Kulephera kwa mtima ndi matenda aakulu omwe sangathe kuchiritsidwa. Kupulumuka ndi umoyo wa moyo ndi kulephera kwa mtima kungakhale bwino ndi chithandizo chamankhwala, kusintha kwa moyo, ndi nthawi zina, ndi opaleshoni yapadera. Mankhwala olembedwa, monga beta blockers, ACE inhibitors, ndi ma diuretics, ndiwo njira zomwe amagwiritsidwa ntchito kwambiri pamtima mankhwala olephera.
Mankhwalawa amagwiritsidwa ntchito popangitsa mtima kupopera bwino kwambiri, kuteteza madzi ochulukirapo kuti asamangidwe m'thupi, kapena kutsika kwa magazi. Kusintha kwa valve, pacemaker, kapena njira zina zingaganizidwe mwa odwala ena.
Malemba
Mankhwala a mankhwalawa ndi mankhwala othandiza kwambiri pa kayendedwe kake ka mtima. Mankhwalawa amafunika kusintha nthawi ndi nthawi ngati matenda anu akupita. Nthawi zina, dokotala wanu angapereke mankhwala omwe amachititsa kuti mtima wanu usapambane chifukwa amatsutsa zizindikiro za mtima kulephera m'njira zosiyanasiyana. Zosankha zikuphatikizapo:
Ophwanya Beta : Ophwanya Beta-Zebeta (bisoprolol), Coreg (carvedilol), ndi Toprol (metoprolol) -gwiritsiridwa ntchito pamtima kusokonezeka chifukwa amachepetsera mtima. Izi zimapangitsa mtima kudzaza kwathunthu musanayambe kuthamanga, zomwe zimapereka thupi ndi magazi ambiri ndi chikho cha mtima.
Izi zimathandiza kuchepetsa zina mwa kutopa zomwe mungathe kuzipeza chifukwa cha kulephera kwa mtima.
Diuretics : Diuretics ndi mankhwala omwe amalimbikitsa kuthetsa madzi m'thupi mwa kuchita pa impso. Izi zimachepetsa mpweya ndi kuperewera kwa mpweya wolephera, popeza zizindikiro zonsezi ndi zotsatira za mphamvu yamadzi m'thupi.
Mankhwala ogwiritsidwa ntchito kawirikawiri amatchedwa Lasix (furosemide), Bumex (bumetanide), ndi Esidrix (hydrochlorothiazide). Mazamu a potaziyamu akhoza kukhala otsika ndi ntchito ya diuretic, kotero mchere wothandizira angapangidwe.
Mankhwala a Angieotensin (ACE) inhibitors : Mankhwala awa amagwira ntchito mwachindunji pamitsinje ya thupi ya thupi kuti athetse kupanikizika kumene mtima wanu ukuyenera kutsutsana nawo. Ambiri omwe amagwiritsa ntchito ACE omwe amagwiritsidwa ntchito mu mtima wolephera kuphatikizapo Prinivil ndi Zestril ( lisinopril ), Lotensin (benazepril), Capoten (captopril), Vasotec (enalapril), ndi Monopril (fosinopril).
Angiotensin II receptor blockers (ARBs) : ARBs zimagwira ntchito pochepetsa kuthamanga kwa magazi, zomwe zimachepetsa kupweteka pamtima. Zitsanzo za ARB zimaphatikizapo Losartan (Cozaar) ndi Benicar (olmesartan).
Aldosterone antagonist: Aldosterone antagonists, monga Aldactone (spironolactone), ntchito motsutsana hormone wotchedwa aldosterone ndi kuchotsa madzi kuchokera thupi. Amadziwika kuti "potassium-sparing," chifukwa amaletsa chiwerengero cha potassium m'thupi kuti chichepetse.
Hydralazine ndi nitrates: Kuphatikizana kumagwira ntchito yochepetsera (kuwonjezera) mitsempha, kutsika kwa magazi. Izi zimalepheretsa kukhumudwa kwa mtima, komwe kumachitika pamene mtima umapopera kupsyinjika kwa zaka.
