Kunyanya kunetseka kunokonzerwa ne- atrial fibrillation is stroke . Mune fiber fibrillation, iyo atria yemwoyo haigoni kurova zvakanaka, iyo inobvumira ropa kuti "dzive" mukati memakamuri aya.
Somugumisiro, anrial thrombus (ropa clot) inogona kuumba. Pakupedzisira, inouraya inrombrus inogona kuvhara-kureva, inogona kusunungura uye inofamba nemumatope.
Kazhinji kacho, ichi chinenge chichizogara muuropi, uye chigumisiro chacho chirwere.
Saka kana iwe uine atrial fibrillation, chiremba wako anofanira kuenzanisa kuongororwa kwengozi yako yekurohwa, uye kana ngozi iyo yakakwirira zvakakwana, iwe unofanira kuiswa kune kurapwa kuti udzivise ropa rekuvhara kubva pakuumba, uye saizvozvo, kudzivirira chirwere.
Kuona Ngozi Yako
Kufungidzira njodzi yako yekurohwa kana iwe uine hutachiona hwehutachiona hunoda kufunga nezvezera rako, zvepabonde, uye zvimwe zvirwere zvaungave nazvo. Chokutanga, kana uine chirwere chemwoyo chinonzi valvular kuwedzera kune utachiona hwemagetsi, iwe uchada kurapwa kuti udzivirire ropa, nokuti dambudziko rako rekurohwa rinowedzera.
Kana iwe usina chirwere chemwoyo, chiremba wako angangodaro anoshandisa chigadzirisa chinotyisa, chinonzi CHA2DS2-VASc chikwata, kuenzanisa dambudziko rako rekurohwa. Mune vanhu vane atrial fibrillation, yakasimudza chikamu CHA2DS2-VASc, inowedzera dambudziko rekurohwa.
Zviratidzo zve CHA2DS2-VASc mabhesi kubva pane zero kusvika mapfumbamwe uye inotarirwa seinotevera:
- Kukanganisa mwoyo kukanganisa = imwe pfungwa
- Hypertension = imwe pfungwa
- Zera 75 kana kupfuura = mairi maviri
- Chirwere cheshuga = imwe pfungwa
- Pamberi purojekiti kana TIA = zvikamu zviviri
- Peripheral artery disease = imwe pfungwa
- Zera pakati pe 64 kusvika 74 = imwe pfungwa
- Mukadzi wechikadzi = imwe pfungwa
Iyo yakasimudza chikamu CHA2DS2-VASc, inowedzera ngozi yegore negore yekurohwa. Saka, kana chikwata chako chiri zero, dambudziko rako rekurohwa is 0.2 muzana pagore, iro rakaderera. Kana uwandu hwako huri zviviri, njodzi yegore negore inodarika 2.2 muzana, uye inokurumidza kubva ipapo. Chikamu chepfumbamwe chinokonzera njodzi yegore negore yekurohwa kwe12.2 muzana. (Nenzira yekufananidza, kune vanhu 100 vese vanopfuura makore makumi matanhatu nevashanu vasingasviki nefriday fibrillation, inenge imwechete pagore ichava nesitiroko.)
Kuchengetedza Stroke Risk
Kushandiswa kweanticoagulant madhiragi kunogona kuderedza zvikuru njodzi yekuti kubatana kubva kuruboshwe kuruboshwe kunokonzera kushungurudzwa kune vanhu vane friction inrial. Zvisinei, zvinodhaka izvi zvinotakura dambudziko rekubudisa chiitiko chikuru chekubuda ropa, kusanganisira chirwere chinopisa (kuchenesa muuropi). Inofungidzirwa kuti muvhareji wegore negore wekurohwa kunokonzerwa neanticoagulants ndi 0.4 muzana.
Izvi zvinorevei kuti kushandisa anticoagulant zvinodhaka zvinonzwisisika apo njodzi yekurohwa kubva kuArifria fibrillation inonyanya kukura kudarika dambudziko rekurohwa kubva pamushonga. Vanachiremba vanobvumirana, nokuda kwechikamu chikuru, kuti kune varwere vane nonvalvular atrial fibrillation vane CHA2DS2-VASc puroti ye zero, anticoagulation haifaniri kushandiswa. Nezviviri zvepamusoro kana kupfuura, zvinodhaka zveanticoagulant zvinofanira kunge zvichishandiswa nguva dzose.
Uye nokuda kwehuwandu humwe, kurapwa kunoda kuve munhu mumwe oga kune mumwe murwere.
Kare, vanachiremba vaifunga kuti kana vakabudirira mukushandisa " rhythm control therapy " yeatrial fibrillation (kureva, kurapwa kwakagadzirirwa kuvhara friction fibrillation nekuchengetedza chimiro chepakati chemoyo), njodzi yekurohwa ichaderera. Zvisinei, hutano hwekliniki kusvika zvino hwakakundikana kuratidzira kuti rhythm control therapy inoderedza ngozi yekurohwa. Saka kunyange kana iwe uye chiremba wako uchisarudza rhythm control therapy, unofanirwa kurapwa kuti udzivise chirwere kana chirongwa chako CHA2DS2-VASc chakakwanira zvakakwana.
Ndezvipi Zvinodhaka Zvokushandisa?
Mishonga inobudirira mukuderedza dambudziko rekurohwa muropa yefriday fibrillation ndiyo anticoagulant madhiragi.
Aya ndiwo madhiragi anovhiringidza kuvhara ropa , uye zvinodzivisa kuumbwa kweropa. Mune varwere vane fibrillation inrial, anticoagulation inoderedza dambudziko rekurohwa zvakanyanya-neanenge zviviri-zvitatu.
