Nyob rau xyoo tas los no, muaj ntau tus neeg mob yws yws ntawm qhov mob hauv plawv. Tom qab kev ntsuam xyuas, nws hloov tawm tias feem ntau ntawm cov neeg mob tau ntsib kev hloov pauv loj hauv kev ua haujlwm ntawm cov leeg nqaij, thiab lawv xav tau kev saib xyuas xwm txheej ceev thiab kev mus pw hauv tsev kho mob ceev. Feem ntau muaj cov kab mob xws li atrial fibrillation, uas lub plawv dhia tawm ntau, uas tom qab ntawd ua rau kev loj hlob ntawm pathologies hauv lwm lub cev. Ib qho ntawm cov qauv ntawm atrial fibrillation yog paroxysmal, nws txaus ntshai npaum li cas, nws qhia nws cov tsos mob li cas, txhua tus neeg yuav tsum paub.
Qhov no pathology yog dab tsi?
Atrial fibrillation ntawm daim ntawv paroxysmal yog ib yam kab mob uas muaj kev ua txhaum loj ntawm kev sib koom tes ntawm kev sib cog lus ntawm cov leeg nqaij myocardial. Tus kab mob no tshwm sim, tab sis raws li ib qho kev ywj pheej nws yog tsawg heev, feem ntau nws yog ib qho kev qhia tsis ncaj ntawm cov kab mob ntawm lub plawv, lub ntsws thiab cov hlab ntsha.
Paroxysmal atrial fibrillation yog qhia hauvLub sijhawm hloov pauv hauv kev ua haujlwm ntawm lub qhov txhab, uas cov atrial myocytes txav mus rau qhov tsis sib xws, lawv cov zaus tuaj yeem ncav cuag li 400 kev cog lus ib feeb. Raws li qhov tshwm sim, tsuas yog cov ventricles ua haujlwm tawm ntawm 4 chav ntawm lub plawv, uas cuam tshuam rau kev ua haujlwm ntawm tag nrho cov hlab ntsha.
Caus of paroxysmal form
Paroxysmal daim ntawv ntawm atrial fibrillation raws li ICD-10:
- Kuv 48 yog atrial fibrillation thiab flutter;
- I 00-I 99 - kab mob ntawm cov hlab plawv;
- I 30-I 52 - lwm yam kab mob plawv.
Lub ntsiab lus tseem ceeb ntawm kev loj hlob ntawm tus kab mob yog ib qho - cov no yog cov kab mob ntawm cov hlab plawv:
- mob plawv ischemia;
- mob ntshav siab;
- txhua yam kev mob plawv;
- txhua yam mob plawv uas ua rau cov txheej txheem inflammatory;
- congenital lossis kis tau qhov tsis xws luag ntawm cov leeg plawv;
- genetic cardiomyopathies.
Tab sis muaj qhov ua rau ntawm daim ntawv paroxysmal ntawm atrial fibrillation uas tsis cuam tshuam nrog kev mob plawv:
- Kev haus luam yeeb thiab haus cawv, kev quav yeeb tshuaj.
- Electrolyte imbalances thaum muaj magnesium-potassium deficiency.
- Cov kab mob ntawm lub cev thiab cov ntaub so ntswg ntawm txoj hlab pa.
- Daim ntawv mob kis tau yooj yim.
- Post-surgery condition.
- Kab mob ntawm endocrinesystem.
- Kho nrog adrenomimetics, plawv glycosides.
- kev nyuaj siab.
Cov qauv ntawm paroxysmal atrial fibrillation yog dab tsi?
daim ntawv no ntawm arrhythmia yog qhov ua haujlwm tsis zoo hauv kev ua haujlwm ntawm lub plawv cov leeg, uas tuaj yeem kav ntev li ntawm 7 hnub. Yog tias qhov kev hloov pauv tau pom ntev dua, ces cov kws kho plawv muab tus neeg mob daim ntawv ntev.
Cov kws kho plawv faib cov kab mob ua ntau hom thiab hom. Ua ntej tshaj plaws, nws raug coj mus rau hauv tus account nrog qhov zaus ntawm daim ntawv cog lus atria, yog li ntawd, lawv raug cais tawm:
- raug flickering ntawm 300 neeg ntaus ib feeb;
- demonstrative flutter tsis ntau tshaj 200 contractions.
Txawm hais tias muaj kev siv zog ntawm kev ua haujlwm ntawm atria, tsis yog txhua qhov kev xav tau ua rau lub plawv ntawm lub plawv. Yog tias peb faib tus kab mob raws li qhov zaus ntawm kev cog lus, ces muaj cov ntaub ntawv xws li:
- tachysystolic, uas qhov contraction ntawm lub ventricles tsis ntau tshaj 90 ib feeb;
- bradysystolic - tsawg dua 60;
- normosystolic lossis feem ntau hu ua intermediate.
