Tachysystolic daim ntawv ntawm atrial fibrillation, txwv tsis pub hu ua "atrial fibrillation", yog qhov tsis ua haujlwm ntawm lub plawv atherosclerosis, vim tias lub plawv dhia ua ntau dua 90 neeg ntaus ib feeb. Fibrillation tshwm sim thaum txhua tus leeg nqaij fiber ntau ntawm lub plawv chamber pib cog lus nquag thiab randomly. Yog li ntawd, qhov no ua rau muaj kev ua txhaum ntawm cov ntshav ntws. Cov tsos mob ntawm tus kab mob tsis tshwm sim rau txhua tus neeg; hauv kev xyaum, ib qho asymptomatic daim ntawv ntawm tus kab mob yog ib txwm muaj.
Kev faib tawm ntawm atrial fibrillation
Systematize atrial fibrillation:
- by ventricular rate;
- chaotic rhythm duration;
- waves ntawm cardiogram.
Fibrillation yog qhov txawv ntawm lub sijhawm:
- Pib - ib qho kev cuam tshuam ib leeg tau sau tseg thawj zaug. Tej zaum nws yuav txawv ntawm qhov chaw kho mob, lub sijhawm thiab qhov teeb meem.
- Persistent - kav ntev tshaj li xya hnub. Tsis nres yam tsis muaj kev kho mob thiab tuaj yeem kav ntev txog ib xyoos.
- Tsis tu ncua - zoo li yav dhau los, lub sijhawm ntev txuas ntxiv, tab sis kev rov ua kom zoo li qub ntawm lub qhov txhab yog qhov ua tsis tau. Lub hom phiaj tseem ceeb ntawm kev kho mob yog kom tswj tau qhov kev sib dhos uas twb muaj lawm thiab tswj qhov zaus ntawm kev cog lus.
- Paroxysmal - Atrial fibrillation pib thiab xaus tsis tau npaj txhij. Txog li xya hnub, kev tawm tsam ntawm atrial fibrillation txuas ntxiv, uas nres ntawm nws tus kheej.
Wave subtypes:
- loj - 300-500 contractions ib feeb. Loj thiab tsis tshua muaj ECG cov hniav;
- me - txog li 800 qhov kev cog lus (cov hniav me me thiab nquag).
Zoo ntawm kev puas tsuaj rau lub plawv li qub, fibrillation tshwm sim:
- Non-valvular - nrog rau cov li qub.
- Valvular - nrog lub plawv tsis xws luag (congenital lossis kis tau). Cov tom kawg tuaj yeem tsim tawm tsam keeb kwm ntawm kab mob endocarditis, rheumatism. Nrog rau hom atrial fibrillation no, kev kho mob pib nrog kev tshem tawm ntawm tus provocateur.
Ntau hom fibrillation yog qhov txawv ntawm zaus:
- Tachysystolic. Lub ventricles cog lus ntau dua 90 zaug hauv ib feeb, thiab tib lub sijhawm yuav tsis muaj mem tes rau qee lub sijhawm. Yog vim li cas rau qhov tshwm sim nyob rau hauv lub fact tias lub plawv tsis ua hauj lwm ntawm tag nrho cov zog. Lub zog tsis txausKev cog lus tsis ua rau lub plawv dhia, lub plawv tso zis tsis zoo, thiab cov hlab ntsha tsis zoo rau cov ntshav.
- Normosystolic. ventricular contractions yog nyob rau hauv qhov kev pom zoo ntawm 60 txog 90.
- Bradysystolic - contractions txog 60 lub sij hawm, kev ua haujlwm ntawm ventricles yog inhibited. Txawm li cas los xij, lub pulse nthwv dej mus ib txwm.
Daim ntawv thib ob thiab thib peb yog qhov zoo tshaj plaws.
