Mwa njira ziwiri zomwe zimagwiritsidwa ntchito pochiza matenda opatsirana , njira yomwe ikukonzekera kubwezeretsa ndi kukhalabe ndi mtima wabwinobwino (kumveka kwa kayendedwe kake) pa nkhope yake ikuwoneka ngati yofunika kwambiri. Komabe, chifukwa njirayi ingakhale ndi chiopsezo chachikulu ndipo nthawi zambiri sichigwira ntchito. Sizolondola kwa aliyense.
Njira yodzitetezera imaphatikizapo njira ziwiri: kubwezeretsa ndi kusunga mtima wachibadwa.
Kutengeka Mtima: Kubwezeretsa Chizoloŵezi cha Mtima Wachikondi
Ngati muli ndi matenda a atrial, dokotala wanu angathe kuyesa kubwezeretsa mtima wanu mwa kugwiritsa ntchito mankhwala osokoneza bongo kapena mtima wamagetsi.
Mankhwala amatsinje angapo amatha kuperekedwa mwachangu poyesera kuimitsa ululu wamagazi ndi kubwezeretsa nyimbo yachibadwa. Izi ndi monga Tambocor (flecainide), Corvert (ibutilide), Rhythmol (propafenone), ndi Tikosyn (dofetilide). Komabe, mankhwalawa amatha kubwezeretsa nyimbo yachibadwa yokha peresenti 50 mpaka 60 peresenti ya nthawiyo, ndipo pangakhale zotsatirapo.
Akatswiri ambiri amatsamba amakonda magetsi pamtima m'malo mwake. Ndi matenda a mtima, mumayikidwa tulo tomwe timayambitsa matendawa chifukwa cha mphindi zingapo. Dokotala adzatulutsa mphamvu zamagetsi pachifuwa pogwiritsa ntchito zida zazingwe. Njirayi ndi yopweteka, yofulumira, yotetezeka komanso yothandiza nthawi zonse.
Kuvuta kwakukulu kwa mtima wa mtima sikuchokera ku ndondomeko yokha, koma ndi zotsatira za kupuma kwa mtima.
Ngati magazi atsopano amapezeka mu atria pamene mtima uyamba kugunda mobwerezabwereza, zotchinga zimatha kusokonekera ndikupweteketsa . (Izi zikhoza kuchitika nthawi iliyonse ndi matenda a atrial koma ndi zochepa zomwe zimachitika kamodzi kokha kamvekedwe ka mtima kakabweretsedwanso.) Chochitikachi n'chosazolowereka pambuyo pa mtima, koma zikachitika zingakhale zowawa.
Kuopsa kwa kupwetekedwa kwa matenda a mtima kumatha kuchepetsedwa kaya mwa kuchiza ndi mankhwala a antiticoagulant (magazi ochepa thupi) kwa milungu ingapo musanayambe kutulutsa mtima kapena polemba kuti palibe maulendo otere pamtundu wa kumanzere pochita opaleshoni yokhala ndi matenda opatsirana pogonana asanayambe kudwala. Kuwonjezera apo, ngati zitsimikiziranso kuti mankhwala opatsirana pogonana akhalapo kwa maola osachepera makumi awiri ndi awiri, cardioversion ingakhoze kuchitidwa ndi yachibale chitetezo.
Gawo loyambalo loyendetsa nyimbo-kubwezeretsa chikhalidwe cha mtima-ndilopambana kuposa 98 peresenti ya nthawiyo.
Kusunga Nyimbo Yachibadwa
Chinyengo chenichenicho kuti muyambe kuyendetsa nyimbo ndi kusunga mtima wamtundu uliwonse pamene wabwezeretsedwa. Kawirikawiri, ndi chiyambi choyamba cha matenda a atrial fibrillation, madokotala ambiri amangobwezeretsa nyimbo yachibadwa ndi kutumiza kunyumba kwa wodwalayo popanda mankhwala enaake a mtima (kupatulapo mankhwala, ndithudi, chifukwa chodzidzimutsa chomwe chimayambitsa matenda a atrial). Anthu ambiri adzakhala ndi chizoloŵezi chachizolowezi kwa miyezi kapena ngakhale zaka popanda mankhwala osokoneza bongo.
