Maererano nekucherechedza kwezvivako zvemoyo, kuwedzera kwepfungwa yemwoyo kunoreva kuvhiringidza kwemazuva ose kunoda kurapwa kwekukurumidzira. Kunyanya kufa nekuda kwechirwere ichi kunokonzerwa nokushaiwa kwezivo pamusoro pekuratidzwa kukuru kwechirwere. Funga nezvazvo, uchitaura zvinokonzerwa nehutachiona, iyo algorithm yekubatsira kwekutanga.
Kuwedzera myocardial infarction
Izwi rokuti "kuwedzera kwemoyo weparction (myocardium)" muhupenyu hwepanyama rinowanzorondedzerwa sekuputsa, umo kune kuchinja kweropa rekuyerera, pamwe chete nekuderera kweropa rekisijeni, rinotungamirira ku necrosis yemutsipa wemwoyo. Chikamu chemasero acho anofa zvachose. Munzvimbo yavo, ruvara runoumbwa kwenguva. Zvichienderana nechinzvimbo chechilonda, nzvimbo yenzvimbo ye-necrosis, titsaure:
- chikamu chemukati wekunaka;
- myocardial infarction.
Pakutanga kukanganisa kune kukanganisa kune ariti yakasara. Chiedza chacho chinoputika zvachose, izvo zvinodzivirira kutenderera kweropa kusvika pamwoyo. Apo rusvingo rwemashure runosvibiswa, hutori hwakanaka huripo hunovapo. Pakati pezvikonzero zvinokonzerwa nekurwara, vanachiremba vanoisa mberi ischemia (98% emhosva). Muchiitiko ichi, maronary coronary inowanzokonzera - kushaya atherosclerotic. Mukuwedzera, kuwedzera kwemwoyo kunogona kuitika nekuda kwe:
- coronary artery thrombosis ;
- kusagadzikana kwea coronary arteries;
- kuvhara kwemitsipa yeropa yakawanda nezvikamu zveeoplasms;
- chirwere chinopisa chinokanganisa maronary artery;
- stratification yekukwira aortic dhipatimendi uye dzidzo pashure pehematoma;
- kushandiswa kwezvinhu zvinonyangadza, izvo zvinokonzera kupisa kwemakironi (corke, amphetamine);
- kukuvadza kwemagetsi, magetsi anokwidza;
- migumisiro yekuvhiya kwomwoyo.
Kunyanya kutsamwa kwemwoyo - zviratidzo, zviratidzo zvokutanga
Zviratidzo zvepfungwa yakawanda yepfungwa zvinotaurwa. Chinhu chokutanga chakataurwa nevarwere ivavo chirwere chakasimba, chinowanzoputika muchikamu chemanheru chechipfuva kana mushure mechifuva, icho chinopinda mukati, rutivi rwezasi, uye kuruboshwe rworuboshwe. Iko kune zvinorwadza zvinowanzoita kwemaminitsi makumi matatu. Chimwe chinhu chakasiyana chechirwere ndechokushaya kwehutano hweNitroglycerin .
Pashure penguva pfupi, manzwiro ekushayikwa kwemhepo anoonekwa, murwere anonyunyuta pamusoro pezvinoitwa. Mukuwedzera, zvinotevera zvinogona kunyorwa:
- cold sweat;
- kurutsa;
- nausea;
- kuderedza ropa.
Chibvumirano chakakura chinoreva maitiro avanoita izvo kumira kwezviratidzo kune unhu. Pane zvikamu zvishanu:
- Nguva yeprodrome (preinfarction). Iyo inoratidzirwa nekuwedzera kwehuwandu hwezvikamu zvekutsvaira kwema angina.
- Nguva yakanyanyisa. Kurara kwemaawa 0.5-2. Unhu hunopisa marwadzo, jira, kuchinja mumoyo wehuwandu, kupera kweropa kunodonha.
- Nguva yakajeka. Nguva yacho inotora mazuva 2-10. Iyo inoratidzirwa nehutano hwekugadzirwa kwesacrosis site munzvimbo yemwoyo. Marwadzo anononoka, asi mwoyo rhythm inoputsika, kutonhora kwemuviri kunomuka.
