WPW ifafaale: sababaha, calaamadaha, iyo daaweynta

WPW syndrome waxaa loo yaqaan cudurada in fiiloyin dareemaha ee muruqa wadnaha sababa qalal iyo tachycardia mudan marinkii excitation ee Suu dareemayaasha on Waddooyinkiisa gaaban oo dheeraad ah oo aan qalbiga ka caafimaad ah.

Xusuuso waxay marka hore

In 1930, saynisyahano caafimaad Wolff Parkinson White ugu horreeyey si aad u sharaxdo calaamadaha iyo daliilka farsamo syndrome ah, taasi oo markii dambe la siiyey magaca syndrome SVC ah (WPW). Waxaa jira wax sida WPW-ifafaale ah sida. Waxa kale oo aanu aad uga fiirsada in this article.

Sida caadiga ah, fiiloyin ah ee wadnaha, habdhiska garaaca wadnaha excitation tabinta si ay u sameeyaan wadada gaar ah, kaas oo bixiya labis iyo qaybinta tartiib ah dardar. Qarni Signal bilaabmaa Guntin Dalqada wadnaha ee Atrium midig gaadho Guntin AV ah (node atrioventricular) ee aagga atrioventricular, ka dibna lugaha oo xidhmo dhex Purkinje fiiloyin excitation loo kala qaado oo dhan fiiloyin muruqa ah intraventricular qalbiga ku jira, iyo jidka dheer noocan oo kale ah waxay bixisaa foosha ah oo isku dubaridan oo synchronous muruqa wadnaha oo dhan.

Sababaha iyo calaamadaha

Haddii WPW dareemayaasha syndrome excitation Suu ka atria si intraventricular ku kordhiyay hab gaaban oo ku jirase aad loogu yeero Kent, Goldogob atrioventricular (AV) Guntin ah. Taasi waa, la ruxruxo ee excitation waa ka dhakhso badan in laxanka caadiga ah ee wadnaha ee, iyo sababta ay jiraan incoordination ee hoos u muruqa wadnaha, iyo noocyada kala duwan ee arrhythmia.

Taasi waa jidka wadnaha wadnaha jabay.

cillado la mid ah in qaab-dhismeedka ee wadnaha lagu dhasho waa iyo waxaa kaliya la sameeyay ay sabab u tahay hiddo cadaadis dhaxlo ama sarkhaansan yihiin arrimo kale, si xun u saamaynaya horumarka ee wadnaha embriyaha aadanaha.

Uurjiifka had iyo jeer joogo giraanta atrioventricular dheeraad ah iyo macdantaa, kaas oo toddobaadkii 20-22-aad ee khafiif ah oo si buuxda u baaba'aan. Haddii fiiloyin sida ku kaydsan yihiin, waxaa jira xaalado jidh WPW syndrome. Foomka A dhaxlo ah ee WPW syndrome waxa lagu gartaa tiro badan oo ah isku xirka AV, cilladaha iyo cillado in qaab-dhismeedka ee wadnaha. Si kastaba ha ahaatee, keliya ee qaangaarnimada dhici kara in kasta oo aan caadi ahayn jidh dhasho, calaamadaha ugu horreeya ee WPW-syndrome. Kiisaska oo dhan, joogitaanka 70% syndrome ee laga helo ragga.

calaamadaha cudurada

Calaamadaha ugu caansan ee ay joogaan suurto galka ah ee WPW syndrome waa kuwan soo socda:

1. Dareen uurkuna waa xoog leh oo soo noqnoqda, oo carruurta soo wici kartaa "boodayaa ama qalbigiisa garaac."
2. wareer lama filaan ah.
3. syncope gedisan, inta badan ee carruurnimada iyo qaangaarka.
4. Riixaya xanuun wadnaha ka, jidhidhico iyo jarida xanuun marka la neefsado.
5. Dareen dhegto, neefsashada oo daran neefta ka da 'yar ah.
6. Dhallaanka diidi kartaa quudinta dhidid miidhan, daciifnimo joogto ah, garaaca wadnaha oo kordhay suurto gal xilliyo in 200-300 garaac daqiiqaddiiba.

Sida loo aqoonsado cudurka?

