M zuciya kasawa: cututtuka a gabãnin mutuwarsa, kuma taimakon farko

A kowace shekara, cutar na zuciya da jijiyoyin jini tsarin da zai kai ga mutuwa na fiye da miliyan 17 mutane a dukan duniya. Kawai 10% na irin pathologies ne nakasar. Mafiya yawa na cutar jihohin auku a kan wani bango na danniya da kuma talakawa salon na zamani mutum. A wannan labarin, za mu dubi abin da yake congestive zuciya rashin cin nasara.

Bayyanar cututtuka na mutuwa da kuma matsalolin da haifar da daga Pathology, hanyoyin da ganewar asali da kuma lura da cuta, da iri da kuma siffofin da cutar - bayani a kan duk wadannan al'amurra za a nuna a cikin kayan da mu review. Bugu da kari, da labarin tattauna da dokoki na gudanarwa, wanda zai iya zama da amfani ga wani daga cikin mu. A ikon aiki a gaggawa samar da a mafi yawan lokuta, da adana mutum rayuwa. Haka kuma, daya ya san abin da taimakon farko ga m zuciya rashin cin nasara.

A ra'ayi na zuciya rashin cin nasara

Zuciya rashin cin nasara (HF) - Pathology, a cikin abin da zuciya daina samar da zama dole adadin na jiki nama da jini. Yana da wani sakamako na sosai ikon da zuciya tsoka (myocardium) ji ƙyama. CH yawanci take kaiwa zuwa tsanani asibiti manifestations, ciki har da na huhu edema, infarction, cardiogenic buga.

Cuta mai saukin kamuwa zuwa mata da maza, amma karshen ana fama da wannan cuta mafi sau da yawa. Mace-mace ne babban isa a Pathology. Hadari a rayuwar mutum yana da wani daga cikin manifestations sa da cututtuka kamar congestive zuciya rashin cin nasara. Alamun a gabãnin mutuwarsa, kira a magani kwatsam, suna sosai bambancin. Sun dogara ne a kan wanda nau'i na cutar faruwa. By yanayin asalin zuciya kasawa suke da daraja:

• Tsokar zuciya rashin cin nasara - da Pathology cewa ne sakamakon kai tsaye lalacewar zuciya tsoka saboda wani take hakkin makamashi metabolism. Wannan irin zuciya rashin cin nasara kaiwa zuwa tabarbarewa na ƙanƙancewa da shakatawa na zuciya.
• Obalodi zuciya rashin cin nasara - da Pathology cewa tasowa a sakamakon wani babban kaya a kan zuciya. Wannan irin a wasu lokuta ci gaba a kan bango na cututtukan zuciya.
• Hada zuciya rashin cin nasara - da wani nau'i na Pathology, wanda hadawa da biyu muka ambata a sama dalilai.

Azuzuwan da zuciya rashin cin nasara

Don kwanan wata, akwai daban-daban sharudda da wanda cutar ne zuwa kashi iri ko siffofin. Medicine, akwai da dama da rarrabuwa tsarin (Rasha, Turai, American), amma mafi mashahuri ne tsarin samarwa da Amurka cardiologists. A daidai da wannan hanya ne hudu azuzuwan cuta:

• Grade 1, cikinsa da haƙuri taso dyspnea aiki motsi, misali, matakai tashi zuwa matakin sama da uku bene.
• Grade 2, a cikinsa akwai dyspnea ko da a low load - a lokacin da dagawa na farko ko na biyu bene. An lura rage jiki aiki na mutum.
• Grade 3, cikinsa da zuciya gazawar m at low lodi, misali a lokacin da tafiya, amma quiescent cuta cututtuka bace.
• Grade 4, a cikin abin da cututtuka faruwa ko a sauran, da kuma karamin jiki take kaiwa zuwa tsanani take hakki na zuciya da kuma dukan zuciya da jijiyoyin jini tsarin a matsayin dukan.

Nau'in CH

Pathology za a iya classified bisa ga dama sharudda. Dangane da na asibiti hoto da cutar magani da aka sani m kuma na kullum zuciya maye.

M zuciya rashin cin nasara (AHF) - a cuta a cikin abin da pathological cututtuka hanzari (a cikin sa'o'i). Kamar yadda mai mulkin, kan bango na sauran cututtuka na jijiyoyin bugun gini tsarin da akwai wani m zuciya rashin cin nasara.

