Hnub no, muaj ntau yam kab mob plawv. Feem ntau ntawm lawv yog suav hais tias yog ventricular arrhythmia, uas tshwm sim los ntawm kev ua kom ntxov ntxov ntawm impulses uas los ntawm lub ventricular system. Nyob rau hauv cov ntaub ntawv no, lub atherosclerosis ntawm lub plawv yog cuam tshuam, extraordinary contractions ntawm nws qis seem tshwm. Ventricular arrhythmia niaj hnub no tau pom nyob rau hauv 60% ntawm cov neeg, feem ntau yog cov laus. Qee zaum kev mob plawv tuaj yeem pom hauv cov tub ntxhais hluas noj qab haus huv. Dab tsi ua rau qhov tshwm sim ntawm cov kab mob no, cov tsos mob dab tsi nws muaj thiab yuav kho li cas - peb mam li tham txog qhov no.
Kev piav qhia tus kab mob
Tus kab mob no yog ib qho teeb meem ntawm lub plawv atherosclerosis, thaum conductive impulses raug tsim nyob rau hauv lub plawv ventricles, hauv qab ntawm qhov chaw uas lub pob ntawm nws rab rawg. Ventricular arrhythmia, kev kho mob thiab cov tsos mob, peb yuav xav txog hauv qab no, muaj ntau hom. Lawv ua raws li cov xwm txheej uas ua rau muaj kev cuam tshuam loj heev hauv kev ua haujlwm ntawm lub plawv, nrog rau kev ua haujlwm ntawm lub cev tam sim ntawd. Kuj ua tauasymptomatic, me me ntawm arrhythmias tshwm.
Forms of ventricular arrhythmias
Hauv cov tshuaj, nws yog ib txwm ua kom paub qhov txawv ntawm peb pawg ntawm cov kab mob no: extrasystole, tachycardia thiab fibrillation (flicker). Nyob ntawm daim ntawv ntawm kev tshwm sim ntawm tus kab mob, kev kho mob tsim nyog raug sau tseg. Tsis tas li ntawd, cov tsos mob ntawm manifestation ntawm arrhythmias kuj txawv. Cia wb mus saib qhov teeb meem no.
YExtrasystole
Tus kab mob no yog ib qho uas nquag tshaj tawm, nws yog tshwm sim los ntawm lub plawv dhia ua ntej. Ventricular arrhythmia (extrasystole) muaj nyob rau hauv 70% ntawm cov neeg muaj hnub nyoog sib txawv, nws cov tsos mob feem ntau tshwm sim los ntawm kev ntxhov siab, cawv thiab nicotine, kas fes. Tsis tas li ntawd, arrhythmia ntawm daim ntawv no tuaj yeem tshwm sim thaum lub myocardium puas vim muaj ntau yam kab mob.
Muaj tsib chav kawm ntawm extrasystole, koj tuaj yeem kuaj pom muaj ib tus ntawm lawv siv ECG rau nees nkaum plaub teev:
- chav kawm xoom txhais tau tias tsis muaj extrasystole;
- thawj chav kawm yog tus yam ntxwv ntawm qhov tshwm sim tsis pub dhau peb caug ib qho kev cog lus rau ib teev;
- chav kawm thib ob yog qhov tshwm sim ntawm ntau dua peb caug ib qho kev cog lus rau ib teev;
- chav kawm thib peb qhia tias muaj polymorphic extrasystoles;
- chav kawm plaub txhais tau hais tias muaj kev sib koom ua ke ntawm polymorphic lossis monomorphic abbreviations;
- qib tsib yog tus cwj pwm los ntawm pab pawg sib cog lus, qee zaum tachycardia tawm tsam tau.
Tachycardia
Ventricular arrhythmia ntawm daim ntawv no yog tshwm sim los ntawm kev nce hauv lub plawv dhia (ntau dua 90 neeg ntaus ib feeb). Tachycardia tuaj yeem tshwm sim nws tus kheej ob qho tib si raws li kab mob thiab ua lub cev tshwm sim thaum muaj kev ntshai, kev tawm dag zog lub cev, thiab lwm yam. Feem ntau, nws yog cov tsos mob ntawm kev loj hlob ntawm ntau yam kab mob ntawm endocrine, autonomic paj hlwb. Tachycardia raws li ib tug pathology tuaj yeem ua rau muaj qhov tshwm sim tsis zoo. Yog li, cov ntshav siab poob qis, cov ntshav ntws mus rau hauv nruab nrog cev qeeb, cov ntshav muab rau lub cev thiab lub plawv, suav nrog, ua rau muaj kev pheej hmoo ntawm cov kab mob coronary lossis plawv nres. Muaj ob peb chav kawm ntawm tachycardia:
1. Sinus - muaj kev ua txhaum ntawm kev sib kis ntawm impulses mus rau lub ventricles los ntawm lub sinus node. Qhov no tuaj yeem yog qhov tshwm sim los ntawm kev ua haujlwm tsis zoo ntawm lub node nws tus kheej, lossis kev ntxhov siab, ntshai, thiab lwm yam.
