Kodi kugunda kwa mtima wanu kukuoneka kochedwa pang'ono? Mwina chifukwa cha Junctional Escape Rhythm (Junctional Escape Rhythm)!

Kodi nthawi zina mumamva ngati mtima wanu ukugunda pang'onopang'ono, kapena mwanjira yachilendo? Tangoganizirani, mukuchita ntchito zanu za tsiku ndi tsiku ndipo mwadzidzidzi mukumva kutopa kwambiri , mukupuma movutikira mukakwera masitepe, ndipo mukumva ngati mugwa mutu wanu ukuzungulira. Zinthu ngati zimenezi sizimangochitika zokha, sichoncho? Zingakhale kusintha pang'ono mu dongosolo la zizindikiro za mtima wanu. Lero tikambirana za vuto limodzi lotere, lotchedwa Junctional Escape Rhythm . Musadandaule, tikambirana izi mosavuta.

Kodi Junctional Escape Rhythm iyi ndi chiyani kwenikweni?

Mwachidule, dzinali limaperekedwa chifukwa chakuti mtima wanu umayamba kugunda motsika pang'ono kuposa momwe uyenera kugunda. Taganizirani ngati makina ang'onoang'ono omwe amagwira ntchito ndi makina amagetsi. Amafunika 'chizindikiro chamagetsi' kuti agunde bwino. Chizindikirochi nthawi zambiri chimayambira pamwamba pa mtima wotchedwa sinoatrial node (kapena `SA node`). Chili ngati kondakitala wamkulu pa siteshoni yoyamba pa sitima. Iye ndiye amene amalamula kuti, 'Chabwino, menyani tsopano.'

Komabe, ngati chinachake chikachitika ku `SA node` iyi, zimakhala ngati kondakitala wagona. Kenako sangayambe bwino kugunda kwa mtima, kapena ngakhale atatero, sadzakhala olimba mokwanira.

Ndiye, chimachitika ndi chiyani zikachitika zimenezo? Mtima sumangokhala pamenepo. Patali pang'ono pansi pa mtima, pamalo pomwe zipinda zapamwamba (atria) ndi zipinda zapansi (ventricles) zimakumana, node ya atrioventricular (kapena node ya AV) imati, "Chabwino, nditenga," ndipo mtima umayamba kugunda. Zili ngati kondakitala pa siteshoni yoyamba akugona, kondakitala pa siteshoni yotsatira amatenga udindo ndikukoka sitimayo. Iyi si ntchito yake yachizolowezi, koma amachita izi chifukwa sangasiye kugwira ntchito.

Komabe, kugunda kwa mtima komwe kumachitika motere sikwachangu ngati komwe kumachokera ku `SA node`. Ngakhale kuti kugunda kwa mtima kwa munthu wathanzi kumakhala pakati pa 60 ndi 100 beats pa mphindi, mu `Junctional Escape Rhythm` iyi, kugunda kwa mtima kumakhala pakati pa 40 ndi 60 beats pa mphindi . Ndiko kuti, pang'onopang'ono.

Ndani amene angakhudzidwe kwambiri ndi vutoli?

Ngakhale kuti vutoli lingakhudze aliyense, anthu ena ali pachiwopsezo chachikulu. Mwachitsanzo, kafukufuku wapeza kuti anthu ambiri azaka zopitilira 65 omwe ali ndi matenda a mtima akhoza kukhala ndi vuto linalake la SA node. Chifukwa chake, ndi vuto lotere, mwayi wokhala ndi junctional rhythm ndi wokwera.

Si zokhazo, vutoli lingakhudzenso anthu ena:

• Ochita masewera olimbitsa thupi omwe akuphunzira bwino: Nthawi zina mtundu uwu wa kayimbidwe ka thupi ungawonekere chifukwa chakuti kugunda kwa mtima wawo kumakhala kochepa.
• Ana aang'ono: Nthawi zina izi zingachitikirenso ana, koma sizofala kwambiri.
• Anthu omwe ali ndi vuto lotchedwa `Sick Sinus Syndrome`:Pankhaniyi, node ya SA sikugwira ntchito bwino, kotero ziwalo zina za mtima ziyenera kulamulira kugunda kwa mtima.

