Qalabka dhimashada ayaa ah xannuun wadnaha ah oo ku xiran siyaabo badan oo loogu talagalay fayriliska atrial . Qalabka dhimashada waxaa lagu gartaa dareen-celin koronto oo aad u dhakhso badan oo ka soo baxa atria, taasoo keenta wadarta garaaca wadnaha oo guud ahaan ah qiyaastii kala bar heerka qiyaastii. Qalabka atrial atrial, heerka atrial inta badan waa qiyaastii 300 garaac daqiiqaddii, iyo heerka garaaca ayaa ku dhawaad 150 garaaca daqiiqadii.
Sababtoo ah arrmintia arrintan waxay ka timaaddaa atria, waxaa loo tixgeliyaa nooc ka mid ah tiknikada supraventricular taachikardia .
Guudmarka
Booqdaha boodboodka ayaa ah nooc ka mid ah arritanka xajmiga ah ; waxay dhacdaa marka korontadu ay noqoto mid "xayiray" wareegga wadnaha gudaheeda, waxayna bilowdaa wareega wareegga iyo wareegga wareegga. Qalabka wareegga ah, wareegga wareegga ayaa ah mid aad u ballaaran kaas oo badiyaa ku yaala dhinaca midigta, oo badanaaba raacaya waddo caan ah.
Xaqiiqadani waxay inta badan ka dhigtaa qashin-qube qaas ah oo ku habboon daaweynta abortiska . Adigoo abuuraya xannibaad meel gaar ah oo ku dhex yaal waddadaas, habka wareegga ah ayaa la jabin karaa, iyo bakhaar-yaraha garab-beelka mar dambe ma dhicin.
Astaamaha
Qiyaasta wadnaha ee degdegga ah ee badanaa soo saara qashinka qashinka waxaa inta badan keena isbedelka , dawakhaad , daal, iyo dyspnea (neefsasho la'aan).
Sida habka ugu habboon, qaylo-dhaan isdaba-joog ah ayaa u muuqda in ay yimaadaan oo ay aadaan si lama filaan ah oo lama filaan ah.
Haddii bukaan-socodka hareeraha qoyaanka ah uu sidoo kale qabo cudurka halbowlaha wadnaha , garaaca wadnaha oo dhakhso ah ayaa keena murugo ku filan muruqa wadnaha si uu u keeno angina . Qalabka dhimashada boodhka ayaa sidoo kale soo saari kara calaamadaha degdega ah ee calaamadaha dadka qaba wadne-la'aanta .
Qaddarin
Sababtoo ah calaamadaha ay soo saartey waxay noqon kartaa mid aan loo dulqaadan Karin, qashin-jarjiraha ayaa noqon kara arrin muhiim ah xitaa haddii wax kastoo ay sameeyeen ay sababeen is-dillaac, madax-wareer iyo dyspnea.
Laakiin dhibaatada ugu weyn ee la xidhiidha bakhaarka atrial-ka ah, waa, sida xaaladdu tahay fayriliska atrial, arrhytmia arrintani waxay u egtahay inay keento unugyada dhiigga (xinjiro dhiig) ee atria. Dhiigxinjirta dhiigu waa ay jabi karaan ( dabeecad ) waxayna keenaan stroke . Sidaa daraadeed dadka qaba qashin-qubka, sida kuwa qaba fibrillada atrial, waxay leeyihiin khatar aad u badan oo istaroog ah.
Intaas waxaa dheer, bakhaarada qulqulka badanaa waxay u egtahay inay tahay "buundada arxan-darrada" oo loo yaqaan 'atrial fibrillation'. Taasi waxay tahay, dadka qaba qashin-qubeyaal badanaa waxay sii wadi doonaan in ay yeeshaan fiiqilaad xannuunsan oo joogta ah.
Waxyaabaha Halista ah
In kasta oo qofna uu ku dhici karayo qulqulatada atrial-ka, maahan arrin caadi ah. Waa wax aad u yar, tusaale ahaan, marka loo eego fiyuuska atrial.
Dadku waxay u badan tahay inay horumariyaan qulqulatada atrial-ka ah kuwa isku midka ah waxay sidoo kale u badan tahay inay yeeshaan fibrillada atrial. Kuwaas waxaa ka mid ah dadka cayayaanka ah, ama qaba cambaarta sanbabada (oo ay ka mid yihiin emboluska sambabada ), apnea hurdada , cilladda sanka ee jirran , pericarditis , ama hyperthyroidism . Qalabka garaacida ayaa sidoo kale lagu arkaa dadka ku dhacay qaliin wadnaha ah.
Ciladeynta
Baadhitaanka qashin-saarka qashinka ah waa mid toos ah. Waxay u baahan tahay oo kaliya inay qabato arrin ku saabsan ECG , iyo raadinta waxa loo yaqaan "hirarka hirarka." Mowjadaha boodbaxu waa calaamad muujinaya ECG oo matalaya dareenka korontada ee ku wareegsan wareegsan iyo wareegga wareegga wareegga.
