CHF: gulu. Zizindikiro kulephera chithandizo aakulu mtima

Matenda mtima kulephera, zizindikiro zake zidzakhala kutchulidwa hereinafter, ndi kudwala, zizindikiro zomwe imakhudzana ndi chisokonezo magazi. State taonera zina ndi pa maganizo ndi limodzi mwa akuchedwa madzimadzi thupi. Chithandizo cha matenda a mtima ambiri mankhwala ndi comprehensively anachita. kupeza nthawi yake kwa dokotala amalimbikitsa ayambe zambiri mofulumira magazi ndi kuthetseratu nthendayi. Kenako, tikambirana mfundo zimene tingachite CHF. Gulu la matenda, zizindikiro zikunena achire adzamva anafotokoza m'nkhani.

mwachidule

CHF, omwe si gulu yaikulu zachokera kuchepetsa mphamvu thupi kutulutsa magazi Ndikudzikhuthula kapena kudzazidwa. Matenda amayamba, poyamba pa zonse, minofu chotupa. Mofanana kwambiri ndi vutoli kachitidwe zokhudza ntchito mtima.

chithunzi matenda

Zinadziwika aakulu mtima kulephera? Zizindikiro za matenda otsatirawa:

• Kufupika kwa mpweya - osaya ndi kusala kupuma.
• Kutopa - kuchepetsa portability zolimbitsa thupi wamba.
• Zotumphukira edema. Iwo kawirikawiri amaoneka pa miyendo ndi mapazi, pa nthawi pamwamba, yaitaliyo ntchafu, khoma kutsogolo kwa peritoneum, m'chiuno ndi zina zotero.
• cardiopalmus
• Chifuwa. Pamisinkhu koyamba ndi youma, ndiyeno nkuyamba kupatukana ochepa sputum. Kenako, mwina kuonedwa ndi kutsegula magazi.
• Malo orthopnea. Wodwala zitavuta kugona ndi mutu wanu kukwezeka (pa cushions, mwachitsanzo). Mu lathyathyathya malo yopingasa kuyamba kukula lalifupi mpweya ndi chifuwa.

mawonekedwe pathological

Ngakhale kumalo a zikunena achire, alili akhoza kuwonongeka. Pankhaniyi, kufunika kwa matenda mokwanira za mtima ndi mitsempha ya magazi. kafukufuku zozama adzafotokoza akapsa chobisika. CHF olekanitsidwa zotsatirazi:

• Woyamba (koyamba). Pa nthawi imeneyi, popanda CHF matenda magazi. Pamene echocardiography anavumbula kukanika chobisika ventricle kumanzere.
• A yachiwiri (symptomatic). State amakhala ndi hemodynamics chakhungu (magazi kayendedwe) mmodzi wa mabwalo.
• The B chachiwiri (aakulu). Mbali imeneyi amakhala ndi hemodynamic Kusakhazikika mabwalo onse. Ndiponso taonera kugonjetsedwa thupi nyumba ndi njira magazi.
• The chachiwiri (chomaliza). State limodzi ndi hemodynamics chakhungu kulitchula. Lolemera kusintha zambiri sizingasinthe mu kapangidwe ka ziwalo chandamale komanso zikusonyeza kuti fomu iyi kulephera mtima.

Gawo kudwala amathanso kuchitikira malinga ndi mtundu zinchito. Onse anai a iwo.

mitundu zinchito

Monga gulu yapita, kusintha akhale mbali ya kusintha ndiponso kuwonongeka, ngakhale ndi maziko a kupitirirabe achire zikunena kulephera aakulu mtima wapezeka. Gawo malinga ndi mitundu ntchito motere:

