Asystole wenhliziyo - kuyini? Izimpawu, izimbangela, ukunakekelwa okuphuthumayo, ukwelashwa

Ukumiswa ngokuzumayo imisipha yenhliziyo, ephelezelwa nokungawuvivinyi bioelectrical kwezokwelapha ibizwa ngokuthi "asystole inhliziyo." Kuyini lokhu? Ziyini izimbangela isimo kusho? Kanjani ukunikeza usizo oluphuthumayo kubantu kwenzeka ukuboshwa inhliziyo? Izimpendulo yonke le mibuzo ungathola kamuva esihlokweni.

Izindlela okuvela asystole inhliziyo

Asystole kwenhliziyo, izizathu zazo izincwadi esizifundayo, ihlukaniswe leso futhi kwenzeka ngenxa i arrhythmia inhliziyo ekhona.

Esimweni sokuqala, sinombono inhlalakahle kanye non-sokwephulwa kwe kwenhliziyo isigqi kuyinto ngokuzumayo ilahlekelwa elektrovozubdimost ukuthi sifana short circuit. Isizathu salokhu ngokuvamile sibi ischemic isifo senhliziyo, ukubukeka, ngenhlanhla, kubangela ukukhuluphala, ukubhema, sikashukela nomfutho wegazi ophezulu.

Endabeni yesibili, isimo eside ogelezayo fibrillation (ukunciphisa wahlukana futhi uncoordinated ka inhliziyo imisipha Imicu yotshani) zenzeka ngokushesha afundwa amaza okungajwayelekile kagesi ukuphazamisa ukugeleza kwegazi ezitsheni yenhliziyo futhi, ekugcineni, kungenzeka wayencisha inhliziyo ungenwa, wabangela ukuba ayeke.

Izizathu ezibanga ukuboshwa inhliziyo

Mayelana 5% kwezinso ezinzima inhliziyo kuholele yokuthi isiguli eba asystole inhliziyo. Izizathu zalokhu isimo esisongela ukuphila ngokuvamile kubangelwa e ukuvela ifomu okukhulu isilethikusebenza noma embolism yamaphaphu.

Asystole futhi kungase kuvuse ukweqisa izidakamizwa of glycosides inhliziyo, izidakamizwa antiarrhythmic noma izinzwa ezithinta ukusebenza kwe wathi kwemisipha. Ngenxa yokwehluleka inhliziyo ingabagulisa ingozi kagesi, intracardiac zokukhwabanisa noma jikelele ezinzima iziyaluyalu umzimba.

asystole ventricular Ikakhulukazi

Kuhle kokusho ukuthi kwaba ventricular asystole (ngci izifinyezo yabo), ngokungafani iyahambisana ukuphila asystole atrial, kuholela kokufa nesineke.

Lokhu zokugula awahlobene le arrhythmia, okuyinto sokucasuka okhushuliwe excitability ethunjini. Izizathu nesenzakalo kwakhona thuthuva conduction ne okusithiyayo okucishe kufane nalokhu ikhono ventricles ungenwa atishaye.

Ngokuvamile isimo okuthiwa kungase kube umphumela atrial noma ventricular fibrillation futhi iza ngemva kwayo, futhi kwezinye izimo kuphakamisa dissociation electromechanical, noma ventricular tachycardia.

Izenzo asystole inhliziyo ezinganeni

asystole inhliziyo ezinganeni uvame cuphuluza ukulimala, ushevu, izinhlobo ezihlukahlukene zezindwangu ezingaba iziyaluyalu zokuphefumula (isib, umgudu isimiso, ukuhogela intuthu, ominzayo noma izifo).

Phela, it is waphawula ukuthi 15-20% eziguli abasha e ukuboshwa inhliziyo kwandulelwe fibrillation noma ventricular tachycardia. Kodwa uphawu oluvame kakhulu ukuthi ingane yakho usongela ukuthuthukiswa asystole, Kuyaphawuleka ukuthi bradyarrhythmias (deceleration okuphawulekayo kwenhliziyo).

