Ngaba isantya sentliziyo yakho sibonakala sicotha kancinci? Isenokuba ibangelwa yiJunctional Escape Rhythm (Junctional Escape Rhythm)!

Ngaba ngamanye amaxesha uziva ngathi intliziyo yakho ibetha kancinci, okanye ngendlela engaqhelekanga? Khawuthelekelele, usenza imisebenzi yakho yemihla ngemihla uze ngequbuliso uzive udiniwe kakhulu , uphelelwa ngumoya xa unyuka izinyuko, uze uzive ngathi uza kuwa phantsi intloko yakho ijikeleza. Olu hlobo lwento aluzenzekeli nje, akunjalo? Isenokuba lutshintsho oluncinci kwinkqubo yokubonisana kwentliziyo yakho. Namhlanje siza kuthetha ngenye imeko enjalo, ebizwa ngokuba yiJunctional Escape Rhythm . Ungakhathazeki, siza kuthetha ngale nto ngokulula.

Yintoni kanye kanye le Junctional Escape Rhythm?

Ngamafutshane, eli gama linikwa into yokuba intliziyo yakho iqala ukubetha ngaphantsi kancinci kunokuba kufanele. Cinga ngayo njengomatshini omncinci osebenza nenkqubo yombane. Ifuna 'isignali yombane' ukuze ibethe ngokufanelekileyo. Esi signali sidla ngokuqala phezulu kwentliziyo ebizwa ngokuba yi-sinoatrial node (okanye 'i-SA node'). Ifana nomqhubi oyintloko kwisikhululo sokuqala kuloliwe. Nguye onika umyalelo othi, 'Kulungile, betha ngoku.'

Nangona kunjalo, ukuba kukho into eyenzekayo kule `SA node`, kuba ngathi umqhubi ulele. Emva koko ayinakuqala ukubetha kwentliziyo ngokufanelekileyo, okanye nokuba iyenzeka, ayiyi kuba namandla ngokwaneleyo.

Ngoko ke, kwenzeka ntoni xa oko kusenzeka? Intliziyo ayihlali nje apho. Ukuya phambili kancinci entliziyweni, kwindawo apho amagumbi aphezulu (atria) kunye namagumbi asezantsi (ventricles) adibana khona, i-atrioventricular node (okanye i-AV node) ithi, "Kulungile, ndiza kuthatha indawo," kwaye intliziyo iqala ukubetha. Kufana nokuba umqhubi wesikhululo sokuqala ulele, umqhubi wesikhululo esilandelayo uyathatha indawo aze atsale uloliwe. Lo asingomsebenzi wakhe wesiqhelo, kodwa uyakwenza kuba akanakuyeka ukusebenza.

Nangona kunjalo, ukubetha kwentliziyo okwenzeka ngolu hlobo akukhawulezi njengaleyo ivela kwi-'SA node'. Nangona ukubetha kwentliziyo okuqhelekileyo komntu ophilileyo kuphakathi kwe-60 kunye ne-100 beats ngomzuzu, kule 'Junctional Escape Rhythm' ukubetha kwentliziyo kuphakathi kwe-40 kunye ne-60 beats ngomzuzu . Oko kukuthi, kancinci kancinci.

Ngubani onokuthi achaphazeleke kakhulu yile meko?

Nangona le meko inokuchaphazela nabani na, abanye abantu basengozini enkulu. Umzekelo, izifundo zifumanise ukuba inani elikhulu labantu abaneminyaka engaphezu kwama-65 ubudala abanesifo sentliziyo banokuba nokungasebenzi kakuhle kwe-SA node. Ngoko ke, xa kukho ingxaki enjalo, amathuba okuba ne-junctional rhythm aphezulu.

