I-Arterial hypertension ivame ukubizwa ngokuthi umbulali othule, ngoba lesi sifo sihlala isikhathi eside ngaphandle kwezimpawu. I-Pathology ibonakaliswa izinga eliphakeme lomfutho wegazi lapho i-systolic ingaphezulu kwe-140 mm Hg. Ubuciko., Diastolic ngaphezu kwe-90 mm RT. Ubuciko.
Ngokwezibalo, umfutho wegazi ophakeme uthinta abesilisa aze afike eminyakeni engama-45 futhi abesifazane emva kokuya esikhathini. Kodwa-ke, lesi sifo siba mncane unyaka nonyaka, sitholakala ezigulini ezincane.
Hlukanisa phakathi kwe-hypertension yangempela (ebalulekile) neyelesibili (uphawu). Owokuqala uwumphumela woshintsho oluhlobene nobudala, imikhuba emibi, ukuthwala ngokweqile ngokomzwelo, ukulimala kwengqondo, ukucindezela, isisindo ngokweqile, umsebenzi ophansi womzimba kanye nesifo sikashukela.
I-Hypertension ye-Syndrome iyakhula ngesisekelo sezifo ezikhona, ngokwesibonelo, ukuphazamiseka kohlelo lwe-endocrine, i-pathologies yesifo senhliziyo, nezinkinga zezitho zohlelo lokuchama. Ezinye izinto ezisongela kusengaphambili ukukhulelwa, ukusetshenziswa kabi kwezidakamizwa.
Ukuhlukaniswa kwe-hypertension
Kwezokwelapha, izigaba namazinga we-arterial hypertension ahlukaniswa. Izigaba zesifo - incazelo yezimpawu nomonakalo obangelwe emzimbeni. Amadatha yidatha yengcindezi yegazi ehlukanisa ukugula.
I-Pulmonary arterial hypertension iba ngenxa yokungasebenzi kahle kwemithambo ye-pulmonary, ukwehla kokugeleza kwegazi, okuthinta kabi ukusebenza kwemisipha yenhliziyo. Le pathology iyivelakancane futhi isongela impilo kakhulu, icasisa ukukhathala komzimba nokuhluleka kwenhliziyo.
Umfutho wegazi obonakalayo ubonakaliswa yingcindezi engenhla kwe-220/30, ibangela ushintsho olukhulu lwe-pathological esimweni se-fundus, ukwakheka kweziqalo zegazi. Kuze kube manje, imbangela eqondile yokuguqulwa kokuqina kokuqina kwegazi ifomu elimazayo ayikasungulwa.
Kukhona nolunye uhlobo lwe-arterial hypertension - i-vasorenal noma ukuvuselela umzimba. Kuhambisana nezinguquko emsebenzini wezinso, ukuphazamiseka ekunikezelweni kwegazi esitho. Imvamisa, udokotela unquma ukwephulwa okunjalo yinkomba ye-diastolic ephezulu kakhulu. Inqwaba yamacala we-hypertension yesibili avela ngokunembile ngalesi sizathu.
I-Labile hypertension:
- kubonakaliswa ukungazinzi kwe-episodic kwengcindezi yegazi;
- lesi sifo asibhekwa;
- kwesinye isikhathi iba yizingqimba zegazi ngokweqiniso.
Izimpawu zomfutho wegazi lomfutho: ikhanda elibuhlungu, ukwaziwa kwezingalo nemilenze, isiyezi. Kwezinye izimo, azikho izimpawu nhlobo. Lokhu kwenzeka nge-hypertension ye-arterial yesigaba sokuqala.
I-hypertension ye-arterial eyisisekelo ihlukaniswe ngezindlela eziningana: i-hyperadrenergic, i-hyporenin, i-hyperrenin. I-Hyperradrenergic hypertension itholakala cishe ku-15% wamacala we-hypertension mapema, okuyisici esiyinkinga seziguli ezisencane. Izizathu zilele ekukhulweni kwama-hormone e-adrenaline, i-norepinephrine.
Izici zesici kuzoba ukushintshwa kokukhanya, ukudonswa kwekhanda, umuzwa wokukhathazeka, kanye nokubanda. Ekuphumuleni kubantu, i-pulse itholakala ngaphakathi kwe-90-95 beats ngomzuzu. Uma ingcindezi ingulethwanga ibe yjwayelekile, isiguli singase sibhekane nengozi yomfutho wegazi, indlela yokukhula kwalesi sifo ayiqondakali ngokuphelele.
Uma umfutho wegazi ophakeme uthuthuka kakhulu, kuthiwa isiguli sinendlela ye-hyperrenin yalesi sifo. Ebantwini:
- ikhanda;
- izikhathi zokuhlanza, isicanucanu;
- isiyezi iba njalo.
Uma kungekho ukwelashwa, i-pathology igeleza ku-atherosulinosis yemithambo yezinso.
