Vasovagal syncope: piav qhia, ua rau, tsos mob thiab kev kho mob nta

Cov txheej txheem:

Vasovagal syncope: piav qhia, ua rau, tsos mob thiab kev kho mob nta
Vasovagal syncope: piav qhia, ua rau, tsos mob thiab kev kho mob nta

Video: Vasovagal syncope: piav qhia, ua rau, tsos mob thiab kev kho mob nta

Video: Vasovagal syncope: piav qhia, ua rau, tsos mob thiab kev kho mob nta
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Anonim

Ntau tus neeg qaug zog rau ntau yam, uas yog qhov tsis nco qab ib ntus. Tus mob no ua rau muaj kev cuam tshuam ib ntus ntawm cov ntshav mus rau lub hlwb. Nws yuav qhia tau tias muaj mob hnyav. Hauv cov tshuaj, muaj xws li vasovagal syncope, uas yog nrog los ntawm kev txo qis hauv lub plawv dhia thiab txo qis ntshav siab.

Nws suav tias tsis ua rau muaj kev phom sij rau lub neej, tab sis yog tias rov ua ntau zaus, lub neej zoo yuav txo qis. Muaj cov tsos mob thaum yau, thiab qhov tshwm sim ntawm qhov kev tawm tsam ntawm lub neej tsis hloov. Cia peb sim xav txog dab tsi vasovagal syncope yog, cov tsos mob, ua rau lawv tshwm sim.

Tus yam ntxwv ntawm tus kab mob

Cov kab mob pathological no tshwm sim los ntawm kev tsis nco qab ib ntus, feem ntau yog thaum tus neeg nyob hauv qhov chaw sawv. Nws tshwm sim raws li hauv qab no: vim yog qhov tsis tshua muaj venous rov qab, nws pib ncelub suab quaj. Nyob rau hauv cov neeg uas raug kev txom nyem los ntawm nquag syncope ntawm no hom, qhov no nce yog heev loj, uas ua rau kom muaj zog contraction ntawm lub plawv. Nthuav impulses nkag mus rau hauv lub hlwb los ntawm cov hlab ntsha, uas ua rau ib tug nce nyob rau hauv parasympathetic thiab ib tug txo nyob rau hauv sympathetic tone. Qhov tshwm sim yog bradycardia, uas txo cov ntshav siab, ua rau qaug zog.

syncope vasovagal
syncope vasovagal

Yog vim li cas

Vasovagal syncope feem ntau tshwm sim vim qhov tsis raug ntawm lub cev ua rau khaus ntawm cov receptors tshwj xeeb ntawm lub paj hlwb.

Qhov feem ntau ua rau tus mob no yog:

  • xov xwm zoo li ntshai;
  • txiav ntshav los ntawm tus ntiv tes lossis leeg, mob;
  • ncig sawv;
  • kev tawm dag zog lub cev nrog kev nres tam sim;
  • hnav khi nruj lossis dab tshos;
  • ntshai mus ntsib kws kho hniav.
vasovagal syncope
vasovagal syncope

Yog li, yog tias vasovagal syncope tau tshwm sim, yog vim li cas rau qhov no yuav txawv. Txawm li cas los xij, nws yog nrog los ntawm kev nthuav dav ntawm cov hlab ntsha, txo qis hauv plawv mus txog rau lub plawv nres, nrog rau kev ua pa qeeb. Kev nco qab rov los ntawm nws tus kheej hauv vib nas this.

Cov neeg mob los ntawm cov kab mob plawv feem ntau yog contraindicated rau lub sij hawm ntev nyob rau hauv lub tshav kub nyob rau hauv ib tug sawv ntsug, raws li muaj feem ntau yuav fainting.

