I-fibrillation ye-atrial iphula umthetho wenhliziyo, okuholela emiphumeleni enzima. Uma ukugxilongwa kwe-pulse kugxila kwi-node ye-sinus noma izicubu ze-atrial, i-myocardium igxila ngokweqile, ngokushesha. Ukushaya kwenhliziyo kufinyelela ku-300-600 U / min. Elinye igama le-pathology yi-fibrillation e-atrial. Kungase ikhule njengesibonakaliso se-ischemia, i-angina pectoris, ukukhubazeka kwenhliziyo nezinye izifo.
Amafomu we-fibrillation e-atrial
Isifo singaqhubeka ngezindlela ezahlukene. Ngombono jikelele, kuye ngokuthi izinhlobo zezinkinga, i-fibrillation ne-flutter ye-atrial ziyahlukahluka. Esikhathini sokuqala, amaqembu ngabanye amafayili enkontileka yemisipha yenhliziyo, i-pulse ihlala ezingeni lika-500 ngomzuzu. Uma kutholakala i-fibrillation ye-atrial, ukunciphisa okuhlanganisiwe akunakwenzeka. Umdlalo we-atrial uhlala ulungile nge-flutter, kodwa inkontileka ye-atria ngokushesha kakhulu: kufike ku-200-400 U / min, cishe ngaphandle kokuphazanyiswa kokuhamba kwe-myocardium. Ikhefu le-diastolic lifushane kakhulu. Ama-ventricles asebenza ngokugqoka nokukhala.
Inkambo nobude be-arrhythmia yisimiso isifo esihlukanisiwe ngaso. Nikeza izinhlobo ezinjalo zokugula njenge:
- ukuqhubeka;
- ukuphikelela;
- i-paroxysmal arrhythmia .
I-fibrillation ephindaphindiwe ye-atrial
Ukungabikho kokubuyiselwa kwesigqi sesine kubonakala ngefomu eliqhubekayo le-fibrillation ye-atrial. Ukuhlasela kuqhubeka iminyaka, ukutholakala kwaleli fomu kuthiwa uma isikhathi siphelela amasonto amabili noma ngaphezulu. Ukungenelela kwezokwelapha okuhlose ukulawula isigqi akukwenziwa noma akuvamile ukuthathwa. Kucatshangwa ukuthi kunokwenzeka ukugcina izibalo. Umphumela omuhle, ongawuthola ngosizo lwezokwelapha, ukwehla kwentengo yenhliziyo kuya ku-60-75 U / min. Iziguli zihlala nokuxilongwa kwazo iminyaka eminingi futhi zizwa kahle.
Ukuphefumula kwe-atrial okuqhubekayo
Uma izimpawu ze-pathology ziqhubeka izinsuku ezingaphezu kwezingu-7, zikhuluma nge-fibrillation e-atrial eqhubekayo (AF). Inkambo yayo ingahle ibuyele emuva, kukhona ukuhlaselwa okuphindaphindiwe. Ukunciphisa okuncane kwe-atriyali kwenzeka ngokungahleliwe, inani legazi elingene emzimbeni liyehla. Lesi simo asisongeli impilo, ngaphandle uma ihamba nezinye izifo zenhliziyo. Ngezinye izikhathi i-fibrillation ye-atrial eside eqhubekayo yenhliziyo, ehlala isikhathi esingaphezu konyaka, ihluke, kodwa ngokungafani nemizamo ehlala njalo, kwenziwa ukuphazamisa inkambo yayo futhi ithathe ukulawula isigqi.
I-paroxysmal fibrillation ye-atrial
Ifomu elilula le-AF, isici esilulame ngayo ngokuzenzekelayo (ngaphandle kokusebenzisa izidakamizwa) sesigqi sesin. Lokhu kungenxa yokuphela komthelela wesici esibangela, isibonelo, ukwehla ngokomsebenzi, ngokomzimba noma ekupheleni kwesimo esicindezelayo. Ukuhlasela kwesifo - i-paroxysm ye-fibrillation ye-atrial - ingabuyekezwa. Inhliziyo yesifo senhliziyo ibhaliswe ngosuku lokuqala (amahora angu-24-48), lesi yisikhathi esihle sokuqeda.
