Zowona za Fungo la Atrial
Kugwiritsira ntchito mankhwala opatsirana pogonana ndi chimodzi mwa zinthu zomwe zimawoneka bwino mtima , ndipo zingakhale zovuta kwambiri kuthana nazo. Ngakhale kutulutsa tizilombo toyambitsa matenda sikungokhala koopsa, nthawi zambiri zimayambitsa zizindikiro zazikulu. Choipa kwambiri, chikhoza kuchititsa mavuto aakulu, makamaka kupwetekedwa , ndi (mwa anthu omwe ali ndi matenda a mtima), kuwonjezereka mtima kulephera . Kuwonjezera apo, ngakhale njira zingapo zothandizira zowonjezereka zimapezeka kuti zikhale ndi matenda a atrial, nthawi zambiri sizimveka bwino-ngakhale pamtima akatswiri a nyimbo-omwe amachiza njira zina ndizovuta kwambiri.
Ngati muli ndi tizilombo toyambitsa matenda, muyenera kuyesetsa kuphunzira zonse zomwe mungathe pokhudzana ndi izi: zizindikiro zake, zifukwa zake, ndi mankhwala omwe alipo kuti muthe kukambirana ndi dokotala kuti mupeze njira yothandizira.
> Penyani momwe mtima ulili ndi zida zofanana ndi mtima wamba.
Kodi Kukhumudwa Kwambiri Ndi Chiyani, Nanga N'chifukwa Chiyani Kuli Kofunika Kwambiri?
Kugwiritsira ntchito mankhwala a atrial ndi mtima wosasinthasintha komanso wofulumira mofulumira, womwe umayambitsa mphamvu zamagetsi zowopsa kwambiri mkati mwa atria ya mtima (zipinda ziwiri zakuda za mtima ).
Ntchito yamagetsi yowonongeka, yotentha kwambiri mumtima imatchedwa "fibrillation."
Pamene atria ikuyamba kugwedeza, zinthu zitatu zikhoza kuchitika:
Choyamba , kuyambira kwa mtima kumakhala kofulumira komanso kosasintha. Nkhono ya AV imayimbidwa ndifupipafupi, zovuta zamagetsi zomwe zimachokera ku atria, ndipo zowonjezera zokwana 200 pamphindi zimatumizidwa ku zinyama, zomwe zimawatsogolera kugunda kwa mtima mofulumira komanso kosazolowereka. Kuthamanga kwa mtima mofulumira, kawirikawiri kumabweretsa zizindikiro zosokoneza.
Chachiwiri , pamene ma atria akugwedeza, sakukhalanso ogwira ntchito bwino. Choncho kugwirizanitsa pakati pa atria ndi ventricles kumatayika.
Zotsatira zake, mtima umagwira ntchito mogwira mtima ndipo ukhoza kulephera.
Ndipo chachitatu , chifukwa ma atria sakugwiranso ntchito bwino, patapita nthawi (nthawi zambiri pambuyo pa maola 24 kapena kuposerapo) magazi amatha kuyamba kupanga atria. Mitsempha yamagazi imatha kuthawa ndikupita ku ziwalo zosiyanasiyana za thupi, monga ubongo.
Choncho, ngakhale kutulutsa tizilombo toyambitsa matenda nthawi zambiri kumatulutsa zizindikiro zazikulu, tanthauzo lake lenileni ndilokuti zimakuika pachiopsezo cha matenda omwe angathe kulepheretsa kapena kufa.
Kodi N'chiyani Chimayambitsa Matenda Oopsa?
Matenda a atrial angapangidwe ndi matenda ambiri a mtima, kuphatikizapo matenda a mitsempha ya m'mimba (CAD) , kuthamanga kwa mitral , matenda aakulu, pericarditis , kulephera kwa mtima, kapena pafupifupi mtundu uliwonse wa vuto la mtima. Izi zimagwirizananso ndi hyperthyroidism , chibayo , kapena pulmonary embolus .
Kusakaniza kwa amphetamines kapena zolimbikitsa zina (monga mankhwala ozizira omwe ali ndi pseudoephedrine ) zingachititse kuti anthu asagwiritsidwe ntchito mowa mwauchidakwa, komanso pambuyo poti amamwa mowa pang'ono kapena zakumwa zoledzeretsa, zomwe zimatchedwa "mtima wa holide." Ngakhale madokotala akhala akunena kuti caffeine imayambitsanso matenda opatsirana pogonana, umboni waposachedwapa wochokera ku maphunziro a zachipatala umasonyeza kuti, mwa anthu ambiri, sizili choncho.
