Ukwahlukanisa arrhythmias inhliziyo

Ngokutsho manani zonyango, kwindawo yokuqala phakathi zonke izifo izifo kwenkqubo sentliziyo olujikeleza. Yintoni ebangele le nto? Isimo izinto ezininzi ezimbi ezichaphazela inkqubo sentliziyo. Omnye wabo - uxinezeleko rhoqo kunye nokungabikho ixesha lokuphumla elifanelekileyo. Indima elibi ekukhuleni kwezi edlalwa ezimbi kunye nongcoliseko lomoya. Kodwa umntu eve nje kuphela zonke ziyonakala iimeko zokusingqongileyo. Kwimpilo abemi umhlaba wethu ube nefuthe elibi imvula ngemagnethi. Ukusuka kwezi Ungqabhuko kwi iLanga sibi bavakalelwa kanye umphakathi. Lokuqala i ezimbi ngakumbi kakhulu, ngokufuthi ukusongela of arrhythmia obulalayo iba.

Kakuhle eli sifo

Ngamaxesha amaninzi igama elithi "arrhythmia" akukho waqonda sithi isifo. Kodwa musani makakuthathe oku njengokwenziwa kokwaphula impilo ikwenze. Ngokwesiqhelo, inani imivumbo akufuneki ibe ngaphezulu kwama-90 umzuzu. Ukuba lo ixabiso kufuneka bungabi ngaphantsi kwe-70 Kodwa abantu abaninzi awaziwa olu lwazi. Ke kaloku, njengokuba umthetho, siya musa ukulawula izinga intliziyo yakho, hayi ukutyelela cardiologist kwaye nokudlulisela iphulo layo, lo ECG. Noko ke, izenzo ezinjalo umlinganiselo iphantsi zokugcinwa impilo yabo.

A lot of iintsilelo kwiqumrhu ezibalulekileyo ezifana entliziyweni, unako ukuthintela nje kuphela, kodwa ukuba ayeke. Kwaye intsimbi yokuqala ukwenziwa kwala manyathelo ingxamisekileyo kude incinane kwezo ebekwe isingqisho, eyayiqwalaselwe eqhelekileyo.

Ezinye zezizathu apho kukho utshintsho kwinqanaba ukubetha, zezi zilandelayo:

- nokudinwa;
- kugci- abanamandla;
- i libanda, utywala;
- yesifo senhliziyo.

Arrhythmia Undoqo kukuba oko kukwaphula nkqubo intliziyo.

Cardiologists aphake degrees ezahlukeneyo ubukhali zokutenxa enjalo. Umzekelo, unyango obulula bakhonza ezinjalo iimeko apho ukuya kumaza afunekayo ntoni awaneleyo imivumbo nje ezimbalwa. Noko ke, izigulane abandezeleke ngokufuthi evela ukwanda okubonakalayo nokuncipha engabalulekanga. Kuyingozi kakhulu ebantwini kunokuba yingozi.

iintlobo zezifo

Ukuhlelwa efanayo arrhythmias engekhoyo okwangoku. Oku kungenxa zonke iingxoxo eziqhubekayo kwimihlaba, ekufuneka abulawe eziqinileyo. Eneneni, nangona isifundo sele eminyaka ubudala lwenzululwazi kwesi sifo, isiphumo wanqwenela ngonyango leengcali enaningamkelanga wona.

Ngokomzekelo, kwacetyiswa ngo-2014 ukuba ulwahlulohlulo arrhythmia ziquka iindidi ezintathu ezisisiseko ezimbi. Phakathi kwabo:

1. Arrhythmias na impendulo eziqhelekileyo, wabonakaliswa kweemeko adaptation, kodwa kukhokelela kwezinye ukuphazamiseka, kuba yingozi.
2. Arrhythmias evela lokulawula umsebenzi intliziyo.
3. Arrhythmias ezibangelwa disorganization antivolnovogo nokusebenza izihlunu zentliziyo.

Ukuhlelwa arrhythmias kwentliziyo (WHO) ichonge amaqela amathathu amakhulu la ezimbi. Ziquka zifo zilandelayo:

- ukubunjwa okubangelwa kwaphula yegazi lo ukubetha yombane;
- ezinxulumene neengxaki Uhanjiso;
- uhlobo zidibene zibangelwa yi zombini lokuqala kunye sizathu yesibini.

