Decompensated mwoyo kutadza - chii? Zviratidzo neMarapirwo

Anosangana ndanyarara hangu uye decompensated mwoyo nokukundikana. Ndanyarara hangu anonzi munyoro kushaikwa (1st Danho).

Decompensated mwoyo kukundikana chinhu chinouraya pavaipfuura chirwere, kunobva pakuti dzaparadzwa pomwoyo hakusi kununura ropa kuti siyana yaishandiswa mugadziriro womunhu muviri. A maitiro chinhu chinoratidza kwete chete panguva yechiitwa, asiwo zororo. Kazhinji kana decompensated mwoyo kutadza kuitika yakatikurei pathological uye dzichipfekeka kuchinja cardiac. kuchinja ava kazhinji kusingarapiki uye zvinogona inouraya. Izvi mhando zvokurwara chokuita zvikuru (wechitatu Danho).

Munyaya ino, decompensated mwoyo kukundikana ichakurukurwa munyaya zvakadzama: chii, ndedzipi mhando dzakasiyana, zviratidzo chirwere uye pazvinobvira kurapwa.

Zvinokonzera SDS

Zvinosuruvarisa kwakabva chirwere ichi nemasayendisiti haasi aizvinzwisisa. Zvisinei, tsvakurudzo munharaunda iyi kunoratidza kuti decompensated mwoyo kukundikana kunogona kuitika kana paine ude. Zvinhu izvi zvinogona kuva kunokonzera chirwere. Pakati pavo:

• Myocardial hypertrophy.
• Kwakakonzerwa chemwoyo, kunotevera, ischemia kana infarction myocarditis shanduko STRUCTURAL kuvimbika.
• Vane chirwere cheBP dambudziko.
• Arrhythmic zviitiko.
• Zviitiko pakarepo vachimanikidzwa kuwedzera pulmonary riparadzirwe.

Saka zvinoratidza pacharo decompensated mwoyo kukundikana. Chii huchikosha vakawanda.

On a ndima chete pamusoro apa ndiwo zvinokonzera chirwere anogona zvose zvemarudzi mira pezvakaitwa ari kufema hurongwa. Muzviitiko zvose izvi pane Kazhinji: ari SDS, uyewo dzimwe mhando mwoyo kukundikana kunoitika pamusana yakaoma zadzisa uye kunyanya kuneta mwoyo tsandanyama.

The kunotoda mufananidzo uye zvakasiyana-siyana decompensated mwoyo nokukundikana zvinorondedzerwa pazasi.

Usati watanga kudzidza SDS zviratidzo, zvinofanira kucherechedzwa kuti kunotoda mufananidzo chirwere zvachose novimba mhando mwoyo kukundikana. Nyanzvi ziva maviri mhando - chirwere uye chakasimba. Ngationei kugara nomumwe wavo.

Chenjera decompensated mwoyo kutadza

It unovapo uye vanova pashure akurumidze decompensation, panowanikwa muripo pazviri pasingabviri. Zvigadziriswe mwoyo kukundikana, akadai yakawedzera venous matauriro, vakawedzera tonic basa kana kuwedzera uwandu ventricular diastolic rokuzadza neropa, haagoni kuonekwa nokuda vasiri zviri chakasimba siyana SDS. Kune vaya zvinhu zvinosanganisira:

1. Kusiyiwa ventricular SDS nenzira rikwanise muchimiro. It kunokonzerwa myocardial kana mitral vharafu stenosis. The maitiro Zviratidzo zviri kunyanya mumatenhere mapapu uye kufema gadziriro overfilling ropa midziyo. Chiizve chinoitika decompensated mwoyo nokukundikana? Zviratidzo ichataura gare gare.
2. Right ventricular SDS nenzira rikwanise muchimiro. Kunoitika nokuti Kutamiswa murwere infarction kana thromboembolism, zvichizoita kwakakanganiswa nerevane kuvimbika mezhduzheludochkovoy septum. Typical zviratidzo chakasimba kuruboshwe ventricular SDS sezvinotevera: pane yakapinza yakawedzera chiropa, ropa stasis ndee kuna systemic kuparadzirwa, mapapu anogona kuzadza neropa.

The chenjera muchimiro ngozi?

Zvinosuruvarisa, nokuti rikwanise chimiro dzinoratidzwa yakakwirira azvipire fatalities nokuti kuti mwoyo tsandanyama rinova kugona kudzinga kutsvakwa huwandu ropa uye is muripo kushanda (kana kukwana), uye nokuda pulmonary edema kana myocardial infarction. Kana zviratidzo chakasimba siyana SDS kukurumidza kupindira nyanzvi kuti achaisa murwere muchipatara uye abate nhevedzano nezviito zvinodiwa nokumutswa.

Zvinoitawo unowanikwa chisingaperi decompensated mwoyo kukundikana. Chii? On ichi akazotevera.