2. Paroxysmal - muaj kev tawm tsam ntawm lub plawv dhia mus txog 300 neeg ntaus ib feeb, uas tshwm sim thiab ploj tam sim ntawd. Qhov no tej zaum yuav yog vim muaj kev nce hauv kev ua haujlwm ntawm lub paj hlwb sympathetic, nrog rau kev hloov pauv hauv myocardium. Feem ntau nws tshwm sim nyob rau hauv rooj plaub thib ob thiab pom nyob rau hauv feem ntau ntawm cov txiv neej. Xws li tachycardia tuaj yeem loj hlob mus rau ischemia, hypotension, thiab tseem mus rau hauv ventricular fibrillation. Kev tawm tsam tsis tu ncua ntawm tachycardia muaj kev cuam tshuam rau lub cev cov ntshav ncig, ua rau muaj kev pheej hmoo tuag.
Kev mob plab
ventricular fibrillation, lossisfibrillation, tus cwj pwm los ntawm lub plawv dhia mus txog 480 neeg ntaus ib feeb, thaum lub ventricles cog lus uncoordinated, lub plawv nws thiaj li nres, tus neeg tuag. Fibrillation feem ntau yog tshwm sim los ntawm lub plawv nres. Hauv cov tshuaj, nws yog ib txwm ua kom paub qhov txawv ntawm ntau chav kawm ntawm atrial fibrillation:
- Pib - tshwm sim thawj ob hnub tom qab pib mob plawv thiab yog ib qho ua rau tib neeg tuag sai sai.
- Secondary ventricular fibrillation tsim vim kev poob siab cardiogenic hauv cov neeg mob plawv.
- Late fibrillation tshwm nyob rau plaub lub lim tiam ntawm tus kab mob.
Fibrillation hauv txhua kis pib sai sai. Peb teev tom qab nws qhov tsos, lub taub hau pib tig, tsis muaj zog tshwm sim. Tom qab nees nkaum teev, ib tug neeg tsis nco qab, tom qab plaub caug teev convulsions pib, cov menyuam kawm ntawv dilate, ua pa maj mam zuj zus, thiab ces nres tag nrho, kho mob tuag tshwm sim.
Kev faib tawm
Txawm li cas los xij tuaj yeem tsim kho tom qab ventricular arrhythmia ntawm lub plawv tau tshwm sim (cov tsos mob yuav tau tham hauv kab lus no), nws yog kev cai rau ib leeg tawm:
1. Functional arrhythmias yog tshwm sim los ntawm qhov tsis muaj lub plawv mob, uas yog mob hnyav. Yeej tsis muaj teeb meem tom qab.
2. Arrhythmias uas txaus ntshai rau tib neeg thiab tsim tawm tsam keeb kwm ntawm kab mob plawv, kev tuag hauv qhov no nce ntxiv.
3. Malignant kev loj hlobmob plawv atherosclerosis, tshwm sim nrog mob plawv mob hnyav thiab feem ntau ua rau tuag.
Yog vim li cas thiaj pom
Kev txhim kho ntawm arrhythmias tuaj yeem tshwm sim rau ntau yam laj thawj, qee zaum lawv tsis paub. Nyob rau hauv rooj plaub tom kawg, nws yog kev cai los tham txog tus kab mob, uas yog idiopathic nyob rau hauv cov xwm. Feem ntau, ventricular arrhythmia (cov tsos mob, kev kho mob thiab kev kwv yees yuav tau tham hauv qab no) tshwm sim los ntawm kev txhim kho cov kab mob plawv: ischemia, plawv nres, cardiosclerosis, mitral valve puas, nrog rau myocardial o, kub siab, uas yog malignant., pulmonary pathology. Qee zaum, VVD, hernia thiab osteochondrosis tuaj yeem ua rau arrhythmias. Idiopathic arrhythmia yog provoked los ntawm lwm yam: haus luam yeeb, haus cawv thiab kas fes, nquag siv tshuaj plawv.