E-diabetesics of age advanced, i-hyporenin hypertension iyakhula, ehambisana nokugcinwa kwamanzi, usawoti emzimbeni. Isibonakaliso esithile kuzoba ukubizwa okubizwa ngokuthi yi-renal.
Amandla we-hypertension
Izinga lokuqala lomfutho wegazi ophakeme lingahlonzwa ngenxa yezilinganiso ezingapheli zomfutho wegazi. Ukuxilongwa kwenziwa endaweni ezolile, kuphela uma lesi simo sihlangabezana, ungathola umphumela ngqo.
Izinga lokuqala lalesi sifo linqunywa ngengozi, imvamisa phakathi kokuhlolwa kwempilo ejwayelekile. Ingcindezi kuleli cala isuka ku-140 (160) / 90 (100) mm Hg. Ubuciko. Kwezinye izimo, ngomfutho onjalo wokucindezela, onesifo sikashukela uhlushwa izinga lesibili lomfutho wegazi, kuncike ekunqotshweni kwezitho zangaphakathi, izici zomzimba ngamunye.
Ngokwanda kwalesi sifo, bakhuluma ngoxhaxha olulinganiselwe noma olulinganiselayo. Kuvezwa emfuthweni wegazi ezingeni le-160 (180) / 100 (110) mm Hg. Ubuciko. Amanani we-diastolic kuphela angakhuphuka noma lapho izimo ezithile zenzeka.
I-Symbomatology yalesi sifo ingakhuphuka masinyane, iba imbangela yokungasebenzi kahle:
- izinso
- inhliziyo
- isibindi.
Ukuthuthukiswa kokwehluleka kobuchopho akunqunyelwe.
Izinga lokugcina lomfutho wegazi likhulu. Ngayo, ingcindezi iphakeme kakhulu, ikhuphuka ngaphezu kwezinga le-180/10 mm RT. Ubuciko.
Kwezinye iziguli, izinkomba zokucindezela kwe-systolic kuphela ezedlula okujwayelekile. Ngokwezibalo, lokhu kujwayelekile ezigulini esezikhulile.
Isigaba Hypertension
Kwezokwelapha, kuyisiko ukuhlukanisa futhi nezigaba ze-hypertension.
Isigaba sokuqala
Owokuqala wabo ulula futhi ongabonakali kakhulu kumuntu onesifo sikashukela, kodwa nguyena owaba imbangela enkulu yezinkinga zezempilo ezalandela. Noma ukwephulwa okuncane, akufanele kunganakwa.
Ayikho i-Symbomatology ethize ngalesi sikhathi, ngaphandle kwengcindezi engenakuphikwa futhi engenamqondo, kuvela ukuthambekela kokushintsha izinkomba. Ngomfutho we-arterial hypertension wesigaba sokuqala, isiguli singase sibe nokuqaqanjelwa yikhanda ngezikhathi ezithile, ukopha okuvela emaphashini emakhaleni, futhi umuntu akalali kahle.
Ukulungisa lesi simo, udokotela utusa ukulandela ukunakekelwa okufanele kokudla, ukunciphisa inani lokudliwayo kwe-sodium, nokwandisa irekhodi losuku. Kodwa-ke, imithetho okuxoxwe ngayo iyaziwa kwabanesifo sikashukela ngaphandle kwayo.
Isigaba sesibili
Ngaphandle kwezinyathelo ezithathiwe, i-hypertension ye-arterial iqala ukuthuthuka, kuvela izinkinga. Manje izimpawu zikhula ngenkuthalo, hhayi ukunamathisela ukubaluleka kwazo ziya ngokuya ziba nzima. Ikhanda lilimala kaningi, ukungaphatheki kahle akusuki isikhathi eside. Ukopha okuvela ekhaleni sekuyinto yaphakade, kubuhlungu enhliziyweni.
Kunzima ukuthuthukisa impilo ngaphandle kosizo lwezokwelashwa. Imiphumela yomfutho wegazi ophakeme ibanga ukukhula kwezigaba ze-arterial hypertension 2, 3 degrees, kudala usongo ngqo empilweni yomuntu. Yonke imiyalo kadokotela kumele ilandelwe ngokugcwele, ngaphandle kwalokhu i-pathology icasukile, igelezela ezigabeni ze-ag3.
Isigaba sesithathu
Uma umuntu okhipha umfutho egazini enganaki empilweni, engawemukeli imishanguzo ebekiwe, engayekanga ukubhema nokuphuza utshwala, utholakala esigabeni sesithathu somfutho wegazi ophakeme. Kulesi sigaba, izitho ezibalulekile zangaphakathi sezivele zithintekile: ubuchopho, isibindi, izinso, inhliziyo.
Ukusakazwa kwegazi okunganele kanye nengcindezi kubangela imiphumela ebuhlungu ngendlela yezimo ze-pathological:
- isifo sohlangothi;
- ukushaya kwenhliziyo;
- i-encephalopathy;
- ukwehluleka kwenhliziyo;
- arrhythmia;
- izinqubo ezingenakuphikiswa ezitsheni zamehlo.
