Kuthamanga kwa m'nyanja ndi mtima wamaganizo womwe umagwirizanitsidwa m'njira zambiri kuti ugwiritse ntchito mankhwala oopsa . Kuthamanga kwapachilendo kunthaka kumachitika ndi magetsi ofulumira kwambiri a magetsi omwe amachokera ku atria, zomwe zimapangitsa kuti muyeso wa mtima womwe umakhala pafupi ndi theka la chiwerengero cha atrial. Mu ntchentche zamagetsi, chiŵerengero cha amphawi nthawi zambiri chimakhala pafupifupi ma beti 300 pamphindi, ndipo mlingo wa ventricular uli pafupi kuzungulira 150 pamphindi.
Chifukwa chakuti chigawochi chimachokera ku atria, chimatengedwa ngati mtundu wa tachycardia .
Mwachidule
Kuthamanga kwa atrial ndi mtundu wa reentrant arrhythmia ; zimachitika pamene mphamvu ya magetsi imakhala "yoyendetsa" m'katikatikati mwa mtima, ndipo imayamba kuyendayenda kuzungulira dera lonselo. Pogwiritsa ntchito ntchentche zamtundu wautali, maulendo oyendetsa malowa ndi aakulu kwambiri omwe nthawi zambiri amakhala mkati mwa malo abwino, ndipo nthawi zambiri amatsatira njira.
Kawirikawiri zimenezi zimapangitsa kuti phokoso lachilendo likhale loyenera makamaka pa mankhwala opatsirana . Pogwiritsa ntchito njira yothawirako, njira yowonongeka ikhoza kusokonezeka, ndipo ntchentche yamagetsi sichitha kuchitika.
Zizindikiro
Kuthamanga kwa mtima mofulumira kumene kumafalikira ndi ntchentche ya atrial nthawi zambiri kumapangitsa kuti phokoso limatchulidwe, chizungulire , kutopa, ndi dyspnea (kupuma).
Mofanana ndi mabungwe ambiri omwe amachitiranso kachilomboka, magulu a ziphuphu zamtunduwu amayamba kubwera ndikudzidzimutsa mosayembekezereka.
Ngati wodwalayo ali ndi ntchentche ya atrial nayenso ali ndi matenda a mitsempha yamtima, kuthamanga kwa mtima msanga kungayikitse kupweteka kwa mtima kumayambitsa angina . Kuwombera kwapachilomboka kungachititse kuti zizindikiro zowonjezereka ziwonjezeke mwa anthu omwe ali ndi vuto la mtima .
Kuyenera
Chifukwa zizindikiro zomwe zimabweretsa zimakhala zosasunthika, kuphulika kwa magazi kungakhale kofunika kwambiri ngakhale kuti zonsezi zinkachititsa kuti zikhale zovuta, chizungulire ndi dyspnea.
Koma vuto lalikulu lomwe likukhudzana ndi ntchentche za m'nyanja ndilo, monga momwe ziliri ndi matenda a atrial fibrillation, izi zimapangitsa kuti thrombus ipangidwe (magazi oundana) mu atria. Mitsempha yamagazi imatha kumasuka ( embolize ) ndi kuyambitsa zilonda . Choncho anthu okhala ndi ntchentche, ngati omwe ali ndi matenda a atrial, amakhala ndi chiopsezo chowonjezereka.
Kuwonjezera apo, kawirikawiri kawirikawiri zimakhala ngati "Bridge Bridge". Izi zikutanthauza kuti anthu omwe ali ndi ntchentche zamagetsi nthawi zambiri amayamba kukhala ndi matenda opatsirana pogonana.
Zowopsa
Ngakhale aliyense angathe kukhala ndi ntchentche, si zachilendo arrhythmia. Nthaŵi zambiri, mobwerezabwereza, mosiyana ndi kuchuluka kwa atrial fibrillation.
Anthu omwe amatha kukhala ndi ntchentche zam'mlengalenga ndi ofanana ndi omwe amatha kukhala ndi mafinya oopsa. Izi zimaphatikizapo anthu omwe ali ochepa kwambiri, kapena omwe ali ndi matenda a m'mapapo (kuphatikizapo kupopera mankhwala ), kupuma kwa kugona , matenda a sinus matenda , pericarditis , kapena hyperthyroidism . Kuwombera kwapanyanja kumapezedwanso mwa anthu omwe akhala akuchitidwa opaleshoni yaposachedwapa.
Kudziwa
Kuzindikira kugunda kwanthaka kumakhala kosavuta. Zimangofuna kutenga chigawo cha ECG , ndi kuyang'ana zomwe zimatchedwa "mafunde a flutter." Mafunde a flutter ndiwo maonekedwe a ECG omwe amaimira mphamvu zamagetsi zomwe zikuzungulira kuzungulira malo ozungulira.
