Decompensated inhliziyo ukuhluleka - kuyini? Izimpawu kanye Ukwelashwa

Ihlangana ihlawulelwa futhi decompensated yokumelwa yinhliziyo. Ihlawulelwa kubhekwa ukuntula omnene (esigabeni 1).

Decompensated senhliziyo isigaba ukuphela kwalesi sifo, okuwumphumela iqiniso lokuthi ezilimele senhliziyo esilimele akakwazi ukuletha igazi izinhlelo ezihlukahlukene nemisebenzi umzimba womuntu. Sici sici wawubonakalisa hhayi kuphela ngesikhathi umsebenzi, kodwa futhi uphumule. Ngokuvamile lapho decompensated senhliziyo kwenzeka izinguquko ezishisiwe inhliziyo sokugembula futhi zisebenza kahle. Lezi zinguquko ngokuvamile awushintsheki futhi kungaholela ezibulalayo. Lolu hlobo zokugula okuhlobene okukhulu (esigabeni sesithathu).

Kulesi sihloko, decompensated senhliziyo kuzoxoxwa ngakho ngokuningiliziwe: ukuthi kuyini, yiziphi izinhlobo ezahlukene, izimpawu zesifo kanye nokwelashwa kungenzeka.

Izimbangela SDS

Ngeshwa, umsuka walesi sifo ososayensi bengayiqondi ngokugcwele. Nokho, ucwaningo kule ndawo kusikisela ukuthi decompensated ukuhluleka kwenhliziyo kungenzeka uma kukhona trigger. Lezi zici zingaba imbangela yalesi sifo. Phakathi kwabo:

• hypertrophy myocardial.
• Ibangelwa ngemuva kokuhlaselwa yisifo senhliziyo, ukuhlukumezeka, ischemia noma infarction myocarditis ushintsho ubuqotho kwesakhiwo.
• Inkinga abanomfutho wegazi ophakeme.
• izenzakalo Arrhythmic.
• Amacala okungazelelwe ingcindezi kwenyuswa yokujikeleza kwegazi eliya emaphashini.

ububonisa Ngakho ngokwayo decompensated yokumelwa yinhliziyo. Kuyini sinesithakazelo kuso abaningi.

Belingana ezibalwe ngenhla futhi nomnyombo sifo kungaba zonke izinhlobo izinqubo amile umgudu wokuphefumula. Kuzo zonke lezi zimo kukhona ojwayelekile: i SDS, kanye nezinye izinhlobo senhliziyo kwenzeka ngenxa sindisa ezibucayi kanye ukukhathala ngokweqile imisipha yenhliziyo.

Isithombe emitholampilo kanye ezihlukahlukene decompensated senhliziyo kuchazwe lapha ngezansi.

Ngaphambi kokuthi uqale isifundo esiphathelene SDS izimpawu, kufanele kuphawulwe ukuthi isithombe emitholampilo ye isifo kuncike ngokuphelele uhlobo yokumelwa yinhliziyo. Ochwepheshe ukukhomba amafomu amabili - chronic oyingozi. Ake ukugxila ngamunye wabo.

Ukwehluleka oyingozi inhliziyo decompensated

It kuvela futhi ithuthukisa emva decompensation okusheshayo, okuvela isinxephezelo lapho akunakwenzeka. Izindlela ukuhluleka nenhliziyo, ezinjengomoya anda ithoni emithambo yegazi, kukhuphuke tonic umsebenzi noma ukwanda ngenani ventricular diastolic ngokugcwalisa ngegazi, ayikwazi ukuvela ngenxa izici bokuphila amafomu okukhulu SDS. Ukuze lezo zinhlelo zihlanganisa:

1. Kwesobunxele SDS ventricular ngendlela oyingozi. Sibangelwa esivimba amanzi noma mitral valve stenosis. Izimpawu sici kukhona ukuvuvukala ngokweqile amaphaphu zokuphefumula uhlelo overfilling imithambo yegazi. Yini okunye okwenzekayo decompensated yinhliziyo? Izimpawu sizoxoxa kamuva.
2. SDS Right ventricular ngendlela oyingozi. Kuvela ngoba idluliselwe infarction nesineke noma thromboembolism, okuholela umsebenzi nobuqotho iphazamiseke mezhduzheludochkovoy septum. izimpawu esivamile acute kwesokunxele SDS ventricular kanje: kukhona ukwanda okukhulu kwezincwadi kwesibindi, igazi stasis eqondiswa kwegazi, emaphashini Ungagcwalisa ngegazi.

Ifomu acute kuyingozi?

Ngeshwa, ifomu acute libhekene ezingeni lelisetulu abashona ngenxa yokuthi imisipha yenhliziyo iba abakwazi ukushayela ngenani elithandekayo igazi kokungaxhunyiwe isinxephezelo umsebenzi (noma enganele), futhi ngenxa edema yamaphaphu noma isilethikusebenza. Endabeni ka izimpawu amafomu okukhulu SDS kokungenela ophuthumayo ochwepheshe ezofaka isiguli esibhedlela bese ubamba uchungechunge yezenzo kwadingeka kwezinhlelo yokusiza umuntu ukuba aphefumule.

