I-fibrillation ye-Atrial kukuphula umthetho wentliziyo, ekhokelela kwimiphumo emibi. Xa kugxininiswa kwengqondo ye-pulse circulation kubonakala kwi-node ye-sinus okanye kwi-tissue ye-atrial, i-myocardium iyancipha ngokukhawuleza, ngokukhawuleza. Inqanaba lentliziyo lifikelela kuma-300-600 U / min. Elinye igama le-pathology yi-fibrillation ye-atrial. Iyakhula njengophawu lwe-ischemia, i-angina pectoris, iintsilelo zeentliziyo kunye nezinye izifo.
Iifom zefayibrillation
Isifo singaqhubeka ngeendlela ezahlukeneyo. Ngomxholo jikelele, kuxhomekeke kwiintlobo zeengxaki, i-fibrillation kunye ne-flutter ye-atrial ziyaziwa. Kwimeko yokuqala, amaqela athile eentambo zeenkontileka zeentliziyo, i-pulse ihlala kwinqanaba le-500 ngomzuzu. Ukuba i-fibrillation ye-agriyo iyabonwa, ukunciphisa ukulungelelaniswa kwabo akunakwenzeka. Isingeniso sangasese sihlala sisilungile kunye ne-flutter, kodwa isivumelwano se-atria sihamba ngokukhawuleza: ukuya ku-200 ukuya ku-400 U / min, phantse ngaphandle kokuphazanyiswa kwentsebenzo ye-myocardium. Ikhefu le-diastolic lifutshane kakhulu. Ama-ventricles asebenza ngokugqoka kunye nokulila.
Ikhosi kunye nobude be-arrhythmia ngumgaqo apho isifo sifakwa. Ukwabela iifom ezifana nezifo:
- rhoqo;
- qhubeka;
- i-paroxysmal arrhymia .
I-fibrillation yonyango rhoqo
Ukungabikho kokubuyiswa kwesigqi se sinus kubonakaliswe ngoluhlobo oluqhubekayo lwe-fibrillation ye-atrial. Uhlaselo luhlala iminyaka, ubukho beli fomu kuthiwa xa ixesha liphela kweveki 2-3 okanye ngaphezulu. Amanyathelo angenelelo lwezonyango okujoliswe ekulawuleni isigqi asiqhubekanga okanye ayifumanekanga. Kucingelwa ukuba kunokwenzeka ukuba kugcinwe i-arrhythmia. Isiphumo esiphumeleleyo, esinokufezekiswa ngoncedo lweyeza, kuncipha kwizinga lentliziyo ukuya kuma-60-75 U / min. Izigulane zihlala kunye nokuxilongwa kwazo iminyaka emininzi kwaye zivakale kakuhle.
Ukunyanzeliswa kwefayili yelifa
Xa iimpawu zentsholongwane ziqhubeka iintsuku ezingaphezu kwe-7, zithetha nge-fibrillation ye-atrial eqhubekayo (AF). Inkambo yayo inokubuyela kwakhona, kukho ukuhlaselwa okuphindaphindiweyo. Ukuncintwa kwamancinci emancinci kwenzeka ngokungaqhelekanga, inani legazi elingena emzimbeni linciphisa. Le meko ayisongeli ubomi, ngaphandle kokuba ihamba nezinye izifo zentliziyo. Ngamanye amaxesha i-fibrillation ye-atrial eqhubekayo yexesha elide, eqhubekayo ngaphezu konyaka, iyahluka, kodwa ngokungafani nokuzama rhoqo, iinzame zenziwe ziphazamise inkambo yayo kwaye zilawule isigqi.
I-Paroxysmal fibrillation ye-atrial
Ifom elula kunazo zonke ze-AF, into ebonakalayo yokuphulukana ngokuzenzekelayo (ngaphandle kokusetyenziswa kweziyobisi) ishythm. Oku kungenxa yokupheliswa kwempembelelo yento ebangela ukuba, umzekelo, ukuncipha kwimeko yomzwelo, ngokomzimba okanye ukupheliswa kweemeko ezixinzelelekileyo. Ukuhlaselwa kwesi sifo - i-paroxysm ye-fibrillation ye-atrial - inokuphindwa. Inhliziyo yentliziyo ibhaliswe ngosuku lokuqala (ii-24-48 iiyure), eli lixesha elifanelekileyo lokuliphelisa.
