CHF: ngezigaba. Izimpawu inhliziyo ezingamahlalakhona ukwelashwa ukwehluleka

Okungalapheki inhliziyo ukwehluleka, izimpawu okuzokwenziwa echazwe lapha, kuyinto zokugula, izimpawu okuyizinto ezihlobene ukuphazamiseka kwegazi. State kushiwo ukuphumula futhi ngesikhathi ukucindezeleka futhi kuhambisana ukubambezeleka uketshezi emzimbeni. Ukwelashwa kwesifo senhliziyo ngo kakhulu kwezokwelapha futhi icubungulisise kwenziwa. ukufinyelela esifike udokotela ikhuthaza ukululama ngokushesha ngaphezulu ukugeleza kwegazi futhi uqede lesi sifo. Ngokulandelayo, sicabanga imininingwane kuyini CHF. Ukwahlukaniswa kwamadamu isifo, izimpawu kanye ezelaphayo nayo izofakwa echazwe esihlokweni.

Uhlolojikelele

CHF, okuyinto ngempela ngezigaba olubanzi kusekelwe zokunciphisa umzimba ikhono ukumpompa igazi bethulula noma ukugcwaliswa. Lesi simo sibangelwa, okokuqala kunakho konke, imisipha lesion. Okunye futhi okubaluleke ngokufanayo ukungalingani izinhlelo ezithinta umsebenzi zenhliziyo.

emitholampilo isithombe

Esiboniswe ezingamahlalakhona yinhliziyo? Izimpawu ze-zifo ezilandelayo:

• Ukuphelelwa ngumoya - ukuphefumula engajulile futhi fast.
• Ukukhathala - ukunciphisa ukuthwala umsebenzi ezivamile.
• edema neuropathy. Ayevame ivele imilenze, izinyawo, ngokuhamba kwesikhathi, ahlule, asinikeze senyonga ngaphambili odongeni peritoneum, okhalweni nokunye.
• cardiopalmus
• Khwehlela. Ngezinye izigaba sokuqala sesomile, bese uqala ukuba ahlukane isikhwehlela kwaphela. Ngemva kwalokho, kungase Kutsho a ukusebenza igazi.
• Isikhundla orthopnea. Isiguli kudingeka ukuba alale ikhanda lakho aphakeme (ezihlalweni, isibonelo). Ngaphakathi a khundla flat ovundlile eqala ukukhula esifushane umoya nokukhwehlela.

ifomu sokugembula

Naphezu ukubamba ezelaphayo, isimo lesiguli kungenzeka zimbi nakakhulu. Kulokhu, isidingo ukuxilongwa kahle inhliziyo futhi sokujikeleza kwegazi. ucwaningo Deep kuyokwembula trigger ezifihliwe. CHF isehlane izinyathelo ezilandelayo:

• Eyokuqala (kokuqala). Kulesi sigaba, akukho iziyaluyalu CHF kwegazi. Lapho echocardiography wembula ukungasebenzi afihlekile ventricle engakwesobunxele.
• Isizathu sesibili (lingaze). State libhekene hemodynamics kahle (igazi ukunyakaza) eyodwa yalezi ziyingi.
• Eyesibili B (esibi kakhulu). Lesi sigaba libhekene ukuntengantenga hemodynamic kuzo zombili imibuthano. Futhi kwazeke ukunqotshwa umzimba izakhiwo kanye neziteshi igazi.
• Eyesibili (lokugcina). State kuhambisana hemodynamics kahle libizwa. izinguquko Heavy ngokuvamile engelapheki kule nokwakheka zazaziwa izitho futhi ayisibonelo salokhu uhlobo yokumelwa yinhliziyo.

zokugula ngezigaba ingaphinda olwenziwa ngokuhambisana uhlobo sokusebenza. Bobane.

izinhlobo obusebenzayo

Njengoba division langaphambilini, izinguquko kungenzeka bebheke ngcono futhi uwohloke ngisho ngokumelene ngemuva kokungenelela okuqhubekayo ezakhelwe ezingamahlalakhona inhliziyo ukwehluleka itholiwe. Ukwahlukanisa ngokuvumelana umsebenzi izinhlobo kanje:

