Atrial fibrillation lossis atrial fibrillation yog hom kev mob plawv tshaj plaws. Raws li muaj kev txheeb cais, kwv yees li 1% ntawm cov pej xeem raug kev txom nyem los ntawm kev ua txhaum cai.
Nyob rau hauv ib txwm lub xeev, cov hlab ntsha impulse nce rheumatically nyob rau hauv lub atria thiab lawv cog lus ntawm ib tug zaus ntawm 60-90 neeg ntaus ib feeb. Nrog atrial fibrillation, ntau qhov sib txawv ntawm qhov sib txawv tshwm sim hauv lawv, thiab qhov zaus ntawm kev cog lus yog kwv yees li 300-700 ib feeb. Qhov no cuam tshuam cov txheej txheem ntshav.
Tus yam ntxwv ntawm tus kab mob
Atrial fibrillation yog ib qho kev cuam tshuam hauv cov hluav taws xob conduction ntawm lub plawv cov leeg. Lub plawv yog ib tug hollow nqaij, muaj 4 kab noj hniav. Ntawm nws lub hauv paus, nws yog lub twj tso kua mis uas muab microcirculation ntawm cov ntshav hauv lub cev thiab tswj cov ntshav siab. Ua li no, nws cog lus rhythmically. Lub plawv dhia li qub yuav tsum hloov ntawm 60-100 neeg ntaus ib feeb.
Tsis zoo li lwm yam kabmob, lub siab tuaj yeem ua tauua hauj lwm yam tsis muaj kev tswj xyuas sab nraud, txij li lub sinus node generates impulses uas provoke ib contraction ntawm lub plawv cov leeg. Nyob rau hauv tsis muaj xws li ib tug hais kom ua, cov nqaij fibers ntawm lub plawv daim ntawv cog lus nyob rau hauv ib tug chaotic yam thiab tag nrho ntawm sync. Yog li ntawd, kev ua haujlwm ntawm lub plawv contractions txo qis thiab cov mem tes nce mus rau 160-180 ib feeb. Ib yam mob zoo sib xws yog hu ua atrial fibrillation.
hom kab mob tseem ceeb
Muaj 3 hom kev sib txawv ntawm atrial fibrillation, uas tau txiav txim siab nyob ntawm lub sijhawm ntawm arrhythmia, uas yog:
- paroxysmal;
- constant;
- mob.
Daim ntawv mob mus ntev ntev thiab yog cov tsos mob tseem ceeb ntawm ntau yam pathologies ntawm lub plawv cov leeg. Daim ntawv paroxysmal ntawm atrial fibrillation yog tus cwj pwm los ntawm qhov tseeb tias arrhythmia yog tsim heev dheev nyob rau hauv ib tug neeg noj qab haus huv tag nrho. Nws kuj mus deb ntawm nws tus kheej yam tsis muaj kev cuam tshuam sab nraud rau qhov siab tshaj plaws ntawm ib lub lis piam. Paroxysmal atrial fibrillation feem ntau kav 24-48 teev, tab sis yuav kav ntev li ob peb feeb xwb.
Persistent or persistent arrhythmia feem ntau kav ib lub lis piam thiab tsis ploj mus raws li nws tus kheej. Ib daim ntawv mus tas li ntawm atrial fibrillation feem ntau xav tau kev kho tshwj xeeb. Yog tias lub plawv dhia rov qab tsis zoo tom qab 48 teev lossis ntau dua, kev kho mob yuav tsum tau kho.
Kev tshwm sim
Qhov ua rau atrial fibrillation tuaj yeem yog qhov feem ntauntau yam. Ntawm cov xwm txheej uas tshwm sim, nws yog qhov yuav tsum tau ua kom pom xws li:
- cardiosclerosis;
- mob plawv thiab angina pectoris;
- rheumatism;
- siab tsis zoo;
- mob ntshav siab;
- myocarditis;
- cardiomyopathy.
