Kugwiritsira ntchito mankhwala opatsirana pogonana ndi kuphwanya chikhalidwe cha mtima, zomwe zimabweretsa mavuto aakulu. Pamene vutoli likuyendayenda pamayendedwe a sinus kapena mitsempha ya m'mimba, myocarimu imathamanga kwambiri, mofulumira. Kuthamanga kwa mtima kufika 300-600 U / min. Dzina lina la matendawa ndi odwala matenda a atrial. Ikhoza kukula monga chizindikiro cha ischemia, angina pectoris, matenda a mtima ndi matenda ena.
Mafomu a fibrification ya atrial
Matendawa akhoza kuyenda m'njira zosiyanasiyana. Mu lingaliro lonse, malingana ndi mtundu wa matenda, fibrillation ndi flutter ya achule amasiyana. Pachiyambi choyamba, magulu amtundu umodzi wa mgwirizano wa minofu ya mtima, umoyo umakhala pamtunda wa 500 pa mphindi. Ngati matenda a atrial akuwoneka, kuchepetsa kugwirizana kwawo sikungatheke. Thupi la atrial limakhala lolondola ndi flutter, koma mgwirizano wa atria mofulumira: mpaka 200-400 U / min, pafupifupi popanda kusokonezeka kwa kayendetsedwe kake. Pause ya diastolic ndi yaifupi kwambiri. Mpweyawu umagwira ntchito.
Maphunziro ndi nthawi ya arrhythmia ndi mfundo yomwe matendawa amagawidwa. Perekani mitundu yosiyanasiyana ya matenda monga:
- nthawi zonse;
- pitiriza;
- paroxysmal arrhythmia .
Zomwe zimagwiritsidwa ntchito pafupipafupi
Kusakhala kobwezeretsa kwa nyimbo ya sinus kumadziwika ndi mawonekedwe a nthawi zonse. Kuukira kumatenga zaka, kupezeka kwa mawonekedwewa kumanenedwa pamene nthawiyo imatenga masabata 2-3 kapena kuposa. Njira zothandizira kuchipatala zomwe zimagwiritsidwa ntchito poyimba nyimbo sizichitika kapena sizichitika kawirikawiri. Zikuwoneka kuti n'zotheka kusunga arrhythmia. Zotsatira zabwino kwambiri, zomwe zingapezeke mothandizidwa ndi mankhwala, ndi kuchepa kwa mtima kwa 60-75 U / min. Odwala amakhala ndi matenda awo kwa zaka zambiri ndipo amamva bwino.
Kulimbana ndi matenda operewera kunthaka
Pamene zizindikiro za matenda zimapitirira kwa masiku opitirira 7, zimayankhula za kutsekemera kwapachirepa (AF). Njira yake ikhoza kubwereranso, pali zochitika mobwerezabwereza. Kusokonezeka kwapang'onopang'ono kwa magazi kumachitika mwadzidzidzi, kuchuluka kwa magazi kulowa m'thupi kumachepa. Matendawa saopseza moyo, kupatula ngati akuyenda ndi matenda ena a mtima. Nthawi zina kupuma kwa mtima kwa nthawi yaitali kwa mtima, komwe kumatenga zaka zoposa chaka, kumasiyana, koma mosiyana ndi kuyesayesa nthawi zonse, kuyesayesa kumayendetsa kayendetsedwe kake ndi kuyendetsa chiyero.
Matenda a paroxysmal acryation
Fomu yovuta kwambiri ya AF, yomwe imawoneka kuti ndi yochizira (popanda kugwiritsa ntchito mankhwala) ya chiyero cha sinus. Izi zimachokera ku kutha kwa zotsatira za chinthu choyambitsa, mwachitsanzo, kuchepa kwa maganizo, zochitika zolimbitsa thupi kapena kuthetsa vuto. Chiwopsezo cha matendawa - chiwonongeko cha mafinydri - chikhoza kubwerezedwa. Chifuwa cha mtima chimakhala cholembedwa tsiku loyamba (24-48 maola), ino ndi nthawi yoyenera kuthetsa.