Symptoms and signs
Ventricular arrhythmia tsis muaj cov tsos mob pom tseeb. Cov neeg sib txawv tuaj yeem muaj qhov sib txawv, uas tsis nyob ntawm qhov ua rau muaj tus kab mob. Feem ntau, cov neeg mob muaj kev qaug zog, ua tsis taus pa, kiv taub hau. Qhov tshwm sim ntawm cov tsos mob ntawm ECG yog pom meej. Ua ntej ntawm tag nrho cov, muaj qhov loj thiab deformation ntawm cov hniav, uas yog ib feem ntawm lub ventricular complex. Ntau tshaj peb qhov kev cog lus ntawm lub plawv ua ke kuj qhia tau tias muaj arrhythmia. Pleev, ntxhov siab vim, tawm hws ntau ntxiv, kev xav ntawm ua tsis taus pa, cuam tshuam hauv kev ua haujlwm ntawm lub plawv yog muaj nyob rau hauv extrasystoles. Nrog tachycardia, kiv taub hau raug pom (mus txog qhov tsis nco qab), mob hauv plawv, mob hnyavpalpitations, ua tsis taus pa, hypotension, convulsions. Fibrillation feem ntau manifests nws tus kheej nyob rau hauv daim ntawv ntawm fainting, mob hauv siab, pulmonary edema, pulse deficit. Nws cov tsos mob yog vim qhov tseeb tias lub ventricles cog lus sai thiab tsis xwm yeem.
Kev kuaj kab mob
Ventricular arrhythmia tuaj yeem lees paub los ntawm ECG saib xyuas, ua haujlwm ECG, VEM lossis treadmill kuaj. Txoj kev tshawb no suav nrog kev kaw lub plawv impulses siv electrodes uas muab tso rau ntawm daim tawv nqaij ntawm tus neeg lub hauv siab, nrog rau ntawm nws txhais tes thiab ob txhais ceg. Cov ntawv nyeem tau kaw rau ntawm lub monitor, tom qab ntawd lawv raug xa mus rau lub tshuab luam ntawv thiab luam tawm ntawm daim ntawv. Nrog VEM, cov ntsuas tau raug coj los siv thaum lub sijhawm ua haujlwm, rau qhov no siv lub tsheb kauj vab. Kev ntsuas treadmill siv lub treadmill. Nyob rau hauv cov ntaub ntawv ntawm kev kuaj mob, nws yog ib qho tsim nyog yuav tsum tau coj mus rau hauv tus account cov yam ntxwv uas cuam tshuam rau qhov pib thiab xaus ntawm qaug dab peg. Qhov no suav nrog kev xav thiab lub siab lub ntsws ntawm tus neeg mob, kev ua si lub cev, noj tshuaj, thiab lwm yam. Lwm txoj kev tshawb fawb ntxiv rau qhov muaj arrhythmias yog: radiography, tomography, ultrasound ntawm lub plawv. Kev kho mob ntxiv ntawm tus kab mob no yuav nyob ntawm qhov txiaj ntsig ntawm cov kev sim no.
Ventricular arrhythmia: kho
Thaum kuaj pom tus kab mob, tsis yog txhua tus neeg mob yuav tsum tau kho tshwj xeeb. Nrog rau kev kho tshuaj, nws raug nquahu kom them sai sai rau cov kev mob tshwm sim ntawm cov tshuaj, nrog rau lub sijhawm ntawm lawv qhov kev noj, vim nws muaj peev xwm ua rau muaj kev phom sij rau kev noj qab haus huv. Hauv qee qhov pathologies ntawm lub plawv, kev siv tshuaj los ntawmarrhythmias, vim qhov no tuaj yeem ua rau lub plawv nres. Xav txog cov hau kev thiab txoj hauv kev kho arrhythmias hauv nws ntau hom.
Kev kho mob ntawm extrasystoles
Ntau zaus, tus kab mob no cuam tshuam nrog qhov tsis muaj electrolytes hauv tib neeg lub cev, uas kuaj pom los ntawm kev kuaj ntshav. Yog li, kev noj zaub mov magnesium-potassium feem ntau pom zoo rau extrasystole. Koj kuj yuav tsum tau xyuam xim rau kev pw tsaug zog thiab so, noj zaub mov, cwj pwm tsis zoo, kev haus kas fes, kev ntxhov siab, thiab lwm yam. Cov tshuaj sedative tuaj yeem raug sau tseg. Yog hais tias ventricular arrhythmia yog mob hnyav, ces cov tshuaj tau muab tshuaj, thiab qee zaum yuav tsum tau phais. Tus neeg mob tau muab tshuaj electrolytes, ACE inhibitors, nitrates, thiab lwm yam. Cov tshuaj tiv thaiv arrhythmia yog qhov tseem ceeb ntawm no.
