Asystole kwomwoyo - chii? Zviratidzo, zvinokonzera, nechimbichimbi kutarisirwa, kurapwa

The pakarepo kumira mwoyo tsandanyama, achiperekedzwa kushaya bioelectrical basa mushonga unonzi "cardiac asystole." Chii? Ndezvipi zvinokonzera akati mamiriro? How kupa zvashata rubatsiro kune vanhu vari chiitiko munhu cardiac kusungwa? Mhinduro dzemibvunzo zvose izvi unogona kuwana papera munyaya.

Marudzi panowanikwa cardiac asystole

Asystole mwoyo, zvikonzero zvatiri kufunga, rakakamurwa nguva imwe uye kunoitika pamusana kumbova cardiac arrhythmia.

Muchiitiko chokutanga, tikafunga zvakanaka uye asiri kukanganisa mwoyo mutinhimira iri pakarepo anorasikirwa elektrovozubdimost chinoratidza dunhu pfupi. Chikonzero ichi kazhinji ndiyo rikwanise chirwere ischemic mwoyo, pakuonekwa iyo, sezvinei, chinokonzera kufutisa, kusvuta, chirwere cheshuga uye BP.

Kana yechipiri, pamwe refu inoyerera ezvinhu fibrillation (ichiparara uye uncoordinated rutapudzo pakati fibers zvomwoyo tsandanyama) kuitika nokukurumidza achiparadzira kwemashifiti nemagetsi nomunhu kuti kukanganisa kufamba kweropa kuburikidza coronary midziyo uye, pakupedzisira, mukana nokunyima mwoyo kuti chibvumirano, zvichiita kuti kurega.

Zvikonzero kuti pave nekukurukurirana cardiac nokusungwa

About 5% chakakomba cardiac abnormalities kutungamirira chokwadi kuti murwere hwapedyo cardiac asystole. Zvikonzero ichi upenyu pamutanhiko kakawanda midzi chidzoke iri rikwanise chimiro myocardial infarction kana pulmonary embolism.

Asystole uye anogona kumutsa ovhadhozi pamusoro cardiac glycosides, zvinodhaka antiarrhythmic kana yokutindivadza kukanganisa kushanda akati tsandanyama. Nokuti mwoyo kutadza kunogonawo kukonzera magetsi tsaona, intracardiac kumonyanisa kana mukuru zvakakomba metabolic zvirwere.

Kunyanya ventricular asystole

Zvinokosha kutaura kuti kwakanga asystole ventricular (zvizere kurega abbreviations dzavo), kusafanana inowirirana upenyu atrial asystole, inotungamirira rufu murwere.

zvokurwara ichi haina chokuita arrhythmia, izvo makatsamwisa rakawedzera ectopic excitability. Zvikonzero parinowanika vari conduction vachivavhiringidza pamwe yakafanana chinovhiringidza pamusoro mano ventricles kuti kubata rhythmically.

Kakawanda ainzi ezvinhu anogona kuva pamusana atrial kana ventricular fibrillation uye anouya shure kwavo, uye mune zvimwe zviitiko izvozvo chinokurwadzai electromechanical dissociation, kana ventricular tachycardia.

Kuratidzwa cardiac asystole muvana

cardiac asystole muvana kakawanda kushatiriswa kukuvara, chepfu uye nekuve kufema zvirwere (semuenzaniso, kufema mhingaidzo, utsi inhalation, unonyura kana chirwere).

Sezvineiwo, zviri kucherechedzwa kuti 15-20% wevarwere muduku cardiac nokusungwa asati fibrillation kana ventricular tachycardia. Asi vakawanda chiratidzo chokuti mwana wako ari kutyisidzira kukura asystole, ndechokuti payo bradyarrhythmias (chinokosha deceleration mumwoyo zvazvingava).

Kana vana kana kuyaruka vane mwoyo chirwere vachiberekwa kwazvo pamberi asystole vakambochipinda zvinogoneka kuchengeta panowanikwa kakawanda kudzika kufema, hypotension uye vasingadzoreki kuziva. Mune mamwe mamiriro ezvinhu, cardiac kusungwa kunotangira kuparara pamwe pfupi (masekonzi asingasviki shanu) pfari.

Sei asystole mwoyo pamusoro unonzi, electrocardiograph

Asystole mwoyo pamusoro unonzi, electrocardiograph kunoratidzwa anenge yakarurama mutsetse vaimiririra ayo magetsi basa.

Mamirire zviri ichi vanogona kunzi vanokara mutinhimira pamusoro atria, nekusagona kuverenga kakawanda sunga, pane imwe nguva apo pasina ventricular sunga. Mune zvimwe zviitiko, kana atrium ichiri imwe nguva mberi mitaro pashure cardiac ventricles ari ECG anogona kuziva atrial P chinozunguzirwa

Ebetsero chingaita nechirwere ose asystole uye anogona kuita asati mamiriro iyi arrhythmia. Saka, kana chinoratidza pacharo muchimiro mangwanani polytopic ventricular vakurumidze anorova ventricular tachycardia, ipapo kuzovatevera kudzima uye flutter, uye kuwedzera blockade kazhinji rinoratidza kuswedera pedyo asystole.

