WPW tītohunga: take, tohu, tātaritanga, me te maimoatanga

huaina WPW syndrome ko māuiuitanga i roto i nga weu karere o te uaua ngakau e ai haurangi me tachycardia tika ki te wahi o te excitation o te pana io i runga i atu ara poto e kore e e i roto i te ngakau hauora.

Ko te whakahua tuatahi

I roto i te 1930, pūtaiao hauora Wolff Parkinson White me te tuatahi ki te whakaahua i te tohu, me mau faaiteraa o te huarahi syndrome, e muri i homai te ingoa o te syndrome SVC (WPW). He he he mea pērā i WPW-tītohunga. whakaaro hoki tatou i te reira i roto i tenei tuhinga.

Tikanga, te weu i roto i te ngakau, io he pini excitation conductive ki te hanga i te ara motuhake, i whakarato kākahu me te tohatoha āta o te torohaki. Tohu whakatupuranga tīmata i roto i te kōpuku pakohu i roto i te marae tika, ka tae, ka te kōpuku AV (kōpuku atrioventricular) i roto i te rohe atrioventricular nga waewae o tona paihere i roto i Purkinje muka tuku te excitation i roto i muka uaua katoa o nga ventricles ngakau, a ka whakarato he taua ara roa te hukihuki ruruku me te tukutahinga te uaua ngakau katoa.

Take me tohu

Ki te toro WPW syndrome karere hihiko excitation i te atria ki te ventricles te ara poto ki te kurupae pera-ka karanga Kent, bypassing te atrioventricular (AV) kōpuku. Ko, he nui tere atu i roto i te manawataki noa o te mokowhiti te poipoi o te excitation, a he aha i reira he incoordination o te whakaiti o te uaua ngakau, me ngā momo o te arrhythmia.

Ko te ara o te he pini ngakau maru.

He congenital kōhikohiko rite i roto i te hanganga o te ngakau, me te e hanga e anake e tika ana ki te ira manga tuku i raro i te mana o te tahi atu āhuatanga ranei, pēhia pa ana te whanaketanga o te tangata te ngakau kukune.

Kukune tonu nei mowhiti atrioventricular atu me nga muka, i roto i te wiki 20-22-th o te kikokore ka ngaro rawa. Ki te rongoa taua muka, i reira he tikanga kikokiko WPW syndrome. āhuatanga te ahua tuku iho o te WPW-syndrome e te maha nui o ngā hononga AV, hē me kōhikohiko i roto i te hanganga o te ngakau. Heoi, anake i roto i te paariraa e puta i roto i te noa'tu o abnormalities kikokiko congenital, te tohu tuatahi o WPW-syndrome. O te wā katoa, pāngia te aroaro o 70% o te syndrome e i roto i nga tangata.

tohu o te māuiuitanga

Ko te tohu tino noa o te aroaro o WPW syndrome taea ko te whai:

1. Ongo'i palpitations kaha, me te auau, tamariki e taea te karanga "peke e āki mai ngakau ranei."
2. whanoke Inamata.
3. syncope aita e, te nuinga i roto i te tamarikitanga, me te taiohi.
4. Te pēhi i te mamae i roto i te ngakau, mania, me te tapahi mamae ina ngongoa.
5. Mana'o o te whakahēmanawatanga, hāhā nui o manawa i te kuao tau.
6. Ka taea e hou te kore kai sweating auau taea, ngoikore tamau, auau ngakau nui haere ia wā ki te 200-300 kapakapa ki te meneti.

Me pēhea te ki te tautuhi i mate?

He rota o te iwi e whai muka atu rerekē i roto i te uaua cardiac, pāngia te syndrome WPW te anake ka whakamana echocardiography cardiac. Deciphering mohio ka hoatu te hua.

e kore e tukua e kawe taua syndrome i pāngia o te tachycardia fibrillation ranei, a kia ara kia mohio o te aroaro o abnormalities i roto i te ngakau.

Tenei asymptomatic kitea i roto i te 35-40% o kawe tāutuhia katoa o te syndrome. āhuatanga rere ngawari o WPW syndrome e tachycardia recurrent wā-poto fibrillation ranei, e hohoro haere kahore te tauturu. Hei whakakore i haurangi i roto i te take o te mahara reo WPW syndrome rapua e taero antiarrhythmic etahi momo o blockers o excitation cardiac ranei.

I roto i te take o hukihuki roa e kore e e rawa nekehia contractions a hauora uaua, me te disordered o te uaua ngakau me te kaka Atrial pāngia tohu nui o te syndrome me tafa tūtohu.

momo syndrome

Whakaröpütia WPW syndrome me ngakau kia rite ki te auautanga a rawa te putanga o ngā tohu haumanu me te kua wehea ki te momo e whai ake nei:

• Faaite mai i te tonu te hiko-poipoi raorao hakari, a puta ATS-tachycardia me pakohu manawataki rä.
• Tuao - āhuatanga e ventricular tūao mua excitation-.
• Huna - whakaahua ana wā AVR-tachycardia, a i roto i te āhua o te okiokinga e kore e pāngia.