Paroxysmal daim ntawv ntawm atrial fibrillation. Tachysystolic variant Y
Ib qho ntawm cov kab mob uas feem ntau kuaj tau hauv plawv yog paroxysmal atrial fibrillation. Hauv ib qho xwm txheej, lub plawv dhia txog xya caum zaus hauv ib feeb. Kev ua txhaum ntawm nws txoj haujlwm contractile ua rau muaj kev hloov pauv ntawm qhov zaus ntawm contractions, uas tuaj yeem ncav cuag 800. Paroxysmal arrhythmia yog nrog los ntawm kev ua haujlwm tsis ua haujlwm. Nws qhov txaus ntshai nyob rau hauv qhov tseeb tias myocytes cog lus randomly, lub sinus node tsis ua haujlwm, tsuas yog ob lub ventricles ua haujlwm. Paroxysm hais txog kev qaug dab peg los yog qaug dab peg. Ib tug yam ntxwv tsos mob ntawm paroxysmal atrial fibrillation yog ib tug nce lub plawv dhia thiab tachycardia tam sim ntawd nrog lub plawv dhia tsis tu ncua. Yog hais tias nyob rau hauv 60 vib nas this qhov zaus ntawm contractions tshaj 90, ces qhov no yog ib tug tachysystolic variant ntawm paroxysmal daim ntawv ntawm atrial fibrillation. Tsawg dua 60 yog bradysystolic, thiab qhov kev xaiv nruab nrab yog normosystolic. Qhov kev tawm tsam ntev li ob peb feeb mus rau xya hnub, nws tshwm sim tam sim ntawd thiab tseem nres. Cov hom ntawv luv luv hauv qab no yog qhov txawv:
- flicker - tus naj npawb ntawm lub plawv dhia ibfeeb - ntau tshaj 300;
- flutter - max 200.
Daim ntawv no ntawm fibrillation tuaj yeem lees paub los ntawm cov tsos mob hauv qab no:
- tshee;
- mob siab;
- suav;
- tawm hws ntau dhau;
- limbs txias;
- tsis muaj zog;
- panic tawm tsam;
- kiv taub hau;
- fainting.
Txawm li cas los xij, qee tus neeg tsis pom qhov kev tawm tsam, thiab daim ntawv bradysystolic lossis tachysystolic ntawm paroxysmal atrial fibrillation raug kuaj pom thaum lub sijhawm kuaj, piv txwv li ntawm kws kho mob teem sijhawm hauv tsev kho mob. Thaum sinus atherosclerosis rov zoo li qub, tag nrho cov cim ntawm arrhythmia ploj mus. Tom qab ib qho kev tawm tsam, ib tug neeg tsim polyuria thiab ua kom lub plab zom mov. Nws yog ib qho tsim nyog kom tsis txhob muaj tus kab mob sai li sai tau, thiab nyiam dua li ntawm ob hnub tom qab qhov pib ntawm kev tawm tsam. Nrog rau qhov fibrillations tas li, kev siv tshuaj kho tau raug pom zoo, uas yuav pab tiv thaiv kev sib tsoo cerebrovascular. Vim lub random contraction ntawm cov phab ntsa atrial, cov ntshav txav ntawm ib tug ceev ceev. Raws li qhov tshwm sim, ib qho ntshav tuaj yeem yooj yim lo rau ntawm phab ntsa ntawm lub atrium thiab ua rau thrombosis, uas ua rau mob stroke. Yog tias daim ntawv tachysystolic ntawm paroxysmal atrial fibrillation degenerates mus rau hauv ib qho chaw ruaj khov, ces muaj kev pheej hmoo loj ntawm lub plawv tsis ua haujlwm.
Kev kuaj mob ntawm atrial fibrillation
Thaum kuaj tus neeg mob, lawv qhia:
- blueness ze ntawm nasolabial quav;
- pajtawv nqaij;
- xov xwm.
