Murefu weTT murefu wehana: tsanangudzo, zvinokonzera zvinokonzera uye zviratidzo zvekurapa

Utano hwevanhu huri hukuru hwehupenyu hwehupenyu uye hwehupenyu. Asi isu hatisi nguva dzose tinonzwa tine utano hwakanaka. Zvinetso zvinogona kusimuka nokuda kwezvikonzero zvakasiyana-siyana, uye kukosha kwavo kunogonawo kusiyana. Semuenzaniso, hutano husati hunoita kuti vanhu vatye, hunokurumidza kurapwa uye harina kukonzera kukanganisa kwakawanda kuhutano hwehutano. Asi kana matambudziko achikwira nhengo dzomukati, izvi zvinotyisa muupenyu uye kwenguva yakareba zvinowedzera hupenyu hwedu hwehutano.

Munguva pfupi yapfuura, vanhu vazhinji vanonyunyutira matambudziko emwoyo uye kazhinji kacho idzi zvirwere zvinowanzova nyore kubata uye kuongorora. Asi pane zviitiko apo murwere anoratidza chirwere chenguva yakakura yeQT. Muchirapa, izwi iri rinoreva hunoonekwa kana hunoonekwa humwe munhu, pamwe chete nekuwedzerwa kwehuwandu hwechikamu ichi pane chikamu chechimirojamiro. Uyezve, iyi chirwere chinonzi inongowedzera kureba kupfuura 55 ms kubva kune dzimwe nharaunda. Uye kana chirwere chichikura, kupotsa kwemukati uyu kunogona kunge kune 440 ms.

Zviratidzo

Muzviitiko zvakawanda, kune murwere pachake, chirwere ichi chinopera chisingaenzaniswi, uye hazvibviri kuzviona zvakasununguka. Nenzira yakawanda, vanhu vane chirwere ichi vanopesana nokudzorerazve uye kuora mwoyo, maererano nekushandurwa kwehutano husina kuchena hwemoyo. Zvinokwanisika kuchengeta izvi chete munguva yekutsvakurudza, pamusoro pezvinyorwa zvemichina yakasiyana-siyana. Chinhu chikuru chinokonzera chiitiko ichi ndechokuti kusagadzikana kwemagetsi kwemuviri wemutsipa.

Vanhu vane QT kwenguva yakareba svondo, vane chirwere chisina kubudirira kana kurasikirwa kwayo, vanogona kukura ventricular fibrillation kana ventricular tachycardia. Izvi zvinetso zvinonyanya kuipa kune hupenyu hwevarwere uye zvinokonzera kukuvadza kune mamiriro ezvinhu ose. Panyaya iyi, kana iwe uchifungira chirwere, iwe unofanira kubva uchitarisira utano hwako, zvisinei iwe unogona kuva nemigumisiro yakaipa. Mukuwedzera, zvinetso nehosha iyi zvakanyanyisa. Zvinogona kutungamirira kwete kungovhiringidza mubasa rekushanda uye kuora kwehupenyu huri hwomurwere, asiwo kune zvinouraya.

Aina

Mukurapa, kukanganisa kwakadaro kwakambove kwakadzidzwa, uye masayendisiti akakwanisa kudzidza zvakawanda nezvayo pamusoro pemakore. Ichi chirwere chakakamurwa kuva mapoka maviri, ayo akawana uye congenital syndrome yekuwedzerwa kwemukati weKT. Sarudza kuti ndeupi rudzi rwevarwere hunowanikwa chete nekutsvakurudza. Nechirwere chekuberekwa, pane dambudziko nekukundikana kweiyo genetic code. Nehosha inowanikwa, zvakasiyana-siyana zvinogona kuchinja.

Forms

Kunewo mamwe mhando dzeboka rechirwere ichi:

• Chimiro chakavanzika. Iyo inoratidzirwa nehutano hwemazuva ose panguva yekuongororwa, uye kurwisa kwokutanga kwe syncope kunokonzera kushungurudza kamwe kamwe.
• Iko kunorwiswa kwe syncope, asi nguva ye QT panguva yekuedzwa haifaniri kupera.
• Kuwedzerwa kwenguva iri kure uye hakuratidziki mune anamnesis.
• Syncopal inoti inopfuurira nechinangwa che QT, kupfuura chikamu che 440 ms uye yakakwirira.

