Rudzi Rwakanyanya Kupisisa Rwenyoka
ST-chikamu kukwirira myocardial infarction (STEMI) izwi rokuti cardiologists rinoshandisa kurondedzera kushaya mwoyo kwemoyo. Imwe rudzi rwemyocardial infarction umo chikamu chemwoyo musumbu (myocardium) yakafa nekuda kwekudziviswa kweropa kunzvimbo yacho.
Chikamu cheS ST chinoreva chikamu chakaperera chekuverenga kwe electrocardiogram (ECG) uye chinomiririra nguva iri pakati pemakumbo emwoyo.
Kana munhu ane chirwere chemwoyo, chikamu ichi hachizove chakanyarara asi chichaonekwa chisina kukwidziridzwa.
Aina uye Kuoma STEMI
STEMI imwe yemhando mitatu yeAacute coronary syndrome (ACS) . ACS inoitika apo bundu rinoputika kubva mukati megoni yerononi, zvichikonzera kusagadzikana kusina chikamu kana chakakwana cheyeri iyoyo. Kuvhiringidzika pachako kunokonzerwa apo ropa rinogadzika rakaita zvakapoteredza nzvimbo yekupera.
Kana kudziviswa, chikamu chemuviri wemwoyo chinoshandiswa nemutsetse iwoyo chichakurumidze kutambura nekushayikwa kweokisijeni, inonzi ischemia . Chep pain ( angina ) inowanzova zviratidzo zvekutanga zveizvi. Kana kuvharidzirwa kwakazara zvakakwana, imwe yemutsipa wemwoyo inotanga kufa, zvichiita kuti myocardial infarction.
Isu tinoronga ACS nehuwandu hwekudzivirira uye izvo zvinokonzera kukanganisa kumutsipa wemwoyo:
- Kana kukanganisa kwakakwana kwechirwere chechironi kuchiitika, zvichiguma nekufa kwemwoyo mutsvuku, tinotarisa kuti se STEMI, iyo yakaipa yeAACS.
- Zvisinei, pane dzimwe nguva, zvivharo zvichaumba, kuputsa, uye kuvezve patsva munguva yemaawa kana mazuva pasina kukonzera kugadziriswa kusingagumi. Kana izvi zvikaitika, munhu wacho angangonzwa pa-zvakare-off-zvakare angina kunyange apo zororo. Izvi zvinonzi ACS inonzi yakasimba isinaina .
- Pakati pe STEMI uye angina isina kugadzikana ndeimwe mamiriro ezvinhu anotaridzwa se "sarudzo yemwoyo." Izvi zvinoitika apo kuvhiringidzika hakubvisi zvachose ropa rekuyerera. Nepo imwe sero rufu ichaitika, dzimwe nhengo dzemaviri dzichapona. Mushonga wezvokurapa weiyi isati iri-ST-segment elevation myocardial infarction ( NSTEMI ).
Pasinei nokuti chiitiko cheAACS chinoratidzirwa sei, ichichiri kuonekwa sechirwere chekukurumidzira kunze kwekuti angina isina kugadzikana uye NSTEMI inowanzotanga zviratidzo zvekurwisa kwemoyo.
Zviratidzo zve STEMI
STEMI inowanzokonzera kurwadziwa kwakanyanya kana kupindira mukati kana kupoteredza chifukidzo, kazhinji kunowedzera kumutsipa, tambo, fudzi, kana ruoko. Zvinokurudzira kufema, kufema, uye pfungwa yakasimba yekuuya kwekuparadzwa kunowanzoonekwawo. Pane dzimwe nguva, zviratidzo zvingave zvisinganyatsooneki, kuratidzira nemasikirwo asina simba kana zviratidzo zvakadai se:
- Uturu hwakapoteredza mapepa emafudzi, ruoko, chifuva, tambo, kuruboshwe, kana mudumbu
- Kunzwa kunorwadza kunorondedzerwa sekuve "nehombodo mubhokisi"
- Kusagadzikana kana kusungwa mumutsipa kana ruoko
- Kuzvipira kana kuora mwoyo
- Nausea uye kurutsa
- Kuneta kana kuora mwoyo kamwe kamwe
- Kupfupika kwemhepo
- Uchechezi kana kuchena
- Kuwedzerwa kana kusagadzikana kwepfungwa yemwoyo
- Clammy ganda
Sezvo mutemo wehuwandu hwechigunwe, munhu wose ari pangozi yekurwisa kwemwoyo anofanira kubhadhara zvakanyanya chero chiratidzo chipi zvacho chisingawanzobuda kubva kumusoro kwechiuno.
