Kore ngakau whakapeka: tohumate i te aroaro o tona mate, me te āwhina tuatahi

Katoa tau, te mate o te pūnaha Cardiovascular ārahi ki te matenga o te neke atu i 17 miriona tangata i te ao. 10 anake% o taua pathologies he congenital. Ko te nuinga o āhua mate nui puta i runga i te whakamārama o te ahotea me te āhua noho rawakore a te tangata hou. I roto i tenei tuhinga titiro tatou ki te mea he kore ngakau congestive.

Tohu o te mate me te pōauautanga e hua i te māuiuitanga, tikanga o te tātaritanga me te maimoatanga o te mate, nga momo me ngā puka o te mate - ka e kitea ngā mōhiohio i runga i enei take katoa i roto i nga rauemi o to tatou arotake. I tua atu, e aparau te tuhinga nga ture o mahi, e taea e whai hua mo tetahi o tatou. Ko te kaha ki te mahi i roto i te ohotata whakarato i roto i te nuinga o te wā, te tiaki o te ora tangata. Fakatatau ki ai, He kotahi ki matau he aha te āwhina tuatahi mō te kore te ngakau whakapeka.

Ko te ariā o te kore ngakau

rahunga Heart (HF) - māuiuitanga, i roto i nei mutu te ngakau ki te homai i te nui e tika ana o te kikokiko o te toto tinana. Ko te putanga o te kaha waimaero o te uaua ngakau (myocardium) ki te holomui. te tikanga arata'i CH ki faaiteraa hauora kino, tae atu edema pūkahukahu, infarction, ru cardiogenic.

Mate i haria ki e rua tangata me nga wahine, ko te whakamutunga e te mamae i tenei mate atu pinepine. he tiketike nui i runga i te māuiuitanga te tahuti nei. Te ati ki te ora te tangata e tetahi o nga mau faaiteraa meinga e mate pērā i te kore ngakau congestive. Tohu ki te aroaro o tona mate, ka karanga i roto i te rongoa huaki tata, he tino kanorau. whakawhirinaki ratou ki runga ki e puta ahua o te mate. Na roto i te āhua o te takenga o te kore ngakau e he nunui:

• kore ngakau myocardial - he māuiuitanga e ko te hua o te kino tika ki te uaua ngakau e tika ana ki te takahi o te pākia e pūngao. Tenei momo o te kore ngakau arata'i ki pōrearea o hukihuki me te whakangā o te ngakau.
• kore te ngakau kikī - he māuiuitanga e whanake rite ki te hua o te kawenga nui i runga i te ngakau. Tenei momo i roto i ētahi wā whakawhanake i runga i te whakamārama o te mate ngakau.
• kore ngakau ngā - he ahua o te māuiuitanga, e fakatahai te take e rua i runga ake-whakahuatia.

Karaehe o te kore ngakau

Ki te rā, i reira e ngā paearu e nei wehea te mate ki ngā momo puka ranei. Medicine, i reira e rave rahi pūnaha whakarōpū (Russian, Pākehā, American), engari te pūnaha tino rongonui e whakaarohia e US cardiologists. I roto i runga ki tenei tikanga he akomanga wha o te mate:

• Grade 1, whakatika ai te manawanui dyspnea nekehanga kaha, mo te tauira, ara kaupae ki te taumata ki runga ake te toru o nga patunga witi.
• Grade 2, ai reira dyspnea noa i kawenga iti - ka ara te papa tuatahi tuarua ranei. heke Kei te kï hoki, mahi tinana o te tangata.
• Grade 3, ai he kite i pikaunga iti te kore ngakau, hei tauira ka haere ana, engari mate āta tohu ngaro.
• Grade 4, i roto i nei te tohu puta noa i te okiokinga, a he mahi iti arata'i ki maumaui nui o te ngakau, me te pūnaha Cardiovascular katoa rite te katoa.

Classification CH

Ka taea te whakarōpūtia māuiuitanga rite ki te maha o paearu. Tei runga i te pikitia haumanu o te rongoā mate mohiotia kore ngakau whakapeka, me te ma'i.

kore ngakau whakapeka (AHF) - he mate i roto i nei tohu pathological tere (i roto i ngā haora). Ka rite ki te tikanga, ki te whakamārama o ētahi atu mate o te pūnaha iaia me reira ko te kore ngakau whakapeka.