ECG rau tus kab mob no tau sau thawj zaug hauv xyoo 1906, thiab tau piav qhia meej hauv xyoo 1930. Ntawm ECG, atrial fibrillation ntawm daim ntawv tachysystolic zoo li no:
- ploj P nthwv dej txhais tau tias tsis muaj qhov sib dhos;
- muaj nthwv dej ntawm qhov siab sib txawv thiab cov duab;
- R-P lub sijhawm sib txawv hauv lub sijhawm;
- S-T ntu thiab T nthwv dej tuaj yeem hloov kho.
Txoj kev kuaj mob ntxiv yog:
- biochemical thiab suav ntshav kom tiav;
- x-ray;
- kuaj mob qog noj ntshav;
- echocardioscopy.
Hauv kev xyaum, kev kuaj mob ntawm "atrial fibrillation, tachysystolic daim ntawv" yog ua los ntawm tus neeg mob cov lus tsis txaus siab, nws cov lus nug, kev kuaj sab nraud thiab ECG.
Ua rau atrial fibrillation
cais cov hlab plawv thiab lwm yam uas ua rau atrial fibrillation. Thawj yog:
- neoplasms hauv siab;
- mob ntshav siab;
- myocardial infarction;
- siab tsis zoo;
- cardiosclerosis;
- cardiomyopathy;
- myocarditis;
- mob plawv ischemia;
- lub plawv tsis ua hauj lwm;
- qhov tshwm sim ntawm kev phais plawv. Arrhythmia yog tsim los ntawm kev ua txhaum ntawm cov leeg nqaij ntawm lub cev ntawm qhov sib npaug ntawm cov kab mob (magnesium, calcium, sodium thiab potassium), nrog rau qhov tshwm sim ntawm cov txheej txheem inflammatory hauv cheeb tsam. u200b cov. Nws kiag li disappears tom qab kawmkev kho mob.
Qhov muaj ntau yam pathologies hauv ib tus neeg, xws li kub siab thiab angina pectoris, ua rau muaj kev pheej hmoo ntawm kev tsim cov kab mob atherosclerosis. Hauv cov neeg laus thiab cov neeg laus, qhov ua rau ntawm daim ntawv tachysystolic ntawm atrial fibrillation yog kab mob hauv cov hlab ntsha nrog rau kev kub siab lossis tsis muaj nws.
Lwm yam:
- Ythyrotoxicosis:
- mob ntshav qab zib mellitus;
- noob mutations;
- obesity;
- hypokalemia;
- kab mob raum;
- mob ntsws obstructive pulmonary pathologies;
- Yvegetovascular dystonia;
- cawv lom;
- haus luam yeeb;
- hluav taws xob raug mob;
- kev mob tshwm sim ntawm qee yam tshuaj.
Cov xwm txheej ntxiv ua rau atrial fibrillation thaum muaj hnub nyoog yau, thiab kab mob plawv hauv cov neeg laus.
Atrial fibrillation tshwm sim hauv kev kho mob tsis paub yog vim li cas - idiopathic arrhythmias.
kho mob tshwm sim ntawm atrial fibrillation
Cov tsos mob hauv daim ntawv tachysystolic ntawm AF tej zaum yuav tsis tuaj, thiab cov kab mob tuaj yeem kuaj tau tsuas yog ntawm ultrasound ntawm lub plawv lossis ECG. Txawm li cas los xij, kev txhim kho ntawm cov tsos mob hnyav kuj tseem ua tau; nyob rau hauv cov xwm txheej zoo li no, lub xeev tsis muaj kev puas siab puas ntsws ntawm tus neeg ua raws li tus neeg tsim txom. Qhov tseeb, thawj qhov tshwm sim ntawm kev cuam tshuam atherosclerosis yog nyob rau hauv daim ntawv ntawm kev npaj txhij txog nres (paroxysm). Kev tawm tsam tom qab dhau los ua ntau zaus thiab ua rau muaj daim ntawv mus tas li lossis tsis tu ncua ntawm fibrillation. Qee tus neeg muaj kev tawm tsam luv luv thoob plaws hauv lawv lub neej, tsis yogdhau mus rau theem mob. Thaum pib ntawm qhov kev tawm tsam, ib qho kev xav hauv siab, zoo li lub hauv siab. Tom qab ntawd cov tsos mob hauv qab no tshwm sim:
- ntshai tuag;
- xov tsis ua pa;
- mob plab;
- tshee tshee thiab lub cev;
- ua tsis taus pa;
- pulse tsis ruaj khov, nws hloov ceev;
- hws txias tawm;
- siab poob;
- daim tawv nqaij;
- polyuria;
- cuam tshuam ntawm lub plab zom mov.
