Ukutadisha kwetafula lokuthambekela kusetshenziselwa ukuhlola iziguli eziye zaba ne- syncope (ukulahlekelwa kwengqondo) okusolakala ukuthi ibangelwa iziqephu ze-vasovagal . Kuyinto elula kakhulu ukutadisha, kanti ezimweni eziningi kuphephile kakhulu.
Ukuhlolwa Kwenziwe Kanjani
Esikhathini sokutadisha kwetafula elithambile, isiguli sigxiliwe etafuleni, okuyinto isetshenziselwa ukubeka endaweni efanele.
Ngenkathi kuqapha ukushaywa kwegazi, umfutho wegazi, i- electrocardiogram , ne- oxygen saturation , isiguli sishiye "esimweni sokuma esingenalutho" imizuzu engu-10 kuya kwangu-60.
Kumuntu onokuvumelanisa kwe-vasovagal syncope, isifundo setafula elithambile sizovame ukuzala isiqephu se-syncopal. Uma lokhu kwenzeka, ucwaningo lubhekwa njengoluhle, futhi ukuxilongwa kwe-vasovagal syncope kuqinisekisiwe.
Indlela Ukuhlolwa Okusebenza ngayo
Ngesikhathi sokuzulazula ngokuqondile - noma ngenxa yalolu daba ngenkathi umile - uhlelo lomuntu lwe-cardiovascular system kufanele luzilungiselele ngokwabo ukuze kuvimbele ingxenye ebalulekile yevolumu yegazi kusukela ekuxhumaniseni emilenzeni.
Lezi zinguquko zihlanganisa ukunyuka okuncane kwenani lenhliziyo kanye ne-constriction yemithwalo yegazi emilenzeni. Uma umuntu ovamile ehlelwe ngokuzenzekelayo, lezi zinguquko ze-cardiovascular zivele ngokushesha, futhi akukho ukuphazamiseka okuphawulekayo ekucindezelekeni kwegazi.
Kodwa-ke, kuziguli ezinezinhlobo ezimbili ze-syncope - hythodetic orthostatic kanye ne-syncope ye-vasovagal - ukuguqulwa kwe-cardiovascular to the inclination ngokuqondile akusebenzi ngendlela evamile.
Nge- hypotension ye-orthostatic , ikhono lomzimba lokuzivumelanisa nokuma okuqondile akujwayelekile. Lapho laba bantu bemi (noma uma benesifundo setafula esifuduzayo), ukushayeka kwabo kwanda ngokuphawulekayo, futhi ukucindezeleka kwegazi kwehla ngokushesha. Lezi ziguli azikwazi ukulungisa isimo esiqondile.
Kodwa-ke, iziguli ezine-hypotension ze- orthostatic azidingeki ukuba zihlolwe isitayela sezintambo ukuze zihlolwe, ngoba odokotela bangenza kalula ukuxilongwa ehhovisi labo nje ngokuthatha umfutho wegazi kuqala lapho isiguli silele bese kuthi lapho simile.
Ukutadisha kwetafula lokuthambekela kubuye kuvamile kubantu abane- syncope ye-vasovagal kodwa ngendlela efihlekile. Ngokuvamile, lezi ziguli ziqale zijwayele ukujwayela ngokuzenzekelayo, kodwa zingakapheli imizuzu engu-20-30 zingashintsha ngokungazelelwe futhi ziphawuleke ngezibonakaliso ezibalulekile - ukucindezeleka kwegazi kwehla ngokuphawulekayo; i-pulse yabo nayo iwa, futhi idlula. Babuyela emuva ngemva kwemizuzwana emva kokuba ithebula libuyiselwe phansi, futhi babuyiselwa endaweni yokulala phansi.
I-syncope ye-Vasovagal ingenxa yokucubungula okubangela ukukhuphuka ngokuzumayo kwemithambo yegazi emilenzeni, nokunciphisa izinga lokushaya kwenhliziyo, kokubili okufaka isandla ekwehleni okukhulu kwegazi. Izenzakalo eziningana ezibangela ukuqala kungase kuqale lokhu okubizwa ngokuthi "i-vasomotor" reflex, kufaka phakathi izinto ezinjengokwesaba, ubuhlungu, nesenzo esibi (njengokubona kwegazi). Ukuhlolwa kwetafula lokuthambekela kuveza ukucindezeleka esimweni senhliziyo esisebenza njengesisusa. Ukutadisha kwetafula lokuthambekela, ke, uhlola ukuthi ngabe umuntu unesisindo se-vasomotor engasetshenzisiwe, nesiphakamiso sokuthuthukisa i-syncope ye-vasovagal.
Ukusetshenziswa Okufanele kweTest Table Test
Ngenkathi isifundo setafula esihlotshaniswayo singasetshenziselwa ukuxilonga i-hypotension ye-orthostatic, lokhu kuhlolwa akumelwe neze kudingeke iziguli ezinezimo, ezitholakala kalula kunoma iyiphi ihhovisi likadokotela. Ukusebenza okuyinhloko kokutadisha kwetafula lokuthambekela kuqinisekisa ukuthi ukuxilongwa kwe-syncope okusolakala ukuthi i-vasovagal. Ukuqaphela isiqephu esivamile se-vasovagal ngenkathi ukugoqa ngokuqondile kungaqinisa ukuxilongwa okwakungakaqiniseki ngaphambili, futhi ngenxa yalesi sizathu, ukutadisha kwetafula okuthambile kungase kube usizo ngezikhathi ezithile.
Ukuhlolwa kwetafula lokuthambekela kungasiza futhi ekuvimbeleni ukuhlukumezeka kokuhlukumeza okungukuthi, ekuhlukaniseni ukuhlushwa kusuka ku-vasovagal syncope ehambisana nokunyakaza okunamandla.
Noma kunjalo, ukuhlolwa kufanele kusetshenziswe ngokuhlakanipha. I-syncope ye-Vasovagal ingatholakala kalula ezimweni eziningi ngokuthatha umlando wezokwelapha nokwenza ukuhlolwa ngokomzimba.
Ngaphezu kwalokho, ngisho nakubantu abane-syncope ebonakalayo ye-vasovagal, isifundo setafula esihlotshaniswayo siveza izimpawu zabo kuphela ngo-70-75% wesikhathi. Ngamanye amazwi, ama-25-30% alawa gciwane anesifundo "samanga amanga". Ngakho-ke, ukutadisha okuthambekeleyo akufanele kuthathwe ngokuthi "izinga legolide" ekuxilongweni kwe-syncope ye-vasovagal. "Inqubo yegolide" isengumlando wezokwelapha oqaphele futhi ophelele wezokwelapha.
Ukuhlolwa kwetafula lokuthambekela kusetshenziswe kangcono kuziguli ezinemlando yazo eziphakamisa iziqephu ze-vasovagal, kodwa lapho kukhona ukungabaza khona. Kulezi ziguli, ukutadisha okunomqondo omuhle kungahamba phambili ekugodleni ukuxilongwa kwe- syncope ye- vasovagal .
Imithombo:
Umsebenzi wokuHlola nokuPhathwa kweSyncope, i-European Society of Cardiology (ESC), i-European Heart Rhythm Association (EHRA), et al. Iziqondiso zokuxilongwa nokuphathwa kwe-syncope (inguqulo ka-2009). I-Eur Heart J 2009; 30: 2631.
U-Leonelli FM, Wang K, u-Evans JM, et al. Ukuthambekela kwekhanda elihle okungamanga: iphrofayela ye-hemodynamic neurohumoral. J Am Coll Cardiol 2000; 35: 188.