Mtundu Wopambana Wopweteka Mtima
Mapeto a ST-sepactial infarction (STEMI) amatanthauza kuti cardiologists amagwiritsa ntchito kufotokozera zakukhosi kwa mtima. Ndi mtundu umodzi wa matenda a myocardial infarction imene mbali ya mtima wamisala (myocardium) yafa chifukwa cha kulepheretsedwa kwa magazi kumalo.
Gawo la ST limatanthawuza chigawo chophatikizira cha kuwerenga kwa electrocardiogram (ECG) ndikuyimira mphindi pakati pa zipsinjo zamtima.
Pamene munthu ali ndi matenda a mtima, gawo ili silingakhalenso lopanda kanthu koma liwoneka ngati losavomerezeka.
Mitundu ndi Kuvutika STEMI
STEMI ndi imodzi mwa mitundu itatu ya matenda oopsa a m'mimba (ACS) . ACS imachitika pamene chikwangwani chimaphulika kuchokera mkati mwa mitsempha yamakonzedwe, kumayambitsa chisokonezo chapadera kapena chokwanira cha mitsempha imeneyo. Kutsekemera palokha kumayambika pamene magazi amatha kupanga mawonekedwe mozungulira.
Pakabisala, gawo la mtima wa mitsempha yomwe imagwiritsidwa ntchito ndi mitsemphayi imakhala yosafulumira chifukwa cha kusowa kwa mpweya, wotchedwa ischemia . Mazunzo pachifuwa ( angina ) kawirikawiri ndi zizindikiro zoyambirira za izi. Ngati kulepheretsa kuli kokwanira, minofu ya mtima imayamba kufa, zomwe zimayambitsa matenda a myocardial infarction.
Timagwiritsa ntchito ACS pamtunda wa chitetezo ndipo zotsatira zake zimayambitsa minofu ya mtima:
- Ngati kuletsa kwathunthu kwa mitsempha yamtunduwu kumapezeka, zomwe zimachititsa imfa ya minofu ya mtima, timatchula kuti STEMI, mtundu woipa kwambiri wa ACS.
- Komabe, nthawi zina, mawotchi amapanga, amasungunuka, ndi kubwezeretsanso nthawi kapena maola osapangika. Izi zikachitika, munthuyo akhoza kuyambiranso kubwereza angina ngakhale pamene akupumula. Mtundu uwu wa ACS umatchedwa angina wosakhazikika .
- Pakati pa STEMI ndi angina osakhazikika ndilo vuto limene ena amanena kuti ndi "matenda a mtima". Izi zimachitika pamene kusokoneza sikulepheretsa magazi kuyenda. Ngakhale kuti maselo ena amatha kufa, mbali zina za minofu zidzatha. Mawu azachipatala a izi ndi mbali ya ST-segment infyoction infarction ( NSTEMI ).
Mosasamala kanthu kuti chochitika cha ACS chimasankhidwa, chimaonedwa ngati chithandizo chachipatala chifukwa chakuti angina osakhazikika ndi NSTEMI nthawi zambiri amasonyeza zizindikiro zoyambirira za matenda aakulu a mtima.
Zizindikiro za STEMI
STEMI idzabweretsa ululu waukulu kapena kupanikizika mkati kapena pafupi ndi chifuwa, nthawi zambiri kumatulukira ku khosi, mmawa, paphewa, kapena mkono. Kutulutsa thukuta, kupuma, ndi kumvetsa kwakukulu kwa chiwonongeko chomwe chikubwera chimakhalanso chofala. Nthawi zina, zizindikiro zingakhale zosadziwika bwino, kuwonetseredwa ndi zizindikiro zosavomerezeka kapena zapadera monga:
- Ululu wozungulira mapewa, mikono, chifuwa, mthunzi, mkono wakumanzere, kapena m'mimba
- Kumva kupwetekedwa mtima kotchulidwa kuti kukhala ndi "nkhonya mu chifuwa"
- Kusokonezeka kapena kumangirika m'khosi kapena mkono
- Kudzikuza kapena kupweteka
- Nsowa ndi kusanza
- Kutopa kapena kutopa mwadzidzidzi
- Kupuma pang'ono
- Chizungulire kapena kumutu
- Kuwonjezeka kapena kusasinthasintha kwa mtima wa mtima
- Clammy khungu
Monga chiwonongeko chachikulu, aliyense amene ali ndi chiopsezo chachikulu cha matenda a mtima ayenera kulipira mosamala chizindikiro chirichonse chachilendo chomwe chimachokera pamwamba pa m'chiuno.