Ayipheleli apho, le meko inokuchaphazela nabanye abantu:

• Abadlali abaziqeqesha kakuhle: Ngamanye amaxesha olu hlobo lwesingqi lunokubonwa kuba isantya sentliziyo yabo yokuphumla siphantsi.
• Abantwana abancinci: Ngamanye amaxesha oku kunokwenzeka nasebantwaneni, kodwa akuqhelekanga kangako.
• Abantu abanemeko ebizwa ngokuba yi-'Sick Sinus Syndrome':Nakule meko, i-SA node ayisebenzi kakuhle, ngoko ke ezinye iindawo zentliziyo kufuneka zilawule ukubetha kwentliziyo.

Zingaba yintoni iimpawu zoku?

Amaxesha amaninzi, usenokungabi nazimpawu . Isenokufunyanwa ngengozi ngexesha lovavanyo lwe-ECG olwenziwe ngesinye isizathu. Nangona kunjalo, ukuba iimpawu ziyabonakala, zingabandakanya:

• Ukudinwa kakhulu (`Ukudinwa`): Ukuziva ngathi awunamandla, udiniwe kangangokuba ufuna ukulala imini yonke.
• Ukuquleka okanye ukungakwazi ukuphumla: Oku kunokwenzeka ukuba isantya sentliziyo siyehla kakhulu, nto leyo enciphisa ubuninzi begazi eliya engqondweni.
• Ukuba nesiyezi okanye ukuba nentloko ende: Oku kungenzeka xa umi okanye xa uvuka ngequbuliso.
• Ukubetha kwentliziyo: Kusenokuvakala ngathi intliziyo yakho ibetha ngaphakathi esifubeni sakho, okanye kusenokuvakala ngathi ngequbuliso ibetha kancinci.
• Ukuphefumla kancinci: Abanye abantu banokuba nokuphelelwa ngumphefumlo xa bediniwe kancinci.

Kutheni oku kusenzeka? Zithini izizathu?

Kukho izizathu ezininzi zokuba i-SA node yakho ingayeki ukuthumela imiqondiso yombane okanye ibe buthathaka. Yiyo le nto ibangela i-Junctional Escape Rhythm. Makhe sijonge izizathu eziphambili.

Ezinye iimeko zonyango kunye nonyango zinokubangela oku:

• I-sleep apnea: Le yimeko apho uyeka ukuphefumla ixesha elifutshane ngelixa ulele. Oku kungayichaphazela intliziyo yakho.
• Unyango ngemitha: Unyango ngemitha, ingakumbi umhlaza okwindawo yesifuba, lungonakalisa inkqubo yombane yentliziyo.
• Uhlaselo lwentliziyo: Uhlaselo lwentliziyo lunokonakalisa izihlunu zentliziyo kunye ne-SA node.
• I-Myocarditis: Ukudumba kwemisipha yentliziyo okubangelwa yinto efana nosulelo lwentsholongwane.
• Ukudumba kwengxowa ejikeleze intliziyo (pericarditis): Oku kunokuchaphazela nokusebenza kwentliziyo.
• Ukulimala esifubeni sakho: Ukuba ufumana isibetho esibukhali esifubeni, njengakwingozi.
• Isifo seLyme: Esi sifo sithwalwa ziincukuthu sinokuchaphazela nentliziyo.
• I-Hypothyroidism: Ukungasebenzi kakuhle kwe-thyroid gland.
• Ezinye iintlobo zotyando: Ingakumbi emva kotyando olunxulumene nentliziyo.

Oku kunokubangelwa nangamanye amayeza:

Amanye amayeza anciphisa ukusebenza kwe-SA node, kwaye le junctional escape rhythm inokwenzeka.

• I-Lithium: Iyeza elisetyenziselwa ukunyanga izifo zengqondo.
• Ii-Beta-blockers: Uhlobo oluqhelekileyo lwamayeza asetyenziselwa ukunyanga uxinzelelo lwegazi oluphezulu kunye nesifo sentliziyo.
• Izithinteli zeCalcium channel: Ezi zikwanikwa abantu abanesifo soxinzelelo lwegazi oluphezulu kunye nesifo sentliziyo.
• I-Digoxin: Liyeza elisetyenziselwa ukunyanga ukungasebenzi kakuhle kwentliziyo kunye neengxaki ezithile zesingqisho sentliziyo.
• Ii-opioids: Iipilisi zokuthomalalisa iintlungu ezinamandla.
• I-Adenosine: Iyeza elisetyenziselwa ukuxilonga nokunyanga iingxaki zesingqisho sentliziyo.
• I-Clonidine (umzekelo, iCatapres® okanye iKapvay®): Iyeza elisetyenziselwa ukunyanga uxinzelelo lwegazi oluphezulu.

