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யாழ் போதனா வைத்தியசாலை இருதய சிகிச்சை நிலையத்தின் சேவைகள் எவை?

யாழ் போதனா வைத்தியசாலை இருதய சிகிச்சை நிலையத்தின் சேவைகள் எவை?
யாழ்ப்பாண போதனா வைத்தியசாலை (Jaffna Teaching Hospital) வடக்கு மாகாணம் மற்றும் நாட்டின் ஏனைய பகுதிகளுக்கும் முக்கிய மருத்துவ நிலையமாக திகழ்கிறது.
இவ் வைத்தியசாலையானது பல்வேறு விசேட சிகிச்சை பிரிவுகளை கொண்டு சிறப்பாக இயங்கி வருகின்றது.
இந்நிலையில் இருதய சிகிச்சை பகுதி (Cardiology Unit) சிறப்பாகச் செயற்பட்டு, பல்வேறு உயர் தர சிகிச்சை மற்றும் பராமரிப்புகளை வழங்குகிறது. அதன்
சேவைகள் பல்வேறு படிநிலைகளைக் கொண்டது . இருதய நோய் என சந்தேகிக்க படுகின்றவர்கள் வைத்தியசாலைக்கு பல்வேறு வழிகளில் வந்தடைகின்றனர்கள்.
வெளி நோயாளர் பிரிவில் சிகிச்சைக்காக வந்த ஒருவருக்கு இருதய நோய் பாதிப்பிற்கான அறிகுறிகள் காணப்பட்டால் அவர் இருதய சிகிச்சை பிரிவுக்கு அனுப்பி வைக்கப்படுகின்றார்.
அவ்வாறே ஏனைய விடுதிகளில் வேறு ஒரு நோய் தாக்கத்திற்கு உள்ளாகி சிகிச்சை பெறுபவர்களுள் எவருக்கேனும் இருதய வியாதி இருக்கும் என சந்தேகிக்கப்பட்டால் அவர்களும் இருதய சிகிச்சை பிரிவுக்கு அனுப்பி வைக்கப்படுகின்றார்கள்.
மேலும் வடக்கிலே இருக்கின்ற பல்வேறு வைத்தியசாலைகளில் சிகிச்சை பெறுகின்ற நோயாளிகள், அங்கே உள்ள வைத்தியர்களினால் மேலதிக சிகிச்சைக்காக இருதய சிகிச்சை பகுதிக்கு அனுப்பி வைக்கப்படுகின்றார்கள்.
இதற்கு அப்பால் வடக்கு மாகாணத்துக்கு வெளியே இருக்கின்ற மாவட்டங்களில் வாழ்பவர்களும் யாழ்ப்பாண போதனா வைத்தியசாலை இருதய சிகிச்சை பிரிவின் சேவைகள் பற்றி கேள்விப்பட்டு நேரடியாகவே வருகை தந்து தங்கள் பெயர்களை இருதய கிளினிக் இல் பதிவு செய்து தங்களுடைய நோய் நிலைகள் பற்றிய பரிசோதனைகளை மேற்கொண்டு சிகிச்சைகளையும் பெற்றுக் கொள்கின்றார்கள்.
பல்லாயிரக்கணக்கானவர்கள் வாரத்தில் ஆறு நாட்களும் நடைபெறுகின்ற கிளினிக்கில் மாதாந்த கிரமமாக சிகிச்சை பெற்று வருகின்றனர். ஆகவே தினசரி நூற்றுக்கணக்கானவர் வருகை தந்து அங்கிருக்கும் வைத்தியர்களினால் பரிசோதிக்கப்பட்டு அவர்களுக்கான மருந்துகளும் ஆலோசனைகளும் வழங்கப்படுகின்ற அதே சமயம், அவ்வப்போது தேவைப்படுகின்ற மேலதிக பரிசோதனைகளை செய்வதற்கான வழிமுறைகள் ஒழுங்குபடுத்தப்பட்டுள்ளது.
இருதய நோய் நிர்ணயத்தின் பின்னர் சிகிச்சை முறைகள் தீர்மானிக்கப்படுகின்றன.
