Rheumatic myocarditis yog tus cwj pwm los ntawm kev puas tsuaj rau cov leeg nqaij ntawm lub plawv, thiab tus kab mob tsim tawm tsam keeb kwm ntawm rheumatism. Thaum thawj cov tsos mob tshwm sim, koj yuav tsum mus ntsib kws kho mob kom kuaj thiab kho.
Rheumatic myocarditis ib txwm yog vim muaj mob rheumatic. Daim ntawv no ntawm tus kab mob no yog characterized los ntawm lub fact tias lub ntsiab tsis txaus siab ntawm tus neeg mob yog mob nyob rau hauv lub cheeb tsam ntawm lub plawv. Mob tshwm sim yog nyob mus ib txhis, npub. Yeej, lawv yog lub sijhawm ntev, tshwm sim ib ntus thiab ua kom muaj zog nrog lub cev ua si.
Rheumatic myocarditis yog tus cwj pwm los ntawm qhov tseeb tias nws tshwm sim nrog kev ua txhaum ntawm lub atherosclerosis thiab conduction ntawm lub plawv. Kev mob plawv tsis txaus tsuas yog tshwm sim hauv cov mob hnyav tshaj plaws.
Basic shapes
Muaj ntau hom thiab hom mob rheumatic myocarditis, ntawm cov hauv qab no:
- ntsim;
- fleet;
- mob rwj;
- mob ntev.
Tus mob rheumatic myocarditis tshwm sim sai heev, feem ntau ua rau arrhythmias thiabplawv tsis ua hauj lwm. Qee zaum, tus kab mob no tuag taus. Daim ntawv hloov pauv ntawm myocarditis provokes kev ua txhaum ntawm kev ua haujlwm ntawm sab laug ventricle ntawm lub plawv, uas yog nrog los ntawm kev puas tsuaj ntawm nws cov hlwb thiab cardiogenic poob siab.
Tus kab mob tsis tu ncua yog tus cwj pwm los ntawm qhov tseeb tias kev ua haujlwm ntawm lub plawv cov leeg tau khaws cia kom txog rau thaum kev hloov pauv ntawm tus kab mob mus rau theem ntawm active borderline myocarditis. Thaum pib ntawm txoj kev loj hlob, tsis muaj cov tsos mob tshwm sim, vim qhov tshwm sim ntawm cov teeb meem tshwm sim thiab lub plawv tsis ua hauj lwm yuav tshwm sim. Nws tsis tuaj yeem tshem tawm txawm tias tom qab nres qhov mob.
Lub sijhawm ua haujlwm ntev ntawm rheumatic myocarditis ua ke ua ke cov cim ntawm cov ntawv mob hnyav thiab ntu ntu. Muaj kev pheej hmoo siab ntawm kev txhim kho cardiomyopathy. Foci ntawm o tuaj yeem tshwm sim tom qab ua tiav tiav. Qee lub sij hawm tus kab mob no nyuaj los ntawm fibrosis, uas yog nrog los ntawm kev loj hlob ntawm cov ntaub so ntswg, nrog rau caws pliav.
Daim ntawv mob ntev tshwm sim thaum tsis muaj kev kuaj mob raws sijhawm thiab kev kho mob ntawm qhov tshwm sim ntawm pathology. Nyob rau hauv ib txoj kev mob ntev, tus kab mob no rov tshwm sim dua, ua rau hnyav dua ntawm keeb kwm ntawm kev loj hlob ntawm cov kab mob viral thiab muaj ntau lwm yam provoking yam.
Kev faib tawm los ntawm cov tsos mob
Muaj ntau hom mob rheumatic myocarditis, sib txawv hauv kev kho mob, xws li:
- polysymptomatic;
- pain;
- arrhythmic;
- pseudo-valve;
- decompensatory;
- thromboembolic;
- mixed.
Daim ntawv asymptomatic yog tus cwj pwm los ntawm qhov tseeb tias tus neeg mob txhawj xeeb txog qhov tsis muaj zog, qaug zog, tab sis tsis muaj cov tsos mob ntawm lub plawv. Nrog kev mob, qhov tsos mob ntawm sternum yog yam ntxwv. Lawv tuaj yeem yog qhov sib txawv thiab zoo li ischemia.