- Subacute. Kunonoka kwevhiki 4-5. Panguva ino, tsvina inoumbwa panzvimbo yezvinyorwa zvakafa. Mwoyo unofanirwa kudzorerwa, chirwere chinorwadza chinonyangarika zvachose, zvinomanikidzwa zvinowanikwa.
- Postinfarction. Nguva yacho inotora mwedzi 3-6. Pamusoro pezvirwere zvemwoyo zvinyoresa, nerubatsiro rwe ultrasound, kuwedzera kwehuwandu hwehutachiona. Mutumbi zvishoma nezvishoma unoshandiswa kune mamiriro matsva.
Kutanga rubatsiro rwekurwadziwa kwemoyo
Chirwere ichi chinoda kukurumidza kuendeswa kuchipatara. Rubatsiro rwekutanga kune myocardial infarction inofanira kupiwa panzvimbo. Iyo sarudzo yezviito zvehama kana hama inofanira kunge iine zvinotevera:
- Ita, usasunungura nguo dzakasimba-dzakakodzera, kora.
- Kana zvichibvira, nyaradza murwere.
- Ipai zvinodhaka zvinomisa marwadzo: Nitroglycerin, Aspirin.
- Danai ambulensi.
Kuwedzera kwepfungwa yemwoyo - migumisiro, mikana yekurarama
Nekuputsa kwakadaro sekuwedzera kwepfungwa yepfungwa, migumisiro, mikana yekubudirira kwekugumira inobva panguva yekutangwa kwerapi. Maererano nehuwandu, 40 varwere vanopfuura zana vanoparara pamutambo we prehospital. Mukuwedzera, kana chiitiko chichiremba vanachiremba vanocherechedza nzvimbo yenharaunda yakagadziriswa, iyo inobata zvakananga mugumisiro. Zvinhu zvinokuvadza muhutano huri:
- kukwegura;
- arterial hypertension in the anamnesis;
- kuvepo kwezviratidzo zvekuvhiringidza mwoyo kusakwana.
Kuwedzera myocardial infarction
Ihwo hutachiona pachahwo hunove nehupamhi hwekufa. Nemhaka yeizvi, kutarisirwa kunofanira kuitwa mumaminitsi makumi matatu ekutanga kwekutanga zviratidzo. Nokuda kweizvi zvakakosha kukwanisa kunyatsorongedza kuwedzera kwekurwadziwa kwemoyo, mhedzisiro inogona kunge iinotevera:
- Kubva pamwoyo musungo. Inotungamirira kurufu. Zvinowanikwa mukati mezuva rimwechete rechibvumirano. Muchiitiko ichi, rusvingo rwechipiri chinonzi ventricle runokanganisa zvakananga.
- Kushushikana kwevanhu. Inoratidzika sechikonzero chegadziriro yakakura umo chironda chemukati wemasvingo (coronary arteries) chinoitika. Iyo inokura apo necrosis inogadziriswa kupfuura 40% yenharaunda yemamotokari. Nekutenda kwechokwadi kwemoyo, kuuraya kunosvika 90%.
- Pulmonary edema. Chibvumirano pakusabatsirana kwekubatsira kunogona kutungamirira kuveveve edema. Dambudziko rakadaro rinoratidzika nekupfupika kwemhepo, kufema kunopera, kunyura kwemhepo, kukwezva ne foamy sputum ye pink hue (an extensive simple heart attack).
Muchiremba avo vakatambura kukanganisa kwakadaro mumavambo okutanga ekudzorera, zvinetso zvinogonawo kuitika:
- mitral insufficiency (muna 25-50% yevarwere);
- aneurysm yemhepo yakasara (10-15%);
- thromboembolism (10%);
- moyo rhythm disorder;
- atrial fibrillation.
Kuwedzera myocardial infarction - migumisiro
Ichi chimiro chekuora mwoyo kakawanda kine zviratidzo zvishoma. Nemhaka yeizvi, varwere havambofungi nezvekurwa kwepfungwa huru, migumisiro yaro yakafanana neyo yakanyorwa pamusoro apa. Izvo zvinofanira kuonekwa kuti rudzi urwu rwehutano hunoonekwa nehutano hwakanaka - hupenyu hwehupenyu kana mushure mekunge rusvingo rusina kubatana rwakawedzerwa. Pakati pemigumisiro inogona kuipa yekuputsa ndeyi:
- Dressler's syndrome;
- rhythm disturbance;
- thromboembolism;
- cardiogenic shock.
