Ukuba une- infyoction ye-myocardial (MI, okanye ukuhlaselwa kwentliziyo), ugcine umonakalo othile kwintliziyo yakho. Ukuba kukho umonakalo okwaneleyo, unokuba usengozini yokuphulukisa intliziyo . Ngoko, ukuthatha amanyathelo okukhusela ukungaphumeleli kwentliziyo yinto ebalulekileyo yonyango emva kwe MI.
Kubantu abano-MI enkulu kakhulu, umngcipheko wokusilela intliziyo unokuphakama.
Kulezi zigulane ukuqala kokukhubazeka kwentliziyo kunokuba nzima, rhoqo kwiiyure ezimbalwa zokuqala okanye iintsuku.
Kodwa nangona i-MI ibangele kuphela umonakalo we-muscle ngokulinganiselayo, ukuphela kwentliziyo kungenzeka. Ulwaphulo oluchanekileyo lweziyobisi kunye nokuguquka kwendlela yokuphila kunokubaluleka ekulibazisekeni okanye ekuthintela ukuqala kwentliziyo.
Yintoni Ukulungiswa?
Ingaba okanye ukungaphumeleli kwentliziyo kwenzeka emva kokuba i-MI ixhomekeke kumlinganiselo omkhulu ngendlela i-heart muscle engaphazamanga isabela ngayo. Emva kwe-MI, imisipha yentliziyo ephilileyo "isalula" kwizame zokuthatha umthwalo womsebenzi we-muscle eyonakalisiwe. Ukwelula oku kukhokelela ekwandiseni kwentliziyo, inkqubo ebizwa ngokuthi "inhliziyo".
Ukuncedisa kunceda inkontileka yeenhlunu zengqondo engapheliyo, kwaye ikuvumela ukuba wenze umsebenzi othe xaxa. Intliziyo yesisu iziphatha into enjengebhola ye-rubber; xa usolulela ngokwengeziwe, "ngaphezulu" kunayo. Nangona kunjalo, ukuba ubeka i-rubber band, okanye uqhubeke ulula ngokugqithiseleyo ixesha elide, ekugqibeleni lilahlekelwa "i-snap" yalo kwaye liba li-flaccid.
Ngelishwa, isisu senhliziyo senza into efanayo. Ukwelula okungapheliyo kwintliziyo yentliziyo kubangela ukuba buthathaka, kunye nokungafuneki kwentliziyo kunokubangelwa. Ngoko ke, ngelixa ukulungiswa kwezinto kunokunceda intliziyo isebenze kangcono kwixesha elifutshane, ukulungiswa kwexesha elide yinto embi. Ukuba ukulungiswa kwinto inokuthi ithintelwe okanye ingagqithwanga, umngcipheko wokuphulwa kwentliziyo unciphisa.
Ukulungiswa Kokulungiswa Kwenziwe Njani?
Inxalenye ebalulekileyo yokuvavanya impilo yakho emva kokuba i-MI iqikelele ukuba kuyenzeka kangakanani ukulungiswa kwentliziyo. Le ngcaciso ingafumaneka ngokwenza i- MUGA ukuskena okanye i- echocardiogram , iindlela ezimbini zokungakhange zibonise i- ventricle ekhohlo .
Indlela efanelekileyo yokuqikelela inani lomonakalo wentliziyo ebangelwa yi-MI, kunye nomlinganiselo wokulungiswa okwenzekayo, kukulinganisa iqhekeza le- ejection ejection (LVEF). I-LVEF yipesenteji yegazi ejoyiweyo nge-ventricle yekhohlo kunye nenhliziyo nganye. Ngenjongo yokwandiswa kwentliziyo (oko kukuthi, ngokulungiswa), inxalenye ye-ejection iyawa. Ukuba i-LVEF ingaphantsi kwama-40% (ngokuqhelekileyo ibe ngama-55% okanye ngaphezulu), ngoko ke umonakalo omkhulu wemisipha uyenzeka. Umzantsi we-LVEF, umonakalo omkhulu, ukulungiswa kwakhona - kunye nomngcipheko wokuphulukisa intliziyo.
