WPW chodabwitsa: zimayambitsa, zizindikiro, matenda ndi mankhwala

syndrome WPW amatchedwa kudwala mu Ulusi mitsempha ya minofu mtima omwe amachititsa khunyu ndi tachycardia chifukwa ndimeyi wa malemeredwe kwa mitsempha mopupuluma pa njira zina wamfupi kuti si mu mtima wathanzi.

Kutchula koyamba

Mu 1930, asayansi zachipatala Wolff Parkinson White woyamba kufotokoza zizindikiro ndi kuwonekera kwa limagwirira syndrome lomwe kenako anapatsidwa dzina la vuto SVC (WPW). Pali chinthu monga WPW-chodabwitsa. Ifenso amaona m'nkhani ino.

Mwachibadwa, Ulusi mu mtima, mantha conductive malemeredwe zimachitika kupanga njira yeniyeni, amene amathandiza yunifolomu ndi kugawa mwapang'onopang'ono patsogolo. Signal m'badwo kumayambira nkusani mfundo mu atrium amayesetsa ndi AV mfundo (atrioventricular mfundo) mu zone ya atrioventricular, ndiye miyendo ya mtolo wake kudzera Purkinje ulusi malemeredwe imafalikira mu misempha yonse minofu ya ventricles mtima, kutali imapereka yolongosoka ndi synchronous chidule lonse mtima minofu.

Zimayambitsa ndi zizindikiro

Ngati WPW syndrome mitsempha mopupuluma malemeredwe ku atria kuti ventricles imafika yochepa njira otchedwa mtengo Kent, anyalanyaza ndi atrioventricular mfundo (AV). Ndiko kuti, funde la malemeredwe ndi zambiri mofulumira kuposa kayendedwe zachibadwa za kugunda kwa mtima, ndipo chifukwa chake pali incoordination wa kuchepetsa minofu mtima, ndi mitundu yosiyanasiyana ya arrhythmia.

Umu ndi mmene a osweka mtima zimachitika.

Similar anomalies mu kapangidwe ka mtima ndi kobadwa nako ndi anapanga basi chifukwa cholowa kupsyinjika jini kapena mutamwa zinthu zina zikuwononga moyo chitukuko cha munthu Ndisanaumbidwe mtima.

Wosabadwa zopezeka zina atrioventricular mphete ndi ulusi umene pa sabata 20-22-TH a n'kakang'ono ndi kutha kwathunthu. Ngati ulusi amenewa kusungidwa, pali zinthu anatomical WPW syndrome. A mtundu kumtundu wa WPW-syndrome amakhala ndi ambiri kugwirizana AV, nthenda ndi anomalies mu dongosolo la mtima. Koma ndi akula kumachitika ngakhale kuvutika kobadwa nako anatomical, zizindikiro loyamba WPW-syndrome. Milandu onse, pamaso pa 70% ya matendawa amawapeza anthu.

Zizindikiro za kudwala

Zizindikiro ambiri pamaso mwina syndrome WPW ndi zotsatirazi:

1. Kumverera palpitations amphamvu pafupipafupi, ana angakhoze kumutcha "kulumpha kapena kusinja mtima."
2. Mwadzidzidzi chizungulire.
3. Zodabwitsa syncope, makamaka ubwana ndi unyamata.
4. Kukanikiza ululu mu mtima, kumva kulasalasa ndi kudula ululu pamene wina akapuma.
5. Kumverera kwa suffocation, aakulu kupuma movutikira ali mwana.
6. Ana angathe kukana kudyetsa zotheka profuse thukuta, kufooka zonse, chinawonjezeka kugunda kwa mtima nthawi kuti kumenyedwa 200-300 pa mphindi.

Kodi kudziwa matenda?

Anthu ambiri amene ali ndi ulusi zambiri nthenda mu mnofu mtima, vuto WPW amawapeza kokha pamene anachita mtima echocardiography. Chinawathandiza kumvetsa n'chakuti zedi adzakupatsani zotsatira.

