Guud ahaan, waxaa jira laba sababood oo uu dhakhtarkaagu rabo inuu kugula taliyo daawada qaliin wadnaha ah . Ugu horreyn, arrmintia waxay kuu keeni kartaa inaad yeelatid calaamadaha, sida isbeddelka ama isbedelka , daaweyntu waxay noqon kartaa mid muhiim ah si loo yareeyo calaamadahaas. Ama, labaad, arrinimada waxaa laga yaabaa in ay keenayso waxyeello ama hanjabaad ah inay sidaa yeelato. Xanuunno badan ayaa sameeya labadan waxyaabood mana u baahna daaweyn gaar ah oo loogu talagalay arrintia lafteeda.
Haddii aad qabto arrin xasaasiyad ah oo u baahan daaweyn caafimaad, waxaa jira saddex nooc oo daawooyin ah oo laga yaabo inay faa'iido u yeeshaan, iyadoo ku xiran nooca arrinimada aad qabto. Kooxdii kowaad waxay ka kooban tahay daawooyinka mukhadaraadka ah ee daawada loo yaqaan antiarrhythmic-drugs, gaar ahaan loogu talagalay in la xakameeyo garaaca wadnaha aan caadi ahayn. Midda labaad waxay ka kooban tahay daroogooyinka saameynaya AV node , kuwaas oo inta badan loo isticmaalo tachycarjistayaasha supraventricular tachycardias (SVT). Kooxda saddexaad waxay ka kooban yihiin daroogooyin kala duwan oo loo soo bandhigay inay yareeyaan khatarta dhimashada deg-degga ah ee ka timaadda qalabka wadnaha.
Mukhaadaraadka La-Dagaalanka
Dawooyinka ladagaallanka ah waa daawooyin isbeddelaya sifooyinka korantada ee unugyada wadnaha, oo markaa sidaas samaynaya, beddel qaabka qalabka korantada ee wadnaha uu ku faafo wadnaha. Tan iyo markii looyarka qalabka yar-yar ah (arrhytalmias oo keena garaaca wadnaha oo degdeg ah) waxay badanaa la xiriiraan cilladaha korantada, daawooyinka isbeddelaya signalka korantada ee wadnaha ayaa badanaaba hagaajiya arxanadaas.
Daawooyinka khatarta ah ayaa badanaaba wax ku ool ah, ama ugu yaraan qayb ahaan wax ku ool ah, ee lagu daweeyo noocyada ugu badan ee tachycardias.
Nasiib darro, daawooyinka antiarrhythmic ee koox ahaan waxay u muuqdaan inay keenaan qadar qumman oo ah hal nooc ama mid kale, iyo natiijo ahaan, way adkaan kartaa inay qaataan. Daawooyinka kasta ee antiarrhythmic waxay leedahay astaanta u gaarka ah ee sunta, iyo ka hor inta aanad daaweynin mid ka mid ah daawooyinkan, waa muhiim in dhakhtarkaagu si taxadar leh u sharaxo dhibaatooyinka suurtagalka ah ee laga yaabo inuu ku dhaco daawada la soo xulay.
Hase yeeshee, waxaa jira dhibaatooyin nasiib daro ah oo caadi ahaan ah wax caadi ah dhammaan daawooyinka dawada ka horjeeda: Mararka qaarkood daroogooyinka ayaa ka dhigaya arrin xummo halkii ay ka fiicnaan lahayd.
Muuqaalkan daawooyinka antiarrhythmic-loo yaqaan "proarrhythmia"-wuxuu ka dhigaa hantida hantida ah ee daroogooyinka beddelaya signalka korantada wadnaha. Si fudud u dhig, markaad wax sameyneyso si aad u bedesho habka calaamad koronto u faafi karto wadnaha, waxaa suurtogal ah in isbeddelku uu ka dhigi doono qalabka daaweynta yar, ama ka sii xun.
