Kutsemuka vharafu 1, 2, 3 madhigirii: zviratidzo, zviratidzo, chirwere, nokurapa

Nhengo womunhu rakasiyana. Zvisinei, dzimwe nguva pane mamiriro ezvinhu apo imwe nhengo iri chakaremara anoita mabasa ayo. It kutyora nemamiriro - iri kutsemuka vharuvhu - dingindira ino.

mazwi

Pakutanga, tinofanira kunzwisisa mashoko dzichashandiswa munyaya ino munyaya. Saka, chii chiri kukundikana pamusoro kutsemuka vharuvhu? Kuvhiringidza ichi muviri, zvichiita kuti anopapama chose regai kuvhara zvakasimba. Izvi zvinotisvitsa dambudziko dzakadai ropa kubva yeropa kukanda kunyika kuruboshwe cardiac ventricle. Izvi zvinoitika panguva diastole - kuzadza mwoyo neropa. Kupfuura rizere? Sezvo muviri womunhu anogamuchira zvishoma pane inodiwa dzose kushanda ropa vhoriyamu. Somugumisiro, izvozvo anowedzera mutoro pamwoyo, kuti aripire vanodzishayiwa.

Kazhinji, wokutanga, kusvikira muviri muduku uye azere simba, kutsemuka vharafu insufficiency vasingawanzotauri kuuya chero matambudziko. Chete, mwoyo kungawedzera zvishoma kukura kuti kukwanisa kudzikamisa yokushomeka ropa. Symptomatology iri pakutanga vasipo, uye murwere havatombozivi zvokufungidzira nezvokuvapo dambudziko. Gare gare anotanga kuitika kupfupika mweya, kurukutika. Kutsungirira chirwere ichi, murwere anogona akatumira kuvhiyiwa kutsemuka vharafu kutsiviwa.

Dambudziko iri nhamba

Masayendisiti dzinoti kuti kubvira matambudziko akadai insufficiency ari kutsemuka vharuvhu, inokanganisa kazhinji vamiririri murume. Kana tikafunga kubva muzana, nhamba yevakafa nezvirwere izvi, kune kufa zvose nomoyo nematambudziko akasiyana-siyana, vanenge 14%. Kana isu vanoona chirwere, zviri vanenge 4% kubva Muzviitiko kutsemuka vharafu insufficiency kunoitika zvayo yakachena chimiro, uye muna 10.3% nyaya - akabatana nevamwe zvirwere mwoyo.

zvikonzero

Kazhinji, chinokonzera dambudziko iri, muna 2/3 dzokushungurudzwa zviri rheumatic mavharuvhu. Zvishoma kacho, chirwere kunokonzera infective endocarditis. Masayendisiti runonziwo mapoka maviri zvikonzero, izvo rakakamurwa chakasimba uye chisingaperi kuitika.

The zvinokonzera chirwere

Muchiitiko chino, vanachiremba kuziva zvikonzero zvinokosha, izvo zvinogona kukonzera chisingaperi pezvakaitwa:

• Vachiberekwa mwoyo chirwere. Vana vanogona kuberekwa chete chete kana maviri nemikova, hunokonzera yakawanda matambudziko uye nematambudziko ari kupomba ropa parutivi mwoyo.
• Vasachembera. Kureva kutsemuka vharuvhu anogona kupfeka, nokufuka kure pamusoro nguva.
• Rheumatic nefivha, iyo hunokonzera scarring ari vharuvhu mapepa, izvo kunotadzisa kwavari zvizere Akanyatsovharwa.
• Infectious pezvakaitwa mumoyo, kana kukura mwaka (yose mapoka utachiona), "kudya" vharuvhu ichibhabhamisa, kana kungoti uchingounganidza pamusoro mavharuvhu, zvomutadzisa kubva nokuvhara zvakanaka.
• Kuwedzera yeropa kana girobhu racho waro rwakaramba kuti mavharuvhu haagoni zvachose chete rakapfigwa pasi.
• Treatment zvinetso zvakasiyana-siyana, izvo zvinogona kukonzera kukundikana kutsemuka vharuvhu. Somuenzaniso, nemwaranzi kurapa kana kushandiswa "Phentermine" - mushonga uremu, iyo wakasuduruka kushandiswa mukupera remakore rechi20. Maererano nokutsvakurudza nenyanzvi, kushandiswa kwayo aigona kukonzera akasiyana-siyana mwoyo nematambudziko, kusanganisira kutsemuka vharafu regurgitation.