I-Fibrillation ye-Atrial ye-Heart-Causes
I-fibrillation ye-Atrial yenza ukuba intliziyo isebenze ngokungaqinisekiyo. Emva kokuphindwa kwamanani amaninzi (2-3). I-fibrillation ye-Atrial idibene ne-pathologies ekhuthaza ukuphuhliswa kwe-arrhythmia, kwaye inokuthi ivele kubantu baluphi na ubudala: ukuya kwi-40% yamatyala e-paroxysmal kunye nama-25% eqhubekayo. Ukuvuselela ukuhlaselwa, njengommiselo, izifo zemithambo yegazi kunye nesisu senhliziyo:
- ukuhlasela kwentliziyo ;
- ukuhluleka kwentliziyo ;
- ischemia;
- xi nzelelo ;
- i-atherosclerosis;
- i ntliziyo ;
- izilonda zetrhematic.
Ezinye izimbangela ze-fibrillation ye-atrial zibizwa kwakhona. Ezi zibandakanya iintsholongwane ezingekho komzimba eziphazamisa umsebenzi we-muscle oyintloko, kunye nezinye iiproducers:
- izifo zomphunga;
- iingxaki ze-endocrine;
- isifo sikashukela;
- u bunzima;
- utywala;
- imeko zoxinzelelo;
- msebenzi oqinileyo;
- kuthatha ezithile iziyobisi;
- ukungabikho kwe potassium;
- ukupheliswa kwamanzi.
I-fibrillation ye-Atrial - iimpawu
Ngokuxhomekeka kwimeko yesifo, iimpawu zombuso we-myocardium kunye nempilo ngokubanzi, i-fibrillation ye-atrial ibonakalisa ngeendlela ezahlukeneyo. Umfanekiso weklinikhi uhluka ukusuka kwi-asymptomatic flow to manifestations of the disease. Iimpawu ezingenakubonwa, umzekelo, kunye ne-paroxysmal arrhymia. Kodwa nangona kunjalo, njengomthetho, ukubonakaliswa kokuqala kwesi sifo kubonakala: intlungu ehlangothini lwesobunxele lwesifuba nokuphefumula okuphefumlelweyo, okungayekiyo kunye nokuphumla. Kungenzeka ukuba, zombini le miqondiso ibonisa ukuba kwakukho i-fibrillation ye-agriyo yenhliziyo, iimpawu ziphawu.
Iimpawu eziphambili kunzima ukudibanisa nezinye iimeko, ngakumbi xa umntu ejongene nalesi sininzi. Ezinye iimpawu zokuthintela:
- ntliziyo;
- khulisa;
- ukugada kwamalungu;
- zixhala;
- ukutsalwa kweemvini;
- ukuthuthumela;
- kutyhafa ;
- ubuthathaka kuwo wonke umzimba;
- ukuqubha rhoqo kunye nokugqithisa;
- ukuxhala, ukwesaba.
Ukuhlaselwa kwe-fibrillation ye-atrial
Iimpawu zefayibrillation ye-atrial zingabonakali, kwaye isiguli sifunda malunga nokugula kwakhe emva kokuvavanya ugqirha. Izihlaselo ziqala ngokukhawuleza kwaye ziphinda kulo lonke ubomi. Ubungakanani kunye nokuphindaphinda kwama-paroxysms ngamnye kumntu, iimpawu zivakalelwa ngeendlela ezahlukeneyo. Kwiimeko eziqhelekileyo, kunobuthathaka, ukuthuthumela, ukubetha, ukuthuka. Ngokunyuka okunzulu kwentlawulo yesimo senhliziyo, i-pallor, isisu, kunye nokuphelelwa amandla kungenzeka.
Ukuphefumula nge-fibrillation ye-atrial
Enye yezindlela apho i-fibrillation ye-orrial (engapheliyo okanye engekho) ifunyaniswa kukuba i-palpation ye-pulse. Isigulane sinokusilela: i-atrium ayisebenzi, i-ventricles ayinayo ixesha elaneleyo lokuzalisa umthamo wegazi oluyimfuneko. Inombolo yentliziyo yentsimbi kwisilinganiselo ayilingana ne-pulse. Ukuba kukho i-flutter ye-atria, iimpawu ze-pathology ezikhankanywe ngasentla zixhaswa yi-arrhythmias engafanelekanga-ngokukhawuleza.
Iyintoni ingozi ye-fibrillation ye-atrial?
Nayiphi na i-pathology ye-cardiac inobungozi. Kwimeko ye-fibrillation ye-atrial, iimpembelelo eziqhelekileyo eziyingozi ziyi-thromboembolism kunye nokungaphumeleli kwentliziyo. I-stralosis ye-Mitral ibangela ukutyhulwa kwe-atrioventricular open-thrombus, ekhokelela ekubanjweni komoya. I-15% yeengxabano zesicakchemic zenzeka ngenxa ye-arrhythmia. Iisongelo zokuba ubomi be-flutter ephilayo buzisa ubomi bubandakanya i-edema ye-pulmatic, i-asthma ye-heart, i-cardiomyopathy (dilated).