Kukhumudwa kwa Atrial kwa Mtima - Zimayambitsa
Matenda a atrial amachititsa mtima kugwira ntchito mosavuta. Pambuyo pa kugwidwa kambirimbiri (2-3), kutuluka kwa matenda opatsirana pogonana kumachitika. Mankhwala opatsirana pogwiritsa ntchito matenda a atrial amagwiritsidwa ntchito ndi matenda omwe amachititsa kuti chitukuko chikhazikike, ndipo chikhoza kuchitika kwa anthu a m'badwo uliwonse: mpaka 40 peresenti ya paroxysmal ndi 25% ya kupitiriza. Kuwombera, monga lamulo, matenda a mitsempha ya mitsempha ndi minofu ya mtima:
- kupweteka kwa mtima ;
- mtima ;
- ischemia;
- chowopsa ;
- atherosclerosis;
- zofooka za mtima ;
- zizindikiro za rheumatic.
Zina mwa zifukwa za matenda a atrial fibrillation zimatchedwanso. Izi zimaphatikizapo matenda osokoneza mtima omwe amasokoneza ntchito ya minofu yaikulu, ndi ena otsutsa:
- matenda a m'mapapo;
- matenda a endocrine;
- shuga;
- kunenepa kwambiri;
- kumwa mowa;
- zovuta;
- zochitika zolimba;
- kutenga mankhwala ena;
- kusowa kwa potaziyamu;
- kutaya madzi.
Matenda a atrial - zizindikiro
Malingana ndi mawonekedwe a matendawa, zizindikiro za boma la myocardium ndi thanzi lachilendo, matenda opatsirana pogonana amadziwonetsera m'njira zosiyanasiyana. Chithunzi cha kachipatala chimasiyana ndi kutuluka kwa thupi mpaka kuwonetsetsa kwakukulu kwa matendawa. Zizindikiro sizingatheke, mwachitsanzo, ndi paroxysmal arrhythmia. Koma ngakhale, monga lamulo, mawonetseredwe oyambirira a matendawa amawoneka: ululu kumbali ya kumanzere ya chifuwa ndi mpweya wochepa, womwe suima ndi kupumula. Zikuoneka kuti zizindikiro zonsezi zikusonyeza kuti pali matenda oopsa a mtima, zizindikiro zake ndizofunikira.
Zizindikiro zikuluzikulu zimakhala zovuta kusokoneza ndi zikhalidwe zina, makamaka ngati munthu akukumana nazo kangapo. Zizindikiro zina za kugwidwa:
- mtima;
- thukuta;
- kusowa kwa miyendo;
- phokoso;
- kupweteka kwa mitsempha;
- chisokonezo;
- kukomoka ;
- zofooka mu thupi lonse;
- kukodza mobwerezabwereza;
- mantha, mantha.
Kuwombera kwa matenda a atrial
Zizindikiro za matenda opatsirana pogonana zimatha kudziwika, ndipo wodwalayo amadziwa za matenda ake pokhapokha atafufuza dokotala. Mavutowo ayamba mwadzidzidzi ndi kubwereza moyo wanu wonse. Nthawi ndi mafupipafupi a phokoso la munthu aliyense, zizindikiro zimamveka m'njira zosiyanasiyana. Muzochitika zowoneka, pali zofooka, kunjenjemera, kutsekedwa kwachisokonezo, mantha. Ndi kuwonjezeka kwakukulu kwa mtima wa chiwombankhanga, zowawa, chizunguliro, ndi kutaya mtima kungachitike.
Pewani ndi matenda oopsa a atrial
Imodzi mwa njira zomwe matenda opatsirana pogonana (aakulu kapena ayi) amapezekedwa ndi palpation of pulse. Wodwala ali ndi kusowa kwake: atrium sagwira ntchito, ma ventricles alibe nthawi yokwanila kudzaza magazi oyenera. Chiwerengero cha mtima kumenyedwa muyeso sizolingana ndi chikoka. Ngati pali flutter ya atria, zizindikiro za matenda omwe tatchulidwa pamwambawa ndizophatikizidwa ndi kasinthasintha kawirikawiri.
Kodi chiopsezo cha mafinya oopsa?
Matenda onse a mtima ali ndi mavuto. Pankhani ya matenda opatsirana pogonana, zotsatira zoopsa kwambiri ndi thromboembolism ndi mtima kulephera. Mitral stenosis imayambitsa kuphulika kwa atrioventricular opening thrombus, zomwe zimapangitsa kuti mtima wamangidwa. 15% ya kugwidwa kwa ischemic kumachitika chifukwa cha arrhythmia. Zopseza kuti moyo wonyansa wa m'thupi umabweretsa moyo umaphatikizapo pulmonary edema, mphumu ya mtima, cardiomyopathy (kuchepetsedwa).