Kuongororwa kwe STEMI
Muzviitiko zvakawanda, kuongororwa kweSIMEMI kunogona kuitwa nokukurumidza kana munhu ari pasi pekurapa. Kuongororwa kwezviratidzo, pamwe chete nekuongororwa kwechikamu che ST pane ECG, zvinowanzoita kuti chiremba atange kurapwa.
Kuongororwa kwemakemikari emwoyo kunogonawo kubatsira asi kazhinji kunosvika zvakanaka mushure mokurapa kwakanyanya kunotanga.
Zvakakosha kugadzirisa munhu wacho nokukurumidza sezvinobvira. Mukuwedzera kune kurwadziwa uye kushushikana, STEMI inogona kukonzera kufa kamwe kamwe nekuda kwekuvhiringidzika kwemhepo (kushungurudza kwakakomba kwomwoyo rhythm) kana kushaya mwoyo kusakundikana (apo mwoyo haugoni kupompa ropa rakakwana kuti ripe muviri zvakanaka).
Mushure mokunge chirwere chemwoyo chave chichitanga, maronda acho pachawo angasara ane kukuvadza kwekusingaperi. Kushushikana kwemoyo kusingaperi ndiko kunowanzoguma kweizvi, sekuwedzera kwehuwandu hwehutano hwemagodhiyrmiaas (kusagadzikana kwepfungwa).
Mushonga we STEMI
Mishonga inofanira kutanga iyo nguva STEMI inowanikwa. Mukuwedzera pakupa mishonga yekusimudzira musimba wemwoyo (kusanganisira morphine, beta blockers , uye mishonga yemasitini ), kuedza kuchaitwa kuti udzidzire zvakare kuvharidza arteri yakavharidzirwa.
Izvi zvinoda kukurumidza. Kunze kwekuti mutambo uzarurirwa mukati maawa matatu ekuvhara, zvimwe zvimwe zvacho zvinokanganisa zvachose zvinogona kutarisirwa. Kazhinji, zvizhinji zvekukuvadza zvinogona kuderedzwa kana dare risina kubhurwa mukati maawa matanhatu ekutanga okurwisa. Kusvikira maawa gumi nemaviri, imwe mhirizhonga inogona kudziviswa. Mushure mezvo, iyo inotora nguva yakareba kuti irege kubvisa ariti, kuwedzera kukuvadza kuchavapo.
Pane nzira dzakawanda dzokugadzirisazve chigadziro chekudzivirira:
- Thrombolytic therapy inosanganisira kushandiswa kwemishonga ye-clot-busting.
- Angioplasty ndiro izwi rezvokurapa rekugadziriswa kwekugadzira / kuzarurazve arteri.
- Kutsiva kunosanganisira kuisa mesh tube kuti aisezve arteri.
Kamwe chikamu chakaoma chekurapa chapera, uye chivharo chakavharidzirwa chinotangwa zvakare, kuchine zvakawanda zvinotofanira kuitwa kuti zvigadzikane mwoyo, uye kuderedza mamiriro ehumwe hutsinye hwemwoyo.
Izvi zvinowanzobatanidza nguva yakareba yekudzoka, kusanganisira chirongwa chekugadzirisa zvirongwa, kushanduka kwezvokudya, uye kushandiswa kweanticoagulants (ropa vanocheka) uye kumira kwemishonga yekurapa.
> Kwakabva:
> O'Gara, P .; Kushner, F .; Ascheim, D .; et al. "2013 ACCF / AHA Nhungamiro yehutungamiri hweS ST-elevation Myocardial Infarction: Executive Summary: Nhoroondo yeAmerican College of Cardiology Foundation / American Heart Association Task Force pamusoro Pemitemo Yezvokuita." Zvinyorwa zveAmerican College of Cardiology. 2013; 61 (4): DOI: 10.1016 / j.jacc.2012.11.018.