Asystole mwoyo: zviratidzo

Signs kubatsira kuona kuti murwere ane cardiac kusungwa, pamwe zvose vanoziva, asi tichiri kusazvidzokorora.

• In mikuru arteries hapana kufamba kweropa. Kuti asimbise ichi, unofanira akapeta indekisi uye minwe pakati kuedza kwayo kuvapo muna carotid tsinga (Vanotsvangadzira kwake mugomba pedyo thyroid shwashwa pamusoro dokeriro (chaAdhamu apple)). Kana pasina kupomba, ipapo asystole mumwoyo womunhu.
• Emergency kubatsirwa, uye kana vadzidzi havana kupindura rinotungamirirwa meso furashiraiti. Kazhinji, dzinofanira kujekesa, uye kana izvi zvikasaitika, zvinoreva kuti myocardium haasi kushanda.
• Kumisa mwoyo inotiwo kushaya mweya kunoitika mukati 2 maminitsi. pashure kunyangarika kurova kwemwoyo. Izvi zvinogona zvinosimbiswa nokuiunzira akatambudzwa miromo yake girazi.
• No zvishoma ounyanzvi ndiye ruvara rweganda ganda. Kana zvava grayish kana rinokwanisa kucheneruka tint (kunyanya miromo, muromo mumhuno nzeve dzavakadzi ndidzo dzaingoboorwa) - iri chiratidzo chakakomba kweropa zvirwere.
• Uye pakupedzisira, kana chavanoziva murwere havagoni kuunza upenyu kupfuura 10-20 masekonzi kushandisa amoniya, pats pamatama kana ruzha ruzha, izvi zvinogona kuva chiratidzo asystole.

All zvezviratidzo izvi ngozi upenyu hwevanhu, saka ivo zvinoda kukurumidzirwa resuscitative matanho, izvo zvinofanira akapa vasati vasvika amburenzi zvikwata. Yeuka kuti kuponesa upenyu iwe kutamba vaifanira kwemaminitsi 10 (nguva kudaro pashure mwoyo rinomira achiri mupenyu uropi hwomunhu).

chimbichimbi nemitemo cardiac nokusungwa

Saka, kana iwe wakawana mwoyo womunhu asystole, murefu hanya, asi nokukurumidza rubatsiro wokutanga sezvinotevera:

1. Dana amburenzi.
2. Free ane napkin mhino uye muromo wacho arutse, nebhitumini kana miviri dzavatorwa.
3. Isa munhu kumusana kwake, asi kuitira kuti musoro wake zvishoma chikakandwa shure.
4. Ipai ake netsoka zvishoma yakakwirira aine akapeta nguo kana nezvifukidzo.
5. Air ikaridzwa mumapapu rechipfuwo kana muromo-kuti-muromo (inogona kukanda hangachepfu) kana muromo-to-mhino. Kuita chimwe jekiseni, vanoita cardiac masaja.
6. Kuti aite izvi, isa muchanza kurukutika ruoko kuitira kuti kwayo pamusoro mujinga rezasi pamuuyo sternum rechipfuwo. Pamusoro paro kuisa mumwe perpendicular kune muchindwe uye rose kurema muviri, pane ruoko kuti urefu, unopinza masangano kuita mutinhimira chakamira pakunodengenyeka zvine (5 kudzvinya). The penguva pakati pavo hakuna kupfuura wechipiri. Tapedza kusundira maoko kubva mubhokisi Bvisa, kwete kupindira neropa kuti takasununguka ichiyerera mumwoyo. Mumwe miniti unofanira kubereka zvinenge 100 zvakaramba.

A mamwe mazano mashomanana akatipa nechimbichimbi rubatsiro

Zviri nani kana pamusoro nokumutswa kuita vanhu vaviri chete - munhu akaridza mhepo, uye mumwe anoita kudzvinya pachipfuva.

Zvakakosha kuyeuka kuti kana murwere anogona kuponeswa, asi zvichaita vanopedza maminitsi anopfuura gumi yakapiwa, zvinogona kuva zvakakura chetsinga zvirwere. Saka kuunganidzwa uye, Chikurukuru, runyararo rwepfungwa, nzira bedzi mwoyo asystole (chii uri ikozvino, Chokwadi, munoziva) achakundwa.

Ose 2 maminitsi, tarisa murwere ezvinhu - ake kufema, kupomba uye pupillary maitiro achangopera yokufema anouya, nechimbichimbi hanya anogona kumiswa. Kana paiva kupomba, asi kufema achiri ikoko, rambai chakagadzirwa kufefetedza.