Kusvikira makore mashomanana adarika, bedzi chisingaperi chemuromo anticoagulant mishonga yaive yakawanikwa yaiva warfarin ( Coumadin ), chirwere chinodzivisa vitamini K. (Vitamin K inobatsira pakuita zvakawanda zvekuvhara.) Kutora Coumadin kunonyanya kusagadzikana uye kazhinji zvakaoma, zvakadaro. Periodic uye kazhinji kazhinji kuongororwa ropa kunodiwa kuti uone "kuderera" kweropa uye kugadzirisa chirwere cheCoumadin. Uyewo, zvinorambidzwa kudya zvinodyiwa zvinodiwa sezvo zvokudya zvakawanda zvinogona kuchinja chiito cheCoumadin. Kana muyero usingashandurwi zvakanaka kana kazhinji, ropa rinogona kuva "rakaonda kwazvo" kana kuti kwete rakaonda zvakakwana, uye kana chimwe chinogona kukonzera zvinetso zvakakomba.
Mumakore mashomanana apfuura, mishonga yakawanda yemaanti anticoagulation yakagadzirirwa iyo isingaiti nekudzivisa vitamini K, asi panzvimbo iyo inodzivisa zvakananga zvimwe zvivharo. Izvi zvinonzi "inozive anticoagulant" zvinodhaka, kana kuti NOACs. NOACs zvino inogamuchirwa muU.S. dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), uye edoxaban (Savaysa).
Iyi mishonga yose inobatsira pane Coumadin. Vanoshandisa maitiro akachengetedzwa zuva rimwe nerimwe, saka kudiwa kwechiitiko chekuongorora ropa uye kuchinja kweiyo kubudiswa. Hazvitsvaki zvipingamupinyi zvekudya. Uye zvidzidzo zvekuchipatara zvakaratidza kuti mishonga iyi mitsva inofanira kuva yakakosha uye yakachengeteka seCoumadin.
Pane zvimwe zvipingamupinyi kuNoACs, zvisinei. Iyo inodhura zvakanyanya kudarika Coumadin, uye kusiyana neLoumadin (iyo inogona kukurumidzirwa kuchinjwa nokupa vitamin K) zvakaoma kuchinja maitiro avo anticoagulant kana dambudziko guru rekubuda ropa rinofanira kuitika. (Kusiyana kusvika kure iyo Pradaxa, mushonga wezvinodhaka uyu wakagamuchirwa muna Gumiguru 2015.)
Mazhinji nyanzvi iye zvino anosarudza kushandisa chirongwa cheNoac pamusoro peCoumadin kune varwere vane inrial fibrillation. Zvisinei, pane vanhu vane Coumadin vachiri kusarudzwa. Coumadin inoramba iri sarudzo yakanaka kana uri kutora Coumadin uye wakagara wakadzikama zvachose pamushonga kana kana uchida kutora mapiritsi kaviri pazuva (izvo zvinotarisirwa kuti Pradaxa naEriquis) kana kana iwe usingakwanise kutenga mari yakakwana yezvino mishonga mitsva.
Mechanical Methods
Nemhaka yezvinetso zvinokonzerwa nekutora anticoagulant zvinodhaka, kuedza kwakave kuchienderera mberi kukura mishonga inogadziriswa kuedza kudzivirira kugadzikana mune varwere vane fibrillation yeAricrial. Iyi nzira dzave dzakatarirwa kuvhara kushandiswa kwemashure ekupedzisira (a "pouch" yebato rinonzi atrium rinosara kubva pakukura kwe fetus). Icho chinotarisa kuti vazhinji vezvipfeko zvinowanikwa muchechi yekunze pairi panguva yefriday fibrillation inowanikwa mumhepo inopera.
Nzvimbo yakasara yega yega inogona kusarudzwa kubva pakuparadzirwa nenzira yekuvhiya kana nekuisa chigadzirwa chakakosha mumuchengetedza kuburikidza nekateti. Kunyange zvazvo vaishandisa kliniki, mbiri idzi idzi dzine dambudziko guru, uye panguva ino dzakachengeterwa zviitiko zvakakosha.
Summary
Stroke ndiyo inotya, uye zvinosuruvarisa zvakanyanya, kunyanya kunetseka kwehutachiona hwehutachiona. Saka kuderedza ngozi yako yekurova chirwere chimwe chinhu iwe uye chiremba wako unofanira kutora zvakanyanya. Nenzira inofadza, iwe iwe kana chiremba wako ukasangana nechinetso nenzira yakarongeka-uchitarisa dambudziko rako uye uchibata zvakakodzera-zvaunofunga zvekudzivisa nyaya iyi zvichavandudzwa zvikuru.
Sources:
Fuster, V, Ryden, LE, Cannom, DS, et al. ACC / AHA / ESC 2006 Nhungamiro Yekutungamira Kwevarwere Nehutachiona hweArper A Report of the American College of Cardiology / American Heart Association Task Force pamusoro Pemitemo Yezvokuita uye neEuropean Society of Cardiology Komitungamiri Yekushandisa Mazano (Komiti Yokunyora kuongororazve Zvinyorwa zve2001 nokuda kwekutungamira kwevarwere nehutachiona hwepanyika). J Am Coll Cardiol 2006; 48: e149.
Fang MC, Go AS, Chang Y, et al. Kuenzaniswa kwezvirongwa zvekuchengetedza njodzi yekufananidzira kufungidzira thromboembolism kune vanhu vasina mavhirivular atrill fibrillation. J Am Coll Cardiol 2008; 51: 810.