Sinoatrial misa: zvinokonzera, kurapwa. Vachivavhiringidza mumoyo mutinhimira

Sinoatrial nechigumbuso - mamiriro pathological icho pamwe nyonganyonga zvakasikwa mwoyo mutinhimira. myocardial mugove asynchronously akaderedzwa, kwamakadarika pane pfupi asystole. Sezvingatarisirwa, zvakadai rusvingo iri ngozi. Varwere vakawanda vari kutsvaka mamwe mashoko nezvechirwere ichi. Sei blockade hwapedyo? Kana pane chero zvekunze zviratidzo? Ndezvipi kurapa anopa mushonga ano? Mhinduro dzemibvunzo iyi ichava kufarira vaverengi vazhinji.

Ndeipi sinoatrial misa?

Kuti kutsanangura zvokurwara, kutanga unofanira kuteerera anatomical uye vasiri zvechadenga dzevanhu myocardium. Sezvaunoziva, moyo - muviri aoma zvionera. rutapudzo Its inopiwa nebasa rinokosha ganglion, izvo zvidzidzo tsinga nomunhu.

Chinokosha vatyairi ose cardiac mutinhimira ndiyo sinus raiva pedyo nebundu. Riri pakati kurudyi atrial manda uye kuvhurika pakati pevane vena cava, munzvimbo rworudyi atrium rusvingo. Sinoatrial remubatanidzwa ane mapazi akawanda, kusanganisira danda Toreli, Bachmann, Wenckebach - kuzvibata nomunhu kumasvingo vose atria. Nokuvhiringidzirwa huta zvairatidza pane ichi nzvimbo uye kufona blockage sinoatrial raiva pedyo nebundu.

Saka, tikafunga zvokurwara mu mwoyo mutinhimira inova isina, zvichitungamirira asystole, izvo, chokwadi, aiva nengozi. Zvinonzi zviri zvisinganyanyi kuitika zvokurwara - zvinonzi chirwere muna 0,16% dzevarwere vari cardiology dhipatimendi. Uye maererano Statistical zveBhaibheri kazhinji vanotambura kutyorwa varume makore makumi mashanu. In nhunzvi, kutsauka akadaro ishoma.

Zvichida kukura blockade uye pauduku, asi kazhinji kunoitika pamusoro yaitwa vachiberekwa Organic myocardial kukuvara.

The kukonzera chirwere

Zvinonzwisiswa kuti CA-blockade haisi yakazvimirira chirwere. Zviri, asi chiratidzo dzimwe pathologies. Vanenge 60% varwere blockage vanotambura nechirwere chomwoyo. Uyezve, pane kazhinji zvokurwara pamusoro kumashure kana mushure myocardial infarction.

Uyezve, pane zvimwe zvikonzero zvinogona kukonzera nokuvhiringidzirwa wenguva mwoyo mutinhimira. zvinokonzera njodzi zvinosanganisira nemavhairasi uye kwemabhakitiriya myocarditis, uyewo cardio myocardio, calcification mwoyo tsandanyama vachiberekwa fomu cardiomegaly. Dzimwe nguva CA blockade ikabuda vanhu vachitambura kubva rheumatism.

Blockade of sinoatrial raiva pedyo nebundu anogona kukonzerwa kushandiswa zvakare guru mishonga ine cardiac glycosides, Beta-blockers, quinidine nezvimwe mishonga. Kutanga zvokurwara zvinowanzoita kuti nekumwisa potassium muropa. Sezvo basa moyo nokudzorwa ari vagus etsinga, zvibereko zvayo matauriro kungakonzera arrhythmias (simba kuvhunduka kana kunotevera pechipfuva, vakabata mamwe dzepanguva nemiedzo iyo kuwedzera basa etsinga harinzwi).

Zvikonzero zvinosanganisira zvimwe zvirwere kusanganisira mwoyo vharafu kuremara, kuvapo bundu muuropi, malfunctions thyroid akaratidza neBP, yomumuzongoza, encephalitis, neleukemia, chepfungwa vascular zvokurwara. Sezvaunogona kuona, pane zvakawanda zvinokonzera njodzi.

