Asystole kwentliziyo - ntoni na? Iimpawu, oonobangela, unonophelo olungxamisekileyo, unyango

Yokuyekwa ngesiquphe imisipha kwentliziyo, sikhatshwe ukungabikho yomsebenzi bioelectrical amayeza ubizwa ngokuba "asystole intliziyo." Yintoni na? Zintoni izinto ezibangela ukuba urhulumente athi? Indlela ukubonelela uncedo olungxamisekileyo abantu xa kuthe zokuma? Iimpendulo yonke le mibuzo ungafumana kamva kweli nqaku.

Iindlela ivela asystole intliziyo

Asystole wentliziyo, izizathu apho esixubusha, yahlulahlulwe lwephanyazo kwaye kwenzeka ngenxa yokuba kukho arrhythmia ekhoyo inhliziyo.

Kwimeko yokuqala, kwimvelaphi well-being non-ulwaphulo kwesingqisho intliziyo Uvele ulahlekelwa elektrovozubdimost ukuba ifane isekethe elifutshane. Isizathu soku kangangokuba yondele isifo kobuchopho intliziyo, ukubonakala kwayo, ngokuzenzekelayo, ebangela ukutyeba, ukutshaya, isifo seswekile kunye noxinzelelo lwegazi.

Kwimeko yesibini, kunye karhulumente elide zihlambo fibrillation (ukuncitshiswa beziko unganxibelelananga Imisonto izihlunu kwentliziyo) zenzeka ajikelezayo ngokukhawuleza ngamaza ombane engavumelekanga eziphazamisana igazi flow kwiinqanawa coronary yaye, ekugqibeleni, kungenzeka ukubandezana intliziyo ukuba osulelwe, ebangela ukuba ayeke.

Izizathu engabangela zokuma

Malunga ne-5% of ezingaqhelekanga kakhulu kwentliziyo kukhokelela yokuba isigulane iphuhlisa asystole intliziyo. Izizathu zale meko ubomi emngciphekweni amaninzi kusekelwe ukuvela uhlobo nokoyika iposi engabalulekanga okanye Embolism miphungeni.

Asystole yaye sichukumise i libanda of glycosides kwentliziyo, iziyobisi antiarrhythmic okanye zomzimba ezichaphazela ukusebenza uthe kwezihlunu. Kuba ukusilela intliziyo kunokubangela ingozi zombane, intracardiac ukuxhaphaza okanye ukuphazamiseka ngokubanzi metabolic eziqatha.

asystole ikakhulu ventricular

Kufanelekile ukuba sikhankanye ukuba ventricular asystole (opheleleyo ayeke iziqupho abo), ngokungafaniyo iyahambelana ubomi asystole atrial, ekhokelela ekufeni umguli.

Le ngezifo akazalani ukuya arrhythmia, leyo wamqumbisa excitability ethunjini zakhula. Izizathu ukwenzeka yalo ukuphazamiseka Uhanjiso kunye inhibition engumzekelo ekukwazini ventricles sincipha ngesingqi.

Amaninzi imeko ogama isenokuba kuba sisiphumo fibrillation atrial okanye ventricular kwaye kuza emva kwabo, kwaye kwezinye iimeko kudale dissociation electromechanical, okanye tachycardia ventricular.

Zokubonisa asystole intliziyo ebantwaneni

asystole wentliziyo kubantwana amaninzi nomsindo yokwenzakala, ukutyhefa iintlobo ezahlukeneyo ukuphazamiseka nokuphefumla (umzekelo, ngokuma isithintelo, umsi inhalation, ukumka namanzi okanye usuleleko).

Phela, ziphawuleka ukuba 15-20% yezigulane abaselula zokuma ngaphambi fibrillation okanye ventricular tachycardia. Kodwa ke umqondiso ixhaphakileyo ukuba umntwana wakho kusongela uphuhliso asystole, yinto yokuba bradyarrhythmias (deceleration ebalulekileyo izinga inhliziyo).

Kwimeko yabantwana okanye intsha yesifo sentliziyo azalwa kakhulu phambi kokuba asystole ngaphambili kunokwenzeka ukuba bagcine kukuvela ukuphefumla nzulu rhoqo, hypotension kunye nokuziqonda kakuhle. Kwezinye iimeko, zokuma owandulelayo ukuwa kunye (imizuzwana ngaphantsi kwe ezintlanu) uhlaselwe elifutshane.

wenza njani asystole kwentliziyo phezu electrocardiogram

Asystole kwentliziyo kwi electrocardiogram kutyhilwa umgca phantse ngqo elimele umsebenzi wayo zombane.

iimpawu uphawu le meko nako kunganikwa ingqwalasela i isingqisho okuthile imithambo, ukungakwazi ukubala amaza kwamathumbu, ngexesha apho kungekho kwamathumbu ventricular. Kwezinye iimeko, xa intendelezo lisekhona iqhubeke ixesha ukwehla emva ventricles kwentliziyo kwi ECG bangabhaqa atrial P wave

element Auxiliary ukuba lokufunyaniswa asystole kwaye enze phambi kwesi simo arrhythmia. Ngoko ke, ukuba kuziveza ngohlobo ekuqaleni ventricular polytopic ibetha ngaphambi kwexesha ventricular tachycardia, ngoko ukubalandela yokudanyaza enomoya, nikhulela ukuqapha ngokuqhelekileyo ibonisa indlela ye asystole.

