Koj lub plawv dhia puas zoo li qeeb me ntsis? Tej zaum nws yog vim Junctional Escape Rhythm (Junctional Escape Rhythm)!

Puas muaj tej lub sij hawm koj xav tias koj lub plawv dhia qeeb me ntsis, lossis ua ib yam txawv txawv? Xav txog seb, koj ua koj tej hauj lwm niaj hnub thiab koj mam li xav tias nkees heev , koj ua tsis taus pa thaum koj nce ntaiv, thiab koj xav tias koj yuav ntog nrog koj lub taub hau tig. Tej yam zoo li no tsis yog tshwm sim xwb, puas yog? Nws yuav yog ib qho kev hloov me me hauv koj lub plawv lub cev. Hnub no peb yuav tham txog ib qho mob zoo li no, hu ua Junctional Escape Rhythm . Tsis txhob txhawj, peb yuav tham txog qhov no yooj yim xwb.

Lub suab paj nruag Junctional Escape no yog dab tsi tiag?

Hais yooj yim xwb, lub npe no yog muab rau qhov tseeb tias koj lub plawv pib dhia qis dua qhov nws yuav tsum tau ua. Xav txog nws zoo li lub tshuab me me uas ua haujlwm nrog lub tshuab hluav taws xob. Nws xav tau 'lub teeb liab hluav taws xob' kom dhia kom raug. Lub teeb liab no feem ntau pib ntawm sab saum toj ntawm lub plawv hu ua sinoatrial node (lossis 'SA node'). Nws zoo li tus neeg tsav tsheb tseem ceeb ntawm thawj qhov chaw nres tsheb ciav hlau. Nws yog tus uas muab lus txib, 'Okay, dhia tam sim no.'

Txawm li cas los xij, yog tias muaj qee yam tshwm sim rau qhov 'SA node' no, nws zoo li tus neeg tsav tsheb tau tsaug zog lawm. Ces nws tsis tuaj yeem pib lub plawv dhia kom raug, lossis txawm tias nws ua li ntawd los xij, nws yuav tsis muaj zog txaus.

Yog li, yuav ua li cas thaum qhov ntawd tshwm sim? Lub plawv tsis tsuas yog zaum ntawd xwb. Ntxiv me ntsis hauv lub plawv, ntawm qhov sib tshuam uas cov chav sab saud (atria) thiab cov chav sab qis (ventricles) sib ntsib, lub atrioventricular node (lossis AV node) hais tias, "Okay, kuv yuav ua tus saib xyuas," thiab lub plawv pib dhia. Zoo li yog tias tus neeg tsav tsheb ntawm thawj qhov chaw nres tsheb pw tsaug zog, tus neeg tsav tsheb ntawm qhov chaw nres tsheb tom ntej yuav ua tus saib xyuas thiab rub lub tsheb ciav hlau. Qhov no tsis yog nws txoj haujlwm ib txwm muaj, tab sis nws ua nws vim nws tsis tuaj yeem tso tseg ua haujlwm.

Txawm li cas los xij, lub plawv dhia uas tshwm sim li no tsis ceev npaum li lub plawv dhia los ntawm 'SA node'. Txawm hais tias lub plawv dhia ib txwm ntawm ib tus neeg noj qab haus huv yog nruab nrab ntawm 60 thiab 100 lub plawv dhia ib feeb, hauv 'Junctional Escape Rhythm' no lub plawv dhia yog nruab nrab ntawm 40 thiab 60 lub plawv dhia ib feeb . Uas yog, qeeb me ntsis.

Leej twg yuav raug cuam tshuam los ntawm qhov xwm txheej no tshaj?

Txawm hais tias tus mob no tuaj yeem cuam tshuam rau leej twg los xij, qee tus neeg muaj feem yuav muaj mob ntau dua. Piv txwv li, kev tshawb fawb tau pom tias muaj coob tus neeg hnub nyoog tshaj 65 xyoo uas muaj kab mob plawv yuav muaj qee qhov teeb meem ntawm SA node. Yog li, nrog rau qhov teeb meem zoo li no, qhov muaj feem yuav tsim lub junctional rhythm ntau dua.

