Hanyar echocardiography damuwa: hanyoyi na gudanarwa

Modern hanyoyin da diagnosing cututtukan zuciya da sun isa tsangwama ba. Bugu da ƙari, irin nauyin zuciya, akwai jerin dukan hanyoyin da za a gano pathologies. Ɗaya daga cikin hanyoyin da suka fi tasiri mafi kyau shine damuwa-echocardiography tare da motsa jiki. Wanene aka bincikarsa? Menene wajibi ne don hanya? Mene ne yunkuri-echocardiography aka jagora? Za mu yi kokarin amsa wadannan da wasu tambayoyi.

Mene ne mawuyacin echocardiography?

Matsalar ECG damuwa ce ta hanyar zamani don nazarin cututtuka masu kamala, wadda ke haifar da ƙirƙirar kaya akan jikin mutum mai rai, wanda zai haifar da karuwa a cikin mita na musgunawa.

Lalacewar gida na kwangila na ɗayan shafukan yanar gizo shine alamar kai tsaye na ci gaban pathology. A mafi yawancin lokuta, yana da wuya a rubuta rikice-rikice kadan a cikin aikin ƙwayar zuciya na zuciya lokacin yin aikin lantarki na lantarki a cikin ƙasa mai kwantar da hankali. A akasin wannan, ƙuduri na ƙwaƙwalwar haɗari ya sa ya yiwu don ƙayyade kasancewar ƙwayoyin maganin ƙwaƙwalwa tare da cikakkiyar daidaito a farkon matakai na ci gaba.

Bikin ɗan gajeren lokaci zuwa tarihin

An fassara ka'idodin fasaha na kimiyya a cikin wallafe-wallafen likitoci na masana Amurka na cututtukan cututtukan zuciya R. Rostom da L. Bath a shekarar 1979. Bayan 'yan shekarun baya, an yi amfani da ergometer na farko da aka yi a cikin kwakwalwa mai kwakwalwa. Daga bisani, mawallafin marubucin kimiyyar kimiyya L. Erbel da S. Berte suka shiga aikin da aka ba da shawarar maye gurbin kayan jiki tare da yin amfani da hanyoyin maganin maganin maganin maganin maganin magungunan kwarewa da kuma hanyoyin samar da kwayar cutar marasa lafiya a cikin binciken.

A cikin aikin gida, ingantaccen hanyar da aka gano ta Mista Alekhin ya yi. "Mawuyacin echocardiography" (PDF format) yanzu yana bukatar buƙata. A cikin wannan bincike, mai bincike ya nuna dukkanin kwarewar da aka gano a cikin shekaru masu yawa. A nan, da gwani ya iya nuna shaidar tushe, wanda ya tabbatar da amfani da hanya domin yin nazarin cardiac ischemia, da sauran cututtuka na zuciya da jijiyoyin jini tsarin.

Mahimmin asali

Cikakken ƙwaƙwalwar haɗari yana dogara ne da zaton cewa ikon hawan ventricle na hagu zuwa kwangila a cikin maganin jinin zuciya yana ciwo a cikin samuwar ischemia a cikin myocardium na zuciya. Abinda ake bukata don ci gaba da ilimin cututtuka shine cin zarafin jini.

Abinda ke damuwa da ƙwaƙwalwa zai ba ka damar rikodin mayar da martani ga kowane ɓangaren ƙananan kwakwalwa na myocardium na hagu don ƙarfafawa, kayan ƙyama da suke kan jikin marasa lafiya. Bugu da ƙari, wajen kawo tsarin na zuciya da jijiyoyin jini a cikin yanayin rashin lafiya, an nuna nauyin muscle na zuciya a cikin layi daya, wanda ya sa hanya ta zama kayan aiki mai tasiri don gudanar da kwakwalwar ƙwayoyin cuta.

Shiri don bincike

A yayin shirye-shirye don ganewar asali, an sanya masu haƙuri su dauki shirye-shirye na pharmacological da ke dauke da nitrates, wanda zai ba da jinkirin rage zuciya da kuma rage girman matakin jini. Sabili da haka, an kare ƙwayar zuciya na zuciya daga kayan aiki na adrenaline a ƙarƙashin nauyin damuwa, wanda zai haifar da mummunar cututtuka a cikin yanayin haƙuri.

A ranar binciken, an yarda da mai yin amfani da nitroglycerin, tare da taimakon wanda zai iya dakatar da angina. Duk da haka, dole ne a yi gargadin mai haƙuri a gaban magungunan zuciya game da shan kwayoyi da ke dauke da abu.