Asystole wentliziyo: zesifo

Iimpawu ukunceda ukuqinisekisa ukuba isigulana uye wamelwa, mhlawumbi bonke eziqhelekileyo kunye, kodwa kusekho ungaziphindi.

• Xa imithambo ezinkulu akukho ukubetha. Ukuze uqinisekise oku, kufuneka isongwe isalathisi neminwe ephakathi ukuvavanya phambi kwayo kwemithambo carotid (ukufuna kuyo emngxunyeni ecaleni ndlala intlala ye kwingqula (apile-Adam)). Ukuba akukho sazi, ngoko asystole entliziyweni yomntu.
• uncedo olungxamisekileyo kuyafuneka, kwaye ukuba abafundi musa ukuphendula ngqo emehlweni isibane. Ngokuqhelekileyo, kufuneka iingqameko, kwaye ukuba oku kungenzeki, oko kuthetha ukuba myocardium akukho liyasebenza.
• Ukumisa intliziyo ithi ukunqongophala umoya lwenzeka kwimizuzu emi-2. emva yokuduka ubume. Oku ukuqinisekiswa ngokuzisa ixhoba emilebeni yomlomo wakhe nesipili.
• Akukho efundileyo omncane kwingxam yesi ulusu. Ukuba uba nombala okanye bamantshontsho ithinti (ingakumbi imilebe, ngencam impumlo kunye earlobes) - yinto umqondiso izifo kwegazi.
• Ke ekugqibeleni, ukuba isigulane zingqondweni akanako ukuzisa ubomi imizuzwana ngaphezulu kwe 10-20 usebenzisa ammonia, neePAT kwi nemihlathi okanye iingxolo elikhulu, oku kunokuba nako luphawu asystole.

Zonke ezi mpawu ziyingozi kubomi babantu, ngoko ke kufuna amanyathelo resuscitative ongxamisekileyo, ekufuneka zinikwe phambi kokufika amaqembu zeenqwelo zezigulane. Khumbula ukuba ndisindise ubomi udlala ubuninzi lemizuzu eli-10 (ixesha kangaka emva intliziyo ayeke wayesaphila ingqondo yomntu).

imithetho engxamisekileyo zokuma

Ngoko ke, ukuba uthe wafumana asystole intliziyo yomntu, unonophelo nomonde, zoncedo kunokuba ongxamisekileyo lokuqala ngolu hlobo lulandelayo:

1. Biza i-ambulensi.
2. Free nge impumlo bujikelwe ngeqhiya kunye umlomo linganihlanzi ixhoba, anodaka okanye amaqumrhu amazwe.
3. Beka umntu emqolo, kodwa ukuze intloko yakhe, waphoswa umva kancinci.
4. Nika iinyawo zakhe ndawo iphakamileyo kancinane kunye ingubo isongiwe okanye pillows.
5. Air ophephuka kungena nemiphunga ixhoba okanye umlomo-to-emlonyeni (oko ukuphosa itshefu) okanye umlomo-to-impumlo. Ukwenza isitofu esinye, yisa nokuphulula intliziyo.
6. Ukuze wenze oku, beka entendeni kwengalo siethe ukwenzela ukuba waphumla nxamnye isiseko ungqameko olungezantsi kwentamo kwixhoba. On top of kuyo beka esinye aa Incopho entendeni iphela ubunzima lomzimba, xa ubude ingalo yakhe, iintshukumo ezibukhali ukwenza iingcangcazela ezinesingqi (5 compressions). Isithuba phakathi kwabo ayikho ngaphezu owesibini. Emva ngasinye tyhala izandla ukusuka Khupha esifubeni, ukuba ukuphazamisa igazi izokwazi ukuhamba lula ukuya entliziyweni. umzuzu omnye kufuneka bavelise ubuncinane 100 umothuko wamva.

A tips ezimbalwa ngaphezulu ngokunika uncedo olungxamisekileyo

Kungcono ukuba ngasentla bazamile abantu nje ezimbini - enye ayivuthele emoyeni, kunye nezinye yenza compressions esifubeni.

Kubalulekile ukukhumbula ukuba xa umntu sisindiswe, kodwa uya kuchitha imizuzu ngaphezu elishumi amaqashiso, elo nxeba izifo luvo. Ngoko ke kuhlanganiswa yaye, okona kubaluleke kakhulu, noxolo lwengqondo, indlela kuphela asystole intliziyo (yintoni ke wena ngoku, Kakade ke, uyazi) uya koyiswa.

Yonke imizuzu 2, khangela imeko yomguli - uphefumla kakuhle, ukubetha kwentliziyo kunye pupillary reaction, ngokukhawuleza umoya uza, ukhathalelo olungxamisekileyo zimiswe. Ukuba bekukho ukubetha kwentliziyo, kodwa ukuphefumla lisekhona, uqhubeke umoya ngumntu.