Zikuoneka kuti chiwerengero chachikulu cha anthu okhala ndi atrial fibrillation alibe chifukwa chodziwikiratu. Amanenedwa kuti ali ndi "idiopathic" matenda opatsirana pogonana. Mankhwala oopsa a athayo amatha kukhala okalamba. Mwachitsanzo, pamene matenda opatsirana pogonana ndi osowa kwa odwala omwe ali ndi zaka zopitirira 50, ndizofala kwa anthu omwe ali ndi zaka 80 kapena 90.
Kafukufuku watsopano asonyeza kuti nthawi zambiri, matenda opatsirana pogonana amakhudzana ndi moyo . Mwachitsanzo, anthu omwe ali onenepa kwambiri komanso omwe amakhala pansi amakhala ndi chiopsezo chokwanira cha matenda opatsirana pogonana. Kuwonjezera pamenepo, mwa anthu omwe ali ndi matenda a atrial okhudzana ndi zosankha za moyo, pulogalamu yaikulu ya kusintha kwa moyo yasonyezedwa kuti yithandize kuthetsa chigamulo.
Zizindikiro Ndi Matenda Aakulu
Anthu ambiri okhala ndi matenda a atrial amakhala ndi zizindikiro zazikulu. Chigamulochi chimakhala chowonekera kwambiri komanso chosokoneza kwambiri. Zizindikiro zofala kwambiri zimakhala zovuta, zomwe kawirikawiri zimawoneka kuti zimakhala zowawa mofulumira, mobwerezabwereza, kapena ngati "kukwapula".
Anthu omwe ali ndi matenda a atrial amagwiritsidwa ntchito mosavuta, kupuma mpweya, komanso (nthawi zina) kumutu. Zizindikiro izi, zogwirizana ndi matenda a atrial okha, zingakhale zosokoneza makamaka anthu omwe ali ndi matenda osokoneza bongo , kapena hypertrophic cardiomyopathy .
Komabe, zikuwonekeratu kuti mankhwala ophera tizilombo toyambitsa matenda amatha kuchitika osabala zizindikiro zilizonse. Ngakhale kuti alibe zizindikiro kawirikawiri ndibwino, kukhala "chete" kumawopsa kwambiri chifukwa chakuti nthawi zambiri kumabweretsa mavuto azachipatala kaya arrhythmia mwiniwakeyo akuchititsa zizindikiro zazikulu kapena ayi.
Mwachitsanzo, kupha tizilombo toyambitsa matenda kungachititse kuti anthu ambiri omwe ali ndi CAD azikhala ovuta kwambiri kapena angina . Matenda a atrial angapangitse kuwonongeka kwakukulu kwa ntchito ya mtima mwa anthu omwe ali ndi vuto la mtima.
Ndipotu, ngati mpweya wamtima wambiri womwe umayambitsa matenda a atrial umatha nthawi yaitali (kwa miyezi ingapo), minofu ya mtima ingayambe kufooketsa, ndipo mtima ukhoza kuchitika-ngakhale anthu omwe mitima yawo ili yachilendo.
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Phunzirani Zowopsa Zopangitsira A-Fib
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Zizindikiro 4 Zimayambitsa Kuperewera kwa Mapangidwe Opanga Atrial
Chotsatira choopsa kwambiri cha matenda a atrial fibrillation, komabe, ndizotheka kupha ziwalo. Kutsekemera kwapachilombo koopsa kumayambitsa chiopsezo chachikulu. Pafupifupi 15 peresenti ya zikwapu zonse zimaganiziridwa kuti zimayambitsidwa ndi tizilombo toyambitsa matenda. Kuwonjezera apo, anthu ambiri amene adwala matenda osokoneza bongo popanda chifukwa chomveka (otchedwa cryptogenic strokes ) amakhala ndi zizindikiro za "chete" zamagetsi.
