Paroxysm ntawm supraventricular tachycardia yog lub plawv dhia ceev txog 140-220 neeg ntaus ib feeb. Kev tawm tsam tuaj yeem pib thiab xaus txhua lub sijhawm, thaum lub suab sib dhos tsis tu ncua. Ectopic impulses tshwm nyob rau hauv lub atria, ventricles, los yog AV junction.
hom tachycardia no txaus ntshai vim lub plawv ua haujlwm nrog kev ua pauj, thaum cov ntshav khiav tsis zoo. Tsis tas li ntawd, sib quas ntus paroxysms ntawm supraventricular tachycardia ua rau circulatory tsis ua hauj lwm.
Types of paroxysmal tachycardia
Kev faib tawm yog tsim nyob ntawm qhov tsim ntawm impulses. Yog li ntawd, atrioventricular, ventricular thiab atrial daim ntawv yog txawv. Cov subpraventricular ntau yam suav nrog atrioventricular thiab atrial hom.
Raws li qhov tshwj xeeb ntawm kev txhim kho tus kab mob, muaj: daim ntawv mob ntev; mob daim ntawv; manifesting tsis tu ncua - tshwj xeeb tshaj yog hnyav, lub sij hawm uas yuav ua tauTsis muaj qhov kawg, nyob rau hauv kev sib txuas nrog uas muaj tag nrho cov tsis muaj ntshav ncig thiab arrhythmogenic dilated cardiomyopathy.
Qhov laj thawj tseem ceeb ntawm pathology thiab nws cov tsos mob
Lub paroxysm ntawm supraventricular tachycardia yog tsim vim deviations ntawm lub paj hlwb los yog cov organic puas. Nyob rau hauv thawj qhov teeb meem, nrog paroxysmal tachycardia, lub plawv cov leeg yog raug rau cov hlab ntsha stimulation. Nws mechanism yog raws li nram no: ib tug pathogenic excitation cheeb tsam tshwm, ua rau txawv txav myocardial kev ua si. Lub plawv atherosclerosis yog cuam tshuam, lub plawv tsis ua hauj lwm contractions, extrasystole raug kuaj, supraventricular extrasystole yog tsim. Hom arrhythmia no feem ntau tshwm sim.
Organic ua rau paroxysmal supraventricular tachycardia yog raws li hauv qab no:
- ua rau lub plawv cov leeg, cov kab mob plawv uas tshwm sim thaum lub sij hawm ischemia, plawv nres, cardiopathies, myocarditis thiab lub plawv tsis xws luag;
- Hma-Parkinson-White syndrome thiab lwm yam kab mob uas tsim txoj hauv kev ntxiv;
- pathology ntawm lub plawv, cov yam ntxwv ntawm lub cev no: ntxiv adhesions, chords, mitral valve prolapse.
Extrasystole thiab paroxysmal tachycardia tuaj yeem tshwm sim txawm tias nyob hauv cov neeg noj qab haus huv yog tias muaj cov kab mob tshwm sim, nrog rau kev ntxhov siab hnyav thiab ua haujlwm ntev ntev.
Cov laj thawj uas teev npe hu ua extracardiac. Ntawm lawv kuj yog tus cwj pwm phem ntawm tus neeg mob,Piv txwv li, haus cawv, haus luam yeeb, quav tshuaj rau cov khoom uas muaj caffeine ntau dhau lawm. Thaum kuaj pom atrial tachycardia, nws raug nquahu kom kuaj xyuas cov thyroid hormones. Pathology ntawm lwm yam kabmob tuaj yeem ua rau paroxysmal supraventricular tachycardia. Cov no suav nrog:
- raum tsis ua haujlwm;
- mob ntsws thiab mob ntsws ntev;
- kab mob plab hnyuv.
Supraventricular tachycardia muaj cov tsos mob uas qhia tau qhov txawv ntawm qhov sinus ntau yam. Qhov tshwm sim sai sai ntawm kev tawm tsam thiab ua tiav tam sim ntawd, tag nrho lub sijhawm tuaj yeem sib txawv ntawm ib feeb mus rau ob peb hnub.