Uma kungalashwa, kunamathuba aphezulu okuthuthuka kwe-systolic hypertension eyedwa. Isiguli sizwa ukuwohloka okusheshayo kwenkumbulo, ukwephulwa komsebenzi wengqondo, ngokwengeziwe kanye naye ukulahlekelwa ukwazi.
Uma kukhulunywa nge-hypertension enezimpawu, ukuxilongwa kuqala ngokunquma imbangela yokuphazamiseka. Ngalezi zinhloso, kuyadingeka ukuqhuba ukuhlolwa kwegazi okuyinkimbinkimbi nge-hematocrit, cholesterol, ushukela; umchamo electrocardiogram. I-Hypertension yesibili iqala kungazelelwe, kunzima ukuyelapha, ayizuzwa njengefa. Kuvame ukubonwa ngesikhathi sokukhulelwa.
Kunezigaba ezi-4 ezinciphisa amathuba wokulimala okukhulu kwezitho zangaphakathi kulokhu okulandelayo:
- ngaphansi kwama-15%;
- cishe ama-20%;
- kusuka kuma-20%;
- ngaphezulu kwama-30%.
I-prognosis engathandeki kakhulu i-hypertension ye-3th yesigaba se-2-3. Ama-diabetesics anjalo adinga usizo olusheshayo, ukwelashwa okuyinkimbinkimbi.
Ngaphandle kwalokho, kuba nenkinga ye-hypertensive, kubonakaliswa ukukhuphuka okukhulu kwengcindezi, ukusokeka kwengqondo okulimazayo kanye nokujikeleza kwenhliziyo.
Yini ubungozi besifo se-hypertensive?
Isimo se-hypertensivegency sibandakanya ukulaliswa esibhedlela esikhungweni sezokwelapha. Izimo zezulu ezingathandeki, ukucindezelwa okungokomzwelo, ukusetshenziswa kwezidakamizwa ezingekho emthethweni, ukusetshenziswa kabi kotshwala, utshwala, nemithi engafanele kungadala ukuhlaselwa.
Ezinye izinto ezisengozini zifaka ukulimala ekhanda, ukusetshenziswa kabi kokudla okunosawoti, ukuntuleka kwamanzi emzimbeni kanye nezinye izinhlobo zama-neoplasms.
Esigulini esiningi seziguli, isifo se-hyperturgency senza izinqubo ezilimazayo ezithweni ezitholwayo. Cishe i-25% yazo zonke iziguli zinqunyelwe ukulimala kwezitho ezimbili noma ngaphezulu.
Izimpawu zesifo yilezi:
- amakhanda abukhali;
- ukuphefumula kwenhliziyo;
- ukungaboni kahle;
- ukudideka nokwazi okufiphele.
Ama-nosebleeds aqinile, izinhlungu ngemuva kwe-sternum, isimo sokuphoxeka, ukukhathazeka, ukwesaba ukwethuka, ukufenda akuhlanganisiwe.
Lapho izimo ezinjalo zenzeka, kufanele ushayele iqembu le-ambulensi ngokushesha.
Ngaphambi kokufika komqeqeshi wezokwelapha, onesifo sikashukela kufanele aphuze umuthi oxutshisayo noma wegazi, uvame ukuwuphuza nezinkinga zokucindezela.
Izindlela zokuvimbela
Lapho ukhomba izinga lokuqala lomfutho wegazi ophakeme, ungapheli amandla, ngoba lesi sifo singabuyiselwa emuva. Isidingo sokululama wukushintsha kwendlela yokuphila, ukwenqaba imilutha, ukubuyekezwa kokudla lapho ubheka khona umsoco ofanele.
Kusebangeni lesibili, lesi sifo sithathwa njengesihlala isikhathi eside futhi singaphenduli ekwelashweni. Umkhuba walesi sifo uqobo, njengesifo sikashukela, uyikhono lokusigcina silawulwa, ngaleyo ndlela uvimbele ubunzima.
Noma esekhulile kwanele ukulandela izincomo zikadokotela.Udinga ukudla ngezingxenye ezincane, ngokuhlakanipha unciphise okuqukethwe kwekhalori kwimenyu. Imikhawulo izosusa uketshezi oluningi emzimbeni futhi iholele ku-cholesterol ejwayelekile.
Izinga lokuqala lesimo se-pathological liphathwa ngezindlela ezingezona izidakamizwa: imfundo yokomzimba, ukudla, ukunciphisa umzimba, ukulahla imikhuba emibi. Ukuze kube ne-AH elinganiselayo kuya ku-ezinzima, ukusetshenziswa kwezidakamizwa kucatshangelwe: ama-diuretics, inhibitors, beta-blockers.
Yimaphi ama-degree we-hypertension akhona achazwe kuvidiyo kule ndatshana.
