Transmural iposi: ezibangela nabanye abantu abane

iqhosha Transmural - isifo eqhelekileyo kwaye iyingozi kakhulu, nto leyo sikhatshwa necrosis kwemisipha kwentliziyo. Kufuneka kuqatshelwe ukuba inani lokufa kuthe leengxaki efanayo liphezulu kakhulu, ingakumbi xa iimpawu zesifo kwentliziyo zange ibonwe kwangethuba, kwaye isigulane zange zifumane unyango kuyimfuneko. Kubalulekile ke ngoko ukuba akwazi ukubonakalisa njani olu hlobo sisifo sentliziyo kwaye iyafuneka ukuze umntu ogulayo luluphi uncedo.

Transmural iposi engabalulekanga: ntoni na?

Okokuqala, makhe ukumelana intsingiselo kota. Inene, abaninzi kuni bayazi ukuba iimeko infarct zihamba kunye Ukubuna yeenxalenye izihlunu zentliziyo. Oku kwenzeka ngenxa yokuyekwa ngokukhawuleza wegazi kwemali entliziyweni, nto leyo izicwili andizifumani eyimfuneko ukuze ubomi ioksijini kunye nezondlo.

Njengoko yaziwa, udonga intliziyo iqulathe ngeengcamba ezintathu - a epicardium (umphandle wayo), umaleko umzobo oseludongeni kwimisipha kunye endocardium (ingxenye engaphakathi izihlunu). Xa intramural isifo ifomu necrosis kuchaphazela kuphela umaleko ube mnye. Acute engabalulekanga transmural - ngezifo, apho iinkqubo necrotic ibonakala zonke zikhabane zentliziyo. Kuthiwa oku lolona hlobo eyingozi kwesi sifo.

Xa yesilungu, ngezifo zihlelwe ngokusekelwe kwasendaweni of nakujoliso olutsha of necrosis. I waphawula qho engabalulekanga transmural udonga iqhosha ngaphambili, ezizezi ventricle ekhohlo. Kuphela omnye iimeko zibe ntlanu, necrosis kwaye ichaphazela udonga ventricle ekunene. Malunga Isiqingatha sesithathu seendidi zonke izigulane ukubandakanyeka kwinkqubo kunye neendonga imithambo.

Ezibangela isifo

Phantse kuzo zonke iimeko, isiphumo engabalulekanga isifo kobuchopho intliziyo transmural. Njengoko sele kukhankanyiwe, kunye ioksijini elanele mzimba esihlunwini iiseli baqale kufa - ngoko okhulayo necrosis. Ngokutsho manani, 90% amatyala unobangela na yamafutha iimpahla coronary, ezivumela igazi ukuhamba ukuya myocardium.

Eludongeni inqanawa akhiwa uqweqwe ekuthiwa-atherosclerotic. Phantsi yempembelelo yeemeko ezithile umonakalo isabelo waphula kude eludongeni livale mithambo kwemithambo yenhliziyo. engabalulekanga Acute transmural ngokuqhelekileyo siqhuba ngokukhawuleza kwezo kwiimeko xa kunyuka engabalulekanga oxygen imfuno kabukhali - oku kwenzeke, umzekelo, ngokusebenzisa amandla kakhulu emzimbeni, ifiva, ntshikilelo kakhulu emphefumlweni.

Acute transmural iposi engabalulekanga: Risk Iimeko

Njengoko ubona, izilonda necrotic intliziyo babumbe isifo elizimeleyo. Kwiimeko ezininzi, ukuba baphuhlise kwisiqalo ngenxa yamafutha kunye ischemia sele ikhona. Ngoko ke kusenokwenzeka ukuba ikheswa nezinto eziyingozi ezininzi:

