Ventricular arrhythmia: Zviratidzo uye kurapwa

Nhasi, pane akawandisa zvirwere mwoyo. Rakajairika pakati pavo iri kuonekwa ventricular arrhythmia kuti kunoitika somugumisiro vakurumidze excitation pulses izvo kubva ventricular mugadziriro zvinobva. Panyaya iyi, mwoyo mutinhimira akashatirwa, pane zvinoshamisa marwadzo repasi pakati madhipatimendi ayo. Ventricular fibrillation ari kuchengetwa nhasi, 60% vanhu, vakawanda vavo vakwegura. Dzimwe nguva mugari kwemwoyo kunogona kuonekwa mune vechidiki hwakanaka. The panowanikwa chirwere ichi kunokonzerwa zvaanotaura zviratidzo uye sei kurapa nayo - tichataura pamusoro pazvo.

Description of chirwere

The chirwere kukanganisika mwoyo mutinhimira, pakuitisa nomunhu ari cardiac ventricles vari yakaumbwa pazasi pokuti mutundu wake mapazi. yatichakurukura pazasi, anogona kuva rakasiyana-siyana ventricular arrhythmias, kurapwa uye zviratidzo. Vanoita sehurumende kuti kukanganisa chidzoke chakakomba zvirwere zvomwoyo, uyewo pakarepo kumbomira mabasa muviri ichi. Uyewo anogona kuonekwa asymptomatic, nyoro siyana arrhythmia.

Marudzi ventricular arrhythmias

In mushonga inokamukana muzvikwata zvitatu chirwere chakadai: arrythmia, tachycardia uye atrial fibrillation (kudzima). Zvichienderana chirwere kuratidzwa anotevera kurapwa. Uyezve, zviratidzo kuratidza arrhythmia dzinogona siyana. Ngatikurukurei muudzame nyaya iyi.

anorova

Ichi chimiro chirwere ndechimwe inonyanyoshandiswa akanyorwa, riri kukonzerwa vakurumidze marwadzo mwoyo. Ventricular arrhythmia (extrasystole) rinowanikwa muna 70% vanhu vemazera akasiyana, ayo chitarisiko kazhinji kukonzera kushushikana, doro uye chikakananda, kofi. Uyewo chimiro ichi arrhythmia zvingaitika kana myocardial kukuvara nokuda kukura zvirwere zvakasiyana-siyana.

Kune mapoka mashanu arrhythmia, dzinoratidza kuvapo mumwe wavo, unogona kushandisa ECG mukati maawa makumi maviri nemana:

- razero kirasi hunotora hapana extrasystoles;

- kirasi yokutanga kunoratidzwa nechitarisiko mwero kwete kupfuura makumi matatu chete kuti awa rimwe;

- kirasi yechipiri kunoratidzwa nechitarisiko mwero anopfuura makumi matatu chete kuti awa rimwe;

- kirasi yechitatu presupposes kuvapo polymorphic extrasystoles;

- mugwaro rechina presupposes peya polymorphic kana monomorphic reductions;

- kirasi wechishanu kunoratidzwa boka sunga, dzimwe nguva zvichiita yokurwiswa tachycardia.

tachycardia

Ventricular arrhythmias chimiro ichi kunoratidzwa kuwedzera kwemwoyo (anorova 90 paminiti). Tachycardia zvingaitikawo ave zvokurwara, uye somunhu vasiri chakajairika panguva vhunduka, panyama nesimba uye zvichingodaro. Kakawanda iri chiratidzo zvinetso zvakasiyana-siyana pamusoro kwemakemikari anobudiswa, autonomic huta gadziriro. Tachycardia somunhu zvokurwara kungaita mutsekwende. Nokudaro, BP Falls, aibuda ropa kusvikira nhengo DZEMUNHU DZINODZORA ropa romugove kuipa muviri uye mwoyo, kusanganisira inotungamirira kuti njodzi coronary tsinga chirwere kana kurwisa mwoyo. Akarigadzirira makirasi anoverengeka tachycardia:

1. Sinus - pane kutyora kupararira nomunhu kuti ventricles ari sinus raiva pedyo nebundu. Izvi zvingava zvichikonzerwa atadze kushanda zvakanaka pamusoro chikwata, uye kushushikana mupfungwa, kutya, uye zvichingodaro.

2. Paroxysmal - pane kurwisa moyo 300 anorova paminiti, unowanikwa uye haarambi pakarepo. Izvi zvinogona vawadzane rakawedzerwa pamusoro tsitsi tsinga, uyewo kuchinja ari myocardium. Kakawanda richiwanika mukupera nyaya iri kuchengetwa vakawanda nyaya nevanhu. tachycardia Izvi zvinogona kuva ischemia, hypotension uye ventricular fibrillation. Constant yokurwiswa tachycardia vane tigume ropa riparadzirwe muviri, kuwedzera pangozi huno.

fibrillation

Atrial ventricular arrhythmia, kana atrial fibrillation, dzinoratidzwa kwemwoyo kusvika 480 anorova paminiti, iyo ventricles panguva iyoyo ipfupi uncoordinated, pakupedzisira mwoyo rinomira, munhu anofa. Atrial fibrillation chinhu kakawanda mutauri inokonzerwa chomwoyo. Mukurapa, kusiyanisa makirasi akati wandei atrial fibrillation:

1. Primary - anozviratidza mumazuva maviri okutanga pashure kutanga chemwoyo uye chikonzero zvinowanzovapo pakarepo rufu vanhu.
2. Secondary atrial ventricular arrhythmia Inokudziridza somugumisiro cardiogenic kuvhunduka pavarwere kutambura nechirwere chomwoyo.
3. Late fibrillation anozviratidza pamusoro vhiki rechina chirwere.