I-Fridayation ye-Atrial yenhliziyo - Izimbangela
I-fibrillation ye-atrial yenza inhliziyo isebenze ngokungaqiniseki. Ngemuva kokuphindaphindwa okuphindwe kabili (2-3), kuvela ukuphefumula okungapheli kwe-atrial. I-fibrillation ye-atrial ihlotshaniswa ne-pathologies ekhuthaza ukuthuthukiswa kwe-arrhythmia, futhi ingenzeka kubantu banobuphi ubudala: amacala angama-40% we-paroxysmal futhi afika kuma-25% okuphikelela. Vusa ukuhlaselwa, njengombuso, izifo zemisipha yegazi kanye nesisu senhliziyo:
- ukuhlasela kwenhliziyo ;
- ukuhluleka kwenhliziyo ;
- ischemia;
- i-hypertension ;
- i-atherosclerosis;
- izinkinga zenhliziyo ;
- izilonda ze-rheumatic.
Ezinye izimbangela ze-fibrillation ye-atrial nazo zibizwa nangokuthi. Lezi zibandakanya izifo ezingezona izinhliziyo ezingaphazamisa umsebenzi we-muscle oyinhloko, namanye ama-provocateurs:
- izifo zamaphaphu;
- ukuphazamiseka kwe-endocrine;
- isifo sikashukela mellitus;
- ukukhuluphala;
- ukuphuza utshwala;
- izimo ezicindezelayo;
- umsebenzi womzimba oqinile;
- ukuthatha izidakamizwa ezithile;
- ukuntuleka kwe-potassium;
- ukuphelelwa amandla kwamanzi.
I-fibrillation ye-atrial - izimpawu
Ngokuya ngesimo sesifo, izici zombuso we-myocardium kanye nempilo ngokujwayelekile, ukucabangela kwe-atrial kubonakala ngezindlela ezahlukene. Umfanekiso wesitholampilo uhlukile ekungenizeni okubonakalayo ekugqibeleni okukhulu kwesifo. Izimpawu zingase zingabonwa, isibonelo, nge-paroxysmal arrhythmia. Kodwa noma kunjalo, njengomthetho, ukubonakaliswa kokuqala kwalesi sifo kubonakala: ubuhlungu ngakwesobunxele besifuba nokuphefumula kokuphefumula, okungayeki nokuphumula. Mhlawumbe, zombili lezi zibonakaliso kubonisa ukuthi kwakukhona ukucabangela kwe-atrial yenhliziyo, izimpawu ziyisici.
Izimpawu eziyinhloko kunzima ukudidanisa nezinye izimo, ikakhulu uma umuntu ebhekene nalezi ezingaphezu kwesisodwa. Ezinye izibonakaliso zokuhluleka:
- izinhliziyo zomzimba;
- ukujuluka okukhulu;
- ukugwinya kwamalungu;
- ukuxubha;
- ukudonsa imifino;
- ukuthuthumela;
- ukuphelelwa amandla ;
- ubuthakathaka emzimbeni wonke;
- ukuvuthwa okuvame futhi okunamandla;
- ukuhlaselwa ukwethuka, ukwesaba.
Ukuhlaselwa kwe-fibrillation ye-atrial
Izimpawu ze-fibrillation ye-atrial zingase zingabonakali, futhi isiguli sifunda ngokugula kwakhe kuphela ngemva kokuhlola udokotela. Ukuhlaselwa kuqale ngokuzumayo bese kuphinda kuyo yonke impilo. Ubude nobude be-paroxysms yomuntu ngamunye, izimpawu zizwakala ngezindlela ezahlukene. Ezimweni ezijwayelekile, kunobuthakathaka, ukuthuthumela, ukuphazamiseka okukhathazayo, ukwesaba. Ngokunyuka okunamandla kwenhliziyo, i-pallor, isizungu, nokuphelelwa amandla kungenzeka.
Pula nge-fibrillation ye-atrial
Enye yezindlela lapho i-fibrillation ye-atrial (engapheli noma engekho) itholakale ukuthi i-palpation ye-pulse. Isiguli sinokuntuleka: i-atrium ayisebenzi, i-ventricles ayinayo isikhathi esanele sokugcwalisa ivolumu edingekayo yegazi. Inombolo yenhliziyo ishaya ngesilinganiso ayilingani ne-pulse. Uma kukhona i-flutter ye-atria, izimpawu ze-pathology okukhulunywe ngenhla zenziwe nge-arrhythmias-fastity engavamile.
Iyini ingozi ye-fibrillation ye-atrial?
Noma iyiphi i-pathology yenhliziyo igcwele izinkinga. Endabeni ye-fibrillation ye-atrial, imiphumela eyingozi kakhulu kunazo zonke i-thromboembolism ne-heart failure. I-Mitral stenosis ibangela ukuxoshwa kwe-atrioventricular open-thrombus, okuholela ekuboshiwe inhliziyo. U-15% wezingxabano ze-ischemic zenzeka ngenxa ye-arrhythmia. Izinsongo zokuthi ukuphila kwe-atrial flutter kuletha impilo kufaka i-edema ye-pulmonary, i-asthma yesifo senhliziyo, i-cardiomyopathy (ihlanjululwe).
