Uhlolojikelele lwezinhlelo ezimbili ezihlukene zokwelapha
I-fibrillation ye-atrial iyinhlangano ye-cardiac arrhythmia evame ukukhiqiza ukuphazamiseka okukhulu, ukukhathala, ngisho nokuphefumula. Okubi nakakhulu, ukubhebhetheka kwe-atrial kungandisa kakhulu ingozi yokushaya isifo . Uma une-fibrillation ye-atrial kukhona umbuzo omncane wokuthi ngabe udinga ukwelashwa. Uyenza. Umbuzo uwukuthi: Yikuphi indlela yokwelashwa okulungile kuwe?
Isizathu sokuthi lo mbuzo uvame ukuba nzima ukuphendula ngoba awukho ukwelashwa kwe-fibrillation ye-atrial, eminingi yeziguli, kokubili ephephile futhi ephumelelayo ekuqedeni ukuhlela nokubuyisela isigqi esivamile. Ukunquma ekwelapheni "okulungile" kunoma yimuphi umuntu one-fibrillation ye-atrial ngokuvamile kuvumelanisa.
Izindlela ezimbili zokwelapha
Uma kwakungelula futhi kuphephile ukubuyisela nokugcina isigqi senhliziyo evamile, khona-ke umgomo wokuphatha i-fibrillation ye-atrial kuzokwenza ukuthi nje wenze lokho-ukuze wenze isigqi senhliziyo yakho siphindele esimweni esijwayelekile futhi sigcine lapho. Le ndlela yokwelapha ibizwa ngokuthi indlela yokulawula isigqi. Futhi kuyilapho lokhu kube yindlela efanele yeziguli eziningi, kwabanye kunomgomo wokunakekelwa okungenakufinyeleleka ezingeni elikwamukelekile leengozi.
Kubantu abaningi abane-fibrillation ye-atrial, enye indlela yokwelapha-eyodwa engasebenza kakhulu futhi ephephile-ukuvumela ukufabulisa kwe-atrial ukuqhubeka, kuyilapho kuthatha izinyathelo zokuqeda izimpawu nokunciphisa ingozi yokushaywa yisifo .
Le ndlela yokwelashwa yesibili, evame ukubizwa ngokuthi indlela yokulawula izinga, kusho ukuvumelanisa ukuthi ukubhebhetheka kwe-atrial "kuyinto evamile" futhi isebenza ekulawuleni izinga lenhliziyo (ukunciphisa izimpawu) nokusebenzisa ukwelashwa kwe- anticoagulation ( igazi elincane ) ukunciphisa ingozi ukushaya. Ngenkathi le ndlela yokulawula izinga ingahle ibonakale engathandeki kunokulawula ukulawula isigqi, kunezizathu eziphoqelekile zokuzisebenzisa ezigulini eziningi ezine-fibrillation ye-atrial.
Uma i-Rhythm Control iyindlela efanele
Kunezimo eziningana ngokuvamile ezikhomba ukulawula isigqi njengendlela yokwelashwa okufanele. Uma i-fibrillation yakho ye-atrial ibangelwa imbangela ethile engase iguquke, ngakho-ke, inhloso yokwelashwa kufanele kube ukuphatha isimo esibucayi bese ubuyisela isigqi senhliziyo evamile. Lezi zimbangela eziguquguqukayo zivame ukuba nezimo zezokwelashwa ezinzima noma ezisanda kutholakala nezilaphayo ezifana ne- hyperthyroidism , i-pneumonia, i- pulmonary embolus (i- clot yegazi emaphashini), noma ukungena kotshwala noma izidakamizwa ezivuselelayo.
I-fibrillation ye-atrial ingabangelwa nezimo zenhliziyo ezifana nesifo se-coronary , isifo senhliziyo se-valvular, i- pericarditis , noma ukuhluleka kwenhliziyo . Uma unesinye salezi zimo zenhliziyo, ukuzama ukubuyisela nokugcina isigqi senhliziyo evamile kuyindlela enengqondo kakhulu, uma inkinga yakho yenhliziyo engaphansi iphathwa ngendlela efanele.
Ukulawula i-rhythm ngokuvamile kuyindlela ethandwayo kubantu abane-fibrillation ye-atrial yamuva kakhulu noma i-paroxysmal-okungukuthi, kwenzeka ngokuzumayo futhi nge-intermittently. Kukhona ubufakazi bokuthi isikhathi eside umuntu ehlala e-fibrillation ye-atrial, kunzima kakhulu ukugcina isigqi esivamile.
Kubantu abanesifo sofuba se-parodyys, futhi ngubani ovamise ngesigqi esivamile, indlela yokulawula isigqi ivame ukuba yimpumelelo kakhulu kunalabo abantu abanokuphefumula kwe-atrial okuqhubekayo noma okungapheliyo.