Tus neeg mob pib hnov qhov kev thawb tseem ceeb hauv lub sternum, tom qab ntawd lub plawv dhia ceev ceev tshwm sim. Los ntawm 140 mus rau 220 neeg ntaus ib feeb yog kev ntxhov siab ntau rau tib neeg lub cev, yog li tus neeg mob hnov cov tsos mob hauv qab no:
- suab nrov hauv taub hau;
- kiv taub hau;
- squeezing lub siab.
Yog tias tsis muaj kev kho mob raws sijhawm, tom qab ntawd hauv kev kho mob muaj cov mob hemiparesis thiab aphasia. Tsis tas li ntawd, ib qho tsis ruaj khov paroxysm ntawm supraventricular tachycardia feem ntau ploj mus ib txhij nrog cov tsos mob ntawm kev tsis sib haum xeeb:
- tawm hws ntau dhau;
- plab hnyuv plab;
- nausea reflex;
- mild subfebrile condition.
Thaum qhov kev tawm tsam xaus, tus neeg mob pom qhov tso zis ntau ntau nrog cov nqi qisceev. Nrog rau qhov txuas ntxiv ntawm paroxysm rau lub sijhawm ntev, ntshav siab txo qis, tsis muaj zog tshwm sim, tus neeg tsis nco qab.
Tsis tshua muaj paroxysmal supraventricular tachycardia tshwm ntawm nws tus kheej. Pathology feem ntau yog tshwm sim los ntawm lwm yam kab mob hauv lub plawv, yog li tus neeg mob xav tau kev kuaj xyuas kom meej thiab txhais tau tseeb ntawm tus kab mob.
Kev kub ntxhov
Nws yog ib qho tsim nyog yuav tsum muaj peev xwm muab kev saib xyuas xwm txheej ceev rau tus neeg mob uas muaj paroxysmal supraventricular tachycardia (ICD-10 code - I47.1.). Tshwj xeeb tshaj yog tseem ceeb yog kev pab thaum muaj xwm ceev, yog hais tias ib tug deterioration nyob rau hauv ib tug neeg tus mob yog pom. Nws zoo nkaus li muaj peev xwm. Thaum muaj xwm txheej ceev, yuav tsum ua raws li hauv qab no:
- Vagus samples. Ua ntej, qhov kev xeem Valsalva tau ua tiav, uas suav tias yog qhov ua tau zoo tshaj plaws. Tus neeg mob yuav tsum nruj thiab nres ua pa rau peb caug vib nas this. Tsis tas li ntawd, nws raug nquahu kom ua pa tob tob thiab nrawm nrawm. Ashner qhov kev xeem kuj ua tiav. Qhov no manipulation muaj nyob rau hauv lub fact tias rau tsib vib nas this lawv nias rau ntawm lub qhov muag. Kev kuaj tsis raug tso cai hauv lub plawv tsis ua haujlwm hnyav, kev ua haujlwm tsis zoo, mob stroke, dyscirculatory encephalopathy thiab glaucoma.
- Massage ntawm carotid sinuses. Txawm li cas los xij, cov txheej txheem zoo li no raug txwv yog tias qhov txo qis hauv lub plawv dhia sai sai.
- Muab koj lub ntsej muag rau hauv dej txias rau ob peb feeb. Txoj kev no kuj tseem yuav pab tau rau kev kho mob ntawm paroxysmsupraventricular tachycardia. Los ntawm qaug dab peg, cov tshuaj hauv qab no feem ntau siv: Verapamil, Aymalin, Adenosine Phosphate, Sotalol, Atenolol, Amiodarone, Procainamide, Propranolol. Yog tias qhov kev ua no tsis muaj txiaj ntsig, ces siv hluav taws xob impulse therapy lossis transalimentary cardiac stimulation yog siv. Ua ntej tuaj txog ntawm lub tsheb thauj neeg mob cov neeg ua haujlwm, koj yuav tsum ua kom tus neeg mob siab, nteg nws horizontally. Nws yog ib qho tsim nyog los muab cov neeg mob nrog kev nkag mus ntawm huab cua ntshiab. Koj tuaj yeem xeem vagal koj tus kheej.
