Indlela yokujonga iimpawu ze-myocardial infarction

Iimpawu ze-infyoction ye-myocardial ziphuhliswa ngenxa yokuphazanyiswa ngokukhawuleza ekunikezeni igazi kwi-muscle ye-heart, ngenxa ye-necrosis eqhubeka kuyo. I-myocardial infarction ibhekisela kwenye yeendlela zesifo senhliziyo.

Ekuphuhlisweni kwesifo senhliziyo, izinto ezibalulekileyo zikhusela izitya ze-coronary cardiac nge-thrombus, ekhokelela ekubunjweni kwe-necrosis enkulu yemisipha, kunye nokunyanzeliswa kweenqwelo zentliziyo ngenxa yokubunjwa kwama-atherosclerotic plaques.

Ukuba ukunciphisa i-lumen yeerterotic coronary ixhaphakile (iimitha ezimbini okanye ngaphezulu zibandakanyeka kwinkqubo), kunye ne-myocardiosclerosis esele ikhona, i-microinfarction iyaqhubeka. Iimpawu zingaphantsi kunezilonda eziqhelekileyo. Nangona le nto i-microinfarction, ingakhokelela kwiinkathazo ezifanayo kunye nemiphumo ephuhliswayo nge-necrosis enkulu.

Iimpawu ze-myocardial infarction

Ekuqaleni kwesi sifo, izigulana zikhalaza ngokubonakala kweentlungu ezinzima kunye nexesha elide emva kwe-sternum. Le nguqulelo yeklastiki yendawo yokwazisa. Intlungu iqhubeka iiyure eziliqela kwaye ayihambi emva kokuthatha i-nitrates. Kukho ezinye iintlobo zentlungu ekuhlaleni, umzekelo, inokuvela kwindawo yesisu (isifo segastralgic okanye esiswini), kwingingqi ye-epigastric nge-concomitant dyspnea (i-asthmatic variant). Ubuhlungu bunokunikwa emva, entanyeni, ngesandla. Ngokuqhelekileyo, ubuhlungu obukhulu bunzima kangangokuthi ukuphazamiseka kwemizimba kwenzeka, kunye nokungaphumeleli kwe-ventricular kunye ne-edema ye-pulmona. Ngokuqhelekileyo, isiqhelo sesimo senhliziyo siphukile, intliziyo yanda, kwaye uxinzelelo lwegazi luya kulwa. Ukuba i-fibrillation ye-ventricular iyenzeka, ukufa kwekliniki kunokufumaneka.

Ukuba kwiiyure zokuqala emva kokuhlaselwa kwenzeka kwi-cardiogram ectopic ventricular arrhythmias kubhalwe, oku kungabonisa ukubuyiselwa kobunzima bebhoriyali yentliziyo.

Ukongeza kwintlungu yentliziyo, iimpawu zokuqala zentsholongwane yintliziyo zixinzelelo lwegazi ephezulu, okusemthethweni, idlula ngosizi lweemfesane, ukuphambuka, ukunyuka kweqondo lokushisa komzimba kwisimo esifanelekileyo. Ubushushu buhlala buphakanyisiwe ukuya kwiintsuku ezintathu ukuya kwezine. Egazini, inani lama-leukocyte landa, i-ESR iyanda kunye nenqanaba le-slags ene-nitrogen (ungayifaki le mpawu ye-uric acid infarction). Zonke ezi zibonakaliso zempendulo yokuvutha. Ngeeyure zokuqala, ukukhula kwama-enzyme kwaqatshelwa: i-creatine kinase, i-ALT, i-AST, i-LDH.

I-cardiogram yeprogram ye-infarction ibonakaliswe ngecandelo lesigxina se-ST, inkalo enkulu ye-Q, ukubonakala kwe-QS eyimfucuza ye-ventricular kulezo zikhokelela apho kwenzeka khona i-myocardium ene-necrotic. Ukuxilongwa ngokuchanekileyo ngokuchanekileyo, ngokukodwa ngokuchithwa okuphindaphindiweyo, kubalulekile ukudubula uluhlu lwemizimba.

Ukuba kwenzeka i-microinfarction, iziganeko zisoloko zithethiwe kwaye intlungu ayinakunzima. Umntu unokukuhambisa "ezinyaweni zakhe" okanye athathe ukuhlaselwa kwe-angina, ngoko kufunyanwa ngengozi kwi-ECG. Iimpawu zesifo senhliziyo esinezilwanyana ezincinci zihlala zibonwa kubantu abaye bahlushwa yi-angina okanye i-cardiosclerosis ixesha elide. Kuloo matyala xa kwenzeka kwiinqanaba zokuqala ze-IHD, i-microinfarction, njengokuba kunjalo, i-harbinger ye-lesion enkulu.

Kwiintsuku zokuqala zesigulane sinokungabikho ngokungadingekanga, mhlawumbi ukuqaliswa kwentlungu entliziyweni, ukuvela kwamachythmia kunye neengcali eziqhotyoshelweyo.

Njengengxaki, i-aneurysm yodonga lwenhliziyo okanye i-aorta, ukungaphumeleli kwentliziyo kunye ne -edema ye-pulmona, ukuxhamla kwemithambo yegazi yeenxalenye kunye nezitho zingakhula.

Unyango

Ulwaphulo lwe-infarction luyimfuneko esibhedlele. Amatyala amaninzi athatyathwa ngokuvuselelwa. Ama-nitrate anqunywe ngohlobo lokungeniswa kwe-intravenous, i-heparin kumaxabiso amakhulu, i-analgesics. Faka isicelo sokuxuba imixube equkethe i-potassium, i-blockers blockers, inhalation of oxygen. Isigulane kufuneka sithobele ukuphumla kombhede kwaye sibe nokukhululeka kunokwenzeka ukukhuselwa kwixinzelelo kunye noxinzelelo.