Jajab Ejection waxyaalaha qalbiga ku jira: caadi iyo cudurada

Maanta, in da'da technology, horumarinta cudurka wadnaha iyo walaac xad halis ah ma aha oo kaliya in ay shaqaalaha hay'adaha caafimaadka, laakiin sidoo kale in heerarka sare ee xukuumadda. Taasi waa sababta xeelado cusub iyo aad u badan oo dheeraad ah si loo yareeyo cudurada la is waydiinayo, cilmi baarista si firfircoon maal iyo horumarinta, kuwaas oo u ogolaan doonaa in mustaqbalka si ay u gaaraan gool kuwaas.

Mid ka mid ah isbeddellada ee daaweynta bukaannada qaba cudurrada wadnaha - waa ka hortagga iyo daaweynta cudurada wadnaha. Haddii aad si guul leh lagu daaweyn karo aagga this qaar ka mid ah cudurrada, halka qaar kalena ay wali yihiin "weydey" sababta oo ah iyaduna ka mid ah qalabka iyo qaybaha kale ee muhiimka ah ee daaweynta ku haboon. Sida article hadda ka hadlaysaa fikirka ah qiiqa serdechenogo, xeerarka iyo hababka daaweynta, jajab ejection wadnaha (iska caadi ah in caruurta iyo dadka waaweyn).

Xaaladda hadda

In xidhiidh la leh korodhka Filashada nolosha ka mid ah dadka waayeelka ah ee kooxda this kordhay jiritaanka cudurka wadnaha, gaar ahaan jajab ejection oo yaraada. Sanadihii la soo dhaafay horumariyo habab la xaqiijiyay of daaweyn caafimaad iyo isticmaalka qalabka resynchronization wadnaha, cardioverter-defibrillator uu cimrigiinnu nolosha, kor loo qaado tayada ee bukaanka qaba cudurada this.

Si kastaba ha ahaatee, hababka aan loo aqoonsaday ee daaweynta cudurada wadnaha la jajabka caadiga ah, daweynta cudurrada this waa taaban karo. Waxaa sidoo kale jira jirto daweyn la xaqiijiyay of decompensation wadnaha ba'an (oedema pulmonary). Ilaa iyo hadda, dawooyinka ugu weyn ee in lagu daaweeyo xaalad this yihiin diuretics, oksijiin, iyo nitropreparatov ah. jajab Ejection, garaaca wadnaha, ay cudurada, waxay u baahan yihiin hab daran dhibaatada.

Arki muruqa wadnaha iyo si loo ogaado shaqada qolal waxyaalaha qalbiga ku jira (atria, intraventricular) Habka Doppler kartaa cardiography. Si aad u fahamto sida wadnaha u shaqeeyo, sahaminta awooddiisa ah inuu qandaraas (function systolic) oo naso (function diastolic) Wadnaxanuun.

The qiyamka jajab

jajab Ejection of wadnaha, taasoo loo arko in hoos iska caadi ah - tilmaanta ugu muhiimsan ee qalab calaamad xoogga muruqa wadnaha.

The qiyamka jajab ejection ah, laga heli by cardiography Doppler:

• heerarka caadiga ah - ka weyn ama la mid ah 55%.
• weecasho yar - 45-54%.
• weecasho Dhexdhexaadka ah - 30-44%.
• weecasho muujiyay - in ka yar 30%.

Haddii tilmaame tani waa in ka yar 40% - "awoodda ee wadnaha" waa la dhimay. qiimaha caadiga ah - kor ku xusan 50%, "xoogga waxyaalaha qalbiga ku jira" waa wanaagsan yahay. Qoondee ah "aaga cirro" 40-50%.

Heart failure - go'an ee daliilka kiliinikada, qalimaan lagmamaarmaanna, waxbarashada, kuwaas (electrocardiography, wadnaha Doppler, xabadka X-ray) ka dhaca ciidanka hoose ee wadnaha.

Kala saaro astaamaha iyo astaamo, systolic iyo diastolic wadnaha.

degdeg ah ee dhibaatada

In 20-kii sano ee la soo dhaafay dhacdooyinka wadnaha oo shaqadiisa gaba ka mid ah Yurub waa la dhimay. Laakiin tiro sii kordhaysa oo ka mid ah xaaladaha ku jira qeybaha dhexe iyo sare ee dadweynaha ay sabab u tahay kor u cimri.

