Ntukabe bihagije kumutima. Memo kubagore batwite kuva mubutunzi

Abantu bose babyaye cyangwa bakemuye abagore batwite bazi icyo ari mugihe cyo gutera ubwoba nuburyo abaganga basuzugura bashobora guhinga umugore utwite mu bwoba. Umuganga wa Carchalogue, Olga Morchan, yadusangiye inyandiko yingirakamaro cyane kubyerekeye mugihe umugore utwite adakeneye guhangayika no kumva abamutera ubwoba.

Icyakora, Aburamu Lvovich Syrkin yari afite ukuri. Ndibuka mu 1993 ku ruziga rw'abanyeshuri yarabajije ati: "Uratekereza ko bigoye kwa muganga?" Kuhagera abumva kureba neza kandi birashoboka ko byari biteganijwe, udategereje kopi iyo ari yo yose, nyuma yo kuruhuka cyane, arasubiza ati: "Biragoye kuri muganga." By'uko bimeze ryari, nta gutabara kwa muganga, birashoboka kandi, byongeye, birakenewe gukora.

Uyu munsi nambujije guhamagara kuri terefone. Bita abo bamenyereye amarira arira no kwiheba. Yahawe guhagarika inda zimaze igihe kinini mugihe cyibyumweru 16 kubera inyongera yavumbuwe. Muganga yamubwiye ko atazatwite, ariko "nubwo Cyereyan atazumva niba izakurwa ku meza."

Ntibicyangoshya kandi ntabwo birakara. Inkuru iramenyerewe. Ntabwo bizaba igikaro cyo kuvuga ko buri cyumweru, abagore baza aho ndi, babujijwe gutwita cyangwa gutanga kubyara inda kubera ko bikabije. Mvugishije ukuri, ndetse no kubyaye ibyerekeye kwandika (mumbabarire, abo mukorana): mu buyobozi ubwo ari bwo bwose bwo gutanga patologiya, kandi mubuyobozi ubwo aribwo bwose, handitswe gusa ko ari inzitizi ya Arthmology handitswe ko ibinyomoro bitarangwamo indwara zidasanzwe. Aha ni ahantu rusange. Ariko ukuri gushika. Abaganga ni kenshi kandi byoroshye gutabara inda mugihe ibinyobwa bigaragaye nta mpamvu.

Imyitwarire yabaganga kugirango ihagarike gutwita ni ingingo itandukanye kandi idasobanutse. Mugihe nahisemo kwandika ingingo izwi, atwite na Stressystole. Birashoboka ko utwite azasoma.

Injyana ya injyana iboneka mu gutwita kenshi. Ibi biterwa nuko mugihe cyo gutwita, bitewe na hormonal impinduka nimpinduka za hemodynamike, hariho ibisabwa kugirango habeho ibibazo byinjyana iriho. Nubwo ihohoterwa rishingiye ku nkunga ribi ridasanzwe, ukuri kwabo akenshi bitera ubwoba abarwayi n'abaganga.

Imbere yanjye umusore mwiza. Isura yerekana isura, mumaso y'amarira. "Muganga, nyamuneka unkize umwana wanjye." Ubwa mbere ubwo natangiraga gukorana n'abagore batwite, tumaze kumva nk'ibi, ndanyeganyega, kandi numva ari umucyo mu murima Plexus.

"Nabwiwe ko ari ngombwa kubangamira gutwita, ariko sinshaka."

Kuri ubu, narimo ninteguwe kugirango numve isuzuma rikomeye n'imizingo mu mutwe w'abantu bashyigikiye umugore, kuko, birumvikana ko hari ubuhamya bwo mu buvuzi kugira ngo bahangane. Burigihe biragoye kandi birababaje cyane.

- Byakugendekeye bite?

Intoki zoroheje zijugunywa mububiko, unyuze mu nyandiko. Hanyuma, mfata ibyavuye mubushakashatsi. Birumvikana ko twese twakuyeho, nibiba ngombwa, ariko abo bagenzi bandika iki? Kureba: "Echocardiografiya aringaniye. Ecg - nta gutandukana mubisanzwe. Ibisubizo byo Gukurikirana buri munsi Horter: 2652 Excrasisestol, harimo imigati 12 kandi (yazengurutse umutuku) kwiruka, buri kimwe muri 3 kiva kumutima igipimo cyumutima 182 WT. muri min. "

Urebye umugore. Ibintu byose ni byiza. - hari icyo ari cyo kiguhangayikishije? - Ntabwo. Nta na kimwe. Umuvuzi w'uyumva yumvise ko impiswi itanganiye, yoherejwe mu bushakashatsi. Kandi niho! - Nibyo byose?