Chotero onyamula syndrome sazunzika ku chifundo cha tachycardia kapena fibrillation, ndiponso mwina sangadziwe pamaso pa kuvutika mu mtima.

asymptomatic Izi anati mu 35-40% ya onyamula onse kuzindikiridwa wa matendawa. Wofatsa otaya syndrome WPW amakhala ndi kobwereza yochepa tachycardia kapena fibrillation, amene mwamsanga akudutsa popanda thandizo. Kuthetsa khunyu pa nkhani ya sing'anga yokoka WPW syndrome amafuna mankhwala antiarrhythmic kapena mitundu ina ya blockers wa malemeredwe mtima.

Mu nkhani ya yaitali khunyu kuti musakhale zayamba kuchotsedwa contractions mankhwala ovuta disordered a minofu mtima ndi matenda flutter matenda digiri choopsa cha matenda ndipo analimbikitsa opaleshoni.

mitundu syndrome

WPW syndrome ndi mtima ali m'magulu malinga pafupipafupi makamaka zikamera zizindikiro zosiyanasiyana matenda ndi anawagawa mitundu zotsatirazi:

• Kumawonetsera pamene electrocardiogram ndi zopezeka ankadziwana yoweyula, ndi ATS-tachycardia ndi nkusani mungoli kuoneka sporadically.
• Zosakhalitsa - amakhala ndi kufupika yamitsempha yamagazi chisanadze malemeredwe.
• Anamubisa - limafotokoza episodic AVR-tachycardia, ndipo mu mkhalidwe zina si matenda.

Kodi wina angathe oterewa matendawa?

Popanda electrocardiogram ndi matenda zotheka WPW-syndrome n'zotheka mwa kumvetsera mtima zikumveka, amene adzakhala gawo la mawu akuti arrhythmic mu chikhalidwe, komanso kugunda apo.

Kuwonjezera ECG matenda a syndrome WPW ndi kuunikira ntchito yapadera kunyamula chipangizo ndi maelekitirodi, ndi ultrasound ndi echocardiography, kumayambiriro maelekitirodi zolimbikitsa mu mmero ndi zotsatira decoding wotsatira wa zikhumbo magetsi, komanso zovuta electrophysiological bwinobwino chimene chimapereka chitsanzo zolondola kwambiri likupezeka mu mtima minofu Kent matabwa ndipo amatilola amalangiza ndiwofatsa kapena opaleshoni chithandizo.

WPW-chodabwitsa

Pamene Kafukufuku pamaso pa syndrome WPW mu oposa 30% ya kuzindikiridwa onyamula syndrome madandaulo aliyense pa thanzi mtima simunayambe anakumana. Chifukwa ambiri ngati asymptomatic, mu 1980, WHO lofalitsidwa malangizo omwe analekana WPW syndrome ndi yeniyeni matenda chithunzi, ndipo WPW-chodabwitsa.

Za zodabwitsazi, iwo anapeza kuti pa electrocardiogram mtima nkusani mungoli ali zizindikiro za malemeredwe msanga yamitsempha yamagazi, koma nkhani palibe limati pathological ndi tachycardia atrioventricular anali anaona.

Ngakhale, pamene chodabwitsa WPW chiopsezo cha matenda oyamba ndi lalitali kwambiri kuwaganizira zimakhudza aliyense - thupi kapena maganizo nkhawa, mowa, kuyenda mabacteria sankadziwa Hrs - zingachititse mawonetseredwe a zizindikiro chokhwima cha matenda WPW. Mu anthu wamkulu mu 0,3% a milandu WPW-chodabwitsa ndi oopsa, ana afufuza anasonyeza kukomoka mu 2% ya milandu.