Sida laga soo xigtay cilmiga Yurub (qabashada echocardiography), waxaa lagu ogaaday in hoos u jajab ejection, nus ka mid ah bukaannada qaba wadnaha astaamaha iyo kalabar dadka bukaanka ah astaamo.

Bukaanka qaba wadne joogsi ka yar awoodaan in ay ka shaqeeyaan, waxa ay leeyihiin tayo la dhimay nolosha iyo soconayo.

Daaweynta bukaan waa ugu qaalisan iyaga, iyo gobolka. Sidaa darteed, waxa wali search degdeg ah siyaabaha si looga hortago dhacdo, ogaanshaha hore iyo daaweyn wax ku ool ah ee cudurrada wadnaha.

Fuliyay in labaatankii sano ee la soo dhaafay, diraasado ah ayaa la xaqiijiyay waxtarka ah tiro ka mid ah kooxaha daroogada si loo hagaajiyo saadaal, yareeyo geerida bukaanka qaba kooxaha wadnaha hooseeya:

• inhibitors enzyme adenozinprevraschayuschego ( "Enalapril");
• angiotensin II Doodeen ( "valsartan");
• Beta-blockers ( "Carvedilol");
• blockers aldosterone ( "spironolactone");
• Kaadida ( "Torasemide");
• "Digoxin".

Sababaha wadnaha oo shaqadiisa gaba

Heart failure - syndrome ah, kaas oo la sameeyay ay sabab u tahay carqalad ah qaab-dhismeedka ama hawlgal ee myocardium ah. cudurada ee laxanka wadnaha ama tabinta, bararka, difaaca, hormoonada jidhka, dheefshiidka, hidaha, geedi socodka neoplastic, uurka noqon karaan sabab ay ku tabar qalbiga la jajab ejection oo yaraada ama aan lahayn.

Sababaha wadnaha oo shaqadiisa gaba,

- cudurada wadnaha (sida caadiga ah ka dib markii wadno a);

- hypertension,

- isku dhafan ee CHD iyo dhiig-karka,

- cardiomyopathy idiopathic;

- wadne;

- cudurka waalka (rheumatic, sclerotic).

Heart failure:

- systole (jajab ejection wadnaha - in ka yar 40% ee caadi ah);

- diastolic (jajab ejection 45-50%).

Garashada systolic wadnaha

Garashada systolic wadnaha waxaa ka mid ah:

1. jajab ejection Wadnaha - in ka yar 40% ka mid ah iska caadi ah;

2. fadhiidka ah ee wareegyada wareegga;

3. isbeddel ah ee qaab-dhismeedka wadnaha (nabaro xagtin, lesions fibrosis, iwm).

Calaamadaha ciriiriga:

- daal,

- dyspnea (neefta oo ku qabata), oo ay ku jiraan orthopnea, dyspnea nocturnal paroxysmal - neefta wadnaha;

- bararka,

- hepatomegaly;

- ballaarinta xididdada Annagaana ugsa dhaw;

- crackles ee sambabada ama effusion pleural;

- buuqa on auscultation qalbiga, cardiomegaly ah.

isku darka A of dhowr ah oo ka mid ah calaamadaha kor ku xusan, helitaanka macluumaadka ku saabsan cudurka wadnaha ka caawisaa in la dhiso wadnaha, laakiin waxaa muhiim ah haya Doppler qalbigaaga u qeexida oo ka mid ah isbadal leh qaabka iyo qiimeynta jajab ejection myocardial. Xaaladdan oo kale, waxa ay noqon doontaa muhiim jajab wadnaha ejection, heerka ka dib markii wadno xanuun kaas oo sida xaqiiqada ah waa mid kale ah.

shuruudaha lagu ogaanayo

Shuruudaha ogaanshaha of wadnaha la jajabka caadiga ah:

- jajab ejection waxyaalaha qalbiga ku jira - heerka of 45-50%;

- fadhiidka ah ee goobada yar (dyspnea, crepitation sambabada, neefta wadnaha);

- jebinta ee nasashada ama la kordhiyo qallafsanaan ee myocardium ah.

