Ngati mwakhala ndi chidziwitso cha syncope (kuperewera kwadzidzidzi kumatchulidwanso ngati kutaya), nkofunika kuti inu ndi dokotala wanu muzindikire chomwe chinachititsa chiwonetserocho. Pali zifukwa zambiri zomwe zingayambitse syncope, ndipo ngati dokotala wanu asayandikire matendawa mwadongosolo, zinthu zingasokoneze mofulumira. Nkhaniyi ikufotokoza njira yowongoka komanso yowonetsera kuti matenda a syncope azindikiridwe.
Choyamba Choyamba Choyamba
Pofufuza chifukwa cha syncope, dokotala wanu ali ndi funso lachangu kuti ayankhe: Kodi syncope mwa inu imasonyeza chiopsezo chowonjezereka cha imfa mwadzidzidzi? Mwamwayi, kufika pa yankho la funsoli nthawi zambiri kumakhala kosavuta, komanso mwachisangalalo, nthawi zambiri yankho la funso ili ndi "Ayi." Komabe, n'kofunika kwambiri kuti muyankhe funso ili pomwepo. Popeza kuti syncope yowopsya nthawi zonse imachokera kumtima, izi zikutanthauza kuti dokotala akufunikira kudziwa ngati muli ndi chikhalidwe chachikulu cha mtima kapena muli nacho. Ngati dokotala wanu akuganiza kuti syncope mwina chifukwa cha chikhalidwe cha mtima, kuyesa mwamsanga ndikofunika - ndipo kungakhale kofunikira kukupatsani chithandizo kufikira mutayika moyo wanu, kapena mukuchitidwa bwino.
Ngati (monga momwe ziliri nthawi zambiri) dokotala wanu sapeza chizindikiro chilichonse chowopsya, ndiye kuti akhoza kuchita kafukufuku mofulumira kuti apeze chifukwa cha syncope, ndipo chipatala sichifunikira kwenikweni.
Njira Yotsata Njira ziwiri Kuti Muyese Syncope
Gawo Loyamba - Mbiri Yachipatala ndi Kufufuza kwa Madokotala
Izi, kutali ndi kutali, ndi sitepe yofunika kwambiri pozindikira chifukwa cha syncope. Mbiri ndi zofufuza zakuthupi zimapereka ndondomeko zofunika pozindikira kuti pafupifupi pafupi zonse zomwe zimayambitsa syncope. Komabe, ngakhale madokotala onse amaphunzitsidwa izi, ambiri, mwatsoka, samawoneka kuti akuphunzira.
Ichi ndi chifukwa chake muyenera kuzindikira izi: Nthawi zambiri, dokotala ayenera kukhala ndi lingaliro labwino kwambiri pa chifukwa cha syncope pambuyo poyankhula ndi kukufunsani. Kotero ngati dokotala akulephera kuchita mbiri yakale ya zachipatala (zomwe zafotokozedwa pansipa), ndipo amachita zokhazokha, ndipo alibe lingaliro la zomwe zinayambitsa syncope, ndiye muyenera kuganizira dokotala wina.
Kulemba mbiri yachipatala mosamala kumaphatikizapo kupeza zambiri zokhudza mbiri yamoyo yonse yomwe mungakhale nayo, kuphatikizapo: a) zonse zokhudza mbiri yakale ya matenda a mtima; b) Ngati mulibe mbiri ya matenda a mtima, penyani zotsatira zanu zoopsa za matenda a mtima ; ndi c) kukufunsani za mbiri yakale ya banja yomwe mungakhale nayo matenda a mtima, makamaka mbiri ya banja la imfa yadzidzidzi. Kuonjezera apo, dokotala ayenera kukufunsani zambiri za zigawo zanu za syncopal - njira yonse yobwerera ku ubwana, ngati kuli kofunika - kuphatikizapo zomwe zimakhalapo pamene zinachitika, zomwe mukuchita panthawiyo, kaya panali chenjezo lirilonse, utatha nthawi yaitali bwanji, kaya mwadzidziwanso mutangogwa pansi, ndipo ngati mwapeza njira yochotseratu zigawo ngati mumamva kuti akubwera.
Kufufuza koyenera kumaphatikizapo kuyeza kwapadera ndi mayesero a mtima. Dokotala wanu ayenera kutenga magazi anu mu mkono uliwonse, ndipo ayenera kuyeretsa kupanikizika kwanu kwa magazi ndi kutuluka pamene mukugona pansi, komanso pamene mwaima.
