CHF: yokuhlela. Iimpawu zonyango senhliziyo ezingapheliyo

ukusilela intliziyo Chronic, iimpawu eziza kuthi achazwe apha, i ngezifo, iimpawu ezi zinto zinxulumene ukuphazamiseka kwegazi. State kuphawuliwe lokuphumla ngexesha uxinezeleko lukhatshwa ukulibaziseka incindi yomzimba. Unyango lwe nesifo sentliziyo kuninzi eyenziwa ngokwezonyango kunye ngokubanzi. ukufikelela ngexesha kugqirha ukhuthaza khona ibuyambo ekhawulezileyo ngakumbi yokumpompoza igazi ukuphelisa esi sifo. Okulandelayo, sicinga iinkcukacha oko okuthathwa CHF. Ulwahlulo esi sifo, iimpawu kunye nongenelelo zonyango ziya kuchazwa kwinqaku.

Overview

CHF, nto leyo kakhulu Ukuhlelwa ngokubanzi isekelwe phezu ukuncitshiswa ubuchule lomzimba sokumpompa igazi ukuya yokulahla okanye ukugcwaliswa. Le meko ibangelwa, kuqala kwiinto zonke, sisilonda esidumbileyoesingaphakathi kwezihlunu. Okubaluleke ngokulinganayo ukungalingani lweenkqubo ezichaphazela umsebenzi sentliziyo.

picture clinical

Njengoko ebonakalisa ukusilela intliziyo ezondeleyo? Iimpawu ezi zifo zilandelayo:

• Ukuphelelwa umoya - eziphefumlayo curl kunye fast.
• Ukukhathala - ukunciphisa ukuthwala umthambo oluqhelekileyo.
• nokudumba zomzimba. Bona ngesiqhelo apha emilenzeni nasezinyaweni, ngokuhamba kwexesha, vuka ngasentla, uqhebeke umlenze, udonga ngaphambili peritoneum, esinqeni njalo njalo.
• cardiopalmus
• Khohlo. Kwizigaba zokuqala njani na kowomileyo, uze emva koko aqalise ukwahlula isikhohlela kwaphela. Kamva, ukuze ibonwe a kusebenze igazi.
• Indawo orthopnea. Isigulane kuba kuyimfuneko ukuba alale intloko yakho esinyusiweyo (ezintofontofo, umzekelo). Kwindawo tyaba oxwesileyo ziqala ukukhula mfutshane umoya khohlo.

ifomu yezifo

Nangona Ukubanjwa ungenelelo unyango, imeko yesigulane ukuze zimbi. Kulo mzekelo, imfuneko ukuxilongwa ngokucokisekileyo intliziyo kunye nenkqubo kwegazi. Uphando olunzulu iyobonisa kusungula ezifihliweyo. CHF bodwa manyathelo alandelayo:

• Eyokuqala (lokuqala). Kweli nqanaba, akukho ukuphazamiseka CHF kwegazi. Xa echocardiography kuveze kwekhono efihlakeleyo ventricle ekhohlo.
• A yesibini (lingaze). State luphawulwa hemodynamics kakuhle (intshukumo kwegazi) ze omnye izangqa.
• I-B yesibini (elimandundu). Eli nqanaba luphawulwa kukungazinzi hemodynamic kuzo zombini kwizangqa. Kwakhona waphawula izakhiwo umzimba ukoyiswa channels negazi.
• Le yesibini (final). State lukhatshwa hemodynamics kakuhle libizwe. utshintsho rhoqo ayibuyiseki umva Heavy kubume amalungu ekujoliswe kwakhona mava le fomu ukuphanza kwentliziyo.

