Izvo zvinodzidza tafura yekudzidza inoshandiswa kuongorora varwere vane syncope (kurasikirwa kwekuziva) iyo inofungidzirwa kuti inokonzerwa nevasovagal episodes . Icho chidzidzo chakareruka zvikuru, uye muzviitiko zvakawanda zvakachengeteka.
Kuedzwa Kwakaitwa Sei
Muchifukidzo chetafura yakadzika, murwere anonamatira patafura, iyo inobva yasungirirwa kune imwe nzvimbo yakarurama.
Kunyange zvazvo pachitarisa kupisa, ropa, electrocardiogram , neropa rega oxygen saturation , murwere anosara mu "nzvimbo isina kusimirira" maminitsi gumi kusvika makumi matanhatu.
Mune munhu ane vasovagal syncope, patafura yekudzidzira tafura inowanzozadza syncopal episode. Kana izvi zvikaitika, chidzidzo chinonzi chakanaka, uye kuonekwa kwevasovagal syncope kunosimbiswa.
Kuedzwa Kwakaitwa Sei
Munguva yekutenderera kwakarurama - kana kuti panyaya iyi paimire-yemunhu yemwoyo inofanirwa kuzvirongedza pachayo kuitira kudzivirira chikamu chakakura cheropa ropa kubva pakubatanidza mumakumbo.
Izvi zvinogadziriswa zvinowedzera kuwedzera kwepfungwa yemwoyo uye kusunungura kwemidziyo yeropa mumakumbo. Kana munhu akajairika akaiswa muchitenderedzwa chakarurama, izvi zvinokonzerwa nemwoyo mhepo zvinoitika nokukurumidza, uye hapana doro rinokosha muropa.
Zvisinei, kune varwere vane marudzi maviri e syncope - orthostatic hypotension uye vasovagal syncope - kuchinja kwepfungwa kune yakarurama kutenderera hakushandi zvakajeka.
Muhutano hwehutano , simba remuviri wekugadzirisa kurongeka kwakanaka harina kunaka. Apo vanhu ava vanomira (kana kuti pavanenge vaine tafura yekudzidzira tafura), kupisa kwavo kunowedzera zvakanyanya, uye ropa ravo rinodonha zvakanyanyisa. Ava varwere havakwanise kuchinja kune nzvimbo yakarurama.
Zvisinei, varwere vane hutachiona hwehutano husingawanzodi kutora tafura yekudzidza kuti vaongororwe, nokuti vanachiremba vanogona kuita kuti kuongororwa muhofisi yavo kungoita kuti vatore ropa rekutanga apo murwere ari kurara uye ipapo paanenge akamira.
Izvo zvinyoro zvinyorwa zvidzidzo zvakare zvinowanzoshamisa kune vanhu vane vasovagal syncope asi nenzira yakajeka. Nenzira yakawanda, varwere ava vanotanga kugadzirisa zvinowanzoenderana nekufamba kwakarurama, asi mukati memaminitsi makumi maviri nemakumi matatu nematatu vanogona kuva nechinzvimbo chisina kushamisika uye chechiratidzo muzviratidzo zvinokosha - ropa ravo rinodonha zvikuru; kupisa kwavo kunodonhawo, uye vanopfuura. Vanopora mumaminitsi mashure mushure mekunge tafura inodzoserwa pasi, uye iyo inodzorerwa kune imwe nzvimbo yekurara.
Vasovagal syncope inokonzerwa nekufungidzira kunokonzera kukurumidza kuwedzera mishonga yeropa mumakumbo, uye kunonoka kwepfungwa yemwoyo, zvose zviri zviviri zvinoita kuti kuwedzere kudengenyeka kweropa. Zviitiko zvinokonzera zvakawanda zvinogona kutanga izvo zvinonzi "vasomotor" reflex, kusanganisira zvinhu zvakadai sekutya, kurwadziwa, uye zvinonyadzisa (zvakadai sekuona ropa). A tilt table test inobvisa kushungurudzika pamwoyo yemagetsi iyo inoshanda sechikonzero. Izvo zvinongororwa tafura yekudzidza, zvino, inoongorora kana munhu ane vasomotor reflex yakaoma, uye chinangwa chokuvandudza vasovagal syncope.
Kushandiswa Zvakakodzera kweTilt Table Test
Kunyange zvazvo chidzidzo chekutsvaga chetafura chinogona kushandiswa kuongorora hutano hwehutano, iyi miedzo inofanira kunge isingafaniri kudiwa kune varwere vane chirwere ichi, chinowanikwa nyore nyore mune imwe hofisi yechiremba. Kunyanya kushandiswa kwetafura yekudzidzira tafura ndiyo kusimbisa kuongororwa kwekufungidzirwa vasovagal syncope. Kucherechedza chiitiko chinowanzoitwa vasovagal panguva yakanyatsotarisa kunogona kubatanidza kuongororwa kwaimbove kusina chokwadi, uye nokuda kwechikonzero ichi, chidzidzo chekudzidzira tafura chinogona kubatsira nguva nenguva.
Izvo zvinenge zvichinyatsooneka patafura zvinogonawo kubatsira mukudzivirira kusarudzwa kwekufa kwechirwere ndiko kuti, mukusiyanisa chifukidzo kubva ku vasovagal syncope pamwe chete nekufamba kwakasimba.
Zvisinei, muedzo unofanirwa kushandiswa nekuchenjera. Vasovagal syncope inogona kuongororwa nyore nyore muzviitiko zvakawanda nekutora nhoroondo yezvokurapa uye kuita chiitiko chekuongorora.
Uyezve, kunyange kune vanhu vane pachena vasovagal syncope, kudzidza kwakadzika kwetafura kunounza zviratidzo zvavo zvinenge 70-75% yenguva. Mune mamwe mazwi, 25-30% yevarwere ava vane "zvisina kunaka" zvidzidzo. Saka kuongorora kunodzidza, saka, hazvifaniri kuonekwa se "yegoridhe standard" mukuongororwa kwevasovagal syncope. Iyo "yegoridhe" ndiyo ichiri chiremba chekucherechedza uye chakakwana nenyaya yezvokurapa.
Iko kutengesa tafura yekuyera ndiyo inonyanya kushandiswa kune varwere vane nhoroondo dzinofungidzira zvevasovagal episodes, asi apo pane imwezve kusahadzika. Muvarwere ava, kuongorora kwakanaka kunodzidza kunogona kufamba nenzira yakareba pakupedza kugadziriswa kwevasovagal syncope .
Sources:
Task Force for Discovery and Management of Syncope, European Society of Cardiology (ESC), European Heart Rhythm Association (EHRA), uye al. Mirayiridzo yekuongororwa uye kutungamirirwa kwe syncope (version 2009). Eur Heart J 2009; 30: 2631.
Leonelli FM, Wang K, Evans JM, et al. Nhema-inofadza musoro-up tilt: hemodynamic uye neurohumoral profile. J Am Coll Cardiol 2000; 35: 188.