Dab tsi yog atrial fibrillation thiab yuav kho nws li cas

2024 Tus sau: James Gerald | [email protected]. Kawg hloov kho: 2023-12-17 14:08

Kev ua haujlwm tag nrho ntawm lub plawv saib xyuas kom tsis muaj ntshav txaus thiab cov pa oxygen rau lub cev sab hauv. Kev ua txhaum ntawm qhov ib txwm ua ntawm kev cog lus yog qhov tshwm sim ntawm kev kis mob ntev, kab mob kis, lom nrog tshuaj lom. Muaj ntau hom kev mob no. Ib ntawm lawv yog atrial fibrillation. Peb yuav pom tias nws yog dab tsi thiab yuav kho nws li cas.

Nws yog dab tsi?

Atrial fibrillation lossis atrial fibrillation tau kuaj pom hauv 2% ntawm cov neeg mob uas muaj kab mob plawv. Pawg neeg pheej hmoo yog ua los ntawm cov neeg laus. Feem pua ntawm cov neeg mob hauv pawg no yog 8%. Pathology ua rau muaj kev rau txim hnyav, yog li ntawd, kev tshuaj xyuas sijhawm thiab kho yog qhov tseem ceeb.

Atrial fibrillation yog suav tias yog ib hom supraventricular tachyarrhythmia. Hauv cov neeg mob uas kuaj mob no, lub plawv dhia (HR) tuaj yeem ncav cuag qhov tseem ceeb 350-700 ntaus ib feeb. Kev cog lus tsis yog tsuas yog nquag tab sis kuj muaj kev ntxhov siab. Tsis tas li, cov neeg mob tau ua txhaum ntawm kev sib koom ua ke ntawm cov tib neeg cov leeg ntawm cov leeg atrial fibers.

Kev tawm tsam atrial fibrillation, uas kav ntev heev, tuaj yeem ua rau tsim cov ntshav khov, thiab ischemic stroke feem ntau tshwm sim. Kev rov kis mob tas li yog qhov laj thawj rau kev nce qib sai ntawm daim ntawv ntev ntawm cov ntshav tsis txaus.

Ua rau ntawm pathology

Txhawm rau nkag siab tias atrial fibrillation yog dab tsi thiab yuav kho tus mob no li cas, nws yog ib qho tseem ceeb kom paub tias qhov kev pheej hmoo ntawm kev mob mus txog 26% hauv cov neeg laus dua 40 xyoo, yog tias peb tham txog txiv neej, thiab 23% ntawm cov poj niam.

Pawg neeg pheej hmoo muaj cov neeg mob uas muaj teeb meem hauv qab no ntawm cov hlab plawv:

• arterial hypertension;
• ischemia (hauv 20% ntawm cov neeg mob);
• tau txais daim ntawv ntawm qhov tsis xws luag;
• Lub plawv tsis xws luag;
• cardiomyopathy;
• cov txheej txheem inflammatory hauv ib feem ntawm lub plawv;
• malignant thiab benign formations;
• kev hloov pauv phais cuam tshuam ntawm lub cev.

Muaj lwm yam laj thawj ib yam nkaus. Cardiologists hu lawv extracardiac. Piv txwv li, keeb kwm. Raws li kev txheeb cais qhia, hauv txhua 4 tus neeg mob uas tau kuaj pom tus kab mob, muaj tus mob zoo sib xws tau pom hauv cov txheeb ze.

Lwm yam ua rau muaj kev cuam tshuam:

• rog dhau;
• mob ntshav qab zib mellitus, tsis hais txog theem twg;
• kab mob obstructive pulmonary ntev;
• apnea (hnyav heev thaum tsaus ntuj snoring thiab txiav ib ntus ntawm kev ua pa);
• mob raum mob raum;
• kis kab mob;
• kev hloov noob neej.