• Le yofuzo ze isigulane ukuba lu dityanisiwe iimpawu ezithile yokwakheka kunye nezifo.
• Kuthatha indawo kunye yokukhula. engabalulekanga Transmural sivame ukuxilongwa kubantu ezingaphezu kwama-45, kunye namadoda ezisengozini kwesi sifo.
• Ukwanda inqanaba cholesterol egazini (ngenxa yale fomu umonakalo kwi iindonga imithambo yegazi, apho kamva ukugubungela egazini).
• Ukudla engafanelekanga (ezinamanqatha ukutya kunye nokutya eqhotsiweyo kwandisa amathuba asakhasayo yamafutha).
• Ukutyeba (nokuthe kwiimeko ezininzi inxulunyaniswa ukutya kakuhle kunye ukutyeba kwandisa umthwalo entliziyweni).
• yokungasebenzi Physical (ukuphila umzimba kukhokelela buthathaka chu imisipha entliziyweni, myocardium emva koko kunzima kakhulu ukumelana nayo nayiphi na umsebenzi emzimbeni).
• uxinzelelo njalo, nokudinwa, ntshikilelo ngokweemvakalelo ikhokelela utshintsho hormone ezichaphazela inkqubo sentliziyo.
• Ukutshaya (Ngokwezibalo, 35% amatyala necrosis engabalulekanga ezinxulumene lo mkhwa).

Iimpawu eziphambili: indlela yokubona wahlaselwa yintliziyo?

Iimpawu necrosis inokuba nomahluko - konke oku kuxhomekeke iqondo umonakalo, ubudala loo mntu, ukubakhona kwezifo ezihamba, njl Kukho iimeko yokumpompoza engabalulekanga nazimpawu ... Noko ke, ezinye iimpawu eziphambili zezi:

• Kwiimeko ezininzi, umntu ikhalazela intlungu kakhulu compressive emva breastbone - kubanikela ngokucacileyo ukuba ekhohlo emagxeni, ingalo, imihlathi, indlebe kunye amazinyo.
• Intlungu esimfaneleko kunye elide - yokuhlaselwa kungaba waphinda kwisithuba iiyure ezimbalwa okanye iintsuku.
• Liphuhlisa tachycardia, isigulane lusiva zisaphila ngokucacileyo rhoqo kwaye buhlungu.
• Kukho kwakhona ingqiqo elifutshane intliziyo ngokunyamalala.
• Kukho iimpawu ngaphandle ngenxa yesifo sentliziyo - ulusu kunye kwiinwebu yomntu bulula kuba luthuthu.
• Ngokuchasene imvelaphi necrosis rhoqo ukuphuhlisa isifuba kwentliziyo - isigulane baphawula ukuphelelwa ngamandla ngumphefumlo, ukuhlaselwa ngesiquphe Ukuphelelwa.

amanyathelo zokuxilonga

Xa umthetho wokuqala kufuneka kuthuthwa ngoko nangoko kumntu ogulayo kwiwadi esibhedlele, apho uxilongo olufanelekileyo unyango yenziwa. Indlela ephambili diagnostic ukuba necrosis engabalulekanga na electrocardiography, kuba xa nkqubo onjalo lula ukulungisa nekhono zombane kwiindawo ezahlukeneyo kwentliziyo.

Ngokuchanekileyo wenziwe, kunye electrocardiogram uguqulwa ivumela ugqirha ukufumanisa kwasendaweni of necrosis (umz, isifo esezantsi transmural intliziyo), lo zingqubane ze sisasazeke inkqubo zophendlo lwezifo kunye nobunzulu sisilonda esidumbileyoesingaphakathi, ixesha sifo.

Ukongeza, kufuneka uvavanyo lwegazi. waphawula izinga neentlenge ukunyuka erythrocyte engabalulekanga, ukwanda kwenani leukocytes evela egazini enqanda ezithile kunye nemixube leyo ngesiqhelo ngaphakathi kwi seli engabalulekanga.

Imigaqo zoncedo lokuqala

Acute transmural iposi engabalulekanga phambi eludongeni - a ngezifo ukuvela ngokukhawuleza kakhulu. iimpawu zayo kunokwenzeka phantse naliphi ixesha, ngoko kufuneka baziqhelanise nalo imigaqo uncedo isigulane ngokwakho. Kakade ke, kuqala kufuneka ubize inqwelo yezigulana.

Ilindele oogqirha, loo mntu kufuneka alale phantsi. An Okungumahluko imeko apho kukho ukuphelelwa ngamandla umoya ukutswina xa uphefumla ahlukileyo - apho isigulana isihlalo ngcono, Mfuleni phantsi emva nomluko okanye umqamelo. Kuyanconywa ukuba athathe i-aspirin. Kufuneka kwakhona ukunika nitroglycerin umntu - ipilisi yokuqala enye, kwaye ukuba iintlungu na ukumka apha, ngoko imizuzu emihlanu kamva omnye (kodwa hayi ngaphezulu kwe ezintathu).

