Nyob rau hauv tsab xov xwm, peb yuav xav txog dab tsi ECG hloov tau pom nrog PE.
Ib qho electrocardiogram tau ua los kawm txog kev ua haujlwm ntawm lub plawv thiab kev ua haujlwm ntawm cov hlab ntsha. Raws li cov txiaj ntsig ntawm txoj kev tshawb fawb no, tus kws tshaj lij tuaj yeem txiav txim siab seb lub cev puas ua haujlwm zoo lossis yog tus neeg mob muaj qee yam kab mob.
Kev piav qhia tus kab mob
PE - pulmonary embolism, uas kuaj tau los ntawm electrocardiogram. Pathology muaj nyob rau hauv kev tsim cov ntshav txhaws nyob rau hauv cov hlab ntsha ntawm lub ntsws. PE yog ib qho ntawm ntau hom venous thromboembolism uas tshwm sim hauv ntau qhov chaw ntawm lub cev. Raws li kev txheeb cais, cov kab mob no yog thib peb ntawm lwm cov kab mob ntawm cov hlab plawv, uas ua rau muaj qhov tshwm sim tuag taus.
ECG qhia dab tsi hauv PE?
Signs of PE
Thaum tsis muaj qhov pib mob ntevCov tsos mob ntawm lub plawv pulmonary embolism yog pom tau zoo ntawm cov txiaj ntsig ntawm cardiogram. Tus kws kho mob tshwj xeeb them nyiaj tshwj xeeb rau kev ua haujlwm ntawm qhov chaw ntawm lub plawv. Tus kab mob no feem ntau sau npe raws li qhov tshwm sim ntawm lwm cov txheej txheem pathological.
Muaj ntau theem ntawm tus kab mob no. Hom ECG txawv txav hauv PE:
- Spicy. Nws kav li ntawm 3 mus rau 7 hnub. Kev tshwm sim ntawm S1QIII tau pom, nyob rau hauv uas muaj qhov pom kev nce hauv cov hniav, kev hloov pauv hauv thaj chaw ntawm thaj chaw hloov pauv mus rau sab laug, kev sib cais ntawm QRS complex hauv V1-2, V6R-3R coj ntawm rSR '(rSr ') hom, thiab ua txhaum txoj haujlwm ntawm ST ntu. Qee zaum, koj tuaj yeem pom qhov tsis sib xws ntawm cov hniav ntawm lub ntsws. Cov tsos mob PE ntawm ECG yuav tsum tsis txhob hnov qab.
- Subacute. Kev loj hlob nyob rau hauv kwv yees li 1-3 lub lis piam. Nyob rau theem no, cov hniav tsis zoo yog tsim, maj mam tob zuj zus. Nyob rau tib lub sijhawm, tseem muaj qhov tsis txaus ntseeg txav ntawm thaj chaw sab nrauv thiab nce me ntsis ntawm cov hniav.
- Kev txhim kho rov qab. Lub sij hawm ntawm theem no kav txog 2-3 lub hlis. Nrog rau txoj kev loj hlob ntawm qhov rov qab, qhov cuam tshuam tsis zoo yog sau tseg: cov hniav tsis zoo maj mam txo qis. Txog rau qhov kawg ntawm theem no, daim cardiogram rov qab mus rau nws daim ntawv qub, uas pom tsuas yog ua txhaum ntawm lub plawv mob pathology.
Tsuas yog tus kws kho plawv uas tsim nyog tuaj yeem ua qhov kev kuaj mob zoo li no thiab kawm nws cov txiaj ntsig.
Cov tsos mob ntawm pathology
Muaj ntau cov tsos mob uas tuaj yeem siv los tsim kom muaj cov kab mob pathologieslub siab. Cov neeg mob nrog thromboembolism kev paub:
- tachycardia;
- ua pa luv luv;
- tachypnea;
- ceeb toom poob hauv SpO2;
- tsis ntev los no;
- hypotension yog ib yam uas tshwm sim hauv PE;
- tsis zoo nkauj ntawm daim tawv nqaij;
- tawm hws hnyav;
- ntshav tawm thaum lub sijhawm expectoration;
- kub taub hau;
- lwm cov tsos mob sab nraud.
Nrog cov cim saum toj no, tus neeg mob tau sau npe hauv chav kho mob plawv thiab tau txais kev kuaj tshwj xeeb.