Enoba akungomntu ukwaziyo ukubuyela ebomini yexhoba, musa ayeke ukumnika yononophelo olungxamisekileyo. zimiswe Oku kuphela xa kufika oogqirha ambulensi. Basebenzisa iindlela zabo ukugcina ubomi umguli.

iingxaki emva zokuma

Njengoko kukhankanyiwe ngasentla, nabancedi kancinane ixesha ukunceda indoda eyafunyanwa asystole kwentliziyo. Ku va imiz 10 kuphela. Kwaye, ngelishwa, nkqu kwimeko isiphumo ithembisa ukuba ixhoba ukubonisa imiphumo a zokuma, umzekelo:

• ukonakala kwengqondo kobuchopho, isibindi okanye isifo sezintso ngenxa kwegazi insufficiency amalungu ngexesha lokufa clinical;
• ophuke ngenxa yoxinzelelo nzima ngexesha yokuthanjiswa intliziyo;
• umoya lweHo- phakathi amaphepha pleura ukuyigubungela imiphunga kunye isifuba (amayeza loo ngezifo kuthiwa pneumothorax).

Kodwa uyazi yintoni wasindisa ubomi kusekho ophuke ngakumbi, yaye ngenxa yoko, musa ukuthandabuza ukunika uncedo olungxamisekileyo kumntu osweleyo.

Iimpawu yonyango olungxamisekileyo womntwana

Ngelishwa, ngokuba oonyana minyaka yokuqala yobomi ochazwe nqaku ngokumphefumlela ingakumbi efanelekileyo yaye, ke ngoko, abazali kufuneka bawuqhele into omawuyenze kwiimeko apho umntwana wabo aphuhlise asystole intliziyo (it lo isenzo eyahlukileyo kancinane imeko echaphazela abadala, wena, Kakade ke, uyazi).

Kwaye ke into ephambili nokungoyiki kwaye enze ngokukhawuleza kakhulu, ukhankanywe ngasentla ngexesha umntwana lifinyele ukuba imizuzu emi-5. Kuqala kwinto zonke, ubize inqwelo yezigulana.

• Emva koko kufuneka ubeke usana phezu kwetafile, strip okanye unswathe, ndimkhulule, ephuma emlonyeni yencindi yomlomo kunye izinto kwamanye amazwe.
• Kwamagqabi i index kunye ngomnwe ephakathi aqhoboshele ezantsi esifubeni. Push phezu webele ngokunzima, kodwa kakuhle, xa jolts 120 imiz 1.
• Ngexesha kuhlabana kwentamo kufuneka kwatshintsha yi ubunzulu ubhontsi.
• Emva zonke compressions 15 umlomo 2 bevuthela wambu ngelaphu kunye impumlo yomntwana.

Asystole wentliziyo: unyango kwi labagula

bazamile okukhethekile zokuma esibhedlele ngokusebenzisa ekumfakeni (ibekwe ityhubhu nezimo zeplastiki ukuziphatha apho yomatshini) kunye bolus (labo okukhawulezayo, ngokungafaniyo dropper) ungenisa emthanjeni amalungiselelo "Epinephrine hydrochloride" and " atropine ".

Ukuba kakuhle Sithole of amathamo eqhelekileyo ogama arhente ilungiselelwayo yonke imiz 5. jet. Emva koko, ithamo ebegqwese Linyuke 5 mg neziqhutywa yonke imizuzu 3 kakade.

Kwiimeko apho ukufikelela yegazi akukho amachiza zilawulwa kwi uqhoqhoqho, kunye idosi lwabo kule meko kabini linyuke. Inaliti qatha entliziyweni lwenziwa kuphela xa ukusilela kwezinye iindlela zonikezelo iziyobisi.

Unokukuthintela asystole

Thina uthetha kweli nqaku njani asystole eyingozi wentliziyo, oko yimeko enokuthi ngokulula kukhokelela umntu ekufeni. Kodwa ngaba kunokwenzeka ukuba siphephe umphumela onjalo? Nokuba ungayinqanda njani na?

Kwezinye iimeko, wenze ita yokwenene. Isizathu abagci- eminye imithetho zokuthintela. Ngoko ke, nokuba isifo, izigulane kunye nesifo sentliziyo kufuneka ngokuchanileyo ulandele imiyalelo ugqirha wakho - musa kungqubana umthamo iziyobisi kunye ukufaneleka isicelo sabo, ukuba iliso kwinqanaba lomsebenzi ngokwasemzimbeni siphephe ukusetyenziswa ezinye kula machiza specialist.

Ukuba kuyimfuneko, aba izigulane kunye nesixhobo sonyango zabelwe ibe nentliziyo-defibrillator okanye ipacemaker ukugcina izinga intliziyo eyaneleyo. Isigulana efanayo kufuneka zilungiselele kwiimeko zongxamiseko wazi njani ukuba abe kwimeko ethile.

Zonke izinto eziyimfuneko zothintelo zaseprayimari azixoxwa ngokwenkcukacha kunye cardiologist yaye kufuneka ukuba enze.