Scheme Treatment of engabalulekanga

Kuxhomekeka kwiziphumo ezifunyenwe ngethuba uxilongo ugqirha imisela unyango. unyango lokuqala aquka zizahlulo ezithathu eziphambili:

• Ukwamkelwa ntlungu ukunciphisa imeko yesigulane. Lidla iintlungu kunokwenzeka ukuba ayeke kuphela ngoncedo kwamachiza enamandla, kuquka "Promedol" yaye "icaffeine". Ukubonakala iimpawu kunye lokufunyaniswa "iposi engabalulekanga" yi ni ntshikilelo loo mntu, yaye uchulumanco kunye noloyiko kwandisa umthwalo entliziyweni kuphela - isigulane nadlamkisayo emiselweyo.
• Irejimeni kufuneka zibandakanye abafumana nitrate beta-blocker, nto leyo eza kunceda ekupheliseni arrhythmia nokubuyisela isingqisho intliziyo.
• Xa transmural Amathuba aphezulu engabalulekanga of egazi kwegazi, nto leyo igcwele necrosis zeminye imibutho kunye nenkqubo kwasasazeka kwiindawo ezikufutshane kule myocardium izilonda luvo kunye nokufa. Ngoko ke, ukulwa thrombosis kufuneka uqale kwi iiyure zokuqala emva kokuqala iimpawu. Ukulungiselela le njongo, sebenzisa amalungiselelo vasospasm eziqulathe lweeHedfowuni kunye fibrinolysin. Ngokuqhelekileyo, xa ukuthatha loo machiza kungenzeka ukuba legazi omkhulu kuba ihlwili legazi zokumisa, ngoko kubalulekile ukuba esweni ngenyameko imeko yesigulane.

Unyango ibithethwa wachitha esibhedlele - nomonde imini nobusuku kufuneka ibe phantsi ngenyameko kagqirha.

Iziphumo kunye iingxaki sifo

iqhosha Transmural - ifomu ezinzima eziyingozi necrosis engabalulekanga, ingakumbi xa kufikwa necrosis enkulu focal. Esi sifo naxa ingumbandela ozaliswe ziziphumo - nophuhliso nokudumba yemiphunga, ukukhubazeka kwamalungu omzimba, ukuphazamiseka intetho. Maxa wambi engabalulekanga ibandakanya ngezifo inkqubo semithambo, ezifana icala.

Imiphumo yale sifo ziquka thromboembolism, fibrillation ventricular, ukupheliswa umsebenzi arhente ezahlukeneyo kunye neenkqubo zabo. amatyala enjalo aphela rhoqo ngokufa, ukuba uncedo lwezonyango isigulane kwalungiselelwa. Enye iingxaki ezisongela ubomi - isifo sentliziyo. Ukuba unciphiso elinqatyisiweyo myocardium nokunyusa uxinzelelo ngaphakathi ventricles kunye nomthambo umngcipheko kokunikezela ngesidima izihlunu kule ndawo necrosis.

Rehabilitation kunye noqikelelo

Ngelishwa, uqikelelo kwiimeko zonyango loo nto intle kakhulu - malunga ne-50% ye amatyala (ingakumbi xa kuziwa abadala) abulawe. Noko ke, ukuba, wakwazi ukuba ukubuyisela ukuhamba kwegazi oluqhelekileyo, kusekho umngcipheko iingxaki kwixesha elizayo, ekubeni kubekho utshintsho kwithishyu engabalulekanga.

Kungenxa yoko le nto kubaluleke kangaka lixesha kwimeko yesiqhelo. Izigulane ziyacetyiswa ukuba kutya elula, kulula, kwaye uqhagamshelwano lwetshiphu emsebenzi-osidingayo. Kwakhona, kubalulekile ukuba inokuphinda umsebenzi weentshukumo, njengokuba yokungasebenzi igcwele yoma izihlunu kunye amileyo emiphungeni. Kakade ke, yonke imisebenzi enxulumene umsebenzi emzimbeni, kufuneka kulawulwe ngokungqongqo specialist.

unyango noncedo kunye nokongamela okuqhubekekayo okwenziwa ugqirha kuyimfuneko phambi kokuphela sobomi. Kakade ke, izigulane kufuneka ukuba balandele yokudla, xiphephana umthambo olunzulu, kuphephe uxinzelelo olomeleleyo yokunyuka kwegazi, uze uyeke ukutshaya.