Chosakwanira bwino mtolo chipika nthambi

M'nkhani ino tikambirana kudwala ichi monga chosakwanira anatseka misewu ya mwendo chipika mtolo nthambi. Izi tsankho kuphwanya zikhumbo magetsi mu mtima. Matenda kawirikawiri asymptomatic, koma umboni wa matenda organic mtima ndipo zimakhudza zotsatira za matenda choyambirira. matenda, potengera zotsatira za maphunziro electrocardiographic. Chosakwanira bwino mtolo nthambi chipika ndi pa imodzi ndi theka awiri lonse anayi magawo zana a milandu, ndi zaka, Chiwerengerochi kuonjezera yekha. Mwa mitundu yonse ya blockades pafupipafupi kudwala ili lili pa nambala wachiwiri.

Etiology wa pakuwonekera kwake

chifukwa angathe kutumikira monga ziwonongeke mtima, inatsekeratu matenda mtsempha wamagazi ndi ambiri osokoneza wa wotsutsa-arrhythmia, mtima m'mapapo mwanga, stenosis wa valavu mitral, matenda oopsa m'mapapo mwanga, mavavu tricuspid mtima, pachimake m'mnyewa wamtima infarction, myocarditis, cardio, hypertensive mtima, vutoli wa electrolytes mu thupi, ndipo yamitsempha yamagazi hypertrophy. yosowa kwambiri chosakwanira bwino mtolo nthambi chipika matenda akuluakulu wathanzi wamng'ono. Zikatero, tikulankhula za n'zabwinobwino.

Chosakwanira bwino mtolo nthambi chipika ndi chifukwa deceleration zimafalitsa onse nkusani ndi nyemba ectopic pomwepo. Zimenezi, kumabweretsa kusintha kwambiri mu malemeredwe mbali zina za mbali ya ventricles kapena basi kwathunthu ventricle.

Chosakwanira anatseka misewu bwino mtolo nthambi chipika: zizindikiro

Nthawi zambiri, kudwala izi sayambitsa zizindikiro zilizonse noticeable, chifukwa kayendedwe ndi pafupipafupi mtima si bwanji.

Matenda a matenda, monga tatchulazi, maziko deta analandira mwa maphunziro electrocardiographic.

Nawu mndandanda wa zizindikiro zowonekera kuti:

• QRS zovuta nthawi ndi kuchuluka pang'ono, mpaka hundredths zisanu ndi zinayi kapena khumi lachiwirilo.
• Choyamba ndi V6 kumabweretsa pang'ono wakulitsidwa dzino S ndi ufulu chifuwa V1 atigwira QRS zovuta akuimira rSr, kapena rsR.

Chosakwanira anatseka misewu bwino mtolo nthambi chipika: chithandizo

Kutalika ndi kukhazikika wa kudwala alipo zambiri popanda mankhwala aliwonse. Koma zinthu komwe chikuoneka chikugwirizana ndi aggravation matenda a mtima, mankhwala yake n'kofunika kwambiri kuti normalization wa conduction mtima. Ngati onse miyendo anatseka misewu ina sukhalitsa AKUYENDA asonyeza, anapereka kuwonjezeka nthawi ya HV-imeneyi pa 80-100 milliseconds. odwala onse akuluakulu ndi kuvutika conduction ngati imvera hospitalization mokakamizidwa. Matenda pachimake ndi pakalibe mankhwala contraindications mankhwala ingagwiritsidwe, popanda n'kuwaiwala inconstancy ndi kusadalirika mwa njira imeneyi pofuna kusokoneza kudwala izi. Ngati bwino, mungathe kudalira kwenikweni kanthawi.

Iwo amagwiritsa ntchito mankhwalawa mankhwala amenewa:

1. Anticholinergics, amene kuchepetsa makhalidwe vagal, mwachitsanzo 0.1% atropine milliliter wina kudzera m'mitsempha 0.2% platifillin monga milliliter wina kapena ngati subcutaneously, m'nsinga, koma mu nkhani iyi m'pofunika kuti atchule 5% shuga mu buku 500 ml.
2. Mankhwala kuonjezera mphamvu ya wachifundo mtima dongosolo conduction Mwachitsanzo, 5% ya ephedrine mu umodzi milliliter mu mnofu, subcutaneous, kapena mtsempha jekeseni, 0.2% norepinephrine, kuchuluka kwa 1 ml kutumikiridwa pa shuga, kapena 0,05% alupent, theka kuti kyubu wina, kutumikiridwa onse intramuscularly ndi m'nsinga, kapena 0.1% izadrin mu umodzi buku milliliter.
3. Monga mahomoni ntchito glucocorticosteroid, mwachitsanzo, hydrocortisone, pa mlingo wa mg wa ku 200 patsiku.
4. Kuchepetsa zili potaziyamu ndi zofunika kugwiritsa ntchito 1% ya Lasix zedi wina milliliter.

Kulosera tsogolo la matenda a matenda ndi yabwino kwambiri, koma anapatsidwa chiopsezo kukulitsa iwo onse a matenda okhudzana mtima, ayenera kukhala kwambiri kwambiri chithandizo.