Kuwedzera kwemoyo wepfungwa - kurapwa
Kuita zvechisimba kunoda kugara muzvipatara uye kutarisira kwakasimba. Nehutano hwakadai sehutano hwepfungwa yakawanda, mikana yekupona inofanirwa nekunyatsoziva kuti nokukurumidza kugadziriswa nekuchengetedzwa kwekukurumidzira kwakapiwa sei. Maererano nevadzidzisi vezvokurapa, kana murwere achitorwa kuchipatara mukati memaminitsi makumi matatu kubva panguva yekutanga kwekurwisana, kuonekwa kwezviratidzo zvekutanga, mikana yemugumisiro wakanaka kune yakakwirira. Munyaya iyi, sarudza:
- mishonga yekuvandudza humodynamics - Prasugrel, Plavix, Clopidogrel;
- zvinodhaka zvinoderedza marwadzo - analgesics, Nitroglycerin
- antiarrhythmic - Amiodarone;
- anticoagulants - Streptokinase, streptodeacase;
- thrombolytics - Heparin, Aspirin.
Kuwedzera kwepfungwa yepfungwa - kuvhiya mwoyo
Kusarudzwa kwakanyanya myocardial infarction kazhinji kunoratidza chiratidzo chekupindira. Imwe nzira inobudirira munyaya iyi ndeye angioplasty - kudzorera hutano hwemakoroni e coronary nekupisa. Inopa midziyo uye mitsetse yakakosha iyo yakakosha, inokonzera kubuda kwakakwana kweropa, inoderedza mutoro uri pamwoyo.
Kushungurudza pashure pekurwa kwepfungwa huru
Yakaparadzirwa yakawanda myocardial infarction, migumisiro yadzo inokurukurwa pamusoro apa, inoda nguva dzose inoda kudzorerwa kwemaitiro emidziyo. Iyi endovascular method inoitwa munharaunda yevascular. Kuvhiya kunoda kuti kuve nekushandisa kwemichina yakakodzera uye vanachiremba vanovhiya. Iyo stent iyo pachayo inonzi tube yakasimba, iyo yakakura iyo yakakwana zvakakwana kune iyo yerita.
Vangani vanorarama mushure mekurwa kwepfungwa huru?
Nokuputsa kwakadaro sekuwedzera kwepfungwa yepfungwa, kufungidzira kunokonzerwa nekugadzirisa kwekupiwa kwechiremba, nzvimbo inobatwa nemwoyo wemisungo. Zvakakosha kuyeuka kuti hutachiona pachahwo hunoendeswa na angina pectoris. Kana isina kugadzikana, 30% yevarwere vanopera mwedzi mitatu mushure mekurwisa. Maererano nenhamba dzekucherechedza, pakati pevarwere vakawana chirwere chikuru, kufa kune 10%.
Upenyu mushure mekurwa kwemoyo
Kuteerera nekurudziro uye mirayiridzo yechiremba - chikonzero chekubudirira kubudirira. Chikafu mushure mokunge chirwere chepfungwa chakanyanyisa chinofanira kuva chakakosha. Kubva pane zvokudya vanachiremba vanokuraira kuti vasabvisa ndiro yakasviba, zvinonaka uye vanosvuta. Mazuva gumi ekutanga anofanira kutevedzera kudya kwakaderera kwekoriori, kurega kudyiwa kwemvura. Chikonzero chekudya kunovaka muviri pakutanga kwekugadziriswa zviyo zviyo zvinodhaka, michero, soda yakasungwa, zvinomera zvemvura.
Papera mwedzi, apo ruvara runotanga kuumba, pane chidimbu chezvinhu zvinenge zvine potassium. Izvi zvishoma nezvishoma zvinoderedza hupombwe, zvichiita kuti kubviswa kwehuwandu hwehutachiona hwemuviri wavo, kunowedzera kubvumirana kwemisungo yemwoyo. Rine:
- peanuts;
- cauliflower;
- almonds;
- walnut;
- prunes.