Pamapeto pa mbiri ndi thupi, dokotala wanu ayenera kukhala ndi lingaliro labwino pa zomwe zikupangitsa syncope. Makamaka, osachepera dokotala wanu ayenera kudziwa momwe mulili ndi vuto la mtima lopangitsa syncope - mulimonsemo, kufa mwadzidzidzi ndikokudetsa nkhaŵa. Ngati matenda osokonezeka mtima sakukayikira, ndiye kuti dokotala wanu safuna kuti awononge mayesero oposa awiri kapena awiri kuti atsimikizire kuti akudandaula.
Ayenera kukuuzani zomwe akuganiza kuti ndizovuta, ndipo akuyenera kukupatsani lingaliro la zomwe mankhwalawo angachite.
Komabe, ngati dokotala watsiriza nanu ndipo akuyima pamenepo, akugwedeza mutu wake, akuyendetsa batire lonse la mayesero ndi njira, mfuti-ngati, yomwe imayankhula machitidwe ambiri a ziwalo, ndiye kuti inu muli ovuta kwambiri nthawi. Ino ndiyo nthawi yoti muganizire kufunafuna lingaliro lachiwiri .
Gawo lachiwiri - Kuyezetsa koyendetsedwa
Pambuyo pa mbiri ndi kuunika kwa thupi:
- Ngati dokotala akudandaula chifukwa cha mtima wanu syncope , kupopera kwa mtima kosakhala kosafunika kumachitika mwamsanga. Kawirikawiri, ntchitoyi idzakhala ndi echocardiogram , ndipo nthawi zina mayesero opsinjika maganizo . Ngati mtundu wina wa matenda a mtima obvunda umapezeka (monga aortic stenosis ), ndiye kuti mankhwala akuthandizira kuthetsa vutoli ayenera kukonzedwa mwamsanga. Ngati kuyesa koyambiriraku kumapangitsa kuti thupi lanu likhale loyambitsa matendawa, mungafunike kuyesedwa kwa electrophysiologic . Pachifukwa ichi, mwinamwake muyenera kukhalabe kuchipatala mpaka mutalandira mankhwala othandiza. Werengani za zifukwa za mtima za syncope.
- Ngati dokotala akudandaula chifukwa cha matenda a ubongo, ndiye kuti akhoza kuyambitsa kanema ya CT kapena electroencephalogram (EEG) , kapena nthawi zina, angiography (kafukufuku wofiira kuti aganizire mitsempha ya ubongo) kuti atsimikizidwe kuti ali ndi matenda. Syncope chifukwa cha matenda a ubongo, komabe, ndizosazolowereka.
- Ngati dokotala wapeza kapena akuwatsutsa kwambiri vasomotor syncope (kutanthauza, orthostatic hypotension , POTS , kapena vasovagal syncope ), kawirikawiri palibe kuyesa kofunikira. Nthaŵi zina, phunziro lapamwamba la patebulo lingakhale lothandiza kutsimikizira kuti matendawa akupezeka. Koma kawirikawiri, pamene mtundu uwu wa syncope ukudziwika, dokotala wanu akhoza kupita nthawi yomweyo kuti ayambe kulandira mankhwala. Ambiri mwa anthu omwe ali ndi syncope amakhala ndi vasovagal syncope .
- Ngati dokotala wanu - ngakhale mutakhala ndi mbiri yachipatala mwakuya komanso mukufufuza bwinobwino - alibe chidziwitso chabwino cha syncope yanu, kawirikawiri ndibwino kuti muyesetse kuyesa matenda osagwira mtima kuti muwonetsetse matenda a mtima wonyenga. Kuyesedwa kotereku kudzakhala ndi echocardiogram, nthawi zambiri kuyendetsa galimoto (komwe mumavala mawonekedwe a mtima kunyumba kwa masiku angapo kapena masabata), ndipo mwina kuyesa kupanikizika . Kuphunzira patebulo losakaniza kungakhale kothandiza. Ngati syncope sichikupezeka pambuyo pa maphunzirowa, kuyesa kwa electrophysiologic kungaganizidwe.
Chidule
Pogwiritsira ntchito njira ziwirizi, zingatheke kuti dokotala akhoze kudziwa chifukwa cha syncope mwamsanga ndi molondola, ndipo adzatha kuyambitsa mankhwala oyenera mwachidule.
Zotsatira:
Strickberger SA, Benson DW, Biaggioni I, et al. AHA / ACCF Scientific Statement pa kuyesa kwa syncope: Kuchokera ku American Heart Association Councils ku Clinical Cardiology, Matanki Achimayi, Matenda a Mtima M'magulu a Achinyamata, ndi Stroke, ndi Quality of Care and Outcomes Research Interdisciplinary Working Group; ndi American College of Cardiology Foundation: mogwirizana ndi Heart Rhythm Society: lovomerezedwa ndi American Autonomic Society. Kuyendayenda kwa 2006; 113: 316.