Mberede aka na cardiogenic ujo: ihe algọridim nke omume. iji tụtee mmadụ ụgbọ ihe mberede

Nnukwu obi odida na-ezo aka a-eyi ndụ egwu ọnọdụ. Na usoro mmepe, ọ na-ekewa nri na n'aka ekpe ventricular och. Ma ndị a na ọnọdụ ndị na-egbukarị. Iji zọpụta ndị mmadụ, ụgbọ ihe mberede dọkịta ga ozugbo amalite iji tụtee mmadụ.

The kasị ekpe ventricular obi ọdịda. Ọ na-emekarị ndị a myocardial infarction, oké arrhythmias na ndị ọzọ dị ize ndụ ọnọdụ. The iche gụnyere och nnukwu cardiogenic ujo. Ọ na-kpatara oké ọnya aka ahu na nke obi ike imipu ọbara kwesịrị.

Echiche nke cardiogenic ujo

Mberede aka na cardiogenic ujo dị mkpa na mbụ nkeji nke ya mmepe. Ọ ga-eti na a sikwuoro na-agaghị agabiga na ha onwe ha. Na na na-anọghị nke ngwa ngwa ọgwụgwọ ga-eduga n'ọnwụ. Cardiogenic ujo - a syndrome bụ nke a ọnụ ke gbasara obi mmepụta. N'agbanyeghị compensatory abawanye na vaskụla eguzogide, ahụ na-apụghị ịnagide nke a sikwuoro, na-enweghị enyemaka nke dọkịta.

Site ya isi ngosipụta nke ọbara na yiri Mbelata ke usu nsogbu, mmamịrị mmepụta, ọnwụ nke nsụhọ. Ọ bụrụ na aka na-adịghị nyere na oge, na-anwụ site cardiogenic ujo emee n'ime ọtụtụ awa mgbe mmalite nke ọrịa. Na steeti a na-adịghị erukwa na ha onwe ha. Ọ na-kpọkwasịwo nnukwu ọrịa nke obi usoro.

Gịnị na-akpata-edu ndú ka cardiogenic ujo?

Na-akpata gbasara obi ujo na-agụnye dị iche iche gbasara obi na vaskụla ọrịa. The kasị etiologic akpata bụ a myocardial infarction. Na nke a, cardiogenic ujo amalite naanị na oke anụ ahụ necrosis , na ọ dịghị ụgbọ ihe mberede. E nwekwara a ugboro ugboro ihe mere ya na omume na-agụnye-eyi ndụ egwu arrhythmias. Ha nwere ike na-ewute a onye ruo ọtụtụ afọ. Ma ha exacerbation na decompensation steeti a na mgbagwoju anya site na ujo.

Mgbe ụfọdụ, ndị na-akpata mmepe nke nnukwu obi odida na-atụle ga a mebiri nke vaskụla ụda. Nke a na-eme mgbe oke ọbara ọgbụgba, ihe mgbu syndrome, nnukwu gbasara akụrụ odida. Ọ ga-echeta na cardiogenic ujo - nke a abụghị otu nọọrọ onwe ha ọrịa, a sikwuoro nke kpatara daa ọrịa. Ya mere, ndị dọkịta dị mkpa ka ihe niile iji gbochie ya mmepe.

Cardiogenic Shock: nhazi ọkwa nke ọrịa

Dabere na ihe na-akpata na pathogenesis mata ọtụtụ iche nke cardiogenic ujo. Onye ọ bụla n'ime ha nwere ya usoro mmepe. Otú ọ dị, ihe niile na nhọrọ na-eduga n'otu mgbaàmà. N'agbanyeghị ya na-akpata, mbụ enyemaka na cardiogenic ujo dị mkpa na ihe ọ bụla ikpe. Ebe ọ bụ na steeti a bụ mgbe niile dokwara ize ndụ. Ihe na-esonụ iche nke nsogbu:

1. Ezi cardiogenic ujo. Ọ na-amalite mgbe mebiri emebi obi anụ ahụ. N'ọnọdụ ka ukwuu, a na ụdị bụ n'ihi transmural myocardial necrosis.
2. Arrhythmic ujo. Ya na-akpata na-agụnye ịpụ flutter ventricular arrhythmias, bradycardia arọ. Ke adianade arrhythmias, na ujo nwere ike ime ka a mebiri nke gbasara obi conduction.
3. Mpiaji cardiogenic ujo. N'okpuru a nhọrọ, gbasara obi dysfunction na-adịghị kpọkwasịwo a sikwuoro. Ọ na-emekarị na-amalite na ọbara gwụrụ, akụrụ odida.
4. Jụ ikwere ujo. Ọ bụ ihe kasị dị ize ndụ nhọrọ. Ọ e kewapụrụ na a iche iche otu, dị ka bụ fọrọ nke nta mgbe egbu na bụghị ngwọta.