Dad badan ayaa qaba fiiloyin more caadi ahayn ee muruqa wadnaha, ka syndrome WPW waxaa lagu ogaada ayado kaliya marka sameeyaa echocardiography wadnaha. Deciphering hubiyo in natiijada siin doonaa.

Noocan oo kale ah sidayaal syndrome ha u oggolaan way ka roonaadaan tachycardia ama aamba, iyo xataa laga yaabaa warqabin joogitaanka aan caadi ahayn ee wadnaha.

astaamo Tani arkay in 35-40% dhammaan sidayaal aqoonsaday of syndrome ah. socodka fudud ee WPW syndrome waxa lagu gartaa tachycardia soo noq-gaaban ama aamba, kaas oo si deg deg ah maraa oo aan caawimaad. Si aad u baabi'iyo qalal in ay dhacdo cuf dhexdhexaad WPW syndrome u baahan daroogada antiarrhythmic ama noocyo ka mid ah blockers of excitation wadnaha.

In case of qalal sii dheeraaday in aadan ku ool ah lama baabbi'in foosha caafimaad ahaan dhib iyo Fasaadi muruqyada wadnaha iyo flutter wadne-ogaadaa heerka ba'an ee syndrome iyo qalliinka lagu taliyey.

noocyada syndrome

WPW syndrome iyo qalbigiisa waa la kala saaraa sida uu soo noqnoqoshada iyo gaar ah ee calaamadaha caafimaad oo kala duwan oo kala qaybsan yihiin noocyada soo socda:

• Mariyo marka electrocardiogram had iyo jeer waa la ruxruxo Delta joogo, iyo ATS-tachycardia iyo laxanka sanka baahsan muuqan.
• Meel - waxa lagu gartaa ventricular transient pre-excitation.
• Qarsoona - qeexayaa qiso AVR-tachycardia, iyo xaalad nasasho aan la ogaadaa.

Sidee kale oo aqoonsan karaa syndrome ah?

Aan electrocardiogram ah si loo baadho suurto gal WPW-syndrome waa suurto gal by dhagaysto qalbigaygu waa u dhawaaqaa, taas oo qeyb ka mid ah muujinta arrhythmic ee dabiiciga ah waxay noqon doonaan, iyo sidoo kale ka mid ah garaac aan caadi ahayn.

Waxa intaa dheer in cudurka ECG ee WPW syndrome waxaa lagula socdaa iyadoo la isticmaalayo qalab gaar ah la qaadi karo la electrodes, by ultrasound iyo echocardiography, hordhaca ah ee electrodes madadaalo u galay hunguriga natiijada kelmadaha xiga ee falalkooda korontada, iyo sidoo kale baaritaanka ee elektarooniga ah oo adag, taas oo ku siinayaa model ugu sax ah la heli karo in murqaha wadnaha saqafka Kent oo noo ogolaadaa in ay ku talinaynaa daaweyn muxaafidka ah ama qalliin.

WPW-ifafaale

Marka sahan ee joogitaanka WPW syndrome in ka badan 30% oo ka mid ah sidayaasha syndrome aqoonsaday wax cabasho ah oo ku saabsan caafimaadka wadnaha aan waligood laga kala kulantay. Sabab u tahay tirada badan ee sida astaamo, 1980, WHO daabacay talooyinka oo soocay WPW syndrome isagoo a sawir caafimaad oo gaar ah, iyo WPW-ifafaale.

About this ifafaale, waxaa la soo gabagabeeyey in on garaaca wadnaha sanka electrocardiogram leeyahay calaamadaha excitation ventricular dhicis ah, laakiin maadooyinka jiraan dalalka bahal ah iyo tachycardia atrioventricular ayaa lagu arkay.

Iyadoo ay taasi jirto, marka arrin ku WPW halista jahawareerka waa mid aad u sarreeya, oo iska xanaajin saameyn kasta - stress jirka ama dareen, khamriga, socdaalka goobaha juquraafi aqoon - keeni kartaa muujinta calaamadaha xun ee WPW syndrome. In dadka waaweyn ee 0.3% ee kiisaska of WPW-ifafaale ah waa loo dhintaa, carruur ah ayaa baaray tusay dhimasho clinical in 2% ee kiisaska.