Cov ntawv mob hnyav
Nyob rau hauv cov ntaub ntawv mob ntsws pulmonary thromboembolism, qhov sib txawv hauv qab no tuaj yeem pom ntawm ECG:
- sib txawv tus yam ntxwv ntawm sinus tachycardia thiab lwm yam mob;
- lub siab thim rov qab;
- Qhov tshwm sim ntawm qhov tsis zoo T nthwv dej ib txhij hauv lub hauv siab ua rau - qhov tshwm sim yog sib npaug kom nce siab hauv cov hlab ntsha pulmonary;
- thaiv ntawm sab xis ntawm Nws - qhov tshwm sim no piv nrog kev pheej hmoo ntawm kev tuag;
- tsis pom ECG cov paib;
- tig lub axis ntawm lub siab mus rau sab xis;
- arrhythmia ntawm hom supraventricular;
- lwm qhov sib txawv uas yog yam ntxwv ntawm pathology thiab pom tau rau tus kws tshaj lij.
Rau lub hom phiaj ntawm kev tiv thaiv, nws yog ib qho tsim nyog yuav tsum tau ua daim cardiogram ib xyoos ib zaug, txij li cov kab mob no feem ntau tshwm sim yam tsis muaj tsos mob.
ECG rau PE yog hom kev kuaj mob uas yuav tsum tau ua.
Kev faib tawm ntawm PE
Lub Koom Haum European ntawm Cardiology tau faib cov kab mob no rau kev kuaj mob yooj yim dua thiab siv cov kev ntsuas kho tau zoo. Nyob rau tib lub sijhawm, cov txheej txheem tseem ceeb rau kev faib tawm yog qhov chaw ntawm qhov txhab thiab qhov hnyav ntawm kev txhim kho cov txheej txheem pathological.
Yog li, PE muaj ob peb yam tseem ceeb:
- loj, uas muaj cardiogenic shock, ntshav siab, tsis cuam tshuam nrog lwm yam kab mob;
- ntsim;
- tsis loj, nrog ruaj khov hemodynamics;
- subacute;
- mob.
- siab mob ntsws ntsws;
- tsis ua pa luv;
- mob cor pulmonale.
Cov cim tseem ceeb ntawm PE hauv ECG kev kuaj mob
Cov cim qhia ntawm pathology yog:
- kos npe ntawm txoj cai atrial overload;
- cim ntawm txoj cai ventricular overload;
- block txoj cai bundles thaiv;
- Siv thaj chaw hloov mus rau sab laug;
- qee txoj axis sib txawv;
- sinus tachycardia;
- atrial extrasystole (ua ntej ntxov thiab txawv tshaj plaw ntawm myocardium);
- paroxysms ntawm atrial fibrillation.
Kev kho mob ntawm PE
Ntawm hauv kev saib xyuas hnyav ntawm cov neeg mob uas muaj cov tsos mob ntawm chaw kho mob PE ntawm ECG.
Piv txwv li, nyob rau hauv ib qho mob hnyav, ib tug neeg tau txais kev cawmdim, thiabKev kho ntxiv yog tsom rau normalizing ntshav ncig hauv lub ntsws, tiv thaiv kev mob ntsws pulmonary hypertension.
Txhawm rau tiv thaiv kev rov qab los ntawm tus kab mob, kev pw tsaug zog yog qhov tsim nyog. Rau oxygenation, oxygen inhalation yog nqa tawm. Tsis tas li ntawd, kev kho mob loj heev tau ua tiav los txo cov ntshav siab thiab tswj kev siab.
Nyob rau theem pib, kev kho thrombolytic tau qhia txhawm rau kom yaj cov ntshav txhaws sai li sai tau thiab rov ua kom cov ntshav ntws hauv cov hlab ntsha pulmonary. Tom qab ntawd, kev kho mob heparin yog ua los tiv thaiv kev rov qab los. Antibacterial therapy yog siv rau kev mob ntsws ntsws infarction.
Thaum muaj PE loj heev thiab tsis muaj txiaj ntsig ntawm thrombolysis, kev ua haujlwm thromboembolectomy tau ua. Raws li lwm txoj hauv kev no, catheter fragmentation ntawm thromboembolus yog siv. Nyob rau hauv cov ntaub ntawv ntawm rov tshwm sim ntawm PE, lub installation ntawm ib tug tshwj xeeb lim nyob rau hauv lub pulmonary hlab ntsha yog xyaum.
