Okuqukethwe
I-extrasystole ye-ventricular - kuyini?
I-Ventricular extrasystole - Lena enye yezinhlobonhlobo ze-arrhythmias yenhliziyo. I-Pathology izibonakalisa ngokugoqa okungavamile, ngaphambi kwesikhathi kwama-ventricles enhliziyo. Ngesikhathi esifanayo, isiguli ngokwaso ngezikhathi ezinjalo sibhekana nesiyezi, ubuthakathaka, ubuhlungu enhliziyweni, umuzwa wokuntuleka komoya. Ukuthola lesi sifo, ukuhlolwa okuphelele kwenhliziyo kuyadingeka. Ukwelashwa ngokuvamile kungokwezokwelapha.
I-Extrasystolic arrhythmias, ehlanganisa i-ventricular extrasystole, yi-arrhythmias yenhliziyo evame kakhulu. Zitholwa kunoma ibuphi ubudala futhi ziyahlukahluka kuye ngendawo okugxilwe kuyo kwesasasa. I-extrasystole ye-ventricular eyenzeka kaningi kunabanye futhi itholakala cishe ku-62% wamacala.
Ngesikhathi se-ECG, i-extrasystoles eyodwa ye-ventricular irekhodwa ngokwesilinganiso ku-5% yabantu abasha abanempilo. Ngokukhula, lesi sibalo sikhuphuka sifike ku-50%. Ngakho-ke, kungashiwo ngokuqiniseka ukuthi i-ventricular extrasystole iyisifo senhliziyo, esivamile ezigulini ezindala kuneminyaka engama-45-50.
Kunezinhlobo ezimbili ze-arrhythmias yenhliziyo: i-benign ne-extrasystole esongela ukuphila (eyingozi) ye-ventricular. Uhlobo lokuqala lwe-pathology lulungiswa ngokwelashwa kwe-antiarrhythmic, kanti okwesibili kuwumphumela wesifo senhliziyo futhi kubhekwa njenge-pathology yenhliziyo (idinga ukwelashwa kwesifo esiyisisekelo).
Ingozi enkulu yalolu hlobo lwe-arrhythmias yenhliziyo ilele eqinisweni lokuthi ingavusa ukuqina kwe-ventricular futhi kuholele ekufeni kwenhliziyo kungazelelwe.
Izinkinga ze-ventricular extrasystole
Izimbangela ze-extrasystole ye-ventricular ikakhulukazi ngenxa yezifo eziphilayo zemisipha yenhliziyo, noma kunjalo, kwezinye izimo, isici se-etiological ekuthuthukiseni i-pathology ayikacaci.
Ngakho-ke, singakwazi ukuhlukanisa izimbangela ezilandelayo zenhliziyo eziholela ku-extrasystole ye-ventricular:
I-CHD.
I-Postinfarction cardiosclerosis. Ngakho-ke, abantu abaye bahlaselwa yinhliziyo bahlushwa i-ventricular extrasystole ku-95% yamacala.
I-Pericarditis kanye ne-myocarditis.
I-Arterial hypertension.
Ukuhluleka kwenhliziyo okungapheli.
Inhliziyo yamaphaphu.
Ukuqina kwenhliziyo.
I-Hypertrophic cardiomyopathy.
Izimbangela ezingahlobene nesifo senhliziyo zihlanganisa:
Ukwephulwa kwe-microexchange yezinto emzimbeni, kubonakaliswa ku-hypomagnesemia ne-potassium, kanye ne-hypercalcemia.
Ukuthatha izidakamizwa ngemithamo ephezulu. Okuyingozi kakhulu kulokhu yi-tricyclic antidepressants, i-diuretics, i-Amitriptyline, i-Fluoxetine, njll.
Ukusetshenziswa kwezidakamizwa ze-narcotic kanye ne-psychotropic, okuhlanganisa i-caffeine, i-cocaine, i-amphetamine, utshwala.
Ukusetshenziswa kwezidakamizwa ezibulala izinzwa.
Ukucasuka kwe-vagus nerve ngenxa yezinkinga zokulala noma ngenxa yomsebenzi onzima wengqondo.
Ukubhema.
I-osteochondrosis yomlomo wesibeletho.
I-Vagotonia kanye ne-neurocirculatory dystonia.