Ezi cardiogenic ujo: usoro mmepe

The ezi obi ujo emee Ọtụtụ. Ọ na-adị mgbe gburu site a akụkụ buru ibu nke myocardium (50% ma ọ bụ karịa). Na nke a, necrosis gbatịrị bụghị naanị gafee thicker uru, ma na-enyene a nnukwu ebe. Ke adianade a nkụchi obi, ezi ujo nwere ike ime ka ọrịa ndị ọzọ. N'etiti ha: .. nje endocarditis, kwupụtara na ọrịa obi, ọrịa decompensated muscular dystrophy, wdg E nwekwara a siri ike gbasara obi aghara-akpata nnukwu hyperthyroidism, ụfọdụ mkpụrụ ndụ ihe nketa ọrịa.

N'ihi ya, necrosis nke obi anụ ahụ contractility na-ebelata budata. Ya mere, ahụ na-apụghị na-arụ ọrụ na zuru ike na iji hụ na ọbara arịa. Minute olu na-ebelata, kwa. N'ihi ya e nwere mụbara vaskụla eguzogide. N'agbanyeghị nke a, obi ka na-apụghị ịnagide ọrụ ha. N'ihi bụ a na-esogbu ọbara ọkọnọ nke niile na akụkụ na anụ ahụ.

Pathogenesis arrhythmic cardiogenic ujo

Ndabere nke a n'ụdị nke ọrịa na-anaghị ekwe nke obi n'afọ iri na ụma na conduction. Ha nwere ike ime spontaneously (dị ka a n'ihi nke myocardial infarction) na ịzụlite nwayọọ nwayọọ. Ọtụtụ mgbe, ihe arrhythmia ndidi na-eche maka ọtụtụ afọ. The otu na-emetụta conduction abnormalities. O sina dị, na-egbu ọnọdụ biliterenụ n'elu a mkpirikpi. Anyị na-ekwu okwu banyere awa na ọbụna nkeji. Ọtụtụ mgbe, cardiogenic ujo, arrhythmias nke ventricular ụzọ agwa. N'etiti ha: tachycardia, mbịne n'ime fibrillation, na atrial flutter. Ke adianade do, ndị a Filiks pụrụ ịkpata Ugboro otu gafere.

Ọzọ ọnọdụ nke pụrụ iduga ujo, bụ a imi bradycardia. Belatara obi ọnụego a na-emekarị ji conduction disturbances. Naa na-akpatakarị cardiogenic ujo fibrilloflutter. N'ihi ya, ọrịa ntutu ịdapụsị contractions na ectopic foci na myocardium (gafere) obi ike ịrụ ọrụ ya. Ya mere, a gụnyere ya ná ọrịa strok na nkeji olu, a ọdịda usu mgbali BP. N'okpuru a nhọrọ, mberede dọkịta ihe mbụ bụ ijide fibrillation, defibrillation, ma ọ bụ na-etinye ihe wuru obi ịhịa aka n'ahụ.

Gịnị bụ a mpiaji ujo?

Nke a na ụdị nke ujo amalite esighịkwa ihe bụghị ibido metụtara na mmebi nke obi muscle. Ịkpalite dị otú ahụ nsogbu nwere ike ịbụ oké ihe mgbu ma ọ bụ na-agba ọbara. N'otu oge, ndị a mgbaàmà na-adịkarịghị jikọtara obi. A, ndị dị otú ahụ a ujo na-chọpụtara mgbe ihe mberede, nnukwu gbasara akụrụ odida.

Nke a na nhọrọ nwere kasị mma prognosis. Mberede aka na cardiogenic ujo mpiaji agwa kwesịrị iji na-agwa okwu ya na-akpata - mgbu, dị ka nke ọma dị ka iji kwụsị ọbara ọgbụgba. N'ihi ihe ndị a, ụkpụrụ nke vaskụla ụda na-amakwa jijiji. N'ihi nke a, ọbara stagnates na veins na akwara, na na interstitial ohere nke a mmiri mmiri exuded, akpụ edema. All a na-eduga ná a ọnụ ke venous eruba obi. Ọzọ, na usoro bụ otu ihe ahụ dị ka ndị ọzọ iche-iche.

Ndị na-akpata na pathogenesis nke ujo ya adịghị ege ntị

Jụ ikwere cardiogenic ujo na-adị mgbe gburu site dum myocardium. Nke a pụtara mgbe reinfarction. Ọzọkwa, ihe mere nwere ike ịbụ a gbasara obi tamponade. Na nke a, e nwere pericardial ọmụmụ nke compresses ahụ, na-egbochi ya na-adakpọ. Mgbe ụfọdụ, tamponade pụrụ iduga agbawa nke obi. Nke a ọnọdụ na-eduga ná ọnwụ. Dị mwute ikwu na, na-enyere ndị ọrịa na nke a bụ ekwe omume. The usoro nke ujo metụtara na a zuru ezu cessation nke obi, na iche ụdị ndị ọzọ nke nkeji olu na-ebelata. Enwe a sikwuoro nso 100%.

