Kusokonezeka kwa mitsempha ya mtima mu matenda ashuga kumatha kuonekera motsutsana ndi matendawa pawokha kapena kumachitika chifukwa cha zovuta zake. Matendawa ndi monga matenda oopsa, matenda a mtima ndi zina.
Ndizofunikira kudziwa kuti kusokonezeka kwa mitsempha komanso phokoso m'misempha kumatha kukhala kosiyana. Chifukwa chake, si milandu yonse yomwe imafunikira chithandizo chachikulu, chifukwa matenda ambiri nthawi zambiri amayenda ndi wodwala moyo wake wonse. Koma matenda ena akupita patsogolo mwachangu, chifukwa chotsatira zovuta kwambiri, zomwe zimafunikira chithandizo chamankhwala mwachangu.
Nthawi zambiri, ndi mtundu wachiwiri wa matenda ashuga, tachycardia imayamba. Koma kodi matendawa ndi chiani ndipo ndi owopsa motani kwa odwala matenda ashuga?
Kodi tachycardia ndi chiyani ndi zizindikiro zake?
Matendawa amapezeka pamene phokoso la mtima lisokonezeka pomwe limakhala pafupipafupi.
Komanso, kulephera kumatha kuchitika osati kokha pakulimbitsa thupi, komanso ngati munthu wapumula.
Tachycardia ndiwachilengedwe komanso waubongo. Ndiwo mtundu wachiwiri wa matenda omwe ungathe kutsagana ndi matenda ashuga.
Koma mwa odwala matenda ashuga omwe amachita nawo masewera, kuchuluka kwamtima kumawonekera ndi katundu aliyense. Kuphatikiza apo, zinthu zina zimathandizira ku izi:
- kupsinjika kwakukulu;
- nkhanza zakumwa zoziziritsa kukhosi;
- mantha ndi zinthu.
Koma atatha kuchita zolimbitsa thupi kapena kuchepa kwa vuto lamanjenje, kugunda kwa mtima kumadzabwezeretsa lokha. Mitengo yamtima yofananira imamenyedwa 60-80 pamphindi. Ngati ili pamwamba 90, ndiye izi zikuwonetsa tachycardia, ndipo ngati wotsika, bradycardia.
Tachycardia mu shuga sikuwonetsedwa nthawi zonse ndi zizindikiro zazikulu, kotero odwala sangadziwe kupezeka kwa kuphwanya koteroko. Nthawi zambiri, matendawa amapezeka pokhapokha atatha mayeso a electrocardiographic.
Komanso, kuwonjezeka kwa kugunda kwa mtima kumatha kutsagana ndi zizindikilo zomwe odwala mosazindikira amakhala ngati matenda ena. Kuphatikiza pa kumva kugunda kwamtima kolimba, tachycardia imakonda kuyenda ndi zizindikiro zina zingapo:
- Chizungulire
- kusinthana mwachangu komanso mwachangu phokoso;
- kupuma movutikira
- kukomoka;
- kumverera kotembenuka kapena kukomoka kuseri kwa sternum;
- kumverera komwe mtima ukugunda.
Nthawi zina zolakwika pamiyeso ya mtima zimapezeka pakawerengedwa mozungulira popanda kukhala ndi chithunzi cha chipatala.
Zizindikiro zingapo zomwe zimachitika kawirikawiri ndimtundu wa matenda ashuga nthawi zambiri zimachitika motsutsana ndi maziko a matenda ashuga othana ndi vuto la matenda ashuga. Ndizovuta zovuta za hyperglycemia, pomwe mitsempha yomwe ili mumtima imawonongeka. Ngati akhudzidwa, ndiye kuti pali kuphwanya mzere wamtima.
Mu matenda a mtima a shuga, sinus tachycardia amachitika. Komanso, imadziwoneka yokha ngakhale wodwalayo akapumula. Kuthamanga kwa mtima mdziko lino kumachokera pa 100 mpaka 130 kumenyedwa. mphindi.
Palinso kuchepa kwa kupuma kwamphamvu pamtima. Munthu akakhala wathanzi, kenako ndikapuma kwambiri, kugunda kwa mtima kumacheperachepera.
