Bated umoya: izimbangela kanye nokwelashwa

Sinking wenhliziyo - ekwelapheni lesi sifo eminyakeni yamuva ekujabulisayo izingqondo nodokotela abaningi inhliziyo, kanye nezinye "inhliziyo" ongoti. Siyini isizathu, yini izimpawu zalesi sifo esiyingozi, indlela yokuphatha kulo - lawa kuphela abanye nezindaba nesithakazelo izakhamuzi zethu. Akusiyo imfihlo ukuthi ngempela inqwaba abantu babe kokutshelwa ngokukhubazeka kwengane ngokuthi "inhliziyo ocwilayo". Izimpawu, ekwelapheni amakhambi abantu, koSanta ezikhungweni ezikhethekile, izifo - lezi imiqondo kufanele uhlole ukuze noma ubani izimpawu zesifo. Into eyayithandwa kunazo okulandelayo ezinye omagazini bamuva be-isihloko.

Bated umoya: izimbangela kanye nokwelashwa

Imbangela umuzwa "lantambama" e izinhliziyo umsebenzi kungaba ezihlukahlukene isigqi conduction thuthuva. Ezinye zalezi uthi asidingi kokungenela yezokwelapha, nezinye izinhlobo ukubambezeleka bangabonwa futhi ukwelashwa kungaba yingozi. Hlukanisa supraventricular futhi ventricular arrhythmias.

arrhythmias supraventricular

Kuyinto ngaphambi kwesikhathi umsebenzi kagesi zenhliziyo. Isizathu ungumthombo ukuthi Itholakala Atria kanye emithanjeni yamaphaphu emgodini futhi kwalapho atrioventricular. Ngemva enjalo ukuncishiswa okungavamile ingaqala esinqunyiwe noma ephelele misa isikhashana postextrasystolic. Njalo amabhithi singakafiki isikhathi kokuhlaba ikhefu isikhathi eside ngemva ukunciphisa okungavamile anganikeza luphola umuzwa, ukuphazamiseka inhliziyo.

ukubaluleka Independent basemtholampilo la mafomu babe arrhythmias, ngaphandle kulezo zimo lapho ukubukeka kwabo iyaqala ukusebenzisa tachycardias supraventricular, flutter atrial noma fibrillation atrial.

In the ukungabikho ukukhubazeka ezihlelekile ukwelashwa okukhethekile senhliziyo esilimele extrasystoles supraventricular ayidingekile. Ezimweni lapho ephelezelwa abalulekile ukungakhululeki subjective, beta-blocker, verapamil, sedatives ingasetshenziswa.

Ngokuvamile extrasystoles supraventricular ibonakalisa sifo main (dystonia, ezingamahlalakhona obstructive isifo samaphaphu, electrolyte disorder), khona-ke uphethwe kudinga intuthuko kanye nokwelashwa inqubo ecashile.

Ventricular fibrillation extrasystolic

extrasystoles Ventricular - yokulinda umsebenzi kagesi inhliziyo maqondana isigqi main kwavusa ishayela zingaveli imilenze noma umehluko besigaxa block legatsha, myocardium Orion noma Purkinje ukusebenza. Ngemva kwalezi izinqubo kakhulu maningi amathuba ukuthuthukisa misa isikhashana ngokugcwele compensatory, okuyinto, njengoba kwaba njalo endabeni ka-amabhithi atrial ngaphambi kwesikhathi, wazizwa ngendlela "lantambama". izinqubo Ventricular ngaphandle ukushiyana kwezidalwa organic isifo senhliziyo akuyona ingozi ngoba ukufa okuzumayo, ngakho ingelashwa. Okuhlukile iziguli obuhle syndromes lezinceku (ukunwebeka azalwa naso noma kokunciphisa QT, Brugada syndrome, njll).

Sinking kwenhliziyo, imbangela kanye nezimpawu zazo kubhekwe ukuba kwenzeke ngenxa inhliziyo isigqi ezingavamile.
Esejwayelekile kwenhliziyo kunqunywa ngaphakathi uthuthumele ngomzuzu 60 kuya ku-100. okwehlisa bokuphila inhlitiyo kungase kwenzeke ngesikhathi sokulala, uma udonsa umoya, e abasubathi.

Uma ukwephula ngasiphi isigaba kanye isizukulwane ishayela inhliziyo eba bradycardia sokugembula, okungase lingaze, asymptomatic, futhi iningi abadinga ukwelashwa.

Izimbangela bradycardia

Ukuhlukanisa phakathi izimbangela ngaphakathi nangaphandle bradycardia.
Izizathu yangaphakathi zihlanganisa:

• ukuguga;
• isifo senhliziyo,
• zezinzwa isifo izicubu;
• izifo azalwa naso, kuhlanganise nobuthakathaka engeyokuqala atrioventricular;
• amyloidosis kwemisipha;
• ukuhlukumezeka kuhlinzwa (orthotics valve, inhliziyo ukufakelwa) ;
• izifo ezithathelwanayo (idiphtheria, rheumatism isifo senhliziyo, ushevu egazini, i-typhoid fever).

Ngu izici sangaphandle bradycardia zihlanganisa:

• ukuqeqeshwa ngokomzimba;
• elektrotonus vagal ngensimbi (blackout vasovagal; itheku supersensibly carotid);
• izidakamizwa (i-beta-blocker, blocker-calcium channel, digoxin, lithium, ama-ejenti antiarrhythmic);
• i-cocaine,
• hypokalemia;
• hyperkalemia;
• iziyaluyalu zezinzwa (CNS isimila, waqinisa intracranial);
• Obstructive elele singathatha syndrome.