• Ukuze uhlobo lokuqala libhekene ukungabi khona komkhawulo lokuzivivinya. umsebenzi wokufika ngokomzimba emzimbeni isiguli kungaba ukubekezelela ngaphandle kokukubonisa izimpawu zezifo. isimo yokutakula Slow noma dyspnea kungenzeka uma i overvoltage.
• Ukuze uhlobo lwesibili libhekene ukuvinjelwa ngezinga elincane. Pathology akusho ukuzibonakalisa uphumule. I evamile, wesiko umzimba umsebenzi ikubekezelele iziguli ezine iphika, ukukhathala, noma ophilisayo isigqi. Kulesi sigaba, kakhulu Kunconywa ukuhlola inhliziyo.
• Ngo uhlobo lwesithathu kukhona ebalulekile umsebenzi komkhawulo. Kabi isiguli uphumule azikho. Ngaphansi okukhulu kuka ukuzikhandla evamile ngokomzimba kuhambisana ukubonakaliswa izimpawu zokugula.
• Lapho Uhlobo lwesine yimuphi umsebenzi isiguli kuhambisana emizweni ezingezinhle. Izimpawu zokugula ebonwe isiguli lapho esephumule, yokukhulisa izwi ngomzamo omncane ngokomzimba.

ukuminyana zone

Kuye kwasendaweni oyithandayo kuphazamiseka, isiguli kungenzeka akhonjwe:

• Kwesokudla ukwehluleka ventricular. Kulokhu, lo yokujama tsi nasemkhakheni yamaphaphu - yamaphaphu iziteshi igazi.
• Kwesobunxele ukwehluleka ventricular. Kulokhu, owenziwe waba owasendaweni ukuminyana kumbuthano ezinkulu - eziteshini egazini labo bonke izitho ngaphandle kwamaphaphu.
• Dvuhzheludochkovaya (biventricular) ukwehluleka. yokujama tsi kwegazi kuleli cala ebonwe imizuliswano emibili ngesikhathi esisodwa.

isigaba

Ukwelashwa kwesifo senhliziyo ikhethwa ngokuhambisana isithombe emtholampilo. I ukubonakaliswa kuxhomeke kwasendaweni pathologies iziyaluyalu futhi ayeke ukunisa izici. Okubaluleke ngendlela efanayo lapho ukhetha yokwelapha inomlando sifo. CHF lingaphathelaniswa ne-diastolic kahle noma / kanye systole. Ngakho, ukukhomba pathologies eziningana izigaba. Ikakhulukazi, kukhona:

• Systole yokumelwa yinhliziyo. It lihlotshaniswa systole disorder - nesikhathi ventricular ukusikwa.
• ukuhluleka diastolic. Lesi sigaba kubangele ukuhlukumeza ka diastole - ventricular ukuphumula nesikhathi.
• ifomu ezixutshiwe. Kulokhu, kukhona ukwephulwa diastole futhi systole.

izizathu

Lapho ukhetha indlela ezakhelwe ekuqedeni CHF degree isigaba nomumo ibalulekile. Nokho, okubalulekile ukuhlonza izimbangela zokugula. Okungalapheki senhliziyo kungadalwa:

• isilethikusebenza. Kulesi simo kukhona ukubhujiswa imisipha yenhliziyo, lihlotshaniswa ukumisa igazi ligeleze ke.
• CHD ngokungabi bikho isilethikusebenza.
• Kwegazi - eziphikelelayo ukwanda ingcindezi.
• Imithi. Ikakhulu, i-pathology ingaqala ngenxa ukusetshenziswa anticancer izidakamizwa imithi yesilinganiso yokutakula.
• Zenhliziyo - senhliziyo esilimele ukulimala ngokungabi bikho kwezinso kwemithambo yegazi emzimbeni siqu umphini walo izilonda, kanye nomfutho wegazi ophezulu.
• Isifo sikashukela.
• Thyroid izilonda.
• Ukungasebenzi kahle umsebenzi adrenal.
• Ukukhuluphala.
• Cachexia.
• Ukuswelakala kokusebenza ngokuhlanganyela eziningi izakhi trace kanye amavithamini.
• Amyloidosis.
• Sarcoidosis.
• Ukutheleleka nge-HIV.
• Isikhumulo esingamahlalakhona kwezinso.
• fibrillation atrial.
• Inhliziyo block.
• pericarditis esomile exudative.
• Azalwa naso futhi wathola inhliziyo yayo yayinezinkinga ezicini.

