Zizindikiro zamatenda oopsa komanso thandizo loyamba

Hypertension ndi limodzi mwa matenda ofala kwambiri, ku Russia amakhudza pafupifupi 40% ya anthu akuluakulu, ndipo kuchuluka kwa odwala kumawonjezeka chaka chilichonse. Kuphwanya kovuta kwa matendawa, vuto la matenda oopsa, limachitika kamodzi pachaka mu 1-7% ya odwala matenda oopsa. Zimayendera limodzi ndi kukwera kwamphamvu kwa ziwonetsero zomwe sizinthu za wodwala wina.

Chifukwa chiyani zovuta zili zowopsa? Ngati zimachitika kwambiri, odwala amakhala ndi zizindikiro za kuwonongeka kwa ubongo kapena kusayenda bwino kwa mtima. Vuto lomwe silinayimitsidwe pakapita nthawi limakhala ndi zotsatila zingapo kwa ziwalo, nthawi zina zosagwirizana ndi moyo. Tikukuuzani momwe mungachitire ndi vuto la matenda oopsa, momwe mungabwezeretsere thanzi lanu pambuyo pake.

Kodi vuto la matenda oopsa ndi lotani

Masiku ano pali kusankha kwakukulu kwa mankhwala otsika mtengo omwe amathandizira kupanikizika. Ndi kudya kwawo kosalekeza, chiopsezo chokhala ndi vuto la matenda oopsa sichochepa. Tsoka ilo, si aliyense amene amagwiritsa ntchito zomwe amapeza: 19% ya odwala matenda oopsa sadziwa za matendawo, ena onse amamwa mankhwalawa mosagwirizana kapena pamtengo wotsika kuposa momwe amafunikira, chifukwa chake kupanikizika kwawo kumachulukitsidwa. 27% yokha mwa odwala ndi omwe amathandizidwa moyenera. Malangizo a madotolo kuti aziyang'anira magazi pafupipafupi salemekezidwanso. Malinga ndi kafukufuku, amatsatiridwa ndi 39% yokha ya odwala. Zinthu zikafika povuta, 40% amayesa kupanikizika, 21% ya odwala oopsa sawongolera matendawa konse.

Mavuto obwera chifukwa cha matenda oopsa ndi zotsatira zoyipa za thanzi lanu lomwe. Mwachizolowezi, vuto limawonedwa kuti ndiwokulira m'munsi, diastoli, kukakamiza mpaka 120 kapena kupitirira. Mlingo uwu ndizovuta kulekerera ndi thupi, motsatana ndi zizindikiro zowoneka bwino komanso kuwonongeka kwakuthwa muumoyo wabwino. Vuto lalikulu kwambiri la m'magazi limagwira ziwalo zomwe zimadziwika kuti mipherezero ya matenda oopsa: ubongo, mtima, retina, impso, motero amayesetsa kuziletsa msanga. Vutoli limatenga nthawi yayitali bwanji? Ndi chithandizo cha panthawi yake - kuchokera theka la ora mpaka maola angapo, ngati sichinapatsidwe, matendawa amakhalapo kwa nthawi yayitali, nthawi zambiri zimapangitsa kuti ziwalo zambiri ziwonongeke komanso kufa. Lisanayambike mankhwala othandiza pakukakamiza, moyo wamankhwala oopsa pambuyo pamavuto oyamba sanadutse zaka 2.

Zolinga zakukhazikitsa HA

Zomwe zimayambitsa vuto lililonse la matenda oopsa ndi kuphwanya kwa magwiridwe antchito amtunduwu kuti apitirize kuthina. Ndi matenda oopsa kwa nthawi yayitali, dongosolo lino limagwira ntchito mothandizidwa ndi kuchuluka. Ngati palibe chithandizo kapena sichikhala chosakhazikika, katunduyo amawonjezeka nthawi zambiri. Pamagawo awiri a matenda oopsa (kuthamangitsidwa kuchokera ku 160/100), kuthamanga kwa magazi kupita ku ziwalo kumakulanso. Kuti muwone kutuluka kwa nthawi yake, kutulutsa bwino kwa mitsempha ndikofunikira, koma mwa kuchuluka kwa matenda oopsa, thupi lake limatha kupereka.