Endabeni izingane noma intsha ezinzima yesifo senhliziyo azalwa naso ngaphambi asystole ngaphambilini kungenzeka bagcine okuvela kuyo njalo ukuphefumula engajulile, hypotension futhi ukwazi kahle. Kwezinye izimo, ukuboshwa inhliziyo ekulandulayo nciphisa ne emifushane (imizuzwana engaphansi kwengu-emihlanu) nokuquleka.

Kanjani asystole wenhliziyo ku-electrocardiogram

Asystole wenhliziyo ku-electrocardiogram wembula umugqa cishe ngqo emelela umsebenzi wayo kagesi.

izici Isici kulesi simo ungase futhi kubhekwe isigqi okungavamile we Atria, ukungakwazi ukubala ukuvama Kufinyeta, ngesikhathi lapho kungekho Kufinyeta ventricular. Kwezinye izimo, lapho ATRIUM namanje isikhathi esithile liyaqhubeka lehla ngemva ventricles inhliziyo ku ECG kungathola atrial P wave

elementi asizayo sitholakele asystole futhi bangase benze ngaphambi kwalesi isimo arrhythmia. Ngakho, uma kubonakala ngesimo ekuseni polytopic ventricular amabhithi singakafiki isikhathi ventricular tachycardia, bese ulandela kubo ukulotha, flutter, nokukhuphula nokuvinjelwa ngokuvamile ibonisa kusondela asystole.

Asystole wenhliziyo: izimpawu

Izimpawu ukusiza ukuthola ukuthi isiguli sine-ukuboshwa inhliziyo, cishe zonke ujwayelene, kodwa sisadinga ukuphinda kubo.

• Ngo imithambo ezinkulu akukho ishayela. Ukuze uqinisekise lokhu, kuzomele eligoqiwe Inkomba neminwe phakathi ukuhlola ubukhona balo ku Umthambo carotid (siphumputha yakhe emgodini eduze uqwanga yegilo ka amalaka (apula sika-Adamu)). Uma kungekho i-pulse ke asystole enhliziyweni yomuntu.
• usizo oluphuthumayo lapho zidingeka, futhi uma abafundi ungaphenduli ziqondiswe emehlweni flashlight. Ngokuvamile, kufanele ayisesemikhulu, futhi uma lokhu kungenzeki, kusho ukuthi myocardium is kodwa angasebenzi.
• Ukuze umise inhliziyo uthi futhi yokuntuleka umoya kwenzeka kungakapheli imizuzu 2. emva ukunyamalala ishayela. Lokhu kungaba ukuqinisekiswa ngokuletha isisulu ukuthonya ezindebeni zakhe esibukweni.
• Ayikho obucacile kancane ukubonakala kwesikhumba. Uma kuba lemicu empunga elinamathela othini noma bluish tint (ikakhulukazi izindebe, ichopho ekhaleni kanye izindlebe) - iyisiginali kuphazamiseka sina kwegazi.
• Futhi ekugcineni, uma isiguli equlekile abakwazi ukuletha ekuphileni ezingaphezu kuka 10-20 imizuzwana usebenzisa i-ammonia, Pats phezu izihlathi noma imisindo elikhulu, lokhu nakho kungaba uphawu asystole.

Konke lokhu izimpawu eziyingozi ukuze ukuphila komuntu, ngakho zidinga izinyathelo esiphuthumayo resuscitative, okuyinto kumele inikezwe ngaphambi kokufika ambulensi nabasebenza. Khumbula ukuthi ukuze kusindiswe ukuphila udlala esingengaphezu kwemizuzu engu-10 (isikhathi eside kangaka emva inhliziyo uyayeka wayesaphila ubuchopho bomuntu).

imithetho eziphuthumayo ukuboshwa inhliziyo

Ngakho, uma kutholakala umuntu inhliziyo asystole, ukunakekelwa nesineke, kunalokho esiphuthumayo usizo lokuqala simiswe ngalendlela lelandzelako:

1. Shayela i-ambulensi.
2. Mahhala nge ekhaleni napkin nomlomo we isisulu ebuhlanzweni, slime noma imigwamanda angaphandle.
3. Beka umuntu emhlane wakhe, kodwa ukuze Ikhanda lakhe laselilethwa kancane aphonswe emuva.
4. Nikeza izinyawo zakhe isikhundla kancane aphakeme nge izingubo eligoqiwe noma imicamelo.
5. Air yizicucu zibe amaphaphu isisulu noma umlomo i-umlomo (kungaba aphonse iduku) noma umlomo-to-ekhaleni. Ukwenza umjovo owodwa, afeze massage inhliziyo.
6. Ukuze wenze lokhu, beka entendeni ingalo buthaka ukuze waphumula ngokumelene phansi onqenqemeni engezansi sternum we isisulu. Phezu ke beka enye perpendicular entendeni futhi wonke isisindo emzimbeni, nobude bengalo, ukunyakaza abukhali ukwenza ukuzamazama Rhythmic (5 compressions). Isikhawu phakathi kwabo akuyona ngaphezu kweyesibili. Ngemva ngamunye push izandla kusukela Khupha esifubeni, hhayi ukuthi liphazamisane igazi ukuze ngokukhululeka iyangena inhliziyo. iminithi Omunye udinga ukukhiqiza Ukundindizela okungenani 100.

Amathiphu ambalwa esengeziwe ukuhlinzeka usizo oluphuthumayo

Kungcono uma okungenhla yokusiza umuntu ukuba aphefumule abantu ababili nje - omunye ashaye emoyeni, kanye nezinye wenza esifubeni compressions.

Kubalulekile ukukhumbula ukuthi uma azikwazanga ukulondolozwa isiguli, kodwa uchitha imizuzu engaphezu kweyishumi eyabelwe, kungase ukuthuthukisa iziyaluyalu sina zezinzwa. Ngakho kumelwe kubuthwe, okubaluleke kakhulu, ukuthula kwengqondo, indlela kuphela asystole inhliziyo (ukuthi iyini wena manje, yebo, uyazi) tshoda.

Njalo ngamaminithi angu-2, hlola isimo lesiguli - ukuphefumula kwakhe, ukushaya kwenhliziyo nomfutho pupillary ukuphendula, ngokushesha nje lapho kufika umoya, ukunakekelwa eziphuthumayo kungenziwa kumisiwe. Uma kwakuba khona ishayela, kodwa ukuphefumula sisekhona, qhubeka ukupholisa yokufakelwa.

Ngisho noma awukwazi abayovuswa lohlaselwayo, bengayeki amnike ukunakekelwa okuphuthumayo. It kungenziwa wayeka kuphela uma odokotela ambulensi ifike. Basebenzisa izindlela zabo silondoloze ukuphila isiguli.

yezinkinga ezingenzeka ngemuva ukuboshwa inhliziyo

Njengoba kushiwo ngenhla, abatakuli impela kancane isikhathi sokusiza umuntu etholakele asystole zenhliziyo. Kuyinto kuphela 10 imiz. Futhi, ngeshwa ngisho esimweni umphumela omuhle ngoba isisulu ingase ibonise imiphumela ukuboshwa inhliziyo, isibonelo:

• ukulimala kobuchopho ischemic, isibindi noma sezinso ngenxa liningi igazi esingamahlalakhona kwezitho ngesikhathi sebefile;
• izimbambo eziphukile ngenxa ingcindezi kanzima ngesikhathi massage inhliziyo;
• umoya phakathi komgodi phakathi amaphepha pleura ukumboza amaphaphu kwesifuba (kwezokwelapha zokugula enjalo ibizwa ngokuthi pneumothorax).

Kodwa uyazi ukuthi wasindisa ukuphila namanje izimbambo eziphukile ngaphezulu, futhi ngenxa yalokho, unganqikazi ukunikeza usizo oluphuthumayo ukuze oswelayo.

