Njira ya matenda oopsa kwa nthawi yambiri imatha kupanikizika ndi vuto la matenda oopsa - kuchuluka kosayembekezereka kwa systolic ndi / kapena kukakamiza kwa diastoli kuchokera pakuloweka kwambiri kapena kuchuluka. Vuto nthawi zambiri limayendera limodzi ndi kuyamba kapena kukula kwa zizindikiritso za ziwalo zomwe akujambulazo (mtima, impso, ubongo).
Zoyeserera zamagazi zamavuto amtunduwu ndi za munthu aliyense payekha - kwa matenda oopsa amatha kukhala 130/90, ndipo kwa wodwala yemwe ali ndi matenda oopsa chifukwa chogwira ntchito ya 150/90, 180-200 / 100 kumakhala vuto.
Zovuta zimasiyana chifukwa cha zovuta, ndipo zimagawika muzovuta komanso zovuta.
Mavuto atha kukhala otere:
- kuchokera kumbali ya ubongo - ngozi yamisala - sitiroko, kusachedwa kwa ischemic;
- mtima - kugunda kwa mtima, kupweteka kwamanzere kwamitsempha yamagetsi (pulmonary edema), paroxysmal tachycardia, ventricular extrasystole;
- impso - kulephera kwaimpso; zotengera - aortic aneurysm.
Mtundu wachiwiri umagawidwa kukhala:
- Mavuto azikhalidwe.
- Hypothalamic kapena vuto lazomera.
- Zovuta zamtima.
Kuphatikiza apo, izi zimaphatikizapo kuwonjezeka kwakukulu kwa kupanikizika kwakanthawi pambuyo pakupanga opaleshoni komanso kuwonjezereka kwakutali kwa magazi a systolic mpaka 250 millimeter a mercury kapena diastolic mpaka mamilimita 150.
Mwachidziwitso, njira ya mavuto imagawika mitundu - neurovegetative, edematous komanso yopweteka.
Zomwe zimayambitsa ndi zizindikiro za HA
Dziwani kuti mwa anthu ambiri matenda oopsa ndi asymptomatic, ndipo vuto lingakhale kuwonekera koyamba.
Zikatero, kuzindikira msanga kuti mavutowo ndi chithandizo chake ndikofunika kwambiri.
Choyamba komanso nthawi zambiri chifukwa chachikulu ndikosakwanira kapena chithandizo chosayenera - kuthetseratu kwakumwa kwa mankhwala a antihypertensive, mankhwala osayenera kwa wodwala kapena mlingo wake.
Palinso zifukwa zina:
- Zochita zolimbitsa thupi mwamphamvu, masewera.
- Kutaya mtima kwambiri, kupsinjika.
- Kusamba kwa akazi.
- Nyengo.
- Kumwa mowa wambiri kapena kuswa chakudya.
Kuti mupeze vuto lomwe latsala pa nthawi yake, ndikofunikira kuti musatchule za kukakamizidwa, koma madandaulo ndi zizindikiro zomwe zingachitike. Ayenera kudziwika osati kwa madokotala okha, koma kwa aliyense amene ali ndi kuthamanga kwa magazi kapena matenda oopsa mwa okondedwa.
Zizindikiro za vuto lalikulu kwambiri:
- Tachycardia - kuchuluka kwa mtima kwaopitilira 90 pamphindi.
- Mutu wakuthwa, tinnitus, chizungulire, kukomoka.
- Kumva kutentha, thukuta, redness nkhope ndi khosi.
- Angina pectoris - kupweteka kumbuyo kwa kupsinjika kwa chikhalidwe choponderezana, choponderezana.
- Zowonongeka - ntchentche zowala pamaso pa maso, kutayika kwa malo owoneka.
- Pakamwa pakamwa, nseru, kusanza.
- Kupuma movutikira, kupuma movutikira.
- Zizindikiro zamitsempha - kugwedeza kwamanja, kulankhula movutikira ndi kukumbukira, chisokonezo, kugona, kulephera kuyendetsa malo ndi nthawi.
- Epistaxis.
Mitundu ya vuto la kuchepa kwa mitsempha imakhala yambiri itachitika chifukwa cha kuchuluka kwa nkhawa, kupsinjika. Mu odwala oterewa, adrenaline ndi ena oimira zotulutsa amamasulidwa kulowa m'magazi, zomwe zimapangitsa kuti magazi azikula, tachycardia, kugwedezeka kwa thupi, pakamwa pouma, ndi nkhawa. Nthawi zambiri, mtundu uwu suwopseza moyo ndipo umatha pambuyo maola 1 - 5 ndi polyuria yokhala ndi mkodzo wowala, ludzu ndi kugona.