The zvinokonzera rikwanise zvokudya

Vanachiremba kukonzera kutsemuka vharafu insufficiency uyewo secrete zvirwere zvakadai endocarditis (chirwere nhengo kukuvara), kutsemuka kwetsinga (yokuti ropa runoyerera kuburikidza pakakoromorwa akaumba). Dzimwe nguva varwere pashure achirapwa kuvhiyiwa kutsiva kutsemuka vharuvhu uyewo kuva kukundikana kwayo. Chenjera zvinokonzera dambudziko anorondedzera zvikuru uye kunotevera pechipfuva (somuenzaniso, panguva motokari kudhumhana kana munhu swipes ane zamu pamusoro dashboard). Izvi kakawanda kunotungamirira kuparadza kune kutsemuka vharuvhu.

symptomatology matambudziko

Ndezvipi zviratidzo kutsemuka vharafu regurgitation, izvo zvinogona kuona kuvapo dambudziko? Sezvambotaurwa pamusoro, pakutanga zviratidzo varege kuva. Kuti, murwere anogona kunyange kunzwa kuti ane zvimwe zvinetso. Zvisinei, nokufamba kwemakore, zvinhu zviri kuchinja. Mwoyo kushanda maziso kuripa nokushaiwa ropa. Somugumisiro, kuruboshwe ventricle kunowedzera zvishoma, uye mwoyo pacharo rine simba. Pano kunoitawo pacharo akanzwa kutsemuka vharafu. Zviratidzo, izvo iyi angamuka:

• Constant kuneta, kusimba muviri wose.
• Murwere ane kupfupika mweya. Anotowedzera kumukomborera panguva kurovedza muviri.
• Vakacherechedzawo arrhythmias kureva yakaoma mwoyo mutinhimira.
• Murwere anganyunyuta kuti nokukurumidza kurova kwehana.
• With mitoro anogona kuitika marwadzo bhokisi (angina).
• Kashoma, varwere achatambudzwa kurasikirwa chavanoziva.

Kana murwere ane rikwanise kukundikana, ipapo zvose zviratidzo kuonekwa pakarepo, simba ravo kupfuura, vanoonekwa yakajeka. Muchiitiko chino, varwere kazhinji zvinoda zvashata rubatsiro rokutanga, kusvikira kuponesa upenyu.

Pamusoro kukwana mwero

Uyewo ane dambudziko yakadai kutsemuka vharuvhu, ukuru pakukura. Ivo zvisingapindirani kureba ndege, iyo jekiseni kunyika ventricle kuburikidza havaratidzi Akanyatsovharwa ichibhabhamisa. Zvichienderana ichi, vari vatatu: kutanga, wechipiri newechitatu.

chokutanga dhigirii

Chii chinokosha pamusoro kutsemuka vharafu regurgitation 1 dhigirii? Panyaya iyi, kuti ndege asingadi kupfuudza 5 mm pakureba kubva kutsemuka mapepa. Saka, dambudziko iri vanongogona kunzi muduku. Pashure pezvose, ropa inounganidzwa anenge pamasuo dzakawanda pasina kukonzera zvinetso. Kutsemuka vharafu 1 dhigirii haakonzeri wandei kuwedzera ventricle kuruboshwe, muchiitiko ichi kunogona izere kwakajairika miganhu.

rechipiri dhigirii

Kutsemuka vharafu 2 madhigirii iri rinokosha pakuti jeti urefu iyi nyaya ichiwedzerwa 10 mm. Kureva ropa "splatters" chinhambwe vanenge 10 mm kubva vharuvhu mapepa. Panyaya iyi, kuti ndege anogona kusvika ichibhabhamisa yacho mitral vharuvhu, izvo yekudyidzana Zvinoipisisa zvinhu. Kutsemuka vharafu regurgitation giredhi 2 anowedzera pulsation ari carotid arteries uye mwoyo, akasiya ventricle inowedzerawo. Ava nyore zvose kuonekwa pamusoro echocardiogram.

dhigirii rechitatu

Kutsemuka vharafu mugwaro 3 Paaiita kuti ropa jekiseni shure kure rinopfuura 10 mm. Panyaya iyi, kuti ndege intersects ari mitral vharuvhu, uye isvike kumusoro ventricle kuruboshwe. Panyaya iyi, mwoyo kumuganhu yakawedzera kupfuura 2 cm, kuti ECG anogona kuva "vaiona" rworuboshwe ventricular hypertrophy.