Infarction, myocarditis me ētahi atu mate e taea te waiho i te keu mō āhua mate, no te mea i raro i enei pathologies, mate e tika ana ki disorders circulatory rohe pūtau uaua ngakau. kia hoki hua och i whati o te taiepa ventricular maui, kore whakapeka o mapuni (te pūtahi o me mitral). I roto i ētahi wā, whakawhanake māuiuitanga kahore maumaui mua.

Och - mate rawa haavare no te mea e taea ai te he tu'unga fakamamahi o te tahi atu ngā pūnaha o te tinana. maha pā fifi o te kore ngakau whakapeka te ngakau e kore e anake te pūnaha romahā engari ano, meinga edema pūkahukahu, huangō cardiac, ru cardiogenic.

kore ngakau ma'i - he mate i roto i i hanga e te māuiuitanga te āta, i runga i wiki, marama ranei ara tau. puta te reira ki te whakamārama o te mate ngakau, takawhita anemia roa ranei.

Momo o DOS i runga i te momo o te hemodynamics

Tei runga i te momo o hemodynamic localization huru o māuiuitanga, i reira ko nga momo e whai ake nei o te kore ngakau whakapeka:

• DOS ki hemodynamics congestive.
• DOS ki hemodynamics hypokinetic.

Hemodynamics - Ko te rere o te toto i roto i nga oko, i meinga pēhanga nui i roto i ngā wāhi rerekē o te pūnaha reretoto. Kei te mohiotia te reira e te nekehanga toto i te rohe o te pēhanga teitei ki raro.

Tei te pēhanga ki runga i te pokey o te toto, me te ātete o nga taiepa o oko toto awa. DOS ki hemodynamics congestive kia pā te matau ranei te roro maui o te ngakau. I roto i runga ki tenei i puta ke:

• Whakapeka rahunga ventricular tika, i roto i nei kitea te stasis venous te i roto i te porohita nui o te rere toto, ie. E. ni'ai tata katoa okana me te kopa.
• mahue koi kore ventricular, i roto i nei puta te stasis venous i roto i te rere toto pūkahukahu. Māuiuitanga i whakatutehu te utu hau i roto i te pūkahukahu, me te arata'i ki te whanaketanga o te edema pūkahukahu huangō cardiac ranei. Ko te kupu, ki te whakamārama o te ofatiraa taua puta whakapeka mate ngakau pūkahukahu.

DOS ki hemodynamics hypokinetic

kore whakapeka ngakau i roto i te hemodynamics hypokinetic - he māuiuitanga meinga e ru cardiogenic - he heke koi i roto i te kaha o te myocardium ki kirimana, hua i roto i te tauwhatinga o te supply toto ki te kopa tinana katoa.

wehewehe:

• ru Arrhythmic, i te mea he hua o disorders manawataki cardiac.
• Ru kahuki - he tauhohenga te mamae ki.
• ru cardiogenic pono - huru pathological e puta, no te pāpaka o te kiko ventricular maui, me te wāhi lesion ko i te iti rawa 50%. Tūkinotanga, rite ki te tikanga, e atu e pängia ana ki te tangata i runga i 60 tau o te tau; iwi e Kua i te whakaeke rua o ngakau; tūroro ki te takawhita me te mate huka mellitus.

Mea nui, te āhuatanga ru cardiogenic e mamae, ohorere hekenga pēhanga toto ki te uara iti (ki raro ki te 0), filiform pini, kiri koma. muri kia māuiuitanga neke ki edema pūkahukahu hua i täkihi ranei.