Izi zikuwonetsa kuchepa mphamvu kwa minyewa ya parasympathetic, yomwe imachepetsa kugunda kwa mtima.
Zoyambitsa Tachycardia
Mu matenda a shuga, mitsempha ya parasympathetic imakhudzidwa, zomwe zimayambitsa kugunda kwa mtima kwachangu. Ndi kukula kwa matendawa, njira yachipatala imakhudza madipatimenti achisoni a autonomic NS.
Pakakhala zopanda zomverera m'mitsempha ya mitsempha, izi zimathandizira osati kukulitsa tachycardia, komanso kukula kwa IHD ndi maphunziro a atypical. Ndi matenda a coronary, ululu sungamveke, chifukwa chake, mwa ena odwala matenda ashuga, ngakhale vuto la mtima limachitika popanda zovuta zambiri.
Ndiye chifukwa chake vuto lalikulu kwambiri la matenda ashuga limakhalapo, chifukwa chithandizo chanthawi yake sichimachitika, chifukwa cha chomwe imfa imachitika. Chifukwa chake, ngati tachycardia yokhazikika imachitika, muyenera kulumikizana ndi katswiri wamtima, chifukwa iyi ndiyo njira yokhayo yochepetsera kapena kusiya kukula kwa mtima wa mtima ndi matenda a shuga.
Ngati zolephera pamiyeso ya mtima sizinazindikiridwe panthawi, ndiye kuti pali kusintha mu NS wachisoni. Vutoli limawonetsedwa ndi zizindikiro za orthostatic hypotension:
- zotupa za goose;
- kusalala mumaso;
- chizungulire.
Zizindikiro zotere zimawonekera pamene mawonekedwe amthupi asintha. Nthawi zina zimadutsa zokha kapena zimasowa pomwe wodwalayo abwerera momwe adalili kale.
Komabe, zizindikilo pamwambapa, kuphatikizaponso kukomoka, zimatha kuchitika ngati pali matenda a sinus node, kusokonezeka kwa phokoso la paroxysmal, komanso chipika cha atrioventricular. Chifukwa chake, kuti mudziwe chomwe chimayambitsa vuto mu mtima, muyenera kudziwa bwino za vutoli.
Kuphatikiza apo, matenda amitsempha yama mtima m'mitsempha ya m'mimba imakhalanso yowopsa chifukwa imawonjezera mwayi womwe umachitika mwadzidzidzi komanso kupezeka kwa kumangidwa kwa mtima kapena m'mapapo kupweteka kwa opaleshoni ya mankhwala pakachitika opaleshoni.
Komanso, matenda a shuga a tachycardia amakula ndi myocardial dystrophy. Amayamba chifukwa cha kusapeza bwino kwa metabolic komwe kumachitika chifukwa chosowa insulini komanso kulephera kwa glucose kulowa mkati mwa cell ya mu minofu yamtima.
Zotsatira zake, ndalama zambiri zamagetsi zomwe zimagwiritsidwa ntchito myocardium zimachitika ndikugwiritsa ntchito mafuta aulere a xylitol. Nthawi yomweyo, mafuta acids amadziunjikira mu cell, omwe samatulutsa mankhwala ambiri, omwe amakhala oopsa kwambiri ngati matenda a shuga akuphatikizidwa ndi matenda a mtima.
Chifukwa chake, myocardial dystrophy imatha kubweretsa mitundu yonse yamatenda oyang'anitsitsa mkatikati, kutsitsika, kusintha kwa fibrillation, ndi zina zambiri.
Ndizofunikira kudziwa kuti chithandizo cha matenda amtunduwu ndi osiyana ndi chithandizo cha matenda ashuga a mtima.
Ndizofunikira kudziwa kuti ndi microangiopathy, ziwiya zazing'ono zomwe zimadyetsa myocardium zimakhudzidwa. Kuphatikiza apo, zimabweretsa zovuta zosiyanasiyana mumtambo wamtima. Kupewa kwabwino kwa matenda ashuga a myocardial dystrophy ndi neuropathy ndikulipira matenda omwe akutsogolera, ndiko kuti, matenda ashuga.