The chirwere muchimiro SDS

CHF anogona kuitika mune decompensated chimiro. Muchiitiko chino, zviratidzo zvakasiyana-siyana zvinogona kuratidza, rose Specification uko anoitwa chirwere nemiedzo. Nokuti CHF mamirire ndiye mufananidzo uyu zvekuchipatara:

• Zviratidzo chakakomba mumatenhere netsoka, pasi mudumbu, scrotum, uyewo vari pericardium.
• Arrhythmia uye hypoxia.
• chando nemakumbo syndrome.
• The unopinza kuwedzera uremu muviri.
• Kuratidza mitral uye tricuspid insufficiency.
• Kuonekwa kupfupika mweya, kusanganisira kusavapo kurovedza muviri.

Decompensated chisingaperi mwoyo nokukundikana - munhu zvokurwara, panguva iyo kazhinji pachena hadzina kufambiswa zvakanaka munyika kufema ino. pulmonary rales (kana murwere ari supine nzvimbo) anogona kuonekwa ne rokuongorora vashandi. Mhosva kuratidzwa akadaro kunyanya ropa riyerere kune kufema hurongwa. Chimwe chiratidzo angava hypoxia uye, somugumisiro, richikwidibira pamusoro chavanoziva. Hypoxia kunoitika somugumisiro kukwana ropa wedzerai uropi musoro okisijeni kukanganisika.

Zvakakosha kuti nenguva kubata chirwere chakadai, zvakadai chisingaperi decompensated mwoyo nokukundikana (chii ikozvino pachena).

Diagnostics

Complex chirwere matanho anosanganisira kudzidza chechetere kuchinja ureticheskogo peptide Beta-mhando, H-kwazvakarerekera peptide, uye kuitisa echocardiography uye X-ray viscera, transkoronalnoy echocardiography.

Kunyatsoenderana ruzivo pamusoro nesimba BP mumwoyo mumakamuri vanachiremba chingawanikwa aite chaiyo muitiro, panguva iyo musimboti tsinga kana pulmonary tsinga anobudisa mushonga zvishoma nezvishoma uye kubereka zvaida chipimo.

Uyewo, chirwere chipi chakafanana nomwoyo kukundikana kuita dzakawanda Murabhoritari nemiedzo, kusanganisira bvunzo ropa creatinine uye urea, nokuti electrolytes, shuga uye transaminases, mutambo mamwe ropa uye weti miedzo; kudzidza. kuvapo uye nhamba magasi muropa arteries

Decompensated mwoyo kutadza: Treatment

Maererano Statistical Data kuti 2010, kubva mumwoyo kukundikana muRussia gore negore inouraya anenge mamiriyoni 1 vanhu. Ndicho panowanikwa decompensation uye mwoyo mutinhimira nenyonganiso anonzi nyanzvi chikuru chikonzero vapamatunhu mwero wokufa kwevanhu. Decompensation zvinowanzoda pakarepo zvokurapa kupindira. Saka, kunze zvisingawanzoitiki kunze, zvinodhaka kurapwa iri kwakaitwa kutungamirira mushonga nomutsinga (kuwana aidzora uye nokukurumidza zvabuda).

More pamusoro nokurapa decompensation

Chinangwa kurapa ndeyokubatsira kuramba chakaipa Chizenga okisijeni saturation pamwero, nokudaro kubvumira kuti kuipa wedzerai reokisijeni kuti nyama uye nhengo uye kudzivisa vakawanda nhego kukundikana.

Mumwe nzira zvinoshanda - kuitisa inhaled okisijeni (kazhinji kushandiswa non-invasive kufefetedza (NPVD) pasi yakanaka kumanikidzwa), iyo anobvisa kudiwa endotracheal intubation. The yokupedzisira rinoshandiswa kuti zvokuimba kufefetedza kana yokukundikana kubvisa obstructive pulmonary chirwere ne NPVD.

Kurapa ne mishonga

Pakurapa decompensation kushandiswa kusanganisira zvinodhaka mishonga. Used zvinodhaka uye mapoka avo;

• "Morphine" uye ayo analogues. Rinoshandiswa kuderedza kwemwoyo uye kuderedza marwadzo.
• Diuretics. Anoshandiswa mvura kunonoka nezviratidzo mumuviri;
• Inotropes kubvisa peripheral hypoperfusion.
• Vasopressor nevasori kuti kukura kwomuzvarirwo nhego perfusion.
• "Dobutamine" inowedzerawo cardiac goho.
• Norepinephrine anovandudza vascular nemishonga.
• Cardiac glycosides kuderedza BP, yekuzvidzivirira rikwanise decompensation.

Zvisinei, imwe ndandanda yakarurama zvakafanira mishonga nokuti zororo uye vabatwe SDS ndiko kuziva uye kuita chete kupinda chiremba.

Takurukura zvazvinoreva decompensated mwoyo kutadza.