Nrog rau hom decompensation, muaj cov cim qhia ntawm cov hlab ntshav. Puffiness tshwm sim, thiab daim tawv nqaij kuj tuaj yeem ua xim xiav. Daim ntawv arrhythmic ntawm myocarditis yog tshwm sim los ntawm kev ua txhaum ntawm lub plawv dhia. Nws tuaj yeem yog arrhythmia lossis bradycardia.
Thromboembolic hom kab mob yog qhov tshwm sim los ntawm qhov tseeb tias nrog hom myocarditis no muaj peev xwm ua rau cov ntshav txhaws hauv cov hlab ntsha thiab cov hlab ntsha. Nrog pseudovalvular myocarditis, deformation ntawm li qub ntawm lub plawv cov leeg tshwm sim, uas manifests nws tus kheej nyob rau hauv qhov tshwm sim ntawm lub plawv yws. Hom sib xyaw tuaj yeem muaj cov cim qhia ntawm txhua hom kab mob.
Qhov laj thawj tseem ceeb
Rheumatic myocarditis yog ib qho kab mob nyuaj uas tshwm sim ob peb hnub tom qab kis kab mob dhau los. Thaum pib, cov pob qij txha thiab cov nqaij mos raug cuam tshuam los ntawm streptococci. Ntawm cov ntsiab lus tseem ceeb cuam tshuam rau kev loj hlob ntawm tus kab mob, nws yog ib qho tsim nyog yuav tsum tau hais txog cov hauv qab no:
- tshwj xeeb ntawm cov khoom antigenic ntawm streptococcus;
- lub cev teb ntawm kev tiv thaiv kab mob kom muaj cov kab mob;
- genetic predisposition;
- nquag tawm tsam los ntawm cov kab mob.
Txhua yam ua rau muaj kev ntxhov siab no ua rau muaj kev txhim kho hauv lub cevkab mob, tshwj xeeb tshaj yog, xws li rheumatism, tawm tsam uas rheumatic myocarditis tsim. Feem ntau, tus kab mob cuam tshuam rau tag nrho cov ntaub so ntswg ntawm lub plawv.
Tus kab mob no tuaj yeem tshwm sim nws tus kheej yog ib qho teeb meem ntawm kev kis kab mob, piv txwv li, mob khaub thuas, tonsillitis, chlamydia, kub taub hau, herpes. Cov ntaub ntawv hnyav tshaj plaws tshwm sim tawm tsam keeb kwm ntawm sepsis.
Cov tsos mob tseem ceeb
Cov tsos mob ntawm tus mob rheumatic myocarditis tuaj yeem mus tsis tu ncua. Feem ntau tus kab mob tsis muaj cov tsos mob tshwm sim txog thaum pib muaj teeb meem. Ntawm cov tsos mob tseem ceeb ntawm rheumatic myocarditis yog cov hauv qab no:
- pain;
- ua tsis taus pa;
- kub nce me ntsis.
Cov tsos mob ntawm tus mob rheumatic myocarditis yog mob hauv cheeb tsam ntawm lub plawv. Nws yog ib nqi sau cia hais tias nws yog heev tsis tshua muaj khaus. Yeej, nws yog mob, rub, mob me thiab tsis ua rau muaj kev ntxhov siab heev hauv cov neeg mob. Tsis tas li ntawd, ib tug neeg kuj tuaj yeem cuam tshuam los ntawm kev mob pob qij txha.
Nrog myocarditis, ua tsis taus pa luv tsis muaj zog thiab tshwm sim tsuas yog thaum lub cev tawm dag zog, yog li tus neeg tsis tas yuav saib xyuas qhov teeb meem. Yog tias ua tsis taus pa tshwm sim thaum so, ces koj yuav tsum tau mus ntsib kws kho mob kom tiav kev kuaj mob. Thaum lub sijhawm muaj tus kabmob, qhov kub tuaj yeem nce mus txog 38 degrees thiab nyob twj ywm rau lub sijhawm ntev. Nrog rau tus kab mob sluggish, qhov kub nce me ntsis.
Thaum mob myocarditis, tag nrho cov cim qhia no yuav tshwm simlos yog tsuas yog ib feem ntawm lawv. Daim duab kho mob feem ntau yog nyob ntawm seb tus kab mob kis tau ntau npaum li cas, thiab nws nyob qhov twg. Nyob rau theem pib, tus kab mob no yuav luag asymptomatic.