I-fibrillation ye-Atrial - ukwelashwa
Uma kutholakala ukuthi i-fibrillation ye-atrial iyatholakala, ukwelashwa kwenziwa ngokuvumelana namaqhinga wezokwelapha okuhloswe ngazo ekuvimbeleni ukuxoshwa okuphindaphindiwe, ukulinganisa izinga lenhliziyo, ukugcina isigqi sesine, ukuvimbela i-thromboembolism. I-fibrillation ye-atrial ayiphilisi ngokuphelele, kodwa ilawulwa, futhi odokotela bazama ukuvikela isiguli ukuba sibuyele emuva, ubuyisele isigqi senhliziyo. Ngaphambi kokwelapha i-fibrillation ye-atrial, udinga ukuthola imbangela ye-pathology futhi uqede ama-provocateurs, futhi ulahle nezimpawu zokubonakaliswa kwesifo.
I-fibrillation ye-Atrial - izincomo zomtholampilo
Uma kukhona i-fibrillation ye-atrial, yini okufanele ngiyenze? Amacebo okwelashwa anqunywa ukuxilongwa, okuyinto, kuye ngezici ezikhubaza izifo, kuhlanganisa ukubonisana kwalabachwepheshe njengo:
- i-arrhythmologist;
- i-neuropathologist;
- i-pulmonologist;
- i-endocrinologist;
- i-cardiosurgeon.
Banikeza ukwelashwa okunye. Izinhloso ezijwayelekile zokwelashwa: ukuthuthukisa ikhwalithi yokuphila kwesiguli, ukwandisa isikhathi salo nalokhu kuhlolisiswa, ukunciphisa inani lezibhedlela. Izimpawu kufanele ziqedwe noma zivinjelwe, isigqi senhliziyo kanye nezifinyezo ezithathwe ngaphansi kokulawula. Nge-AF ungaphila, kodwa odokotela kufanele bathuthukise ukubikezela.
Ukulungiswa kwe-fibrillation ye-atrial
Kungenzeka futhi kanjani ukwelapha i-fibrillation ye-atrial yenhliziyo ngosizo lwemithi? Ukwelashwa kwezokwelapha okugcinayo kuyasetshenziswa ngempumelelo (10-15%). Ezimweni ezingathí sina kakhulu - i-ciliary paroxysmal arrhythmia - ivaliwe nge-novocaineamide, i-cordarone, i-quinidine noma i-parapanorm. Imithi ithathwa ngokungenasisindo noma ngomlomo, kodwa usizo kufanele lunikezwe ngaleso sikhathi, futhi izinga lokucindezelwa lihlale libhekwa. Uhlelo lwezokwelapha neminye imithi kanje:
- Ukuze unciphise izinga lentliziyo futhi unciphise izimpawu ezingathandeki, kusetshenziselwa amalungiselelo eqembu le-beta-blocker: Carvedilol, Proprorol, Pindolol, Anaprilin, nabanye.
- I-excitability yezintambo zenhliziyo isuswe yi-Cordanon, i-Quinidine, i-Allapinin.
- Ama-glycosides agcizelela umsebenzi we-myocardium (Digoxin, Korglikon, Celanid).
- Ukwakhiwa kwe-thrombi kuvinjelwa yi- Warfarin no-Pradax kanye nama-anticoagulants Enoxaparin, i-Heparin, i-Fondaparinux.
- Izidakamizwa ezihlanza igazi - dezagreganty - zimelelwa yimithi efana ne-Aspirin Cardio, i- Cardiomagnolo , i-TromboAss, njll.
Ukuphumula kwenhliziyo nge-fibrillation ye-atrial
Uma ukwelapha izidakamizwa akuzange kunikeze imiphumela, ukungenelela kokuhlinzwa kungenzeka. I-catheter ablation yindlela yokwelashwa lapho ukugxila kokuhlelwa komzimba kubhujiswa yithonya lomzimba. Lokhu kusebenza akusizi kakhulu, ngoba akudingi ukuvulwa kwesifuba - kwenziwa ukucubungula okuncane kuphela futhi kufakwe i-catheter engena ku-myocardium. Ithonya lesi sifo singenziwa ngezindlela eziningana: ngokushisa, imithi yamakhemikhali, laser, impulane kagesi, amandla amagagasi omsakazo-frequency (RFA) ne-fibrillation ye-atrial.
Kunezinhlobo ezinjalo zokuqeda (ukubhujiswa) njenge:
- i-ultrasound;
- i-laser;
- i-radiofrequency (cauterization ye-node atrioventricular ene-electrode);
- ukuhlelwa kwemininingwane;
- i-electrodestruction.