Izifo ezithathelwanayo.
Ukucindezeleka okuvamisile, ukuveza ukuphazamiseka kwemizwelo.
Kuye kwasungulwa ukuthi kubantu abanomsebenzi owandayo wesimiso sezinzwa ze-parasympathetic, i-ventricular extrasystole ivela ngesikhathi sokuphumula, futhi ngesikhathi sokuzikhandla ngokomzimba, ngokuphambene nalokho, ingase iphele. Akubandakanyi ukubukeka kokuphazamiseka kwesigqi senhliziyo kubantu abangenazo izifo, okungukuthi, ngokumelene nesizinda sempilo ephelele.
Izimpawu ze-ventricular extrasystole
Izimpawu ze-ventricular extrasystole zingase zingabikho ngokuphelele, nakuba kwezinye izimo iziguli ziba nezikhalazo ezilandelayo:
Ukubonakala komuzwa wokuphazamiseka emsebenzini wenhliziyo. Ngezinye izikhathi kungase kube nokufiphala noma umuzwa wokwanda "ukucindezela".
Ukukhathala, ukucasuka ngokweqile, iziqephu zekhanda elibuhlungu, isiyezi - zonke lezi zimpawu zingase zibonise i-ventricular extrasystole uma kwenzeka ngokumelene nesizinda se-vegetative-vascular dystonia.
Umuzwa wokuthi umuntu udonsa ngenxa yokuntuleka komoya ngokuvamile uvela lapho isigqi senhliziyo siphazamiseka ngokumelene nesizinda se-cardiopathologies. Mhlawumbe ukubukeka kobuhlungu benhliziyo, imizwa yobuthakathaka. Kwezinye izimo, ukuquleka kwenzeka.
Ngesikhathi sokuhlolwa, udokotela angase aqaphele ukushaywa kwesici se-veins entanyeni, okubizwa ngokuthi i-cardiology terminology ebizwa ngokuthi amagagasi e-venous Corrigan. I-pulse i-arrhythmic, inokuma okude namagagasi angavamile. Ukuqinisekisa ubukhona be-arrhythmias yenhliziyo, kuyadingeka ukwenza ukuxilongwa kwezinsimbi. Okokuqala, lena i-ECG ne-Holter ECG.
Ukuhlukaniswa kwe-ventricular extrasystole ngokusho kwe-ryan
Ukuhlukaniswa kwe-ventricular extrasystole ngokusho kwe-ryan kungenye yezinketho zokuhlukanisa ama-arrhythmias enhliziyo. Lena incazelo ephelele ye-extrasystole, ngakho-ke isetshenziswa odokotela benhliziyo okwamanje, nakuba yagcina ukuguqulwa ngo-1975.
Ngakho-ke, izigaba ezilandelayo ze-ventricular extrasystoles zihlukaniswa:
O - ayikho i-extrasystole.
I-1 - inani le-extrasystoles alidluli iziqephu ezingu-30 emaminithini angu-60 (i-ventricular arrhythmia engavamile).
2 - inani lama-extrasystoles lidlula iziqephu ezingama-30 ngemizuzu engama-60.
3 - ukuba khona kwe-multifocal extrasystoles.
4a - ukuba khona kwama-extrasystoles e-monotropic abhanqiwe.
I-4b – i-polymorphic ventricular extrasystoles ene-fluttery ne-ventricular flutter.
I-5 - i-tachycardia ye-ventricular ene-extrasystoles ye-ventricular emithathu noma ngaphezulu.
Ukwelashwa kwe-ventricular extrasystole
Ukwelashwa kwe-extrasystole ye-ventricular kuwumsebenzi onzima kakhulu. Amaqhinga okwelapha kufanele anqunywe yizici eziningi, futhi okokuqala, ubukhulu be-extrasystole. Ngaphezu kwalokho, uma umuntu engenaso isifo senhliziyo esibalulekile, futhi i-extrasystole ingabonakali nganoma iyiphi indlela, khona-ke ukwelashwa akwenziwa nhlobo.