Zvinokonzera

Zvinhu zvakawanda zvinogona kukonzera kukura kwechirwere ichi. Saka, somuenzaniso, inotanga kukura nekuda kwehutachiwana, kusanganisira RW syndrome. Muchiitiko ichi, kazhinji kacho kunokonzerwa nekurasikirwa kwekuziva, iyo inotungamirira kukukura kwechirwere ichi. Uyewo chirwere cheE-R-L, kana murwere ane hutema husina maturo. Nekubatanidzwa kwakadaro kwezviratidzo kwakabatanidzwa uye kuti zvakanyatsokonzera sei kukura kwechirwere, masayendisiti haana kukwanisa kuwana. Uyewo kuchinja kwemajini kunogona kukonzera kukura kwechirwere ichi. Ichi ndicho chikonzero chinonyanya kukonzera chirwere chepenital, asi pane dzimwe nguva hachiratidzike pakarepo, asi chave chave chiri munhu mukuru, mushure mokunge kushandiswa kunetseka. Kazhinji ndiyo matambudziko ehutachiona hwepuroteni mumitambo ye sodium uye potassium inova izvo zvinokonzera chirwere chenguva yakakura yeQT. Chikonzero chacho chinogona kunge chiri mumigumisiro yechirango chekutora mamwe mishonga. Kunyanya, zvose zvinotyisa zvinokonzera mishonga inorwisa mabhakitiriya, izvo murwere anogona kutora kuti apore dzimwe zvirwere.

Kuita kuti chirwere chacho chive chirwere chemagetsi kana kuti kudya kunotarirwa kuderedza makirogiramu muzvokudya. Kuyerera kwehupenyu mumamiriro ezvinhu akadaro kunogona kusanganisa kwete mwoyo chete. Nokudaro, kudya kwakadaro kunofananidzwa nechiremba uye nguva dzose iri pasi pekutarisira kwake. Kuderera kunogona kutungamirira kumagariro ehumwe zvirwere zvepfungwa, zvakadai sesischemic kana mitral valve prolapse. Dzimwe nguva chirwere chinowanzokonzerwa neCSS pathologies uye ne vegetovascular dystonia, pamwe nekumwe kushungurudzika kwehutongi hwehutongi hwehutongi.

Zviratidzo

Iko kune zviratidzo zvakasiyana zvinoratidza kuti murwere ane chirwere chenguva yakakura yeQT. Zviratidzo zvechirwere ichi zvinotevera:

• Kurasikirwa kwekuziva kunogara kubva kumaminitsi mashomanana kusvika kwechina cheawa. Mune zvimwe zviitiko, kurwisa kunogona kupera kusvika kumaminitsi makumi maviri.
• Kushungurudzika mumagariro echinyakare, kufanana nechirwere chinokonzera kunze kunobata kunze, asi izvo zvinoita kuti vaite zvakasiyana zvachose.
• Kushaya simba kamwe-kamwe mumuviri, pamwe chete nerima mumeso.
• Kusimba kwakasimba kwemoyo kunyange musipo kwekuita zvekuita muviri kana kushushikana mupfungwa.
• Chifuva chechifu chechimiro chakasiyana, kupfuurira panguva yekubata moyo kwepamwoyo, pamwe nekugunzva kana kugunun'una uye kushaya simba mumaoko nemakumbo.

Diagnostics

Kakawanda, chirwere chenguva yakakura yeQT, mune vana kunyanya, inoitika pasina zviratidzo. Mumamiriro ezvinhu akadaro, murwere anogona kunzwa akanakisisa zvakakwana uye kamwe kamwe anofa. Saka, kana munhu ari munzvimbo ine ngozi yechirwere ichi, zvinofanira kuongorororwa nguva dzose nechiremba kuti ataure kunze kwekukwanisa kuwedzera chirwere chacho. Kuongorora chirwere ichi, mushonga wemazuva ano unoshandisa nzira dzakawanda.