Tsis yog li ntawd xwb, tus mob no kuj tseem tuaj yeem cuam tshuam rau lwm tus neeg:

• Cov neeg ncaws pob uas tab tom cob qhia zoo: Qee zaum hom kev dhia no tuaj yeem pom vim tias lawv lub plawv dhia thaum so qis.
• Cov menyuam yaus: Qee zaum qhov no kuj tshwm sim rau cov menyuam yaus thiab, tab sis nws tsis tshua muaj.
• Cov neeg uas muaj tus mob hu ua 'Sick Sinus Syndrome':Hauv qhov no, lub SA node tsis ua haujlwm zoo, yog li lwm qhov ntawm lub plawv yuav tsum tswj lub plawv dhia.

Cov tsos mob ntawm qhov no yuav yog dab tsi?

Feem ntau, tej zaum koj yuav tsis muaj tsos mob dab tsi li . Tej zaum yuav pom tau los ntawm kev kuaj ECG vim lwm yam. Txawm li cas los xij, yog tias muaj tsos mob tshwm sim, tej zaum yuav muaj xws li:

• Xav tias nkees heev ('Qaug zog'): Xav tias koj tsis muaj zog, nkees heev uas koj xav pw tsaug zog tag hnub.
• Tsaus muag los yog syncope: Qhov no tuaj yeem tshwm sim yog tias lub plawv dhia qeeb dhau, txo cov ntshav ntws mus rau lub hlwb.
• Kiv taub hau los yog lub taub hau me me: Qhov no tuaj yeem tshwm sim thaum koj sawv ntsug lossis thaum koj sawv ntxov tam sim ntawd.
• Kev Nyuaj Siab: Tej zaum nws yuav zoo li koj lub plawv dhia hauv koj lub hauv siab, lossis nws yuav zoo li nws dhia ib pliag tam sim ntawd.
• Ua tsis taus pa: Qee tus neeg yuav ua tsis taus pa thaum lawv nkees me ntsis.

Vim li cas qhov no thiaj tshwm sim? Yog vim li cas?

Muaj ntau yam ua rau koj lub SA node tsis xa cov teeb liab hluav taws xob lossis tsis muaj zog. Qhov no yog qhov ua rau muaj Junctional Escape Rhythm. Cia peb saib cov laj thawj tseem ceeb.

Qee yam mob thiab kev kho mob tuaj yeem ua rau qhov no:

• Kev pw tsaug zog apnea: Qhov no yog ib qho mob uas koj tsis ua pa rau lub sijhawm luv luv thaum koj pw tsaug zog. Qhov no tuaj yeem cuam tshuam rau koj lub plawv.
• Kev kho mob hluav taws xob: Kev kho mob hluav taws xob, tshwj xeeb tshaj yog rau mob qog noj ntshav hauv thaj tsam hauv siab, tuaj yeem ua rau lub plawv lub zog hluav taws xob puas tsuaj.
• Mob plawv nres: Mob plawv nres tuaj yeem ua rau cov leeg nqaij plawv thiab lub SA node puas tsuaj.
• Myocarditis: Mob plawv o los ntawm ib yam dab tsi zoo li kab mob viral.
• Kev o ntawm lub hnab nyob ib puag ncig lub plawv (pericarditis): Qhov no kuj tuaj yeem cuam tshuam rau kev ua haujlwm ntawm lub plawv.
• Kev raug mob rau koj lub hauv siab: Yog tias koj raug ntaus rau ntawm lub hauv siab, xws li thaum muaj xwm txheej.
• Kab mob Lyme: Kab mob uas kis los ntawm kab laum no kuj tseem tuaj yeem cuam tshuam rau lub plawv.
• Hypothyroidism: Kev ua haujlwm ntawm cov thyroid caj pas txo qis.
• Qee qhov kev phais mob: Tshwj xeeb tshaj yog tom qab kev phais mob ntsig txog lub plawv.

Qhov no kuj tseem tuaj yeem tshwm sim los ntawm qee cov tshuaj:

Qee cov tshuaj txo qhov kev ua haujlwm ntawm SA node, thiab qhov kev sib txuas khiav tawm no kuj tuaj yeem tshwm sim.

• Lithium: Ib yam tshuaj siv los kho mob hlwb.
• Beta-blockers: Ib hom tshuaj uas siv los kho ntshav siab thiab kab mob plawv.
• Cov tshuaj calcium channel blockers: Cov no kuj tau muab rau cov ntshav siab thiab kab mob plawv.
• Digoxin: Ib yam tshuaj siv los kho mob plawv tsis ua haujlwm thiab qee yam mob plawv dhia tsis xwm yeem.
• Cov tshuaj Opioids: Cov tshuaj tua kab mob muaj zog.
• Adenosine: Ib yam tshuaj siv los kuaj mob thiab kho cov teeb meem plawv dhia tsis zoo.
• Clonidine (piv txwv li, Catapres® lossis Kapvay®): Ib yam tshuaj siv los kho cov ntshav siab.