Matenda a atrial - mankhwala
Ngati mankhwalawa akupezeka, mankhwalawa amachitika malinga ndi njira zamankhwala zomwe zimapangidwira kupewa kutaya mtima, kuyima kwa mtima, kusunga nyimbo, kuteteza thromboembolism. Matenda a atrial sathana kwathunthu, koma amalamulidwa, ndipo madokotala amayesetsa kuteteza wodwalayo kuti abwererenso, kubwezeretsa chiyero cha mtima. Musanayambe kuchiza matenda oopsa, muyenera kupeza chifukwa cha matendawa ndi kuthetseratu otsutsa, komanso kuchotsa zizindikiro za matendawa.
Matenda a atrial - malingaliro ochipatala
Ngati pali mankhwala opatsirana pogonana, ndiyenera kuchita chiyani? Njira zamachiritso zimatsimikiziridwa ndi matendawa, omwe, malinga ndi zomwe zimachititsa matenda, zimaphatikizapo kukambirana kwa akatswiri monga:
- arremthmologist;
- kachipatala;
- pulmonologist;
- wotchedwa endocrinologist;
- cardiosurgeon.
Amapereka mankhwala ena. Zolinga zachidziwitso za mankhwala: kukonza umoyo wa wodwalayo, kuonjezera nthawi yake ndi matendawa, kuchepetsa chiwerengero cha zipatala. Zizindikiro ziyenera kuthetsedwa kapena kutetezedwa, zizindikiro za mtima ndi zidule zomwe zasungidwa. Ndi AF mungathe kukhala ndi moyo, koma madokotala ayenera kupititsa patsogolo matendawa.
Kukonzekera kwa fodya
Kodi n'zotheka ndi momwe angachiritse matenda oopsa a mtima ndi thandizo la mankhwala? Thandizo lachipatala lodziletsa limagwiritsidwa ntchito bwino (10-15%). Pazifukwa zochepa kwambiri - ciliary paroxysmal arrhythmia - imayimitsidwa ndi novocaineamide, cordarone, quinidine kapena parapanorm. Mankhwala amatengedwa mwakachetechete kapena pamlomo, koma thandizo liyenera kuperekedwa nthawiyo, ndipo msinkhu wachangu umayang'aniridwa nthawi zonse. Chiwembu cha mankhwala ndi mankhwala ena ndi awa:
- Pofuna kuchepetsa mtima komanso kuchepetsa zizindikiro zoipa, kukonzekera gulu la beta limagwiritsidwa ntchito: Carvedilol, Proprorol, Pindolol, Anaprilin, ndi ena.
- Zokondweretsa zamagetsi zimachotsedwa ndi Cordanon, Quinidine, Allapinin.
- Glycosides amaimiritsa ntchito ya myocardium (Digoxin, Korglikon, Celanid).
- Mapangidwe a thrombi amaletsedwa ndi Warfarin ndi Pradax ndi anticoagulants Enoxaparin, Heparin, Fondaparinux.
- Mankhwala omwe amatsitsa magazi - dezagreganty - amaimiridwa ndi mankhwala monga Aspirin Cardio, Cardiomagnolo , TromboAss, ndi zina.
Kuchokera kwa mtima ndi matenda a atrial fibrillation
Ngati mankhwala osokoneza bongo sanapereke zotsatira, kupititsa opaleshoni ndi kotheka. Kuperekera kwa catheter ndi njira yachipatala imene cholinga cha arrhythmia chikuwonongedwa ndi kukhudza thupi. Opaleshoniyi siipweteketsa kwambiri, chifukwa safuna kutsegula pachifuwa - zimangokhala zochepa zomwe zimapangidwa ndipo kathete imalowetsedwa kupita ku kachipatala. Chikoka cha zilondachi chikhoza kuchitika m'njira zingapo: ndi chimfine, mankhwala, laser, magetsi, mphamvu zamagetsi maulendo a ma radio (RFA) ndi mafilimu a atrial.
Pali njira zoterezi zowonongeka monga:
- chithandizo;
- laser;
- mafilimu (cauterization ya nthenda ya atrioventricular ndi electrode);
- chithunzi;
- electrodestruction.