Raws li chav kho mob, daim ntawv nruab nrab ntawm cov kab mob yog pom zoo. Kev tawm tsam ntawm atrial fibrillation ntawm daim ntawv paroxysmal tuaj yeem rov ua dua, qhov twg nws hu ua rov tshwm sim.
Hais txog qhov chaw ntawm lub foci ntawm kev nce siab, paroxysm tuaj yeem muab faib ua peb hom:
- atrial arrhythmia yog thaum impulses tsim nyob rau hauv atrial node;
- ventricular arrhythmia - impulses pib hauv qhov kev coj uaventricles;
- hom sib xyaw muaj ntau lub chaw ib zaug.
Cov tsos mob ntawm tus kab mob
Muaj ntau qhov ncaj thiab tsis ncaj ua rau paroxysmal arrhythmia, cov tsos mob yuav txawv ntawm tus neeg mob mus rau tus neeg mob. Yog li qee tus neeg mob yuav ntsib kev tsis xis nyob hauv cheeb tsam ntawm lub plawv, thaum lwm tus tuaj yeem taug qab cov tsos mob no:
suddenly lub plawv pib dhia ceev;
- qaug zog thoob plaws lub cev;
- tsis muaj cua;
- txias lim hiam;
- shivering in tsawg kis.
Tsis tas li ntawd, cov neeg mob yuav ntsib pallor ntawm daim tawv nqaij thiab cyanosis ntawm daim di ncauj. Yog tias tus neeg mob qhov teeb meem nyuaj txaus, ces lwm cov tsos mob yuav tshwm sim:
- kiv taub hau;
- tsis nco qab;
- ib nrab faint;
- panic.
Tab sis koj yuav tsum tsis txhob txhawj tam sim ntawd, tej zaum cov tsos mob zoo li no qhia txog kev mob uas tsis muaj dab tsi cuam tshuam rau lub plawv. Tsuas yog ECG thiaj li paub qhov laj thawj.
Tom qab muaj kev tawm tsam ntawm paroxysmal atrial fibrillation, cov neeg mob tuaj yeem ua rau kom cov leeg nqaij du ntawm txoj hnyuv thiab muaj kev tso zis ntau ntxiv. Thaum lub plawv dhia qis mus rau qis qis, cov ntshav ncig hauv lub hlwb ua rau tsis zoo. Tus mob no tuaj yeem tshwm sim nws tus kheej hauv daim ntawv ntawm kev tsis nco qab, ua pa nres, nws nyuaj rau kev txiav txim siab ntawm lub plawv. Hauv qhov no, tus neeg mob yuav tsum tau xa mus rau kev saib xyuas hnyav.
Txoj kev kuaj mob
Ntawm zaus thiabrhiab heev contractions ntawm lub plawv txiav txim qhov chaw kho mob ntawm tus kab mob. Qhov tseem ceeb tshaj plaws yog tshawb xyuas qhov kev sib dhos thiab sau cov mem tes, txij li thaum nyob rau hauv atrial fibrillation nws qhov tsis txaus yog feem ntau pom.
Txhawm rau txiav txim siab kom raug daim ntawv ntawm paroxysmal atrial fibrillation, koj yuav tsum mus dhau cov kev tshawb fawb:
- myocardial auscultation - thaum lub sij hawm fibrillation, lub plawv dhia arrhythmic tau pom, atrial flutter manifests nws tus kheej nyob rau hauv daim ntawv ntawm ib tug poob ntawm txhua tom qab yeej;
- electrocardiography tso cai rau koj pom tias QRST txoj kev hloov pauv hauv lub ventricular variant ntawm tus kab mob li cas, yog tias cov duab ntawm R yoj txawv txav thiab muaj cov cim qhia ntawm kev cuam tshuam kev cuam tshuam ntawm sab xis ntawm nws cov pob nrog atrial daim ntawv, kev hloov pauv hauv P nthwv dej lossis yog tias nws yog superimposed ntawm QRST, tom qab ntawd qhov no qhia txog cov kab mob sib xyaw ua ke;
ECHOCG ua rau nws tuaj yeem soj ntsuam cov duab thiab qhov loj ntawm atria, qhov xwm txheej ntawm lub plawv li qub yog dab tsi
Ua ntej tus kws kho mob xa tus neeg mob mus kuaj, nws ua tib zoo kawm txog keeb kwm kho mob (atrial fibrillation, paroxysmal daim ntawv thiab hom), kawm txog cov kab mob sib kis. Yog tias tus neeg mob tau ua haujlwm hnyav, qhov no yog qhov cuam tshuam loj rau kev kho tus kab mob. Cov kab mob sib kis yuav pab koj xaiv txoj kev kho mob zoo tshaj plaws.