Koj kuaj qhov no li cas?

Yog koj muaj cov tsos mob uas tau hais los saum toj no, lossis yog koj tus kws kho mob xav tias muaj qhov no, lawv yuav kuaj koj.

• Keeb kwm mob thiab kev kuaj lub cev: Ua ntej, lawv yuav nug txog koj cov tsos mob, cov tshuaj uas koj noj, thiab seb puas muaj leej twg hauv koj tsev neeg muaj kab mob plawv. Tom qab ntawd, lawv yuav kuaj lub cev dav dav.
• Electrocardiogram (tseem hu ua ECG lossis EKG): Qhov no yog qhov kev xeem tseem ceeb tshaj plaws. Nws sau cov haujlwm hluav taws xob ntawm lub plawv. Yog tias muaj lub suab nrov nrov, nws tus qauv tshwj xeeb yuav pom ntawm ECG (piv txwv li, tsis muaj lossis hloov pauv P nthwv dej, lub plawv dhia qeeb).
• Kev kuaj ntshav: Cov no tuaj yeem pab tshem tawm lwm yam ua rau, xws li teeb meem thyroid lossis electrolyte tsis sib npaug.
• Kev kuaj lub plawv ultrasound (Echocardiogram): Qhov no tuaj yeem saib tej yam xws li lub qauv ntawm lub plawv, kev ua haujlwm ntawm cov valve, thiab lub zog ntawm cov leeg nqaij plawv qhov kev sib cog lus.
• Holter saib xyuas: Qee zaum, yog tias cov tsos mob tsis tshwm sim txhua lub sijhawm, lub cuab yeej zoo li no tuaj yeem siv los kaw ECG dhau lub sijhawm 24 lossis 48 teev.

Cov kev kho mob rau qhov no yog dab tsi?

Kev kho mob nyob ntawm seb koj puas muaj tsos mob thiab dab tsi ua rau muaj mob.

• Yog koj tsis muaj tsos mob: Feem ntau, yog tias koj noj qab nyob zoo thiab tsis muaj tsos mob, tsis tas yuav kho mob tshwj xeeb. Tej zaum koj tus kws kho mob yuav tsuas saib koj xwb.
• Yog tias muaj cov tsos mob:
• Kev Kho Mob Qhov Ua Rau Mob: Piv txwv li, yog tias mob yog los ntawm tshuaj, tus kws kho mob yuav tsum tsis txhob noj tshuaj lossis hloov mus rau lwm yam tshuaj. Yog tias nws yog ib yam mob zoo li "pw tsaug zog apnea," nws yuav tsum tau kho.
• Tshuaj: Yog tias lub plawv dhia qis dhau thiab muaj cov tsos mob xws li kiv taub hau, cov tshuaj xws li atropine (piv txwv li, Atreza® lossis Sal-Tropine®) tuaj yeem muab rau lub sijhawm luv luv kom ua rau lub plawv dhia nce me ntsis.
• Lub tshuab ua pacemaker: Yog tias cov tsos mob tseem muaj, lub plawv dhia qis heev, lossis qhov ua rau tsis zoo dua txawm tias kho mob lawm los xij, tej zaum yuav xav tau lub tshuab ua pacemaker mus tas li .Tej zaum yuav pom zoo kom muab lub tshuab ua pacemaker ntxig rau hauv. Qhov no yog ib lub cuab yeej me me uas raug phais muab tso rau hauv qab daim tawv nqaij ntawm lub hauv siab. Nws xa cov teeb liab hluav taws xob mus rau lub plawv, pab kom lub plawv dhia zoo li qub. Tej zaum yuav tsim nyog muab qhov no ntxig rau thaum ntxov li hnub nyoog nruab nrab.
• Kev rho catheter ablation: Qhov no tsis yog kev kho mob rau kev sib koom ua ke ntawm lub plawv dhia ceev, tab sis nws yuav raug txiav txim siab rau qee kis tshwj xeeb (piv txwv li, yog tias nws cuam tshuam nrog lwm yam teeb meem ntawm lub plawv xws li AV nodal reentrant tachycardia). Qhov no suav nrog kev txiav me me rau hauv thaj chaw ntawm lub plawv uas ua rau muaj cov teeb liab hluav taws xob tsis zoo, ua rau lawv nres.