Komabe, posakhalitsa matenda opatsirana pogonana amatha kubwereranso. Pamene izi zichitika, gawo lokonzekera limakhala lovuta kwambiri.
Kawirikawiri, kamodzi kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri, kachilombo kamene kalibwezeretsa kachilombo kamene kamakonza kachilomboko kamalimbikitsa chimodzi mwa mankhwala osokoneza bongo. Mwamwayi, mankhwala osokoneza bongo, kupatulapo kukhala pakati pa mankhwala oopsa kwambiri omwe amagwiritsidwa ntchito pa zamankhwala, amangochita bwino kwambiri poonetsetsa kuti mankhwalawa asabwerere. Chifukwa chake, kukwaniritsa cholinga cha kulamulira nyimbo kumafuna "mayesero" ambiri ndi mankhwalawa, kufunafuna imodzi yomwe imakhala ndi nyimbo yachibadwa ndipo imalekerera.
Ngakhale ndi njira yovuta yowonongeka, mankhwala osokoneza bongo omwe amachititsa kuti muyambe kugwiritsira ntchito mankhwala osokoneza bongo popanda kuwononga zotsatira zoopsa zomwe amapeza zimapezeka pafupifupi theka la nthawi.
Kupambana kotereku ndi mankhwala osokoneza bongo kumakhala kovuta kwambiri. Pa chifukwa chimenechi, madokotala ndi ochita kafukufuku akhala akugwira ntchito mwakhama kwa zaka zoposa 10 kuti akhale ndi njira zowonetsera kuti athe "kuchiritsa" matenda opha tizilombo-kutanthauza kuti, kukhala ndi mtima wamba nthawi zonse-kugwiritsa ntchito njira zothandizira puloteni . Ngakhale kuti zambiri zapita patsogolo, mankhwala opatsirana pogwiritsira ntchito mankhwala a atrial amakhalabe othandiza komanso amakhala ndi chiopsezo chachikulu cha mavuto aakulu. Ablation ndi njira yabwino kwa odwala ena omwe ali ndi matenda a atrial, koma si onse.
Pomalizira, odwala omwe amapeza bwino kugwiritsira ntchito mankhwala osokoneza bongo kapena ablation, umboni womwewo ukuwonetsa kuti chiopsezo chawo chokhala ndi matendawa chilipobe. Choncho, akatswiri ambiri amalimbikitsa odwalawa kuti azikhala ndi mankhwala osadziwika bwino ngakhale kuti ali ndi chizoloŵezi chodziwika bwino.
Chidule
Ngati njira yothandizira kugwiritsira ntchito mankhwala opatsirana pogonana inali yotetezeka komanso yogwira mtima, ingagwiritsidwe ntchito pafupifupi aliyense amene ali ndi arrhythmia. Mwatsoka, pamene kuyimba kwa nyimbo kumakhala njira yabwino kwambiri kwa anthu ambiri, imasiya zofunikanso. Ichi ndichifukwa chake njira yowonjezera - kuyendetsa - imagwiritsidwa ntchito mmalo mwa odwala ambiri. Ndipo chifukwa chake muyenera kuphunzira zambiri momwe mungathere musanapange chisankho chabwino cha mankhwala opatsirana pogwiritsira ntchito mankhwala.
Zotsatira:
Fuster, V, Ryden, LE, Cannom, DS, et al. ACC / AHA / ESC 2006 Malangizo Othandizira Odwala Odwala Matenda Aakulu Padziko Lonse Lipoti la American College of Cardiology / American Heart Association Task Force on Practice Guidelines ndi European Society ya Komiti Yokonza Maphunziro Otsogolera (Komiti Yolemba Kubwereza Malangizo a 2001 kwa Utsogoleri wa Odwala Amene Ali ndi Nthenda Yamatenda). J Am Coll Cardiol 2006; 48: e149.