Ntawm cov laj thawj tseem ceeb uas ua rau muaj qhov tshwm sim ntawm pathology, tej zaum yuav muaj qhov ua rau idiopathic. Cov pab pawg no suav nrog txhua qhov xwm txheej uas nws tsis tuaj yeem txiav txim siab qhov laj thawj uas ua rau muaj qhov tshwm sim ntawm qhov teeb meem no. Cov teeb meem tuaj yeem tshwm sim los ntawm qee yam tshuaj, nrog rau cov tshuaj stimulants xws li caffeine, cawv thiab siv yeeb tshuaj.
Ntawm cov laj thawj tseem ceeb yog cov kab mob uas tsis yog mob plawv, tshwj xeeb, xws li:
- kab mob thyroid;
- obesity;
- mob ntshav qab zib;
- kab mob ua pa;
- hernia of the esophagus.
Paroxysmal atrial fibrillation feem ntau tshwm sim hauv cov neeg uas tau mob plawv nres. Ntawm cov laj thawj tseem ceeb, sclerosis ntawm cov leeg plawv kuj tuaj yeem paub qhov txawv. Qee zaum, cov kab mob pathology tuaj yeem cuam tshuam nrog pathologies hauv ntau lwm yam kabmob.
Cov tsos mob tseem ceeb
Nyob ntawm kev faib tawm ntawm atrial fibrillation, cov tsos mob tuaj yeem sib txawv heev. Nyob rau hauv daim ntawv mob ntev ntawm tus kab mob, tus kab mob tuaj yeem ua tiav asymptomatic. Yog tias muaj cov tsos mob tshwm sim, ces lawv nyob ntawm qhov loj ntawm qhov contraction ntawm lub ventricle. Yog hais tias qhov contractions nce mus txog 120 neeg ntaus ib feeb, ces tus kab mob no asymptomatic, thiab ntau dua.tus nqi siab provoke ntau yam ntawm cov cim, tab sis lawv tsis tas tam sim no ua ke. Ntawm cov cim tseem ceeb, ib tus tuaj yeem paub qhov txawv xws li:
- nce plawv dhia;
- qaug zog thiab qaug zog;
- ua tsis taus pa;
- tsis sib xws thiab ceev mem tes;
- angina;
- sudden tsis nco qab;
- kiv taub hau;
- lub plawv tsis ua hauj lwm.
Thaum daim ntawv tsis tu ncua tshwm sim, cov tsos mob tsis txaus hais. Hauv qhov no, tej zaum yuav muaj cov cim qhia txog kev ua txhaum ntawm lub plawv.
Tachysystolic daim ntawv yog tus cwj pwm los ntawm kev cog lus nrawm ntawm lub ventricles. Feem ntau, xws li kev ua txhaum cai manifests nws tus kheej nyob rau hauv daim ntawv ntawm ib tug kev xav ntawm kev cuam tshuam nyob rau hauv kev ua hauj lwm ntawm lub plawv. Cov tsos mob feem ntau yog nyob ntawm qhov tshwm sim uas ua rau lub plawv dhia tsis zoo. Nrog ischemia, tej zaum yuav ua tsis taus pa.
Lwm cov cim qhia suav nrog kev ntshai thiab tawm hws. Lub sijhawm ntawm kev tawm tsam tuaj yeem yog los ntawm ob peb teev mus rau ob peb lub lis piam lossis ntau dua. Kev tsis txaus siab ploj mus thaum lub qhov ntswg qhov ntswg rov zoo li qub.
Yog tias fibrillation feem ntau rov ua dua, ces qhov pathology tau txais kev kawm ntev. Lwm tus tsis tshua muaj qaug dab peg. Lawv tuaj yeem raug provoked los ntawm ntau yam ntawm sab nraud thiab sab hauv, tshwj xeeb, xws li cuam tshuam kev ua haujlwm ntawm cov hnyuv, kev ntxhov siab, kev quav dej quav cawv, kev hloov pauv hauv huab cua.
