Ukwahlukanisa arrhythmias inhliziyo

Ngokwezibalo yezokwelapha, kwasekuqaleni phakathi kwazo zonke izifo izifo zenhliziyo kanye semithambo uhlelo. Yini eyaholela kulokho? Isimo izici eziningi ezingezinhle ezithinta uhlelo senhliziyo nemithambo yegazi. Omunye wabo - ukucindezeleka njalo kanye nokuntuleka isikhathi ukuphumula ngokwanele. A abayizibonelo ezimbi ekukhuleni lezi pathologies kudlala nokungcola komoya. Kodwa umuntu esimphethe hhayi kuphela kuzo zonke izimo zemvelo eziwohlokayo. On impilo abakhileyo iplanethi yethu abe nomthelela omubi iziphepho magnetic. Kulezi Ukuvutha on the Sun kubi ikakhulukazi nokuzwakala ncamashi cores. I besanda kuqala pathologies ukuba ungaguli kakhulu, ngokuvamile okusongela ka arrhythmia ebulalayo kuba.

Ingqikithi yalo isifo

Ngokuvamile elithi "arrhythmia" akuyona ziqondakala kithi njengoba isifo sakhe. Kodwa musa aphathe lokhu njengoba kuqeda impilo ikwenze. Ngokuvamile, inani imivimbo akufanele bube ngaphezu kuka-90 ngeminithi. Uma lena ukubaluleka akufanele kube ngaphansi kuka-70 Kodwa kubantu abaningi lolu lwazi alwaziwa. Futhi, njengoba umthetho, singakwazi ukulawula kwenhliziyo yakho, ukuvakashela wenhliziyo hhayi ukudlula ngokusuka lalo, ECG. Nokho, izenzo ezinjalo ziphuma isilinganiso aphansi ukuze kulondolozwe impilo yabo.

Baningi ukwehluleka onjalo umzimba ebalulekile njengoba inhliziyo, awukwazi kuphela ukuvimbela, kodwa futhi ukuba ayeke. Futhi insimbi yokuqala kwamukelwa izinyathelo eziphuthuma kakhulu iyona ukuphambuka kancane kulezo setha isigqi, okuyinto ezibhekwa kuyinsakavukela.

Ezinye izizathu okuyinto kukhona ushintsho ezingeni ishayela, imi kanje:

- ukukhathala;
- ekucindezelekeni eqinile;
- ukweqisa izidakamizwa utshwala;
- yesifo senhliziyo azalwa naso.

Arrhythmia Iphuzu liwukuthi ukuthi kungukuphula kohlelo inhliziyo.

Nangodokotela bababhekene nezifo zenhliziyo ukwaba ngamazinga ahlukene kobukhulu ukuphambuka ezinjalo. Ngokwesibonelo, ukwelashwa elula wakhonza izimo ezinjalo lapho imvamisa oyifunayo akusho suffice imivimbo embalwa nje. Nokho, iziguli ahlupheke kaningi kusukela nokwanda okuphawulekayo ukusikwa esivimba amanzi. Kuyingozi kakhulu abantu futhi zingaba yingozi.

zezifo

ngezigaba umfaniswano arrhythmias okwamanje ayikho. Lokhu kungenxa zonke nezingxoxo eziqhubekayo ngezizathu, okuyinto kufanele bafake isisekelo salo. Ngempela, naphezu cwaningo kakade eminyaka ubudala yesayensi yalesi sifo, umphumela oyifunayo ekwelashweni yayo ochwepheshe asamukelanga.

Ngokwesibonelo, kwasikiselwa ngo-2014 ukuthi ngezigaba arrhythmia kuhlanganisiwe izinhlobo ezintathu eziyisisekelo pathologies. Phakathi kwabo:

1. Arrhythmias kukhona impendulo evamile, ebonakaliswa nemibandela lithathelwe, kodwa ingaholela neziyaluyalu, ngoba umzimba kuyingozi.
2. Arrhythmias ezivukayo ukulawulwa umsebenzi inhliziyo.
3. Arrhythmias kubangelwa ukusebenza disorganization antivolnovogo of imisipha yenhliziyo.

Ukwahlukanisa arrhythmias inhliziyo (WHO) ukhomba amaqembu amathathu ezinkulu lezi pathologies. Bahlanganisa zifo ezilandelayo:

- Ukwakheka kubangelwa kungukuchotshozwa esimiso senhliziyo nemithambo yegazi ye-pulse kagesi;
- elihlobene ne conduction iziyaluyalu;
- uhlobo kuhlanganiswe kubangelwa kokubili kuqala futhi imbangela yesibili.