Kuzindikira kwa STEMI
Nthaŵi zambiri, matenda a STEMI akhoza kupitidwa mofulumira kamodzi munthuyo ali kuchipatala. Kupenda zizindikiro, kuphatikizapo kuunika kwa gawo la ST pa ECG, nthawi zambiri ndikwanira kuti dokotala ayambe mankhwala.
Kuwunika kwa mapuloteni a mtima kumathandizanso koma kawirikawiri kumabwera bwino pakatha mankhwala ovuta.
Ndikofunika kukhazikitsa munthu mwamsanga mwamsanga. Kuwonjezera pa zopweteka ndi zowawa, STEMI ikhoza kupha imfa mwadzidzidzi chifukwa cha kuvutitsa kwapakati pa mtima (kapena kusokonezeka mtima kwa mtima) pamene mtima sungakhoze kupopera magazi okwanira kuti apereke thupi).
Pambuyo pa matenda a mtima atatha, minofu yokha imangotsala pang'ono kuwonongeka. Kulephera kwa mtima kusagwirizana ndi izi, monga momwe chiwopsezo chochuluka cha matenda a mtima oopsa (kupha mtima kosasinthasintha) kumakhala koopsa.
Chithandizo cha STEMI
Chithandizo chiyenera kuyamba pomwe STEMI imapezeka. Kuwonjezera pa kupereka mankhwala osokoneza mitsempha ya mtima (kuphatikizapo morphine, beta blockers , ndi mankhwala a statin ), kuyesetseratu kuyambanso kutsegula mitsempha yotsekedwa.
Izi zimafuna kufulumira. Pokhapokha ngati mitsempha imatsegulidwa mkati mwa maola atatu a kutseka, chiwonongeko chosatha chikhoza kuyembekezera. Nthawi zambiri, zowonongeka zingathe kuchepetsedwa ngati mitsempha imatsekedwa mkati mwa maola asanu ndi limodzi oyambirira a chiwonongeko. Mpaka maola 12, kuwonongeka kwina kungathetsedwe. Pambuyo pake, kutenga nthawi yaitali kutsegula mitsempha, kuwonongeka kwakukuluko kudzakhalapo.
Pali njira zingapo zothandizira kutsegulira:
- Mankhwala opatsirana pogwiritsa ntchito mankhwala osokoneza bongo amatanthauza kugwiritsa ntchito mankhwala osokoneza bongo.
- Angioplasty ndilo mankhwala omwe amachititsa opaleshoni / kukonzanso opaleshoni.
- Kuwongolera kumaphatikizapo kuika tiyi yamatope kuti atsegule mitsempha.
Katemera wa mankhwalawa atatha, ndipo mitsempha yotsekedwa imatsegulitsidwa, pali zambiri zomwe ziyenera kuchitidwa kuti zikhazikitse mtima, komanso kuchepetsa mavuto a mtima wina.
Izi nthawi zambiri zimaphatikizapo nthawi yambiri yochira, kuphatikizapo ndondomeko yowonetsera masewero olimbitsa thupi, kusintha kwa zakudya, komanso kugwiritsa ntchito anticoagulants (ochepa magazi) ndi mankhwala oletsa mankhwala.
> Chitsime:
> O'Gara, P .; Kushner, F .; Ascheim, D .; et al. "2013 ACCF / AHA Malangizo othandizira kulamulira kwa ST-elevation Myocardial Infarction: Chidule Chachidule: Lipoti la American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines." Journal ya American College of Cardiology. 2013; 61 (4): DOI: 10.1016 / j.jacc.2012.11.018.