இருதய சிகிச்சை பிரிவின் நோய் நிர்ணயத்தில் அதே பிரிவில் பல சிகிச்சைகள் வழங்கப்படுகின்றன. ஆனால்
கடுமையான இருதய முடியுரு நாடி அடைப்புகள் மற்றும் இதய வால்வு சிதைவுகள் போன்ற நிலையில் உள்ளவர்கள் சத்திர சிகிச்சை செய்து கொள்வதற்காக வைத்தியசாலை இருதய சத்திர சிகிச்சை பிரிவுக்கு (Cardiothoracic Surgery Unit) அனுப்பி வைக்கப்படுகின்றனர். அங்கு இவர்களுக்கான சத்திர சிகிச்சைகள் மேற்கொள்ள வசதிகள் இருக்கின்றன. இருப்பினும் ஆயிரக்கணக்கானவர்கள் இந்த சத்திர சிகிச்சைக்காக காத்திருப்பதனால் எல்லோருக்கும் உடனடியாக சிகிச்சை செய்வது இயலாத நிலையாக காணப்படுகிறது.
இருப்பினும் சத்திர சிகிச்சை அணியினரின் குறிப்பிட்ட வழிகாட்டலுக்கு அமைவாக ஒவ்வொரு வாரமும் நான்கிற்கு மேற்பட்டவர்களுக்கு சத்திர சிகிச்சைகள் மேற்கொள்ளப்படுகின்றன. இதய சத்திர சிகிச்சை என்பது மிகவும் சிக்கலான சத்திர சிகிச்சை. ஒருவருக்கு சத்திர சிகிச்சை செய்ய பல மணி நேரங்கள் தேவைப்படுவதனால் நாள் ஒன்றுக்கு ஒருவருக்கு மாத்திரமே சத்திர சிகிச்சை செய்யக் கூடியதாக இருக்கின்றது.
எதிர்வரும் காலங்களில் மேலும் விரிவாக்க வசதிகள் ஒழுங்கமைக்கப்பட்ட பின்னர் பின்னர் வாரம் ஒன்றில் அதிகரித்த எண்ணிக்கையானவர்களுக்கு இருதய சத்திர சிகிச்சைகள் மேற்கொள்ள முடியும்.
இருதய நோய் இருக்கலாம் என்ற சந்தேகத்தின் பெயரில் அனுமதிக்கப்படுகின்றவர்களுக்கு வைத்தியசாலையின் இருதய சிகிச்சை பிரிவில் தங்கி பரிசோதனைகளையும் சிகிச்சையும் பெறுவதற்காக இரண்டு விடுதிகள் இயங்குகின்றன.
இருதய சிகிச்சை பிரிவில்
ECG, Echocardiogram, Tredmeal, 24 hrs holter monitoring, Angiogram, மற்றும் பல்வேறு இரத்த பரிசோதனைகள் செய்யப்படுகின்றன.
இதய தொகுதியில் உள்ள இதயத் தசை, முடியுரு நாடி,இதய பேஸ்மேக்கர், இதய வால்வுகள், இதய அறைகள், பெருநாடி மற்றும் பெருநாளம் போன்ற பல்வேறு பகுதிகளில் நோய்கள் ஏற்படுகின்றன. ஆகையால், இவற்றில் ஏற்படும் நோய்களுக்குச் சிகிச்சை அளிப்பது மிகவும் சிக்கலானது. இதற்கான சிகிச்சைகளை வழங்க Cardiac catheterization laboratory machine அத்தியாவசியமானது.
தினசரி Cardiac Catheterization laboratory (cath lab) இல் பலருக்கு அஞ்சியோகிராம் செய்யப்படுகின்றது. அதில் குருதிக் குழாயில் அடைப்பு குறைவாக காணப்பட்டால் சிலருக்கு உடனடியாகவே Angioplasty செய்யப்படுகின்றது. இருதய இரத்தக் குழாய்களில் (coronary arteries) அதிக அடைப்பு காணப்படுகின்ற போது, சிறிய அடைப்பாக இருந்தால் Angioplasty செய்யப்படுகிறது. குருதிக் குழாயின் அடைப்பு அதிகமாக காணப்பட்டால் cardiac stent வைக்கப்படுகின்றது. இது மிகவும் சிக்கலான சிகிச்சை முறை. வைத்திய நிபுணர்கள், வைத்தியர்கள், தாதியர்கள், எக்ஸ் கதிர் இயக்குனர்கள் மற்றும் உதவியாளர்களின் ஒருங்கிணைந்த சேவையில் இந்த சிகிச்சை வழங்கப்படுகின்றது. இதனைத் தவிர இதய வால்வு சிகிச்சை
வடக்கில் யாழ் போதனா வைத்திய சாலையில் மாத்திரம் இந்த சேவை வழங்கப்படுகின்றது.
இலங்கையில் இருக்கும் பல பிரதான வைத்தியசாலைகளில் சிலவற்றில் மாத்திரம் இந்த சேவை இருக்கின்றது. நாட்டிலே பல்லாயிரக்கணக்கானவர்கள் இந்த சேவைக்காக காத்திருக்கின்றார்கள். பண வசதி படைத்தவர்கள் சிலர் தனியார் மருத்துவமனைகளில் இந்த சிகிச்சை செய்து கொள்கின்றார்கள்.