Daaweynta
Iyadoo hal ka weyn oo laga reebo, daaweynta qashinka atrial wuxuu la mid yahay kuwa fibrillada atrial. Mid ka mid ah tan ka reeban waa, marka la barbardhigo fibrillada atrial, iyadoo la adeegsanayo daaweynta abortiska si loo tirtiro bakhaarka atrial-ka fudud in la dhammaystiro.
Dhacdooyin Ba'an
Bukaanjiifka qaba xaalad ba'an, qashin-qubka ayaa si fudud loo joojin karaa qalabka korontada, ama si deg deg ah loo maareeyo dawooyinka ka hortagga uurka (sida caadiga ah, ibutilide ama dofetilide).
Haddii calaamadaha ay daran yihiin inta lagu jiro xaalad ba'an, hoos u dhigidda garaaca wadnaha ayaa lagama maarmaan ah markaad u diyaargaroobeyso wadnaha. Tani waxay badanaa si dhakhso ah u fulin kartaa iyada oo la maareynayo qiyaasaha xididada ee calcium-blockers diltiazem ama verapamil, ama asmolol-ga buste-boogaha oo si deg deg ah u shaqeynaya. Si kastaba ha ahaatee, daawooyinkaas waa in si taxadar leh loo isticmaalaa, si kastaba ha ahaatee, bukaanka qaba wadnaha oo aan shaqeynin.
Daaweynta muddada dheer
Marka xaalad degdeg ah la xakameeyo, tallaabada xigta waa in la isku dayo in lagu xakameeyo dhacdooyinka kale ee qashin-qubka. Marka la eego arrintani waa muhiim in la raadiyo, loona daweeyo, sabab kasta oo macquul ah, sida hyperthyroidism, apnea hurdada, ama cayilka. Hyperthyroidism badanaa waxaa lagu fili karaa dhowr maalmood gudahood, iyo hurdada hurdada ayaa sidoo kale guud ahaan lagu daaweyn karaa waqti macquul ah. Inkastoo cayilku uu sidoo kale u yahay sabab macquul ah oo qashin-saarka qashinka ah, hadana macquul ah in badanaa looma beddelin ama ku filan oo ku filan si loogu faa'iideysto daaweynta arrin-diimeed - sidaas awgeed habab kale oo loo xakameynayo waa in loo isticmaalo.
Haddii aan la helin sabab macquul ah, waxaa lagama maarmaan ah in daaweynta antiarrhythmic joogto ah. Daaweynta joogtada ah ee boodhadhka hareeraha guud ahaan waxay ka kooban tahay xakameynta arxanka oo leh daroogo, ama isticmaalida daaweynta abortiska.
Dawooyinka khatarta ah waxay leeyihiin heer guul ah oo la jaanqaadaya qulqulka qulqulka - kaliya 20% ilaa 30% bukaannada lagu daaweeyo daawooyinka ayaa si guul leh loo kontaroolaa sanad kadib daaweyn. Sababtan awgeed, iyo sababta oo ah sunta badan ee la wadaago daaweynta daawada dawada ee antiarrhythmic, daaweynta aborted waa fogeyn daaweyn doorasho loogu talagalay qulqulka atrial.
Nasiib wanaag, sida hore loo xusay, abortiska qulqulatada hareeraheeda badanaa waa nidaam toos ah oo toos ah, oo leh heer aad u wanaagsan oo ah guusha - in ka badan 90%. Inta badan dadka bukaanka qaba arrhytmia, abortus waa in si adag loo tixgeliyaa.
Maadaama ablilku si fiican u shaqeeyo, isagoo u adeegsanaya istiraatiijiyad xakameyn ah (badanaa loo isticmaalo qulqulka atrial) ayaa marar dhif ah lagama maarmaanka u ah qashin-qubaha. Istaraatejiyadda xakamaynta sicirka macnaheedu waa u ogolaanayaa arrinfaanka inay dhacaan, iyo xakamaynta heerka wadnaha ee soo-baxa, si loo yareeyo calaamadaha.
Xakamaynta garaaca wadnaha ee qashinka atrial-ka waa mid aad u adag marka loo eego hurgunka atrial, waxaana badanaa u baahan yahay isticmaalka isku-darka beta-blockers iyo kalsiyum-blockers. Munaasabadda, si loo helo garaaca wadnaha oo hoos loo dhigo waa lagama maarmaan in la daboolo nidaamka wadnaha ee wadnaha si loo abuuro qalab wadnaha ah , ka dibna geli qalabka wadnaha si uu u dhiso xaddiga garaaca wadnaha. Sida iska cad, ka takhalusida qashin-qubka guud ee guud ahaan habka abortiska ayaa badanaaba ah tallaabo aad u fara badan.
Si kastaba ha noqotee, xeeladaha xakameynta xakamaynta ayaa la isticmaalaa, si kastaba ha ahaatee, daaweynta xinjirowga dabiiciga ah ayaa lagula talinayaa inay ka hortagto istaroogga, sida iyada oo la socota fayruuska atrial.
Ilaha:
Wellens HJ. Maaraynta casriga ah ee bakhaarka qashinka. Wareegga 2002; 106: 649.
Granada J, Uribe W, Chyou PH, iyo al. Dhibaatada iyo saadaalinta qashinka qashinka ah ee guud ahaan dadka. J Am Coll Cardiol 2000; 36: 2242.