Insufficiency muvana

Yoga kuda funga kutsemuka vharafu insufficiency vana. Pachava chero kusiyana mukuru uye mwana? Saka, muduku uchava zviratidzo zvakasiyana. Muchiitiko chino, kuvana kakawanda kuchengetwa pallor, pulsation zviri arteries vari kumigumo zvingamuka chiratidzo Musset (mwana vachadzungudza musoro wake kudivi, zvichienderana kwemwoyo). Kana marapirwo uye zvokuongorora matambudziko, uye vana nevakuru, nzira iyi ichava zvakafanana.

Diagnostics

The rokutanga chirwere "kutsemuka vharafu" anogona kuisa chiremba pashure pokuteerera (auscultation) uncharacteristic ruzha mumwoyo (diastolic kutsutsumwa ndiro kujairika). Zvisinei, izvi zvichiri kuva fembera chete. Zvadaro, chiremba muchakumbira pamusoro zviratidzo zvingaratidza pamberi dambudziko, vanounganidza wakazara anamnesis. Zvadaro, chiremba achatuma murwere muzvidzidzo okuwedzera kuti achasimbisa kana agodzivisa zvokuongorora kuti pre-akagadzira.

• Palpation. Muchiitiko ichi mumwe anogona kuona jitter pamusoro mujinga mwoyo achishandisa inoda kufunga. Izvi kunoitika nokuda pakabudiswa guru kwazvo Vhoriyamu ropa. Uyewo, "pane" percussion, kana miganhu mwoyo "enda" kuruboshwe.
• ECG. nzira Izvi zvinoita kuti tizive kuwedzera kukura rworuboshwe ventricle mwoyo.
• Echocardiography. nzira iyi zviri zviviri-dimensional nzira inoratidza rworuboshwe ventricular hypertrophy. Mugore rimwe-dimensional - anokwanisa kusiyanisa atrial mitral vharafu nokuda rakapinza kupinda jeti.
• Doppler anopa mukana kuona ukuru insufficiency of kutsemuka vharuvhu - inoratidza Kureba ropa yorwizi shure kuti jekiseni.
• X-ray. Kana kutsemuka vharuvhu kunoratidzirwa, nzira iyi zvinoita kuti tikwanise "ona" kuwedzera kukura mumwoyo, calcification pakati mapepa.
• Kuwedzera kuziva miedzo intracardiac chingavabvisa kupiwa cardiac catheterization nzira in. Muchiitiko chino, vanachiremba vane madhigirii mana kutsemuka vharafu insufficiency maererano Vhoriyamu jekiseni musana ropa. Chokutanga dhigirii ndiyo inenge 15%, ukuwo rechipiri - kubva 15 kusvika 30%, ari wechitatu - kubva 30 kusvika 50%, ukuwo wechina - vanopfuura 50%.

Kana murwere kare chirwere se "kutsemuka vharafu" dambudziko chirwere vangasava aitwe tichibatsirwa nzira zvose izvi. Saka, chiremba anozvisarudzira chii murwere Panguva iyi zvakakodzera. Zvinofanira kucherechedzwa kuti kuwedzera pamusoro nzira nechirwere, dzimwe nguva akangoshandisa uye coronary angiography, izvo zvinogona kupiwa nokuda chete zvinoratidza mune kutsemuka stenosis.

zvinodhaka kurapwa

Kana murwere chirwere "kutsemuka vharafu" kurapwa achavaponesa murwere chirwere. Saka, nguva yapera kushandisa zvimwe zvinodhaka kana kurapwa correlated pamwe kwokuomerwa kuratidzwa zviratidzo. Kana chimiro chirwere - chirwere, zvichida yokurapwa.

