WPW sabon abu: haddasawa, cututtuka, bincike da kuma magance

WPW ciwo ne ake kira Pathology a cikin jijiya zaruruwa na zuciya tsoka da cewa yana sa seizures da tachycardia saboda da nassi daga cikin zumudi na wani jijiya turu a kan ƙarin guntu hanyoyi da cewa ba a da lafiya zuciya.

A farko ambaci

A 1930, likita masana kimiyya Wolff Parkinson White kuma na farko da ya bayyana da ãyõyinMu, kuma manifestations na ciwo inji, wanda daga baya aka ba sunan da SVC ciwo (WPW). Akwai irin wannan abu a matsayin WPW-sabon abu. Mun kuma yi la'akari da shi a cikin wannan labarin.

Yadda aka saba, zaruruwa a cikin zuciya, juyayi da conductive zumudi bugun jini ta samar da wata takamaiman hanya, wanda ya samar da uniform da kuma sauka a hankali rarraba lokacinta. Generation na siginar fara a cikin sinus kumburi a dama atrium kai AV kumburi (atrioventricular kumburi) a cikin atrioventricular zone, sa'an nan kafafu cuta reshe block ta cikin Purkinje zaruruwa da zumudi da aka canjawa wuri zuwa duk tsoka zaruruwa na ventricles na zuciya, da kuma dogon hanyar tabbatar da wani hadewa da kuma lokaci daya raguwa dukan zuciya tsoka.

Sanadin da cututtuka

Idan WPW ciwo jijiya turu zumudi daga atria ga ventricles kara a takaice hanya zuwa ga abin da ake kira katako Kent, bypassing da atrioventricular (AV) kumburi. Wato, da kalaman na zumudi ne da yawa fiye da a cikin al'ada kari na bugun zuciya, kuma me ya sa akwai incoordination na rage daga cikin zuciya tsoka, kuma daban-daban iri arrhythmia.

Wannan ita ce hanyar da karayar zuciya bugun jini.

Similar anomalies a cikin tsarin da zuciya ne nakasar da aka kafa kawai saboda hereditary iri gene ko a ƙarƙashin rinjayar sauran dalilai, adversely shafi ci gaban da mutum tayi zuciya.

Tayin ko da yaushe ba ƙarin atrioventricular zobe da zaruruwa, wanda a 20-22-th mako na sirara kuma bace gaba daya. Idan irin wannan zaruruwa suna adana, akwai ilimin Halittar Jiki yanayi WPW ciwo. A hereditary nau'i na WPW-ciwo ne halin da yawa daga AV sadarwa, lahani kuma anomalies a cikin tsarin da zuciya. Duk da haka, kawai a adulthood na iya faruwa a duk da nakasar ilimin Halittar Jiki munanan, na farko bayyanar cututtuka na WPW-ciwo. Na duk lokuta, gaban 70% na ciwo ne kamu a cikin maza.

ãyõyin Pathology

Mafi na kowa bayyanar cututtuka na yiwu gaban WPW ciwo ne da wadannan:

1. Feeling karfi da kuma m palpitations, wanda yara za su iya kira "tsalle ko pounding zuciya."
2. Kwatsam juwa.
3. Unexplainable syncope, yafi a lokacin kuruciya da kuma samartaka.
4. Danna maɓalli zafi a cikin zuciya, tingling da kuma yankan zafi a lokacin da inhaling.
5. Feeling na shaƙa, mai tsanani shortness na numfashi a wani matasa shekaru.
6. Jariri zai iya ki ciyar yiwu profuse sweating, m wani rauni, ta ƙara zuciya rate lokaci zuwa lokaci zuwa 200-300 lashe minti daya.

Yadda za a gane cutar?

A yawa na mutanen da suke da mafi mahaukaci zaruruwa a cikin cardiac tsoka, da WPW ciwo ne kamu kawai a lokacin da ya yi cardiac echocardiography. Deciphering tabbata zai ba da sakamakon.

Irin wannan dako ciwo ba wahala daga bouts na tachycardia ko fibrillation, da kuma iya ko zama Mai gafala daga gaban munanan a cikin zuciya.

Wannan asymptomatic lura a 35-40% na dukkan gano dako na ciwo. M kwarara daga WPW ciwo ne halin da maimaita gajere tachycardia ko fibrillation, abin da sauri ya wuce ba tare da taimako. Don kawar seizures a cikin hali na matsakaici nauyi WPW ciwo bukatar antiarrhythmic kwayoyi ko wasu iri blockers na cardiac zumudi.

A hali na tsawo seizures cewa ba ma cire lafiyar rikitarwa da kuma tarwatsewa contractions daga cikin zuciya tsoka da kuma atrial flutter kamu mai tsanani mataki na ciwo da kuma shawarar tiyata.

ciwo iri

WPW ciwo da kuma zuciya suna classified bisa ga mita da kuma musamman zargin daban-daban na asibiti da ãyõyinMu, kuma ya kasu kashi da wadannan iri:

• Bayyana lokacin da electrocardiogram ne ko da yaushe ba Delta kalaman, kuma ATS-tachycardia da sinus kari bayyana sporadically.
• Canji - ne halin da mai shudewa na ramin zuciya pre-zumudi.
• Boye - ya bayyana episodic AVR-tachycardia, da kuma a Jihar sauran ba kamu.