Ukuhlelwa ngezifo kwakhona kuqhutywa ngokungqinelana uhlobo esebenza. Zonke ezine kubo.

iintlobo ezisebenzayo

Njengoko kwiCandelo odlulileyo, utshintsho inokuba kwicala ukuphuculwa kunye ukwehla, nxamnye kwimvelaphi zokungenelela oluqhubekayo zonyango ukusilela intliziyo ezinganyangekiyo elibhaqiweyo. Classification njengako iintlobo umsebenzi ngolu hlobo lulandelayo:

• Kuba udidi lokuqala esibonakala ngokungabikho lilinganiselwa umzimba. umsebenzi wokufika umzimba umzimba isigulane bangamelana ngaphandle ukubonisa iimpawu zesifo. karhulumente ukululama okanye dyspnea kunokwenzeka xa overvoltage.
• Kuba udidi lwesibini ubonakala nomqathango umsebenzi kangangoko encinane. Pathology akuthethi ukuzibonakalisa ukuphumla. Lo wesiqhelo, wesiNtu umthambo umzimba zivunwe izigulane ukuphelelwa umoya, ukudinwa, okanye bandile isingqisho. Kweli nqanaba, kucetyiswa kakhulu uxilongo inhliziyo.
• Xa Uhlobo wesithathu kukho umda umsebenzi omkhulu ngakumbi. Kabi kumguli ukuphumla zilahlekile. kakhulu ngaphantsi amandla kunesiqhelo emzimbeni sikhatshwa ngokubonakala iimpawu zokugula.
• Xa Uhlobo lwesine nawuphi na umsebenzi isigulane kunye mizwa ekhathazayo. Iimpawu leengxaki iqatshelwe isigulana ukuphumla, zwi kwenkxamleko eninzi emzimbeni.

zone ukuxinana

Kuxhomekeka lizwe preferential ukuphazamiseka, isigulane ingachongwa:

• ukusilela Right ventricular. Kulo mzekelo, kokoma iqatshelwe pulmonary - pulmonary channels igazi.
• Ekhohlo ukusilela ventricular. Kulo mzekelo, yenzelwe nokumfixana kwisangqa enkulu - kungena kwimijelo egazini onke amalungu ngaphandle emiphungeni.
• Dvuhzheludochkovaya (biventricular) ukusilela. mihla le nangenxa yokudodobala igazi kule meko uyaqapheleka imijikelo emibini kwangoko.

isigaba

Unyango isifo sentliziyo uyonyulwa ngokungqinelana kunye nomfanekiso clinical. Wabonakala zixhomekeke kwasendaweni of ezimbi ukuphazamiseka kunye imiba ayeke. Enye into ebaluleke kakhulu ekukhetheni unyango unembali kwesi sifo. CHF esinxulunyaniswa ne ukuzala othile okanye / kunye systole. Ngako oko, ukuchonga ezimbi ezininzi izigaba. Ngokukodwa, kukho:

• senhliziyo iSystolic. Inxulunyaniswa sigulo systole - ixesha ventricular ukusikwa.
• ukusilela ukuzala. Esi sigaba ukuba nokuhluthwa diastole - ixesha kuthanjiswa ventricular.
• ifomu Mixed. Kulo mzekelo, kukho ukutyeshelwa diastole kunye systole.

izizathu

Xa ukhetha indlela zonyango ukuphelisa kwisigaba degree CHF nemilo zibalulekile. Noko ke, ebalulekileyo ukuphawulwa ngoonobangela kunye ngezifo. Ukungaphumeleli intliziyo Chronic ezinokubangelwa:

• iposi engabalulekanga. Kule meko kukho ukutshatyalaliswa izihlunu intliziyo, linxulunyaniswa ekuyekeni igazi ngumsinga ukuya kuyo.
• Isifo kwi yokungabikho iposi engabalulekanga.
• Lwegazi - ziqhu uxinzelelo ukwanda.
• Imithi. Ingakumbi, le ngezifo unokuba ngenxa yokusetyenziswa kweziyobisi anticancer kunye imithi ngenqanaba ekuphulukenwe nalo.
• Cardiomyopathy - imisipha ukonzakala intliziyo kungekho ezingaqhelekanga kwemithambo omzimba kunye amanxeba ayo vana, kwakunye noxinzelelo lwegazi.
• Seswekile.
• izilonda ndlala.
• Ukuphazamiseka komsebenzi adrenal.
• Ukutyeba.
• Cachexia.
• Ukungabikho kwenani lweziqalelo zokulanda umkhondo kunye neevithamini.
• Amyloidosis.
• Sarcoidosis.
• HIV.
• insufficiency yesiphelo sezintso.
• fibrillation Atrial.
• Heart block.
• pericarditis eyomileyo exudative.
• ngenhliziyo ukukhubazeka azalwa nayo.