Muaj peev xwm tshwm sim ntawm cov tsos mob ntawm lub paj hlwb:
- poob siab;
- tus kab mob;
- coma;
- paresis.
Daim duab kho mob no yog tam sim no yog tias muaj kev cuam tshuam kev sib dhos ua rau muaj thrombosis.
Ib tug neeg tsim edema thaum kawg ntawm hnub nrog ib daim ntawv tsis tu ncua ntawm arrhythmia.
Qee yam ntawm tachysystolic daim ntawv ntawm atrial fibrillation
Irregular atherosclerosis, nrog rau kev ua haujlwm tsis tu ncua thiab chaotic ntawm lub plawv chamber, hu ua tachysystolic atrial fibrillation. Lub hauv paus ntawm xws li excitation yog myofibrils nyob rau hauv lub atria (ectopic foci ntawm hluav taws xob impulses), uas ua rau 700 contractions ib feeb. Nyob rau hauv cov ntaub ntawv no, lub ventricles nyob rau tib lub sij hawm ua rau ntau tshaj 90 shocks. Cov tsos mob zoo ib yam li atrial fibrillation:
- tawm hws hnyav;
- shake;
- tsis xis nyob hauv thaj tsam hauv siab;
- panic tawm tsam;
- ua tsis taus pa;
- kiv taub hau;
- tsis muaj zog;
- pulsing neck veins.
Ib lub cim ntawm tachysystolic daim ntawv ntawm atrial fibrillation yog mem tes tsis ua haujlwm nrog lub plawv dhia nrawm, uas ua rau:
- flickering, yog qhov ua rau ua rau lub plawv dhia, ces tus naj npawb ntawm contractions yog 350-700;
- atrial flutter. Contractions tshwm sim 200-400 ib feeb. Hauv qhov no, qhov tseeb atrial atherosclerosis yog khaws cia thiab xa mus rau ventricles.
Atrial fibrillation ntawm daim ntawv tachysystolic yog qhov txaus ntshai dua li lwm tus thiab nyuaj rau kev zam, txij li qhov no muaj qhov loj loj tau muab tso rau hauv lub plawv. Ib qho teeb meem uas tshwm sim yog mob plawv tsis ua hauj lwm vim cov hlab ntshav tsis ua hauj lwm hauv cov hlab ntsha peripheral vim qhov txo qis hauv feeb thiab cov ntshav systolic.
Tachysystolic variant ntawm atrial fibrillation nyob rau hauv daim ntawv mus tas li yog ib yam kab mob txaus ntshai uas nyuaj rau kho. Txawm li cas los xij, nws muaj peev xwm ua neej nyob nrog nws zoo. Qhov tseem ceeb tshaj plaws yog ua raws li tag nrho cov kws kho mob cov tshuaj. Tus provocateur ntawm atrial fibrillation nyob rau hauv cov neeg laus thiab cov laus laus yog kab mob coronary artery, nrog rau kub siab los yog tsis muaj nws. Hauv cov tub ntxhais hluas, qhov ua rau muaj kev ntxhov siab yog:
- hyperthyroidism;
- siab tsis zoo;
- rheumatism.
Cov xwm txheej uas tachysystolic atrial fibrillation tuaj yeem tshwm sim:
- IHD;
- mob cor pulmonale;
- cardiomyopathy;
- myocarditis;
- pericarditis;
- myocardial infarction thiab qee yam pathologies.