Kuti vuto la matenda oopsa libwereke m'dziko lino, ngakhale kuchulukitsa pang'ono pamitolo ndikokwanira.

Zifukwa zake zimakhala:

• kupsinjika, chisangalalo chilichonse ngakhale chisangalalo;
• kusintha kwa kuthinikizidwa kwa mlengalenga;
• kugwiritsa ntchito molakwika zakudya zamchere;
• kudya kwamadzi ambiri;
• kumwa mowa;
• zolimbitsa thupi zilizonse;
• kudumpha mapiritsi a kukakamiza, kuletsa kulandira chithandizo mosavomerezeka;
• matenda a chiwindi;
• kusala kudya;
• aimpso kuwonongeka;
• kusokonezeka kwa mahomoni;
• mwa akazi - kusintha kwa thupi;
• akugwira mpweya wako m'maloto (apnea);
• kuvutika
• othandizira opaleshoni;
• Prostate adenoma wokhala ndi kwamikodzo amuna.

Chomwe chimapangitsa 70% yamavuto oopsa kwambiri ndimankhwala osagwiritsidwa ntchito nthawi yayitali. M'dziko lino, kuwonjezeka kwa kukakamizidwa kumatha kukupatsani mwayi uliwonse. 10% ya mavuto amabwera ndi kukonzanso magazi. Zimachitika pamene patency ya aimpso imalephera chifukwa cha atherosulinosis, kuvulala, ndi chotupa. Zomwe zimayambitsa zovuta 10% yotsatira ya matenda a shuga ndi nephropathy. Pa malo 4 a matenda amanjenje, amakwiya pafupifupi 6% ya kupsinjika kwa mphamvu. Pafupifupi 3% ya mavuto amabwera mwa anthu omwe ali ndi pheochromocytoma. Zina zomwe zimayambitsa mabvuto siopitilira 1% ya milandu.

Ndi vuto la matenda oopsa, kayendetsedwe kamamvekedwe ka mtima kamasokonekera, kukhudzika kwa dongosolo la ziwonetsero zamagetsi pakumayenda kwa magazi kumawonjezeka, ndipo zotulutsa zamtima zimawonjezeka. Pazakusokonezedwa, thupi limatha kuyankha mosayenera, zovuta zomwe zimachitika pakuwonjezera kukakamiza zimatha kukhala zosakwanira komanso zochulukirapo.

Gulu la WHO la mavuto oopsa

Lingaliro la "zovuta" pagulu la WHO likusowa. Kuwonjezeka kwa kuthamanga kwa diastolic pamwambapa pa 120 kumayesedwa ngati matenda oopsa kapena osasinthasintha. Kulekanitsidwa pakati pamagulu awa kumapangidwa malinga ndi kuwonongeka kwa ziwalo:

Ku Russia, izi zimafanana ndi magawano otsatirawa:

1. Mavuto Osavuta - Chifukwa chachikulu choimbira foni mwadzidzidzi. Ogwira ntchito ma ambulansi atha kuchepetsa kukakamiza. Kugonekedwa sikuti nthawi zonse. Ngati vutoli limachitika koyamba kapena kubwerezedwa kachiwiri patsiku, kupsinjika kumatsika pang'onopang'ono kapena kukayikira za kusowa kwa zowopsa, wodwalayo akulimbikitsidwa kulandira chithandizo mosagwirizana. Khodi ya ICD 10, yomwe imapatsidwa matendawa: I10 ngati matenda oopsa ali pachiwonetsero, I15 ngati amayamba ndi matenda ena.
2. Vuto lalikulu la matenda oopsa - imafunikira kuti wodwala amutumize ku chipatala cha odwala kapena a mtima, ndipo ngati apezeka kuti ali ndi matenda opha ziwalo, atapita kuchipatala chamanjenje. Izi zakhazikitsidwa kutengera cholinga chowonongeka: I11 - mtima, I12 - impso, H35 - retina, I60-69 - ubongo.

