Sinoatrial chipika: zimayambitsa, chithandizo. Chisokonezo mungoli mtima

Sinoatrial chipika - chikhalidwe pathological zomwe limodzi ndi kusokonezeka kwa zachilengedwe mungoli mtima. gawo m'mnyewa wamtima asynchronously yafupika, limene pali asystole zosakhalitsa. Mwachibadwa, ngati kuswa ndi woopsa. odwala ambiri akuyembekezera zambiri za matenda amenewa. Chifukwa anatseka misewu akufotokozera? Ngati pali zizindikiro kunja? ndi mankhwala zimene amapereka mankhwala amakono? Mayankho a mafunso amenewa adzakhala chidwi kuti owerenga ambiri.

Kodi chipika sinoatrial?

Pofuna kufotokoza kudwala, choyamba muyenera khutu ku makhalidwe anatomical ndi thupi la myocardium anthu. Monga inu mukudziwa, mtima - thupi pang'ono yoyenda yokha. lawo Ndikulichepetsa amaperekedwa ndi ntchito yapadera ganglion, amene akuchititsa zikhumbo mitsempha.

Mbali yofunika ya madalaivala a mungoli mtima ndi nkusani mfundo. Malowa ali pamtunda pakati pa chabwino matenda mafuta ndi kutsegula kwa aakulu vena cava, mu lamanja atrium khoma. Sinoatrial pawiri ali nthambi zosiyanasiyana, kuphatikizapo mtengo Toreli, Bachmann, Wenckebach - amatani zikhumbo malinga a atria onse. Kusokonezeka kwa mopupuluma mantha pa malo ndi kuitana blockage izi sinoatrial mfundo.

Choncho, ndi maziko a kudwala mu kayendedwe mtima amakhala osakhazikika, zikubweretsa asystole, amene, ndithudi, woopsa kwambiri. Akuti n'kovuta kwambiri kudwala - izo amawapeza mu 0,16% odwala mu dipatimenti cardiology. Ndipo malinga ndi maphunziro zowerengera zambiri amadwala kuyan'anila za amuna a zaka zoposa makumi asanu. Mu zazikazi, zopatuka ngati si wamba.

Mwina chitukuko cha anatseka misewu ndi ana, koma nthawi zambiri amapezeka pa maziko a kobadwa nako organic kuwonongeka m'mnyewa wamtima.

The chikuchititsa mavuto a matenda

Iwo ankadziwa kuti CA-anatseka misewu si nthenda palokha. Ndi, kani, chizindikiro cha pathologies ena. Pafupifupi 60% ya odwala blockage amadwala matenda a mitima. Komanso, pali zambiri kudwala pa maziko kapena pambuyo infarction m'mnyewa wamtima.

Komanso pali zifukwa zina zimene zingachititse kuti kusokoneza mungoli yachibadwa mtima. Zifukwa monga tizilombo toyambitsa myocarditis, komanso cardio myocardio, calcification ya mtima minofu kobadwa nako mawonekedwe cardiomegaly. Nthawi zina CA anatseka misewu akufotokozera anthu akuvutika ndi vuto la misempha.

Anatseka misewu ya mfundo sinoatrial ingayambe ntchito mlingo waukulu kwambiri wa glycosides mtima, beta-blockers, quinidine ndi mankhwala ena. Kukhala kudwala nthawi zambiri zotsatira zake mu owonjezera potaziyamu m'magazi. Popeza ntchito za mtima ndi Lamulo mitsempha vagus, kuenjezera kamvekedwe ake akhoza kuyambitsa arrhythmias (mantha amphamvu kapena kupwetekedwa m'chifuwa, atagwira ena mayesero reflex omwe amaonjezera ntchito za molekezera mitsempha).

zifukwa komanso matenda ena kuphatikizapo zophophonya mtima valavu, pamaso pa chotupa mu ubongo, malfunctions chithokomiro anasonyeza matenda oopsa, kakhosi, encephalitis, khansa oziziritsa mtima kudwala. Monga mukuonera, pali zinthu zambiri chiopsezo.