Si aad u saaro wadnaha sannadihii ugu danbeeyay loo ogaado calamado noolaha: peptide natriuretic wadne (failure wadnaha ba'an - in ka badan 300 bogga / ml, chronic ka badan 125 bogga / ml). heerarka peptide caawin doonaa go'aaminta saadaasha cudurka, doorashada ee therapy fiicnayn.

Bukaanka qaba jajab wadnaha sii raagayaan inta badan ka weyn, iyo waxa ka badan inta badan waa haween. Waxay leeyihiin comorbidities badan, oo ay ku jiraan hypertension. In bukaanka, kuwaas oo, heerarka plasma of natriuretic peptide nooca B waa ka hooseeyaa in bukaannada qaba jajab hoose, laakiin ka badan in dadka caafimaad qaba.

Dhibaatooyinka dhakhaatiirta daaweynta bukaanka

Goolal daaweynta bukaannada qaba wadnaha oo shaqadiisa gaba, marka ejection jajab wadnaha ka sarreeya caadi ah ee:

- yareeyo calaamadaha cudurka,

- Dhimista xaaladood oo dib;

- hortagga dhimashada dhicis ah.

Tallaabada ugu horreysa ee saxo wadnaha waa daaweynta aan daroogada ah:

- xaddidaadda of dhaqdhaqaaqa jirka,

- cusbo aqbaliddoodii xanibaada;

- xadaynta dheecaan;

- miisaanka oo yaraada.

Daaweynta bukaanka qaba hoos ku xeeraan

Tallaabo 1: durayo The ( "Torasemide") + inhibitor of angiotensin diinta enzyme ( "Enalapril") xanibaha receptor ama angiotensin II ( "valsartan") qiyaasta la koror tartiib ah in ay dawlad xasiloon + beta-xanibaha ( "Carvedilol").

Haddii calaamadaha aan baxayn - Tallaabo 2: Ku dar antagonist aldosterone ah ( "Veroshpiron") ama receptor angiotensin P.

Haddii calaamadaha ku adkaystaan, waxaa suurtagal ah in lagu daro in daaweyn jiray "Digoxin", "Hydralazine" nitroprepaty ( "Kardiket") iyo / ama qaban-gelinta invasive (dejinta qalabka resynchronization nimo cardioverter-defibrillator, wadnaha-tallaalidda), ultrasound hore ku qaatay waxyaalaha qalbiga ku jira. jajab Ejection, heerka of taas oo kor lagu sharaxay, haddii ay taasi waxaa lagu go'aamiyaa ultrasonography.

tabaha daaweyn Modern angiotensin wadnaha oo shaqadiisa gaba diinta inhibitors enzyme, blockers receptor angiotensin P, beta-blockers, blockers aldosterone, diuretics, Nitrate, hydralazine, digoxin, Omacor, haddii qalabka resynchronization rakibidda lagama maarmaan iyo cardioverter-defibrillator in labaatankii sano ee la soo dhaafay ayaa keentay in koror weyn oo badbaadada bukaanka qaba foomamka terminal cudurka. Taasi waxay u keentay caqabado cusub oo loogu talagalay dhakhaatiirta iyo cilmi.

Waxaa weli hababka bedelka search ku habboon oo unug nabar ah myocardium ah.

gunaanad

Sayidka, ka articles gudbiyey aad ka arki kartaa qiimaha ku ool ah ku dadaaleen by dhaqanka dhakhaatiirta. jajab Ejection waxyaalaha qalbiga ku jira (iska caadi iyo cudurada) waxaa weli si buuxda looma fahmin. Inkastoo hadda daawada waa wakhti ku habboon in la cudurada this macaamilo aan kaamil ah, waxaa lagama maarmaan ah in ay rajeynayaa, iyo in ay maal lacagta ku filan oo maal horumarinta iyo horumarinta cilmi sayniska ee ku yaala goobahan. Ka dib oo dhan, ka saynisyahano inta badan ku xiran tahay horumarinta warshadaha caafimaadka. Sidaa darteed, masuuliyiinta dawladda waa in ay taageeraan dhammaan hay'adaha caafimaadka sayniska, isku dayayaan inay shabaqa ka badan arrinta laga wada hadlay.