Tus neeg mob zoo li cas
Qhov tshwm sim ntawm tus neeg mob myocarditis feem ntau nyob ntawm seb tus kab mob mus li cas, nrog rau nws qhov hnyav. Nrog rau kev kawm me me thiab nyob rau theem pib, tus neeg mob tau xyaum tsis paub qhov txawv ntawm tus neeg noj qab haus huv, vim nws tsuas yog txhawj xeeb txog kev qaug zog. Raws li tus kab mob loj hlob zuj zus, nrog nws cov kev kawm nruab nrab thiab nyob rau theem siab, ib tus neeg muaj cov tawv nqaij daj ntseg, thiab cov ntiv tes thiab daim di ncauj tig xiav.
Nrog rau daim ntawv decompensated, o ntawm cov leeg ntawm lub caj dab yog pom meej, uas tshwj xeeb tshaj yog pom thaum lub cev tawm dag zog. Thaum taug kev, ua tsis taus pa luv tau sau tseg, uas ua rau tus neeg ua haujlwm tsis tu ncua. Daim ntawv no yog tus cwj pwm los ntawm cov tsos ntawm edema ntawm ob txhais ceg. Yog muaj tej yam tshwm sim no, mus ntsib kws kho mob.
Thawj cov tsos mob ntawm tus kab mob tuaj yeem tshwm sim 3-8 lub lis piam tom qab kis kab mob. Nws tuaj yeem yog khaub thuas, mob khaub thuas, mob caj pas.
ntsuas ntsuas
Nyob rau hauv rheumatic myocarditis, kev kuaj mob yog qhov nyuaj heev, vim tias cov cim tshwj xeeb yuav tsis tuaj yeem mus ntev. Kev kuaj mob muaj cov kauj ruam hauv qab no:
- sib sau anamnesis;
- lab test;
- instrumental exam.
Thawj zaug, tus kws kho mob sau ib qho anamnesis, tham nrog tus neeg mob,pom tias qhov kev tsis txaus siab yog dab tsi, yog vim li cas rau lawv qhov tshwm sim, nrog rau qhov xwm txheej ntawm kev hloov pauv ntawm cov tsos mob ntawm lub sijhawm. Kev saib xyuas tshwj xeeb yog them rau cov mob yav dhau los, tshwj xeeb tshaj yog nyob rau hauv cov kab mob thiab kab mob.
Kev kuaj mob ntawm tus neeg mob yog tsom rau kev txiav txim siab ntawm lub plawv tsis ua haujlwm, xws li o ntawm ob txhais ceg, ua tsis taus pa, cyanosis ntawm daim tawv nqaij, o ntawm cov leeg ntawm caj dab. Ces tus kws kho mob mloog lub ntsws thiab lub plawv. Nrog myocarditis, lub xub ntiag ntawm muffled tones tau sau tseg. Ntawm lub ntsws, feem ntau ua pa tsis muaj zog vim qhov tseeb tias ntshav stagnation tshwm sim.
Percussion txhais tau hais tias tus kws kho mob ua tapping los txiav txim txog thaj tsam ntawm lub siab. Kev kuaj thiab ntsuas ntsuas yog suav tias yog theem tseem ceeb ntawm kev kuaj mob, vim qhov no tso cai rau koj los txiav txim siab myocarditis, yog tias muaj. Rau qhov no, cov kev xeem hauv qab no tau qhia:
- electrocardiogram;
- ntsuas ntsuas;
- kuaj mob ultrasound;
- radioography;
- tomography;
- scintigraphy;
- kuaj ntshav thiab zis.
Ntau tus kws kho mob tshwj xeeb koom nrog kev kuaj mob ntawm tus kab mob no, tshwj xeeb, kws kho mob rheumatologist, kws kho plawv, kws kho hluav taws xob. Qhov tseem ceeb ntawm rheumatic myocarditis yog micropreparation ntawm lub plawv, vim nws muaj peev xwm txiav txim siab qhov loj ntawm cov leeg nqaij. Hauv qhov no, myocardium yuav tsis muaj zog, thiab cov nplooj ntawv valve yog thickened. Tsuas yog tom qab ntawd thiaj tuaj yeem kuaj pom tseeb.
