Ngokutsho kwimiba yezinhliziyo, ukuhlaselwa kwentliziyo epheleleyo kubhekisela kwizifo eziqhelekileyo ezifuna ukunakekelwa ngonyango oluphuthumayo. Ukufa okuphezulu ngenxa yesi sifo kuba ngenxa yokungabi nolwazi ngolwazi oluphambili lwesifo. Cinga ngabo, ubiza izizathu zokugula, i-algorithm yokunceda.
I-infyoction ye-myocardial
Igama elithi "i-cardiac infarction" ebizwa nge-cardiacity (cardiac) ebizwa ngokuba yi-cardiology ngokuqhelekileyo ichazwa njengophulaphulo, apho kukho utshintsho ekuphumeni kwegazi, kuhamba kunye nokunciphisa isalathisi se-oksijini, ekhokelela kwi-necrosis yentliziyo yesisu. Icandelo leeseli lifa ngokupheleleyo. Endaweni yabo, iqela lenziwa phezu kwexesha. Ngokuxhomekeke kwindawo yesikhumba, indawo yendawo ye-necrosis, ukwahlula:
- ukuguqulwa kwodonga lwangaphambili;
- i-myocardial infarction.
Kuhlobo lokuqala lokuphulaphulwa kukho umonakalo kwi-artery ekhohlo. I-lumen yayo igqoke ngokugqithiseleyo, ekhusela ukuhamba kwegazi ngokuqhelekileyo entliziyweni. Xa udonga olusemva luchaphazelekayo, i-artery coronary right ihamba. Phakathi kwezizathu ezinokwenzeka zokukhubazeka, oogqirha baqhubela phambili ischemia (ama-98% amatyala). Kule meko, iirriyari ze-coronary ziyakwazi ukulimala - utshintsho lwe-atherosclerotic. Ukongezelela, ukuhlaselwa kwentliziyo eninzi kunokwenzeka ngenxa yoku:
- i-coronary artery thrombosis ;
- ukungasebenzi kwemibhobho yegononary;
- ukukhutshwa kwemithambo yegazi emikhulu ngeengxenye zeeoplasms;
- inkqubo yokuvuvukala echaphazela iimitha zeeronari;
- ukucwangciswa kweSebe le-aortic elikhulayo kunye nemfundo emva kwe-hematoma;
- ukusetyenziswa kwezidakamizwa, ezenza i-spasm yeeronari (i-coke, i-amphetamine);
- ukulimala kombane, ukutshatyalaliswa kombane;
- nemiphumo yentliziyo.
Ukuhlaselwa kwentliziyo epheleleyo - iimpawu, iimpawu zokuqala
Izibonakaliso zokuhlaselwa kwentliziyo epheleleyo zibizwa. Into yokuqala ephawulwe yizo zigulane yintlungu eqinile, eqhoqhoqhaqhayo yokuqhayisa kwisiqingatha sesifuba okanye ngasemva kwesifuba, esichukumisa kwisandla, umhlathi osezantsi, kunye ne-scapula yasekhohlo. Kukho iziganeko ezibuhlungu ubuncinane imizuzu engama-30. Isici esahlukileyo sesifo kukuba ukungabikho komthelela wokwelapha weNitroglycerin .
Emva kwexesha elifutshane, uvakalelo lokungahambi komoya luphawulwe, isigulane sikhalaza oko kukhwaza. Ukongeza, oku kulandelayo kubhalwe:
- ukuthunga okubandayo;
- ukuhlanza;
- isicefe
- ukunciphisa uxinzelelo lwegazi.
I-infarction epheleleyo ibhekisela kulawo mathambo apho isigxina seempawu ziphawu. Kukho amaqanaba amahlanu:
- Ixesha leprodrome (preinfarction). Ibonakala ngokunyuka kwinani leepasiti zokuhlaselwa kwe-angina.
- Ixesha elibukhali. Ukuhlaliswa kweeyure ezingama-0.5-2. Ubunzima bokubandezeleka, ukujuluka, utshintsho kwinqanaba lentliziyo, ukunyuswa kwengcinezelo yegazi.
- Ixesha elibukhali. Ixesha liphela iintsuku ezingama-2-10. Kubonakaliswe yinkqubo yokwakhiwa kwesayithi le-necrosis kwisihlunu senhliziyo. Intlungu iyancipha, kodwa intliziyo yesisu iphukile, ukushisa komzimba kuphakama.