Neprilysin inhibitors : Entresto ndi kuphatikizapo valsartan, ARB inhibitor ndi wothandizira, sacubitril. Sacubitril imaletsa maantimicine neprilysin, kuwonjezera kuwonjezeka kwa mitundu ya peptides ya natriuretic, yomwe imathandiza kuchepetsa kuthamanga kwa magazi, komanso mchere ndi madzi. Ichi ndi chithandizo chatsopano cha mtima wosalimba, ndipo zotsatira zake poyerekeza ndi mankhwala ochiritsidwa, komanso zotsatira zake za nthawi yaitali, sizikumvetsetsanso.
Dopamine: Pochititsa mtima kugunda mwamphamvu, dopamine imathandiza kuti magazi azikhala olemera kwambiri. Dopamine imachulukitsa kuchuluka kwa mkodzo womwe thupi limapanga, zomwe zimathandiza thupi kuchotsa madzi owonjezera m'mapapo, mikono, ndi miyendo.
Chochititsa chidwi n'chakuti mosiyana ndi mankhwala ambiri omwe amagwiritsidwa ntchito pamtima kusokonezeka kwa magazi, dopamine imayambitsa kuthamanga kwa magazi. Nthawi zina, zotsatirazi ndi zothandiza chifukwa kutsika kwa magazi kumakhala kovuta mumtima.
Dopamine si nthawi yoyamba yothetsera chisamaliro cha mtima, koma ndiwothandiza makamaka kwa ana asanabadwe ndi ana omwe ali ndi mavuto ena amtima. Zimatha kuwonjezera mitima ya ana ndi kuthamanga kwa magazi, makamaka kuwonjezera mwayi wawo wopulumuka. Dopamine sayenera kutengedwa ndi beta blockers , yomwe imatalika ndi kulimbitsa zotsatira zenizeni za dopamine.
Zothetsera Pakhomo ndi Moyo Wamoyo
Ngati muli ndi vuto la mtima, zithandizo zapakhomo ndi kusintha kwa moyo wanu ndizofunikira kwambiri pakuyang'anira matenda anu. Ngakhale kuti njirazi sizingathetse vuto la mtima, kusatsatira zotsatirazi zikugwirizana ndi kuwonjezereka kwa zizindikiro za mtima kulephereka ndi kupitirira kwa matendawo.
Kuletsa kwa mchere: Kugwiritsa ntchito mchere kumakhudzana ndi kuchuluka kwa madzi m'thupi. Ichi si vuto kwa anthu a thanzi, pamene thupi lingathe kusinthanitsa ndi kuthetsa madzi owonjezera ndi mchere mokwanira. Komabe, ngati muli ndi vuto la mtima kapena matenda a impso, izi sizingachitike moyenera monga momwe ziyenera kukhalira, kuwonjezera mwayi wanu wokhutira madzi. Anthu ambiri omwe ali ndi vuto la mtima amazindikira kuti zizindikiro za kutupa ndi kupuma kwapang'ono kumawonjezeka ndi kuwonjezeka kwa mchere. Mukhoza kulandira uphungu kwa dokotala wanu kapena dokotala ponena za kuchuluka kwa mchere womwe mungathe kudya tsiku ndi tsiku.
Chakudya : Kudya chakudya chopatsa thanzi nthawi zonse, popanda cholesterol ndi mafuta (makamaka mafuta opatsirana) , kungathandize kupewa matenda a mitsempha (CAD) ndi kulephera kwa mtima kuti zisapitirire.
Kuwona kulemera kwanu : Kukhalabe ndi thanzi labwino kumathandiza kuteteza mtima wanu ku zolemetsa za kukakamizidwa kupopera magazi kuti muthandize thupi lolemera-nkhawa, monga vuto m'mtima liri kale vuto mu mtima wosalimba. Kuti muchepetse kulemera, mungafunike malangizo kwa odyetserako zakudya, omwe angayang'anitse zakudya zanu kuti muwone ngati muyenera kudula mafuta, mafuta, kapena makilogalamu ambiri.
Zomwe mukuchita : Kukhalabe wokhutira kumateteza mtima wanu kumaso. Ngati muli ndi vuto la mtima, nkofunika kuti muzichita masewera olimbitsa thupi ndikuchita mwanzeru, ngati kuwonjezereka kungakhale koopsa pamtima wanu. Lankhulani ndi dokotala wanu za chiwerengero cha mtima wanu pa nthawi yochita masewera olimbitsa thupi kuti muonetsetse kuti simukuchita nawo ntchito yomwe ikukuphwanyani.