Kunyange kana usingakwanisi kudzokera upenyu akuvara, hatimiri kumupa nechimbichimbi kutarisirwa. Rinogona kumiswa chete kana amburenzi vanachiremba vanosvika. Ivo kushandisa nzira dzavo kuramba upenyu murwere.

Possible yematambudziko pashure cardiac nokusungwa

Sezvataurwa pamusoro apa, vanunuri vakasvimha nguva yokubatsira munhu akawanikwa asystole mwoyo. Chinongova 10 min. Uye, zvinosuruvarisa, kunyange nyaya yakanaka mugumisiro wacho aratidze migumisiro cardiac kusungwa, somuenzaniso:

• ischemic uropi, chiropa kana chirwere cheitsvo nokuda ropa wedzerai insufficiency zvomukati panguva zvekuchipatara rufu;
• akaputsika mbabvu somugumisiro zvakaoma kumanikidzwa panguva cardiac masaja;
• mhepo kupinda mhango pakati machira ane pleura kufukidza mumapapu uye chipfuva (mu mushonga zvokurwara yakadaro inonzi pneumothorax).

Asi munoziva akaponesa upenyu uchiri yembabvu zvikuru yakaputsika, uye naizvozvo, usazeza kupa nechimbichimbi kubatsira vanoshayiwa.

Zviri zvashata vatarisire mwana

Zvinosuruvarisa kuti vana makore okutanga oupenyu zvinorondedzerwa munyaya nokumutswa nonyanya akakodzera uye, naizvozvo, vabereki vanofanira kuva aiziva zvokuita zviitiko apo mwana wavo kuva cardiac asystole (nayo ichi chiito kuti siyanei mamiriro kushandiswawo vakuru, imi muri Chokwadi, imi munoziva).

Uye chikuru ndechokuti kuti tidzikame uye wakurumidza kwazvo, sezvo ainzi pamusoro panguva mwana ipfupi kuti maminitsi 5. Chokutanga, dana amburenzi.

• Zvino unofanira kuisa mwana patafura, ubvise kana unswathe uye kusunungura kubva mumuromo madzihwa uye dzimwe nyaya.
• The Mapedhi of indekisi uye pakati nomunwe kuisa pasi pechipfuva. Kusundira navo pachipfuva kuzviita, asi zvinyoronyoro, pa 120 jolts muna 1 min.
• Munguva kuvaparadzanisa sternum anofanira zvava pedyo thumbs udzamu.
• Pashure ose 15 kudzvinya kuti 2 anoridza muromo nejira uye mwana mhino.

Asystole mwoyo; mishonga iri yevanenge

Specialised nokumutswa kubva cardiac asungwa ari muchipatara kuitwa kuburikidza tracheal intubation (izvozvo akaisa anonzwisisa epurasitiki chubhu kuburikidza iyo akatakura zvokuimba kufefetedza pamusoro mapapu) uye bolus (vane nokukurumidza, kusiyana inodonha) kuva tsinga zvinodhaka "Adrenaline hydrochloride" uye " atropine ".

Kana kuona inefficiency pamusoro kwakajairika mishonga ainzi nevasori chinotarisirwa ose 5 min. jeti. Zvadaro, dose iri kuwedzera zvishoma nezvishoma kusvika 5 MG uye chinotarisirwa 3 maminitsi ose kare.

Mumamiriro ezvinhu umo kuwana mutsinga hapana zvinodhaka raitongwa kupinda trachea, uye avo chipimo chemushonga iyi nyaya iri kaviri ichiwedzerwa. Jekiseni mumwoyo akaita chete kana kukundikana dzimwe nzira zvinodhaka pakusununguka.

Unogona kudzivisa asystole

Tiri kutaura munyaya sei nengozi asystole kwomwoyo, icho chirwere kuti inogona nyore nyore kuti munhu rufu. Asi zvinoita kuti kudzivisa migumisiro yakadaro? Uye sei kuzvidzivisa?

Mune zvimwe zviitiko, kuti zvachose zvechokwadi. Munhu chete kuchengeta zvimwe mitemo chokudzivirira. Saka, pasinei nechirwere, varwere mwoyo chirwere vanofanira zvakarurama kutevedzera mirayiridzo chiremba wako - regai mukaputsa chipimo chemushonga kwezvinodhaka uye timeliness kuti chikumbiro chavo, kuongorora pamwero kurovedza muviri uye kudzivisa kushandiswa zvimwe zvinodhaka izvi mazvikokota.

Kana zvakakodzera, varwere izvi uye zvokurapa mudziyo tanzi somunhu cardioverter-defibrillator kana pacemaker kuramba yakakwana kwemwoyo. A yakafanana murwere anofanira kupiwa ezvinhu uye kuziva sei kuita imwe nyaya.

All zvinhu zvinodikanwa chikuru kudzivirira zvinokurukurwa zvizere pamwe cardiologist uye vanofanira kuita.