- Subacute. Ukulala kwamaviki 4-5. Ngeli xesha, kubonakala inqabunga kwisiza seethambo ezifileyo. Isingeniso senhliziyo sibuyiselwe, i-syndrome yesifo iyakwehla ngokupheleleyo, uxinzelelo luqhelekile.
- Postinfarction. Ixesha lithatha iinyanga ezi-3-6. Eentliziyo zonyango zibhalisa, ngoncedo lwe-ultrasound, ukwanda kwentsholongwane yesikhumba esisila. Umzimba uqhutyelwa ukusetyenziswa kwiimeko ezintsha.
Uncedo lokuqala lokuhlaselwa kwentliziyo
Esi sifo sidinga ukunakekelwa kwezibhedlele eziphuthumayo. Uncedo lokuqala lwe-myocardial infarction kufuneka lunikezwe kwisayithi. I-algorithm yezenzo zamaqabane okanye izalamane kufuneka zibe nokulandelelana okulandelayo:
- Beka, unqamle iimpahla ezilungeleyo, ikhola.
- Ukuba kunokwenzeka, khuthaza isigulane.
- Nika iziyobisi ezinqanda intlungu: iNitroglycerin, Aspirin.
- Shayela i-ambulensi.
Ukuhlaselwa kwentliziyo epheleleyo - iziphumo, amathuba okuphila
Ngenxa yokuphulwa okunjalo njengentliziyo ehlaseleyo, imiphumo, amathuba okuphumelela ekuxhomekeke kwixesha lokuqaliswa kweyeza. Ngokwezibalo, izigulane ezingama-40 kwabangama-100 ziyafa kwi-prehospital. Ukongezelela, xa kuxela ukuba oogqirha baqwalasele indawo yommandla ochaphazelekayo, ochaphazela ngqo umphumo. Izinto ezinokunyusa kwiimeko ezi:
- ubudala;
- isifo somngcipheko kwi-anamnesis;
- ubukho bemiqondiso ye-congestive heart failure.
I-infyoction ye-myocardial
Ukukhubazeka ngokwayo kunomlinganiselo ophezulu wokufa. Ngenxa yoko, ukulaliswa kwezibhedlele kufuneka kwenziwe kwimizuzu engama-30 ukuqala kweempawu zokuqala. Ngenxa yoko kuyimfuneko ukuba ukwazi ukuchonga ngokuchanekileyo ukuhlaselwa kwenhliziyo, nemiphumo yinto enokuthi ilandele oku:
- Ukuphuma kwintliziyo yesisu. Kukhokelela ekufeni. Iyenzeka ngenye imini ye-infarction. Kule meko, udonga lwe-ventricle ekhohlo luchaphazela ngqo.
- Ukutshatyalaliswa kwecardiogenic. Kuphawulwa njengesiphumo soqhekeza olubanzi apho udongeni lwangaphakathi lwangaphakathi (iirriyari ze-coronary) zenzeka. Iyakhula xa i-necrosis isetyenziselwe ngaphezu kwe-40% yendawo ye-myocardium. Ukutshatyalaliswa ngokwenene kwenhliziyo, ukubulala kwabantu kufikelela kuma-90%.
- Edema. Ukuphazamiseka ekungabikho kwencedo kunokukhokelela kwi-edema ye-alveolar. Ingxaki enjalo ibonakalisa ukuphefumla okufutshane, ukuphefumula okuphosakeleyo, ukuqhuma, ukukhwehlela nge-spamum ye-pink hue (ukuhlaselwa kwenhliziyo elula).
Kwizigulane eziye zaphulukana nokuphulwa okunjalo kumanqanaba okuqala okuhlaziya, kukho iingxaki ezinokwenzeka:
- ukungakwazi ukufikelela (kwi-25-50% yezigulane);
- aneurysm ye-ventricle yekhohlo (10-15%);
- i-thromboembolism (10%);
- intliziyo yeengxaki zesifo;
- fayili
I-infyoction ye-myocardial eyingozi
Le ndlela yexinzelelo ihlala iphethe iimpawu ezinzima. Ngenxa yoko, izigulane azikrokreli ukuhlaselwa kwenhliziyo enkulu, iziphumo zazo zifana nezo zidweliswe ngasentla. Kufuneka kuphawulwe ukuba olu hlobo lwe-pathology lubonakaliswe ngeprojekiti efanelekileyo - inqanaba lokusinda xa kwenzeka ukuthatha udonga oluphezulu. Phakathi kweziphumo ezinobungozi zokuphulwa:
- I-dressler's syndrome;
- ukuphazamiseka kwengqungquthela;
- thromboembolism;
- tshutshiswa kwemizimba.
