisekeni kwemizwa. Lezi zinto zizoshukumisa ama-neuron futhi zikhuthaze ukudalwa kokuxhumana okusha kwemizwa.

I-Electroconvulsive therapy (ECT) ingenziwa ngesikhathi sokulaliswa esibhedlela noma ngesisekelo sokulaliswa esibhedlela. Imvume yesiguli iyimpoqo, njenganoma yisiphi isenzo sezokwelapha.

Ngokungafani nokuqala kwe-seismotherapy, isiguli manje sibekwe ngaphansi kwe-anesthesia emfushane evamile (imizuzu emi-5 kuya kweyi-10) kanye ne-curarization: sijova nge-currare, into ebangela ukukhubazeka kwemisipha, ukuze kuvinjelwe ukudlikizeka kwemisipha futhi kuvimbele 'akenzi'. ukuzilimaza.

Udokotela wengqondo uyobe esebeka ama-electrode ahlukene ekhanda lesiguli, ukuze akwazi ukuqapha ukusebenza kobuchopho kuyo yonke inqubo. Bese ukuvuselela kagesi okuphindaphindiwe kwesikhathi esifushane kakhulu (ngaphansi kwamasekhondi angu-8) kwamandla aphansi kakhulu (ama-ampere angu-0,8) kulethwa kugebhezi ukuze kubangele ukubanjwa kokudlikiza okungamasekhondi angamashumi amathathu. Ubuthakathaka balo msinga kagesi kwenza kube nokwenzeka ukugwema imiphumela engemihle ebonwe ngaphambilini ngemva kokushabalala kwe-electroshock:

Izikhathi zingaphindwa izikhathi ezi-2 noma ezi-3 ngeviki, ukuze zelashwe kusukela ezikhathini ezimbalwa kuye kwezingamashumi amabili, kuye ngokuvela kwesimo sempilo yesiguli.

Ngokwezincomo zezempilo, i-ECT ingasetshenziswa njengomugqa wokuqala lapho kunobungozi obusongela impilo (ingozi yokuzibulala, ukuwohloka okukhulu kwesimo esijwayelekile) noma lapho isimo sempilo yesiguli singahambelani nokusetshenziswa ” kolunye uhlobo olusebenzayo. ukwelashwa, noma njengokwelashwa komugqa wesibili ngemuva kokwehluleka kokwelashwa okujwayelekile kwemithi, kulawa ma-pathologies ahlukene:

• ukucindezeleka okukhulu;
• i-bipolarity ekuhlaselweni kwe-manic acute;
• izinhlobo ezithile ze-schizophrenia (i-schizoaffective disorders, i-acute paranoid syndromes).

Nokho, akuzona zonke izikhungo ezenza i-ECT, futhi kunomehluko oqinile endaweni walokhu kunikezwa kokwelashwa.

Ngemva kweseshini

Kuvamile ukubona ubuhlungu bekhanda, isicanucanu, ukulahlekelwa inkumbulo yesikhashana.

Imiphumela

Ukuphumelela kwesikhashana kokwelapha kwe-ECT ekucindezelekeni okukhulu kuboniswe ku-85 kuya ku-90%, okungukuthi ukusebenza kahle okuqhathaniswa nama-antidepressants. Ukwelashwa kokuhlanganiswa kuyadingeka ngokulandela ukwelashwa nge-ECT, ngenxa yezinga eliphezulu (35 kanye ne-80% ngokusho kwezincwadi) zokuphindaphinda kokucindezeleka ngonyaka olandelayo. Kungaba amaseshini we-ECT wokwelapha noma wokuhlanganisa.

Ngokuphathelene ne-bipolarity, ucwaningo lubonisa ukuthi i-ECT iphumelela njenge-lithium ekuhlaselweni kwe-manic acute ezigulini ezithola i-neuroleptics, futhi ivumela ukuthola isenzo esisheshayo ekuyaluzeni nasekujabuleni.

Izingozi

I-ECT ayikubangeli ukuxhumana kobuchopho, kodwa ezinye izingozi ziyaqhubeka. Ingozi yokufa ehambisana ne-anesthesia ejwayelekile ilinganiselwa ku-2 ngezikhathi ze-ECT ze-100, kanye nezinga lokugula engozini ye-000 ngeseshini engu-1 kuya kwe-1.