Uma ngesikhathi sokuhamba kwe-electrocardiogram idivaysi ibhala ushintsho oluthile emsebenzini wenhliziyo, ukuxilongwa "kuyisifo se-repolarization ekuqaleni kwe-ventricles". Isimo esinjalo akusiyo njalo isifo noma isifo, kodwa ukuhlolwa okuqhubekayo udokotela kuyodingeka.
I-Syndrome ye-repolarization yokuqala ye-ventricles yenhliziyo-iyini?
Muva nje, i-syndrome ye-ventricular repolarization (ARVD) iyavame kakhulu - 8% wamadoda, abesifazane nabantwana abaphilile ngokugcwele bafunde ngalolu daba lwe-ECG ngesikhathi sokuhlolwa okuvamile. Iqembu lesingozi lihlanganisa:
- Iziguli ezinezinambuzane ezinenhliziyo, ezihambisana nokuphazamiseka emsebenzini;
- abantu abathintekayo ezemidlalo;
- amadoda amnyama;
- iziguli ezine-collagenosis e-dysplastic.
Iningi leziguli zibuza umbuzo ngokuthi yini i-syndrome ye-ventricular repolarization eshoyo. Kuyinto inguquko engaqondakali emkhawulweni we-electrocardiogram futhi ingaba unomphela noma unomphela. Ngokuvamile, isenzakalo se-ECG senziwa ezinganeni nasezingane. Kunezinhlobo ezingu-3 ezinezici ezivamile, kodwa zihluka ngezinga lobukhulu:
- esiphezulu - inezingaphezu kuka-6 ehola;
- ukulinganisela - kuqukethe umzila we-4-5;
- ubuncane - oboniswe ngu-2-3.
I-syndrome ye-repolarization yokuqala ye-ventricles ayiveli kuphela ezigulini ezitholakale noma ezitholakalayo ezinhliziyweni, kodwa nakwabo abanakho:
- i-hypertrophic cardiomyopathy;
- i-dysplasia yezicubu ezixhunyiwe (iminwe ye-spider, ukuhamba kwe-hyper okuhlangene, ibuyele emgodini we-mitral);
- hyperlipidemia yomndeni;
- izifo zenhliziyo;
- i-dystonia ye-neurocircular;
- izakhi zofuzo.
Iyini ingozi ye-ventricular repolarization syndrome?
Phakathi nochungechunge lwezifundo, ososayensi baye babonisa ukuthi isenzakalo se-ECG sokuqala kabusha kwe-ventricular repolarization kungaholela ekufeni ngokuzumayo kwe-coronary, uma kuhambisane nesimo se-syncope esivela emvelaphi enhliziyweni. I-syndrome ivame ukusiza ekuthuthukiseni izifo ezinjengalezi:
- ukuhluleka kwenhliziyo;
- ukulungiswa okuphezulu;
- i-sinus tachycardia ne-bradycardia;
- ischemia yenhliziyo;
- i-fibrillation ye-atrial;
- i-tachycardia ye-paroxysmal;
- ukuwohloka kwe-hemodynamics;
- umonakalo ezitsheni zenhliziyo, njll.
I-Syndrome ye-repolarization yokuqala ye-ventricles ezinganeni
Uma ngemuva kwe-electrocardiogram ubhekene nenkinga enjenge-syndrome yokubuyiselwa kokuqala kwe-ventricles yenhliziyo ezinganeni, ngakho-ke kudingeka ukwazi ukuthi ukuqinisekisa ukuthi ukuhlolwa kwengane kuyodingeka ukuthi ihlolwe ngokugcwele. Ngenxa yalokhu, odokotela banikela ekudluliseni ukuhlolwa kwegazi okuningiliziwe (kusuka emunwe naseveni) nomchamo, kanye nokwenza izikhathi eziningana i-ultrasound yenhliziyo. Ukuvama kuncike esimweni sempilo yesiguli.
Lokhu ukuxilongwa ebuntwaneni akuyona isinqumo. Ukuhlolwa kwenziwa ukuze kukhishwe ukuphazanyiswa emsebenzini wenhliziyo kanye nesigqi sayo. Kukhona izifo ezitholakala emthonjeni omkhulu womuntu, kuphela umuntu we-cardiologist onganquma. Ubeka ukuhlola njalo ingane ngesikhatsi sezinyanga ezimbalwa. Kukhona isifo kulabo bantwana ababenezinkinga zokujikeleza kwegazi esibelethweni.
Uma ingane yakho ithola ukuthi une-syndrome ye-repolarization yakuqala ye-ventricles, esikhathini esizayo uzodinga:
- Nciphisa umsebenzi wokuzivocavoca futhi unciphise amandla abo.
- Vikela ingane kuzo zonke izinhlobo zokucindezeleka.
- Qaphela ukudla.
- Qinisekisa ukuthi ingane iphila ngendlela enempilo.
I-Syndrome ye-repolarization yokuqala ye-ventricles ezincane
Intsha iyona ethinteka kakhulu yilesi simo. Lokhu kubonakala ngokukhethekile ngesikhathi sokukhulelwa. Izakhi zesifo se-repolarization zakuqala ze-ventricles zimelela izinguquko ezincane emsebenzini wenhliziyo. Izingane kufanele zithole ukuhlolwa okuphelele, okuyinto, ngaphezu kwezivivinyo, kuhlanganisa i-ECHO-CG ne-ECG. Uma izifo ze-pathologies zingabonakali, akukho ukwelashwa okubekiwe. Odokotela abazali batusa:
- Hlola ingane njalo ezinyangeni eziyisithupha.
- Ukunikeza abantwana amavithamini.
- Qinisekisa ukuthi ingane iphila ngendlela ezolile (ngaphandle kokucindezeleka nokuzikhandla ngokomzimba).