Symptoms

Faintvasovagal yog nrog los ntawm cov tsos mob hauv qab no:

  • tawm hws, xeev siab, qhov muag tsis pom kev, tinnitus;
  • daim tawv nqaij tig daj;
  • txo qis lub plawv dhia thiab siab;
  • faint yeej ib txwm tshwm sim thaum ib tug neeg nyob rau hauv ib tug upright txoj hauj lwm, thiab yog hais tias thaum pib ntawm ib tug nres nteg nws horizontally, tus kab mob yuav rov qab.
vasovagal syncope hauv cov neeg ncaws pob
vasovagal syncope hauv cov neeg ncaws pob

Diagnosis

Tus kws kho mob yuav tsum tau sab laj sai li sai tau thaum thawj qhov kev tawm tsam tshwm sim. Feem ntau cov ua rau xws li qaug zog tsis txaus ntshai, tab sis qee zaum nws tuaj yeem qhia tau tias muaj kev ua txhaum loj ntawm lub cev. Piv txwv li, hais txog cov qog thiab cov kab mob plawv uas tuaj yeem ua rau tuag taus.

Ua ntej, tus kws kho mob pom los ntawm tus neeg mob thaum pib qaug dab peg, txawm tias lawv mus rau tib txoj kev, ua ntej qhov tsis nco qab thiab qhov twg tus neeg mob tuaj yeem koom nrog lawv qhov tshwm sim. Tom qab no, tus kws kho mob pib xav txog cov lus nug hauv qab no:

  • txoj haujlwm ntawm tus neeg mob thiab seb nws puas cuam tshuam nrog kev pheej hmoo rau lub neej (tus tsav tsheb, tsav tsheb, tus neeg dhia dej, tus neeg tsav nkoj);
  • Tus neeg mob cov neeg txheeb ze puas muaj kab mob plawv, puas yog lawv puas tsis nco qab, vim vasovagal syncope tuaj yeem ua los ntawm noob neej.
vasovagal syncope tom qab qoj ib ce
vasovagal syncope tom qab qoj ib ce

Tom qab ntawd tus kws kho mob tshuaj xyuas tus neeg mob, sau nws cov xim ntawm daim tawv nqaij, qhov pom ntawm cov rau tes, plaub hau, qhov ua pa ntawm lub ntsws, muaj lub plawv yws yws thiab hawb pob hauv lub ntsws. Assigns general thiabKev kuaj ntshav biochemical.

Ntxiv rau, kev kuaj mob suav nrog cov txheej txheem hauv qab no:

  • Electrocardiography (ECG), uas ntsuas kev ua haujlwm ntawm lub plawv.
  • 24-teev Holter electrocardiogram saib xyuas (HMECG). Tsis pub dhau 24-72 teev, ib qho electrocardiogram tau kaw, thiab yog tias nws tuaj yeem kho qhov muag tsis pom, ces qee qhov kev hloov pauv tau tshwm sim rau ntawm nws. Sab nraud ntawm syncope, cov ntsuas ib txwm raug sau tseg.
  • Echocardiography (EchoCG). Nws tsuas yog ua kom tshem tawm cov kab mob ntawm cov hlab ntsha thiab lub plawv.
  • YOrthostatic test. Nrog kev pab los ntawm txoj kev no, kev kuaj mob ntawm "vasovagal syncope" yog tsim. Lub ntsiab ntawm cov txheej txheem no yog tias tus neeg mob pw ntawm lub txaj tshwj xeeb ntawm lub kaum sab xis ntawm 60 degrees rau 30 feeb. Lub sijhawm no, cov ntsuas electrocardiogram raug coj, thiab cov ntshav siab tau txiav txim siab lossis ntsuas tus kheej. Thaum tsaus ntuj, muaj ntshav siab poob qis thiab cuam tshuam hauv kev ua haujlwm ntawm lub plawv.