Ziwerengero WPW chodabwitsa ana

WPW-syndrome ali ndi malo otsogolera pakati pa zinthu kuchititsa tachycardia ndi arrhythmia ana. Ndi maziko zinkaoneka kuti kusokonezeka zina za kayendedwe mtima, ndipo ngakhale sitili pa madandaulo si kuchepetsa kufala kwa matendawa. Aliyense zimamuchulukira thupi mwamphamvu thupi, mavuto amaganizo lingachititse kulephera kwa kungoganiza wachimwemwe ndipo ngakhale kuyambitsa imfa vuto la mtima.

Yaitali polojekiti kwa zaka 20 chifukwa gulu lalikulu la ana amene amapezeka mtima WPW syndrome, mibadwo atabadwa kwa zaka 18, anasonyeza zotsatira izi:

• 8% mwa ana anakumana isanayambike mwadzidzidzi ABP-tachycardia;
• 8.2% nkhani anakumana ndi kufupika chodabwitsa kusintha WPW syndrome;
• 8.5% ya imfa chosakhalitsa cha chikumbumtima zinachitika;
• 2% ya ana pa nthawi ya Musanayambe kale zowawa kukomoka;
• 1.2% - anyamata okha - atamwalira mwadzidzidzi nthawi kafukufuku;
• % 9 okha ana WPW chodabwitsa lipoti mofulumira deta zizindikiro.

Koopsa chodabwitsa WPW?

Kuyambira Chiwerengerochi zikuonekeratu mmene kukhalapo ngakhale chosasamalidwa WPW chodabwitsa. Izi amaposa zizindikiro chowawa ndipo pathologies ali wamng'ono amapereka malo kuganiza kuti popanda yosalekerera nkhawa thupi ndi za maganizo popanda dongosolo la polojekiti ndi miyeso achire ndi zaka ndi kuchuluka izi ndi kuopseza moyo kuonjezera yekha.

Ana ndi WPW chodabwitsa sayenera kumenya katswiri wa mpira, ndi pansi zinthu zonse nkhawa. CHENJEZO ayenera kumwedwa mosinthana mwadzidzidzi nyengo kapena zochitika, amachititsa aakulu zopsa maganizo. Zonsezi zingakhale kwambiri ayenera kuyambitsa matenda aakulu kapena imfa. Anthu amene akhazikitsa pamaso pa syndrome WPW kapena chodabwitsa, sakutchedwa usilikali.

Kuchiza ndi mpumulo wa matendawa

Zizindikiro ndi mankhwala nthawi zambiri zogwirizana. Pali mankhwala ambiri kuthetsa matenda a mtima chifukwa cha matenda WPW, ndi kuchepetsa chiwonetsero cha zizindikiro zake.

blocker mankhwala gulu normalizes pafupipafupi contractions wa minofu mtima. Komabe, mphamvu ya njira imeneyi kukuonetsedwa yekha pa mlingo wa 50-60% ndipo sangathe ntchito pa hypotension zonse ndi mphumu.

Antiarrhythmics khola ndithu cropped kuukira AVR-tachycardia, matenda kugunda kwa mtima pa 80% odwala, komanso pali zinthu zingapo contraindications zinachitikira hypotension, matenda a mtima ndi matenda ena mtima, ubwana ndi unyamata. Makashiamu blockers mwamtheradi contraindicated mu syndrome WPW, ngati chithunzi kumbuyo bwino kufala kwa mitsempha mopupuluma, iwo ikulephera mwa atria, amene ali mavuto aakulu ndipo sizingasinthe.

Komanso, nthawi zina, kugwiritsira ntchito mankhwala ATP gulu anati zoyipa pa chidule matenda. Palinso njira si mankhwala a mpumulo zizindikiro.