Chithandizo chabwino kwambiri cha odwala ndi kugona mokwanira komanso mankhwala azitsamba.
Zimayambitsa chisokonezo
Fomu yotupa imapezeka kwambiri mwa anthu onenepa kwambiri komanso matenda oopsa. Zomwe zimayambitsa izi ndizovuta kugwira ntchito kwa renin - angiotensin - aldosterone system. Chifukwa cha izi, kusefedwa ndi kubwezeretsanso kwa mkodzo mu impso kumachepa, kuchuluka kwa magazi ozungulira kumawonjezeka, ndipo mulingo wamchere wamadzi umasokonekera. Odwala ali otumbululuka, amatupa kapena kutalika kwa miyendo, miyendo, manja. Mavuto amatha kufalitsa arrhythmias, kufooka kwa minofu, oliguria. Momwe matendawo amathandizira moyenerera ndipo chithandizo chamankhwala ndichabwino.
Choopsa kwambiri pa zonse ndimavuto opweteketsa mtima, chifukwa amatha kuthana ndi kukanthidwa, kukha magazi muubongo, chamitsempha cham'mimba kapena subarachnoid, edema yam'mimba, paresis kapena ziwalo zam'mphepete. Kutalika - kuchokera maola angapo mpaka masiku atatu. Thandizo ladzidzidzi liyenera kuperekedwa mwachangu komanso mokwanira. Nthawi-yowukira pambuyo pa odwala ambiri imadziwika ndi amnesia pang'ono.
Mosasamala kanthu za mtundu wamavuto, ndi mawonekedwe amanjenje monga mutu wokhazikika, kusanza komwe sikubweretsa mpumulo, kusalankhula bwino, chisokonezo, kusokonekera kwa kayendedwe, chisamaliro chodzidzimutsa mwanjira yochepetsera kupanikizika kuyenera kuperekedwa mkati mwa ola limodzi kuchokera ku chiyambireni kuukira.
Kuzindikira ndi kuphatikiza kwa chithunzi cha matenda ndi kuthamanga kwa magazi. Njira zowonjezera zowunikira ndizowonetsa mtima ndi mapapu, electrocardiography.
Koma muyenera kukumbukira kuti nthawi yocheperako yomwe imagwiritsidwa ntchito pozindikira, imakhalabe pamankhwala.
Momwe mungapereke chithandizo choyambirira ndi chithandizo?
Thandizo lachipatala pakagwa vuto la kuthamanga kwa magazi limaperekedwa ndi madokotala a ambulansi ogwira ntchito mwadzidzidzi, ndiye kuti othandizira oyenerera amaperekedwa ndi akatswiri a mtima m'm zipatala zachigawo komanso zachigawo.
Kufika madokotala atenga anamnesis matendawa, kuyeza kuthamanga kwa magazi ndi kukoka, kutenga electrocardiogram ndikupitiliza ndi kuperekera mankhwala omwe amachepetsa kuthamanga kwa magazi.
Algorithm yosamalira odwala mwadzidzidzi chifukwa cha mavuto oopsa kwambiri imaphatikizapo chithandizo chamankhwala chisanachitike komanso chofunikira. Pa nthawi yachipatala asanachitike, wodwalayo komanso anthu ena omwe ali pafupi naye angathe kudzithandiza okha.
Njira zotsatirazi zamankhwala zingathe kusiyanitsidwa asanafike ambulansi kapena dokotala wopita:
- Itanani ambulansi, dokotala wanu kapena yambani kunyamula wodwalayo kuchipatala.
- Kuti mutsimikizire wodwala, pangani malo opanda phokoso, chotsani zakunja zakunja.
- Ndikwabwino kuti wodwalayo akhale pansi ndikugwetsa miyendo yake pansi, kuti asamangitse zovala zolimba.
- Tsegulani mawindo, pindikirani chipinda.
- Onaninso kuthamanga kwa magazi, gwiritsani ntchito tonometer kuti mupeze kuthamanga.
- Funsani wodwalayo zamtundu wa matenda oopsa, mankhwalawa. Ndikofunikira kudziwa ngati munthu amamwa mowa, ngakhale kuti anali ndi nkhawa yayikulu kapena amakhala wolimba thupi. Izi zitha kukhala zothandiza kwa madotolo kuti adziwitse matenda ndi chithandizo.