Feem ntau, kev txhim kho atrial fibrillation yog cuam tshuam nrog Graves tus kab mob, kev qaug cawv los ntawm kev quav cawv, tsis muaj poov tshuaj, ua rau lub paj hlwb thiab kev nyuaj siab ntxhov plawv.

Muaj atrial fibrillation, qhov ua rau uas tsis tuaj yeem pom. Cov xwm txheej zoo li no hu ua idiopathic.

Kev faib tawm, hom sib txawv, theem

Txhawm rau nkag siab yuav kho tus mob atrial fibrillation li cas, ib tus yuav tsum tsis yog tsuas yog paub tias nws yog dab tsi, tab sis kuj yog hom thiab qib twg yog qhov txawv. Yog tias peb coj lub sijhawm kawm raws li lub hauv paus rau kev faib tawm, peb tuaj yeem paub qhov txawv ntawm cov txheej txheem hauv qab no:

• transient lossis paroxysmal - lub plawv dhia tsis xwm yeem dhau los ntawm ib hnub mus rau xya hnub;
• tsis tu ncua - daim duab kho mob tseem nyob ntev txog 7 lossis ntau dua hnub;
• ntev - hauv qhov no, txawm tias mus sij hawm ntev thiab xaiv qhov kev kho mob tsis muab qhov txiaj ntsig kho.

Lwm qhov kev faib tawm ntawm atrial fibrillation tau thov los ntawm European Society of Cardiology. Nws yog raws li qhov tshwm sim ntawm cov paib. Raws li, muaj 4 chav kawm ntawm atrial contractions:

• Hoob I - qhov xwm txheej tshwm sim thaum tsis muaj chaw kho mob;
• Hoob II - cov tsos mob tsis tseem ceeb, tus neeg mob cov haujlwm ib txwm tsis cuam tshuam;
• III chav kawm - daim duab kho mob tau hais tawm;
• IV chav kawm - kev pheej hmoo ntawm kev xiam oob qhab yog siab, kev ua ub no txhua hnub yog xiam oob qhab.

Qee tus kws kho plawv, hais txog atrial fibrillation yog dab tsi, cais lwm qhov kev faib tawm. Nws yog raws li hom atrial atherosclerosis cuam tshuam:

1. Atrial fibrillation los yog atrial fibrillation. Vim tias muaj ntau qhov hluav taws xob cuam tshuam hauv atrioventricular hlws ris, lub ventricular myocardium pib cog lus sai. Nyob ntawm qhov no, atrial fibrillation tau muab faib ua bradysystolic (tsawg dua 60 neeg ntaus ib feeb), normosystolic (60-90 neeg ntaus / min.) Thiab tachysystolic (90 lossis ntau dua ntog).
2. Atrial flutter. Hauv qhov no, lub plawv dhia mus txog qhov tseem ceeb 200-400 neeg ntaus. Tab sis, qhov tseem ceeb, kev sib dhos tsis tawg. Tsis muaj lub sijhawm diastolic ncua, atria nruj nreem.

Cov tsos mob atrial fibrillation

Daim duab kho mob ntawm kab mob pathological cuam tshuam nrog nws daim ntawv. Muaj qee kis thaum paroxysmal fibrillation yog asymptomatic. Qhov teeb meem ceeb toom nkaus xwb yog qhov txhaws ntawm cov hlab ntshav los ntawm thrombus lossis thromboembolism.

Cov tsos mob tseem ceeb ntawm atrial fibrillation yog palpitations, hauv siab tsis xis nyob. Daim ntawv tachysystolic ntawm pathology raug mob hnyav los ntawm cov neeg mob. Lawv tuaj yeem yws txog:

• lub plawv dhia muaj zog;
• mob thiab cuam tshuam hauv kev ua haujlwm ntawm lub plawv;
• ua tsis taus pa uas hnyav zuj zus nrog rau kev siv lub cev.