Fibrillation dzose nyaya inotanga pakarepo. maawa matatu pashure chitarisiko wake anotanga kunzwa nzwa dzungu, utera anooneka. Mushure memaawa makumi maviri, munhu anorasikirwa kuziva, kugwinha, vadzidzi dilate mumaawa makumi mana, kufema zvishoma nezvishoma inova shoma, uye ipapo akamira chose, ipapo navanachiremba vafa anouya.

kupatsanura

Zvichienderana chii zvaigona kugadzirwa pashure paiva ventricular arrhythmia mwoyo (zviratidzo ichakurukurwa munyaya ino), izvozvo akasarudza govera:

1. Functional arrhythmia dzinoratidzwa kusavapo cardiac maronda vari kwazvo. Chero matambudziko pashure anenge asina kuchengetwa.

2. Arrhythmias kuti kune ngozi vanhu uye kutanga kundorwa mwoyo chirwere, mwero wokufa kwevanhu munyika iyi inowedzerwa.

3. akaipa Kugadzirwa cardiac mutinhimira zvirwere, kunoitika apo zvikuru mwoyo chirwere uye kazhinji kunotungamirira kurufu.

zvinokonzera

Pokumuka arrhythmias anogona kuitika nokuda kwezvikonzero zvakasiyana-siyana, dzimwe nguva havazivi. Mukupera nyaya itsika kutaura pamusoro chirwere, chiri idiopathic zvakasikwa. Kakawanda ventricular fibrillation (zviratidzo, kurapwa uye kufembera ichakurukurwa pazasi) rinowanikwa somugumisiro mwoyo zvirwere: ischemia, infarct, Cardiosclerosis, mitral kukuvara vharafu uye myocardial kuzvimba, BP, malignancy ndiko pulmonary zvokurwara. Mune zvimwe zviitiko, VSD, herniation uye vakaderera musana marwadzo zvinogonawo kukonzera kugadzira arrhythmias. Idiopathic arrhythmia wakatsamwisa nezvinenge zvaitika: kusvuta, doro uye kofi, asi kakawanda kushandiswa cardiac mishonga.

Zviratidzo uye zviratidzo

Ventricular fibrillation Zviratidzo zviri pachena vakanyorwa, hazvina. vanhu vakasiyana vangava manzwiro akasiyana kuti regai kuvimba mhaka chirwere. Kakawanda, varwere kuona utera, kupfupika mweya, dzungu. Well kuonekwa nokuratidzwa zviratidzo pamusoro ECG. Chokutanga, pane nokuwedzera kukura uye deformation pamusoro zino, inova chikamu ventricular yakaoma. Vanopfuura matatu akatevedzana sunga mwoyo iri kunooneka Kuvapo arrhythmia. Nokuti arrhythmia hwokuratidza paleness, kufunganya, vakawedzera vangadikitira, kunzwa kupfupika mweya, mugari mwoyo ushande. Kana tachycardia kunoitika dzungu (chavanoziva), marwadzo ari pamwoyo, palpitation, dyspnea, hypotension, chinyamunhari chinorwadza. Atrial fibrillation rinowanzoshandiswa richiratidzwa muchimiro kufenda, muchipfuva marwadzo, pulmonary edema, mwoyo kukanganisika. Zviratidzo zvacho zvine chokuita nokuti ventricles nokukurumidza uye zvisiri zvenguva dzose.

kuongorora chirwere zvirwere

Ventricular fibrillation kunogona yasimbiswa kushandisa ECG zvichiongororwa Vaitakurawo ECG mutoro VEM kana wekusimbisa muviri bvunzo. Kudzidza kunosanganisira kunyoresa mwoyo pulses Via electrodes izvo akatasva paganda muchipfuva kwevanhu uye maoko nemakumbo. Zvinoratidza pazvinhu tarisisa, uye ipapo chakasvitswa kudhinda mudziyo uye akadhindwa panze papepa. Apo VEM zviratidzi vanobviswa panguva yechiitwa, nokuti ichi, kushandisa muviri bhasikoro. Kana wekusimbisa muviri bvunzo aishandisa wekusimbisa muviri. Kana nechirwere zvakafanira kufunga zvinhu itibatsire panowanikwa uye kumira kurwiswa. Izvi zvinosanganisira mupfungwa murwere, kurovedza muviri, kudya zvinodhaka uye zvichingodaro. Zvimwe nzira tsvakurudzo pamusoro kuvapo arrhythmias zvinosanganisira: maekisirei, tomography, Ultrasound mwoyo. Kubva migumisiro nemiedzo izvi kuchaenderana mberi pakurapa chirwere.