Ambulansi sikuti nthawi zonse imazindikira kukula kwamavuto oopsa kwambiri. Ngati madokotala alibe chitsimikizo chodziwitsa za matendawa ndipo akuumirira kuti agonekere kuchipatala, ndibwino kuti mugwirizane nawo, ngakhale atapanikizika kuti ayambe kutsika, ndipo thanzi lakhala bwino.

Zizindikiro zoyambira ndi chizindikiro

Chizindikiro chachikulu chavutoli ndikuwonjezereka kwa nkhawa. Mlingo wovomerezeka kwambiri wopanikizika kwambiri kuposa 120 ndi wofunikira, chifukwa aliyense wa ife ali ndi zake zomwe zingatsimikizidwe. Zimatengera zaka, kulemera, matenda oyanjana. Mavuto amawonedwa kuti ndiwowonjezera kukakamizidwa kwa oposa 40% abwino.

Matenda oopsa oopsa nthawi zambiri amatchedwa chikhalidwe chokhacho chomwe chimayendera limodzi ndi zizindikiro zazikulu:

1. Mutu. Nthawi zambiri imakhala kumbuyo kwa mutu kapena kuphimba mutu ngati mutu. Chizindikiro chimawonjezeka ndikusintha kwa kayendetsedwe ka thupi, mutu umatembenuka.
2. Kugwedezeka pamakachisi, kumverera kwa liwiro la magazi kumutu.
3. Ululu m'maso, kumva kukakamizidwa pa iwo. Zizindikiro zitha kukhala zowoneka bwino (zinthu zakutsogolo kwa maso zikuwoneka bwino kuposa kuchokera kumbali), ntchentche, mawanga amtundu kapena mozungulira pamaso pa maso.
4. Maonekedwe a edema, nthawi zambiri nkhope.
5. Pali zizindikiro za kuyambitsa dongosolo lamanjenje: kukwiya, mkwiyo, nkhawa kwambiri.
6. Mutu umatha kukhala chizungulire kwambiri, mpaka kulephera kusuntha pawokha. Chizindikiro ichi chimatchulidwa kwambiri kwa odwala omwe ali ndi vuto loyambitsa matenda oopsa.
7. Zofooka zakuthwa, kugona kungatheke, muzovuta kwambiri - chisokonezo.
8. Khungu lakhungu kapena, mosiyana, nkhope lofiira ndi mawanga pakhosi, kumakulitsa thukuta.
9. Zizindikiro zakuwoneka kwamavuto akuchuluka mu ubongo ndi mseru, kusanza kwa chakudya, komanso kukomoka.
10. Kusakwanira kwa kufalikira kwa ubongo kumatha kuwonetsedwa ndi zizindikiro zamitsempha: kunjenjemera, kusokonezeka kwa mgwirizano, kulephera kukhazikika.
11. Ndi mavuto a mtima, kupuma movutikira komanso kuperewera, kupweteka pachifuwa kumatha kuchitika.
12. Ndi chotupa cha msempha, Zizindikiro zake zimakhala kupweteka kwambiri, kukomoka.

Zizindikiro zodziwika kwambiri zamavuto oopsa kwambiri (> 80% ya odwala) amadziwika kuti ndiotatu: kupweteka kumbuyo kwa mutu - nseru - chizungulire.

Momwe mungapereke thandizo loyamba mu Civil Code

Mutha kuchita popanda thandizo la kuchipatala ngati mukuzindikira za vutoli ndipo muyenera kusiya. Ngati vuto la matenda oopsa lachitika kwa nthawi yoyamba, zizindikirazi ndizosiyana kapena kupanikizika ndikokwera kuposa kale, ndibwino kuyimba 03.

