Koj puas tau muaj lub siab xav tias koj lub plawv dhia qeeb qeeb lossis koj lub plawv yuav tsaus muag ? Tej zaum koj twb pom tias koj lub plawv dhia qeeb qeeb, ceev ceev, lossis tsis xwm yeem. Tej zaum koj yuav paub ib tus neeg uas tau muaj cov tsos mob no. Qee zaum, cov kev xav no yog los ntawm kev cuam tshuam me me hauv koj lub plawv lub zog hluav taws xob - zoo li lub xov hlau tsis zoo hauv tsev. Tshwj xeeb, peb tab tom tham txog ib qho mob hu ua Bifascicular Block , qhov twg cov teeb liab hluav taws xob raug qeeb lossis thaiv hauv ob ntawm peb txoj kev tseem ceeb ntawm koj lub plawv lub zog hluav taws xob.
Bifascicular Block yog dab tsi? Cia peb piav qhia yooj yim.
Hais yooj yim xwb, ib hom "Bifascicular Block" yog ib hom thaiv plawv tshwj xeeb. Yuav kom koj lub plawv nqus ntshav tau zoo, nws xav tau cov teeb liab hluav taws xob uas taug kev raws txoj kev tshwj xeeb hu ua "bundle branches" - xav txog cov no ua cov xov hluav taws xob tseem ceeb uas muab zog rau koj lub tsev.
Xav txog koj lub plawv muaj peb txoj kev loj rau cov teeb liab hluav taws xob no. Hauv '(Bifascicular Block)', ob ntawm peb txoj kev no raug thaiv ib nrab lossis tag nrho. "Bi" txhais tau tias "ob," thiab "fascicle" txhais tau tias cov leeg nqaij uas ua cov ceg no. Vim tias cov teeb liab mus rau cov chav qis ntawm koj lub plawv - '(ventricles)' - raug ncua lossis thaiv, koj lub plawv lub suab thiab kev ua haujlwm ntawm lub plawv tuaj yeem raug cuam tshuam.
Cov kws kho mob faib qhov no ua "lub plawv tsis tiav." Nws tuaj yeem tshwm sim los ntawm cov mob plawv txij thaum yug los lossis lwm yam kab mob plawv. Txawm hais tias qee tus neeg yuav tsis muaj tsos mob li, cov neeg uas muaj cov tsos mob tseem ceeb lossis cov kab mob plawv siab heev xav tau kev soj ntsuam thiab kev kho mob los ntawm pab pawg kws tshaj lij Nirogi Lanka.
Cov fascicles no nyob qhov twg hauv koj lub siab?
Raws li koj paub, koj lub plawv muaj plaub chav. Ob chav sab saud yog "(atria)," thiab ob chav sab hauv qab yog "(ventricles). Cov chav no yuav tsum sib koom tes ua ke kom cov ntshav ncig thoob plaws koj lub cev.
`(Bifascicular Block)` tshwj xeeb cuam tshuam rau kev xa hluav taws xob mus rau `(ventricles)`.
- Lub plawv sab xis: Nyob rau sab xis qis, lub chamber no twj cov ntshav uas tsis muaj oxygen mus rau lub ntsws. Nws muaj ib txoj kev hluav taws xob tseem ceeb: ceg ntawm lub plawv sab xis .
- Sab laug ventricle : Qhov no yog lub chamber uas muaj zog tshaj plaws. Nws xa cov ntshav uas muaj oxygen ntau dhau los ntawm aorta mus rau tag nrho lub cev. Nws lub cev hluav taws xob muaj ob lub fascicles tseem ceeb: sab laug pem hauv ntej fascicle thiab sab laug posterior fascicle . Ua ke, lawv tsim cov ceg sab laug bundle , uas faib ua ntau lab lub me me '(Purkinje fibers)'.
Cov Blocks Plawv thiab Cov Blocks Bundle yog dab tsi?