• Mtundu woyamba amakhala ndi kusapezeka kwa malire zolimbitsa thupi. Kabwerebwere zolimbitsa thupi m'thupi wodwala kulekerera popanda kuonetsa zizindikiro za matenda. Wosakwiya kuchira boma kapena dyspnea kumachitika pamene overvoltage.
• Mtundu wachiwiri wofanana ndi kuletsa ntchito Pamlingo yaing'ono. Kudwala alibe kuonekera pa mpumulo. Mwachizolowezi, mwambo thupi zolimbitsa analekerera ndi odwala ndi kufupika kwa mpweya, kutopa, kapena kufulumizitsa mungoli. Pa nthawi imeneyi, kwambiri analimbikitsa diagnostics mtima.
• Mu mtundu wachitatu pali zofunika kwambiri ntchito malire. Kusapeza mu mtima pa mpumulo zikusowa. kwambiri zosakwana mwachizolowezi yaikulu thupi limodzi mwa chikwaniritso cha zizindikiro cha kudwala.
• Pamene yachinayi ntchito iliyonse wodwalayo limodzi ndi zomverera zosasangalatsa. Zizindikiro za kudwala anati mu mtima pa mpumulo, amplifying ndi chidwi thupi.

zone kuchulukana

Malinga ndi kutanthauzira ŵakwenera matenda, wodwala akhoza kuzindikiridwa:

• Kumanja yamitsempha yamagazi kulephera. Mu nkhani iyi, stagnation anamuona pa m'mapapo mwanga - m'mapapo mwanga njira magazi.
• Kumanzere kulephera yamitsempha yamagazi. Pankhaniyi, isanafalikire kuchulukana bwalo lalikulu - mu njira magazi a ziwalo zonse kupatula m'mapapo.
• Dvuhzheludochkovaya (biventricular) kulephera. stagnation magazi Pankhaniyi zimawonedwa mu zipolopolo ziwiri nthawi imodzi.

gawo

Chithandizo cha matenda a mtima amasankhidwa molingana ndi chithunzi matenda. Mawonetseredwe zimadalira kutanthauzira kwa pathologies matenda ndi zinthu precipitating. Ofunika kusankha mankhwala ali ndi mbiri za matendawa. CHF likhoza kulumikizidwa ndi mkhutu diastolic kapena / ndi systole. Choncho, kudziwa pathologies angapo mbali. Makamaka, pali:

• Systolic mtima kulephera. Iwo amagwirizana ndi matenda systole - nthawi ya chidule yamitsempha yamagazi.
• Diastolic kulephera. imeneyi chifukwa kuphwanya diastole - yamitsempha yamagazi zosangalatsa nthawi.
• Obwerawa mawonekedwe. Pankhaniyi, pali kuyan'anila za diastole ndi systole.

zifukwa

Posankha njira achire kwa kuchotsa CHF digiri gawo ndi mawonekedwe ndi zofunika. Komabe, zofunika ndi chizindikiritso cha zimayambitsa ndi kudwala. Matenda kulephera mtima chifukwa cha:

• M'mnyewa wamtima infarction. Mu chikhalidwe ichi pali kuwonongedwa kwa minofu mtima, amagwirizana ndi kutha kwa magazi kwa izo.
• CHD pakalibe infarction m'mnyewa wamtima.
• Matenda oopsa - kakamirani kuwonjezeka kuthamanga.
• Mankhwala. Makamaka, kudwala angathe chifukwa ntchito mankhwala anticancer ndi medicaments kwa mlingo ayambe.
• Cardiomyopathy - mtima minofu choipa, pakalibe kuvutika kwa mitsempha m'thupi yekha ndi matenda ake valavu, komanso matenda oopsa.
• Shuga.
• Chithokomiro zotupa.
• Matenda a kugwira ntchito adrenal.
• Kunenepa.
• Cachexia.
• Chosowa angapo kufufuza zinthu ndi mavitamini.
• Amyloidosis.
• Sarcoidosis.
• HIV.
• Osachiritsika aimpso insufficiency.
• Matenda fibrillation.
• Mtima chipika.
• Youma ndi exudative pericarditis.
• Kobadwa nako ndipo anaphunziranso mtima zopindika.