Mgbaàmà nke cardiogenic ujo

The adakarị picture bụ otu ihe ahụ, n'agbanyeghị ihe kpatara mere cardiogenic ujo. Mgbaàmà nsogbu na-esonụ: ọdịda ọbara mgbali na usu, tachycardia, oliguria (ebelata mmamịrị mmepụta). Dabere na ọbara mgbali na-adakarị data, igbunye 3 degrees. On ule, onye ọrịa nwere ike mata, na ndị ọzọ na ihe ịrịba ama nke cardiogenic ujo. Ndị a gụnyere:

1. Oyi na clammy ajirija.
2. Egwu ọnwụ ma ọ bụ ntụbọ.
3. Cyanosis - blueness nke anụ.
4. Atụmatụ nke ọrịa iru nwere ike mụwo, ọdịdị ihu - n'ihi okwukwe.
5. Skin na agba na oké ogo na-agba ntụ.

Olee otú ịchọpụta ujo?

Diagnosis nke cardiogenic ujo na-emekarị dabeere na-adakarị data na-ajụ ajụjụ nke ọrịa ndị ikwu. Ebe ọ bụ na ọ dị mkpa na-eme ihe ozugbo, dọkịta inwale ọbara mgbali, ọnọdụ nke anụ ahụ, pupillary nzaghachi, obi ọnụego na akụkụ okuku ume ọnụego. Ọ bụrụ na onye ọrịa nwere ihe ịrịba ama nke ujo, ozugbo inye mberede aka.

Na ọnụnọ nke free ọgwụ mkpara chọpụtara akụkọ ihe mere eme nke ọrịa. The dọkịta jụrụ ma ọ bụrụ na onye ọrịa na-ata ahụhụ site na arrhythmia, rịaworo, eleghị anya, ahụhụ a nkụchi obi tupu? Ọ bụrụ na nsogbu mepụtara n'ụlọ ma ọ bụ n'okporo ámá, nchoputa nke ujo ụgbọ ihe mberede dọkịta n'ebe. Mgbe ọdịnaya nke onye ọrịa na ọzụzụ kpụ ọkụ n'ọnụ na-elekọta unit gburugburu ebe obibi, ke adianade do, na n'ihe bụ usu nsogbu, vaskụla eguzogide, diuresis. Mụkwaara ọbara, haruru.

Cardiogenic ujo: mbụ enyemaka, algọridim nke omume

Ọ bụ uru na-echeta na na otú ngwa ngwa na rụọ ọrụ nke ọma enyere ndị ọrịa ndụ na-adabere. Ọ bụrụ na e nwere ihe ịrịba ama nke ndị dị otú ahụ nsogbu, ndị dọkịta na-amalite na-eme ihe ozugbo. Ọ bụrụ na ị na-echefu na-eme ihe dị mkpa, ọ bụ ike iji merie cardiogenic ujo. Emergency - usoro nke omume bụ dị ka ndị:

1. Tinye onye ọrịa na a kehoraizin ọnọdụ na a zụrụ ụkwụ ọgwụgwụ. Ke adianade do, ọ dị mkpa iji hụ na ohere nke ikuku (unbutton uwe, na-emeghe window).
2. Oxygen ọkọnọ. Ọ nwere ike na-eme site na a pụrụ iche nkpuchi ma ọ dịghị òkè cannula.
3. Nkụnwụ. Myocardial infarction na ujo mpiaji maka na iji narcotic ọgwụ ọjọọ. ọgwụ ọjọọ, "Morphine" mee ihe mgbe mgbe. Ya diluted na saline na agbara / ngwa ngwa.
4. Mweghachi nke ọbara na Bcc. Maka ochichi a ngwọta "Reopoligljukin".
5. Ọ bụrụ na enweghị mmetụta dị mkpa iji bulie ọbara mgbali via "atropine" nkwadebe 0,1%. Na-ndinọ ke ichekwa 0.5-1 ml.

Ke adianade do, ọ dị mkpa iji wepụ ihe kpatara nke ujo. Myocardial infarction na-rụrụ thrombolytic na antiplatelet ọgwụ (preparations "Alteplase" "clopidogrel", "Ọgwụ Aspirin"). Ọzọkwa iji ọbara thinners "heparin" ngwọta. agwọ ọrịa "Lidocaine" Mgbe ndinọ ventricular n'afọ iri na ụma disturbances. Mgbe ụfọdụ, a defibrillation.

Emergency-elekọta na a ọgwụ

Mberede aka na cardiogenic ujo na-aga n'ihu na kpụ ọkụ n'ọnụ na-elekọta unit. E na-ekenịmde kpụ ọkụ n'ọnụ ọgwụ, na-aga n'ihu nlekota nke egosi, ichoputa akpata nsogbu. Myocardial infarction a rụrụ ịwa - uzo akwara stent pụrụ isi chọta. Ọzọkwa, ịwa ahụ na-elekọta dị mkpa na ụfọdụ nke arrhythmia na conduction abnormalities. N'otu oge iru keakamere pacemaker n'ịrụ contractile ọrụ nke obi.