Ukuchongwa leengxaki

Uxilongo "CHF" obekwe kwi ngokusekelwe kuhlalutywe kwezikhalazo kunye anamnesis. Kudliwano-ndlebe kunye ugqirha kufuneka uxelele isigulane xa kukho iimpawu ngezifo yaye yintoni inxibelelanisa kwabo bayimilwelwe. Kubonakala ezinye zifo umntu kunye nentsapho yakhe. Ingcali kufuneka azi onke amayeza ezithathwe sisigulane. On ukuxilongwa ngokwasemzimbeni, yahlola yebala, ubukho nokudumba. Xa ukumamela intliziyo uzimisele ingaba ingxolo langoku. Ngokusichazela ubukho ingxinano emiphungeni. Njengoko izifundo ezifunekayo eyabelwe iimvavanyo zegazi umchamo. Uphando bangabhaqa comorbidities ezinokuba nefuthe ekuhambeni CHF. Unyango kulo mzekelo sinzima, ezijolise ukuphelisa izifo imvelaphi. Abamiselweyo njengegazi ezinto eziphilayo. Ngokutsho iziphumo emiselwe yoxinaniso cholesterol namaqhezu zayo, urea, creatinine, iswekile, potassium. Uhlalutyo on hormone. Yingcali angamisela uphononongo ngumzimba. Ngexesha kusenziwa isigqibo yi umgangatho antibodies inyama nentliziyo ezincane.

Studies usebenzisa izixhobo

ECG ivumela ukuhlola kwisingqi zisaphila, ukuchonga arrhythmias, amasebe nomzimba, kwakunye ukuchonga loloyiko ventricular. Ukuze uhlaziye ingxolo iyasetyenziswa phonocardiogram. Ngoncedo lwe uqikelelo ivelufa emiselwe ebusweni ingxolo iSystolic okanye ukuzala. Ukuvavanya ukwakheka imiphunga kunye intliziyo isetyenziswa ray okungenanto kwentamo. Olu phando nokujonga kwakhona ubungakanani kunye umthamo organ, yetha igazi ukufumanisa ubukho kungekho kukhula. Echocardiography isetyenziswa ukuba iphande ngazo zonke iinkalo intliziyo. Ngexesha inkqubo echazwe amacandelo kodonga ubukhulu kunye lwezivalo. Kwakhona, esebenzisa echocardiography kungabonwa njengoko kuboniswa ukwanda koxinzelelo nasezimpahleni miphungeni. Uhlalutyo yokumpompoza kwegazi eyenziwa ngexesha dopplerEhoKG. Ugqirha wakho unokuchaza nezinye uphando, ukongeza kwezo ezichazwe.

unyango CHF: izincomo

Okokuqala, isigulane wabelwa ukuba batye ukutya okuthile. Adla kuphela mali wetyuwa grams amathathu kulwelo ukuya kwiilitha 1-1.2 ngosuku. Products kufuneka kube lula ukuba ukugaya, ukuba kakhulu phezulu-osidingayo, vitamin kunye iiprothini mali efunekayo. Rhoqo isigulane kufuneka yenze ezikhathaza. ubunzima nzuzo ezingaphezu kwe-2 kg iintsuku 1-3 kudla kubonisa ukulibaziseka incindi yomzimba kwaye ukusilela intliziyo decompensated. Unyango kwakhona iquka uncedo nasengqondweni. Ijolise kukhawuleziswe ekuphulukenwe yesigulane. uncedo Psychological inganikezelwa nezalamane yesigulana. Kuba izigulane akunqwenelekile ukunikezela imithwalo ngokupheleleyo. kwinqanaba umsebenzi uzimisele ukuba isigulane ngamnye. Kuqala kufuneka inikwe imithwalo ezinamandla.

