Thandizo Emergency mu mantha cardiogenic: ndi aligorivimu zochita. kuwatsitsimula ambulansi

Pachimake mtima kulephera amatanthauza chikhalidwe moyo pachiswe. Pa limagwirira chitukuko, izo lagawidwa lamanja ndi lamanzere yamitsempha yamagazi OCH. Onse zinthu izi kawirikawiri amapha. Kupulumutsa munthu, ambulansi dokotala ayenera yomweyo anayamba kuwatsitsimula.

Ambiri kumanzere yamitsempha yamagazi mtima kulephera. Nthawi zambiri motere ndi infarction m'mnyewa wamtima, arrhythmias kwambiri ndi mavuto ena oopsa. mitundu komanso OCH pachimake cardiogenic mantha. Iwo amayamba ndi zotupa kwambiri kwa thupi limene mtima sangathe kutulutsa magazi bwinobwino.

Lingaliro la mantha cardiogenic

thandizo Emergency mu mantha cardiogenic chofunika mu mphindi woyamba wa chitukuko. Tiyenera kukumbukira kuti vuto ili sudzatha paokha. Ndipo, pakalibe chithandizo mwamsanga idzatsogolera ku imfa. Cardiogenic mantha - ndi matenda amene pali kuchepa linanena bungwe mtima. Ngakhale kuwonjezeka compensatory mu kukana mtima, thupi sangathe kulimbana ndi vuto ili, popanda thandizo la madokotala.

Ndi mawonetseredwe amafotokoza za wolumikizira ndi kuchepetsa athu zimachitika kuthamanga, mkodzo linanena bungwe, imfa ya chikumbumtima. Ngati thandizo si operekedwa mu nthawi, anthu ofa ndi mantha cardiogenic amapezeka mkati maola angapo pambuyo isanayambike matenda. boma limeneli silipezeka paokha. Iye nthawizonse yoyamba matenda pachimake a dongosolo mtima.

N'chiyani chimachititsa patsogolo kwa mantha cardiogenic?

Zimayambitsa mantha mtima monga matenda osiyanasiyana mtima ndi mtima. Ambiri etiologic Chinthu ndi m'mnyewa wamtima infarction. Pankhaniyi, cardiogenic mantha akufotokozera yekha ndi chachikulu minofu necrosis , ndipo palibe ambulansi. Palinso chifukwa kawirikawiri kwa pakuwonekera kwake monga moyo pachiswe arrhythmias. Iwo akhoza kusokoneza munthu kwa zaka zambiri. Koma exacerbation ndi decompensation awo boma ndi kobvuta ndi mantha.

Nthawi zina, chinthu chitukuko kulephera pachimake mtima akuti ndi kuphwanya kamvekedwe mtima. Izi zimachitika pamene magazi chachikulu, matenda ululu, pachimake aimpso kulephera. Kumbukirani kuti cardiogenic mantha - si chinthu matenda palokha, vuto la kudwala chimapangitsa. Choncho, madokotala ayenera kupanga zonse kuteteza chitukuko.

Cardiogenic Shock: gulu la matenda

Timauza ndi pathogenesis kudziwa njira zosiyanasiyana kakasi cardiogenic. Aliyense ali njira zake chitukuko. Komabe, mungachite chotani zizindikiro zomwezo. Kaya zimayambitsa, thandizo ku mantha cardiogenic n'kofunika Mulimonsemo. Popeza boma nthawi zonse mofanana oopsa. Zotsatirazi mitundu ya mavuto:

1. N'zoona cardiogenic mantha. Akufotokozera pamene kuonongeka mtima minofu. Nthawi zambiri, mawonekedwe ndi chifukwa transmural m'mnyewa wamtima necrosis.
2. Arrhythmic mantha. zimayambitsa monga kukulowa ndi flutter yamitsempha yamagazi arrhythmias, bradycardia lolemera. Kuwonjezera arrhythmias, kuti mantha mwina chifukwa kuphwanya conduction mtima.
3. Reflex cardiogenic mantha. Mu njira iyi, mtima kukanika si yoyamba Vuto ndi. Nthawi zambiri akufotokozera mu ataya magazi, impso kulephera.
4. Kusamvera mantha. Ndi njira yoopsa kwambiri. Iwo anali olekanitsidwa mu gulu lapadera, monga pafupifupi amapha osati mankhwala.