Kev kho mob ntawm tachycardia
Muaj ob pawg ntawm cov tshuaj, qhov kev txiav txim yog tsom rau kev kho mob ntawm tachycardia: sedatives thiab tshuaj antiarrhythmic. Sedatives raug ntaus nqi yog tias muaj GVA. Nws tuaj yeem yog "Diazepam", "Persen", "Glycine" thiab lwm yam. Cov tshuaj antiarrhythmic rau ventricular arrhythmia yog raug sau tseg tom qab tsim qhov ua rau ntawm pathology. Nws tuaj yeem yog "Verapamin", "Anaprilin", "Adenosine" thiab lwm yam. Txawm li cas los xij, tus kws kho mob tshwj xeeb yuav tsum tau kho.
Kev kho mob Fibrillation
Yog tias qhov kev tawm tsam ntawm fibrillation tshwm sim thawj zaug lossis tsis sib xws, nws yog qhov tsim nyognres nrog kev pab ntawm "Quinidine", "Cordorone" lossis "Novocainamide". Yog tias fibrillation nyob mus ib txhis, koj yuav tsum noj tshuaj kom tsis txhob mob stroke. Hauv qhov no, txoj kev kho anticoagulant yog qhov tsim nyog, koj yuav tsum noj acetylsalicylic acid, Warfarin, heparins.
Kev ntsuas rau arrhythmias
Qhov kev cia siab rau tus mob no yuav nyob ntawm nws daim ntawv, muaj lub plawv pathology, thiab cov hlab ntsha hauv tib neeg. Ventricular thiab supraventricular arrhythmias, uas tsis cuam tshuam nrog kab mob plawv, tsis ua rau tib neeg lub neej thiab kev noj qab haus huv. Yog hais tias tus kab mob no tshwm sim tawm tsam keeb kwm ntawm kab mob plawv, qhov kev tshwm sim yuav tsis zoo. Lub neej expectancy ntawm no yuav nyob ntawm kev kho raws sij hawm. Yog li ntawd, nws raug nquahu kom saib xyuas kev ua haujlwm ntawm lub plawv thiab ua raws li tag nrho cov lus pom zoo kho mob, ces tus kab mob tuaj yeem raug tso tseg. Tib lub sijhawm, ib tus yuav tsum tsis txhob hnov qab txog kev tiv thaiv, txij li kev saib xyuas kev noj qab haus huv tuaj yeem ua lub luag haujlwm loj, thiab qee zaum, cawm tib neeg txoj sia.
Kev Tiv Thaiv
Ua ntej tshaj plaws, kev tiv thaiv ntawm arrhythmias yog tsom rau kev kho mob plawv pathology, uas ua rau muaj kev cuam tshuam ntawm kev sib dhos thiab kev cuam tshuam. Nws tseem yog ib qho tsim nyog los tshem tawm qhov ua rau ntawm qhov pib ntawm tus kab mob, cov no tuaj yeem yog intoxication, VDS, kev nyuaj siab, electrolyte imbalance, thiab lwm yam. Nws yog ib qho tsim nyog yuav tsum txwv tsis pub haus cawv, nicotine thiab caffeine, nrog rau kev ywj pheej ntawm kev siv. tshuaj tiv thaiv arrhythmia. Kev kho mob yuav tsum tau ua nruj me ntsis los ntawm kws kho mob. Yog li, kev tiv thaiv kab mob yog raws li hauv qab no:
- kho mob plawv loj;
- noj;
- cais tus cwj pwm phem;
- tswj lub cev ua si, qhov hnyav, siab;
- tiv thaiv nrog tshuaj.
Nws raug pom zoo kom noj "Panangin" (potassium thiab magnesium), vitamin B6, "Ritmonorm", "Allapinin" thiab lwm yam kev npaj.
Nrog arrhythmia, koj tuaj yeem ua si kis las, tab sis kev ua si ntawm lub cev yuav tsum me me. Tsis txhob overload lub cev. Los ntawm kev ua raws li tag nrho cov lus pom zoo thiab saib xyuas koj txoj kev noj qab haus huv, koj tuaj yeem cawm tsis tau koj txoj kev noj qab haus huv xwb, tab sis kuj rau koj lub neej, thiab tus kws kho mob yuav pab koj txiav txim siab txog kev xaiv tshuaj.
