Kwesokudla ventricular ukwehluleka: izimbangela, izimpawu, ukwelashwa

ukuhluleka Inhliziyo. Lapho ukhuluma ngabantu bakubo ngokuvamile babe engqondweni noshintsho okuhlotshaniswa ukusebenza kahle ka -ventricle engakwesobunxele. Futhi nje isikhashana edlule, ososayensi balithanda umsebenzi i-ventricle yangakwesokudla. izifundo okuqhubekayo baye babonisa umehluko ukusebenza abalulekile kwesokunxele bese kwesokudla inhliziyo emakamelweni. Kukhona ilungelo ventricular ukwehluleka ngenxa yokwephula we yokujikeleza kwegazi eliya emaphashini ngenxa ukungasebenzi esivimba amanzi. Ngoba ngezinye izikhathi ibizwa inhliziyo njengoba yamaphaphu.

Izimbangela kwesokudla ukwehluleka ventricular

ukuhluleka Inhliziyo kungavuka esingamahlalakhona noma oyingozi, oyinhloko noma lesibili. Kususelwa uhlobo lwesifo, izazi lakhomba inani izizathu ivela khona.

Ukwehluleka oyingozi ventricular ngakwesokudla (izimpawu kuzoxoxwa ngezansi) ingaqala uma: ukudabuka we septum interventricular; omkhulu embolism yamaphaphu; myocarditis; ukuhlasela okungathi sína kwezazi somoya bronchial; Kwesokudla ventricular isilethikusebenza; inyumoniya Imininingwane oyingozi.
Omsakazo we ezingamahlalakhona ventricular kwesokudla ukwehluleka ngesimo:

• Lapho pericarditis ezakhayo futhi azalwa naso inhliziyo yayo yayinezinkinga ezicini, okuyinto zenzeka, ngokweqile i-ventricle yangakwesokudla (yomthambo i-aorta ne-valve lesion; triskupidalnogo valve esingamahlalakhona).
• Pathology umgudu wokuphefumula (bronchiectasis, sarcoidosis, emphysema, ukucinana kwemigudu yokuphefumula, isifuba somoya).
• ukukhuluphala Sinzima nge amplitude ukuncipha ukunyakaza diaphragm.
• Ukwephula yamaphaphu Uhlelo kwegazi (vasculitis; thromboembolism, umfutho ophakeme wegazi yamaphaphu), kokucindezelwa kusukela ngaphandle (useshonile yomthambo i-aorta, isimila).
• ukuhamba Limited esifubeni ukuthi kubangelwa izifo kohlelo kwamanyuroni (autoimmunity, uvendle nesifo), emgogodleni (isifo Bechterew sika, ukugobeka komhlandla).

Futhi, ilungelo ukuhluleka inhliziyo ingaba yesibili ukuvuma okwakufunwa kwesokunxele ukwehluleka ventricular emva yi kuphazamiseka okunzima yokujikeleza kwegazi eliya emaphashini kwaba ukwanda yamaphaphu izitsha Umthambo wegazi futhi okuvela ukunqwabelana iminyango efanele.

symptomatology

Acute kwesokudla ukwehluleka ventricular kubangela nomfutho wegazi ophezulu yamaphaphu, okuholela ekugcineni ukunciphisa inani igazi ukhiphe i-ventricle engakwesobunxele.

uvele Isiguli elikhula ngokushesha, lezi zimpawu ezilandelayo: isikhumba lokushisa lehla (akrozianoz); ophilisayo inhliziyo; pulsate sikhukhumale bese umthambo jugular; kukhona umuzwa yokuntuleka emoyeni, futhi iphika; edema yamaphaphu ngenxa lenyuka capillary permeability. Okungalapheki ukwehluleka ventricular kwesokudla ububonisa kancane ehlukile uqobo.