Inde, ndi munjira imeneyi pokhapokha kupezeka kwa zovuta za hyperglycemia, kuphatikiza microangiopathy, neuropathy ndi myocardial dystrophy. Chifukwa chake, kuchuluka kwa shuga m'magazi sikuyenera kupitirira 6 mmol / l sutra pamimba yopanda kanthu komanso osapitirira 8 mmol / l pambuyo pa mphindi 120. itatha chakudya.
Pali zinthu zingapo zomwe zimathandizira kukula kwa tachycardia mu shuga:
- kukhalitsa kwa shuga;
- kunenepa
- matenda oopsa;
- kubwezeredwa kwa shuga;
- kusuta
- mavuto okhudzana ndi matenda a hyperglycemia.
Mitundu ya Tachycardia
Mtundu wofala kwambiri wamasokonezo amtundu wa mtima ndi sinus tachycardia, pomwe ma stroko amakwana kupitilira 70. Chidziwitso cha izi ndichakuti zikachitika, kayendedwe ka mtima kamakhala kosasinthika, ndipo chiwerengero chokhacho chimasintha.
Matendawa amakula mu sinus node, pomwe vuto limayamba mwa magwiridwe abwinobwino kufalikira. Mtunduwo umapezeka mbali yakumanja kwa mtima, poyamba kutulutsa kumakhudza gawo ili chabe, kenako chikopacho chimaperekedwa kudzera munjira yopita kumanzere kumanzere.
Ngati magwiridwe antchito ya sinus-atrial asokonezeka, ndiye kuti izi zimabweretsa chovuta pamatanthauzira obwera kuchokera mnjira kupita ku ma ventricles.
Pa ECG, sinus tachycardia imawonetsedwa ndi zizindikiro zotsatirazi:
- Kuthamanga kwamtima kwa 90 pamasekondi 60;
- kusowa kwa zopatuka mu phokoso la sinus;
- kuchuluka kwa imeneyi PQ ndi matalikidwe P;
- zabwino dzino R.
Komanso, motsutsana ndi maziko a matenda ashuga, paroxysmal tachycardia imatha kuchitika, yomwe imadziwika ndi mawonekedwe akuthwa komanso kuzimiririka komweko. Mtundu wa paroxysmal wa mtundu wa kusokonekera kwa mtima kumawoneka ngati vuto lakachitika pacompaker.
Kutalika kwa nthawi yowukira kungasiyane mphindi ziwiri mpaka masiku angapo. Potere, kugunda kwa mtima kumasintha kuchokera ku 140 mpaka 300 kumenyedwa. mphindi.
Pali mitundu itatu ya paroxysmal tachycardia, yomwe imasiyanitsidwa ndi kutukuka. Ndi nodular, atgency komanso kwamitsempha yamagazi.
Chifukwa chake, ndi mawonekedwe amkatikati, mawonekedwe amatsenga amapezeka mu gawo ili. Chifukwa chake, minofu yamtima imayamba kukhazikika mwachangu (mpaka kumenyedwa ndi 220 pamphindi).
Matenda a tachycardia siofala. Kwa odwala matenda ashuga, mawonekedwe owopsa a matendawa ndi pricxular paroxysmal tachycardia.
Kupatula apo, njira yamtunduwu ya PT ndiyowopsa, ndikulumphalumpha m'magazi ake. Kupezeka kwa matenda amtunduwu kumawonetsa vuto la mtima.
Komanso, mwa matenda ashuga, michere yamitsempha yamagazi imatha kuchitika pamene minofu yamtima imachita mgwirizano mosakhalitsa mpaka 480. Komabe, kuchepetsa kwathunthu sikuchitika.
Pa ECG, flutter yam'mimba imawonetsedwa ndi mano ang'onoang'ono komanso pafupipafupi. Vutoli ndikulumikizidwa kwa vuto lalikulu la mtima, lomwe nthawi zambiri limatha ndikumangidwa kwamtima.
Chithandizo ndi kupewa
Cholinga chachikulu cha chithandizo cha tachycardia ndi chithandizo cha matenda ashuga komanso zina zomwe zimachitika. Nthawi yomweyo, endocrinologist, neuropathologist, cardiologist ndi madokotala ena ayenera kutenga nawo mbali pakusankha njira zochizira.
Pali magulu awiri azitsogozo omwe amagwiritsidwa ntchito mu tachycardia. Amakhala ndi mankhwala osokoneza bongo komanso othandizira chidwi.