Arrhythmia libhekwa futhi ngenxa imvelaphi yabo. Ngakho, uyisithulu elingalodwa, aluthola pathology idiopathic. Eyokuqala yalezi zinhlobo ezintathu itholakala kusukela mzuzu ukubukeka umuntu emhlabeni. arrhythmia Idiopathic Akuqinisekwa ukuthi livelaphi. Njengoba isifo aluthola, kwenzeka kulo lonke ekuphileni isiguli kanye is phetho ezinye izifo ezingathi sína kwababhemayo, kuhlanganise - isifo senhliziyo, sikashukela nomfutho wegazi ophezulu.

Esimeni arrhythmia imisipha inhliziyo ngendlela efanayo njengoba ngaphambi, uyaqhubeka ukumpompa igazi. Nokho, lokhu zokugula kungaholela ukuthuthukiswa pathologies ezifana thromboembolism futhi senhliziyo. Futhi okhuluma ngengozi arrhythmia.

Ukwephula ukushaya kwenhliziyo

Lena enye yezinhlobo ezingu izizathu ukuthuthukiswa zokugula. Kule ndaba, kukhona ngezigaba arrhythmias yenani kwenhliziyo. Kuhlanganisa:

1. itheku tachycardia. Lokhu zokugula ehlangene kokunikezwa kwe-engeyokuqala itheku okuyinto lo mshini eyinhloko inhliziyo amaza kagesi.

Lapho lolu hlobo tachycardia kwenhliziyo idlula embundwini eliphezulu elilingana imivimbo ayisishiyagalolunye ngomzuzu. isimo esinjalo esiyitholayo yisiguli njengoba kweso.
2. Itheku arrhythmia. Lokhu zokugula kuyinto alternation olungalungile kwenhliziyo. Ngokuvamile, itheku arrhythmia ebonwe izingane nentsha. Ngokuvamile, kuba ukusebenza futhi unobuhlobo ngqo umoya. Phakathi ephefumula ukushaya kwenhliziyo njalo, futhi uma exhale, kunalokho, babe ngaphezulu ezingavamile.
3. itheku bradycardia. uphawu wayo lomkhulu nokuncipha kwenhliziyo 55 amabhithi ngeminithi. Lesi simo esiyingqayizivele sibangelwa kungabonakala nasemkhakheni ngisho abantu bephilile futhi benamandla ngokomzimba ngenkathi elele noma aphumule.
4. paroxysmal fibrillation atrial. Kulokhu, kukhona palpitations Inhliziyo eqinile, ukuba isigqi esifanele. ngezinye izikhathi kwenhliziyo kubantu ifinyelela 240 ngomzuzu. Ngesikhathi esifanayo, kudala ngobuthakathaka pallor, ukujuluka yanda, futhi lightheadedness. Isizathu salokhu mkhuba kukhona amaza ezengeziwe zingaveli Atria. Ngenxa yalokho, ukubukeka kwabo ukunciphisa esinamandla kakhulu isikhathi sokuphumula kwemisipha esivimba amanzi.
5. tachycardia Paroxysmal. Lokhu zokugula ilungile, kodwa isigqi njalo kakhulu imisipha yenhliziyo. Kwenhliziyo kulokhu ku ezahlukene amabhithi ngeminithi 140 ku-240. yokwelapha Paroxysmal, njengoba umthetho, kubonakala futhi iphele ngokuzumayo.
6. Arrythmia. Lolu hlobo arrhythmia kuhanjwa (ngaphambi kwesikhathi) ukuncipha imisipha esivimba amanzi. Kulokhu, umuntu uzwa ukundindizela futhi wasisekela enhliziyweni, futhi wokudamba yayo.

Ukuze basize wenhliziyo

I elula kunazo kusukela iphuzu eliwusizo umbono kubhekwa for ngezigaba arrhythmias Kuszakowski. Amaqembu amathathu pathologies azifaka kuwo. Ngesikhathi esifanayo babe incazelo eningiliziwe wonke amalungu ala pathologies. Ake sicabangele typology, okubandakanya Ukwahlukaniswa arrhythmias.