Matenda a Atrial - opaleshoni
Nthaŵi zina, n'zosatheka kuthetsa arrhythmia popanda opaleshoni. Kuthandizira kuima mtima kwa mtima kumathandiza pacemaker - chipangizo chogwirana chomwe chikugwirizana ndi khungu la wodwalayo pafupi ndi collarbone. Pogwiritsa ntchito mitsempha, electrode imagwirizanitsa ndi imalowa mkatikati mwa mtima. Chipangizochi chimapangitsa chidwi cha minofu kuti chigwirizane pafupipafupi, kutulutsa mafinya komanso kutulutsa mafinya.
Njira ina yopaleshoni yomwe amagwiritsidwa ntchito pozindikira kuti matenda a atrial fibrillation ndi opaleshoni ya "labyrinth". Ntchito yake ndi kuthetsa kusagwirizana pakati pa mtima, kukakamiza malo osokoneza bongo kuti agwe mwadongosolo. Chizindikiro cha magetsi chikufalikira njira yowonetsera - yomwe imatchedwa "labyrinth", yomwe imapangidwa ndi mapangidwe a zilonda pamutu wa mtima. Zidutswa zimapangidwa osati kokha ndi scalpel, komanso ndi ablation zomwe zafotokozedwa pamwambapa: RFA (moxibustion) ndi crystestruction (yozizira).
Matenda a atrial - mankhwala ndi mankhwala ochiritsira
Mosasamala kanthu za kuopsa kwa matenda a mtima, kusintha kwake kungatheke mothandizidwa ndi mankhwala enaake - kuphatikizapo mankhwala ozunguza bongo kapena mwachindunji, mwachitsanzo, monga njira zothandizira. Ngati pangakhale tizilombo toyambitsa matenda, mankhwala amtunduwu amagwiritsidwa ntchito mosamala, pansi pa kuyang'aniridwa ndi dokotala. Mankhwalawa ndi othandizira.
Njira zogwira mtima zimachokera pa zabwino za zomera zina. Mu mankhwala a zitsamba, muyenera kumvetsera mankhwala omwe angachepetse kutseka ndi kuteteza zizindikiro za arrhythmia. Wotchuka kwambiri komanso wogwira mtima:
- Hawthorn ndi njira yabwino kwambiri yothetsera vuto la kuchotsa arrhythmias. Chomeracho chimachokera ku valerian kapena motherwort.
- Kulowetsedwa kwa mbewu ya katsabola ndi chida chothandiza chomwe chimachepetsa kuopsa kwa matenda.
- Kutayika kwa zipatso za Kalina kumayendera bwino kuthamanga kwa magazi, kumakhudza kwambiri zotengerazo. Nthawi zina tengani ndi uchi.
- Yarrow (masamba am'madzi) amaledzera kawiri patsiku mu supuni ya tiyi, kuchepetsa chiopsezo cha magazi.
Matenda a Atrial - kufotokoza kwa moyo
Matenda a mtima, omwe ali ovuta ndi arrhythmia, amachulukitsa chiopsezo chakupha ndi maulendo oposa 1.5. Choncho, odwala omwe ali ndi matendawa akufunsidwa ndi funsoli: ndi angati omwe amakhala ndi matenda a atrial fibrillation? Izi zimadalira zifukwa zomwe zimayambitsa matenda, zovuta zomwe zilipo komanso zovuta, vuto la myocarimu ndi zinyama. Chowopsya kwambiri cha arrhythmias - zomwe zimayambitsa kukula kwa mtima kusalimba. Zimayambitsidwa ndi kuwonongeka kwa myocardial, mwachitsanzo, matenda a mtima. Matenda ofanana ndi ofanana ndi matenda a mtima, koma maulosiwo ndi enieni.
Zizindikiro zonse zomwe zimasonyeza kusayeruzika mu mtima sayenera kunyalanyazidwa. Ndi AF, minofu imayamba kunjenjemera, ikani mofulumira kwambiri, mosalekeza. Kugonjetsa sikungotsiriza kuposa miniti, koma iyenera kuchenjeza. Kugwiritsira ntchito mankhwala opatsirana pogonana ndi matenda ofala omwe amapezeka 2% mwa anthu onse. Koma matenda aakulu akhoza kupezeka ndi kuchiritsidwa. Mankhwala amakono amapereka njira zothandiza komanso zatsopano polimbana ndi arrhythmia.