Bated ume: akpata na ọgwụgwọ

Emikpu nke obi - ọgwụgwọ nke ọrịa a na-adịbeghị anya excites n'obi nke ọtụtụ ndị gbasara obi dọkịta na-awa, na ndị ọzọ na "obi" nke ọkachamara. Gịnị bụ ihe mere, ihe mgbaàmà nke a dị ize ndụ ọrịa, na-emeso ya - ndị a bụ nanị ụfọdụ mbipụta nke na-adọrọ mmasị anyị ụmụ amaala. Ọ bụ mba na nzuzo na ezi a ukwuu nke ndị mmadụ nwere ndị dị otú a nchoputa ka "a na-emikpu obi". Mgbaàmà, ọgwụgwọ nke ndiife ịgba akwụkwọ, na-arịọ ka pụrụ iche oru, diagnoses - a echiche ga-enyoba na onye ọ bụla nwere mgbaàmà nke ọrịa. Ndị na-esonụ na-egosi ihe ụfọdụ nke ugbu a mbipụta nke isiokwu.

Bated ume: akpata na ọgwụgwọ

Ime ka a echiche nke "aṅacha" na obi nke na-arụ ọrụ nwere ike ịbụ a dịgasị iche iche nke n'afọ iri na ụma na conduction disturbances. Ụfọdụ n'ime ndị a na-ekwu anaghị achọ ọgwụ aka, na ụdị ndị ọzọ nke na-egbu oge na nchọpụta na ọgwụgwọ nwere ike igbu. Ịmata Ọdịiche supraventricular na ventricular arrhythmias.

supraventricular arrhythmias

Ọ bụ akaghi aka eletriki ọrụ nke obi. Ihe kpatara ya bụ isi iyi na-emi odude ke atria na akpa ume veins nke olulu na na atrioventricular nkwụsị. Mgbe ihe dị otú ahụ pụrụ iche na Mbelata ike ịzụlite ele mmadụ anya n'ihu ma ọ bụ zuru ezu postextrasystolic kwusi. Ugboro akaghi gafere na a ogologo kwụsịtụ mgbe ndị pụrụ iche na Mbelata ike inye mmetụta ebelata, emeghasịkwa nke obi.

Independent adakarị ndị a pụtara forms nwere arrhythmias, ma e wezụga na ndị ahụ mgbe ha dị na-amalite na-agba ọsọ supraventricular tachycardias, atrial flutter ma ọ bụ atrial fibrillation.

Na-anọghị nke bughi ntụpọ na obi muscle supraventricular extrasystoles pụrụ iche ọgwụgwọ bụ chọrọ. N'ọnọdụ ebe ha na-esonyere ịrịba nke onye ahụ erughị ala, beta-blockers, verapamil, sedatives nwere ike ji mee.

Ọtụtụ mgbe supraventricular extrasystoles bụ ngosipụta nke isi ọrịa (dystonia, ala ala okpo ọrịa akpa ume, electrolyte aghara), mgbe ahụ, nchoputa na-achọ ukpụhọde na ọgwụgwọ nke isi usoro.

Ventricular fibrillation extrasystolic

Ventricular extrasystoles - anticipatory eletriki ọrụ nke obi na ikwu na isi n'afọ iri na ụma kpaliri usu ịda na ụkwụ ma ọ bụ iche iche ùkwù alaka ngọngọ, Orion ma ọ bụ Purkinje arụ ọrụ myocardium. Mgbe ihe ndị a Filiks budata yikarịrị ịzụlite full compensatory kwusi, nke, dị ka n'ihe banyere atrial akaghi gafere, chere na ụdị "aṅacha". Ventricular Filiks enweghị ihe ọ bụla gradation nke organic ọrịa obi na ọrịa abụghị a n'ihe ize ndụ na-akpata ọnwụ mberede, ya mere untreated. Wezụga na ike ọrịa na butere n'aka ọrịamkpokọta (congenital elongation ma ọ bụ shortening nke QT, Brugada syndrome, wdg).

Emikpu nke obi, na-akpata ya na ihe mgbaàmà nke na-atụle ga-eme ka a N'ihi nke a obere obi rhythms.
A nkịtị obi ọnụego kpebisiri ike n'ime 60 100 ịtụnanya kwa nkeji. N'ahụ slowing nke obi ike-eme n'oge na-ehi ụra, mgbe na-eku ume nke ukwuu, na-eme egwuregwu.

Bụrụ na nke mebiri mgbe ọ bụla ogbo na ọgbọ nke gbasara obi usu-amalite enweghị nchịkwa bradycardia, nke nwere ike ịbụ symptomatic, asymptomatic, na ọtụtụ mkpa ọgwụgwọ.

Na-akpata bradycardia

Ọdịiche dị n'etiti esịtidem na mpụga akpata bradycardia.
The esịtidem ihe na-agụnye:

• merela agadi;
• ịrịa ọrịa obi;
• connective anụ ahụ ọrịa;
• congenital ọrịa, gụnyere adịghị ike nke atrioventricular ọnụ;
• muscular amyloidosis;
• ịwa trauma (orthotics valves, obi transplantation) ;
• na-efe efe (diphtheria, rheumatic ọrịa obi, ọrịa ọbara nsi, ịba ahụ ọkụ).