Uyixilonga njani le nto?

Ukuba uneempawu ezichazwe apha ngasentla, okanye ukuba ugqirha wakho ukrokrela oku, uza kukuhlola.

• Imbali yezonyango kunye novavanyo lomzimba: Okokuqala, baza kubuza ngeempawu zakho, amayeza owasebenzisayo, kunye nokuba kukho umntu kusapho lwakho onesifo sentliziyo na. Emva koko, baza kwenza uvavanyo lomzimba ngokubanzi.
• I-Electrocardiogram (ekwabizwa ngokuba yi-ECG okanye i-EKG): Olu lolona vavanyo lubalulekileyo. Lurekhoda umsebenzi wombane wentliziyo. Ukuba kukho isigqi sokuphuma esidibeneyo, ipateni yaso ephawulekayo iya kubonakala kwi-ECG (umzekelo, amaza e-P angekhoyo okanye atshintshileyo, isantya sentliziyo esicothayo).
• Uvavanyo lwegazi: Olu vavanyo lunokunceda ekuqinisekiseni ukuba akukho zizathu zimbi, ezifana neengxaki ze-thyroid okanye ukungalingani kwe-electrolyte.
• I-ultrasound yentliziyo (i-Echocardiogram): Oku kunokujonga izinto ezifana nolwakhiwo lwentliziyo, umsebenzi weevalvu, kunye namandla okucutheka kwemisipha yentliziyo.
• Isixhobo sokujonga iHolter: Ngamanye amaxesha, ukuba iimpawu azikho rhoqo, isixhobo esifana nesi singasetyenziselwa ukurekhoda i-ECG kangangeeyure ezingama-24 okanye ezingama-48.

Zithini iindlela zonyango zoku?

Unyango luxhomekeke ekubeni unazo na iimpawu okanye awunazo kunye nokuba yintoni ebangela loo meko.

• Ukuba awunazo iimpawu: Kwiimeko ezininzi, ukuba usempilweni kwaye awunazo iimpawu, akukho nyango lukhethekileyo lufunekayo. Ugqirha wakho mhlawumbi uza kukujonga nje.
• Ukuba kukho iimpawu:
• Ukunyanga unobangela oyintloko: Umzekelo, ukuba imeko ibangelwa liyeza, ugqirha angaliyeka iyeza okanye atshintshele kwelinye iyeza. Ukuba yimeko efana ne-"sleep apnea", kuya kufuneka inyangwe.
• Amayeza: Ukuba isantya sentliziyo siphantsi kakhulu kwaye kukho iimpawu ezifana nesiyezi, amayeza anjenge -atropine (umz., i-Atreza® okanye i-Sal-Tropine®) anokunikwa ixesha elifutshane ukuze anyuse isantya sentliziyo kancinci.
• I-Pacemaker: Ukuba iimpawu ziyaqhubeka, isantya sentliziyo siphantsi kakhulu, okanye unobangela awuphucuki nangona unyango lukhona, kunokufuneka i-pacemaker esisigxina .Kungacetyiswa ukuba kufakwe i-pacemaker. Esi sisixhobo esincinci esifakelwa ngotyando phantsi kwesikhumba sesifuba. Sithumela imiqondiso yombane entliziyweni, sincede ukugcina isantya sentliziyo siphezulu. Kungafuneka ukuba sifakwe kwasekuqaleni.
• Ukususwa kweCatheter: Olu asilonyango oluqhelekileyo lwe-junctional escape rhythm, kodwa lunokuqwalaselwa kwiimeko ezithile ezikhethekileyo (umzekelo, ukuba lunxulumene nezinye iingxaki ze-rhythm ezifana ne-AV nodal reentrant tachycardia). Oku kubandakanya ukwenza imingxunya emincinci kwiindawo zentliziyo ezibangela imiqondiso yombane engaqhelekanga, eziyekisa.

