'ōpeʻapeʻa hanu: mea, lalau mai a me ka lapaʻau

Palemo o ka naau - ka iapaau ana o keia maʻi i loko o nā makahiki excites na naau o na mea he nui cardiac surgeons, a me ka "naau" o ka hoʻomalu. He aha ka ke kumu, i ka mea a na symptoms o keia pilikia maʻi, pehea e hana ia - i kēia mau mea wale nō kekahi mau kumuhana o ka hoihoi i ko kakou poe kanaka. Ua mea i ike ole ia e hala loa ka nui helu o ka poʻe i ia i kaʻike, me "ka palemo naau". Symptoms, hana maikaʻiʻole o ka poʻe kānaka Kids, 'āinana apau i hana kūikawā kulanui, diagnoses - këia mau manaÿo e e kaupaona i nā i ka mea ka mea symptoms o ka maʻi. ʻO kēia ka Naauao kekahi o na Kumuhana o kēia wā o ke kumuhana.

'ōpeʻapeʻa hanu: mea, lalau mai a me ka lapaʻau

I ke ano o ka "mae wale o" i loko o ka naau o ka hana hiki e keʻano o ka pāpana a me ka conduction haunaele. Kekahi o kēia mau Hawaii mai i koi 'inikua' uao, a me nā ano o kali hou aku; i loko o ka ka loaʻaʻana a me ka hana hiki e ona. Hoomaopopo supraventricular a me ka ventricular arrhythmias.

supraventricular arrhythmias

He premature uila haʻawina o ka naʻau. Ke kumu o ke kumu i kahi i loko o ka atria a me pulmonary aa koko o na puha, a ma ka atrioventricular huina. Ma hope o ia he halawai ka ho'ēmiʻana hiki hoʻomōhala ka helehelena a piha postextrasystolic kakali. Pinepine premature kui iho oe a me kekahi ihola loa ma hope o ka halawai ka ho'ēmiʻana ke haawi aku i ka manao mae, hoʻohuikau o ka naau.

Kuokoa lapaʻau manaʻo nui o kēia mauʻano a i arrhythmias, ke ole ia ma ia mau hihia, i ka wa o ko lakou mau helehelena e hoʻomaka ana e holo supraventricular tachycardias, atrial kolili a atrial fibrillation.

I ka wa e kaawale aku o mall mā i loko o ka naʻau Muscle supraventricular extrasystoles kūikawā lapaʻau 'aʻole koi' ia. Ma na wahi a lakou i pu e nui pilikino discomfort, Hoʻokolohua-blockers, verapamil, kiaha dala hiki ke hoʻohana.

Pinepine supraventricular extrasystoles i ka hoike ana o ka papa kuhikuhiE maʻi (dystonia, maʻi obstructive pulmonary maʻi, electrolyte kāna hana), a laila, i kaʻike, pono ano hoohanohano a me ka lapaau ana o ka nń ku kaʻina.

Ventricular fibrillation extrasystolic

Ventricular extrasystoles - anticipatory uila haʻawina o ka naʻau ma ka pili ana i ka papa kuhikuhiE pāpana hauma¯na lāʻau ikiʻai wale i kupu mai ana ma nā wāwae a me oko puapua lala aeie, Orion a Purkinje ka hana myocardium. Ma hope iho o kēia mau keʻano o ka hanaʻana me ka nui loa aku paha, e hoʻoikaika i piha uku 'kakali, i, e like me ia ma ka hihia o atrial premature kui iho oe, i manao ai ma ka palapala o ka "mae wale o". Ventricular keʻano o ka hanaʻana me kekahi gradation o ke aloha naau maʻi mea,ʻaʻole he kamepiula ololi no ka manawa e make, no ia mea, untreated. 'Ia, ua ola nā mea maʻi me ka hereditary syndromes (congenital elongation paha hua'ōleloʻo o ka QT, Brugada maʻi pale, etc.).

Palemo o ka naau, i ka mea a me na symptoms o i i manaoia e hana ana i ka hopena o ka ke nānā naʻau rhythms.
A maʻamau naau i kela me ka nānā 'i loko o 60 a hiki i 100 puu hua palaoa no minuke. Physiological ka meheu o ka naau e hana ana i ka hiamoe, i ka wa a ha nui iho la ia, i loko o 'âlapa.

I Ina o ka 'aʻe' ana i kekahi kahua a me ka hanauna o cardiac pāpaʻa e hoʻomōhala ana i pathological bradycardia, a hiki e symptomatic, asymptomatic, a me ka hapanui ma ka pono o ka nohoʻana.

Nā kumu o ka bradycardia

Maopopo ma waena o na, a mawaho kumu o ka bradycardia.
O na kumu loaʻa:

• kūnewa;
• coronary naau maʻi;
• connective'aʻaʻa maʻi;
• congenital maʻi, me ka nawaliwali o ka atrioventricular wahi;
• muscular amyloidosis;
• ʻoki lāʻau lapaʻau trauma (orthotics kiwikā, naau transplantation) ;
• infectious maʻi (diphtheria, rheumatic naau maʻi, ke koko kaʻapu kōheoheo, typhoid kuni).

Ma mawaho aʻe o ka bradycardia nā:

• physical aʻo;
• elektrotonus heʻoiʻoi vagal (vasovagal blackout; supersensibly carotid sinus);
• ai '(Hoʻokolohua-blockers, kalipuna Kanal blockers, digoxin, likiuma, antiarrhythmic konohiki);
• cocaine;
• hypokalemia;
• hyperkalemia;
• neurological kāna hana (CNSʻeho, a mahuahua nui intracranial puʻe);
• Obstructive hiamoe apnea maʻi pale.