Txoj Kevkho mob
Nyob rau lub sijhawm mob hnyav ntawm cov kab mob, tus neeg mob yuav tsum tau mus pw hauv tsev kho mob, tsis hais seb tus kab mob tshwm sim thawj zaug lossis qhov exacerbation. Tus neeg mob yuav tsum txwv tsis pub lub cev ua si, yog li nws yog ib qho tseem ceeb uas yuav tau saib xyuas kev pw tsaug zog. Tag nrho cov kev ua ub no yog tsom los txo cov load ntawm lub plawv thiab them nyiaj rau kev ua haujlwm plawv.
Thaum kho, nws tseem ceeb heev uas yuav tsum ua raws li kev noj zaub mov tshwj xeeb, uas txhais tau tias:
- liquid restriction;
- txoov ntsev;
- tsis suav cov zaub mov kib, nqaij haus, ncuav pastries, nqaij.
Kev kho mob myocarditis yog txhawm rau tshem tawm cov kab mob ua rau tus kab mob, ua rau mob thiab cov tsos mob tseem ceeb. Kev teem caij ntawm cov tshuaj tiv thaiv kab mob, tshuaj tua kab mob tsuas yog ua tiav yog tias muaj cov kab mob sib kis hauv lub cev raug xav tias yuav. Hauv qhov no, nws yog ib qho tseem ceeb kom tshem tawm tag nrho cov tsos mob ntawm tus kab mob nyob rau hauv lub cev.
Thaum muab tshuaj tua kab mob, nws yog qhov tsim nyog los pib txiav txim siab qhov rhiab ntawm cov kab mob rau cov tshuaj no. Koj tuaj yeem tshem tawm qhov mob nrog kev pab ntawm glucocorticosteroids, tshuaj tiv thaiv kab mob thiab tshuaj tiv thaiv. Txhawm rau tshem tawm cov tsos mob sab nraud ntawm tus kab mob, cov tshuaj tiv thaiv coagulants, tshuaj antiarrhythmic thiab tshuaj ua kom ntshav siab tau raug tshuaj.
Thaum lub sijhawm kho, nws yog qhov tsim nyog los txhawb lub myocardium, yog li ntawd, cov kws kho mob tau sau cov tshuaj uas txhawb nqa cov metabolism thiab normalize cov khoom noj ntawm lub plawv cov leeg. Nco ntsoov xav tau cov vitamin complexes. Lub sijhawm ntawm kev kho mob yog kwv yees li 4 lub hlis, thiab tom qab ntawd yuav tsum muaj kev kho kom rov zoo.
Ntseeg haiv neeg
Kev kho neeg pej xeem tsuas yog kev pabcuam pabcuam hauv kev kho tus kabmob no xwb. Lawv tuaj yeem siv tau nrog kev tso cai los ntawm kws kho mob, thiaj li tsis ua rau muaj kev puas tsuaj rau kev noj qab haus huv. Ntawm cov kev kho pej xeem, cov kws kho mob paub qhov txawv hauv qab no:
- qej;
- tshuaj ntsuab npaj;
- birch sap.
Qej suav hais tias yog ib qho khoom noj muaj txiaj ntsig zoo tshaj plaws rau cov leeg nqaij. Cov tshuaj muaj nyob rau hauv nws pab tiv thaiv lub plawv nres thiab ntshav txhaws. Nws tuaj yeem noj tshiab lossis ua rau hauv infusion. Nrog myocarditis, cov nroj tsuag hauv qab no yuav pab tau:
- hawthorn;
- fennel;
- horsetail;
- motherwort.
Cov tshuaj ntsuab no tuaj yeem muab tso rau hauv ib qho me me thoob plaws hnub. Ntuj birch kua txiv pab ntxiv dag zog rau myocardium thiab tshem tawm o. Txhawm rau npaj cov tshuaj, koj yuav tsum sib tov birch, kua txiv qaub, thiab zib ntab.
Cov tshuaj kho neeg pej xeem muaj txiaj ntsig zoo, txhawm rau ua tiav cov txiaj ntsig zoo, koj yuav tsum coj lawv mus rau hauv cov kev kawm thiab ua tib zoo saib xyuas cov tshuaj.
Ntawm tus kab mob thaum yau
Rheumatic myocarditis hauv cov menyuam yaus yog tus cwj pwm los ntawm qhov tshwm sim ntawm qhov cuam tshuam ntawm myocardium, uas ua rau cov txheej txheem congestive hauv cov hlab ntsha. Cov menyuam yaus muaj mob ntau dua li cov neeg laus, txij li lawv txoj kev tiv thaiv tsis tau ua tiav. RauTxoj kev loj hlob ntawm pathology ua rau cov kab mob nquag provoked los ntawm streptococci. Qhov no tej zaum yuav yog vim qhov ntws ntawm qhov mob hauv lub cev.