Kwezinso e zokwakheka isigqi

Leli qembu siqukethe sub-izigaba ezintathu. Ngo owokuqala, okuyinto Ukwahlukaniswa arrhythmias ukukhishwa ngaphansi incwadi "A", faka nomotopnye egunjini lokuhlolwa kwezifo. Bakha kokunikezwa kwe-engeyokuqala itheku. Kulo release:

1. itheku tachycardia.
2. itheku barikardiyu.
3. itheku arrhythmia.
4. Sss, noma syndrome, itheku ogulayo.

Ngakusasa sub-section kuhlanganisa ethunjini izimbangela arrhythmia zenhliziyo.

Ukwahlukanisa ikhomba uhlu pathologies ngaphansi incwadi "B". Lesi sigaba kuhlanganisa iziyaluyalu kubangelwa isigqi heterotopic ukuthi iphakame mayelana nesigameko predominance ka automatism ezindaweni ethunjini. Lolu hlu lufaka:

1. obambele (ukubambezela) futhi fly ukuphuma isigqi izakhiwo, kuhlanganise atrial futhi ventricular kanye kusukela AV-compounds
2. Migration ebonwe pacemaker supraventricular.
3. Neparoksizmalnye izinhlobo tachycardia noma isigqi yashesha ezifana ethunjini.

Lesi sigaba esilandelayo icacisa non-ukwephulwa of automaticity ka arrhythmia inhliziyo. Ukwahlukanisa ihlukanisa idatha zokugula ngaphansi incwadi "B". Lezi zihlanganisa:

1. extrasystole (ventricular, atrial, futhi AV compounds).
2. paroxysmal tachycardia ukubukwa.
3. atrial flutter.
4. fibrillation (kulokolokoza) Atria.
5. Ventricular fibrillation.

Yokuphazamiseka conduction

Leli qembu kuhlanganisa nezinye eziningana arrhythmias ventricular.

Ukwahlukanisa Kuszakowski inike kule:

1. block sinoatrial.
2. block intraatrial.
3. AV block.
4. ukuvinjelwa intraventricular amagatsha akhe lenqwaba, kuhlanganise mono-, bio- futhi triofaostsikulyarnye zokugula ezithinta ngokulandelana amagatsha eyodwa, ababili noma abathathu lenqwaba atrioventricular.
5. ventricular asystole.
6. syndromes nisebancane ventricular excitation.

Kuhlanganiswe zokugula isigqi

Leli qembu kuhlanganisa zinkinga:

1. Paraksistopiyu.
2. isigqi ethunjini libhekene ukuvaleka ophumayo.
3. AV dissociation.

uhlelo ngamazwe

Kuwufanele ethi ekutholweni isifo esinjengo arrhythmia, i-WHO ngezigaba uyazicabangela maqembu cishe ngendlela efanayo. Kulesi zokugula sehlukaniswe izifo zibangelwa yezizathu ezihlukahlukene ukusebenza iziyaluyalu senhliziyo esilimele. Ngakho, i-WHO likhombe amaqembu elandelayo arrhythmia:

1. kubangelwa thuthuva ka automaticity, kuhlanganise:

a) elawula ukushaya kwenhliziyo e engeyokuqala itheku (tachycardia itheku, arrhythmia futhi barikardiyu futhi Sss futhi okungezona zokuphefumula itheku arrhythmia);
b) elawula ukushaya kwenhliziyo ngaphandle engeyokuqala itheku (nizhepredserdny, atrioventikulyarny futhi idioventikulyarnye isigqi).

2. Call iziyaluyalu excitability, kuhlanganise:

a) I-pathology imithombo (ventricular, atrial futhi atrioventikulyarnye);
b) inani imithombo (mono- futhi polytropic);
c) Isikhathi nesenzakalo: ekuqaleni (ngesikhathi ukusikwa atrial), kamuva (ngesikhathi ukuphumula imisipha yenhliziyo) kanye interpolated (nge kwasendaweni iphuzu phakathi ukusikwa atrial nokungcebeleka wenhliziyo);
d) imvamisa: iqembu (nge irowu eziningi), umusi (ezimbili ngesikhathi), iyunithi (lasihlanu nobe lamancane kunaloko) futhi amaningi (ezingaphezu kwezinhlanu);
d) for iyala (quadrigemini, trigeminy, bigeminy);
e) paroxysmal tachycardia.

3. conduction thuthuva eyenga, isb uwakhuphule (WPW-syndrome) noma ukwehla (izinhlobo ezahlukene ukuvalwa).