Uma izimpawu zokuphazamiseka kwesigqi senhliziyo zisaphazamisa umuntu ngezikhathi ezithile, ngakho-ke kunconywa ukuba agweme izici eziba nzima ngangokunokwenzeka, okuhlanganisa: ukucindezeleka, ukuphuza utshwala, ukubhema, njll. Ukwelashwa kufanele kuhloswe ekugcineni ibhalansi evamile ye-electrolyte, it kubalulekile ngokufanayo ukulawula izinga lomfutho wegazi .
Ngaphezu kwalokho, zonke iziguli, ngaphandle kokukhetha, zinconywa ukuba zihambisane nokudla okunomsoco okuzophinde kuhlanganiswe nosawoti we-potassium. Okubaluleke ngokufanayo ukulwa nokungasebenzi komzimba, okubandakanya ukwanda okwanele kokusebenza komzimba.
Ukwelashwa kwe-Antiarrhythmic
I-Ventricular extrasystole isabela kahle enanini elikhulu lezidakamizwa, kufaka phakathi:
Fast sodium blockers. Lokhu kuhlanganisa izigaba eziningana zezidakamizwa. I-Class 1A ihlanganisa i-Disopyramide, i-Quinidine, i-Procainamide. I-Class 1B ifaka i-Mexiletin. I-Class 1C ihlanganisa i-Flecainide, i-Propafenone. Ikilasi ngalinye lezidakamizwa linezinzuzo zalo kanye nokubi futhi kufanele likhethwe udokotela ngokusekelwe ezicini zesithombe somtholampilo. Ngaphezu kwalokho, izifundo zomtholampilo zibonise ukuthi ukusetshenziswa kwalezi zidakamizwa ezigulini ezine-myocardial infarction kuholela ekwandeni kokushona.
Izidakamizwa ze-Beta-blocker. Zinqunyelwe iziguli ezinezifo eziphilayo zemisipha yenhliziyo.
Imithi efana ne-Amiodarone ne-Sotalol inqunywa kuphela ezimweni ezimbi kakhulu, lapho kune-arrhythmias esongela ukuphila. Nakuba ngezinye izikhathi odokotela bashintsha izidakamizwa nge-beta-blockers nge-Amiodarone (uma isiguli sinokungabekezelelani komuntu ngamunye).
Ukuqokwa kwama-block blockers e-calcium akubandakanyiwe, noma kunjalo, idatha yakamuva ibonisa ukuthi ayidlali indima ebalulekile ekwelapheni ukushaya kwe-ventricular ngaphambi kwesikhathi.
Kunconywa ukuphuza umuthi othile ngokukhethekile ngudokotela okhona, owazi umlando wesiguli.
I-Radiofrequency ablation (RFA) ye-extrasystoles
I-RFA njengokwelashwa kwe-ventricular arrhythmia ayinconywa kuso sonke isiguli. Kunezinkomba ezithile lapho lolu hlobo lomphumela wokwelapha lunqunyelwe. Kunconywa ezigulini ezingasizwa ukulungiswa kwezidakamizwa, kodwa i-extrasystole i-monomorphic, yenzeka kaningi futhi ikhathaza isiguli ngezimpawu ezinzima. I-RFA iyanconywa futhi kulawo maqembu eziguli ezenqaba ukulungiswa kwezokwelapha isikhathi eside.
I-RFA ihilela ukungenelela kokuhlinzwa okungavami kakhulu ngaphansi kokulawulwa kwemishini ye-x-ray. Lokhu ukuhlinzwa kwe-catheter okunengozi ephansi okubuyisela isigqi senhliziyo kahle.
Ukufakwa kwe-cardioverter-defibrillators
Ukufakwa kwezimila kusetshenziswa kuphela uma iziguli zine-extrasystole ye-ventricular eyingozi, enengozi enkulu yokufa ngokuzumayo kwenhliziyo.
I-prognosis ye-ventricular extrasystole incike ekutheni yiluphi uhlobo lwe-arrhythmia yenhliziyo etholakala esigulini, kungakhathaliseki ukuthi kukhona i-organic pathology yenhliziyo kanye nokuphazamiseka kwe-hemodynamic. Uma sikhuluma nge-extrasystole esebenzayo, khona-ke ayibeki usongo empilweni yomuntu. Nokho, lapho kukhona izilonda zemisipha yenhliziyo, ingozi yokufa ngokuzumayo iyanda kakhulu.