Hauv thawj theem, arrhythmia feem ntau yog ua qaug dab peg. Yav tom ntej, chav kawm ntawm tus kab mob yuav siv tus yam ntxwv ntawm tus kheej. Qhov no txhais tau tias zaus thiab ntev ntawm paroxysms hauv ib pawg neeg mob tsis tshua hloov pauv, tsis muaj cov cim ntawm kev nce qib. Hauv lwm qhov, ob lossis peb qhov kev hloov pauv tau txaus thiab atrial fibrillation hloov mus ua daim ntawv ntev.

Kev tawm tsam ntawm atrial fibrillation tuaj yeem nqa tau hauv ntau txoj kev. Piv txwv li, cov tsos mob tsis zoo tuaj yeem tsis tuaj, tus mob tau kuaj pom los ntawm qhov xwm txheej. Tab sis qhov no yog qhov zam.

tag nrho, qaug dab peg nrog rau daim duab hauv qab no:

• kev xav ntawm chaos hauv plawv dhia;
• tshee hauv cov leeg;
• tsis muaj zog;
• tsim cov zis ntau heev;
• nce tawm hws.

Hauv qhov mob hnyav tshwj xeeb, cov neeg mob tuaj yeem yws ntawm kiv taub hau, tsaus muag, Morgagni-Adams-Stokes tawm tsam.

Thaum mloog lub plawv, tus kws kho mob pom lub suab nrov sib txawv. Lawv feem ntau tsis zoo. Nws yog ib qho tseem ceeb kom paub tias atrial fibrillation yog ib yam mob uas muaj lub plawv dhia tsis txaus. Hauv lwm lo lus, tus naj npawb ntawm cov mem tes yoj tsawg dua tus naj npawb ntawm lub plawv dhia. Qhov no yog vim tias tsis yog txhua qhov kev sib tw ntawm lub ventricular tau ua raws los ntawm kev tso ntshav tawm.

Kev kuaj mob

Kev kuaj mob atrial fibrillation tsis nyuaj. Kev kuaj mob feem ntau yog ua tom qab kuaj thawj zaug. Thaum soj ntsuam cov hlab ntsha peripheral, lub suab tsis sib haum ntawm pulsation tau txiav txim siab. Los ntawm kev mloog lub plawv nrog lub mloog pob ntseg, tus kws kho mob tuaj yeem tshawb pom qhov hloov pauv tseem ceeb hauv lub suab ntawm lub plawv.

Txhawm rau kom paub tseeb qhov kev kuaj mob, kev kawm ntsuas tau ua tiav:

1. Electrocardiography … Qhov tseem ceeb tshwj xeeb yog ntsuas txhua hnub - saib xyuas raws li txoj kev Holter. Ib qho ntxiv, kev tawm dag zog tuaj yeem ua tiav, uas tso cai rau koj txheeb xyuas cov tsos mob ntawm ischemia thiab xaiv cov tshuaj txhawm rau tshem tawm cov cim ntawm arrhythmia.
2. Echocardiography … Nws suav nrog kev tshuaj xyuas lub plawv dhia nrog lub tshuab ultrasound. Thaum lub sijhawm kuaj mob, qhov ntsuas ntawm kab noj hniav hauv plawv tau tsim, muaj cov ntshav txhaws hauv cov txheej txheem sab hauv ntawm lub cev tau lees paub lossis tsis lees paub. Txoj kev no tseem muab cov ntaub ntawv qhia txog kev ua haujlwm systolic thiab diastolic ntawm sab laug ventricle. Echocardiography cov txiaj ntsig tseem ceeb hauv kev nkag siab yuav ua li cas kho cov txheej txheem khov.
3. MRI. Txoj hauv kev pom kev ntawm txhua qhov ntawm lub plawv pab txheeb xyuas qhov zoo ntawm lawv txoj haujlwm.
4. Transesophageal electrocardiography tso cai rau koj kom raug txiav txim siab cov txheej txheem ntawm kev txhim kho ntawm tus mob. Kev kawm zoo li no feem ntau ua ntej kev npaj phais mob.

Raws li txoj cai, ntau txoj hauv kev kuaj mob tau siv kom tau daim duab raug.

