Kwiindlela ezimbini eziqhelekileyo ezisetyenziselwa ukhathaza i-fibrillation ye-agrification , indlela ejolise ekubuyiseni nokugcina isisu sesiqhelo (indlela yokulawula isigqi) ebusweni bayo ibonakala iyinqweneleka. Nangona kunjalo, kuba le ndlela inokuthatha ingozi enkulu kwaye ayisoloko isebenze ngokupheleleyo. Akulungele wonke umntu.
Indlela yokulawula isigqi iquka amanyathelo amabini aqhelekileyo: ukubuyisela nokugcina intsingiselo yentliziyo evamile.
I-Cardioversion: Ukubuyisela iRhythm yesiNgqiqo eqhelekileyo
Ukuba unesibindi sokuphefumula, ugqirha wakho unokuzama ukubuyisela isigqithiso sakho senhliziyo ngokusebenzisa iziyobisi ezinqamlekileyo okanye i-cardioversion yamandla kagesi.
Izidakamizwa eziliqela ezinokuthi zinikezelwe ngenyameko ekuzameni ukuyeka ukufabiliswa kwegazi kunye nokubuyisela isigqi esivamile. Ezi ziquka i-Tambocor (flecainide), i-Corvert (ibutilide), iRhythmol (propafenone), kunye ne-Tikosyn (i-dofilelide). Nangona kunjalo, eli liyeza liza kubuyiselwa ngempumelelo isigqi sesigxina kuphela ngama-50 ekhulwini ukuya kuma-60 ekhulwini kwexesha, kwaye kuya kuba nemiphumo emibi.
Uninzi lwabalandeli be-cardiologists bakhetha ukuphefumula kombane endaweni yoko. Nge-cardioversion yombane, uza kufakwa ebuthongweni, ukulala kwe-anesthesia embalwa imizuzu. Ugqirha uya kuqhuba ukukhutshwa kombane kwisifuba sakho usebenzisa isethi yamadada. Le nkqubo ayibuhlungu, ikhawuleza, ikhuselekile kwaye iphantse iphumelele.
Inkxalabo enkulu ye-cardioversion ayiphumeli kwinkqubo ngokwayo, kodwa kunoko kukuphumela kwe-cardioversion ephumelelayo.
Ukuba ama-clots amatsha ekhoyo akhoyo kwi-atria xa intliziyo iqala ukubetha ngokuqhelekileyo kwakhona, ama-clots angakwazi ukuphazamisa kwaye abangela ukubetha . (Oku kunokwenzeka nanini na nge-fibrillation ye-atrial kodwa kungenakwenzeka ukuba kwenzeke emva kokuba isigqithiso senhliziyo esele sibuyiselwe.) Esi siganeko asiqhelekanga emva kwe-cardioversion, kodwa xa kwenzekayo inokuphazamiseka.
Umngcipheko we-post-cardioversion stroke unokuncitshiswa kakhulu okanye ngokunyanga nge-antiticoagulant drug (igazi elincinci) kwiiveki ezimbalwa ngaphambi kokuba wenze i-cardioversion okanye ngokubhaliweyo ukuba akukho zikhethi kwi-atrium ekhohlo ngokuqhuba i- echocardiogram ye-transopoprogeal ngaphambi kwe-cardioversion. Ukongezelela, ukuba kuqinisekiswe ukuba i-fibrillation ye-atrial ibekho kwiiyure ezingama-24, i-cardioversion ingenziwa ngokukhuselekileyo.
Eli nyathelo lokuqala lokulawula isigqi-ukubuyisela isigqithiso senhliziyo esipheleleyo-siphumelele ngaphezu kwe-98% yexesha.
Ukugcina isiqhelo sesiqhelo
Iqhinga lokwenene lokulawula isigqi ligcina isandi sesiqhelo senhliziyo xa sele sibuyiselwe. Ngokuqhelekileyo, kunye nesigaba sokuqala se-fibrillation ye-agriyo, oogqirha abaninzi baya kubuyisela isigqithiso esivamile kwaye bathumele ekhaya isigulane kungekho nonyango oluthile lwenyango (ngaphandle kwonyango, ngokuqinisekileyo, nayiphi na into ebangela ukuba i-fibrillation ye-atrial ishicilelwe). Abantu abaninzi baya kugcina isigqi sesigqirha kwiinyanga okanye nokuba neminyaka ngaphandle kwonyango lokusetyenziswa kweziyobisi.