Kana zvichifungidzirwa kuti murwere ane chirwere chakareba cheStT syndrome uye matambudziko ehutano anonyatsoratidza izvi, saka electrocardiography ndiyo inonyanya kukosha kuongorora kurwara. Kuitakura panguva yekurwisa, chigadzirwa chacho chicharatidza zviratidzo zvetricycardia inonzi ventricular, iyo inoshanduka kuva ventricular fibrillation. Iyi nzira ndiyo inonyanya kugadzirisa maitiro echirwere ichi.

Panewo imwezve yedzidzo inobvumira kuziva chirwere chenguva yakakura yeQT. Inoitwa kwezuva. Saka, inonzi zuva nezuva kutarisa kweEECG. Chidzidzo chacho chinobvumira kugadzirisa chirwere chemuviri wehupenyu munguva ino. Chimwe chinhu chiduku chinosungirirwa mumuviri wake, chinonyora kuverenga kwemoyo, uye pashure pokuchibvisa, nyanzvi inobatanidzwa mukududzira data yakanyorwa nechokushandisa. Vanobvumira kuti vaone kana murwere ane chirwere chakaoma chebrascardia, ingave morphology yeT wave iri kuchinja, uye kana kune kukanganiswa mumagadziriro ekudzorera myocardial uye extrasystole ye ventricular.

Kurapa

Kana murwere akaonekwa kuti ane chirwere chakareba cheHT, chirwere chacho chinofanira kunge chakazara uye chakakwana, nokuti nenzira iyi chete inogona kuvhara kukura kwezvinetso zvinokuvadza kuhutano uye zvinogona kuuraya.

Kurapa Kwemishonga

Kuporesa chirwere ichi chinogona kunge chiri kushandisa zvinodhaka zvinodhaka. Kunyatsosarudzwa mishonga yedzidzo hakungogumiri kupedza zviratidzo zvechirwere ichi, asiwo kunogadzirisa mhepo yehutano kwenguva refu. Iyi ndiyo imwe yenzira dzinobvumira kuporesa congenital syndrome yepakati refu QT LQTS.

Mushonga wokuvhiya

Kana murwere ane dambudziko rekutyisidzira upenyu nekuda kwerhythmia mune chirwere ichi, nyanzvi dzinokurudzira kuiswa kwepemaker. Basa rake nderokusimudzira kuwanda kwezvipikiso zvemuviri wemutsipa. Mishonga yemazuva ano yakagadzirisa zvipfeko zvakasarudzwa izvo zvinogadzirisa kukanganisa kwemaitiro mune basa remwoyo. Chirwere ichi chinogona kukonzerwa kubva kunze. Nekushingaira kwemuviri, semuenzaniso, chidimbu hachizopindura. Asi kana pfungwa dzacho dziine hutachiona hwevanhu, inowanzoita basa romuviri.

Kushanda nechirwere chakadai sechirwere chenguva yakakura yeQT iri nyore uye isina kuchengeteka. Iyo pacemaker inosungirirwa kuruboshwe rweganda guru repectoral. Kubva pairi kuenda ma electrode, ayo vanovhiya vanogadzirisa nzvimbo inodikanwa, vachiitungamirira kuburikidza nemhepo inonzi subclavia. Chigadzirwa chacho chinogona kugadziriswa kuburikidza nemuitevedzeri. Nezvo, iwe unogona kuchinja zviyero zvekukurudzira mwoyo, zvichienderana nezvinodiwa nemurwere. Chigadzirwa chacho chichashandurwa nguva dzose kana musimba wemwoyo inoshanda ichienda mberi kwepasimenti yepassetse.

Mhedziso

Chirwere ichi hachigoni kuonekwa nguva dzose, sezvo chisingawanzozviratidza zvakajeka. Asi panguva imwechete kutyisidzirwa kwehutano hwemurwere kwakanyanya kwazvo. Nokudaro, kana pane zvingangova pangozi duku yekuitika kwayo, zvakakosha kuti nguva dzose iongorore kuongororwa uye kubvunzurudza nevadzidzisi. Kana kuongororwa kuri kusimbiswa, saka chirwere chakakwana uye chakakwana chechirwere ichi chinodikanwa, nokuti chinogona kutungamirira kurufu.