எனவே நாட்டின் ஏனைய பாகங்களில் இருந்தும் சிகிச்சைக்காக யாழ் போதனா வைத்தியசாலை வந்தடைகின்றார்கள். யாழ் போதனா வைத்திய சாலையில் இங்கே வருகை தரும் நோயாளிகளை திருப்பி அனுப்பாமல் சிகிச்சைகளை வழங்குவதற்காக மூன்று வைத்திய நிபுணர்கள் மற்றும் குழுவினர் தங்கள் அர்ப்பணிப்பான சேவையை வழங்குகின்றமை காரணமாக இருக்கிறது.
ஆகவே வடபகுதி மக்கள் அதிர்ஷ்டசாலிகள் என்று குறிப்பிடலாம். ஏனெனில் நாட்டின் ஏனைய பாகங்களில் உள்ள அரச வைத்தியசாலைகளில் பலர் Angiogram செய்வதற்காக வருட கணக்கில் காத்திருக்கின்றார்கள்.
யாழ் போதனா வைத்திய சாலையில் அஞ்சியோகிராம் செய்யப்பட்டு stent வைக்க வேண்டும் என்ற நிலையில் இருப்பவர்கள் சுகாதார அமைச்சின் ஊடாக வைத்தியசாலைக்கு வழங்கப்படுகின்ற stents கையிருப்பில் இருப்பதால் வைக்கப்படுகின்றன. ஆனால் சுகாதார அமைச்சின் வழங்கப்படுகின்ற Stents களில் குறித்த நோயாளிக்குரிய அளவு பிரமாணத்தைக் கொண்ட Stents காணப்படாத நிலையில் அல்லது வழங்கலில் தடங்கல் ஏற்படட்டு கையிருப்பு இல்லாத நிலைமையும் காணப்படுகின்றது.
அவ்வாறான சந்தர்ப்பங்களில் குறிப்பிட்ட நோயாளி அவற்றை வாங்கி கொடுப்பதன் மூலம் அன்றைய தினமே வைப்பதற்கான நடைமுறையும் இருக்கின்றது.
( தனியார் மருத்துவமனை ஒன்றில் இவற்றை செய்து கொள்வதற்கு பல இலட்சம் தேவைப்படும்.) ஆகவே இவ்வாறான சந்தர்ப்பங்களில் குறித்த நோயாளி இதனை வாங்கித் தருகின்ற போது உடனடியாகவே வைக்கப்பட்டு சிகிச்சையை முடிவுறுத்தி காத்திருப்பினால் ஏற்படும் உயிரிழப்பு அல்லது சிக்கலான நோய்நிலை தவிர்க்கப்படுகின்றது.
இந்த நடைமுறையை நாம் செய்யாவிட்டால் இங்கும் பலர் காத்திருக்க வேண்டும். இவ்வாறான சந்தர்ப்பங்களில் அனைவரும் காத்திருக்கும் காலங்களில் தனியார் மருத்துவமனைகளுக்கு பல லட்சம் ரூபாய் செலவில் செய்து கொள்வது தவிர வேறு வழியில்லை. மேற்படி stents களை குறைந்த விலையில் பெற்றுக் கொள்வதன் பொருட்டு வைத்தியசாலை நலன்புரி சங்கம் விற்பனை செய்கின்றவர்களிடமிருந்து குறைந்த விலையில் வழங்குவதற்காக ஏற்பாடுகளை செய்துள்ளமையும் வரவேற்கத்தக்கது.
தற்போது யாழ் போதனா வைத்தியசாலையில் இருக்கின்ற Cardiac catheterization lab equipment 13 வருடங்கள் பழமை வாய்ந்தது. இது செயலிழக்கும் நிலையில் உள்ளதால் புதிய இயந்திரம் ஒன்று இவ்வருடம் கட்டாயம் மாற்றீடாக பொருத்தப்பட வேண்டும். இது விடயமாக சுகாதார அமைச்சிடம் புதிய இயந்திரத்தை கோரியிருக்கின்றோம். சுகாதார அமைச்சினால் இவ்வருடம் மேற்படி இயந்திரம் தருவிக்கப்படாவிட்டால் நன்கொடையாளர்களின் உதவியில் மேற்படி இயந்திர அன்பளிப்பை எதிர்பார்க்கின்றோம். இவ்வாறான இயந்திரம் ஒன்றை பெற்றுக் கொள்வதற்கு ரூபாய் 200 மில்லியன் தொடக்கம் 300 மில்லியன் தேவைப்படுகின்றது.