Nrog rau normo- thiab bradysystolic daim ntawv ntawm lub plawv arrhythmias, tej zaum yuav tsis muaj kev xav lossis tej zaum yuav muaj lub plawv dhia tsis tu ncua. Objectively, ib qho arrhythmic mem tes nrog nws qhov tsis txaus yog txiav txim siab. Nrog rau daim ntawv tachysystolic, cov tsos mob ntawm lub plawv tsis ua hauj lwm thiab o tshwm sim.
Kev kho mob
Kev kho mob ntawm daim ntawv tachysystolic ntawm atrial fibrillation yog txhawm rau txo cov tsos mob tsis zoo thiab tiv thaiv qhov tshwm sim tsis zoo. Txhua yam kev kho mob raug coj mus rau:
- kom tswj tau qee zaus ntawm kev cog lus;
- rov qab mus rau lub suab qub.
Yuav kom ua tiav cov hom phiaj no siv:
- tshuaj kho nrog cov tshuaj tiv thaiv coagulants, antiarrhythmics, calcium channel blockers thiab beta-adrenergic receptors;
- electrocardioversion, i.e. raug hluav taws xob tam sim no;
- txhim kho lub pacemaker;
- catheter RF ablation.
Kev siv cov tshuaj tiv thaiv coagulants pab tiv thaiv thromboembolism. Cov tshuaj ntawm pab pawg no tuaj yeem siv tau ntev. Cov neeg mob ntawm cov hnub nyoog laus uas muaj cov kab mob sib kis (IHD, ntshav qab zib mellitus, thyrotoxicosis, kub siab, mob plawv tsis ua haujlwm, kab mob rheumatic) raug pom zoo "Warfarin". Cov tshuaj uas tsis tshua muaj molecular hnyav ntawm pawg heparin yog siv rau cov xwm txheej nyuaj thaum xav tau kev ntsuas kub ceev. Txhua pawg ntawm cov neeg mob tau muab tshuaj "Acetylsalicylic acid", "Dipyridamole". Nws yog ib qho tseem ceeb kom paub tias kev noj cov tshuaj no provokes los ntshav, yog li nws yog ib qho tsim nyog yuav tau tswj xyuasntshav khov.
Txhawm rau kom lub plawv dhia zoo li qub hauv kev kho mob ntawm tachysystolic atrial fibrillation, Amiodarone, Diltiazem, Metoprolol, Verapamil, Carvedilol tau pom zoo. Kev siv cov tshuaj no ua rau nws muaj peev xwm txo tau qhov mob thiab tshem tawm cov tsos mob tsis zoo, thiab ntxiv rau, txhawm rau tiv thaiv kev txhim kho ntawm cov xwm txheej uas ua rau muaj kev hem thawj rau tib neeg lub neej. Hmoov tsis zoo, txoj kev kho no tsis tuaj yeem nres qhov kev loj hlob ntawm cov kab mob atherosclerosis.
Electrocardioversion. Catheter radiofrequency ablation
Nrog rau daim ntawv tsis tu ncua tachysystolic ntawm atrial fibrillation, nws muaj peev xwm ua kom muaj kev ruaj khov ntawm lub plawv dhia nrog cov hluav taws xob tawm tam sim no. Nws yog tsuas yog siv nyob rau hauv ib qho teeb meem ntawm lub neej. Manipulation yog ua los ntawm ECG tswj thiab tshuaj loog. Ib lub cuab yeej hu ua cardioverter defibrillator xa cov teeb liab hluav taws xob synchronous rau lub plawv yam tsis ua rau lub plawv mob plawv. Nyob rau hauv cov ntaub ntawv ntawm cov teeb meem ntawm cov ntshav ncig nrog ib tug luv luv nres ntawm arrhythmia, ceev cardioversion yog qhia. Nyob rau tib lub sijhawm, kev npaj tshuaj heparin yog siv. Kev cuam tshuam ntawm lub plawv tuaj yeem nqa tawm ob qho tib si los ntawm sab nraud thiab sab hauv. Nyob rau hauv thawj rooj plaub, los ntawm lub hauv siab, thiab nyob rau hauv lub thib ob, lub electrode yog coj los ntawm lub catheter mus rau lub cev. Kev npaj electrocardioversion yog siv rau cov neeg mob uas muaj lub sijhawm ntev arrhythmia yam tsis muaj kev cuam tshuam ntawm cov hlab ntshav. Ua ntej cov txheej txheem no, peb-lub lim tiam ntawm kev noj "Warfarin" raug sau tseg, uas txuas ntxiv tom qab kev tswj hwm rau ib hlis.