I-fibrillation ye-Atrial - ukusebenza
Kwezinye izimo, akunakwenzeka ukuqeda ukuguquka ngaphandle kokuhlinzwa. Ukusekela isilinganiso senhliziyo esifanele kusiza i-pacemaker - idivaysi ehlanganisiwe ehambisana nesiguli sesiguli esiseduze ne-collarbone. Nge-vein, i-electrode ixhunywe kuyo iphinde ingene ngaphakathi kwenhliziyo. Idivaysi idala izimpendulo eziphoqa isisindo senhliziyo ukuba sivumelane nemvamisa efanele, i-frilling inrial and blogger fibrillation.
Enye indlela yokuhlinzwa esetshenziselwa ukuxilongwa kwe-fibrillation ye-atrial yiyona "labyrinth" yokusebenza. Umsebenzi walo ukuqeda ubumbano enhliziyweni, ukuphoqelela izingosi ze-atrial ukuba zinciphise ngendlela ehlelekile. Isignali kagesi iqhubekela phambili endleleni ekhonjisiwe - okuthiwa "i-labyrinth", eyakhiwa ukwakheka kwezibazi emathangeni enhliziyo. Ama-cuttings akwenziwa nje nge-scalpel kuphela, kodwa futhi yi-ablation echaziwe ngenhla: i-RFA (moxibustion) kanye ne-cryodestruction (i-frost).
I-fibrillation ye-Atrial - ukwelashwa ngamakhambi abantu
Kungakhathaliseki ubukhulu besifo senhliziyo, ukulungiswa kwalo kungenzeka ngesizo lomuthi ohlukile - kanye nokwelapha izidakamizwa noma ngokwehlukana, isibonelo, njengezinyathelo zokuvimbela. Uma kwakukhona i-fibrillation ye-atrial, amakhambi omuntu asetshenziswa ngokuqapha, ngaphansi kokuqondiswa udokotela. Ukwelashwa kungokwemvelo.
Izindlela eziphumelelayo zisekelwe ezintweni ezinhle zezitshalo ezithile. Emithi yokwelapha, kufanele uqaphele izidakamizwa ezinganciphisa ukuvimba nokuvimbela izimpawu ze-arrhythmia. Eyaziwayo kakhulu futhi esebenzayo:
- I-Hawthorn iyisimo esihle semakhaya sokususa ama-arrhythmias. Ukukhishwa kwalesi sitshalo kungaxubaniswa ne-valerian noma i-motherwort.
- Ukumnika imbewu ye-dill iyithuluzi eliphumelelayo elinciphisa ubukhulu be-pathology.
- I-Decoction yamajikijolo ka-Kalina ijwayelekile ukucindezela kwegazi, ngokuthembisa ithinta izitsha. Ngezinye izikhathi uthathe uju.
- I-Yarrow (i-tincture yamaqabunga engokomoya) idakiwe kabili ngosuku epasipuni, ukunciphisa ingozi yezindwangu zegazi.
I-fibrillation ye-Atrial - ukubikezelwa kokuphila
Izifo ze-cardiac, eziyinkimbinkimbi yi-arrhythmia, ukwandisa ingozi yokubulala ngokuphindwe izikhathi eziyi-1.5. Ngakho-ke, iziguli ezinalezi zifo zinesithakazelo kulo mbuzo: bangaki abaphila ngokuxilongwa kwe-fibrillation ye-atrial? Ukuchazwa kwesifo kuncike ezintweni ezifana nezimbangela ze-pathology, izinkinga ezitholakalayo nezinokwenzeka, isimo se-myocardium kanye nama-ventricles. I-arrhythmias eyingozi kunazo zonke - okuholela ekuthuthukiseni okusheshayo kokuhluleka kwenhliziyo. Zibangelwa umonakalo omkhulu we-myocardial, isibonelo, ukuhlaselwa kwenhliziyo. Izinkinga ezifanayo zihlotshaniswa nesifo senhliziyo, kodwa izibikezelo zizodwa.
Noma yiziphi izimpawu ezibonisa ukungalungi enhliziyweni akufanele zikhishwe. Nge-AF, imisipha eqala iqala ukuthuthumela, yehlisa ngokushesha, ngokungavamile. Ukuhlaselwa akuhlali okwedlula umzuzu, kodwa kufanele uqaphele. I-fibrillation ye-atrial iyinkinga evamile eyenzeka ngo-2% wabo bonke abantu. Kodwa isifo esibi singatholakala futhi siphathwe. Imithi yesimanje inikeza amasu aphumelelayo namasu okulwa nokulwa komzimba.