Block Sinoatrial: izimbangela, ukwelashwa. Yokuphazamiseka inhliziyo isigqi

block Sinoatrial - isimo sokugembula okuyinto kuhambisana ukuphazamiseka kwemvelo inhliziyo isigqi. ingxenye esivimba amanzi asynchronously encishisiwe, lapho kukhona asystole yesikhashana. Ngokwemvelo, kuwukwephula enjalo iyingozi. Iziguli eziningi ufuna ukwaziswa okwengeziwe ngalesi sifo. Kungani ukuvinjelwa okhula ngayo? Kungakhathaliseki ukuthi kukhona izimpawu zangaphandle? Yiziphi ukwelashwa linikeza imithi yesimanje? Izimpendulo zale mibuzo ziyoba abafundi abaningi.

Kuyini block sinoatrial?

Ukuze ukuchaza zokugula, okokuqala kudingeka sinake izici yokwakheka bokuphila we myocardium womuntu. Njengoba wazi, inhliziyo - umzimba kancane ezizimele. ukunciphisa Its olunikezwa umsebenzi okhethekile ganglion, okuyinto ukuqhuba emsipheni amaza.

Ingxenye ebalulekile yokuphikelela abashayeli isigqi inhliziyo kuyinto itheku engeyokuqala. Itholakala phakathi ilungelo neseleko atrial nokuvulwa we aphakeme vena cava, ku ilungelo ATRIUM udonga. kwakwakhe Sinoatrial has amagatsha amaningana, kuhlanganise ugongolo Toreli, Bachmann, Wenckebach - baqhuba amaza kagesi sibe izindonga kokubili Atria. Ukuphazamiseka ngiyibona sezinzwa ngalesi indawo futhi ucingo ukuvaleka node sinoatrial.

Ngakho, sinombono zokugula e isigqi inhliziyo iba engazinzile, okuholela asystole, okuyinto Yiqiniso, kuyingozi kakhulu. Kuthiwa ukuthi zokugula ngempela ezingavamile - ke sitholakale 0,16% eziguli uMnyango nezenhliziyo. Futhi ngokuvumelana izifundo imininingwane ngokuvamile uhlushwa ukwephula amadoda phezu engamashumi amahlanu. Esikhathini nabesifazane, ukuphambuka enjalo lingaphansi ezivamile.

Mhlawumbe ukuthuthukiswa nokuvinjelwa kanye ebuntwaneni, kodwa ngokuvamile kwenzeka ku isizinda azalwa naso organic umonakalo esivimba amanzi.

Ziyini izimbangela eziyinhloko zalokhu yesifo

Kuyaqondakala ukuthi CA-ukuvinjelwa akusona isifo ezimele. Kuyinto, kunalokho, uphawu nezinye pathologies. Cishe 60% of iziguli ukuvaleka isifo semithambo yenhliziyo. Ngaphezu kwalokho, kukhona ngokuvamile zokugula ku ngemuva noma ngemva isilethikusebenza.

Ngaphezu kwalokho, kunezinye izizathu ezingaholela ekubeni ukuphazamiseka evamile inhliziyo isigqi. Izinto eziyingozi ezingabangela i zihlanganisa myocarditis ezibangelwa amagciwane kanye ezibangelwa amagciwane, kanye myocardio cardio, calcification we senhliziyo esilimele ifomu azalwa naso cardiomegaly. Ngezinye izikhathi CA ukuvinjelwa yenzeka kubantu abaphethwe rheumatism.

Nokuvinjelwa engeyokuqala sinoatrial kungahle kubangelwe ukusetshenziswa amaphilisi amaningi kakhulu glycosides inhliziyo, beta-blocker, quinidine kanye neminye imithi. Ukuze wenze uhlelo lokusetshenziswa zokugula Imvama ngokweqile potassium igazi. Njengoba umsebenzi inhliziyo kulawulwa emsipheni vagus, nesanda ithoni yayo nakho kungaholela arrhythmias (ukushaqeka eqinile noma ukuhlukumezeka kwesifuba, ebambe ezinye izivivinyo reflex okuyinto ukwandisa umsebenzi eziyimpumelelo emsipheni).

Izizathu zihlanganisa nezinye izifo kuhlanganise nenhliziyo valve ukukhubazeka, khona isimila ebuchosheni, eziyimbangela yezinkinga ezizuzwa yegilo uzwakalise umfutho wegazi ophakeme, meningitis, encephalitis, wegazi, i-cerebral zokugula semithambo. Njengoba ubona, kunezindlela eziningi ezibangela le ngozi.

