Ukuba ngexesha lokuhamba kwe-electrocardiogram ifowuni ibhalise utshintsho oluthile kwimisebenzi yentliziyo, ngoko ukuxilongwa "yi-syndrome ye-repolarization yokuqala ye-ventricles". Ingxaki enjalo ayisoloko isifo okanye isifo, kodwa uviwo olongezelelweyo ngudokotela luya kuba luyimfuneko.
I-Syndrome yokuvuselelwa kwangaphambili kwee-ventricles zenhliziyo-yintoni na?
Kungekudala, i-syndrome ye-ventricular repolarization (ARVD) ixhaphake kakhulu - i-8% yamadoda aphilileyo, abafazi kunye nabantwana bafunda ngento enjalo ye-ECG ngexesha leemviwo. Iqela lomngcipheko liquka:
- Izigulane ezineentsholongwane nentliziyo, ezihamba kunye nokuphazamiseka emsebenzini;
- abantu abachaphazelekayo kwimidlalo;
- madoda amnyama;
- izigulane ezine-dysplastic collagenosis.
Uninzi lwezigulane zibuza umbuzo malunga nokuba isifo se-ventricular repolarization sithetha ntoni. Inguqu engatshintshiyo kwinqwelo ye-electrocardiogram kwaye inokuhlala isigxina okanye idlulileyo. Ngokuqhelekileyo, isiganeko se-ECG senziwa kwiintsholongwane kunye nabantwana. Kukho iintlobo ezi-3 ezineempawu eziqhelekileyo, kodwa zihluke kwizinga lobunzima:
- ubuninzi - uhamba ngaphezu kwe-6;
- i-moderation - iqulethe i-4-5;
- ubuncinci - oboniswe ngu-2-3.
I-syndrome yokuvuselelwa kwangaphambili kweemvolumu ayifaki kuphela kwizigulane ezithe zafunyanwa okanye zentlungu ye-congenital ngentliziyo, kodwa nakwabo abanayo:
- i-hypertrophic cardiomyopathy;
- i-dysplasia yezicubu ezixhamlayo (iminwe yesicabangca, ukuhamba ngokuxhamla ngokuxhamla, ukubola kwi-canral);
- hyperlipidemia yomndeni;
- izifo zenhliziyo;
- neurocircular dystonia;
- imfuza.
Iyintoni ingozi ye-ventricular repolarization syndrome?
Ngexesha lophando lwezifundo, izazinzulu ziye zabonisa ukuba imeko ye-ECG yokuvuselela i-ventricular repolarization ingakhokelela ekufeni ngokukhawuleza kwe-coronary, ukuba ihamba kunye ne-synncope yesiqhelo senhliziyo. I-syndrome isoloko igalelo ekuphuhliseni izifo ezifana:
- ukuhluleka kwentliziyo;
- i-arthmia;
- isusus tachycardia kunye ne bradycardia;
- ischemia yentliziyo;
- fayili
- tachycardia;
- ukutshabalalisa i-hemodynamics;
- umonakalo kwiinqanawa zentliziyo, njl.
I-Syndrome yokuphulukiswa kwangaphambili kwama-ventricles kubantwana
Ukuba emva kwe-electrocardiogram ubhekene nengxaki enjenge-syndrome yokuvuselelwa kwangaphambili kweengcambu zentliziyo kubantwana, ngoko kufuneka uqinisekise ukuba ukuqinisekisa ukuba ukuxilongwa komntwana kuyakufuneka ihlolwe ngokupheleleyo. Ngenxa yoko, oogqirha banika ukuba baphumelele iimvavanyo zegazi (ukusuka kumnwe kunye nemvini) kunye nomchamo, kunye nokwenza amaxesha ambalwa nge-ultrasound yentliziyo. Ixesha lixhomekeke kwisimo sengqondo somguli.