Vasovagal syncope tuaj yeem ua ib leeg. Lawv tsis tas yuav ua rau muaj kab mob, feem ntau tsis nco qab tshwm sim hauv cov neeg noj qab haus huv zoo kawg nkaus.

pab thawj fainting

Yog tus neeg mob muaj mob qaug dab peg los yog twb tsis nco qab lawm, nws yuav tsum tau muab tso rau ntawm kab rov tav, unbuttoned los yog tshem tawm ntawm nws cov khaub ncaws - nws txwv tsis pub nws ua pa - thiab muab nws ob txhais ceg rau saum toj kom ntseeg tau cov ntshav ntws. mus rau lub taub hau. Feem ntau, qhov kev pab no tso cai rau tus neeg kom rov zoo sai sai.

vasovagal syncopeua rau
vasovagal syncopeua rau

Tab sis kuj tshwm sim tias nws tseem tsis nco qab. Nyob rau hauv rooj plaub no, nws yog ib qho tsim nyog yuav tsum muab lub hlwb qee yam teeb liab los ntawm lub ntiaj teb sab nraud kom nws tshwm sim thiab pib tag nrho "system". Qhov no yuav tsum muaj kev txhawb zog. Piv txwv li, koj tuaj yeem muab ammonia rau nws kom hnov tsw, txau dej txias rau ntawm nws lub ntsej muag, lossis maj mam txhuam nws lub plhu.

Tus neeg mob yuav tsum tsis txhob tso cai sawv tam sim ntawd tom qab vasovagal syncope tau tshwm sim, vim tias cov ntshav tseem tsis tau rov qab los. Nws yog ib qho tsim nyog yuav tsum coj nws mus rau nws lub siab maj mam, kom deb li deb tau los ntawm kev tswj hwm nws tus mob. Yog tias txoj kev zoo li no tsis pab, koj yuav tsum hu rau lub tsheb thauj neeg mob ceev, vim tias lub paj hlwb hypoxia ntev tuaj yeem ua rau muaj kev hloov pauv tsis tau, txawm tias tuag.

kev kho mob

Yog tias vasovagal syncope raug kuaj pom, kev kho mob nyob ntawm qhov mob hnyav. Qee zaum, kev tsis nco qab tshwm sim ntau zaus, thiab nws kuj tshwm sim tias kev qaug zog ploj mus ntawm nws tus kheej. Kev kho mob feem ntau yog muab rau cov neeg uas muaj cov kab mob pathological no tshwm sim ntau zaus uas tus neeg ua haujlwm tsis tau.

Kev kho tshuaj suav nrog kev siv beta-blockers xws li Atenol thiab Metoprolol. Nrog kev pab los ntawm cov tshuaj no, cov txheej txheem ntawm myocardial contraction raug txo qis thiab kev ua kom ntau dhau ntawm cov mechanoreceptors ntawm lub plawv yog tiv thaiv.

Kev kho mob vasovagal syncope
Kev kho mob vasovagal syncope

Bradycardia yog kho nrog M-cholinoblockers. Yeej, cov no yog thaj ua rau thaj uas muaj scopolamine. siv lawvua raws li peb hnub ib zaug. Txhawm rau txo qhov zaus ntawm kev qaug zog, tus kws kho mob tau sau ntawv "Disopyramide", uas muaj M-anticholinergic thiab tsis zoo inotropic teebmeem. Theophylline feem ntau siv tsawg dua.

Yog tias thaum lub sijhawm kuaj mob hnyav ntawm lub plawv, tsis muaj cov kab mob lossis cov qog tau pom, ces tus kws kho mob yuav tsum tau sau cov txheej txheem kho raws li cov kab mob no.

kev kho mob phais

Kev kho mob no suav nrog kev teeb tsa ntawm lub tshuab pacemaker. Qhov no yuav tsum muaj kev sib xyaw ua ke ntawm cov hauv qab no:

  • tus neeg mob hnub nyoog tshaj 40;
  • frequent fainting;
  • tsis pom qhov tsis nco qab (blackout, kiv taub hau, tinnitus);
  • mob plawv nres.