Kodi zizindikiro za izi zingakhale zotani?

Nthawi zambiri, simungakhale ndi zizindikiro zilizonse . Zitha kupezeka mwangozi panthawi yoyezetsa ECG pazifukwa zina. Komabe, ngati zizindikirozo zichitika, zitha kuphatikizapo:

• Kumva kutopa kwambiri (`Kutopa`): Kumva ngati ulibe mphamvu, kutopa kwambiri moti umafuna kugona tsiku lonse.
• Kukomoka kapena kukomoka: Izi zitha kuchitika ngati kugunda kwa mtima kwachepa kwambiri, zomwe zimachepetsa kuchuluka kwa magazi omwe amapita ku ubongo.
• Chizungulire kapena mutu wopepuka: Izi zingachitike mukamayimirira kapena mukadzuka mwadzidzidzi.
• Kugunda kwa mtima: Kungamveke ngati mtima wanu ukugunda mkati mwa chifuwa chanu, kapena kungamveke ngati ukudumpha mwadzidzidzi.
• Kupuma movutikira: Anthu ena amatha kupuma movutikira akatopa pang'ono.

N’chifukwa chiyani izi zikuchitika? Kodi zifukwa zake ndi ziti?

Pali zifukwa zingapo zomwe SA node yanu ingasiye kutumiza zizindikiro zamagetsi kapena kufooka. Izi ndi zomwe zimayambitsa Junctional Escape Rhythm. Tiyeni tiwone zifukwa zazikulu.

Matenda ena ndi njira zina zochiritsira zingayambitse izi:

• Kupuma movutikira: Iyi ndi vuto lomwe limakulepheretsani kupuma kwa kanthawi kochepa mukamagona. Izi zingakhudze mtima wanu.
• Chithandizo cha radiation: Chithandizo cha radiation, makamaka khansa pachifuwa, chingawononge dongosolo lamagetsi la mtima.
• Matenda a mtima: Matenda a mtima amatha kuwononga minofu ya mtima komanso node ya SA.
• Myocarditis: Kutupa kwa minofu ya mtima komwe kumachitika chifukwa cha matenda monga kachilombo.
• Kutupa kwa thumba lozungulira mtima (pericarditis): Izi zingakhudzenso ntchito ya mtima.
• Kuvulala pachifuwa: Ngati mwamenyedwa kwambiri pachifuwa, monga mwa ngozi.
• Matenda a Lyme: Matendawa oyambitsidwa ndi nkhupakupa amathanso kukhudza mtima.
• Hypothyroidism: Kuchepa kwa ntchito ya chithokomiro.
• Maopaleshoni ena: Makamaka pambuyo pa opaleshoni yokhudzana ndi mtima.

Izi zitha kuchitikanso ndi mankhwala ena:

Mankhwala ena amachepetsa ntchito ya node ya SA, ndipo njira imeneyi yotulukira m'malo olumikizirana mafupa imatha kuchitikanso.

• Lithium: Mankhwala ogwiritsidwa ntchito pochiza matenda amisala.
• Beta-blockers: Mankhwala odziwika bwino omwe amagwiritsidwa ntchito pochiza kuthamanga kwa magazi ndi matenda a mtima.
• Zoletsa njira za calcium: Izi zimaperekedwanso pa matenda a kuthamanga kwa magazi ndi matenda a mtima.
• Digoxin: Mankhwala ogwiritsidwa ntchito pochiza kulephera kwa mtima ndi matenda ena a mtima.
• Opioids: Mankhwala amphamvu ochepetsa ululu.
• Adenosine: Mankhwala ogwiritsidwa ntchito pozindikira ndi kuchiza matenda a mtima.
• Clonidine (monga Catapres® kapena Kapvay®): Mankhwala ogwiritsidwa ntchito pochiza kuthamanga kwa magazi.