வைத்தியர்களின நேரடி பரிசோதனைகள் மற்றும் ஆய்வுகூட இரத்த பரிசோதனைகள் மற்றும் உபகரணங்கள் பரிசோதனைகளின் முடிவுகளின் முடிவில் இருதய நோய் உள்ளவருக்கு சரியான நோய் நிர்ணயம் செய்யப்படுகின்றது.
இருதய நோய் ஒன்று நோய் நிர்ணயமாக காணப்படுகின்ற போது அவர்களுக்கான சிகிச்சைகள் கிரமமாக வழங்குவதற்கான வசதிகள் செய்யப்படு உள்ளன.
தற்போதைய நிலையில் நாட்டில் அநேகமானவர்களுக்கு இருதய நோய் ஏற்படுகின்றது. ஒருவருடைய உணவு பழக்க வழக்கம், சுறுசுறுப்பற்ற வாழ்க்கை முறை, அதிகரித்த மனநெருக்கீடு, உடற்பயிற்சி செய்யாமை, புகைப்பிடித்தல், அதிகமான மதுப்பாவனை என்பன ஒருவரை இருதய நோய்க்குள் தள்ளி விடுகின்றது. இதற்கு மேல் அதிகமாக காரணம் இன்றி ஏற்படுகின்ற இருதய நோய் வயோதிபத் தன்மை, சலரோகம், அதி உயர் அமுக்கம் போன்ற நிலையில் உள்ளவர்களும் இதய நோயினால் பீடிக்கப்படுகின்றார்கள்.
இருதய நோயினால் பீடிக்கப்பட்டுகின்றவரின் இருதயத்தின் செயல்பாடுகள் படிப்படியாக பாதிப்படைகின்றன. இவ்வாறான இந்த நிலையில் உரிய முறையில் வைத்தியரை அல்லது வைத்தியசாலையை நாடாத போது திடீரென நெஞ்சு வலியை ஏற்படுத்தி அல்லது ஹார்ட் அட்டாக் ஏற்படுத்தி அல்லது இருதய செயலிழப்பை ஏற்படுத்துகின்ற போது உயிர் ஆபத்தான நிலையில் வைத்தியசாலைக்கு அனுமதிக்கப்படுகின்றார்கள்.
நெஞ்சுவலியென வைத்தியசாலையில் அனுமதிக்கப்படுகின்றவர்களில் பலருக்கு heart attack எனும் கடுமையான வருத்தம் ஏற்படுகின்றமை கண்டுபிடிக்கப்படுகின்றது.
மேலும் சிலர் திடீர் இருதய செயலிழப்பு காரணமாக அனுமதிக்கப்படுகின்றார்கள்.
வைத்தியசாலைக்கு அனுமதிக்கப்படுகின்ற அல்லது கிளினிக் பகுதிகளில் நோய் நிர்ணயம் செய்யப்படுகின்றவர்கள் சிகிச்சை பிரிவினரின் ஒழுங்குபடுத்தலில் ஒவ்வொருவருக்கும் ஏற்ற வகையில் சிகிச்சை ஒழுங்குபடுத்தப்பட்டிருக்கின்றது.
நோயாளிகளின் இதய ஆரோக்கியத்தையும் செயற்பாட்டையும் முழுமையாக மதிப்பீடு செய்ய ECG, Echo Cardiogram, Treadmill Test (TMT) போன்ற உபகரணங்கள் பயன்படுத்தப்படுகின்றன. இதனை இயக்குவதற்கு விசேட பயிற்சி பெற்ற உத்தியோகத்தர்கள் கடமையில் இருக்கின்றார்கள்.
கடந்த வருடம் யாழ் போதனா வைத்தியசாலை Cardiac catheterization laboratory இல் நாட்டின் பல்வேறு பகுதிகளையும் சேர்ந்தவர்களில் 3775 பேருக்கு சிகிச்சை அளிக்கப்பட்டிருக்கின்றது. பல்லாயிரக்கணக்கானவர்களுக்கு Echo பரிசோதனை செய்யப்பட்டு இருக்கின்றது.
மேலும் இருதய கிளினிக் பகுதியில் 51840 பேருக்கு சிகிச்சை அளிக்கப்பட்டிருக்கின்றது. மேலும் 7603 பேர் இருதய சிகிச்சை விடுதிகளில் சிகிச்சை பெற்று இருக்கின்றார்கள் அத்துடன் 840 பேருக்கு அதிதீவிர இருதய சிகிச்சை பிரிவில் சிகிச்சை வழங்கப்பட்டிருக்கின்றது.
