Maola angapo oyambirira ndi ovuta
Kuopsa kwa mtima (komwe kumatchedwanso myocardial infarction , kapena MI) ndizochitika mwamsanga zachipatala. Kukhala ndi MI kumatanthawuza kuti imodzi mwa mitsempha yanu yamakono yatulukira mwadzidzidzi, ndipo minofu ya mtima yomwe imaperekedwa ndi mitsempha imeneyi ikuyamba kufa. Thandizo lachipatala loyambirira ndi loopsa ndilofunika kuti mukhazikitse dongosolo lanu la mtima ndi kuteteza kapena kuchepetsa mavuto a nthawi yaitali kuchokera ku matenda a mtima.
Zomwe Zikufunika Kwambiri Kuukira kwa Mtima Wopweteka
Choyamba chofunika mukatha kufika kuchipatala ndi MI chotheka ndi:
- Kuti muonetsetse kuti zizindikiro zanu (kuthamanga ndi kuthamanga kwa magazi) zimakhazikika
- Kukonzekera kuthana ndi mikhalidwe yoopsya yomwe ingawoneke (monga ventricular fibrillation )
- Kusankha ngati muli ndi MI
Kusanthula mtundu woopsa kwambiri wa matenda a mtima - malo opatsirana pogonana a ST-segment infyoction (STEMI) - nthawi zambiri zimakhala zosavuta kuti madokotala azichita. Zimatheka poyang'ana kusintha kwa khalidwe pa ECG .
Ngati muli ndi mawonekedwe ochepa a MI, omwe si STEMI (omwe amatanthauza kuti mitsempha sizimaletsedweratu), matendawa angafunike kuyesedwa - makamaka kuchuluka kwa mapulaneti a michere ya mtima , mapuloteni otulutsidwa m'magazi ndi maselo osokonezeka a mtima.
Ngati zikutanthauza kuti mukukhala ndi STEMI, masitepe amodzi ayenela kuthandizidwa kuti athetse kutseka kwa magazi ndikuthetsanso kuti magazi akuyenderera pamtunda.
Kodi Makhalidwewa Amachotsedwa Motani?
Pali njira ziwiri zowonjezeretsa kutsekemera kwachitsulo kosasinthika: mankhwala a thrombolytic ndi angioplasty ndi otupa .
Mankhwala opatsirana pogwiritsa ntchito mankhwalawa amatenga mankhwala osokoneza bongo (otchedwa "clot-busters", monga Activase (t-PA), streptokinase, urokinase, kapena anistreplase), omwe amatha kuthetsa mwamsanga magazi omwe atseka mitsempha.
Kafukufuku wasonyeza kuti pafupifupi 50 peresenti ya mitsempha yamakono ingatsegulidwe mwa kupereka mankhwalawa kumayambiriro kwa chifuwa cha mtima ndi omwe odwala omwe mitsempha yawo imatsegulidwa kumapeto ndi kuwonongeka kwa mtima kwambiri ndi mwayi wabwino kwambiri wopulumuka kwa nthawi yaitali.
Mu phunziro lililonse, mankhwalawa aperekedwa, ndibwino kuti apambane. Zotsatira zabwino zimapezeka m'maola atatu oyambirira; zotsatira zokhutiritsa zimapezeka pakati pa maola atatu kapena asanu; ndipo kupindula kwina kumawonekera mpaka maola 12, opanda phindu kapena phindu lokha pambuyo pake.
Njira yaikulu ya mankhwala opatsirana pogwiritsa ntchito mankhwalawa amachotsa magazi, ndipo mtundu uwu wa mankhwala sayenera kugwiritsidwa ntchito kwa odwala omwe ali pachiopsezo chachikulu chotuluka m'magazi (mwachitsanzo, ngati mwachitidwa opaleshoni yatsopano, mukhale ndi mbiri ya kupweteka chifukwa cha kuwonongeka kwa ubongo, kapena ali ndi kuthamanga kwa magazi kwambiri ).
Kugwiritsira ntchito angioplasty ndi stenting mmalo mwa mankhwala osokoneza bongo tsopano akuwoneka kuti ndiwothandiza kwambiri potsegula mitsempha yowonongeka mu MI. Angioplasty yofulumizitsa komanso yothamanga kwambiri imatsegula mitsempha yotsekedwa pafupifupi 80 peresenti ya nthawiyo. Zowopsya za njirayi ndizomwe zimakhala zovuta, ndipo ngati chipatalachi chimafuna kuti angioplasty ichitike mosavuta, kutsegula kwa mitsempha ya magazi kungatheke mwamsanga ndi mankhwala opatsirana.
Mfundo yaikulu, ziribe kanthu njira yomwe imagwiritsidwira ntchito, ndiyo kutsegula chotengera chodziwika mofulumira momwe zingathere. Izi zili choncho, kusankha pakati pa mankhwala opatsirana pogonana ndi angioplasty nthawi zambiri kumadalira zochitika.
Akatswiri ambiri a zamoyo amatha kusankha angioplasty ngati labata yawo yothandizira anthu akhoza kuyendetsedwa mofulumira, ndipo ogwira ntchito zamadzidzidzi amapezeka mosavuta. Njira yowonongeka iyenso idzasankhidwe ngati pali chifukwa chabwino chopezera chithandizo chamtunduwu.