Ventricular fibrillation: kurapwa

Pamusoro kuonekwa chirwere haisi muzviitiko zvose zvinoda vavashandire. Kana mushonga kurapwa yakarumbidza kuteerera kurutivi anokonzerwa nemishonga, uyewo nguva nzira dzavo, sezvo vanogona kutarisira kukuvadza utano. Mune dzimwe pathologies iri contraindicated kushandiswa mwoyo zvinodhaka nokuda arrhythmia, sezvo izvi zvinogona kukonzera cardiac kusungwa. Funga nzira uye nzira kurapa arrhythmias wayo-siyana.

arrythmia kurapwa

In kakawanda kacho, maperembudzi chokuita nokusava electrolytes mumuviri womunhu, uko kunoratidzwa nokuva kuongororwa ropa. Saka kazhinji kana arrhythmia vanokurudzira magnesium-potassium zvokudya. Uyewo kuteerera kurara uye zororo utongi, zvokudya, tsika dzakaipa, kakawanda kunwa kofi, kuvapo mupfungwa uye zvichingodaro. sedatives kungadiwa. Kana ventricular fibrillation anomhanya zvakaoma, ipapo aisirwe mushonga, uye mune zvimwe zviitiko zvinoda kuvhiyiwa. Murwere zvikanzi pamwe electrolytes, ACE FIs, nitrates, uye zvichingodaro. kukosha Great anopiwa nezvinodhaka pamusoro arrhythmia.

tachycardia kurapwa

Kune mapoka maviri mishonga, iyo chiito inoendeswa Mabatirwo tachycardia: protivoaritmichnye uye kunonyaradza nevamiririri. Sedatives kuchanzi ari chiitiko kuti pane GVA. Izvi zvinogona kuva "Diazepam", "Persian", "Wisteria" uye vamwe. antiarrhythmic mishonga nokuti ventricular arrhythmia vakagadzwa pashure mhaka zvokurwara inovhurwa. Izvi zvinogona kuva "Verapamin" "Inderal", "adenosine" uye zvichingodaro. Chero zvazvingava, kurapwa kunofanira vavimbisana nyanzvi.

fibrillation kurapwa

Kana kurwisa atrial fibrillation akazviratidza kekutanga kana riri inoratidza, zvinokosha kurega kushandisa "Quinidine", "Kordorona" kana "procainamide". Kana atrial fibrillation zvachose, nguva dzose unofanira kutora mishonga kudzivirira sitiroko. Muchiitiko chino, zvakakodzera anticoagulation kurapa, unofanira kutora aspirin, "Warfarin" heparins.

The fungidziro pamusoro arrhythmias

The fungidziro kuti chirwere ichi kuvimba chimiro chayo, kuvapo chemwoyo, kuparadzirwa zvirwere muvanhu. Ventricular fibrillation uye supraventricular dzisina chokuita chemwoyo, regai kuisa upenyu hwomunhu pangozi uye utano. Kana hosha hwapedyo pamusoro pakanyorwa mwoyo chirwere, asi fungidziro iri zvisingafadzi.. Life anotarisirwa pano runotsamira vachinyatsoziva mharuro kurapwa. Naizvozvo inokurudzirwa kudzora chokupika mwoyo uye kutevera zvose zvokurapa vanorumbidza, zvino chirwere chinogona akamira. Panguva iyoyo hatifaniri kukanganwa pamusoro matanho, nekuti kutarisira utano hwako unogona kuridza guru basa, uye mune zvimwe zviitiko kuponesa upenyu hwevanhu.

dziviriro

Chokutanga, dziviriro arrhythmia nechinangwa mishonga chemwoyo, izvo zvinoita kuti kutyorwa mutinhimira uye conduction. Zvakakodzera haabatanidzi mhaka chirwere, zvinogona chepfu, GVA, kushushikana, electrolyte kusaenzana, uye zvichingodaro. D. Zvakakodzera kutirambidza yaunodya doro, chikakananda uye caffeine, uyewo vakazvimirira kushandisa zvinodhaka nokuda arrhythmia. Treatment yaifanira vakaraira nachiremba. Saka, kudzivisa chirwere sezvinotevera:

- mabatiro mikuru mwoyo chirwere;

- Kudya;

- achisiya tsika dzakaipa;

- kuongorora muviri, uremu, kumanikidzwa;

- kudzivirira zvinodhaka.

Sezvo gadziriro vari zano kutora "Panangin" (potassium uye magnesium), vhitamini B6, "Ritmonorm", "VFS" uye vamwe.

Kana arrhythmias anogona kutamba mitambo, asi muviri kunofanira kuva diki. Regai wakaremedza muviri. Nokutevera dzose kunenge uye kuti akuteerere utano hwavo, unogona kuponesa kwete iye chete, asi neniwo hwake, uye chiremba, zvichaita kukubatsira kuona kusarudza zvinodhaka.