Ukukhusela iCardiac Remodeling
Izifundo ezininzi zeklinikhi zibonise ukuba iiklasi ezimbini zezidakamizwa zinokunciphisa kakhulu ukulungiswa emva kwe-MI, kwaye kuphuculwe ukusinda kwezigulane ezineempawu zokungaphumeleli kwentliziyo. Ezi zi yobisi ziyi- blocka blockers kunye ne- ACE inhibitors .
B block blockers basebenza ngokuthintela umphumo we-adrenaline entliziyweni, kwaye banemiphumo ebalulekileyo kwiintlobo ezininzi zesifo senhliziyo.
Iibet blockers zinciphisa umngcipheko we- angina kwizigulane ezinezifo ze- coronary disease (CAD) ; ukuphucula ukusinda kwezigulane ezinokukhubazeka kwentliziyo; ukunciphisa umngcipheko wokufa ngokukhawuleza kwizigulane emva kokuhlaselwa kwentliziyo; kunye nokulibaziseka, ukuthintela nokuze kube lula ukuguqulwa kwenhliziyo emva kwe MI.
Ngoko, ngaphandle kokuba kukho izizathu ezinamandla zokungazisebenzisi (ezinye izigulane ezinezifo ezinzima zesifo se-asthma okanye ezinye izifo zamaphaphu azikwazi ukuzisebenzisa ezi ziyobisi), phantse zonke iintsholongwane zentsholongwane kufuneka zifakwe kwi-beta blocker. I-blocka eyaziwa ngokuqhelekileyo emva kokuba i-MI i-Tenormin (i-atenolol) ne-Lopressor (i-metoprolol).
Ii-inhibitors ze-ACE ziphucula kakhulu impilo yokuhlala ixesha elide emva kwe-MI enzima, kwaye ngaphezu koko, ukunciphisa ingozi yokuphulukisa intliziyo (kubonakala ngokuthintela okanye ukulibazisa ukulungiswa). Kananjalo banciphisa umngcipheko we-MIs rhoqo, ukubetha, kunye nokufa ngokukhawuleza.
I-ACE inhibitors, njenge-blocka blockers, ithathwa njengokuba kufuneka ukuba uhlaselwe yintliziyo. I-Vasotec (i-enalapril) kunye neCapoten (i-captopril) yizilwanyana ezisetyenziswa kakhulu emva kwe-MI.
Ukugcina iMpilo yeCardia
Ukongeza kwiprogram ejoliswe ngokukodwa ekukhuseleni ukukhubazeka kwentliziyo emva kokuhlaselwa kwentliziyo, uya kufuna ezinye iindlela ezibalulekileyo zokulondoloza impilo yakho yempilo. Nantsi i-post-check attack checklist kufuneka ubuyekeze ugqirha wakho.
Kwaye nangona ungeke wenze nantoni na malunga nokuba sele unayo i-CAD, kukho izinto ezininzi ozenzayo ukucotha okanye ukuyeka ukunyuka kwe-CAD yakho, kwaye ngokunjalo ukukhusela umonakalo wentliziyo. Ezi ziquka amanyathelo okuphucula ukutya kwakho, amaqondo e-cholesterol, amandla okusebenzisa, kunye nokwandisa ubunzima bakho kunye noxinzelelo lwegazi.
> Imithombo:
I-Nuttall, i-SL, i-toescu, i-V, i-Kendall, i-MJ. beta I-Blockade emva kwe-infyoction ye-myocardial. Ababhali bebeta banendima ephambili ekunciphiseni ukuxhatshazwa nokufa emva kokuphazamiseka. BMJ 2000; 320: 581.
Smith, SC Jr, Allen, J, Blair, SN, et al. Izikhokelo ze-AHA / I-ACC zokukhusela okwesibini kwizigulane ezinezonyango kunye nezinye izifo zesifo se-atherosclerotic: uhlaziyo luka-2006 oluvunywe yiNational Heart, Lung, ne-Blood Institute. J Am Coll Cardiol 2006; 47: 2130.
Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF / AHA izikhokelo zolawulo lwe-ST-elevation infarction: isishwankathelo esipheleleyo: ingxelo ye-American College of Cardiology Foundation / i-American Heart Association Task Force kwiZikhokelo zokuSebenza. Uhambo luka-2013; 127: 529.