Ndondomeko Zoyendetsedwa ndi Zapadera
Kuchita opaleshoni kapena njira zina sizichiritsa mtima kulephera. Komabe, amatha kusintha ntchito ya mtima, kuyendetsa mtima wosasinthasintha, kapena kukonzanso zida za mtima, zomwe zingakhale zoyenera komanso zopindulitsa kwa ena-ngakhale osati onse-anthu omwe ali ndi vutoli.
Kumangidwanso kwapakitala: Chombo chopangidwa ndi pacemaker chomwe chimagwiritsidwa ntchito pofuna kuteteza kufa kwadzidzidzi kwa anthu omwe ali pachiopsezo chachikulu chotere. Ngati nthendayi yotayika imapezeka, munthu amene amatha kuyambitsa matendawa amatha kukhumudwitsa mtima kuti abwezeretse chiyero kumbuyo.
Kachilombo ka mtundu wa cardiac (CRT): Chida cha CRT ndi pacemaker yapadera yomwe imatha kugwirizanitsa ntchito ya kupopera kwa mtima wa kumanja ndi kumanzere, kuti zitheke bwino. CRT ikhoza kukhala yothandiza kwa anthu osankhidwa omwe ali ndi vuto la mtima omwe ali ndi mitundu yambiri yamatabwa.
Zonsezi zikhoza kuchitika mu chipinda chogwiritsira ntchito kapena mu chipatala chapadera cha chipatala. Kaŵirikaŵiri zimachitidwa pansi pa anesthesia wamba ndipo amavomerezedwa bwino. Anthu ambiri amakhala m'chipatala kuti awonetsere kwa maola 24.
Kumeneko kumalo osungira chithandizo (LVAD): LVAD ndi mapampu ogwiritsidwa ntchito ndi batri omwe amapangidwa m'thupi kuti athandize mtima pakupopera. Poyambirira iwo ankawoneka ngati njira yothandizira mtima kwa anthu omwe anali kuyembekezera kusintha kwa mtima, koma ndi othandiza ndipo angagwiritsidwe ntchito ngati ndondomeko ya nthawi yayitali.
Kuyika kwa zipangizozi kumafuna anesthesia wambiri ndi nthawi yowonongeka kwa masiku angapo. Muyeneranso kuyembekezera gulu lanu lachipatala kuti liziyesa momwe ntchitoyo ikugwiritsidwira ntchito posakhalitsa nthawi ndi nthawi.
Kuika pamtima : Kuika mtima ndi njira yomwe mtima wako amawachotsera opaleshoni ndikutsitsimutsa mtima wa wopereka. Imeneyi ndi njira yaikulu yopaleshoni, yomwe imakhala ndi matenda ambiri a anesthesia komanso kuyang'anitsitsa kwakukulu pa opaleshoni. Muyenera kuyembekezera kuyang'anitsitsa pafupi ndi opaleshoni, masabata angapo akuchira, komanso ndondomeko ya kukonzanso mtima pamapeto pake.
Kuperekera kwa catheter : Kupereka kwa catheter ndi njira yomwe imalepheretsa ntchito zamagetsi zolakwika zomwe zimayambitsa mtima wamtundu wosasintha popanga zilonda m'madera omwe amayambitsa mavuto. Mungapindule ndi ndondomekoyi ngati muli ndi mtima wosasinthasintha.
Mukhoza kukhala ndi chipatala mu chipinda chogwiritsira ntchito kapena mu chipatala chapadera chotsatira mu chipatala. Mukhoza kuyembekezera kuti mwamsanga mwamsanga ngati njira yanu ili yophweka.
Kuikapo valve: Chotsitsimutsa mtima wamagetsi chimatha kuchepetsa kuyimitsa kwa magazi chifukwa cha mawonekedwe osadziwika a valve. Izi zikhoza kukhala ndondomeko ya chizoloŵezi, kapena zingakhale zozama kwambiri, malingana ndi kuopsa kwa vuto la valve ndi ma valves angati omwe akukhudzidwa.