Site mpụga ihe nke bradycardia na-agụnye:

• anụ ahụ ọzụzụ;
• elektrotonus mụwo vagal (vasovagal blackout; supersensibly carotid imi);
• ọgwụ ọjọọ (beta-blockers, calcium ọwa blockers, digoxin, lithium, antiarrhythmic mmadụ);
• cocaine;
• hypokalemia;
• hyperkalemia;
• akwara ozi ọgba aghara (CNS akpụ, mụbara intracranial mgbali);
• Okpo ụra apnea syndrome.

Maka nchoputa nke bradycardia eji eduzi Holter nlekota oru, merenụ counters na ndekọ, implantable ngwaọrụ, nakwa dị ka ndị na-eme ihe electrophysiological ọmụmụ.

ọgwụgwọ nke bradycardia

Nzọụkwụ mbụ bụ ịmata ihe na-akpata na-ekwe omume iwepụ bradikaridii omume ha (discontinuation nke beta-blockers). Ọ bụrụ na e nweghị mbughari isi, i nwere ike mkpa usoro ọgwụ ma ọ bụ ruo nwa oge ma ọ bụ na-adịgide adịgide pacing).

ọgwụ

Iji kpalie ịrịba obi ọnụego deceleration (n'ihi na ogologo karịa 3 sekọnd) iji atropine, isoproterenol, aminophylline. Otú ọ dị, oriri nke ndị a ọgwụ ọjọọ nwere ike ịkpalite arrhythmias, gụnyere-eyi ndụ egwu ventricular disturbances.
Na ọrịa na myocardial ischemia na bradycardia dị ka a N'ihi ya, na-emefu antiischemic ọgwụ na na-biding oge ha, iji pacing ma ọ bụrụ na ọ dị mkpa.

Ọrịa na ịda mbà n'obi imi syndrome kaadị na atrioventricular ngọngọ na-inyocha ka nwa oge ma ọ bụ na-adịgide adịgide pacemaker.
E mepụtara European-egosi maka echichi nke na-adịgide adịgide pacemakers na ọrịa na-arịa ọrịa imi syndrome, atrioventricular ngọngọ.

dịgasị iche iche nke stimulants

Ịmata Ọdịiche otu-ulo, sọrọ-ulo, atọ-ulo stimulators. Nwere mbụ na nke abụọ electrodes 1 na 2 (atrial na / ma ọ bụ nri ventricular). Atọ-ulo na ngwaọrụ na-eji maka biventrikulyatnoy ebighị na nwere ihe ọzọ ndu n'ihi na n'aka ekpe ventricle.

Mgbe nri atrial mmalite ventricular synchronism a kpaghasịrị ya. The ECG n'oge usoro a na ite iche nri ùkwù alaka ngọngọ.
N'elu mmalite nke ma ventricles chekwara ha synchronous ọrụ, gbasara obi hemodynamics na nke a, ka mma.

nkunye

The mbụ dị otú ahụ unit e guzobere 1958. Ndị na-esonụ bụ ha evolushọn. Ugbu a ọ bụ oge a na, dị nnọọ nta, elu-tech ngwaọrụ.

Ugbu a, e bụ kwa afọ osisi si 400 na 1,200 stimulants kwa nde bi.

Kardiopribor enịmde eletriki ebighị nke myocardium. The mgbaàmà propagates tinyere gbasara obi muscle na-abụghị n'ahụ. Ya ogologo oge n'ebe nwere ike ime ka ọkụ na n'ibu mgbanwe myocardium. The echichi a chọrọ ka na-emepụta site na stimulator oké njọ na-egosi.

Atụmatụ mmalite ụdịdị

N'oge nri ventricular pacing eletriki usu-etinyere n'aka ekpe ventricular onu ire na depolarizes medlennoprovodyaschy myocardium. The ECG kwupụtara mgbochi nke ekpe ùkwù alaka ngọngọ. Ndị dị otú ahụ ọrịa a ala ejection nta karịa ọrịa na-enweghị mgbochi. Ọzọkwa, mgbe usoro a emee eletriki gbasara obi remodeling. Nso nso a, e nwere a ọchịchọ belata egosi maka echichi stimulants data na njikọ na a ịrịba ama ọtụtụ ndị oghom mgbanwe.

E guzobere ya na nke kasị ala ejection nta kpụrụ n'okpuru ihe nke ventricles. Nkezi - ebighị nke atria, mgbe ahụ, ndị ọzọ obi. The kasị elu ẹnịm ejection nta n'oge mmalite nke atria na ventricles nke eke ụzọ.

Gosiri na erughị mepere emepe atrial fibrillation na ọrịa na atrial ebighị na a abụọ-ulo karịa na ọrịa na ventricular naanị mmetụta nke ngwaọrụ.

The sọrọ-ulo ngwaọrụ, pụtara nnyocha na experimentation, ọ dị mma na emega ahụ mgbe ọrịa.
Pacemakers ugbu a gold ọkọlọtọ na ọgwụgwọ nke ọrịa na symptomatic bradycardia. The search na-aga n'ihu n'ihi na ọtụtụ n'ahụ N'ụzọ nke uru na myocardium.

ọgwụgwụ

N'ihi ya, na-emikpu nke obi (ụra ma ọ bụ na ndị ọzọ ọnọdụ) - a dị nnọọ ize ndụ ọrịa. Mgbe mbụ mgbaàmà nke ọrịa a ga-ozigbo ụlọ ọgwụ na-ebu niile ule ma jiri nlezianya na-emeso. The ngwa ngwa mmalite ọgwụgwọ na mgbochi, na ndị ọzọ dị irè ga-agwọ ọrịa.