Ngā āhua e hāpai ki te putanga o och

Ko te whanaketanga o te te kore ngakau ki te akoranga whakapeka, kia kia mua i te manawanui e te tūpono i mua mate o te iaia pūnaha. Taua tikanga ngā:

• mate ngakau meinga e kino ki te uaua ngakau, ārahi ki te hekenga koi i roto i te myocardium kaha ki te kirimana;
• kore ngakau ma'i, e wawahi ka te supply toto noa ki whēkau me te kopa;
• kino ki te tapatahi o nga mapuni ngakau me korere;
• haaputuputuraa o te wai i roto i te pericardium, e arata'i ki te takahi o te auau ngakau tika tika ki te pēhanga ka puta i runga i te kōhao o te ngakau (i huaina tenei māuiuitanga ko tamponade cardiac);
• thickening o nga taiepa o te ngakau - hypertrophy myocardial;
• hypertensive raruraru - tohua pīari pēhanga toto.

take noncardiac

I tua atu ki ngā raruraru ki te ngakau ki te putanga o āhua mate ai kia uru i roto i te māuiuitanga e pā ana ki te pēhanga toto tiketike i roto i te rere toto pūkahukahu. Mate e arahi ki te tātaritanga o "kore ngakau whakapeka":

• patunga - ofatiraa tohanga roro, e whakaoho tona kiko pakaru, me te katoa whakararuraru, mahi roro;

• thromboembolism iatuku o te pūkahukahu (puta te mate rite ki te hua o blockage o te iatuku pūkahukahu, me te ona tukanga o clots toto (thrombi), te nuinga noa clots toto puta i roto i te nui uaua e alangá papatoiake me raro);
• mate pūkahukahu - he nawe o te bronchi (Bronchitis), mumura o te kiko pūkahukahu (pneumonitis);
• auau dysrhythmia ngakau (whakaterenga whakapōturinga ranei) - tachyarrhythmia, bradyarrhythmia;
• mate meinga e ngā tukumate.

He hoki āhuatanga ārahi ki te whanaketanga o te kore ngakau, engari e kore te faaiteraa o mate o tetahi pūnaha okana. Ko ētahi o ēnei:

• pokanga;
• whara me te roro whara;
• whakaeke paitini i runga i te uaua ngakau - waipiro, pukuriri te rongo raau;
• mīhini ngakau-pukapuka, te whakamahi o nei arata'i ki etahi hopearaa;
• electrotrauma - pānga i runga i te tinana o te nāianei hiko;
• tautooraa psycho-aronganui tinana ranei.

Tātaritanga o te kore ngakau whakapeka

Tātarihia te kore ngakau te matua whakahaua ki te faaotiraa o te take i arahina ki te whanaketanga o te māuiuitanga. I mua e mau ana i roto i whakamātautau taiwhanga me whawhe ki te whakamahi o te taputapu hauora, ka whakatau i te tākuta i roto i whakahaere ki te manawanui te aroaro ngaro ranei i roto i tona ora o ngā āhuatanga takoha ki te whanaketanga o taua mate rite kore ngakau whakapeka. Tohu o te mate (ohorere) puta i roto i te 24 haora, kia ngoikore puta, me te mahi motuhake - e kore e ki te ngaro wa, me te tango ki te pūkete nga amuamu katoa o te manawanui rite wawe tonu ki te whakatū i te tātaritanga tika.

Ko te tikanga rangahau matua whakamahia i roto i te tātaritanga o AHF, ngā:

• he hiko-;
• echocardiogram;

• pouaka X-hihi;
• whakamātautau toto whānui, me te matatau;
• Kei te te tahi mau taime te whakamahia te reira mo tātaritanga och cardiovisor - he kore rerekē i te ine hilo-parau tumu pūrere o te mahi.

paearu tātaritanga

Ka taea te huaina e te tohu nui, me te tino korerotia o whakapeka nāianei kore ngakau pakohu tachycardia - te hanga i tachyarrhythmias supraventricular, hoki i whakatere te āhuatanga te pakohu te manawataki - te auau o contractions o te ngakau o te pakeke, ko te neke atu i te 100 ia meneti. whakaatu whakairoiro o te mahi ngakau whakaatu mahue te rohe mana whakarei tika ranei. I tua atu, i runga i te tihi o runga ake ranei te tukanga xiphoid puta tuatoru oro.

faaite whakapeka kore ngakau tika congestive iho i roto i te maha o ngā āhuatanga:

• rua waha me uaua ate ki pupuhi, ka pupuhi;
• pēhanga venous tiketike;

• te whakanui ake ate, pepa jaundice;
• alangá tetere;
• maihao cyanosis fehangahangai (taringa, kauwae, ihu);
• te manawanui he mamae nui i roto i tona hautahi runga matau;
• tuhi ECG te ngakau kikī ohorere o te mānawanawa matau me te marae, kitea nei e niho koikoi teitei.

