Transmural infarction: zvikonzero uye fungidziro

Transmural infarction - nevakawanda uye ngozi chaizvo chirwere, icho pamwe necrosis mwoyo tsandanyama. Zvinofanira kucherechedzwa kuti vanourayiswa mwero iri huye zvokurwara chakafanana zvakakwirira chaizvo, kunyanya kana zviratidzo cardiac chirwere havana kuonekwa nguva, uye murwere havana kugamuchira zvakafanira kurapwa. Saka zvinokosha kuziva sei kuratidza fomu iri chomwoyo uye chii rubatsiro zvinodiwa kuti munhu anorwara.

Transmural myocardial infarction: chii?

Chokutanga, ngationei kubata zvinoreva izwi. Zvirokwazvo vazhinji unoziva kuti infarct ezvinhu vari pamwe ne unooma kuti zvikamu pomwoyo. Izvi zvinoitika nokuda chimbichimbi kumira ropa riyerere pamwoyo, zvichiguma zvinyama hamugamuchiri anodiwa upenyu okisijeni uye zvinovaka muviri.

Sezvo chikazozikamwa, mwoyo rusvingo inoumbwa matatu akaturikidzana - a epicardium (yokunze rukoko), seinäkartta tsandanyama rukoko uye endocardium (menzvimbo tsandanyama). Kana intramural chimiro necrosis chirwere chinobata chete chete rukoko. Chenjera transmural myocardial - zvokurwara, apo necrotic maitiro inogona kuonekwa akaturikidzana zvose mwoyo. Zvinonzi izvi muchimiro chirwere ichi chakaipa kwazvo.

In mushonga ano, zvokurwara iri Classified kwakavakirwa localization kuti foci kuti necrosis. Inonyanyoshandiswa kuchengetwa transmural myocardial infarction pamberi porusvingo, kureva kuruboshwe ventricle. chimwe chete kubva nyaya shanu, necrosis uye kunokanganisa zvakarurama ventricle rusvingo. About chetatu varwere muzvirongwa kwacho uye pamasvingo atria.

Zvinokonzera chirwere

Anenge ose nyaya, mugumisiro transmural myocardial ischemic mwoyo chirwere. Sezvambotaurwa, pamwe kukwana okisijeni uye zvinovaka muviri kuti tsandanyama masero vanotanga kufa - saka kutanga necrosis. Maererano nenhamba, 90% kuti zviitiko chikonzero ndiyo atherosclerosis pamusoro coronary midziyo, hunoita ropa riyerere kuti myocardium.

Pamadziro ngarava chakaumbwa vanonzi atherosclerotic Dombo. Nokupesvedzera zvimwe zvinhu plaques mugove Unokanganisa kubva parusvingo uye anovhara lumen ari coronary tsinga. Kazhinji chenjera transmural myocardial mberi nokukurumidza avo ezvinhu apo myocardial okisijeni kudiwa inowedzera zvikuru - ichi zvingaitika Somuenzaniso, ane simba mumuviri nesimba, fivha, zvikuru mupfungwa.

Chenjera transmural myocardial infarction: Zvinhu Risk

Sezvaunogona kuona, necrotic maronda kwemoyo hadzisi yakazvimirira chirwere. Kazhinji, vanokurukura pamusoro pakanyorwa hunotovapo atherosclerosis uye ischemia. Saka zvinoita kuti kuzviparadzanisa nevamwe uye zvinoverengeka njodzi:

