Ngokuhluleka kwenhliziyo, okuphazamisa inkinga ye-infarction ye-myocardial, kungase kube nokunciphisa okukhulu ekucindezelweni kwegazi, ukuphazamiseka kwegazi ezingxenyeni, izinga lentliziyo elandayo nokulahlekelwa ukwazi. Lesi simo sibizwa ngokuthi ukushaqeka kwe-cardiogenic. Kwenzeka ngesikhathi esibucayi se-infarction ye-myocardial futhi ema-60% amacala aholela ekufeni.
Ukuphazamiseka kwe-cardiogenic - kubangela
Izici eziyinhloko ezithinta ukuthuthukiswa kwalesi simo, i-necrosis yodonga, ehlanganisa i-ventricle engakwesobunxele, ukubhujiswa kancane kancane kwe-myocardium, ukwehluleka kwesigqi kanye ne-aneurysm enzima. Ukuphazamiseka kwe-cardiogenic kuyatholakala nge-infarction encane ye-myocardial, uma:
- Isifo senhliziyo asikho okokuqala futhi sihambisana nensimu yezinsizakalo;
- kukhona i-arrhythmia ethinta i-hemodynamics.
Ukuphazamiseka kwe-cardiogenic - isigaba
Kunezinhlobo eziningana zalesi sizwe:
- Ukushaqeka kwe-Reflex, okuyizinto eziyingozi kakhulu ezingabangeli ekubhujisweni kwe-myocardium, kodwa kubangelwa ukushaqeka ubuhlungu obuhambisana nesifo senhliziyo. Ngokupheka okufika ngesikhathi, ingcindezi iphakama, ngaphandle kwalokho ukushaqeka kungakhula ibe yisiteji sangempela.
- Ukwethuka kweqiniso okubonakala ekuhlaselweni okukhulu kwenhliziyo. Kwenzeka ngenxa yokungasebenzi kokungena kwe-ventricular.
- I-AREA enezici zayo ayifani ngokungafani nendlela eqinisweni yokwethuka, noma yikuphi okwedlula futhi ehlala isikhathi eside. Ukushaqeka okunjalo akuphenduli kokwelapha futhi kumacala angu-100% aholela ekufeni.
- Ukuphazamiseka kwe-arrhythmic kubonakala ngenxa ye-paroxysm ye-tachycardia, eyenzeka ezimweni zokuvimbela i-atrioventicular.
Ukuphazamiseka kwe-cardiogenic - izimpawu
Isimo esiphezulu sesiguli sihlolwe njengezinzima. Ngakho kukhona izibonakaliso ezinjalo:
- ukuphuza kokuphendula;
- ukuphazamiseka kwengqondo, ukulahlekelwa kwayo kungenzeka;
- isiguli sithola isizungu;
- inkungu e-galaz;
- ubuhlungu ngemuva kwe-sternum;
- i-palpitation;
- ukukhwehlela;
- ukudonsa okubukhali ekucindezelekeni;
- ukuvuselela ukuphefumula.
Ekucwaningweni kwangaphandle okulandelayo kuvezwe:
- i-acrocyanosis;
- isikhala sesikhumba;
- umswakama wesikhumba;
- izandla ezibandayo nezinyawo;
- Ekugcineni, i-necrosis yamasu ezindlebeni nasempumeni ingabonwa.
Ukwethuka kwe-cardiogenic yilona usizo lokuqala lwezokwelapha
Usizo lokuqala luhlanganisa ukuqinisekisa ukuphumula kwesiguli kanye nokuletha ngokushesha esibhedlela. Odokotela banganikeza isiguli uchungechunge lwemisebenzi endleleni eya esikhungweni sezokwelapha. Lokhu kungaba okulandelayo:
- Geda ubuhlungu nge-nitrous oxide.
- Ukwethulwa kwe-mezaton (i-1%) ngaphakathi kwe-intravenously ne-cordiamine (10%) nge-intramuscularly.
- Usizo lokuqala lwe-cardiogenic shock nalo lusekelwe kilo-radiotherapy.
- Ukudonsa kwebhola le-norepinephrine (2%).
- Ukwenza ukuhlanekezeka kwenhliziyo, uma ukushaqeka kubangelwa i-tachycardia ye-paroxysmal.
Ukwelashwa kokuphazamiseka komzimba
Ukwelashwa kuhloselwe ukulondoloza imisebenzi ye-myocardium. Ukuvimbela kuyindlela enkulu yomzabalazo.
Uma kukhona ukwehla okusheshayo ekucindezelweni, isiguli sijojowe nge-norepinephrine kuze kube yilapho ingcindezi ifinyelela ku-90 mm Hg. Bese bashintsha ku-dopamine, okuthinta kahle isimo, ukwandisa imikhumbi ye-cerebral, izitsha zezinso nezinye izitho ezisemgodini wesisu.
Thatha izinyathelo zokuvimbela kufanele zibe ngaphansi kobuso obandulelwe:
- I-anesthesia ene-nitrous oxide, i-neiroletoanlagezii, i-electroanalgesia.
- Ukuvimbela ukuhlelwa komzimba ngokusungulwa kwe-lidocaine, etatsizina ne-ornid.
- Ukwelapha ukwelashwa kwe-fibrinological.
- Ukuqeda ukwehluleka kwenhliziyo ngokusebenzisa i-lasix, i-oksijeni ne-strophanthin.
- Isidingo sokuqala esibhedlela kanye nokuhlinzeka isigceme ngemishini yokulawulwa kwezidakamizwa.