N'zoona cardiogenic mantha: limagwirira chitukuko

Woona mtima mantha limapezeka nthawi zambiri. Kumachitika pamene chidwi ndi gawo lalikulu la myocardium (50% kapena zambiri). Pankhaniyi, necrosis chimafikira osati kudutsa minofu thicker, komanso ali ndi lalikulu. Kuwonjezera vuto la mtima, mantha woona angachititse matenda ena. Pakati pawo .. bakiteriya endocarditis, anasonyeza matenda a mtima, decompensated akulu dystrophy, etc. Pali komanso chaukali mtima matenda amachititsa pachimake hyperthyroidism, matenda ena chibadwa.

Chifukwa, necrosis a mtima minofu contractility yafupika kwambiri. Choncho, thupi silingaone ntchito pa mphamvu zonse ndi kuonetsetsa ziwiya magazi. buku Minute yafupika, nayenso. Choncho pali kuchuluka mtima kukana. Ngakhale zili chomwechi, mtima komabe sangathe kulimbana ndi ntchito zawo. Chifukwa ndi kutanganidwa magazi kundipatsako kwa ziwalo zonse ndipo zimakhala.

Pathogenesis arrhythmic cardiogenic mantha

Chifukwa cha mawonekedwe matenda ndi matenda a mungoli mtima ndi conduction. Iwo angayambe zokha (chifukwa cha infarction m'mnyewa wamtima) ndi kukhala pang'onopang'ono. Nthawi zambiri, ndi arrhythmia mtima nkhawa kwa zaka zambiri. N'chimodzimodzinso ndi kuvutika conduction. Komabe, kufa chikhalidwe zimatenga yochepa. Tikuyankhula zokhudza maola ndipo ngakhale mphindi. Nthawi zambiri, cardiogenic mantha, arrhythmias khalidwe yamitsempha yamagazi patsogolo. Pakati pawo: tachycardia, osatembenukira ku fibrillation, ndi matenda flutter. Komanso njira izi kungapangitse pafupipafupi kumenyedwa gulu.

chikhalidwe china chimene chingatsogolere ku mantha, ndi nkusani bradycardia. Yafupika mlingo mtima nthawi yodziwika ndi zipolowe conduction. Pasanathe zambiri kumayambitsa cardiogenic fibrilloflutter mantha. Chifukwa, nthenda contractions ndi ectopic foci mu myocardium (kumenyedwa) ndi mtima akulephera ntchito yake. Choncho, kuchepetsa matenda opha ziwalo mphindi buku, ndi kugwa mu zimachitika kuthamanga BP. Mu njira iyi, mwadzidzidzi dokotala chinthu choyamba ndi kukamanga fibrillation, uyambenso, kapena kuthera yokumba kutikita mtima.

Kodi mantha reflex?

mawonekedwe mantha akufotokozera chifukwa zifukwa poyamba amagwirizana ndi kuwonongeka kwa minofu mtima. Choyambitsa mavuto amenewa kungakhale kupweteka kapena magazi. Pa nthawi yomweyo, zizindikiro zimenezi kawirikawiri kugwirizana ndi mtima. Childs, monga mantha amawapeza pambuyo ngozi, pachimake aimpso kulephera.

Izi njira ali kuti madokotala ananena zawo zabwino kwambiri. thandizo Emergency mu cardiogenic mantha reflex khalidwe ayenera kuthetsa zimayambitsa - ululu, komanso kuti magazi asiye kutuluka. Chifukwa zinthu izi, lamulo kamvekedwe mtima anawawidwa. Chifukwa cha ichi, magazi stagnates mu mitsempha ndi mitsempha, ndipo mu malo interstitial wa madzi exuded, kupanga edema. Zonsezi zimathandiza munthu kuchepa otaya venous mtima. Kenako, limagwirira ndi chimodzimodzi monga mitundu ina.

Zimayambitsa ndi pathogenesis cha kusamvera mantha

Kusamvera cardiogenic mantha kumachitika pamene chidwi ndi myocardium lonse. Izi zimachitika pamene reinfarction. Komanso, chifukwa angakhale mtima tamponade. Pankhaniyi, pali pericardial madzimadzi lomwe compresses thupi, kuteteza izo kuchokera pansi. Nthawi zina, tamponade kungachititse kuti chotupa cha mtima. chikhalidwe ichi limadzetsa imfa. Mwatsoka, kuthandiza wodwalayo mu nkhani iyi si zotheka. Limagwirira kakasi kugwirizana ndi kutha kwathunthu kwa mtima, mosiyana ndi njira zina zimene mphindi buku yafupika. Imfa ku vuto ili pafupi 100%.