Ukuxilongwa ebuntwaneni akusikho isigwebo. Uviwo luqhutyelwa ukwenzela ukuba ungabandakanyi ukuphazamiseka emsebenzini wentliziyo kunye nesingqisho. Kukho i-pathologies kwisigxina esisisiseko somntu, kuphela isifo se-cardiologist esinokumisela. Ubeka uviwo oluqhelekileyo lomntwana ngexesha elide leenyanga. Kukho isifo kulabo bantwana abaneengxaki zokujikeleza kwegazi esiswini.
Ukuba umntwana wakho ufumene ukuba une-syndrome yokuvuselelwa kwangaphambili kwee-ventricles, ngoko uya kuyimfuneko kwixesha elizayo:
- Ukunciphisa umzimba kunye nokunciphisa amandla abo.
- Khusela umntwana kuzo zonke iintlobo zoxinzelelo.
- Gcina ukutya.
- Qinisekisa ukuba umntwana unokuphila ngendlela enempilo.
I-Syndrome yokuvuselelwa kwangaphambili kwama-ventricles kuma-adolescents
Abaselula bachaphazeleka kakhulu kule meko. Oku kubonakala ngokugqithiseleyo ngexesha lokukhulelwa. Izinto ze-syndrome zokuvuselelwa kwangaphambili kwe-ventricles zimela utshintsho oluthile kumsebenzi wentliziyo. Abantwana kufuneka bafumane uviwo olunzulu, oluya kuthi, ngaphezu kweemvavanyo, luquka i-ECHO-CG ne-ECG. Ukuba i-pathologies ayibonakalwanga, akukho nto imiselweyo unyango. Abagqirha abazali bayancoma:
- Hlola umntwana emva kweenyanga ezintandathu.
- Ukunika abantwana iivithamini.
- Qinisekisa ukuba umntwana unokuphila ngokuzinzileyo (ngaphandle koxinzelelo kunye nokuzikhandla ngokomzimba).
- Ukunyusa abantwana kunye nokutya okunobomi kunye nokutya.
I-Syndrome yokuvuselelwa kwangaphambili kwama-ventricle kwiimbaleki
Ngexesha lophando, okwakubakho kwi-supervision yabadlali bezemidlalo, kwafunyanwa ukuba malunga nama-80% abo bane-bradycardia (izinga lentliziyo kwiminithi eli-1 lifikelela kuma-60). I-syndrome yokuvuselelwa kwangaphambili kwe-ventricles yentliziyo ibonakaliswe kwiindawo eziphambili zeempembelelo ze-vagal kunye nophuhliso kwi-ventricle ekhohlo yodonga oluguqukayo. Abantu abanjalo kufuneka:
- Nciphise umthwalo.
- Ukukhuphela ngaphandle ukufumana amayeza (i-mudope).
- Qaphela ngogqirha.
I-Syndrome yokuvuselelwa kwangaphambili kwe-ventricles ngexesha lokukhulelwa
Xa umama ozayo efunyaniswa ukuba ene-syndrome yokuphulukiswa kwangaphambili kwe-myocardium ye-ventricular, uqala ukwethuka, ukhathazeke kakhulu kwaye umbuzo uvela malunga nendlela le meko ichaphazela ngayo umntwana kunye nenkqubo yokunyanyisa. Iingcali zenzululwazi ziye zatshengisa ukuba i-ECG isichaphazelekayo ayikuchaphazeli uphuhliso lwentlungu kunye nempilo nangayiphi indlela, ukuba umfazi okhulelwe akanalo ezinye izifo ezibi (umzekelo, i-arrhythmia).
I-Syndrome yokuvuselelwa kwangaphambili kwe-ventricles - iimpawu
Ngokuqhelekileyo i-ECG-phenomenon ifunyanwe ngengozi ngexesha loviwo kwezinye izifo. Izigulane zingenakho izikhalazo okanye zihlobene nokuxilongwa. Izibonakaliso zesifo se-repolarization zakudala ze-ventricle zibonakaliswe ngendlela ye-arrhythmias eyahlukeneyo, enokuthi ingengozi enkulu kwimpilo kwaye ingakhokelela ekufeni (i-ventricular fibrillation).