Puas muaj teeb meem dab tsi nrog kev kho mob?

Ib yam li kev kho mob, muaj qee qhov kev pheej hmoo, tshwj xeeb tshaj yog thaum nws los txog rau kev cog lub pacemaker:

• Kev kis kab mob ntawm qhov chaw phais.
• Cov ntshav txhaws.
• Kev tsim cov nqaij caws pliav nyob ib puag ncig lub pacemaker.
• Cov xov hlau ntawm lub cuab yeej tab tom txav mus los yog tawg qhov chaw uas lawv yuav tsum nyob.
• Kev puas tsuaj rau lub ntsws (tsis tshua muaj).

Txawm li cas los xij, cov no feem ntau yog cov teeb meem me me, thiab cov kws kho mob paub yuav ua li cas tswj hwm lawv. Kev ntxig lub tshuab pacemaker feem ntau yog ib qho kev kho mob muaj kev nyab xeeb heev.

Yuav siv sijhawm ntev npaum li cas thiaj rov zoo tom qab kho tas?

Yog koj muaj lub tshuab ua pacemaker, feem ntau koj tuaj yeem rov qab mus ua koj cov dej num ib txwm li ntawm ob peb hnub. Txawm li cas los xij , koj yuav tsum tos ib lossis ob lub lis piam ua ntej ua lwm yam, xws li tsa cov hnyav lossis tsav tsheb , nyob ntawm koj tus kws kho mob cov lus qhia. Yog tias koj tau txais kev kho mob nrog tshuaj, koj yuav zoo dua thaum koj cov tsos mob pib ploj mus.

Peb ua tau dab tsi los txo qhov kev pheej hmoo no?

Peb tsis tuaj yeem tswj tau qee yam uas ua rau muaj Junctional Escape Rhythm (piv txwv li, cov mob caj ces). Txawm li cas los xij, muaj qee yam uas peb tuaj yeem ua tau los txo peb qhov kev pheej hmoo:

• Ua raws li kev ua neej noj qab haus huv: Noj zaub mov kom sib npaug, tawm dag zog tsis tu ncua , thiab tsis txhob haus luam yeeb tuaj yeem pab kom koj lub plawv noj qab haus huv.
• Kho cov kab mob tseem ceeb kom zoo: Yog tias koj muaj cov mob xws li ntshav qab zib, ntshav siab, thiab pw tsaug zog apnea, nrhiav kev kho kom zoo.
• Kev Xav Txog Kev Siv Tshuaj: Tham nrog koj tus kws kho mob txog cov tshuaj uas koj noj. Yog tias muaj kev xav tias muaj ib yam tshuaj tshwj xeeb ua rau muaj teeb meem, koj tus kws kho mob yuav nrhiav lwm txoj hauv kev. Tsis txhob tsum noj tshuaj yam tsis tau kev qhia los ntawm kws kho mob.

Yog tias muaj kev sib txuas ntawm kev khiav tawm, yuav ua li cas? Yav tom ntej yuav ua li cas?

Feem ntau, cov neeg uas muaj Junctional Escape Rhythm feem ntau yuav zoo, tshwj xeeb yog tias lawv tsis muaj tsos mob lossis yog tias lawv cov tsos mob tuaj yeem tswj tau nrog kev kho mob. Yog tias koj muaj lub tshuab pacemaker, koj tuaj yeem ua neej nyob li qub. Qhov tseem ceeb tshaj plaws yog ua raws li koj tus kws kho mob cov lus qhia thiab mus kuaj mob tsis tu ncua.

Kuv yuav tsum saib xyuas kuv tus kheej li cas?

Thaum koj muaj Junctional Escape Rhythm, koj tus kws kho mob yuav tsom mus rau qhov mob uas ua rau nws. Yog li, nyob ntawm tus mob lossis tshuaj uas ua rau muaj teeb meem, koj yuav tsum noj tshuaj sib txawv lossis tau txais kev kho mob uas koj tus kws kho mob pom zoo.

• Ua raws li cov lus qhia kho mob kom meej.
• Noj koj cov tshuaj raws sijhawm.
• Yog koj muaj lub tshuab ua pacemaker, ua raws li koj tus kws kho mob cov lus qhia txog nws (piv txwv li, nyob deb ntawm qee yam khoom siv hluav taws xob).
• Yog tias muaj kev hloov pauv ntawm cov tsos mob (nce ntxiv, cov tsos mob tshiab tshwm sim), qhia rau tus kws kho mob tam sim ntawd.