Drug kurapwa kuti murwere angafanira:

1. Diuretics. The chikuru chinangwa zvinodhaka izvi nyaya - goho zvakawandisa mvura kubva pamuviri, BP.
2. Mishonga. Dai kupiwa sezvo prophylaxis kwezvirwere zvinotapuriranwa mu zvomusejari kana mazino dzokuvhiya.
3. Uye vakagadzwa sezvo karusiyamu mugero blockers (kunyanya zvinodhaka "Nifedipine") nechinangwa chikuru - kuderedza ropa leakage. Zvinofanira kucherechedzwa kuti mune zvimwe zviitiko kushandisa zvinodhaka izvi zvinogona kuva chakanakisisa pane kuvhiyiwa.
4. Vanogonawo kupiwa uye zvimwe zvinodhaka zvakadai ACE FIs kana angiotensin Kanotokonya blockers.

Zvinofanira kucherechedzwa kuti varwere dambudziko iri, kunyange kana aripo ari chirwere chimiro, anofanira vanyorwe chiremba. Ivo nguva nenguva kuti kushanyira chiremba. Kukuru matanho iyi haisi nguva dzose kuratidzwa.

kuvhiya kupindira

Kana hosha huru, pane kudiwa kwokukurumidzira kuvhiya kupindira. Nokukurumidza munhu zvikanzwika chiremba, dzakanga mukana varambe vachirarama. Kunyange zvazvo mwero wokufa kwevanhu yakaderera iyi, kureva vanachiremba kunonoka hungada murwere kunyange upenyu.

Uyewo, Kuvhiya unoratidzwa varwere vari zvikuru kare nechirwere "kutsemuka vharafu". Kana murwere kwakasimbiswa zviratidzo, kunyange kana pakutanga munyoro, akasiya ventricle contractility anorasikirwa - zviri ose zvairatidza kuti zvomusejari kutsemuka vharafu kutsiviwa.

Sokunoratidza zvinofanira kucherechedzwa kuti nhasi, kuvhiya kazhinji zvakanaka miromo uye unounza aida murwere mugumisiro. Ake oparesheni yokutanga yakadaro zvakaitwa shure muna 1960 naDr Harkenom kuti prosthetic yeropa epurasitiki marozari uye simbi keji. On mundima Soviet Union, kuvhiyiwa uku kwaiva kwekutanga akaita muna 1964, akabudirira. Kubvira panguva iyoyo, chiremba yakatanga nzira zhinji uye nzira yokuita kuvhiyiwa ichi kunonyanyisa unhu uye inobudirira.

raramo

Kana murwere ane mwero kana munyoro mwoyo kukundikana, kwemakore 10 wokurarama zvakakwirira chaizvo uye yaiva vanenge 90% wevarwere zvose. Kana kunyunyuta vari kutanga kubuda, pane zviratidzo, mamiriro aigona kuderera nokukurumidza. Muchiitiko chino, kana musingadi kuita kuvhiyiwa, rufu zvinogona kuitika munenge 2-5 makore, zvichienderana dzimwe zvirwere.

Kana hosha chose asymptomatic, kupfuura zvakanaka fungidziro. Pakadaro, kushanda kupindira kunodiwa 4 chete% nyaya. Panguva iyoyowo, kunyunyuta anogona kuitika mu varwere panguva mashanu okutanga - 20% wevarwere, makore manomwe - anenge 25% wevarwere. Kana chenjera kukundikana, zvikuru, zvichida zvinouraya pakuparwa ventricular fibrillation. Kana nguva yokuita kuvhiyiwa, budiriro iri zvinogona kudziviswa.

dziviriro

Preventative matanho kwete kuwana chirwere, kwete. Muchiitiko chino, zvokudya kana mumwe mararamiro havazokwanisi kubatsira. Asi pano ndiyo varwere vari pangozi anogona kuzvidzivirira. Saka, nguva dzose kuti zvakaitika bvunzo panguva chiremba, taronga pakuvhiya. Kuronga kuongorora angava akasiyana, asi haugoni kushanyira chiremba wako zvishoma kazhinji pane 1 nguva pagore.