Nyob rau hauv daim ntawv kho mob ntawm cardioversion, txhais tau tias yog siv los kho sinus atherosclerosis, uas yog muab intravenously:
- Nibentan muaj zog. Raws li qhov tshwm sim ntawm cov kev mob tshwm sim, suav nrog cov cuam tshuam rau lub ventricular contractions, tus neeg mob yuav tsum tau saib xyuas thaum nruab hnub.
- "Amiodarone" zoo nres qaug dab peg. Nws yog qhia rau cov neeg uas muaj cov organic myocardial disorders. Kev noj tsis tu ncua tuaj yeem txo qhov kev pheej hmoo ntawm lub plawv nres sai li 50 feem pua.
- "Procainamide" muaj cov nyhuv ua kom ruaj khov. Feem ntau provokes pliaj tshwm sim nyob rau hauv daim ntawv ntawm mob taub hau, hallucinations, txo siab.
Hom kev cardioversion no feem ntau siv rau paroxysmal arrhythmia thiab thawj fibrillation. Kev kho mob tau ua nyob rau thawj teev ntawm kev tawm tsam ua rau muaj txiaj ntsig zoo.
Radiofrequency catheter ablation yog ib qho kev phais phais uas siv thaum lwm txoj hauv kev tsis muab cov txiaj ntsig xav tau. Lub catheter muab tso rau hauv cov hlab ntsha muab ib qho electrode mus rau lub plawv cov ntaub so ntswg. Nws rhuav tshem thaj chaw anomalous uas generates impulses nrog hluav taws xob tawm. Lub pacemaker tau cog rau tib lub sijhawm.
Kho thiab tiv thaiv atrial fibrillation
Thaum tsis muaj contraindications, tshuaj tiv thaiv kab mob yog siv hauv tsev kho mob:
- "Aimalin";
- "Novocainamide";
- Y"Disopyramide".
Yog sivntawm saum toj no txhais tau tias, lub suab tsis zoo, ces lawv hloov mus rau lwm yam tshuaj:
- Flecainide;
- "Amiodarone";
- YPropafenone.
Tshuaj rau kev tiv thaiv ntawm thromboembolism raug pom zoo rau kev pheej hmoo atrial fibrillation:
- YWarfarin;
- "Fenilin";
- Sinkumar.
Thaum tsis muaj cov tshuaj, sim electrocardioversion. Tom qab qhov kev sib dhos tau rov qab los, nws yuav tsum tau tswj nws. Hauv kev xyaum, nws tau raug pov thawj tias qhov ua tau zoo ntawm kev noj tshuaj nrog rau daim ntawv tsis tu ncua ntawm arrhythmia yog li 50 feem pua, thiab los ntawm cardioversion - 90, yog tias tus kws kho mob hu rau lub sijhawm. Lwm txoj hauv kev los kho cov kab mob tachysystolic ntawm ib daim ntawv mus tas li ntawm atrial fibrillation yog siv cov cuab yeej tshwj xeeb uas ua rau lub ventricles nrog hluav taws xob impulses. Lub pacemaker ua haujlwm txawm tias cov tshuaj ua tsis tiav.
Ntau tus neeg mob tau rov zoo dua hauv thawj xyoo. Provocative yam yog:
- kev ua lub cev;
- kev nyuaj siab;
- dej cawv;
- noj diuretics;
- kho lub cev.