Infarction, myocarditis da kuma sauran cututtuka zai iya zama mai jawo wa cuta jihohin, saboda a karkashin wadannan pathologies, zuciya tsoka Kwayoyin mutu saboda gida Sistem sakulasan cuta. Och iya haifar da daga karaya na hagu na ramin zuciya bango, m gazawar bawuloli (da aortic da mitral). A wasu lokuta, Pathology tasowa ba tare da kafin take hakki.

Och - quite insidious cuta saboda shi zai iya sa mai raɗaɗi yanayin sauran tsarin na jiki. Matsalolin m zuciya rashin cin nasara sau da yawa shafi ba kawai zuciya amma kuma miciwa, haddasa huhu edema, cardiac fuka, cardiogenic buga.

Kullum zuciya maye - wani cuta a cikin abin da Pathology da aka kafa a hankali, a kan makonni, watanni ko ma shekaru. Yana faruwa a kan wani bango na cututtukan zuciya, hauhawar jini ko tsawo anemia.

Nau'in na DOS a kan irin hemodynamics

Dangane da irin hemodynamic halayyar sarrafawa na Pathology, akwai da wadannan siffofin m zuciya kasawa:

• DOS da congestive hemodynamics.
• DOS da hypokinetic hemodynamics.

Hemodynamics - shi ne ya kwarara daga jini ta hanyar tasoshin, wanda ya sa mai girma matsa lamba a fagage daban-daban na jijiyoyi. An sani cewa jini motsa daga yankin na mafi girma matsa lamba ga ƙananan.

A matsa lamba dogara a kan danko na jini, da kuma juriya daga cikin ganuwar jini da nisa da tushe. DOS da congestive hemodynamics iya shafar dama ko hagu ventricle na zuciya. A daidai da wannan fifiko:

• M dama na ramin zuciya rashin cin nasara, a cikin abin da venous stasis aka lura a wani babban da'irar jini ya kwarara, watau. E. Rinjayar kusan dukan gabobin da kyallen takarda.
• M bar na ramin zuciya rashin cin nasara, a cikin abin da venous stasis auku a cikin huhu jini ya kwarara. Pathology tamkar da gas musayar a cikin huhu da take kaiwa zuwa ga cigaban huhu edema ko cardiac asma. Saboda haka, a kan bango da irin wannan take hakkin ya auku m na huhu da cutar zuciya.

DOS da hypokinetic hemodynamics

M zuciya rashin cin nasara a lokacin a hypokinetic hemodynamics - a Pathology lalacewa ta hanyar cardiogenic tura - mai kaifi dakushe da ikon na myocardium mu'ãmalar, sakamakon a cikin rushewa daga jinin samar wa duk jikin kyallen takarda.

rarrabe:

• Arrhythmic buga, wanda shi ne sakamakon cardiac kari cuta.
• Reflex Shock - a dauki ga zafi.
• Gaskiya cardiogenic tura - pathological yanayin abin da ya auku a lokacin da raunuka na hagu na ramin zuciya nama, da kuma rauni yanki ne a kalla 50%. Take hakkin, kamar yadda mai mulkin, sun fi yiwuwa ga mutane a kan shekaru 60 da haihuwa; mutanen da suka yi wata biyu ciwon zuciya. marasa lafiya tare da hauhawar jini da kuma ciwon sukari mellitus.

Mahimmanci, cardiogenic buga ne halin da zafi, kwatsam jini rage ga m dabi'u (saukar zuwa 0), filiform bugun jini, kodadde fata. Pathology iya baya matsawa zuwa huhu edema ko haifar da daga na koda gazawar.

