Mlembi: William Ramirez
Tsiku La Chilengedwe: 16 Sepitembala 2021
Sinthani Tsiku: 12 Novembala 2024
Anonim
Kusokonezeka kwamtima - Mankhwala
Kusokonezeka kwamtima - Mankhwala

Kusokonezeka kwa mtima kumachitika mtima ukawonongeka kwambiri kotero kuti sungathe kupereka magazi okwanira m'ziwalo za thupi.

Zomwe zimayambitsa kwambiri ndimatenda akulu amtima. Zambiri mwazi zimachitika pakadwala matenda amtima kapena atadwala (myocardial infarction). Zovutazi ndi monga:

  • Gawo lalikulu la minofu ya mtima lomwe silimayendanso bwino kapena silimasuntha konse
  • Kusweka kwa minyewa ya mtima chifukwa cha kuwonongeka kwa mtima
  • Nyimbo zowopsa, monga ventricular tachycardia, ventricular fibrillation, kapena supraventricular tachycardia
  • Kupsyinjika pamtima chifukwa cha kuchuluka kwa madzi ozungulira (pericardial tamponade)
  • Kutulutsa kapena kuphulika kwa minofu kapena matope omwe amathandizira mavavu amtima, makamaka valavu ya mitral
  • Kung'ambika kapena kung'ambika kwa khoma (septum) pakati pama ventricles akumanzere ndi kumanja (zipinda zam'munsi zamtima)
  • Nyimbo yocheperako (bradycardia) kapena vuto lamagetsi amtima (mtima)

Kusokonezeka kwa mtima kumachitika pamene mtima sungathe kupopera magazi ochuluka monga momwe thupi limafunira. Zitha kuchitika ngakhale sipanakhalepo vuto la mtima ngati limodzi mwamavutowa likuchitika ndipo mtima wanu ukugwira ntchito modzidzimutsa.


Zizindikiro zake ndi izi:

  • Kupweteka pachifuwa kapena kupanikizika
  • Coma
  • Kuchepetsa kukodza
  • Kupuma mofulumira
  • Kutentha kwambiri
  • Thukuta lolemera, khungu lonyowa
  • Mitu yopepuka
  • Kutaya tcheru komanso kutha kuyang'ana
  • Kusakhazikika, kusakhazikika, kusokonezeka
  • Kupuma pang'ono
  • Khungu lomwe limamverera bwino kukakhudza
  • Mtundu wofiirira kapena khungu lakuthwa
  • Zofooka (thready) zamkati

Kufufuza kukuwonetsa:

  • Kuthamanga kwa magazi (nthawi zambiri ochepera 90 systolic)
  • Kuthamanga kwa magazi komwe kumatsika kuposa mfundo za 10 mukaimirira mutagona (orthostatic hypotension)
  • Zofooka (thready) zamkati
  • Khungu lozizira komanso lopanda kanthu

Kuti mupeze matenda am'magazi, catheter (chubu) imatha kuikidwa m'mitsempha yam'mapapo (catheterization yamtima wamanja). Mayeso atha kuwonetsa kuti magazi akubwerera m'mapapu ndipo mtima sukupopa bwino.

Mayeso ndi awa:

  • Catheterization yamtima
  • X-ray pachifuwa
  • Zowonera Coronary
  • Zojambulajambula
  • Electrocardiogram
  • Kujambula kwa nyukiliya pamtima

Kafukufuku wina akhoza kuchitika kuti apeze chifukwa chomwe mtima sukugwira bwino.


Mayeso a labu ndi awa:

  • Magazi amitsempha yamagazi
  • Magazi amadzimadzi (chem-7, chem-20, electrolytes)
  • Mavitamini a mtima (troponin, CKMB)
  • Kuwerengera kwathunthu kwa magazi (CBC)
  • Mahomoni otulutsa chithokomiro (TSH)

Kusokonezeka kwa Cardiogenic ndizadzidzidzi zamankhwala. Muyenera kukhala mchipatala, nthawi zambiri mu Intensive Care Unit (ICU). Cholinga cha chithandizo ndikupeza ndikuthandizira zomwe zimayambitsa mantha kuti mupulumutse moyo wanu.

Mungafunike mankhwala kuti muwonjezere kuthamanga kwa magazi ndikusintha magwiridwe antchito amtima, kuphatikiza:

  • Dobutamine
  • Dopamine
  • Epinephrine
  • @Alirezatalischioriginal
  • Milrinone
  • Norepinephrine
  • Vasopressin

Mankhwalawa atha kuthandiza munthawi yochepa. Sagwiritsidwa ntchito kwa nthawi yayitali.

Kusokonezeka kwamitima ya mtima (dysrhythmia) ndikofunikira, chithandizo chofulumira chitha kufunikira kuti chibwezeretse kukhazikika kwamtima. Izi zingaphatikizepo:

  • Thandizo lamagetsi lamagetsi (defibrillation kapena cardioversion)
  • Kukhazikitsa pacemaker kwakanthawi
  • Mankhwala operekedwa kudzera mumtsempha (IV)

Muthanso kulandira:


  • Mankhwala opweteka
  • Mpweya
  • Zamadzimadzi, magazi, ndi zinthu zamagazi kudzera mumtsempha (IV)

Mankhwala ena achisokonezo atha kukhala:

  • Catheterization yamtima yokhala ndi angioplasty yam'mimba ndi kununkha
  • Kuwunika mtima kuwongolera chithandizo
  • Kuchita opaleshoni yamtima (opaleshoni yamitsempha yamitsempha yodutsitsa, kusintha kwa valavu yamtima, chida chothandizira chamitsempha yamanzere)
  • Intra-aortic balloon counterpulsation (IABP) yothandiza mtima kugwira ntchito bwino
  • Wopanga zida
  • Ventricular assist chipangizo kapena chithandizo china chamakina

M'mbuyomu, kuchuluka kwa omwe adafa chifukwa chodabwitsidwa ndi Cardiogenic kuyambira 80% mpaka 90%. M'maphunziro aposachedwa kwambiri, milanduyi yatsika mpaka 50% mpaka 75%.

Matenda a cardiogenic akachiritsidwa, malingaliro ake ndiabwino kwambiri.

Zovuta zingaphatikizepo:

  • Kuwonongeka kwa ubongo
  • Kuwonongeka kwa impso
  • Kuwonongeka kwa chiwindi

Pitani kuchipinda chodzidzimutsa kapena itanani nambala yadzidzidzi yakomweko (monga 911) ngati muli ndi zizindikiritso zamatenda amtima. Kusokonezeka kwa Cardiogenic ndizadzidzidzi zamankhwala.

Mutha kuchepetsa chiopsezo chodwala matenda a mtima mwa:

  • Kuthetsa mwachangu chifukwa chake (monga vuto la mtima kapena vuto la valavu yamtima)
  • Kupewa ndikuchiza zomwe zimayambitsa matenda amtima, monga matenda ashuga, kuthamanga kwa magazi, cholesterol komanso triglycerides, kapena kugwiritsa ntchito fodya

Shock - mtima

  • Mtima - gawo kupyola pakati

Felker GM, Teerlink JR. Kuzindikira ndikuwunika kwa kulephera kwamtima. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: chap 24.

Hollenberg SM. Kusokonezeka kwamtima. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 99.

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