Uninzi lwezigulane zi:
- ukungasebenzi kweentliziyo, ezikhokelela ekukhathazeni i-hemodynamic;
- i-edema yepommonari ;
- ukuphefumula okufutshane ;
- tshutshiswa kwemizimba ;
- ntlekele .
Uvavanyo lomntu omdala luquka uvavanyo:
- Ukubeka iliso kwi-ECG emini okanye ngaphezulu;
- ukuqaliswa kwe-novocainamide engena-intravenous, ukwenzela ukuba kwisixhobo sichaze iimpawu zokungahambi kakuhle;
- isampuli kunye ne-potassium, xa isigulane sithatha isidakamizwa (umthamo ngu-2 g) ukubonakaliswa kweempawu;
- vavanyo lwegazi;
- lipidogram.
I-Syndrome yokuvuselelwa kwangaphambili kwama-ventricles kwi-ECG
Ukuba kukho ukukrokra kokuba neentliziyo zentliziyo, i-cardiogram ihlala iyenziwa, i-syndrome yokuvuselelwa kwangaphambili kwe-ventricles iyakwazi ukubonakalisa kwi-device ngoku:
- ukubonakala kwesangqa esongezelelweyo J kwi-complex QRS;
- utshintsho kwi-T wave xa isiseko esibanzi;
- ukufuduka kwe-axis kagesi ngakwesobunxele;
- utshintshe umlo we-particle ST, iyahla, emva kokuba inotshi ikhuphuke;
- Ukuphakama (ukunyuswa kwamathambo) kwinqanaba le-ST kwisitrato se-thoracic ngaphezu kwe-isoline (ukuya kwi-3 mm).
Iimpawu ze-anomaly ziyabonakala kwisayithi ye-thoracic ekhokelela kwi-ECG. Kufanelekile ukunikela ingqalelo kwizinyo S, kuba iyanciphisa kakhulu ubukhulu okanye isitshixo esivela kwinqanaba le-thoracic kwicala lasekhohlo. Esi sibonakaliso sibonisa oogqirha ukuba intliziyo yomntu iphendukele i-longitudinal counter-clock-clockwise. Kule meko, i-QRS enzima (uhlobo lweQR) kwiindawo ze-V5 ne-V6 ziya kwenziwa.
I-Syndrome yokuvuselelwa kwangaphambili kwee-ventricles kwi-ECHO
Ngethuba loviwo, oogqirha banokumisela i-echocardiography yokuphumla (ECHO) kunye ne-ECG, i-syndrome yokuvuselelwa kwangaphambili kwe-ventricles kumntwana ibonakaliswe kakuhle ngale ndlela. Banceda ukufumanisa iimpazamo ezifihlakeleyo entliziyweni, banike ingcamango yeenkqubo, isigqi kunye nomsebenzi wesistim esisisiseko. Ukuxilonga okunjalo kuphephile ngokupheleleyo kwimpilo yabantwana.
I-Syndrome yokuvuselelwa kwangaphambili kwe-ventricles - unyango
Ukunyanga i-ECG-phenomenon ayinangqiqo, kuba ayinayo impawu kwaye ayiyiyo isifo. Ukuze i-syndrome yokuvuselelwa kwangaphambili kwe-myocardium ye-ventric kubantwana kunye nabantu abadala ukuba bangahlakuli ingxaki enkulu, oogqirha bancomela:
- Yiza kuzibona zonke iinyanga ezintandathu.
- Ukuzibandakanya ngokukhawuleza kwiintlobo ezahlukeneyo.
- Ukuchitha ixesha emoyeni omtsha.
- Kuhle ukutya.
- Ukuphelisa yonke imikhwa emibi.