Pehea atu e taea te tātari te syndrome?

Te kore te hiko-ki te tātari he taea taea WPW-syndrome mā te whakarongo ki te ngakau tangi, e ka hei wahi o te faaiteraa arrhythmic i roto i te natura, me te o mokowhiti kōhikohiko.

I tua atu ki ECG tātaritanga o WPW syndrome E aroturuki te whakamahi i te pūrere kawe motuhake ki electrodes, i te ultrasound me echocardiography, te whakataki o electrodes whakaongaonga ki te pū kai ki hua muri wetemuna o ponana hiko, me te whakamātautau electrophysiological matatini, e homai i te tauira tika tino wātea ana i roto i te uaua cardiac Kent kurupae ka taea ki a tatou tūtohu te maimoatanga momo hāparapara ranei.

WPW-tītohunga

A, no te nga rangahau mo te aroaro o WPW syndrome i roto i neke atu i te 30% o te syndrome kawe tāutuhia tetahi amuamu i runga i te hauora ngakau kua kore i tūpono. Nā ki te maha nui o taua asymptomatic, i 1980, WHO whakaputaina taunakitanga i wehea WPW syndrome he pikitia haumanu motuhake, me WPW-āhuatanga.

Mō tenei āhuatanga, kua mutu te reira e runga hiko-manawataki pakohu ngakau he tohu o te excitation ventricular halá, engari he rite kahore āhua pathological me tachycardia atrioventricular i te kaupapa.

Ahakoa tenei, ina ko tiketike rawa te āhuatanga WPW te mōrea o pōauautanga, whakapataritari tetahi pānga - ahotea tinana ranei aronganui, waipiro, haere i roto i ngā rohe matawhenua tauhou - e taea meinga te faaiteraa o tohu kino o WPW syndrome. I roto i te mea mate te taupori pakeke i roto i te 0.3% o ngā take o WPW-tītohunga, whakakitea tamariki i te uiui mate haumanu i roto i te 2% o te wā.

tītohunga Tatauranga WPW i roto i ngā tamariki

WPW-syndrome noho te wahi ārahi i roto i te āhuatanga meinga te tachycardia me arrhythmia i roto i ngā tamariki. Ko te reira i te pūtake kitea mō te rangirua anō o te manawataki ngakau, a kahore e ara te ngaro o amuamu whakaiti te mōrea o taua disorders. Tetahi kikī tinana, mahi kaha, ka taea e ngā āhuatanga hinengaro tīmata te kore o pohewa te ngakau hari, me te noa arahi ki te mate i te whakaeke ngakau.

aroturuki wā-roa mō te tata 20 tau mo te rōpū nui o ngā tamariki e pāngia ngakau WPW syndrome, tamarii fanau tau ki 18 tau, whakakitea te hua e whai ake nei:

• 8% o ngā tamariki ite tīmatanga ohorere o ABP-tachycardia;
• 8.2% o te kaupapa i ite i te WPW syndrome tūao tītohunga whakawhiti;
• 8.5% o te mate rangitahi o puta te mahara;
• 2% o nga tamariki i te wa o te rangahau tuatahi kua tukua kua mate haumanu;
• 1.2% - tamariki anake - ohorere mate wā rangahau;
• % 9 anake o ngā tamariki ki te WPW tītohunga korerotia ngaro o tohu raraunga.

Kia pehea te kino āhuatanga WPW?

Mai i enei whika ko reira mārama pehea te aroaro ara haumaru ko WPW āhuatanga. Tenei ōrau nui o ngā tohu kino me pathologies i roto i tamarikitanga homai whenua ki te amo i taua e kore e tohungia ahotea tinana, me te aronganui, kahore te pūnaha o te aroturuki me te mehua haumanu ki tau, me tenei ōrau ko te riri ki te ora, ka whakapiki ake i anake.

Tamariki ki te WPW tītohunga kore e whai wāhi i roto i ngā hākinakina ngaio, ka waiho i raro ki ngā āhuatanga ahotea tamau. kia Whakatūpatotanga kia tangohia ki huri āhuarangi ohorere ngā ranei, ai he wawahi aronganui kino. kia tino pea ki te arahi ki te puke lahi mate ranei katoa o enei āhuatanga. Tangata e kua whakapumautia te aroaro o te syndrome WPW tītohunga ranei, e kore karangatia e ake mo te mahi hōia.

Treatment me te tauturu o te syndrome

Kei te maha te honohono tohu me maimoatanga. He maha ngā rongoā e atawhai patua ngakau meinga e te syndrome WPW, a tino whakaiti i te faaiteraa o ona tohu.

normalizes rōpū taero pūārai te auau o contractions o te uaua ngakau. Heoi, whakaaturia te whai huatanga o taua tikanga ko anake i te taumata o 50-60%, me te kore e taea te whakamahi i te hypotension tamau me te huangō.