Nateguritse ubutabazi. Ibimenyetso kugirango ihagarike yo gutwita na Cardiologiya ntabwo. Uzigame, birashoboka cyane, ntawe uzagomba. Hooray! Umugore iminota 10 ararira, akamenyero kumakuru mashya, ubu kuva umunezero. Nibyo, agomba kubahirizwa kuri cardiologue mugihe cyo gutwita, ariko ntakintu giteye ubwoba.

Mu myaka ibiri ishize, mu bagore batwite basabye ihohoterwa rishingiye ku nterahamwe kugira ngo bagirwa inama mu ishami ryacu, ubuhamya bwo guhagarika gutwita bwari muri 2 gusa. Imanza zombi zahujwe n'umuvuduko ukabije urwanya inyuma ya DMPP idakoreshwa (indwara y'umutima).

Imanza zisigaye ziteye ubwoba abaganga badakeneye guhagarika gutwita gusa, ariko akenshi ntizisaba kwivuzaga na gato, nubwo hari impamvu zo kwitegereza abategarugori. Nubwo yatangajwe kenshi ingingo na kenshi inyandiko z'ubuvuzi bwo kuvura injyana y'injyana, bivuze ko arrhthias iteye akaga adakunze gutwita, cyangwa ngo asabe gutwita intego zose, cyangwa ngo asuzume inda kubera ihohoterwa rishingiye ku ntera Mu manza iyo nta bitekerezo byo gutwita.

Indwara y'injyana ibaho mugihe cyo gutwita kenshi. Nk'uko abashakashatsi batandukanye baturutse kuri 7 kugeza kuri 52% batwite batera Arrhhthias runaka. Mu byifuzo by'ishyirahamwe ry'ubutaka bw'ibihugu by'abahanga mu bihugu, havuga ko 20-44% by'abagore batwite bamenya injyana zitandukanye na mu bikorwa byo gukora. Nubwo atwite, kurenga ku njyana birashobora kubaho, akenshi ntabwo ari ubuzima, ntibikenera guhagarika gutwita kandi akenshi ntibikenera no kuvurwa muburyo bwihariye. Nubwo bimeze bityo ariko, byanze bikunze, hari ibihe bikenewe.

Twahisemo gutangaza algorithm ishobora ibikorwa kandi twifuje kubagore batwite basuzugura amakosa yumutima injyana yumutima.

Impamvu yo kwiyambaza umuganga w'umutuzi kandi ikizamini kirashobora kuba:

- Arrhythmia asuzumwa kuri ECG yateguye igihe cyo gutwita; - Muganga uhangayikishijwe n'ikintu kiri muri ibi bikurikira: - Ibitero bikabije umutima byihuse; - kumva ko imvururu zikabije; - ibyiyumvo byo guhagarika umutima mu mirimo ; - Kunanirwa k'umutima; - Guhumeka neza; - Ibihugu byabanjirije cyangwa ibihugu biterana; - kubyimba; - wongera umuvuduko wamaraso; - wasabwe umuvuduko wamaraso mbere yo gutwita.

Niba umuganga yahishuriye imvururu, ntutinye. Wibuke ko mugihe cyo gutwita, guhungabana injyana birasanzwe. Nabo, nk'ubutegetsi, ntabwo ari impamvu yo guhagarika inda, mu bihe byinshi ntibigira ingaruka ku mutituzi, ubushakashatsi na rimwe na rimwe, mu manza.

Nkibizamini byinyongera, murimuganga birashoboka cyane ko azagusaba:

- Echocardiography yo gukurikirana ECG ya Gusetsa Amaraso Isesengura ryamaraso, Rusange, ni ikizamini cyamaraso (byanze bikunze kwigira kuri elecmolytes) - ikizamini cyamaraso kuri glande ya tiroyide, nibiba ngombwa, ikizamini cyamaraso kuri Myocardium

Witondere gutsinda ubushakashatsi kugirango umenye impamvu za Arrhthmia. Ibi bizemerera umuganga guhitamo niba ukeneye kuvura kuri iki cyiciro cyangwa birashobora kugarukira gusa.