Foci ntawm tus kab mob ntev tuaj yeem ua rau qhov pib ntawm tus kab mob, uas ua rau muaj kev nkag siab ntawm lub cev. Tsis tas li, lub luag haujlwm tseem ceeb hauv kev ua txhaum ntawm lub cev tiv thaiv kab mob yog ua los ntawm kev ua haujlwm dhau los, hypothermia thiab kev noj tsis txaus. Kev kis tus mob rheumatic kub taub hau tuaj yeem yog vim kev siv tshuaj tua kab mob tsis raug.
Cov tsos mob ntawm tus mob rheumatic myocarditis hauv cov menyuam yaus muaj xws li ua tsis taus pa, ua npaws, ua daus no, thiab txawm tias qaug zog. Tsis tas li ntawd, tej zaum yuav muaj mob nyob rau hauv lub sternum. Cov tsos mob ntawm tus mob rheumatic myocarditis hauv cov menyuam yaus yog qhov mob hauv pob qij txha, nrog rau qhov muaj mob ntawm lub plawv.
Thaum kho, yuav tsum tau pw so. Raws li kev kho tshuaj, tshuaj tua kab mob thiab tshuaj tiv thaiv kab mob yog siv. Nrog kev kho tsis raug lossis tsis raws sijhawm, ntau yam teeb meem tuaj yeem txhim kho.
Muaj Teeb Meem
Myocarditis tuaj yeem ua rau muaj ntau yam tshwm sim. Nws cov chav kawm nyob ntawm tus yam ntxwv ntawm lub cev, kev tiv thaiv kab mob, nrog rau theem ntawm kev loj hlob ntawm tus kab mob. Cov teeb meem tuaj yeem cuam tshuam rau lub plawv thiab lwm yam kabmob. Qhov feem ntau tshwm sim ntawm myocarditis muaj xws li:
- thromboembolism;
- ascites;
- lub plawv tsis ua hauj lwm;
- -cardiosclerosis.
Ascites yog tus cwj pwm los ntawm kev sib sau ntawm cov kua hauv lub plab kab noj hniav. Nyob rau hauv cov ntaub ntawv no, lub plab nce nyob rau hauv loj, muaj ib tug zoo nkaus li hnyav thiab fullness. Thromboembolism yog ib qho mob hnyav uas cov hlab ntsha txhaws hlab ntsha lossis hlab ntsha. Nyob rau tib lub sijhawm, cov ntshav ncig raug cuam tshuam, ntau yam teeb meem tshwm sim. Yog tias cov hlab ntsha tawg, nws tuaj yeem ua rau cov hlab ntsha thib ob thiab cov neeg mob tuag.
Nrog cardiosclerosis, caws pliav nqaij tsim, uas nws thiaj li loj hlob thiab txo cov contractility ntawm lub plawv. Qhov teeb meem txaus ntshai tshaj plaws yog lub plawv tsis ua haujlwm thiab mob plawv nres.
khoom noj kom raug thiab noj qab nyob zoo tuaj yeem tiv thaiv lub plawv ntawm ntau yam kab mob. Nrog rau kev kho mob raws sij hawm, qhov kev ntsuas tau zoo heev. Ntau tus neeg raug tus kab mob no tsis muaj teeb meem. Nrog txoj kev kho tsis ncaj ncees lawm, pathology tuaj yeem dhau mus ntev. Hauv qhov no, kev rov qab los yuav hloov pauv nrog kev zam txim.
Thaum tus kab mob hnyav, nws tuaj yeem ua rau lub plawv tsis ua haujlwm, uas ua rau muaj kev pheej hmoo ntawm kev tuag. Txhawm rau tiv thaiv kev txhim kho ntawm myocarditis, koj yuav tsum ua raws li cov cai tseem ceeb ntawm kev tiv thaiv, uas suav nrog:
- khaw;
- khoom noj kom raug;
- kho mob raws sijhawm;
- muab tus cwj pwm phem.
Txhua yam kev tiv thaiv no pab tsis tau tsuas yog tiv thaiv kev txhim kho myocarditis, tab sis kuj muaj ntau yam kab mob.lub siab.