Tshwj xeeb yog mob hnyav, muaj qhov tsis nco qab tam sim ntawd thiabua tsis taus pa. Thaum lub sij hawm tawm tsam tom ntej, tus neeg blushes heev. Kev qaug dab peg mus ntxiv rau ob peb feeb. Nrog rau qhov tsis tu ncua ntawm atrial fibrillation, ib tug neeg nres ua ib qho kev tsis txaus siab, thiab nws tsis txawm mob hnyav dua.
Cov kab mob plawv zoo li no tuaj yeem dhau los ua ib qho tseem ceeb ntawm cov teeb meem txaus ntshai heev thiab txawm tias lub plawv nres tuaj yeem ua tau, vim li ntawd, thaum thawj cov tsos mob ntawm kev ua txhaum cai tshwm sim, nws yog ib qho tsim nyog yuav tsum tau kuaj xyuas thiab kho tom ntej..
Diagnostics
Koj yuav tsum paub tsis yog dab tsi ua rau thiab cov cim qhia ntawm pathology, nws yog ib qho tseem ceeb kom nkag siab tias yuav kuaj tau li cas atrial fibrillation. Txoj kev kuaj mob tseem ceeb yog electrocardiography. Nws ua rau nws muaj peev xwm los ntsuas lub xeev ntawm ib tus neeg chav tsev ntawm lub plawv thiab kev ua haujlwm ntawm lub cev tag nrho. Lwm txoj kev kuaj mob muaj xws li:
- daim ntawv ntsuam xyuas tus neeg mob;
- kuaj lub cev;
- saib xyuas txhua hnub;
- sau npe ntawm lub cev ua si hauv lub sijhawm;
- echocardiography;
- nqa tawm ntau yam kev sim ua haujlwm nrog kev thauj khoom;
- magnetic resonance imaging;
- CT scan.
Qee zaum, kev kuaj mob transesophageal tau ua. Cov dej ntws ntawm fibrillation tuaj yeem kuaj pom twb thaum lub sij hawm ntsuas pulse. Nws ua tsis zoo. Tsis tas li ntawd, tus kws kho mob yuav sau ntawv rau kev kawm txog vascular system. Rau qhov nocoronary angiography yog qhia. Cov txheej txheem kuaj muaj xws li kuaj ntshav.
Kev kho mob
Kev kho mob ntawm atrial fibrillation feem ntau yog kev kho mob. Nrog rau chav kawm ntawm daim ntawv mus tas li ntawm arrhythmia, cov tshuaj yuav tsum tau noj thoob plaws lub neej. Qhov no tso cai rau koj ua kom lub cev muaj zog thiab lub plawv ua haujlwm.
Kev kho mob ntawm paroxysmal atrial fibrillation yog ua los ntawm kev saib xyuas. Hauv qee kis, kev kho mob yog ua nyob rau theem. Yuav tsum tau npaj thawj zaug. Rau fibrillation ntev tshaj li 2 hnub, cov tshuaj heparin yog siv. Yog tias qhov kev tawm tsam txuas ntxiv ntev dua 2 hnub, cov tshuaj "Warfarin Nycomed" yog siv. Cov tshuaj tau muab tshuaj ua ntej thiab tom qab lub normalization ntawm lub plawv dhia.
Nws tsim nyog sau cia tias txhua yam tshuaj muaj cov lus qhia nruj thiab contraindications, uas yog vim li cas tsuas yog tus kws kho mob uas xaiv cov tshuaj yuav tsum tau sau rau lawv. Kev tawm tsam yog pom zoo kom nres hauv thawj 2 hnub. Txhim kho lub plawv dhia kom raug tuaj yeem ua hluav taws xob. Hauv qhov no, kev tso tawm yog dhau los ntawm ib tus neeg. Cov kev kho mob zoo li no tsuas yog ua thaum tsis ua tiav ntawm kev kho tshuaj.