4. Mixed (kulokolokoza / ventricles / Atria flutter).

Zonke izinhlobo izifo ahambisana ukwephulwa hhayi kuphela isakhiwo yokwakheka inhliziyo. Bona kuholele Ukungadli nazo zonke izinqubo umzimba okwenzeka infarction kwemisipha. Lokhu kuhlukile nemvelo kanye nesikhathi arrhythmias. Beka uphethwe kweqiniso can wenhliziyo kuphela. Bayoba setha imbangela arrhythmias inhliziyo, ngezigaba, etiology, pathogenesis, ukubonakaliswa emitholampilo ngesisekelo idatha electrocardiographic.

uhlobo ciliated zokugula

Ngesisekelo lolu hlobo isifo ngezigaba kuhlanganisiwe ubunjalo busebenze yomtholampilo, izindlela electrophysiological futhi izici etiological.

Kuyini atrial fibrillation? Ukwahlukanisa ikhomba lezi zinhlobo ezilandelayo ke:

- okungamahlalakhona (njalo);
- eziphikelelayo;
- lezivakashi (paroxysmal), okuthatha amahora angu-24 izinsuku eziyisikhombisa.

Kulesi amafomu chronic eziphikelelayo zokugula bangaba yansukuzonke.

Liphinde zihlukaniswa uhlobo fibrillation atrial amabhithi inhliziyo. isehlane Ngakho flutter futhi fibrillation atrial.

Ukuze imvamisa ventricles ziyancipha ngawo, ukuhlukanisa fibrillation atrial:

- tahistolicheskuyu (izikhathi ezingu-90 noma ngaphezulu ngeminithi);
- normosistolicheskuyu (izikhathi 60-90 ngomzuzu);
- bradisistolicheskuyu (izikhathi angaphansi kuka-60 ngomzuzu).

amabhithi

Lokhu kuhluka a zokugula libhekene Kufinyeta engavamile imisipha yenhliziyo noma izingxenye zayo ngazinye (extrasystoles). Ngesikhathi esifanayo lo muntu uzizwa nokukhathazeka, iphika, yisisusa esinamandla sokuba inhliziyo noma eshabalalayo. Lokhu zokugula ngokuvamile kuholela angina neziyaluyalu kwegazi cerebral palsy.

Noma yimuphi amabhithi libhekene uxhaxha nemingcele. Yingakho izigaba ezingaphezu kuka abayishumi sasikhipha ngesikhathi ngezigaba wako. Nokho, i-ngokoqobo ezishisa kakhulu zikhipha izinhlayiyana kuphela labo ezingasetshenziswa Ubuningi bamahora cishe libonise Yiqiniso lesi sifo.

Ukwahlukanisa arrhythmias Lawn kwaba yisinyathelo esibalulekile emlandweni nezenhliziyo. Ukusebenzisa Ukubuthelela ezihlongozwayo, udokotela uyakwazi ngokwanele ukuhlola ulwazi olutholakala isiguli kobukhulu zokugula ukugeleza yayo. Iqiniso lokuthi inhliziyo esiswini ishaya (VPB) yande kakhulu. Lokhu zokugula siyenzeka cishe amahlanu amaphesenti iziguli engixoxa wenhliziyo. Kwezinye zazo isifo ingozi futhi akukho ezisongela ukuphila ngokwako ongaqhubeki. Nokho, kukhona ezigulini athungathe ifomu ebulalayo of PVCs esidinga Yiqiniso ethize yokwelapha.

Umsebenzi oyinhloko ezenziwa Ukwahlukaniswa utshani, bavele bahlale ngokwahlukana abulalayo kusukela zokugula kungavamile ukuba ingozi. Kulokhu, kukhona kwaba namakilasi amahlanu athatha lesi sifo:

1. monomorphic ventricular extrasystole, ogama imvamisa - engaphansi kuka-30 ngehora.
2. PVCs monomorphic nge imvamisa ezingaphezu kuka-30 ngehora.
3. politopnye.
4. ekilasini lesine lwabelwe izigatshana ezimbili (PVCs abhanqiwe futhi ventricular tachycardia lapho PVCs ezintathu noma ngaphezulu elandelanayo).
5. extrasystole lapho R-wave yokuqala 4/5 wave T.

Lokhu kuhlukaniswa uthola isebenza nezenhliziyo nokuhlinzwa inhliziyo. Kwaphela iminyaka eminingi, uyisebenzisa nabanye odokotela. Ibe ngo-1971, kube ukwesekwa onokwethenjelwa ochwepheshe phakathi nokufaka arrhythmia ngezigaba kanye nokwelashwa leli egunjini lokuhlolwa kwezifo.