Anatseka misewu ya mlingo woyamba, ndi zochititsa

Mu mankhwala amakono lagawidwa madigiri atatu azikhala matenda. Aliyense wa iwo ali ndi makhalidwe yake. Ambiri wofatsa ankaona sinoatrial chipika digiri yoyamba. Woterowo kudwala lililonse zimachitika amene amapezeka mu mfundo nkusani, ndi atria ukufika. Koma kuchitsatira akubwera ndi kuchedwa ena.

kudwala Izi sangathe kuona pa electrocardiogram, ndipo palibe mawonetseredwe kunja - odwala kwakukulukulu kumva bwinobwino. Kupeza Vuto digiri yoyamba akhoza anatseka misewu pa intracardiac EFI.

Anatseka misewu ya kwaciwiri: kufotokoza mwachidule

Sitepe ndi chitukuko cha kudwala angathe ogaŵikana mitundu iwiri:

• Anatseka misewu ya digiri 2 wa mtundu woyamba wa madutsidwe akutsatiridwa ndi kuchepa pang'onopang'ono ndi mfundo nkusani. Chotero wakuswa akhoza kale apezeke pa electrocardiogram ndi. Pankhani zizindikiro zakunja odwala Kawirikawiri wa kumatchula chizungulire, kufooka. Matendawa pafupipafupi mu moyo anthu wadazi, ndi imfa zina chosakhalitsa cha chikumbumtima chikwiyire ndi kuchuluka zolimbitsa thupi, chifuwa amphamvu, ankasinthana lakuthwa mutu, ndi zina zotero D..
• Anatseka misewu ya 2 na- digiri ya mtundu wachiwiri kale limodzi ndi yeniyeni mtima arrhythmia, amene angaganize wodwalayo. Mwachitsanzo, mtima koyamba nakweza (munthu angaganize contractions), kenako mwadzidzidzi mabasi, ndipo tikupitiriza pambuyo chete kwa munthu. M'nthawi ya asystole, wodwala akumva kufooka lakuthwa, nthawi zambiri wotaya kutsitsimuka.

Kodi zizindikiro limodzi ndi anatseka misewu ya digiri wachitatu?

Kudwala wa digiri lachitatu - wathunthu sinoatrial chipika. Mu nkhani iyi, myocardium ndipo sanalandire zikhumbo ku mfundo nkusani. Mwamsanga kudwala anawona pa electrocardiogram, chifukwa wodwala akufotokozera asystole pa maziko a utumiki conduction anatseka misewu. Choncho pali chisawawa ectopic mungoli kuthokoza ntchito za lamulo lachitatu madalaivala. Pa ECG Tingaone kuti palibe maofesi PQRST.

mankhwala

Mwakucimbidza ayenera kuti chiwembu cha chithandizo kumatengera chifukwa cha kudwala kwambiri. Ngati sinoatrial chipika tsankho ndipo si kuukira moyo wa wodwala, ndi mankhwala enieni sizingakhale zofunika - mtima mungoli abwerere mwakale palokha.

Komabe, muyenera kuchitira matenda choyambirira. Mwachitsanzo, ngati anatseka misewu chikwiyire ndi kuwonjezeka mu kamvekedwe vagal, ndikofunika wodwala, "atropine" (mmalo "ephedrine", "Ortsiprepalinom", "isoprenaline"). Kukachitika kuti disruptions aliyense wa mungoli mtima pa maziko a mankhwala osokoneza bongo, kumwa mankhwala zikanavulaza ayenera kusiyidwa pomwepo ndi kuyesa kubweretsa thupi la zatsalira mankhwala.

Mwatsoka, nthawi zambiri izi chisokonezo mungoli kumabweretsa chitukuko cha fibrosis mu myocardium lapansi. Zikatero, kuonetsetsa chidule yachibadwa ya minofu mtima n'chotheka mwa zonse kukondoweza magetsi.

thandizo kwa anatseka misewu

Monga tanenera kale, nthawi zambiri, blockage ndi tsankho ndipo si kuopseza mwachindunji kwa moyo wa wodwalayo. Komabe, zina kutha kwathunthu kufala kwa zikhumbo za magetsi kumabweretsa kuletsa mwadzidzidzi mtima.

Ngati mtima kayendedwe zimawonedwa m'mbuyo pang'ono kwambiri kuletsa, ndiye unachitikira matenda AKUYENDA. Monga mukhoza amaumiriza eyeballs ndi (zimathandiza kusintha mlingo mtima) ngati muyeso yochepa. Mwatsoka, nthawi zina mtima amafuna odwala kwambiri kutikita mtima ndi kugwirizana kwa makina moyo thandizo.