Kodi mumazindikira bwanji izi?

Ngati muli ndi zizindikiro zomwe zatchulidwa pamwambapa, kapena ngati dokotala wanu akukayikira izi, adzakuyesani.

• Mbiri ya zachipatala ndi kuyezetsa thupi: Choyamba, adzakufunsani za zizindikiro zanu, mankhwala omwe mukumwa, komanso ngati pali aliyense m'banja mwanu amene ali ndi matenda a mtima. Kenako, adzakuyezeni thupi lonse.
• Electrocardiogram (yomwe imatchedwanso ECG kapena EKG): Iyi ndi njira yofunika kwambiri yoyezera. Imalemba momwe magetsi a mtima amagwirira ntchito. Ngati pali kamvekedwe kake kotuluka mumtima, mawonekedwe ake adzawonekera pa ECG (monga mafunde a P omwe sanasinthe kapena omwe sanasinthe, kugunda kwa mtima pang'onopang'ono).
• Kuyezetsa magazi: Izi zingathandize kupeza zifukwa zina, monga mavuto a chithokomiro kapena kusalinganika kwa ma electrolyte.
• Kujambula kwa mtima (Echocardiogram): Izi zitha kuyang'ana zinthu monga kapangidwe ka mtima, ntchito ya ma valve, ndi mphamvu ya kukokana kwa minofu ya mtima.
• Chowunikira cha Holter: Nthawi zina, ngati zizindikiro sizikupezeka nthawi zonse, chipangizo chonga ichi chingagwiritsidwe ntchito kujambula ECG kwa maola 24 kapena 48.

Kodi mankhwala ochizira izi ndi otani?

Chithandizo chimadalira ngati muli ndi zizindikiro kapena ayi komanso chomwe chikuyambitsa vutoli.

• Ngati mulibe zizindikiro: Nthawi zambiri, ngati muli ndi thanzi labwino ndipo mulibe zizindikiro, palibe chithandizo chapadera chomwe chikufunika. Dokotala wanu mwina adzakuyang'anirani.
• Ngati pali zizindikiro:
• Kuchiza chomwe chimayambitsa vutoli: Mwachitsanzo, ngati vutoli layamba chifukwa cha mankhwala, dokotala angasiye kumwa mankhwalawo kapena kusintha mankhwala ena. Ngati ndi vuto monga "kupuma movutikira," liyenera kuthandizidwa.
• Mankhwala: Ngati kugunda kwa mtima kuli kotsika kwambiri ndipo pali zizindikiro monga chizungulire, mankhwala monga atropine (monga Atreza® kapena Sal-Tropine®) angaperekedwe kwa kanthawi kochepa kuti awonjezere kugunda kwa mtima pang'ono.
• Wothandizira pacemaker: Ngati zizindikiro zikupitirira, kugunda kwa mtima kumakhala kotsika kwambiri, kapena chifukwa chake sichikuyenda bwino ngakhale mutalandira chithandizo, pacemaker yokhazikika ingafunike.Mungalimbikitsidwe kuyika pacemaker. Ichi ndi chipangizo chaching'ono chomwe chimayikidwa pansi pa khungu la pachifuwa. Chimatumiza zizindikiro zamagetsi kumtima, zomwe zimathandiza kuti kugunda kwa mtima kukhale koyenera. Zingakhale zofunikira kuyika izi ali aang'ono.
• Kuchotsa catheter: Iyi si njira yodziwika bwino yothandizira rhythm yotuluka m'thupi, koma ingaganizidwenso nthawi zina zapadera (monga ngati ikugwirizana ndi mavuto ena a rhythm monga AV nodal reentrant tachycardia). Izi zimaphatikizapo kupanga mabala ang'onoang'ono m'malo amtima omwe amayambitsa zizindikiro zamagetsi zosazolowereka, kuziletsa.