Qhov no yog kev kho mob xwm txheej ceev rau paroxysmal supraventricular tachycardia.
Kev kuaj mob nta
Rau qhov paroxysm ntawm supraventricular tachycardia (ICD-10 code, saib saum toj no), qhov tshwm sim ntawm qhov pib tshwm sim sai sai thiab qhov sib npaug tam sim ntawd dhau los ua qhov raug. Qhov kev tawm tsam nws tus kheej raug kuaj pom raws li lub plawv dhia ceev, uas yob tshaj 130 tus neeg ntaus ib feeb ntawm so.
Thaum muab piv cov supraventricular thiab ventricular hom, peb tuaj yeem hais tias lawv txawv ntawm qhov nce hauv lub plawv dhia.
Piv txwv li, thawj zaug yog tus cwj pwm los ntawm lub plawv dhia ntau tshaj 220-250, thiab qhov thib ob yog tus cwj pwm los ntawm lub plawv dhia mus txog 180 neeg ntaus ib feeb. Supraventricular tachycardia ploj thaum siv txoj kev vagal, thiab ntau yam ventricular tsis cuam tshuam los ntawm cov txheej txheem no.
Cov kev hloov pauv twg tuaj yeem sau npe siv ECG rau luv luv paroxysm ntawm supraventricular tachycardia?
- P-wave polarity zoo li dhau loslwm yam.
- Nyob rau qhov sib txawv ntawm lub ventricular tivthaiv.
Atrial hom yog qhia los ntawm tus qauv tso ntawm P-wave ua ntej QRS complex. Thaum lub paroxysm yog vim muaj kev sib txuas ntawm atrioventricular, nthwv dej zoo li tsis zoo, nyob tom qab lub complex, los yog txuas nrog nws tag nrho. Lub ventricular ntau yam zoo qhia txog kev nthuav dav ntawm cov khoom sib txuas, feem ntau cov hniav yog tsau rau hauv nws daim ntawv li niaj zaus, txawm li cas los xij, ventricular extrasystoles kuj pom.
Qee zaum, txawm tias ECG nrog paroxysm ntawm supraventricular tachycardia tsis tuaj yeem qhia meej qhov xwm txheej thiab qhia txog qee yam ntawm pathology. Hauv qhov no, cov kws kho mob tau sau ntawv ECG thaum nruab hnub. Cov cuab yeej txuas nrog rau tus neeg mob lub cev, uas sau npe thiab qhia txog lub sijhawm luv ntawm paroxysm thoob plaws hnub, uas yog, nyob rau hauv qhov txwv ntawm ventricular 3-5 complexes. Cov ntu no tsis tshua hnov los ntawm cov neeg mob, tab sis ECG ntes thiab khaws cia hauv nco.
Yog tias tsim nyog, cov kws kho mob tshwj xeeb siv qhov endocardial ECG. Txhawm rau kom txhua yam ua tiav, koj yuav tsum nrhiav tus kws paub txog kev mob plawv hauv nws daim teb. Cov hluav taws xob tau muab tso rau hauv lub plawv, kho los ntawm cov cuab yeej soj ntsuam, sau los ntawm tus kws kho mob, thiab raws li lawv, cov lus txiav txim siab tau kos tom qab, uas tso cai rau kev teem caij kho kom zoo thiab tsim nyog rau tus neeg mob.
Txhawm rau tshem tawm qhov muaj peev xwm ntawm cov kab mob organic, nws kuj tseem tsim nyog ua MCST, MRI lossis ultrasound ntawm lub cev nrog cov kab mob.
Kev kho mobparoxysmal supraventricular tachycardia Y
Tus neeg mob xav tau mus pw hauv tsev kho mob yog tias qhov kev tawm tsam tsis nres ntawm qhov chaw lossis muaj lub plawv dhia tsis txaus. Kev npaj kho yog tsim nyog yog tias muaj kev tawm tsam ntau dua ob zaug hauv ib hlis. Tus kab mob no yuav tsum tau kho nrog kev sib koom ua ke, uas muaj nyob rau hauv kev tsim kho txhua hnub, kev noj zaub mov kom raug, kev siv tshuaj thiab cov txheej txheem physiotherapy. Tus kws kho plawv feem ntau sau tshuaj beta-blockers. Cov tshuaj no muaj xws li Metaprolol, Anaprilin, Propranolol, Atenolol, Obzidan, Vasocardin. Tsis tas li ntawd, cov tshuaj sedative, xws li tranquilizers lossis barbiturates, yog siv los kho.