Algorithm ya zochita zothandizira poyang'anira dokotala ndizosavuta:

1. Khazikitsani wodwala kuti akhale mutu wabwino. Wodwalayo saloledwa pamtundu uliwonse, ngakhale kukwera masitepe. Mavutowa atayamba mumsewu, ndibwino kudikirira kwa dokotala pabenchi kapena malo ogulitsira apafupi.
2. Yesetsani kumukhazika mtima pansi, ngati zingatheke, chotsani ana ndi alendo kunyumba.
3. Ngati mukulephera kugona, gonekerani wodwala kumbali yake.
4. Tsegulani zenera m'chipindacho kuti mlengalenga muthamangire.
5. Ganizirani za zomwe wodwala amayesetsa kuchita ndi zomwe amakonda. Kuyeza kuyenera kutengedwa kotala lililonse la ola mpaka madokotala atafika.
6. Ngati mutu wanu ukupweteka kwambiri, ikani pulasitala ya mpiru kumbuyo kwa khosi, m'munsi kumbuyo kwa mutu.
7. Tenthetsani mapazi anu. Zitha kutsitsidwa kwa mphindi 20 mu beseni ndi madzi otentha.

Ndikothekanso kuthana ndi vuto la kuthamanga kwa magazi kunyumba mothandizidwa ndimankhwala posachedwa kuthamanga. Mankhwalawa nthawi zambiri amaperekedwa ndi akatswiri othandizira odwala pamodzi ndi mapiritsi akale a antihypertensive ndikuwachenjeza kuti akuyenera kutengedwa ngati njira yomaliza, mopanikizika kwambiri.

Momwe mungathetse zovuta: nifedipine amadziwika kuti ndi mankhwala othandiza komanso otetezeka kwambiri pa chithandizo choyamba. Mapiritsi amodzi kapena awiri (10-20 mg a nifedipine) amayikidwa pansi pa lilime. Pogwiritsa ntchito njira imeneyi, mankhwalawa amapereka kuchepa kwa odwala ambiri oopsa omwe ali ndi zovuta zosakwana mphindi 5-30. Kutalika kwa vutoli kuli mpaka maola 5, nthawi ino ndikwanira kuyambiranso kapena kuyambiranso chithandizo chamankhwala omwe akhala akuchita kwa nthawi yayitali. Ngati mankhwalawa sagwira ntchito mkati mwa theka la ola, mutha kumwa piritsi linanso.

Mankhwala okhalitsa omwe ali ndi nifedipine (chosabwezera, chosinthika kapena chowongolera) sayenera kuledzera pakakhala zovuta, chifukwa zotsatira zake zimachedwa. Kordafen, Fenigidin, Kordafleks (koma osati Kordafleks RD!), Nifedipine wa Valenta, Ozone ndi Obolenskoye makampani azachipatala azichita.

Mphamvu ya nifedipine imatchulidwa kwambiri pakuwonjezeka kuposa ndi kuwonjezeka pang'ono, odwala okalamba oopsa amathanso amphamvu kuposa achinyamata. Contraindication kutenga nifedipine ndi chizindikiro cha ubongo ndi mtima kuwonongeka.

Ngati palibe nifedipine kapena wapakati, kuphatikizidwa kwa mlingo wa 23-50 mg angathe kutengedwa ngati mwadzidzidzi vuto la HC. Piritsi iyenera kuyikidwa pansi pa lilime, ndiye kuti iyamba kutsitsa kupsinjika pambuyo pa mphindi 10, ndipo nthawi yonse yochita ikhale 1 ora.