Ukukhomba zokugula

Sifo "CHF" ibekwe ngesisekelo ekuhlaziyweni izikhalazo kanye anamnesis. Lapho exoxa ne-udokotela kufanele batshele nesineke lapho kukhona izimpawu zokugula futhi yini uxhuma zigule. Kubonakala ezinye izifo Umuntu nomkhaya wakhe. Uchwepheshe kumele ukwazi yonke imithi ezithathwe isiguli. On behlolwa, ahlolwe umbala kwesikhumba, khona-edema. Lapho ukulalela inhliziyo uzimisele ngabe umsindo samanje. Futhi lwembula ukuba khona ukuminyana emaphashini. Njengoba izifundo adingekayo umchamo ababelwe ukuhlolwa igazi. Ucwaningo kungathola comorbidities ezingaba nomthelela inkambo CHF. Ukwelashwa kulokhu eziyinkimbinkimbi, okuhloswe ngalo ukuqeda izifo ngemuva. Esimisiwe njengoba igazi kwamakhemikhali. Ngokusho imiphumela kunqunywa lokuhlushwa cholesterol bese kukhishwa nezingxenyana yayo, urea, creatinine, ushukela, i-potassium. Uhlaziyo ku-hormone. Lo chwepheshe angabeka ocwaningweni immunological. Phakathi kwalo kunqunywa ezingeni omzimba izicubu zenhliziyo nezinto ezincane eziphilayo.

Izifundo usebenzisa umshini

ECG ivumela ukuhlola isigqi sokushaya kwenhliziyo, ukukhomba arrhythmias, usayizi umzimba neminyango, kanye ukuhlonza nezibazi ventricular. Ukuze sihlaziye umsindo isetshenziswa phonocardiogram. Ngosizo a Iwumbono valve kunqunywa khona umsindo systolic noma diastolic. Ukuze ukuhlola izakhiwo kwamaphaphu futhi inhliziyo lisetshenziswa esimweni yasethafeni sternum. Lolu cwaningo futhi ukunquma usayizi ivolumu isitho, uzotshala igazi ukucacisa khona yokujama tsi. Echocardiography isetshenziswa ukuphenya zonke izindawo inhliziyo. Ngesikhathi inqubo ebizwa ngokuthi izigaba odongeni ukujiya kanye valve. Futhi, usebenzisa echocardiography kungatholakala njengoba kwasho ukwanda ingcindezi izitsha yamaphaphu. Ukuhlaziya ukugeleza kwegazi eyenziwa ngesikhathi dopplerEhoKG. Udokotela wakho angase akunikeze nezinye ucwaningo, ngaphezu nalezo ezichazwe lapho.

ukwelashwa CHF: izincomo

Okokuqala, isiguli inikezwa uhlobo olukhethekile lokudla. Ukudla kungagcini inani usawoti ezintathu amagremu uketshezi 1-1.2 amalitha ngosuku. Imikhiqizo kufanele kube lula ukugaya, ukuba ngempela okunama-kilojoule amaningi, amavithamini amaprotheni ku lemali edingekayo. Njalo isiguli kufanele afeze enesisindo. kwesisindo engaphezu kuka 2 kg izinsuku 1-3 ngokuvamile eyabonisa ukubambezeleka uketshezi emzimbeni futhi decompensated yokumelwa yinhliziyo. Ukwelashwa kungase kuhlanganise nosizo ngokwengqondo. It ihlose ukusheshisa ekululameni kwesiguli. usizo kwenqondo unganikezwa futhi izihlobo lesiguli. Ezigulini hhayi efiselekayo ukunikeza imithwalo ngokuphelele. ezingeni umsebenzi kunqunywa isiguli ngayinye. Oluthandwayo kufanele inikwe imithwalo ashukumisayo.

