Phunziro lapamwamba la patebulo limagwiritsidwa ntchito poyesa odwala omwe ali ndi syncope (kutayika kwa chidziwitso) zomwe akuganiza kuti zimayambitsidwa ndi vasovagal episodes . Ndimaphunziro ophweka kwambiri, ndipo nthawi zambiri ndi otetezeka.
Mmene Kuyesedwa Kulili
Mu phunziro lapamwamba la patebulo, wodwalayo amangirizidwa patebulo, lomwe limakonzedweratu ku malo owongoka.
Pamene akuyang'ana kuthamanga, kuthamanga kwa magazi, electrocardiogram , ndi kuika magazi m'magazi, wodwala akusiyidwa "pamalo osayima" kwa mphindi 10 mpaka 60.
Mu munthu yemwe ali ndi vasovagal syncope, kuphunzira patebulo lopindika kumabweretsa kachilombo ka syncopal. Ngati izi zikuchitika, phunziroli likutengedwa kuti ndilolondola, ndipo matenda a vasovagal syncope akutsimikiziridwa.
Mayesero Ogwira Ntchito
Panthawi yoyendayenda - kapena pa nkhaniyi panthawiyi - mtima wa munthu umayenera kudzikonza wokha kuti upewe gawo lalikulu la magazi pamagazi.
Kusintha kumeneku kumaphatikizapo kuwonjezeka kwa mtima wa chiwombankhanga komanso kupopera kwa mitsempha ya m'magazi. Munthu wamba akaikidwa mozungulira, kusintha kwake kwa mtima kukuchitika mofulumira, ndipo palibe kutsika kwa magazi.
Komabe, kwa odwala okhala ndi mitundu iwiri ya syncope - orthostatic hypotension ndi vasovagal syncope - kusintha kwa mtima kumalo oongoka sikugwira ntchito mwachizolowezi.
Mu maonekedwe a hypotension , mphamvu ya thupi kuti ikhale yowongoka ndi yachilendo. Pamene anthuwa amaima (kapena atakhala ndi pulogalamu yowonongeka), magetsi awo amakula kwambiri, ndipo magazi awo amatsika mofulumira. Odwalawa sangathe kusintha maonekedwe awo.
Komabe, odwala omwe ali ndi vuto la hypotension samafunikanso kuti apange kaye kaye kaye kaye, chifukwa madokotala amatha kupeza mankhwalawa mwachangu pokhapokha atatenga magazi nthawi yoyamba pamene wodwalayo wagona ndiyeno ataimirira.
Kuphunzira patebulo lokhazikika kumakhalanso kawirikawiri kwa anthu omwe ali ndi vasovagal syncope koma m'njira yowonekera. Kawirikawiri, odwalawa amayamba kusintha kawirikawiri kuti ayendetse bwino, koma mkati mwa mphindi 20-30 angathe kusintha mwadzidzidzi ndi kusintha mwazizindikiro zofunikira - kuthamanga kwa magazi kumathamanga kwambiri; mapulaneti awo amathanso kugwa, ndipo amatha kutuluka. Iwo amachira patangotha mphindi zochepa kuchokera pamene tebulo ikubwezeretsedwanso, ndipo amabwezeretsedwa kumalo ogona pansi.
Vasovagal syncope ndi chifukwa cha zomwe zimayambitsa mitsempha ya mitsempha mwadzidzidzi m'milingo, ndi kuchepetsa kuthamanga kwa mtima, zonse zomwe zimapangitsa kuti kugwa kwa magazi kuwonjezeke kwambiri. Zochitika zambiri zochititsa chidwi zingayambitse izi zotchedwa "vasomotor" reflex, kuphatikizapo zinthu monga mantha, ululu, ndi zoopsa (monga kuona magazi). Kuyeza kwa tebulo lopindika kumapangitsa kuti maganizo a mtima asokonezeke. Phunziro la patebulo lopindika, ndiye, limayesa ngati munthu ali ndi reflex ya vasomotor yowonongeka, komanso kuti ayambe kupanga vasovagal syncope.
Kugwiritsa Ntchito Moyenerera kwa Tilt Table Test
Ngakhale kuti phunziro lapamwamba la patebulo lingagwiritsidwe ntchito kuti lizindikire mkhalidwe wa hypotension, mayesowa sayenera kukhala ofunikira kwa odwala omwe ali ndi vutoli, lomwe limapezeka mosavuta ku ofesi iliyonse ya udokotala. Chinthu chofunikira kwambiri pa phunziro la patebulo lokhazikika ndicho kutsimikizira kuti akudziwika kuti vasovagal syncope. Kuwona chizoloŵezi cha vasovagal pamtundu woongoka kumatha kukhazikitsa chitsimikizo chomwe poyamba sichikudziwika, ndipo chifukwa cha ichi, phunziro lapamwamba la patebulo nthawi zina lingakhale lothandiza kwambiri.
Kuyeza kwa tebulo kumathenso kumathandiza kupewa matenda odwala matenda a khunyu omwe, posiyanitsa khunyu kuchokera ku vasovagal syncope pamodzi ndi kayendetsedwe kake.
Komabe, yesero liyenera kugwiritsidwa ntchito mosamala. Vasovagal syncope amatha kupezeka mosavuta nthawi zambiri mwa kutenga mbiri yachipatala ndikupanga kuunika.
Kuwonjezera pamenepo, ngakhale anthu omwe ali ndi vasovagal syncope, phunziro lopangira patebulo limatulutsa zizindikiro zawo zokwana 70-75 peresenti ya nthawiyo. Mwa kuyankhula kwina, 25-30% mwa odwala awa ali ndi "zolakwika zabodza". Choncho, kuphunzira movutikira sikuyenera kuonedwa kuti ndi "golide" muyezo wa vasovagal syncope. "Miyezo ya golidi" akadakali mbiri yakale yokhudza zachipatala.
Kuyeza kwa tebulo komweko kumagwiritsidwa bwino kwambiri kwa odwala omwe mbiri zawo zimakhala zokopa zamagulu a vasovagal, koma kumene kulibe kukayika. Odwalawa, kuphunzira mozama kumapangitsa kuti apeze vasovagal syncope .
Zotsatira:
Task Force for Discovery and Management of Syncope, European Society of Cardiology (ESC), European Heart Rhythm Association (EHRA), et al. Malangizo othandizira kupeza ndi kusamalira syncope (2009). Mtima; 30: 2631.
Leonelli FM, Wang K, Evans JM, et al. Kupotoza mutu wonyenga: mbiri ya chilengedwe ndi yachisanu. J Am Coll Cardiol 2000; 35: 188.