Nangona kunjalo, ngokukhawuleza okanye kamva i-fibrillation ye-atrial isenokubuyela kwakhona. Xa oko kwenzeka "isondlo" isigaba senkqubo yokulawula isigqi kuya kuba nzima kakhulu.
Ininzi ngokuqhelekileyo, xa isigqimi esivamile sibuyiselwa ugqirha uya kuncoma enye yezidakamizwa ezichanekileyo ukukhusela ukuphindaphinda kwe-fibrillation ye-atrial. Ngelishwa, iziyobisi ezinqamlekileyo, ngaphandle kokuphakathi kwezidakamizwa ezinobungozi ezisetyenziselwa unyango, zisebenza ngokukhawuleza ukugcina i-fibrillation ye-atrial ingabuyi. Ngenxa yoko, ukufezekisa injongo yokulawula isigqi kudla ixesha elide ludinga "izilingo" ezininzi ngezidakamizwa, zikhangela enye egcina isigqi esivamile kwaye iyanelisekile ngokwaneleyo.
Ngaphandle kwendlela yokuvavanya-kunye nephutha, isicatshulwa esichaphazelekayo esenza ulawulo olufanelekileyo lwefayibrillation ye-atrial ngaphandle kokubangela iziphumo ezichaphazelekayo ziza kufumaneka kwisiqingatha sithuba.
Olu hlobo lwezinga lokuphumelela ngezilwanyana ezinqamlekileyo lishiya kakhulu into enqwenelekayo. Ngenxa yalesi sizathu, oogqirha nabaphandi baye basebenza nzima kwiminyaka engaphezu kweli-10 ukuze babe neendlela ezikhuselekileyo nezisebenzayo "zokunyanga" i-fibrillation ye-atrial-oko kukuthi, ukugcina intliziyo yesigxina ngokusisigxina-usebenzisa i-catheter-based ablation procedures . Nangona kukho inkqubela eninzi eyenziwe, ukwelashwa kwe-acill for frilling inrial is still effectively and still holds a risk of serious complications. I-Ablation yinto enhle kwizigulane ezithile ezine-fibrillation ye-atrial, kodwa akuyiyo yonke into.
Ekugqibeleni, kwizigulane eziphumelelayo ukulawula isigqi sonyango kunye ne-ablation, ubungqina obunje bubonisa ukuba umngcipheko wokuba uhlangothi luhlale luphakanyisiwe. Ngoko ke, ezininzi iingcali zincoma ukuba izi gulane zihlale zonyango lwama-antiticoagulation nxamnye nokuba ziyingqungquthela evamile.
Isishwankathelo
Ukuba indlela yokulawula isigqi yokuphatha i-fibrillation ye-atrial yayinokukhuseleka kwaye isebenzisekile, ngoko iya kusetyenziswa phantse kuwo wonke umntu onokwenza oku ku-arrhythmia. Ngelishwa, ngelixa i-rhythm yolawulo ngokucacileyo yindlela efanelekileyo kubantu abaninzi, ishiya into enqwenelekayo. Yingakho enye indlela yokulawulwa kwemilinganiselo yeendlela-isetyenzisiweyo endaweni yezigulane ezininzi. Yaye yimi kutheni kufuneka ufunde njengoko unakho malunga nazo zonke iindlela ngaphambi kokuba wenze isigqibo malunga nonyango olufanelekileyo lwe-fibrillation yakho.
Imithombo:
Fuster, V, Ryden, LE, Cannom, DS, et al. I-ACC / AHA / ESC 2006 Izikhokelo zokuLawula izigulane ezine-Fibrillation ye-Atrial Ingxelo ye-American College of Cardiology / American Heart Association Umsebenzi wamaKhokelo kunye ne-European Society yeKomiti yeCardiology yokuSebenza ngeziKhokelo (iKomiti yokuBhala ukuHlola izikhokelo zika-2001 ukuLawula izigulane ezine-Fibrillation ze-Atrial). J Am Coll Cardiol 2006; 48: e149.