Arrhythmia ihlelwa nangenxa imvelaphi yabo. Ngenxa yoko, azalwa ekwanti, ezifunyenwe kunye kwizifo idiopathic. Eyokuqala kwezi ntlobo zintathu kufunyanwa kusukela ngomzuzu yimbonakalo yomntu phezu kwehlabathi. arrhythmia Idiopathic ke imvelaphi yokungaqiniseki. Njengokuba isifo ezifunyenwe, oko kwenzeka kuyo ubomi isigulane kwaye ngenxa ezinye izifo ezoyikekayo, kuquka - isifo sentliziyo, isifo seswekile kunye noxinzelelo lwegazi.

Xa kuthe arrhythmia kwezihlunu kwentliziyo ngendlela efanayo ngaphambili, eqhubeka okumpompa igazi. Noko ke, le ngezifo kunokukhokelela kuphuhliso ezimbi ezifana thromboembolism kunye nokungaphumeleli intliziyo. Kwaye ithetha ingozi arrhythmia.

Ukophulwa izinga intliziyo

Esi sesinye sezizathu sokuphuhlisa ngezifo. Kulo mba, kukho ukuhlelwa arrhythmias yexabiso izinga intliziyo. Oku kuquka:

1. Sinus tachycardia. Le ngezifo na edibene ukuhlukunyezwa esiludumbo sinus yona indlela engundoqo neemvakalelo zombane inhliziyo.

Xa olu hlobo izinga tachycardia intliziyo likumyinge eliphezulu elingana imivumbo asithoba ngomzuzu. Loo urhulumente ziviwa ngabemi nomonde njengoko uVuyo.
2. Sinus arrhythmia. Le ngezifo na alternation engalunganga kwezinga kwentliziyo. Amaninzi, sinus arrhythmia waphawula abantwana nabafikisayo. Amaxesha amaninzi, oko luyasebenza kwaye ubudlelwane ngqo kunye umoya. Ngexesha inhalation ukubetha kwentliziyo rhoqo, kwaye xa siphefumla, phezu koko, kudlule ngakumbi.
3. Sinus bradycardia. main uphawu yawo ukwehliswa izinga intliziyo ibetha 55 ngomzuzu. Le nto ibonakala naxa abantu okunempilo wayesenamandla elele okanye kokuphumla.
4. fibrillation paroxysmal atrial. Kulo mzekelo, kukho iyangongoza akomelela, yaphakama intliziyo, ukuba isingqisho ekunene. izinga Heart abantu ngamanye amaxesha ufikelela ibetha 240 ngomzuzu. Ngelo xesha, loo nto ibangela ubuthathaka kunye pallor, ukubila wande, lightheadedness. Isizathu sale meko zizimvo ezongezelelweyo evela imithambo. Ngenxa yoko, inkangeleko yabo ukuncitshiswa esinamandla kakhulu namaxesha okuphumla izihlunu engabalulekanga.
5. tachycardia Paroxysmal. Le ngezifo ilungile, kodwa ukuba isingqisho rhoqo kakhulu imisipha yenhliziyo. izinga Heart kule meko ku ezahlukene ibetha 140 ukuya 240 ngomzuzu. unyango Paroxysmal, njengoko umthetho, kuvela ekho ngesiquphe.
6. Arrythmia. Olu hlobo arrhythmia kuhanjwa (ngaphambi kwexesha) ukuncitshiswa izihlunu engabalulekanga. Kulo mzekelo, umntu va komhlaba kwaye luqiniswe entliziyweni, kunye ngokunyamalala kwawo.

Ukunceda cardiologist

Elula kakhulu ukusuka kwindawo ezenziwayo igqalwa sokuhlelwa arrhythmias Kuszakowski. amaqela ezintathu ezimbi ebandakanyiweyo kuwo. Ngelo xesha linye babe inkcazelo eneenkcukacha onke amalungu la ezimbi. Makhe sihlolisise typology, ebandakanya ukuhlelwa arrhythmias.

Na ukungaqheleki kule iimanyano rhythm

Eli qela ibandakanya sub-amacandelo amathathu. Xa lowo wokuqala, nto leyo ukuhlelwa arrhythmias oyiyekayo phantsi ileta "A", faka nomotopnye ngezifo. Ukuba kumisela ukugxojwa esiludumbo sinus. Kolu khutsho:

1. Sinus tachycardia.
2. Sinus barikardiyu.
3. arrhythmia sinus.
4. SSS, okanye syndrome, sinus abagulayo.

I-sub-icandelo elilandelayo kuquka ethunjini ezibangela arrhythmia kwentliziyo.