Zilakolako minofu mitsempha kudutsa ulusi wachifundo ndi parasympathetic. Yoyamba ulusi imayendetsa mtima, mtundu yachiwiri kubweza mlingo mtima, monga ngati vagus mitsempha nervus vagus, ndipo limatchedwanso vagal reflex. Ndiko kuti, kutsegula kwa ndendende mtundu uwu bongo adzakupatsani zotsatira za olimba za mtima. Chophweka njira yambitsa zikhumbo vagal ndi otchedwa reflex Aschner amene chikwiyire 20-30 wachiwiri kukhudza waulemu pa eyeballs ndipo nthawi zambiri amathandiza kuti asiye tachycardia.

Komanso, mitsempha vagus bwino adamulowetsa ndi mpweya-likhale ndi voteji minofu m'mimba, moti chodabwitsa WPW matenda kapena othandiza kuchita anati yoga ndi kupuma kokoka.

Kuyambira njira yosatheka chizindikiro mwa elekitirodi anaikapo mu kholingo, mwaluso kwambiri mabasi katundu yaitali tachycardia, koma nthawi zina zikubweretsa fibrillation mtima, kotero kuchitidwe makabati wapadera zida ndi Makina amenewa a.

Uyambenso imagwiridwa okha Zikavuta kwambiri, pamene anaopsezedwa kwambiri kwa moyo, koma nthawi zambiri amathandiza kuthetsa kumachitika mikangano yoopsa zikhumbo zakunja minofu mtima ndi matenda a mtima mungoli ntchito.

Ntchito mankhwala WPW syndrome ndi kufunika awo

Ngati wapezeka chodabwitsa WPW ECG ntchito njira za kuwonongedwa ndi okhawo mu mavuto aakulu, ndi pafupipafupi ndi yaitali tachycardia, amene sakhoza kuchotsedwa mankhwala, komanso milandu okhazikika imfa yadzidzidzi mtima, achibale a wodwalayo kapena zifukwa akatswiri.

Opaleshoni mankhwala tikulimbikitsidwa kokha pamaziko a kufufuza mabuku ndi amphumphu, amene amapereka chithunzi molondola kwambiri za pathological nyumba minofu ya mtima. Choncho, muyenera kuona ngati kuti ntchito ndi chodabwitsa WPW.

opaleshoni imagwiridwa ntchito elekitirodi wapadera, amene anaikapo mwa mtsempha wamagazi femoral mtima minofu ndi kuonerera X-ray ndi m'madera ena umabala radioprizhiganie kapena ablation, ulusi mitsempha.

Angagwiritsidwenso kriorazrushenie pathological ulusi mitsempha. Ndipo kwenikweni, pa milandu onse Mwachangu ntchito ukufika 95%. Musabise zimachitika chifukwa chiwonongeko chosakwanira ndi kuliika foci, ndi pamaso mabungwe wosadziwika zimakhala zina ubongo. Palokha, opaleshoni angathe kuchitidwa pansi mankhwala oletsa ululu pamalopo, pafupifupi yopanda magazi, sayambitsa mavuto, ali ndi kuchira nthawi yochepa kwambiri choncho angathe kuchitidwa pa msinkhu uliwonse.

malo mtima mu Moscow

Institute of Opaleshoni. A. V. Vishnevskogo - kunyada kwa mankhwala zoweta, ali maofesi zamakono zochizira ndi matenda, amachititsa kafukufuku zina zamakono diagnostics mitundumitundu ndi wapadera opaleshoni ya mtima. FGBU "NNP Center wa mtima Opaleshoni iwo. A. N. Bakuleva "amachita ntchito zachipatala, sayansi ndi maphunziro a pulogalamuyi" mtima Surgery. "

Russian Cardiology Research ndi Yopanga ovuta amachita kafukufuku ndi kuchiza matenda mtima zina zamakono dziko mlingo. Mu "cardoid" malo mukhoza kukumana wathunthu mtima kuwunikira kulandira khalidwe kuchizira matenda pa outpatient maziko. Mtima Center ku Moscow ntchito bwino, choncho ngati muli kufunika alowererepo opaleshoni kuchitira, mukhoza musazengereze.