Mitundu ya Fungo la Atrial
Nthawi zambiri madokotala amagwiritsa ntchito mitundu yambiri yosiyanasiyana, ndipo makamaka machitidwe osiyanasiyana osokoneza magulu omwe amagwiritsidwa ntchito poyambitsa matenda a atrial agwiritsidwa ntchito. Koma pofuna kukuthandizani kusankha njira yothandizira njira yoyenera kuchiza, ndibwino kupukuta mitundu ya mitundu yosiyanasiyana ya mankhwala m'thupi mwa mitundu iwiri yokha:
- Kusintha kwatsopano kapena mafilimu opatsirana pogonana . Pano, matenda opatsirana pogonana ndi vuto latsopano, kapena vuto limene limapezeka pokhapokha. Mafilimu oopsa omwe amagwiritsidwa ntchito kuntchito nthawi zambiri amatchedwa "pooxysmal toxic fibrillation." Anthu omwe ali m'gulu lino amakhala ndi mtima wamba nthawi zambiri, ndipo zigawo zawo za matenda oopsa a atrial zimakhala zochepa ndipo nthawi zambiri zimakhala zochepa.
- Kugwiritsira ntchito mankhwala osokoneza bongo . Pano, matenda opatsirana pogonana amapezeka nthawi zonse, kapena amapezeka nthawi zambiri-kotero kuti nthawi ya mtima wamtima ndi yochepa kapena yochepa.
Kusanthula Fibrillation ya M'thupi
Kafukufuku wa matenda a atrial fibrillation nthawi zambiri amamveka bwino. Zimangotenga kujambula electrocardiogram (ECG) pa nthawi ya matenda opatsirana pogonana. Chofunika ichi sichimavuta kwa anthu omwe ali ndi matenda osokoneza bongo osatha kapena omwe amatha, omwe arrhythmia angawonekere nthawi iliyonse yomwe ECG imatengedwa.
Komabe, mwa anthu omwe mafinyria amatha kuchitika moyenera, kuyang'anitsitsa kwa ECG kwa nthawi yaitali kungafunikire kuti azindikire. Kuwunika kwa ECG kwa nthawi yaitali kungakhale kofunika makamaka kwa anthu omwe adamva matendawa, chifukwa chakuti kuchiza matenda oopsa a m'magazi (ngati alipo) kungathandize kupewa kupweteka kwapadera.
Kuchiza Matenda a M'thupi
Ngati zinali zophweka kwambiri komanso zotetezeka kuti zichite, zikuwoneka kuti mankhwala abwino kwambiri okhudzana ndi matenda a atrial angakhale kubwezeretsa ndi kusunga mtima wabwino. Mwatsoka, nthawi zambiri sizitetezedwa makamaka kapena zosavuta.
Nthaŵi zambiri, makamaka ngati matenda a atrial alipo kwa milungu kapena miyezi, zimakhala zovuta kwambiri kukhala ndi chizolowezi choposa maola angapo kapena masiku ochepa. Choonadi choipa ichi chafuna njira ziwiri zochiritsira zosiyana siyana za matenda a atrial fibrillation. Yoyamba ndi njira ya "rhythm-control", ndipo yachiwiri ndiyo njira "yoyendetsa".
Njira ya "control rhythm" amayesera kubwezeretsa ndi kusunga mtima wabwino. Poyang'ana poyamba izi zikuoneka kuti ndizofunikira kwambiri, pali mavuto ambiri. Kuchita kayendedwe ka rhythm kumakhala kovuta, kosasangalatsa, kosagwira ntchito bwino, ndipo nthawi zambiri kumakhala ndi chiopsezo chachikulu chowopsya. Zimakhala zovuta kugwira ntchito ndi anthu omwe ali ndi matenda oopsa omwe amayamba posachedwa kapena ochepa kwambiri, komanso omwe sagwiritsidwa ntchito mofulumira kwa anthu omwe arrhythmia ndi osatha. Komabe, kwa anthu ambiri okhala ndi matenda a atrial iyi ndi njira yopitira.
Njira yogwiritsira ntchito kayendedwe kawirikawiri imafuna kugwiritsa ntchito mankhwala osokoneza bongo , mankhwala opatsirana , kapena onse.
Njira yowonjezereka ya matenda opatsirana pogonana imasiya kuyesa kubwezeretsa ndi kusunga mtima wabwino. Mankhwala opatsirana pogonana amavomereza kuti ndi "chizoloŵezi" cha mtima, ndipo mankhwalawa amawongolera kuchepa kwa mtima kuti athe kuchepetsa zizindikiro zilizonse zomwe zimayambitsa matenda opatsirana pogonana. Kupindula kwa njira yochepetsera njira ndikuti nthawi zonse zimatha kuthetsa kuyima kwa mtima kwa anthu omwe ali ndi matenda a atrial, ndipo nthawi zambiri zimachepetsera zizindikiro zilizonse zomwe zimapangidwa ndi arrhythmia palokha. Komanso mankhwala omwe amagwiritsidwa ntchito poyesa kuchepetsa nthawi zambiri amakhala otetezeka komanso olekerera. Kuwonjezera apo, kafukufuku wa nthawi yayitali awonetsa kuti zotsatira zachipatala ndi njira yochepetsera kayendetsedwe kake ndi yabwino kwambiri (ndipo mwina ndi yabwino kuposa) kayendedwe ka kayendedwe kake.
