Ibloko Sinoatrial: oonobangela, unyango. Yokuphazamiseka rhythm entliziyweni

ibloko Sinoatrial - imeko zophendlo lwezifo leyo sikhatshwa kuphazamisa intliziyo isingqisho yendalo. isabelo engabalulekanga asynchronously zancitshiswa, apho kukho asystole okwethutyana. Ngokuqhelekileyo, ulwaphulo okunjalo kuyingozi. izigulane ezininzi ukhangela oluninzi ulwazi malunga nesi sifo. Kutheni ukuvimba okhula? Nokuba kukho naziphi na iimpawu zangaphandle? Yintoni unyango inikela iyeza namhlanje? Iimpendulo zale mibuzo ziya kuba nomdla kubafundi abaninzi.

Yintoni na block sinoatrial?

Ukuze achaze ngezifo, kuqala kufuneka ukuba uhlawule ingqalelo kwiimpawu yokwakheka kunye nokomzimba le myocardium yabantu. Njengoko usazi, intliziyo - umzimba ngokungaphelelanga elizimeleyo. zokunciphisa wayo inikezelwa ngumsebenzi okhethekileyo ganglion, leyo kuqhuba azilawule luvo.

Inxalenye ebalulekileyo ngabaqhubi isingqisho kwentliziyo na sinus node. Le ibekwe phakathi umhlehlo ekunene atrial kunye nokuvulwa kwe Vena cava awongamileyo, eludongeni intendelezo ekunene. compound Sinoatrial iye amasebe eziliqela, kuquka umqadi Toreli, Bachmann, Wenckebach - baqhuba amaza kweendonga zombini imithambo. Ukuphazamiseka ngokwentshukumisa novalo kule sayithi kunye umnxeba ukuvaleka node sinoatrial.

Ngenxa yoko, kwimvelaphi leengxaki kwi isingqisho intliziyo iba ukutshabalala, okukhokelela asystole, leyo, Kakade ke, kakhulu yingozi. Kuthiwa ukuba ngezifo kakhulu inqabile - oko banesifo ngo-0.16% yezigulane kwisebe zentliziyo. Yaye ngokutsho amaphononongo manani zidla ubunzima ukwaphula yabantu abangaphezulu kweminyaka engamashumi amahlanu. Xa iimazi, loo ukuphambukiswa azixhaphakanga.

Mhlawumbi uphuhliso kwafa kwaye ebuntwaneni, kodwa ngokuqhelekileyo kwenzeka phezu imvelaphi naso umonakalo organic engabalulekanga.

Eyona eziphambili ezibangela izifo

Kuyabonakala ukuba CA-kwafa nto sisifo elizimeleyo. Ngoko ke, kunoko, umqondiso nezinye izinto ezimbi. Phantse i-60% ezigulane kunye ukuvaleka ubunzima ngenxa nesifo sentliziyo. Ukongeza, kukho basoloko ngezifo kwisiqalo okanye emva iposi engabalulekanga.

Ukongeza, kukho ezinye izizathu ukuba enokukhokelela ukuphazamiseka eqhelekileyo intliziyo rhythm. Imiba yomngcipheko ziquka myocarditis wentsholongwane egazini kunye yintsholongwane, kwakunye myocardio Cardio, calcification entliziyweni izihlunu ifomu naso cardiomegaly. Ngamanye amaxesha CA ukuvimba senzeka abantu abanengxaki rheumatism.

Kuvalwe iindlela esiludumbo sinoatrial ukuba zibangelwa yi ukusetyenziswa amathamo ezinkulu kakhulu glycosides kwentliziyo, beta-blocker, quinidine kunye namanye amayeza. Ukuphuhlisa leengxaki kudla ngokuphumela agqithisile potassium egazini. Ekubeni umsebenzi intliziyo kulawulwa yi le luvo vagus, ukwanda isandi sayo nako kunokubangela arrhythmias (ukothuka eyomeleleyo okanye nongcungcutheko esifubeni, ephethe ezinye iimvavanyo reflex leyo ukwandisa umsebenzi ke kwalapho).

Izizathu ziquka nezinye izifo kuquka iziphene yentliziyo nokufakelwa, ubukho ithumba ebuchotsheni, ukungasebenzi kakuhle lengqula wavakalisa lwegazi, meningitis, kobuchopho, wegazi, ebuchotsheni ngezifo nemithambo. Njengoko ubona, kukho izinto ezininzi lomngcipheko.