Yog tias muaj kev tawm tsam tsawg dua ib hlis ib zaug, tsis tas yuav kho cov tshuaj tiv thaiv arrhythmic. Nrog kev tawm tsam tsis tu ncua, kev tswj hwm thiab kev noj tshuaj ntawm cov tshuaj raug xaiv rau txhua tus neeg mob. Kev kho mob yog saib xyuas siv:
- ECG;
- echocardiography;
- saib xyuas txhua hnub.
Nyob rau hauv lub xub ntiag ntawm ib daim ntawv mus tas li ntawm atrial fibrillation (tachysystolic los yog lwm yam), nws yog tsis tsim nyog los kho qhov ntswg atherosclerosis. Lub hom phiaj ntawm kev kho mob yog los tiv thaiv thromboembolism thiab txo qhov zaus ntawm contractions. Tsis tas li ntawd, cov tshuaj txuas ntxiv tau qhia:
- calcium antagonists;
- mob plawv glycosides;
- beta-blockers.
Aspirin lossis indirect anticoagulants raug pom zoo los tiv thaiv thromboembolism.
Contraindications rau kev nyem ntawm kev tawm tsam ntawm atrial fibrillation
Kev kho mob tsis pom zoo rau cov xwm txheej hauv qab no:
- Tachy-bradysystolic syndrome.
- Nquag tawm tsam ntawm atrial fibrillation, nyob rau hauv uas electrocardioversion lossis kev taw qhia ntawm cov tshuaj antiarrhythmic rau hauv cov hlab ntsha yog qhia. Nyob rau hauv kev pom ntawm qhov tseeb tias nyob rau hauv cov neeg mob no nws yog tsis yooj yim sua kom tswj lub sinus atherosclerosis rau lub sij hawm ntev, nws tsis pom zoo kom nres ib tug arrhythmia nres.
- mob plawv tsis ua hauj lwm hnyav thiab pom sab laug ventricular o.
- Ib qho tsis txaus ntseeg yog keeb kwm ntawm thromboembolism thiab muaj cov thrombus hauv atria.
Kev nyuaj siab
Nyob rau ntawm atrial fibrillation provokes qhov tshwm sim:
- mob hnyav cardiomyopathy nrog cov tsos mob ntawm lub plawv tsis ua haujlwm, tsim tawm tsam keeb kwm ntawm atrial fibrillation.
- Thromboembolism tshwm sim los ntawm kev ua haujlwm tsis zoo ntawm atrial contractions. Cov ntshav txhaws tuaj yeem ua rau lub raum, lub ntsws,spleen, paj hlwb hlab ntsha, peripheral hlab ntsha ntawm extremities.
- Hemodynamic tsis meej uas ua rau muaj kev tsim lossis kev loj hlob ntawm lub plawv tsis ua haujlwm, txo lub neej zoo thiab kev ua haujlwm ntawm tus kheej.
Qee feem pua ntawm cov neeg tuag ntawm cov neeg uas muaj atrial fibrillation vim qhov tshwm sim ntawm ventricular fibrillation. Ntawm qhov xwm txheej tshwj xeeb yog daim ntawv tachysystolic ntawm atrial flutter, yog li nws raug nquahu kom ua raws li cov lus qhia ntawm cov kws kho mob tshwj xeeb ntawm kev noj tshuaj thiab lwm yam kev tiv thaiv. Cov kev ntsuas dav dav yuav pab tiv thaiv kev tawm tsam tshiab, ua rau qeeb ntawm kev hloov pauv ntawm tus kab mob mus rau hauv daim ntawv ntev, uas muaj kev pheej hmoo siab ntawm qhov tshwm sim hnyav.