Thaum nrog paroxysm ntawm supraventricular tachycardia nrog lub plawv tsis ua haujlwm, cov tshuaj raws li foxglove yog siv: Isoptin, Digoxin. Cov tshuaj uas muaj poov tshuaj kuj raug sau tseg. Nws yuav tsum nco ntsoov tias cov cuab yeej zoo li no muaj zog heev. Tias yog vim li cas tus kws kho plawv yuav tsum xaiv lawv, coj mus rau hauv tus account qhov hnyav ntawm tus kab mob, nrog rau tus kheej tus yam ntxwv ntawm lub cev. Thaum kho, cov txheej txheem physiotherapeutic tau pom zoo uas cuam tshuam nrog dej (kho kho da dej, da dej nrog hydromassage, da dej ncig). Hauv cov xwm txheej hnyav, cov txheej txheem phais yog siv. Cov no muaj xws li: pacemaker implantation; kev puas tsuaj nrog catheters; radiofrequency ablation.
Kev kho mob rov qab los
Ntawm ntxivKev kho tshuaj yog nqa tawm raws li qhov tshwm sim ntawm qaug dab peg. Thaum tsis muaj qhov tshwm sim los ntawm kev tso nws tus kheej, tus neeg mob tau teem sijhawm ntev, uas suav nrog cov tshuaj xws li Quinidine, Celanide, Etmozin, Digoxin, Amidaron, Desopyramid, Verapamil.
Kev siv tsis tu ncua ntawm lub plawv glycosides txo qhov zaus ntawm kev rov tshwm sim ntawm kev tawm tsam thiab txo qhov hnyav ntawm cov kab mob. Yog tias tsis muaj txiaj ntsig zoo los ntawm kev kho mob rov qab los, kev siv phais phais yog siv, suav nrog kev tshem tawm cov xov tooj cua zaus, kev puas tsuaj ntawm cov txheej txheem tsim tawm ntxiv, kev siv cov pacemakers uas muaj cov kev pab cuam ntawm ib lossis lwm qhov kev txhawb nqa ntawm lub plawv dhia.
Kev noj haus
Teem ib feem tseem ceeb ntawm kev kho mob yog kev noj zaub mov kom raug. Yog vim li cas koj thiaj li yuav tsum tso tseg cov khoom uas ua rau tachycardia. Cov khoom noj tsis zoo yog: confectionery, kas fes, khoom noj khoom haus starchy, lard, fatty nqaij, butter, mayonnaise, qaub cream, kib zaub mov, margarine, kaus poom zaub mov.
Cov zaub mov no muaj cov roj cholesterol ntau dhau, uas ua rau lub plawv tsis zoo. Tsis tas li ntawd, kev noj ntsev yuav tsum tsawg. Nws raug pom zoo rau paroxysmal tachycardia noj cov zaub mov tsis muaj rog thiab zaub. Kev noj zaub mov yuav tsum muaj cov zaub mov nram qab no: zaub, cereals, txiv hmab txiv ntoo qhuav, cov khoom noj muaj roj tsawg thiab cov khoom noj siv mis, txiv hmab txiv ntoo, nqaij nruab deg, txiv ntseej, zaub roj.
Noj zaub mov tsawg kawg rau ib hnub. Sib nrug los ntawmQhov no yuav tsum tsis txhob haus luam yeeb thiab haus cawv. Thaum kho, nws yog ib qho tsim nyog kom tsis txhob muaj kev ntxhov siab thiab overstrain ntawm lub hlwb. Yuav tsum tau pw tsaug zog txaus thiab qoj ib ce. Cov neeg mob tau saib xyuas cov roj cholesterol thiab ntshav qab zib. Koj tuaj yeem noj cov nroj tsuag tshuaj hauv tsev los kho tachycardia. Cov tshuaj zoo tshaj plaws yog los ntawm motherwort, viburnum, qus sawv, lovage, hawthorn thiab valerian.