• The majini kubatwa murwere kuti Rinobatanidzwa zvimwe anatomical zvinhu uye nhaka zvirwere.
• Zvinotora nzvimbo uye zera chinhu. Transmural myocardial kazhinji chirwere mune vanhu vanopfuura 45, uye vanhu tichikurumidza chirwere ichi.
• Inosimudzira pamwero remafuta akawandisa muropa (nokuti ichi fomu plaques pamasvingo midziyo ropa, vakazochinja kufukidza muropa).
• Usava kudya (kudya mafuta uye zvakakanyiwa namafuta zvokudya kunowedzera mukana wokuti dzichiri atherosclerosis).
• Kufutisa (izvo kakawanda Rinobatanidzwa murombo kudya uye uremu kunowedzera mutoro pamwoyo).
• Nokusarovedza muviri (ndakagara mararamiro kunotungamirira zvishoma nezvishoma kwakaderera mwoyo tsandanyama, kuti myocardium pashure zvakaoma chaizvo kutsungirira chero kurovedza muviri).
• Constant kushushikana, kurukutika, mupfungwa kunotungamirira kuchinja kwemakemikari omuviri chokuita kumwoyo.
• Kusvuta (maererano nenhamba, 35% kuti zviitiko myocardial necrosis chokuita tsika iyi yakaipa).

Main zviratidzo: sei kuziva chemwoyo?

Zviratidzo necrosis angava akasiyana - zvose kunoenderana dhigirii kukuvara, yomunhu zera, kuvapo concomitant zvirwere, etc. Pane zviitiko myocardial kuyerera asymptomatic ... Kunyange zvakadaro, vamwe huru zviratidzo ndiwo:

• Kazhinji, munhu anonyunyuta chakakomba compressive marwadzo seri breastbone - zvakajeka anopa rworuboshwe, ruoko, shaya, nzeve uye kunyange mazino.
• Marwadzo Wavy uye refu - kurwisa zvinogona kudzokororwa mumaawa mashomanana kana mazuva.
• Anovandudza tachycardia, murwere kazhinji anonzwa zvakanaka kakawanda uye kunyange kurwadza heartbeats.
• Panewo pfungwa pfupi rinooma mwoyo.
• Kune kunze zviratidzo chemwoyo - ganda uye mucous membranes womunhu payakakurudzirwa zvacheneruka.
• Tikafunga necrosis kazhinji kuva cardiac asima - murwere wakadaro kupfupika simba kufema, pakarepo yokurwiswa breathlessness.

chirwere matanho

Apo kukanganisa wokutanga anofanira zvifambiswe pakarepo munhu anorwara muchipatara muwadhi, apo chirwere uye kurapwa kwakakodzera rinoitwa. Huru chirwere nzira myocardial necrosis ndiko electrocardiography, nekuti kana zvakadaro nzira zvinobvira kugadzirisa yemagetsi potentials munzvimbo dzakasiyana dzenyika mwoyo.

Nemazvo akaita, uye decrypted unonzi, electrocardiograph rinobvumira chiremba yokuziva localization pakati necrosis (semuenzaniso, nechepazasi transmural mwoyo kurwisa), ukuru kuparadzirwa mumwe pathological kwacho uye lesion nokudzika, nguva yose chirwere.

Uyezve, unoda bvunzo ropa. Myocardial akaona kuwedzera erythrocyte sedimentation zvazvingava, vakawedzera uwandu leukocytes dzinowanika ropa dzakananga makemikari uye yeimwe izvo anowanzoita vari mukati myocardial muchitokisi.

Terms rwekutanga

Chenjera transmural myocardial infarction pamberi porusvingo - a zvokurwara kuti anovandudza nokukurumidza. Zviratidzo zvinogona kuitika chero nguva, unofanira saka uzive mitemo kubatsira murwere. Zvechokwadi, pakutanga kwezvose tinofanira kudaidza amburenzi.

Tichimirira vanachiremba, munhu anofanira pasi. An Kunze ndiko ezvinhu apo pane kupfupika simba kufema uye wheezing kana kufema vakasiyana - umo kana murwere nani chigaro, tucked pasi seri mutsago kana pamutsago. Zvinokurudzirwa kuti kutora asipurini. Munofanirawo kupa munhu nitroglycerin - Wokutanga piritsi, uye kana kurwadziwa asingadi kuenda, ipapo maminitsi mashanu gare gare mumwe (asi hapana zvinopfuura zvitatu).