Nyob rau hauv daim ntawv mob ntev ntawm atrial fibrillation, kev kho mob yog nqa tawm nrog kev siv cov tshuaj tiv thaiv coagulants, calcium channel blockers, cardiac glycosides, adrenoblockers. Hauv qhov xwm txheej hnyav, yuav tsum tau kho radical. Qhov zoo tshaj plaws yog kev cais RF. Hauv qee kisablation yog ua. Nrog ua tiav lub plawv thaiv, cov neeg mob tau pom tias lub installation ntawm lub pacemaker. Kev phais catheter tau ua tiav.
Drug therapy
Kev kho mob ntawm atrial fibrillation suav nrog kev siv tshuaj kho mob. Kev kho mob antiarrhythmic yog nqa tawm, tshwj xeeb, xws li Amiodarone lossis Propafenone. Yog tias nws tsis tuaj yeem rov ua lub plawv dhia li qub, nws yog qhov yuav tsum tau nqa tawm atrial fibrillation mus rau normoform. Rau qhov no, calcium antagonists, beta-blockers, cardiac glycosides thiab ntau lwm yam tshuaj siv.
Beta-blockers tau muab tshuaj los tswj kev ua haujlwm ntawm lub plawv cov leeg thiab cov ntshav siab. Lawv pab txhawb lub neej expectancy nyob rau hauv lub xub ntiag ntawm lub plawv tsis ua hauj lwm. Ntawm cov contraindications rau kev siv cov tshuaj no, nws yog ib qho tsim nyog los qhia txog qhov muaj mob hawb pob bronchial.
Txhawm rau txo qhov kev pheej hmoo ntawm cov ntshav txhaws, cov ntshav thinner tau sau tseg. Tshwj xeeb, cov tshuaj tiv thaiv kab mob ncaj qha, xws li Fraxiparin, Heparin, Fondaparinux, thiab cov tshuaj tiv thaiv tsis ncaj, xws li Warfarin, tuaj yeem raug tshuaj.
Thaum muaj atrial fibrillation, tus kws kho mob cov lus pom zoo yuav tsum tau ua raws li nruj me ntsis, vim tias ntau yam kev ua txhaum cai tuaj yeem ua rau muaj teeb meem txaus ntshai. Lub complex ntawm kev kho implies lub normalization ntawm metabolic dab. Rau qhov no, cov nyiaj tau sau tseg uas txhim kho cov txheej txheem metabolic thiab khoom noj khoom haus hauv lub plawv cov leeg. Cov tshuaj no muaj cov nyhuv cardioprotective.
Ntseeg haiv neeg
muajntau yam tshuaj sib txawv rau kev kho mob ntawm atrial fibrillation, txawm li cas los xij, lawv tuaj yeem siv tau tom qab sab laj nrog kws kho mob. Lwm txoj hauv kev tsuas yog siv ua ke nrog kev kho tshuaj. Ib qho txiaj ntsig zoo tuaj yeem tau txais los ntawm kev siv hawthorn nrog motherwort thiab qus sawv. Noj cov khoom tiav 3 zaug hauv ib hnub ua ntej noj mov.
Yarrow zoo rau lub siab. Ua li no, koj yuav tsum tau ua tib zoo zom cov nroj tsuag, ncuav nws mus rau hauv lub khob iav thiab ncuav cawv. Kaw lub thawv kom nruj thiab tawm hauv qhov chaw txias kom infuse rau ib lub lim tiam. Koj yuav tsum noj nws peb zaug ib hnub. Txiv qaub yuav pab tau rau hauv kev kho mob. Ua li no, grind lub tev ntawm ob txiv hmab txiv ntoo thiab sib tov nyob rau hauv sib npaug proportions nrog zib mu. Muab tso rau hauv tub yees thiab tawm mus rau infuse, ces noj tshuaj txhua hnub thaum mus pw.
Grapefruit tuaj yeem siv los ua tus neeg sawv cev zoo. Ua li no, muab cov kua txiv hmab txiv ntoo ntawm ib nrab ntawm cov txiv hmab txiv ntoo no nrog 15 ml ntawm txiv roj roj. Sib tov tag nrho cov khoom xyaw kom huv si thiab noj tam sim ntawd. Rau kev kho mob, koj tuaj yeem sib tov sib npaug ntawm figs, raisins, walnuts thiab zib mu. Koj yuav tsum noj cov tshuaj uas tshwm sim ob zaug ib hnub. Kev pab zoo heev rau lub plawv infusion ntawm calendula, uas yuav tsum tau noj txhua hnub.