Okokugcina, ukulawula isigqi kuyindlela engcono kubantu abanesimo esithile senhliziyo lapho ukulahlekelwa kwemithwalo ye-atrial esebenza kahle (ehlala njalo ne-fibrillation ye-atrial) kungenza ukulimala okuphawulekayo emsebenzini wenhliziyo. Lezi zimo zivame ukufaka umfutho wegazi ophezulu , i- aortic stenosis , i- hypertrophic cardiomyopathy , ne- diastolic ukungasebenzi . Kuzo zonke izimo, i-ventricle yesokunxele ijwayele ukuba "nzima," ukuze ukugcwaliswa okuhle kwe-ventricle kwesokunxele kuxhomeke kakhulu ekuvaleni okunamandla kwe-atrial.
Uma kukhona noma yikuphi kwezimo zezokwelapha noma zenhliziyo ezikhona, ngokuvamile kuvumelana ukuba nesibindi ekusebenziseni indlela yokulawula isigqi-okungukuthi, ukubuyisela nokugcina isigqi senhliziyo evamile-uma isimo esibucayi siphethwe ngendlela efanele. Lapha, "ukufutheka" kungase kusho ukuzama izidakamizwa eziningana zokuhlukunyezwa ukuze ugcine isigqi esivamile. Kungase kusho ukucubungula ngokucophelela inqubo yokuqeda ukubhubhisa i-fibrillation ye-atrial. Ngalinye yalezi zinyathelo kuhlanganisa ingozi. Abanye abantu abangenayo yalezi zimo bazobe bengakhetha ukulawula isigqi. Lesi sinqumo esilungile, uma nje beqonda ngokugcwele izingozi.
Lapho Ukulawulwa Kwezinga Kuyindlela Efanele
Kubantu abanokuphefumula kwama-atrial okungapheli noma okuphikisanayo (okungukuthi, abaye babhekana ne-frill fibrification isikhathi esiningi okungenani amasonto ambalwa noma izinyanga), ikakhulukazi uma i-fibrillation yabo ye-atrial ingu-idiopathic (okungukuthi, ayikho into ebonakalayo futhi ephathekayo imbangela), kunezizathu ezimbili ezinhle ukuthi kungani izinga lokulawula ngokuvamile lindlela engcono.
Okokuqala, kulaba bantu, izinkinga zokubuyisela nokugcina ngempumelelo isigqi senhliziyo esijwayelekile isikhathi eside sincane. Okwesibili, ucwaningo lwezokwelapha lubonisa ukuthi umphumela wesikhathi eside kulaba bantu awusizo kangcono-futhi kungenzeka ngempela ube mbi kakhulu-nge-antiarrhythmic therapy yezokwelapha okuhloswe ngokulawula isigqi, kunokuba kube nendlela yokulawula izinga. Kulaba bantu, izingozi zokulawula isigqi ngokuvamile zidlula zonke izinzuzo ezikhona.
Odokotela abaningi bayokwenza umzamo owodwa wokubuyisela isigqi esivamile ngisho nakulezi ziguli. Lokhu kuvame ukuwenziwa ngokumane uvuselele iziguli emuva kwisigqi esivamile futhi ubone ukuthi benzani ngaphandle kokwelashwa kwezidakamizwa ezingavamile. Kodwa uma lo mzamo oyedwa ungaphumeleli (okungukuthi, uma kusetshenziselwa ukuguqulwa kwama-atrial fibrillation), odokotela abaningi bayashesha ukwamukela ukulawulwa kwesilinganiso njengendlela evikelekile futhi ephumelelayo yokwelapha.
Okubalulekile
Ngokusobala, uma une-fibrillation ye-atrial kunezinto eziningi okufanele uzicabangele ekukhetheni indlela efanele yokwelapha-ubukhulu bezimpawu zakho; izinkinga zakho zezokwelapha nezenhliziyo, uma kukhona; imvamisa kanye nobude beziqephu zakho ze-fibrillation ye-atrial; izintandokazi zakho; kanye nemibono odokotela bakho. Lesi isinqumo esidinga ukuba sibe ngabanye.
> Umthombo:
I-Fuster V, i-Ryden LE, i-Cannom DS, et al. I-ACC / AHA / ESC 2006 Imihlahlandlela yokuphathwa kweziguli ezine-fridaying ye-Atrial Umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice kanye ne-European Society of Cardiology Committee for Guiding Practice (Ikomiti Yokubhala Ukubuyekeza Iziqondiso Zika-2001 for the Management of Patients With Fibrillation Atrial). J Am Coll Cardiol . 2006; 48: e149.