Kev nyuaj siab
Nquag cuam tshuam hauv kev ua haujlwm ntawm lub plawv nrog kev ntaus nrawm ua rau qhov tseeb tias myocardium overstrained. Daim ntawv paroxysmal ntawm lub plawv arrhythmias ua rau muaj kev cuam tshuam loj hauv cov ntshav ncig, uas tuaj yeem ua rau muaj cov ntshav txhaws thiabthromboembolism. Tias yog vim li cas nws thiaj li yuav tsum tau ua txhua yam kev ntsuas tau thiab pib kho daim ntawv paroxysmal ntawm fibrillation sai li sai tau, txwv tsis pub tus neeg mob yuav muaj qhov tshwm sim hauv qab no:
- xeev ntawm kev poob siab - thaum ntshav siab poob sai, tus nqi ventricular txo;
- txhim kho lub plawv tsis ua hauj lwm;
- o ntawm lub ntsws cov ntaub so ntswg - mob hawb pob;
- arrhythmic cardiomyopathy;
- deterioration ntawm kev noj haus ntawm lub paj hlwb.
Yog tias qhov kev tawm tsam tsis zoo, ces muaj kev pheej hmoo ntawm kev tsim cov thromboembolism. Cov ntshav txhaws tuaj yeem sau rau hauv cov kab mob atrium, uas tuaj yeem txav mus rau lwm qhov ntawm lub cev. Tsuas yog ob hnub tom qab paroxysmal atrial fibrillation vim qhov txhaws ntawm cov hlab ntsha, lub plawv nres, mob stroke lossis gangrene tuaj yeem txhim kho.
Atrial fibrillation xwm txheej
Ua ntej tus neeg mob paroxysmal atrial fibrillation tau txais kev kho mob xwm txheej ceev, nws yuav tsum tau pab hauv tsev. Kev pab yog ua kom muaj txiaj ntsig zoo ntawm cov hlab ntsha vagus:
- Valsalva xeem suav nrog kev sim nqus pa, thaum thaiv huab cua nkag. Npog qhov ntswg thiab qhov ncauj nrog xib teg thiab nqus pa.
- Ashner qhov kev sim cuam tshuam nrog nias koj cov ntiv tes rau ntawm lub kaum sab xis ntawm lub qhov muag, tab sis koj tsuas yog yuav tsum ua txhua yam kom ua tib zoo li sai tau kom tsis txhob ua mob.
- Qhov kev xeem Goering-Chermak yog ua tiav sivsiab ntawm cov hlab ntsha carotid kom txo cov pa oxygen thiab lub plawv dhia ib feeb.
- Spongling nrog dej txias yuav pab kom koj ua pa thiab lub plawv dhia qeeb.
Koj tuaj yeem nres qhov kev tawm tsam yog tias koj ua rau gag reflex
Nws yog ib qho tseem ceeb heev uas yuav tsum xa tus neeg mob mus rau lub tsev kho mob tam sim ntawd tom qab qhov kev tawm tsam, txwv tsis pub txawm tias cov kws kho mob uas muaj kev paub dhau los yuav pom tias nws nyuaj rau kho qhov mob ntawm lub qhov ntswg ob hnub tom qab kev tawm tsam.
kev kho mob
Hauv tsev kho mob, cov kws kho mob siv cov tshuaj hauv qab no:
- "Digoxin" - pab tswj lub plawv dhia;
- "Kordaron" muaj qhov tsawg kawg nkaus ntawm qhov tsis txaus ntseeg tshwm sim, uas qhov no yog qhov tseem ceeb ntxiv;
- "Novocainamide" - yog siv sai sai, pab txo cov ntshav siab.
Tag nrho cov tshuaj no yog muab tso rau hauv cov hlab ntsha. Cov neeg mob feem ntau tau txais kev pab hauv thawj teev tom qab kev kho mob zoo li no.
Tus kws kho mob tuaj yeem pom zoo rau kev kho mob ntawm paroxysmal atrial fibrillation nrog Propanorm, uas muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, yog li tus neeg mob tuaj yeem noj yam tsis muaj kev pab.
Electropulse kho
Yog tias kev kho mob tsis tau pab tus neeg mob, qhov no, tus kws kho mob yuav pom zoo rau kev kho hluav taws xob. Cov txheej txheem no yog raws li nram no:
- tus neeg mob tau txhaj tshuaj loog;
- tshajob lub electrodes muab tso rau hauv lub plawv thiab nyob rau hauv lub clavicle ntawm sab xis;
- tus kws kho mob ntawm lub cuab yeej teeb tsa hom synchronization, qhov no yog qhov tsim nyog txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau ventricles;
- tus nqi tam sim no xav tau yog teem, nws tuaj yeem sib txawv ntawm 100 txog 360 J;
- ua kom muaj hluav taws xob tawm.