Khoom noj khoom haus
Ntxiv rau kev siv tshuaj thiab pej xeem txoj kev, nws yog ib qho tsim nyog los npaj cov khoom noj kom raug. Kev noj zaub mov muaj peev xwm, sib npaug tsis yog tsuas yog kev tiv thaiv zoo ntawm arrhythmia, tab sis kuj muaj pov thawj heevtxoj kev tiv thaiv kev loj hlob ntawm tus kab mob. Cov microelements xws li potassium, magnesium, calcium yuav tsum muaj nyob rau hauv cov khoom noj, vim tias tsis muaj cov tshuaj no lub plawv cov leeg tsis tuaj yeem ua haujlwm ib txwm.
Cov neeg mob fibrillation tau qhia kom noj zaub mov me me, tsawg kawg 5 zaug hauv ib hnub. Tsis tas li ntawd, nws raug nquahu kom txo cov dej kom tsawg thiab noj zaub mov sov xwb. Nws raug nquahu kom noj ntau cov txiv hmab txiv ntoo tshiab, zaub thiab txiv hmab txiv ntoo li sai tau. Nws yog txwv tsis pub noj cov nqaij rog, qe, dej qab zib, rog, ntsev, kib, ntsim.
Muaj Teeb Meem
Cov neeg mob atrial fibrillation yuav tsum tau ua tib zoo saib xyuas lawv txoj kev noj qab haus huv, vim lawv muaj kev pheej hmoo ntawm kev mob plawv thiab mob stroke. Cov txheej txheem ntawm kev puas tsuaj yog tus cwj pwm los ntawm qhov tseeb tias thaum lub sij hawm ntawm atrial fibrillation nws yog tsis yooj yim sua kom txo tau lawv tag nrho, uas yog vim li cas ntshav stagnates nyob rau hauv lub parietal qhov chaw thiab cov ntshav txhaws.
Yog tias cov ntshav txhaws nkag mus rau hauv aorta thiab lwm cov hlab ntsha me nrog cov ntshav ntws, ces thromboembolism tshwm sim. Qhov kev tso ntshav ntawm cov ntshav provokes kev loj hlob ntawm lub plawv nres ntawm lub cev. Cov teeb meem feem ntau yog:
- thromboembolism thiab mob stroke;
- lub plawv tsis ua hauj lwm;
- kev poob siab cardiogenic;
- dilated cardiomyopathy.
Atrial flutter thiab fibrillation tuaj yeem ua rau cov cim qhia ntawm cov hlab ntshav tsis ua haujlwm,mus txog rau kev mob ntsws asthma thiab pulmonary edema. Qee zaum, fibrillation tuaj yeem ua rau mob plawv thiab mob plawv.
Huab cua thiab tiv thaiv
Cov neeg mob uas muaj kev tawm tsam ntawm fibrillation feem ntau yuav tuag los ntawm cov kab mob ntawm cov hlab plawv dua li cov neeg uas tsis muaj kab mob zoo sib xws. Yog hais tias vascular thrombosis tshwm sim, qhov kev tshwm sim loj zuj zus tuaj. Cov tshuaj xaiv kom raug thiab kev teeb tsa ntawm lub tshuab pacemaker tuaj yeem txhim kho lub neej zoo thiab ua kom lub sijhawm ntev.
Qhov kev pheej hmoo ntawm kev txhim kho fibrillation tuaj yeem txo qis yog tias koj kho cov kab mob ntawm cov hlab plawv kom raws sijhawm, ua rau lub neej noj qab haus huv, thiab ua kom lub cev muaj zog txaus. Ntxiv thiab, nco ntsoov tswj koj qhov hnyav thiab noj kom raug.