Chizindikiritso cha kudwala

Matendawa "CHF" aikidwa pa maziko a Khadili madandaulo ndi anamnesis. Mu kuyankhulana ndi dokotala kumuuza wodwalayo pamene pali zizindikiro za kudwala ndi zimene zikugwirizana kudwala. Komanso limapezeka pafupifupi matenda anali munthu ndi banja lake. Katswiri ayenera kudziwa za onse mankhwala anatengedwa ndi wodwalayo. Kuzionetsetsa thupi, imawunikidwa pa khungu, pamaso pa edema. Akamalankhula mtima akufunitsitsa ngati phokoso pano. Ukutionetsera pamaso pa kuchulukana mu mapapo. Monga maphunziro chofunika anatumizidwa mkodzo ndi mayesero magazi. Research angazindikire comorbidities kuti angachite njira ya CHF. Chithandizo mu nkhani iyi ndi zovuta, umalimbana ndi kuthetsa matenda maziko. Anaikidwa kukhala magazi amuzolengedwa. Malinga ndi zotsatira anatsimikiza mtima ndende ya mafuta ndi tuzigawo twa ake, urea, creatinine, dzuwa, potaziyamu. The kusanthula pa mahomoni chithokomiro. The katswiri mwina mankhwala kuphunzira immunological. Pa amaonekera ndi mlingo wa chitetezo kwa minofu mtima ndi tizilombo.

Studies ntchito zida

ECG amalola kuti aone kayendedwe ka heartbeats, kudziwa arrhythmias, m'madipatimenti thupi kukula, komanso kudziwa amamuyambitsa timabala yamitsempha yamagazi. Yosanthula phokoso ntchito phonocardiogram. Mothandizidwa ndi ziyerekezo valavu anatsimikiza ndi kukhalapo kwa phokoso systolic kapena diastolic. Kuonanso bwino nyumba ya m'mapapo ndi mtima ntchito radiography m'chigwa cha sternum lapansi. Phunziro ili ndi kudziwa kukula ndi buku la limba, ikukoka magazi kuti adziwe kupezeka kwa stagnation. Echocardiography ntchito kufufuza madera onse a mtima. Pa ndondomeko chimafotokozera mbali khoma makulidwe ndi mavavu. Komanso, ntchito echocardiography angathe kuonedwa ngati zowonetseredwa ndi kuwonjezeka mu kuthamanga ziwiya m'mapapo mwanga. Analysis wa magazi anachita pa dopplerEhoKG. dokotala anu mwina mankhwala ndi kafukufuku wina, kuwonjezera pa anthu amene akuvutika.

CHF mankhwala: ayamikira

Choyamba, mtima ulipo zakudya zina. The zakudya zochepa kuchuluka kwa mchere magalamu atatu a madzi malita 1-1.2 tsiku. Zamgululi ziyenera kukhala zosavuta kupukusa, kuti ndithu mkulu-kalori, vitamini ndi mapuloteni mu kuchuluka chofunika. Zonse wodwala ayenera kugwira masekeli. kunenepa wa makilogalamu oposa 2 kwa masiku 1-3 zambiri zimasonyeza akuchedwa thupi madzimadzi ndi decompensated kulephera mtima. Chithandizo Mwina mulinso thandizo maganizo. Ndi Cholinga imathandizira kuchira wodwalayo. thandizo maganizo angathe kuperekedwa ndi achibale a munthu wodwalayo. Kwa odwala si zofunika kupereka katundu kwathunthu. ntchito mlingo anatsimikiza kwa wodwala aliyense payekha. Zokonda ayenera katundu zazikulu.