Yuav ua li cas kho tachycardia nrog tshuaj hauv tsev
tshuaj ntsuab tuaj yeem nres thiab txo tus neeg mob. Txhawm rau kho tus neeg mob, nws yog ib qho tsim nyog yuav tsum rov ua kom muaj feem ntawm electrolytes hauv cov ntshav. Supraventricular paroxysmal tachycardia yog tus cwj pwm los ntawm qhov tsis txaus ntseeg loj. Nws yog ib qho tsim nyog los kho cov tshuaj hauv qab no: potassium, calcium thiab chlorine. Qhov no tuaj yeem ua tiav los ntawm kev kho mob nrog zaub glycosides thiab tshuaj ntsuab. Cov no suav nrog: valerian, motherwort, mint, hawthorn thiab txiv qaub balm.
Koj tuaj yeem kho yam tsis muaj tshuaj nrog cov tshuaj hauv qab no:
- 40 g ntawm lovage cag yuav tsum tau nchuav nrog ib liter ntawm dej kub thiab lim tom qab yim teev. Haus me me hauv ib hnub kom txog thaum tus mob zoo dua.
- Ncuav peb khob ntawm viburnum berries rau hauv ib lub ntim peb-liter, ces ncuav ob litres ntawm boiling dej, kaw lub thawv, qhwv thiab insist rau rau teev. Lub broth yog lim, cov txiv hmab txiv ntoo yog squeezed tawm, 0.5 liv ntawm zib mu yog ntxiv, thiab lub hub yog muab tso rau hauv lub tub yees. Haus ib feem peb ntawm ib khob ua ntej noj mov rau ib hlis. Tom qab ntawd so rau kaum hnub thiab rov kho dua. Ntawmparoxysmal arrhythmia tsuas yog xav tau peb lub voj voog.
Tshuaj yej tinctures ntawm valerian, hawthorn thiab motherwort yog tov, ib lub raj mis txhua. Cov muaj pes tsawg leeg yog muab tso rau hauv lub tub yees, koj yuav tsum tau haus peb zaug ib hnub twg, ua ntej noj mov, ib tug teaspoon.
Yuav ua li cas thaum muaj kev tawm tsam?
Thaum muaj kev tawm tsam ntawm paroxysmal tachycardia tshwm sim hauv tsev, koj yuav tsum ua li no:
- Kuv ua rau lub siab tawv, tsis txhob ntshai thiab tiv nrog cov kev xav;
- yog tias tsis muaj zog, kiv taub hau thiab xeev siab, pw lossis zaum xis;
- tus neeg mob yuav tsum tau muab cov huab cua ntshiab, nws yog qhov tsim nyog qhib qhov rais thiab tshem cov khaub ncaws;
- ua rau khaus ntawm lub paj hlwb: tuav koj txhais tes rau nees nkaum vib nas this, tso siab rau koj lub qhov muag thiab tuav koj lub hauv siab nias;
- haus cov tshuaj uas kws kho mob tau sau tseg, soj ntsuam cov tshuaj noj;
- yog tias koj mob hnyav, hu rau lub tsheb thauj neeg mob.
Yoga pa
Nrog paroxysmal tachycardia, yoga ua pa thiab lwm yam kev pab zoo sib xws. Cov txheej txheem ntawm Buteyko thiab Strelnikova kuj tsim nyog. Piv txwv ntawm kev ua pa ua pa uas tau ua los daws qhov kev tawm tsam yog raws li hauv qab no:
- ib lub qhov ntswg kaw nrog tus ntiv tes, dhau ntawm qhov pub dawb koj yuav tsum tau nqus pa, ces exhale dhau los ntawm qhov uas tau clamped ua ntej;
- inhale rau peb suav, tsis txhob ua pa rau ob suav thiab exhale rau peb suav, tuav ob suavua pa.
Peb saib nws yog dab tsi - paroxysm ntawm supraventricular tachycardia.