Ngaphezu kwalokho iveza izimpawu ukucinana kwegazi:

• oliguria, perfusion kwezinso;
• ubuhlungu ngakwesokudla quadrant eliphezulu ukungezwani amaphilisi, kweNdikimba isibindi;
• ekuqongeleleni uketshezi izimbotshana thoracic futhi besisu (hydrothorax futhi ascites);
• edema nemilenze aphansi futhi ngokushesha - the anterior udonga besisu.

Izimo zethu zihluke kakhulu ngokwemvelo kuzoba ukuthuthukiswa okuthile engqondweni, okuwumphumela ephula outflow ka-cerebral nomfutho wegazi ophezulu pooling eyeqile kolwelwesi.

Njengoba kwembulwe ukwehluleka ventricular kwesokudla?

ekuxilongweni

Nquma ilungelo inhliziyo ukwehluleka wedwa akunakwenzeka, ingenza onguchwepheshe agcwele isifo satholakala. Kulokhu, sikhonjiswa lezi izifundo zokwelapha njengoba-X-ray thorax, i-MRI, i-ultrasound, electrocardiogram. ukuhlolwa ezidingekayo laboratory - urinalysis, kwamakhemikhali futhi emtholampilo ukuhlolwa igazi.

Uma umuntu linelungelo ukwehluleka oyingozi ventricular, bese phakathi ECG ungakwazi bagcine sindisa okunamandla umnyango senhliziyo esifanele, ultrasound ikhomba izimila ahlukahlukene kanye nezinguquko endaweni esivimba amanzi. MRI wenziwa uma isithombe emtholampilo ngokuphelele.

Uzothini igazi?

Ngokuvamile, ukuhlaziya igazi kungabonwa inani leukocyte, futhi ngenxa yalokho, degree of Ukulandelana ukuvuvukala. Igazi ukuhlaziywa kwamakhemikhali ikhombisa khona kuthikameze impilo kanye nesimo amazinga ama-hormone. Ngemva imiphumela zonke izifundo kanye cwaningo kuyoba ezandleni onguchwepheshe, ngemuva kwekufundza tikhatsi letinyenti izikhalazo lesiguli kanye kabusha luhlolo kungaba ukusazi ngokunembile isifo esikuphethe nezindlela ukwelashwa okufanele. Uma une nobunzima ekwenzeni uphethwe lizodinga MRI kanye-X-ray.

ukuhluleka ventricular Right kuyingozi ngempela.

ekuvimbeleni izifo

Yiqiniso, zikhona izimo lapho akwenzeki ukugwema isifo senhliziyo, ikakhulukazi uma kuziwa yofuzo. Kodwa lokhu akusho ukuthi ukuthola eqenjini ingozi ekhulula umuntu ofeza zokuvimbela. Ngokuvamile senhliziyo esifanele ukwehluleka ventricular kwenzeka ku isizinda isifo eziyimbangela, okwenza umsebenzi ekuvimbeleni nokuvimbela esifike lokubuya kwesifo izinqubo ezingamahlalakhona sokugembula futhi kulondolozwe ukuthethelelwa isikhathi eside.

Izinyathelo kudinga umsoco ofanele, balondoloze yokuphila asebenzayo, ezolile ngokomzwelo, Yiqiniso njalo yokwelapha izidakamizwa, ukulawula isisindo cardio. Uma yokwelapha izidakamizwa is contraindicated reception izindlela ezingaziwa ngaphandle kokubonisana ngaphambi udokotela.

inhliziyo Right yokwelapha ukwehluleka

Ekwelapheni kwekhora pulmonale sibhekiswe ekhuluma isifo umsuka ukunciphisa izenzo isifo senhliziyo-omunye umsipha (ukwelashwa okunezimpawu). Acute kwesokudla ukwehluleka ventricular kudinga ukuqedwa ngokushesha ngezimbangela zako:

• Isimo asthmaticus kudinga ukuqashwa kukaNksz corticosteroids ebulilini.
• ukususwa Steel noma kuqedwa ihlule legazi umfula yamaphaphu liyadingeka uma PE.
• Amaphaphu pneumothorax kudinga amanzi ka ingaphakathi pleural, esisogwini yesibili isikhala intercostal.
• nomfutho wegazi ophezulu yamaphaphu kuyehla usebenzisa ganglioblokatorov futhi aminophylline.
• Isifo samaphaphu kudinga imithi elwa namagciwane nge spectrum ebanzi senzo.
• Esivimba amanzi ukugeleza kwegazi kudinga yokutakula ku nemithambo yegazi yenhliziyo.
• Ngashaqeka iphathwa ngu ekuphathweni emthanjeni ukutshezi kanye sympathomimetics.

ukwehluleka ukwelashwa Okungalapheki

Okungalapheki kwesokudla ventricular senhliziyo iphathwa ngu izindlela eziningana ezahlukene. Ukuze kuncishiswe yokujama tsi wegazi letindzala kwegazi ngokuvamile ezinqunyiwe ukwelashwa isisu. Yesifo senhliziyo azalwa naso ngokuvamile kudingeka uhlinzwe, kuhlanganise ukufakelwa wenhliziyo / wamaphaphu noma inhliziyo kuphela. Ukuze kuncishiswe ingcindezi ngaphakathi Umthambo yamaphaphu, ingasetshenziswa:

• Ukuze wehlise Imininingwane izitsha ukumelana neuropathy, ukuphumula kwemithambo yegazi kanye emithanjeni usebenzisa i-alpha 1-blocker.
• Okuningi amelana ukuntuleka komoya-mpilo myocardium ukwenza calcium abamelene ( "Diltiazem", "Nifedipine"), ukuphumula imisipha bushelelezi yegazi ku yokujikeleza kwegazi eliya emaphashini.
• Ukwehlisa inani igazi yamaphaphu futhi kwehle ukubuya emithambo yegazi ngakwesokudla ATRIUM imbangela nitrate (isosorbide dinitrate).
• I ukumelana kule Umthambo yamaphaphu, umthamo wegazi, nangemuva Layisha ngakwesokudla ventricle imbangela ACE inhibitor ( "Enalapril" "Capoten") lapho isinyathelo renin-angiotensin uhlelo aldostenovuyu.

Okufanele ukwenze uma izinkinga?

Lapho kuvela izinkinga zokulungile inhliziyo ukwahluleka ezingamahlalakhona fibrillation atrial ngempela walungisiswa ukuqashwa kukaNksz inhliziyo glycoside digoxin.

Amathuba kwesinyathelo esiqondile ekwelapheni isifo kuxhomeke ezingeni esiphakamisa umonakalo izitho ezigulayo futhi comorbidity. Therapy olunzima in iziguli eyinhloko nomfutho wegazi ophezulu yamaphaphu futhi thromboembolism yansukuzonke. Lapho kwesokudla senhliziyo decompensation lesiguli ngefomu okungamahlalakhona, empilweni yalo sokuphila kubalulekile iminyaka kungekho kuka ezintathu kuya kweziyisihlanu.

ukuntula elingalodwa

Muva nje, abacwaningi unesithakazelo angawodwa kwesokudla ukwehluleka ventricular, okuyinto kwaqala ngemva ukuvela izindlela ezintsha sokutadisha inhliziyo. Ososayensi bathole ukuthi kudala kungenzeka izifo yamaphaphu, kanye ukungasebenzi izitsha yokujikeleza kwegazi eliya emaphashini futhi i-ventricle yangakwesokudla. It lingahunyushwa baphetha ukuthi in iziguli isifo samaphaphu Kunoma yikuphi, ukuhluleka kwenhliziyo, okuyinto zingase ziqale ukubonakala engakapheli yezinkinga ezibangelwa yilokho. kwesokudla senhliziyo Primary zingatholakala kakhulu kuyaqabukela. Ngokuvamile ihlobenenamanye kwezinso azalwa nako.

Sesihlole into ezifana kwesokudla ukwehluleka ventricular. Ukwelapha wachaza ngokuningiliziwe.