Qhov "(Lub Plawv Thaiv)" tshwm sim thaum muaj kev cuam tshuam hauv lub plawv "(lub cev ua haujlwm)". Qhov no ua rau qeeb hauv kev xa cov cim, ua rau lub plawv dhia tsis xwm yeem. Nws cuam tshuam ncaj qha rau koj lub plawv dhia, lub plawv dhia ceev , thiab seb cov ntshav raug tso tawm zoo li cas.
Txawm hais tias `(Heart Block)` thiab `(Atrioventricular Block / AV Block)` feem ntau siv sib pauv tau, `(Bundle Branch Block)` yog ib hom subtype tshwj xeeb uas qhov kev thaiv tshwm sim hauv cov bundles uas tau teev tseg.
Koj lub plawv lub zog ua haujlwm li cas? Nws yeej txaus nyiam kawg li!
Koj lub siab vam khom rau lub kaw lus hluav taws xob sab hauv uas ua haujlwm tau zoo heev:
1. Lub teeb liab pib ntawm '(SA node)' hauv lub plawv sab xis, uas hu ua lub plawv lub '(pacemaker)'.
2. Lub teeb liab hla lub '(atria)' mus rau '(AV node)'.
3. Los ntawm `(AV node)`, nws nkag mus rau `(Bundle of His)`.
4. Txoj kev ces faib ua ob ceg sab xis thiab sab laug, thaum kawg mus txog '(Purkinje fibers)' hauv '(ventricles)'.
5. Thaum tau txais cov cim no, lub '(ventricles)' yuav qaug zog, thiab nws yuav tso cov ntshav ua ntej lub voj voog rov ua dua tam sim ntawd.
Tag nrho cov txheej txheem no tshwm sim hauv ib feem ntawm ib pliag, rhythmically thiab txuas ntxiv mus.
Puas muaj ntau hom Heart Blocks sib txawv?
Yog, cov kws kho mob faib ua pawg '(AV blocks)' raws li lawv qhov hnyav:
- Kev thaiv theem ib: Lub teeb liab hluav taws xob raug ncua thaum nws txav mus los ntawm lub atria mus rau lub ventricles. Feem ntau, tsis muaj tsos mob, thiab tsis tshua xav tau kev kho mob.
- Kev thaiv theem ob: Qee cov teeb liab hluav taws xob mus txog rau hauv cov hlab ntsha hauv lub plawv. Qhov no tuaj yeem ua rau lub plawv dhia qeeb ( bradycardia ) lossis lub plawv dhia tsis xwm yeem (arrhythmia). Yog tias cov tsos mob ua rau koj mob siab, yuav tsum tau mus ntsib kws kho mob.
- Kev thaiv theem peb: Kuj hu ua "kev thaiv lub plawv tag nrho." Cov chav sab saud thiab sab hauv qab tsis sib txuas lus kiag li, txhua lub plawv dhia ntawm lawv tus kheej lub sijhawm. Qhov no yog xwm txheej ceev kho mob uas xav tau '(lub tshuab ua pacemaker)'. Ib qho '(Kev thaiv ob sab)' qee zaum tuaj yeem nce mus rau qhov xwm txheej no.
Puas muaj ntau hom Bifascicular Blocks sib txawv?
Yog, muaj ob peb yam qauv uas feem ntau siv:
- Ib lub pob txha ceg sab xis ua ke nrog lub pob txha fascicular sab laug.
- Ib lub bundle branch block sab xis ua ke nrog ib lub left posterior fascicular block.
- Qee zaum, ceg ntawm sab laug ntawm lub paj hlwb raug thaiv tag nrho (txhais tau tias ob qho tib si pem hauv ntej thiab tom qab ntawm lub paj hlwb raug cuam tshuam, thaum ceg ntawm sab xis ntawm lub paj hlwb tseem ua haujlwm tau).
Tus mob no feem ntau tshwm sim li cas?
Cov kev tshawb fawb qhia tau tias kwv yees li ntawm 1.5% ntawm cov neeg uas tau kuaj '( ECG )' pom tias muaj '(Bifascicular Block)'. Yog tias koj mob hauv siab, tsaus muag, lossis kiv taub hau hnyav, thov hu rau cov kev pabcuam thaum muaj xwm txheej ceev lossis mus rau chav kho mob ceev ze tshaj plaws tam sim ntawd.