Izici usizo oluphuthumayo wengane

Ngeshwa, abantwana eminyakeni yokuqala yokuphila ezichazwe yokusiza umuntu ukuba aphefumule sihloko ehambisana ikakhulukazi, futhi ngenxa yalokho, abazali kumele ayejwayele ukuthi benzeni ezimeni lapho izingane zabo ukuthuthukisa asystole inhliziyo (it lokhu isenzo okungukuthi uhlukile isimo ezisebenza abadala, wena, yebo, wazi).

Futhi into eyinhloko ayikona ukuhlanganisa ukwethuka ukwenza ngokushesha okukhulu, njengokungathi elishiwo ngenhla ngesikhathi ingane kuyehla kube amaminithi angu-5. Okokuqala, shayela i-ambulense.

• Khona-ke udinga ukubeka umntwana etafuleni, strip noma unswathe futhi ukuyikhulula emlonyeni isikhwehlela futhi ndaba angaphandle.
• I pads index kanye umunwe phakathi ukunamathisela phansi esifubeni. Push kubo isifuba wakwenza ngokuzimisela, kodwa ngesisa, ngesikhathi jolts 120 elingu-1.
• Phakathi push the sternum kufanele sigudluke ngu isithupha ukujula.
• Ngemva zonke compressions 15 wenze 2 ohlabayo umlomo limbozwa ngendwangu futhi ekhaleni wengane.

Asystole wenhliziyo: ukuphathwa e labagula

yokusiza umuntu ukuba aphefumule ezikhethekile ezivela ukuboshwa inhliziyo esibhedlela ezenziwe usebenzisa intubation (ibekwe a nezimo plastic tube lapho ukuqhuba ukupholisa mechanical) kanye bolus (labo babe okusheshayo, ngokungafani weThrojani) ethula emthanjeni amalungiselelo "Epinephrine hydrochloride" futhi " atropine ".

Uma nokungasebenzi Kutholwe amazinga okukhishwa ezivamile okuthiwa ejenti iqondiswa zonke 5 imiz. jet. Khona-ke, umthamo liyakhula kancane kancane kuze kufinyelele 5 mg yaphinde yaphathwa njalo ngemva kwemizuzu engu 3 kakade.

Ezimweni lapho ukufinyelela ngemithambo akukho izidakamizwa iphathwa kuqhoqhoqho, umthamo wabo kuleli cala kabili anda. Umjovo ku inhliziyo kwenziwe kuphela uma ukwehluleka ezinye izindlela izidakamizwa ukulethwa.

Ungakuvimbela asystole

Sizama ukuxoxa esihlokweni kanjani asystole esiyingozi kwenhliziyo, kuwumbandela ukuthi kungaholela kalula umuntu afe. Kodwa kungenzeka ukugwema umphumela onjalo? Futhi indlela ukuze ngikuvimbele?

Kwezinye izimo, ukwenza kube ngokuphelele yangempela. Kudingeka abagci- imithetho izifo. Ngakho, kungakhathaliseki ukuthi uphethwe, iziguli isifo senhliziyo kufanele ulandele ngokunembile imiyalelo udokotela wakho - ingangqubuzani umthamo izidakamizwa kanye Ukwenza isicelo sabo, ukuqapha ezingeni lokuzivivinya futhi ugweme ukusetshenziswa ezinye zalezi izidakamizwa onguchwepheshe.

Uma kudingeka, kulezi ziguli kanye nedivaysi yezokwelapha babelwa njengoba cardioverter-ovuselela noma pacemaker nokugcina ezanele kwenhliziyo. A Ngokubonisa isineke esifanayo kufanele lilungele izimo eziphuthumayo futhi wazi kanjani isinyathelo endabeni ethile.

Zonke izinto ezidingekayo ukuze kuvinjelwe eyinhloko, kuxoxwa ngokuningiliziwe ne wenhliziyo futhi ziyadingeka ukwenza.