Kev kho mob atrial fibrillation nrog tshuaj

Lub hom phiaj tseem ceeb ntawm kev kho mob suav nrog:

• kev kho kom rov zoo thiab kho cov kab mob anatomical sinus;
• tiv thaiv qaug dab peg.

Nws yog ib qho tseem ceeb ib yam kom coj lub plawv dhia hauv kev tswj hwm thiab siv txoj hauv kev tiv thaiv kab mob thromboembolism.

Cov tshuaj Amiodarone thiab Novocainamide, uas muaj cov tshuaj tiv thaiv kev tiv thaiv kab mob, pab nres qhov kev tawm tsam. Txhawm rau tswj ntshav siab thiab thaum lub tshuab hluav taws xob, Quinidine thiab Propafenone tau sau tseg.

Yog tias qhov kev tshuaj ntsuam pom muaj kev pheej hmoo siab ntawm thromboembolism, cov tshuaj ua kom ntshav qis tau sau tseg. Cov tshuaj zoo li no tau sau tseg nruj me ntsis ntawm tus kheej. Ib txhia ntawm lawv xav tau kev xeem tas mus li.

Rau cov xwm txheej no thaum kev tawm tsam ntev tshaj ob hnub thiab, raws li, kev pheej hmoo ntawm cov ntshav txhaws nce ntxiv, cov tshuaj los ntawm pab pawg ntawm cov tshuaj anticoagulants tsis ncaj qha tau qhia. Piv txwv li, Warfarin.

Txhawm rau tswj hwm lub xeev kev noj qab haus huv thaum muaj atrial fibrillation, kev txo qis hauv lub plawv yog qhov tseem ceeb. Β-blockers thiab calcium channel blockers pab daws qhov teeb meem no. Cov tshuaj zoo li no ua rau lub plawv dhia qeeb vim qhov uas lub qhov ncauj sib cog lus tsawg dua.

Tseem ceeb! Ua ntej siv tshuaj, sab laj nrog tus kws tshaj lij.

Txhawm rau kom tus naj npawb ntawm lub plawv dhia ntawm qib 60 ntaus, kev noj cov tshuaj uas yog cov pab pawg hauv qab no tau qhia:

• calcium antagonists;
• β-blockers;
• kev npaj digitalis;
• tshuaj antiarrhythmic.

Ib qho piv txwv ntawm cov tshuaj zoo tshaj plaws los ntawm pab pawg digitalis yog Digoxin ntsiav tshuaj. Verapamil pab txo qis qhov tshwm sim ntawm arrhythmias. Qee qhov xwm txheej, kev kho mob tau ua hauv tsev kho mob - qhov no yog tib txoj hauv kev los tswj lub cev cov tshuaj tiv thaiv.

Nws yog ib qho tseem ceeb rau cov neeg mob kuaj mob atrial fibrillation thiab qaug dab peg ntau zaus kom paub yuav kho li cas tom tsev. Raws li txoj cai, Propanorm lossis Propafenone tau sau tseg kom tswj tau tus mob.

Kev kho mob atrial fibrillation nrog kev kho neeg pej xeem

Thaum lub sijhawm teem tseg, cov kws kho mob feem ntau muab cov ntaub ntawv qhia rau cov neeg mob txog kev kho atrial fibrillation nrog kev kho neeg pej xeem. Txoj kev kho no ua tiav qhov yooj yim, kev kho tshuaj.