Dab Tsi Ua Rau Muaj Bifascicular Block? Nkag Siab Txog Cov Yam Uas Ua Rau Muaj
Feem ntau, qhov kev thaiv bifascicular yog txuas nrog kab mob plawv txij thaum yug los, txhais tau tias koj yug los nrog qhov sib txawv ntawm cov qauv hauv koj lub plawv. Txawm hais tias cov mob no muaj txij li thaum yug los, lawv yuav tsis qhia cov tsos mob kom txog thaum koj loj hlob lossis hnub nyoog nruab nrab. Thaum koj laus zuj zus , qhov kev pheej hmoo ntawm kev tsim cov kev ncua sij hawm ntawm lub plawv kuj nce ntxiv.
Muaj tej yam tsawg tsawg uas tus mob no yuav yog los ntawm noob caj noob ces los ntawm kev hloov pauv ntawm cov noob caj noob ces, feem ntau hu ua kev hloov pauv ntawm tsev neeg lub plawv. Qhov kev hloov pauv ntawm noob caj noob ces no tuaj yeem ua rau cov nqaij caws pliav loj hlob.(fibrosis) lossis calcium deposits (calcification) nyob rau hauv lub plawv txoj kev hluav taws xob, ua rau muaj kev thaiv.
Tsis tas li ntawd xwb, kev puas tsuaj rau lub plawv tuaj yeem ua rau muaj kev thaiv bifascicular. Cov neeg pab txhawb feem ntau suav nrog:
- Muaj mob plawv nres yav dhau los (myocardial infarction).
- Lwm yam kab mob plawv hauv qab.
- Kab mob plawv .
- Cov potassium ntau hauv koj cov ntshav (hyperkalemia).
Cov tsos mob ntawm Bifascicular Block: Koj puas muaj cov cim no?
Cov mob plawv tsis tiav (thawj lossis theem ob) feem ntau yuav tsis muaj tsos mob li. Thaum muaj cov tsos mob tshwm sim, cov cim qhia feem ntau yog tsaus muag yam tsis paub meej (syncope). Qhov no tshwm sim thaum lub plawv dhia qeeb dhau (bradycardia) lossis tsis xwm yeem (arrhythmia), ua rau cov ntshav tsis txaus mus txog koj lub hlwb.
Qee zaum, qhov kev thaiv bifascicular tuaj yeem nce mus rau qhov thaiv tag nrho (theem peb). Yog tias koj muaj ib qho ntawm cov tsos mob hauv qab no, nrhiav kev kho mob tam sim ntawd yog qhov tseem ceeb :
- Mob hauv siab los yog mob siab (angina).
- Hnov mob taub hau lossis kiv taub hau.
- Qaug zog tas li, tsis paub piav qhia.
- Cov kev xav ntawm lub plawv dhia tsis xwm yeem lossis dhia ceev (palpitations).
- Xeev siab.
- Ua pa nyuaj (ua pa luv).
Yuav muaj teeb meem dab tsi tshwm sim?
Kev thaiv lub plawv tuaj yeem ua rau koj lub plawv tsis tuaj yeem nqus ntshav tau zoo. Yog tias kev thaiv ob sab ntawm lub plawv nce mus txog qib peb tag nrho, nws tuaj yeem ua rau muaj teeb meem loj heev, uas ua rau tuag taus, suav nrog:
- Arrhythmia (lub plawv dhia tsis sib xws).
- Mob plawv.
- Lub plawv tsis ua haujlwm.
- Lub plawv nres tam sim ntawd.
Tsis txhob ntshai! Cov teeb meem no tsis tshwm sim rau txhua tus. Nrog kev tswj hwm kev kho mob thiab kev kho mob kom zoo los ntawm cov kws tshwj xeeb Nirogi Lanka, koj cov kev pheej hmoo tuaj yeem txo qis ntau.