Iphinde kwenzeka ngo ezingamahlalakhona decompensated yokumelwa yinhliziyo. Kuyini lokhu? On lokhu kamuva.

Ifomu njalo SDS

CHF kungavuka ifomu decompensated. Kulokhu, izimpawu ezihlukahlukene engaveza, lonke sokunqophisa okuyinto eyenziwa sivivinyo seluhlololucwaningo. Ukuze CHF isici lokhu isithombe emtholampilo:

• Izimpawu ukuvuvukala okunzima izinyawo, phansi esiswini, scrotum, kanye kule pericardium.
• Arrhythmia futhi hypoxia.
• abandayo nemilenze syndrome.
• I abukhali ukwanda isisindo emzimbeni.
• Izenzo mitral futhi esingamahlalakhona tricuspid.
• Ukubukeka iphika, kuhlanganise ukungabi khona umzimba.

Decompensated ezingamahlalakhona inhliziyo ukuhluleka - a zokugula, lapho semfene ngokuvamile zibonakala umgudu wokuphefumula. rales yamaphaphu (lapho isiguli osesimweni lisalele) kungatholakala by ukuhlolwa izisebenzi. Imbangela ezinjalo kuwukweqisa igazi ligeleze umgudu wokuphefumula. Olunye uphawu kungenzeka hypoxia futhi, ngenxa yalokho, ukwehlisa ukwazi. Hypoxia kwenzeka ngenxa enganele igazi ebuchosheni ikhanda futhi ukuntuleka komoya-mpilo.

Kubalulekile ngesikhathi esifanele babone leso sifo, ezifana ezingamahlalakhona decompensated senhliziyo (lokho manje kucace).

ukuhlola

izinyathelo Inxanxathela zokuxilonga zihlanganisa ukutadisha izinguquko ezingeni ureticheskogo peptide beta-hlobo, peptide H-hlangothi, futhi beqhuba echocardiography futhi-X-ray viscera, transkoronalnoy echocardiography.

Olunye ulwazi eqondile mayelana amandla wegazi emakamelweni inhliziyo Ochwepheshe ingatholakala ngokufeza inqubo ekhethekile, phakathi kwesikhathi lapho vein emaphakathi noma yamaphaphu Umthambo ipayipi futhi iveza edingekayo ukulinganisa.

Futhi, ukuxilongwa noma yiluphi uhlobo senhliziyo ukuba sifeze eziningi zocwaningo, kuhlanganise creatinine ukuhlolwa igazi urea, ngoba electrolyte, ne-glucose transaminases, futhi ezinye izivivinyo egazi noma omchamo; ukufunda khona kanye isilinganiso yamagesi egazini imithambo.

Decompensated senhliziyo: Ukwelashwa

Ngokusho idatha kwezibalo zonyaka we-2010, kusukela senhliziyo eRussia unyaka ngamunye ubulala abantu abangaba ngu-1 million. Kuyinto okuvela decompensation futhi inhliziyo isigqi thuthuva ngokuthi ochwepheshe isizathu esiyinhloko high bebeletha. Decompensation ngokuvamile edinga lwezokwelashwa olusheshayo. Ngakho-ke, ngaphandle okuhlukile ezingavamile, ukwelashwa izidakamizwa is okwenzeka esasikhipha imithi ngemithambo yegazi (ukuthola imiphumela elawulwa futhi ngokushesha).

Okuningi ku ekwelapheni decompensation

Umgomo oyinhloko wabo yokwelapha iwukuhlale evamile elithwala umoya-mpilo-mpilo saturation ezingeni, ngaleyo ndlela ikwazi ukuba supply ejwayelekile umoya-mpilo ezicutshini futhi kwezitho ukugwema lezo zitho zomzimba eziningi.

Enye amasu esebenzayo - kokuqhuba-mpilo imuncwe (ngokuvamile asetshenziselwa ukupholisa non-koda (NPVD) kwengcindezi positive), okwenza kungabi nesidingo endotracheal intubation. Lesi sakamuva isetshenziselwa ukupholisa mechanical uma kwenzeka ukwehluleka ukuqeda obstructive isifo samaphaphu ngu NPVD.

Ukwelashwa ngemithi

Ekwelapheni ukusetshenziswa decompensation kuhlanganise ukwelashwa. izidakamizwa ezisetshenzisiwe kanye namaqembu abo:

• "Morphine" futhi analogue yayo. Isetshenziselwa ukunciphisa ukushaya kwenhliziyo ekunciphiseni izinhlungu.
• Isisu. Asetshenziswa uketshezi alibale izimpawu emzimbeni;
• Inotropes ukuqeda hypoperfusion neuropathy.
• Vasopressor ejenti sokuthuthukiswa evamile isitho perfusion.
• "Dobutamine" inyuka okukhipha inhliziyo.
• Norepinephrine kuthuthukisa ukumelana semithambo.
• glycosides senhliziyo ukunciphisa blood pressure, kuncishiswe ingozi decompensation oyingozi.

Nokho, uhlu olunembile imithi edingekayo ngempumuzo kanye nokwelashwa SDS ukubona futhi wenze udokotela kuphela adla.

Sesihlole ukuthi kusho ukuthini decompensated yokumelwa yinhliziyo.