Classification achonge uluhlu ezimbi phantsi ileta "B". Eli candelo libandakanya ukuphazamiseka yabangela izingqisho heterotopic eyavela ngenxa ngakumbi ubukho bezinto automatism kumaziko ethunjini. Olu luhlu luquka:

1. Tshintsha (inciphise) kunye izakhiwo isingqi fly-phandle, kuquka atrial kunye ventricular kwakunye ukususela AV-zakhi
2. Ukungeniswa waphawula kwi izingqisho umqhubi supraventricular.
3. iintlobo Neparoksizmalnye of tachycardia okanye izingqisho okukhawulezileyo ezifana ethunjini.

Eli candelo lilandelayo ikhankanya non-calulo olwaphula ukuzenzekela of arrhythmia intliziyo. Classification eyenza data ngezifo phantsi ileta "B". Ezi ziquka:

1. extrasystole (ventricular, atrial, AV of iikhompawundi).
2. izimvo paroxysmal tachycardia.
3. enomoya Atrial.
4. fibrillation (yokudanyaza) imithambo.
5. fibrillation Ventricular.

Yokuphazamiseka Uhanjiso

Eli qela kuquka nabanye arrhythmias ventricular.

Classification Kuszakowski yabela kule:

1. block sinoatrial.
2. block intraatrial.
3. block AV.
4. ukuvimba intraventricular Omasebe bundle, kuquka mono-, kwizifo anayiphi kunye triofaostsikulyarnye echaphazela ngokulandelelana amasebe enye, ezimbini okanye ezintathu esiqhumeni atrioventricular.
5. asystole ventricular.
6. Syndromes ngaphambi kwexesha ventricular excitation.

Luhlangene zokugula rhythm

Eli qela libandakanya onokugula okunjalo:

1. Paraksistopiyu.
2. izingqisho ethunjini luphawulwa ukuvaleka ngomnyango.
3. dissociation AV.

scheme ngamazwe

Iyafuna esithi ekumisweni sifo ezifana arrhythmia, ulwahlulohlulo UMbutho Wehlabathi Wempilo ulibona amaqela afana phantse ngendlela efanayo. Kule ngezifo wohlulwe izifo ezibangelwa yezizathu ezahlukeneyo ukusebenza ukuphazamiseka zentliziyo kwezihlunu. Ngenxa yoko, i-WHO iye amaqela zilandelayo arrhythmia:

1. okubangelwa ukuphazamiseka kwendlela ukuzenzekela, kuquka:

a) abanezincedisi-ntliziyo kwi esiludumbo sinus (tachycardia sinus, arrhythmia kunye barikardiyu kunye SSS and non-zokuphefumla sinus arrhythmia);
B) abanezincedisi-ntliziyo ngaphandle esiludumbo sinoatrial (nizhepredserdny, atrioventikulyarny kunye izingqisho idioventikulyarnye).

2. Biza ukuphazamiseka excitability, kuquka:

a) ukuba imithombo ngezifo (ventricular, atrial kunye atrioventikulyarnye);
b) inani ngemithombo (mono- kunye polytropic);
c) Ixesha ingenzeka: ekuqaleni (ngexesha ucutheko atrial), kamva (ngexesha ukunyenyiswa imisipha yentliziyo) kwaye uthathwa (kunye eyendawo point phakathi ucutheko atrial nokuphumla yentliziyo);
d) njalo: Iqela (kunye kumqolo ezininzi), umphunga (ababini ngexesha), iyunithi (ezintlanu okanye ngaphantsi) kunye ezininzi (ngaphezu ezintlanu);
d) yoku-odola (quadrigemini, trigeminy, bigeminy);
e) paroxysmal tachycardia.

3. ukuphazamiseka Uhanjiso eyabangelwa, ngamanye ndiyandise (WPW-syndrome) nokuncipha (iintlobo ezahlukeneyo yokuvalwa) okanye.