Uthomalaliso ngamachiza esisiseko

Iziyobisi yokungaphumeleli intliziyo bohlulwa babe ngamaqela: lokuqala, elesibini abangabancedani. Iqela lokuqala luquka:

• ACE inhibitor. Baya kuba negalelo ukwehlisa ukuqhubela phambili kwesifo, akhusele intliziyo, izintso, imithambo yegazi, ukulawula uxinzelelo lwegazi.
• abamelene receptor angiotensin. Ezi zixhobo Kucetyiswa ukuba hypersensitive ACE inhibitors okanye kunye nabo ile.
• Beta-blocker ( "Concor" iziyobisi, "Inderal" kunye nabanye). Ezi ndlela zinika ulawulo phezu unciphiso uxinzelelo kwaye izinga zibe nesiphumo antiarrhythmic. Beta-blocker ziqhutywa kunye ACE inhibitors.
• Womchamo ( "amiloride" iziyobisi "Furosemide" kunye nabanye). Ezi ndlela kunceda ekupheliseni kulo mzimba ulwelo abangaphezu kwemfuneko kunye netyuwa.
• glycosides inhliziyo. Ezi ndlela ke advantageously zilawulwa ngeedosi ezincinane arrhythmia atrial.

mali yongeziweyo

• Habib oqeshwe apho unobangela ukusilela zentliziyo wakhetha isifo sentliziyo.
• Anticoagulants yesenzo ngqo. Amalungiselelo eli qela unikwe amathuba eliphezulu thromboembolism kunye fibrillation atrial.

iziyobisi encedisayo

Ezi mveliso ke emiselweyo kwiimeko ezizodwa, xa luboniswa iingxaki. Ezi ziquka:

• Nitrate. Le arhente ukuphucula ukungena kwaye dilates imithambo yegazi. Amayeza eli qela ozimiselweyo angina.
• abamelene Calcium. Ezi amayeza ziboniswe angina abutment, hypertension (ukwamkelwa), uxinzelelo lwegazi esiphakamileyo ngamajelo pulmonary, ukusilela abuthethileyo lwezivalo.
• Antiarrhythmics.
• arhente Antiplatelet. Le arhente bayakwazi ukuthob coagulation ziyibuyisela zegazi agglutination. Imithi eli qela ziboniswa kwi ezizisekondari kuthintelo iqhosha.
• Neglikozidnye evuselela inotropic. Ezi mali esetyenziswa ukuhla uxinzelelo lwegazi kunye namandla intliziyo.

iindlela zotyando

Xa engekho sesichengeni iziyobisi isicelo ukusebenza yentsebenziswano ukuphazamiseka ngoomatshini. Ingakumbi, le isigulane ufakwe:

• Uqhaqho kwimithambo esa yokumilisela. Umsebenzi wenziwa xa wavakalisa izilonda atherosclerotic nemithambo.
• Zotyando nokulungisa iziphene vana. Le uphazamiseko oluqhutywa kwimeko stenosis kakhulu (exineneyo) okanye ukusilela vana.
• Abohlukeneyo. Abohlukeneyo entliziyweni yokukala kakhulu kakhulu. ukuphunyezwa kwayo kubandakanya inani kobunzima:
  
  - ukulahlwa kungenzeka;
  - inani elingonelanga amalungu ukunikela;
  - Amajelo igazi ekubulaleni organ zilinywe, kunzima kancinane ukunyanga.

• Ukusetyenziswa kwezixhobo elibona ukunika inkxaso kwegazi. Bafaka ngqo kumguli. Emva kokuba umphezulu bamhlophe ahlangene ibhetri ibekwe ebhantini yesigulane. Noko ke, izixhobo isicelo kwakhona sikhatshwe yi iingxaki. Ngokukodwa, amathuba iingxaki ezasulelayo, thromboembolism kunye thrombosis. Kuthintela ukusetyenziswa ebanzi kakhulu izithuthi kunye neendleko zabo eziphakamileyo.
• Ukusebenzisa isakhelo web ilastiki. Bona lisibekele intliziyo kwi cardiomyopathy inimba. Lo mlinganiselo kwenza kube lula ukuba isantya nokunyuka ubukhulu emzimbeni, ukuphucula ukusebenza sesichengeni iziyobisi, ukuphucula imeko yesigulane.