Ngakhale njira iliyonse yothandizira ikasankhidwa, chinthu china chofunika kwambiri chochiza matenda opatsirana pogonana ndikutenga njira zofunikira kuti kuchepetsa chiopsezo cha stroke. Izi zimafuna kutenga mankhwala osokoneza bongo , koma pali njira zina zothandizira.
Ngati Mwayamba Kuzindikiridwa Ndi Nkhalango Zam'thupi
Pali zinthu zingapo zomwe muyenera kukumbukira pamene inu ndi adokotala mumasankha njira yoyenera kwa inu. Izi zikuphatikizapo:
- Nchifukwa chiyani muli ndi tizilombo toyambitsa matenda? Kodi pali chinachake chimene inu kapena dokotala wanu mungachite (monga kuchiza matenda oopsa, kupewa kumwa mowa, kapena kusintha moyo wanu) zomwe zingathandize kuthetsa vutoli?
- Ngati mafinyria anu odwala matenda a atrial sakhala aakulu kapena osapitirira, kodi ma episodes anu amapezeka kangati, nthawi yayitali bwanji, ndi zizindikiro ziti zomwe zimayambitsa?
- Kodi muli ndi matenda oopsa a mtima omwe amachititsa kuti thupi likhale lopweteka kwambiri, kapena limapangitsa kuti mavitamini ambiri asokoneze mavuto ena monga angina kapena mtima wosalimba?
- Kodi zizindikiro zanu zimakhala zovuta bwanji?
- Kodi mumakhala ndi mavuto ambiri olekerera mankhwala osokoneza bongo?
- Kodi mumamva bwanji za njira zowonongeka zomwe zimapangidwira kukonzanso?
Kusankha mwa njira ziwiri zothandizira zokhazokha- "chigamulo choletsa" kapena "kuyima kwachangu" -ndibwino kwa inu kudalira pazifukwa zonsezi.
Kusankha pa chithandizo choyenera ndi nkhani yofunika kwambiri ndi matenda a atrial fibrillation. Zingakhale zosankha zovuta, ndipo ndizoyenera kuti zizigwirizana ndi munthu aliyense. Mukamamvetsa bwino za izi, mutha kuthandiza dokotala kuti apange chisankho choyenera kwa inu.
Mawu Ochokera
Kumbukirani kuti anthu mamiliyoni ambiri akukhala moyo wabwinobwino ngakhale kuti ali ndi matenda opatsirana pogonana. Icho chiyenera kukhala cholinga chanu, nayenso. Pamene mukufika pa chisankho choyenera chithandizo kungakhale kovuta, ndipo pamene kupereka mankhwala kungatenge nthawi ndi khama, mutatha mankhwala anu mutha kubwerera kumoyo wanu wokhazikika (mwinamwake ndi kusintha kwa moyo wanu). Izi ziyenera kukhala chiyembekezo chanu. Ndipo pamene mukukambirana zomwe mungachite ndi dokotala, onetsetsani kuti ali ndi chiyembekezo chomwecho kwa inu.
Zotsatira:
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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.
Meier B, Blaauw Y, Khattab AA, et al. EHRA / EAPCI katswiri wogwirizana pankhani ya catheter yochokera kumalo ochepa omwe amachokera kunthaka. Europace . 2014; 16: 1397.
Pathak RK, Middeldorp ME, Lau DH, et al. Kuphunzira kochepetsa chiopsezo chotenga chiopsezo cha atrial fibrillation ndi zotsatira za zotsatira zowonjezera: KUWERENGA KU AFRIKA-AF. J Am Coll Cardiol . 2014; 64: 2222-2231.
Wann LS, Curtis AB, January CT, et al. 2011 ACCF / AHA / HRS ndondomeko yowunika kwa odwala omwe ali ndi matenda oopsa a m'thupi (Kusintha Zotsatira za 2006): Lipoti la American College Association of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol . 2011; 57: 223.