Ta yaya kuma za a iya gane asali ciwo?

Ba tare da wani electrocardiogram gane asali yiwu WPW-ciwo ne zai yiwu ta na sauraron zuciya sauti, wanda zai zama wani ɓangare na magana arrhythmic a cikin yanayi, kazalika da na sababbu bugun zuciya.

Bugu da kari ga ECG ganewar asali WPW ciwo ake kula ta amfani da musamman šaukuwa na'urar tare da wayoyin, ta hanyar duban dan tayi da kuma echocardiography, gabatarwar haramta motsa wayoyin cikin esophagus tare da m dikodi mai sakamakon lantarki hasken dake fitowa ta, kazalika da hadaddun electrophysiological jarrabawa, wanda ya ba da mafi m model samuwa a cikin cardiac tsoka Kent bim kuma ya yale mu mu bayar da shawarar a ra'ayin mazan jiya, ko m magani.

WPW-sabon abu

Lokacin da safiyo ga gaban WPW ciwo a fiye da 30% na gano dako ciwo wani gunaguni a kan zuciya kiwon lafiya sun taba aka ci karo. Saboda da manyan yawan irin asymptomatic, a 1980, WHO da aka buga shawarwari wanda rabu WPW ciwo da ciwon musamman na asibiti hoto, kuma WPW-sabon abu.

Game da wannan sabon abu, shi ne kammala da cewa a electrocardiogram zuciya sinus kari yana da ãyõyin wanda bai kai na ramin zuciya zumudi, amma batutuwa ba pathological jihohin da atrioventricular tachycardia aka lura.

Duk da wannan, a lokacin da sabon abu WPW hadarin rikitarwa ne sosai high, sa wani tasiri - a zahiri ko wani tunanin danniya, barasa, tafiya a cikin wanda ba a sani Gwargwadon zones - zai iya sa bayyanuwar m bayyanar cututtuka na WPW ciwo. A na yawan balagaggun jama'a a 0.3% na lokuta da WPW-sabon abu ne m, sun yi nazari yara nuna asibiti mutuwa a 2% na lokuta.

Statistics WPW sabon abu a cikin yara

WPW-ciwo bautar wani abu wuri a cikin abubuwan da haifar da tachycardia da arrhythmia a yara. Shi ne ya bayyana dalilin kara rushewa daga cikin zuciya launi, har ma da rashi na gunaguni ba na rage hadarin irin wannan cuta. Duk wani jiki obalodi, m motsa jiki, m dalilai iya fararwa da gazawar kirkirarriyar farin ciki zuciya har ma da kai ga mutuwa daga wani ciwon zuciya.

Dogon lokacin da monitoring domin kusan shekaru 20 ga babban rukuni na yara wanda ake bincikar lafiya zuciya WPW ciwo, zãmunna jariri shekaru 18, ya nuna da wadannan sakamakon:

• 8% na yara samu kwatsam farko na ABP-tachycardia.
• 8.2% na batutuwa samu wani mai shudewa sabon abu mika mulki WPW ciwo.
• a 8.5% na gajere asarar sani.
• 2% na yara a lokacin da farko binciken sun riga sha wahala asibiti mutuwa.
• 1.2% - kawai boys - ba zato ba tsammani ya mutu duba lokaci.
• kawai 9% na yara da WPW sabon abu ruwaito bacewar alamun data.

Ta yaya hatsari sabon abu WPW?

Daga wadannan Figures shi ne bayyananne yadda gaban ko unsafe ne WPW sabon abu. Wannan high yawan m bayyanar cututtuka da kuma pathologies a lokacin suna yara ba filaye su ɗauka cewa ba tare da sunã rãyar da jiki da kuma wani tunanin danniya, ba tare da wani tsarin sa-ido da warkewa matakan da shekaru, wannan kaso, kuma da barazana da rayuwar za ta kara.

Yara da WPW sabon abu kada tafiyar da sana'a wasanni, kuma ya hõre su m danniya dalilai. Kariya kamata a dauka don ba zato sauyin yanayi canjawa ko events, sa mai tsanani wani tunanin, sakamakon. Dukkan wadannan dalilai na iya zama sosai m to kai ga tsanani rashin lafiya, ko mutuwa. Mutane waɗanda suka shar'anta gaban WPW ciwo ko sabon abu, ba ya kira up for soja.

Magani da kuma taimako na ciwo

Alamun da jiyya da ake sau da yawa m. Akwai da yawa magunguna da cewa taimaka zuciya harin ya sa ta WPW ciwo, da kuma rage bayyanuwar ta bayyanar cututtuka.

a shafi kwayoyi kungiyar daidai a cikin mita na contractions daga cikin zuciya tsoka. Duk da haka, da tasiri na wannan wajen da aka nuna ne kawai a matakin 50-60%, kuma ba za a iya amfani da m hypotonia da kuma asma.