Abubuwan Gudunmawa zuwa fitowan da och

A ci gaba da zuciya rashin cin nasara tare da m ba shakka, da mãsu haƙuri a iya wadda ta gabãta daga wani baya ci karo da cututtuka na jijiyoyin bugun gini tsarin. Irin wannan yanayi sun hada da:

• cututtukan zuciya da lalacewa ta hanyar lalacewar zuciya tsoka, abu zuwa kaifi karu a myocardium ikon yi mu'ãmalar.
• kullum zuciya maye, wanda ya karya a lokacin da al'ada jinin samar wa gabobin da kyallen takarda.
• lalacewar da mutunci da zuciya bawuloli da shambura.
• jari na ruwa a cikin pericardium, wadda take kaiwa zuwa wani take hakkin da dama zuciya rate saboda da matsa lamba exerted a kogo na zuciya (wannan Pathology aka kira cardiac tamponade).
• thickening na ganuwar da zuciya - tsokar hypertrophy.
• hawan jinni rikicin - alama jini abnormality.

noncardiac haddasawa

Bugu da kari ga matsalolin da zuciya zuwa fitowan da cuta jihohi na iya za a implicated a Pathology dangantawa da cutar hawan jini a cikin huhu jini ya kwarara. Cututtuka da kai ga ganewar asali da "m zuciya kasawa":

• bugun jini - take hakkin kwakwalwa wurare dabam dabam, wanda tsokani ta lalace nama da kuma total kwakwalwa aiki cuta.

• thromboembolism jijiya daga cikin huhu (da cutar na faruwa a sakamakon blockage na huhu jijiya, kazalika da ta tafiyar matakai na jini clots (thrombi), mafi yawan jini clots faruwa a cikin manyan pelvic da ƙananan reshe jijiyoyinmu).
• cutar huhu - wani kumburi daga cikin bronchi (mashako), kumburi da huhu nama (pneumonitis).
• dysrhythmia zuciya rate (hanzari ko deceleration) - tachyarrhythmia, bradyarrhythmia.
• cututtuka da lalacewa ta hanyar daban-daban pathogens.

Akwai kuma dalilai da zai kai ga ci gaban da zuciya rashin cin nasara, amma ba a bayyana cututtuka na wani sashin jiki tsarin. Wadannan sun hada da:

• tiyata.
• rauni da kuma kwakwalwa rauni.
• mai guba hari a kan zuciya tsoka - barasa, m miyagun ƙwayoyi daukan hotuna.
• zuciya-huhu na'ura, da yin amfani da wadda take kaiwa zuwa wani sakamakon.
• electrotrauma - sakamako a kan jikin lantarki yanzu.
• Psycho-wani tunanin ko ta jiki exertion.

Ganewar asali da m zuciya rashin cin nasara

Diagnosing zuciya rashin cin nasara ne da farko nufi ga tabbatar da dalilin da Sanadin da ya kai ga ci gaban da Pathology. Kafin dauke da fitar dakin gwaje-gwaje gwaje-gwaje da kuma jan kafa tare da yin amfani da kayayyakin kiwon lafiya, likita zai ƙayyade ta hanyar zance da haƙuri gaban ko rashinsa a cikin rayuwarsa na daban-daban dalilai bayar da tasu gudunmuwar da ci gaban irin wannan cututtuka kamar m zuciya rashin cin nasara. Bayyanar cututtuka na mutuwa (kwatsam) ya auku a cikin sa'o'i 24, za su iya bayyana da rauni, da kuma wani gwani aiki - ba su rasa lokaci, da kuma shan la'akari duk da gunaguni na haƙuri maza maza tsayar da daidai ganewar asali.

Babban bincike hanyoyin amfani a cikin ganewar asali AHF, sun hada da:

• wani electrocardiogram.
• echocardiogram.

• kirji X-haskoki.
• janar da kuma ci-gaba jini gwajin.
• An wani lokacin amfani ga ganewar asali och cardiovisor - na'urar manufa na aiki ne ba daban-daban daga electrocardiograph.

diagnostic sharudda

Manyan kuma mafi pronounced ãyã daga m zuciya rashin cin nasara yanzu za a iya kira sinus tachycardia - samar supraventricular tachyarrhythmias, ga abin da halayyar da aka kara sinus launi - da mita na contractions daga cikin zuciya na fara tasawa ne fiye da 100 da minti. Graphic nuni da zuciya aiki misalta da inganta dalĩli iyakar hagu ko dama. Bugu da kari, a kan saman ko sama da xiphoid aiwatar uku sautin bayyana.