Kei te mārama whakakitea e X-ray, me te hiko-tohu o te kore ngakau tika. Ko te wāhanga whakamutunga o tenei momo o te mate ngakau arata'i ki kēkeno o te tinana, whakaiti i te taumata o te pūmua i roto i te toto me te ngangau o te toenga tote i roto i te tinana.

Tohu o te kore ventricular maui, me te ru cardiogenic

I roto i tahuri, i te aroaro o te kore ventricular maui whakapeka ki hemodynamics congestive kitea e te maha o te āhuatanga e whai ake nei:

• hāhā o te manawa, tahuri ētahi wā ki huangō;
• mare paroxysmal maroke, expectoration ētahi wā e huhuka, tukua nei te i te mangai ihu ranei;
• te aroaro o rales mākū e e rongo ki runga i te mata katoa o te pouaka.

He he maha o ngā tohu āhuatanga o ru cardiogenic, ara:

• Ko te pēhanga toto o te manawanui makaka ki uara o 90-80 mm HG. Art. a tae noa iti. Ki te mamae tetahi tangata i takawhita, ko te tohu o te ru ka peka e 30 mm HG. Art. i te taumata takitahi rā.
• heke pēhanga he pini - iti iho i te 25-20 mm HG. Art.
• kia meinga māharahara o te ru cardiogenic koma o te kiri, me tona makariri. whakakitea ēnei faaiteraa i te takahi o te microcirculation i nga kopa o te tinana.

Ki te tangata e kitea e nga tohu i runga ake o te māuiuitanga, i reira kia kia he raupapa o ngā i mua i te taenga mai o ngā tohunga. kia whakahaua āwhina Tuatahi mō te kore te ngakau whakapeka ki te whakarite kia (Stroke, whakaeke ngakau, me ētahi atu.):

• whakarite uru ki te rangi hou;
• whakarite i te tūnga whakapae o te manawanui (ki te ia kahore tohu o te kore ventricular maui);
• mau pānga analgesic.

Maimoatanga o te kore ngakau whakapeka

Maimoatanga o te kore ngakau - he therapy matatini hāngai, te tuatahi, me te tuatahi, ki te whakarite kia:

• whakakore i te kikī uaua cardiac - tutuki tenei mehua e mā te whakamahi i taero e raro pēhanga toto me te auau ngakau;
• hopu i te tohu o te mate (ka whakawhirinaki mehua whakaora i runga i te mau faaiteraa faaiteraa mate).

Ki te mea kua tipu DOS rite ki te hua o te infarction myocardial, he reira e tika ana, no te taea ki te whakahoki rere uaua toto coronary. Tikanga, te huru ai infarct iatuku Thrombosis, te faaamuraa i te ngakau. tauturu rongoa katinga toto tino whakahoki patency o te oko toto, me te ki te ū huru o te manawanui.

whakaaro te tikanga tino rongonui i roto i tenei take e ki thrombolysis, engari kia te tukanga whakamana wawe tonu i muri i te tīmatanga o te infarction noa he "hou" tonu te katinga. āwhina Tuatahi mō te kore te ngakau whakapeka whai wāhi te whakamahi o te raau taero (thrombolytics), kua hāngai ana ki te whakakorenga o clots toto nei mahi. Medicaments whakahaeretia e pâmuhia, Kei te tino whakaritea ratou tere o penetration ki te rauropi.

Maimoatanga o te kore whakapeka (ventricular matau) ki hemodynamics congestive tā tango ai meinga reira, - .. Tūnga asthmaticus, clots toto i roto i te pera pūkahukahu, etc. Tīmata therapy ūnga manawanui "Nitroglycerin" ranei "Furosemide" ka māuiuitanga ngā ru cardiogenic whakamahia inotropic tikanga. I roto i ngā ki te mehua i runga kawea i roto i te hāora inhalation i roto i te pū tōngāmimi.