யாழ் போதனா வைத்தியசாலையில் இருதய சிகிச்சை பிரிவு சிறிய அளவில் 2005 ஆம் ஆண்டு தொடங்கப்பட்டது. இருதய சிகிச்சை பிரிவு ஆரம்பிக்கும் போது மறைந்த இருதய வைத்திய நிபுணரின் குடும்பத்தினரால் அவர் பெயரில் நடாத்தப்படும் அறக்கட்டளைகள் (Dr. G. R. Handy Memorial fund) உதவி கிடைத்தது. ஆகவே யாழ் போதனா வைத்தியசாலை இருதய சிகிச்சை பிரிவு Dr. G. R. Handy Memorial Cardiology Unit என அழைக்கப்படுகிறது.
2008 ஆம் ஆண்டு Dr. லக்ஷ்மண் அவர்கள் பொறுப்பேற்ற நாளில் இருந்து படிப்படியாக இதனுடைய சேவைகள் விரிவுபடுத்தப்பட்டன. சுகாதார அமைச்சின் நிதி ஒதுக்கீட்டில் சில அபிவிருத்தி வேலைகள் இப்பிரிவில் செய்யப்பட்டாலும் உதவி நிறுவனங்களின் பங்களிப்பு கணிசமான அளவில் உதவியது.
பிரான்ஸ் நாட்டு தூதரக , IMHO – USA, AMAF – Australia உதவிகள் குறிப்பிடத்தக்கன.
இதய சிகிச்சை பிரிவின் சேவைகள் விரிவடைந்து வருகின்ற அதே நிலையில் இப்பகுதியில் உள்ளவர்களில் இருதய நோய்களும் அதற்கு அதிகமான வகையில் பெருகிய வண்ணமே இருக்கின்றன. இதற்கு இப்போது காணப்படுகின்ற சுகாதாரமற்ற வாழ்க்கை முறை முக்கிய காரணமாக இருக்கின்றது.
இதனால் இதய சிகிச்சை பிரிவு மற்றும் இதய சத்திர சிகிச்சை பிரிவு பல்கிப் பெருகி வரும் நோயாளிகளுக்கு சிகிச்சை அளிப்பதில் சிக்கலை எதிர்கொண்டுள்ளது. ஆயிரக்கணக்கானவர்கள் இருதய சத்திர சிகிச்சைக்காக (Open Heart Surgery) காத்திருக்கின்றார்கள்.
இதற்கு தீர்வாக மேலும் இதனுடைய சேவைகளை விரிவுபடுத்தப்பட வேண்டிய தேவை இருக்கின்றது. புதிய கட்டிட தொகுதியாக அமைப்பதற்கான முயற்சிகள் மேற்கொள்ளப்படுகின்றது. ஆளணி அதிகரிக்கப்பட வேண்டும். அதற்கான ஆயத்தங்கள் நடைபெறுகின்றன. எதிர்காலத்தில் இருதய சிகிச்சை மற்றும் இருதய சத்திர சிகிச்சைக்கான கட்டிடத் தொகுதியும் உபகரணங்களும் வைத்தியசாலையில் நிறுவப்படும்.
இலங்கையில் நிலவும் பொருளாதார நெருக்கடியால் சுகாதார சேவையின் விரிவாக்கம் மிகவும் கட்டுப்படுத்தப்பட்டுள்ளது. அதிகரித்த நோயாளிகளின் அனைத்து மருத்துவ தேவைகளையும் பூர்த்தி செய்யும் வகையில் ஆட்பணியினர், மருந்துகள், உபகரணங்கள் மற்றும் கட்டிட வசதிகள் இல்லாத நிலை காணப்படுவதை நாம் தெரிந்து கொள்ள வேண்டும்.
இருதய சிகிச்சைகளை சிறப்பான முறையில் வழங்கினாலும் இவ்வாறான நோய் ஒன்றை ஏற்படுத்திக் கொள்ளாமல் நமது இளைஞர்கள் கவனமாக இருக்க வேண்டும். அதாவது சுகாதார வழிமுறைகளை கடைப்பிடிப்பதன் மூலம் இருதய நோயாளியாக எதிர்காலத்தில் வருவதை தடுத்துக் கொள்ள முடியும். தடுக்க வேண்டிய பல இருதய நோய்களை பெற்றுக் கொண்டு இங்கே வருகை தரும் போது வைத்தியசாலையினால் எல்லாவற்றையும் சீர் செய்ய முடியாது.
“Prevention is better than cure”.

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