M congestive dama zuciya rashin cin nasara bayyana kanta a dama fasali:

• mahaifa jijiya da kuma hanta jijiyoyinmu to kumbura, kuma kumbura.
• high venous matsa lamba;

• kara hanta, jaundice zanen gado;
• reshe busa.
• cyanosis yatsunsu fuskantar (kunne, Chin, hanci).
• da mãsu haƙuri yana da ciwo mai tsanani a hannunsa na dama sama quadrant.
• ECG rubũta da zuciya kwatsam obalodi na dama ventricle da atrium, wanda aka nuna ta high nuna hakora.

Ãyõyin dama zuciya kasawa ne a fili saukar da X-ray, kuma electrocardiogram. A karshe mataki na irin wannan cututtukan zuciya da take kaiwa zuwa depletion na jiki, rage matakin na gina jiki a cikin jini da kuma tashin hankali na gishiri balance a cikin jiki.

Ãyõyin hagu na ramin zuciya da kuma gazawar cardiogenic buga

Bi da bi, da gaban m hagu na ramin zuciya gazawar da congestive hemodynamics evidenced da da dama daga cikin wadannan siffofin:

• shortness na numfashi, wani lokacin juya cikin fuka.
• paroxysmal bushe tari, expectoration wani lokacin frothy, wanda aka saki daga bakin ko hanci.
• gaban rigar rales wanda ake ji a kan dukan surface daga cikin kirji.

Akwai da dama daga halayyar bayyanar cututtuka na cardiogenic buga, wato:

• A jini na haƙuri saukad da zuwa dabi'u na 90-80 mm Hg. Art. kuma ko da kasa. Idan wani mutum ne yake shan wahala daga hauhawar jini, akwai ãyã daga buga za ki karbar ta 30 mm Hg. Art. daga kullum mutum matakin.
• rage bugun jini matsa lamba - kasa da 25-20 mm Hg. Art.
• Tuhuma da cardiogenic buga kamata sa paleness na fata da kuma ta sanyin cewa. Wadannan manifestations bayyana wani take hakkin da microcirculation a cikin tsokoki na jiki.

Tare da mutumin wanda ya sami sama da bayyanar cututtuka na Pathology, akwai kamata a yi wani jerin abubuwan da suka faru kafin zuwa na kwararru. Taimakon farko ga m zuciya rashin cin nasara (. Bugun jini, ciwon zuciya, da dai sauransu) ya kamata a directed tabbatar da cewa:

• shirya samun sabo ne iska.
• tabbatar da kwance matsayi na haƙuri (idan ba ya da ãyõyin hagu na ramin zuciya kasawa).
• rike analgesic sakamako.

Jiyya na m zuciya rashin cin nasara

Jiyya na zuciya rashin cin nasara - da hadaddun far da nufin, da farko, kuma farkon, don tabbatar da cewa:

• kawar da obalodi cardiac tsoka - wannan ma'auni aka samu da yin amfani da kwayoyi da runtse jini da kuma zuciya rate.
• kama da bayyanar cututtuka da cuta (warkewa matakan zai dogara ne a kan cutar manifestations bayyananen).

Idan DOS ya samo asali a sakamakon tsokar zuciya infarction, shi wajibi ne maza maza don mayar da jijiyoyin zuciya jijiya jini ya kwarara. Yawanci, da yanayin sa infarct jijiya thrombosis, m da zuciya. Magani taimaka jini gudan jini gaba daya mayar patency na jini jirgin ruwa da kuma dattako da haƙuri da yanayin.

A mafi m hanya a cikin wannan yanayin ne dauke thrombolysis, amma hanya ya kamata a yi maza maza bayan farko na infarction har gudan ne har yanzu "sabo ne". Taimakon farko ga m zuciya rashin cin nasara shafi yin amfani da kwayoyi (thrombolytics), wanda mataki ne da nufin a rushe jini clots. Medicaments gudanar intravenously, su kudi na shigar azzakari cikin farji cikin kwayoyin ne tsananin kayyade.

Jiyya na m gazawar (dama na ramin zuciya) da congestive hemodynamics ya shafi kau sa shi ya sa, - .. Status asthmaticus, jini clots a cikin huhu arteries, da dai sauransu An fara far manufa haƙuri "Nitroglycerin" ko "Furosemide" a lokacin da a hade Pathology cardiogenic buga amfani inotropic yana nufin. A hade da sama da matakan da aka za'ayi da oxygen inhalation ta hanyar da catheter.