The mankhwala zofunika mankhwala

Mankhwala kulephera mtima anawagawa m'magulu: pulayimale, sekondale ndi wothandiza. Gulu loyamba zikuphatikizapo:

• Ace zoletsa. Amathandiza kuti amachepetsa mphamvu ya matenda, kuteteza mtima, impso, mitsempha ya magazi, ulamuliro wa magazi.
• angiotensin cholandilira muzikangana. Zida akulimbikitsidwa zoletsa hypersensitive Ace kapena pamodzi kuphatikiza.
• Beta-blockers ( "Concor" mankhwala, "Inderal" ndi ena). njira izi kupereka ulamuliro pa kuthamanga ndi mlingo kuchepetsedwa ndi zotsatira antiarrhythmic. Beta-blockers ndi kutumikiridwa mu molumikizana ndi zoletsa Ace.
• Okodzetsa ( "amiloride" mankhwala "Furosemide" ndi ena). njira amenewa amathandiza kuthetsa m'thupi la madzi owonjezera ndi mchere.
• Mtima glycosides. njira izi advantageously kutumikiridwa mu Mlingo kakang'ono arrhythmia matenda.

ndalama zina

• Bafuta akusankhidwa chochitika kuti chifukwa cha kulephera mtima mokomera CHD.
• Anticoagulants zochita zina. Kukonzekera kwa gulu ili anatuma Mwina mkulu wa thromboembolism ndi matenda fibrillation.

mankhwala ancillary

mankhwala awa zinafotokozedwa milandu mwapadera, pamene anafotokoza zosokonezeka. Njirazi ndi monga:

• Ku feteleza. Makampaniwa kusintha otaya ndi dilates Mitsempha. Mankhwala a gulu amaikidwa kuti angina.
• Kashiamu muzikangana. mankhwala awa anasonyeza mu angina abutment, matenda oopsa (phwando), kuthamanga okwera magazi mu njira m'mapapo mwanga, kulephera kutchulidwa mavavu.
• Antiarrhythmics.
• Antiplatelet wothandizira. Makampaniwa angathe kunyoza coagulation inhibiting kupatsidwa zinthu za m'mwazi agglutination. Medicaments wa gulu amaoneka mu sekondale kupewa infarction.
• Neglikozidnye ogalamutsa inotropic. Ndalama zimenezi zimagwira ntchito mu kuchepa Amowabu magazi ndi mphamvu mtima.

njira opaleshoni

Popeza kukhudzana mankhwala ntchito Mwachangu ntchito makina kusokonezedwa. Makamaka, wodwala angathe kuperekedwa:

• Inatsekeratu mtsempha wamagazi kulambalala kumezetsanitsa. Opaleshoni anachita pamene anafotokoza atherosclerotic zotupa mtima.
• Opaleshoni kuwukonza zopindika valavu. kusokonezedwa ndi ikuchitika mu nkhani ya stenosis aakulu (kuchepetsa) kapena vavu kulephera.
• Chiwalo kupatsidwa zina. Kupatsidwa zina za mtima ndi kwambiri ndithu muyeso. kukhazikitsa kumafuna angapo mavuto
  
  - Nkosatheka kukanidwa;
  - osakwanira chiwerengero cha ziwalo mwiniwake;
  - njira magazi kugonjetsedwa kwa chiwalo kuziika, zovuta pang'ono kuchitira.

• Kugwiritsa ntchito zipangizo yokumba kuti amathandiza magazi. Iwo atchule mwachindunji mu mtima. Pambuyo padziko khungu n'zokhudza batire ili pa lamba wodwalayo. Komabe, zida ntchito amadziwikanso limodzi ndi mavuto. Makamaka Mwina mavuto opatsirana, thromboembolism ndi thrombosis. Chindiletsa ntchito ochulukirapo galimoto ndi ndalama mkulu.
• Ntchito zotanuka ukonde chimango. Iwo uzikuta mtima pa cardiomyopathy dilated. Izi muyeso limachititsa m'mbuyo kuwonjezeka kukula thupi, kusintha Mwachangu kukhudzana mankhwala, kusintha alili.