Cov ntaub ntawv kho mob rau cov neeg mob tau txais kev kho mob hauv tsev kho mob
Rau tus neeg mob uas raug kho hauv tsev kho mob, cov ntaub ntawv kho mob tau sau tseg, uas txhua yam ntaub ntawv hais txog nws lub xeev kev noj qab haus huv, xws li keeb kwm kho mob, tau nkag mus. "Atrial fibrillation, tachysystolic daim ntawv" yog lub ntsiab kev kuaj mob, ua raws li concomitant thiab teeb meem. Tsis tas li ntawd, cov ntaub ntawv hauv qab no tau nkag mus rau hauv keeb kwm kho mob:
- Pab lub npe;
- chaw ua haujlwm;
- hnub;
- hnub nkag mus rau hauv tsev kho mob;
- tsis txaus siab;
- case keeb kwm;
- life history;
- tus mob ntawm tus neeg mob (tshwj xeeb los ntawm lub cev);
- kev tshawb fawb;
- sib txawv thiab kuaj mob;
- etiology thiab pathogenesis ntawm tus kab mob hauv qab;
- kev kho;
- kev tiv thaiv;
- xov xwm;
- pawg;
- recommendations.
Nov yog qhov keeb kwm kho mob zoo li cas.
Yuav ua li cas daws cov teeb meem ntawm atrial fibrillation? Cov lus qhia los ntawm cov kws kho mob plawv
Txawm hais tias yog vim li cas thiab daim duab kho mob ntawm atrial fibrillation, koj yuav tsum:
- tiv thaiv rov qab;
- tuav lub qhov ntswg ib txwm muaj;
- tswj qhov zaus ntawm kev cog lus;
- tiv thaiv kev nyuaj.
Rau qhov no, kev noj tshuaj tas li yog qhia nyob rau hauv kev saib xyuas ntawm tus kws kho mob. Kev tiv thaiv thib ob txhais tau hais tias kev tsis lees paub tag nrho ntawm cawv, haus luam yeeb, ua haujlwm dhau - ob lub hlwb thiab lub cev. Cov tsos mob ntawm tus kab mob yog nyob ntawm qhov ua rau ua rau tachysystolic daim ntawv ntawm atrial fibrillation thiab nws qhov tshwm sim. Kev txhim kho lub neej zoo yuav tsum tau txais kev pab raws sij hawm los ntawm tus kws tshaj lij uas paub txog. Nrog rau qhov fibrillation tas li, nws raug pom zoo tsis tsuas yog noj cov tshuaj tsim nyog, tab sis kuj hloov koj cov dej num ib txwm muaj. Tsuas yog ib qho kev sib koom ua ke yuav txhim kho lub neej zoo thiab ncua lossis tshem tawm qhov tshwm sim ntawm cov teeb meem. Rau qhov no koj xav tau:
- Tsis txhob noj zaub mov muaj roj. suav nrog cov khoom noj uas muaj cov poov tshuaj thiab magnesium hauv koj cov zaub mov noj txhua hnub. Noj zaub, nplej, txiv hmab txiv ntoo.
- Kev ua lub cev yuav tsum maj mam.
- Ua raws li kev saib xyuas ntawm lub plawv tsis tu ncua. Thaum thawj cov tsos mob tsis txaus siab lossis txaus ntshai, sab laj nrog kws kho mob.
- Cia li tso cawv thiab luam yeeb.
Tsis tas li ntawd, mus tas li atrial fibrillation(tachysystolic daim ntawv) txhais tau tias nquag mus ntsib kws kho plawv thiab kuaj ntsuas tsis tu ncua. Cov neeg mob yuav tsum paub tias thaum lub sij hawm atrial fibrillation, ob feeb thiab cov ntshav systolic txo qis, uas ua rau tsis ua hauj lwm ntawm peripheral ncig. Qhov xwm txheej no ua rau muaj qhov ua rau muaj kev ntxhov siab thiab ua rau lub cev tseem ceeb tsis cuam tshuam nrog nws txoj haujlwm thiab lub cev pib ua rau tsis muaj cov as-ham thiab oxygen, hauv lwm lo lus, lub plawv tsis ua haujlwm tshwm sim.