Zizindikiro za shoko cardiogenic

Chithunzi matenda ali yemweyo, ziribe kanthu chifukwa anachititsa mantha cardiogenic. Zizindikiro mavuto otsatirawa: kugwa magazi ndi kugunda, tachycardia, oliguria (utachepa mkodzo linanena bungwe). Malinga kuthamanga magazi ndi deta matenda, kuonetsetsa madigiri 3. Kuzionetsetsa, wodwala akhoza kuzindikiridwa, ndi zizindikiro zina mantha cardiogenic. Njirazi ndi monga:

1. Cold ndi clammy thukuta.
2. Kuopa imfa kapena kukomoka.
3. Cyanosis - blueness wa khungu.
4. Features nkhope wodwala akhoza lakuthwa, nkhope - ophedwa.
5. Khungu mu digiri aakulu amakhala imvi.

Kodi matenda mantha?

Matenda a mantha cardiogenic nthawi zochokera deta matenda ndi kufunsa achibale a munthu wodwalayo. Popeza m'pofunika kanthu mwamsanga, madokotala amayang'anitsitsa magazi, mmene khungu, pupillary Poyankha, kugunda kwa mtima ndi kupuma mlingo. Ngati wodwalayo zizindikiro za mantha, nthawi yomweyo yolimbikitsira mwadzidzidzi.

Pamaso pa ufulu madokotala anapeza mbiri ya matenda. dokotala akufunsa ngati wodwala akudwala arrhythmia, angina, mwina anadwala matenda a mtima pamaso? Ngati mavuto anayamba kunyumba kapena pa msewu, matenda a mantha madokotala ambulansi pomwepo. Pamene zili mu mtima mwa tima chilengedwe chisamaliro wagawo, kuwonjezera, kayesedwe ndi kuthamanga zimachitika, mtima kukana, diuresis. Nayenso anaphunzira mpweya magazi.

Cardiogenic mantha: thandizo, aligorivimu zochita

M'pofunikanso kukumbukira kuti mmene mofulumira ndi efficiently anathandiza moyo wodwalayo zimatengera. Ngati pali zizindikiro za mavuto amenewa, madokotala ayamba mwamsanga. Ngati inu kuiwala kuchita zinthu zofunikira, n'zotheka kupambana cardiogenic mantha. Emergency - ndondomeko ya zochita chiri motere:

1. Ikani wodwala angathe yopingasa ndi anamuukitsa mapeto phazi. Komanso, m'pofunika kuonetsetsa mwayi wa mpweya (zovala unbutton, windo).
2. Mpweya okwanira. Izo zikhoza kuchitidwa kupyolera chigoba wapadera kapena cannula m'mphuno.
3. Mankhwala ochititsa dzanzi. M'mnyewa wamtima infarction ndi reflex mantha kuti ntchito mankhwala chomwa mankhwalawa. mankhwala "Morphine" amagwiritsidwa ntchito kwambiri. kuchepetsedwa wake mu saline ndi jekeseni mu / pang'onopang'ono.
4. Kubwezeretsa magazi ndi Bcc. Pakuti makonzedwe njira "Reopoligljukin".
5. Ngati palibe zotsatira n'kofunika kwezani magazi kudzera "atropine" kukonzekera 0,1%. Kodi kutumikiridwa mu kuchuluka kwa 0.5-1 ml.

Komanso, m'pofunika kuchotsa chifukwa cha mantha. M'mnyewa wamtima infarction ikuchitika thrombolytic ndi antiplatelet mankhwala (kukonzekera "Alteplase" "clopidogrel", "Aspirin"). Komanso ntchito thinners magazi "heparin" njira. medicament "lidocaine wa" Pamene kutumikiridwa yamitsempha yamagazi mungoli chisokonezo. Mu zina, uyambenso.

chisamaliro Emergency m'chipatala

Emergency thandizo mantha cardiogenic akupitiriza odwala mwakayakaya. Pali wochititsidwa mankhwala tima, mosalekeza kuwunika zizindikiro, kufufuza chifukwa matendawo. M'mnyewa wamtima infarction ndi opaleshoni - kulambalala mtsempha wamagazi stent Kusinthaku. Komanso, chisamaliro opaleshoni chofunika zina za arrhythmia ndi conduction kuvutika. Pa nthawi yomweyo kukhazikitsa pacemaker yokumba akuchita contractile ntchito za mtima.