Ma Sites amatha kukhala opangidwa komanso zachilengedwe. Mu shuga, ndibwino kugwiritsa ntchito mankhwala okhala ndi zinthu zachilengedwe, ndipo ayenera kusankhidwa ndi adokotala.
Mu zinthu zachilengedwe zimagwiritsidwa ntchito monga:
- hawthorn;
- valerian;
- peony;
- amayi ndi zinthu.
Palinso mankhwala ovuta omwe ali ndi mbewa, valerian ndi melissa pakupanga kwawo. Izi zikuphatikizapo Persen ndi Novo-Passit.
Ngakhale kuti mankhwalawa ali ndi sucrose, mutha kumwa ndi matenda a shuga. Kupatula apo, piritsi limodzi lili ndi shuga wochepa, zomwe sizikhudza kuchuluka kwa shuga.
Ma synthetiki ophatikizira amaphatikizapo Phenobarbital, Diazepam ndi analogues. Ndi chithandizo chawo, muthana ndi nkhawa komanso mantha, muchotse tulo ndipo mupewe kukula kwa mavuto a tachycardia.
Mankhwala othandizira odwala matenda ashuga ayenera kusankhidwa mosamala kwambiri, chifukwa amaikidwa malinga ndi zomwe zimayambitsa matendawa. Chifukwa chake, kumwa mapiritsi amtundu wina wamatenda amangochita kukulitsa mtundu wina wa matenda.
Chifukwa chake, ndi tachycardia, mankhwala otsatirawa amagwiritsidwa ntchito:
- Verapamine imagwira ntchito makamaka pamtundu wa supraventricular matenda, koma nthawi yomweyo amathandiza kuchepetsa shuga.
- Rhythmylene - imagwiritsidwa ntchito kukhazikika pamimba yamatumbo ndi ma atria.
- Adenosine - amatchulidwa paroxysmal ndi supraventricular tachycardia.
Komanso, ndi zovuta muntchito ya mtima, Anaprilin akhoza kutumikiridwa, komwe kumachepetsa kugunda kwa mtima, ndikupereka mphamvu. Mankhwalawa amayambiranso kuperekera okosijeni ku myocardium, ndikuyambitsa ntchito yake. Komabe, Anaprilin amachepetsa kugunda kwa mtima, potero amabisa kugunda kwamtima kolimba, komwe ndiko chizindikiro chachikulu cha hypoglycemia.
Komanso, tachycardia imatha kuthandizidwa pogwiritsa ntchito njira zolimbitsa thupi, zomwe zimaphatikizapo kukhudzana ndi ma electro-pulse komanso Reflexology. Njira yotsirizayi imagwiritsidwa ntchito paroxysmal mawonekedwe amtundu wamtima wosokoneza. Mukamachita izi, wodwalayo amaikidwa chikhodzodzo cha nkhope yake, ndipo kenako amayesetsa kutsokomola.
Ngati njirayi idakhala yopanda phindu, ndiye kuti mphamvu yamagetsi imagwiritsidwa ntchito. Potere, ma elekitirodi amamangiriridwa pachifuwa cha wodwalayo, kenako kutulutsa kochepa komwe kumachitika kudzera mwa iwo, komwe kumathandizira kuyambitsa kugwira ntchito kwa myocardium. Komabe, chithandizo chotere chimatha kuchitika kuchipatala, nthawi zambiri chimagwiritsidwa ntchito povulala pamtima.
Opaleshoni ya tachycardia imachitika pawiri. Loyamba ndi matenda a mtima obadwa nawo, matenda a mtima a ischemic ndipo pambuyo povutitsidwa ndi rheumatism, chachiwiri ndi kusokonekera kwa mahomoni.
Kupewa tachycardia mu shuga ndikupewa kuchita zinthu zovuta komanso zopanikiza. Kuphatikiza apo, muyenera kusiya mphamvu, khofi, mowa ndi chikonga. Koma choyambirira, kubwezera anthu omwe ali ndi matenda ashuga ndikofunikira kotero kuti kuphatikiza shuga nthawi zonse kumakhala koyenera.
Kanemayo munkhaniyi amafotokoza tachycardia ndi chithandizo chake.