Ngaba kukho naziphi na iingxaki ngonyango?

Njengakwezinye iindlela zonyango, kukho iingozi ezithile ezibandakanyekayo, ingakumbi xa kufikwa ekufakeni i-pacemaker:

• Usulelo kwindawo yotyando.
• Amahlwili egazi.
• Ukwakheka kwezicwili ezijikeleze isixhobo sokuncedisa ukujikeleza kwentliziyo.
• Iingcingo zesixhobo ziyahamba okanye ziyaphuka apho zifanele ukuba khona.
• Umonakalo wemiphunga (akuqhelekanga).

Nangona kunjalo, ezi ziingxaki ezincinci eziqhele ukubonwa ngoogqirha. Ukufakwa kwe-pacemaker yinkqubo ekhuselekileyo kakhulu.

Kuthatha ixesha elingakanani ukuchacha emva konyango?

Ukuba une-pacemaker, ungabuyela kwimisebenzi yakho yesiqhelo kwiintsuku ezimbalwa. Nangona kunjalo , kunokufuneka ulinde iveki okanye ezimbini ngaphambi kokuba wenze nantoni na, njengokuphakamisa iintsimbi okanye ukuqhuba , kuxhomekeke kwimiyalelo kagqirha wakho. Ukuba unyangwa ngamayeza, uya kuziva ungcono njengoko iimpawu zakho ziqala ukuncipha.

Singenza ntoni ukunciphisa lo mngcipheko?

Asinakulawula ezinye zezinto ezibangela i-Junctional Escape Rhythm (umz. iimeko zemfuza). Nangona kunjalo, kukho izinto esinokuzenza ukunciphisa umngcipheko wethu:

• Ukulandela indlela yokuphila enempilo: Ukutya ukutya okunesondlo, ukuzilolonga rhoqo , nokuphepha ukutshaya kunokunceda ukugcina intliziyo yakho isempilweni.
• Phatha ngokufanelekileyo izifo ezisisiseko: Ukuba uneengxaki ezifana nesifo seswekile, uxinzelelo lwegazi oluphezulu, kunye ne-sleep apnea, fumana unyango olufanelekileyo.
• Izinto Omele Uziqwalasele Ngamayeza: Thetha nogqirha wakho malunga namayeza owasebenzisayo. Ukuba kukho ukurhaneleka kokuba kukho amayeza athile abangela ingxaki, ugqirha wakho uza kukhangela enye indlela. Ungaze uyeke ukuthatha amayeza ngaphandle kwengcebiso kagqirha.

Kuza kwenzeka ntoni ukuba kukho isigqi sokubaleka esidibeneyo? Liyintoni ikamva?

Ingqikelelo yabantu abaneJunctional Escape Rhythm idla ngokuba ntle, ingakumbi ukuba abanazo iimpawu okanye ukuba iimpawu zabo zinokulawulwa ngonyango. Ukuba une-pacemaker, ungaphila ubomi obuqhelekileyo. Eyona nto ibalulekileyo kukulandela imiyalelo kagqirha wakho kwaye uye kuhlolwa rhoqo.

Ndingazinyamekela njani?

Xa une-Junctional Escape Rhythm, ugqirha wakho uya kugxila kwimeko ebangela loo nto. Ngoko ke, ngokuxhomekeke kwimeko okanye amayeza abangela ingxaki, kunokufuneka uthathe elinye iyeza okanye ufumane unyango olucetywayo ngugqirha wakho.