Shawarwari don ƙwaƙwalwar echocardiography ya hada da ƙi ƙin cin abinci kimanin sa'o'i 6 kafin ganewar asali. Kafin nazarin, ana maraba da amfani da ruwa sosai. Ranar kafin ganewar asali, mai haƙuri dole ne ya daina maganin kafeyin, tun da yake tasirin karar jiki zai iya rinjayar daidaitattun sakamakon. Nan da nan kafin hanya, an hana shan taba.

Indiya ga ganewar asali

A waɗanne hanyoyi ne wannan nau'in ganewar ya shafi? An sanya nauyin echocardiography ga marasa lafiya:

• Tare da tsammanin ci gaba da ischemia na rashin lafiya mai wahala;
• Da buƙatar tantance yanayin suturar na jijiyoyin jini;
• Bincike game da yiwuwar nama marar tsami;
• fama da cardiac, na kullum siffofin jijiyoyin zuciya da cututtukan zuciya .
• Bukatar yin amfani da tsoma baki don nufin shunting, stenting, angioplasty na maganin jinin jini;
• Bukatar yin nazarin sakamakon farfado da amfani da magani;
• Ginar da alamar ƙaddamar da pathologies na zuciya;
• Bincike na yiwuwar rikitarwa bayan jiyya na cututtukan zuciya na zuciya;
• Shirye-shiryen yin aiki mai mahimmanci akan zuciya, huhu, aorta;
• Da buƙatar gano ƙananan abubuwan da ke ciki na zuciya;
• Gudanar da binciken da aka tsara domin tantance ikon mai aiki na aiki.

Contraindications

Don matsaloli tare da lafiyar, a gabanin abin da yunkuri-echocardiography ba zai yiwu ba a Vladimir da sauran birane, ci gaba da ƙananan ƙananan ƙwayoyin cuta a cikin mataki mai mahimmanci ya dace. Ba a yarda a nazarin da marasa lafiya da aortic aneurysm, mai tsanani jijiya stenosis, congestive zuciya rashin cin nasara, zuciya wadda tun ainahi lahani. Saboda hadarin lalata ƙullufi na ƙwayar zuciya da ƙuƙwalwar jini, maganin ƙararraki da motsa jiki yana ƙuntatawa ga marasa lafiya waɗanda ke shan wahala daga thrombophlebitis mai tsanani. Dalilin yin watsi da hanya shi ne mutum wanda ba shi da hakuri na kayan da ake amfani da kwayoyi na kwayoyi, waɗanda aka wajaba a cikin jikin su a shirye don binciken.

Abubuwan da suka shafi zumunci

Idan ya cancanta, za a iya gwada gwajin gwaji:

• Mata masu juna biyu;
• Mutane masu fama da rashin hankali;
• Marasa lafiya da ke fama da kiba;
• Mutane masu fama da rashin ƙarfi na ayyuka na pancreatic;
• Magunguna da ke fama da ciwon sukari, wanda a cikinsa akwai ƙaddamar da bayyanar cutar.

Dikita ya yanke shawara ko ya gudanar da ganewar asali a cikin wadannan ƙwayoyin marasa lafiya.

Gwajin gwajin

Ƙarƙashin rubutun ƙwaƙwalwa (Nizhny Novgorod ko wani gari - duk inda aka gudanar da shi) ana iya yin shi tare da yin amfani da gwaje-gwajen gwagwarmaya daban-daban. Yanayin gwajin da aka yi amfani da ita ya ƙayyade ta ɗawainiya da kuma ƙirar yanayin asibiti. Alal misali, don ƙayyade haƙurin jikin mutum mai haƙuri zuwa manyan kaya, da kuma tsammanin yiwuwar ci gaba da cike da ƙananan jihohi zuwa ga gwaji masu gwaji. A wannan yanayin, ana gudanar da nazarin ta hanyar amfani da kayan aiki ko veloergometer.

Ƙwararrun marasa lafiyayyu sun fi damuwa a kan kayan aiki. Musamman, irin wannan hanya don gudanar da gwaji bazai haifar da abin da ke faruwa na ciwo mai radicular, wanda zai iya inganta lokacin amfani da wani ɓangaren ƙwayar cuta, wadda mai haƙuri zai zauna a cikin wani wuri maras dacewa. Babban mahimmanci na kayan aiki shine rashin ikon yin sigogi tare da sakamakon bincike a yayin gwajin. Mahimmancin da ke nuna yiwuwar dakatar da jarabawar jaraba shi ne wuce haddi na zuciya.