Thaum twg kuv yuav tsum nrhiav kev pab kho mob?

• Yog koj muaj cov tsos mob uas tau hais ua ntej (qaug zog, kiv taub hau, mob taub hau me ntsis, mob hauv siab).
• Yog koj muaj lub tshuab ua pacemaker, koj yuav tsum tau mus ntsib koj tus kws kho mob li ib hlis tom qab phais. Tom qab ntawd, koj yuav tsum mus ntsib kws kho mob ib lossis ob zaug hauv ib xyoos.
• Yog koj xav tias koj lub pacemaker tsis ua haujlwm zoo (piv txwv li, yog tias cov tsos mob qub rov qab los), lossis yog tias koj muaj kev kis kab mob (liab, o, kua paug) qhov chaw uas koj lub pacemaker tau ntxig, koj yuav tsum hu rau koj tus kws kho mob tam sim ntawd.

Koj yuav tsum nug tus kws kho mob li cas?

Tsis txhob hnov ​​qab nug cov lus nug no thaum koj mus ntsib kws kho mob:

• "Kuv puas xav tau kev kho mob rau qhov 'Junctional Escape Rhythm' no?"
• "Vim li cas kuv thiaj li muaj "Junctional Escape Rhythm"?"
• Kuv yuav tsum hloov pauv kuv txoj kev ua neej li cas?
• "Yog tias qhov xwm txheej uas ua rau qhov no tshwm sim dua, kuv puas yuav tau txais 'Junctional Escape Rhythm' dua?"
• Yog tias xav tau lub tshuab ua pacemaker, qhov zoo thiab qhov tsis zoo yog dab tsi?
• Kuv yuav tsum zam tej yam dab tsi?

Nov yog cov ntsiab lus luv luv ntawm yam peb tau tham txog (Cov Lus Coj Mus Tsev):

Zoo, yog li tam sim no koj nkag siab zoo txog qhov peb tau tham txog hu ua 'Junctional Escape Rhythm'. Qhov tshwm sim hauv qhov no yog tias thaum 'SA node', uas yog qhov chaw lub plawv dhia pib tsis ua haujlwm, lub plawv pib dhia los ntawm 'AV node', lossis qhov sib tshuam, nyob rau hauv qab ntawm lub plawv. Qhov no feem ntau ua rau lub plawv dhia qeeb me ntsis (kwv yees li 40-60 lub plawv dhia ib feeb).

Tej tus neeg yuav tsis muaj tsos mob dab tsi li, tiam sis lwm tus yuav qaug zog, kiv taub hau, mob taub hau me ntsis, thiab mob hauv siab. Qee yam mob (piv txwv li, pw tsaug zog tsis taus pa, plawv tsis ua haujlwm) thiab qee yam tshuaj (piv txwv li, beta-blockers) tuaj yeem ua rau qhov no.

Qhov tseem ceeb tshaj plaws yog tias yog koj muaj cov tsos mob no, tsis txhob tsis quav ntsej lawv thiab mus ntsib kws kho mob kom paub tseeb tias muaj dab tsi tshwm sim. Qhov no tuaj yeem kuaj pom los ntawm kev kuaj yooj yim xws li ECG.

Kev kho mob yuav suav nrog cov tshuaj, thiab qee zaum siv lub tshuab ua pacemaker, nyob ntawm seb ua rau muaj dab tsi. Yog tias koj tsis muaj tsos mob, koj yuav tsis xav tau kev kho mob. Txawm li cas los xij, yog tias koj muaj tsos mob, koj tus kws kho mob yuav tsom mus rau kev kho qhov ua rau muaj dab tsi. Tham nrog koj txog koj cov kev xaiv kho mob, thiab nug cov lus nug yog tias muaj dab tsi tsis meej. Tom qab ntawd, nws yog ib qho tseem ceeb uas yuav tsum noj koj cov tshuaj thiab mus kuaj mob tsis tu ncua. Tom qab ntawd koj tuaj yeem noj qab nyob zoo thiab tsis muaj kev txhawj xeeb.

Lub plawv dhia ceev (Junctional Escape Rhythm), Lub plawv dhia ceev (Plawv dhia ceev), Lub plawv dhia ceev (Plawv dhia ceev), SA Node, AV Node, Pacemaker, Kev noj qab haus huv ntawm lub plawv