Ukuxilongwa okuvamile, njengokuhluleka kwenhliziyo (OCH), kuyisifo lapho izinhliziyo zilahlekelwa khona ukuvumelanisa ngokuvumelana. Lokhu kubangela ukwehla komsebenzi wepompi, ngoba zonke izicubu ziqala ukungena oksijini.
Izimbangela zokuhluleka kwenhliziyo
Ukuvame ukuqina kwe-cardiovascular acute kubangelwa ukugula okungapheli. Ezimweni ezingama-60 kuya ku-70%, ikakhulukazi asebekhulile, i-OSS iqala ngenxa yokwehliswa kwesifo se-ischemic esivele sikhona (i-myocardial infarction noma izinkinga zayo).
Ezitheni ezincane, ukukhubazeka kungabangelwa yi:
- endocarditis;
- i-arrhythmia;
- isifo senhliziyo;
- i-cardiomyopathy (dilatation of the heart cavity);
- i-aortic stenosis enkulu;
- tamponade yenhliziyo;
- i-myocarditis enzima kakhulu.
Ngaphezu kwezimbangela eziyinhloko ze-pathology, okuthiwa. izici ezingenabuhlungu ezibangela ekuthuthukiseni kwayo:
- isifo esibi ;
- ukuhluleka kwezinso;
- i-pneumonia, i-septicemia nezinye izifo;
- ukudlula izidakamizwa;
- ukuphathwa kabi kotshwala;
- i-asthma ye-bronchial;
- pheochromocytoma.
Kunezinhlobo ezihlukahlukene zokubonakaliswa kwemitholampilo ye-syndrome yokuhluleka kwenhliziyo:
- I-OCH ye-ventricular kwesokunxele;
- i-ventricular DOS;
- ukuphazamiseka kwe-cardiogenic.
Izimpawu zokuhluleka kwenhliziyo
Nge-OOS ye-ventricular kwesokunxele, ukushintshaniswa kwegesi emaphashini kuphazamiseka ngokuyinhloko ngenxa yokuqhuma emjikelezweni omncane wokujikeleza. Izikhalazo ezijwayelekile ziyi:
- ukuphefumula okukhulu;
- i-arrhythmia;
- ubuthakathaka obunzima;
- ukukhwehlela.
Umuntu o-OSS uzama ukuhlala esikhundleni. Uma kungekho usizo olunikezwayo, futhi ukuqhuma kwegazi kumbuthano omncane kuyaqhubeka, ukukhwehlela nge-sputum egazini kungase kuqale, nge-pulse enezinkinga ezinzima, isikhumba siba sephuzi, sibanda futhi sinamathele.
Uma kwenzeka i-OCH ehamba nge-ventricular efanele, lapho kunezinkinga emithanjeni (umjikelezo omkhulu wegazi), lezi zimpawu ezilandelayo zilotshiwe:
- ubuhlungu ngemuva kwe-sternum;
- ukujula okubandayo kanye ne-cyanosis yesikhumba;
- ukuvuvukala emithanjeni (ikakhulukazi entanyeni);
- wehla ekucindezelweni kwegazi;
- ukuphefumula, ukuphefumula;
- ukushayela okufana nentambo;
- ukuvuvukala kwemilenze, ukwehla;
Ngokuphazamiseka kwengqondo (kubizwa nangokuthi i-syndrome yokukhishwa kwenhliziyo encane), umuntu anganciphisa kakhulu ingcindezi (kuze kube yizilinganiso zero). Isiguli sibhekene nosizi, ukushayela kwakhe kufana nentambo, isikhumba siphundukile. Kukhona i-anuria (akukho mchamo esithombeni). Kamuva, ukwehluleka kwezinso, i-edema ye-pulmona iyaqala.
Usizo lokuqala lokuhluleka kwenhliziyo
Ngenxa yokuthi i-DOS yisimo esiphuthumayo esisongela ukuphila komuntu ngokungathí sina, ngezibonakaliso zokuqala zesifo, "i-ambulensi" kufanele ibizwe. Ukuqaphela ngaphandle kokubandakanyeka kohlobo lwezobuchwepheshe kunzima, kodwa uma isiguli sihlaselwa akuyona okokuqala, kungenzeka ukuthi unomdlavuza we-medication we-nitroglycerin, oqokwe udokotela. Kumele kuqashelwe ukuthi kuyaphikisana ukuthatha le mithi noma ukuyinikeza umuntu ngaphandle kokunconywa kukadokotela, kusukela umlenze angaphazamisa kalula ukuhlaselwa kwenhliziyo ngisho nokudangala okuvamile, lapho i-nitroglycerin iyingozi kakhulu.
Usizo lokuqala lokuqala lokuhluleka kwenhliziyo ukubiza udokotela futhi unikeze isiguli umoya omusha. Udokotela cishe ubeka i-diuretics kanye nezidakamizwa zeqembu le-nitroglycerin (uma ingcindezi yegazi ingaphakathi kwendabuko futhi kune-OCH ye-ventricular kwesokunxele). Uma ingcindezi iphansi, nikeza i-dopamine, i-dobutamine.
Ukwelashwa kwesimo senhliziyo esifaneleko se-oxygenation, ukuphathwa kwe-analgesics kwesiguli, i-prednisolone, i-diuretics, i-nitrate, i-glycosides yenhliziyo.
Ukuphazamiseka kwe-cardiogenic kuyaphathwa futhi nge-oxigenotherapy, i-adrenaline, i-norepinephrine, i-dopamine, i-anticoagulants inqunywe.