Psychomotor agitation ci gaba narcotic analgesics, kamar "morphine", wanda rage aiki na numfashi tsokoki da kuma rage danniya a kan zuciya.

Kawar da hagu na ramin zuciya gazawar cututtuka

Stagnation na jini a cikin huhu sau da yawa take kaiwa zuwa tsanani sakamakon kamar na huhu edema. A lokacin da irin magudi marasa lafiya wajabta gudanarwa ta "Nitroglycerin" intravenously.

Idan m hagu na ramin zuciya gazawar da congestive hemodynamics a hade tare da cardiogenic buga, rubũta gabatarwar "dobutamine" ko "noradrenaline" intravenously. Akwai lokuta idan wadannan kwayoyi suna hade a wani hadadden.

Fitar kumfar cropped via nufin samar da kumfa auka.

Idan hemodynamics stabilized, amma huhu edema cututtuka dage, da mãsu haƙuri gudanar glucocorticoids. A wannan yanayin, da taimako na farko a cikin m zuciya rashin cin nasara zai taimaka wajen rage permeability na membranes.

Far da cardiogenic buga farawa zuwa kara cardiac fitarwa, a cikin rashi na manifestations congestive zuciya rashin cin nasara ya qunshi gudanarwa ta jini Expanders. Wannan hanya da aka yi ne kawai karkashin iko da zuciya rate, jini da kuma numfasawa. Idan kafin ya faru na m cututtukan zuciya da ya faru a babban rashi na ruwa, sodium chloride da ake amfani.

Kawar da bayyanar cututtuka na cuta, ba shakka, da farko hade da yin amfani da kwayoyi, amma idan dauka matakan da ba su kai ga so sakamako, za ka iya amfani da hanyar da ta dace - to yi hemodynamic Ana saukewa ta tourniquet a kan reshe jijiyoyinmu.

A lokuta inda ra'ayin mazan jiya magani ne m ƙarasa da tiyata. Data ta shafe ta da matsaloli dangantawa da occlusion na jijiya, sauyawa zuciya bawuloli. Dattako da zuciya rate taimaka wajen kafa wani pacemaker ko defibrillator.

rigakafin

Hanya mafi kyau don hana ci gaban cuta - shi ne don cika da sauki dokoki - wato, to kai da lafiya salon, daina shan taba da kuma daina wuce kima yin amfani da barasa, don gudanar da wani lokaci-lokaci na saka idanu na data kasance kullum cututtuka. Duk da haka, a lokuta idan cutar da ake har yanzu bayyana kanta, kamata ya bi wani takamaiman tsarin mulki a rayuwar yau da kullum.

Marasa lafiya da congestive zuciya ya kamata faɗuwarsu ta saka idanu a hankali su nauyi. Karin kilo tsokane da karuwa a cikin jini sugar da kuma samuwar cholesterol plaques a cikin jini, wanda ya haddasa hawan jini. An muhimmanci sharadin rike da yanayin jiki kullum ne batun da musamman rage cin abinci abinci. Wajibi ne a tsananin tsara da ci na gishiri, da wuce haddi na shi ne mafi sharri a gare kiwon lafiya - shi sa ruwa riƙewa, edema samuwar, ta ƙara load a kan zuciya.

Yana da amfani a yi wasan motsa jiki, ba a aza wa tsokoki da kuma gidajen abinci, amma wasanni azuzuwan kamata ba sa obalodi na jiki. A sa na bada da za a amince da likita. Yana da muhimmanci a akai-akai ziyarci bude iska, barci, guje wa danniya da hankulansu aikinsa.

Don takaice, ana iya lura da cewa, m zuciya rashin cin nasara - da Pathology cewa shi ne sau da yawa m. The rashin lafiya yawanci tasowa a bango na sauran cuta jihohin na zuciya da jijiyoyin jini tsarin da take kaiwa zuwa daban-daban rikitarwa, ciki har da bugun jini, cardiogenic buga, na huhu edema, da sauransu.

Akwai alamu, wanda aka yi fama m zuciya rashin cin nasara. Bayyanar cututtuka na mutuwa iya jabu bayyana, shi ne saboda haka wani muhimmin aiki na kwararru akwai wani Littãfi daga duk haƙuri gunaguni, kuma m nunawa.