• Landela iingcebiso zonyango ngokuchanekileyo.
• Thatha amayeza akho ngexesha.
• Ukuba unesixhobo sokuncedisa umgudu wokusebenza (pacemaker), landela imiyalelo kagqirha wakho ngayo (umz., ukuphepha izixhobo ezithile ze-elektroniki).
• Ukuba kukho utshintsho kwiimpawu (ukwanda, kuvela iimpawu ezintsha), yazisa ugqirha ngoko nangoko.

Ndingalufuna nini uncedo lwezonyango?

• Ukuba uneempawu ezikhankanyiweyo ngaphambili (ukudinwa, isiyezi, ukuba buhlungu, ukuxinana kwesifuba).
• Ukuba une-pacemaker, kuya kufuneka ubone ugqirha wakho malunga nenyanga emva kotyando. Emva koko, kuya kufuneka uye kugqirha wakho rhoqo kanye okanye kabini ngonyaka.
• Ukuba uvakalelwa kukuba i-pacemaker yakho ayisebenzi kakuhle (umz., ukuba iimpawu zakudala ziyabuya), okanye ukuba unosulelo (ububomvu, ukudumba, ubomvu) apho i-pacemaker yakho yayifakwe khona, kufuneka uqhagamshelane nogqirha wakho ngoko nangoko.

Yeyiphi imibuzo omele uyibuze ugqirha?

Ungalibali ukubuza le mibuzo xa ubona ugqirha:

• "Ngaba ndifuna unyango lwale 'Junctional Escape Rhythm'?"
• "Yintoni isizathu esikhethekileyo sokuba ndibe ne-'Junctional Escape Rhythm'?"
• "Zeziphi iinguqu zendlela yokuphila ekufuneka ndizenze?"
• "Ukuba imeko ebangele oku iphinda yenzeke, ngaba ndiza kuphinda ndifumane i-'Junctional Escape Rhythm'?"
• "Ukuba kufuneka i-'pacemaker', zithini izinto ezilungileyo nezingalunganga?"
• "Zeziphi izinto ekufanele ndiziphephe?"

Nantsi isishwankathelo sento esiyithethileyo (Umyalezo Wokubuyela Ekhaya):

Kulungile, ngoku uyaqonda kakuhle into ebesithetha ngayo ebizwa ngokuba yi-'Junctional Escape Rhythm'. Okwenzekayo apha kukuba xa i-'SA node', apho ukubetha kwentliziyo kuqala khona, ingaphumeleli, intliziyo iqala ukubetha kwi-'AV node', okanye i-junction, ekwinxalenye esezantsi yentliziyo. Oku kudla ngokucothisa ukubetha kwentliziyo kancinci (malunga ne-40-60 beats ngomzuzu).

Abanye abantu basenokungabi nazo naziphi na iimpawu, kodwa abanye banokuba nokudinwa, isiyezi, ukuba neentloko ezikhaphukhaphu, kunye nokuqina kwesifuba. Ezinye iimeko zonyango (umz., i-sleep apnea, ukusilela kwentliziyo) kunye namayeza athile (umz., ii-beta-blockers) zinokubangela oku.

Eyona nto ibalulekileyo kukuba ukuba unale mpawu, ungazityesheli uze ubone ugqirha ukuze ufumane ukuba kwenzeka ntoni kanye kanye. Oku kunokufunyanwa ngovavanyo olulula olufana ne-ECG.

Unyango lunokubandakanya amayeza, kwaye ngamanye amaxesha i-pacemaker, kuxhomekeke kwisizathu. Ukuba awunazo iimpawu, usenokungadingi unyango. Nangona kunjalo, ukuba uneempawu, ugqirha wakho uya kugxila ekunyangeni unobangela oyintloko. Thetha nawe malunga neendlela zakho zonyango, kwaye ubuze imibuzo ukuba kukho into engacacanga. Emva koko, kubalulekile ukuthatha amayeza akho kwaye ufumane uhlolo rhoqo. Emva koko ungahlala usempilweni kwaye ungakhathazeki.

I- Junctional Escape Rhythm, I-Heart Rhythm, I-Heartbeat, i-SA Node, i-AV Node, i-Pacemaker, iMpilo yeNtliziyo