- Patsani wodwala mankhwala ake a antihypertensive ngati sangamwe mapiritsi munthawi yake.
- M'malo mwake, mutha kupatsa mankhwala othamangira msanga - Captopril, Corinfar, Pharmadipine, Nifedipine, omwe amagwiritsidwa ntchito pansi pa lilime.
- Kuti muchepetse mutha kupereka sedative - valerian, motherwort.
- Ndi tachycardia yofunika, achire zotsatira zake zimakhala ndi nthenda ya carotid. Njira yodabwitsayi imapangidwa pakatikati pa khosi m'dera la chotupa cha mtsempha wama carotid kwa mphindi khumi ndi zisanu. Zomwe zimachitika kuti zimachitika kuti mtima usakomoke, kugwiritsa ntchito mankhwala ndikofunikira.
Ngati wodwala ali ndi kupweteka pachifuwa, kufupika kwa dokotala asanafike, amaloledwa kumwa piritsi la nitroglycerin mu mlingo wa 0.5 mg. Mankhwalawa ndi abwino popewa kulowetsedwa kwa myocardial.
Asanachitike ambulansi, imaloledwa kutenga mapiritsi atatu pakadutsa theka la ola ndi nitroglycerin pansi pa lilime. Onetsetsani kuti mwakonza nthawi yakumwa mankhwalawo.
Kodi muyenera kukumbukira chiyani mukamalandira mankhwalawa?
Limodzi mwa malamulo akuluakulu azithandizo ndi kuchepa kwakanthawi pang'onopang'ono, chifukwa chithandizo champhamvu kwambiri, makamaka kwa okalamba, chingayambitse kuphwanya kwamwazi pama ziwalo.
Chifukwa chake, kutsika koyenera ndi 25% ya koyamba kwa maola 24 mpaka 48.
Kwa zovuta zosavuta, chithandizo chimaphatikiza kugwiritsa ntchito jakisoni wamkati ndi pakumwa mankhwala osokoneza bongo, ndi zovuta - okhomera okhazikika.
Mankhwala otsatirawa amagwiritsidwa ntchito pochiza mavuto:
- Lasix kapena Furosemide ndi diuretic, imagwiritsidwa ntchito mwa njira yochepetsera magazi kuti muchepetse magazi komanso kuti muchepetse kupanikizika.
- Nifedipine kapena Captopril amathandizidwanso, kupatsidwa mankhwala omwe adamwa kale.
- Mutha kubwereza kuyambitsidwa kwa Nitroglycerin m'mitsempha mosungitsa kupweteka pachifuwa.
Zomwe zimagwiritsidwanso ntchito ngati mankhwala monga Magnesium sulfate, Dibazole, Papaverine, Eufillin.
Ndi zowawa kwambiri, Droperidol, Nitroxoline ingagwiritsidwenso ntchito. Ndi kapangidwe ka matenda opatsirana, ndikofunikira kukhazikitsa Seduxen, Magnesium sulfate. Tachycardia yofunikira ikhoza kuyimitsidwa ndi beta - blockers, mwachitsanzo, Propranolol, Atenolol.
Chithandizo cha zovuta zovuta zimatengera mtundu wa complication. Ndi hypepensive encephalopathy, sodium nitroprusside, labetalol, nimodipine imayendetsedwa. Ndi kukula kwa sitiroko, kugwiritsa ntchito Nimodipine, Enalaprilat, sodium nitroprusside ndiyofunikira.
Pambuyo pochotsa matendawa ndikuwongolera momwe wodwalayo alili, chithandizo chikuyenera kupitilizidwa kunyumba. Kupitiliza mankhwala osokoneza bongo ndikofunikira kuti tipewe mavuto amtsogolo. Chithandizo chamankhwala:
- Kusintha kwamoyo - kusiya kusuta, kuledzera;
- kudya - kupatula mafuta, yokazinga, zakudya zamchere, amakonda zipatso, ndiwo zamasamba, mbewu monga chimanga.
Chofunika kwambiri ndicholimbitsa thupi.
Chithandizo cha mankhwala chikuwonetsedwanso. ACE inhibitors, calcium blockers blockers, beta blockers ndi angiotensin receptor antagonists amagwiritsidwa ntchito kwambiri. Ma diuretics nthawi zina amapatsidwa mtundu wachiwiri wa matenda ashuga, koma mankhwalawa amatha kuyambitsa shuga m'magazi.
Momwe mungaperekere chithandizo choyamba pamavuto oopsa kwambiri akufotokozedwa mu kanema munkhaniyi.