Blockade wokutanga dhigirii, uye mamiriro ayo

In mushonga ano rakakamurwa madhigirii matatu kwokuomerwa chirwere ichi. Mumwe nomumwe wavo ane pachake zvachiri. Most nyoro vaiona sinoatrial nechigumbuso wokutanga dhigirii. With zvokurwara kwakadaro neimwe kupomba kunoitika muna sinus raiva pedyo nebundu, ari atria rinosvika. Asi vakabata anouya neumwe kunonoka.

zvokurwara Izvi hazvigoni kuonekwa musi unonzi, electrocardiograph, uye hapana zvimwewo kuratidzwa - varwere vakawanda vanonzwa dzose. Diagnosing wokutanga dhigirii kunogona blockade panguva intracardiac subotnji.

Blockade dzeboka rechipiri: tsanangudzo pfupi

danho iri kukura zvokurwara inogona rakakamurwa mhando mbiri:

• Blockade pamusoro 2nd dhigirii rokutanga mhando conductivity anoteverwa zvishoma nezvishoma vasanyanye sinus raiva pedyo nebundu. Kwakadaro rwakavhunika dzinogona kutowanikwa chirwere musi unonzi, electrocardiograph. Panyaya zvokunze zviratidzo, varwere kazhinji chokunyunyuta pamusoro nekorasi dzungu, utera. Sezvo chirwere kakawanda muupenyu hwevanhu vari takananga, uye dzimwe nguva inopfuura kurasikirwa pfungwa kushatiriswa yakawedzera kurovedza muviri, simba chikosoro, unopinza madzoro musoro, uye zvichingodaro. D.
• Blockade 2 nd it dhigirii rechipiri mhando ratova achiperekedzwa chaiwo cardiac arrhythmia, izvo vanganzwa murwere. Somuenzaniso, mwoyo kutanga yakakura (munhu anogona kunzwa sunga), uye ipapo payakakurudzirwa Anodzivisawo, uye anoenderera mberi pashure kumbomira. In nguva asystole, murwere anonzwa rakapinza simba, kazhinji anorasikirwa kuziva.

Chii zviratidzo kubatana blockade kuti dhigirii rechitatu?

Zvokurwara kuti dhigirii wechitatu - yakakwana sinoatrial nechigumbuso. Panyaya iyi, iyo myocardium uye havana kugamuchira nomunhu kubva sinus raiva pedyo nebundu. Sezvinotarisirwa, zvokurwara kuonekwa pamusoro unonzi, electrocardiograph, nekuti murwere hwapedyo asystole pamusoro pakanyorwa zvizere conduction blockade. Saka pane saonekwa ectopic mutinhimira anoonga basa wechitatu hurongwa kwavatariri. Panguva ECG anogona kuonekwa kuti hapana zvivako PQRST.

mishonga

Pakarepo zvinofanira kutaurwa kuti zano kurapwa kunoenderana mhaka zvokurwara. Kana sinoatrial misa zvishomanana uye haisi kukanganisa upenyu murwere, chaiyo kurapa angasava zvakakodzera - mwoyo mutinhimira anogona kudzokera zvakajairika roga.

Kunyange zvakadaro, unofanira kubata zvikuru chirwere. Somuenzaniso, kana ari blockade kushatiriswa kuwedzera vagal matauriro, zvakakosha murwere, "Atropine" (chinotsiva "ephedrine", "Ortsiprepalinom", "isoprenaline"). Kuri kuti chero disruptions ose cardiac mutinhimira pamusoro pakanyorwa ane ovhadhozi, kushandisa zvinodhaka nengozi vanofanira kumiswa nokukurumidza uye edza kuuya muviri residues mishonga.

Zvinosuruvarisa, kazhinji ichi mutinhimira chainetsa zvinotungamirira kukura fibrosis ari myocardium. Muzviitiko zvakadaro, kuti pave nechokwadi chokuti dzose marwadzo kwomwoyo tsandanyama zvinogoneka chete chenguva magetsi dzishande.

rubatsiro First nokuti blockade

Sezvambotaurwa, kazhinji, blockage kukwana uye haisi zvakananga kutyisidzira upenyu murwere. Kunyange zvakadaro, mune zvimwe zviitiko, rimwe kumira nokupfuuridzirwa magetsi nomunhu kwakakwana kunotungamirira pakarepo vanorega mwoyo.

Kana mwoyo mutinhimira iri kuchengetwa chakakomba chipingamupinyi kune kumisa, ipapo akabata atrial pacing. Sezvaunogona vomanikidza eyeballs (zvinobatsira kuchinja mwoyo mwero) chiyereso pfupi. Zvinosuruvarisa, dzimwe nguva murwere kunoda yevanorwara zvikuru, cardiac masaja uye riine upenyu-kutsigirwa muchina.