Antiarrhythmics rawa pūmau Katohia patua AVR-tachycardia, haerenga, auau ngakau i roto i 80% o tūroro, engari ano hoki i te maha o contraindications i te take o te hypotension, whakaeke ngakau, me te tahi atu mate ngakau, tamarikitanga, me te taiohi. Ētahi blockers konupūmā tino contraindicated i roto i te syndrome WPW, rite te pikitia i runga i te hoki o ake tuku o te pana io, e oreraa ratou i roto i te atria, e he ngaahi nunua mamafa, me te tina heke.

Hoki, i roto i ētahi wā, te whakamahi o te raau taero rōpū ATP kitea he pānga kino i runga i te hukihuki Atrial. He hoki tikanga kore-tarukino o te tauturu o tohumate.

Ko te ponana uaua io tika na waenganui i te muka pukuaroha, me te parasympathetic. Ko te momo tuatahi o weu whakahohetia te ngakau, te rua o nga ahua o pōturi iho te auau ngakau, kia rite ki te ahua o vagus vagus karere nervus, ka huaina hoki pūpū vagal. E ko, ka hoatu te faaitoitoraa o ïa tenei ahua o reflexes te pānga o stabilization o te ngakau. Ko te huarahi māmā ki te whakahohe ponana vagal ko te Aschner kahuki pera-ka karanga nei whakapataritari 20-30-rua he ngawari pa i runga i te nenewha me maha āwhina ki te aukati i tachycardia.

Ano, te karere vagus te pai whakahohe e manawa-pupuri me te ngaohiko uaua puku, kia e ki te āhuatanga o WPW syndrome whai hua ranei te mahi yoga, me te kupukupu tonu mahi.

Tīmata tikanga tohu rahi i roto i te kawehiko whakaurua ki te pū kai, rawa tōtika mutu tachycardia taimaha auroa, engari i ētahi wā ārahi ki fibrillation o te ngakau, na mahi i roto i te kāpata motuhake rawa ki te defibrillator.

whakamana Defibrillation te anake i roto i te wā tino kino, ka riri kino ki te ora, engari reira maha āwhina ki te whakakore hotbeds kino o ponana ke i roto i te kiko cardiac, me te haerenga, te mahi manawataki ngakau.

Operative syndrome maimoatanga WPW me ratou hei akiaki

Ki te tono tītohunga kitea WPW ECG tikanga whakahaere o te whakakorenga e anake i roto i ngā āhuatanga rawa, ki te tachycardia auau, me te auroa, e kore e taea te nekehia atu ki te rongoā, me te i roto i pumau take o te mate cardiac ohorere, whanaunga o te manawanui mō take ngaio ranei.

tūtohutia maimoatanga hāparapara te anake i runga i te pūtake o te whakamātautau whānui, me te oti, e homai i te pikitia tika tino o te hanganga kiko pathological o te ngakau. Na reira, kia whakaaro koutou ranei ki te hanga mahi ki te WPW āhuatanga.

whakamana ana te mahi kei te whakamahi i te kawehiko motuhake, whakaurua nei i roto i te iatuku femoral ki te uaua ngakau i te X-ray kitea me i etahi wāhi hua radioprizhiganie ablation ranei, weu karere.

taea hoki te te kriorazrushenie te reira i muka io pathological. A i roto i te meka, i roto i te wā e rua i te tōtika mahi tae 95%. Relapses puta tika ana ki te whakangaromanga pahara e whakaritea aronga, me i te aroaro o hinonga unidentified atu te kopa neural. I tahaki, ka taea te whakamana i te mahi i raro i rehunga rohe, tata kohakore, e kore e meinga pōauautanga, kua he wā whakaora poto rawa, me te reira e taea te kawea atu i tetahi tau.

pokapū cardiac i roto i Moscow

Institute o Surgery. A. V. Vishnevskogo - te whakapehapeha o te rongoā kāinga, he whakaurunga hou mo te maimoatanga me te tātaritanga, tataki rangahau, whänuitanga tātaritanga tiketike-tech me ahurei tafa cardiac. FGBU "NNP Center o Cardiovascular Surgery ratou. A. N. Bakuleva "mahi mahi hauora, te pūtaiao, me te mātauranga o te hōtaka" Surgery Cardiovascular. "

Russian Cardiology Rangahau me Production Complex whakahaere rangahau me te maimoatanga o te mate ngakau i roto i te taumata tiketike-tech ao. I roto i "cardoid" pokapū taea e koe te amohia e te aro mātai cardiac oti, riro i te maimoatanga whakaora kounga i runga i te kaupapa tūroro. mahi pai Cardiological Center i Moscow, na ki te te hiahia mō te wawaotanga hāparapara ki te hamani whai koutou, e kore koutou e taea e feaa.