I-fibrillation ye-Atrial - unyango
Xa i-fibrillation ye-arial ifunyaniswa, unyango lwenziwa ngokuhambelana neendlela zonyango ezijoliswe ekukhuseleni ukutshatyalaliswa ngokuphindaphindiweyo, ukulinganisa intliziyo yesimo, ukugcina isigqi sesono, ukukhusela i-thromboembolism. I-fibrillation ye-Atrial ayiphilisi ngokupheleleyo, kodwa ilawulwa, kwaye oogqirha bazama ukukhusela isiguli ukubuyela kwakhona, ubuyisele isigqi sentliziyo. Ngaphambi kokuba uphathe i-fibrillation ye-agriyo, kufuneka ufumene imbangela yokukhubazeka kunye nokuphelisa i-provocateurs, kwaye ulahlekise iimpawu zokubonakalisa kwesi sifo.
I-fibrillation ye-Atrial - iingcebiso zeklinikhi
Ukuba kukho i-fibrillation yamagciwane, kufuneka ndiyenze ntoni? Amaqhinga enyango ayanqunywe yi-diagnostic, enokuxhomekeka kwizinto ezibangelwa zizifo, kubandakanya ukubonisana kwale ngcali njenge:
- i-arrhythlogistist;
- i-neuropathologist;
- pulmonologist;
- endocrinologist;
- cardiosurgeon.
Bayalela enye unyango. Iinjongo eziqhelekileyo zonyango: ukuphucula umgangatho wobomi besigulane, ukwandisa ubude balo kunye nokuxilongwa, ukunciphisa inani lezibhedlele. Iimpawu kufuneka zisuswe okanye zithintelwe, isingeniso senhliziyo kunye nezifinyezo ezithathwe phantsi kolawulo. Nge-AF ungaphila, kodwa oogqirha kufuneka baphucule ukuxela.
Ukulungiswa kwefayibrillation ye-agriyo
Ngaba kunokwenzeka kunye nendlela yokuphatha i-fibrillation ye-agriyo yenhliziyo ngoncedo lwamachiza? Ulwaphulo lwezokwelapha olugcinayo lusetyenziswa ngokufanelekileyo (10-15%). Kwiimeko ezincinci kakhulu - i-ciliary paroxysmal arrhythmia - imisiwe nge-novocaineamide, i-cordarone, i-quinidine okanye i-parapanorm. Amachiza athatyathwa ngokuthe ngqo okanye ngomlomo, kodwa uncedo kufuneka lunikezwe ngelo xesha, kwaye izinga loxinzelelo lugqitywa rhoqo. Iskimu yokonyango namanye amayeza lulandelayo:
- Ukunciphisa intliziyo kunye nokunciphisa iimpawu ezingathandekiyo, ilungiselelo leqela le-beta-blocker lisetyenzisiweyo: I-Carvedilol, i-Proprorol, iPindolol, i-Anaprilin kunye nabanye.
- Ukukhutshulwa kwemizi yenyama kuya kususwa yiCordon, i-Quinidine, i-Allapinin.
- I-Glycosides igxininisa umsebenzi we-myocardium (Digoxin, Korglikon, Celanid).
- Ukubunjwa kwe-thrombi kuvinjelwa yiWarfarin no-Pradax kunye ne-anticoagulants Enoxaparin, i-Heparin, i-Fondaparinux.
- Iziyobisi ezihlaziye igazi - dezagreganty - zimelelwa yiziyobisi njengeApirin Cardio, Cardiomagnolo , TromboAss, njl.
Ukuphulukiswa kweentliziyo kunye ne-frilling acryation
Ukuba unyango lonyango aluzange lunikeze iziphumo, ukungenelela ngonyango kunokwenzeka. I-catheter ablation iyinkqubo yezokwelapha apho kugxininiswa kwe-arrhythmia kubonakaliswe yimpembelelo yenyama. Lo msebenzi awubuhlungu kakhulu, kuba awufunanga ukuvulwa kwesifuba - kuphela ukuboniswa okuncinci kwenziwa kwaye i-catheter ifakwe efakwe kwi-myocardium. Impembelelo kwisilonda inokwenziwa ngeendlela eziliqela: ngokubanda, i-chemical, i-laser, umbane wamandla, amandla e-waves-frequency waves (RFA) kunye nefayilifayili ye-atrial.
Kukho iifom zokutshatyalaliswa (ukutshabalalisa) njenge:
- ultrasound;
- laser;
- i-radiofrequency (cauterization yenodeji ye-atrioventricular nge-electrode);
- ukucinywa;
- i-electrodestruction.