Yog li no, tus kws kho mob, raws li nws tau, rov kho lub plawv. Txoj kev no yuav luag 100% zoo.
Surgery
Kev phais raug pom zoo rau cov neeg mob uas nquag tawm tsam thaum kev kho mob ntawm paroxysmal atrial fibrillation tsis tau muab qhov xav tau.
Kev ua haujlwm muaj nyob rau hauv cauterization ntawm foci ntawm excitation ntawm lub plawv cov leeg nrog lub laser. Txhawm rau ua tiav cov txheej txheem, cov hlab ntsha yog pierced thiab tshwj xeeb catheters tau muab tso rau hauv nws. Qhov ua tau zoo ntawm cov txheej txheem los ntawm txoj kev ntawm radiofrequency ablation yog ntau tshaj 80%. Yog tias thawj txheej txheem tsis muab cov txiaj ntsig xav tau, ces nws rov ua dua.
tshuaj ntsuab rau atrial fibrillation
Ua ntej siv cov kev kho pej xeem hauv kev kho mob, koj yuav tsum sab laj nrog koj tus kws kho mob kom tsis txhob ua mob rau koj txoj kev noj qab haus huv, uas twb tau shaken. Yog tias tsis muaj contraindications, koj tuaj yeem siv cov zaub mov nram qab no:
- Lawv noj hawthorn thiab nws cov tinctures rau cawv, motherwort thiab valerian. Koj yuav tsum noj peb lub fwj ntawm txhua lub tincture thiab sib tov rau hauv ib lub thawv, co txhua yam kom zoo thiab xa mus rau lub tub yees rau ib hnub. Ib hnub tom qabkoj tuaj yeem pib noj 1 teaspoon peb zaug ib hnub ib nrab ib teev tom qab noj mov.
- Noj ib nrab ib kilo ntawm txiv qaub, finely chop lawv thiab ncuav zib mu, ntxiv 20 apricots pits. Noj cov tshuaj kho mob ob zaug ib hnub twg, 1 tablespoon.
- Koj yuav xav tau Adonis tshuaj ntsuab 4 grams, uas yog poured rau hauv ib khob dej thiab boiled nyob rau hauv lub enamel thawv rau tsis pub tshaj 3 feeb. Tom qab ntawd, muab tso rau hauv lub broth rau 20 feeb nyob rau hauv warmth. Noj ib decoction ntawm ib tablespoon peb zaug ib hnub twg.
Cov yam ntxwv ntawm paroxysmal daim ntawv ntawm atrial fibrillation yog qhov kev tawm tsam tuaj yeem tshwm sim txhua lub sijhawm, yog vim li cas tus neeg mob yuav tsum muaj kev kho mob nyob rau hauv qhov chaw nkag uas yuav pab nws hloov tau yooj yim dua. Tab sis nws yog qhov zoo dua kom tau txais kev pab tsim nyog los ntawm tus kws tshaj lij tom qab thawj qhov kev tawm tsam thiab ua txhua yam ua tau kom tsis txhob tshwm sim dua.
Kev Tiv Thaiv thiab Tiv Thaiv Kab Mob
Cov neeg mob uas twb mob plawv lossis muaj cov txheeb ze uas muaj teeb meem loj hauv tsev neeg yuav tsum tiv thaiv kab mob plawv. Ntxiv thiab, koj xav tau:
- txo lossis txawm tshem tawm tag nrho kev haus cawv;
- zam kev ua lub cev hnyav, nws yog qhov zoo dua los hloov lawv nrog kev taug kev hauv huab cua ntshiab;
- noj cov zaub mov kom sib npaug, tsis suav tag nrho cov khoom noj rog thiab ntsim uas muaj cov poov tshuaj thiab magnesium;
- noj sulfate, asparaginate ua kev tiv thaiv.
Raws li kev kwv yees rau tus neeg mob uas muaj paroxysmal atrial fibrillation, nws tsis tuaj yeem hu uaunfavorable, tshwj xeeb tshaj yog yog hais tias tus tawm tsam tsis provoke txoj kev loj hlob ntawm loj pathologies. Yog tias koj ua raws li txhua tus kws kho mob cov lus pom zoo, ces tus neeg mob tuaj yeem nyob tau ntau xyoo nrog kev kuaj mob zoo li no.
Qhov tshwm sim ntawm cov kab mob loj heev hauv cov neeg uas muaj qhov kev kuaj mob no yog ib ntawm 6 tus neeg, uas ua rau muaj kev pom zoo rau txhua tus neeg mob. Nws yog ib qho tseem ceeb los hloov koj txoj kev ua neej thiab ua raws li tag nrho cov lus pom zoo.