Piv txwv ntawm qhov ua tau zoo tshaj plaws decoctions thiab tinctures:

1. Viburnum decoction. Lub berries yog nchuav nrog dej npau thiab tso cai rau brew. Noj 200 ml ob zaug - thaum sawv ntxov thiab yav tsaus ntuj, ua ntej yuav mus pw. Cov cuab yeej vitaminizes lub cev, muaj txiaj ntsig zoo rau lub plawv dhia, nrog rau cov tshuaj noj.
2. Tincture ntawm yarrow. Cawv muaj pes tsawg leeg, uas txwv nws qhov kev nkag los ntawm cov neeg uas muaj teeb meem ntawm txoj hnyuv. Noj 1 tsp ua ntej noj tshais thiab noj su.
3. Dill decoction … Cov noob ntawm cov nroj tsuag tau nchuav nrog dej npau thiab tso cai rau brew rau ib nrab teev. Siv ⅓ khob peb zaug ib hnub. Cov kua zaub yog paub tsis yog rau cov uas tab tom nrhiav rau txoj hauv kev kho atrial fibrillation nrog kev kho neeg pej xeem. Dill pab tua cov roj ntau dhau.
4. Ib qho dej qab zib ntawm Lily ntawm hav, hawthorn thiab valerian paj nqa hauv 2: 1: 1 piv yog qhov ua tau zoo.

Ua ntej pib kho atrial fibrillation nrog kev kho neeg pej xeem, koj yuav tsum sab laj nrog koj tus kws kho mob.

Kev Pab Thawj thiab Thaum Muaj Xwm Ceev

Txhawm rau zam kev qaug dab peg, kws kho mob pom zoo noj cov tshuaj uas tau qhia los txhawm rau txhim kho lub plawv dhia kom raws sijhawm. Yog tias muaj kev tawm tsam atrial fibrillation tau tshwm sim, yuav tsum hu rau lub tsheb thauj neeg mob.

Cov neeg mob yuav tsum paub yuav kho atrial fibrillation hauv tsev li cas. Nws txhais tau tias lawv yuav tsum muaj Validol, Valokordin hauv kev nkag tau yooj yim.

Cov teeb meem ntawm atrial fibrillation

Qhov tseem ceeb thiab txaus ntshai tshaj plaws ntawm tus mob yog ntshav stasis. Feem ntau, cov pob txha tsim nyob rau sab laug atrium. Lwm yam teeb meem suav nrog:

• cov xwm txheej uas tau tsim tawm tsam keeb kwm yav dhau los ntawm kab mob plawv ua rau lub plawv tsis ua haujlwm;
• qhov kev pheej hmoo ntawm mob ntsws ntsws, mob hawb pob hauv lub siab yog siab dua hauv cov neeg mob mitral stenosis;
• arrhythmogenic poob siab;
• ventricular fibrillation, uas tuaj yeem ua rau lub plawv nres.

Kev kwv yees rau pathology yog txiav txim siab los ntawm qhov hnyav ntawm tus kab mob uas ua rau atrial fibrillation.

Tiv thaiv atrial fibrillation

Hais txog yuav ua li cas kho atrial fibrillation hauv tsev, kws kho plawv feem ntau txhais tau tias yog thawj thiab ntxiv rau kev tiv thaiv theem ob. Hauv thawj kis, qhov no yog kev kho mob ntawm cov kab mob uas feem ntau ua rau atrial fibrillation. Qhov no tshwj xeeb tshaj yog rau lub plawv tsis ua hauj lwm thiab mob ntshav siab.

Lub neej noj qab nyob zoo, kev noj zaub mov kom zoo thiab kev tawm dag zog lub cev yog qhov tseem ceeb hauv yuav kho tus mob li cas. Kev noj zaub mov yuav tsum muaj ntses ntau, zaub cog, thiab nqaij nruab deg. Nco ntsoov saib xyuas koj qhov hnyav, ua pa thiab ua haujlwm kho mob.

Qhov xav tau rau kev ntsuas tiv thaiv theem ob tshwm sim hauv cov neeg mob uas muaj qhov tshwm sim tas li ntawm arrhythmia. Txawm tias nws yog ib leeg thiab tsis ntev. Lub hom phiaj tseem ceeb hauv qhov no yog txhawm rau tiv thaiv qhov rov tshwm sim ntawm tus mob. Thawj qhov chaw los daws qhov teeb meem no yog kho lub sijhawm, thiab qee zaum kev phais.