Kupuma kwa mtima kumagwiritsa ntchito valavu yopangira kapena yodziwika ndi minofu ya anthu kapena nkhumba. Ndi mtundu wanji wamagetsi wotsitsi wamtima umene umakhala wabwino kwa inu kumadalira vuto lanu la mtima wa valve wa mtima ndi zokonda zanu.
Mankhwala Ophatikiza (CAM)
Pali njira zina zochiritsira zosagwiritsidwa ntchito zomwe zatsimikiziridwa kuti zimapindulitsa mu kuyang'anira mtima kulephera. Njirazi sizichiza kapena kusintha vutoli, ndipo sizinatsimikizidwe kuti zikhale ndi moyo wambiri. Komabe, akhoza kusintha zizindikiro ndi kuthandizira kupeŵa kupweteka mtima kwa mtima.
- Kutenga thupi kumaganizo: Njira monga yoga, tai-chi. zojambula, biofeedback, ndi reflexology nthawi zambiri amachita ndi kutsogolera ndi kuyang'anira katswiri wodziwa bwino. Kafukufuku wasonyeza kuti mapulogalamuwa angapereke phindu lochepa kwa anthu omwe ali ndi mtima wolephera.
- Kupanikizika kwapanikizika : Kusamalidwa maganizo pogwiritsa ntchito njira monga kusinkhasinkha, uphungu, kulingalira, ndi kusintha kwa moyo wanu zonse zasonyezedwa kuti zikhale zopindulitsa pamtima kusalimba. Kawirikawiri, pali njira zosiyanasiyana zoyendetsera nkhawa, ndipo ndikofunikira kusankha njira yomwe ikugwirizana bwino ndi umunthu wanu.
- Curcumin: zonunkhira zakuthupi zomwe zimachokera ku mchere, curcumin zasonyeza malonjezano oyambirira pamtima kusalidwa kwa zinyama. Sitikudziwika kuti kulimbikitsa kapena kuteteza mtima kulephera kwa anthu.
Njira Zochiritsira Zambiri
Mankhwala osokoneza bongo sakhala opindulitsa mu mtima wosalimba. Ndipotu, angapo angapangitse mtima kulephera. Ena angathenso kusokoneza mankhwala osokoneza bongo amtima, kuwaletsa kuti asamagwire ntchito moyenera. Ngati muli ndi vuto la mtima, ndibwino kuti musagwiritse ntchito mankhwala osokoneza bongo, ngakhale kuti mumakhala ndi thanzi labwino, osayang'anitsitsa ndi dokotala kapena katswiri wa mankhwala.
Zina mwa mankhwala omwe amagwiritsidwa ntchito kwambiri pazomwe mukuyenera kupewa ngati muli ndi vuto la mtima ndi awa:
- Non-steroidal anti-inflammatories (NSAIDs): Mankhwala monga aspirin, Advil kapena Motrin (ibuprofen), ndi Aleve kapena Naprosyn (naproxen) angachititse kuwonjezeka kwa magazi.
- Mankhwala osokoneza bongo omwe ali ndi pseudoephedrine (Sudafed, Actifed, Contrex, ndi Nyquil) angathandizenso kuwonjezera magazi.
Mankhwala oposa ena omwe amawoneka otetezeka kuti atenge ngati muli ndi vuto la mtima ndi awa:
- Chlortrimeton kapena Aller-Chlor (chlorpheniramine)
- Robitussin DM (guaifenesin ndi dextromethorphan)
- Claritin (loratadine)
Koma kachiwiri, nthawi zonse ndi bwino kuyendera dokotala musanayambe mankhwala atsopano ngati muli ndi vuto la mtima.
> Zotsatira:
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> Ichijo S, Miyazaki S, Kusa S. et al. Zotsatira za kuperekera kwa catheter kwa mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana kwa nthawi yaitali kwa odwala omwe ali ndi vuto la mtima. J Cardiol. 2018 Mar 30. pii: S0914-5087 (18) 30063-7. lembani: 10.1016 / j.jjcc.2018.02.012. [Epub patsogolo pa kusindikiza]
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> Verbrugge FH, Martens P, Ameloot Ket al. Spironolactone ikulitsa natriuresis mu kusokonezeka mtima kwa mtima ndi matenda a cardiorenal. Acta Cardiol. 2018 Mar 27: 1-8. lembani: 10.1080 / 00015385.2018.1455947. [Epub patsogolo pa kusindikiza]
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