4. Mixed (yokudanyaza / ventricles / imithambo enomoya).

Zonke iintlobo zezifo zihamba ukunyhashwa kuphela kubume yokwakheka kwentliziyo. Akhokelela ukuba ukungalingani kunye nazo zonke iinkqubo pathways ibakho xa iqhosha kwezihlunu. Oku kwahlukile ngokwendalo kunye nexesha arrhythmias. Beka diagnosis yangempela kungaba cardiologist kuphela. Baya kuzimisa unobangela arrhythmias kwentliziyo, Ukuhlelwa, umyalezo weimeyile, Pathogenesis, ezibonisa lwezonyango ngokususela kwidatha electrocardiographic.

uhlobo Ciliated leengxaki

Isiseko sale hlobo yokuhlelwa sifo ziquka ubume zawo zonyango, iindlela electrophysiological nezinto etiological.

Yintoni atrial fibrillation? Classification uchonga ntlobo zilandelayo kuwo:

- ezingapheliyo (njalo);
- ziqhu;
- eziphelayo (paroxysmal), ihleli ukususela kwiiyure ezingama-24 ukuya kwiintsuku ezisixhenxe.

Kule fom ezingapheliyo kwaye gqolo leengxaki unokuba yomhla nezolo.

Kwakhona azakubalulwa uhlobo fibrillation atrial ibetha inhliziyo. Ngaloo bodwa enomoya kunye fibrillation atrial.

Kuba kumaza ngawo ventricles kuyehla, ukwahlula fibrillation atrial:

- tahistolicheskuyu (amaxesha 90 okanye ngaphezulu ngomzuzu);
- normosistolicheskuyu (amaxesha 60-90 ngomzuzu);
- bradisistolicheskuyu (amaxesha ngaphantsi kwe-60 ngomzuzu).

beats

Olu uhlobo a ngezifo luphawulwa izishunqulelo engaqhelekanga le izihlunu zentliziyo okanye iinxalenye zayo ngamnye (extrasystoles). Ngelo xesha linye umntu uziva ixhala, ukuphelelwa umoya, umfutho ngamandla entliziyweni okanye ayaphela. Le ngezifo kukhokelela angina kunye nokuphazamiseka ejikelezayo lobuchopho.

Nayiphi beats ebalasele uluhlu yemida. Kungenxa yoko le nto amacandelo ngaphezu kweshumi eyazi yokuhlelwa ngokupheleleyo. Noko ke, ngokuba izicelo practical ayikhuphi kuphela ezo leyo kakhulu ukubonakalisa malunga ikhondo sifo.

Ukuhlelwa arrhythmias Ezisongwayo yaba linyathelo elibalulekileyo kwimbali zentliziyo. Ukusebenzisa eliCebisayo ecetywayo, ugqirha uyakwazi ukuhlola ngokwaneleyo ulwazi ezifumanekayo kumguli ubungqongqo ngezifo sokuqukuqela yayo. Inyaniso yokuba intliziyo esiswini ibetha (VPB) yande kakhulu. Le leengxaki uyaqapheleka phantse amahlanu ekhulwini kwizigulane kubuzisa cardiologist. Kwezinye kubo sifo nabungozi yaye akukho ezisongela ubomi ngokwayo engawuthwali. Nangona kunjalo, kukho izigulane abaye bafumanisa ukuba kukho uhlobo onobungozi ze PVCs, nto leyo endinga indlela ethile unyango.

Lo msebenzi ungundoqo olwenziwa yi lucalulo ingca, kukuba ukwahlula amabi ukusuka ngezifo elihle. Kulo mzekelo, kukho iiklasi ezintlanu sifo:

1. extrasystole monomorphic ventricular, ogama rhoqo - ngaphantsi kwe-30 ngeyure.
2. PVCs monomorphic kunye kumaza ezingaphezu kwama-30 ngeyure.
3. politopnye.
4. kwiklasi yesine yabelwa icandelwana ezimbini (PVCs ngeziBini tachycardia ventricular xa PVCs ezintathu okanye ezingaphezulu ezilandelelanayo).
5. extrasystole xa R-yomtshangatshangiso kwi T. 4/5 igagasi lokuqala

Oluhlobo ifumana isicelo sayo zentliziyo kunye notyando intliziyo. Iminyaka emininzi, esebenzisa ngayo nabanye oogqirha. Kuqaliswa ngo-1971, iye yaba inkxaso oluthembekileyo ukuba iingcali ngexesha lofakelo arrhythmia zohlelo kunye nonyango yale ngezifo.