Scheme nekurapwa myocardial

Zvichienderana vakawana zvabuda panguva nechirwere chiremba prescribes kurapwa. Kazhinji Initial kurapwa chinosanganisira chikuru zvikamu zvitatu:

• Kubvuma inonyaradza marwadzo omusoro kuderedza murwere ezvinhu. Kazhinji, marwadzo zvinogoneka kumisa chete tichibatsirwa mishonga simba, kusanganisira "Promedol" uye "Morphine". Pakuonekwa zviratidzo uye zvokuongorora kuti "myocardial infarction" ari kunetseka kuti munhu, uye mufaro, uye kutya chete anowedzera mutoro pamwoyo - murwere waakaudzwa sedatives.
• Zvimwe zvaiitwa inofanira kusanganisira kugamuchira nitrates uye Beta-blockers, izvo zvinobatsira kubvisa arrhythmia uye adzorere mwoyo mutinhimira.
• Kana transmural myocardial mukuru ndingangokuvara ropa clots, iro hwakazara necrosis nedzimwe nhengo uye kupararira muitiro pamusoro pedyo nzvimbo myocardium, tsinga maronda uye kunyange rufu. Naizvozvo, pakurwisa thrombosis vanofanira kutanga pakutanga maawa pashure kutanga zviratidzo. Nokuti chinangwa ichi, shandisa vasospasm kugadzirira ane heparin uye fibrinolysin. Sezvingatarisirwa, kana kushandisa zvinodhaka zvakadai chinowanzoitika muhombe ropa nokuti ropa clot rinomira, saka zvakakosha nokungwarira kuongorora murwere ezvinhu.

Treatment zvinenge hwakapedzerwa kuchipatara - murwere kumativi wachi inofanira kuva pasi chiremba kutarisirwa.

Migumisiro uye zvakaoma kunzwisisa zviri chirwere

Transmural infarction - chinonetsa uye ngozi chimiro myocardial necrosis, kunyanya kana totaura guru zvatichiri necrosis. The chirwere hwakazara nemigumisiro - pave pulmonary edema, kuoma maoko nemakumbo, kutaura zvirwere. Dzimwe nguva myocardial rinobatanidza mamwe zvokurwara pamusoro vascular ezvinhu akadai sitiroko.

Migumisiro chirwere ichi zvinosanganisirawo thromboembolism, ventricular fibrillation, kugumiswa basa masangano akasiyana uye kunyange nehurongwa hwavo. Muzviitiko zvakadaro kazhinji vanoguma murufu, kunyange kana murwere rubatsiro yezvokurapa yakanga zvakagoverwa. Chimwe zvinouraya yematambudziko - chomwoyo. Kana rutapudzo simba pamusoro myocardium uye kuwedzera kuita mukati ventricles uye atria ngozi zvinopesana kuvimbika tsandanyama munzvimbo necrosis.

Rehabilitation uye Zvaifungidzirwa

Sezvineiwo, Zvaifungidzirwa nezvirango vezvokurapa kwakadaro hauziri zvakanaka - vanenge 50% dzokushungurudzwa (kunyanya kana totaura vakwegura) vakaurayiwa. Zvisinei, kana, achiri akakwanisa kudzosera ropa aibuda kuipa, pachine ngozi yematambudziko mune ramangwana, sezvo kwave nokuchinja myocardial tishu.

Ndokusaka zvichikosha ndizvo rokuchinjwa nguva. Varwere vari varumbidzwa kuva nyore, nyore, uye mukuru-mafuta zvokudya. Uyewo, zvinokosha kuti zvishoma nezvishoma vawanezve locomotor basa, sezvo basa hwakazara atrophy kuti tsandanyama uye mira mumapapu. Chokwadi, mabasa ose chokuita kurovedza muviri, inofanira zvakasimba kuzvidzora nyanzvi.

Rutsigiro kurapa uye kuramba zvichiongororwa nachiremba kunodikanwa mugumo woupenyu usati. Chokwadika, varwere vanofanira kutevera zvokudya, kudzivisa kuneta mupfungwa uye zvikuru muviri, kudzivisa simba BP, uye kusvuta.