Kodi pali zovuta zilizonse ndi chithandizochi?

Monga momwe zimakhalira ndi chithandizo chilichonse chamankhwala, pali zoopsa zina zomwe zingachitike, makamaka pankhani yoika pacemaker:

• Matenda opatsirana pamalo ochitira opaleshoni.
• Magazi amaundana.
• Kupangika kwa minofu yozungulira pacemaker.
• Mawaya a chipangizocho akusuntha kapena kusweka komwe ayenera kukhala.
• Kuwonongeka kwa mapapo (kawirikawiri).

Komabe, nthawi zambiri awa ndi mavuto ang'onoang'ono, ndipo madokotala amadziwa momwe angawathanitsire. Kuyika pacemaker nthawi zambiri ndi njira yotetezeka kwambiri.

Kodi zimatenga nthawi yayitali bwanji kuti munthu achire pambuyo pa chithandizo?

Ngati muli ndi pacemaker, nthawi zambiri mungabwerere ku zochita zanu zachizolowezi mkati mwa masiku ochepa. Komabe , mungafunike kudikira kwa sabata imodzi kapena ziwiri musanachite china chilichonse, monga kunyamula zolemera kapena kuyendetsa galimoto , kutengera malangizo a dokotala wanu. Ngati mulandira chithandizo ndi mankhwala, mudzamva bwino pamene zizindikiro zanu zikuyamba kuchepa.

Kodi tingatani kuti tichepetse chiopsezochi?

Sitingathe kuwongolera zina mwa zinthu zomwe zimayambitsa Junctional Escape Rhythm (monga matenda a majini). Komabe, pali zinthu zina zomwe tingachite kuti tichepetse chiopsezo chathu:

• Kutsatira moyo wathanzi: Kudya zakudya zoyenera, kuchita masewera olimbitsa thupi nthawi zonse , komanso kupewa kusuta kungathandize kuti mtima wanu ukhale wathanzi.
• Chitani bwino matenda omwe amayambitsa matendawa: Ngati muli ndi matenda monga matenda a shuga, kuthamanga kwa magazi, komanso kupuma movutikira, pitani kuchipatala moyenera.
• Zoganizira za Mankhwala: Lankhulani ndi dokotala wanu za mankhwala omwe mukumwa. Ngati pali kukayikiridwa kuti mankhwala enaake akuyambitsa vutoli, dokotala wanu adzafunafuna njira ina. Musasiye kumwa mankhwala popanda upangiri wa dokotala.

Kodi chimachitika n’chiyani ngati pali kayimbidwe kothawirako? Kodi tsogolo ndi lotani?

Nthawi zambiri anthu omwe ali ndi Junctional Escape Rhythm amakhala ndi chiyembekezo chabwino, makamaka ngati alibe zizindikiro kapena ngati zizindikiro zawo zitha kuthetsedwa ndi chithandizo. Ngati muli ndi pacemaker, mutha kukhala moyo wabwinobwino. Chofunika kwambiri ndikutsatira malangizo a dokotala wanu ndikupita kukayezetsa nthawi zonse.

Kodi ndiyenera kudzisamalira bwanji?

Mukakhala ndi Junctional Escape Rhythm, dokotala wanu mwina adzayang'ana kwambiri vuto lomwe limayambitsa vutoli. Chifukwa chake, kutengera vuto kapena mankhwala omwe amayambitsa vutoli, mungafunike kumwa mankhwala ena kapena kulandira chithandizo chomwe dokotala wanu akukulangizani.

• Tsatirani malangizo a dokotala molondola.
• Imwani mankhwala anu pa nthawi yake.
• Ngati muli ndi pacemaker, tsatirani malangizo a dokotala wanu okhudza izi (monga kupewa kugwiritsa ntchito zipangizo zina zamagetsi).
• Ngati pali kusintha kwa zizindikiro (zizindikiro zatsopano zikuwonjezeka), dziwitsani dokotala nthawi yomweyo.