Ukuhlaselwa kwentliziyo epheleleyo - unyango
Ulwaphulo-mthetho ludinga ukulaliswa esibhedlele nokunyamekela. Ngenxa yokukhubazeka okunjalo njengesifo senhliziyo esiphezulu, amathuba okuphila axhomekeke ngokukhawuleza ngokukhawuleza ukunyamekelwa kwezibhedlele kunye nokunakekelwa ngongxamiseko. Ngokutsho kweengcali zonyango, ukuba isigulane sithathwa esibhedlele zingakapheli imizuzu engama-30 ukususela ekuqaleni kokuhlaselwa, ukubonakala kweempawu zokuqala, umphumo wesiphumo esihle kakhulu. Kule meko, khetha:
- iziyobisi ukuphucula i-hemodynamics - iPrasugrel, Plavix, Clopidogrel;
- iziyobisi ezinciphisa intlungu - i-analgesics, i-nitrolycerin
- i-antiarrhymic - Amiodarone;
- i-anticoagulants - iStreptokinase, streptodeacase;
- thrombolytics - Heparin, Aspirin.
Ukuhlaselwa kwentliziyo epheleleyo - ukuhlinzwa kwentliziyo
I-infarction eninzi ye-myocardial ekhunjulwe ngokuqhelekileyo iba yinto yokubonisa ukungenelela. Inkqubo efanelekileyo kulo mzekelo ngu-angioplasty - ukubuyisela ubuchule beempawu ze-coronary by stenting. Inika izitya kunye neetriyiti ububanzi obuyimfuneko, obangela ukuhamba kakuhle kwegazi, kunciphisa umthwalo entliziyweni.
Ukuqhaqhazela emva kokuhlaselwa kwenhliziyo enkulu
I-infarction eninzi ye-myocardial ehlehlisiwe, imiphumo exoxwa ngayo ngasentla, phantse rhoqo ifuna ukubuyiselwa kweempahla. Le ndlela yokugcina i-endovascular iyenziwa kwisigaba se-vascular. Umsebenzi ufuna ukufumaneka kwezixhobo ezifanelekileyo kunye nabagqirha abaqeqeshiweyo. I-stent ngokwayo ityhubhu eqinile, ububanzi obuhambelana ngokupheleleyo neyomitha.
Bangaphi emva kokuhlaselwa kwenhliziyo enkulu?
Ngenxa yokuphulwa okunjalo njengesifo esiyintloko senhliziyo, ukugxekwa kubangelwa ukukhawuleza kokubonelelwa ngononophelo lwengonyango, ummandla ochaphazelekayo ngesifo senhliziyo. Kufanelekile ukukhumbula ukuba i-pathology ngokwayo ihamba ne-angina pectoris. Xa kungenasimo, 30% yezigulane ziyafa emva kweenyanga ezintathu emva kokuhlaselwa. Ngokwezibalo zembalo, phakathi kwezigulane ezithatha izibhedlele eziphambili, ukufa ku-10%.
Ubomi emva kokuhlaselwa kwentliziyo enkulu
Ukuthotyelwa kweengcebiso kunye nemiyalelo kadokotela - isiseko sokuvuselelwa ngokuphumelelayo. Isondlo emva kokuhlaselwa kwentliziyo epheleleyo kufuneka kube nokulinganisela. Ukususela kwizonyango oogqirha bacebisa ukuba bangabandakanyi izitya zetyuwa, iziqholo kunye nokutshaya. Iintsuku ezi-10 zokuqala mazihambelane nokutya okuphantsi kweekhalori, ukunciphisa ukungenisa kwamanzi. Isiseko sesondlo kwinqanaba lokuqala lokubuyiswa kwezidalwa, ukutya, izithelo, isobho, imifuno yemifuno.
Inyanga kamva, xa iqela liqala ukwenza, kukho imfuno yemveliso equkethe i-potassium. Le microelement iyanciphisa ngokukhawuleza ukukhukhumeza, okwabangela ukuba kususwe umkhuhlane womzimba wabo, ukwandisa isivumelwano sokwenza intliziyo. Iqulethe:
- iigqabi;
- ikholifulawa;
- iamangile;
- i-walnut;
- ziqhekeza.