Whakamātau tinana mamae tonu Pë whakapōauau, pērā i "rehunanu", i te whakaiti i te mahi o nga uaua romahā me te whakaiti te ahotea i runga i te ngakau.

Whakakorenga o tohu kore ventricular maui

E arata'i pinepine te stagnation o toto i roto i te pūkahukahu ki nunu'a kino pērā i edema pūkahukahu. A, no te whakaritea taua kōtītiti tūroro whakahaere "Nitroglycerin" pâmuhia.

Ki te te whakapeka kore ventricular maui ki hemodynamics congestive ngā ki ru cardiogenic, whakahau te whakataki o "dobutamine" ranei "noradrenaline" pâmuhia. He take, ina e ngā enei raau taero i roto i te matatini.

Huka Katohia mā tikanga whakarato pahuka i tiango.

Ki te ähuareka hemodynamics, engari tonu tohu pūkahukahu edema, whakahaere te manawanui glucocorticoids. I roto i tenei take, āwhina tuatahi i roto i te kore te ngakau whakapeka e tauturu i ki te whakaiti i te uruhanga o kiriuhi.

Therapy ki ru cardiogenic tīmata ki te whakapiki ake i putanga cardiac, i roto i te ngaro o nga mau faaiteraa o te kore ngakau congestive Kei roto te reira whakahaere expanders wē. whakamana ana tēnei tukanga te anake i raro i te mana o te auau ngakau, pēhanga toto me te respiration. Ki te mua ki te takanga o te mate ngakau whakapeka puta he mate nui o te wai, whakamahia te konutai pūhaumāota te.

Whakakorenga o tohu o te mate, o te akoranga, matua e pā ana ki te whakamahi o te raau taero, engari ki te kahore e arahi tangohia mehua ki te pānga e hiahiatia ana, ka taea e koe te whakamahi i te ara tika - ki te mahi unloading hemodynamic roto i te pāpuni i runga i te uaua e alangá.

I roto i te wā i reira he kahakore rongoa momo ki te huihui ki te pokanga. Raraunga e whakakorea nga raruraru e pā ana ki occlusion o pera, takirere whakakapinga ngakau. Ū tauturu te auau ngakau ki te tāuta i te pacemaker defibrillator ranei.

ārai

Ko te ara pai ki te ārai i te whanaketanga o te mate - he reira ki te ū ki te ture ohie - ara, ki te arahi i te āhua noho hauora, whakatane paowa, me te hoatu ake te whakamahi nui o te waipiro, ki te kawe i roto i te aroturuki wā o ngā mate mau. Heoi, i roto i te wā ka te whakakitea tonu ano te mate, kia whai i te tikanga motuhake i roto i te ora ia rā.

kia āta aroturuki Tūroro ki te kore te ngakau congestive ratou taimaha. toka tāpiri whakapataritari he hua i roto i te huka toto, me te hanganga o whakatū papa cholesterol i roto i te oko toto, e ai te pēhanga toto tiketike. He huru nui mō te whakaū i te huru tinana tikanga he i raro ki te kai kai motuhake. He mea tika ki tino whakahaere te rōpū o te tote, te taikaha o te mea kino mo te hauora - faatupu te reira pupuri inu, edema hanganga, nui haere kawenga i runga i te ngakau.

He pai ki te mahi i mahi tinana, hoatu he kawenga ki uaua me hononga reira, engari e kore e akomanga hākinakina meinga kikī o te tinana. He huinga o te mahi ki te kia whakaae ki te tākuta. He mea nui ki te haere ki pinepine tuwhera te rangi, moe, te karo te ahotea me te itoito hinengaro.

Hei huihuia ake, kia tuhia ai i te reira e kore te ngakau whakapeka - he māuiuitanga e he maha mate. te tikanga whanake te mate i roto i te papamuri o te tahi atu āhua mate o te pūnaha Cardiovascular me arata'i ki ngā pōauautanga, tae atu patu, ru cardiogenic, edema pūkahukahu, me pera i runga i.

He tohu, pāngia nei te kore ngakau whakapeka. kia kakato whakakitea tohu o te mate, kua koia reira ko te mahi nui o te ngaio i te lekooti o amuamu manawanui katoa me te āta arä.