Nokuvinjelwa ngezinga lokuqala, kanye nezici zayo

Ngo inqubo yokwelapha yesimanje sehlukaniswe degrees ezintathu nokugasela ngamandla kwalesi sifo. Ngamunye wabo has izici zayo siqu. omnene kubhekwe block sinoatrial idigri yokuqala Iningi. Nge zokugula enjalo ishayela ngamunye okwenzeka engeyokuqala itheku, le Atria ifinyelela. Kodwa ebambe kuziwa ephethe ukulibala ezithile.

Lokhu zokugula ingabonakali ku-electrocardiogram, futhi akukho ukubonakaliswa kwangaphandle - iziguli engxenyeni enkulu esivamile. Ukuhlonza Ukugula kuqala degree ikani ukuvinjelwa phakathi intracardiac EFI.

Ukuvinjelwa besigaba sesibili: incazelo emfushane

Lesi sinyathelo ukuthuthukiswa kwe-pathology zingahlukaniswa zibe izinhlobo ezimbili:

• Nokuvinjelwa degree wesi-2 Uhlobo lokuqala conductivity kulandele ukwehla kancane kancane engeyokuqala itheku. kuwukwephula okunjalo kungaba kakade ihlonzwe ku-electrocardiogram. Ngokuphathelene izimpawu zangaphandle, iziguli kaningi esekhala okuvela isiyezi, buthakathaka. Njengoba isifo njalo ekuphileni kwabantu walibangisa nokulahlekelwa ngezinye izikhathi izivakashi ukwazi cuphuluza bandisa inkonzo ngokomzimba, ukukhwehlela eqinile, badedelane abukhali ikhanda, njalo njalo. D.
• Nokuvinjelwa ngezinga 2 nd yohlobo yesibili isivele ephelezelwa arrhythmia eqondile inhliziyo, okuyinto ungase uzizwe njengo-nesineke. Ngokwesibonelo, inhliziyo wokuqala iyakhula (umuntu angase abe nomuzwa Kufinyeta), bese zenyuka ngokushesha zamabhasi, bese uqhubeka ngemva kokuhlaba ikhefu isikhathi. Ngezikhathi asystole, isiguli uzizwa ubuthakathaka abukhali, kuqedwe ukwazi.

Yini izimpawu kuhambisane nokuvinjelwa ngezinga wesithathu?

Pathology degree yesithathu - ephelele block sinoatrial. Kulokhu, myocardium futhi akatholanga izinzwa engeyokuqala itheku. Ngokwemvelo, lokhu kusho zokugula kubonakala ku-electrocardiogram, ngoba nesineke eba asystole ku isizinda conduction ukuvinjelwa egcwele. Ngakho kukhona esiyivelakancane isigqi ethunjini sibonga imisebenzi oda wesithathu abashayeli. Phakathi ECG kuyabonakala ukuthi azikho izakhiwo PQRST.

imithi

Ngokushesha kufanele kusho ukuthi uhlelo ukwelashwa incike imbangela egunjini lokuhlolwa kwezifo. Uma block sinoatrial ngokwengxenye futhi akuyona ingozi empilweni esiguli, imishanguzo ethile kungase kungadingeki - inhliziyo isigqi ungase ubuyele esimweni esivamile ngokwalo.

Noma kunjalo, kudingeka aphathe lesi sifo eyinhloko. Ngokwesibonelo, uma nokuvinjelwa cuphuluza ukwanda ithoni vagal, kubalulekile ukuba nesineke, "Atropine" (esikhundleni "ephedrine", "Ortsiprepalinom", "isoprenaline"). Uma kwenzeka ukuthi noma iyiphi ukuphazamiseka isigqi inhliziyo ku ngemuva ngokweqile, ukuphuza imithi yingozi kufanele simiswe ngokushesha bese uyazama ukuletha umzimba izinsalela kwemithi.

Ngeshwa, kaningi le ukuphazamiseka isigqi kuholela ukuthuthukiswa cystic e myocardium. Ezimweni ezinjalo, ukuqinisekisa ukusikwa ezivamile imisipha yenhliziyo kungenzeka kuphela ukushukuma njalo kagesi.

Usizo lokuqala for ukuvinjelwa

Njengoba sekushiwo, ezimweni eziningi, ukuvaleka aluphelele futhi akuyona usongo ngqo impilo isiguli. Noma kunjalo, kwezinye izimo, ukumisa okuphelele ukudluliselwa amaza kagesi kuholela stop okungazelelwe inhliziyo.

Uma isigqi inhliziyo siyenzeka Ukushiyeka sina yokuma ke aphethwe EHAMBAHAMBA atrial. Njengoba ungase acindezele zamehlo (kuyasiza ukushintsha kwenhliziyo) njengoba isilinganiso yesikhashana. Ngeshwa, ngezinye izikhathi isiguli sidinga labagula kakhulu, massage zenhliziyo uxhumano umshini esisekela ukuphila.