I-fibrillation ye-Atrial - ukusebenza
Kwezinye iimeko, akunakwenzeka ukuphelisa i-arrhythmia ngaphandle kokusebenza. Ukuxhasa isantya senhliziyo esifanelekileyo kunokunceda i-pacemaker - isicatshulwa esihambelana nesigulane segulane ejikeleze i-collarbone. Ukuhamba nge-vein, i-electrode ifanelwe kuyo kwaye ingena entliziyweni. I sixhobo sivelisa iimvakalelo ezenza ukuba imisipha yeentliziyo ivumelane kwixesha elifanelekileyo, i-fibrillation ye-agrifu kunye ne-fibrillation ye-ventricular block.
Enye indlela yokugada esetyenziselwa ukuxilongwa kwe-fibrillation ye-atrial yi-"labyrinth". Umsebenzi wayo kukuphelisa ubundlululo entliziyweni, ukunyanzelisa iindawo zeerriyiti ukuba zinciphise ngendlela echanekileyo. Isalathisi sombane sisasaza kwindlela ebonakalisiweyo - okubizwa ngokuba yi "labyrinth", eyakhiwa ngokubunjwa kwezikhonkwane kwiisisu zenhliziyo. Izicucu azenziwanga kuphela nge-scalpel, kodwa kunye nokucinywa okuchazwe ngentla: i-RFA (i-moxibustion) kunye ne-crystalstruction (i-frost).
I-fibrillation ye-Atrial - unyango kunye nezilwanyana zomntu
Kungakhathaliseki ubunzima besifo senhliziyo, ukulungiswa kwayo kunokwenzeka ngoncedo lwamayeza athile - kunye neyeza zonyango okanye ngokwahlukileyo, umzekelo, njengemilinganiselo yokukhusela. Ukuba kwakukho i-fibrillation ye-agriyo, izilwanyana zamadoda zisetyenziswe ngokuqaphela, phantsi kolawulo logqirha. Unyango luyinkxaso engumncedisi.
Iindlela eziphumelelayo zisekelwe kwiimpawu ezintle zezityalo ezithile. Kwizonyango zemfuyo, kufuneka uqaphele iziyobisi ezinganciphisa ukucima kunye nokukhusela iimpawu ze-arrhythmia. Eyona edume kakhulu kwaye isebenzayo:
- I-Hawthorn yilungiselelo elihle kwikhaya lokuphelisa i-arrhythmias. Ukukhutshwa kwesi sityalo kunokuxutywa kunye ne-valerian okanye i-motherwort.
- Ukuxutywa kwembewu yelitha kuyisisombululo esisebenzayo esinciphisa ubunzima besifo.
- I-Decoction yeebhanki ze-Kalina imele ibeke umxhesho ophezulu wegazi, ichithe kakubi iinqanawa. Ngamanye amaxesha uthatha nobusi.
- I-Yarrow (i-tincture yokomoya yamagqabi) inxila kabini ngosuku kwipaspoon, ukunciphisa umngcipheko wee-clots zegazi.
I-fibrillation ye-Atrial - ukuchaswa ngobomi
Izifo ze-cardia, eziyinkimbinkimbi yi-arrhythmia, ukwandisa umngcipheko wokubulala ngokuphindaphindiweyo kwama-1.5. Ngako oko, izigulane ezineli gulane zinomdla kulo mbuzo: bangaphi abantu abahlala kwi-fibrillation? Ukuxhaswa kwezixhomekeke kuxhomekeke kwiimeko ezinjengezimbangela ze-pathology, iingxaki ezikhoyo kunye neendlela ezinokwenzeka, imeko ye-myocardium kunye ne-ventricles. Into eyingozi kakhulu ye-arrhythmias-ekhokelela ekuphuhliseni okukhawulezileyo kokusilela kwintliziyo. Zibangelwa umonakalo omkhulu we-myocardial, umzekelo, ukuhlaselwa kwentliziyo. Iingxaki ezinjalo zihambelana nesifo senhliziyo, kodwa izibikezelo zizodwa.
Naliphina iimpawu ezibonisa ukungenakunyani entliziyweni akufanele zinyanzeliswe. Nge-AF, i-muscle enkulu iqalisa ukuthuthumela, yehla ngokukhawuleza, ngokungaqhelekanga. Ukuhlaselwa akuhlali ngaphezu kweminithi, kodwa kufuneka uqaphele. I-fibrillation ye-Atrial yisifo esiqhelekileyo esenzeka kwi-2% yabantu bonke. Kodwa isifo esibi singasifumana kwaye siphathwe. Iyeza zanamhlanje zinikela ngobuchule kunye neendlela ezintsha zokulwa ne-arrhythmia.