Statistics WPW ifafaale ee carruurta

WPW-syndrome meedka meesha hogaamineed ka mid ah arrimaha ay sababeen tachycardia iyo arrhythmia carruurta. Waxaa aasaas u muuqata carqalad dheeraad ah garaaca wadnaha, iyo xataa maqnaanshaha cabashooyinka ma loo yareeyo khatarta cudurada sida. dollar kasta oo jirka ah, jimicsi aad u daran, arrimaha cilmi nafsiga waxay keeni kartaa failure ee wadnaha khayaali ah farxad iyo xataa dhimasho sababi ka wadno.

la socodka muddada dheer muddo ku dhow 20 sano koox caruur ah oo badan kuwaas oo cudurka wadnaha WPW syndrome, da 'Dullaysi ilaa 18 sano, waxay muujiyeen natiijooyinka soo socda:

• 8% carruurta la kulmay lama filaan ah ABP-tachycardia;
• 8.2% ka mid ah maadooyinka soo maray a guurka ifafaale transient WPW syndrome,
• 8.5% ka mid ah khasaaraha transient miyir dhacay;
• 2% caruurta waqtiga baadhitaan ugu horeysay ee horay u soo gaaray dhimashada kiliinikada;
• 1.2% - wiilasha oo kaliya - si kedis ah ku geeriyooday muddo sahanka;
• % Carruurta la ifafaale WPW kaliya 9 sheegay waayay xogta calaamadaha.

Sidee khatar ah arrin WPW?

From tirooyinkan waxaa iska cad sida ay joogaan xitaa ammaan ahayn waa arrin WPW. Boqolkiiba Tani sare ee calaamadaha xun oo heley inta ilmanimada lagu siinayaa sababo in loo qaato in aan uubatooyin stress jirka iyo shucuurta, aan nidaam socodka iyo tallaabooyin ku daweyn la da'da iyo boqolkiiba tani waa ay khatar ku tahay nolosha kordhin doonaa oo kaliya.

Caruurta leh ifafaale WPW waa in aanay ku lug leh ciyaaraha xirfadeed, oo sakhiray si ay arrimo stress joogto ah. Taxadarka waa in la qaado si loo gelinba cimilada kadis ah ama dhacdooyin, sababa baxda dareen aad u daran. Dhammaan arrimahaasi waxay laga yaabaa in aad u badan tahay in ay keento xanuun halis ah ama dhimasho. Dadka ku adkeeyey joogitaanka syndrome WPW ama arrin, oo aan loogu yeeray inay ka adeegaan military.

Daaweynta iyo gargaarka ee syndrome ah

Calaamadaha iyo daaweynta waxaa inta badan wada xiriira. Waxaa jira daawooyin badan oo caawin wadne keeno syndrome WPW, oo si weyn u yareeyo muujinta calaamadaha ay.

Kooxda daroogada xanibaha normalizes inta jeer ee foosha muruqyada wadnaha. Si kastaba ha ahaatee, waxtarka hab sida lagu muujiyay kaliya ee heerka of 50-60% oo aan loo isticmaali kartaa hypotension joogto ah iyo neefta.

Antiarrhythmics arrin deggan jaray weeraro AVR-tachycardia, garaaca wadnaha caadi in 80% ka mid ah bukaannada, laakiin sidoo kale waxay leeyihiin tiro ka mid ah sababo ay dhacdo hypotension, wadno xanuun iyo cudur kale qalbigiisa, carruurnimada iyo qaangaarka. blockers calcium Qaar ka mid ah gabi ahaan uu u ee syndrome WPW, sida sawirka bogga dambe ee gudbinta hagaagay ee Suu dareemaha ah, ay ku guuldareysteen in atria ah, taas oo uu leeyahay cawaaqib xun iyo karin.

Sidoo kale, mararka qaarkood, isticmaalka daroogada group ATP arkay saamayn xun ku foosha ku wadne. Waxa kale oo jira habab aan daroogada ee gargaarka calaamadaha.

The falalkooda dareemayaasha muruqyada maraan macdantaa oo garawsi iyo parasympathetic. Nooca ugu horeeya waxa fiiloyin wadnaha, nooca labaad ee hoos garaaca wadnaha shidaa, sida nooc ka mid ah vagus vagus nervus dareemayaasha, oo sidoo kale loo yaqaan reflex vagal. In uu yahay, hawshooda u ah ee si hufan noocan oo kale ah hummaag saamaynta xasilinta qalbiga ku siin doonaa. Habka ugu fudud ee aad dhaqaajiso falalkooda vagal waa wax-u Aschner reflex oo ka xanaajisay 20-30-labaad taabashada fudud ku jallo oo inta badan ka caawisaa in ay joojiyaan tachycardia ah.