Daim duab ntawm ECG nrog PE yog nthuav tawm hauv qab no.
Kev Pabcuam Thaum Muaj Xwm Ceev
Thawj qhov uas yuav tsum tau ua yog tias koj xav tias thromboembolism yog hu rau lub tsheb thauj neeg mob sai, muab tus neeg mob tso rau ntawm qhov chaw tiaj tus. Nws yuav tsum tau so kiag li.
Pib nrog, cov neeg ua haujlwm kho mob ua cov kev ntsuas kev rov ua kom rov zoo, uas suav nrog kev kho cov pa oxygen thiab lub tshuab ua pa. Raws li txoj cai, ua ntej mus pw hauv tsev kho mob, tus neeg mob uas muaj PE tau muab cov tshuaj heparin intravenous unfractionated ntawm ib koob ntawm 10 txhiab units, nrog rau cov tshuaj no, 20 ml ntawm rheopolyglucin yog muab.
Ntxiv rau, thaum muab kev saib xyuas xwm txheej ceev rau cov tsos mob ntawm PE ntawm ECG, cov tshuaj npaj tshuaj hauv qab no tau muab rau tus neeg mob:
- "Eufillin" (2, 4% tov) - 10 ml;
- "No-shpa" (2% tov) - 1 ml;
- "Platifillin" (0.02% tov) - 1 ml.
Nrog ib qho tshuaj txhaj tshuaj Eufillin, tus neeg mob yuav tsum paub seb nws puas muaj cov kab mob xws li qaug dab peg, tachycardia, arterial hypotension, kom paub tseeb tias nws tsis muaj cov tsos mob ntawm myocardial infarction.
Nyob rau hauv thawj teev, tus neeg mob kuj tau txhaj tshuaj loog "Promedol", thiab thaum nws tsis tuaj, "Analgin" raug tso cai. Nyob rau hauv cov xwm txheej ntawm kev loj hlob ntawm tachycardia hnyav, kev kho kom tsim nyog tau ua sai sai, thiab thaum ua tsis taus pa, resuscitation yog nqa tawm.
Thaum muaj mob hnyav, kev qhia txog tshuaj 1% tshuaj "Morphine" hauv ntim ntawm 1 ml yog qhia, tab sis ua ntej muab cov tshuaj no rau hauv cov hlab ntsha, nws yog ib qho tsim nyog yuav tsum tau ua kom paub tseeb tias cov tshuaj "Morphine". tus neeg tsis muaj tus mob convulsive.
Tom qab kev ua haujlwm zoo li qub, lub tsheb thauj neeg mob xa tus neeg mob sai li sai tau mus rau lub chaw kho mob plawv, qhov chaw uas nws tau txais kev kho mob tsim nyog nyob rau hauv cov neeg mob.
Reviews
Kev tshuaj xyuas txog tus kab mob piav qhia tau lees paub tias PE yog qhov nyuaj heev thiab ua rau muaj kev phom sij rau tib neeg lub neej. Cov neeg mob nco ntsoov tias cov neeg ua haujlwm tsheb thauj neeg mob feem ntau tsis muaj sijhawm los ua electrocardiogram, vim tias thaum twgmob hnyav provoked los ntawm pulmonary embolism, lawv tam sim ntawd pib siv cov kev ntsuas resuscitation. Cov neeg mob hais tias daim cardiogram tau ua tiav nyob rau hauv tsev kho mob, tom qab kev ruaj ntseg ntawm tus neeg mob. Nyob rau hauv cov ntaub ntawv me me ntawm tus kab mob no, daim cardiogram tuaj yeem ua tau nyob hauv tsev thaum hu lub tsheb thauj neeg mob, tab sis tus neeg mob yuav raug coj mus rau hauv tsev kho mob txawm li cas los xij. Cov neeg mob hauv kev tshuaj xyuas tau piav qhia txog qhov xwm txheej ntawm qhov tshwm sim ntawm pathology - mob hnyav hnyav hauv lub sternum, nyuaj nyuaj hauv cov txheej txheem ua pa, hais palpitations, kiv taub hau, feem ntau - tsis nco qab.
Peb tau tshuaj xyuas qhov ECG qhia nrog PE.