Yuav kuaj mob Bifascicular Block li cas?
Cov cuab yeej kuaj mob tseem ceeb yog Electrocardiogram (ECG/EKG) . Qhov kev kuaj mob yooj yim, tsis mob, 15 feeb no sau koj lub plawv txoj kev ua haujlwm hluav taws xob.
Koj tus kws kho mob yuav muab cov khoom siv me me (electrodes) lo rau ntawm koj lub hauv siab, caj npab, thiab ceg. Cov no txuas nrog lub tshuab ECG, uas kos duab koj lub plawv lub zog hluav taws xob. Thov nco ntsoov tias tsis muaj hluav taws xob xa mus rau hauv koj lub cev; lub cuab yeej tsuas yog sau cov teeb liab hluav taws xob uas koj lub plawv tsim tawm. Daim duab no tso cai rau koj tus kws kho mob kom paub meej tias qhov twg cov teeb liab hluav taws xob raug thaiv lossis ncua.
Muaj Kev Kho Mob Dab Tsi?
Yog tias koj muaj lub plawv thaiv ob sab tab sis tsis muaj tsos mob, tej zaum yuav tsis tas yuav kho mob. Txawm li cas los xij, koj tus kws kho mob yuav saib xyuas koj lub plawv kom zoo, tej zaum yuav los ntawm kev kuaj ECG ntau zaus kom paub seb puas muaj kev nce qib mus rau qhov thaiv plawv tag nrho.
Yog tias koj muaj cov tsos mob xws li tsaus muag lossis mob plawv dhia tsis tu ncua, koj tus kws kho mob yuav pom zoo kom ua ib txoj kev kho mob los tswj koj lub plawv dhia siv ib qho ntawm cov hauv qab no:
- Cov tshuab pacemakers: Cov khoom siv me me no xa cov teeb liab hluav taws xob mus rau koj lub plawv kom pab tswj lub plawv dhia kom ruaj khov thiab noj qab nyob zoo.
- Cov Tshuab Hluav Taws Xob Rau Lub Plawv (ICDs): Cov no ua haujlwm zoo li cov tshuab pacemakers tab sis kuj saib xyuas seb puas muaj cov teeb meem arrhythmias uas yuav ua rau tuag taus. Yog tias kuaj pom, ICD yuav xa hluav taws xob me me los kho kom rov qab ua haujlwm ntawm lub plawv dhia li qub, ua lub luag haujlwm tseem ceeb los tiv thaiv kev nres plawv tam sim ntawd.
Cov khoom siv no yog muab tso rau hauv los ntawm tus kws kho mob plawv electrophysiologist.
Koj puas tuaj yeem tiv thaiv Bifascicular Block?
Muaj ntau yam ua rau lub plawv tsis ua haujlwm, xws li teeb meem txij thaum yug los lossis cov txheej txheem laus zuj zus, peb tsis tuaj yeem tiv thaiv tau. Txawm li cas los xij, koj tuaj yeem ua cov kauj ruam ua ntej kom tswj tau kev noj qab haus huv ntawm lub plawv thiab txo koj cov kev pheej hmoo. Cov no suav nrog:
- Yog koj haus luam yeeb, thov hu rau kev pab kom koj tso tseg. Nws tseem ceeb heev rau kev tiv thaiv koj tus kheej ntawm cov pa luam yeeb uas koj haus.
- Ua tib zoo saib xyuas kev noj zaub mov kom zoo rau lub plawv thiab ua kom koj lub cev tawm dag zog txhua hnub.
- Txwv koj cov dej cawv.
- Tswj tau zoo heev rau cov mob uas yuav ua rau koj lub plawv mob, xws li ntshav siab, ntshav qab zib, thiab roj cholesterol ntau.
- Nrhiav txoj hauv kev noj qab haus huv thiab ruaj khov los tswj koj qhov kev ntxhov siab.
- Lub hom phiaj yog kom koj lub cev muaj qhov hnyav zoo.