Mukapereka chithandizo choyamba, konzekerani kuyankha mafunso:

• kaya kupanikizika kudabuka kale;
• mulingo uti;
• ngati madandaulo tsopano akusiyana ndi omwe anali nthawi yamavuto apitawa;
• kuchuluka ndi kuthamanga kwanthawi;
• mankhwala omwe wodwala amamwa;
• ngati panali mapiritsi osowa;
• mapiritsi omwe wodwala amatenga podikirira adotolo.

Matenda oopsa oopsa

Mavuto osagwirizana nthawi zambiri amachotsedwa ndi mapiritsi. Kuphatikiza pa nifedipine ndi Captopril, carvedilol, amlodipine, furosemide amagwiritsidwa ntchito nthawi zambiri. Chithandizo cha mavuto amayamba ndi kamodzi, kawiri kawiri mankhwala. Kugwa kothinikizidwa kwa nkhawa kumatha kukhala kowopsa, kotero mu maola awiri oyamba muyenera kukwaniritsa kuchepa kwake ndi 25%. Ndikofunika kuti mufike pazapanthawi yotsalira masiku 1-2.

Momwe mungayimitsire zovuta zovuta zimatengera ziwalo zomwe zakhudzidwa komanso kuchuluka kwa kuwonongeka kwawo. Mankhwala amathandizidwa kudzera m'mitsempha. Malangizo azachipatala amaphatikizapo okhawo omwe ali ndi chitsimikiziro chothandiza: sodium nitroprusside, nitroglycerin, enalaprilat, furosemide, metoprolol, esmolol, urapidil, clonidine. Maola 2 oyamba, kupanikizika kuyenera kutsika ndi 15-25%, m'maola 6 otsatira - mpaka 160/100. Ndizosatheka kuti muchepetse kuthamangitsidwa kwazomwe zimachitika ndi GC yovuta, chifukwa kuchuluka kwa magazi kwa ziwalo kumatha kuwonongeka.

Vuto pambuyo mowa limachotsedwa makamaka ndi beta-blockers ndi ACE inhibitors. Kugwiritsa ntchito ma vasodilators, okodzetsa ndi clonidine amapetsedwa, chifukwa amakulitsa kuledzera ndipo angayambitse tachycardia.

Kubwezeretsa ndi kukonzanso

Pambuyo povutika ndi matenda oopsa, odwala ambiri amawona kuwonongeka m'moyo wabwino. Mutu, chizungulire, kusilira kungapitirizebe kwa nthawi yayitali. Kukonzanso nyumba sikungatheke nthawi zonse. Kuti mubwerere ku moyo wabwinobwino, mungafunike thandizo la akatswiri a zamankhwala, othandizira, ndipo nthawi zina akatswiri amisala.

Momwe muyenera kukhalira mutachitika kuukira:

1. Choyamba, onetsetsani kuti mulandila thandizo pakagwa vuto lachiwiri: nthawi zonse tengani foni yolowera, kuyenda ndi opita maulendo ataliatali, komanso kukana kuyendetsa kwakanthawi. Kumbukirani malamulo opewera zovuta, pitani mankhwala omwe akuchita mwachangu.
2. Gawo loyamba pakusintha momwe zinthu ziliri ndikusankha mapiritsi kuti atikakamize, omwe akuyenera kutengedwa mosalekeza. Pambuyo pamavuto, kukonzekera kovuta kumakhazikitsidwa nthawi zambiri, kumakhala ndi zinthu ziwiri, zosagwiritsidwa ntchito katatu. Amasankhidwa poganizira matenda omwe alipo, kotero nthawi zina kungakhale kofunikira kukayezetsa. Kuti mapiritsi ayambe kugwira ntchito mwamphamvu, zimatenga mwezi umodzi. Pakadali pano, kupanikizika kumatha kukhala pang'ono kuposa kwabwinobwino.
3. Pewani ntchito iliyonse kwa sabata limodzi, ngakhale mukhale ndi moyo wokwanira, osapereka tchuthi chodwala, musapite kuntchito.
4. Pewani mowa, khofi wamphamvu komanso tiyi. Chepetsa mchere.
5. Patsani thupi lanu madzi. Onetsetsani kuti nthawi zambiri amachotsedwa m'thupi ndipo sakwiyitsa edema. GP wanu angalimbikitse tiyi wokongoletsa.
6. Chithandizo cha kupweteka kwa mutu ndichizindikiro, chimakhala chifukwa chotenga antispasmodics kapena analgesics, omwe amalembedwa ndi akatswiri.
7. Zotsatira zoterezi zimayambitsa zovuta, monga chizungulire, zimatha kuchepetsedwa m'njira yosavuta: inhale ndi mphuno, gwiritsani ntchito kupuma, pumulani ndi pakamwa panu, ndikubwereza kangapo.
8. Pambuyo pamavuto oopsa, mkhalidwe wopsinjika umatha kukhalapo kwa nthawi yayitali. Kuti mubwezeretse thupi mwachangu, muyenera kuonetsetsa kuti mudzakhala ndi mtendere wambiri, muziganizira kwambiri za thanzi lanu, khalani ndi nthawi yopuma komanso yopuma. Ngati kuvutika maganizo ndi nkhawa sizikuchoka, musanyalanyaze thandizo la akatswiri.