Kuvalwe iindlela iqondo lokuqala, kunye neempawu zayo

Xa yesilungu yohlulwe manqanaba mathathu ubukhali kwesi sifo. Ngamnye kubo uneempawu zawo. Uninzi enomoya luthathwa ibloko sinoatrial isidanga sokuqala. Ekubeni ngezifo ezifana ukubetha nganye okwenzeka esiludumbo sinus, imithambo ifikelela. Kodwa sisibambile iza kolibaziseko ethile.

Le ngezifo ayikwazi kubonwa kwi electrocardiogram, yaye akukho mpawu zangaphandle - izigulane ukuba becala uzive eqhelekileyo. Uxilongo isidanga sokuqala itoti yaye kuvalwe ngexesha intracardiac Enterprise.

Kuvalwe iindlela ngokuzalana: inkcazelo emfutshane

Eli nyathelo lo uphuhliso ngezifo lungohlulwa lube iintlobo ezimbini:

• Kuvalwe iindlela degree ye2 Uhlobo lokuqala conductivity elandelwa ukuhla kancinane esiludumbo sinus. ulwaphulo olunjalo sele ngaphande phezu electrocardiogram. Ngokuphathelele iimpawu zangaphandle, izigulane badla ezikhala ephindaphindekayo nesiyezi, buthathaka. Njengoko esi sifo rhoqo ebomini lomntu uyaphi, kunye nelahleko maxa wambi otshintsho ezingqondweni ondiqumbise ngokwanda ukusebenza komzimba, ukhohlokhohlo eyomeleleyo, ubhekisa ezibukhali entloko, njalo-njalo. D.
• Kuvalwe iindlela weqondo 2 nd lohlobo yesibini sele kunye arrhythmia ngqo kwentliziyo, leyo unokuziva isigulane. Umzekelo, intliziyo kuqala ziyanyuswa (umntu azive izishunqulelo), yaye emva koko evele ime, bese uqhubeka emva kokunqumama. Kwisithuba asystole, isigulana uziva ubuthathaka elibukhali, ngokufuthi ulahlekelwa abazi lutho.

Ziziphi iimpawu sikhatshwe kwafa weqondo wesithathu?

Pathology weqondo wesithathu - epheleleyo block sinoatrial. Kulo mzekelo, i myocardium yaye abazange bafumane eyenza ukusuka esiludumbo sinus. Ngokuqhelekileyo, le ngezifo kubonwa kwi-electrocardiogram, ngenxa yokuba isigulane iphuhlisa asystole phezu yangasemva Uhanjiso ukuqapha ngokupheleleyo. Ngenxa yoko kukho ukubonga isingqisho ethunjini kucacile nemisebenzi kwelesithathu abaqhubi. Ngexesha ECG kunokubonwa ukuba akukho izakhiwo PQRST.

amayeza

Ngoko nangoko ke kufuneka ke ukuba inkqubo yonyango kuxhomekeke unobangela ngezifo. Ukuba block sinoatrial buso kwaye akukho kusisisongelo kubomi kwisigulana, uthomalaliso zisenokuba yimfuneko - isingqisho intliziyo uyakubuyela eqhelekileyo ngokwayo.

Nakuba kunjalo, kufuneka ukunyanga esi sifo zaseprayimari. Umzekelo, ukuba kwafa ondiqumbise kukwanda ilizwi vagal, kubalulekile kwisigulana, "Atropine" (endaweni "ephedrine", "Ortsiprepalinom", "isoprenaline"). Kwimeko apho naliphi na ukuphazamiseka kwesingqisho kwentliziyo kwisiqalo se-libanda, iziyobisi ezinokuba yingozi kufuneka simiswe nangoko uze uzame ukuba umzimba iintsalela amayeza.

Ngelishwa, ngokufuthi le ukuphazamiseka rhythm kukhokelela kuphuhliso abanesigulo kwi myocardium. Kwiimeko ezinjalo, ukuqinisekisa ucutheko eqhelekileyo imisipha intliziyo kunokwenzeka kuphela zovuselelo rhoqo zombane.

uncedo lokuqala for kwamabutho

Njengoko sele kukhankanyiwe, kwiimeko ezininzi, ukuvaleka kuyinxenye kwaye isoyikiso ngqo kubomi umguli. Noko ke, kwezinye iimeko, ukumisa ngokupheleleyo ekudluliseni ngamaza ombane kukhokelela wayeka ngesiquphe intliziyo.

Ukuba isingqisho intliziyo wabona oyi esinzulu iphele, koko kubanjwa isantya atrial. Njengoko uyakwazi ukubeka uxinzelelo phezu amehlo (kuyanceda ukutshintsha izinga lentliziyo) njengenyathelo elifutshane. Ngelishwa, ngamanye amaxesha isigulane kufuna labagula kakhulu, yokuthanjiswa ezesifuba uqhagamshelwano kumatshini ubomi inkxaso.