Txawm hais tias cov kauj ruam no yuav tsis tiv thaiv tau tag nrho Bifascicular Block, lawv tseem ceeb heev rau kev tswj hwm kev noj qab haus huv ntawm lub plawv.
Koj puas nyob tau nrog qhov mob no? Qhov kev cia siab yog li cas?
Muaj coob tus neeg uas muaj Bifascicular Block tsis tas yuav kho mob. Txawm tias thaum twg yuav tsum tau kho mob los xij, cov tsos mob feem ntau yuav zoo tom qab muab lub tshuab pacemaker ntsaws rau hauv.
Yog tias koj tau txais kev kho mob zoo, qhov uas tus mob no yuav ua rau lub plawv nres tag nrho yog qhov tsawg heev. Qhov tseeb, lub plawv dhia tsis xwm yeem uas tsis tau kho (arrhythmia) muaj kev pheej hmoo ntau dua li lub plawv nres nws tus kheej. Yog li ntawd, nrhiav kev pab kho mob raws sijhawm thiab ua raws li kev kho mob uas tau sau tseg yog qhov tseem ceeb tshaj plaws uas koj ua tau.
Thaum twg koj yuav tsum mus ntsib kws kho mob?
Yog koj muaj ib qho ntawm cov tsos mob hauv qab no, thov nrhiav kev kho mob tam sim ntawd lossis hu rau cov kev pabcuam thaum muaj xwm txheej ceev (911):
- Qaug zog dhau.
- Lub plawv dhia tsis xwm yeem lossis lub plawv dhia tsis xwm yeem.
- Mob hauv siab hnyav heev.
- Ua tsis taus pa.
- Cov tsos mob ntawm kev mob plawv nres (piv txwv li, muaj kev nyuaj siab heev hauv nruab nrab ntawm lub hauv siab mus rau sab caj npab).
- Xeev siab uas tsis paub meej.
Cov lus nug tseem ceeb uas yuav tsum nug koj tus kws kho mob
Thaum koj mus ntsib koj tus kws kho mob, tej zaum koj yuav xav nug cov lus nug no:
- Vim li cas kuv thiaj tsim lub Bifascicular Block no?
- Kuv yuav tsum ua li cas thiaj li txo tau qhov kev pheej hmoo ntawm kev mob plawv lossis lwm yam mob plawv?
- Kuv puas xav tau lub pacemaker lossis ICD?
- Cov kev pheej hmoo cuam tshuam nrog kev tau txais lub pacemaker lossis ICD yog dab tsi?
- Puas muaj tej yam teeb meem tshwj xeeb uas kuv yuav tsum tau ceev faj? Cov cim qhia ntawd yog dab tsi?
Kev nug cov lus nug no yuav pab koj nkag siab zoo dua txog koj tus mob thiab xyuas kom meej tias koj paub meej txog koj cov kauj ruam tom ntej.
Cov lus kawg: Yam koj yuav tsum nco ntsoov
Ib qho Bifascicular Block txhais tau tias yog kev cuam tshuam hauv ob ntawm peb txoj kev tseem ceeb uas coj cov teeb liab hluav taws xob hla lub plawv. Qhov no tuaj yeem hloov koj lub plawv dhia thiab qhov kev sib law liag ntawm kev nqus ntshav. Txawm hais tias qee tus neeg yuav tsis muaj tsos mob, lwm tus yuav muaj cov tsos mob xws li tsaus muag.
Qhov tseem ceeb tshaj plaws yog kom nyob twj ywm thiab ua raws li cov lus qhia ntawm kws kho mob. Tus mob no tuaj yeem txheeb xyuas tau yooj yim los ntawm kev kuaj yooj yim xws li ECG. Thaum tsim nyog, nws tuaj yeem tswj tau zoo los ntawm kev kho mob zoo li lub tshuab pacemaker. Saib xyuas koj lub plawv, ua lub neej noj qab haus huv, thiab koj tuaj yeem nyob zoo. Nrog Nirogi Lanka, koj nyob hauv tes zoo.