Daawooyinka caadiga ah ee loo isticmaalo daawooyinka waxaa ka mid ah amiodarone (Cordarone, Pacerone), sotalol (Betapace), propafenone (Rhythmol), iyo drdonarone (Multaq).
Amiodarone waa daawada ugu haboon ee daawada lidka ku ah iyo sidoo kale waxay u badantahay in ay keento daaweyn kale oo daawada kale ah. Nasiib darro, noocyada kale ee sunta lagu arkay amiodarone waxay noqon kartaa mid aad u xun, daawadanna waa in la isticmaalo oo keliya (sida daawooyinka antiarrhythmic) marka loo baahdo.
Qeybta hoose ayaa ah in dhakhaatiirtu ay yihiin-iyo in ay tahay in ay diidaan in ay soo qoraan daawooyinka khatarta ah. Daawooyinkaan waa in la isticmaalo keliya marka arrin xasaasiyadeed ay soo saarto calaamado muhiim ah ama ay khatar ku tahay caafimaadka wadnaha.
AV Nodal Daroogooyinka Argagixisada
Daawooyinka loo yaqaanno daroogooyinka AV block-blocked beta-blockers , kumbiyooleyaasha dhiigga ee calcium , iyo digoxin-shaqeynaya oo hoos u dhigaya signalka korontada ee wadnaha ah sida ay u gudbiso nuucyada AV ka hor inta u dhaxaysa atria ilaa ventricles.
Tani waxay ka dhigaysaa dawooyinka xannibaadda AV ah ee daaweynta SVT. Qaar ka mid ah noocyada SVT (oo si gaar ah, gaar ahaan taakawidhiyada AV iyo duubikada oo ay sababeen waddooyinka gadaashooda), waxay ubaahan yahiin AV node inuu si fiican u shaqeeyo calaamadda korantada, iyo haddii AV node loo samayn karo si loo sameeyo qalabka korontada si tartiib ah SVT joojiyaa.
Wixii SVT oo loo yaqaan fibrillation atrial , daawooyinka AV block-ka ee joojiya ma joojinayaan arrinfaha, laakiin waxay hoos u dhigaan heerka garaaca wadnaha si ay uga caawiyaan ciribtirka calaamadaha. Xaqiiqdii, xakamaynta garaaca wadnaha ee leh daroogooyinka xirmidda AV ayaa badanaa ah habka ugu wanaagsan ee lagu maareyn karo fayriliska atrial .
Mukhaadaraadka Yareynaya Khatarta Dhimashada Deg dega ah
Daawooyin yar ayaa loo maleynayaa in ay yareeyaan halista geerida lama filaan ah, oo ay u badan tahay in la yareeyo khatarta kufsiga xididada qanjidhada ama fayruuska lagu duro , xannuunada soo saarida wadnaha .
Cilmi-baaristu waxay muujinaysaa in dadka beta-tuubada ah ay yareyn karaan halista dhimashada deg-degga ah iyada oo xannibaysa saameynta adrenaline ee muruqa wadnaha, taas oo yareyneysa fursadaha lagu kobcin karo xaalado duufan. Dhammaan bukaanada ka badbaaday weerarrada wadnaha ama kuwa qaba wadnaha oo shaqeyn waayey waa inay qaataan beta blockers.
In yar oo sahlan oo la sharraxo waa dhimashada dhimashada degdega ah ee laga soo sheegay bukaanada qaadata daawooyinka, ama kuwa isticmaala dufanka omega-3, laakiin dawooyinkaas ayaa sidoo kale u muuqda inay caawinayaan.
> Ilo:
> Grant AO. Wareegyada Cudurka Wadnaha. Circer Arrythm Electrophysiol 2009; 2: 185.
> Sicilian Gambit. Qaab cusub oo loogu talagalay Qeybinta Mukhaadaraadka La-Dagaalanka Musuqmaasuqa ayaa laga jaray ficilladooda ku saabsan hababka Arxiddaanka. Guddi-hawleedka Koox-Howleedka Arrimaha Xidhiidhka Bulshada ee Yurub. Wareegga 1991; 84: 1831.