- Ukondla izingane ngokudla okuwusizo nokuhlukahlukene.
I-Syndrome ye-repolarization yokuqala ye-ventricles kubadlali
Phakathi nezifundo, ezenziwa ekuqondeni kwabagijimi bezobuchwepheshe, kwatholakala ukuthi cishe amaphesenti angu-80 azoba ne-bradycardia (isilinganiso senhliziyo eminithini engu-1 sifinyelela ku-60). I-syndrome ye-repolarization yokuqala ye-ventricles yenhliziyo ikhonjiswe kakhulu ekuthandeni kwamathonya e-vagal kanye nokuthuthukiswa kwe-ventricle yangakwesokunxele yokuqina kwodonga oluguquguqukayo. Abantu abanjalo kufanele:
- Nciphisa umthwalo.
- Ukukhipha njalo ukwamukelwa kwemithi (dope).
- Qaphela nodokotela.
I-syndrome ye-repolarization yokuqala ye-ventricles ngesikhathi sokukhulelwa
Uma umama esizayo ethola ukuthi une-syndrome ye-repolarization yangaphambili ye-myocardium ye-ventricular, uqala ukwethuka, ukhathazekile kakhulu futhi umbuzo uvela ngokuthi lesi simo sithinta kanjani ingane kanye nenqubo yokubeletha. Ososayensi baye bafakazela ukuthi isenzakalo se-ECG asithinti ukuthuthukiswa komntwana nesimo nganoma iyiphi indlela, uma owesifazane okhulelwe engenazo ezinye izifo ezinzima (isibonelo, arrhythmia).
I-Syndrome ye-repolarization yokuqala ye-ventricles - izimpawu
Ngokuvamile i-ECG-phenomenon itholakala ngengozi ngesikhathi sokuhlolwa kwezinye izifo. Iziguli zingenaso izikhalazo noma zihlobene nokuxilongwa okuyisisekelo. Izimpawu zesifo se-repolarization zakuqala ze-ventricles zibonakaliswa ngesimo se-arrhythmias ehlukahlukene, okubhekwa njengengozi enkulu empilweni futhi ingaholela ekufeni (fibrillation ye-ventricular).
Iningi leziguli zinezi:
- ukungasebenzi kwenhliziyo, okuholela ekuphazamiseni kwe-hemodynamic;
- i-edema yamapulmari ;
- ukuphefumula ;
- ukuphazamiseka kwengqondo ;
- Inkinga enkulu .
Ukuhlolwa komuntu omdala kufaka ukuhlolwa:
- Ukuqapha kwe-ECG phakathi nosuku noma ngaphezulu;
- ukwethulwa kwe-novocainamide engenayo, ngakho-ke lapho kusebenza khona ukuveza izimpawu ze-anomaly;
- isampula nge potassium, lapho isiguli sithatha lesi sidakamizwa (umthamo u-2 g) wokubonakaliswa kwezimpawu;
- ukuhlola igazi kwegazi;
- i-lipidogram.
I-Syndrome ye-repolarization yokuqala ye-ventricles ku-ECG
Uma kukhona ukusola kokuba ne-pathologies ye-cardiac, i-cardiogram ihlale iyenziwa, i-syndrome ye-repolarization yokuqala ye-ventricles ingazibonakalisa kumadivayisi afana nalokhu:
- ukubonakala kwegesi elengeziwe J ngaphakathi kwenkimbinkimbi ye-QRS;
- izinguquko ku-T wave uma isisekelo esibanzi;
- ukufuduka kwe-axis kagesi ngakwesobunxele;
- shintsha ukuma kwe-particle ST, iqhuma phansi, ngemuva kokukhishwa kwesikhwama;
- Ukuphakama (ukuphakanyiswa kwamaphutha) we-ST ingxenye endaweni ye-thoracic ngaphezu kwe-isoline (kufika ku-3 mm).
Izimpawu ze-anomaly zingabonakala esakhiweni se-thoracic e-ECG. Kufanelekile ukunaka izinyo S, ngoba kunganciphisa kakhulu usayizi noma umcibisholo ovela emagatsheni ama-thoracic ngakwesobunxele. Lesi sibonakaliso sibonisa odokotela ukuthi inhliziyo yomuntu iphendukile ngokuhambisana ne-longitudinal axis counter-clockwise. Kulesi simo, i-QRS eyinkimbinkimbi (uhlobo lwama-QR) ezifundeni ze-V5 ne-V6 izokwakhiwa.
I-Syndrome ye-repolarization yokuqala ye-ventricles ku-ECHO
Ngesikhathi sokuhlolwa, odokotela bangachaza i-echocardiography yokuphumula (ECHO) ne-ECG, isifo sokubuyiselwa kokuqala kwe-ventricles kwengane kubonakala kahle ngalezi zindlela. Basiza ekutholeni ukukhubazeka okufihlekile enhliziyweni, banikeze umbono ngezinqubo, isigqi kanye nomsebenzi we-muscle oyinhloko. Ukuhlola okunjalo kuphephile ngokuphelele empilweni yabantwana.
I-syndrome ye-repolarization yokuqala ye-ventricles - ukwelashwa
Ukwelapha i-ECG-phenomenon ayinangqondo, ngoba ayikho izimpawu futhi akusona isifo. Ukuze i-syndrome ye-repolarization yokuqala ye-ventricular myocardium ezinganeni nakubantu abadala ukuba ingabi yinkinga enkulu, odokotela batusa:
- Woza ukubona njalo ezinyangeni ezingu-6.
- Hlanganisa ngokuzenzakalelayo ezihlukahlukene.
- Ukuchitha isikhathi emoyeni omusha.
- Kuhle ukudla.
- Ukuqeda yonke imikhuba emibi.