Mavuto a GC

Mavuto ambiri oopsa kwambiri sachititsa kuti ziwalo ziwonongeke. Masabata angapo pambuyo pawo, odwala amatha kukhala moyo wodziwika. Komabe, popanda kuwongolera kupanikizika kwachipatala, kuukira kotsatira ndi nkhani ya nthawi yochepa chabe. Ndipo palibe chitsimikizo kuti imachitidwanso modekha, popanda zovuta. Nthawi yayitali thupi imagwirira ntchito kwambiri, kumakhala pachiwopsezo chovuta kwambiri.

Kodi chiwopsezo cha matenda oopsa m'magazi ovuta kwambiri ndi chiani?

• matenda amitsempha yamagazi
• kuchuluka kwa encephalopathy - 16%;
• matenda a mtima - 12%;
• kuperewera kwa coronary - 15%;
• pulmonary edema - 23%;
• Zotsatira zina, kuphatikizapo kuwonongeka kwa kuwona chifukwa cha retinopathy pachimake, zimawonedwa mwa 6% ya odwala.

Momwe mungapewere kachiwiri

Njira yothandiza kwambiri yopewa kubwereranso m'mavuto ndi chithandizo cha moyo wathunthu, popanda mapiritsi. Kuti muwonetsetse kuti mapilitsiwa amagwira ntchito, kuyeza kuthamanga kawiri pa tsiku. Chitani izi mokhazikika, mutakhala pansi, lembani zotsatirazo ndi deti lolemba. Ngati kuchuluka kwa mavuto kumayamba kupitirira 140/90, kapena kudumpha masana, komwe kunalibe kale, muyenera kukonza chithandizo. Onani dokotala. Adzakuwonjezera kuchuluka kwa mankhwalawo, kapena kupereka yatsopano, yothandiza kwambiri.

Mutha kuthana ndi zovuta osati mapiritsi okha. Ngati mungalumikize njira zosagwiritsa ntchito mankhwala, chiopsezo chobwereza magazi kwambiri chikhala chotsika kwambiri. Monga lamulo, odwala matenda oopsa amalangizidwa kuti azitsatira zakudya, kuchepa thupi kunenepa (kukwaniritsa BMI yochepera 25), kusiya chikonga ndi mowa, ndikuwonjezera ntchito. Mlingo wakuchita zolimbitsa thupi umatsimikiziridwa ndi dokotala. Mungafunike kukayezetsa zina kuti mulandire chilolezo chokhala otsimikiza mtima. Zakudyazo zimaphatikizapo masamba ndi zitsamba zambiri, tirigu wowuma, mchere woletsa (patsiku <5 g), mafuta a nyama, kupatula mafuta a trans.