No ka meaʻike, o ka bradycardia i hoʻomalu Holter ka mālamaʻana, hana 'counters a me recorders, implantable manaʻo, e like me ka hooko ana mai he electrophysiological mahele.

lapaʻau o bradycardia

Ke anu u mua mea e kuhikuhi i na kumu, a hiki hoʻopau bradikaridii kā lākou mau hana (discontinuation o Hoʻokolohua-blockers). Inā he mea i weheʻia kumu, oe e hemahema lāʻau Inc a me ka pokole a me ka mau i auhele).

ka lapaʻauʻia

E hoʻoulu nui naau kōmi deceleration (no ka hou ma mua o 3 kekona) hoʻohana atropine, isoproterenol, aminophylline. Eia naʻe,ʻai ana o kēia mau ai 'ke kāhea arrhythmias, me ke ola-na olelo hooweliweli e ventricular ka haunaele.
Ma nā mea maʻi me ka myocardial ischemia a me ka bradycardia like me ka hopena, ke lilo aku antiischemic Inc, a e biding i ko lakou manawa, ka hoʻohana 'ana i auhele ina e pono ai.

Nā mea maʻi me ka kaumaha sinus maʻi pale kāleka a atrioventricular hihia ua kūpono e kau aku i ka pokole a me ka mau pacemaker.
Aia ulu Europa nāʻikepili no ka mea hoʻonoho o paʻa pacemakers i loko o nā mea maʻi me ka maʻi sinus maʻi pale, atrioventricular aeie.

ʻano o nā stimulants

Hoomaopopo hookahi-keʻena, pālua-keʻena, ekolu-keʻena stimulators. I mua a me ka lua o nā uila aʻa lolo 1 a me 2 (atrial a / a pono ventricular). Ekolu-keʻena i na mea maalea i hoʻohana no ka biventrikulyatnoy ho'ā hope, a i ka hou alakai no ka ventricle hema.

Ka wā pono atrial stimulation ventricular synchronism ua kupikipikio. Ke ECG i keia kaʻina ua ua paʻaʻia hoʻokaʻawale pono pua lala hihia.
Ma ka stimulation o nā ventricles malamaia lākou synchronous hana, cardiac hemodynamics ma keia hihia, ka maikaʻi.

implantation

Ka mua ua pa alima i hoʻokumu 'ia i loko o 1958. Ma ke kēia mau mea kā lākou evolution. Ano ia mea he laekahi, uuku loa, kiʻekiʻe-ʻenehana na manao ona.

Currently, he mea ka makahiki kanu mai ka 400 a hiki i 1.200 stimulants o ka miliona ka heluna.

Kardiopribor e lawelawe uila ho'ā hope o ka myocardium. Ke neaiae hoʻopulapula ma ka cardiac Muscle ma ka 'ole-physiological. Kona lōʻihi-makahiki waiū hiki i uila, a me mechanical loli ma ka myocardium. Ka mea hoʻonoho Ua koi 'ia e hua mai ma ka stimulator koʻikoʻi nāʻikepili.

Features stimulation 'ole

Ma'ākau ventricular i auhele uila pāpaʻa ua pili i ka hema ventricular apex a depolarizes medlennoprovodyaschy myocardium. Ke ECG Ua kaheaia blockade o ka hema pua lala hihia. Ua hoʻomanawanui iki mai i ka haʻahaʻa ejection hapa iki ma mua o nā mea maʻi me ka blockade. No hoi, i ka wa a keia kaʻina ia lŘlŘ uila cardiac remodeling. Nei, aia no he ka welelau o ka emi na nāʻikepili no ka mea hoʻonoho stimulantsʻikepili ma ka pili me ka nui helu o adverse hou.

Ua Ua hoʻokumu i ka haahaa ejection mahele i hanaʻia ma lalo o ka hana ana o na ventricles. Ka - ka ho'ā hope o ka atria, laila, i ke koena o ka naau. I ka lani kiekie loa malamaia ejection hapa iki i stimulation o ka atria a me ventricles o na alahele hele maoli.

Hoao i ka emi e hoʻomōhala ana i atrial fibrillation i loko o nā mea maʻi me ka atrial ho'ā hope, a he mau-keena ma mua i loko o nā mea maʻi me ka ventricular wale i ka aoao o ka noonoo o kanaka.

Ke pālua-keʻena lima kūlana kiʻekiʻe, ai ka noiʻi a me ka experimentation, ia mea maikaʻi i loko o ka hoʻopā 'hana nā mea maʻi.
Pacemakers i Ke ke gula hae ma ka iapaau ana o nā mea maʻi me ka symptomatic bradycardia. Ke huli nei no ka hapanui physiological mau alahele o ka maikaʻi 'ole ma o ka myocardium.

ka hopena

Ke'ī mai, i ka palemo o ka naau (e haule ana e hiamoe ana paha i loko o nā wahi, i hiki) - he mea weliweli loa maʻi. I ka ka mea mua symptoms o keia maʻi e koke e kelepona i ka haukapila, e lawe mai i nā ho'āʻo ma, a akaheleʻia. Ka wikiwiki hoʻomaka lapaau a me Kāohiʻana, me ka nui ka hoʻokō e e nohoʻana.