Fam tom qab kev tawm dag zog

Muaj cov xwm txheej uas vasovagal syncope tshwm sim tom qab kev tawm dag zog. Nyob rau hauv cov ntaub ntawv no, provoking yam yog: ib tug nruj dab tshos, ib tug ntse tig ntawm lub taub hau, ib tug muaj zog compression ntawm lub hauv siab, siab nyob rau hauv lub cheeb tsam ntawm lub carotid sinus.

Vasovagal syncope tshwm sim hauv cov neeg ncaws pob hauv txoj kev no:

  • muaj qhov tshwm sim sai sai ntawm cov hlab ntsha peripheral, ua rau muaj qhov txo qis hauv lub plawv thiab lub hlwb hypoxia tsim;
  • sudden reflex suppression ntawm lub plawv ua haujlwm los ntawm cov hlab ntsha vagus kom ua tiav lub plawv nres.

Hauv thawj kis, muaj ib txwm ua haujlwm, thiab hauv qhov thib ob, cov ntshav ncig dheev nres, uas yuav tsum tau ua.kev kho mob tam sim ntawd.

ntsuas kev tiv thaiv

Yog tias tsis tau kuaj pom tus kab mob loj, nws yuav tsum tau ua tib zoo xav txog kev siv cov kev tiv thaiv, uas yog raws li hauv qab no:

  • yuav tsum zam cov xwm txheej uas tuaj yeem ua rau tsis nco qab;
  • koj tsis tuaj yeem nyob hauv tshav kub ntev, tshaib plab, haus luam yeeb, haus cawv, ua haujlwm dhau;
  • yuav tsum txwv kev tawm dag zog rau peb lub hlis;
  • yuav tsum tau txhim kho kev noj qab haus huv - ua lub teeb jogging thaum sawv ntxov, ua luam dej, dej aerobics;
  • sib piv da dej thiab tawv tawv muaj txiaj ntsig zoo rau cov hlab ntsha;
  • txhawm rau kom ntshav siab ib txwm nyob li qub, nws yuav tsum ua raws li kev ua haujlwm niaj hnub, piv txwv li nrhiav qhov pom kev sib npaug ntawm kev ua haujlwm thiab so, uas yuav pab txuag lub zog;
  • koj tsis tuaj yeem khoov tau nrawm dua thiab sawv ntawm txoj haujlwm yooj yim, vim tias orthostatic tawg tuaj yeem tshwm sim;
  • normalizes ntshav siab zoo siv tshuaj ntsuab tshuaj ntsuab los ntawm chamomile thiab mint, St. John's wort, thiab txiv qaub balm.
vasovagal syncope tshwm sim
vasovagal syncope tshwm sim

Kev lom zem thaum cev xeeb tub

Qee zaus vasovagal syncope tshwm sim thaum cev xeeb tub. Tus mob ntawm ib tug poj niam nyob rau hauv ib tug nthuav txoj hauj lwm yog feem ntau nrog los ntawm ib tug general malaise thiab tsis muaj zog, thiab qhov no yog vim muaj zog load ntawm lub cev. Qhov tsos ntawm fainting ua rau nws txhawj xeeb heev. Lawv tshwm sim hauv cov xwm txheej hauv qab no:

  • hloov pauv sai sai hauv kev ncig;
  • qisntshav qab zib;
  • ntse txav;
  • ntev ntev thiab nquag pw tom qab;
  • toxicosis.

Feem ntau zaus yog qhov txaus ntshai vim poob, yog li nco ntsoov qhia rau koj tus kws kho mob gynecologist txog qhov no.

Zoo kawg

Yog li, vasovagal syncope tuaj yeem ua rau muaj kab mob hnyav heev, yog li koj yuav tsum tau mus ntsib kws kho mob kom kuaj xyuas thiab kho. Lawv kuj qee zaum tshwm sim hauv cov neeg noj qab haus huv. Ua tsaug rau kev tiv thaiv, tus kab mob no tuaj yeem zam tau.

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