Nazarin Pharmacological

Kimanin kashi 40 cikin 100 na marasa lafiya da ke buƙatar maganin ƙwaƙwalwa a cikin Ekaterinburg da sauran birane ba su da ikon canja wuri mai yawa. Wadannan marasa lafiya suna buƙatar yin gwajin maganin kantin magani.

A halin yanzu, ana amfani da rubutun echocardiography tare da Dobutamin. Gabatarwa cikin jiki na abu yana buɗe yiwuwar yin kwaikwayon yanayin da ke faruwa a lokacin motsa jiki. Aikace-aikacen wannan bayani zai ba da damar ƙara yawan matsin lamba, ƙara yawan kwangilar zuciya. Karuwa a cikin buƙatar oxygen a cikin kyallen takalma lokacin amfani da maganin ƙwayoyin cuta, wanda ya zama tushen dalili don gano alamun ischemia na damuwa.

A matsayin madadin Dobutamine, ana amfani dipiridamol sau da yawa. Jarabawar ta samo asali ne akan karuwa a hankali a cikin kashi daga cikin abu a jiki. A kowane ɓangare, an bincika cin zarafin ƙwaƙwalwar ƙwayar zuciya na myocardium. Idan, a kan gabatarwar farko na "Dipiridamol", nau'in HR yana da kimanin 120 na minti daya a minti daya, kashi na "Atropine" a cikin adadin 1 MG yana da amfani. A karshen gwajin, 240 MG na "Aminophylline" - likita da ke aiki a matsayin maganin "Dipyridamole" - an yi masa inji cikin intravenously.

Analysis of results

Sakamakon mawuyacin hali na echocardiography shi ne samar da hotuna masu girma guda biyu. Wannan karshen yana ba da zarafi don gano kasawa cikin kwangila na ventricle na hagu. Lokacin da aka tsara sakamakon zai la'akari da nauyin katako da kuma motsi na kyakyawawan ɓacin rai a yankuna.

Binciken farko na jadawalin ne mai gwadawa yake yi nan da nan bayan an karɓa. Bayan kammalawar ganewar asali, likitan zuciyar mutum na iya duba bidiyo na binciken a jinkirta motsi. Rabaffen rabuwa na hanya ana adanawa a kan kwakwalwa na kwamfuta kuma suna wakiltar kyakkyawan tushe don ƙarin ayyukan bincike.

A ina za a yi mawuyacin echocardiography?

Don gudanar da binciken ta amfani da gwajin gwagwarmayar ko gwaji na gwaji, ya isa ya je gidan kasuwa mafi kusa. Ana iya gane asali don ɗakin dakunan musamman na cibiyoyin kiwon lafiya na jama'a. Wani zaɓi mafi tsada don hanya zai iya zama rikodin shiga zuwa ɗakin asibiti mai zaman kansa wanda ke da kayan aikin da ya dace don gudanar da gwaje-gwaje kuma yana da kwararru na cancantar da ya dace.

Abubuwan da ke tattare da bincikar maganin ischemia na damuwa tare da ƙwaƙwalwar echocardiography

Daga cikin manyan abubuwan da ake amfani da ita ita ce:

• Abinda ke da ban sha'awa na yin nazarin fasalin fasalin zuciya.
• Gudanar da kayan aiki na echocardiographic, wanda ke bada damar yin gwaje-gwaje a waje da asibitin.
• Ƙimar kuɗi mai daraja na ganewar asali.
• Da yiwuwar kima na gwaji game da yanayin thickening na myocardium.
• Hanyar tsaro ga masu haƙuri.

Abubuwa mara kyau

Idan mukayi magana game da raƙuman damuwa na ƙwaƙwalwa, dole ne mu fara lura da matsalolin da za a iya auna sakamakon sakamakon samfurori na samfurori. Saboda wannan dalili, ƙuduri na ainihin sakamakon zai iya yiwuwa ne kawai idan an gano magungunan ta hanyar mai bincike mai zurfi sosai.

Bugu da ƙari, a lokacin gwaje-gwajen fasaha, matsalolin fasaha sukan taso. Halin yiwuwar bayyanar su a matsakaita shine na 5-10%.

A ƙarshe

Har ila yau, rubutun echocardiography na ci gaba da kasancewa hanyar ƙwarewa ta hanyar bincike ga cututtukan zuciya. Ana fitar da waɗannan nau'o'in binciken na farko zuwa ga marasa lafiya waɗanda suka kaddamar da gwaje-gwaje na lantarki na lantarki, waɗanda ba su ƙyale su sami cikakken bayani game da bayyanar cututtuka ba. A karshe, danniya echocardiography sa ya yiwu don gane stenosis na jijiyoyin zuciya arteries, hoto ne har yanzu m bayan da angiography.