Chithandizo
Ndi chimodzi chosiyana kwambiri, chithandizo cha ntchentche zapanyanja chili chofanana ndi chimfine chamagetsi. Chosiyana ndi ichi, poyerekeza ndi mafinyria owononga thupi, kugwiritsa ntchito mankhwala ochepetsa ablation pofuna kuthetsa ntchentche zapafupi ndi zosavuta kukwaniritsa.
Zovuta Zambiri
Kwa odwala omwe ali ndi chiwombankhanga chowopsa, ntchentche yamagetsi imatha kuyimitsidwa mosavuta ndi magetsi, kapena mwa kugwiritsa ntchito mankhwala osokoneza bongo (nthawi zambiri, ibutilide kapena dotilide).
Ngati zizindikiro zili zovuta panthawi yovuta, kuchepetsa kuthamanga kwa mtima kungakhale kofunikira pokonzekera mtima. Izi zikhoza kuchitidwa mofulumira mwa kupereka mankhwala osakaniza a calcium blockers diltiazem kapena verapamil, kapena intravenous beta block blocker esmolol. Mankhwalawa ayenera kugwiritsa ntchito mosamala, komabe, odwala omwe ali ndi vuto la mtima.
Kuchiza kwa nthawi yaitali
Kamodzi kake kakakhala kovuta kwambiri, gawo lotsatira ndi kuyesa kuthetsa zigawo zina zazomera zam'nthaka. Pankhani imeneyi ndikofunikira kuyang'ana, ndikuchiza, chifukwa chokhazikitsiratu, monga hyperthyroidism, kugona tulo, kapena kunenepa kwambiri. Hyperthyroidism kawirikawiri imatha kulamuliridwa mokwanira masiku angapo, ndipo kugona tulo kumatulutsidwa nthawi ndithu. Pamene kunenepa kwambiri kumayambitsanso chifukwa cha ntchentche, nthawi zambiri sichimasinthidwa mokwanira kapena mwamsanga kuti lipindule ndi mankhwalawa - kotero njira zina zoyenera kuzigwiritsira ntchito ziyenera kugwiritsidwa ntchito.
Ngati palibe chifukwa chokhazikitsanso mosavuta, amachiza matenda aakulu omwe amawathandiza. Chithandizo chokhalitsa cha ntchentche yamagetsi kawiri kawiri chimaphatikizapo kupondereza arrhythmia ndi mankhwala, kapena kugwiritsa ntchito mankhwala opatsirana.
Mankhwala osokoneza bongo ali ndi vuto lopambana labwino ndi chiwombankhanga cha madzi - 20 peresenti mpaka 30 peresenti ya odwala omwe amachizidwa ndi mankhwala akuyendetsedwa mosamala pakatha chaka chimodzi. Pachifukwa ichi, ndipo chifukwa cha mankhwala ambiri omwe amapezeka ndi mankhwala osokoneza bongo, mankhwala opatsirana ndi mankhwala omwe amachitirako mwayi wopanga madzi.
Mwamwayi, monga tanenera poyamba, kubwezeretsa kwazomera zapanyanja nthawi zambiri kumakhala kosavuta, ndipo ndibwino kwambiri - pafupifupi 90%. Ambiri mwa odwala ali ndi arrhythmia, ablation ayenera kuganiziridwa mozama.
Popeza kuperekera ntchito kumagwira ntchito bwino, kugwiritsa ntchito "njira yowonetsera ndalama" (yomwe imagwiritsidwa ntchito popanga tizilombo toyambitsa matenda) sikungowonjezereka kofunika kuti tizilombo toyambitsa matenda. Njira yowonongeka kumatanthauza kulola arrhythmia kuti ichitike, ndi kuchepetsa kuchuluka kwa mtima mtima, kuchepetsa zizindikiro.
Kulamulira chiwerengero cha mtima mu ntchentche yowonongeka kumakhala kovuta kwambiri kusiyana ndi kupha tizilombo toyambitsa matenda, ndipo kawirikawiri kumafuna kugwiritsa ntchito kuphatikizapo beta blockers ndi calcium blockers. Nthaŵi zina, kuti chiwerengero cha mtima chiziyendetsedwa ndifunikira kubwezeretsa kachitidwe kachitidwe ka mtima kamene kamayambitsa mtima , kenaka ikani pacemaker kuti mukhazikike pamtima. Mwachiwonekere, kuchotseratu ntchentche yaphari yonse pamodzi ndi njira yobweretsera nthawi zambiri ndiyo njira yabwino kwambiri yogwirira ntchito.
Nthawi zina njira yogwiritsira ntchito njira yothandizira, amagwiritsidwa ntchito pofuna kupewa matenda, monga momwe ziliri ndi matenda a atrial.
Zotsatira:
Wellens HJ. Kusamalira kwamakono kanyumba kameneka. Kuyendayenda 2002; 106: 649.
Granada J, Uribe W, Chyou PH, ndi al. Zochitika ndi zowonongeka za ntchentche zapanyanja pa anthu ambiri. J Am Coll Cardiol 2000; 36: 2242.