Mugihe cyo kuvura ari ngombwa, ntugahangayike. Mugihe uhisemo kuvura ibiyobyabwenge, umuganga azabanza ayoborwa numutekano kubwurunduro no kuri wewe. Ubuvuzi bwerekanwa niba:

- yerekanye akamenyetso ka Arrhythmia birashobora guhungabanya ubuzima bwawe n'ubuzima bwawe cyangwa ingaruka ku iterambere ry'umwana; - Kurenga ku iterambere ry'umwana; - Kurenga ku ntera biherekejwe n'umuvuduko wamaraso (harimo no kugwa mu bihaha); - Arrhythia yimuwe nabi Nawe, uherekejwe no gutangara, guhangayika, guhangayika.

Nubwo muganga yakemeza ko kwivuza ari ngombwa, kandi imiti yagenwe ntabwo ikora bihagije cyangwa idakora, ntukihebe. Ibi bibaho cyane. Ariko muriki gihe nta kimenyetso cyuzuye cyo guhagarika gutwita. Gutabara abaganga bakorana bahagaze birashobora gufasha gukuraho ihohoterwa ryinjyana mubihe nkibi. Hifashishijwe ibikoresho byihariye, munsi ya x-ray, uzana electrode unyuze mu bikoresho mu mwobo w'umutima, mu bihe byinshi umuganga ashobora gukuraho urumuri rwa Argen - icyateye Arktthmia. Nibyiza gukora inzira nkiyi mugihe cyibyumweru 26-28, kubera ko ikibonaga kuri iki gihe cyerekanwe hafi.

Hano haribintu injyana yinjyana bisaba gutabara ubuvuzi bwihutirwa. Niba wumva ko urwanya inyuma yihohoterwa ryinjyana, wavuze intege nke, uhindagurika, umuvuduko wamaraso uragabanuka cyane, leta ibanziriza ikirungo ibaho, ni ngombwa guhita bitera ambulance.

Niba warasuzumye injyana ya injyana kandi urateganya gutwita gusa, nibyiza gusaza umuganga wumutima kandi usuzume ingaruka zo kwiyongera kwibibazo byinjyana mugihe utwite mugihe utwite mugihe utwite mugihe utwite mugihe utwite mugihe utwite mugihe utwite mugihe utwite mugihe utwite mugihe utwite mugihe utwite mugihe utwite mugihe utwite mugihe utwite mugihe utwite mugihe utwite mugihe utwite mugihe utwite mugihe utwite mugihe utwite mugihe utwite. Birashoboka ko ufite ikibazo cyinjyana ntikeneye kuvura kandi ingaruka zizaba nke. Noneho biratangaje. Gutwi no kwishimira. Ariko igihe Arrkthmia imaze kuvurwa cyane, kandi irashobora kuvaho, bizarushaho gukuraho ibimenyetso bidakenewe "ku nkombe." Muburyo bumwe bwa Arrhythmias, birashoboka gukuraho umutima wa Arrhytthmogenic hamwe nubufasha bwo kubagwa bahagaze. Hanyuma ukaroba utwite, ntuzongera kugenda ngo ugende muri parike, umva umuziki, cyangwa ngo uhure n'inshuti, muri rusange, kora ibyo ukunda, aho gukurura ku mutizi.

Hanyuma, niba ihohoterwa ryinjyana ryasuzumwe, hari ibyifuzo byinshi bishobora kunoza imiterere yawe mbere yuko ukubita umutima. Urashobora: - Kuraho ikawa kuva indyo, icyayi gikomeye nibindi binyobwa bishimishije - kutanywa inzoga- Gusinzira nibura amasaha 8- Gusinzira byibuze kumasaha 8 - Gerageza kuri distan mubihe bishobora gutera psycho-amarangamutima. Nubwo akenshi bigoye kuruta kureka shokora, gerageza kwirinda ibintu byose bishobora kukubuza wenyine. Gutwita - Ntamwanya wo kwiga kwerekana amarangamutima. Ni ukuvuga, niba ubishoboye, byiza. Ariko, niba atari byo, gusa ukari kure yibihe birababaje.

Rimwe na rimwe, izi mpinduka zoroshye mubuzima irashobora kunoza cyane. Kandi ibi birahagije, cyangwa bikeneye ikizamini cyinyongera no kuvurwa, uzafasha kumva umuganga wujuje ibyangombwa.

Ibyo ari byo byose, niba uhabwe gutwita kubera pathologiya ya Cardiac, mbere yo gufata icyemezo, shaka igitekerezo cya kabiri mu nzobere.