Antiarrhythmics quite barga cropped harin AVR-tachycardia, normalize zuciya kudi a 80% da marasa lafiya, amma kuma da yawan contraindications a cikin hali na hypotension, ciwon zuciya da kuma sauran cututtukan zuciya da yara da kuma samartaka. Wasu alli blockers cikakken contraindicated a cikin WPW ciwo, kamar yadda hoton a baya na inganta watsa wani jijiya turu, suna kasawa a atria, wanda yana da tsanani, kuma babu ja sakamakon.

Har ila yau, a wasu lokuta, da amfani da kwayoyi ATP kungiyar lura da wani mummunan sakamako a kan atrial ƙanƙancewa. Akwai kuma wadanda ba magani hanyoyin da taimako na bayyanar cututtuka.

A tsoka jijiyar ratsa cikin m da kuma parasympathetic zaruruwa. A farko da irin zaruruwa activates da zuciya, na biyu irin slows saukar da zuciya rate, kamar yadda wani irin vagus jijiya nervus vagus, da kuma kira vagal reflex. Wato, da kunnawa da daidai wannan irin reflexes zai ba da sakamako na karfafawa daga cikin zuciya. A mafi sauki hanyar Don kunna vagal hasken dake fitowa ne da ake kira reflex Aschner wanda tsokani 20-30-biyu mai laushi touch a kan eyeballs kuma sau da yawa taimaka wa tasha tachycardia.

Har ila yau, da vagus jijiya ne da kunna ta numfashin-Holding da kuma irin ƙarfin lantarki na ciki tsokoki, don haka wannan al'amari na WPW ciwo ko amfani gudanar da aiki yoga da numfashi bada.

An fara Hanyar saran alama ta wani lantarki saka a cikin esophagus, sosai yadda ya kamata tsaya a nan nauyi shafe tsawon tachycardia, amma wani lokacin kai ga fibrillation na zuciya, don haka a yi a musamman kabad sanye take da wani defibrillator.

Defibrillation aka yi kawai a sosai mai tsanani lokuta, a lokacin da tsanani barazana ga rayuwa, amma shi sau da yawa taimaka wajen kawar da hadarin gaske hotbeds na waje hasken dake fitowa a cardiac nama da kuma normalize zuciya kari aiki.

Gudanar da magani WPW ciwo da su larura

Idan gano sabon abu WPW ECG aiki Hanyar kawar aka yi amfani ne kawai a na kwarai yanayi, da m da kuma shafe tsawon tachycardia, wanda ba za a iya cire tare da magani, kazalika da a kafa lokuta na kwatsam cardiac mutuwa, dangi na haƙuri ko don sana'a dalilai.

M magani bada shawarar kawai a kan tushen da wani m da kuma cikakken jarrabawa, wanda ya ba da mafi m hoto na pathological nama Tsarin daga cikin zuciya. Saboda haka, ya kamata ka bincika ko yin aiki tare da sabon abu WPW.

The aiki aka yi amfani da musamman lantarki, wanda an saka ta cikin femoral jijiya da zuciya tsoka ta X-ray kallo da kuma a wasu wuraren samar radioprizhiganie ko ablation, jijiya zaruruwa.

Yana iya ma iya za'ayi kriorazrushenie pathological jijiya zaruruwa. Kuma a gaskiya, a lokuta biyu da aiki yadda ya dace ya kai 95%. Sake komowan cutar faruwa saboda bai cika halaka ana gyarawa foci, da kuma a gaban san ko su wanene abokai da sauran na tsarin jijiya kyallen takarda. By kanta, da aiki za a iya yi a karkashin maganin sa barci, kusan zubar da jini ba, ba ya haifar da rikitarwa, yana da matukar gajeren dawo da lokaci da kuma iya haka za'ayi a kowane zamani.

Cardiac cibiyoyin a Moscow

Cibiyar Surgery. A. V. Vishnevskogo - da girman kai na cikin gida da magani, yana da hanyoyin zamani domin lura da ganewar asali, gudanar da bincike, iri daban dabam high-tech bincikowa da kuma musamman cardiac tiyata. FGBU "NNP Cibiyar da cututtuka na zuciya Surgery su. A. N. Bakuleva "aikin likita, kimiyya da ilimi da ayyukan da shirin" zuciya da jijiyoyin jini Surgery. "

Rasha Cardiology Research and Production Complex gudanar da safiyo da kuma lura da cututtukan zuciya a high-tech duniya matakin. A "cardoid" cibiyar za ka iya sha cikakken cardiac kimantawa, sami ingancin warkewa magani a kan wani outpatient akai. Cardiological Center a Moscow yi aiki da kyau, don haka idan kana da bukatar m baki da su bi, ba za ka iya yi shakka.