Ukuze sitholakele ukusetshenziswa bradycardia kokuqhuba zokuqapha Holter, isehlakalo zokubala futhi abalobi, amadivayisi implantable, kanye ufeza cwaningo electrophysiological.

ekwelapheni bradycardia

Isinyathelo sokuqala ukuba uthole ukuthi iyini izimbangela futhi kungenzeka ukuqedwa bradikaridii izenzo zabo (ukuqedwa beta-blocker). Uma kungekho base esikhiphekayo, kungase kudingeke ukwelashwa noma EHAMBAHAMBA okwesikhashana noma unomphela).

imithi

Ukukhuthaza abalulekile kwenhliziyo deceleration (amasekhondi isikhathi eside kunaleso 3) usebenzisa atropine, isoproterenol, aminophylline. Nokho, engayitholi le mithi kungase kubangele arrhythmias, kuhlanganise esisongela ukuphila ventricular thuthuva.
In iziguli ischemia esivimba amanzi futhi bradycardia ngenxa yalokho, zichitha yokwelapha antiischemic futhi elindele isikhathi esifanelekile zabo, besebenzisa EHAMBAHAMBA uma kunesidingo.

Iziguli nokucindezeleka itheku syndrome ikhadi bese vimba atrioventricular izwakalwa ukusetha pacemaker okwesikhashana noma unomphela.
Kube athuthukile izinkomba European ukufakwa elawula ukushaya kwenhliziyo unomphela in iziguli ogulayo itheku syndrome, vimba atrioventricular.

ezihlukahlukene evuselela

Hlukanisa olulodwa-chamber, ezimbili-chamber, ezintathu-chamber stimulators. Have electrode lokuqala nelesibili 1 no-2 (atrial kanye / noma ventricular kwesokudla). amadivaysi Three-chamber asetshenziselwa biventrikulyatnoy kusebenze futhi ube inkombandlela eyengeziwe ngoba i-ventricle engakwesobunxele.

Lapho kwesokudla atrial ukushukuma ventricular synchronism kuyaphazamiseka. I ECG ngesikhathi le nqubo ngemvume ngabodwa kwesokudla besigaxa block legatsha.
Lapho ukushukuma kokubili ventricles walondoloza nokusebenza kwabo zokuvumelanisa, hemodynamics inhliziyo kuleli cala, ngcono kakhulu.

yenzeka

Iyunithi yokuqala enjalo yasungulwa ngo-1958 Ngo okulandelayo ukuziphendukela kwaso. Manje kuba yesimanje, lincane kakhulu, amadivaysi zobuchwepheshe.

Okwamanje, kukhona esimila yonyaka kusukela evuselela ngamunye million labantu 400 ukuze 1,200.

Kardiopribor uqhuba kusebenze kagesi we myocardium. Isignali Ukhuthaza kanye imisipha inhliziyo non-bokuphila. ukuchayeka yakhe yesikhathi eside kungabangela ushintsho kagesi kanye mechanical myocardium. Ukufakwa kudingeke ukuba ezivezwa stimulator izinkomba sina.

Izici ukushukuma izindlela

Phakathi ventricular kwesokudla sivinini ishayela kagesi sisetshenziswa kwesobunxele ventricular isihloko kanye depolarizes myocardium medlennoprovodyaschy. I ECG sivezwe nokuvinjelwa besigaxa kwesokunxele legatsha block. Iziguli ezinjalo anesilinganiso esiphansi ejection ingxenyenamba kuneziguli ngaphandle ukuvinjelwa. Futhi, lapho le nqubo kwenzeka kagesi zilungiswe inhliziyo. Muva nje, kukhona ukuthambekela ukwehlisa izinkomba yedatha ukufakwa evuselela ngokuqondene nabaningi izinguquko ezingezinhle.

It yasungulwa ukuthi aphansi ejection ingxenyenamba esakhiwa ngaphansi isenzo ventricles. Isilinganiso - ukusebenza kwawo Atria ke lonke inhliziyo. The esiphezulu walondoloza ejection ingxenyenamba ngesikhathi ukukhuthazwa Atria futhi ventricles we izindlela zemvelo.

Wafakazela ukuthi ngaphansi athuthukile fibrillation atrial in iziguli kusebenze atrial kanye-chamber ezimbili kuka in iziguli ventricular kuphela ithonya zedivayisi.

Idivayisi ezimbili-chamber, ucwaningo lukhombise kungasebenti kanye nokucwaninga, kungcono in iziguli umzimba.
Elawula ukushaya kwenhliziyo njengamanje indinganiso egolide nokwelashwa kweziguli bradycardia lingaze. Usesho iqhubeka izindlela eziningi bokuphila nemiphumela elihle myocardium.

isiphetho

Ngakho, kucwila wenhliziyo (ngilale noma kwezinye izimo) - isifo esiyingozi kakhulu. Lapho izimpawu zokuqala zalesi sifo kufanele axhumane ngokushesha ne esibhedlela ukuze sifeze wonke ukuhlolwa futhi ziphathwe ngokucophelela. Ngokushesha ukwelashwa kokuqala kanye nokuvimbela ngempumelelo ngaphezulu kuyoba yini engakusiza.