Sidoo kale, dareemaha vagus si fiican u shaqeysiin neefta-haynta iyo danab murqaha caloosha, si ay arrin ku WPW syndrome ama faa'iido leh in ay ku dhaqmaan yoga iyo layliyada neefsashada.

Laga bilaabo hab signal baaxad weyn iyada oo koronto ah la geliyo hunguriga, aad u wax ku ool ah istaago tachycardia culus dheer, laakiin mararka qaarkood keentay in aamba waxyaalaha qalbiga ku jira, sidaas sameeyo in golaha wasiirada gaar ah u qalabaysan .Fabrice.

Rogidda waxaa la sameeyaa oo keliya in Xaaladaha aadka u daran, markii ay halista daran nolosha, laakiin waxa ay inta badan ka caawisaa si loo baabi'iyo Exprees khatar ah falalkooda shisheeye ee unugyada wadnaha iyo kan caadiga ah shaqo garaaca wadnaha.

Operative WPW daaweynta syndrome iyo sida loogu baahan yahay

Haddii arrin la ogaado WPW ECG habka hawlgalka reebay waxaa laga codsadaa oo keliya xaaladaha gaarka ah, la tachycardia soo noqnoqda oo daba dheeraaday, oo aan la dhaqaajin karo daawo, iyo sidoo kale kiisaska la aasaasay dhimashada wadnaha lama filaan ah, qaraabada bukaanka ama sababo xirfadeed.

daaweynta Qalliinka waxaa lagula talinayaa oo keliya ku salaysan baaritaan dhamaystiran oo dhamaystiran, kaas oo ku siinaya sawirka ugu sax ah oo ka mid ah dhismayaasha unugyada bahal waxyaalaha qalbiga ku jira. Sidaa darteed, waa inaad tixgelisaa in in la sameeyo qalliin la WPW ugub ah.

Hawlgalka ayaa waxaa la sameeyaa iyadoo la isticmaalayo koronto gaar ah, kaas oo la geliyo iyada oo halbowle ah bidig muruqa wadnaha ayadoo la eegayo X-ray iyo in meelaha qaar saarta radioprizhiganie ama ablation, fiiloyin dareemayaasha.

Waxa kale oo la kriorazrushenie kartaa fiiloyin dareemayaasha bahal ah. Oo ahaantii, labada kiis ee oolnimada howlgalka gaadho 95%. Soo noqoshada dhacaan sabab u ah burburinta dhamaystirnayn go'an yihiin Axdigu, iyo in joogitaanka hay'adaha aan haybtooda la unugyada kale ee neural. keligeed, qaliinka lagu samayn karaa suuxin hoos maxaliga ah, ku dhowaad Majar, ma keeno dhibaatooyin, ayaa muddo soo kabashada aad u gaaban oo sidaas daraaddeed waxaa loo samayn karaa da 'kasta.

Xarumaha Daaweynta Wadnaha ee Moscow

Institute of Surgery. A. V. Vishnevskogo - kibirka daawada gudaha, ayaa goobaha casriga ah ee daaweynta iyo ogaanshaha, ayaaba cilmi, Baadhista teknoolojiyad sare kala duwan oo u gaar ah qalliinka wadnaha. FGBU "NNP Xarunta Qalliinka Wadnaha iyaga. A. N. Bakuleva "qabata hawlo caafimaad, sayniska iyo waxbarashada ee barnaamijka" Qalliinka Wadnaha. "

Ruush Research Wadnaha iyo Production Complex sameeyaa sahan iyo daaweynta cudurada wadnaha ee heerka dunida teknoolojiyad sare. In xarunta "cardoid" aad mari kartaa qiimayn wadnaha dhamaystiran, hesho daaweyn tayo leh daweynta ku salaysan bukaan socod ah. Cardiological Center ee Moscow si fiican u shaqeeyay, sidaa darteed haddii aad leedahay baahida loo qabo in qalliin si loo daweeyo, ma waxaad ka waaban kartaa.