Kodi ndiyenera kupeza upangiri wa dokotala liti?

• Ngati muli ndi zizindikiro zomwe zatchulidwa kale (kutopa, chizungulire, mutu wopepuka, kufinya pachifuwa).
• Ngati muli ndi makina oyeretsera mtima (pacemaker), muyenera kuonana ndi dokotala wanu patatha mwezi umodzi kuchokera pamene opaleshoniyo inachitidwa. Pambuyo pake, muyenera kupita kukaonana ndi dokotala kamodzi kapena kawiri pachaka.
• Ngati mukuona kuti pacemaker yanu sikugwira ntchito bwino (monga ngati zizindikiro zakale zikubweranso), kapena ngati muli ndi matenda (kufiira, kutupa, mafinya) kumene pacemaker yanu inayikidwa, muyenera kulankhulana ndi dokotala nthawi yomweyo.

Ndi mafunso ati omwe muyenera kufunsa dokotala?

Musaiwale kufunsa mafunso awa mukapita kwa dokotala:

• "Kodi ndikufunika chithandizo cha 'Junctional Escape Rhythm' iyi?"
• "Chifukwa chenicheni cha 'Junctional Escape Rhythm' yanga ndi chiyani?"
• "Ndi kusintha kotani kwa moyo komwe ndiyenera kusintha?"
• "Ngati vuto lomwe linayambitsa izi litachitikanso, kodi ndilandiranso 'Junctional Escape Rhythm'?"
• "Ngati pakufunika 'pacemaker', ubwino ndi kuipa kwake ndi kotani?"
• "Ndi zochita ziti zomwe ndiyenera kupewa?"

Nayi chidule cha zomwe takambirana (Uthenga Wopita Nawo Kunyumba):

Chabwino, tsopano mwamvetsa bwino zomwe takhala tikukamba za `Junctional Escape Rhythm`. Chomwe chimachitika apa ndi chakuti pamene `SA node`, komwe kugunda kwa mtima kumayambira, kulephera, `AV node`, yomwe ili pansi pa mtima, imayambitsa kugunda kwa mtima. Izi nthawi zambiri zimachepetsa kugunda kwa mtima pang'ono (pafupifupi 40-60 beats pa mphindi).

Anthu ena sangakhale ndi zizindikiro zilizonse, koma ena akhoza kukhala ndi kutopa, chizungulire, mutu wopepuka, komanso chifuwa cholimba. Matenda ena (monga tulo tofa nato, kulephera kwa mtima) ndi mankhwala ena (monga beta-blockers) angayambitse izi.

Chofunika kwambiri ndichakuti ngati muli ndi zizindikirozi, musamazinyalanyaze ndipo pitani kwa dokotala kuti mudziwe zomwe zikuchitika. Izi zitha kuzindikirika ndi mayeso osavuta monga ECG.

Chithandizo chingaphatikizepo mankhwala, ndipo nthawi zina pacemaker, kutengera chomwe chimayambitsa. Ngati mulibe zizindikiro, simungafunike chithandizo. Komabe, ngati muli ndi zizindikiro, dokotala wanu mwina adzayang'ana kwambiri pochiza chomwe chimayambitsa vutoli. Adzakambirana nanu za njira zomwe mungasankhire chithandizo, ndipo afunseni mafunso ngati pali chilichonse chomwe sichikudziwika. Pambuyo pake, ndikofunikira kumwa mankhwala anu ndikupita kukayezetsa nthawi zonse. Kenako mutha kukhala ndi thanzi labwino komanso osadandaula.

` Junctional Escape Rhythm, Mtima Rhythm, Kugunda kwa Mtima, SA Node, AV Node, Pacemaker, Thanzi la Mtima