Ukuphazamiseka kwe-cardiogenic kuyisimo esiphuthumayo

Ukuphazamiseka kwe -cardiogenic ukuhluleka okukhulu kwe-ventricular ngokuncipha okubukhali emsebenzini wenkontileka futhi, ngenxa yalokho, ukwehla kwegazi nokunikezwa kwegazi ezingxenyeni. Ngokuvamile, ukuphazamiseka kwengqondo kuvela njengengcindezi ye-infarction ye-myocardial futhi ezimweni eziningi kuholela ekufeni.

Izimbangela zokuphazamiseka komzimba

Phakathi kwezici ezivusa ukuhlukanisa:

• i- infarction enkulu ye-myocardial , lapho okungaphezu kuka-40% we-myocardium ithinteka, futhi inhliziyo ayikwazi ukuvumelanisa nokupaka igazi;
• ukuvuvukala kwemisipha yenhliziyo (myocarditis enzima);
• ukuqhuma kwe-septum yangasese ehlukanisa i-ventricle efanele yenhliziyo ukusuka kwesobunxele;
• i-stenosis ephawulekayo (i-constriction) ye-valve yenhliziyo;
• ukwehluleka okukhulu kwama valve enhliziyo;
• i-thromboembolism enkulu ye-arterium artery.

Izinhlobo zokuphazamiseka komzimba

Kuzokwelapha, kuyisiko ukuhlukanisa izinhlobo ezintathu zokuphazamiseka kwemizimba: ukucabanga, ukushaqeka kweqiniso ne-arrhythmic:

1. Reflex. Kuyindlela elula kunazo zonke, okungukuthi, njengoba kubusa, kungabangelwa umonakalo omkhulu emkhatsini we-myocardium, kodwa ngokuncipha kwengcindezi yegazi ngenxa yobuhlungu obukhulu be-syndrome. Njengoba kunesihluthulelo esifike ngesikhathi sobuhlungu, ukubikezelwa okuqhubekayo kufana nokuhle.
2. Ukwethuka kweqiniso kwe-cardiogenic. Kwenzeka ngokuhlaselwa kwenhliziyo ejulile. Uma kwenzeka ukuthi u-40% noma ngaphezulu kwenhliziyo isifo socansi, isilinganiso sokufa siseduze no-100%.
3. Ukuphazamiseka kwe-Arrhythmic. Ivela ngenxa ye-tricycardia ye- ventricular ebukhali noma i-bradyarrhythmia ephawulekayo. Ukuphazamiseka kwegazi kuhlotshaniswa noshintsho emvuthweni wezinhliziyo zenhliziyo futhi ngemva kokujwayelekile kwesigqi sayo, izimpawu zokuthuthumela ngokuvamile ziyahamba.

Izimpawu zomtholampilo kanye nokuxilongwa kwe-cardiogenic shock

Phakathi kwabo kukhona:

• ukwehla okubukhali ekucindezelekeni kwegazi (ngaphansi kuka 90 mm Hg) nokucindezela (ngaphansi kwengcindezi engaphansi kuka-20 mm Hg);
• i-tachycardia;
• I-Pale (kaningi enezici ze-cyanotic) nesikhumba esinomanzi;
• iziphetho ezibandayo;
• I-C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C
• ukulahlekelwa kokuqonda;
• ukwephula ukuchama (ngesisindo somzimba esingaphansi kuka-50 mm Hg, izinso ziyayeka ukusebenza).

Uma isiguli sinempawu yokukhathazeka kwemizimba, odokotela bahlola ubunzima balezi zimpawu, balinganise ukucindezela kokugulana nokugulisa, ukushaya kwenhliziyo, nokuhlola inkomba yenhliziyo. Izinqubo ezilandelayo zisetshenziselwa ukusungula isizathu esiqondile kanye nendawo ethintekile:

1. I-Electrocardiogram - ukucacisa isiteji nendawo ye-infarct, ukujula kwayo nobukhulu bayo.
2. I-ultrasound yenhliziyo - kusiza ukuhlola ubuningi bomonakalo, ukucacisa inani legazi elilahliwe yinhliziyo e-aorta, ukucacisa ukuthi yimiphi iminyango yenhliziyo ehlupheka.
3. I-Angiography iyindlela yokuhlukanisa i-x-ray yokuhlola izitsha, lapho i-agent ehlukile ejojelwa khona emthini wesifazane. Lokhu kuhlolwa kwenziwa uma izindlela zokwelashwa zingenzeka.

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Ukwelashwa kwalesi sifo kuqhutshwa kuphela ekamelweni lokunakekelwa esibhedlela esibhedlela. Izinyathelo eziphuthumayo zokuphazamiseka kwengqondo zihloswe ukwandisa ukucindezelwa kwegazi nokujwayelekile ukuhlinzeka ngegazi kwezitho ezibalulekile.

Izindlela ezijwayelekile:

1. Anesthesia. Kubaluleke kakhulu esimweni esicasulayo sokuthuthumela.
2. Oxygenotherapy. Ukusetshenziswa kwe-mask oksijeni ukuvimbela umoya we-oksijeni wendlala ebuchosheni.
3. Ukwelashwa kwe-thrombolytic. Ukulawulwa kwezidakamizwa ezingenakulinganiswa ukuze kuthuthukiswe ukujikelezwa kwegazi futhi kuvimbele ukwakheka kwegazi.
4. Ukwelashwa okusekelayo. Ukulawulwa kwezidakamizwa nge-potassium ne-magnesium ukuze kuthuthukiswe umsoco we-muscle wenhliziyo.
5. Ukukhuthazwa. Ukwethulwa kwezidakamizwa ezikhuthaza ukunciphisa imisipha yenhliziyo.

Ukwelashwa kwesifo senhliziyo kuyahambisana nokuqapha imisebenzi yezitho ezibalulekile:

1. Umqapha womzimba.
2. Ukulinganisa okuvamile kwesilinganiso nokushaya kwenhliziyo.
3. Ukufaka i-catheter ye-urinary ukuhlola umsebenzi wezinso.

Ngemuva kokuthatha izinyathelo eziyinhloko, ukwelashwa okuqhubekayo kunqunywe kuye ngokuthi uhlobo lwesimo sesiguli nesibindi kangakanani, futhi kungaba kokubili ukuhlinzeka nokuqapha.