Uhlelo oluyisisekelo oluthi yokwelapha izidakamizwa

Izidakamizwa ngokwehluleka inhliziyo zihlukaniswe amaqembu: lokuqala, lesibili nasizayo. Isigaba sokuqala sihlanganisa:

• ACE inhibitor. Isiza ukubambezela Ukudlondlobala kwalesi sifo, ukuvikela inhliziyo, izinso, imithambo yegazi, ukulawula umfutho wegazi.
• angiotensin yokwamukela abantu abamelene nani. La mathuluzi Kunconywa hypersensitive ACE inhibitor noma kanye nabo inhlanganisela.
• Beta-blocker ( "Concor" izidakamizwa, "Inderal" kanye nabanye). Lezi izindlela ukunikeza ukulawula ingcindezi futhi ulinganisele entengo nethonya antiarrhythmic. Beta-blocker iphathwa ngokuhlanganyela ACE inhibitor.
• Isisu ( "amiloride" izidakamizwa "Furosemide" kanye nabanye). Lezi izindlela ukusiza ukuqeda emzimbeni uketshezi ngokweqile kanye usawoti.
• glycosides senhliziyo. Lezi izindlela kuthiwa advantageously iqondiswa ngemithamo emincane ukuze arrhythmia atrial.

imali eyengeziwe

• Habib esinqunyiweyo umcimbi imbangela yinhliziyo esivuna CHD.
• Anticoagulants yesenzo engesobala. Amalungiselelo yaleli qembu inikezwa awokuthi thromboembolism futhi fibrillation atrial.

izidakamizwa ezihambisana

Le mikhiqizo kuyabekwa ezimweni ezikhethekile uma eshiwo ukuxakeka. Lezi zihlanganisa:

• Nitrate. Laba basizi ngcono ukugeleza futhi dilates imithambo yegazi. Imithi yaleli qembu amiswa ngenxa angina.
• Calcium abantu abamelene nani. Lezi imithi akhonjiswa e angina abutment, umfutho wegazi ophakeme (reception), ephakeme blood pressure eziteshini yamaphaphu, ukwehluleka liphinyiselwe valve.
• Antiarrhythmics.
• ejenti Antiplatelet. Laba basizi unekhono zilulaza coagulation ezivimbela platelet agglutination. Ukuthaka imithi yaleli qembu ziboniswe yesibili zokuvimbela infarction.
• Neglikozidnye evuselela inotropic. Lezi zimali asetshenziswe ukwehla okuphawulekayo wegazi futhi amandla inhliziyo.

izindlela kuhlinzwa

In the ukungabikho izidakamizwa ukuchayeka isicelo kahle op ukuphazamiseka lokukhanda. Ikakhulukazi, isiguli ingasatshenziswa:

• Yenhliziyo Umthambo dlula ngokuxhunyelelwa. Ukusebenza asenza lapho uzwakalise izilonda atherosclerotic semithambo.
• ukulungiswa Steel of valve zamehlo. I ukuphazamiseka Kwenziwa esimweni stenosis okukhulu (ukuvaleka) noma ukwehluleka valve.
• Isitho ukufakelwa. Ukufakelwa enhliziyweni kuyingozi isilinganiso ngempela ezinqala. nokuqaliswa kwalo kuhilela izinto eziningi nezinkinga:
  
  - kwenqatshwa kungenzeka;
  - anenombolo enganele donor izitho;
  - iziteshi igazi kokunqotshwa isitho utshalwe kabusha, kancane kunzima ukuyelapha.

• Ukusetshenziswa kumadivayisi yokufakelwa ukuthi abahlinzeka ukwesekwa kwegazi. Betfula ngqo isiguli. Ngemva ebusweni isikhumba ukuthi yizinto ezihlobene ibhethri esisogwini ibhande lesiguli. Nokho, ama-apharathasi isicelo futhi ephelezelwa izinkinga. Ikakhulu, i-okungenzeka yezinkinga ezithathelwanayo, thromboembolism futhi thrombosis. Ivimba ukusetshenziswa eningiliziwe izimoto futhi izindleko zazo eziphakeme.
• Ukusebenzisa uhlaka web nokunwebeka. Bona lisibekele inhliziyo zenhliziyo osuke usuvulekile. Lesi isilinganiso kwenza kube nokwenzeka ukubambezela yonke ukwanda ngobukhulu umzimba, ngcono izidakamizwa ukuchayeka, ukuthuthukisa isimo lesiguli.