Komabe, ngati nthawi zina zimakhala zochepa kwambiri kuti achite opaleshoni ya angioplasty, kapena ngati pali chifukwa chabwino chopewera njira yowonongeka, ndiye kuti chithandizo chabwino cha thrombolytic chidzakhala bwino.
Njira ziwirizi zikhoza kukhala zogwira mtima kwambiri ngati ziperekedwa mofulumira. Chinthu chofunikira kwambiri sichigwiritsa ntchito njira, koma kuti muchite mofulumira. Nthawi ndi yeniyeni, ndipo njira yosankhidwiratu iyenera kukhala njira iliyonse yomwe ingathe kutsegula mitsempha mofulumira kwambiri.
Kuwonjezera pa kutseka mitsempha yotsekedwa mwamsanga, palinso mankhwala ena ambiri amene ayenera kuperekedwa pa MI.
Kodi Ndi Njira Ziti Zochiritsira Zina Zimene Ziyenera Kuperekedwa Panthawi Yopweteka Kwambiri ya Mtima?
Kuwonjezera pa kuchita mofulumira kuti mutsegule chotengera chowoneka ndi kubwezeretsa magazi ku minofu ya mtima wanu, zingapo zingapo ziyenera kuthandizidwa pokuchizani pa MI. Izi zikuphatikizapo:
Aspirin
Kutenga aspirin (theka la aspirin wamkulu wamkulu wosapyoledwa, wochepetsedwa kapena woponderezedwa) mwamsanga ngati nthawi iliyonse MI (kapena mtundu uliwonse wa aconic coronary syndrome ) akukayikira akhoza kusintha kwambiri zotsatira. Aspirin imagwira ntchito pochepetsa "kukhuthala" kwa mapulogalamu a magazi ndipo motero imaletsa kukula kwa magazi omwe amachititsa MI.
Heparin
Kupatsa heparin yowopsa kapena magazi ochepa mkati mwa maola 24 oyambirira a vuto lalikulu la mtima mwinamwake limachepetsa kufa kwa nthawi yaitali. Mankhwala a antiticoagulant , omwe heparin ndi amodzi, amathandiza kupewa kapangidwe ka magazi atsopano .
Ophwanya Beta
Olemba Beta, mankhwala omwe amalepheretsa zotsatira za adrenaline, amathandiza kwambiri odwala omwe ali ndi MIs, ndipo ayenera kupatsidwa kwa odwala onse pokhapokha pali chifukwa cholimba (monga matenda a m'mapapo, kufooketsa mtima , kapena kuchepa mtima mitengo). Mankhwalawa nthawi zambiri amayamba tsiku lotsatira matenda a mtima.
ACE Inhibitors
Angiotensin kutembenuza mazira a ACE (inhibitors) awonetseredwa kuti akuwongolera kwambiri zotsatira za odwala omwe ali ndi matenda aakulu a mtima kapena zizindikiro za mtima wosalimba. Odwalawa ayenera kuyamba ACE inhibitors pa maola 24 oyambirira atatha kudwala matenda a mtima. ACE inhibitors angathandizenso odwala omwe amavutika kwambiri ndi mtima.
Statins
Mankhwala opangidwa ndi zilembo ayenera kuyambika kwa odwala onse omwe ali ndi MI asanafike kuchipatala, ndipo mwinamwake mwamsanga pokhapokha mutayambitsa matenda a mtima. Ma Statins amawoneka kuti apambana moyo pambuyo pa MI ngakhale kuti palibe cholesterol, mwinanso kuchepetsa kutupa kapena kukhazikitsa miyala yamitengo yowonjezereka.
Pambuyo pa maola 24 oyambirira
Maola 24 oyambirira ndi ovuta. Kupeza thandizo lachipatala mofulumira momwe mungathere n'kofunika kuti muteteze mtima wamkati , kuteteza mtima wanu wamisala, ndi kuteteza kuwonjezera magazi kuti asapangidwe mu mitsempha yanu yamakono.
Koma ngakhale mutatha kukambirana bwino tsiku loyamba lovuta, palinso ntchito zambiri zoti muchite. Kuvutika kwa mtima sikungokhala kokhakokha komwe, kamodzi kupirira, kukhoza kuiwalika. Ndithudi kupulumuka ku matenda a mtima kumafuna khama lopitirira pa gawo lanu, ndipo pa gawo la dokotala wanu.
Zotsatira:
> Antman, EM, Hand, M, Armstrong, PW, ndi al. Zotsatira za 2007 / AHA 2004 Zotsatira za Ulamuliro wa Odwala Ndi ST-Elevation Myocardial Infarction: Lipoti la American College of Cardiology / American Heart Association Task Force on Practice Guidelines (Gulu Lolemba Kukambitsirana Umboni Watsopano ndi Kukonzekera ACC / AHA 2004 Malangizo Otsogolera Odwala Odwala ST-Elevation Myocardial Infarction). J Am Coll Cardiol 2008; > 51: XXX >.
> Cannon, CP, Hand, MH, Bahr, R, et al. Njira zovuta zothandizira odwala omwe ali ndi syndromes yamakono: kuyesedwa ndi Pulogalamu ya National Heart Attack Alert Program. Amtima J 2002; 143: 777.